Newbie to testing Type 2 - confusing blood sugar levels

[Juzzyjk]

Hi.

So i was diganosed 12 months ago but told no drugs or testing needed. Just life style changes.

12 months on while pre op for a test my hba1c came back at 110

Ive been given Gliclazide 80mg 2x per day and monitor and my annual review is on the 7th Feb.

Initially my readings were over 20mmol/L all day (testing 6x daily) with an initial average of 20.2 with a projected Hba1c of 123.

7 days on the average is down to 9.1 with a projected Hba1c of 87.5 so things are happening (yes im working hard and hitting my low carb diet really well).

However my morning results seem to all be 11 to 15 then all my afternoon results fall to within normal levels.

I dont know how to bring my morning numbers down .. i tried a late night snack last night but no joy.

I eat at 9, 12.30, 7.30 and try not to snack and drink 2L water per day my Carbs and Fat are always in budget 130g and 30g respectively. Gliclazide at Breakfast (9.00) and Teatime (7.30).

Can any one help, is this normal, if not what can i do to get it down,

I weigh 24st (incase thats relevant)

I cant find anything about this on the www.

Any help appreciated

Thanks
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[catinahat]

Morning @Juzzyjk
There is not much we can do about our fasting levels, if you think about it your body has been desperately trying to get rid of the glucose in your blood. Because of the your T2, insulin is not working as it should it has been storing glucose any place it can, mainly your liver. Overnight you are not eating and adding to the glucose load so your body takes the opportunity to dump some stored glucose into your blood. Anytime you see a rise in levels when you haven't had any food it's your body using up its glucose stores.
The way to solve this issue is to concentrate on keeping your levels down through the day. Test before meals and again 2hrs later the difference in the 2 results will show you how your meal has affected your levels. Ideally the 2 readings would be around the same, and the amount of carbs in that meal was perfect for you. However things are quite often not ideal so most of us allow ourselves a 2mmol rise limit. In other words if the post meal level is more than 2mmol above the pre meal then there were too many carbs in that meal. By doing this eventually your levels will come down and the amount of glucose you have stored will also reduce. As you are taking gliclazide you will need to keep a close eye on your levels because it's possible that combined with low carb it could cause your levels to dip too low. If you keep a diary and note down your meals along with the glucose readings you will soon see what needs changing in your diet and will have some useful data to show your Dr if your meds need adjusting. I've a feeling that testing around meals will show that your 130g of carbs may need a rethink.

 

[finzi1966]

Hi there! You are doing amazingly well! Average down from 20 to 9 in seven days - that’s fantastic!

Its really, really normal for us to have fasting/morning numbers be high. Google “dawn phenomenon” and/or search for it on the forum. It’s frustrating because there isn’t really very much we can do about it. I’ve read SO many threads suggesting every possible solution and the conclusion that I’m coming to is that there isn’t really one magic bullet that makes a difference.

The one thing that will make a difference is time. Providing you keep up the excellent work you’ve been doing so far, your blood sugars throughout the day will continue to improve and, as they do, the glucose stores in your liver will drop and it will be less inclined to pump out big amounts of glucose. Also, as you lose fat, particularly fat around your organs (which I’m sure you will - maybe you have had some weight loss already?), your pancreas will function better at producing insulin, and you will be less insulin resistant, so that when your liver *does* unhelpfully pop out too much glucose, your body will do the right thing with it! But its very very early days still. My morning numbers are still higher than the rest of the day although I’ve been low-carbing (<30g carbs) since 1 September, HbA1C from 64 to 37, lost 4 stone. But they’re better than they were.

If you’re eating 130g carbs there *may* be scope to lower that, BUT i would only do so cautiously, because you’re on quite a high dose of gliclazide, which can make you go hypo. On the other hand, a high dose of gliclazide combined with a high-ish carb intake is going to make weight loss more difficult (glic can cause weight gain in the same way that insulin injections can). Maybe talk to your doctor about trying to lower both - if you can do that and still keep your blood sugar in a good range, that may be better for your long term health (the more weight you can lose, the better chance your pancreas will function better)

 

[Juzzyjk]

Morning @Juzzyjk
I've a feeling that testing around meals will show that your 130g of carbs may need a rethink.

I think the 130 is to get the numbers down quickly and reduce my hba1c so i can be cleared for a kidbey stone op. But also to reduce my weight. Does this mean its likely my carb allowance will increase once ive hit the targets needed ?

 

[Juzzyjk]

Hi there! You are doing amazingly well! Average down from 20 to 9 in seven days - that’s fantastic!



If you’re eating 130g carbs there *may* be scope to lower that, BUT i would only do so cautiously, because you’re on quite a high dose of gliclazide,

Thanks yes lost just under a stone since xmas ... big scare has focused me somewhat. I think the Gliclazide is to get it down for a kidneys stone op and get my weight down. Potentially my nurses long term goal is no meds and self regulation i think.

What is normal diabetic carb level per day ?

 

[ianf0ster]

I think the 130 is to get the numbers down quickly and reduce my hba1c so i can be cleared for a kidbey stone op. But also to reduce my weight. Does this mean its likely my carb allowance will increase once ive hit the targets needed ?

Hi, I think you have not understood the prior posts. Those members were saying that if you start using your BG meter for what it's best at (testing each meal) you will probably discover that 130gms of carbs per day is currently too much for you and =that it needs to be more like 50gms.
Every Type 2 diabetic is different. Of those using Low Carb/Keto to manage their blood glucose levels, some eat under 20gms of carbs per day (though you can't go that low because you are taking Gliclazide). Others (like me ) find that between 20gms and 50gms per day is about right, some other eat between 50gms and 100gms and a few eat 100gms to 130gms of carbs per day.

Once in remission, some of us have the scope to increase our carb intake a little (according to our meters)- but not too much otherwise we risk our HbA1C rising too high again.

 

[catinahat]

What is normal diabetic carb level per day

That's not a question anyone could answer because we are all different, we have different metabolisms and different levels of insulin resistance, that's why testing your meals and finding your own carb threshold is so important. Some people manage to get decent numbers on 100-150g of carbs a day, for me though to keep my levels in the non diabetic range without medication I have to be below 50g.
To complicate things further, not all carbs are equal and their impact on blood sugar levels is very personal, what one person can tolerate will send another person's blood sugar sky high.

 

[finzi1966]

I think the 130 is to get the numbers down quickly and reduce my hba1c so i can be cleared for a kidbey stone op. But also to reduce my weight. Does this mean its likely my carb allowance will increase once ive hit the targets needed ?

Oh (((

No, I think what people were meaning is that 130g might be rather high

Like I said before, the thing that you will have to take into account is that gliclazide can lower your sugar to the point where you are hypo, so although I think ideally you *should* lower your carbs, you should only do so carefully. The aim, of course, would be to eat lower carb, reduce the gliclazide as a result, keep your blood sugar at a good level (say, between 5 and 7) AND as a result of the lower carb, you should lose weight without really even trying.

I have to say, when I was on Gliclazide, I put on a ton of weight (*and* had loads of hypos). Insulin + carbs equals weight gain. Gliclazide makes you pump out insulin. I think at the moment, you probably need the gliclazide, I wouldn’t be saying you should stop it, but maybe have a chat with your GP and try just lowering your carbs just a little (say, by 10g a day, then if that’s OK another 10g the following week etc?).

 

[MrsA2]

my Carbs and Fat are always in budget 130g and 30g respectively. Gliclazide at Breakfast (9.00) and Teatime (7.30).

Who gave you that budget? I'm wondering if it's the wrong way round and should be 130g fats and 30g carb...
but with the warning that because of the gliclazide you should reduce to those amounts slowly and in consultation with your doctor re the amount prescribed. Don't suddenly drop your carb level

Could you share what typical days eating and drinking is for you?