Have I cut the carbs too much, too soon?

[Signs]

Since I started on glicklazide 5 weeks ago I've gained 5lbs - that doesn't please me! The upside is that my BGs are so much better.

Last week I was very careful with the carbs I eat, not counting just cutting out the obvious stuff but still put on a pound. This week I decided I wanted to shed the extra pounds so starting this morning I've been counting the carbs aiming for around 60 a day.

My BGs and carbs intake today has been;-
0700 7.1
0730 Took 80mg Glicklazide
0800 Breakfast 1 slice burgen with scrape butter (Usual brekkie)
1045 BG 7.6
1300 BG 6.1
1330 Lunch 2 lamb burgers with 2 slices burgen

40 gram carbs so far leaving me 20 for dinner and supper.

1830 arrived home feeling the start of a hypo - BG 3.5
Had 4 lucozade sweets & then dinner (Fish, no breadcrumbs, dipped in egg and fried)
Was still feeling shaky so had a kiwi fruit for desert
1930 BG 6.6
2100 7.5

I was meant to take another glicklazide before dinner but gave it a miss the but had it at 1930.
I'm thinking maybe I should have missed it altogether?

Did I have too few carbs or did I cut the carbs too quickly?

Confused here, I want to cut carbs to control BGs & lose the extra pounds but certainly don't want another hypo.
Any advice appreciated.

Cheers, John

 

[xyzzy]

Hi John

I would say you have two options. Glicklazide can and does produce hypos because it is an insulin stimulating drug so simplistically if it makes your pancreas send out more insulin than is needed to be processed a hypo condition can arise so you do need to be careful. It is a bit more complex than that but lets not worry too much about the finer details as avoiding hypos is the serious thing.

In my opinion you should either up your carbs so that the amount "matches" the power of the glicklazide or you could reduce the glicklazide dosage but of course before doing that you should speak with your gp and explain you have been reducing carbs and take his advise.

Really it comes down to your personal preference of the balance you want between diet and meds. You do need to get that balance right however!

 

[Signs]

Thanks for that. No probs with low carb diet and it does seem to help BGs but I don't want to put weight on. Seeing the DN next Thursday so will discuss it with her. She had suggested at my last visit swapping the evening glicklazide for metmorfin.

Cheers, John

 

[Signs]

Had another hypo yesterday (3.1) and one on Wednesday (3.3). Both around 4pm. My readings before lunch at 1230 were 6.2 & 6.1. The one previous to that was on Monday. Can't belive how quick it drops or how bad it feels. That's 3 in 4 days - gave my wife a real scare yesterday! Try not to complain too much to her and hadn't told her about others. Got a real rollicking . . .
Also don't understand why it drops at that time when I've had my gliclazide about 8 hours previous and have had breakfast and lunch. Only about 40mg of carbs there though? I suppose in a perverse kind of way I've proved to myself that low carbs help reduce BGs?

My DN is on hols until middle of next week - got a regular appointment with her on Thursday. I could get an emergency appointment with a doc if I sat in the surgery for 4 hours. Even then the chances are I'll get the junior who I have very little faith in.

I don't want to stop the low carb eating now I've started or up my carbs to match the meds so today I've decided to have half a tab - 40mg - this morning and the other half before dinner tonight. (DN did suggest on my last visit about substituting one of the gliclazide with metmorfin.)

I know that ultimately it's my decision and no-one is keen to give medical advise (rightly so) but is there any reason why I shouldn't do this until I see DN?

Cheers, John

 

[MaryJ]

Hi signs

What you are suggesting seems to make perfect sense to me but I'm diet only controlled so don't suffer hypos or juggling meds

Mary x

 

[Unbeliever]

I was neer on glic but was on glimepiride. I had been on it for 3 years , quite a high dose. When I started taking j januvia and low carbing I was told by the hospital I should be avble to cut tthe glimepiride {same sort of thing as glic} gradually.

I had to cut it it very quickly as i was having hypos several times a day. Had I waited to see the nurse in my practice I would have been very ill I think.

When I had my HBAic - the only time a GP will talk to you about diabetes in my practice} they totally agreed with me.

If you are havning hypos after lowcarbing then you are over medicated. Of course noone can officially give you medical advice but I know you will find that they would be more concerned wih your having hypos than lowering the medication.
You may get someone who tells you that you should eat more carbs but you have to ry to avaoid getting into the "meds make you put on weight which raises your levels so you have to have more meds " etc

I would not tell them that you are low carbing because they may not understand what you mean, Just say you are being careful with your diet and reducing starchy carbs.

I dont think it would be a good idea to eat more carbs han you want just o accommodate the medication. It is often difficult to get he dosage righ in the beginning. You may need to increase it again in the future when you have worked ou a sustainable diet for yourself but I doubt if you will get much help with this from the HCPs who are bound by NHS guidelines.

I was told to eat more carbs because of the effects of metformin , This I got into that spiral with other drugs which have caused complicaions.

Changing to tjhe metformin sounds like an excellent idea. That will give you a bit of help should you need it without causing hypos.
Obviously your nurse was just doing what everyone has to dio in the beginning, just try various doses to see how they work.

I have had exercise-induced hypos and found that they were far less unpleasant than the medication induced s You dont want many of those!

The only point of taking the glic is to increase the insulin production so if you dont need it dont take i. That doesnt apply to all medication but seems to make sense in these circumstances.

 

[Signs]

Thanks for the input there guys. I would have been happier talking to my DN first but there's so much knowledge on here it's just as good. Going down to half a tab twice a day until I see DN.

Weird (to me anyway) but my BGs now - 6.1 - just before lunch is the same as they've been last couple of weeks on 80mg gliclazide. Added to that I had an extra slice of toast this morning. Will check a couple of hours after lunch and make sure below 8.5 (or 7.8?) and hopefully below 7 before dinner. Having eggs for lunch and perhaps some strawberries so less than 20g carbs. Will probably end up over my 60g limit today but was very hungry this morning.

Judging by what I read on here I may be one of the lucky ones in that my DN is very helpful and willing to help. When I told her I intended to low carb she said OK, we'll need to keep an eye on BGs and gave me more strips. Said she was happy that I was taking responsiblity for my diabetes (Her words, not mine).

Put on almost 7lbs since I started meds, just hoping I can get rid of it as quick.

Cheers, John

 

[Unbeliever]

You are definitely very lucky with your Dn John. That helps so much! I found that the weight just dropped off once i reduced the meds which had caused it. A little extra exercise can kickstart it!

 

[mistee71]

With the meds i was on i too put on loads of weight and coz of the sickness i could move to much either. Since stopping the list of meds in signature bit, i dont feel sick anymore so once sugar levels are stable i will be back out being active.

It might be a case of out of the frying pan and into the fire by going on insulin thiough.

 

[Signs]

Oh boy. 2 hours after lunch yesterday I was at 5.1. Out for the afternoon, feeling ******, tested at 5pm and was at 3.5. Had some lucozade sweets and a couple of biscuits. At 6.30 I'm back at 5.9

Took my other half (40mg) gliclazide and dinner at 7pm. At 10pm I'm back down to 4.1.

Half a bottle of lucozade and a sandwich, 2 hours later at midnight it's 5.6.

Seems to my layman thinking that with gliclazide I'm now producing too much insulin?

Morning reading was 6.1 at 8am.

Late brekkie at 10am and midday BG was 7.5

I've decided not to take any gliclazide today, stick with low carb and see how it goes. Obviously if BG start creeping up I'll start again. Seeing DN on Thursday so only a few days.

Is it possible that the the low carb diet (between 60 and 80 grams a day) could result in much lower BGs and eliminate the need for gliclazide? If yes, I guess that increased carbs will mean need to take gliclazide again?

Also read somewhere (Can't find link) that the pancreas can "wake up" and start working more efficiently after a few weeks on meds? Sounds unlikely to me but I know nothing!

Cheers, John

 

[Unbeliever]

Exactly right. The low carbs could mean you no longer need the gliciazide and part of itthe reason could be that your pancreas has been kickstarted .
Just a word of caution you dont want to throw the baby out with the bathwater and have your levels rising. You have to learn to balance the meds wen you eat and exercise. Not so easy.

I
Thats why I said you needed to find a sustainable level of carbs for you to fit into your lifestyle. I don't nwow what you did when you went out bu tperhaps it involved more waliking han ussual? That would account for your levels going down.
It may be that you will be able to cut the glic down or do without it altogether but if you can't sustain your precsent diet
then you might have to readjust later.Its best to take it all gradually although it is very satisfactory to see a quick result..

It is good that you have a sensible DN because it is hard to advise patients on this class of drugs but she will, I am sure be able to give you the correct advice.

 

[Signs]

This last week I seem to have got it right, at last.

No glicklazide, just low carb. You guys were right about the low carb. I'm a total convert. My DN is happy but not convinced? She reckons it's the glicklazide that has kick started the pancreas however I had a traditonal Sunday roast beef beef dinner with the goodies (Purely for research purposes!) and Monday I was a couple of points higher all day. Maybe we're both right. Who knows. I for one don't care as long as it works.

Keeping carbs between 60 -80 my morning reading is around 6 - 6.5, then runs about 5. Readings 2 hours after food in the 7s. I'm happy with that. Was running low towards mid afternoon so have started having a few more carbs arround lunchtime. Huge benefit is losing 3lb of the weight I'd put on. I won't say I don't miss all the "healthy" foods I ate before but needs must.

I hope to get back to the gym soon so will have to work out how to balance carb intake with exercise. There's so many at the gym who tell me loads of ****!

DN has agreed that I no longer need glicklazide and has started me on metformin since Thursday. No ill effects so far. Still working on BP, now on 8mg perindropil. DN tells me I'll be starting a statin in a few weeks time which seems to be standard for choelestrol over 4? Mines at 4.5. Need to research that.

Cheers, John

 

[borofergie]

Well done John! You're doing brilliantly!

I won't say I don't miss all the "healthy" foods I ate before but needs must.

Forget about them. Think of all the "unhealthy" things you can eat in their place (and especially all that cream you can now eat).

I hope to get back to the gym soon so will have to work out how to balance carb intake with exercise. There's so many at the gym who tell me loads of ****!

Yes. A little bit of knowledge is a dangerous thing, most of what you hear in the gym is absolute rubbish. Having said that, there are some members of the body building community that seem to know more about nutrition than the whole of the NHS put together (which isn't that difficult).

My only advice is not to expect miracles in the first few weeks. When I first started I ran two of my slowest ever 5k times and felt rubbish. Since then I've managed to run faster every week, including (I hope) 4 consecutive PBs, knocking nearly 2 minutes off my time.

In the last 2 weeks I've tried eating a small carby snack (20g of carb) just before I race, to aid recovery, and to try and prevent a huge liver dump. It worked last week, but not this, as my BG was @ 11mmol/l after the race :shock: , although it soon dropped down to 5mmol/l.

You just have to test and see, test and see, test and see.

 

[Grazer]

Got to say signs, I think you're balancing the equation just right. This illness is a choice between meds and diet for a lot of people - sadly not all. There are many that have come off the stronger meds on the back of a good diet and exercise. That's where you're going, so well done.

 

[xyzzy]

Well done Signs. At that 60 - 80 you are doing roughly the same as me. I found after a few weeks you don't miss those "healthy" foods at all so hopefully it will be the same for you. Once you get to that point people start to think you're quite strange and do a "does not compute" look when you tell them you don't care about losing them from your diet.