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Newbie terrified

Just a reminder to everyone that this is a thread from a new member. Please try to keep on topic and stay polite.
 
Hi this is a truly great forum to join and I AM Hoping someone can help.

I am T2 SINCE around 18 months ago. I stupidly did not take it seriously enough and my HBA1C went from 56 NMOL - 64 - 56 and then went to a whopping 94NMOL over last xmas. I have started Metformin since February ( 500Mg) and last reading was done to 71 a couple of weeks . Since April I have aggressively started to work out again, running around 25 miles a week and doing 15k steps a day, radically overhauled my diet and am almost certain my next HBA1C will return to the 50's, my other biomarkers have come down radically along with BP and. producing better VO2 max and runs in the gym. I have lost around 25 pounds since February but still around 17 stone.I know that this is still high but I am now losing around 4 pounds a week.

My concerns;

As I am cutting Carbs, I only having 2 meals a day i.e Porridge and fresh blueberries in the morning and fish and Green veggies for dinner ( my carbs have come down significantly) I had my first couple of night hypos given my lips went numb and HR went up , and it was terrifying. I had some mint sweets and an apple and was all ok after 15 mins or so .
Can anyone please give advice around how to avoid this? I was told that carb elimination is the crux of remission but clearly I am eating too little? I am almost tempted to have another bowl of oatmell late in the evening ( I don't tend to eat after 6 pm) so I don't hypo in middle of night?

I have a Aqu- check monitor- is there any advice on when and how to take readings to establish a baseline?

Thanks. in advance
If you're feeling off, always test and see what's going on. When you make big changes, your body has a lot to get used to, and you can experience false hypo's. They feel exactly as a real one would, because your body ends up in a complete panic because it thinks it's low... It's not, but it needs to get used to more normal numbers. Throwing carbs at a false hypo'll only mean they'll continue on, as your body won't adjust. (Speaking from experience here, it took me forever to get used to normal numbers because I didn't know! Popping Dextro tabs left and right all the time so didn't help!) Try eating something protein- and fat rich next time, it'll calm the hypo-ish feelings and won't spike you.

As for the porridge, that's a lot of carbs right there... I'd not be able to tolerate it, and considering your HbA1c, the odds are, it's not doing you any favours either. https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html might be of some help to get the basics of low carbing down. And maybe let your body get used to more normal numbers due to diet, before putting it through such rigorous exercise. It's taking a beating getting used to a new way of eating, it'll take a little while before it can handle all you're making it do, now. This didn't come on overnight, you don't have to fix it overnight. Give your body a bit of a break, take it a little slower, and you're more likely to have an easier time of it.

Good luck!!!
Jo
 
@Prince4 I'd agree fully with @JoKalsbeek .

two thing stood out over my early experiences as T2D.

One was the lowering of my morning fbg was not linear.
Almost as if like a small child my body was defying me & refusing to accept the change in diet.

It would sit stubbornly at 9 for instance, regardless of how little carbs I fed it, until it went ok, you're not trying to kill us, and over a month the all 9's dropped down to mix of 8's until finally settling with all 8's

This went on each month until I finally began getting regular 5's in the morning testing.

And secondly the 'shakey' awful false hypo symptoms...they only lasted a week or two at most I think.

Because I had learned from others on here about them, i pushed through with a piece of cheese, etc rather than the piece of chocolate or some such I had used previously (had similar pre DX, & treated with a mars bar or snickers )

Symptoms faded once my body realised it wasn't in danger, it felt like to me.

Jo & others are right, it's a lot of change we are putting ourselves through.
Take the time to be kind to yourself & pace yourself sensibly.

We're all different & our bodies will respond at differing speeds.

Best wishes for a smoother journey.
 
If you are cutting carbs porridge is an odd thing to retain being 2/3 carbs. More oatmeal is likely to make things worse not better.

Where are the fats that are essential? And there is very little protein too. I strongly suspect you are simply eating too little food to sustain your body and exercise and that is the cause of feeling bad.

Hypos on Metformin alone would be most unusual, it simply doesn’t work that way. I’m not convinced that’s what happened especially without any bgl readings at the time. You really need to test when feeling the way you describe. Maybe it was a fast drop rather than a low one, maybe it was something else entirely (like your minimalist diet perhaps).
Correct call on the Porridge. Just check 2 hours after porridge and berries and was 11.5% - almost doubled!
 
Correct call on the Porridge. Just check 2 hours after porridge and berries and was 11.5% - almost doubled!
Classic for a plain uncomplicated type 2 - we just do not do well on carbs no matter how much they are touted as a healthy choice, we are not nourished or sustained by them.
Personally I went for two meals a day with protein and fat plus around 10 gm of carbs in the morning and up to 40 in the evening if I had a dessert. I cut town the evening meal to no more than 30 to try to lower my Hba1c, and it didn't work, so it is obviously not a straight mechanical link between intake and Hba1c for me at least.
These days - 5 years of normal numbers, I am only eating one meal a day, not deliberately, I am just not hungry.
I don't do deliberate exercise, and some days I just stay at home but other times I go out to play music for the morris dancers, some weekends I do quite a bit of walking, but I find that control of my blood glucose is all about diet, not exercise.
 
@Prince4 I strongly disagree with @Liam E about having all measurements less than 7 mmol. I have been in low carb controlled T2 D remission for 3yrs and I normally get more than 7.0 mmol at the 2hrs after eating measurement. I still even get some Fasting readings (morning - so includes Dawn Phenomenon) of over 7.0 mmol.
The figure to aim for is to get all (or almost all) readings below or at 8.0mmol, some even say 8.5.

It is hugely important not to push too hard for the lowest possible numbers because this new way of eating needs to be enjoyable or else you won't be able to keep it up over the many healthy years you have ahead of you. Controlling any/all forms of diabetes is a marathon, not a sprint!

Question - If I have a lets say 11 .5 spike after oatmeal and berries but its so fibrous that it keeps me full until the afternoon and then I have fish and Greens then I tend to average out around 7.7. So is the 11.5 temporary spike worth the spike on the basis to helps generate a NET daily 7.7 average right?
 
That is a question I was asking myself - if I were to generate readings of between 6.5 and 8.5 fairly consistently across a 2 week period, for example, would the odd spike of between 10 and 12 be a problem.
If that spike of those numbers were to be a problem, then to what degree?

It's not easy is it?
 
Question - If I have a lets say 11 .5 spike after oatmeal and berries but its so fibrous that it keeps me full until the afternoon and then I have fish and Greens then I tend to average out around 7.7. So is the 11.5 temporary spike worth the spike on the basis to helps generate a NET daily 7.7 average right?
Nope. Not in my opinion. I feel it’s important to both keep the average down and the spikes. Look at it this way every spike both microscopically pushes towards damage and raises the average and the higher of that the more chance of harm too.

Surely it’s better to simply replace the items that cause the spikes for something else
 
I agree with @HSSS, We need to address both shorter term spikes as well as longer averages. Both can cause damage.
In other words, 'cheat' meals or days are out if we are taking it seriously. High BG (or ultra low as in hypos) isn't something to be treated like a couple of extra pounds weight gain or low - it can have lasting consequences!
 
Would have to agree with keeping both average and spikes down insofar as we are able. But as we do not exist in an ideal world, those averages are going to creep at times and the spikes are going to spike at other times. Yes do what you are able to do, but beat yourself up if you fall down from time to time? Now there is a different question.
 
We each have to find our own way. Some of us prefer to keep things as low as possible for ever, others will allow themselves more leeway.
But in any case all newbies should first aim to get as low as possible and then, and only then, think about relaxing control a bit.
Don't try to run before you can walk.
There's a lot to learn and adapt to. Changing lifelong habits takes months.
Initially all of us "grieve" or try to keep what's "normal", that's natural and it's only with practice and time that you will find a Way of Eating For Life (woefl) that fits with your individual lifestyles, bodies and situations.
It's not a short term diet that can be stopped once achieved, our bodies will not process carbs but with adopting a woefl that fits you well , it will be easy and normal to maintain. You will even find your taste buds change and what you used to like you no longer do.

I used to love binging on milk chocolate, now it tastes slimy, oily and claggy... and that the good quality stuff! I'd never have believed I'd ever be saying that, now it holds no attraction to me at all.
Time, patience and one day at time, stop worrying about future events/foods. There's always support here
 
Like others have also mentioned, lower average is a good thing but a straight line is more important. As diabetics we are very susceptible to a bizarre graph with significant spikes making the 24 hours BG graph look like a sine wave and while that could mean a low average it will cause far more damage than say if you had a nearly flat line graph with a slightly higher average.... to put it in numbers, a highly fluctuating graph with an average of 5.5 is worse than a flatline with an average of 6.5 or even 7.

From all I have read, my understanding of this boils down to the explanation that spikes put our organs through a sort of shock and relief which creates more stress and damage for them but a constant blood glucose even if slightly elevated helps avoid that shock and relief cycle thereby keeping them relatively safe. I don't have link for where I read it but this is pretty much the gist and to my mind it does make some logical sense.
 
I don't understand. I woke up at 5.6% and just had a cup of black coffee and water and ran 3 miles -fasted and it has increased to 9.6%? Does exercise alone increase BG?
 
I don't understand. I woke up at 5.6% and just had a cup of black coffee and water and ran 3 miles -fasted and it has increased to 9.6%? Does exercise alone increase BG?

I’m afraid so. Especially that sort of exercise. Try having a small low carb snack first. But the Adrenalin rush, like foot on the floor applies with exercise. I’m a Type 1 early morning serious swimmer who downs a spoon of Greek Yoghurt and 1-2 units of insulin first. I still get out of the pool high. But I figure the actual swimming is better for my overall fitness and mental health so worth it.
 
Ok...so a healthy spike as exercise is most powerful lever we can pull as a type 2 diabetic. Does it negate the need to eat breakfast then and try and make it until lunch?
 
Ok...so a healthy spike as exercise is most powerful lever we can pull as a type 2 diabetic. Does it negate the need to eat breakfast then and try and make it until lunch?
diet is the most power lever, although exercise is also good.

there is no need to eat breakfast whatever. As you’ve seen your body will provide the required glucose for at least some exercise from stores. If these stores are excessive as is common in type 2 that’s a good thing even if it shows as a short term spike. It’s also likely levels later in the day are reduced for longer as a delayed benefit.

If you are long term, low enough carb your body gets really good at providing fuel for prolonged periods from fats via nutritional ketosis, metabolic flexibility and fat adaptation. Obviously I’m not saying you should exercise fasted but it is a reasonable option for many, not all.
 
Ok...so a healthy spike as exercise is most powerful lever we can pull as a type 2 diabetic. Does it negate the need to eat breakfast then and try and make it until lunch?
The most important lever is the food you eat. Exercise helps but isn't the most important and in fact heavy workouts will cause spike in everyone (non-diabetics included). This is because when we exercise, multiple things happen at the same time.

For one - exercising makes the body burn energy so brain sends signal that it needs more energy and Liver obliges by producing more glucose and sending it through our bloodtream. For another - exercising puts stress on the body and that in this scenario is addressed by release of helpful homones such as Adrenaline or in some extremely stressful situation Cortisol - both of which also triggers the response to focus and direct energy to specific areas of body that need reinforcement. All this is good, even great because it helps in improving the metabolism of body so exercising is good but for diabetics this can result in spikes higher than desirable.

Now when we go low-carb we slowly train our body to rely more and more on the alternate source of energy for normal usage and thus there is less of of glucose floating around in blood, so when the exercise induced surge of glucose does enter the blood stream it does not cause a spike to dangerous levels and because we were exercising that gets utilised fairly quickly too thus keeping blood glucose levels within reasonable zone.

While your body is adapting to newer way of life, you probably will be better served walking longer distances than running in the morning because among other things most diabetics if not all are also plagued with what is called "Dawn Phenomena" or DP for short... If you not aware of what this is, it will serve you well to read a bit about it because to my knowledge there is nothing much we can do about it - it just is our body's response to us getting up in the morning at which point our body releases energy in anticipation that we will need it to get started. This is also the reason though for us being able to survive without eating anything for breakfast because body is already serving to cells whether we eat or not and when we do not eat but body keeps serving, it is basically getting it from stored reserves and thus helping us lose weight.

On exercising while fasting, I would say it varies for each individual but so long as you are not aiming to bulk up, fasting and exercising together can actually work quite well to help you maintain a leaner frame and have a stronger core. It does depend though on the kind of exercises you take up during fasting - heavy weights on days you fast might not be a good idea - they aren't in my case - but exercises using your body weight will be very helpful - TRX, jogging, stretching, sit-ups, planks etc will help... again Exercising is good but not necessary to manage BG, diet absolutelyi is. There are ofcourse exceptions, I am sure, but it is true for most diabetics like me. :)
 
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The most important lever is the food you eat. Exercise helps but isn't the most important and in fact heavy workouts will cause spike in everyone (non-diabetics included). This is because when we exercise, multiple things happen at the same time.

For one - exercising makes the body burn energy so brain sends signal that it needs more energy and Liver obliges by producing more glucose and sending it through our bloodtream. For another - exercising puts stress on the body and that in this scenario is addressed by release of helpful homones such as Adrenaline or in some extremely stressful situation Cortisol - both of which also triggers the response to focus and direct energy to specific areas of body that need reinforcement. All this is good, even great because it helps in improving the metabolism of body so exercising is good but for diabetics this can result in spikes higher than desirable.

Now when we go low-carb we slowly train our body to rely more and more on the alternate source of energy for normal usage and thus there is less of of glucose floating around in blood, so when the exercise induced surge of glucose does enter the blood stream it does not cause a spike to dangerous levels and because we were exercising that gets utilised fairly quickly too thus keeping blood glucose levels within reasonable zone.

While your body is adapting to newer way of life, you probably will be better served walking longer distances than running in the morning because among other things most diabetics if not all are also plagued with what is called "Dawn Phenomena" or DP for short... If you not aware of what this is, it will serve you well to read a bit about it because to my knowledge there is nothing much we can do about it - it just is our body's response to us getting up in the morning at which point our body releases energy in anticipation that we will need it to get started. This is also the reason though for us being able to survive without eating anything for breakfast because body is already serving to cells whether we eat or not and when we do not eat but body keeps serving, it is basically getting it from stored reserves and thus helping us lose weight.

On exercising while fasting, I would say it varies for each individual but so long as you are not aiming to bulk up, fasting and exercising together can actually work quite well to help you maintain a leaner frame and have a stronger core. It does depend though on the kind of exercises you take up during fasting - heavy weights on days you fast might not be a good idea - they aren't in my case - but exercises using your body weight will be very helpful - TRX, jogging, stretching, sit-ups, planks etc will help... again Exercising is good but not necessary to manage BG, diet absolutelyi is. There are ofcourse exceptions, I am sure, but it is true for most diabetics like me. :)
Thanks. Great advice. Last question - I accidentally took an HBA1C Test only 2 weeks after I took my last 12 week test. It was come down 13 points in around 14 weeks. Is that normal? in terms of decrease?
 
HbA1c as I understand is the count of red blood cells which have a shelf life of roughly 3 months and are higher when BG is higher their population tends to increase and hence higher HbA1c results are bad... so if you have severe blood loss due to injury you can have a a HbA1c showing lesser number not indicative of actual BG situation... reverse can be true if one was suffering from some illness that warranted an army of red blood cells... I can't say a drop of 13 points in 2 weeks is normal or not but its possible depending on various factors involved... I personally don't think HbA1c is a better measure than CGM ... CGM tends to give me better indication of what is going on every minute of the day within reasonable tolerance level of +/- 15% which is good enough... I try and focus on the graph and try keeping it as straight as possible and between 3.8 to 7.6 as much as its in my control... there are still things we just can't control like a stressful day at work, arguments or good old cough and cold... if you are a person with dog(s) they can help a lot with easing some of the stress and with keeping you on straight and narrow for walking schedules as is in my case
 
HbA1c as I understand is the count of red blood cells which have a shelf life of roughly 3 months and are higher when BG is higher their population tends to increase and hence higher HbA1c results are bad... so if you have severe blood loss due to injury you can have a a HbA1c showing lesser number not indicative of actual BG situation... reverse can be true if one was suffering from some illness that warranted an army of red blood cells... I can't say a drop of 13 points in 2 weeks is normal or not but its possible depending on various factors involved... I personally don't think HbA1c is a better measure than CGM ... CGM tends to give me better indication of what is going on every minute of the day within reasonable tolerance level of +/- 15% which is good enough... I try and focus on the graph and try keeping it as straight as possible and between 3.8 to 7.6 as much as its in my control... there are still things we just can't control like a stressful day at work, arguments or good old cough and cold... if you are a person with dog(s) they can help a lot with easing some of the stress and with keeping you on straight and narrow for walking schedules as is in my case
Hba1c isn’t just a count of red blood cells (although that is another test) so straight forward blood loss doesn’t necessarily affect hba1c.

It’s about measuring how much glycation (glucose affecting them) the cells you have have been exposed to. If your cells live longer or shorter than the typical 12 weeks that can affect the results and things like iron deficiency anemia or sickle cell would come int9 that category. So if the blood loss caused anemia then it could affect it that way.

blood glucose levels show what’s happening in the moment, whereas hba1c shows an overall effect of all those moments added together. One is not better or worse than the other because they measure and demonstrate different things.
 
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