Afternoon Slump

[duckonhand]

Relatively recently diagnosed with type 2 diabetes - 3 months. On 850mg metformin, twice daily (and 10mg Ramipril for high blood pressure - all part of the package).

Since increasing to these levels, I have noticed a slump in energy everyday around about 4 o'clock. This is characterised by extreme tiredness, yawning and difficulty concentrating; not great as I don't finish work until about 6! This usually wears off a little on the train on the way home and by 7, before I've eaten, I feel fine.

My normal pattern is breakfast (9ish), lunch (12/12:30) and snacks - fruit mostly and plenty of water at my desk between times.

I've taken a reading a couple of times during this slump for comparison's sake:

Today - 15.7(!) - are carrots particularly sugar packed?!
Yesterday - 7.9
Tuesday - 9.3
Monday - 7.9

I mentioned this to my GP and after testing full blood count and thyroid function which were fine, she wondered if it was just a temporary reaction to my medication changes. I've got an appointment next week with the diabetic nurse - it'd be nice to be forearmed with some sensible questions.

Any thoughts?

Thanks

Scott

 

[cugila]

Looking at your post we really need more information.......what sort of diet do you have. Can you give us a typical days dietary ontake ? What are your Bg levels throughout the day, fasting, and 2 hrs after meals.
Might help us to help you.

Here is the guidance we offer to newly diagnosed Diabetic's.......have a read and see if there is anything that might help you understand things better. As for carrot's....basically anything that grows underground is usually higher in carbs/sugar so needs to be restricted for a lot of people. Testing is the only way to know.

Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.

As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!
If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l.(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l. ( Type 2)

2hrs after meals....... no more than 9 mmol/l (Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Ken/Sue.

 

[Alanem]

Hi Scott and welcome to the fun world of chasing your tail. I don't know how old you are but I've been having a "tired time" around 4pm for years and only a quick siesta puts it right. Ok for me I'm retired.... Also like the idea of stirring my wife's coffee with a carrot saves having sugar in the house!! :roll:

 

[cugila]

Almost forgot.....a few things you might want to ask when you go for your first appointmenet:

Here are a few questions you can ask.

What can I do to control it, diet,medication ??

Appointments to see dietician, podiatrist, retinal screening.

Test meter /strips.

Test results and what do they mean ? a print out of the results for your own records.

Who will I be seeing the nurse or GP ? I f I have problem can I see either of you ?

Are there any courses I can attend, DESMOND for Type 2, DAFNE for Type 1's ? Any other Diabetes Education classes available.

How often do I get blood tests, Hba1c/Cholesterol/full lipid panel.. Should be every 3 months initially till in control.

Take a notebook with you and write down what you are told. If the doctor/nurse says things that you do not understand then ask them to explain it so that you can write it down.

This is your condition, your diabetes, you should be encouraged to take part in the treatment that you will be getting, not dictated to.

If you find that the doctor/nurse is unsympathetic then we suggest you find out which doctor in the practice is good with diabetes. Some doctors have a special interest in certain subjects, it’s worth finding this out.

Ken/Sue

 

[mimo]

Its really strange you mention this 4pm slump, as I have been experiencing it too recently.
I am 32 and was diagnosed with type 2 few months ago. I mentioned this tiredness to the GP and he didnt seem to be bothered about it. For me it was really odd that it was at exactly the same time every day. What I ended up doing was have a lie down for 10 mins and seems to perk me up. Am lucky at the moment because I am on summer holidays, not sure how its going to be when I go back to work?!?!
Just thought I would let you know you are not the only one out there with 4pm slump

 

[duckonhand]

Thanks Mimo - glad it's not just me! Also 32, also met with indifference from GP - have arranged a KIT with the diabetic nurse this week to see if I can get some more answers... Haven't yet tried a "power nap" yet, although pretty much fell asleep yawning at my desk on Friday!

Cuglia - thanks for the round up of information available.

S