Hello, Thank You! ... and Help?

[DawnOfTheZed]

My first post! I've been lurking for a little while! I want to start by saying thank you to y'all here. You've helped me enormously already. You're all just amazing!

Me: fbg 8.7 then 9.2 (UK units), Hba1c 54, Oct 2018. Put on 500 mg metformin.
I had 18 months of extreme fatigue and brain fog prior to this, including 2 prior visits to my GP before fbg test was thought of!
Am 48 yrs old, BMI 33, PCOS (no meds now but was on Dianette until 3 yrs ago) and chronic urticaria (ceterizine hcl antihistamine).

Because of You, I immediately dropped starchy carbs from my diet. Then, started reducing carbs (currently about 50 - 100 g per day). Immediately felt improved regarding above symptoms.

Because of urticaria, I asked for c- peptide and gada tests to rule out LADA. C-peptide 1.26 nmol/L, insulin 131 pmol/L and gada < 5. T2 confirmed. Offered ed prog and did X-pert. Requested and got bg monitor but only 1 px for strips and self funding afterwards.

3 months later - hba1c 42 from 54! BMI 31 from 33 (not a huge drop compared to some of you, but in the right direction?) I ascribe these improvements to this wonderful place. Thank you!

Current average bg is 6.5, generally higher morning (fasting 7-7.5) and lowers over the day (5.5-6).

If it's not too impertinent (and too long a first post), would you kindly offer comments or suggestions for these issues:

1. My eGFR was 88 in Oct 2017, 76 in Nov 2018 and 68 end of Feb 2018. ACR <2.5, so no protein in urine. I've got a GP appt soon. Should I ask for repeat blood and urine tests for these in 3 months?

2. Also, I was keen to up my metformin coz of PCOS, obvious hyperinsulinemia and insulin resistance. Is it worth raising this again with my GP, given my decreasing eGFR?

3. Lastly, I have been low carbing by upping both protein and fat. Given the worsening trend in my eGFR, should I concentrate on fat rather than protein? (I'd prefer not to if it won't matter.) What other changes should I start to improve my kidney function, or at least not make it worse?

Thanks again! Y'all amaze-b*lls!

 

[Rachox]

Hi Dawn, welcome to the forum officially!
Well done on your achievements so far. I started low carbing by keeping under 100g/day plus 3 x 500mgs of Metformin/day when I was diagnosed. I gradually reduced my carbs over that first year to staying under 50g/day, I continue to stay under 50g now nearly another year on. This keeps my HbA1c in the mid 30s. I can’t advise about your protein intake and your kidney function nor your Metformin dose, but I think they are things definitely worth talking over with you dr. I’m sure that a further reduction in carbs and possibly increasing your Metformin would reduce your HbA1c further.

 

[DawnOfTheZed]

Thank you Rachox.
I think I'll try 70 g/day carb for the next 3 months.

I'm aware that doses can be up to 2 g/ day of metf but my HCPs were v huffy when I asked 'please sir, can I have some more?'

 

[Debandez]

My first post! I've been lurking for a little while! I want to start by saying thank you to y'all here. You've helped me enormously already. You're all just amazing!

Me: fbg 8.7 then 9.2 (UK units), Hba1c 54, Oct 2018. Put on 500 mg metformin.
I had 18 months of extreme fatigue and brain fog prior to this, including 2 prior visits to my GP before fbg test was thought of!
Am 48 yrs old, BMI 33, PCOS (no meds now but was on Dianette until 3 yrs ago) and chronic urticaria (ceterizine hcl antihistamine).

Because of You, I immediately dropped starchy carbs from my diet. Then, started reducing carbs (currently about 50 - 100 g per day). Immediately felt improved regarding above symptoms.

Because of urticaria, I asked for c- peptide and gada tests to rule out LADA. C-peptide 1.26 nmol/L, insulin 131 pmol/L and gada < 5. T2 confirmed. Offered ed prog and did X-pert. Requested and got bg monitor but only 1 px for strips and self funding afterwards.

3 months later - hba1c 42 from 54! BMI 31 from 33 (not a huge drop compared to some of you, but in the right direction?) I ascribe these improvements to this wonderful place. Thank you!

Current average bg is 6.5, generally higher morning (fasting 7-7.5) and lowers over the day (5.5-6).

If it's not too impertinent (and too long a first post), would you kindly offer comments or suggestions for these issues:

1. My eGFR was 88 in Oct 2017, 76 in Nov 2018 and 68 end of Feb 2018. ACR <2.5, so no protein in urine. I've got a GP appt soon. Should I ask for repeat blood and urine tests for these in 3 months?

2. Also, I was keen to up my metformin coz of PCOS, obvious hyperinsulinemia and insulin resistance. Is it worth raising this again with my GP, given my decreasing eGFR?

3. Lastly, I have been low carbing by upping both protein and fat. Given the worsening trend in my eGFR, should I concentrate on fat rather than protein? (I'd prefer not to if it won't matter.) What other changes should I start to improve my kidney function, or at least not make it worse?

Thanks again! Y'all amaze-b*lls!

Ho and welcome.

It seems you've got a good handle on things already but I'm going to tag @daisy1 in for some invaluable info.

I stick to between 50g and 70g carbs a day. It has worked well in reducing my hba1c significantly. But we are all different. Some need to be lower for it to have good impact and some not so low.

You have a testing kit which is great. They the mysugr app. It will give you an estimate of hba1c so you can see how you are doing and tweak things accordingly. Its a fantastic tool.

 

[DCUKMod]

Thank you Rachox.
I think I'll try 70 g/day carb for the next 3 months.

I'm aware that doses can be up to 2 g/ day of metf but my HCPs were v huffy when I asked 'please sir, can I have some more?'

Dawn, for some time there was a nervousness around people with chronic kidney disease (CKD) using Metformin, although that has relaxed a bit, except for those whose CKD is quite advanced.

If or when you ask your medics to increase your Metformin, if they are nervy about it, ask them to explain why, so that you can do your own reading around it, to either accept or better challenge their position.

I'm not suggesting you go into battle with them on anything, but sometimes it's useful to understand why thinks might be as they are.

 

[daisy1]

@DawnOfTheZed
Hello Dawn and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS



Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 220,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[DawnOfTheZed]

@Debandez
Thank you. I'm a little frustrated that I'm only losing 0.3 kg a week at the moment. I think trying 70g as a max might help improve that.,

 

[DawnOfTheZed]

@daisy1
Thanks for the info - I feel like I've properly arrived now that I've got that.

 

[DawnOfTheZed]

@DCUKMod
Thanks re metf and ckd. It's all so new to me and I've lost confidence in my HCPs.
Your info has helped me so much!

 

[DawnOfTheZed]

Hi peeps!
Sorry I've not been around for awhile. Life's been busy.
I thought I might post a good news update on myself, in the hope it is useful to others.

Been doing a low cal (Cambridge 1:1) diet from May 2019 until now, starting to switch back to low carb. Since dx in Oct 2018 I've lost 27 kg and gone from a bmi of 33 to 23.
My hba1c in the last year have been 36 - 39.
I felt too ill when exercising at first after dx but after getting my hba down into 30s began again and found the exercise enjoyable. (I was feeling like I had a hangover when I tried previously when hba was in 50s, so I think reducing the glycated red blood cells helped - better oxygen supply to the muscles? idk)

Currently doing about 3-4 classes a week of Zumba, yoga and a core strength class. All going well. My recent kidney and liver tests all OK too.

Slight fly in the ointment (this is diabetes as you know which is a sneaky fiend at times), is my 2nd eye screening result came back 'background tretinopathy'. V sad and worried about that, but I ran back here and I can see a lot of reassuring posts about this subject. Thank you! You help me so much!

Because I was having a managed diet, I've been a bit lazy with bg testing and cal counting. But as I move up the Cambridge diet steps back to cooking more myself, I shall start back with that. I note a couple of important posts about retinopathy on other threads regarding
a) some scientific evidence that retinopathy progress relates to past years diabetes control vs current control, so my retinopathy might get worse before it gets better, reflecting undiagnosed diabetes from a few years' back?
b) bg spikes maybe significant for retinopathy. I need to get back in to the habit of checking bg, especially 2 h post prandial.

Thank you, thank you, lovely people, wonderful information from you!

 

[Rachox]

Good news you are feeling so much better @DawnOfTheZed and some fantastic results there, best of luck converting to low carb, I’m sure you’ll find it easier than calorie controlled, I know I do!
As for the retinopathy changes, I notice that this morning you reacted to a comment on my thread from nearly two years ago where I was upset by a background retinopathy result. I was very reassured by the replies I got and just to complete that story, I received a clear result last year which I was overjoyed with. Fingers crossed yours will follow suit

 

[DawnOfTheZed]

Thank you @Rachox, yes the old threads are so useful!