Advice needed.

Hi, how long have you been a type 2 and what are your numbers in general . Whats your diet like?

Can you be more specific than “crashes”? Are you testing do you have actual numbers? Type 2 not on medication are no more likely than anyone else to have a hypo caused by rare things other than diabetes medication.

What changes have you made to diet and how long have you been doing them? I’m wondering about false hypos (lower levels than you are used to but still not an actual low) or lack of fuel in general.

Your body has for two years at least been used to high glucose levels, and of pumping insulin at high rate to control it. Now you are telling it to lower the glucose below its 'normal' level, but is is probably still pumping flat out. Looking at the list of foods you are eating, then I am not surprised to see 10 or 11 mmol/l after a meal, but most of the things you eat are glucogenic, meaning they will be high sugar but not complex, so will create a sugar apike of between 10 and 20 minutes only, so I am not surprised to see it drop quickly. The level of 4.8 is what non diabetics will often run at and it is not considered low. Hypos start below 3.9 going south. So the CGM warning is too high for someone not using insulin or a hypoglycemic medication. False hypo's most probably, and your body may take a while to get used to the new 'You' and for it to be less agressive with the foot on the floor response.

scottiehoff said:

Hey. I've been type 2 for 2 years and 6ft 1 and about 270lbs. range is 5.8mmol waking/fasting to around 11mmol an hour after eating. Generally I am active. Up to a week ago I walk the dog once a day for 30 mins and 2 x per week I'll play 18 holes of golf which is apprx 5 -7 miles depending on how I play.

Food wise I've recently scaled back to approx 2000 calories per day as started eating a lot healthier. Swapping starchy carbs like potatoes and pasta for lower gi things. Generally I have 2 x toast (sourdough or wholemeal) with an apple for breakfast. An orange or apple with a low sugar graze bar for snacks, lunch would be a sandwich or salad with a bag of low fat crisps (snak a jacks) and fruit, then another piece of fruit or berries in the afternoon with some oats or nuts to keep me going and then a balanced meal in the evening like chicken salad with sweet potatoes wedges or steak and carrots with broccoli.

I'll occasionally have a snack in the evening which could be natural yogurt and berries or an oat bar. Something like that.

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Ok so those post meal readings and the foods you are choosing might be conventionally what’s “healthy” but they still contain a lot of carbs. You also need to see where the readings are immediate premeal and compare to 2 hrs later. A non diabetic usually returns to the same baseline. So if you are more than 2mmol higher then even giving some leeway you aren’t coping normally with that meal. You also want to be back under 7.8mmol at that later reading ultimately but that might take a while. Do you know your latest hba1c? And how long ago was that?

GI doesn’t really seem to work for a lot of us. Yes it might slow the spike a little but in turn it prolongs the rise as those carbs still need to be processed. And it’s the carbs that raise levels not any fats (but I’d still avoid processed seed oils and factory made fats - stick to naturally occurring ones). I’d be checking the bread response, definitely the bar (low sugar is not the same as low carb at all), the sandwich, the crisps, the fruit other than berries, the oats, and the sweet potato. So a lot of what you are choosing. Many of us choose to focus on meat and fish (without breadcrumbs etc or carb sauces), non starchy veg, salad, eggs, cheese, full fat dairy, butter, olive oil, ghee or coconut oils, and adding herbs and spices etc and avoid all grain based options including flour, oats and cereals.

scottiehoff said:

I did keto when I was diagnosed and lowered my levels too quickly. Lost my near sighted vision so had to reintroduce carbs whilst getting it down to good levels.

Apart from that it worked very well. High energy and low sugars. Didnt like the keto flu though.

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Lost it ? Do you mean the common temporary adjustment of blurry sight when the eyes are no longer bathed in glucose that passes in a few weeks and is caused by them re adapting without the glucose or do you mean actual issues with retinopathy etc?

So you know what to do but perhaps more gradually or less extreme to avoid the keto flu (water and electrolytes go a long way to avoid that btw).

Hey @scottiehoff
Sorry to hear about your BG level problems. I think as some others have said your carb in take is actually quite high which may result in a large range between your peak post prandial BG and your BG level once your insulin gets to work. This large drop might be giving you the feeling of a false hypo despite the fact you actually have a healthy BG level. Try reducing your carbs and increasing your protein. Any glucose you need your body can create from your glycogen stores and from any excess protein. But upping your protein slows down your digestive system so that the body can keep the food there long enough to digest it and get all the nutrients. This not only keeps you feeling fuller for longer, it also keeps your BG levels more stable over time, it takes time (and energy) for the conversion of protein to glucose. One other thing at 6' 1" and 270 lbs you are not from your food intake description eating very much, this itself may be causing you to feel very tired. I know if you want to lose weight you want to be in a calorie deficit, but a 270 lb man walking 5 to 7 miles a day is burning a good amount of fuel. And just being 270 lbs requires a lot of fuel to be burned even if you do very little. Try reducing carbs (eat non starchy veg only, with just the occasional bit of refined carb if you feel you really need it perhaps just before your golf), don't let the fats get too high (eat natural foods for your protein sources and they come with all the fat you need you don't need extra), eat lots of protein but keep your calories under control (you will feel very full on lots of protein so this pretty much takes care of itself. Don't make your calorie deficit so big that you get so fatigued that a healthy lower BG level makes you want to crash. Try it and see if it works for you. Good luck mate.

scottiehoff said:

Thanks for the replies all, I've started keto again today and the results are already astounding. From carbs yesterday to low carb from 1830 last night. The difference is incredible. View attachment 60948

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Proof of the Lack of Pudding?

scottiehoff said:

Hey. I've been type 2 for 2 years and 6ft 1 and about 270lbs. range is 5.8mmol waking/fasting to around 11mmol an hour after eating. Generally I am active. Up to a week ago I walk the dog once a day for 30 mins and 2 x per week I'll play 18 holes of golf which is apprx 5 -7 miles depending on how I play.

Food wise I've recently scaled back to approx 2000 calories per day as started eating a lot healthier. Swapping starchy carbs like potatoes and pasta for lower gi things. Generally I have 2 x toast (sourdough or wholemeal) with an apple for breakfast. An orange or apple with a low sugar graze bar for snacks, lunch would be a sandwich or salad with a bag of low fat crisps (snak a jacks) and fruit, then another piece of fruit or berries in the afternoon with some oats or nuts to keep me going and then a balanced meal in the evening like chicken salad with sweet potatoes wedges or steak and carrots with broccoli.

I'll occasionally have a snack in the evening which could be natural yogurt and berries or an oat bar. Something like that.

Click to expand...

Low carb high protein is what I do. Looking at what you’re eating, do you eat meat and fish? It is possible to eat too little, especially if you’re very active.

Provided you have energy and are not hungry NO, Once fat adapted any shortfall is taken from body fat.