At a loss any suggesting Please

[Overwhelmed]

Hi all, I understand that rules are no diagnosis on here but I'm looking for suggestions or advise from others on here who may have similar experience to me and managed theirs.
I was dx type 2 one year ago just before Christmas with Hba1c of 59. At first I was hard to deal with but got on with sorting myself and finding this forum was really beneficial to me reading all the different threads.
So my dilemma now is my fbg just seems to be slowly rising all the time since first dx and I'm trying things from eating piece of cheese before bed , to eating dinner earlier with less carbs , to stretching breakfast out later in the morning time and even two meals a day but nothing seems to be working . My latest hba1c has gone from 41 to 45 with no difference to foods as I'm sticking with that I know isn't spiking me. I really don't want to go down the route of medication as doctor has now said we may have to consider so on here looking for some suggestions or advise from wonderful community here who may have had similar experience and has managed themselves. Thanks

 

[Fenn]

Hi, all we can really do is reduce carbs lower and lower until our numbers are better, if this stops working, medication may be your only option.

exercise can help also.

I had a similar experience, when you are doing your best but nothing seems to wrk, it’s horrible, best of luck finding a path

 

[Oldvatr]

Suggestion - if you have weight to lose then look at the Newcastle Diet as a possible reset to the system.

Second suggestion - have you tried Intermittent fasting? It works best if you vary the time and duration and do not use a regular schedule so it surprises your body when it happens. Regular fasting and the body adjusts to the rhythm.

Third suggestion, are you able to increase exercise. I am not talking Gym or HIIT here, just a gentle increae in walking will do.

You do not appear to be using ketosis as a dietary approach, which many here find helpful,

Then there are the Witch Doctor 'cures' such as Green Tea, Berberine, Bitter Melon, cinnamon etc. The caveat is Emptor Beware - these are not proven remedies and may be harmful to the pocket book. The ones that can be of benefit are magnesium , zinc, vitamin D, but use in moderation.

Finally, you mention fbg and HbA1c but no self testing. If you have a meter then are you 'eating to meter'? If not then why not? It can identify any meals or food classes that are detrimental.

 

[catinahat]

As you have already discovered your fasting level is going to be what it is no matter what you do. You can't stop your liver dumping stored sugar, its what it has evolved to do. You can try to fool it with lumps of cheese or glasses of wine on a evening but that does nothing to address the main problem of too much sugar stored around your body.
It's all about carbs, you say you're eating dinner with less carbs but what does that mean, how many carbs is less?
Don't forget the often quoted "we're all different" some can eat what is for me a huge amount of carbs, over 150g a day and get good results. I have to avoid as many as possible to keep my hba1c where I want it. My diet consists of mainly protein and fat with just a few low carb vegetables thrown in for the sake of variety. It's not ideal but it's kept me healthy and medication free for the last 8 years.
If your numbers are getting worse, there are still too many carbs in your diet for your body to deal with. Your only options are to revisit your diet and exercise regime or consider the possibility that medication is the way forward for you.
There is nothing wrong with using medication if you have to, it doesn't mean you have failed in any way. It just means that you are managing your diabetes the best way you can.

 

[Overwhelmed]

As you have already discovered your fasting level is going to be what it is no matter what you do. You can't stop your liver dumping stored sugar, its what it has evolved to do. You can try to fool it with lumps of cheese or glasses of wine on a evening but that does nothing to address the main problem of too much sugar stored around your body.
It's all about carbs, you say you're eating dinner with less carbs but what does that mean, how many carbs is less?
Don't forget the often quoted "we're all different" some can eat what is for me a huge amount of carbs, over 150g a day and get good results. I have to avoid as many as possible to keep my hba1c where I want it. My diet consists of mainly protein and fat with just a few low carb vegetables thrown in for the sake of variety. It's not ideal but it's kept me healthy and medication free for the last 8 years.
If your numbers are getting worse, there are still too many carbs in your diet for your body to deal with. Your only options are to revisit your diet and exercise regime or consider the possibility that medication is the way forward for you.
There is nothing wrong with using medication if you have to, it doesn't mean you have failed in any way. It just means that you are managing your diabetes the best way you can.

@catinahat . Thanks for the reply , I've tried the cheese and wine thing you have suggested and still do. My diet consists of mainly protein and fat also with a variable amount of carbs/veg from 10g-30g at most per day . I tend not vary off the food im eating now as I have an idea what bs will do afterwards or maybe i knew .I know liver will dump but I thought at this stage would be no huge amount of stores left for such an increase. Maybe a revisit to what im consuming and start weighing it again.

 

[Goonergal]

@Overwhelmed while it can be demotivating to see a rise, 41 to 45 is not such a big jump especially if rounding is taken into account - if the 41 was 41.4 and the 45 was 44.6, that’s not a vast difference and there’s always a margin of error. I’d want to see a pattern of rises over 12-18 months before assuming things were going badly off track. Doubling down as you suggest may we’ll sort it out, but I’ve also made a few suggestions below.

Have you ever used a freestyle Libre? In your situation it could be a useful tool to understanding your blood glucose patterns more fully. If you haven‘t, the 2 week free trial is still running: https://www.freestylelibre.co.uk/libre/free-trial.html

Personally I don’t buy the so called ‘liver block’ of eating something later in the evening/before bed. It’s another episode of eating (however small) which triggers an insulin response. If you’re trying to reverse insulin resistance associated with tyoe 2 then to me it’s counter productive.

With alcohol the liver will prioritise dealing with that so your rising FBG could be a delayed response to carbs injested earlier in the day.

Dairy can be an issue - for some it can raise blood sugars higher and for longer than the carb count alone would suggest. I’m one of them, with yoghurt a particular culprit.

 

[Overwhelmed]

Suggestion - if you have weight to lose then look at the Newcastle Diet as a possible reset to the system.

Second suggestion - have you tried Intermittent fasting? It works best if you vary the time and duration and do not use a regular schedule so it surprises your body when it happens. Regular fasting and the body adjusts to the rhythm.

Third suggestion, are you able to increase exercise. I am not talking Gym or HIIT here, just a gentle increae in walking will do.

You do not appear to be using ketosis as a dietary approach, which many here find helpful,

Then there are the Witch Doctor 'cures' such as Green Tea, Berberine, Bitter Melon, cinnamon etc. The caveat is Beware - these are not proven remedies and may be harmful to the pocket book. The ones that can be of benefit are magnesium , zinc, vitamin D, but use in moderation.

Finally, you mention fbg and HbA1c but no self testing. If you have a meter then are you 'eating to meter'? If not then why not? It can identify any meals or food classes that are detrimental.

@Oldvthanks for the reply, I've lost 17kg so for and I'm at my weight /height . I'm still loosing weight but very slowly now.
Intermittent fasting , would it be for a particular time frame . Some days I wouldn't eat for 16hrs . Would u suggest longer ?? I work shifts work so alternating different days would suit me but would be afraid of weakness from not eating as I've a very physical job and need energy.
Exercise is hit or miss with me but I would get 10k steps in /day if in work at home I may not get opportunity. May have to look at this bit more
I test morning time every day , then few times during the day then at night before bed.I used to test before and 2hrs after meals but not as much any more unless i eat something I havnt had in a while ill test afterwards .
I'll try some of the Witch Doctor remedie and see if helps and also may get some.of the supplements you suggested . Thanks again

 

[filly]

I try my best to do the 16/8 fast. Some days it works and others I have that sneeky piece of cheese. Oh and tomato!
I am trying to get the sugars down again. My best days are when I have 20g or under. eg in the past week at least 3 days between 30-40
Liver still dumping and hoping everything settles again soon.
It is certainly trial and error. Fasting is good overall but numbers in the morning can still be stubbonly higher than liked. Good Luck.

 

[Overwhelmed]

@Overwhelmed while it can be demotivating to see a rise, 41 to 45 is not such a big jump especially if rounding is taken into account - if the 41 was 41.4 and the 45 was 44.6, that’s not a vast difference and there’s always a margin of error. I’d want to see a pattern of rises over 12-18 months before assuming things were going badly off track. Doubling down as you suggest may we’ll sort it out, but I’ve also made a few suggestions below.

Have you ever used a freestyle Libre? In your situation it could be a useful tool to understanding your blood glucose patterns more fully. If you haven‘t, the 2 week free trial is still running: https://www.freestylelibre.co.uk/libre/free-trial.html

Personally I don’t buy the so called ‘liver block’ of eating something later in the evening/before bed. It’s another episode of eating (however small) which triggers an insulin response. If you’re trying to reverse insulin resistance associated with tyoe 2 then to me it’s counter productive.

With alcohol the liver will prioritise dealing with that so your rising FBG could be a delayed response to carbs injested earlier in the day.

Dairy can be an issue - for some it can raise blood sugars higher and for longer than the carb count alone would suggest. I’m one of them, with yoghurt a particular culprit.

@Goonergal , I'm in ireland and I'm not sure if the trial is still running here ..I was on the Irish version of the link you sent . Got a code but have heard nothing since I think ill have to purchase one myself .
As for the dairy something to read up on I havnt come across it on here mentioned before . I hope I'm not one who gets raises to it as cheese and greek yogart is a huge part of my diet now as is cream in coffee . Greek yougart i eat every few days for breakfast but when first diagnosed and I was testing everything I would of cut both cheese and greek yogart out if noticed any big raises .Maybe a test now after consuming to see if I'm reacting differently Is needed . Was planning on having in the morning so it test afterwards and see. Only alcohol I drink now is red wine and at that it's very little 1/2 a glass maybe twice a week. I've a few I can look into now ..thanks for that

 

[Overwhelmed]

Hi, all we can really do is reduce carbs lower and lower until our numbers are better, if this stops working, medication may be your only option.

exercise can help also.

I had a similar experience, when you are doing your best but nothing seems to wrk, it’s horrible, best of luck finding a path

Thanks @Fenn , I really don't want to go down the medication route if at all possible for now but as you've said may be my only option for better control and my long terms health.. lower carbs will defo be looked at as you and others have mentioned thanks again

 

[Goonergal]

As for the dairy something to read up on I havnt come across it on here mentioned before

It’s a long thread, but this is where I learnt about it: https://www.diabetes.co.uk/forum/threads/one-of-my-meters-is-lying.181754/

As an aside, I do much better with yoghurt later in the day rather than in the morning.

 

[bulkbiker]

I had a similar experience

But that was surely because you had been misdiagnosed as T2 when in fact you weren't?

 

[Oldvatr]

It’s a long thread, but this is where I learnt about it: https://www.diabetes.co.uk/forum/threads/one-of-my-meters-is-lying.181754/

As an aside, I do much better with yoghurt later in the day rather than in the morning.

As the OP of that linked thread I can confirm that one of my meters is defintely lying. The problem is, which one? I am getting differences of 5 mmol/l even when confirmed by repeat readings. At the moment one of the meters is consistently 2 mmol/l higher than the other on the same blood drop, and it makes no difference which meter I use first. So we do not always get accurate readings, and I am convinced that one of my meters is sensitive to something other than glucose in my blood. Maybe lipids, or protein or salt. The meters use different sensor technologies (i.e. enzymes) so it seems to be inherent to the design, not due to simple accuracy issues.

 

[chrisjohnh]

Hi, all we can really do is reduce carbs lower and lower until our numbers are better, if this stops working, medication may be your only option.

exercise can help also.

I had a similar experience, when you are doing your best but nothing seems to wrk, it’s horrible, best of luck finding a path

“All we can do is reduce carbs…” ?
I would be interested to know if anyone here has sound knowledge concerning the question of whether the typical high fat content of low carb regimes, especially if having a high amount of animal-derived saturated fat, gradually degrades the beta cells. There are quite a few papers arguing this but they are very technical indeed and beyond my ken. I ask because I have wondered whether these cases of HbA1c gradually rising post-remission whilst all one’s other circumstances appear stable might be due to slow degradation of insulin response for one reason or another. My own daily diet has 43g of sat fats and despite the comforting tales we hear of fats being no longer demonized I do often wonder about this. I think the question also connects with Taylor’s view that if remission has been sufficient to clear visceral fat from the liver and pancreas then thereafter one can eat whatever macronutrient mix one prefers, subject to not regaining weight. So LCHF would be unnecessary if that were true (IF …). The OP has lost an impressive 17kg, but perhaps there is scope to lose a bit more and see if that pulls the A1c back again?

 

[Fenn]

“All we can do is reduce carbs…” ?
I would be interested to know if anyone here has sound knowledge concerning the question of whether the typical high fat content of low carb regimes, especially if having a high amount of animal-derived saturated fat, gradually degrades the beta cells. There are quite a few papers arguing this but they are very technical indeed and beyond my ken. I ask because I have wondered whether these cases of HbA1c gradually rising post-remission whilst all one’s other circumstances appear stable might be due to slow degradation of insulin response for one reason or another. My own daily diet has 43g of sat fats and despite the comforting tales we hear of fats being no longer demonized I do often wonder about this. I think the question also connects with Taylor’s view that if remission has been sufficient to clear visceral fat from the liver and pancreas then thereafter one can eat whatever macronutrient mix one prefers, subject to not regaining weight. So LCHF would be unnecessary if that were true (IF …). The OP has lost an impressive 17kg, but perhaps there is scope to lose a bit more and see if that pulls the A1c back again?

Sorry I’m too stoopid to even understand what you said

 

[Fenn]

But that was surely because you had been misdiagnosed as T2 when in fact you weren't?

Yes apparently but the experience is still similar, once misdiagnosed it’s very hard to trust any future diagnosis, maybe we are both T2 or both T1 I’ve no idea

 

[Diablo T2]

@Overwhelmed - I know you've looked at my experience and picked up a couple of pointers already, but there is one thing I didn't mention as I've only come across it recently. I heard somewhere that using apple cider vinegar (ACV) might be most effective if I drank the water with a teaspoon of ACV just prior to eating. I wouldn't say I have enough testing to be sure, but the first few occasions I tried it, it did seem to reduce my post-prandial BG. It a very minor modification so I figured nothing to lose in trying.

 

[Oldvatr]

@Overwhelmed - I know you've looked at my experience and picked up a couple of pointers already, but there is one thing I didn't mention as I've only come across it recently. I heard somewhere that using apple cider vinegar (ACV) might be most effective if I drank the water with a teaspoon of ACV just prior to eating. I wouldn't say I have enough testing to be sure, but the first few occasions I tried it, it did seem to reduce my post-prandial BG. It a very minor modification so I figured nothing to lose in trying.

Effect of Dietary Acetic Acid Supplementation on Plasma Glucose, Lipid Profiles, and Body Mass Index in Human Adults: A Systematic Review and Meta-analysis - PubMed

Supplementation with dietary acetic acid is well tolerated, has no adverse side effects, and has clinical potential to reduce plasma TAG and FBG concentrations in individuals with type 2 diabetes, and to reduce TAG levels in people who are overweight or obese. No significant effects of dietary...

pubmed.ncbi.nlm.nih.gov

A metastudy analysis of some small scale trials. None of the studies examined appeared to be properly controlled and are not of the standard to support a 'proof' conclusion, but the general flavour is favourable as regards fbg level reduction in T2D subjects.

 

[Overwhelmed]

Effect of Dietary Acetic Acid Supplementation on Plasma Glucose, Lipid Profiles, and Body Mass Index in Human Adults: A Systematic Review and Meta-analysis - PubMed

Supplementation with dietary acetic acid is well tolerated, has no adverse side effects, and has clinical potential to reduce plasma TAG and FBG concentrations in individuals with type 2 diabetes, and to reduce TAG levels in people who are overweight or obese. No significant effects of dietary...

pubmed.ncbi.nlm.nih.gov

A metastudy analysis of some small scale trials. None of the studies examined appeared to be properly controlled and are not of the standard to support a 'proof' conclusion, but the general flavour is favourable as regards fbg level reduction in T2D subjects.

Thanks I'll have a read of it

 

[Overwhelmed]

@Overwhelmed - I know you've looked at my experience and picked up a couple of pointers already, but there is one thing I didn't mention as I've only come across it recently. I heard somewhere that using apple cider vinegar (ACV) might be most effective if I drank the water with a teaspoon of ACV just prior to eating. I wouldn't say I have enough testing to be sure, but the first few occasions I tried it, it did seem to reduce my post-prandial BG. It a very minor modification so I figured nothing to lose in trying.

I'll give it a try thanks @Diablo T2