Newbie with problems

[Blackwater5]

Last summer I was picked up as almost in the diabetic range. Around two months later I'd reduced carbs and lost weight but my my hba1c had gone up to 50, then 55. At that point I was given lipigliptin. 2 months later I had bullus pemphigoid covering most of me, believed to be caused by the lipigliptin, so it was stopped and I was given high strength topical steroids. They did very little to help and just over a week ago I was prescribed 30 mg daily of prednisolone. Steroids have nasty effects and one is an increase in blood glucose. So now I am on no medication and my hba1c increased to 57.
Today I collected an Accu-Chek Instant meter and prescribed lancets and test strips. Originally I was to be given lessons on using it and collected the meter on Feb 10th, but because of the autoimmune condition and my being very worried that the steroids were increasing glucose I watched your testing 'how-to' and after 2 hours learning how to set up and use the meter I did two tests today, one 4 hours after breakfast which was 17.7 mmol/L, then another 4 hours after that, which was 23.6 mmol/L. I've not been able to do a fasting test yet as I didn't have the testing stuff then.
I'm seeing my dermatologist in 2 weeks time and I think the self-testing is to give an idea of what medication to give me. I was told I couldn't have metformin due to liver damage (all liver tests are normal) and I'm worried about medication because the gliptin caused a skin problem which is still giving me a few blisters. I am still losing weight (from 60 kg in August to 53.5 today) and am sure I'm not getting enough calories to maintain a stable weight.
Does anyone have advice or ideas about any of this?

 

[catinahat]

Welcome Blackwater's
You are certainly having a rough time at the moment, the steroids don't make things easier but that can't be helped. you say you have reduced carbs, lost weight and you don't think you're getting enough calories. Have you replaced the carbs with extra protein and fats? It's difficult if not impossible to cut carbs without adding some healthy fats.
If you let us know what your meals look like maybe we can make a few suggestions to help control your levels.
Take a look at the link at the bottom of my post, you might find it helpful

 

[HSSS]

Just as a point of reference many type 2 diagnosed at you level aren’t given any medication at all. (Therefore no side effects). I for example was diagnosed at 55 mmol and got a 3 month trial of “diet”. Luckily by then I’d found, and my nurse prescribed, lower carb. I went further than she suggested and hit keto and at 3 months was down to 44mmol. So I’m confused why with normal kidney and liver function they went straight to gliptans rather than metformin or diet alone. Steroids might counteract the side effects you experienced but will make blood glucose worse. So the best option is no side effects and no steroids.

Lowering carbs to reduce blood glucose requires increasing either proteins or dietary fats to maintain calories, if weight loss isn’t the goal. There is so much controversy over the low fat message now, particularly for those of us carb sensitive, that you really must dig deeper than standard advice. The usual cholesterol advice is also hugely debated now and for more nuanced that total figures suggest and also deserves deeper digging before you just accept the “usual” advice.


Those levels are pretty high. What are you eating before testing? Give us a few days typical meals and we can suggest “edits”. Also have a read of this page for explanations of where many of us come from ethos wise, www.dietdoctor.com/diabetes

 

[Daibell]

Hi. I'm surprised you were prescribed one of the Gliptins as they are not usually given as an initial med. For most people they are not a problem but you were unlucky. You may want to suggest Gliclazide to to your GP. I had to suggest that to my rather useless GP. It is frequently prescribed for those with high BS but not overweight. There are other meds as well. If you continue to suffer weight loss then do ask for the two tests for T1 as mis-diagnosis is always possible. With regard to diet, don't think Calories but the three food groups. Most of us need to keep the Carbs down and have enough Fats and Proteins to keep us feeling full. Don't be tempted to increase the Carbs to gain weight.

 

[Blackwater5]

Welcome Blackwater's
You are certainly having a rough time at the moment, the steroids don't make things easier but that can't be helped. you say you have reduced carbs, lost weight and you don't think you're getting enough calories. Have you replaced the carbs with extra protein and fats? It's difficult if not impossible to cut carbs without adding some healthy fats.
If you let us know what your meals look like maybe we can make a few suggestions to help control your levels.
Take a look at the link at the bottom of my post, you might find it helpful

I am hopeless at cooking so my main meals usually are supposedly healthy, balanced ready meals. always looking for those with the lowest carbs. I can cook salmon but apart from frozen mixed veg I'd have to leave out the potatoes. I'm not very fond of veg and I've been told to have a lott of food containg calcium because of the steroids.
So my typical day starts with a bowl of shredded wheat with semi-skimmed milk and sometimes a little granulated sweetener. For lunch I have either reduced sugar baked beans on wholemeal toast and/or a banana sandwich. My evening meal is usually a ready meal, meat, potatoes and some mixed veg or leaf salad. Often I have a yoghourt as I've always eaten dessert, but all I have are thick yoghourt with fruit. I used to snack on biscuits or cake and have something like a slice of cheesecake for dessert.
I'm planning my shopping for next week and have included cheese, natural yoghurt, raspberries and bananas, but these things cost a lot more and I have to watch the pennies as I'm a pensioner.
I think I'm probably getting under 1000 calories a day and so many of the low carb foods I just don't like.
Thanks for the link.

 

[EllieM]

So my typical day starts with a bowl of shredded wheat with semi-skimmed milk and sometimes a little granulated sweetener. For lunch I have either reduced sugar baked beans on wholemeal toast and/or a banana sandwich. My evening meal is usually a ready meal, meat, potatoes and some mixed veg or leaf salad. Often I have a yoghourt as I've always eaten dessert, but all I have are thick yoghourt with fruit. I used to snack on biscuits or cake and have something like a slice of cheesecake for dessert.

Well the good news is that you have quite a lot of scope to reduce your carbs there.

It looks to me that you have been going for low fat rather than low carb options, and increasing the fat and decreasing the carbs will hopefully help both your weight and your blood sugar levels.

Do you like cheese, eggs, meat, fish, nuts?

Yoghurt can be fine but you need to read the nutritional info. Many companies produce "healthy" low fat versions packed full of sugar to replace the fat and not so healthy for T2s. Unsweetened Greek yoghurt is fine : add berries (you can defrost frozen ones or make them into delicious ice cream with a mixer). A lot of conventional fruit (bananas, apples, pineapple) is unfortunately packed full of carbs, so in your position I might rethink the banana choice.

But now you have a meter you'll be able to tell how your body is coping with different foods by testing your blood sugar just before you eat and 2 hours later. Try to aim for a rise of less than 2mmol/L.

Good luck.

 

[Blackwater5]

Hi. I'm surprised you were prescribed one of the Gliptins as they are not usually given as an initial med. For most people they are not a problem but you were unlucky. You may want to suggest Gliclazide to to your GP. I had to suggest that to my rather useless GP. It is frequently prescribed for those with high BS but not overweight. There are other meds as well. If you continue to suffer weight loss then do ask for the two tests for T1 as mis-diagnosis is always possible. With regard to diet, don't think Calories but the three food groups. Most of us need to keep the Carbs down and have enough Fats and Proteins to keep us feeling full. Don't be tempted to increase the Carbs to gain weight.

I was put on meds because my hba1c went from 50 to 55 in spite of trying to cut sugars and carbs. Why I was given a gliptin I don't know, but the diabetic nurse said 'don't worry, I'm not giving you metformin'. I'd lost weight by them (a year ago I was somewhat overweight) and have now dropped to 53.5 kg. At one time I was given statins but I'm allergic to them. With the loss of weight to 60 kg my cholesterol became normal. Unfortunately gliptins can rarely cause an autoimmune blistering disease and that seems to be a painful effect of them. The connective tissue between the epidermis and dermis are attacked by the immune system and before the steroid tablets I had blisters on my hands and feet which makes doing anything difficult. The steroids have a lot of bad side-effects and I've been told to eat a lot of calcium-containing foods. That means I picked a thick high protein low carn yoghourt for next week's shop.

 

[Blackwater5]

Well the good news is that you have quite a lot of scope to reduce your carbs there.

It looks to me that you have been going for low fat rather than low carb options, and increasing the fat and decreasing the carbs will hopefully help both your weight and your blood sugar levels.

Do you like cheese, eggs, meat, fish, nuts?

Yoghurt can be fine but you need to read the nutritional info. Many companies produce "healthy" low fat versions packed full of sugar to replace the fat and not so healthy for T2s. Unsweetened Greek yoghurt is fine : add berries (you can defrost frozen ones or make them into delicious ice cream with a mixer). A lot of conventional fruit (bananas, apples, pineapple) is unfortunately packed full of carbs, so in your position I might rethink the banana choice.

But now you have a meter you'll be able to tell how your body is coping with different foods by testing your blood sugar just before you eat and 2 hours later. Try to aim for a rise of less than 2mmol/L.

Good luck.

I can't find Greek yoghourt that isn't low fat here so I'm trying an unsweetened high protein one that I plan to have with raspberries. I like everything you list apart from nuts. Todays tests were around 17.7 mmol/L after my shredded wheat and semi-skimmed milk breakfast and my reduced sugar baked beans on toast lunch.

I've been told to test 3 times a day, on getting up, and before lunch and dinner. The idea is to assess me and how much the steroids increase my blood sugar.
I've been eating bananas because of their pottassium content, and oranges as snacks. The diet for steroids can conflict with some low carb foods.

 

[Antje77]

I can't find Greek yoghourt that isn't low fat here

Do you have a Lidl close by? They do a very tasty 10% fat one in a tub of a litre. Cheap too!

 

[MrsA2]

@Blackwater5 are you aware that the hba1c test results are in different measures to the ones from a finger prick?
Levels after meals of 17 and 23 are quite high, and would equate to an hba1c of over 100.
While steroids may raise bg, I am concerned that rapid unplanned weight loss with increased bg may be a sign of type 1 (or Lada) rather than type 2.

I can understand you wanting to avoid medication as much as possible, the best way to achieve this is to go much lower carb. There's plenty of calcium in it

 

[HSSS]

Baked beans, toast, shredded wheat, bananas and fruit yogurt are all higher carb options. All of which will keep your levels high. Test before and 2 hrs after your meals and see for yourself. A suitable meal should leave you no more than 2mmol higher than before eating when tested 2 hrs after starting to eat.

 

[Blackwater5]

@Blackwater5 are you aware that the hba1c test results are in different measures to the ones from a finger prick?
Levels after meals of 17 and 23 are quite high, and would equate to an hba1c of over 100.
While steroids may raise bg, I am concerned that rapid unplanned weight loss with increased bg may be a sign of type 1 (or Lada) rather than type 2.

I can understand you wanting to avoid medication as much as possible, the best way to achieve this is to go much lower carb. There's plenty of calcium in it

I know that hba1c results are different to finger prick results. But I only was given a meter yesterday and have my first fasting result for that today. This morning my fasting level was 7.4, 3 hours after shredded wheat and semi-skimmed milk it was 17.8. My two tests yesterday showed an increase between meals and it seems to be the same pattern so far today.
I've been trying to follow the foods recommended by my GP, which include carbs that take longer to break down such as wholemeal bread, cereals, pasta, any type of beans and pulses, what I think is the NHS recommendation.

I need to get my bg down without losing more weight but have hardly anything that's low carb and sugar. I'm isolating now as my neighbour has covid and I'm alone, have nobody to go shopping for me.so I'm trying to make a list of low carb high protein foods to be delivered Monday.

I don't know if I've been wrongly diagnosed, if my foods are causing my bg to soar, or if the steroids are partly to blame. My best friend died after a long period on low strength steroids after developing diabetes and heart problems leading to heart failure. But the disease caused by the gliptins is very painful and can be fatal. I've only been able to walk without a lot of pain in the last few days and the preparation and cooking of food can be painful and increase the risk of infection.

I've not been on any diabetic meds for several months, since the reaction to gliptins. They were stopped and nothing else (or advice) has been given..

 

[Blackwater5]

Do you have a Lidl close by? They do a very tasty 10% fat one in a tub of a litre. Cheap too!

I wish I did, but the closest Lidl would cost me more in petrol than anything I've saved.

 

[Antje77]

if my foods are causing my bg to soar, or if the steroids are partly to blame.

Both, most likely, considering the jump in BG after your breakfast.

This morning my fasting level was 7.4, 3 hours after shredded wheat and semi-skimmed milk it was 17.8.

What about trying bacon and eggs (no toast) for breakfast as soon as you can lay a hand on them and see what happens with your blood glucose?

 

[Granny_grump_]

I can't find Greek yoghourt that isn't low fat here so I'm trying an unsweetened high protein one that I plan to have with raspberries. I like everything you list apart from nuts. Todays tests were around 17.7 mmol/L after my shredded wheat and semi-skimmed milk breakfast and my reduced sugar baked beans on toast lunch.

I've been told to test 3 times a day, on getting up, and before lunch and dinner. The idea is to assess me and how much the steroids increase my blood sugar.
I've been eating bananas because of their pottassium content, and oranges as snacks. The diet for steroids can conflict with some low carb foods.

Hi Blackwater5 your breakfasts and lunch you listed are all high carb foods this will spike your BG I’ve recently changed from cereal and milk for breakfast and was advised from a lovely person on here to try Greek yogurt and berries at breakfast, I did this and it’s brought my BG down well. But beans low sugar or not are carbs and that and your bread plus your carbs breakfast will give you high BG readings. Try asking on here for alternative foods that are either low carb or no carb this will help your BG readings to go lower remember carbs make sugar and push up your BG readings. It’s hard being diabetic and it seems such a hard slog but living with it everyday is a learning curve you have to meet to keep you and your BG at a good level, before any food reaches your lips test BG level then test again 2 hours after food that way you get to find out what particular foods spike your BG it’s the only way to manage your BG high spikes in BG are not good for any diabetic. Try and aim for no more than two units raised after food it will keep your BG more level. Lots of good people on here they will help you just ask don’t struggle.K

 

[TeddyTottie]

I understand that you are inclined to follow the advice from your GP with regards to diet, but many of us here have found that the medical profession are woefully behind the times and are still recommending a low fat, ‘healthy’ whole grain diet, as you have found. This may be fine for the metabolically normal, but it is a disaster for a T2 diabetic.

Why should you follow the advice of random strangers on the internet as opposed to that from your trusted GP? Well of course, you should not. But as you get more accustomed to testing, try a few seriously low carb meals and see what your meter says. That has no bias and will not lie to you.

Good luck with everything!

 

[Granny_grump_]

I understand that you are inclined to follow the advice from your GP with regards to diet, but many of us here have found that the medical profession are woefully behind the times and are still recommending a low fat, ‘healthy’ whole grain diet, as you have found. This may be fine for the metabolically normal, but it is a disaster for a T2 diabetic.

Why should you follow the advice of random strangers on the internet as opposed to that from your trusted GP? Well of course, you should not. But as you get more accustomed to testing, try a few seriously low carb meals and see what your meter says. That has no bias and will not lie to you.

Good luck with everything!

The NHS diet for type2 diabetics is all about eating carbs with every meal rubbish we will never get the lower BG readings if we do this. That’s why I tell my nurse at doctors about this site the NHS have got it so wrong K
K

 

[Blackwater5]

The NHS diet for type2 diabetics is all about eating carbs with every meal rubbish we will never get the lower BG readings if we do this. That’s why I tell my nurse at doctors about this site the NHS have got it so wrong K
K

I've learnt that now, but it took me months to be able to check my own levels and I've only been doing that for a couple of days. I do as much research as I can and had to tell my DBN about bullous (autoimmune blistering disease as a side effect of gliptins) after I got it. The gliptin didn't do anything else so my glucose spikes, they're probably that's a complication of steroids and NHS diet.

 

[Marianne67]

I've learnt that now, but it took me months to be able to check my own levels and I've only been doing that for a couple of days. I do as much research as I can and had to tell my DBN about bullous (autoimmune blistering disease as a side effect of gliptins) after I got it. The gliptin didn't do anything else so my glucose spikes, they're probably that's a complication of steroids and NHS diet.

I feel very lucky, my DN told me NOT to follow the eat well plate recommended by the NHS, I told her I was using the fast800 books and she was very happy. She has had him give talks to the diabetic folks at my local hospital, that I am also under and the dietitian there was thankfully on board with my low card diet. I cut out bread, rice, pasta and potatoes over 2 years ago, before my foot ulcer, but I had slipped a little through lock down. I know for me personally any carbs, even whole meal are a no no.

I hope you feel better soon.

 

[Angelofthemarches]

I'm not a newbie - type 2, diagnosed in 2015. My hba1c was 62 on diagnosis. Through keto I promptly got it down to 39 over the next 6 months. I used the Abbott libre for the first few years. But recently I started the libre again and was horrified at my glucose levels. Even when strict keto I rarely get below 7-9. And if I have even 1 cheat day it takes a week to get back to the not very good levels I described.
I have chronic fatigue syndrome so it's difficult to up the exercise much though I try.
Was wondering if I should try medication. It was far easier after diagnosis..