Diabetes behaviour change

[Jakjo55]

I was diagnosed with type 2 diabetes about 2 years ago and since I have lost 4 stone and am using diet/exercise control. I had my 3 month HbA1c test and my results came out at 38. The nurse said that she would not prescribe me medication and said that I should slowly introduce small portions of starches and test.

This morning I tested 4.6 and then had porridge (before this made my BG's rocket!) 2 hours later it was 4.5 and then half an hour after that it was 4.2.

I am worried this is rather on the low side, can somebody comment please?

 

[sally and james]

I'm not medically trained, but that sounds perfect to me. Your new slim line, well exercised body is coping with the carbs you have given it, returning your blood sugar levels to normal, in a prompt fashion, after a meal. Bear in mind that there is an up to 20% inaccuracy in the home monitoring kits, so very exact figures are not worth worrying about. Should your body be in very urgent need of higher sugar levels, your liver will provide!
Your challenge now is to keep the weight off, keep exercising and maintain your improved health. Well done!
Sally

 

[Jakjo55]

Thanks for your kind, reassuring comments Sally. I shall certainly maintain my diet and exercise. What a shock this morning after porridge!

 

[Yorksman]

All sounds perfectly normal to me and not disimilar to my own experience. I found the same with eating porridge too.

Your body will always add extra glucose to your system when you get roughly below 4.0 via a process called gluconeogenesis. It is one of a number of homeostatic processes that keep various things like body temperature, hydration levels, glucose, iron, calcium leves etc etc within strict ranges. It is perfectly normal. Even if you didn't eat anything for a week, your BG would go up and down, say between 4.0 and 6.0. Certain medications though can interfere with this process so people who take insulin have to be careful, but it doesn't apply to you.

I take some carbs now but keep them restricted to things like brown rice, barley, wholewheat pasta etc. I still avoid white bread, mashed potatoes etc. I eat things like lentils, peas, beans which provide enough carbs for me but which also make my body have to work a bit harder to digest them, so I have a sort of balance that way.

If you still have weight to lose, limiting your carb intake is still a good idea but you might like to start enjoying things like strawberries as they will shortly be in season, raspberries, blackberries, cherries, pears, apples, pears and plums and, personally, I eat loads of tomatoes. In fact, I have loads of fruit and veg but still avoid things like melons, grapes and other very sweet fruits.

But, as Sally and James write, your levels sound very good. Don't worry.

 

[bernie.freeman]

Hi Jacko, you are doing fantastically well ! You have the right idea with testing to see what effects you, I too have tried porridge and I am ok with a small portion. I do have a treat now and then, you could try too and see what effect it has. Stawberries and cream yumm

 

[andy williams]

is this mmol measurements?

 

[sally and james]

The HbA1c at 38, will be mmol/mol. HbA1c is sometimes shown in percentages. 38 = approx 5.6%.
The before and after meal readings in the 4's will be mmol/L.
Sally

 

[andy williams]

I was uncertain because for mmol/l itseems a bit on the low side for a diabetic - even a disciplined one. A 'normal' person is around 5.5 , a very disciplined full blownT2 is in the area of 6.5 - 7.7 once past the 2 hours after eating and again a disciplined T2 is around 7 on the fasting hb1ac

I'm only guessing, but I would suggest that you may well have been caught in time and that if you continue you will probably be declared OK at some stage.

 

[sally and james]

My husband is very definitely T2 diabetic, with complications to prove it and a diagnosis reading of 24 mmol/L, but his fasting and pre-meal readings are now in the 4's, sometimes even 3's. Low to modest carb meals give a two hour increase of less than one. This is after 3 stone weight loss and upping his gym visits to 5 or 6 a week.

My understanding (and I can't remember my source, I'm afraid) is that "normal" fasting/pre-meal is 4 to 5.9 and T2 is 4 to 7. This is mmol/L and is measured with a finger prick test, which shows the amount of sugar in the blood at that exact moment.

HbA1c is a test carried out in a laboratory, following having a blood sample taken from the arm by a medic. Fasting is irrelevant to this test. In simple terms is shows the build up of sugars, which have become attached to the blood cells over a two to three month period, so is a kind of average. It is measured in mmol/mol, with "normal" being 41 or less, or in "old money" in percentages, where less than 6% would be considered normal.

So Jakjo's readings, like James', taken in isolation, would not be considered diabetic. However, if Jakjo were to regain weight and re-adopt a lazier lifestyle and push his/her luck with the jam donuts, diabetic readings could return, as they would for James.

Hope this clarifies things. There is a lot of information on the main site, which is well worth a look.
sally.

 

[andy williams]

I weigh 12 stone and am 56 years old, I run 5 miles carrying a 30lb sand pack 3 times a week, visit the gym for intense weight circuits a minimum of 3 times a week and I go hill walking a lot and even competitiveky orienteer (I have always been this active - I was in the infantry for 22 years. I didn't start this because I was diabetic, I have always done it)). I even have a cycle machine in the lounge and will usually watch the news while on it (about 5-6 times a week). I was diagnosed about 7 years ago purely by fluke and once stabilised (which took several months) my twice yearly hb1ac count has remained fairly static at around 40-45 . My random blood tests (disregarding the first 2 hours after eating) average out at around 7mmol.

I take a shed load of tablets - 2000mg of metformin a day, gliclazide and half a dozen more.

I'm considered one of the best disciplined T2s at my surgery and am often asked to talk to the support group.

 

[sally and james]

Yes, but Andy, what are you eating? If you and your doctor are happy, then it's not for me to criticise or comment on you, but we would regard the readings you mention as high, for James. We are, of course, all different and your exercise routine sounds amazing.
Out of interest, have you looked at the Blood Sugar 101 site? The writer, Jenny Rhul, is very keen on the 5% club (basically HbA1c less than 41 mmol/mol) for everyone and rejects the idea that higher (potentially damaging) levels are good enough for diabetics.
On diagnosis, last summer, James went straight on to low carb and achieved non-diabetic levels for finger prick tests within a couple of weeks and three months later his HbA1c was 38 and has fallen further. He has also dropped all diabetic drugs. I don't think, for one moment, that he is no longer diabetic, it's just that he doesn't put sugar (or much carbs) into his system, so it isn't there to raise his sugar levels and, hopefully, it isn't there to add to the complication he was diagnosed with. Exercise and weight loss, will also have increased his insulin production and sensitivity.
Sally.

 

[andy williams]

I don't eat potatoes, rice, pasta, bread, cereals etc etc. I don't eat any sweets at all, I don't take any artificial sweeteners, I don't eat things like carrots, peas, apples, oranges, yellow bananas etc, gravy, iceburg lettuce or ripe tomatoes. I don't eat anything that tastes sweet. I don't drink fruit juices or canned drinks. I only take milk in tea and only skimmed milk other than that I don't drink it. I don't eat salt, I don't cook with it. I don't eat ready meals. or tinned foods other than things like sardines.

For breakfast I eat a green banana, some walnuts, a quarter of a yellow grapefruit. Occasionally poridge made from just oats and water.

Lunch I will eat some meat or fish plus salad or some homemade soup (today I had homemade lentil)

Dinner meat or fish and salad or vegetables.


When I was picked up by fluke (I was displaying no symptoms), it took a couple of months to get my readings down to where they are and then only by adjusting the medication. My diet was already basically as above and there was little that could be done diet wise and likewise I was already very fit and so there was little that could be done that way either.

I have no complications other than ED. Something that threw the doctor a bit because I must have been T2 for a few years before it was picked up for it to get as bad as it had.

Incidentally, I have the constitution of an ox. I haven't had a cold, flu, cough, sore throat, upset stomach etc since childhood and other than when I got run over in the 1980s I have not had any time off work through sickness. (a;though I did finish early one day to go for surgery to have a Dupuytrens Contracture removed by surgery)

 

[Daibell]

Hi. Meters vary a lot. I have one which measures 4.3 when the other reads 5.2 yet both are within calibration level when tested with test solution. They typically have an accuracy of +/- 15%, so may be yours reads a bit low?