Can someone please help me with this?

[Bellx15]

Type 2 diagnosed four years ago. No meds.

In the past four years or so I have gone through periods of unmonitored sloth and debauchery, only to get a shock when my denial finally gives way to a need to test my BG and get real again. Each time this has happened, I went onto a low carb diet, did a couple of energetic walks every day, drastically reduced alcohol intake, and within a couple of weeks or so my BG was behaving itself again. The first time this happened, four years ago (?) my fasting BG was 17.3, or thereabouts, and within a few weeks I had it down to 6-7ish. One thing I tended to do was practically starve myself all morning, do a strenuous walk, and only then take my BG reading. It seemed to work overall, though.

Last October I had all my blood readings done via the NHS, and my fasting BG was 5.3.

This time, my return to reality and BG readings was a shock. Again, morning readings have averaged 11-13, but this time I am not getting it down during the day. I'm not exercising as much as on previous health drives, and I am drinking quite a lot of red wine, but I am hoping someone will be able to give me a clearer reality check than I seem to be able to muster unaided.

A few questions, perhaps:

1. What is an effective way to achieve a rapid short-term drop in my BG levels? I feel I need this in order to stay motivated. When things feel hopeless I tend to go back into denial. I know I answered my own question above, but I'd appreciate others' ideas.

2. What long-term effect on BG levels does regular alcohol intake have?

3. How effective are the available medications? I read that metformin only brings BG down by a modest amount. Should I get on to meds of some sort, at least initially, or should I just go back onto my usual diet and exercise regime and be patient?

I realise this post sounds a bit feeble, and my only excuse is that I have been going through a horrible time this year - separated from my beloved wife in May. I feel the need for some guidance. Thanks.

 

[Patsuiter]

Hi, It seems to me that you are attempting to control your BG by giving yourself a 'quick fix' sol'n.
You could try and face the reality that you really do have to make lifesyle changes that may seem beyond you.
Firstly - stop living in denial - you have diabetes - not the end of the world but a challenge to manage at times.
The quick fix of starving yourself and exercising is clearly not a long term solution...short term maybe but you have to realize yr in for the long haul.
Plan a regular days menu - Breakfast, MTea, lunch ATea, dinner and supper.
Reduce or stop yr alcohol intake.
Exercise regularly - daily if possible - you dont have to knock yourself out - a brisk walk will do the trick.
Reduce the carbs - increase vege's and some fruit.
Basically you need CONSISTENCY in managing yr diabetes.
If the above fails to reduce levels you may need meds - thats no the end of the world either.
Hope this helps.

 

[Bellx15]

Yes, thanks. I do have to get to grips with this, I agree.

I'd appreciate any specific information, though, on my three questions. On the first one, I think in the past I used morning starvation plus exercise as a quick morale boost, but it turned out to have long-term benefits for my BG management.

 

[Squire Fulwood]

1. What is an effective way to achieve a rapid short-term drop in my BG levels? I feel I need this in order to stay motivated. When things feel hopeless I tend to go back into denial. I know I answered my own question above, but I'd appreciate others' ideas.

2. What long-term effect on BG levels does regular alcohol intake have?

3. How effective are the available medications? I read that metformin only brings BG down by a modest amount. Should I get on to meds of some sort, at least initially, or should I just go back onto my usual diet and exercise regime and be patient?

I will attempt a meaningful reply but only in terms as it applies to me. I am not an expert and don't know what effect my regime would have on another person.

1. Definitely lower the carbs although in my case I find no need to cut them out altogether. I try to match carbs to activity. Weetabix and a brisk morning walk bring the numbers down. Some carbs at lunch since I am still active. No carbs in the evening since I might be watching TV. The no carbs in the evening helps lower the following fasting number, I don't know why.

2. Alcohol raises my blood sugar and also makes me careless about snacking. There is a delayed effect in that I had alcohol two days ago but this morning still shows the effect and I don't expect lower readings until tomorrow at the earliest. In short the rise and fall in fasting readings suffers a lag.

3. Metformin does nothing for my blood sugar. I view it as a mild laxative only. I have been on stronger tablets but I have never noticed a dramatic benefit from them. I get significantly better results from diet and exercise should I be disciplined enough to keep at it.

 

[Pompeygirl]

Like squire i try only to eat carbs if i know i am going to be active as ANY carbs i eat will give me higher readings. I have lowered my BS readings by eating as few carbs as i can and sporadic exercise. The exercise definitely lowers my BS pretty much right away. I dont drink. I am on max metformin and im a long way from being convinced that it does anything for me at all. So in my opinion.. Low carbs and exercise.


Sent from the Diabetes Forum App

 

[Bellx15]

Squire - you have good readings there. Am I right to infer from what you say that these have been achieved through diet and exercise? How were they when you were first diagnosed?

Pompey - same question for you, but also what readings are you getting now?

Thanks.

 

[Squire Fulwood]

Squire - you have good readings there. Am I right to infer from what you say that these have been achieved through diet and exercise? How were they when you were first diagnosed?

I will look up paperwork for when I was diagnosed but I remember little about it. I was given pills and diet sheets and I still had faith in the NHS.

When I started to understand what was going on I took more notice and remember an Hba1c of 68 and so I was put on Glimepiride.

I am an unfortunate person and usually get side effects from pills and few of the benefits so I set about seeing what I could do with diet and exercise alone. The latest Hba1c of 43 was achieved without any pills whatsoever which demonstrates that I can do more with diet etc. than the pills.

 

[CollieBoy]

Bellx15,
as other posters have said, the "rapid, sharp drop in BGs is not the best way to go and,as you have found, falling off the wagon is all too easy :twisted:
what I suggest is a multi-pronged approach.
Food: look carefully at what & when you eat, trying to drop snacking and trying to drop carby foods and trying to substitute non-carby, higher fibre foods, and moving to smaller plates to encourage smaller portions.
If you post what you are eating i'm sure we will crowd round with suggestions for improvement.
Also try to find a diet you like as this makes it much easier to stick to.
Exercise: Find activities that you enjoy and can stick to( dog walking or gardening can be great and don't forget ding things to music via a "walkman") Make it fun and it gets easier.
Good luck.
alcohol: Alcohol can loosen the inhibitions and sap resolve.
The form of alcohol is important as pure alcohol itself ( in form of eg whisky & soda) will not raise your BGs ( as it is dealt with in preference to carbs is may cause a short term drop) but carby drinks such as beer, liqueurs or mixers may raise your BG. In short keep the carb count low and be the master of it rather than let it be master of you and you should be oK.
WRT drugs, i would try to master the diet & exercise route but if you are struggling don't be afraid to try some pharmacological help via your GP. It could be the short term push you need to help you succeed.

 

[Bellx15]

Fergus - many thanks.

Yes, I understand about the problem with sudden drops in BG levels. People get those when they go on to insulin, I think. I had my retinal scan last October and it was completely clear.

My diet has lapsed over the year, as I have had a lot of stress and worry. The lapsed diet contained w/m bread, pasta, battered fish, all in limited amounts. I was mainly on cheese, tomatoes, tuna, a small sliced loaf every two days (too much toast, I think), eggs and a lot of broccoli and sprouts. Mayonnaise and curry paste to add interest to the veg.

On a disciplined diet I cut down on the bread, removed the pasta and batter, but no big changes, really.

I've been drinking wine, red recently, and getting through too much of it. I know I need to cut down on that for other reasons, but I wonder what you findings might be regarding the longer-term effects of alcohol, even in low carb form.

 

[Squire Fulwood]

I've been drinking wine, red recently, and getting through too much of it. I know I need to cut down on that for other reasons, but I wonder what you findings might be regarding the longer-term effects of alcohol, even in low carb form.

I like rose wine but will accept any wine as a gift. I used to make vast quantities of grape wine and was smashed much of the time. Confession over.

I made that confession to make it clear that I know how much sugar there is in wine (not that much) and to indicate that if you drink it in quarts the sugar adds up. Furthermore It always seems to be a good idea to have a sausage sandwich or a bag of crisps when you are drunk enough to believe that you will reform tomorrow. This sort of combination puts weight on me and raises my blood sugar considerably.

When sober I have a rule that I have no sugar or flour. A seemingly simple rule until you find out how many supermarket offerings are made almost entirely of sugar and flour. If I stick to this rule I slowly lose weight and my sugar levels become lower.

 

[CollieBoy]

Yes, I understand about the problem with sudden drops in BG levels. People get those when they go on to insulin, I think. I had my retinal scan last October and it was completely clear.

Not just the BG level effects of "short, sharp shock" diets but the danger of being on a diet you cannot stay on and enjoy life with.

 

[Squire Fulwood]

Not just the BG level effects of "short, sharp shock" diets but the danger of being on a diet you cannot stay on and enjoy life with.

I agree with that statement entirely. Evolve to another diet by trying it and if you like it, keep it.

 

[Bellx15]

Yes, I'll accept your confession and forgive you! :mrgreen:

But what about the alcohol itself? Doesn't that convert to glucose? And/or doesn't it affect the liver function in some way? If I move over to whisky or vodka, will my long-term BG be affected just by the alcohol?

Sorry if I sound like a down-and-out; as I explained, I have been going through a very upsetting domestic break-up, and alcohol has helped take the edge off my emotions. If I am going to get down to a serious diet and exercise regime, it would help to know that at least one comfort food is OK to keep.

Re. the next reply, yes, I do clearly need to sustain a healthy regime. I accept that. Getting off to an encouraging start would help me to commit to a more sustainable long-term regime. That's how I am thinking.

 

[Squire Fulwood]

But what about the alcohol itself? Doesn't that convert to glucose? And/or doesn't it affect the liver function in some way? If I move over to whisky or vodka, will my long-term BG be affected just by the alcohol?

Perversely alcohol lowers your blood sugar levels. I happily informed my nurse of this fact but she didn't laugh.

Your body if healthy tries to maintain a balance of sugar in your blood. If you run out completely you die. Mostly it converts food that you eat into what it wants but if you have not eaten in a while the liver will provide sugar to keep you going.

The liver has priorities and if there is alcohol in your blood it will deal with that first instead of supplying sugar. This is one of the reasons why a symptom of a hangover is low blood sugar. It is also the reason why some insulin dependent diabetics get an unexpected hypo. They drink alcohol and take insulin to deal with food intake and the "liver rush", but, no liver rush so they go hypo.

If you move over to whiskey or vodka then you not only have the low sugar problem but a rotted liver anyway so I don't really see that as a sustainable answer.

If you get your levels under some control then there is no reason why you can't have the occasional sup of wine. I suppose that if I say to drink it less often and in smaller quantities then I am wasting my breath?

I may have wine today. Unwise possibly but just look at my Hba1c. It gives some encouragement.

 

[Bellx15]

Well, look at me, here again!

I just felt motivated to report on my recent achievements. Once again, I had allowed complacency to set in, and when I checked my BG in January it had shot back up to the mid-teens. How depressing!

However, I decided this time simply to cut down the calorie intake, regardless of where it comes from, and of course, get a 30 minute walk every day. I'm still imbibing fair amounts of red wine, but that doesn't appear to matter. Within two months I have brought my after-walk readings down to between 4.7 and 5.3.

No meds. No significant weight-loss. Just controlled caloric intake, and a bit of exercise. AND I can stay with it. I don't even feel hungry.

Job done!