Hba1c of 103

[hoolyuk]

Hello all,

Shocking HBA1C at my last test has finally spurred me to count my carbs....it has been building since i stopped smoking in feb 2016 with reading of 54, 65, 75 and now this. GP has kept me on 2000mg of metformin and 100mg of januvia and made me an appointment to see the Endocrinologist, but with a reading like that am thinking i might need insulin, even as a temporary measure.

My query is that despite restricting my carb intake to under 300g in total per day [which is low compared to what i had been shovelling in] i am not seeing any great improvement on my monitor, 6.9 is the lowest reading i've had in a fortnight, with readings between 11 and 13...2 hours after eating. Should i not be seeing a drop on monitor readings by now or is that my meds have stopped working [on metformin 8 years now] and insulin is the only way i can get back to a normal reading?

 

[lowedb]

You might still be too high on carbs. The reason I say this, I was at HbA1c 90 when diagnosed, but down to 46 within 4 months. I'm taking 2x500mg Metformin and 40mg Gliclazide per day. I don't count carbs, just make efforts to avoid the worst ones. I reckon I'm on around 50-60 per day.

 

[hoolyuk]

Struggling a bit to balance diet between carbs and calories as i need to lose about 3 stone and unfortunately anything that i like with few carbs tends to be packed with calories.....had expected to be put onto gliclazide this time and was surprised when GP left things as they were...an added complication is that i hold an HGV licence so was relieved he gave me a chance to get things down with diet and exercise, but the fact that my readings are still high after a fortnight of dieting cant be a good sign.

Had kept half-decent control until i quit smoking, then diet just went off the rails but only displayed mild symptoms in past few months ie peeing every 3 hours which didnt overly concern me, as was peeing every hour on the hour, with a raging thirst, prior to my original diagnosis, when my hba1c was round the 10 mark in old money...think this one translates as 11.5

 

[Art Of Flowers]

The rules for low carb are quite simple. Avoid breakfast cereals, bread, potatoes, rice, pasta, fruit juice, fizzy drinks. Best to avoid most fruits, especially bananas as they are high in sugar. Porridge can spike some people's blood sugar.

You can eat more fat e.g. Cheese, full fat yoghurt, cream, butter, nuts, avocados. See dietdoctor.com for some recipe ideas.

If you measure before eating and two hours after you will see if the food you are eating is causing blood sugars to rise.

If you are on insulin it may impact your driving licence as there are risks of hypos.

 

[Engineer88]

Struggling a bit to balance diet between carbs and calories as i need to lose about 3 stone and unfortunately anything that i like with few carbs tends to be packed with calories.....had expected to be put onto gliclazide this time and was surprised when GP left things as they were...an added complication is that i hold an HGV licence so was relieved he gave me a chance to get things down with diet and exercise, but the fact that my readings are still high after a fortnight of dieting cant be a good sign.

Had kept half-decent control until i quit smoking, then diet just went off the rails but only displayed mild symptoms in past few months ie peeing every 3 hours which didnt overly concern me, as was peeing every hour on the hour, with a raging thirst, prior to my original diagnosis, when my hba1c was round the 10 mark in old money...think this one translates as 11.5

You mught want to look at LCHF if you also need to loose weight. I don't think I could possibly eat 300g of carbs in a day that's huge still.

 

[Resurgam]

I might eat 300gm of carb in a week, and that gives me normal numbers - but I can't hold out any hope of lower blood glucose levels for you at present, unless you are training for a marathon, perhaps.
If you are type 2 you might need large amounts of insulin, and could put on weight easily and quickly.

 

[bulkbiker]

You are still consuming an enormous amount of carbs... what are you eating?
Sounds like you are trying to avoid fat?

balance diet between carbs and calories

If you really want to give LCHF a go try to cut out all carbs and forget about calories..
I did that and lost 6 stone effortlessly.. now I have to monitor things a bit more to loose but at the beginning it was simple.
Ok I was starting from 23 stone so any major adjustment in diet may have helped but by cutting carbs I was never hungry and loosing consistently.
Stick to meat, fish, eggs, green veg, salad, cheese, butter and cream.
Pork scratchings for snacks although you shouldn't really need them)
The higher fat content of food fills you up and the carbs won't be stored as fat because you won't be eating many.
It does almost feel like magic and intuitively you feel like it shouldn't work but it does...
it may seem like a leap of faith but to be honest what have you got to loose (apart from weight) give it a couple of months and see how you go.

 

[hoolyuk]

Is it total carbs i should be counting or the "of which sugars" carbs? maybe i've been counting wrongly....my diet has always been carb heavy but i've had diabetes for 8 years now and had fair control up until 6 months ago...i cut out the obvious sugars once diagnosed but just hit the chocolates and crisps too hard since quitting smoking.

Have been testing a lot lately and one example i can give is that 2 weetabix with 100ml of semi skimmed milk gave me a lower reading after 2 hours than I started with...9.4...2 hours later 8...that has happened a few times, so doesnt seem to be any rhyme or reason to my readings other than they are all far too high.

 

[Engineer88]

Is it total carbs i should be counting or the "of which sugars" carbs? maybe i've been counting wrongly....my diet has always been carb heavy but i've had diabetes for 8 years now and had fair control up until 6 months ago...i cut out the obvious sugars once diagnosed but just hit the chocolates and crisps too hard since quitting smoking.

Have been testing a lot lately and one example i can give is that 2 weetabix with 100ml of semi skimmed milk gave me a lower reading after 2 hours than I started with...9.4...2 hours later 8...that has happened a few times, so doesnt seem to be any rhyme or reason to my readings other than they are all far too high.

No you should count total carbs.
the more carbs you eat the more resistant to insulin you'll become and gain more weight. You may as well start on insulin if your going to continue as you are but you'll be injecting massive doses. I've been diabetic 27 years and haven't ever eaten over 100g a day (that's when I have pizza or curry)

 

[bulkbiker]

Is it total carbs i should be counting or the "of which sugars" carbs? maybe i've been counting wrongly....my diet has always been carb heavy but i've had diabetes for 8 years now and had fair control up until 6 months ago...i cut out the obvious sugars once diagnosed but just hit the chocolates and crisps too hard since quitting smoking.

Have been testing a lot lately and one example i can give is that 2 weetabix with 100ml of semi skimmed milk gave me a lower reading after 2 hours than I started with...9.4...2 hours later 8...that has happened a few times, so doesnt seem to be any rhyme or reason to my readings other than they are all far too high.

Look at total and I try not to buy anything with more than 5g of carb per 100g.
but if you eat what was on my list above you won't go far wrong..
Far better to have bacon and eggs for breakfast than any cereal .. although I skip breakfast altogether.

 

[Resurgam]

Total carbs minus fibre if you are in the USA, the net carbs are shown on the back of packaging in the UK.
My personal limit is 10 percent, but I don't eat large amounts. I have even been trying fasting recently.
It can sometimes seem unfair that a diabetic can't eat all that is on offer, but I really do very well on what I can eat.

 

[Bluetit1802]

The normal recommended daily amount of carbs is 260g. so you are eating more than a healthy non-diabetic should be eating as part of a healthy diet. 300g is far too many.

It is carbs that get stored as fat. Dietary fat will not make you fat PROVIDING yo cut your carbs.

If you cut your carbs down to around 50g a day you will see a miraculous improvement in your glucose levels and will also lose weight. If you do this you will have to increase your fats to make up for lost energy. How much you increase your fats is up to you, but it needs to be enough to stop you being hungry and to keep your energy levels up. What could be better than a bacon and egg breakfast with mushrooms and a tomato?

 

[JRTwalker]

Like Resurgam says - I won't consume 300g of Carbs in a week. It's a big change to rule out carbs from your diet but I don't consider what I'm losing out on, only what I will gain.
My Achilles heel was potatoes, rice, fruit and fruit juice. A few berries and the odd Kiwi fruit are still in there but the rest are now in Room 101.

 

[kokhongw]

My query is that despite restricting my carb intake to under 300g in total per day [which is low compared to what i had been shovelling in] i am not seeing any great improvement on my monitor, 6.9 is the lowest reading i've had in a fortnight, with readings between 11 and 13...2 hours after eating. Should i not be seeing a drop on monitor readings by now or is that my meds have stopped working [on metformin 8 years now] and insulin is the only way i can get back to a normal reading?

Given that T2D will fail a Oral Glucose test of 75g glucose...a 300g carbs per day means you have 4 meals worth of glucose that will exceed your body capacity to clear.

And what are the conventional way for the body clear the glucose?
1. Burn it off thru exercise
2. Use medication (metformin/sulfonylureas) /insulin to improve insulin sensitivity and force it into any available fat cells.
3. Use medication to expel it from the kidney by lower the threshold for glucose (SGLT2 inhibitor)

Alternatively, you can eat less than 50g carbs per meal. 2-3 meals per day and start to see some improvements.
Replace your carbs with proteins and fats.
You may even want to consider intermittent fasting, eg skipping dinner to lower it even further.
Check out the low carb program offered on this site.

All the best.

 

[Nicksu]

I try to keep under 100 a day (or lower if possible). Makes a huge difference. Basically avoid bread, potatoes, sugar. Re vegetable carbs - anything that grows below ground is to be avoided if at all possible. Make your carbs the leafy green kind if you can. Avoid anything that says low fat as the carbs will increase proportionally. And walk walk walk! Good exercise, good for the heart and good for bringing BS levels down. It won't happen immediately but it will improve with continued application.

Good luck!

PS. Walnuts increase insulin sensitivity.

 

[hoolyuk]

Have been keeping a food diary and perhaps my 300 carbs claim was a bit high...i had 226 yesterday and 148 the previous day still too high i know, but a major improvement for me, am eating about 1/4 of what i was 2 weeks ago so am bound to see an improvement soon...will give it another week to see if readings come down as have dug out my exercise bike too, if not then will try to eliminate carbs altogether.

Thank you all for the advice, had resigned myself to being on insulin but hopefully i can avoid it yet.

 

[Bluetit1802]

Have been keeping a food diary and perhaps my 300 carbs claim was a bit high...i had 226 yesterday and 148 the previous day still too high i know, but a major improvement for me, am eating about 1/4 of what i was 2 weeks ago so am bound to see an improvement soon...will give it another week to see if readings come down as have dug out my exercise bike too, if not then will try to eliminate carbs altogether.

Thank you all for the advice, had resigned myself to being on insulin but hopefully i can avoid it yet.

Good start, and sometimes it is best to reduce them gradually to avoid upsetting your system too much. I reduced mine gradually and escaped the carb flu symptoms others seem to get.

 

[hoolyuk]

Finally got my carbs to under 100 yesterday..95..have seen a dramatic drop in blood sugar averages since I started seriously carb counting on Friday, so it seems to be working ok for me.

Have read in several places that strawberries are ok for T2's so having had a few small portions and seeing an actual drop in 2 hour PP...I decided to have slightly more than usual last night...150g or 13 carbs max...my sugars spiked to 13.2....should a snack consisting of so few carbs have spiked me so dramatically or have I missed something?

 

[Resurgam]

Finally got my carbs to under 100 yesterday..95..have seen a dramatic drop in blood sugar averages since I started seriously carb counting on Friday, so it seems to be working ok for me.

Have read in several places that strawberries are ok for T2's so having had a few small portions and seeing an actual drop in 2 hour PP...I decided to have slightly more than usual last night...150g or 13 carbs max...my sugars spiked to 13.2....should a snack consisting of so few carbs have spiked me so dramatically or have I missed something?

If you are eating the strawberries by themselves, yes, easily reaching 13.2. I always have cream with mine, and usually eat later in the day, and I know I should not eat a large portion. That last part doesn't always happen, but at least the spikes are just that, not long lasting.
After some weeks or months of low carbing you could well find that your response is reduced, but it is not an overnight alteration, is comes in gradually and can be set back by over indulging in such things as strawberries and grapes - my meter told me so quite plainly.

 

[Bluetit1802]

Finally got my carbs to under 100 yesterday..95..have seen a dramatic drop in blood sugar averages since I started seriously carb counting on Friday, so it seems to be working ok for me.

Have read in several places that strawberries are ok for T2's so having had a few small portions and seeing an actual drop in 2 hour PP...I decided to have slightly more than usual last night...150g or 13 carbs max...my sugars spiked to 13.2....should a snack consisting of so few carbs have spiked me so dramatically or have I missed something?

It is all down to portion size and the full contents of the meal/snack. Also what has been eaten within the 3 hours or so before, the time of day, and the starting level. Sometimes there is absolutely no rhyme or reason for it. Same meal, same time, same circumstances - different rises.

When I eat strawberries or raspberries I have to restrict the numbers. I don't weight them but I count them. 3 strawberries is my max, or 6 to 7 raspberries, but I always eat them as part of a bigger meal and always with cream, and these days always after evening meal. I used to have them for breakfast with yogurt, but had to stop that.