New T2

DCUKMOD

I’m a newbie type 2 been over a month for me and I normally don’t eat carb and sugar unless carb are low

Jokalsbeek might can help u too

lazybum said:

Hi there,

I was diagnosed a week ago with T2. I'm 36/m, family history of diabetes; my father was diagnosed with T2 in his early 30s. I'm of asian descent, so rice is a staple and hence my diet is quite heavy on carbs. I've also had hyperthyroidism, however this has gone into remission and my GP suspects this is a contributing factor as it caused my metabolism to slow down.

I felt particularly lethargic after a carb heavy day last week, bought myself a BG meter. Had a fasting glucose of 11.8 mmol, dragged myself to the GP and got put on 2000mg/day Metformin ER. A1C came back at 11.1. Tests also showed mild non-alc induced fatty liver.

Since then, I've gone on a mainly LCHF diet and started exercising 45-60 mins per day. I've been on Metformin for exactly 7 days, BG levels have dropped significantly and my fasting glucose over the last 3 mornings (taken right after I get up) have been 5.x mmol.

I've been introducing some carbs and sugars back in and actively monitoring BG to see how much my body can tolerate while keeping BG in check. In most cases postprandial BG is consistently between 6.8-7.8 mmol after 2 hours, even if I take a significant amount of fruits, eg. 300g of mixed melon pieces.

The only thing I've noticed is when taking particularly carb/sugar heavy food, BG takes a while to peak. I had a very sweet cream cheese danish for tea, and BG was as follows:
- 6.0 mmol @ 1 hour before meal
- 10.4 mmol @ 1 hour after first bite
- 12.8 mmol @ 1.5 hours
- 11.4 mmol @ 2 hours
- 8.5 mmol @ 2.5 hours
- 6.0 mmol @ 3 hours

I'm assuming BG in non-Ds aren't likely to peak that high, however is the late BG peak @ 1.5 hours typical of insulin resistance, or just slow digestion?

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The numbers you're seeing are thoroughly diabetic, so, no, not slow digestion, just your body trying it's damnedest to deal with what you put in there, and failing miserably. It just can't deal. You're looking for a rise of no more than 2.0 mmol/l between before the meal and 2 hours after the first bite, and you're nowhere near it. So the question becomes: Why in heaven's name are you reintroducing carbs and sugars? Once you're diabetic, that's what you are. I've been in remission for years, but I'll always be a T2. While your tolerance can improve some, and it'll take months if not years for that to happen, the moment one goes back to the old, previously usual carb load, numbers will rise again. You've been diagnosed for a week and you expect miracles? Or is it just a matter of experimenting? I'm all for experiments, but please, do be careful. You only get one body to live in, take care of it. I had non alcoholic fatty liver disease so bad it hurt to breathe, and carbs, and especially fructose, can make it that much worse. Cutting carbs and fruit can fix it, like it did mine.

https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ might help a little, but do yourself a favour and stay away from the Danishes.
Good luck!
Jo

Hello and welcome,

I also find your post a bit confusing. You have been diagnosed as a type 2 diabetic at a reasonably young age. You seem to have some understanding that us type 2s can't tolerate carbs but then say after a week that you are introducing some carbs and sugars back into your diet. The levels you post in relation to your blood sugar levels are all higher than I personally like. If I see a 6 I take that as a message to reduce my carbs, try to reduce my stress (easier said than done) and maybe get out for another walk. I am a lot older than you- in my 50s and the reason I take it this seriously is that I don't want to do any more damage to my body and I absolutely do not want to increase my insulin resistance. You as someone much younger than me doesn't seem concerned with the issue of your insulin resistance and that makes me a bit sad.

You will be a diabetic for the rest of your life. That is a fact. You can make a real effort to put it into remission and make it non-symptomatic and try to decrease your insulin resistance or you cantata the path you seem to be on and have levels well into the diabetic range which will increase your insulin resistance and end up having to take insulin. It is your choice.

I sincerely hope you can see how much @JoKalsbeek was trying to help. She is one of the most generous people I have 'met' her link that she posted has helped at least thousands of people. The people here are so generous with their advice and time and as a result of that generosity and advice I like many many others have had my diabetes in remission within three months of diagnosis. I have found that journey difficult as I love carbs and they formed a huge part of my diet pre-diagnosis. The help and support I have been given when complaining about how hard I have found it was amazing.

Good luck with your journey- only you can make the choice about the path you will follow.

lazybum said:

No one has been able to provide any additional information on what a postprandial BG curve should look like other than 'it should be no more than 2.0mmol higher at 2 hours'. It doesn't tell me if 2.0mmol is post peak? It would mean by BG could go from 6 -> 10 -> 7mmol in the span of 2 hours and that would be acceptable being less than 2.0mmol higher @ 2 hours.

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Hi there. I don’t think there is a definitive answer to this. The ‘2 hour rule’ is the one generally used and it’s a very helpful guide as above all when testing and experimenting with food, you need to be consistent in how and when you test so that you get a good picture of what is happening.

The ‘curve’ before and after the 2 hour mark will be affected by many things - your own insulin response; the macronutrient content of what you ate; portion size and so on. For example, if what you eat has a high fat content, the curve, even for a relatively high carb meal, may be ‘lower and slower’ than for a pure carb hit, where the spike may be more pronounced and short-lived.

In my own case, for example, there are things I eat which are not high carb but are considerably more carbs than I’d usually eat (I go for as close to zero as possible), but as they’re high fat content, the initial rise is low, but hours later I’ll see a bigger, prolonged rise and sometimes even a ‘double’ dip, where it goes down and then shoots back up, sometimes higher than the first rise.

@lazybum

You may find it helpful to consider that it is the 'area under the curve' which is more important than the highest number, which is no more than a snapshot at a set time.

Yes, as @Goonergal mentioned, the actual peak will vary considerably depending on whether you eat just sweet stuff (a steep needlelike graph which may well drop nice and low by the 2 hour mark) or you eat a complex, slow release meal high in carbs, protein and fat where the peak could be anywhere from 3 to 6 hours after eating in which case the graph curve would look like a long low plateau.

In both cases it is the area under the curve that mounts up, once damaging numbers are reached.

Finger prick testing at 2 hours is a fabulously useful tool to help us tailor our way of eating, and to keep track of how well we are managing our condition. However, in order for it to provide us the kind of detail that you are looking for, it would be necessary to finger prick every 15 or 30 minutes, which would kind of take over your life.

If you want to see your blood glucose plotted out on a curve, to see exactly what is going on pre and post meal, when your peaks are, and what happens at night, then you would need a different gadget for blood glucose monitoring. Many here on the forum use the Freestyle Libre for this. It has its faults (all bg monitoring methods do), but it was certainly a revelation when I started using it.

Also, please understand that the people here on the forum are trying to help you. They wouldn't be here, and they wouldn't be posting if they weren't willing to spend their free time and leisure trying to pass on their experiences and help people through what can be a very stressful condition. Especially soon after diagnosis.

What is frustrating to all of us, whether we are newly diagnosed or have been dealing with D for 50 years, is that it is a very multifaceted beast, that can vary from week to week and from hour to hour. There are very few clear cut answers, and the more you learn, the more you discover that worked today, or last week may well not continue to work in months and years to come. I would urge you aim for a period of stability to allow your body to make the best recovery it can - with nice low numbers and regular eating patterns - before you start rocking the boat with experiments to find your upper carb tolerance - cos sure as eggs is eggs, your carb tolerance will change in the next few months.

lazybum said:

I believe the timing and delta of postprandial spikes/peaks are also important.

I can have a small serve of rice, bread or potatoes with my meal and my 2 hour postprandial will be low 7s.

Yet some have the opinion that any amount of carbs are bad and this will lead to insulin dependency in 10 years.


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I think it depends on the individual that's why testing is so important. Now my blood sugars are more stable I do eat foods like pasta and potatoes every now and again and it doesnt raise my blood sugars by much. I plan my food diary in advance and will have a lower carb breakfast and lunch on those days and increase exercise. My portion size is a lot smaller than it used it be. I don't eat normal bread as the low carb alternative is really tasty so I haven't needed it. I find rice bland, so swapping to cauliflower rice was easy. Good luck with everything, it gets easier. I was diagnosed 4 months ago age 33 and I was/am devastated but tracking food and blood sugars has given me motivation. There is hope.

EllieM said:

@Sugarlisa . For future reference, if you want to send an alert to another member to join the thread you put an @ followed by their name. Then they get a notification that their name has been mentioned in the thread

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Thanks

I think that the 2 hours from starting the meal timing is used as it showed me both my progress and how the meal affected me - but I don't have high carb foods at all so I saw my numbers reducing week by week.