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Type 2 BG Slow rise and drop and HbA1C

R

rjnkanwal

Member
Messages
14
Location
London
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi Everyone
Its my first post although I have been a member for a year. I have two questions. First let me describe about my treatment.
I was diagnosed as type 2 in June 2014 with a HbA1C 79mmol(9.4%) and fasting plasma sugar 10.8. Started on Metformin 500mg twice a day, which was increased to 1000mg twice a day in Nov 14. That time my HbA1c was 68mmol(8.4%). I was also put on Dapagliflozin 5mg a day for a month then increased to 10mg a day. It worked well and in the next 3 months end of Feb 2015 my HbA1C dropped to 53mmol(7%). By end of Aug my HbA1c dropped to 48mmol(6.5%) and I was taken off Dapagliflozin.
So far everything has worked well with medication and diet control although no exercise.

My first question is that with 1000mg Metformin and Dapaglifozin combined my HbA1C in the first 3 months dropped by 15mmol(1.4%) then in the next 6 months on the same medication and diet control, HbA1C dropped by 5mmol(0.5%) only. I am wondering why such a little drop in those six months.

My second question.
My bg peaks at 2 hours and takes about 3 hours to come down after meals. Is there a problem as the guidelines say that it should be less than 8.5 at 2 hours after meals.
Day before yesterday1.5 hours after lunch, BG was 7.3, at 2 hour it jumped to 10.7. So yesterday I took quite few readings.
Before lunch 4.8
1.5 hour later 7.3
2 hour later 9.7
2.20 hour later 8.9
2.35 hour later 8.5
3 hour later 7.7
Fasting sugar this morning after a 10 hour night fast 5.2

Forgot to mention I also take Lansoprazole 15mg to stop acid reflux.
Thanks.
 
Last edited by a moderator:
Hello and welcome. I have no knowledge of medication for diabetes and so I often wonder if the medical profession regards pills as the first and only line of defence. On this forum, as you will know if you have been browsing it, we don't necessarily start with meds -- we go for diet and exercise.
However, medicine is important to many, so someone else will advise you on that.
Secondly, and logically, I'd need details of what you've been eating to give you those numbers in that time span.
Thirdly, not to worry, if possible. Your BS figures are not too bad at all.:)
 
Depending on what you ate and by your readings, you ate something digested slowly.
Two hours is an average for testing but because of slow digestion your 2.5 or 3 hours could slightly increase.
Not really something to over worry about.

About your meds not having more of an impact on your levels, it will take longer because it has to slow down as you get to your normal levels. It's a marathon not a sprint and once again, what you eat and how much you eat.

By your readings your not far off and doing really well.
 
Looking at your numbers I would say that you are eating a fair amount of fat along with quite a fair amount of carbohydrate (too much by the 9.7) The guidelines work if you eat one standard meal (that would be a Glucose Drink) but not for the real work when other food types get in the way of glucose dumping from your digestive system into your blood stream immediately after ingestion
 
Thanks guys for your quick response.
I am a 45 year old vegetarian Indian and eats chappatis(wholemeal flour) and curries at lunch and dinner time, porridge or slice of bread at breakfast.. We cook curies in coconut oil now, used to be rapeseed oil. The oil is used very very moderately, 15ml for eight portions.
The day my bg went up to 10.7 I ate only two chappatis with aubergines currie. Next day when my bg went up to 9,7 I actually ate more carbs and fat. it was two paranthas stuffed with potatoes(equal to three chappatis) with butter.

Thanks
 
Last edited by a moderator:
rjnkanwal said:
Thanks guys for your quick response.
I am a 45 year old vegetarian Indian and eats chappatis(wholemeal flour) and curries at lunch and dinner time, porridge or slice of bread at breakfast.. We cook curies in coconut oil now, used to be rapeseed oil. The oil is used very very moderately, 15ml for eight portions.
The day my bg went up to 10.7 I ate only two chappatis with aubergines currie. Next day when my bg went up to 9,7 I actually ate more carbs and fat. it was two paranthas stuffed with potatoes(equal to three chappatis) with butter.

Thanks
Click to expand...

I believe you might want to review how many carbs you are eating at the moment, I would be having serious hypers with the amount you mention, have a read of the carb forum.
I've tagged @daisy1 to give you the newcomers welcome information.
 
Thanks nosher8355.
You are right that yesterday I ate a lot of carbs, normally I only eat 4 chappatis in a day, 2 at each main meal.
What is baffling me is that, day before yesterday I ate my regular lunch of 2 chappatis and nothing else, no drinks either and my bg was way too high in comparison to yesterday.
Your suggestion of slow digestion seems to be correct as I am taking lansoprazole to reduce acid.
I think I'll have to start the exercise and reduce my weight further.
 
@rjnkanwal

Hello and welcome to the forum :) Here is the information we give to new members which includes a lot of detail about carbs which you need to reduce to get your levels down. Ask as many questions as you need to and someone will 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 over 150,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

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

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 bloodglucose 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.
 
Thanks daisy1.
I am aware about carbohydrates and their effect on BG. Most of the helpful information I gained is from this forum, either reading here or through regular emails. I feel lucky that diabetes.co.uk exist to help us and I am grateful to all the contributors to these forums.

It is that sometime we slip away from our goals and that's what happened to me. Usually I keep my carbs around 40-45 gram per meal. Just once or twice a month I can't resist the taste. I need to do better control and start some exercise.

Another thing I must mention that how this forum helped me in the past. Being a vegetarian I was taking B12 oral supplement. By learning on here I asked my GP to monitor my B12 levels as metformin interferes with its absorption. Even I was still taking 1000 micro gram B12 daily, my levels started dropping significantly. Now my GP has put me on B12 injections.
 
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