3 weeks - Controlling what I can, accepting what I can't.

[Signs]

Hi there.

Was diagnosed type 2 just under 3 weeks ago. Definitely not news I was happy with but I deal with life by controlling those things that I can and accepting those that I can't. Works for me.

Even after lots of reading I'm more than a little confused by contradictory advice I read. This forum seems to be one of the more sensible and friendly ones so reckon I'll park my butt here . . .
First off, my apologies for the length of the post but I like to give as much information as possible. If you're still awake after reading there are some questions evetually.

In the last 6 months I've probably seen my doc more than in the last 6 years. All minor complaints but taken together all pointing towards diabetes and to be honest it's a bit of a relieve to have something to account for them.

I was being treated with antibiotics for a chest infection and 2 weeks after finishing the course felt as though I now had a sinus infection - tender around my eyes, poor vision, pressure in my ears, general all over uncomfortable headache. Not a real belter, just uncomfortable and generally feeling not right. (Google and a little knowledge is dangerous!)

I noticed a marked change in my vision over a weekend so made an appointment to see an optometrist - good old specsavers fitted me in that day. She suggested going to the doc immediately which I did later that day. Doc took some blood and got a call within a few hours to say blood sugar "alarmingly" high, to fast overnight and see nurse first thing in the morning.

Overnight fasting - about 15 hours - reading was 22. The practises' diabetic nurse took plenty of time to explain everything to me, gave a testing kit and put me on 40mg Glickazide first thing in the morning before breakfast.

Taking readings 4 times daily until it "settles down". Before breakfast, lunch, dinner and last thing at night.

Back to nurse 5 days later with readings.
day1 17, 23.1, 15.2, 18.3
day2 13.6, 18.2, 9.4, 13.6
day3 15.3, 18.9, 11.1, 11
day4 16.4, 14.2, 17,2, 18.8
day5 14.7, 18.4, 17,2, 15.5

She now doubles my dose of glicklazide to 40mg twice daily. Before breakfast and dinner.
day6 12.8, 16.8, 14.6, 12.3
day7 13.2, 10.2, 11.1, 9.8
day8 8.9, 10.2, 10.8, 11.2
day9 10.9, 10.8, 7.1, 9.8
day10 11.3, 10.6, 8.3, 10.2
day11 9.2, 11.8, 5.2, 5.7 (Felt really ill - see question below)
day12 10.1, 8.1, 6.9, 11.9
day13 8.7, 10.2, 6.9, 9.2
day14 8.3, 9.5, 6.7, 13.8
day15 6.3, 8.8, 6.1, 10.8
day16 7.9, 8.9, 8.8, 8.7

So at last, some questions.

Looks to me as though the readings are levelling out - or are they still too high?

Day 11 question. Mid afternoon I gradually over about an hour began to feel really ill - headache, dizzy, sweating, blurred vision, suddenly very,very tired to the point of having to ask a friend to take me home. Scared the c*** out of me.

My nurse had explained all about hypos and I thought this was one but my reading was 8.4 not below 4 as I expected. This was at 3pm and what I do notice is that my readings were falling from 11.8 at midday to 5.2 at 6pm. That's a bigger fall than any other time - could that have been the cause? Was this a false hypo?

Hypo is the part of this that scares me a little. Well, more than a little.
How do I tell the difference between a false and real one?
What if I have one when I'm sleeping - will it wake me?

HBA1c - was told my current reading was "equivalent" to high 20s.
Really don't understand the HBA1C - I know that it's testing levels over the previous 8 - 12 weeks but not sure exactly how to compare the figure I was given which was a perecentage to the ones I take daily.

OK, diet, exercise - male 54, 6', 15 st. Up until 6 years ago I was always between 13 to 14st depending on my training routine. Practised various martial arts since I was 18 and regularily ran half marathons. Hip replacement, change of job from very active to sedentary, very little excercise and in 2 years my weight ballooned to over 17st. Over the last 4 years, careful, sensible eating, lots of walking and weight steady at around 15st for best part of a year.

I asked the nurse about dietary changes but she says "normal" diet until readings level out. By normal diet she means low fat, low sugar. (I asked). What I want to avoid is putting any weight back on, in fact I'd really like to shed another stone. (Got a wardrobe full of smaller clothes!) Only too happy to change diet if needs must. As it is I avoid processed carbs but still probably eat too much bread, albeit wholemeal. I see lots of advice re low carbs and GI diet and must admit to being a little confused as to what is best.

Also is it best to wait "until readings level out" or start looking at dietary solutions now? In fact, can diet really help that much when medication is keeping readings down? Done lots of reading here and as you can see I'm a little confused with this aspect. Perhaps I'm missing something obvious?

Eyesight - was extremely concerned with this initially but looks like it will probably be OK. I wear glasses. When I visited the opticians I got a pair of cheap distance glasses to keep me legal for driving. That prescription lasted only a few days and I was back to original glasses for a few days. Now however I'm using my intermediate/reading glasses for distance! Strangely it appears that my eyesight is better now than it's been for a long time in that I still need distance but not as strong. Confused again.

Been settled for about 10 days now. Obviously I need to get eyes tested again and get new prescriptions. I see estimates online of 3 months for eyesight to settle down but I appear to be at that stage already? Is that possible or should I expect more changes?

Back to see nurse on Monday - are there any questions I should be asking?

Last question (for the moment!) - I'm in Scotland. Read somewhere about a scheme I could sign up to where my diabetes information would be accessible online. My practise is fairly well up on technology so I've no doubt they participate. I forgot to bookmark - anyone point to a link for that please?

Apologies once more for the over long post.

Cheers, John

 

[Grazer]

Re: 3 weeks - Controlling what I can, accepting what I can't

Hi there and werlcome!
A few answers I* hope below.
First, your BGs are still too high in my opionion. You need to adjust your diet to get them down, or go on even more meds. Below is a bit of advice I've sent to a few people, so ignore the bits that don't apply!
In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on stronger medication like yourself normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. That’s 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reduce the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts. Your wholemeal is not suitable.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. Level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Regarding HbA1c:- it measures different things in different units to your meter. Your meter reads your instant blood glucose level in mmols. The HbA1c measures the amount of glucose platelets that have attached to your blood cells over the previous 8 to 12 weeks, and give an indication of your average BG over that period, although heavily weighted to the last month.You can conbvert an average BG figure to an HbA1c figure, but it depends on getting a TRUE average which is far more difficult than you might imagine. Once you settle in to your testing routine, I could happily give you the equation to convert together with some tips to go with it; reckon you've got enough to occupy yourself for now!
Do ask lots of questions; there is normally an answer on here. The more you get to learn about your diabetes, the better it will be.
Good luck!

 

[didie]

Re: 3 weeks - Controlling what I can, accepting what I can't

Hi Signs

Welcome to the board

I'm just popping on from work very quickly to post the link to the Scottish diabetes online information thread.


viewtopic.php?f=25&t=24169

 

[Grazer]

Re: 3 weeks - Controlling what I can, accepting what I can't

Forgot to mention eyesight. It's commonb for eyesight to improve as blood sugar levels get lower. I wouldn't get new glasses yet; wait 'till you're settled at a BG level ok with you first, so your eyes can settle properly at that level.
Regarding the HbA1c again- to convert from a TRUE average BG to HbA1c using the %age measure that you mention, and which most of us still refer to on here, ( a new measure in IFCC units has come in; if you get readings in that you need to adjust this equation) you do this: HbA1c=(avge BG-2.15)*10.929

 

[Signs]

Re: 3 weeks - Controlling what I can, accepting what I can't

Didie, thanks for the link. printed off the form and will get it signed on Monday when I see the nurse.

Grazer, thanks for loads of info there!

I have more questions. Not sure what the forum protocol is but I'll ask them here until I get chased . . .

Decided today to start counting carbs, it seems to be the way to go. I'm hoping that will keep levels down AND help lose weight?

I've used Tesco stoneground wholemeal for a while now but got some Burgen bread instead and here's where the confusion starts.

Stoneground. carbs 18.1, sugar 1.5, fat 1.4 with 105 calories per slice.
Burgen. carbs 12, sugar 2.4, fat 4.4 with 124 calories per slice.

So less carbs but more sugar, fat and calories per slice. So if I have have a sandwich I'm eating 12 less carbs but 40 or so more calories, 6g more fat and 2g more sugar.

I though I was trying to avoid sugar? Or do I have the wrong end of the stick again?

Thanks, John

 

[Daibell]

Re: 3 weeks - Controlling what I can, accepting what I can't

Hi Signs. Although the numbers for the bread seem strange don't forget sugar is just another carb so it's the total carbs that matter i.e. carbs including sugar so the Burgen bread is better in that respect. Don't worry about the fat level. I suspect it comes from the seeds and is probably not saturated. The extra calories is probably due to the fat. I think you will find that by low-carbing not only will your BS stay low but your weight will come down as the calorie intake overall will also be quite low. You may need to adjust your diet depending on the weight you need to achieve.

 

[Grazer]

Re: 3 weeks - Controlling what I can, accepting what I can't

The problem with sugar is that it's very high GI - that is, high on the glycemic index. Other than that it's just another carb. High GI means it gives fast peaks in your Blood Glucose level (not good). However, Bergen bread OVERALL has a very low GI because of the soya and linseed content so gives good results. Not sure about the calorie count, but overall if you reduce carbs and forget calories you WILL lose weight. My problem now is keeping it ON, so I graze on nuts! By the way, no protocol, keep asking.

 

[Grazer]

Re: 3 weeks - Controlling what I can, accepting what I can't

Sorr Daibell, was writing while you were posting! at least we agreed!