Have I missed something about blood glucose control for type 2 diabetes?

Royjk

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Insulin
So, after 5 weeks of intensive interest in type 2 diabetes, I have read lots and have been doing my medications. I started a low carb diet, cutting out all of the food that I enjoy, and I started taking a SGLT2 inhibitor, two things that reduce sugar in my blood. Also I started basal and bosul insulin which I have gradually increased on the advice of my doctor over the five weeks. But dispite the reductions in the original test results, I still am unable to reach a finger blood test that is within the control limits for 2 hours after eating. Don't misunderstand me I am closer than five weeks ago, but I cannot reach the target written in my diabetes diary.
So my question is what am I missing, what can I do next?
There's not a lot more I can cut from my low carb diet, I am not sure if taking more SGLT2 is a good idea, and I dont really want to increase insulin too far, but I will admit to not knowing how much is too much.
Royjk
 

MG426

Member
Messages
14
Type of diabetes
Type 2
Treatment type
Tablets (oral)
For me...walking after eating is the most helpful thing that I do...30 to 40 minutes makes a very noticeable differance in my After meal readings...
 
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KennyA

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3,648
Type of diabetes
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Diet only
Nobody should be advising you to alter your medication without getting your doctor's agreement in advance. So really, what we can help with is more about the food you're taking in.

It might help if you could give a typical day's eating - everyuthing, including things like cups of tea - or better, several days. Are you keeping a food diary to set alongside your testing?
 
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Royjk

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Insulin
Hello @KennyA ,

Yes, that sounds like a good idea. I have tried to stick too a similar eating habit over the past five weeks.
Mostly,
Breakfast, mint tea, bacon, egg, tomatoes
Lunch, chicken or fish, boiled brussels, leak, broccoli, small carrot,
Evening meal, ham, boiled egg, celery, red pepper, cherry tomatoes, small pickled gherkin.
Snacks, raw carrot, boiled egg, kohlrabi, celery, nuts.

I also eat now from a smaller plate.

Royjk
 
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Royjk

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Insulin
Hello @MG426

Yes, I would love to go for a walk after eating, however that is just a bit difficault at the moment.
Royjk
 

Marikev

Well-Known Member
Messages
61
Type of diabetes
Type 1
Treatment type
Insulin
Couple of random thoughts, that may help, are you drinking enough fluids? Preferably water.
Alternately if you are taking drinks of fruit juice, or sugary squash or fizzy pop…they will up your levels big time.
Some form of exercise or movement will put your levels down. I understand post meal walks are out. The ‘Type 1 talks’ guy, uses a regime of flexing his calf muscles if he needs to sit still at a desk for a while.
That diet looks very low carb to me. As you say not much further you can take down the carb count.
not type 2 myself but I wonder if your liver is playing a part here and dumping some sugar in your system for you! Trying to ‘help’! Maybe a type 2 expert can comment.
Another thought..you have cut out all the food that you enjoy? That’s just miserable! Hope you find a way of adding at least a few things you like.
 

Resurgam

Master
Messages
10,035
Type of diabetes
Treatment type
Diet only
@Royjk have you noticed your waist shrinking?
For some people going low carb gives their liver the chance to kick out glucose, which could be quite a long process for it to get back to normal.
I lost 12 inches off my waist in the months following diagnosis.
 

Royjk

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Insulin
Hello @Marikev

Thanks for your suggestions.

I live on the edge of the city, so there are 5 supermarkets within easy shopping distance, all of them have low carb offers, but I don't really fancy most of them. So buying the right fresh food is not difficult here. I often shop in the morning as it gets me out of my armchair and have a breath of fresh air.

I do drink a lot of water, and tea, and in finding a substitute for beer and soft drinks, I turned to a glass of dry red French wine in the evenings. All soda's went out of the window along with the sugar in my tea.

I would really like to do some walking after eating, that is possible but in reality just a bit difficult. I miss exercise, but hey in life you can't always have everything you want.

Yes I have cut out a lot of foods that I enjoy, but as the Fung diabetes code book said, 'a person must reduce the sugar going in to lower blood sugar levels'

I recently made the drastic decisions about reducing carb input, there are no regrets. I must just stop them from creeping back into my diet again. However the low carb, insulin and tablet still does not seem to be the full answer, there must still be something more.

I looked briefly at the liver making extra glucose idea, but if that is the case then I fear I will not be able to reach my goals in regard to blood sugar control. That seems to mean that my body wants to run on higher than what my diabetes diary calls the normal levels. I will investigate this, perhaps I need to adjust my target range.

So thanks for the thoughts and good luck with your Libra 3. Even though I know it can be harsh living in the north, I'll bet the photos of your island must be pretty.
Royjk
 
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Royjk

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Insulin
Hello @Resurgam

Strange that you should ask, but although my weight is still approximatly the same, my waistline looks as if it has changed.
I will look into this liver and glucose thing a little closer. Thank you.
Royjk
 

Resurgam

Master
Messages
10,035
Type of diabetes
Treatment type
Diet only
Hello @Resurgam

Strange that you should ask, but although my weight is still approximatly the same, my waistline looks as if it has changed.
I will look into this liver and glucose thing a little closer. Thank you.
Royjk
My pleasure - you might notice that bending over is getting a bit easier too - all part of the same process.
The floor used to seem further off than it does now.
 

Royjk

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Insulin
Hello @Resurgam,

Ah well, the floor is just as far away, however my feet have been within reach over the past two weeks. That is somethng that was has been a problem for the past 10 years. I used to wonder how to check my feet for diabetic problems, and now it is not such a big problem to look. Yes I do hope that I will lose a few Kg but it is only five weeks so far.
The thing is that with this second diabetes diagnosis I think I know what the consiquences are. So it is important for me to take it seriously, that is why I am looking for getting my blood sugar in order as a first action.
Royjk
 

Royjk

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Insulin
Hello @MrsA2,

Well I do have some other meds, some things like blood thinners, iron and calcium, something for cholesterol. Main medication is prednisone and mestinon, which I have been doing for the past 4 years. But these are only small tablets, they are more to do with immune system than diabetes. They just make me a little fat around the face.
Cutting them out is also not an option.
Royjk
 
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EllieM

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Main medication is prednisone and mestinon, which I have been doing for the past 4 years.
My understanding is that prednisone is a steroid that can cause steroid induced diabetes, so it may be contributing to your T2 issues

If you need it you need it, but it may explain why low carb is insufficient to cope with your diabetes....???

Here are a couple of threads by steroid insuced diabetics, which may (or may not) be of interest



If you use the search function at the top right of the page there are quite a few more threads by steroid induced diabetics.
 
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Royjk

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Insulin
Hello @EllieM,

Well that is a lot to unwrap.
Yes, and it is quite interesting and informative. I know that steroids affect diabetes, in that my neurologist originally sent me to the diabetic clinic four years ago because of the high doses steroids. But then I only did the metformin tablets, and that was diabetes type 2.
I will search out more of these stories, because they appear to point to some of the other things that need to be taken into concideration. Perhaps it is not possible to meet the general targets indicated for the blood tests, and I should just be satisfied that the numbers are now better than they were five weeks ago.
Thank you very much.
Royjk
 

NKIqbal1994

Member
Messages
6
Type of diabetes
Type 1
Treatment type
Insulin
Just as @EllieM said the prednisone is probably the main reason why you're having a tough time bringing the blood glucose levels to normal range. Steroids unfortunately makes it harder for the body to absorb insulin. I had to be put on prednisone 40mg daily for about a week and I remember I had to take extra units of both my basal and bolus insulin to try and keep my blood glucose levels in the normal range because the prednisone was spiking my blood glucose levels.

Speak to your doctors and see if that's the reason why you're having trouble and if it is the reason, then ask them what you should do. You can also ask the doctor in charge of prescribing you medicine for your immune system (prednisone tablets) if they have an alternative that you can take, which won't have an affect on your diabetes.
 

Royjk

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Insulin
Hello @NKIqbal1994,
Yes it could be the prednisone, and if it is perhaps I would need to increase my insulin units, as it may be more important to have BG at a lower level. I will consider asking the doctor about changing from the steroid, but some of the alternatives are plasmapheresis, and IVIg neither of which are particularly pleasant.
Thank you.
Royjk
 

NKIqbal1994

Member
Messages
6
Type of diabetes
Type 1
Treatment type
Insulin
All the best and hopefully the doctors can come up with a suitable treatment plan to keep your blood glucose levels in normal range and not have any side effects on your other conditions.
 
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