Managing bGs

[janeecee]

I'll admit it, I'm venturing into the unknown. I've managed 103g carbs today but after a post lunch reading of 7.0, I nixed the idea of having couscous with my dinner for fear of spiking and opted to share an apple with my OH to bring my total carb count up to my target of 100g per day. That's still a bit more than recently but it was a low carb dinner. I'll find out tomorrow whether I go into ketosis overnight i.e. above trace level on a Ketostix test first thing.

Pre dinner I was 5.3. That's OK but still a tad higher than I was getting before my levels 'jumped' last week. That's why I decided against the couscous. I was playing safe. Anyway, I was +6.5 at 2 hours, so not too bad. I still think it would be better to spread out the starchy carbs across three meals but I still reached my target of 100g.


Sent from the Diabetes Forum App

 

[xyzzy]

I found one explanation online, along the lines of low carbing creating insulin resistance as a result of ketosis, with the result that the second phase insulin becomes less effective. People find that not only are their FBG levels up, their post prandial readings rise after 2 hours and stay high. Their bodies produce less insulin when the glycogen stored in the liver is used up and in the absence of glucose they start breaking down fats for energy. When glucose from food enters the bloodstream, it remains in the bloodstream not being used because the body has adapted to using fat as its primary fuel source.

I'd like to see that research as it conflicts with mine and literally hundreds of others experiences who have used various forms of LC'ing over the years this forum has been operating.

I am coming up to two years since a T2 diagnosis with an hBA1c of 11.3% Within 3 months I reduced my hBA1c to 5.3% on a low carb high fat regime (roughly 15% carbs, 20% protein and 65% fat) I got sub 5% within 6 months of diagnosis. My last three quarterly hBA1's have been 4.8%, 4.8% and most recently 4.9%. I started out using ************** and simply reduced my sugar and starchy food intake until by BG's came back within a non diabetic range which took me around 8 weeks. I lost 4 stone in six months and now have a BMI of 23 and weigh around 13 stone. I take 1500mg of Metformin a day and have normal cholesterol and excellent blood pressure readings. My GP (a diabetic specialist) and DSN fully support my regime to the extent that my GP also prescribes a modest amount of test strips for my use. I exercise by walking my dogs around 3 to 5km a day.

At diagnosis I had to drop my carb intake to roughly 50g a day to get safe but now with a load of insulin resistance gone (both through weigthloss and giving my pancreas a much deserved holiday) I can tolerate up to around 100g / day and more on one off occasions. what's important as a T2 diabetic is my two hour post main meal reading and of course other major health factors such as weight, blood pressure and in my opinion to a lesser extent cholesterol. I also still occasionally take a wake up reading to make sure I'm not getting a large DP effect. If I see my levels begin to rise over a period of a few days then I'll simply drop the carbs down for a few days until things get back to a level I'm happy with. Happy for me on any normal day is under 7.8 at one hour and under 6.0 at two hours.

I redid a OGTT test a few months ago and tested every 15 minutes. The results were very interesting. It showed I am very much still diabetic as I have lost a lot of my first phase insulin response presumably through beta cell loss from running high BG's for around a year prior to diagnosis. At 60 minutes into the OGTT I was spiking into the high teens. I did the OGTT test to WHO guidelines and "carbed up" to over 150g / day for several days before hand. In direct contradiction to your statement "the second phase insulin becomes less effective" I found mine was actually very effective as it reduced my BG back down to 6.5 by 120 minutes (I dropped roughly 12 points in the second 60 minutes). At that final 6.5 reading the strength of my second phase response would mean I would no longer even be diagnosed as glucose impaired let alone fully diabetic using a standard OGTT test yet patently I am still T2 as a healthy non diabetic who does the test would rarely exceed 7.8 at any point over the two hours.

I would strongly recommend an lchf regime to any newly diagnosed T2.

Take care

Steve

 

[Anonymous]

I'd like to see that research as it conflicts with mine and literally hundreds of others experiences who have used various forms of LC'ing over the years this forum has been operating.

Steve, you raised an interesting question in my mind in case any else does a self-OGTT. It goes without saying that, unless someone is on insulin, no diabetic meds should be taken on the day until the test is completed. Should meds be stopped before the day of the test or just on the day? The reason I ask is that I have zero knowledge of diabetic meds and don't know if they linger for longer than the day on which they are taken. I guess I am referring specifically to Metformin on this occasion.

 

[janeecee]

I'm sure my experience is at odds with others. I'm pre-d, not T2, so my metabolism of glucose may well be operating differently from others who have presumably less function. Cutting carbs has resulted in an initial drop in BG readings and then a sudden overnight rise in BG at approximately one week later. This has happened twice within one month. I am trying to understand why and seeing if I can correct it. I understand that's not your experience, nor that of many others. I have to live within my body and its quirks, and not anyone else's, and just as some people find what works for them, I have to discover what works for me.

I'm not here to debate the merits of low carb diets, or medium carb or whatever. I'm already living with one debilitating illness as well as having blood sugar problems. I have more important challenges to deal with than citing sources that say this or say the opposite. Things have been getting a bit ugly on this board of late and I have no wish to go there. Just saying…

I'm glad that you and many others have discovered what helps you. I am looking to discover what helps me. I wish you well.




Sent from the Diabetes Forum App

 

[LittleWolf]

Whoah whoah, teens means your first phase insulin response is GONE? I thought it was only bad if you went into 20s and stuff?

I and many others arent considered diabetic, it's only because I started testing because I felt unwell and found up until the hour mark I am hitting up to 19. How many people are walking around and too they are fine but their first phase is actually totally shot??!

This kind of reinforces how far along the line people are when they actually get diagnosed @_@

Well is that reversible at all? Or do all T2s rely on maintaining good second phase response. Ugh


Sent from the Diabetes Forum App

 

[CollieBoy]

I am a T2 low(er) carber, having weaned off Basal & Bolus insulin, down through Gliclazide to Diet & Exercise alone.
Having carbed up @ 150g yesterday, I just re-did my OGTT and find my first phase insulin is sh*t , but my second phase Insulin response still pumps through well :thumbup:
I fasting BG'd @5.0
peaked at +1hr, +hr'd BG<6.0 and continued to bottom out at BG=4.0 at +3hr before rising slightly to BG=4.5 before breakfasting 8)
like xyzzzy found ************** naturally found my carbs drifting down 8)

 

[janeecee]

According to the Newcastle Diet study, some of the people who went on it recovered some of their first phase response. However, it's basically an extreme low calorie diet designed for substantial weight loss, and as I'm neither an apple nor a pear, but a "chilli" apparently, I'd be like a twig within a week!


Sent from the Diabetes Forum App

 

[janeecee]

Eating to my meter hasn't helped me, I'm afraid. Initially yes, but after about a week my BGs jumped. Yes, I know it's counter intuitive. I had trouble getting my head around it at first, and as I have stressed, I don't know if adding carbs to my diet is going to lower my BGs or not. Bear in mind that I don't have the usual risk factors and no family history. Only age (can't change that) and the enforced inactivity as a consequence of my disability—I try to be as active as I can but not enough to impact on my blood sugar. I've no weight to lose, no sugar habit, nothing. I've got low BP, low BMI, low cholesterol. Even my calorie intake is low. I'm not the typical profile of a prediabetic. Perhaps my contributing factors are different and what helps me may well turn out to be different from what helps a previously overweight junk food junkie with a real ale habit…I dunno.


Sent from the Diabetes Forum App

 

[LittleWolf]

Don't think I could do the Newcastle Diet- I'm an ex anorexic. The whole reason I want to sort this **** out is so I do not develop an aversion/negative image of/fear of food again. Being underweight was when I was chronically hypoglycemic, then loaded with sugar which is what I think screwed me in the first place

Really janeecee? I think your numbers sound great lately, and any differences you noted are well within the meter's margin of error. Too demanding? Hard on yourself! Wanna swap numbers with me lol x


Sent from the Diabetes Forum App

 

[Neil Walters]

Really janeecee? I think your numbers sound great lately, and any differences you noted are well within the meter's margin of error. Too demanding? Hard on yourself! Wanna swap numbers with me lol x

I have to agree I think you are reading too much into small margins - relax a little and keep eating what you are as it is working




Diagnosed Type II 1998 1 x 80 mg Gliclazide, 4 x 500mg Metformin and 1 x 100mg Sitagliptin - HbA1c - 48 mmol/mol

 

[Anonymous]

I am a T2 low(er) carber, having weaned off Basal & Bolus insulin, down through Gliclazide to Diet & Exercise alone.
Having carbed up @ 150g yesterday, I just re-did my OGTT and find my first phase insulin is sh*t , but my second phase Insulin response still pumps through well :thumbup:
I fasting BG'd @5.0
peaked at +1hr, +hr'd BG<6.0 and continued to bottom out at BG=4.0 at +3hr before rising slightly to BG=4.5 before breakfasting 8)
like xyzzy, I found ************** naturally found my carbs drifting down 8)

Your pattern is very similar to mine.

 

[xyzzy]

I'd like to see that research as it conflicts with mine and literally hundreds of others experiences who have used various forms of LC'ing over the years this forum has been operating.

Steve, you raised an interesting question in my mind in case any else does a self-OGTT. It goes without saying that, unless someone is on insulin, no diabetic meds should be taken on the day until the test is completed. Should meds be stopped before the day of the test or just on the day? The reason I ask is that I have zero knowledge of diabetic meds and don't know if they linger for longer than the day on which they are taken. I guess I am referring specifically to Metformin on this occasion.

I didn't take the Met on the day in question but given its a non insulin stimulating medication I can't see how it would aid or hinder a phase 2 insulin response which is by definition a release of insulin.

On another matter you seem to be suffering from a lot of low BG readings? Studies show (I'll hunt the link out when I have more time) that only 1 in a 1000 hypos occurred in people not on any diabetic medication and that only rises to 3 in a 1000 for those on Metformin. The definition of hypo in the study was where a person reported they needed third party help or medical assistance to recover. If you are getting those kind of symptoms and are not on any insulin stimulating medication then I would seriously suggest you go and seek some professional advice, maybe ask your GP to refer you to an endocrinologist, as it sounds like you might be suffering some kind of reactive hypoglycemia which you should get treatment for as it sounds most unusual regardless of what dietary regime you follow.

 

[xyzzy]

Eating to my meter hasn't helped me, I'm afraid. Initially yes, but after about a week my BGs jumped. Yes, I know it's counter intuitive. I had trouble getting my head around it at first, and as I have stressed, I don't know if adding carbs to my diet is going to lower my BGs or not. Bear in mind that I don't have the usual risk factors and no family history. Only age (can't change that) and the enforced inactivity as a consequence of my disability—I try to be as active as I can but not enough to impact on my blood sugar. I've no weight to lose, no sugar habit, nothing. I've got low BP, low BMI, low cholesterol. Even my calorie intake is low. I'm not the typical profile of a prediabetic. Perhaps my contributing factors are different and what helps me may well turn out to be different from what helps a previously overweight junk food junkie with a real ale habit…I dunno.


Sent from the Diabetes Forum App

If you have reduced your carbs for a prolonged period (say a couple of weeks or more) and do not begin to see a gradual improvement in BG's then I would suggest you report that to your GP and take his or her professional advice as it could be symptomatic of other conditions. You could for example ask for tests to see if you are in the early stages of LADA etc. A LC dietary regime will only work if you are producing at least some insulin. During my time posting on this forum the vast majority (hundred's) of "bog standard" T2's who followed a carbohydrate restricted regime in whatever form found it a very effective way of gaining control of the condition you simply need to read the "low carb success story" thread to see that.

 

[xyzzy]

Well is that reversible at all? Or do all T2s rely on maintaining good second phase response. Ugh

I rely on my second phase response and a restricted carbohydrate regime, monitoring my weight and Metformin to help my weakened first phase response. I don't believe at present the condition is fully reversible but hope it will become so in the future. Acceptance of that is all part of responsibly managing the condition for your and your loved ones benefit.

 

[paul-1976]

Eating to my meter hasn't helped me, I'm afraid. Initially yes, but after about a week my BGs jumped. Yes, I know it's counter intuitive. I had trouble getting my head around it at first, and as I have stressed, I don't know if adding carbs to my diet is going to lower my BGs or not. Bear in mind that I don't have the usual risk factors and no family history. Only age (can't change that) and the enforced inactivity as a consequence of my disability—I try to be as active as I can but not enough to impact on my blood sugar. I've no weight to lose, no sugar habit, nothing. I've got low BP, low BMI, low cholesterol. Even my calorie intake is low. I'm not the typical profile of a prediabetic. Perhaps my contributing factors are different and what helps me may well turn out to be different from what helps a previously overweight junk food junkie with a real ale habit…I dunno.


Sent from the Diabetes Forum App

If you have reduced your carbs for a prolonged period (say a couple of weeks or more) and do not begin to see a gradual improvement in BG's then I would suggest you report that to your GP and take his or her professional advice as it could be symptomatic of other conditions. You could for example ask for tests to see if you are in the early stages of LADA etc. A LC dietary regime will only work if you are producing at least some insulin. During my time posting on this forum the vast majority (hundred's) of "bog standard" T2's who followed a carbohydrate restricted regime in whatever form found it a very effective way of gaining control of the condition you simply need to read the "low carb success story" thread to see that.

Hi Steve! Good to see you!

Yes,you raise a good point and as you know from my history..NO amount of low carbing is enough IF you have been misdiagnosed T2 when actually you have LADA and you are no longer producing enough of your own insulin,I would URGE anyone who may be in a similar position to me to INSIST on further tests,only then with the right treatment and **************can you reap the rewards.

Best wishes

Paul

 

[Anonymous]

I am a T2 low(er) carber, having weaned off Basal & Bolus insulin, down through Gliclazide to Diet & Exercise alone.
Having carbed up @ 150g yesterday, I just re-did my OGTT and find my first phase insulin is sh*t , but my second phase Insulin response still pumps through well :thumbup:
I fasting BG'd @5.0
peaked at +1hr, +hr'd BG<6.0 and continued to bottom out at BG=4.0 at +3hr before rising slightly to BG=4.5 before breakfasting 8)
like xyzzy, I found "************" naturally found my carbs drifting down 8)

How does a meter fit in with with somebody who is on a low carb diet which is under control? In other words, how often do you resort to your meter and what is the rationale?

 

[LittleWolf]

Well is that reversible at all? Or do all T2s rely on maintaining good second phase response. Ugh

I rely on my second phase response and a restricted carbohydrate regime, monitoring my weight and Metformin to help my weakened first phase response. I don't believe at present the condition is fully reversible but hope it will become so in the future. Acceptance of that is all part of responsibly managing the condition for your and your loved ones benefit.

Acceptance is hard when I don't even have a diagnosis or the support of my GP I can't get any help apart from talking to people here.

Can't do anything about my weight because like i said I only just got back from underweight. I cut out all carbs and dairy when I was anorexic then had even diabetics pushing me to eat carbs and physical fights with my family over me not eating- now I have to go back to restricting myself but not fall into the pit of an eating disorder? How do I explain to people my dietary needs or choices?

It's like how I have a high IQ but no social skills and dyslexia 'Youre smart, you'll cope. You're talented, why are you depressed.' 'you're under 40 and not obese, you can't possibly have chronic pain or diabetes'

My whole life has been full of expectations on top of my own high ones and being expected to get on with it. I can't really... And as stupid as it sounds I am losing the motivation to manage this if no one else but you guys cares :'(

The only time I get a kick up the ass is when I end up in the teens and feel like **** for days or pass out. Maybe I'll email the GP again and reiterate how much this is upsetting me. I need someone to help more than shrug their shoulders at my blood work and numbers *bangs head against wall*


Sent from the Diabetes Forum App

 

[janeecee]

I suppose I ought to rephrase—eating to my meter HAS helped in that I was able to bring down the large after dinner spikes by having carb reduced evening meals. Initially it seemed to work but then things started getting a bit weird, as I have explained. I don't appear to be a textbook case. I also wondered about T1.5/LADA, and for all I know it could be a possibility.

I think there could be other factors relating to my low calorie intake and my metabolism, as if I'm in a sort of starvation mode. I need to so few calories at my present level of activity – only about 1000 cal per day. It's not intentional. It's all that I can physically manage to eat and digest in one day, but on such a low intake it's possible in the long term for the body to alter its metabolism of macro nutrients to adapt. I don't know whether my problems with blood sugar have developed from this and/or perhaps my physical inactivity.

What ever is going on, it's a very tough nut to crack. Yes, I seem to have my numbers under control to a great extent, but I'm also aware of this strange pattern of sudden jumps. I take in my numbers to the GP, but that's another story in itself…


Sent from the Diabetes Forum App

 

[janeecee]

LW, I know too well what being confronted with disbelief feels like. I get it too from the GP because my fasting test was 'normal' and I don't have the usual risk factors. The only thing I can do is to try and manage as best I can in the absence of any support from my health care providers. Like you, I don't have the usual options of losing weigh and changing my diet because it wasn't as if I was consuming sugary foods or too many refined carbs, or anything like that. If you don't fit the stereotype of a chubby person with high blood pressure and a stodgy diet, you are disbelieved.

I've decided that I won't post my figures here whilst I try and figure out what's going on re my own BG. I was very much in ketosis this morning at ++ on the scale. That's 4.0. My BG was OK, in the usual fasting range, so not overly concerned but concerned enough to retest later. I was still showing some ketosis two hours after breakfast. My BGs have also jumped back up a bit. I'm not here to argue the merits of ketosis or otherwise, I'm going through a learning process to find out what helps me manage my BGs. It's probably better to keep it to myself for the time being. I've said all along that I could be wrong and that this experiment may not work.


Sent from the Diabetes Forum App

 

[LittleWolf]

Well if you do find yourself stabilising do let us know what worked.. I don't know enough about ketones to say anything but if your numbers are generally good then running like that works for you I guess. Are you feeling well or satisfied with how you're eating at the moment?x

Breakfast/lunch

1hr 12.8, 90 minutes 7.2, 2hrs 8.5, 3hrs 9

What. The. Flip

It's better than 16 though. I think greek yoghurt is better than soy milk. I like rice milk better but that's asking for trouble

I wonder if this has anything to do with my skin drying out, my psoriasis coming back and my usually clean stretched piercing becoming infected in the last week and a half :/



I think a group hug is in order..


Sent from the Diabetes Forum App