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FBG management. How to reduce it?

Discussion in 'Type 2 Diabetes' started by Beelady, Feb 11, 2021.

  1. Beelady

    Beelady Type 2 · Active Member

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    My BG control is currently very poor and, since breaking my ankle in January and my CABG procedure in July, I am really struggling. I've just checked my diary and in the last 3 weeks my fasting readings have been as high as 16.4 and the lowest only 10.7. Needless to say, I've been feeling pretty rough and utterly exhausted. But that could be due, in a large way, to convalescing from heart surgery. How much is the high BG, I just don't know. I'm between a rock and a hard place at the moment and really struggling. My life has a huge amount of stress in it caring for husband with Alzheimers.
     
    • Hug Hug x 6
    #1 Beelady, Feb 11, 2021 at 3:28 PM
    Last edited: Feb 19, 2021
  2. Jaylee

    Jaylee Type 1 · Moderator
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    Hi,

    I'm sorry you're having a tough time with your BGs.

    Would you prefer if i took your post & created your own thread for you? :)

    Your post may get a little lost in this topic..
     
  3. Beelady

    Beelady Type 2 · Active Member

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    I think my biggest unknown is this: When I wake up with such high BG, how do I reduce it? Thank you for your considerate offer. You know best so I'll follow your guidance about threads. :)
     
  4. Jaylee

    Jaylee Type 1 · Moderator
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    OK, consider it done.. :)

    Edit to tag in a few people who may help. @Rachox @Goonergal @Brunneria
     
    #4 Jaylee, Feb 11, 2021 at 3:49 PM
    Last edited: Feb 11, 2021
  5. Brunneria

    Brunneria Other · Guru
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    Hi and welcome!

    I’m sorry you are having such a tough time, the high bgs will be adding to the stress and making you feel worse, which then adds to the stress... It ain’t easy looking after yourself, acting as a carer AND recovering from surgery.

    Before I make any suggestions, can you just confirm that the only diabetes medication you are on is Metformin?
    And what is your current/normal eating pattern? Could you list a typical day’s eating?
     
    • Agree Agree x 1
  6. EllieM

    EllieM Type 1 · Moderator
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    You tick a lot of boxes which make your bg go up
    1) illness
    2) less exercise
    3) stress

    So, if you're not on meds the normal way to reduce bgs is
    1) exercise (not sure if you can do any with your ankle)
    2) reduce those carbs.

    But if you're already low carbing then I'd suggest you talk to your medical team. Those sugar levels will be impacting on your coping abilities and making any stress/depression worse. It may be that some extra medication could help you while you're going through this difficult period.

    I'm so sorry that your husband has alzheimers. My FIL had dementia and it was heartbreaking watching the toll it put on him and my MIL. Are you able to get any help for him and/or yourself?

    Lots of virtual hugs.
     
  7. Beelady

    Beelady Type 2 · Active Member

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    Thank you for your questions, Brunneria. I have just been through and updated my personal details.
    I'm taking Gliclazade and Sitigliptin. No Metformin now. Although I still have 4 packets left over from when I used to take it.
    Edit: Sorry! I'm struggling to negotiate the site at the moment. I've somehow just lost the rest of my reply to you. Try again.
    Typical day's eating. As of yesterday I am trying to eat very low carb food. Breakfast: 2 egg plus cream omelette. Lunch: Home made cauliflower and Stilton soup. Dinner: Butternut squash, carrot and sweet potato soup with a chicken stock. Mango chunks for dessert.
    Today. Brunch: 1 medium avocado with 2 fried eggs and dsp of pickled cauliflower. Dinner will be cold roast chicken pieces with salad leaves, cherry tomatoes, red onion slices and fennel pieces.
    I belong to a local DUK support group and we had our zoom meeting on Monday. The biggest advice was to make soups - they keep you feeling full!
    I have an issue that I have a very poor sleep pattern and often feel hungry in the middle of the night. My go-to solution is to eat a can of baked beans, with a very liberal dollop of salad cream, cold from the can. Then I can get to sleep! However I did manage to NOT eat the beans last night!
     
    #7 Beelady, Feb 18, 2021 at 3:54 PM
    Last edited: Feb 18, 2021
  8. Beelady

    Beelady Type 2 · Active Member

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    Hi EllieM!
    Thank you for your input, it's greatly appreciated. I know that the Alzheimer's has to be experienced to be believed how great the impact is on your own life/wellbeing. It is not good! Since being registered as my husband's carer, that has given me access to support from a local Dementia support team. I'm currently taking part in an online course that they run giving me 'coping strategies' on how to deal with him. I'm finding it most useful and the lady who runs it is a friend from beekeeping!
    I am literally taking the first steps into low carbing. I'm going to give it a month and see what effect that has on my fasting readings and if they are still up there in silly numbers (over 13m/mols/l) then I will go back to my GP. The problem with that is they are very 'old school' and just keep showing me the Eatwell plate. I find that there is more practical advice here.
     
    • Like Like x 1
    #8 Beelady, Feb 18, 2021 at 4:50 PM
    Last edited: Feb 20, 2021
  9. ianf0ster

    ianf0ster Type 2 · Well-Known Member

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    Hi @Beelady,
    Fasting Blood Glucose is the thing that takes the longest to reduce. So I think you are setting yourself an impossible target in trying to get it down that fast in only one month.
    Many of us take a year or 2 to manage that. However Although my FBG is still on the higher side, my HbA1C is well into the non-diabetic levels - not even pre-diabetic. and has been since before September.

    I suggest that you concentrate on keeping the BG spikes from food low enough to be a 'normal response' i.e. no more than a 2 mmol/l increase from before a meal to 2hrs after 1st bite. This will lower your maximum BG and reduce your average BG.
    But your Fasting BG mostly depends upon whether you suffer from 'Dawn Phenomenon', where your liver 'helps you out in your quest to hunt/gather your breakfast' by dumping glucose into your bloodstream as a quick source of energy.
    Your liver doesn't know about fridges or supermarkets!
     
  10. MrsA2

    MrsA2 Type 2 · Well-Known Member

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  11. Brunneria

    Brunneria Other · Guru
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    thanks for answering my questions :)

    since you are on medications to lower bg, then pls take your low carbing steadily, and monitor your bg frequently as you do so.
    You may well find that in future you will need to reduce your medication as the low carbing reduces your blood glucose levels. But until that point, you don’t want to be battling hypos.

    Thanks for your menus. The second day was much lower carb than the first, since the carrot, sweet potato and mango are all carb heavy for a low carb way of eating. But those are all things you can tweak and monitor with your glucometer, to discover the best options for you.

    if I were you, I would check how many carbs are in your late night baked bean snack - you will likely be horrified! :)
    My suggestion? Organise an alternative, and have it ready, so that you know exactly what you will eat the next time it happens. How about cheese? Or hummus, or full fat greek yog? Whatever you like, so long as you have it planned, find it appetising, and it is easy to grab.

    having said that, as your bgs improve and stabilise, you may well find that midnight feasts become a thing of the past.
     
  12. Beelady

    Beelady Type 2 · Active Member

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    Thank you MrsA2 for that warning. I was also told by a Dr speaking at our local DUK support group that Gliclazade also causes weight gain. I felt a bit cross when I found that out when my previous GP visit was because of my concern about my weight gain.
     
    #12 Beelady, Feb 19, 2021 at 12:01 PM
    Last edited: Feb 19, 2021
  13. Beelady

    Beelady Type 2 · Active Member

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    Hi ianf0ster and thank you for your input. I don't have any details from my last bloods relating to HDL/LDL, only HbA1c of 71. I will start testing more frequently after eating and see how it goes. Thank you for pointing out that it will take more than a month to make an improvement.
     
  14. desidiabulum

    desidiabulum · Well-Known Member

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    Hi. If you've had heart surgery then as you know getting BGs down is very important. Late night bean snack sounds like the main culprit and that of course will mean sky-rocketing fasting level in the morning. Trouble is the body easily gets into a routine where it expects to have something at the same time. Any carby thing is best eaten during the day when you can hope to exercise it off. You haven't mentioned what your gliclazide dosage is and when you take it -- this might be worth discussing as one area where you might be able to control the timing of sme of your highs. Good luck!
     
  15. Beelady

    Beelady Type 2 · Active Member

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    Hi! I take the Gliclazade (80mg) first thing in the morning, along with the Sitigliptin (100mg). I also take Ezetimibe (10mg) and Lansoprazole (30mg) at night and two Aspirin (75mg) at lunchtime. I'm only on day two of very low carb eating and I've been given the tip to take BG reading when I eat and then two hours after eating to see how specific food is affecting the BG.
    I know where this bedtime habitual eating comes from. As children we were fed large bowls of 'Boily' (large cubes of very thickly buttered white bread, liberally covered in sugar with hot milk poured over). Their methodology was to put us to bed 'Stuffed' so that we wouldn't wake up in the night feeling hungry. It's just a very bad habit and it needs to stop. It's not easy to break it! I have, this week, managed not to eat the beans. But it's a big battle not to succumb!
    The other issue is that of being forced to stay sitting at the table until you've cleared your plate. Even when you've asked not to be given some food that you really didn't like! My father was quite a bully of a man and we would regularly be thrashed over his knee with his slipper if we didn't conform. I think a large amount of my poor relationship with food can be put down to this.
     
    • Hug Hug x 2
    #15 Beelady, Feb 20, 2021 at 12:51 PM
    Last edited: Feb 20, 2021
  16. desidiabulum

    desidiabulum · Well-Known Member

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    Sorry to hear about your childhood conditioning -- I know how deeply engrained it can become. I well remember being forced to stay sitting at the table until plate had been cleared, no matter how cold and congealed the food became -- but now I can never bring myself not to clear the plate. The odd thing is how in many other cultures you are not meant to clear your plate if you are a guest because it implies that you want more.
    I think the advice on BG readings is spot-on. I would suggest discussing with your doctor whether it might be worth spacing out your gliclazide dosage between morning and evening (or even repeating morning dosage in evening) just to see whether it makes a difference. Timing of dosage can sometimes be as important as amount -- the body ingests in different ways at different points in the day and can vary a lot between individuals (as I'm sure all our T1 friends will confirm). I suspect that stress is behind a lot of your high BGs, but if experimenting with timing and size of dosage (as directed by doctor) can mitigate some of the impact it might be worth a shot. Good luck!
     
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