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need help as confused type 2

axle 222

Well-Known Member
Messages
243
Location
Essex U.K
Type of diabetes
Type 2
Treatment type
Insulin
Dislikes
Not being able to do what I would like to be able to do
Hello please can anyone out there give me some advice.....was seen by SDN,as have had a few hypos in last week but high readings rest of day,( I'm on permanent steroids) she has reduced my morning insulin by 2 units but told me to add/increase my carbohydrate intake.
Now I've been following forums and every one says cut back carbs.....so what do I do?????
 
Not on meds myself but will give this a bump and someone will help ... increasing carbs doesn't sound like a good idea, though. I haven't read your previous postings so I'll be careful but wish you all the best.
*EDIT* Now I've read about your other health issues and am even more cautious about advice. Have you had @daisy1's excellent guide? I can't find it just now.
 

I watched a video by one of the people presenting the CGM by Abbott. He seemed to be concerned about the Hbac1 of people using insulin and said it should be higher than other peoples. His reasoning was that since the Hba1c is an average it should be maintained at a level where the low readings do not give you a hypo.

Also, somewhere in the Diet Doctor site is a warning that if you are going to low carb then you must adjust your insulin accordingly.

It might take hours but here are the presentations for Freestyle Libra.

http://abbottnextfrontier.com/EASD2014
 
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I think the advice to increase your carbs is totally wrong. I wonder what reason she could give? It must be difficult enough being on steroids but to increase the carbs for no good reason would just add to your blood sugar level. You meter surely tells you that carbs increase you blood sugar. It's your choice but the majority on this forum who also have diabetes would tell you not to increase your carbs. Ask your DN why we carb count when on insulin?
 
Thank you for advice..
 
Thank you,I will watch and see.
 
The reason she said I was to increase my carbohydrate is because she says I should be having about 260 a day,or to lose weight 130, but my total carbs a day is less than 50,generally less that 30. She says if I don't eat enough I won't get any energy and why I hypo......you helped me before diabell with regards the steroids,I'm just confused.
 
No I've not had daisys link.....
 
@axle 222

Hello and welcome to the forum

Here is the information we give to new members mentioned above. It will give you a lot of advice about carbs. Ask more questions if you need to and someone will help.


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 over 150,000 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-and-whole-grains.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 bloodglucose 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.
 
Thank you have received daisys link....have read through,unfortunately due to another medical condition I can not have fibre,grains,etc....perhaps someone else out there has the same.?...I understand why now how strange it is that DN suggested more carbs.....the more I read on this forum the more I believe the people over the DN....
 
Yes, you have particular needs although some of us don't eat grains anyway. It's nearly always confusing to start with and I hope from Daisy1's guide you'll be able to work out your strategy.
The other point is I believe some people find that gradually as they persevere with whatever diet they find is best for their diabetes, some or all of the other health issues are either reduced or disappear.
Obviously that doesn't apply universally.
 
it's difficult with steroids. My experience is that 5 months after diagnosis i can be as low as 4.8, or as high as 7.8 in a morning. I'm having quite a lot of trouble with an infected toe, and when the infection is having a flare up, my bs levels will rise.

But whatever they start at, the bs will rise very little after breakfast, but then slowly rise from about 11.00 am and are likely to reach 10 by 13.00 hours. This is irrespective of what I have eaten or exercise. The only things which correlate with my bs rise are

1 Whether the steroids are enteric coated or not. I have 2.5 mg and 5 mg which are enteric coated, and it is usually about 2.00pm before they start causing a bs rise. I've recently gone from 12.5 mg to 11mg. 12.5 mg was all enteric coated, but I have dropped to 11mg, which is 4 enteric coated plus 1 uncoated. I have been finding that the bs rise starts sooner. Certainly by 12.00 noon

2 The size of the cortisone dose. When diabetes was diagnosed, I was on 40 mg, and readings in the high teens were not unusual. However, I have got down to 11 mg. My GP has always said that I might reverse is I get low enough, but he thought I wouldn't notice anything significant until I got to 6 mg. However this hasn't happened. I went from 40mg to 30 mg in 5 mg drops, and noticed my high bs levels dropping. Then I dropped by 2.5 mg intervals, and noticed a further drop in my bs levels; by 12,5 mg there were hardly any readings above 10.5 mg. You need to plan drops od dose carefully with your GP. It can be very dangerous to drop too much too fast.

3 Plan carefully. if it looks like a stressful week avoid doing a drop as this will cause a rise in blood sugar. Delay the drop until everything is calm.

This of course assumes that you are able to drop your prednisolone, and that may not be possible, it will depend on your condition.

An extra point, quite a lot of posters will make comments about your post meal bs levels 2 hours after eating, and if your bs has risen more than 2.0, then maybe you should be cutting that food out. Don't be too hasty. You may well need to do more tests. Your bs level may be going up because of food, or it may be because that day's prednisolone dose is getting into your blood stream, and that effect will continue until mid evening. Or both things are happening together, One amplifying the other!
 
Thanks for the info. Some would say 250gm/day is too much as long as you are having energy from proteins and fats. 130gm/day is quite a sensible number. As you say you are very low-carbing which is fine as long as you make up with the other foods. Your nurse is assuming all energy needs to come from carbs and that you should have a low fat diet? In practice having more fat and protein will slow carb absorption and reduce spikes and overall blood sugar but insulin timing needs to take account of the slower absorption. If you have hypos with a given level of insulin then surely it should be reduced/re-balanced?
 
Thank you very much for your very kind message. I take 40mg steroid on flair up and titrate down,as you do. Unfortunately the steroids have caused damage to my adrenal glands whereby I now have adrenal insufficiency,so can never go below 10mg. This is ok with my endocrinologist. Like you I get the rises from lunch time,always up in high teens,I take my insulin with meals and it brings it to 8 or 9s then climbs up again( have had a couple of 6+ at bedtime but that's rare. But it's the morning hypos I awake too....
Thank you for the food reference,that has helped. Also about stress,I have a very big hurdle to face in the not to distant future and that is majorly stressing me out......so your help has answered a lot of my questions. Thank you.....
 
Thank you diabell,makes sense what you are saying,she did just say eat the carbs,which is why I queried it on here....I've been messaged by Margaret R who has an understanding of the steroids and so with her info and yours I feel better. I have the hypo on awaking,just tested and I'm 10.6 now before bed,no insulin as only to take with a meal,so will see what I awaken on.....thank you.
 
I think us steroid users need to stick together, their aren't many of us around!

Margaret
 
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