HB1AC creeping up...

[pinkiepunksmummy]

As the title says, my HB1AC is creeping up despite having good control previously.

I can't tolerate Metformin or Metformin Slow Release, Gliclizade wasn't very effective so was switched to Glimeperide. Dosage was upped, HB1AC has gone up.
Blood pressure and cholesterol are fine.
I am having investigations for Coeliacs and Crohns because I have had diarrhoea for nearly two years and have lost over two stone in the past year without dieting/trying.
I feel that meds are just going through my system far too fast to have any affect. I had a diabetes check this week and got 'told off' by the nurse. I have been seen by the dietician who says my diet is excellent and she doesn't want me to make any changes....I keep a food diary and don't cheat (my step dad and three grandparents died of diabetes related illness, that's enough incentive for me!)

Is the next step a different tablet? Injections? I'm getting fed up of trying hard without much success!

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[Avocado Sevenfold]

HI @pinkiepunksmummy I believe that anything that puts stress on your body can put your hba1c up - two years of diarrhoea must be pretty stressful

Before increasing meds or moving to injections, I would make sure there is no part of your diet that couldn't be tweaked first.

 

[magsiesss]

They would possibly look at upping your Glic ... but as Avocado Sevenfold says, is there anything in your diet that can be tweaked? Exercise?

 

[pinkiepunksmummy]

It's all really tricky....I have to eat some carb at every meal, or I get hypos. Doctors solution to hypos is to eat toast every 2 hours! I think that is madness, so eat varied carbs at each meal, but not more than 100gr a day.
I can't exercise much as I have two failed hernia repairs/complications from that, but do a session of hydrotherapy/aquaerobics once a week and I'm not exactly a coach potato with three kids and three dogs!
I also have severe allergies including food allergies and medicine allergies, so along with the stomach issues i'm finding it hard to juggle everything. A couple more weeks and I get the biopsy and CT results....hopefully then the diarrhoea will be treated.
I'm wondering if it might just be easier to go onto insulin. I'm 39 and been diagnosed for four years, control was good the first year.

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[AndBreathe]

It's all really tricky....I have to eat some carb at every meal, or I get hypos. Doctors solution to hypos is to eat toast every 2 hours! I think that is madness, so eat varied carbs at each meal, but not more than 100gr a day.
I can't exercise much as I have two failed hernia repairs/complications from that, but do a session of hydrotherapy/aquaerobics once a week and I'm not exactly a coach potato with three kids and three dogs!
I also have severe allergies including food allergies and medicine allergies, so along with the stomach issues i'm finding it hard to juggle everything. A couple more weeks and I get the biopsy and CT results....hopefully then the diarrhoea will be treated.
I'm wondering if it might just be easier to go onto insulin. I'm 39 and been diagnosed for four years, control was good the first year.

Sent from the Diabetes Forum App

Hello there.

How long have you been having hypos? I'm sure if you're eating carbs with every meal, and some additional toast, that is likely to be could be one of those tricky things where the solution may be contributing to the problem.

What sort of diet do you have, generally? Could you maybe describe a typical day's eating and drinking? Do you test your bloods at home? If so, what are your levels actually like?

Sorry for asking so many questions, but the additional context is likely to really help us to try to help you.

 

[JenniferG]

What's your diet? How many grams of carbs per day? The carbs you do eat do they come from above ground non-starchy veggies, nuts, legumes and other natural whole foods? Fruits such as berries or large (selectively cross-bread ) fructose bombs of fruit?

I cut the carbs, ditched all refined carbs.. and am losing weight and numbers came down dramatically (A1C of 9 to 11 for four years down to A1C of 5.8 in two months) and now am off 120 units of insulin per day and all oral diabetes medications.

Type 2 diabetes is a dietary disease, and medications are secondary only after particular dietary metabolic needs are addressed first.

I recommend Gary Taubes book "Why We Get Fat".

 

[pinkiepunksmummy]

Thanks for replies.
I am allergic most fruits, though can eat some dried, so have been given permission to include a small amount of dried fruits in my diet!
To clarify, I DO NOT eat the 2 hourly toast doctor recommended.
I cook almost all meals from scratch and try to add in as much veg as possible as I can't eat fruits.
I am allergic to fish and shellfish.
I test my bloods at home, but am told not to do it too often, just 1-2 a week. I test before/after food for a few days to keep an eye on it, then go back to the 1-2 a week. It is always high, 8-9 before breakfast, but this drops to 4 or lower before lunch so I have to have a snack in between, then back up to 8-10 after lunch and Glimepiride 2mg, going up again after supper. Sometimes too low between lunch aand supper as well. Usually 8-9 before bed.
I was having hypos even on the Metformin, although told it was impossible. My doctor says I should be eating more. I haven't taken the nurses advice to drink half a can of coke for a hypo, I've been having a no added sugar muesli bar or small sandwich and a glass of milk.

Okay - foods I eat on a typical day:
Breakfast - 2 x poached eggs, with 1 slice brown toast OR plain porridge with semi-skimmed milk and sprinkle of dried raisins OR 2 slices brown toast & Bovril/Philadelphia.
Lunch - Homemade Chilli (beef & pork mince, onions, tomatoes, tomato puree, carrots, celery, kidney beans, spices) with Rice and salad, homemade tomato salsa
OR Chicken breast, with gluten free pasta in pesto sauce with broccoli, sweetheart cabbage, peas, olives, cherry tomatoes.
OR Ham, lettuce, tomatoes, cucumber, radishes, beetroot, peppers, new potatoes, homemade coleslaw.
Supper - Rice cakes, slice of cheese, olives, cucumber, cherry tomatoes OR small bowl of cereal (Oatibix flakes/Cornflakes/Fruit and Fibre) OR carrot sticks and hummus.
Snack - small box raisins/cucumber chunk/ready salted crisps/handful of nuts/plain air popped popcorn/few strawberries/few cherries.
Treat - couple of squares of dark chocolate/2 rich tea biscuits.
Drinks - Tea with skimmed milk (no sugar) or soda water. Very occasional gin and tonic or bottle of low alcoholic lager.

 

[Jasperville]

Thanks for replies.
I am allergic most fruits, though can eat some dried, so have been given permission to include a small amount of dried fruits in my diet!
To clarify, I DO NOT eat the 2 hourly toast doctor recommended.
I cook almost all meals from scratch and try to add in as much veg as possible as I can't eat fruits.
I am allergic to fish and shellfish.
I test my bloods at home, but am told not to do it too often, just 1-2 a week. I test before/after food for a few days to keep an eye on it, then go back to the 1-2 a week. It is always high, 8-9 before breakfast, but this drops to 4 or lower before lunch so I have to have a snack in between, then back up to 8-10 after lunch and Glimepiride 2mg, going up again after supper. Sometimes too low between lunch aand supper as well. Usually 8-9 before bed.
I was having hypos even on the Metformin, although told it was impossible. My doctor says I should be eating more. I haven't taken the nurses advice to drink half a can of coke for a hypo, I've been having a no added sugar muesli bar or small sandwich and a glass of milk.

Okay - foods I eat on a typical day:
Breakfast - 2 x poached eggs, with 1 slice brown toast OR plain porridge with semi-skimmed milk and sprinkle of dried raisins OR 2 slices brown toast & Bovril/Philadelphia.
Lunch - Homemade Chilli (beef & pork mince, onions, tomatoes, tomato puree, carrots, celery, kidney beans, spices) with Rice and salad, homemade tomato salsa
OR Chicken breast, with gluten free pasta in pesto sauce with broccoli, sweetheart cabbage, peas, olives, cherry tomatoes.
OR Ham, lettuce, tomatoes, cucumber, radishes, beetroot, peppers, new potatoes, homemade coleslaw.
Supper - Rice cakes, slice of cheese, olives, cucumber, cherry tomatoes OR small bowl of cereal (Oatibix flakes/Cornflakes/Fruit and Fibre) OR carrot sticks and hummus.
Snack - small box raisins/cucumber chunk/ready salted crisps/handful of nuts/plain air popped popcorn/few strawberries/few cherries.
Treat - couple of squares of dark chocolate/2 rich tea biscuits.
Drinks - Tea with skimmed milk (no sugar) or soda water. Very occasional gin and tonic or bottle of low alcoholic lager.

Hi,

I think you may be miscalculating your carbs..............although you list a lot of alternatives, Toast/porridge/kidney beans/rice/new potatoes/cereal will all raise your BG significantly..................you could be closer to 150-200g per day? Then it is possible you have reactive hypos after going too high?

I know it is difficult, but if you could get down to perhaps 50 grams of carbs per day, i suspect your Hba1c would improve, and perhaps your bowel problems as well. If you can do this, you might be able to ditch the meds.................I was going down to low 4's before evening meals when on Gliclazide, but I have stopped this, so no risk of hypos now. Average BG has gone up a bit, so trying to be more strict with my carbs.