Organ damage if Blood Sugars over 6 mmol?

I agree with you that restricting levels to under 6mmol/l at all times is unnecessarily restrictive.
If you use google to find Libre graphs for people without diabetes, you will see their levels are not flat and can rise to 9 or 10. The difference is that their levels will fall back to "normal" numbers pretty quickly.
It is prolonged high levels that cause complications rather than a spike that come back down.

This page (https://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html) provides recommended target ranges, You will see these are higher than 6mmol/l

keithgg said:

Hi all,

Sorry to intrude, but I was really hoping you could offer me some advise.

My wife is a type 2 diabetic (diet controlled), with nephropathy and tries to keep her numbers below 6 mmol at all times.

She puts very tough constraints on what she can eat, to the point where she now insists she can only eat one meal day.

I'm really worried she is not eating enough, and she is underweight.

He main rationale is that she can't risk her bloods going over 6 mmol, due to the "organ damage" that may occur.

I feel this is over the top, and short periods over 6 mmol aren't really a big deal re. damaging organs. I fear she is doing more harm to herself by eating just ~500 calories a day, (than bloods going over 6mmol for a period would cause)

Can anyone help me reassure her that numbers over 6 mmol for a period is not such an issue, and she should prioirtise eating more, over trying to keep below 6mmol at all time. Or is my outlook wrong?

Thanks so much for any help,

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What kind of things does she eat?

I prefer to keep my blood sugars sub 6 mmol/l too and eat accordingly (mainly no carb foods).

The NHS has a value of 7.8 to keep below. 500 calories will be doing damage, that's putting the body in starvation mode 9The worry being that you start digesting your own muscles and ultimately organ damage occurs for totally different and unrelated reasons then diabetes).

Note that if she is totally adamant about keeping bloods down, the other very strong point is that she can "go to town" on none carb foods without impacting them. She could eat a huge steak, a box and eggs and a pound of cheese washed down with 500ml melted butter and it would cost her 5000 calories and keep bloods low. (A silly example but calories do not affect blood sugars, carbs do)

If she is not willing to eat more foods that don't impact her bloods and maintaining the very low calorie intake, i would start to be concerned and consider getting help for the possibility the diabetes has caused her to fall into an eating disorder as a coping mechanism. This is a totally understandable reaction, but one that should be addressed with professional help if its not just a simple misunderstanding about how blood sugars work.

If she hasn't got one already, get a blood glucose monitor. eat and test.

You should test yourself at the same time to show that "normal" peoples bloods go above 6 - my wife has a HBA1C of 30. We eat the same meal and her bloods can be at 7.1 or 7.4 - what ever after a meal. (We did the same tests a few times just for interest) That's perfectly normal.

I am a skinny type 2 and I also try to keep my BGS low but I eat lots of high calorie food such as cheese and butter on green veg full fat yoghurt and double cream and my levels stay fairly stable and come down very quickly after a meal .If I can help in any way please let me know .
Carol

I am afraid I think this may be a mental health issue. Can you talk to her go in some way?

@keithgg

Show her this thread, it's CGM data on 153 non-diabetics.
Guess what, they spike too, average 30 mins per day >7.8

https://www.diabetes.co.uk/forum/th...ine-normal-glucose-the-results-are-in.182221/

It may ease her anxiety

To help give another bit of perspective here as well, if going above 6 did so much damage I would be very very dead by now.

Heck I'm not sure I'm likely to ever have had a single day since 1977 where my sugar levels have stayed below 6 all day (there is no way of telling until the introduction of CGM's recently),
Note: I'm Type 1 so treatment is a different kettle of fish ,and my target range that the hospital would like to get me to stay in are 4-10.

keithgg said:

Dear all,

Thank you for your replies, really appreciate your inputs. I am honestly at my wits end, due to my wifes continued and ongoing weight loss.

E.g. today at 2pm she has a Blood Sugar of 5.1 mmol, but she is refusing to eat a second meal (even something low carb like a steak) due to the risk of bloods going over 6.

My feeling is that the risk is being overblown (i.e. if bloods go over 6 for a while it's not the end of the world), and she is putting herself at more danger by eating such low volumes of food (just 500 calories and 1 meal daily).

Do others think I should I should support her in choice of diet, or fight it? She is determined to not go on medication, no matter what.

I am so conflicted (and indeed lonely) here, a partners normal duty would be to support their other half, but I feel here is taking things over the top, and my duty as a husband is also try to ensure she eats enough.

Thanks so much for any thoughts xx

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You are being very supportive but she's lost track on what's healthy and is depriving herself of the nutrients she needs to keep her organs healthy.
The research done in the early 2000s suggested that an average blood sugar of below 7 led to the least risk of complications but this doesn't mean never going above 6.
For example as type 1 my average blood sugars hba1c) have averaged 7+ and any damage I've suffered has been done due to extreme spikes . Fpr a type 2 the damage is done by having higher bgs but also high insulin levels; if she is keeping her bgs so low without meds it seems likely that her insulin levels are also low. In any case her doctors will be monitoring her with blood and urine tests to check for these issues.
Try testing yourself with her and she'll see that your blood sugars probably go up beyond this for short periods.
It is possible that her doctors are congratulating her on the low blood sugars without seeing the weight loss.
Her organs (heart, kidneys) that she's worried about will start to be consumed by her own body is she doesn't try and up her protein/fat intake.
Starchy foods are non essential for health but she may need a few to regain weight.
IF she won't eat more then it suggests some kind of eating disorder e.g. orthorexia where she's deriving comfort from anxiety by restricting her diet even if the anxiety is likely misplaced.

keithgg said:

does anyone else here see their anxiety / mental health deteriorate with high blood sugars? I'm trying to ascertain how common this is, or are diabetes and mental health usually rather detached issues?

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as she doesnt have high blood sugar levels then no, they wont affect her mental health. Howvever, starvation will affect her mental health.

keithgg said:

Dear all,

Thank you for your replies, really appreciate your inputs. I am honestly at my wits end, due to my wifes continued and ongoing weight loss.

E.g. today at 2pm she has a Blood Sugar of 5.1 mmol, but she is refusing to eat a second meal (even something low carb like a steak) due to the risk of bloods going over 6.

My feeling is that the risk is being overblown (i.e. if bloods go over 6 for a while it's not the end of the world), and she is putting herself at more danger by eating such low volumes of food (just 500 calories and 1 meal daily).

Do others think I should I should support her in choice of diet, or fight it? She is determined to not go on medication, no matter what.

I am so conflicted (and indeed lonely) here, a partners normal duty would be to support their other half, but I feel here is taking things over the top, and my duty as a husband is also try to ensure she eats enough.

Thanks so much for any thoughts xx

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It might be helpful to find out her latest hba1c number, as that gives a three month average. I am sorry you are both suffering like this.

To reinforce what others have said, apologies if this seems a bit harsh.

Your partner seems to have a mental health issue.
She has an eating disorder.

I think the most common cause of anorexia nervosa is an anxiety about being too fat.
Despite being emaciated, sufferers convince themselves that they are fat and all will be well if they just lose weight.

In your case your partner is blaming the issue on diabetes.
This is not correct, as illustrated up thread.

My personal (inexpert) feeling is that trying to use logic to address the issue is a waste of time.
In the same way that someone is convinced they are too fat will not believe that they are too thin, any explanation that BG levels aren't harmful is unlikely to change behaviour.
This should be addresses primarily as a mental health issue and treated by people with this expertise.

Hopefully your GP will be understanding and can arrange a referral for counselling.

https://www.nhs.uk/mental-health/conditions/anorexia/treatment/

The very best of luck, and I hope this helps.