Advice please

[sue512]

I’m a type 2 diabetic on glicazide, Dulaglutide injection and have recently been started on metformin as my hba1c had gone up to 71.I’m also on medication for hypertension and asthma. I’ve been diagnosed for about 5 years and only recently discovered this forum! Very helpful forum I might add. 6 weeks ago I had exacerbation of asthma and needed steroids and antibiotics. My blood sugars shot up to 33.3 and hi where monitor wouldn’t record levels. Over the last 5 weeks I’ve been recording and testing my blood sugars more religiously and have started a low carb high protein and fat regime. This morning my fasting was8.7, shooting up to 13 mol/l 1.5 hours after breakfast of Greek yoghurt 30g mixed nuts and teaspoon of chi seeds with 2 cups decaf coffee, white no sugar. Have I missed anything? What have I done wrong? My asthma and chronic back pain has improved dramatically over last 5 weeks which I’ve attributed to change in diet, I don’t want to slip back!

 

[catinahat]

Welcome @sue512
Did you confirm the 13mmol result by re washing your hands and taking another reading?

 

[MrsA2]

Hi @sue512
Your doing the right things. A sudden rise could be activity, a hot bath or stress, amongst other things. Food is a major part in bg, but not the only part.
With any odd reading, wash hands and test again.
The time to worry is if it keeps going up and up and you get ketones too.
It might be that after a few weeks of low carb that your medications need adjusting.
Could be many things, keep testing and keep posting

 

[sue512]

Welcome @sue512
Did you confirm the 13mmol result by re washing your hands and taking another reading?

Yes and repeated it in the other hand. I’ve only just realised whole milk in my coffee would also have carbs

 

[Oldvatr]

Might be worth investing in a tub of weestix to measure for ketones, just in case. The steroids are known to push up bgl levels significantly, and even if stopped now, will take a while for the effects to wash out. The Gliclazide needs to be taken at least 20 mins before eating, since it has to be absorbed in advance of the sugar hit from the meal. The glutide med increases insulin output and this may be pumping glucose into your liver, which acts like a rechargeable battery. What goes in needs to come out again. The LCHF should help reduce this and settle down but it may take a couple of weeks. You are taking 2 meds that make the pancreas create more insulin, (Glic and the glutide) so if you are insulin resistant, then this is probably not helping. Imcreasing insulin may be a sledgehammer cracking a nut by force feeding your cells with glucose. The sugar has to go somewhere.

 

[Oldvatr]

Yes and repeated it in the other hand. I’ve only just realised whole milk in my coffee would also have carbs

milk is only really a consideration if you are drinking Latte. it is only a couple of gms when splashed. I am talking dairy milk, but plant based milk alternatives can be higher carb.

 

[Oldvatr]

Testing at 1.5 hrs rather than the usual 2 hrs may give you a higher reading than expected when comparing to others using the 2hr time. You should aim for the rise to be less than 2 mmol/l at the 2hr mark.

 

[sue512]

Testing at 1.5 hrs rather than the usual 2 hrs may give you a higher reading than expected when comparing to others using the 2hr time. You should aim for the rise to be less than 2 mmol/l at the 2hr mark.

Thank you for the info, no ketones even when blood sugars were in the 30’s on steroids.

 

[Rachox]

…but plant based milk alternatives are higher carb.

Not strictly true I drink unsweetened coconut milk, either Koko (0.3g/100mls) or Alpro (0.0g/100mls), which are both lower carb then dairy milk

 

[Oldvatr]

Thank you for the info, no ketones even when blood sugars were in the 30’s on steroids.

So you seem to be producing ample insulin. I was the same at 32+ felt perfectly well and no bother! Is the glutide helping on the weight front? If your insulin production is acually in working order, then the meds for increasing insulin will not be effectively working to reduce glucose levels, as I found out myself on glic at max dose and it only started working when my sugar levels started dropping from the diet changes. What dose are you on? The low carb diet should assist in reducing insulin resistance and then you will not need to boost insulin so much. You need to prepare to change medication doses as your levels drop to avoid hypo's.

 

[Daibell]

Hi. What is your BMI? If it's high, the low-carb diet should help with insulin resistance and weight. Steroids are a big BS problem so try to keep the dose as low as you can agree with the GP.

 

[Deleted member 475901]

I found that too many nuts at one meal is too high for me. And of course even full fat plain Greek yogurt isn't carb free although it is better than most.
I found through testing that a max of 30g per meal and max 85g a day was enough to get me into remission but research suggests that it was easier for me as I started low carb immediately - others need to go lower.

 

[sue512]

So you seem to be producing ample insulin. I was the same at 32+ felt perfectly well and no bother! Is the glutide helping on the weight front? If your insulin production is acually in working order, then the meds for increasing insulin will not be effectively working to reduce glucose levels, as I found out myself on glic at max dose and it only started working when my sugar levels started dropping from the diet changes. What dose are you on? The low carb diet should assist in reducing insulin resistance and then you will not need to boost insulin so much. You need to prepare to change medication doses as your levels drop to avoid hypo's.

Glicizide is 160 mg twice a day and has been same for a few years now. Nothing has helped the weight until I started low carb high fat and protein 5 weeks ago. I’ve dropped about 1 1/2 stone since then, now down to a steady plod. I haven’t had any hypos in last 5 weeks was more likely to have them when I had wildly swinging blood sugars. 4.8 is my lowest reading, most readings about 6-8, with the occasional spike, although this mid morning spike the highest

 

[sue512]

Hi. What is your BMI? If it's high, the low-carb diet should help with insulin resistance and weight. Steroids are a big BS problem so try to keep the dose as low as you can agree with the GP.

My bmi is down to34 at moment as my weight is coming down with low carb high fat high protein regimen. This seems to be the first time since diagnosed 5 years ago that I’m managing to lose weight relatively easily. Long may it continue!

 

[sue512]

My bmi is down to34 at moment as my weight is coming down with low carb high fat high protein regimen. This seems to be the first time since diagnosed 5 years ago that I’m managing to lose weight relatively easily. Long may it continue!

My asthma has improved hugely with change in diet so I’m hoping to avoid steroids in future!

 

[Oldvatr]

Glicizide is 160 mg twice a day and has been same for a few years now. Nothing has helped the weight until I started low carb high fat and protein 5 weeks ago. I’ve dropped about 1 1/2 stone since then, now down to a steady plod. I haven’t had any hypos in last 5 weeks was more likely to have them when I had wildly swinging blood sugars. 4.8 is my lowest reading, most readings about 6-8, with the occasional spike, although this mid morning spike the highest

Prepare for a soft landing. The glic dose is max (320 mg a day) so maybe negotiate with the doctor about stating to reduce it now that some stability has returned. If you are still running at max insulin output, then it is possibly working againt the insulin resistance reduction efforts of the diet. I concentrated on getting the diet controlling my return back to control. I still have a pill bottle full of glic tabs and half glic tabs as a momento of my journey. Glad to hear things are resolving.

 

[ianf0ster]

You should find a noticeable reduction in Blood Glucose when you no longer need the steroids. But they are only one thing that can raise BG.
Illness, injury, stress, lack of sleep, statins (and some other medication), for some even certain artificial sweeteners are just some of the others.
Also be aware that depending upon the type, intensity and length, exercise can either temporarily reduce BG or temporarily increase it!

 

[sue512]

You should find a noticeable reduction in Blood Glucose when you no longer need the steroids. But they are only one thing that can raise BG.
Illness, injury, stress, lack of sleep, statins (and some other medication), for some even certain artificial sweeteners are just some of the others.
Also be aware that depending upon the type, intensity and length, exercise can either temporarily reduce BG or temporarily increase it!

Thank you for that, steroids were a short course of 5 days back in may so not an issue at moment, but I’ll consider the rest you’ve mentioned. The only stress yesterday was when cat brought in dead mouse but that was after my bs rise!!!

 

[MrsA2]

Thank you for that, steroids were a short course of 5 days back in may so not an issue at moment, but I’ll consider the rest you’ve mentioned. The only stress yesterday was when cat brought in dead mouse but that was after my bs rise!!!

Better than the stress of it bringing in a live mouse!

 

[sue512]

Spikes in glucose of a morning persist, reasonable the rest of the day 4-8. As I used my mouthwash this morning I wondered. I don’t swallow the stuff but would that be enough to spike morning blood sugars? I use dentyl