Introduction and a panicking question

[Finzi]

Hi everyone! I am a newly diagnosed type 2 - had a HBA1C done routinely before Christmas because I have polycystic ovaries and when I rang up for the results on Jan 11, was told that I needed to come and see the doctor because it was 64 which is 8% in old money. Was really upset, then found this forum, read about low carbing and spent the next week doing that, until my doctors appointment yesterday. Have been really pleased with it so far, because I have found it amazingly easy - after some hunger pangs on the first day or two I literally haven't felt hungry since, and no cravings. I started with an aim of 100-150g carbs a day, but I've reduced that to 75g because I just wasn't finding it difficult. I have lost about 4kg in weight this week -I have a LOT to lose - I started at 132kg and now weigh 128kg. Still very long way to go, but its been a good start, especially considering how easy I've found it.

I have other health problems, I have heart failure actually not related to my weight at all but to a virus I caught in 2009 which caused myocarditis, an infection of the heart. Because of this I am taking beta blockers, ramipril and two different diuretics - furosemide and spironalactone. It's also meant that my exercise capacity has been very limited and I've also had to take medical retirement from work a pain at only 43 years old. I also have high cholesterol diagnosed on the same blood test, 7.9 total, don't know the breakdown, so I've been started on Atorvastatin and Metformin.

Anyway, to my question - as I say I've basically been thrilled with how things are going, and when I went for my "official diagnosis" at the doctors yesterday they did a BM which was 6.9 fasting and I was thrilled. HOWEVER, I did a pre-breakfast one today for the first time with my brand new meter and it was 9.8!! I was absolutely devastated - sobbing. Yesterday was my best day ever eating wise - only 51g carbs and 1200 calories. HOW could my BM be so high when I hadn't eaten for over 12 hours? I think it didn't help my frame of mind that I was so stressed just trying to get the meter to work, I'd lost the instructions, and I couldn't get enough blood on the first prick so I wasted a test strip, so I was already quite emotional before I got the reading, and then I completely lost it!! Lol sigh.

So what am I doing wrong? I think I would find it hard to cut carbs and calories much further, but maybe I need to. But why was yesterday's reading, which followed a much less "good" day food wise, only 6.9 when today's was 9.8? Which is likely to be right? My Hba1c suggests an average of 10mmol which would mean the 9.8 might be right, but then also means that all that I've done this week hasn't made any different apart from the weight loss which is nice

 

[carb-counting-mum]

Hi,

Well done on your weight loss and working so hard. I'm not an expert on blood glucose levels, but I am wondering if you've considered the dawn phenomenon? Apparently this can cause high sugar levels in the morning for some people? Have a search on this topic, plenty of threads on it. Perhaps it might be this?

 

[Yorksman]

You're not doing anything wrong. It happens to many, if not most people. You get a spike early morning because the liver, for some reason, appears to dump extra glucose into your system. You can google up Dawn Phenomenon and see how common it is, http://en.wikipedia.org/wiki/Dawn_phenomenon

Your glucose level isn't like a petrol tank slowly going down if you don't refill it. As you lose weight, your fats break down and extra glucose is released. It's a bit weird to begin with, you start to think "I haven't had any carbs, why does it go up?" Fact is, it will be up and down like a yo yo. Over time though, the highs and the lows will be on a decline. I was 8 to 10s then 7 to 9s and now 6s and 7s with occasional lows in the 5s and very occasionally maybe an 8.

If you eat whole grains, they release very slowly so sometimes you can pin an unexpected rise on something you ate some time ago. This is where exercise becomes of benefit. It seems to help evening out the levels as the body adjusts to the person who is constantly active.

Your readings seem to be similar to mine about 4 weeks ago. That scary 9.8 will go down over time.

 

[daisy1]

Hi Finzi and welcome to the forum

Here is the information we give to new members which I hope you will find useful. Ask any questions you like and someone will help you.


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 30,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

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

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.

 

[Daibell]

Hi. Yes, the Dawn Phenomenon is probably the cause. It's why I always suggest to people that you should not test early in the morning unless you have a specific reason as the liver may have released glucagon (glucose). This is said to get the body ready for the day. It is also a protective mechanism the body has when your sugar goes too low to help avoid a hypo. Test 2 hours after a meal to find out what foods affect you and average these results and/or rely on the HBa1C for an average.

 

[Dark Horse]

Also, you mentioned that it was a new meter and you had lost the instructions. If the meter has not been calibrated correctly or you take the blood sample incorrectly e.g. by squeezing your finger you end up with an unreliable result. It's best to read the instructions carefully and keep re-reading them until everything is clear. Then follow the instructions to the letter.

 

[spmccann]

My early morning readings are consistently higher than the rest of the day. I was a bit scared at first .
Then I read this http://www.mayoclinic.com/health/dawn-effect/AN01213 its from the Mayo clinic so it probably fairly recent research.
I try to excessive before I work to burn off the excess Glucose. I notice that my morning BG level are higher in the morning after resistance training.

Well done on the weight loss, and remember the words of Mr Douglass Adams "Dont Panic!" Your doing the right things it may take your body a while to get used to the new regime. Just monitor it. Keep us posted on your progress and remember to enjoy your achievements.

This is a great place to get help support and advice, I'm so glad I found it and grateful to those who have shown me t thru their example he diabetes can be managed and its impact lessoned.

 

[Finzi]

Many thanks for everyone's replies! I've read about the dawn phenomenon and while it sounds very convincing, I'm not sure it's entirely down to that because I tested later in the day, mid afternoon (not had any lunch that day) and it was 9.9! HOWEVER, after an indian meal (carefully chosen - just had chicken tikka) it was 6.7. And today after breakfast 7.2. And the difference between the two lower redings and the two higher ones was that I didn't squeeze my finger. Could it really be that? Maybe coincidence, who knows. Or maybe weirdly my blood sugar is higher when I fast than when I don't! But anyway, much happier now. Obviously they still need to come down a lot more, but I don't think 6.7 after eating is TOO bad.