Need help to inderstand

[Sadsac@21]

I’m still new to all this so I apologise if this is a silly question.
i was diagnosed in January, refused medication, mainly because I can’t see how I know I’m controlling things if also taking medication.
up until last week I have been doing finger prick testing three times a day. I was persuaded to get a libre sensor. This week I have been using it and getting lower readings with it than with finger prick, but I understand that this is normal. It’s also quite interesting to see the graph throughout the day.
What I don’t understand is: I can clearly see by the graph when I have eaten but my readings shoot up from the 7’s into the high 9’s to 10.5 after eating anything.
this I presume is really not good, but I haven’t been able to anything without this happenin. Does this mean I’m going to have to go on medication?

 

[Antje77]

What I don’t understand is: I can clearly see by the graph when I have eaten but my readings shoot up from the 7’s into the high 9’s to 10.5 after eating anything.
this I presume is really not good, but I haven’t been able to anything without this happenin. Does this mean I’m going to have to go on medication?

What type of foods do you typically eat?

 

[Sadsac@21]

I have completely changed my diet. I am now eaten salads and vegetables with either salmon or chicken. I don’t remember the last time I had a potato or rice or pasta but can’t stop my morning slice of toast and cup of tea with milk and half a sugar.

 

[Antje77]

Do you see those rises after every meal or after breakfast only?

 

[Sadsac@21]

I am seeing them after every meal. I am back within range within the hour which is why I never saw it before with just using finger pricks.

 

[Rachox]

You could try swapping out your regular bread with a low carb one and use sweetener instead of sugar in your tea. I wonder are you having the sweet tea with all your meals?

 

[Sadsac@21]

No I only have one cup a day when I get up. I drink water the rest of the day.

 

[JoKalsbeek]

I have completely changed my diet. I am now eaten salads and vegetables with either salmon or chicken. I don’t remember the last time I had a potato or rice or pasta but can’t stop my morning slice of toast and cup of tea with milk and half a sugar.

What's in the salad? Dressing can drive numbers up. And which veg? Above ground or under? Got to be an answer in there somewhere. I hope so, anyway.

 

[Sadsac@21]

No dressing. I didn’t know that about veg. I’m eating lettuce, cucumber, beetroot, tomatoes, peppers, cauliflower rice, onions of all types, courgettes, grated carrots. The only below ground things are beetroot and carrot. I will try leaving them out and see what happens.

 

[TheSecretCarbAddict]

Just to throw another thought out there. Blood glucose going up after a meal is normal and happens in healthy people, too. The main difference is how high it spikes and how quickly your body is able to process these spikes.

I find that as a T2, I need to aim for the lowest starting point I can before a meal and optimise my meals through experimenting to be as non-spiking as I can.

For example, I have quite a pronounced dawn phenomenon where my blood glucose goes up quite a bit without me having to eat anything. If I eat breakfast, my blood glucose can get really high. If I wait until my dawn pehnonenon has reached its peak and blood glucose is coming down, the spike from the meal is less pronounced.

When it comes to food, I had to cut down my carb intake to less than 20g net carbs per day. That alone wasn't enough. I also need to watch how much protein I eat. For me, it is no more than 1g per 1kg of my lean body mass. I arrived at these for now optimal figures through weighing, measuring, and tracking everything I eat and correlating to impact on my blood glucose levels.

Remember that there are other factors that will play a role here. Your sleep patterns, stress, exercise, illness, etc.

 

[Mrs T 123]

I have completely changed my diet. I am now eaten salads and vegetables with either salmon or chicken. I don’t remember the last time I had a potato or rice or pasta but can’t stop my morning slice of toast and cup of tea with milk and half a sugar.

I really missed bread/toast too but don't have to do without as I use these low carb co's https://srslylowcarb.com or https://lowcarbfood.co I swapped to earl grey tea with a little milk and don't need any sugar or sweeteners added and I used to take 2/3 sugars in my tea before (sorry I can't remember exactly as it was that long ago now)

 

[Sadsac@21]

Just to throw another thought out there. Blood glucose going up after a meal is normal and happens in healthy people, too. The main difference is how high it spikes and how quickly your body is able to process these spikes.

I find that as a T2, I need to aim for the lowest starting point I can before a meal and optimise my meals through experimenting to be as non-spiking as I can.

For example, I have quite a pronounced dawn phenomenon where my blood glucose goes up quite a bit without me having to eat anything. If I eat breakfast, my blood glucose can get really high. If I wait until my dawn pehnonenon has reached its peak and blood glucose is coming down, the spike from the meal is less pronounced.

When it comes to food, I had to cut down my carb intake to less than 20g net carbs per day. That alone wasn't enough. I also need to watch how much protein I eat. For me, it is no more than 1g per 1kg of my lean body mass. I arrived at these for now optimal figures through weighing, measuring, and tracking everything I eat and correlating to impact on my blood glucose levels.

Remember that there are other factors that will play a role here. Your sleep patterns, stress, exercise, illness, etc.

So if it spikes to 10.5 but is back down to 8 in two hours is this ok? Or is it the size of the spike that is the problem.

 

[JoKalsbeek]

No dressing. I didn’t know that about veg. I’m eating lettuce, cucumber, beetroot, tomatoes, peppers, cauliflower rice, onions of all types, courgettes, grated carrots. The only below ground things are beetroot and carrot. I will try leaving them out and see what happens.

Onions are underground as well... The rest should be fine, but I do hope you add in some fats and protein, otherwise it's not much of a meal. (I find salad a bit dry on its own, with some olive oil and maybe vinegar it's a lot more palatable, and those shouldn't do anything to your blood glucose).

I still find the rise a bit high, considering, but who knows... I hope the adjustment helps!

 

[TheSecretCarbAddict]

So if it spikes to 10.5 but is back down to 8 in two hours is this ok? Or is it the size of the spike that is the problem.

It is both your blood glucose levels as well as the spike.

As blood glucose is variable, it is useful to think about your target level as a range rather than a single number. Ideally, you would set the target range in consultation with your health provider and take into account your individual health requirements. There are a couple of standard ranges targeted at reducing diabetes related complications.

Standard: 3.9 mmol/l - 10.0 mmol/l
Tight (for less risk): 3.9 mmol/l - 7.8 mmol/l

CGMs tend to use the standard range as a default one and measure your time in range.

For spikes, a general rule of thumb is to optimise your meals to return blood glucose within 2mmol/l of your pre-meal reading two hours after your meal. It can spike more than 2mmol/l, the important bit is that it returns to within 2mmol/l.

Here is a bit more detailed overview:

Normal and Diabetic Blood Sugar Level Ranges

Normal blood sugar ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine diabetes.

www.diabetes.co.uk

There will also be quite a few previous discussions on this on the forum if you want to look around.

 

[Sadsac@21]

As blood glucose is variable, it is useful to think about your target level as a range rather than a single number. Ideally, you would set the target range in consultation with your health provider and take into account your individual health requirements. There are a couple of standard ranges targeted at reducing diabetes related complications.

This is my problem. Since being diagnosed in January the only people I have seen is the podiatrist, the eye people and in May had a follow up hba1c test which was 57, down from 114. I haven’t spoken to the nurse since February. She didn’t even ring to let me know my blood results I found these out through the NHS’s app. I did try to make an appointment and was told she would ring me back which never did.

Ive not been given any advice about anything and really do feel abandoned. Its like here is a life changing diagnosis, go away and deal with it oh and by the way we want you to have a shed load of medication and you have to take that for the rest of your life and just accept it.

Everything I know is through my own research. I know I must be doing something right as my finger prick results are down from an average of 17 to 8. I have lost 6kg and exercise every day now for at least 30 minutes.

Sorry a bit of a ranting post but I’m feeling very confused and angry about it all.

 

[TheSecretCarbAddict]

Sorry a bit of a ranting post but I’m feeling very confused and angry about it all.

Rant all you need! You've already have made massive progress despite the lack of information and support. You are in the right place to learn from the collective wisdom of the wider diabetes community. While we can't diagnose or give you advice on your most appropriate treatment, we can share our experience, which can help you plan your own approach.

One thing I have learned is that while many of us share the label of 'diabetes', this is a very individual condition, even if you have the same type as someone else. Our bodies are very intricate and how they react to different stimuli (nutrition, exercise, sleep, stress, etc.) will be unique to you and your current context. While some principles will be quite generic and apply to most of us, you will find lots of variation on an individual level. I guess this is a long way of saying, you will need to go on a journey to discover what's right and sustainable for you.

The way I approached was to set my blood glucose target to a healthy range. Whent that didn't work out, I reset and went for tight range. Then I had a massive wobble with my carb addiction and now am targeting standard range. Once I've stabilised, I'll probably will refocus on targeting tight range. Going wider than the standard range is likely to increase different diabetes related risks, but then again, this is very individual - for some, those risks might be acceptable if, for some reason, keeping within range is more risky.

It does take a lot of trial and error to figure how your body reacts to different interventions, deciding which changes you are happy with and turning them into lifelong habits. But it is well worth it. And I have to keep reminding myself every day that it is not a straight line journey, but a scenic route with ups and downs, backs, and forths...

 

[TheSecretCarbAddict]

Just to add to the above... when you choose a range, there are further tradeoffs to figure out... are you going to achieve with lifestyle changes, lifestyle with support from some medication or over-index on medication at the expense of no lifestyle changes. Keep in mind, there's no universal right or wrong, just what's right for you. Many T2s in this forum favour focus on lifestyle changes, but not everyone can get to their target level by just eating differently. When it comes to lifestyle, you have many interventions to explore. From nutrition (and different forms of fasting), to exercise, sleep, and stress management.

 

[Melgar]

Just setting your frustrations aside for a moment, you have done great getting your blood sugars down from 114 to 57. That’s a great achievement. And that’s down to you.

Members have already given you some dietary advice which will help. The exercise you are doing will very Likely help to lower your insulin resistance, which as a type 2, is the main driver in keeping your blood sugars raised. Exercise involving working your muscles to the point of exhaustion are the exercises that will reduce your IR. By that I mean, if you use weights and you work your muscles to the point that you can no longer pick up that 5lb weight. It sounds brutal, but in fact it doesn’t take many repetitions to achieve this. I do stomach crunches. I can muster 22 of them before I am unable to anymore. So, over time your IR will reduce, that means that the excessive insulin production your body is producing will lessen. (Excessive insulin production can increase IR) so it’s a bit of a vicious circle.

As for your poor treatment, care and support from the NHS this forum is full of members accounts , similar to yours, where newly diagnosed T2 ‘s are given their Metformin, told to come back in a year, given outdated dietary advice that only increases circulating blood sugar, and told not to test because as we will do that for you. Well all I can say is you have found this site with members who are very knowledgeable and only happy to offer up their help and experience.

 

[Sadsac@21]

Thank you everyone for your help and advice. I am so glad I found this site as I have learnt so much. I will keep going with trying to alter my diet etc and hopefully I’m not going to have to start taking medication

 

[Outlier]

To add to the good advice you have already received, I am a T2 and can only do light exercise (walking), but diet changes have brought my T2 into the non-diabetic range and kept them there. So if gym exercise is out of your reach, you can still make quite a difference to your glucose readings.