My diabetic getting worse no matter what

[Farida Easmin]

Hi everyone,
I am new to the forum. My age is around 52 (weight 53kg and height 150cm) and I have been diagnosed with type 2 diabetic 4 years ago. My doctor prescribed me few medicines (details below) and physical activities. Although I had those medicines on regular basis but I was not doing any 40 minutes or so walking. But my diabetic was around 11 mmol/L after food 2-3 years ago.

Recently my diabetic is getting around 17-19 mmol/L even though i have started to doing exercise and walking for few months lately. Also following every diet rules but It seems noting working and it even getting worse. Can anyone suggest how I can improve?

Medicines
Morning
Before food : Gliclazide (Modified Release 30 mg)
After food : Sitagliptin + Metformin Hydrochloride (50 + 500 mg)

Night
After food :Sitagliptin + Metformin Hydrochloride (50 + 500 mg)

 

[xfieldok]

Welcome to the forum. What do you eat in a typical day please?

 

[Farida Easmin]

Welcome to the forum. What do you eat in a typical day please?

Thank you for your kind reply. My food list is following -

Morning : Oats with berries (sometime whole wheat bread), Vegetables (Broccoli, Beans, Potato), Egg (Boiled)
Mid Morning : Oranges, Pomegranates (Not juice or anything only fruit)
Lunch : Rice, Vegetables, Fish/Meat
Afternoon : Green tea, Roti/Bread (very little amount), Fruits (Oranges)
Dinner : Rice/Whole wheat Roti, Vegetables, Meat/Fish
Before Sleep : Skimmed milk (sometimes)

as I am an Indian descendent so most of my meals does contain rice or roti. But I try to consume as low as possible rice/roti. I mostly rely in vegetables and other foods.

 

[EllieM]

Welcome to the forums.

That's a lot of medication for someone who has only been T2 for 4 years. Do you know if you've ever been tested to see if you are T1 instead of T2? (Slow onset T1s are often misdiagnosed as T2 for the first few years, and only get the correct diagnosis after all the T2 meds fail.)

Hmm, but there are a lot of carbs in your diet so you do have a lot of scope to reduce them and thereby reduce your bg levels. If you are genuinely T2 then diet will make more difference than anything else, but I am concerned that there is a possibility that you are T1.

 

[Andydragon]

Welcome to the forums.

That's a lot of medication for someone who has only been T2 for 4 years. Do you know if you've ever been tested to see if you are T1 instead of T2? (Slow onset T1s are often misdiagnosed as T2 for the first few years, and only get the correct diagnosis after all the T2 meds fail.)

Hmm, but there are a lot of carbs in your diet so you do have a lot of scope to reduce them and thereby reduce your bg levels. If you are genuinely T2 then diet will make more difference than anything else, but I am concerned that there is a possibility that you are T1.

I was on bydureon and Metformin within a few months of being diagnosed type 2, so Some start on more but losing control over time certainly should be discussed with the doctor and could be as you say a sign of different but we cannot diagnose

So, for me, my levels started after a decade to move to out of control, increasing meds needed, to reverse that I needed to carb control and lose weight. It's possible like me your body is losing g ability to cope even with the drugs. Type 2 in my experience is progressive and doctors often state it is but that is for me, because I ate a lot of carbs. The diet described appears carb heavy

Given BMI seems in the right level It may be carbs here. But really, doctor visit time.

 

[Farida Easmin]

Welcome to the forums.

That's a lot of medication for someone who has only been T2 for 4 years. Do you know if you've ever been tested to see if you are T1 instead of T2? (Slow onset T1s are often misdiagnosed as T2 for the first few years, and only get the correct diagnosis after all the T2 meds fail.)

Hmm, but there are a lot of carbs in your diet so you do have a lot of scope to reduce them and thereby reduce your bg levels. If you are genuinely T2 then diet will make more difference than anything else, but I am concerned that there is a possibility that you are T1.

Thank you for your reply. I have been diagnosed with T2 from my doctor. I never had any complications or symptoms until my age was around 46 or so. One day i had some hyperglycemic symptoms and then I was diagnosed with T2. On the first day of diagnosis my doctor prescribed me those meds back in 2016. Never had to change them because I had it under control with meds only. Because I was pretty great at not following any rules for last 3.5 years. Was eating full plate of rice, no walking or exercise. But from last October my bg is showing these unexpected results.

 

[Farida Easmin]

I was on bydureon and Metformin within a few months of being diagnosed type 2, so Some start on more but losing control over time certainly should be discussed with the doctor and could be as you say a sign of different but we cannot diagnose

So, for me, my levels started after a decade to move to out of control, increasing meds needed, to reverse that I needed to carb control and lose weight. It's possible like me your body is losing g ability to cope even with the drugs. Type 2 in my experience is progressive and doctors often state it is but that is for me, because I ate a lot of carbs. The diet described appears carb heavy

Given BMI seems in the right level It may be carbs here. But really, doctor visit time.

Thank you for replying. I understand that my reckless behavior with food and exercise might be the reason.

 

[xfieldok]

Carbs are the devil for T2s. Have a look at headbangerskitchen.com he has recipes for roti. Have you tried cauliflower rice,,?

 

[Tophat1900]

Thank you for your kind reply. My food list is following -

Morning : Oats with berries (sometime whole wheat bread), Vegetables (Broccoli, Beans, Potato), Egg (Boiled)
Mid Morning : Oranges, Pomegranates (Not juice or anything only fruit)
Lunch : Rice, Vegetables, Fish/Meat
Afternoon : Green tea, Roti/Bread (very little amount), Fruits (Oranges)
Dinner : Rice/Whole wheat Roti, Vegetables, Meat/Fish
Before Sleep : Skimmed milk (sometimes)

as I am an Indian descendent so most of my meals does contain rice or roti. But I try to consume as low as possible rice/roti. I mostly rely in vegetables and other foods.

Are you eating a low fat diet?

Also, that seems like a lot of carbs, bread (Regardless of white or wholegrain or brown) and potato, beans, rice and fruit like you are eating are certainly not gong to be kind to your pancreas and will result in higher levels. I'd consider ditching those, eat above ground veggies that are low carb especially green leaf stuff and if that brings your levels down. ALso discuss with your doctor the glick drug... going low carb while taking it has it's hypo risks before under taking a low carb approach if you want to try lowering levels by eliminating the main cause of elevated levels in T2

Check out www.dietdoctor.com for more info.

And take a look at this below, it's good advice from one of our members here.
https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/

Worth while getting tested to see if you are possibly slowly developing T1

And welcome

 

[VashtiB]

Hello and welcome,

I agree with @EllieM that's a lot of medication and a lot of carbs. Unfortunately it looks like you were following the standard medial advice.

I'm going to suggest that your first step needs to be going back to the dr to get the tests to determine whether you are type 1 or type 2. It is actually important.

The second thing- assuming type 2 is to start logging the carbs in what you eat and then the blood sugar levels- not necessarily changing g what you eat at first except by very small margins. Then- with strict and regular testing start reducing very very slowly the amount of carbs in each meal. When the results are such that the levels are within the normal range then go back to your dr to work out a strategy for gradually reducing your meds while also reducing your carb intake. but my biggest caveat is that I have never been on the sort of medication you are on so I am not an expert.

While waiting for the tests I would start logging your carb intake and the resulting blood sugar levels.

 

[Andydragon]

Thank you for replying. I understand that my reckless behavior with food and exercise might be the reason.

No not reckless, standard advice from doctors are often that carbs are okay. I was where you are, eating what I thought was healthy with a lot of fruit, cereal and rice/pasta etc

My levels were controlled by pills for a lot longer than you so assumed I could just keep.eating what I wanted. I did also eat bad stuff but again, meds worked

Until they didn't... So its progressed, and if you are type 2 then lowering carbs works for many, I am nearly off drugs altogether so sample size of 1, there are options to try

But staying on the carb heavy food, the progression likely leads to one answer, more drugs and finally insulin but again, you can try different but it needs a change to what you eat and forget what you might have been told is the way to eat

 

[Farida Easmin]

Carbs are the devil for T2s. Have a look at headbangerskitchen.com he has recipes for roti. Have you tried cauliflower rice,,?

No I have not. Thank you for recommending and I will surely give it a try.

 

[Farida Easmin]

Are you eating a low fat diet?

Also, that seems like a lot of carbs, bread (Regardless of white or wholegrain or brown) and potato, beans, rice and fruit like you are eating are certainly not gong to be kind to your pancreas and will result in higher levels. I'd consider ditching those, eat above ground veggies that are low carb especially green leaf stuff and if that brings your levels down. ALso discuss with your doctor the glick drug... going low carb while taking it has it's hypo risks before under taking a low carb approach if you want to try lowering levels by eliminating the main cause of elevated levels in T2

Check out www.dietdoctor.com for more info.

And take a look at this below, it's good advice from one of our members here.
https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/

Worth while getting tested to see if you are possibly slowly developing T1

And welcome

Thank you for reply.

 

[Farida Easmin]

Hello and welcome,

I agree with @EllieM that's a lot of medication and a lot of carbs. Unfortunately it looks like you were following the standard medial advice.

I'm going to suggest that your first step needs to be going back to the dr to get the tests to determine whether you are type 1 or type 2. It is actually important.

The second thing- assuming type 2 is to start logging the carbs in what you eat and then the blood sugar levels- not necessarily changing g what you eat at first except by very small margins. Then- with strict and regular testing start reducing very very slowly the amount of carbs in each meal. When the results are such that the levels are within the normal range then go back to your dr to work out a strategy for gradually reducing your meds while also reducing your carb intake. but my biggest caveat is that I have never been on the sort of medication you are on so I am not an expert.

While waiting for the tests I would start logging your carb intake and the resulting blood sugar levels.

Thank you a lot

 

[VashtiB]

Well apart from your carb rich diet things such a stress, sleeplessness and sickness an effect your blood sugar levels so the current world situation may be affecting your levels. But really you are young and I would seriously suggest that you look at your diet.

 

[Farida Easmin]

Well apart from your carb rich diet things such a stress, sleeplessness and sickness an effect your blood sugar levels so the current world situation may be affecting your levels. But really you are young and I would seriously suggest that you look at your diet.

Thanks I would. I consider my previous food choices had never any boundaries. Before last October I was eating what ever I want and whenever I want apart of no regular exercise or anything. My friend had T2 who was similar as me in behavior with food. He had over 20 mmol/L with Metformin 500 then his doctor changed that to 1000 now he seems to have a good grasp over this BG. I think i really need to visit my doc.

 

[VashtiB]

Hi again- I'm sorry but I guess it comes down to a decision for you. Type 2s are insulin resistant so if you keep eating carbs you will need to increase your mediation which is what it sounds like you are facing now. If that is something you are okay with that is absolutely fine.
I have made a different decision than you. I want to delay the need for insulin for as long as possible and if possible I would like to reduce my insulin resistance.

For me it sounds a bit like you are at a crossroad. One way is go keep eating carbs and keep increasing your medication. If this is the route you choose you will have to make sure you monitor your levels so the medication is increased as needed.

The other way is to radially change your diet and try to reduce your mediation and reduce your insulin resistance.

It's a decision for you and I wish you well whichever decision you make.

 

[Farida Easmin]

Hi again- I'm sorry but I guess it comes down to a decision for you. Type 2s are insulin resistant so if you keep eating carbs you will need to increase your mediation which is what it sounds like you are facing now. If that is something you are okay with that is absolutely fine.
I have made a different decision than you. I want to delay the need for insulin for as long as possible and if possible I would like to reduce my insulin resistance.

For me it sounds a bit like you are at a crossroad. One way is go keep eating carbs and keep increasing your medication. If this is the route you choose you will have to make sure you monitor your levels so the medication is increased as needed.

The other way is to radially change your diet and try to reduce your mediation and reduce your insulin resistance.

It's a decision for you and I wish you well whichever decision you make.

Thanks for your kind advice. I think reducing med and insulin resistance would be a better choice.

 

[BRSBRI]

Hi @Farida Easmin

I'm a relatively newly diagnosed T2 and it has involved a huge amount of relearning even to the extent of ignoring much of the dietary advice from my local surgery and elsewhere.

As T2 diabetics, we're insulin resistant and by having a carb heavy diet - and those high sugar fruits (sometimes known as sugar bombs), it's going to be an uphill struggle to get BG down even with a medical cocktail I'd say.

There's a lot of great advice here which I've sucked up in the month I've been on this forum - there's always an alternative!

As an aside, I've always loved sushi - but when you see the carbs on a medium sized platter of California rolls, due to the rice, then for me at any rate, it's a no-no...same with my fave Indian breads and biryani...

Wish you all the best!

 

[Daibell]

Hi. I don't think you have mentioned so far what what your weight/BMI is? This is quite important as a pointer to whether you are a T2 with insulin resistance or a late onset T1 (LADA). If you are slim and losing weight then LADA is quite likely. With excess weight, insulin resistance is likely. I think you know that keeping the carbs down should help a lot. The three drugs you have should be helping (I've been on all of them). The Gliclazide dose is very low and could be increased by the GP but may not relevant if you do have excess weight. There is a weekly injectable that may be relevant and worth discussing with the GP. So, do what can in reducing the carbs in your diet and let us know where you weight is.