Newly Diagnosed and Extremely Confused

[mayadevi]

Hi everyone, I was diagnosed about a month ago. I had no discernible symptoms aside from being thirsty/hungry a lot and waking up once or twice a night to use the bathroom. I went to the hospital because I had an abscess in my leg, and it needed to be drained. They did some blood work and panicked because my BG was over 30, and they said I was on the verge of going into a coma. I was obviously beyond shocked! I spent the night at the hospital where they administered insulin every 4 hours until they deemed it safe to perform the surgery on my leg.

The following day, I was prescribed gliklazid 60mg once daily, metformin 500mg twice daily, and vildagliptin 50mg twice daily. Yesterday, my fasting BG was 7.8. The doctor was very pleased, and he replaced the gliklazid with dapagliflozin 10mg once a day. He told me to go back for a test in two months.

I’m currently living in Istanbul, and my doctor doesn’t speak English. I’m planning on finding a doctor who does, but I’m sticking with him for the time being as he was there on day 1.

Here’s where I’m super confused. Everything I’ve read so far is that carbs should be limited. Meanwhile, the dr. handed me a leaflet with a 2000 calorie diet, which is as follows:

Breakfast
3 thin slices for bread, 2 thin pieces of cheese, 3 olives, 1 tomato, 1 small cucumber, tea or coffee.

Snack
1 portion fruit, 2 thin slices of bread

Lunch
2 portions red meat/chicken/fish, 1 portion cooked veggies, 3 thin slices of bread, 2 table spoons of rice/pasta, half cup of yogurt

Snack
1 portion fruit, 2 thin slices of bread, 2 thin pieces of cheese

Dinner
2 portions red meat/chicken/fish, 1 portion cooked veggies, 2 thin slices of bread, 1 bowl of soup, half cup of yogurt

Snack
1 cup sugar free milk, 2 portions fruit

This seems like an incredible amount of carbs (12 slices of bread!!!) Am I supposed to be eating like this because of the meds I’m on or is there something off with this diet? How did my BG drop so significantly in a month without me following this diet plan?

I’ve made some changes to my diet (nothing major) like consuming less bread (I used to live on sandwiches) and having more chicken + salads/veggies, switching to sugar free plant based milk (almond/hazelnut) in my coffee, and having a chia pudding for breakfast (chia, flax, pumpkin seeds, 100% peanut butter, banana, pear, some dried blueberries, a tiny bit of oats, plant based milk).

I still have chocolate (90%), drink a ton of coffee, and I got drunk with my friends twice in the last month. Due to my work schedule, I often skip lunch. Breakfast is around 10-11am, and then I usually don’t eat until 6-8pm depending on the day.

Any insight into what I’m doing right/wrong (aside from the last paragraph of baddies) would be really appreciated. Is it normal for my BG to drop so much in just a month? Is it because of the meds? What is the relationship between diet and medication? Why did he replace one medication with another if they seem to be working? Should I follow the prescribed diet, or should I seek a second opinion? Is two months too long for another blood test? Should I be testing at home?

Sorry for the long post, but I wanted to lay it all out on the table for the sake of clarity. Thank you for reading!

 

[catinahat]

Welcome @mayadevi
I'm guessing that you have T2 going by the medication you are taking. Metformin limits the amount of stored glucose released by your liver, dapagliflozin works by making you pee out excess glucose and vildagliptin puts the squeeze on your pancreas to make it produce more insulin.
So yes the meds will have helped to reduce your high levels. The changes you have made to your diet will also have made a big difference.
It seems to me that the Dr's in Istanbul are just as clueless as most UK ones when it comes to a suitable diet fot T2 diabetes
All carbs when digested are turned to glucose which will cause your sugar levels to rise. If you have T2, your problem is insulin resistance. Although we still produce plenty of insulin, our insulin in no longer as effective as it was and just can't handle the amount of carbs in the modern diet.
Base your diet on meat, fish, eggs, dairy, natural healthy fats like olive oil and butter and above ground vegetables & salads.
Avoid bread, rice, potatoes, cereals and most fruit although people are generally OK with a few berries, strawberries, raspberries, blueberries.
Have a look at the nutritional thingy link below my post for more info

 

[mayadevi]

Welcome @mayadevi
I'm guessing that you have T2 going by the medication you are taking. Metformin limits the amount of stored glucose released by your liver, dapagliflozin works by making you pee out excess glucose and vildagliptin puts the squeeze on your pancreas to make it produce more insulin.
So yes the meds will have helped to reduce your high levels. The changes you have made to your diet will also have made a big difference.
It seems to me that the Dr's in Istanbul are just as clueless as most UK ones when it comes to a suitable diet fot T2 diabetes
All carbs when digested are turned to glucose which will cause your sugar levels to rise. If you have T2, your problem is insulin resistance. Although we still produce plenty of insulin, our insulin in no longer as effective as it was and just can't handle the amount of carbs in the modern diet.
Base your diet on meat, fish, eggs, dairy, natural healthy fats like olive oil and butter and above ground vegetables & salads.
Avoid bread, rice, potatoes, cereals and most fruit although people are generally OK with a few berries, strawberries, raspberries, blueberries.
Have a look at the nutritional thingy link below my post for more info

Thank you so much for your thoughtful reply, catinahat (such a cute name)! Yes, doctors here do seem to be rather clueless especially since the diet leaflet I was given is published by a diabetes association in Turkey.

I guess I’ll continue with what I’m doing and make other adjustments as time goes on. I’ve also been trying to walk to work (about 10k steps there and back) rather than cabbing it.

In case this might help others, I read about a small study which found that having 150ml of camomile tea at mealtimes over a period of 8 weeks significantly decreased BG levels in participants. I’ve been trying to do that as well.

 

[Outlier]

Hi, and congratulations on your lovely positive attitude. You are already doing really well.

Blood glucose readings usually rise when we are ill or under stress. You were in hospital, which is enough to send them rocketing - it did me. Now you can get control of your diet and exercise - you are already doing brilliantly - it is highly likely that you can progress to normal blood glucose readings in time, though like almost all of us here, you will always have to look out for those carbs.

 

[EllieM]

Welcome to the forums @mayadevi .

Do you have access to your test results? Your doctor will probably have done an hba1c, which is a measure of your average blood sugar over the last 3 months, and is either measure in % (over 6.5% is diabetic) or mmol/mol (48 or over is diabetic). As it measures levels over the last 3 months, there is no point in doing the test too often.

He may or may not have done additional tests to determine whether you are T1 or T2 (cpeptide and GAD), though the medications you are on sound to be for T2. As T2 is a lot more common than T1 many doctors will assume T2 without doing any more tests.

The link at the end of @catinahat 's post is an awesome quick intro to low carb and T2.

Good luck, the language problem sounds tricky.

 

[sno0opy]

Hi,

You can be on a bit of a catch 22 with the meds until you get to grips with it. Some of the medication your being given is such that it forces your body to produce as much insulin as possible to keep your blood sugars down.

However in doing so, if you go low carb too quickly your body wont stop producing insulin (as the drugs wont let it) so you can find your self then going too low without any carbs in your system to burn away. That is very likely one of the reasons they have given you so much intermittent bread/carb requirements.

Once you stabilize and are testing your bloods on a regular basis, you will be able to slowly remove carbs and then if successful at sticking to the new diet should be able to slowly start reducing your medicine. Once your off any medicine that's actively forcing your insulin levels up you can go onto a full low carb diet without the risks you may face now.

So medium to long term a significant reduction in carbs is the way to go, but short term you have to be very careful.

That said, if you don't change your diet your bloods will eventually start getting worse again as the medication your taking to increase insulin production just increases your resistance over time and will eventually accelerate the burn out of your body's ability to produce it naturally leading to a need for top ups (by injecting inulin). Typically this means that they start increasing the dose till your on max, then introduce the next stage medication, then finally insulin.

 

[mayadevi]

Thank you all for your kind words of encouragement and for taking the time to explain things to me. I’m much less confused, but a lot more scared now. There seems to be a mountain to climb, so onwards and upwards I go.

 

[Outlier]

It's one of those deceptive mountains that looks tall and steep when you stand at the bottom, but is much easier on the gradient when you start the climb. Plenty of helping hands here.

 

[mayadevi]

Thank you so much, Outlier! You’re right, and I’m trying to look at it this way. Last night was really tough, and I had a good cry. I haven’t told my parents yet, so that in itself terrifies me, but one step at a time, right?!

 

[Outlier]

Yep: one step, as you say. Ref. your parents - I find rehearsing dialogue beforehand can guide us to the best outcome. I don't know what is worrying you about their reaction, but you do know, and so it can be helpful to have it ready in your mind the way you would like the conversation to go.

 

[mayadevi]

That’s very sound advice, Outlier! I prefer to tell them face to face, so there’s plenty of time to rehearse until we see each other as I live abroad.