• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Type 2 New here - raft of questions - sorry :-(

S

SirLance-alot

Member
Messages
15
Evening all.

Please excuse a few newbie questions and a fairly long post. I'm age 51, diagnosed Type 2 on 13/Jan 2021. I had started getting tell-tale symptoms, like constant thirst, very dry mouth in the morning, and waking up 5 times a night for a pee - so I bought a little blood glucose meter from Amazon, and was consistently reading 28 mmol/L, so went to see my GP and got properly tested, with predictable results. So - still getting used to it, although trying to address it constructively by (finally) sorting out my diet and intake of red wine GP has put me on Metformin, and also I'm trying to follow Keto - 20g Net carbs a day, and 1200 calories. Fairly dramatic results - surprising, actually - hence these questions - apologies if they are silly to those of you in the know.

Firstly - the diabetes specialist at my local medical practice (it's not my GP - they have an actual Diabetes guy there) told me I'd be on the Metformin "for the foreseeable future" and that they would see me again in March for repeat testing. However - 11 days after beginning the Metformin, by 26th January, I was reading 7.7 mmol/L in the morning, 5.6 mmol/L mid afternoon, and 6.2 mmol/L just before bedtime. And this has continued - I have never been above 6.8 since then. Right now, 2 hours post-prandial, I just tested at 4.6. It has dropped dramatically, and seems to have levelled out.

So here's the question - is this in fact TOO FAST of a decline ? He told me to "phase in" the Metformin - 1 a day for week 1, twice daily in week two, three times daily in week three.... but here I am, just after week three, I stuck to twice a day - it seems to be stable - should I step up to 3 a day ? I'm not having any adverse symptoms (tummy trouble etc) and the medicine seems to be working. OR - in fact, is my combination of the Metformin, and a Keto diet, potentially giving false positive results which will not last and might even be unhealthy ?

I'm worried that my sugars may have dropped too far too fast. I've noticed that my eyesight has altered dramatically, in the last few weeks, and also I have become extremely clumsy. I keep bumping into doorways, and dropping things. My brain also seems a bit "vague", and foggy. Meanwhile the waking up all night, has gone. The constant thirst, has gone, and the morning parched mouth, has gone too. On the other hand - I'm very sleepy in the mornings, often not waking up until midday (I'm furloughed at the moment, thank goodness).

So anyway - I understand that this is not a medical forum, so of course am clearly not looking for any medical opinions - just generalised opinions based on peoples's experiences - is this "normal", for the first 2 or 3 weeks on Metformin, for a type 2 ? Should I step up the Metformin to 3 a day, as prescribed... or might this run a risk of getting TOO low ? Is the medication + Keto combination, having too dramatic an effect ? Are my changed physical symptoms (clumsiness, brain fog, eyesight, plus weird constant back-ache) normal... or not, at this stage ?

Many thanks to all in advance.

Kind Regards

Chris.
 
Last edited:
Sounds like you’re making great progress @Sir-Lancelot

Your ketogenic diet is likely having way more effect than the metformin so whether you decide to increase the dose or not (your call), the reduction in carbs is the thing to stick to. Incidentally no need to count the calories too, although if you’re not getting hungry and you’re getting the results you want, I’d say ‘if it ain’t broke, don’t fix it’!

And it’s highly, highly unlikely you’ll go ‘too low’ on metformin alone. It’s not a blood glucose lowering medication, rather it helps with insulin resistance by reducing the amount of sugar your liver releases into the blood (that’s why dietary changes are the most important thing).

I started with a very high HbA1c and also went keto. My eyesight was affected - was a bit odd at first, but my next visit to the optician confirmed it was improving so all was good. Similarly I got tingling, in fact a bit more than tingling in my legs and feet, but again it was short lived and a sign of blood sugars improving. And my migraines got worse for a short period, but have now completely vanishe,d.

If you’re restricting calories as well as carbs, that could be one reason for you feeling tired - you may be depriving yourself of the energy from fat that your body needs in the absence of carbs.

Stick at it and stick around!
 
I have got an exact situation; doc prescribed to increase metformin 1000 intake to 2 a day from second week onwards. BUT I am doing pretty great with just one as my morning fasting readings are 4.4 - 4.9 mmol. So, I will not be increasing my intake. Of course I have modified my lifestyle which includes walking longer distances almost everyday and cutting out all the junk and empty calories. They seem to have helped a lot. I'll definitely ask the doc as to why I need to increase my Metformin intake when everything seems fine with just one..will keep you updated.

Take care until then
Ash
 
Awesome work lowering your BG levels, I recommend eating at maintenance calories unless you’re trying to lose weight, if that’s the case only decrease by about 10%. You may consider getting more adjusted to keto first before changing your calories.

Don't forget to keep an eye on your sodium if you’re losing water weight. I add a pinch of salt salt lite to my drinking water jug as it has potassium.
 
Hi Chris

It would appear that you have many things under control and testing your blood is a great idea. I'm type 1 and have been for 47 years, took a dafne course and have to admit it was brilliant proving that we're all still learning.

A few words which hopefully will be of benefit .(please excuse me if I'm teaching my grandmother to suck eggs).

Always wash your hands before a finger test, only if you're handled a biscuit or any sugars it will effect the result massively.

In terms of clumsy when you experience this event do a test to confirm if it is low blood related (always learning) as it may impact your medication review with your constant.

Record all test results, it's the only thing that will enable you to spot regular trends and act upon them.

Eating is easier for me (even as Coeliac), as I alter the dosage to the current Blood level and carbs in the meal, but in your case you can still apply the principles in recording the carbs as it will eventually help you with what's good or bad for your body.. everyone's different, so no fixed rules. Think of your condition as an exercise to plan, make precautions and monitor but being diabetic does have it's advantages in the you are forced to look after yourself, (with any sense).

Testers, so many.. but throughout my life I've tested and pushed the limits of many, so review e.g. YouTube and others for advice before changing, but can assure you that even the correct finger pricker with a fine needle will eventually pay dividends.

Many talk about life expectancy, everything in moderation and don't let diabetes stop you doing anything (covid aside) just plan for eventualities. I always carry a fresh sealed full sugar Lucazade (as a liquid it enters the body faster and purchased everywhere). It has on several occasions saved serious complications, not only myself, but on many instances with walker's not even diabetes as a low blood sugar can have consequences for angina suffers as just one example.

Don't want to overload you, now at 59 rest assured keeping things on an even keel will and does eventually make a difference to less or no complications and you'll feel a great deal better when you discuss with your Doctor etc.
All the best .. Stay safe
 
Not that you are wrong for a type 1 but the op is type 2 and only on metformin. Hypos and their treatment are highly unlikely to be an issue. It might be confusing for him at this early stage to get both sets of information when only one is relevant to him right now.
 
A12345 said:
I'll definitely ask the doc as to why I need to increase my Metformin intake when everything seems fine with just one...
Click to expand...

Because many assume you wont make any or sufficient changes and more drugs will be the end result required. Not helped by the fact that these same drs fail to provide the useful information necessary how to make said successful changes. Double whammy of assumptions.
 

Thanks Mike. I have no idea what my HBA1C is/was, to be honest - it didn't occur to me to ask him, at the time - the number "80" seems to spring to mind, but I have no idea if I'm just making that up. Presumably I'm entitled to call them and ask ? All I know is that my blood glucose was coming out at between 26 and 28 mmol/L every time I measured it - and I have no reason to think this is "new" - ie, I reckon it had been like this for some little while. I know for a fact that my blood pressure has been elevated for at least 2 years, which (I imagine) goes hand in hand with high blood glucose ? Since embarking on keto, and metformin, it has certainly normalised - I test it twice daily and it's now averaging 112/70 (yes, I do also have a blood pressure monitor - bit of a gadget fan plus obsessive control freak ?! )
 

Thanks Goonergal

Seriously, you think the diet is probably the key factor ? That's a shame - I was hoping to start reintroducing pasta to my world, in a couple of weeks I really miss pasta. And bread. And pies. And cake :-( Seriously though, I think the eyesight changes are rattling me the most. Also, my feet feel tingly all the time and tonight I noticed a painful red patch on the side of one foot, which is probably nothing but I've heard all the horror stories. Why would my eyesight deteriorate ONCE I have been diagnosed and started getting the sugars under control ? I can imagine sky-high glucose would affect various things... but surely not "normalised" sugars ? As regards the restricting calories thing - well, I'm really struggling to reconcile the idea of a keto diet - low carb, yes fine, but high fat (= high calories)... surely not ? It seems to boil down to ... carbs, or calories. And neither, apparently, is good for me, or maybe it is, depending on which particular diet you are following ?!. I'm losing weight on the Keto, but bacon and eggs cooked in butter, for breakfast, just doesn't feel right. Weight loss is another goal, since I also have Obstructive Sleep Apnoea, for which the only known credible cure is dramatic weight loss..... so I suppose I'm taking the bull by the horns with this diabetic diagnosis, and jumping in very deep ?
 
Last edited:

Cheers Ash. Your Metformin are 1000's ? Mine are 500's.... so sounds like you're already on (the equivalent of) what I'm on ? Yes please, keep us informed - although (and this might be a bit contentious.....) I'd rather, to be honest, take Metformin, if it allows me to still eat yummy carby food. Or will that equilibrium break down over time ?
 
Thanks Dan. Yes, I am also using this as a kick up the proverbial, to lose some serious weight. I also have Sleep Apnoea, which is BMI-related. I don't mind a bit of cold turkey, but - as you're clearly into body health - how long do you reckon this will take before it all settles down ? By which I mean - a regular eat/sleep pattern emerges in which I don't feel like something is missing (which I do, at the moment...) ?
 
I'm just about a year ahead of you, and yes , at first there were all sorts of odd signs and things happening with my body, but now I look back and see them as signs that my broken body was coming back to life, and back to working the way it should.
Yes I was cross and angry that I wouldn't be able to eat all the things I liked, or to cook the cakes I loved to make for friends and family, but now my body and appetite has adjusted so much that I no longer miss or care much food. In fact most of the old stuff I see as poison.
Yes keto and low carb seem odd diets, but they are a way of eating for life that seems to suit us diabetics well.
I'm not on any medication, and would prefer not to be, preferring a natural remedy of giving my body the food that is right for it.
Give it time, this is lifelong, even if controlled well, so no rush. It took my head longer to adjust than it did my body.
 
I suspect that to remain in the excellent situation you seem to be in, grains are going to be off the menu. There are alternatives though, low carb versions to make - as they are not available commercially.
Where type twos diagnosed over 3 years ago might gather, if allowed, they usually lament the Lidl triangular rolls which were low carb, but were discontinued.
Your eyesight is not so much deteriorating as changing - the high sugar content of your various fluids is reducing, and that is distorting the lenses in your eyes. It should recover in the fairly near future as it gets sorted out.
To stay in ketosis we usually need to have what were normal amounts of fat in the diet - low fat has done nothing to improve health, in fact some illnesses are now more common.
Fried eggs are actually not going to absorb the fat they are cooked in, the heat seals them. I have scrambled eggs and incorporate butter into them, but the three eggs with butter, cheese and a tomato have to fuel me for the next 12 hours, and they do - along with a cup of coffee with cream. One of the joys of eating a low carb diet is not being hungry - the almost two years of a low fat high carb low calorie diet I was on before diagnosis resulted in my teeth cracking under the teeth clenching from almost constant hunger and the anxiety that caused.
I found that I had lost 50 lb without trying after diagnosis, just by eating low carb without restricting calories.
 
Last edited:
Probably took me about 6 months before Sleep Apnea, GERD, excessive wind and getting up to pee multiple times finally went away. By that time I'd established an ultra low carb eating pattern with 2 meals a day.
Went from morbidly obese (BMI 43) 143 kg to my current Overweight (BMI 28) 94kg.Eventual aim if for about 80kg although that may take some time!
 
Drugs may control the blood levels and allow more carbs, but metformin on its own is highly unlikely to do that significantly and if you keep eating carbs and pushing your limits you will probably have increase drugs, add drugs and eventually end up on insulin.

Also, High blood complications are not insignificant by far. I don’t need to share the complications I saw my father go through but suffice to say, I should have done better sooner but to be fairer to me, NHS advice was wrong too

over time, likely yes, it will breakdown. But you can change this now.

I took a long time to make the change and it’s hard, dropping carbs is a lifelong change and maybe you can tolerate some, but you may be talking low hundred and below, or less, everyone is unique

Of course some of my advice was wrong from the nhs, but now I’ve been doing this since May I am nearly drug free, non diabetic hba1c and 30kg lighter. Healthy BMI and apart from some saggy bits I need to work on, pretty darn happy with how I am looking. Thankfully no long term damage it seems and hopefully even the slight retinopathy can now heal

But apart from rare exceptions, no bread, pasta, rice, most fruit etc. It’s just I’m afraid a major lifelong change.

but I am sure you can do it, seeking advice on here is a good start
 

MrsA2, thanks for your reassuring words. To be honest, I'm finding it hard to see the wood from the trees, in terms of "odd signs and things happening" - I'm newly (unexpectedly, and traumatically) separated and single, recently unemployed and now on benefits (never saw THAT one coming ?!!), struggling financially (savings all gone) and diagnosed 2 months ago with depression, and now more recently with Type 2. It would all be a bit overwhelming, if I let it. The diabetes thing is, in some ways, the lesser of my various evils - I am trying to see it as an opportunity to sort out my lifestyle and diet. As a passionate home cook (ex-restaurant chef) I have a deep relationship with food, which is now being challenged - but TBH I am embracing the idea of exploring low-sugar / low-carb alternatives - for example I made an amazing Smoked Mackerel Kedgeree today, using cauliflower rice and home-smoked fish... it was honestly lovely, and 5 grams net carbs, and made me feel quite proud. I'm very impressed with Xylitol as a sugar alternative... just need to find a decent Bread recipe that is low carb and doesn't taste like Victoria sponge. I miss pasta very much, but found Konjac noodles recently - have ordered some, but not tried them yet - fingers crossed. Fruit, too, is a big gap - I have apple and pear trees in my garden, and a freezer full of them .... :-( However - I have found zero sugar and zero carb fruit jellies, in Lidl, that are doing the trick for now. Maybe I'll splash out on a "proper" fruit crumble, once things have settled down. For now though, I'm going to give this hard-core Keto thing a month, to see what happens. The weirdest thing at the moment,m is a nagging pain in my back, close to where I imagine my kidneys to be (but just on the right hand side). Maybe that's the gap left by Croissants in the morning
 

Thanks Resurgam. I'll agree with you that, on the Keto diet, I'm not hungry, per se.... but I'd say that I am "bored". Breakfast options, in particular, seem limited... and snacking seems out of the question - even carrots and celery are apparently not so ketogenic ?!. I like that you say I'm in an "excellent situation" - from my point of view, newly diagnosed, it does njot seem to excellent, and I did not recount my experience in order to seem in any way pleased or smug - this has been a really big deal for me, as an ardent Foodie.... I'm doing my best to deal with it constructively, but I predict (am CERTAIN) that I will fall off the wagon in the next few days, and buy a bottle of wine, or a fish and chip supper :-(

So - you never restricted calories ? You see, that whole conundrum still baffles me. I have been told that the key to controlling many things - Diabetes (which I have), and Sleep Apnoea (which I have) - is reducing your BMI. Reducing your BMI, unless you can manage to grow taller, means reducing your weight. Weight loss comes from burning more calories than you take in. Exercise actually burns very few calories, so your best bet is to take in fewer. Fat is high in calories. A diet high in fat does not help calorie intake reduction, therefore should not help with weight loss. And YET - on my Keto diet, over the past 3 weeks or so, I have lost about 6 lbs. Not a lot, but probably healthy and sustainable.

Is a successful Ket diet progam DEPENDENT on high calories ? It doesn't seem to be, in my experience so far, but high calories seem inextricable from the basic principles of the diet itself.
 
And here in lies the paradox with current thinking. Weight loss comes with USING more energy that you take in. As type 2 we cannot USE the carbs we take in due to insulin resistance so they sit there til doing nothing useful they turn to body fat and harmful deposits. We can use the fat we take in however. And as it has more calories per gram than carbs we actually need less of it in comparison and it keeps use full for longer gram for gram.

keto is not so much about high fat once adapted and fat burning, but avoiding low fat replacements and benefiting from the natural fats that come with natural proteins. The last 50 yrs of low fat mantra simply makes a normal fat intake look high. Higher fats are useful whilst changing from being a glucose driven animal to a flexible or ketone burning mammal.
 
exactly what HSSS said
Plus check out a lot of the videos and talks on this thread which show the science behind the low carb thinking, and debunking the calories in, calories out model.
https://www.diabetes.co.uk/forum/threads/low-carb-denver-march-8-10-2019.162070/

Yes, it is all very different to what we have been taught, (or sold by marketeers) but it seems to work.
With your culinary skills I think you'll find it a fascinating and rewarding way of eating.
Ally Houston is a chef who cooks and podcasts about paleo, which is another form of low carb. Check him out too.
 
ps I have lost 3 stone in about 6 months by not counting a single calorie. I cut out carbs as much as I could, and I am rarely hungry. My body is finally working again, I was unknowingly giving it the wrong fuel.
 
You must log in or register to reply here.
Menu
Log in
Register
Cookies are required to use this site. You must accept them to continue using the site. Learn More.…