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Type 2 DKA recovery

thanks for the advice Andrew.

I feel like I've been left a bit too because being told don't worry about the high readings just record them . I've had bloods on Thursday so will get my hba1c result at my review on Tuesday. I guess I might end up like you on insulin (only temporary hopefully!)

I actually need to put weight and muscle on because I've lost nearly 2 stone when in hospital in DKA state a couple of weeks before being admitted. I'm spending a fortune on cooked fresh chicken and beef for snacks because I'm always starving! the only thing different to your advice is I've been told to always have carbs with every meal? approx 30g? I've requested a dietician referral and been told ive been referred for the Desmond course?
 

I wouldn't make too many changes too fast. Simply cut down out the carbs, keep it to around 30g/meal. Up your proteins and fats, think roast pork belly. You don't want to cut out all carbs because you are still on gliclizide, but choose them wisely like nuts/leafy veg. Reducing carbs will usually bring it down unless you have other medical issues.

To regain muscle mass consider sets of squats and push up.
 

I don't think that you have said how much you weigh and how tall you are.
Being starving all the time is usually a sign that you are on the carbohydrate roller coaster of eating carbs, banging out the insulin, storing the glucose and going low, then starving to bring your BG up again.

I am not convinced that you need to eat more to "get your strength up"; I think your general weakness/tiredness is more likely to be due to your roller coaster ride with your BG levels. If you really are weak due to being in hospital then as others have said you need to exercise to build muscle.

High fat is a good way to reduce hunger; it has the opposite effect to carbohydrates and usually makes you feel full instead of starving. One way to start the day is to have coffee with a big lump of butter and some double cream. This gets your dietary fat content up right at the start of the day. Looking at your breakfast I would personally skip the porridge, skip the bread, and double up on the bacon, sausage and eggs (although you don't say how much you are having).

Assuming you aren't dairy intolerant I would add cheese to your protein snacks because that has a lot more fat. Much more than chicken and beef which are both usually lean.

If there is a Lidl near you try some of their high protein rolls. They are brown triangles with seeds on top.They are (I think) 11 grams of carbs per roll. With butter and cheese you can make a substantial sandwich and it will help to keep you full.

You seem to be eating low(ish) carbohydrate but not seriously low carbohydrate; difficult I know because you are on insulin boosting drugs. One thought is you may be stuck in permanent "carbohydrate flu" where you are having too many carbohydrates to go fully into ketosis but not enough to supply all your energy needs from glucose.

About your ketones. You seem to think 1.5 is scary high. It usually isn't a problem.
See https://ketodietapp.com/Blog/post/2013/11/30/Ketosis-Measuring-Ketones for some more information.

If you look at the chart

you will see that 1.5 is just at the start of the optimal ketone zone. Ketoacidosis starts around 10.
My last ketone test a couple of days ago was 2.1 and I am pretty happy with that. Normal BG etc. at the moment.

I understand the worry about ketones because you can develop ketoacidosis if your ketones are too high, but as far as I know on your medication you would see very high BG before you slipped into diabetic ketoacidosis.
 
Hi Dave,

I would advice you to sign up for the “low carb program” asap. It’s only £30 and it’s for life.

I signed up last week and I find it very invaluable.

The state of the NHS is pretty bad and we seem to be left on our own. No advice whatsoever!

https://www.lowcarbprogram.com/

This is my typical day:

2 teaspoon plain soya yougurt (unsweetened)
6 raspberries
Walnuts
Dash of cinnamon

Sometimes just 1 fruit (pear or plum)

Or fried egg / bacon (no bread)

Lunch:

Chicken, Fish or Beef (quarter plate)
1 small potato or half whole wheat bread
Salad (half plate)


Dinner:

Soup or similar to lunch.

There are loads of recipes online for low carb diet.

Be careful with portion sizes and what you put on your plate because any food can spike blood sugar levels.

Go for “low glycemic” foods.

Always read the labels at the back of each packet and start carb counting when shopping.

Avoid processed foods. Start making your own.

Avoid big portions of carbohydrates and starchy foods. Instead of having 3-4 potatoes, just have one or two.

Remember this is a lifestyle change.

Strict diet and exercise is the key to fighting diabetes.

Also try to walk daily even for a few minutes. And when you get your energy back, go to the gym.



Andrew
 

hi ,

I was 12 stone before this happened down to 10 st 7 now and 5ft 11" tall. I look really thin and gaunt etc.. I'm going to try and just eat healthily until Tuesday when I have my review and see if they change my medication. I think you will all be interested (or flabbergasted!) when I put on here the dietery advice im expecting to be given from my diabetic nurse at this review because it will differ greatly from the majority in this forum.

everyones advice and help is greatly appreciated thankyou x
 

Just ran your numbers through the BMI calculator.
https://www.nhs.uk/Tools/Pages/Healthyweightcalculator.aspx
This shows your BMI as 20.5 and nicely in the healthy weight.

I really understand the difference a change in appearance can make in your own view and of those around you.
I got my weight down from 13 stone to just under 12 stone (I am 6 feet tall) and all around me were panicking because they thought I had lost too much weight.
I would like to get down to 11 stone 7 lbs but I wouldn't be too concerned if my weight went lower.

I think you should seriously consider focusing on your blood glucose control and not worry about your weight short term. Trying to eat yourself a stone heavier whilst also trying to settle into a dietary and drug routine to manage your blood glucose is unlikely to work well in the short term. IMHO.

Another thing to consider; I and another poster @Grateful both have been within normal BMI but have had quite a large waist measurement. I don't know if this was the same for you but if you have lost such a lot of weight (****, I would love to lose the weight but not at the rate you did) you may have undergone a version of the Newcastle Diet which purges fat from your liver and pancreas.

Given that you may have lost a lot of insulin resistance and perhaps you no longer need as much medication.

I would focus on just keeping your BG stable and trying eating patterns which make you feel full and not worry about your weight. More important to sort out the weak and wobbly feelings. As I said, I suspect that this is due to your roller coaster BG. If you are lucky you may be able to reduce or cut out entirely much of your medication.

You are not emaciated. You are fashionably svelte.
Live it for a bit; you may even get to like it!
Worth checking @Grateful posts because there is one which gives his weight loss (it is also in his signature).
If my failing memory serves he is 6 foot 4 inches tall and has got his weight down to 11 stone 2 lbs which has worked wonders for his BG control.
 
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Hi I’m currently on 4 x 80 gliclazide ( 2 morning 2 night ) I’m also in 2 x1g glucophage (metfirmin) I was also on victoza injections.
Following a period of ups and Downs including my mum dying and my husband being very ill , a very stressful period in my life my bg was all over the place -I ended up collapsing in a hypo in my classroom -so my hba1c went up to 9.1 I tried anagliptin and my daily readings were even more erratic. So my diabetic nurse suggested insulin-I’ve been expecting insulin for 2 years. So it wasn’t a shock or any great upset as I went through that 2 years ago. So off I went humalin m 3 apart from weight gain I think it’s the best thing for me .i have done lots of research since going on insulin and the vest advice I’ve had following a period of getting used to insulin I’m trying low carb and I feel more stable and less anxious .ive only cut down to 75 g carbs each day I’ve given up pasta potato rice bread crisps etc.i love vegetables and don’t really like meat.and I don’t drink so I’m happy to use up my carbs on milk in my tea and veg. My advice is to find lots and lots of opinions from people on here there is a lot of experience and a lot of trial and error.ive been diagnosed t2 15 years now Bd I’m still learning something new every day
 
Remember you can buy a whole chicken, cook it, and have it cold over the next few days. The roast in the bug chickens come out very nice with no mass, and no cooking skills needed.
 
You are possibly thinking of Bulkbiker, perhaps. Definitely not me as erm... I am female lol.
 
Guzzler said:
You are possibly thinking of Bulkbiker, perhaps. Definitely not me as erm... I am female lol.
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Finger trouble. @Grateful should have been tagged.

Now edited to correct.

I assume you are also not 6 foot 4 inches and 11 stone 2 pounds.
Although no reason that you shouldn't be.
 
LittleGreyCat said:
Finger trouble. @Grateful should have been tagged.

Now edited to correct.

I assume you are also not 6 foot 4 inches and 11 stone 2 pounds.
Although no reason that you shouldn't be.
Click to expand...

No, I do not have that build but thanks, it made me chuckle
 
Guzzler said:
No, I do not have that build but thanks, it made me chuckle
Click to expand...

I am honored to have been mistaken for @Guzzler who is a voice of wisdom here.

BTW as of the past two weeks I have lost another kilo so am now 70KG or exactly 11 stone. That puts my BMI on the edge of "underweight" but as I said in another thread, "BMI is bunk." Considering my body shape at diagnosis, I was "overweight" even with a BMI of 21.7 and I do not consider myself to be even remotely "underweight" now, despite the weight loss. I weighed almost 10 kilos less in my 20s and early 30s.
 
When are you going to find out if you're going to be back on Metformin or Insulin?

Btw, for your info, injecting yourself with Insulin on a daily basis is NOT painful. The needle is very thin and it's subcutaneous - skin deep!

Remember, the evil stuff is carbohydrates and sugar - NOT insulin.
 
probably Tuesday at my review. I've used insulin for a short time a couple of years ago and they were hitting me with it in hospital every day . it's not the needles I'm worried about it's the effects of the high sugar and long term effects. I'm being allowed back to work tomorrow on a part time basis after 6 weeks off (just 4 hrs a day forxthe first week thrn 6hrs a day the following week) so I'm hoping the extra exercise and routine and being more active will help too!
 
I strongly suggest to go for low-carb high fat diet which means no more potatoes, bread, rice, pasta and all starchy foods and vegetables.

Instead of potatoes, use brown whole meal bread, plenty of vegetables and a small portion of protein like fish, beef or chicken.

Eat in small portions at a time spread throughout the day so you won't feel hungry.

I have a small breakfast, then lunch, then snack of walnuts, almonds, or carrot, 1 fruit before dinner. Before going to bed, I have berries.

I know it's tough but it doesn't have to be punishing. Just need to be creative and disciplined. There are tons of recipes on the low-carb program.

Remember, be careful and avoid foods that can spike your blood sugar levels!
 
I use Alpha Lipoic Acid, Pomegranate Extract (Anti-Oxidants), Multivitamins & Minerals, Potassium, Magnesium, Garlic Food, Cod Liver Oil Supplements.

Also try Cinnamon (500mg) with food as it helps lower down blood glucose levels.
 
NewTD2 said:
I use Alpha Lipoic Acid, Pomegranate Extract (Anti-Oxidants), Multivitamins & Minerals, Potassium, Magnesium, Garlic Food, Cod Liver Oil Supplements.

Also try Cinnamon (500mg) with food as it helps lower down blood glucose levels.
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I've made a start with cod liver oil (as I'm not a fish lover!) . I'm going to get multivitamins today . I've even bought the tins of mackerel fillets in sauce which look ok nutrition wise and might mask the fishy taste and limiting to about 30g carbs per meal for now until my review on Tuesday. as I've stated in my earlier posts this has really knocked me for six because went from totally controlled to out of control in this space of 3 weeks not looking after myself . just hope my body settles down and I can get my numbers down and control back with injecting hopefully!
 
We can't afford to going back to bad habits I'm afraid.

It's a complete change of life-style otherwise suffer the consequences later on.

Good luck on Tuesday!
 
NewTD2 said:
We can't afford to going back to bad habits I'm afraid.

It's a complete change of life-style otherwise suffer the consequences later on.

Good luck on Tuesday!
Click to expand...
lesson learned the very hard way! thanks again for taking the time with the advice
 
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