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Newby confused by target BG levels

Dougie22

Dougie22

Well-Known Member
Messages
319
Location
Scotland
Type of diabetes
Type 2
Treatment type
Other
Hi,

As you may see from my signature line, I'm new to all this and trying to control by diet and excise alone for now. (I've posted in the new arrivals section.) I have started testing with a BG meter.

I'm confused about the "target" "2 hour" level that I'm aiming for:
- The NHS booklet I was given at the surgery suggests keeping it under 10
- The NICE levels quoted within the forum (Sid Bonkers et al) suggest 8.5
- The last explanatory note I looked at (on here, five minutes ago) said 9

My doctor has so far been little help on this matter as she (diabetic specialist in our group practice) believes that type 2 patients who are trying diet only should not be using a BG meter, so an answer that says "your doctor will set a level with you" doesn't really help. Nor does "Get it as low as you can", even though that may be the correct answer!

I'm 57, overweight but quite healthy and I'm upping my gym time as well as dieting including trying to reduce my carbs (after reading opinions here). I'm not expecting miracles as it will take a few months to lose significant weight but I'd like to make progress to help my case for "no medication yet".

Also, the same doctor has asked me to get another HbA1c test done, even although it will only be six weeks since the previous one(the literature seems to support 8-12 weeks as reasonable). Is this likely to show any improvement from my previous 7.8, given the short time on the new diet?

I'm worried that she'll use it as an argument to start me on tablets as that seems to be her normal approach.

Any help or relevant experiences on these two points gratefully received. Cheers.
 
Hi,

Welcome to the forum - an expert will be along in a few minutes - just wanted to say hi.

Cheers
Ailz

PS There's a lot of helpful stuff on this site
 
Dougie22 said:
I'm confused about the "target" "2 hour" level that I'm aiming for:
- The NHS booklet I was given at the surgery suggests keeping it under 10

I too was quoted the level 0f 10 mmol/l as being the target for newly diagnosed. That information came from a DSN on a course I was recently on. I immediately took this person to task and said what was the point of telling them levels that were way above the NICE guidelines, telling them they were OK when most people thought the NICE figures were too high anyway ?

After a 'conference' with her pals they stuck to that figure as they thought it might stress the poor newly diagnosed person..........you couldn't make it up ! Personally I wish somebody had told me the 'facts' when I was first dignosed rather than lie to me about levels which I too once thought were fine. They are not and never will be.

- The NICE levels quoted within the forum (Sid Bonkers et al) suggest 8.5
- The last explanatory note I looked at (on here, five minutes ago) said 9

The levels quoted from NICE of 8.5 mmol/l are for Type 2's, 9 mmol/l is for Type 1's. You will find this information clearly posted in the 'Basic Guide for Newly diagnosed' in the Greetings and Introduction section. This is the advice that Sue and I put together as we were continually getting the same questions being asked so thought a 'quick reference' guide was needed to save us posting individual replies to every new member. A time consuming task........
We both believe that the guideline levels from NICE are just a starting point, a jumping off point only. It is clear that we also both believe that even lower post prandial levels are better if they can be acheived. We state that in the advice. An individual is free to set their own targets however. We certainly don't push anybody to do what they possibly cannot achieve in some cases, for whatever reason.

My doctor has so far been little help on this matter as she (diabetic specialist in our group practice) believes that type 2 patients who are trying diet only should not be using a BG meter, so an answer that says "your doctor will set a level with you" doesn't really help. Nor does "Get it as low as you can", even though that may be the correct answer!

They would say that ......it saves them Money but does nothing for the Patient's healh and well being !

Also, the same doctor has asked me to get another HbA1c test done, even although it will only be six weeks since the previous one(the literature seems to support 8-12 weeks as reasonable). Is this likely to show any improvement from my previous 7.8, given the short time on the new diet?

.
Click to expand...

As for the HbA1c after such a short time........pointless really, you should wait until 3 months have passed before your next HbA1c. Defer your appointment till then if that is all it is for. Then you may have some ammunition to approach your GP with if your HbA1c has gone down and so avoid going onto medication.

There are also tips there for trying to get a meter and/or strips. Have a read.
 
Welcome to the forum, Dougie-
The 2-hour BG levels quoted are far above those of non-diabetics. It makes sense to aim for the best control you can without risking severe hypoglycaemia. (This is much easier if you are not taking insulin and can keep your total carbohydrates low.) I've read that 2-hr BG levels for non-Diabetic fit young people are between 5 and 6.
 
Hello Dougie, you have made the most important discovery regarding T2 and your treatment.
It is: Look after yourself and your own treatment, set your own targets, and do your own research.

Many Doctors are very good, some are not, some know a great deal about T2, some do not.

So simply by querying the advice you have been given you have made the first important step.

Keep doing the research and keep asking questions.

It is my humble opinion that the nearer you can get to non diabetic levels without having any problems the better. It may not be possible, but there is nothing lost in trying.

It is a fact that tight control of your BGs will reduce the chances of any complications dramatically,

H
 
Thanks for all your responses.

I have put my HbA1c appointment back by two weeks. This will at least give an 8 week picture rather than a 6 week picture.(I didn't think I could push it out much further without falling out with the doctor.)

I continue to take multiple BG readings and have now got it down to a simple, easy routine.

Probably most confused about my fasted morning levels, taken 10 minutes or so after I get up. I thought these would be quite consistent but they seem to swing about without any obvious reason from my diet the day before. To date, they have been 7.9, 7.8, 8.2, 6.4, 6.8, 8.4.

Is this a fairly normal variance or should I be able to achieve tighter control than this at this stage?

Does this show I need to think more carefully about my evening meal (I'm not eating anything after about 6.30pm, except maybe a mug of green tea)?
 
Morning (fasting) levels are, frankly, something you cannot do a lot about. They will come down as you get tighter control but only by a bit, at least that's what happened to me. Mine are still 6's and maybe a 7 every now and then. I believe the reason is that your liver dumps glucose to prepare you for the mornings hunting and foraging before you get to eat breakfast. I tried various things but nothing works.

I doubt your evening meal would have any effect on your morning readings, you are effectively in a fasting state.

Some people get better morning results if they eat a small carbs snack before bed.
If you are offered Metformin you can take it at night and it will reduce your morning levels, well, it did for me. By the way, have a read of the British Heart Foundation article under "Ultrabad LDL" (do a search on their site) as a bit more research for you :D .

H
 
Another day, another surprising result (for me as a newby at least).

So I had a pretty good (controlled) dinner tonight.
I didn't take areading immediately beforehand but I had a fasting 6.8 this morning, which is on the good side for me, and a very controlled day (no bread at lunch for example).
Finished dinner about 6.30pm.

Had to go out for a walk so I took my reading at 8.20pm (only 10 or 15 minutes earlier than usual) and got a dissappointing 11.8 - not the end of the world but poorer than I've had for the last few days.

Then went for a brisk walk and decided to do another one when I got back at 9.10pm (only 50 minutes later). My reading was 4.1 - the lowest I've had since I started!

So, anticipating the responses I might get, I guess I'm going to have to concentarte on my dinner readings, do a reading immediately before dinner, then after 1hr, 2 hrs and every half hour till it gets low and repeat with and without exercise.

To say this is complex is an undersatement! :?
 
Sorry but the above prompts more questions about the "2 hour reading" which I'm sure others at my stage will have asked (feel free to direct me elsewhere to read up if appropriate).

- If I sart my meal at 6pm and it takes half an hour including a coffee, at what time should I be doing my "2 hour" reading?

- If my "2 hour" reading is slightly high, but returns to a good level a half hour afterwards, is this "good" or do I need to find ways to bring the low reading forward?

- If I'm eating slow release (low GI) stuff, will my peak be later and is this good or bad?

I tried looking at this in the literature, but got lost in the "your mileage may vary" concept
 
I know it may seem like a daft question, but did you wash your hands before the 11+ reading???

I'm type 1-but have had a high reading that absolutely threw me-because I immediately corrected it by my insulin etc (won't give you the boring details)-except I hadn't washed my hands-and within 2 minutes I was literally in a very, very poorly hypo state-because the high reading was wrong-because I had not washed my hands first.......going from a 11 to 4 within 50minutes is a very quick drop indeed for a type 2, so just a thought.....
 
You could be right. On one or the other. I was distracted as I was rushing to go out and again as I'd just come in, so I possibly didn't wash my hands one or both times. Will be more careful going forward! Thnaks.
 
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