Diabetes, life and all that - personal diary

Hi

I intend to use this thread to record things about me, and my life as a t2 diabetic. This is really mostly for my own benefit, just a place to record my thoughts and experiences, which I expect will prove therapeutic to me.

I had a scheduled visit with my doctor yesterday and he and I were very pleased with the progress I have made since my last visit - I have brought my HbA1c down to 5.3%, which is an all time low for me. My weight is also down to 92kg, although my BMI still classes me as overweight - about 5 more kg to go before I am healthy weight.

At this rate I will be the healthiest looking unhealthy guy on the beach this summer!

Beginning of last December, after an extremely stressful period at work and a period of somewhat complacent approach towards my previously well controlled diabetes, I found myself with morning fasting glucose levels of almost three hundred mg/dl.

As well as reintroducing all the beneficial lifestyle changes I had previously successfully adopted but somehow allowed to fall by the wayside in my complacency, I went to see my doctor. His verdict was that it looked like my diabetes had progressed (not all progress is good!) and I needed something stronger to help me with it. So he prescribed twice daily Janumet 50/1000 instead of the 3 x 500mg of metformin I had been on to that point.
Janumet 50/1000 is a combination pill consisting of 50mg januvia ( sitagliptin, a PDP4 inhibitor) and 1000mg metformin.

Now I have been reading a number of things about PDP4 inhibitors, some of it good - the possibility that they may protect pancreatic beta cells, but a lot of it bad- the known risk of pancreatitis and the suspected links with pancreatic cancer and heart failure.

I explained to the doctor that given my progress I wanted to experiment with going back to a metformin only regime. I I explained that I was happier being on a long established drug like metformin than the newer and hence less proven to be safe drugs.

Luckily he agreed to let me try, monitor my sugar levels for thee weeks and then review the results with him to decide way forward. So this next three weeks I am even more commited to keeping on top of things and part of the reasonining behind this thread is to assist me in achieving this.




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Day 1 of the new medication regime and already forgot about the pill I am supposed to take with lunch. A good thing I left a spare box in the office. Must remember to set up an alarm on the phone.

I was rather anxious to see what my fasting level would be this morning, after not taking Januvia last night. Thankfully 98mg/dl (5,4 mmol) so in line with other recent results.

Two hours after a five km walk and a breakfast of one piece of multigrain whole meal toast, a slice of cheese and some tea (22g carbs) and level was 116mg/dl (6,3 mmol), so again in line with recent experience despite the change in medication. Or could it be that there is still Januvia in my system from yesterday morning? Time will tell.

Another 2 km walk over lunch of salad and grilled pork kebab. Did not have any of the pitta bread as worried about missing the metformin dose.


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One hour after lunch, which remember did not include anything obviously carby and my sugars are at 89 mg/dl (4,9 mmol). Perhaps I could have had that piece of pitta bread after all.

According to my myfitnespal my total carbs so far today is 35g.

As I am not really a low carber more of a restricted carber, this is unprecedented for me.

Step count so far at


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At two hours after lunch I am at 80 mg/dl (4,4 mmol/l). I do not feel particularly hungry . Perhaps an apple would make a nice snack!


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Ended up feeling a bit lightheaded this afternoon, probably because of running. comparatively low. Had a crisprol and a small square of 85% dark chocolate as afternoon snack,

Morning snack was a handful of raw unsalted pistachio nuts.

Dinner tonight was pot roast pork with three small roast potatoes 110g of which about 20g carbs, a small tomato and cabbage salad and a Granny Smith apple for desert

Carb count so far 102g or 30% of my calories. Maybe I am more of a low carber than I thought!


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One hour after dinner and I am at a surprising 85mg/dl (4,8 mmol/l). For some reason I can handle roast potatoes.

If this keeps up I will have lots of ammo to hit my doctor with and I will not wait two weeks to do so.

I am a bit unhappy that he put me on a very high dosage of 3x850 mg of metformin to compensate for the januvia I no longer take. Recommended dosage for metformin is 2000 mg daily ( with max of 3000). I am currently on 2550 daily. I hope to reduce this to 2000 or less. I just need to convince my doctor that it is safe for me to do so!


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There is something very satisfying about reaching a target, especially when it is a nice large round number

In fact it has been a very active last seven days on the walking front


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Our cat must have done a lot of walking today as well!.

This is the life!


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2h after dinner and 115 mg/dl (5,7mmol/l)


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Thank you to anyone reading and especially for all your encouraging comments.

My motive in setting up this thread were entirely selfish, I want to keep my glycemic control very tight over the next couple of weeks, so that I can convince myself first and my doctor second that I can manage my diabetes with less medicine. So it is important to me to maintain detailed records of more rigorous monitoring of my progress than I would otherwise keep.

- Normally for instances, I would probably only test my morning fasting levels on a daily basis, while I would test two hour after meal levels only if I had something new that I was unsure how it would affect my levels.

- This is also the first time that, inspired by a thread on this forum, I am looking to find more about my levels one hour after meals.

The change in medication means that I have to re-educate myself about my body and diabetes almost like a newly diagnosed diabetic person. I have a couple of advantages though, effectively giving me a head start:

- my HbA1c score is already 5,3%,

- I have already introduced previously lifestyle changes to help me manage my condition.

If what I am doing helps inspire others to make similar changes that is great. My one concern is that people appreciate that we are all different and that what is important is that they show steady improvement over their own scores rather than trying to match or improve on mine. It took me a while for instance before I was able to walk as far as I am able to walk today. What is important is to not give up, to stick with it and improvement will surely come!

In order to make sure that you do stick with the lifestyle changes, I would advise that you

- try to make sure that you select things to eat and physical activities that not only are good for your diabetes but that you also enjoy. I chose to start playing tennis again after a couple of decades of giving the game up.

- find activities that you can easily incorporate into your routines. Walking is something which, hopefully most of us can still do, other health issues permitting, we can do anywhere, and does not require special preparation or assistance.

- find healthy food choices that you enjoy eating. I love berries for instance and they are a lifesaver for me when I want to have something sweet to eat. I have also found that a small square of 85% dark chocolate can go a long way ( and is actually supposed to have beneficial health effect!)

- make sure that the right food is available to you for when the munches hit. I always have raw unsalted nuts and vegetables like carrots celery kohlrabi in the house. I find that having small snacks between meals helps me not to overeat during meals, but we are all different.

- find what motivates you to stick with this and keep it clear in your mind.

I am not an expert on diabetes by any means. I am just a diabetic trying to stay on top of his condition.

By keeping a public diary over the next three weeks, I am putting pressure on myself to stick with a more rigorous routine. If what I write helps you in any way as well then so much the better. But remember that we are all individuals and what works for one may be less effective for another.

Stay positive, stay committed and make the changes today that will help you stay healthy tomorrow!

Pavlos

P.S. this morning's fasting level 93mg/dl (4,8mmol/l)



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Beezee said:

Pavlosn - this is brilliant, I'm trying to get control and seeing what you are achieving is amazing. You are giving me some great ideas, please keep it up!

A small question - which app are you using to log your steps?




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Click to expand...

I am using an app called "pacer" the free version on my iPhone. Search for pedometer on your phones App Store and you should have many suggestions.

Pavlos


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Having completed my morning 5km walk (step count at six thousand something), breakfast



80g of raspberries, 100 g of fat free Greek yogurt and a sprinkling of raw unsalted pistachio nuts with a cup of tea; about 150 calories and 20g of carbs




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I like to take five minutes each morning to see what is going on in the garden. Osteospermum are blooming nicely on shades if purple and white, as is the orange strelitzia (bird of paradise flower)

Talking of flowers the roses I gave the wife on Valentines are still looking pretty


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Just had a call from my son at school? What was the emergency?
I had to take some toothpicks to him.
Back In my days girls had cookery lessons at school and boys did woodwork. In this politically correct days, everyone does everything. They are having a fifth form cookery competition today and toothpicks must be an important element in whatever culinary masterpiece has in mind. Masterchef has a lot to answer for.

If my son thinks he is some kind of Gordon Ramsey, he is due for a serious awakening. He has never cooked anything in his life.

All I ask for is that he does not burn or cut himself. Otherwise, a bit of catching up with reality never hurts.


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