BG out of control, what to try next?

[blueprudence]

Hello board

I was formally diagnosed on Wed but had been put on 4 x 500mg Metformin the week before when my GP suspected type II. The first few days on the increased dose of Metformin (I was taking 1 x 500mg for PCOS previously) was hellish but I'm tolerating it better now. Since last week, I've been "good" and not had any choc, sweets, cakes, biscuits, potatoes, white rice, etc. I got my glucose monitor a couple of days ago and have been taking my fasting, pre meal and 2 hour post meal readings and am really shocked at how high they are:

HbA1c on diagnosis was 125 or 13.6% DCCT/19mmol/l

Yesterday:

Fasting & before Lunch: 12.4 - taken at 14:00 as felt too ill to eat till then yesterday (migraine)
2 hours after Lunch: 14.3

Today:

Fasting & before Breakfast 19.1
2 hours after Breakfast 24.9
Before Lunch: 15.6

For lunch I've had a small tin of crabmeat with 1 egg and about 5 cherry tomatoes so no simple carbs. Breakfast today was 100g of Jordan's no sugar added muesli. Is there somewhere online I can enter British foods to count the carbs and sugars maybe?

What can I do immediately to bring them down to a better level? I was going to try low carbing after attending my "Spotlight" structured education but should I start it now? I feel now that every minute they are this high is making me more likely to have complications and I want them down NOW! :evil: Feeling a bit frightened that my feet are cold and tingly (despite warm house) and that my vision is "darkened" and that I feel like poo too - exhausted and just wanting to sleep constantly.

I did have an appointment to see the practice nurse for the first time for a foot test, to teach me how to test (I knew anyway from testing my type II father after his stroke), etc but the silly receptionist booked me in with a nurse not qualified to do diabetes work so it's been put back till after Easter. I also have a GP follow up after diagnosis appointment booked but again no slots till after Easter. Should I telephone or see my GP sooner as an emergency with these readings?

Sorry to be so panic stricken and thank you for any advice.

Jules

 

[Daibell]

Hi. Yes, your sugars are very high. Do you mind me asking how old you are and whether you are overweight just in case you are not Type 2 but one of the other variants? 100gm of muesli strikes me as being a very large portion and for many of us would cause sugars to skyrocket. Yes, do start a low-carb diet and set yourself a target of, say, 150gm/day to start with. Most things we eat have packaging that defines the amount of carbs so it shouldn't be too difficult to work out how much you are eating. Although Metformin is a good drug it won't reduce your glucose by more then 1-2 mmol so diet is the key plus further meds if necessary

 

[blueprudence]

Hello Daibell

Thank you for your response. I'm 40 years old and yes I'm overweight/obese too.

Oh dear - I thought that muesli would be ok as it's oats and with no extra sugar. :? I thought I'd have a nice big bowl to set myself up for the day. Breakfast like a king, lunch like a prince, supper like a pauper, etc. As it is I'm totally bloody starving now anyway.

When I'm counting carbs, is it the whole carb, including sugar figure I count and do the sugars need to be restricted further - what percentage of sugars should a "good" carb contain?

Also can the 150gm/day carb allowance be eaten whenever or does it need spreading evenly over the day?

Finally does anyone know of a good website where I can enter what I eat as a food diary that will count my carbs so I can show the nurse when I see her.

Sorry for all the questions but I do feel a bit dumped out in the cold and left to fend for myself by my practice. I'm worried that such high figures are doing damage right now and that there might be something else needed. My GP just said to eat complex carbs and avoid sugar both added and hidden in processed food, which is what I have tried.

 

[Daibell]

Hi. OK, thanks. It does look like you are probably Type 2 and probably insulin resistant at present. The Metformin will help gradually work on the insulin resistance and does reduce appetite a bit as well. There's nothing wrong with oats but they are a carb and middling GI so have them but in proportion. Note that carbs taken with fat have a slower rate of absorption. You doc is correct in saying have complex carbs; refined white flour is the problem with many foods we see when we shop. It's the total carbs on a packet including the sugar that matters. Sugar is quite high GI and so are white flour bakery products so mainly look at the total carb content; there really isn't a correct sugar proportion. I try to avoid foods where the sugar is just added for sweetness when it isn't really needed e.g. most yoghurts. I find sugar that comes from fruits in a product more acceptable. It's always best to spread meals out to reduce the spike from a single big meal. The 150gm/day is my own target. You will find around the forum that some go slightly higher and many a lot lower. As you reduce your carb intake you should find you feel less hungry as carbs are addictive. I don't know any suitable food/carb websites but I know there are some and if you dig deep on this website you will find posts in the past with foods and their carb value. You are basically doing the right things, so give it time and keep at it. You will gradually discover the good foods out there and even 85% Dark Chocolate is quite good!

 

[carty]

Hi there blueprudence
I think you could lower your BG levels by lowering your carb intake I know it is hard at first but if you "think outside the box" it is not too difficult, for instance there are lots of things to eat for breakfast instead of cereals which are quite high carb try scrambled eggs and /or bacon. I can eat Burgen bread with pate or cheese ,cooked ham and cheese .You can eat loads of green veg with chicken or fish or meat for your main meal .Celeriac is a good substitute for potato I cook it with swede and either mash or roast them ,dont be afraid of good fats like butter i know you want to lose weight but at first it is better to get used to lower carbing and not feeling hungry
CAROL

 

[DaveNN]

Hello Daibell

Thank you for your response. I'm 40 years old and yes I'm overweight/obese too.

Oh dear - I thought that muesli would be ok as it's oats and with no extra sugar. :? I thought I'd have a nice big bowl to set myself up for the day. Breakfast like a king, lunch like a prince, supper like a pauper, etc. As it is I'm totally bloody starving now anyway.

When I'm counting carbs, is it the whole carb, including sugar figure I count and do the sugars need to be restricted further - what percentage of sugars should a "good" carb contain?

Also can the 150gm/day carb allowance be eaten whenever or does it need spreading evenly over the day?

Finally does anyone know of a good website where I can enter what I eat as a food diary that will count my carbs so I can show the nurse when I see her.

Sorry for all the questions but I do feel a bit dumped out in the cold and left to fend for myself by my practice. I'm worried that such high figures are doing damage right now and that there might be something else needed. My GP just said to eat complex carbs and avoid sugar both added and hidden in processed food, which is what I have tried.

Hi,
If you use an ipad/iPod then have a look for the diabetes free app.
It's excellent!
You can also add your exercise, BP, BG etc.


Sent from the Diabetes Forum App

 

[dawnmc]

Myfitnesspal or myfatsecret are both good for inputting foods and getting the carbs/cals/fat etc.
It seems you may be sensitive to carbs. Try eggs foe brekkie, scrambled, poached, fried omlettes etc with bacon.

 

[LaserMum]

I'd second http://www.myfitnesspal.com as a website for counting carbs. I use it too. My name on there is lasermum - you can add me as a friend if you want to see my food diary. I limit carbs to 100g per day.

 

[Sid Bonkers]

Hi blueprudence, as has already been mentioned I would think your high bg level is down to the large portion of muesli, I have just looked at Jordans UK web site and I see that their Natural Muesli has 63.7g of carbs per 100g without counting the milk, couple that with it being a morning meal when many people are at their most sensitive to carbs and I think you have your answer.

I would suggest trying a much smaller portion or another type of breakfast with fewer carbs and I would say you will start to see an improvement

 

[hanadr]

blueprudence
I find I need to keep my carbs VERY low to keep well. Under 50 per day. I also eat small portions. I was obese and now am merely overweight. It's taken several years to get here and I know loads of people lose weigh fast on low carb. [I wish I were one!], but some of us are weightloss resistant.
Just don't give up. I've never heard of anyone who didn't improve by cutting carbs, although I've come across lots who decided to give up on it. It's not always easy, but you accustom to it.
Good Luck! stay strong and be well!
Hana
Ps low carb can be the long term answer. I'm about10years diagnosed with T2 and 8 of low carb still on 2 x 500mg Metformin and rarely ill [except recently! I've had the nasty virus doing the rounds] Hb A1c in the 5% range consistently
Hana

 

[viviennem]

Hi, Blueprudence

I love the pup but thought it was a Bloodhound! From your profile, I assume it's a Dane?

Have a look at the diet I use, Viv's Modified Atkins Diet, is a Sticky Thread on the Low Carb section of the forum. Almost everybody who tries it finds it gives good weight loss, as well as lowering blood glucose, blood pressure and cholesterol levels. A few don't get on with it - we are all different!

It's almost exactly the Atkins Induction Phase, and if you stick to the lists of allowed foods you can eat as much as you like, except where daily totals are given. It is very-low-carb, at 25g to 30g per day; you will see weight loss results immediately, which should also bring your blood glucose levels down. If you want to set yourself a higher daily carb allowance, get yourself a carb counter book, and add in carbohydrates with a Low GI - those don't hit your bloodstream too fast. As you up your carbs, so you decrease your fat intake. If you go for the basic diet, don't worry about fats - your body burns fat for energy instead of glucose.

Carbohydrates are the "problem" for diabetics - all carbohydrate is turned into glucose during digestion, and put into the bloodstream to be transported to the organs for use as fuel. Insulin is what pushes the glucose into the cells ready for use. Many Type 2s have insulin resistance, which means that the muscle cells are resistant to the action of insulin, and it stays in the blood. Unfortunately the fat cells aren't resistant to insulin, so the extra glucose gets shoved into there instead - a double whammy! no energy and extra fat. :roll:

Some people can tolerate many more carbs than others. Usually I stick under 50g per day; on that amount I can usually keep my blood glucose (BG) levels at non-diabetic levels. At the moment I'm doing an experiment by eating extra carbs, up to 150g daily, for 3 months. Not only are my BG readings going up steadily, but I'm putting weight on as well . On the other hand, there are Type 2s on this forum who manage their BGs perfectly well on 150g daily of carbs. Others don't cut carbs out, but manage very well by testing to find out which carbs spike their BGs, then using portion control to keep their levels down.

Have a good read round on the forum and see which methods other people use to control their BGs; but if you want fast results, it's worth trying the Atkins. Once you feel you're getting control, you can change things to suit you better.

Do ask any questions you like; there's no such thing as a silly question on here, and usually someone around to answer.

Let us kow how you get on

Viv 8)