Type 2 Confused and frustrated

davidjb · May 28, 2016

I was diagnosed T2 about 2 years ago. I've never had a weight problem (BMI 21-23 since age 18), and have been paraplegic for 4 years. After diagnosis I stopped adding sugar to drinks and cereals (about 10-12 teaspoons a day). I take 2 x 850 mg Metformin a day. My diet for the last 20 years has generally been 'Mediterranean' with no coke type drinks. After about 3 months my fasting BG went down from somewhere between 8 and 8.3 to between 6 and 6.5 with the occasional 5.7. and, apart from the occasional expected high and unexpected low readings, my fasting BG readings have been about the 5.7-6 mark. Until about a month ago. With no change to anything it went to around 7.2-7.8. After about a week I thought I would give low-carb a try. After 3 weeks the fasting BG is still around the 7.5 mark BUT my pre-lunch and pre-bedtime readings have gone up from about 5 and 5.5 to about 6 and 6.5 (apart from once).

I understand the principle of 'liver dump' or 'dawn phenomenon'. What I don't understand is that if this happens and it affects your fasting BG what value can a fasting BG have, as you can never know when it happened and what the reading would have been before it did. A couple of days ago my BG on going to bed was 5.6 and the following morning when I got up at 7o'clock my fasting BG was 7.9. Please enlighten me if you can.

Squire Fulwood · May 28, 2016

davidjb said:
I understand the principle of 'liver dump' or 'dawn phenomenon'. What I don't understand is that if this happens and it affects your fasting BG what value can a fasting BG have,

Not much in my opinion and even the NHS now uses the Hba1c for diagnosis.

Lamont D · May 28, 2016

davidjb said:
I was diagnosed T2 about 2 years ago. I've never had a weight problem (BMI 21-23 since age 18), and have been paraplegic for 4 years. After diagnosis I stopped adding sugar to drinks and cereals (about 10-12 teaspoons a day). I take 2 x 850 mg Metformin a day. My diet for the last 20 years has generally been 'Mediterranean' with no coke type drinks. After about 3 months my fasting BG went down from somewhere between 8 and 8.3 to between 6 and 6.5 with the occasional 5.7. and, apart from the occasional expected high and unexpected low readings, my fasting BG readings have been about the 5.7-6 mark. Until about a month ago. With no change to anything it went to around 7.2-7.8. After about a week I thought I would give low-carb a try. After 3 weeks the fasting BG is still around the 7.5 mark BUT my pre-lunch and pre-bedtime readings have gone up from about 5 and 5.5 to about 6 and 6.5 (apart from once).

I understand the principle of 'liver dump' or 'dawn phenomenon'. What I don't understand is that if this happens and it affects your fasting BG what value can a fasting BG have, as you can never know when it happened and what the reading would have been before it did. A couple of days ago my BG on going to bed was 5.6 and the following morning when I got up at 7o'clock my fasting BG was 7.9. Please enlighten me if you can.

I do know that some T2s don't do their fasting bloods when they get up.
That's because it's not what you really need to concern yourself with as a liver dump in the morning is natural and there isn't a lot you can do.

The best way to judge, how you are doing is doing the pre meal and two hours after.
If a food or a combination of foods is higher at two hours than 2mmols higher than the pre meal, then something in that meal is driving your blood glucose levels up and should not be eaten.

If you don't mind, could you give us an example of what your diet is?

Hope this helps.

davidjb · May 28, 2016

nosher8355 said:
I do know that some T2s don't do their fasting bloods when they get up.
That's because it's not what you really need to concern yourself with as a liver dump in the morning is natural and there isn't a lot you can do.

The best way to judge, how you are doing is doing the pre meal and two hours after.
If a food or a combination of foods is higher at two hours than 2mmols higher than the pre meal, then something in that meal is driving your blood glucose levels up and should not be eaten.

If you don't mind, could you give us an example of what your diet is?

Hope this helps.

Hi Nosher, my diet consists of: breakfast - cereal (Weetabix or porridge + oatbran), or scrambled egg and smoked salmon, or fruit. Cup of tea.
Lunch - normally either grilled or poached chicken breast, or grilled fish, occasionally a chicken casserole - all with either vegetables or salad. Small quantity of bread and fruit or yoghurt (Greek natural). Glass of wine (not always) + water
Evening (about 7:30) - Canned tuna with salad, or cheese omelette with salad, or a cheese and ham salad. Fruit or yoghurt (opposite to lunch). Cup of tea
Sometimes nuts or fruit between meals if peckish + a couple of cups of coffee and water during the day. Olive oil dressing on the salad (which usually comprises lettuce, tomato, avacado, olives and grated carrot), no added salt on anything and the occasional cake from the diabetics cookbook.

Thanks

Lunch - either

Lamont D · May 28, 2016

Hi @davidjb most of that sounds fine, though the cereals or porridge would have my bloods rocketing!
You will have to test them individually to see what happens.
Little things matter a lot, like what type of milk do you use in your tea?

But, honestly, because of your circumstances, your bloods are not that bad, not brilliant, but not bad. Don't worry about your fasting.
The ones the docs use to test is your hba1c test, that gives you an average.

You noticed that things have changed, are you eating more?
That's why you need to keep a diary, cos then you can see, especially if you can lose weight and then as you have already done see trends in your blood results.
Once your insulin resistance is better, your response to some carbs will be different.
So, it's definitely worth keeping an eye on how you are doing.
And also, you can show your doc/dsn how you are doing.
Are you on other meds?

Sorry about all the questions but I'm nosey!

davidjb · May 29, 2016

nosher8355 said:
Hi @davidjb most of that sounds fine, though the cereals or porridge would have my bloods rocketing!
You will have to test them individually to see what happens.
Little things matter a lot, like what type of milk do you use in your tea?

But, honestly, because of your circumstances, your bloods are not that bad, not brilliant, but not bad. Don't worry about your fasting.
The ones the docs use to test is your hba1c test, that gives you an average.

You noticed that things have changed, are you eating more?
That's why you need to keep a diary, cos then you can see, especially if you can lose weight and then as you have already done see trends in your blood results.
Once your insulin resistance is better, your response to some carbs will be different.
So, it's definitely worth keeping an eye on how you are doing.
And also, you can show your doc/dsn how you are doing.
Are you on other meds?

Sorry about all the questions but I'm nosey!

Thanks Nosher, I don't mind nosey if it's helpful ! (I am too but I like to call it being curious!). I'm eating the same as before, but less bread, pasta or rice. I'm very lucky weight-wise as I've never had a problem (about 5'11" and never more than 11 stones - currently 10st 8lbs). When diagnosed as T2 the blood analysis showed raised blood pressure and highish cholesterol so am on 1x50mg hydrochlorothiazide and 1x10mg simvastatin per day.

Thanks again

Lamont D · May 29, 2016

Hi again, I think maybe and I'm guessing again that your meds may put your blood glucose levels up a wee bit!
I would keep testing and writing it all down to track what is happening..
If you continue to reduce your carbs, especially breakfast cereals, your insulin resistance will improve and in a few months hopefully, your bloods may be back in normal levels even with the meds.
And then, you can have your little treats now and then!

Best wishes mate!

davidjb · May 29, 2016

nosher8355 said:
Hi again, I think maybe and I'm guessing again that your meds may put your blood glucose levels up a wee bit!
I would keep testing and writing it all down to track what is happening..
If you continue to reduce your carbs, especially breakfast cereals, your insulin resistance will improve and in a few months hopefully, your bloods may be back in normal levels even with the meds.
And then, you can have your little treats now and then!

Best wishes mate!

Thanks Nosher, I think I may have been getting a bit paranoid and obsessed, but your info and advice have pulled me back from that. I'll try the things you've suggested and see what happens over the next few months.

Thanks a lot, I appreciate it

Lamont D · May 29, 2016

davidjb said:
Thanks Nosher, I think I may have been getting a bit paranoid and obsessed, but your info and advice have pulled me back from that. I'll try the things you've suggested and see what happens over the next few months.

Thanks a lot, I appreciate it

Hey, no worries,

You now have to keep us informed how you are doing, you can gain the same knowledge as I have and it has took me a long time to learn and get my head around the way this condition works and how to control it.
Your experience can help others and you are bound to ask more questions about how we go about this that and the other.
Like for example, what fats are good for his?
You can eat full fat dairy, anything low fat or zero fat is bad for us?

That sort of thing!

But keep in touch because, you know you are not the only one with this condition and you are not so alone.

I might have the answer to that question!
Why me?

Best wishes mate and look after yourself cos no one else will!

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