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Any ideas please?

A

Ali H

Well-Known Member
Messages
790
Location
Somerset
Type of diabetes
Type 2
Treatment type
Insulin
I am getting seriously fed up now. Things had been getting a little worse before I had a knee arthroscopy nearly 3 weeks ago but not totally dire. However, since then my blood sugar readings are through the roof.

I am getting 8.8s fasting after having nothing to eat after my evening meal and spikes of 15 or more 2 to 3 hours after a meal. This weekend I really cut back my carb intake but that has had no effect whatsoever.

I take 1 X 80 mg gliclazide before breakfast and before my evening meal and recently had 1 X 500 mg slow release metformin added in to try and combat this rise. Nothing is changing at all.

My GP thinks I have LADA but I don't think he did GAD or CPep tests. I am going to ask him to do these but with current funding issues who knows if that will be possible. Has anybody paid for them themselves and if so, what sort of cost was involved?

I am pretty certain he is going to go the insulin route but he isn't back in until Friday and he is the only diabetic specialist at the practice AFAIK. I am keeping a food diary and meter readings to show him. Meantime, am I banging my head against a brick wall trying everything under the sun with no decent readings to show for it or should I bash on with the low carbing?

Ali
 
Hi Ali

I'm not on tablets so can't comment re them.

What do you eat? What has been a typical days food for you?

Mary x
 
Thursday 15th March

8.4 – after 11 hour fasting

10.3 – before evening meal

10.9 – 4 hours later before bed


Food eaten

Thursday 15th March

2 X weetabix with chopped banana and semi skimmed milk, 1 coffee for breakfast

1 X Nairns oatcake and coffee mid morning

2 No added sugar Ribenas during morning

1 X cheese and salad sandwich (home made wholemeal seeded bread)

1 X coffee

Home made burgers X 2 (no breadcrumbs), jacket potato, broccoli, green beans and carrots


Friday 16th March

8 – fasting

15 – 3 hours after breakfast

9.1 – before evening meal

2 X slices of toast with reduced sugar jam spread thinly, 1 coffee

1 X NAS Ribena

Smoked salmon, 2 small hard boiled eggs, 2 X cheese triangles, salad and 3 wholewheat crispbreads
1 light chocolate mousse (contains sweeteners not sugar)
1 coffee

Chicken, wholewheat pasta in vegetable sauce, sprinkle of cheese on top and salad
NAS Ribena

Fresh strawberries, small amount of evap milk

1 coffee

Exercise

2 hours hair appointment, weekly shop, pharmacy run, unpack car and pack away shopping. Walk dogs 20 minutes



Saturday 17th March


7.8 – 12 hour fasting

11.1 – 3 hours after breakfast

Food eaten

I slice of toast with scrambled eggs, grilled bacon and fresh mushrooms
1 coffee

1 NAS ribena

2 wholewheat crispbreads, 1 cheese triangle and small serving of smoked salmon
1 coffee
1 X weight watchers fromage frais, 4.6 grams of sugar

Sausages, mash, steamed carrots, leeks and brussel sprouts
NAS Ribena

2 rich teas and a coffee
Exercise

30 minute walk with the dogs


Sunday 18th March

7.6 – overnight fasting

13.1 – bedtime!!!!!!

Food

2 sausages, 2 scrambled eggs and one slice of toast
1 coffee

1 X NAS Ribena

3 X Ryvitas, one with salmon, cucumber and cheese triangle, one applewood cheddar and cucumber and one with peanut butter
1 X weight watchers fromage frais 4.6 g carbs
1 X coffee

1 square of 81% chocolate

Roast lamb, roast potatoes, cabbage, leeks, carrots and broccoli

1 coffee

Exercise

1 ½ hours housework and dog grooming

30 minutes across the fields with the dogs

Monday 19th March

8.8 11 hour overnight fasting

13.1 -2 hours after breakfast

Food

1 small bowl of porridge with a little cold semi skimmed milk
1 x coffee


This is the food diary I have been keeping since Thursday. As you can see since Friday lunchtime I have dramatically reduced carbs but that doesn't seem to be helping either. Porridge is meant to be low GL, ie slow release not causing spikes but as you can see, that didn't work either! I am basically experimenting with different food types but so far nothing is working.

Ali
 
Ali
i couldn't eat what you've listed and keep in my 4.5 - 5.5 target range. I certainly can't handle breakfast cerealsor "normal" breads.
I'd try low carb if you don't want to use insulin.
Hana
 
totally agree.

Couple of things jumped out from what I learnt about myself

I can't handle Porridge - got reading of 15+
I cant handle bread - even 1 slice of burgen

Also, I found I can eat some carbs later iin the day that I can't eat at breakfast, eg I can have 3 Nairns oat ibscuits in the evening but not for breakfast . This condition is just WEIRD.

You are doing the right thing, dairy, testing. If you get a spike after a certain carb reduce, eliminate or try at different time of day.

Mary x
 
The strange thing is that it wasn't a problem until I had this knee op! Surely reducing my carbs should have had some effect though?

I don't eat weetabix very often and I thought I would try the porridge this morning because some people say it is ok and others say it spikes. Well obviously it spikes me!! The whole thing is just very curious, things have been stable for 18 months and then bam. Yes the last two HBA1Cs weren't marvellous but I didn't know the results of them until a fortnight ago because they were done as part of the pre ops for my knee. I asked one GP to find out the results for me but she said they hadn't been given to them, I asked at the second pre op for the first result last Sept but he couldn't find it either. Finally another GP logged into a screen somewhere and pulled them up.

Surely to goodness though I should be able to eat some carbs without such ridiculous readings? Something is awry somewhere.

:-(

Ali
 
Have you always tested?

Don't want to sound negative but the HBA1c's you've been having, even before the op, suggest average bg readings of up to 11.2. (7.8 one)

Perhaps its not a sudden change post op but not low enough carb or medication needs altering?

It's a choice thing but if it was me I'd be trying to lower my carbs before upping meds. I guess it depends what is more important to you?
 
Hi

I think your problems are due to the amount of carb that you are eating every day. Your breakfast alone is about 50g carb. I wouldn't be eating that and I use insulin. It would cause the weight to pile on.
 
I have always tested but after the first 3 months the GP told me to do only morning fastings randomly. However I started to feel like I felt pre diagnosis which prompted me to up the testing. I hadn't felt like that at all prior to the knee op. I agree that prior to there were probably too many carbs but what is baffling me is that surely halving those carbs should produce some results?

If it is LADA then in all likelihood nothing I do will alter things because if I am just not producing enough insulin, then I am not. I am only taking 1/2 the amount of gliclazide you can take and a 1/4 of the permissable metformin I think so not really an awful lot of medication. Of course I don't want to up meds or go onto insulin but equally I need to see some results from my actions. I lost 2 1/2 stone in about a fortnight prior to medication, had a reading of 29 on my Dad's meter, a 16 hour fasting test of 14.6 at the Docs and an HBA1C of 12.6. Within 3 months with just the gliclazide and cutting out normal fruit squash and any chocolate, cakes and junk etc which there wasn't much of to begin with, my HBA1C plummetted to 7.

Ali
 
iHs said:
Hi

I think your problems are due to the amount of carb that you are eating every day. Your breakfast alone is about 50g carb. I wouldn't be eating that and I use insulin. It would cause the weight to pile on.
Click to expand...

Hi IHS, presumably the 50 carbs one is the toast? Yes I agree that was probably too much but why am I not getting lower readings over the weekend since lowering the carbs and upping the protein?

Ali
 
Actually, didnt look at the toast. It's the weetabix (plus milk) equals about 30g carb and the banana depending on its size is about 20-30g carb.

Do start to look at the carb info on the packets of food that you are eating..............and look online for carb info re mash potatoe. You may feel that you are eating a healthy diet but you are still eating more carb than the tablets you are taking can handle.
 
Yes I do look at the carb info and I agree with what you are saying although it was only about 6 slices of a small unripe banana so should have been below 20 grams of carbs by quite a bit.

But if I have halved my carbs in the last couple of days why am I still seeing similar readings to those I was getting on the days I had 2 slices of toast or weetabix? That was only a small amount of mash as I have read that mash can cause spikes. Usually exercise will bring it down but it doesn't seem to be helping right now. I calculate my carbs as being below 100 these last couple of days for instance with much more protein than I would usually eat. Sigh, it is a total minefield. I was brought up in the fat is bad for you era and having always battled my weight watched my diet carefully. Not frying things, minimal amounts of chocolate and cakes, plenty of chicken and fish etc etc but back then carbs were always touted as a good thing, grrrrr.

Ali
 
Hi Ali

Whatever the underlying reason it looks like your BG's are suffering badly and you need to get them back under control as soon as possible. There really is only three choices. Eat less carbs than you are, try taking more or different drugs or go on insulin.

I see you're taking gliclazide this will only work if your pancreas is still producing insulin and maybe the reason your doc is suspecting LADA as LADA implies a lack of insulin production. There are other drugs that work in different ways without stimulating insulin production so maybe talk to your doc about them but whether they will get your BG's down without cutting down on your carbs is doubtful in my opinion. Based on the daily menu you posted you are eating far more carbs than I think you are realising.

Why not see what happens if you do cut your carbs down significantly for a few days so halve the bread, rice, cereals, pasta and potatoes and see what happens and up the protein, fat and veggies to compensate. That way if your BG change has become pretty permanent you know you do have the choice of low carbing more rather than going on insulin or taking more powerful drugs. It will let you make the final choice.
 
Adding on from the excellent suggestions above, it may take 2 or 3 days before you see the lower readings, so persevere for at least a week.
 
Hi. Answering one part of your question i.e. having c-peptide and GAD done privately, there is one company that comes up in a Google search i.e. MediChecks. The cost of each test could be around £200. I have no connection with this company but believe it may be the only one offering these tests directly to the public; I may be wrong?
 
So since Friday lunchtime when I have been cutting down the carbs considerably I reckon it is down to 100 g or below now. Today I have only had a small bowl of porridge and 3 wholemeal crispbreads. I have calculated my tea has 37g of carbs so added together the above is below 100g. Before I even start my tea I still have a reading of 11.

Anyway I will carry on trying to do 100 g or below which this website states is a typical low carbers intake as opposed to an extreme one. I am sorry but I just cannot go any lower than that and live an active life. I am starving all the time as it is. I care for 2 elderly parents, a large house and gardens and work part time. I am on the go all of the time and I cannot function on protein and veg alone! I would be kidding myself if I thought I could extreme low carb because I can't, that just isn't for me.

Ali
 
Well still sticking to less than 100 carbs a day and my readings are no better. Taking 2 Metformin slow release as well as my 2 gliclazide, nothing. Why does the GP diabetes specialist have to be on holiday this week of all weeks!

Will be beating his door down on Monday morning. Quite clearly, something has gone very wrong here.

Ali
 
Ali H said:
Thursday 15th March

8.4 – after 11 hour fasting

10.3 – before evening meal

10.9 – 4 hours later before bed


Food eaten

Thursday 15th March

2 X weetabix with chopped banana and semi skimmed milk, 1 coffee for breakfast

1 X Nairns oatcake and coffee mid morning

2 No added sugar Ribenas during morning

1 X cheese and salad sandwich (home made wholemeal seeded bread)

1 X coffee

Home made burgers X 2 (no breadcrumbs), jacket potato, broccoli, green beans and carrots


Friday 16th March

8 – fasting

15 – 3 hours after breakfast

9.1 – before evening meal

2 X slices of toast with reduced sugar jam spread thinly, 1 coffee

1 X NAS Ribena

Smoked salmon, 2 small hard boiled eggs, 2 X cheese triangles, salad and 3 wholewheat crispbreads
1 light chocolate mousse (contains sweeteners not sugar)
1 coffee

Chicken, wholewheat pasta in vegetable sauce, sprinkle of cheese on top and salad
NAS Ribena

Fresh strawberries, small amount of evap milk

1 coffee

Exercise

2 hours hair appointment, weekly shop, pharmacy run, unpack car and pack away shopping. Walk dogs 20 minutes



Saturday 17th March


7.8 – 12 hour fasting

11.1 – 3 hours after breakfast

Food eaten

I slice of toast with scrambled eggs, grilled bacon and fresh mushrooms
1 coffee

1 NAS ribena

2 wholewheat crispbreads, 1 cheese triangle and small serving of smoked salmon
1 coffee
1 X weight watchers fromage frais, 4.6 grams of sugar

Sausages, mash, steamed carrots, leeks and brussel sprouts
NAS Ribena

2 rich teas and a coffee
Exercise

30 minute walk with the dogs


Sunday 18th March

7.6 – overnight fasting

13.1 – bedtime!!!!!!

Food

2 sausages, 2 scrambled eggs and one slice of toast
1 coffee

1 X NAS Ribena

3 X Ryvitas, one with salmon, cucumber and cheese triangle, one applewood cheddar and cucumber and one with peanut butter
1 X weight watchers fromage frais 4.6 g carbs
1 X coffee

1 square of 81% chocolate

Roast lamb, roast potatoes, cabbage, leeks, carrots and broccoli

1 coffee

Exercise

1 ½ hours housework and dog grooming

30 minutes across the fields with the dogs

Monday 19th March

8.8 11 hour overnight fasting

13.1 -2 hours after breakfast

Food

1 small bowl of porridge with a little cold semi skimmed milk
1 x coffee


This is the food diary I have been keeping since Thursday. As you can see since Friday lunchtime I have dramatically reduced carbs but that doesn't seem to be helping either. Porridge is meant to be low GL, ie slow release not causing spikes but as you can see, that didn't work either! I am basically experimenting with different food types but so far nothing is working.

Ali
Click to expand...

Oo 'eck Ali, there is no way I could go near the level of carbs you are taking in. I eat 30g a day or less, and that keeps my BG reasonably stable. Porridge is a no-no, banana's no-no, roasties no-no, rich tea's, chocolate, mash all no-no's as are weetabix, jam and jacket spuds. Evaporated milk and pasta are also on my 'can't have' list. Perhaps cutting down drastically will help? We are all so very different and that's why advising some one on what to eat, or not to eat is so hard. I have put what would send my BG high in the hope it will help you to perhaps cut down or better still eat and test and find out what you can and can't eat. I will be honest, when I read your post that I have copied, my eyes almost popped out their sockets :lol: Good luck, I hope you can get your BG down, as I am sure you will feel happier in yourself, and if you're a worry wart like me, feel more at peace too.
 
As I said, I was trying those things to see what did what, some people do tolerate them on this forum, some don't. They are meant to be slow release after all....... Having halved my carbs I am seeing zero effect on my levels. This cannot be right. It should have some effect. Sorry but ultra low carbing isn't for me and I consider my current level of under 100 a day sensible. What is wrong with 1 square of 81% chocolate in a week? It too is meant to have no effect due to the high cocoa content?

Other people on here report plummetting levels with similar carb reductions. I might as well end it all now if the next 40 years consists of nothing but veg and salad quite frankly!

Ali
 
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