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Newly diagnosed, 82 HbA1c 82 MMOL/MOL

After talking to the doctor I started shaking, little confused and I did a quick test and sugar was 10. From 7.1 this morning after a skinny flat white. I had to have some porridge with semi skimmed milk. Why is it fluctuating so much? I sit because I am newly diagnosed and making to many changes at once?
 
Its so strange only two weeks ago I wold have a flat white skinny everyday and a normal lunch as I didn't know I was diabetic. Now I ma getting these shakes and I am eating so less than 2 weeks ago. Why am I feeling like this? Is it my body going through changes etc
 

You can answer it yourself, if you want and have the will to make a strict diet, then try no meds first... if you want some bread then take the pills...

I was given the same meds... only took one to try (the side effects were a NO). The second one makes your kidneys drop excess G into urine. The first one, tells your (EDIT: Liver not kidneys) to not dump reserve G into the blood, and there are suspected non-explained factors in improving insulin resistant (not really demonstrated).
 
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BTW, after eating some porridge my shakes etc have clamed down. I feel better now. Clusco I dont understand the first one tells the kidneys to drop G in urine and the 2nd one is stopping it. That is a conflict right? Why would they subscibe me that. Forum members did you find it hard at first to adjust to the new diet? Did you experience shakes etc
 

As for milk (never take skimmed), the more they remove fat the more it concentrates lactose and the faster it speeds up digestion (fat slows it down). Take whole milk or what I do, I take coffee with a single drop of 35% fat cream (the one to use for cakes).

Lactose free is even worse, means lactose has been converted and concentrated into pure G ready to be absorved at maximum speed. I learned this with the continuous meter then searched online and found out it's actually known science. I will send you the video if I can find it.

Dont know about the shaking.
 

I made a mistake above, Dapagliflozin is one active principle, that induces the kidneys to filter G from blood and drop it into urine (means you waste G).

Metformin induces the Liver (not Kidneys) - to not dump reserve G into the blood.
 
Ok, she said both of these things will bring my G under control. Going by your explanation it sounds like they both work together and could bring my Blood Sugars control control. She was not forceful but she said she would recommend it, get thinsg under control then observe via a Blood test in 3 months. Then if better we can reduce or stop medication and people do that she said.

I prefer going solo but when will I see improvements, its been 10 days so far....
 
Well the shaking certainly wasn’t from low blood sugar, right? If your glucose was 10? So possibly adding a huge carb load in the form of porridge at that point might not have been the best idea. What was it after the porridge, did you check?

Two possibilities I can think of for why it was 10 when you’d only had a coffee: for me, coffee has a bit of a tendency to make me spike early in the day (it’s fine by the afternoon/evening). Skimmed milk would definitely make me spike more than full fat. And for some reason, hot milk seems worse than cold (so I can have an iced latte with no problem). The other possibility (or both, of course) is that you were a bit stressed by the doctors appointment and that made you spike.

Try not to be too downhearted about the 10. With an HbA1C of 82, it’s likely that up until now, your blood sugar has been well higher than 10 for a significant percentage of the time. So you’re already making good progress!! And fluctuations up and down really are normal, this isn’t something that you’re doing wrong.
 

You will not:

- Correct a insulin resistance problem in 10 days.
- Burn your excess in blood and liver reserves, etc...
- Change your metabolic and hormonal issues (insuline and glucagon) in 10 days.

After 2 months I have passed G tolerance test (which means they take blood and check the BG, then you drink 75gr of pure G, then they take blood again to test you after 2 hours).

I started at 4.6 morning, 5.8 after 2 hours (EDIT: you need to be under or equal to 7.8 after 2 hours to pass). I checked with the continuos monitor, I have reached a very fast peak of 11.4, then came down like a hammer... which means my insulin resistance improved dramatically in just 2 monts.

Note that my starting point (diagnostic) was higher than yours (11.4 first morning test, estimate average G of 3 months 14.2

So if you take things seriously you can make a lot of improvements (that doesn't include bits of bread in your diet)
 
Your shakes were probably what are called a false hypo. They're caused by your blood sugar levels reducing to more normal levels. The problem is your body has gradually, over the years, become used to high levels, so it reacts as if your levels were becoming dangerously low as if you had hypoglycemia (but you don't). There is a period of readjustment necessary. Our bodies are marvellous but sometimes get a little out of whack.

As regards the medication - I took the metformin I was offered and went low carb at the same time. I was happy to have all the help I could get to start getting healthier. Now, I don't need it as my levels stay in the normal range just from diet. But that's taken me a year. Type 2 diabetes takes years to develop, so it can't be fixed overnight - it takes time and patience. It's why people often talk about a new way of eating rather than a new diet because diet conjures up the idea of a temporary change that we can drop when our goal has been reached.

My breakfasts typically feature Greek yoghurt with a few berries and sweetener or eggs (omelettes, boiled, as part of a fried breakfast, scrambled, or egg & milk) or, if I'm not hungry, just a cup of tea or coffee. Less often, I'll do some melted cheese with some herbs and/or spices.
 
So firstly I want to thank everyone for their contributions, I am a little nervous and new to this hence all the questions. So everyone is saying it is not going to be fixed in 10 days. That's true I guess. Only two weeks ago I wasn't even thinking about this stuff and eating my so called normal diet without panicking or shakes etc.. Now I have made changes I am getting these effects. I still feel a little shakey and I think its me driving up the levels, I am stressing and I am work from home today, in the office I would have been more calm. Two hrs after eating the porridge the sugar is 10.

BTW
 
Most of us find the triglycerides seriously lower as desired, hdl increases as desired. Ldl is the more variable measure. BUT you need to understand

1. ldl is calculated not measured and makes assumptions not valid on very low carb.
2. Particle size of ldl is vital in predicting outcomes and isn’t measured as part of the standard testing. Keto encourages the “safe” larger ldl and discourages the “harmful” small particles. This isn’t seen by the drs without the extra testing
3. cholesterol is essential for life.
4. total numbers are meaningless. You need ratios and particle sizes etc to get any meaningful data.
5. Food accounts for less than 15% of body cholesterol. The body makes what it needs so if you eat less, you make more
6. Cutting carbs does way more good for most ratios than cutting fats.
7. As many people with low cholesterol have cvd as with high
8. Statistically as a population the difference statins make is days of life. Obviously as individuals your mileage may vary.

There’s a huge thread about cholesterol and statins with lots of links discussion and evidence started by bulkbiker that will educate you to phd level is you do a search for it.

It seems crazy to me to medicate so many people with a drug that raises bgl and has other side effects to muscles and cognition when only a small % will actually benefit. Surely it’s better to identify and treat just those who need it. But it’s a cheap drug and cheaper to do the buckshot effect.
 
High blood sugar is not the cause of your diabetes, it is a symptom.
The cause is that you have become resistant to insulin, which means that you have trouble using the glucose you get from the carbs in your diet.
Treating the high blood sugar with medication does nothing to improve insulin resistance.
Your blood scores may come down and please your Dr, but if you continue to eat a carb heavy diet, your insulin resistance will not improve, quite the opposite.
Eventually more meds will be required until the only thing that will work is insulin. Most Dr's consider T2 to be progressive, they expect you to need an ever increasing amount of medication..
Nothing wrong with getting help from medication if that's what you decide, but the only way to prove the Dr's wrong and to get into remission with normal blood sugars and improved insulin resistance. Is to stop eating carb heavy food like your porridge.
 
The shakes were not a low (not at 10) so didn’t need carbs/glucose. It’s more likely causes by the high levels you now aren’t so used to (ie a hyper not a hypo) and the stress of the appointment (don’t underestimate that effect ). When you were high all the time it felt normal. Now it’s feeling horrible because you actually feel it. Think of the boiling frog analogy

Metformin is a widley used drug for many decades. Its main purpose is to control excessive dumping of glucose into the blood by the liver, a normal process that’s goes a bit haywire in type 2. It also does something clever in the gut to help improve insulin sensitivity a little. It doesn’t have a huge effect but it helps. Its main drawbacks are diarrhoea. Mostly that settles quickly, sometimes it doesn’t. There are slow release versions that solve that for some people if you need it. Otherwise the only other thing is long term it can lower b12 absorption. So if you use it get a baseline check now and getnit checked with hba1c in future. If you start it now you can always drop it later.

Dapagliflozin is an sglt2 medication that makes you pee out excess glucose from your blood. It can result in uti type issues in a few. Also it is not compatible with a keto risk of DKA (diabetic keto acidosis is raised and in this interaction blood glucose levels are often much lower than with typical DKA meaning it’s easier to miss the warning signs and have real issues. It’s rare but definitely documented. I’m surprised if you told the dr you are doing keto she recommended this. I wouldn’t mix the two. One or other and my money is on the keto having a better long term effect on health and lowering the risk of complications. Again if you start on diet and it doesn’t work (I’m sure it will) you can always go to this next.

I’m not a dr these are just my personal opinions based on all my reading and listening to others who have done the same. If you are unsure discuss these concerns with your dr. (Once she’s looked it up!)
 
In a ideal world I want to start with a low carb diet I'm doing now, its much lower in carbs then before. On the way home from the office I used to grab a sandwich daily. Not now, nothing of the sort for 10 days. Had the porridge and tonight no bread etc tonight for dinner I am only doing two meals a day. Eventually I will go lower. The weight is dropping off without no chocs or crisps and lower carb intake. Just checked again now, 3 hours after porridge which contained some syrup as well its sitting on 7.2. I have done around 5 tests already and its only 2:30pm now. I will have my dinner around 5pm a low carb one for sure and no more tests.

Still doesn't explain the shakes and nervous stature this morning, maybe I am really nervous I keep testing or its my body getting used to my new low sugar and low carb regime which I have started 10 days. I used to eat cholate every day maybe the shakes are due to the change. Bread was normal as well on a daily basis. Things have chnaged drastically in my diet but its definitly not net zero carbs
 
0110 said:
I prefer going solo but when will I see improvements, its been 10 days so far....
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You have seen improvements. You’re fasting today for example. Your ability to feel the hyper today.

When will the hba1c be repeated. As a newly diagnosed person it should be 3mthly til stable according to NICE guidelines. That will show you lots.

In the meantime testing before and after meals will educate you most. An old style meal will probably raise you a lot. A good new low carb one not much at all. All these better meals will keep levels more stable and lower hba1c. Eventually it shows in morning fasting consistently. But that last measure can take many months to be where you are happy with it. I’d ignore it entirely for the first few months now you know what it’s at. Go back to it later to see the changes rather than waste strips and get frustrated by it now.

A freestyle libre sensor would show you what’s happening all day everyday. They are expensive and have their own quirks (don’t always match meters and have odd lows in the night if you lie on it) but there’s a free trial for one sensor that lasts 2 weeks if you go on the website and register. Well worth it, even if it’s just the one, to see the patterns of what raises you by how much and for how long.
 
So make it an ideal world if that’s your preference and do that first. It’s incredibly effective done well. Look at the success stories thread. Many get from your level, and higher, to significantly better numbers that way. Two meals is great so long as you’re not hungry. If you are, eat bigger meals of the good low carb stuff. Porridge is not low carb though. I know the nhs bang on about weight, and it is an issue that causes insulin resistance but it’s also the result of it too. Getting blood glucose sorted makes you lose weight as much if not more than the other way around.

Test as much as you need (can afford) to. The test is worth doing if it helps. At your stage I’d be testing before and after each meal. If you‘re still more than 2mmol above the starting number testing hourly til you are. That show you which foods do what to you so you can stick with it or adjust it next time. It’s a process. almost no one goes zero carb. Working your way down as you learn which foods are good is fine.

Getting the shakes when dropping lower than you are used to being (but remains at or above normal) is called a false hypo. Feel similar to a real one but isn’t dangerous. They will stop as you get used to lower better numbers. However if you were at 10 that seems unlikely unless it had already happened and your liver had already done a dump to compensate and overdone it a bit. Stress can do a lot too. Try not to worry too much about a one off. Stress raises levels too.

You are doing great. you’ll hear a lot that it’s a marathon not a sprint.
 
Are you eating enough?
Not eating enough can make you feel shakey even if BG is fine or high.

Are you replacing the carbs you're not eating with calories from protein and fat? It's quite easy to accidentally be on a low calorie diet if you reduce one food group but don't increase other food groups.
 
Thank you so much guys for the words. It really is helping me and encouraging me to keep going and not to give up. HSSS I am definitly going to take your advice not to test fast on a daily, You mentioned that number is the last to improve and will take time. False Hypo I never knew that existed, I am eating way less maybe that's why the I feel shaky, maybe my body is getting used to the lower numbers and making it panic. 4pm here now only had porridge and my level is 7.5. I guess that is respectful or not? Going to have dinner in an hour. I guess two weeks ago i was eating Sushi or rice and sandwiches my numbers must have been in double figures and maybe because its in single figures i feel abit weak and shakey,
 
It’s sounding more and more likely you simply aren’t eating enough added onto the adaptation to being at more reasonable levels. Add more naturally occurring fats (even if that just means avoiding low fat versions of anything) and more unadulterated proteins. Make sure you’re getting the electrolytes. And it’s highly likely porridge isn’t helping. Test them a few times and see what it does.
 
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