New to diabetes

Hi @Ceppo,

Really well done. A reading of 7.6 is really good when starting with an HbA1c of 100. It definitely looks as if you are making good progress.

The most important thing is to establish a regular testing pattern, whether this is right out of bed or maybe one our later. What you would like is to be able to compare numbers from one day to the next to uncover trends in your blood sugar readings. So, if you test, try to test at around the same time/same situation as the days before.

This being said, this is what a lot of us do, especially in the beginning to get the most out of testing:

1. Right upon getting up.
2. Right before breakfast.
3. Two hours after having your first bite of breakfast (goal: less than 2 mmol rise compared to the before breakfast reading)-
4. Right before lunch.
5. Two hours after lunch.
6. Right before dinner.
7. Two hours after dinner.
8. Before going to sleep.

Don't worry if your blood sugars take a while to get to truly normal levels. It takes a while for your body to get used to these lower levels (and it initially tries to maintain the higher levels it has become accustomed to). Also many of us (including me) have observed that fasting levels usually take the longest to come down, so that blood sugars in the morning are often higher than at night.

Keeping my fingers crossed for you and congrats on the progress.

Hi @Ceppo,

Wow -- what an inspiring meeting with your DN. Glad she was interested in how you achieved this. (Btw, the reaction of my GP was pretty much the same -- he said he's never seen anything like this before).

Btw, congrats on your readings. Just because I was curious, I calculated the average of your readings so far (7.2 mmol) and looked up what your HbA1c would be if you maintained these readings (though very likely your blood sugars will still come down a bit further with time). So, based on this your next HbA1c would be between 43 mmol and 44 mmol (see table below). So, really well done. I am impressed. Very likely, though, your blood sugars will still come down a bit further.

What did the DN say as to adding more medication?

Hi @Ceppo,

Yes, it is definitely a steep learning curve, but I am sure in no time at all you'll be welcoming and advising newbies too.

The reason, we T2s often see higher levels in the morning (also termed dawn phenomenon) is insulin resistance. All people release hormones in the morning to provide energy for getting up and starting the day. Many of these hormones also raise blood sugar levels (e.g. epinephrin, cortisol, glucagon among others), but they are counterbalanced by insulin. However due to insulin resistance, the insulin released is insufficient to overcome the resistance in T2s. As you gradually lower blood sugar levels and insulin levels due to eating fewer carbs, insulin resistance will likely also decrease and this should normalize fasting blood sugar levels with time. For me, it took about half a year to get truly normal fasting levels. (Btw, non-diabetics also experience dawn phemomenon, but it just isn't very pronounced). So, I definitely wouldn't really worry if your fasting levels are slightly higher initially.

By the way, being active in the kitchen can also raise blood sugar levels a bit (as can exercise and higher stress levels, sometimes even taking a shower will do this). The reason for this is probably again the release of stress hormones and glucagon to provide more energy (similar to the dawn phenomenon). So, a level that is 1.5 mmol higher compared to the day before (without this activity), would be absolutely consistent with this.

It is good that your DN has agreed to hold off on medication for the time being, this allows to focus on your way of eating first without having to worry about hypos, weight gain, beta cell exhaustion ... and who knows what the situations will be 3 months down the road when you will have your follow-up HbA1c.

Hi @Ceppo,

Things really seem to be going well to you. I often do the same as you, have coffee with cream in the morning and have food around noon (unless I am very hungry). I also try to have my last meal of the day earlier around 6 or 7 p.m. and very little after this (though can't sleep when I am hungry, so might have a bit of cheese right before sleeping).

As to the chart -- the first two lines of every row are correspond to the HbA1c results (the first line is in British units, the second line in U.S. units), the last two lines is the average of daily blood glucose meter readings (line 3 is in U.S. units and line 4 in British units). So, in your case when the average of daily readings was 7.2 mmol, you would look at the second and third square in the second row (square 2 bottom line says 7.1 mmol and square 3 bottom line says 7.3 mmol). If you then refer to the top line in each of these squares, you'll see that this would correspond to an HbA1c of between 43 to 44 mmol if you maintained these readings for three months. Hope this explanation helps a bit.

As to testing before a meal, it certainly won't make a difference if you test 10 minutes earlier. Blood sugars levels usually don't tend to vary very much within a short period of time (unless you eat or do sports or are very stressed). When it comes to testing publicly, however, I've experienced that others don't seem to notice much when I do a test while sitting at a table in a restaurant.

You are really doing great on your journey so far. How are you adjusting to your new way of eating?

Hi, it is not my first time to check on this website, but anxiously came back because my GP told me yesterday my blood test A1C is 65 and saw my liver functions elevated. It was shocking talking to my GP over the phone and I did not immediately think questions to ask, but a second test is going to happen in about 10 days. I could not sleep last night, self blame, guilt...I think it is more than likely I will be diagnosed T2 and there were many signs few years ago by another GP told me I need to have life changing plan. I did for 2 yrs and blood sugar gone back to normal and I fed up then gave up...Sorry very emotional. Now feeling very stressed, like I am going to be sentenced for life. I hope and I want to have the last chance to put this in remission and keep going losing weight and maintain healthily. Sorry to write all about myself. @Ceppo your post made me feel related. I hope we both and all people find supports, answers and educational lessons here and get our lives back to normal.

Ceppo said:

Yes that makes it much clearer. I am relieved that I was interpreting the table correctly. As levels have gone down it somehow became more important not to be deluded...

It seems at the moment that skipping breakfast is impacting considerably.
Fasting 6.4 yesterday all the way through to pre-lunch and 6.8 after, 5.6 before dinner and 6.9 after. Fasting 6.3 today. They certainly are going well. I will try a breakfast one as comparison next week.

I suppose I am still eating in a similar way as before - Mediterranean diet - however, without all the starchy carbs, sugars, snacks or ... mostly all fruit. Limiting tomatoes, peppers and onions for a while. Ratatouille surprised me with the biggest post dinner reading (still under 2). Ruthless elimination.

My neighbours have benefitted from cupboard emptying and a charity book for half of my baking and cookery books. Leaving me with some classics and the Caldesi books - which are brilliant. Eating more eggs, cooked breakfast, frittatas, more oil on salad. Adding more fats, eg double cream and slapping butter on my steamed veg or frying it in olive oil. I have had a few strawberries with cream and tiny amounts of blueberries.

What I need to be sure of its getting the ratios of fat to protein right. Somehow dinner seems to be when the protein portion might be too much. Mind you eating earlier would be better too. Being confident of quantities of cheese and nuts. The scales are out for that. I quite like to have a small portion that I eat in tiny slices with a knife and fork. A strawberry or a couple of blueberries work well in the same way but I really should try very hard not to have any at the moment.

I haven't yet taken a reading before getting out of bed. Is that likely to be higher or lower than the end of fasting or pre-breakfast one. Best to know what to expect.

I certainly had a carb addiction which I couldn't conquer. Fingers xxd that I can do this permanently.

@ziggy_w

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Hi @Ceppo,

You are doing brilliantly. It's also nice to see your blood sugars coming down even further. I would definitely think that you have reached normal (not-even prediabetic) levels by now. You have every reason to be proud of your achievements.

I agree this way of eating defintely is very different from the way most of us ate before. My biggest downfall before diagnosis was fruit juice (which I even believed healthy -- you know as one of your "five a day"). In the beginning of this journey, it was hard to fathom having to follow this way of eating for the rest of my life. I even have to admit to experiencing a feeling of mourning ... but it gets easier the longer you do this and this soon will become your new normal.

Another aspect which has also helped greatly on this journey is finding ways to make low carb versions of old favorites. For example, I really wanted New England clam chowder the other day, but knew it would be too starchy -- so I used egg yolks instead of flour as a thickener and Jerusalem artichokes as a substitute for the potatoes. Personally, I believe the most important thing is to make this way of eating sustainable long-term (meaning not feeling deprived).

May I ask a question? Why do you worry about macros other than carbs? There is wide range of opinions on this anyway with some tending more towards more protein (e.g. Ted Naiman) and some tending more towards more fat (e.g. Ron Rosedale). Personally, I don't really believe this is too important as long as it works for you and you're happy with your way of eating.

As to fasting blood sugars -- let me preface this by saying that we are all different and that this might certainly also change with time. However, this is my personal experience. It took about half a year for me for fasting blood sugars to truly normalize (i.e. to be below 5.6 mmol consistently). Also, blood sugars for me tend to stay pretty much the same throughout the morning, even if I don't eat (and only go up minimally for a short time if I do).

Ceppo said:

Thanks for sharing so much and all the encouragement.

I'd say I haven't yet read sufficiently widely on keto and low carb diets. Nor have I the knowledge of the main protagonists in the low carb approach. More research and reading. I haven't joined diet doctor or the pay section of this website yet. Still pondering options. So much more to discover and understand of what approaches are out there and about how my body reacts to food.

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Dietdoctor is an excellent site and I've never joined: everything I needed to know from them, was on there for free. This site's Low Carb Program might be funded through the NHS if prescribed from what I understand, so yeah.... All this doesn't have to break the bank. The Nutritional Thingy whose link you were given in one of the first replies you got can get you started, and speaking for myself, groceries are less expensive now with my current way of eating. Mind you, my husband has a crazy metabolism so he can and will eat anything, but with my carby snacks/food/drinks and the like out of the equation, we're cheaper off than we were before. Well, technically speaking we pay more, but that's because there was a tax increase here in the Netherlands. If I added all that stuff back in we'd be paying even more for the weekly groceries. probably about double wht we pay now. So yay for my diabetic timing. Just keep in mind that things can be bought on sale or in bulk and frozen. I've gone over to a carnivore way of eating at the moment -still getting my bearings- but my freezer used to be packed full of cauliflower- and broccoli rice, and I never met a frozen berry I didn't like. (Especially nice in the summer). That's all off the menu for me now, as I'm trying to fix other conditions as I seem to have done with the T2, but for you, LCHF/Keto would work just fine, should you choose that route... Read, learn, check groceries online for their nutritional information so you won't be stuck at the store for 2 hours and walking out with nothing, and you'll be fine.

Also, keep in mind that while there's lots of groups on FB and the like, some are more "militant"about their way of eating than others. A vegan will bash the brains of a Paleo eater in over their beliefs, and I've seen groups where carnivores ridicule keto-eaters. Blah. Basically though, what works for one may not for another. If you find a whole lot online about dogma's, rules and resulting flame wars that make things extra confusing.... Keep in mind that this is your body, not the one of bloggers and posters and whatnot. Your meter'll keep you posted on what's working for you.

Good luck,
Jo

Ceppo said:

Thanks both of you. All very wise. Perhaps I am being too perfectionist.
DN still perplexed by the difference between the glucose readings, many of which are normal and the HbA1c test of 100. So I am to continue as I am, no medication, - good keep it up. She is waiting for a test result at the end of October to make her mind up about what is going on. She's tolerant of low carb but hasn't advocated any specific way of handling diabetes.

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If the HbA1c makes no sense in relation to your finger pricks, get your iron levels tested. If you're low, they can scew the results, and a frucosamine test would then be more useful to determine where you're really at.

Ceppo said:

A new revelation every day. Do laugh..
A piece of protein eg a steak has a protein value per 100g. The protein content does not = the weight of the piece of steak. Time to stop overthinking protein quantities on my plate. Extra cheese tonight to celebrate that late realisation.....

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Hi @Ceppo,

Yes, meat and fish usually have about 20g to 30g protein per 100g. Seriously, I wouldn't be overthinking this if I were you -- as even the experts disagree on how much protein versus fat we should be having.

I also believe that our bodies will tell us what they need. So, personally if I start feeling a lack of energy (when exercising for example), it usually means I was having too little protein lately ... and I will then increase it for the next few days.