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Hi and a little help please!

J

johnoo

Well-Known Member
I am in my 60's fit, play Badminton, enjoy Walking weight 75Kg for height of 5' 8", don't feel over weight.
Diagnosed as Type 2 in 2001, first on diet them medication.
Things started to get better, HBa1C down to 6.4, but now things are getting out of control, HBa1C up to 7.1, medication recently increased to :- Metformin 4x500g per day & Gliclazide 2x80mg per day (this has recently been increased from 1 per day.
Having great problems in controlling morning blood sagar test average now 10.5, 2 hours after Breakfast
Evening test, 2 hours after supper is on average 6.2
Diet:- Breakfast, Toast and coffee, no sugar.
Lunch Fruit
Supper Mainly home prepared:- Meat/Fish/Vegtables/Rice/Pasta
Desert :- Generally Yogurt/Cheese/ Fruit

Drink red wine 4 days per week
Concern that Blood/Sugar is out of control and since increasing Gliclazide seems to have got worse.
Great diabetic nurse, interested in my graphical results and trys her best for me.

But i am worried that the medication is wrong.
Can you suggest anything?

Sorry to be a pain/wringer!
 
Hi Johnoo!
I am a similar age to you, but I am overweight. However, I have prevented my T2 from progressing. I need less medicine now than I did 6 years ago. Gliclazide in particular, I was glad to get rid of. It has a tendency in many people to cause weight gain. It also burns out what Islet beta cells you have left..Horrible stuff. the doctors don't mind, because once those beta cells are gone, there's nothing left but insulin.
there's a balance between your medication, your biochemistry and your activity and your diet
Please allow me to comment on diet and make suggestions.
It's the starchy carbs in your food which put your blood glucose up even more than sugar does.

Diet:- Breakfast, Toast and coffee, no sugar.I slice bread, approx 50% carbohydrate depending on type
Lunch Fruit Fruits often are high in carbs and especially in sugars. I did a rough check and many fruits come out at about 10 - 15% carbs berries are slightly better/less
Supper Mainly home prepared:- Meat/Fish/Vegtables/Rice/Pasta . Rice is about 30% carb depending on type and pastaabout 25%
Desert :- Generally Yogurt/Cheese/ Fruit Fruit yougurts contain up to 25grams of sugar
All this is putting your blood glucose up.May I suggest
Breakfast ~ scrabled eggs, no toast
lunch~ a green salad
Supper as before, but with a much smaller portion of rice or pasta and more green vegetables.
read labels on ready prepared foods and watch out for total carbs, not just sugar.
Do you test regularly?
get a copy of "Collins Little Gem Carbohydrate Counter" costs about £5 and keep a food diary. You will be able to recognise which foods cause blood sugar to rise[spikes] Treat them with caution. Keep portions minuscule or cut them altogether.
Look through the threads on reduced carbohydrate eating. Other than taking more medicine, that's what will work.
If you were told that you need to eat a balanced diet based on starchy foods and low fat,you have found it doesn't work without high doses of medication. the higher your doses, the more likely you are to have wild swings of blood sugar. Insulin may be your preferred choice, but remember it has its drawbacks, as in the risk of hypos and a restricted driving license.
Hana
 
Hanadr,
Thanks for your input, & I hear what you say, but i have been trying to follow advise in the GI diet book. Most of the items I eat are in the "Green" zone so i can't understand your comments on fruit etc.

My main problem is that my morning blood test is showing very high results circa 10.5 whilst the evening results are circa 6.2.
I used to take tests every three days but since the increased dosage of Gliclazide I have been taking daily.
i feel that the Gliclazide has made my results worse rather than better.
Any ideas from others on how to control the morning result?
 
Hi johnoo,

To be successful with the G.I. diet you do need to eat a balanced meal.
You say you have toast for breakfast. That is pure carbohydrate. You need some protein as well. How about toast, scrambled egg and mushrooms?
Because foods are listed as G.I. it does not mean that you can just carry on eating them regardless. You have to balance them out. The fruit on it's own at lunch time will give another surge in your blood sugars..
The rice and pasta at dinner may also be a problem. Because a food is low G.I. does not mean that every diabetic's response to it will be the same. Try testing it after 3hrs. and see what the reading is. I can eat bread rice and pasta, in small portions but I cannot eat any potatoes. Most cereals are out for me but I can eat porridge if I balance it with some fruit and flaked almonds.
You also have to think about portion control.
I don't know what book you are using, does it just list the foods or is it specifically aimed at diabetics?
Do you test your blood sugars as soon as you get up? This reading may be high and that will start the upward trend if you do not balance your breakfast.

Hope this helps,

Catherine.
 
Hi Johnoo

What is your fasting blood glucose level i.e. reading taken first thing in the morning before any breakfast is taken?

Regards

Pavlos
 
Catherine/Pavlos,
I have not been taking fasting Blood/ Sugar untill today, but out of interest I tok it this morning got a result of 7.0.
Then had my wholemeal toasted bread with Marmite, retoook test 2 hours later to find it was 11.7
Only a one off but it could be the Breakfast thats bumping up the level.
I will take few more tests to confirm.

The i have to think of new breakfast menu's Porridge?
 
johnoo
GI is a measure of how FASTthe carb turns to glucose, it doesn't tell you how MUCH glucose you will produce.
some people use GI successfully, especially if they have enough insulin response to keep up with the rate of glucose production. In most cases, I suspect, they will be diet controlled only. If you use a sulphonylurea medication, like Gliclazide, you don't have a natural response to the food. The gliclazide will take over.
You do need to keep on top of the QUANTITY of carbohydrate that you consume.
Low GI is definitely better than high GI. hOWEVER, Some people ,like me cannot handle much carb at all. In fact I have only what's in green veggies and RARE treats.
It's worth trying porridge, but do monitor carefully. Don't be surprised if it sends your Bg number up. It does to loads of people.
 
Johnoo, when you toast bread it changes the carbs in the bread putting up the carb content by about 4. So if a slice of bread is 17 carbs then it will increase to about 21 when toasted thus increasing your blood sugar levels as well.
 
Hi,

I'm a Type 2 also - I can't eat cereals or bread/toast in the mornings without it sending my blood glucose levels into double figures and because of that I've stopped eating those things for breakfast.

In general, I recommend that you cut back on any starchy carbohydrates that you eat - e.g. cereals, bread, potatoes, pasta and rice etc. Doing that usually leads to a major improvement in blood glucose levels.

Best wishes - John
 
Wallycorker,
OK, i am still going to do some more trials with Toast, then change to Porridge, just to see any change.
But if one stops Carbs. for B/fast, what does one eat?
 
johnoo said:
Wallycorker,
OK, i am still going to do some more trials with Toast, then change to Porridge, just to see any change.
But if one stops Carbs. for B/fast, what does one eat?
Click to expand...
Hi johnoo - Personally, I can't see that changing from toast to porridge will be likely to give you any improvement whatsoever. I predict you will get readings of double figures every time!

What about bacon, egg, mushrooms, tomatoes etc - or yoghurt, fruit etc?

John
 
No reply as I have been doing some trials, see chart.
It looks as if Marmite pushes my morning level up, but generally Toast does not.
It also appears that my Fasting level is the other problem.
Yet when I take evening tests they are quite low.So I am making sugar in the night, is this normal?
Any ideas on how to control?
Day Breakfast Food Fasting Level 2 Hours After Remarks
1 Toast/Marmite 7 11.7 up
2 Ditto 6.8 8.2 up
3 Toast 7.7 6.4 down
4 Toast 8.4 7.7 down
5 ditto 9.6 9.3 ditto
6 Porridge/Milk 6.7 11.4 Up
7 Ditto 7.9 8.3 up
8 Toast/Marmite 8 5.2 why the drop?
9 Toast 8.1 6.6 down
10 Yoghurt 8.7 8.5 ditto
11 Toast 9.6 12.3 Why increase?
 
No replies, was it because you could not u/stand chart?

Now that I know that Marmite is a probable cause of increasing blood/suger results in the morning i have stopped using.
But I think my other problem is that my fasting level is too high, strange thing is I seem to make suger during the night is this normal?
My evening count results are quite low, but at fasting in the morning they have increased, any ideas how I can control?
 
Johnoo
I can't see why Marmite should be the cause of raising BG. It conains very little if any carbs.
I often make a mid morning drink wih i and it makes no effect on me. Try making a drink and test either side. then You'll eliminate the effect of the toast. Could you be using less butter when you have marmite? Butter( or spread) will slow the absorption of the carbs. you'd need to test after 1, 2 and 3 hours to be sure.
My favourite breakfast of the moment is a piece of Brie ( 40g)cheese, put on a pyrex plate and 1.5 minutes in the microwave.
It's not a large breakfast, but enough.
One problem I have had to overcome is my perception of how much food I actually need to eat. It's now very little and nearly all the bulk is from green veggies or salads.
I estimate that I eat about 1 loaded plateful per day, split into 3 or 4.It's high quality food and plenty for me.
At least i'm still struggling to lose weight, so it must be enough.
 
Best to test and find out yourself but I find that oat based products arent too bad for me including porridge try and go for the more traditionally rolled oats though rather than the highly processed packaged sort. As for bread forget wholemeal its as bad as white in my experience. Grannery is pretty good and in my case causes only a small rise in BS levels, burgen loaves are even better. Someone on here suggested the weightwatchers loaves to me but I found they were awful and even worse when toasted but each to there own. Also if you are getting high levels in the morning that might be because you are going too low overnight and getting a liver dump? It might be worth having a small snack before bedtime to keep your blood sugar levels stable through the night until breakfast. A small amount of something carby, maybe even hot milk or a digestive or oat buiscuit depending on what effect these have on you.
 
Hi again,

No responses from me because I've been away in Italy watching my ice hockey team - the Sheffield Steelers - play in the European Cup semi-finals. The good news is that they won and now go through to the Finals so I'm a very happy man indeed - even after 24 hour coach trips there and back! :D

I agree with Ken when he says:

cugila said:
Seems to me that toast and Porridge have a lot to answer for here....... :!:
Click to expand...

In my opinion, at this stage, you need to be trying to get your pre-meal results lower because they are too high. As indicated earlier, to have a chance of achieving that, you really ought to be working at cutting out - or drastically reducing - the starchy carbohydrates in your diet such as your bread and porridge. By the way, I don't think that you need to be worrying about the Marmite! Why not test a grilled - or even fried - breakfast of bacon, tomatoes, mushroom, egg or something similar because that will have no major effect on your blood glucose levels.

In using two hour after eating results, you need to realise that by that time your readings are quite sharply well on their way down and will have been much higher - i.e. you are testing on a quicky dropping reading. You need to understand that readings in the 11s are very high indeed two hours after finishing eating - I wouldn't be happy with 8s and 9s also.

These days, I hardly ever test at that time because I now generally use one hour after finishing eating results when your levels are generally at their highest. That is where you need to be aiming to get to yourself and then start fine tuning your diet. However, you do need to realise that all of the improvement might not come about immediately. You will need to work at it!

Stick with it - you'll get there!

Best wishes - John
 
Thanks for all of your responces,
Hanadr, The effect of toast has already been eliminated, day 3/4/5 of the chart shows a toast only b/fast and the 2 hours after results improved, leading to the conclusion that the Marmite was the prime cause of increase.
I take your point about Brie i will try this next week.
Fordperfect, The Porridge was the old type, but this, by the results had a bad effect on blood suger.
Never heard about "liver dump" but again have noted to try the idea of a midnight snack.
Cugila, Agree on Porridge, but looking at the results toast does not in general put the results up.
Wallycorker, i do not like fried b/fasts, not enough time to enjoy!

I will keep trying, this week I have stopped taking the Gliclizide tabs to see the effect, next week I will modify diet again, probably by having an evening biscuit.

Any comments welcome
 
Thanks for all of your responces,
Hanadr, The effect of toast has already been eliminated, day 3/4/5 of the chart shows a toast only b/fast and the 2 hours after results improved, leading to the conclusion that the Marmite was the prime cause of increase.
I take your point about Brie i will try this next week.
Fordperfect, The Porridge was the old type, but this, by the results had a bad effect on blood suger.
Never heard about "liver dump" but again have noted to try the idea of a midnight snack.
Cugila, Agree on Porridge, but looking at the results toast does not in general put the results up.
Wallycorker, i do not like fried b/fasts, not enough time to enjoy!

I will keep trying, this week I have stopped taking the Gliclizide tabs to see the effect, next week I will modify diet again, probably by having an evening biscuit.

Any comments welcome
 
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