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Blood glucose levels - Help !

D

DaveB64

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Hi ,I'm hoping someone on here can offer some advice. I have been type 2 diabetic for over 10 years. I take 2 gms of metformin ( 1gm morning, 1gm night) and 80mg Gliclazide ( 1 morning , 1 night) ramparil once a day 50mg .

So i am constantly being told by my GP that my diabetes is very poorly managed and my glucose levels are far too high ( 1 average between a low of14.5mmol and a high of 26mmol). I am on a strict zero carb diet and have been for months ( only eating natural carbs in vegetables and an occasional piece of fruit) but I cannot get my blood sugar levels below 14 - 16mmol.I only ever drink black coffee or tea and water ( no juices, fizzy drinks, squashes etc)

I have fasted for the day = 15.6mmol average with no food
I have eaten,3 eggs scrambled for breakfast, 3 celery sticks for lunch and a chicken breast with a tomato for dinner with no snacks - 17.9mmol average for the day
Eat a normal diet for the day (inc carbs like potato, bread, pasts or rice ) = 17.5-21.5mmol average.

I would also like to add that I have never had a hypo or hyper , no issue with my eyes or any diabetic symptoms in the 10 years since being diagnosed

I am 6 kilos heavier than i was aged 28 ( i am now 57 ) and my weight is 91kgs or 14st 4 lbs . Does anyone have similar problems or advice i can use to get them down ?

Any help would be appreciated .
Dave
 
Welcome along, Dave. First thought is that you need to have your fasting insulin or c-peptide measured by a knowledgable doctor in order to ascertain whether or not you are underproducing your own insulin. Over a period of time, Gliclazide could potentially have given your pancreas a kicking and it may now be struggling even though you've subsequently gone low carb. There could of course be any number of contributory factors but I think you need to speak to your GP about insulin testing. If he/she is unwilling, which is quite likely, then badger for a referral to an endocrinologist.
 
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Thanks Jim , Ill give them a nudge
 
DaveB64 said:
I am on a strict zero carb diet and have been for months ( only eating natural carbs in vegetables and an occasional piece of fruit) but I cannot get my blood sugar levels below 14 - 16mmol.
Click to expand...

Some vegetables (eg potatoes) contain a lot of carbs, as does some fruit, so you probably aren't on zero carbs, but it does sound pretty low. (Unfortunately the pancreas doesn't distinguish between natural and unnatural carbs.).

Have your levels always been running that high or is this a recent thing? Long term high blood sugars can impair the pancreas' ability to produce insulin so you may just not be producing enough insulin any more..... It may be that you need more medication, at least for a while, in order to get your bgs under control.

And I agree with @Jim Lahey that it would be really useful to know how much insulin you are still producing, but am not sure how willing your GP will be to do those tests.

Good luck.
 
Yes my BGL have always been high which is what confuses me. I also don't eat any potatoes, starchy vegetables or fruit which has a high natural sugar content. I refer to low GI guides for all vegetables and fruit and I'm confident I eat less than 5gms of carbs per day . Its frustrating when i see the GP as they always doubt my food choices even though i keep a food diary on my Diabetes app !
 
Hi. I agree you must ask for a GAD and C-Peptide test to check you aren't a LADA (T1). Mis-diagnosis is common. Your weight implies T2 rather then T1 but you need to have the tests. You say you have a very low carb diet but to be honest your weight doesn't reflect that? You talk about natural carbs and low-GI carbs. Carbs are carbs whether natural or not - some just have more fibre etc. Also don't go by low-GI rating as such as it depends on the weight of each. Go by the Total carbs for each day based on what the back of the packet says or calculating the carbs in loose foods using one of the only guides for carb content for a small plateful. BTW your 'normal' diet you list is certainly not low-carb.
 

Sounds like @Jim Lahey nailed it above.
If you are truly eating low carb then you're either not producing insulin or your body has become resistant.
Either way a c-peptide & fasting insulin test is a must, I'm surprised your doc didn't automatically recommend one.
 
Don't forget it's far from impossible to be simultaneously resistant and deficient. They're not mutually exclusive. So even if you are now deficient, this doesn't necessarily point to misdiagnosis. Rather it can mean that things have changed. The shifting sands of diabetes are hard to pigeon-hole. I sometimes prefer to think of non-autoimmune diabetes as two sliders of deficiency and resistance. Both can change. Without serious and lifelong intervention, usually for the worse.
 
This ! My uncle has been a T1 since he was 13, now at almost 70 he's got double diabetes (both T1 and insulin resistant)
 
Yes, I agree, while *maybe* you might be eating slightly more carbs than you think (easily done), it definitely doesn’t sound like it’s even close to the level that should be causing those pretty high numbers. @Daibell mentions your weight, but of course unless we know your height, we can’t really comment on your weight. 91kg might be overweight for some men, but not others.

Definitely speak to your GP
 
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