Diagnosed - advice welcomed

[MrsA2]

All those signs are good. Seems like what you are doing is working.
When is your next hba1c due?

Remember that all though food (carbs) has the biggest effect on bg so do about 40 other things including :
Quality and quantity of sleep, or lack of it
Duration and intensity of exercise, or lack of it
Stress
Illness
Medications
Hydration levels
External temperature (weather,)
And many more.

All of which, in multiple combinations, can have an effect.

For example I'm currently in an ongoing situation of stress and my bgs are at least 2 points higher than they'd usually be.

 

[Paul_]

Hi all - I'm trying to work out if I'm making actual progress or not and starting to get a bit frustrated with my numbers. I've gone low carb (between 20-45g most days, usually in the 25-35 range) - I've pretty strict on the diet and most carbs are from veg and nuts. I've also added in a quick 10 minute cross-trainer session after each meal the last few days to try and save storing anything I'm consuming, as well as more intensive exercise at least every other day. I think I'm about 7 weeks in and I can't work out if what I'm doing is enough! I've lost about 6kg in weight and I no longer drink water like a fish or need to get up every night for the loo, and my wonky vision has gone away - so I guess something positive is happening?

The lack of consistency is my biggest irritation I think! I had the same lunch today and yesterday and got completely different pre and post meal changes it is really making me question what I'm doing.

I think deep down I know it is helping and that I'm stupidly expecting years of poor glucose management to be remedied too quickly and probably just need a little reassurance to keep me motivated!

Sorry for the ramble - just needed to get it out!

Let's ignore the waking results for this, they're often inconsistent and there's a limited amount you can do to affect them in the immediate term.

Your data shows:

1) Your diet is working and the food you're eating isn't placing your insulin response under stress. You're consistently returning close to your pre-meal reading for the 2hr post-meal reading, which is ideal.

2) Your pre-breakfast readings have reduced from an average of 10.5 - 12 in early November, down to 8 - 9 for the last 10 days or so. This is positive and the trend should continue downwards if you maintain your diet/lifestyle changes. It just takes some time - have patience.

3) Your dinner readings have reduced from a average pre-meal of around 8.5 - 9.5 down to 7 - 8. Again, this is positive and heading in the right direction.

4) If you don't already track your food intake, from experience then I'd recommend doing so. You have the odd meal here and there where your 2 hour post-meal reading hasn't returned as close to your pre-meal reading as is ideal. Nothing outrageously high, don't get me wrong, and it's well within what could potentially be a testing meter margin of error. However, if you've had a higher carb meal than normal leading to one of those results, tracking carbs in meals would help identify "offending" meals/foods or portion sizes.

Overall though, you're doing great, keep up the good work! It's a marathon, not a sprint, so try to maintain the mindset that individual results aren't important by themselves. It's not a competition with your last result, instead it's all about improving result averages over time, which in turn will improve your hba1c.

 

[Cluuur]

All those signs are good. Seems like what you are doing is working.
When is your next hba1c due?

Remember that all though food (carbs) has the biggest effect on bg so do about 40 other things including :
Quality and quantity of sleep, or lack of it
Duration and intensity of exercise, or lack of it
Stress
Illness
Medications
Hydration levels
External temperature (weather,)
And many more.

All of which, in multiple combinations, can have an effect.

For example I'm currently in an ongoing situation of stress and my bgs are at least 2 points higher than they'd usually be.

Thanks for the reply MrsA2. I think my sleep is a contributing factor at the moment. I'm trying to shift my bedtime to be earlier in the hope of getting more sleep but outside factors are making that a little harder.

I have had some stressful periods during the last month which I suspected wouldn't help matters - hopefully I can avoid super high stress levels for a while (though I seem to have anxiety attacks despite there being no obvious trigger making it hard to mange at times).

I hope your stressful situation eases soon x

 

[Cluuur]

Let's ignore the waking results for this, they're often inconsistent and there's a limited amount you can do to affect them in the immediate term.

Your data shows:

1) Your diet is working and the food you're eating isn't placing your insulin response under stress. You're consistently returning close to your pre-meal reading for the 2hr post-meal reading, which is ideal.

2) Your pre-breakfast readings have reduced from an average of 10.5 - 12 in early November, down to 8 - 9 for the last 10 days or so. This is positive and the trend should continue downwards if you maintain your diet/lifestyle changes. It just takes some time - have patience.

3) Your dinner readings have reduced from a average pre-meal of around 8.5 - 9.5 down to 7 - 8. Again, this is positive and heading in the right direction.

4) If you don't already track your food intake, from experience then I'd recommend doing so. You have the odd meal here and there where your 2 hour post-meal reading hasn't returned as close to your pre-meal reading as is ideal. Nothing outrageously high, don't get me wrong, and it's well within what could potentially be a testing meter margin of error. However, if you've had a higher carb meal than normal leading to one of those results, tracking carbs in meals would help identify "offending" meals/foods or portion sizes.

Overall though, you're doing great, keep up the good work! It's a marathon, not a sprint, so try to maintain the mindset that individual results aren't important by themselves. It's not a competition with your last result, instead it's all about improving result averages over time, which in turn will improve your hba1c.

@Paul_ Thank you. Your response is really appreciated. I know the trend is generally in the right direction - I just started seeing a good few 6s and then they tended back into the 7s and it was a bit demoralising to see.

I do indeed track my food intake using My Fitness Pal so I can check back to see which foods don't come down as quickly as I'd like. The blue colour coding shows when I've done exercise before that test so I know that this is a factor that may cause a skewed result - and i think accounts for most of the less than ideal post-meal results you mention (although I do tend to try and do any activity between post testing and the next meal to avoid this where possible). The one outlier with no exercise skew I can see was dinner on 30th Nov when I had too many carbs in one go (as many as I now have in a full day) so I've prevented that happening again - although I do intend to try the swedish meatballs again with different portion sizes and vegetable choices! I'm still trying to unlearn 25 years of a "if you're hungry, fill up on veg" mentality.

 

[Paul_]

@Paul_ Thank you. Your response is really appreciated. I know the trend is generally in the right direction - I just started seeing a good few 6s and then they tended back into the 7s and it was a bit demoralising to see.

I do indeed track my food intake using My Fitness Pal so I can check back to see which foods don't come down as quickly as I'd like. The blue colour coding shows when I've done exercise before that test so I know that this is a factor that may cause a skewed result - and i think accounts for most of the less than ideal post-meal results you mention (although I do tend to try and do any activity between post testing and the next meal to avoid this where possible). The one outlier with no exercise skew I can see was dinner on 30th Nov when I had too many carbs in one go (as many as I now have in a full day) so I've prevented that happening again - although I do intend to try the swedish meatballs again with different portion sizes and vegetable choices! I'm still trying to unlearn 25 years of a "if you're hungry, fill up on veg" mentality.

All sounds good, in my opinion you're doing all the right things, many of which mirror the overall approach I took at a high level to reduce my hba1c.

When you're riding high with blood glucose levels, my understanding of various articles (and input from other members here) is that your body kind of acclimatises to those higher BG levels. It thinks it needs levels that high to sustain normal function. As such, as your levels drop due to diet and lifestyle improvements, your liver gets the signal to dump glucose into your system to top you back up. That's also why I originally said there's little you can do to directly improve waking BG readings. It takes time for your body to acclimatise to the lower BG state, realise it doesn't need to boost your levels with liver dumps, and for everything to settle down. Even on keto levels of carb intake for 5 months now, my waking readings are still often anywhere between 6 and 8 mmol (higher end when my inconsistent/unpredictable dawn phenomenon rears its head). The rest of the time I'm between 4.5 and 5.5 before and after meals now, having lost a significant amount of weight and maintained keto levels of carb intake for 5 months. On the way to where I am though, I saw results like you're seeing, where they dip down some days, but then go up. My advice here is that if you look at your results, the averages are coming down week on week, so look back again in 2-3 weeks and you'll hopefully see the same compared to the numbers you're currently getting. I get it though, I'm not the patient "wait and see in a couple of weeks" type either!

Basically, my post here is just a long way of saying don't get disheartened and keep at what you're doing!

 

[Cluuur]

All sounds good, in my opinion you're doing all the right things, many of which mirror the overall approach I took at a high level to reduce my hba1c.

When you're riding high with blood glucose levels, my understanding of various articles (and input from other members here) is that your body kind of acclimatises to those higher BG levels. It thinks it needs levels that high to sustain normal function. As such, as your levels drop due to diet and lifestyle improvements, your liver gets the signal to dump glucose into your system to top you back up. That's also why I originally said there's little you can do to directly improve waking BG readings. It takes time for your body to acclimatise to the lower BG state, realise it doesn't need to boost your levels with liver dumps, and for everything to settle down. Even on keto levels of carb intake for 5 months now, my waking readings are still often anywhere between 6 and 8 mmol (higher end when my inconsistent/unpredictable dawn phenomenon rears its head). The rest of the time I'm between 4.5 and 5.5 before and after meals now, having lost a significant amount of weight and maintained keto levels of carb intake for 5 months. On the way to where I am though, I saw results like you're seeing, where they dip down some days, but then go up. My advice here is that if you look at your results, the averages are coming down week on week, so look back again in 2-3 weeks and you'll hopefully see the same compared to the numbers you're currently getting. I get it though, I'm not the patient "wait and see in a couple of weeks" type either!

Basically, my post here is just a long way of saying don't get disheartened and keep at what you're doing!

@Paul_ thanks again for another encouraging response. It helped me today when I had a rather unexpected 9.3 pre-breakfast reading out of the blue (I retested and got a 9.1)...instead of freaking out, I ate sensibly and increased the length and intensity of my post-food exercise and had it down to 6.5 pre-dinner (and where it has returned to pre-bed just now)

 

[Welshman1952]

Hi there,

I am currently living abroad and have just been prescribed metformin (2x500mg daily) after a 11.4mmol/L fasting BG level.

I am reticent to start taking this without first adjusting my diet and activity levels and trying to improve my sleep and anxiety, which have all been less than ideal for a while now (plus I have PCOS which I believe affects insulin resistance).

My doctor is saying that diet alone will only work for a BG level of 9 or lower and that it will only reduce mine from 11.4 to ~9.5 without the metformin. Is this true?

Like I say, my preference would be to avoid medication if possible - is this realistic or am I too far gone for this?

Thanks, Claire

At the beginning of December my fbg was averaging 14.0 and I had an Hba1c of 101. Today my fbg was 6.7 and my average A1c (according to MySugr app) is coming out at about 53. I also lost 8lbs in a bit over 2 weeks. I did all this on diet. Now I'm not a medic so I can not advise, all I can say is that I did it.