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Are My Expectations Realistic?

Gman1

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I have been recently diagnosed as a T2 diabetic. 8 years prior I had gestational diabetes and was never given any post partum follow up. fast forward to last October, I was feeling I'll thought I'd pass out and amended up in the ER. my random glucose was 24. I was went to a diabetes clinic.
my first A1C was 12.0% and my doctor wanted to tackle the diabetes aggressively, she suggested insulun-based on the A1C and i asked her to give me some time to manage it on my own.
Janumet 2X day and some serious retraining of my eating habits and my A1C was down to 6.7 in 3 months! she was elated and said " keep doing what you're doing "

anyways, the 2nd A1C was 6.4, so it's now been 6 months and I'm managing my numbers well but I keep thinking this numbers should be getting lower.
I was disappointed my A1C wasn't any lower than 6.4, I am constantly watching what I eat, I think deep down I'm still in denial and hoping the diabetes will go away if I lose some weight, If I dont eat bread, maybe one day I wont have to worry about diabetes ....
am I setting myself up for future failure? are my preconceived notions of diabetes getting in the way of me accepting this? am I being unrealistic?....
 
You will always have to worry about diabetes. You've got for life. It's not all bad news though. With diet control and discipline you can keep the symptoms and complications at bay. May I ask how many grams of carbs you consume each day. Often it is not enough to simply cut out the spuds and bread. My own readings didn't come down to acceptable levels ( 5.7 ) until I cut back carbs to only 60g per day.
Have fun,
Glenn
 
I have been recently diagnosed as a T2 diabetic. 8 years prior I had gestational diabetes and was never given any post partum follow up. fast forward to last October, I was feeling I'll thought I'd pass out and amended up in the ER. my random glucose was 24. I was went to a diabetes clinic.
my first A1C was 12.0% and my doctor wanted to tackle the diabetes aggressively, she suggested insulun-based on the A1C and i asked her to give me some time to manage it on my own.
Janumet 2X day and some serious retraining of my eating habits and my A1C was down to 6.7 in 3 months! she was elated and said " keep doing what you're doing "

anyways, the 2nd A1C was 6.4, so it's now been 6 months and I'm managing my numbers well but I keep thinking this numbers should be getting lower.
I was disappointed my A1C wasn't any lower than 6.4, I am constantly watching what I eat, I think deep down I'm still in denial and hoping the diabetes will go away if I lose some weight, If I dont eat bread, maybe one day I wont have to worry about diabetes ....
am I setting myself up for future failure? are my preconceived notions of diabetes getting in the way of me accepting this? am I being unrealistic?....
I'm not a doctor. I am a T2 diabetic and I've accepted, after a while, that I'll always be one. (The term remission is still under debate here and there, and I won't use it). That said, my HbA1c is well into the non-diabetic range on diet only, I don't have the regular pus-filled toes and random fungal outbreaks anymore, my cholesterol is lower and the fatty liver is, I think, getting better. The PCOS too. I follow a rather strickt diet of 20 grams of carbs or less per day (keto combined with intermittent fasting), but I used to do pretty good on 75 to 85 grams a day; that got me into the non-diabetic range to begin with. Just found I did/felt better on less. So considering the rheumatism, hypothyroidism, chronic migraines, mental issues and what have you, diabetes is the only thing I don't worry about anymore, but not because it's gone. It's well controlled and I've "won". It's the only affliction I'm stuck with, in which I have a say in how it goes. So in those terms, you might say the worry can abate. Coming from someone who'd wake up in the morning to find she'd been crying in her sleep over diabetes... I'd say that's not bad.

You say you radically changed your diet, but you only mentioned ditching bread... Did you cut out other carb-heavy foods too? Not saying you have to go as far as I did, as everyone's needs/journey is different, but there might be room for improvement yet. What does a regular day's meals consist of, if I may ask?
 
Hi @Gman1 and welcome. Congratulations on your great results so far.

Don’t think you have unrealistic expectations about managing diabetes yourself, but as the others have said, it’s here for life. I started with the same a1c as you and it’s now 5%, all through diet. I’m very low carb - Keto at 20g or less a day - and suggest looking at your diet and the carb content would be the best way to go if you want to get your numbers lower.

Are you testing your own bloods before and after meals so you can see which foods suit you best?

Tagging @daisy1 for an introductory information pack.
 
I have been recently diagnosed as a T2 diabetic. 8 years prior I had gestational diabetes and was never given any post partum follow up. fast forward to last October, I was feeling I'll thought I'd pass out and amended up in the ER. my random glucose was 24. I was went to a diabetes clinic.
my first A1C was 12.0% and my doctor wanted to tackle the diabetes aggressively, she suggested insulun-based on the A1C and i asked her to give me some time to manage it on my own.
Janumet 2X day and some serious retraining of my eating habits and my A1C was down to 6.7 in 3 months! she was elated and said " keep doing what you're doing "

anyways, the 2nd A1C was 6.4, so it's now been 6 months and I'm managing my numbers well but I keep thinking this numbers should be getting lower.
I was disappointed my A1C wasn't any lower than 6.4, I am constantly watching what I eat, I think deep down I'm still in denial and hoping the diabetes will go away if I lose some weight, If I dont eat bread, maybe one day I wont have to worry about diabetes ....
am I setting myself up for future failure? are my preconceived notions of diabetes getting in the way of me accepting this? am I being unrealistic?....
Some people find liver dumping as their biggest obstacle to a lower hba1c.

Have you ever tested through the night? Mine shoots up then down on insulin. Without a fatty protein for supper (just a nibble) it woke on 10s or more.
Blocking my through the night liver dump I can awake 2-3mmol/l less.
Think of how many hours that is.? ... Sleeping and unaware of glucose being filtered into your blood stream, even thou you don't need it.
Without liver dumps your HbA1c will drop.

Enjoy exploring your own bodies response to different fatty proteins. (eg nuts, cheese, pork scratchings).
Once you've found those foods which block by eating before bed, treasure them as they will see you through the rough type2 periods.
You hold the key to the lower hba1c.
We are all different so explore. They won't shoot your bgs up but the right ones will block that over helpful liver, other organs and muscles glucose release.
 
@Gman1

Hello and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you want and someone will be able to help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
Welcome @Gman1. First of all well done on your A1c results so far. To halve your figures in 6 months is an achievement and no wonder that the doctor was amazed. You have truly grasped the situation and done something to change your life. Unfortunately, like the other respondents I must say that diabetes is here for life even if you lose weight, however the changes you have made to your lifestyle will result in you feeling so much better, healthier and able to cope with active children. Keep doing whatever you are doing, like with a weight loss diet, with the initial changes the results may be dramatic then stall while the body 'catches up' with itself and settles into the new mode. With patience and possibly a couple of tweaks to your diet, the numbers will start to drop again until you reach a figure that you are happy to live with. At your next review the HCP may suggest that you start to reduce medication. Have a look at the Diet Doctor website, it is informative about how many carbs are found in common foods. Accept that you have won the admiration of a good many people, hold your head high, and keep on going.
 
Some people find liver dumping as their biggest obstacle to a lower hba1c.

Have you ever tested through the night? Mine shoots up then down on insulin. Without a fatty protein for supper (just a nibble) it woke on 10s or more.
Blocking my through the night liver dump I can awake 2-3mmol/l less.
Think of how many hours that is.? ... Sleeping and unaware of glucose being filtered into your blood stream, even thou you don't need it.
Without liver dumps your HbA1c will drop.

Enjoy exploring your own bodies response to different fatty proteins. (eg nuts, cheese, pork scratchings).
Once you've found those foods which block by eating before bed, treasure them as they will see you through the rough type2 periods.
You hold the key to the lower hba1c.
We are all different so explore. They won't shoot your bgs up but the right ones will block that over helpful liver, other organs and muscles glucose release.


Thank you for the reply. I have not checked overnight but do have the freestyle Libre. I have noticed there are lows overnight, where I end my day with a 5.8 but wake up anywhere between 6.9 -7.1. I had not really given this any thought, as I am quite new to the diabetes and its management. I have been given great resources, an educator, a dietitian, a nurse, and endless internet resources. Since I do have the style Libre I can see pretty much real time the impact any food has on me. I will definitely ensure I check my overnight numbers and pay attention more closely.
 
I got back to normal numbers by eating 50 gm of carbs a day, but I have had a lifelong tendency to put on weight and so as an adult I had to stick to 50 gm of carb a day or my weight increased.
Now I am at 40 gm of carbs a day to try to reduce body fat, so even though I could eat more carbs and not have the same sort of BG levels as before, I simply can't eat 'normal' amounts of carbs and maintain my weight.
 
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