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Newly diagnosed and very confused

I

ianmetaxa

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10
Hi there, glad I've found this forum - hope someone can help, and apologies in advance for the long story!

After a fortnight of drinking litres of anything I could get my hands on and going to the loo every half hour I went to the doctor last Monday. Blood test result on Tuesday showed my blood glucose to be 650 mg/dl (I'm not in the UK at the moment so it's measured differently) - I think it equates to around 36 mmo/l. I was admitted to hospital that night and released on Friday when my BG was down to around 300 (16.6 still high, obviously).

Since then I have been taking Metformin 850 twice a day, injecting 15 of Insulin at night and also taking Januvia, Micardis (for high BP) and Lipitor (for high cholesterol) as well as following a low calorie diet (which I'm also trying to make low carb having read comments on this forum) and walking every day.

BG was coming down gradually, by around 20 mg/dl (1 mmo/l) each day. Saw GP on Monday who seemed happy with the hospital's plan, and wants to see me again in a month. However, yesterday morning I was back at 300 (16.6) which came down to 240 by yesterday evening , but this morning I'm back at 300.

Does anyone know why my readings are going up so much overnight, and also roughly how long I should expect it to take for my levels to reach the 'normal' range, (doctor said to expect them to come down slowly but not what slowly meant).

To add insult to injury I have a sprained foot which is making it difficult to walk (although I have managed a short hobble this morning) and constipation (!) - could either of these be having an effect?

Thanks in advance,

Ian
 
Welcome to the club no-one wants to join :? I hope we can help with your condition, & you see a return to good health.

At those levels, you have been diabetic for some time, or something has triggered diabetes. Have been ignoring other symptoms, such as chronic tiredness, weight gain or weight loss?

How old are you? Have you attributed diabetes symptoms to 'getting older?' At those high sugar levels, 'simple' T2 is in question, & your immediate treatment indicates that.

I presume you are measuring your BG with a meter.

Regarding exercise, you don't want to aggravate your foot injury so concentrate on chair exercises & breathing & singing. You want to do things that improve your circulation. My wife & I go to the hospital gym for heart rehab exercises, & I have complained at the emphasis on walking, step-ups, & so many leg-based exercises. (I play tennis & table tennis, so I am very mobile, but there are times when I have injuries that prevent me doing them.)

Constipation will tend to maximise food absorption & ensure high over-night levels. I found not having supper was very beneficial. I also eat a lot of root & green veg, & snack on nuts & cheese & fresh fruit.

You may find these threads helpful.
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DUK conference - Self Management
 
Hi Ian, thank you for the welcome and your response. So.. answers: I am 53 and am currently 21.5 st and 5'7" with a classic apple shape, (2 stones came off through being ill prior to being diagnosed), I measure the BG with a Bayer Contour meter, but at the moment I am trying not to test my blood more than once or twice a day. We think the original BG reading, that was off the scale, may have been a little false as for days before the blood test I had been chugging down litres of Fanta orange and Coke and, stupidly, energy drinks! The reading came down quite quickly to under 16.

I did have a blood test 3 years ago that gave me a clean bill of health for diabetes, cholesterol & blood pressure - so it would seem to have developed quite quickly.

Being way overweight I did consider that I could be a candidate for diabetes, but, as with all blokes, considered myself to be invulnerable. With hindsight there were indications, particularly with my feet, but being ignorant of diabetes symptoms I simply put it all down to being fat. My job, (computer programmer), has meant that I have become very unfit over the years.

The doctor has indicated that if things return to normal and I lose weight and get fit, there is a good chance that I can come off the medications, but we will see.

At the moment exercise consists of a walk around our block which measures 1 kilometer. Next week will be 1.5 times around ect... Which I feel is doable while the sugar is so high.

I am currently eating 3 pieces of fruit a day, green apples, pears and kiwi fruit, and I have dried apricots and raisins. The green stuff is quite difficult at the moment having always been a 'salad dodger' in the past. I am on a 1600 calorie, low fat, low carb diet and honestly I feel that I am doing OK on it, not really feeling hungry.

The last 2 days BG morning readings are a mystery, because up until then it had been coming down nicely, so maybe I am doing something wrong in the diet, or eating at the wrong times.

As with many people though, I do consider being diagnosed as a good thing, it really focuses attention on ones lifestyle and I am determined to change things around and beat this thing.

The constipation thing I had before I was diagnosed and has hung on a little, but is gradually fading.

Hope this all helps give you a picture of things.
 
Hi ianmetaxa and welcome to the forum :D

I note that you say that you are trying to test only once or twice a day so it is important to make sure that you can learn something from it. It is a good idea to test before and 2 hours after meals to see what your food is doing to your BG level and in that way you will know what foods to avoid or increase.

As regards the constipation you clearly need the green and leafy veggies - including the salad! :D

The walking is good and any kind of activity will make some difference. We look forward to hearing how you are getting on with things.
 
Hi Synonym,

I am slowly coming round to the idea that I have to eat cabbage :( .

One of the confusing things for me is that I'm not sure if it is the food that is having the odd effects on my BG, as I am sticking pretty closely to my diet sheets. I am paranoid about becoming paranoid over the blood testing, if you see what I mean. When I go to bed my BG has been around 13.5 and I am waking up with 17. The constipation is easing and the foot injury will probably be OK by tomorrow, so it will be interesting to see what I wake up with tomorrow. I'll post my morning BG tomorrow.
 
Ianmetexa wrote “One of the confusing things for me is that I'm not sure if it is the food that is having the odd effects on my BG, as I am sticking pretty closely to my diet sheets.”

Well, I guess that would depend on what is on the diet sheets! Please let us know what you are eating.
 
I am currently eating 3 pieces of fruit a day, green apples, pears and kiwi fruit, and I have dried apricots and raisins.
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Fresh fruit - YES, but remember fresh fruit is about 10% sugar (ripe bananas 20%) so 3 is a reasonable limit. NOT fruit juice, a 250 ml glass of which is 25 g sugar.

Dried fruit is very easy & pleasant to scoff. For a food diary I recorded 15 dried apricots - 60 g sugar. Most other dried fruit is 70-80% sugar. I recommend you stick to fresh.

You may have been given a 'Healthy Eating for Type 2 Diabetes' booklet - the one that warns you against cutting carbs. My dietitian, pharmacist & Dr were all horrified at the recommendations regarding eating carbs, & making starchy carbs 50% of our diet. It even threatens you with brain damage if you don't. I recommend you shred it & recycle it.
 
my diet is 1600 cal's per day, low carb, low fat. I am counting carbs and calories.

The foods in my diet are:

Veggies - beetroot, cabbage, carrot, cauliflower, celery, cucumber, leek, lettuce, mushroom, onion, peppers, tomatoes, broccoli, spinach, green beans.

Fruits - as described above.

Meat - chicken, lean pork & beef

Cheeses - feta, gouda, (both low fat)

Pulses - non really, but I am allowed occasional lentils or chickpeas.

Fats - olive oil 1 tsp, 1 tsp marg

Breads/Pastas/Rice - 1 small slice wholemeal, 1/2 cup wholemeal pasta, 1/3 cup rice

Dairy - 180g 2% fat Greek yogurt, 1 glass semi-skimmed milk

That's about it really.
 
Hi Ian,

That sounds a very good diet for a Type 2 as far as I am concerned. Certainly, from my own experience, I'd expect your blood glucose levels to drop fairly quickly eating such a diet.

Good luck and best wishes - John
 
Thank you John, your comments are very encouraging.

Taking earlier advice I have checked my BG after having had my lunch and it's down to 13.5 from 17 this morning, so I'm quite pleased at the moment. Lunch was 2 slices low fat boiled ham + green salad and pickles.
 
Hi Ian

I suggest that you keep a total food diary and also note your BG levels before and after. In that way you will get a clearer picture of what is happening. :)
 
Hi again Ian,

That sounds a good lunch as far as blood glucose levels are concerned. Just so long as it satisfies your hunger because it doesn't sound very much.

Please be aware that I'm a Type 2 on metformin only - I have no experience of using insulin.

I've been eating a diet of around 1300 to 1500 calories a day for around sixteen months and my appetite seems to have adjusted because I can say that I never really feel hungry. In that time I have just about normalised my blood glucose levels and at the same time I've lost 5 stones in weight.

Most of my improvement in blood glucose levels came almost immediately that I changed my diet - i.e. before I had lost any weight of any significance. What's more I do very little exercise - infrequent steady walking of two to three miles occasionally - I really did ought to try to do more.

I really have been totally amazed as to how powerful diet has been.

Keep at it you sound to be on the right track - I'm confident that you will get there!

Very best wishes - John
 
Synonym said:
Hi Ian

I suggest that you keep a total food diary and also note your BG levels before and after. In that way you will get a clearer picture of what is happening. :)
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Yes - I agree with that Synonym.

Personally, I do a weekly one and record everything on it - i.e. what I eat, calories, carbs, BG readings and time in relation to food, weight, blood pressures etc, etc.

In my opinion, such diaries become even more useful in the longer term because looking back, comparing and trying to work out why something is happening becomes much more relevant and understandable.

John
 
Hi John,

Welcome to the diabetes wagon train! You are worried about your bg going up overnight and so do I. It was suggested I look up "Dawn Phenomena" and it was certainly worth it because it explained what was happening.

As for testing, it may be you need to test a little more to start with and then cut back when you've learned what suits you. You might find the dried fruit will cause it to go high but you'll only find out by testing. Sometimes eating some nuts or something with higher fat will help stop the sudden surge of bg with things like dried fruit or a banana according to the dietician I saw.

Hope that helps.

Sara
 
Hello all,

Thank you all for so much good, useful advice. We are doing daily food diary sheets, with the BG result after each meal.

Sara, re the 'Dawn Phenomenon' this has only manifested over the last 3 days. Yesterday I woke with a BG of 17, after lunch this had reduced to 13 and after dinner it was down to 11. This morning after a good nights sleep my morning fasting BG test was 15.8. So still a big spike, but less so than yesterday and during the day it falls a lot.

I am taking my insulin at around 9pm and going to bed at around 11 - 11:30pm. So tonight I am going to take the insulin immediately prior to going to bed and instead of snacking on fruit I will try the nuts. Constipation still an issue and I am sure this is having an effect.

Thank you,

Ian
 
Hello all,
just thought I would update you.

After taking the advice offered in this thread, i.e. not eating fruit before bed, last night my supper snack was cheese and also I delayed my insulin shot until 1 hour before bed. This morning my BG was 12.4! :D After 3 days of 'Morning Phenomenon' this was a great start to the day. If my sugars come down today along the lines of what they normally do during the day I should have a really good reading tonight.

Cheers and thank you again.
 
ianmetaxa said:
Hello all,
just thought I would update you.

After taking the advice offered in this thread, i.e. not eating fruit before bed, last night my supper snack was cheese and also I delayed my insulin shot until 1 hour before bed. This morning my BG was 12.4! :D After 3 days of 'Morning Phenomenon' this was a great start to the day. If my sugars come down today along the lines of what they normally do during the day I should have a really good reading tonight.

Cheers and thank you again.
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Hi Ian.
A belated welcome to the Forum. Been away for a while. Although some things may have been covered previously this encapsulates the advice the HCP's don't give you ! Hope it helps.

Here is the advice we usually give to newly diagnosed type 2 diabetics.This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different .

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

The main carbs to avoid or reduce are the complex or starchy carbohydrates such a bread, potatoes, pasta and rice also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating then two hours after eating you will see the effect of certain foods on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.

As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try !!

As a Type 2 the latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l.
2 hrs after meals......no more than 8.5 mmol/l.
If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.
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Hello,

I just thought I would post my progress, as the advice I got from this forum was very useful. After just over 2 weeks from release from hospital with a BG of 16.6 and problems with very high morning readings, I am now down to around 6.3 and this reading remains reasonably constant throughout the day, moving up or down by only one point.

I am still on my night-time insulin shots, but I am hoping that I can come off these after my next consultation in a couple of weeks. I must admit, I did think it would take much longer to get my readings down to something like normal, but who am I to complain. I am continuing with diet and exercise and am losing weight steadily.

Best regards

Ian
 
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