HBA1C

Dennis-

Type 2 is not just insulin resistance- it also has post prandial hyperglucugonaemia which contributes to hyperglycaemia. Also, type 2 has 3 times the normal rate of liver gluconeogenesis. All these abnormalities are modified by exenatide/sitagliptin drugs. That is why these new drugs are so exciting to me.

Animal studies are suggesting these GLP drugs also stop progression of pre-diabetes. Both sitagliptin and exenatide are assocaiated with increasing the numbers of beta islet cells. All good news- timw will tell.

Marty B

As fergusc rightly points out, reducing carbs is the only way to go. A piece of toast could have 20+ carbs, and a small bowl of cereal with milk can have 30+ carbs. I find it more manageable to aim for 12 carbs a meal, and inject small dosages (1-3 units) frequently before meals or to adjust elevated blood sugar.

And it is negligent for the ADA to say 7% is acceptable, I was told normal is between 4.7 - 5.2% and with every little decimal percentage point increase, you are also increasing the risks of complications. And as for the food pyramid, don't even get me started on that one!

I feel for Jojo but you can get around it by boiling some eggs for the morning, bring along some cheese and nuts or munch on slices of ham. I get around eating pizza by eating the topping only!

The other thing is that it's mainly carbs that put on the pounds and you will probably find you are eating more (and better), and not putting on weight.

Sadly (for now hopefully), Diabetes isn't something you can take a break from. The way I see it is that I want to be around healthy and well for my family for as long as possible, and that is the thing that keeps me going after being diabetic for 30+ years.

Hi Marty,

Thanks for making that point - as you rightly say Type 2s have more than just insulin resistance to worry about. My belief is that the primary problem is the insulin resistance, because without that we wouldn't be diabetic and therefore wouldn't have the additional problem of a hyperactive liver! What a lot of the studies into low carb regimes seem to be finding is that if you can maintain a balanced but low level of carbohydrate intake (i.e. much lower than official guidelines) then this also has the effect of reducing gluconeogenesis.

How this works in practice I haven't managed to work out because the presence of insulin inhibits gluconeogenesis, but you would expect a low carb diet to result in less insulin being generated. Beats me.

fergus, I was just interested to hear your thoughts as you said that you nromally run between 3-5.5 and also said you have no hypos, was just trying to match that up in my head. For me I still go with the below 4.0 it's a hypo, I do not get warning signs in the 3.0-3.9 range most of the time either. looking to work on that.

My target A1c is between 5.2-5.8%

chocoholic- I haven't really been in your situation as I do eat those sweet things, not as much as before, but I still eat them when i want, and actually don't have problems with bolusing for them. I would go insane if I couldn't.

I think that low carb works for alot of people, but for others like me there are other ways that do work. i eat a reasonable amount of carbs, ad the % of carbs in my diet is quite high, but I can maintain a good A1c- 5.4%

Hi Sofaraway,

Something I have seen a number of people mention is the different levels at which they seem to suffer hypos. There seems to be a trend that if your body has become accustomed to a high BS level then hypo symptoms can occur when the level drops to what would for non-diabetics be normal (i.e. somewhere around 5). Maybe it works the other way where if your highest level is 5 then a hypo wouldn't occur unless under 3?

Wow..interesting thread.
Jo-Jo, you have mentioned what you eat,, just wondered what your pre/post meal blood tests were? This would give you a clue as to what was going wrong. I am guessing that they are always quite high, and if this is the case, if you do not want to change your diet....and I hate being hungry, so can appreciate why this isn't a great option then you need more insulin. To make adjustments though, you need lots of bg reading to base them on. Don't give up though...it can be done, and it is so so worth it.

Hi Fergus and welcome. I am really impressed with your levels! Can I ask a nosy question? I had a HBA1C of 5.8 recently...after years and years of trying to be better controlled. I honestly sat in the Dr's office and waited for the congratulations...and got, "We think you are running too low" in response. I was a bit gutted!

Sofaraway, I lost sensation of hypos, and itw as becaasue my body was used to having low blood sugars. (Obviously...my simple explanation, and not teh detailed medical one!) My consultant said that they were not happy for me to drive if my blood sugar was below 4.0, and I was advised to let myself run a little bit higher until I got the sensations back. Now, I do test my blood before getting in the car, but my consulatant is still not happy. The problem is, I was having hypos, they came on very quickly, and were dibiltating. I think in your case, if this is not the case...take care before you drive, but if it isn't broke...don't fix it! My latest HBA1C was 6.7...and guess what? Now it's too high!
Fergus, I hope you stick around the forum, I am 6 months pregnant a the moment, so I am not going to change anything diabeteswise at teh moment, but when junior is here, I am going to try reducing my carbs...and would really apprecaiste being able to ask for a few pointers,
Good luck all,
Jill

Hi Jill,

I know exactly how you feel! When my consultant gave me my 4.6% score, it was accompanied by a deep sigh and a dismayed shake of the head. I honestly thought it was going to be really bad news. He thinks I'm nuts running a 'normal' blood sugar. I think it's nuts not to.
To my mind eating very low carb does many things - lowers triglycerides, lowers VLDL and LDL, raises HDL and loses a few pounds in weight at the same time. There's no catch that I can see.
The crucial thing, I think, is that I need very low doses of insulin, so I don't have big blood sugar fluctuations - either up or down. That makes hypos much less of a problem for me these days. I found the DUK diet really dangerous since it demands far more insulin and therefore much more risk of hypos.
I'll give you whatever help I can if you want to give it a go.
You can get me on sixcraigs@hotmail.co.uk if you like.
Congratulations on the baby-to-be as well! I hope it all goes well.

All the best,

fergusc

Hi Sarah,
It's certainly a problem having lost hypo awareness. Mind you, I lost it years ago, long before I went low-carb and regained normal blood sugar levels.
I check my blood glucose regularly, certainly before driving, so there is no risk there.
I wish I could get 'the shakes' again, but if not, I'll just have to use the meter I suppose.

All the best,

fergusc