Am I expecting too much?

[letswalk]

Hi All,
To introduce myself I was diagnosed with T2 in May '17 with a HbA1c of 109 (fortunately picked up by my medical at work as I didn't have any obvious symptoms) The doctor said to loose weight so I stopped eating all obvious sources of carbs immediately and after a little research I embarked on the 8 week Blood sugar diet by Michael Mosley. I will admit it is the most successful diet I have ever tried & I lost 2stone fairly quickly & with some effort another half stone so I now weigh 9stone which at 5ft 3" & 53yrs young I am fairly happy with.
Two subsequent HbA1c test results have been 51 in Sept & 46 in Dec. The nurse is very happy with my progress (she has not seen this sort of result before on diet alone) I am also happy with this positive progress but there is a BUT !!! I have been testing my BG to try and understand how the foods I eat affect me & to understand my glucose levels better on a daily basis as waiting 3 months for my next test is too long!
The down side of this is my results don't look as promising as my HbA1c suggest. This is where I am hoping to get some advice.
So my research tells me as a type 2 that between meals my glucose levels should be between 4 & 7 & post eating <8.5.
I have just looked at my last weeks results and mostly 2hrs post eating I have been within target. (there may have be a flaw with my testing as I have been timing two hrs from finishing my meal & I read today that it is two hours after your first mouthful. Is this the correct way??) Anyway I can correct that going forward but what worries me is that my waking/fasting BG is generally mid 7's to mid 8' which I think is high from what I have been reading on this site and it generally goes up before I eat breakfast. Is this normal?
Also I am very rarely getting into the 4 to 7 range. I get some pre meal 6's but mostly 7 & 8.5! I find this a worry as I suspect it is not healthy.
So back to my opening question "am I expecting too much?" Its only been 8 months I've made a lot of changes & a lot of progress but I still don't feel satisfied with my results and I really don't know what to do next.
To anyone who makes it to the end of this Thanks for sticking with it & do you have any advice?
Paula

 

[miszu]

Hi Paula, welcome.
Ur improvements sound amazing to me, congrats on them ! Waking up with higher BG seems to happen to others as well. While asleep, glucose is released in to ur blood to prevent going low. If its not dangerously high, I wouldnt worry about FBG too much. About postmeal readings, yes it is correct to test from 2 hours after ur first bite.
Losing that much weight and getting ur BG under control in such a short time is definitely something to be proud of. I understand the feeling of still being unsatisfied, but I think it is a major point to be able to see ur progress and be happy with what u have reached so far. Just a sidenote, but I find that when being unhappy, stressed over my diabetes it wont let me control it.
U say ur postmeal readings are in target, but knowing u might have been checking it the wrong time, I would suggest to now check ur post meals properly and if they are within target, I wouldnt worry much. Of course theres always room to improve, but reading ur post, I think ur doing well, if u keep it up then u will be alright. Im more worried how stressed u might be, that definitely wont do u good.

Have a good night. X

 

[pleinster]

Hi All,
To introduce myself I was diagnosed with T2 in May '17 with a HbA1c of 109 (fortunately picked up by my medical at work as I didn't have any obvious symptoms) The doctor said to loose weight so I stopped eating all obvious sources of carbs immediately and after a little research I embarked on the 8 week Blood sugar diet by Michael Mosley. I will admit it is the most successful diet I have ever tried & I lost 2stone fairly quickly & with some effort another half stone so I now weigh 9stone which at 5ft 3" & 53yrs young I am fairly happy with.
Two subsequent HbA1c test results have been 51 in Sept & 46 in Dec. The nurse is very happy with my progress (she has not seen this sort of result before on diet alone) I am also happy with this positive progress but there is a BUT !!! I have been testing my BG to try and understand how the foods I eat affect me & to understand my glucose levels better on a daily basis as waiting 3 months for my next test is too long!
The down side of this is my results don't look as promising as my HbA1c suggest. This is where I am hoping to get some advice.
So my research tells me as a type 2 that between meals my glucose levels should be between 4 & 7 & post eating <8.5.
I have just looked at my last weeks results and mostly 2hrs post eating I have been within target. (there may have be a flaw with my testing as I have been timing two hrs from finishing my meal & I read today that it is two hours after your first mouthful. Is this the correct way??) Anyway I can correct that going forward but what worries me is that my waking/fasting BG is generally mid 7's to mid 8' which I think is high from what I have been reading on this site and it generally goes up before I eat breakfast. Is this normal?
Also I am very rarely getting into the 4 to 7 range. I get some pre meal 6's but mostly 7 & 8.5! I find this a worry as I suspect it is not healthy.
So back to my opening question "am I expecting too much?" Its only been 8 months I've made a lot of changes & a lot of progress but I still don't feel satisfied with my results and I really don't know what to do next.
To anyone who makes it to the end of this Thanks for sticking with it & do you have any advice?
Paula

Hi Paula. To be honest, we all vary..so while the two hour thing is a great guideline it is not written in stone. Some say two hours after the last mouthful, some say the first...people differ. I have found that my system is a bit slow and so I look at my levels between 2.5 and 3 hours after I finish eating. I too manage my levels purely through diet; that's nearly three years now. Frankly, I don't think your levels are at all scary. It would be nice if they were lower..yeah. the HbA1c is the really important level as it establishes your average over the preceding 3 months. Meter readings (and note that I value them highly) are less accurate and have margins of error...they serve as good guide to your levels at a given moment and patterns over time can be very informative...but don't get too stressed by them if your HbA1c is good. You are making good progress. My own levels are similar at the minute because I am being deliberately less strict with my low carb diet but if I do really focus I can get them down a bit further. You don't say exactly what you are eating..maybe you could try even less carbs (purely to see what kind of reading that gets) but bear in mind all diets have to be sustainable..so be realistic. If the jump between meals is around 2mmols or less and it doesn't; go much above 8ish..you're doing ok. I suggest keeping a record of what you eat as well as the meter readings and seeing if there is anything you can learn from that. As for the morning readings, you should note that (crudely put) the liver can dump glucose into the system to prepare our bodies for the day ahead and that results in higher levels when we wake. Generally, over time, these will come down the lower out overall levels are but, again, we vary and many find these levels the hardest to alter. Good luck.

 

[Cal M]

Hi let's walk,
your story sounds very like mine but I am 1year post diagnosis. Enjoying the diet and getting lots of variety, lost 2.5 stone as yourself. But unlike you my last HbA 1c was creeping up, I am on 4 metformin a day, my fasting BG Averages 9.5. I was expecting the good results you have achieved. So very well done. Satisfaction is difficult as really what I wanted was to not have diabetes, to prove my GP wrong. I thought I had come to terms with it, made real life long changes but I still struggle with acknowledging my pancreas isn't playing the game. Ho hum.
So are you expecting too much? Hope is good for us it keeps you striving to improve. So no, but but keep your actual goals in mind, it sounds like you have had great success.

 

[letswalk]

Hi All, Thanks for getting back to me and for you reassurance. This is not a medium for conversation that I would normally use & have been pondering writing for months as there seems little other support out there. My family & friends & been very supportive & encouraging but knowledge comes from more & more reading which in itself can be stressful as there is so much conflicting information.
Miszu I think you made a fair point about stress! I have been worrying about food since diagnosis in a way I have never done before. I never thought I ate a particularly bad diet as I wasn't into junk food or takeaways, fizzy drinks & the sort of things they like to demonize and although I will freely admit I was overweight not excessively so. However now all I seem to think about is food & BG levels which stresses me. I worry much less about finding the right foods to eat but more silly things like :
Should I have my coffee with my meal rather than later when I would normally fancy one! so that it does not mess up my test!! Is it ok to have coffee between meals? Sounds silly now I write it down so I really should stop stressing & get on with being normal again!!
Pleinster thanks I will see how the new testing regime goes and when possible will try and test a range of times post eating for a little bit to see what the trend is and how my body responds to food.
Interestingly I have been keeping a food diary mostly to keep me on track so I don't regain the weight & theoretically to keep a record of my carbs when I enter it into myfittnesspal but it is so time consuming that I am not up to date on that at the moment although I was aiming for <70 carbs per day from vegetables, dairy, nuts & some fruit. I am not eating any potato, pasta, rice, bread, cakes etc (excluding a few squares of 70% choc) but I refuse to completely give up certain vegetables like carrots & parsnips that are considered by some as bad (I eat in moderation & certainly not everyday) and I still try and include some fruit of the lower carb varieties (berries) I very much believe in a balanced diet & really don't want to exclude certain foods that I know are good for us just because they contain some carbs (an apple a day keeps the doctor away!! must start introducing some apple again) so what I guess I am saying is I don't plan to go on an extremely low carb diet as I don't think it will suit me & you are right it wont be sustainable. I am starting to do some research into the low GI foods that also have a low GL so I can introduce some of those with more confidence.
I guess one other thing that has been worrying me is that although my nurse is happy and supportive of my progress I feel she would be happier if I was on metformin as she thinks my diet has got me as low as I am going to go and that my system just isn't playing ball right now & feels my HbA1c should be lower! So Cal M I think I know how you feel as well it can be very frustrating when you put in so much effort. I had a conversation with a specialist dietician the other day to discuss my concerns (I was unfortunately in Sainsbury's at the time so maybe not the most structured conversation :0) however she seemed most interested in my numbers & that I was now in pre diabetic range! That didn't really reassure me as in my mind if I went to the doctors with those results they should recommend for a pre diabetic to Go on a diet, change what they are eating & take more exercise!! all of which I am already doing. Hence my poor confused & stressed mind is saying what next?

Anyway given your advice I will keep persevering with the diet & testing. Really try & worry less and see what my next HbA1c brings. Thanks :0)
(of to continue painting the bedroom now before treating myself to a low carb pancake (egg & cream cheese) filled with spinach, mushroom & bacon) Have a good Sunday it's not raining here.

 

[david1968]

I found the morning readings the hardest to get under control.

You don't say what medication, if any, you're on Paula - are you trying to contol things by diet alone or are you taking medications as well?

I think the trick is to set yourself targets, but not to get too worried if you're not hitting them, otherwise you're only going to get stressed and that isn't going to help. You've already made excellent progress by the sounds of things - more than halving your HbA1c - so whatever you've been doing is working.

Keep at it!

 

[Pinkorchid]

I think you are stressing to much because you are actually doing really well and your levels are within the recommended ranges Some take much much longer to achieve what you have done. You have lost weight eat a good diet with low carbs and you exercise so all good. As to levels we are all very much different when it comes to those some never get below the 6s or even 7s between meals no matter what they do and some can get into the 4's but those and anything in between is good because just as non diabetics all have different levels so do those with diabetes. We do not try to get the same levels as others do but get into as good a range as we personally can. I would say keep on doing what you are now and I am sure you will get a very good HbA1c next time

 

[letswalk]

Thanks,

It does sound like maybe I am expecting perfection (in my nature :0) so I will keep doing what I am doing, worry less & keep learning.
I am not on any medication at the moment and hope to keep it that way if possible.

 

[pleinster]

I think you're doing ok, Paula. Stop worrying. If you feel you need to get the levels lower, think again about even fewer carbs..but if you can keep your level around where it is...I would think less about it all and get one with life. One point to note is that metformin is not really about lowering blood sugar levels...drugs like Gliclazide are better designed for that...but, for me personally, I'd stick with diet alone if it's working pretty well.

 

[Resurgam]

One thing to remember is that there are no essential carbs. The concept of a balanced diet has no scientific backing.
I eat a wide variety of low carb foods, a lot of them fresh, quite a lot uncooked. Despite having two apple trees in the garden I only at a few small ones last year. I do recommend keeping to diet only control if it is possible, but do check that you can cope with the amount of carbs you eat when introducing higher carb foods, or more of them.
The only thing I can think of to suggest is adding two short bursts of activity each day - I have a trampoline in the garden and as soon as the weather is warm enough I go out and bounce, and there is a noticeable drop in my BG levels. It only takes ten to fifteen minutes at a time and it is enjoyable - I really ought to get one of those little rebounders to have indoors, for the winter, but the climate is so mild down here on the south coast that I can go out for a good 9 months of the year.

 

[letswalk]

Thanks guys,
Already worrying less
Went to the gym today and now have a program to complete twice a week so feel positive about that.
Will keep low carbing and keep positive.