Managing bGs

[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 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?

I test:
1) if I am trying a different foodstuff
2) if ill
3) trying a new activity
4) if feel "hypo" or hyper.
5) random "fasting" tests.
so, How often: Less & less but a few a week
Rationale: Originally tighter control of BG, but now control of exceptions 8)

 

[janeecee]

I will update but blogging every meal and meter reading isn't going help because it's highly variable and doesn't show an overall trend.

I don't do 1 hour readings, I just can't face those spikes. 2 hours is all I can cope with. :lol:

My readings are within 'normal' so far today, bearing in mind that the 2 hour 'normal' is 7.8, but my breakfast was still about 1.0 higher than it was 1-2 weeks ago with the same breakfast. Whether the increase has any correlation with the higher level of ketones, I have no idea.

I have a good appetite, enjoy my food, eat three meals a day at regular times, etc, but really, I just don't have the metabolism to eat more than I do. I reached 1200 kcal on Saturday, 118g carbs, but I was so stuffed full on it. When I was younger I was a skinny hyperactive thing, constantly hungry. I needed a lot of fuel. It's so frustrating being trapped inside the illness known as ME because I can't even walk to the local shop. I desperately want to do more. I hate being sedentary. I relapsed big time last year after doing quite well, going out on the bus, bits of shopping and walking 5-10 minutes at a time, going to my class, meeting up with friends, etc etc. I was so much more active. I had no inkling of blood sugar problems back then so I have no idea what my BG levels would have been then compared with now. I've put a lot of effort into managing my illness to maximise improvement, and it is paying off but very, very, VERY slowly. I'm sure if I could get back to where I was I could influence my BG for the better, but when will that be....and what will my BG be like by then :-(


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[xyzzy]

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?

I test:
1) if I am trying a different foodstuff
2) if ill
3) trying a new activity
4) if feel "hypo" or hyper.
5) random "fasting" tests.
so, How often: Less & less but a few a week
Rationale: Originally tighter control of BG, but now control of exceptions 8)

I find the trying a different foodstuff and random wake up fasting tests are fine for controlling your long term BG levels once you know what you are doing. I would recommend that any newly diagnosed person adopt quite a structured testing routine at least initially as it teaches you very quickly what you can tolerate and what you can't. Once you've learnt how to successfully control then the need for testing diminishes. I'd personally think test strips should be prescribed for all newly diagnosed T2's for at least the first 6 months after diagnosis. This forum runs an excellent government petition campaign organised by former and current members that argues for exactly that kind of action. The campaign is often maligned as advocating expensive test strips for all but that is far from the truth. The intention behind it was always to help newly diagnosed people educate themselves in the first critical few months after diagnosis. Once you know what you are doing and combine that with other sensible dietary and health advice along with taking responsibility for your condition it gives people the chance to control the disease and thus minimise the risk of progression etc. That's what eat to your meter is about - the physical act of taking a BG reading is just a minor part of the whole ethos.

 

[Anonymous]

Re: Managing bGs - diabetes resolved

have just spent 40 minutes with my Diabetic Nurse. I am now classified officially as "diabetic resolved" (HbA1C 38 with no meds) which was confirmed by the kidney specialist in the practice. The DN said I have done fantastically well ... three times during the conversation which was very pleasing. I asked her if I should lower my carb intake and she said there was no need. The way forward now is no more metering, no change to my carb intake, check-up once a year. I have to avoid gaining weight as 'it could all come back' and still need to reduce my cholesterol from 4.1 to below 4.

Regarding carb intake, she is positive about low-carbing as this is used as part of the treatment to control a newly-diagnosed person's blood glucose along with appropriate meds until it stabilises. But she would not recommend that people follow 'ultra low-carb/high protein' diets as this could lead to kidney damage over time. When I asked her where the evidence for this was, she said that this is why hospital renal units include reduced-protein diets in the treatment of their patients.

Anyway, I still have the personal challenge of losing another stone in weight and not to fall off the wagon.

 

[janeecee]

Well,done, Gezzathorpe!

Of course we all know there is no such thing as "cure"… if only! ;-)

You have shown that it is possible to manage this condition well. If a T2 can turn it around, there is certainly hope for many people who in the prediabetic range. You know what works for your lifestyle and metabolism, so long may those good HbA1c numbers remain. I just hope that dog of yours is not going to wear out to soon!

Even though you feel ready to quit the testing and measuring, it's really important to keep managing your diet and exercise on a daily basis…or else! You know you can do it…because you've done it already! I'd still test from time to time though, because you still need to keep an eye on your BG just in case thing start progress and you don't realise it.

Keep up the good work!




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[Anonymous]

Well,done, Gezzathorpe!

Of course we all know there is no such thing as "cure"… if only! ;-)

You have shown that it is possible to manage this condition well. If a T2 can turn it around, there is certainly hope for many people who in the prediabetic range. You know what works for your lifestyle and metabolism, so long may those good HbA1c numbers remain. I just hope that dog of yours is not going to wear out to soon!

Even though you feel ready to quit the testing and measuring, it's really important to keep managing your diet and exercise on a daily basis…or else! You know you can do it…because you've done it already! I'd still test from time to time though, because you still need to keep an eye on your BG just in case thing start progress and you don't realise it.

Keep up the good work!




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Thanks ... I will check from time to time. Also, I am not going anywhere .... I can hear the woeful sighs even now!! 8)

 

[Sid Bonkers]

I test when trying new foods too, in fact my wife couldnt buy the bread I usually eat yesterday so today I tried a Sainsburys wholegrain roll which Ive never eaten before, I had the roll cut into three slices and the top and bottom I filled with ham and mexicana cheese so a roll with the middle section removed, the middle slice I was going to throw away but as I was hungry I decided to have it as an open sandwich with some cheddar and followed it with an apple.

Ive no idea what the carbs were and neither do I care really, as different foods affect me differently regardless of the carb count, so I dont bother sticking to a set number of carbs a day, I guess its do do with the GI although I'm not really sure..

Anyway
Pre lunch reading..............12:25pm 5.4 mmol/L
post lunch reading.............14:21pm 5.3 mmol/L

I'll be eating these again it was very nice :thumbup:

I dont test much any more, there doesnt seem much point to it now so just the odd test here and there or like today when I eat something new.

 

[janeecee]

Well,done, Gezzathorpe!

Of course we all know there is no such thing as "cure"… if only! ;-)

You have shown that it is possible to manage this condition well. If a T2 can turn it around, there is certainly hope for many people who in the prediabetic range. You know what works for your lifestyle and metabolism, so long may those good HbA1c numbers remain. I just hope that dog of yours is not going to wear out too soon!

Even though you feel ready to quit the testing and measuring, it's really important to keep managing your diet and exercise on a daily basis…or else! You know you can do it…because you've done it already! I'd still test from time to time though, because you still need to keep an eye on your BG just in case thing start progress and you don't realise it.

Keep up the good work!




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[janeecee]

Sid, I find that the carb content of different foods doesn't predict what my BG is going to be. I've had high readings with very few carbs and lower readings with considerably greater amounts of carbs. There isn't some neat little equation that tells me x amount of carbs = y on the meter. I tolerate some carbs better than others, and even then it's better on some days and worse on others.

Good numbers with the bread roll, too.




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[Robinredbreast]

Well,done, Gezzathorpe!

Of course we all know there is no such thing as "cure"… if only! ;-)

You have shown that it is possible to manage this condition well. If a T2 can turn it around, there is certainly hope for many people who in the prediabetic range. You know what works for your lifestyle and metabolism, so long may those good HbA1c numbers remain. I just hope that dog of yours is not going to wear out to soon!

Even though you feel ready to quit the testing and measuring, it's really important to keep managing your diet and exercise on a daily basis…or else! You know you can do it…because you've done it already! I'd still test from time to time though, because you still need to keep an eye on your BG just in case thing start progress and you don't realise it.

Keep up the good work!




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Thanks ... I will check from time to time. Also, I am not going anywhere .... I can hear the woeful sighs even now!! 8)

Well done on the good results, onwards and upwards Geeza :thumbup:

RRB

 

[Anonymous]

Well,done, Gezzathorpe!

Of course we all know there is no such thing as "cure"… if only! ;-)

You have shown that it is possible to manage this condition well. If a T2 can turn it around, there is certainly hope for many people who in the prediabetic range. You know what works for your lifestyle and metabolism, so long may those good HbA1c numbers remain. I just hope that dog of yours is not going to wear out to soon!

Even though you feel ready to quit the testing and measuring, it's really important to keep managing your diet and exercise on a daily basis…or else! You know you can do it…because you've done it already! I'd still test from time to time though, because you still need to keep an eye on your BG just in case thing start progress and you don't realise it.

Keep up the good work!




Sent from the Diabetes Forum App

Thanks ... I will check from time to time. Also, I am not going anywhere .... I can hear the woeful sighs even now!! 8)

Well done on the good results, onwards and upwards Geeza :thumbup:

RRB

Thanks ... upwards (except the weight!)

PS I also discussed the availability of test strips etc generally. At the end of the guidance/dictat? to GPs on dishing out free test strips there is a phrase along the lines of 'unless clinically required' or words to that effect. It's that phrase that my local practice uses to get round the problem

 

[Anonymous]

By the way, for the avoidance of doubt, I was reminded by my DN today that I was on Metformin in 2009. It disagreed with me and so I was taken off it. So, to any doubters reading this, either my GP is dishing out diabetic meds to anyone or maybe I am a diabetic who has moved to the position of 'diabetic resolved'. Now,let me think about that ....

 

[janeecee]

Did you ask your DN what the results of your original OGTT was?


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[Anonymous]

Did you ask your DN what the results of your original OGTT was?


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I did ask whilst she was reviewing my notes but somehow my question got forgotten as she explained about their now reliance on HbA1C. I will be dropping a note to her tomorrow to get a copy of the detailed results which should have OGTT and other blood test results. The only OGTT I can recall is from May 2012 which was 44, which she was pleased with then, so I expect the original to have been higher than that, but will let you know.

 

[xyzzy]

There isn't some neat little equation that tells me x amount of carbs = y on the meter.

Agree which is why using a meter is such a good thing as you get to know what you personally can and cannot tolerate. I do think however that in general you can rely on sugary or starchy foods to have a large effect on BG's especially if you are newly diagnosed and therefore you would generally find restricting your intake of those kinds of carbs will have a very positive effect on your BG's. I don't personally draw any distinction between eating sugary foods and eating starchy ones like rice, pasta, bread, potatoes and cereals. All high starch foods are high GI and like sugar will act rapidly to raise BG's. Other forms of carbs are a lot less fast acting.

When I was first diagnosed I counted the carbs in everything because the total carbs I consumed each day most definitely was determining my average BG. I think its your average BG which is overall more important than any one particular BG reading (within sensible limits). I would recommend any newly diagnosed person learn to carb count as like using a meter it quickly teaches you what your personal limits are. Nowadays I can generally guestimate the carb count and because my insulin resistance has dropped I can for example ignore the carbs I'm eating in any non starchy vegetable because as they are low GI it means I can process them quite safely with very little movement in my BG's.

Todays main meal in a case in point. Effectively it was Spag Bol without the Spag and had a high vegetable content (carrots, onion, leeks, corgette). I would guess it turned out to be around 40g of carbs. So ...

Premeal : 4.6
2 hours: 5.2.

That 40g of carbs would roughly equate to two slices of bread yet I know if I ate that I would spike far more because the starchy carbs in the bread act far faster to raise BG's than the non starchy carbs in the vegetables.

... and that in my opinion is why its so stupid for Type 2 diabetics to be told to "base every meal around starchy carbohydrates" It's like telling an alcoholic to ensure every drink contains vodka.

 

[janeecee]

The 'eat to the meter' philosophy is basically sound re finding what works, but in my experience I have not fared so well by cutting carbs because, as I explained before, it works for a week or so and then my readings jump overnight. When I cut the carbs in response, the same thing happens again. Low carbing does not work for me in some linear "cut the carbs and the BG levels will follow" way. We're all different, and what works for one won't necessarily work for another.


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[Anonymous]

There isn't some neat little equation that tells me x amount of carbs = y on the meter.

Agree which is why using a meter is such a good thing as you get to know what you personally can and cannot tolerate. I do think however that in general you can rely on sugary or starchy foods to have a large effect on BG's especially if you are newly diagnosed and therefore you would generally find restricting your intake of those kinds of carbs will have a very positive effect on your BG's. I don't personally draw any distinction between eating sugary foods and eating starchy ones like rice, pasta, bread, potatoes and cereals. All high starch foods are high GI and like sugar will act rapidly to raise BG's. Other forms of carbs are a lot less fast acting.

When I was first diagnosed I counted the carbs in everything because the total carbs I consumed each day most definitely was determining my average BG. I think its your average BG which is overall more important than any one particular BG reading (within sensible limits). I would recommend any newly diagnosed person learn to carb count as like using a meter it quickly teaches you what your personal limits are. Nowadays I can generally guestimate the carb count and because my insulin resistance has dropped I can for example ignore the carbs I'm eating in any non starchy vegetable because as they are low GI it means I can process them quite safely with very little movement in my BG's.

Todays main meal in a case in point. Effectively it was Spag Bol without the Spag and had a high vegetable content (carrots, onion, leeks, corgette). I would guess it turned out to be around 40g of carbs. So ...

Premeal : 4.6
2 hours: 5.2.

That 40g of carbs would roughly equate to two slices of bread yet I know if I ate that I would spike far more because the starchy carbs in the bread act far faster to raise BG's than the non starchy carbs in the vegetables.

... and that in my opinion is why its so stupid for Type 2 diabetics to be told to "base every meal around starchy carbohydrates" It's like telling an alcoholic to ensure every drink contains vodka.

You could have used a julienne peeler on your courgettes for a 'pseudo spaghetti'.

 

[Anonymous]

The 'eat to the meter' philosophy is basically sound re finding what works, but in my experience I have not fared so well by cutting carbs because, as I explained before, it works for a week or so and then my readings jump overnight. When I cut the carbs in response, the same thing happens again. Low carbing does not work for me in some linear "cut the carbs and the BG levels will follow" way. We're all different, and what works for one won't necessarily work for another.


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Whilst I remember, my DN wasn't interested at all in my +01:00 readings on my chart and focusses on the +02:00.

 

[xyzzy]

You could have used a julienne peeler on your courgettes for a 'pseudo spaghetti'.

Yes. You can also slice them into chunky chip shapes, coat them with Parmesan cheese and shove in the oven to make a delish replacement for chips.

 

[Anonymous]

You could have used a julienne peeler on your courgettes for a 'pseudo spaghetti'.

Yes. You can also slice them into chunky chip shapes, coat them with Parmesan cheese and shove in the oven to make a delish replacement for chips.

That sounds nice, but wouldn't look so good in a spaghetti sauce. :***: