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Newly Diagnosed and Confused

IBEX82 said:
Ahhhh you were a little low but I’m assuming not too bad pre eating?
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3.8mmol/L is fine when hypoglycaemic medicines are not involved. Very low risk of hypoglycaemia. Also, those who are ketosis have much lower glucose requirements and can function very well at the lower end. I’m fairly sure @Caeseji eats ketogenic, although I may be wrong there.
 

Ohh this is good to know. As I’m on meds they always say to do something to bring it up below 4.

So 3.8 in non medicated type 2 is actually good? That’s awesome. Well done @Caeseji

And Jim, when you gonna set up a diabetic clinic?! You’re so knowledgable I’ve learnt so many things from your replies!
 

Hahaha, I do my best really! It's all we can do isn't it? I'm glad though that you have gotten a handle on it early and adjusting things to suit because it must have been such a shock. Trust me I was a beast for carbs too, just scoffing down pasta and bread like a typical millennial! Anytime really as I don't want anyone here feeling like it's an impossible battle.


Jim is right there, not on any meds myself so there's no risk at all of any hypos going on and I do eat sorta ketogenically, more of a LCHP these days because it works for me. They do have a point though Jim, time for you to step up and open your own clinic
 


And once the clinic is up and running, he can lead his own course... forget DES.... We’ll have JEM... ‘just eat meat..’
 
Okay new one on me... what about when you’re blood sugar is lower post meal than pre?!

So fasting reading 5.5, took gliclazide waited an hour took pre breakfast 4.8... had breakfast, 1 scrambled egg, one heck sausage, one rasher of bacon... waited two hours andddd 4.1 - what?

Is it just the gliclazide making it lower?
 

Possibly your liver was secreting glucose preprandial, and eating arrested the process. Possibly the gliclazide still reducing blood glucose three hours after taking it. Possibly a combination of both.

If you’re getting 4.1 after eating then it may be time to consider talking to your doctor about reducing your medication.
 

Thank you I have a review next week with getting it reduced, DN just wanted to make sure I’d had consistent BG readings for a few weeks first so hopefully she’ll agree to reduce it with a view to stop if I can maintain the levels with diet though I appreciate this may not be possible yet being on high dose steroids.

I take 80mg bd so maybe she’ll go to 40mg bd instead.
 
Just a quick update.. I had my review and my medication was not lowered as I’d wanted. I was encouraged instead to up my carbs to manage my lower BGs and given another appointment for two weeks time.

So I’m still on the 80mg BD gliclazide and now eating more carbs which has got me where? Oh higher day time and fasting BG but somehow still low evening BGs which in order to get up as ‘I mustn’t be below 8–10..’ before bed I’m having to eat silly amounts of carbs... I feel rubbish and have seen numbers in the 10s frequently this week.

I guess we’d call this little experiment a fail I’m so stressed with it all which I’m sure isn’t helping.
 
You really need to get that glic down if you are going to reduce carbs, can’t see why they would encourage you to reduce if they are not going to work with you on that front. Stress will drive it up but remember you are doing your best and it is a marathon! You’ll get there and keep us posted, brightens the place up a bit

I feel that is a bit of a high number to keep to before bed though, especially with daytime readings being so high. Might have to reduce the carbs a little over time to let your body get used to it and hopefully the glic can go with it.
 

Yes I know.. it’s all contradictory which is the part that stresses me.. I was doing so well, keeping my carbs around 30-40g, getting good readings but then they started becoming increasingly lower (which is the objective surely) so it would make sense to drop the gliclazide to see how the BGs go. But after showing the DN (who previously seemed supportive) my food diary and readings she was all ‘you’re eating too few carbs! And you can’t risk being less than around 8-10 at bed time due to the risk of hypoglycaemia. Ideally you need to be eating more carbs at each meal to keep your BG consistent throughout the day then you’ll avoid low bed time readings and overnight hypoglycaemia.’

In my mind I’m thinking...’yes and staying low carb but ditching the afternoon gliclazide would have the same effect?..’ I tried to counter with this in around about way to be told ‘but this could lead to more hyperglycaemia episodes due to your steroids as the gliclizade would not be balancing these out.’

And round in circles we go... le sigh!

But thank you! And I’m sorry to vent.. I haven’t been posting as I’ve been so frustrated and moping. I might low carb and ‘forget’ the afternoon gliclazide dose.. see what happens. I know.. I’m terrible..
 
Can't agree less on the third paragraph of your post on Jim
 
tayelola said:
Can't agree less on the third paragraph of your post on Jim
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You couldn’t agree less? So you don’t find his posts knowledgable or he shouldn’t set up a diabetic clinic?
 
I’m sorry you’re contending with so much! It’s a very difficult balancing act!

It is madness though to be told to Eat to the meds. Telling you to eat carbs so you don’t hypo whilst giving you gliclazide - all kinds of crazy

I spend FAR too much time watching my 600lb life I love DrNowzardan he’s a lovely but absolutely no nonsense Dr specialising in bariatric surgery - if you haven’t seen it, you should.

He gets all of his patients on a low carb, high protein calorie restricted diet, before surgery to reduce liver size and to prove they can do it, because the surgery only works if they can be self disciplined enough to follow his advice after surgery

All his diets are tailored to each patient but range (generally) from 800-1200 calories) but bear in mind these patients are 500-800 lbs

I had an emergency appendix removal
last year & the operation/food/medication completely screwed my BGL long boring story, but a few days after escaping from hospital I stopped taking all the medication they’d forced on me (metfirmin gliclizide,, BP & whatever else. I wasn’t on anything before I went in (good BGL (with diet only) and it was all making me feel ill and my BGL were awful. Very quickly from eating low carb again they were back in a good range

I’m not advising you to do that because you have added meds and complications, but it’s vital to read as much as you can (Briffa/Bernstein/Fung) and make decisions for yourself because no one else has the overview that you do, they all look at their own ‘area of concern’ (and frankly some aren’t even much good at that)

I’d choose something other than lucozade for a hypo these days since they took the sugar out. But I don’t know what as it’s not something I have to worry about (thankfully)

Your profile picture is beautiful you don’t look overweight or 36 I’m envious!!
 

Thanks so much for your detailed reply. I couldn’t agree more! The madness of this situation is unreal. I’m just at a loss with it. I understand it’s a more complex issue than the usual type 2 and no other issues situation but I’m not unique and I’d have thought the DN at the GP surgery would be a little more forthcoming with a solution as opposed to just eat more carbs.

I think you’re right.. my specialists are fabulous.. really but they do tend to focus on their part and overlook the bigger picture. I’m so pleased you got back on track with your BGL and the low carb is working.

I am reading avidly but I think it’s having the confidence to ‘follow your own path’ with me..I don’t want to end up making anything worse.

You’re so sweet about your comment on my profile pic.. I’m lucky I don’t carry much weight in my face so selfies are fine, lol! However, I am more than ‘overweight.’ unfortunately. At 5’6 and 126kg I fall firmly into the morbidly obese category so I will definitely check out the show you mentioned
 

I'm sorry, but the advice to increase your carbs is just crazy. If it is possible, in your circumstances I would protect myself by acting against such medical advice. By that I mean reducing the meds by taking fewer tablets, or in the worst case by chopping tablets in 2 and taking a half rather than a whole one (I know that this isn't an accurate way of halving the medication, but needs must).
 
IBEX82 said:
But thank you! And I’m sorry to vent.. I haven’t been posting as I’ve been so frustrated and moping. I might low carb and ‘forget’ the afternoon gliclazide dose.. see what happens. I know.. I’m terrible..
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Sometimes you gotta be the master of your own condition, I ended up dropping Metformin way before I was told to stop taking it because it was doing nothing for me. Don't worry about venting, let it all out and we will be here to listen but it's the same stuff I got from my DN as I had ketones in my pee. "Eat more carbs! Your HBA1C is fine!" Erm... THAT IS BECAUSE I AM NOT EATING THEM! Oyyyyyyy but I hope you can get through to them soon, honestly I think trying it out and keeping the carbs down may be beneficial for you. Plus throwing your care team the papers that Dr. Unwin has published recently might be a good shout too
 

What?!!! - The DN actually said that you need to have excessively high (8 to 10) BG at bed time to avoid hypoglycaemia ? Just so that you can take more Glic ! - That is utter madness.

Eat to your meter and medicate to your meter - nobody should ever advise eating to your medication!
 

This is how I feel. It’s almost as if ‘ohh your blood sugar is low..’ yes, that’s due to eating less carbs and being on meds that lower it further.. ‘oh well.. eat more carbs..’ when the real answer should be ‘medicate less..’

I could scream it’s so frustrating. I have another review on Wednesday and I’m hoping I can make her see what this is doing to my BGL which are now running high due to too many carbs at the DNs suggestion. If not, then I’m unfortunately going back to my LCHF diet, which I felt great on and was giving me good steady BG readings and reducing the glic in response - I have my meter and will monitor religiously but I cannot continue like this.
 

It’s crazy right?! It’s almost like they’re scared to admit the LCHF way of eating or even LCHP way of eating can be doing you so much good - that you must eat these magical carbs, despite the fact they’ve never done you any good in the first place.

I’m back there on Wednesday..I’m not sure I can take another appointment without losing my cool. Pray for me
 
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