How low to go?

[katereiki]

Background: I am in remission from type 2 for 5 years now, initially lost lots of weight and inches, but now struggle to keep it off. I don't eat sugar (or honey) except for tiny amounts occasionally. I am much more fit and active than when diagnosed, walking every day and doing some resistance training too. HbA1c went from 66 to 49 in 1st 3 months, then down to 45, eventually to 39. However last test was back up to 43.

I am struggling with how much carbs to have, especially in the evening. I am now accustomed to having less starchy foods and generally eat slow release carbs such as brown rice (plus veg, fish and occasional red meat, low sugar fruit i.e. berries and apple). I followed the Low Carb diet for a while, counting everything and found when I counted the carbs that I was having less than the 250g suggested. So thinking maybe I wasn't having enough and this was making my metabolism sluggish I upped the carbs. Not good - weight and glucose levels up.

So I went back to having much less carbs - and now find that my morning glucose levels refuse to go below 6.2 and have been higher. Then one day I had what I thought would be a disastrous evening of too much carbs: popcorn followed by white rice noodles at 8.00 pm and found that the next day my bg was 5.6. The following day, having eaten less carbs especially in the evening, it was back up over 6. Huh?

Can anyone advise on how to manage this? No starch carbs in the evening, which worked before, now seems to make my bg higher - which may be dawn phenomenon - but is this good that my liver is dumping too much glucose in the early morning? How do I get my bg below 6.2 again?

 

[HSSS]

250g suggested!! Wow that’s an awful lot. It’s not really low carb. Maybe slightly reduced at best. No doubt dodgy official advice from people not up to date with how effective (and now supported by the nhs and ada) low carb eating is. I doubt you’ll find many type 2 on here that eat that many. A fair few eat as few as 20g and I’d guess most are under 150g. Having fewer cabs will not make your metabolism sluggish. Too few calories might though. Carbs are not essential. Apart from practical difficulties you could have zero and exist just fine if the rest of your diet was good. Protein and fats are essential for life however. Slow release carbs still have the same carbs overall pretty much. It might not spike as high but takes longer to clear. End result the same amount of glucose created but stretched out in time.

I’m guessing here but first time round you lost a lot of weight and dramatically increased exercise yes? This dropped your figures well probably by taking fat from around your organs and using up more of the glucose in the blood. Since then carbs and weight have crept up both making the insulin resistance worse so that what worked then no longer does, hence the rising numbers. It’s like you’ve topped up the tanks and it’ll take a while to drain them again.

As to the unexpected low reading I did similar a while back. I think what happened was the high carbs caused a massive insulin rise trying to deal with the shock of it and and overshot a bit taking me lower than I expected.

What to do? In your shoes I’d be dropping the carbs a fair bit lower.

 

[Rachox]

Hi Kate and welcome to the forum. I know you’re not new to type 2 however you might like to read the useful stuff on a post that @daisy1 provides for newbies. I’ve tagged her so she’ll post it for you when she’s next online.
Can I just ask a question to ensure you get the right advice, do you take any meds for your diabetes? Assuming you’re not or just taking Metformin then you can go as low as you choose with carbs as you won’t risk hypos. Personally I feel 250 g per day is way too high. I eat between 30 - 50g per day, so sugar, honey, rice (of any colour), pop corn and noodles never feature on my menus. I think a period of testing before and after meals is needed to methodically work out what foods you can tolerate. Here are the levels you are aiming for:
https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html

 

[Antje77]

Agree with the above and like to add that if you want to see what a particular meal (popcorn followed by white rice noodles at 8.00 pm) does to your bg it makes a lot more sense to test right before eating and some 2 hours after. I suppose you tested 10, 12 hours after the meal, which doesn't tell you much except that your fasting bg isn't alarmingly high. The meal from last night will have some impact on your fasting bg, but not much.

Good luck!

 

[Bluetit1802]

I agree. I think you would benefit from going right back to basics. Use your meter to show you what each meal is doing to your levels, and keep a food diary including portion sizes. If you record your levels alongside the food you will soon see patterns emerging and be able to see which foods you should be changing. The absolute maximum rise from before to 2 hours after first bite is 2mmol/l and preferably a whole lot less. You may also find it worthwhile to test at 1 hour, 90 minutes,and 2 hours after, and even keep going until any rise has gone back to where you started.


Are you serious that you eat 250g of carbs? That is the recommended amount for non-diabetic healthy people, and is definitely not low carb. Under 150g is considered low carb, but most of us find we cannot eat anywhere near that many and keep normal blood glucose levels without the aid of medication.

 

[daisy1]

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

BASIC INFORMATION FOR NEW MEMBERS

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 600,000 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.