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Please Help

Discussion in 'Ketogenic diet forum' started by emerald0, Aug 6, 2020.

  1. emerald0

    emerald0 · Member

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    Hi, I'm new here so please forgive me if I should have posted this elsewhere but I'm desperate for some help. I've been T2 for about 20 years, been on Glimiprimide 4mg and Pioglitazone 45mg for several years (can't take metformin - tried it and the slow-release type and was so ill my GP took me off it). Been with my current GPs for almost 2 years and seen diabetic nurse twice - first time was when I was in really bad place (in every sense of the word) and blood glucose was way too high and she threatened to put me on insulin, which I refused. My situation has improved a lot (I've now got somewhere to live - with cooking facilities!!!!) and have been on Keto diet all this year and my last Hb1Ac (in March) was 56%. My weight has gone down by about 1 stone. However, despite eating, on average, 140g fat, 80 - 120g protein and a maximum of 20g carbs per day, I cannot get into ketosis (have some uristix for testing ketones + other stuff as I am prone to UTIs) and cannot get my morning glucose readings to be consistently below 8.0 (morning reading has always been the highest of the day for me, regardless of what I'm doing or eating). In June I decided to try cutting my glimipremide down to 2mg without consulting drs 'cos, due to the lockdown here, my GP surgery has been designated for covid patients only and my last nurse appointment, scheduled for June, was changed to a telephone appt and then cancelled due to staff sickness. The only time that my morning glucose readings have been below 8.00 this year was for 1 week in June when I was taking antibiotics for a UTI (prescribed after a telephone consultation!). I admit to being very sedentary and - at the moment - depressed and desperate so any help/advice anyone can offer will be very welcome. Thanks.
     
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  2. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Welcome to the forum.

    What are you eating in a typical day please? Are you using a meter to test before and after eating?

    High morning numbers are probably due to the dawn phenomenon.
     
  3. emerald0

    emerald0 · Member

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    Hi xfieldok, thanks for this reply.
    Typical food is coffee. (about 100mls milk, no sugar/sweetners), 2 eggs, scrambled with 150mls milk, 50g butter for lunch or breakfast (I seldom eat both), dinner is either salad with chicken/turkey (about 150gms),tomato, cucumber and 60ml mayonnaise or fish in sauce (commercial stuff - about 200g with cauliflower or broccoli and 50g butter. I snack on pecan nuts (between 50 -100g per day depending on how much protein/fat/carbs allowance I have left and add butter/olive oil to meals, again, depending on allowance. I limit myself to a maximum of 114g protein and 30g carbs per day. (I found a website somewhere that said you should eat the amount of protein for the weight you want to be - not the weight you are, so that is where that figure came from and I now know that I am hopelessly addicted to carbs and if I eat much more than 20g I just crave carbs - in any form - and that makes me hungry and in desperate search for food!!) On the levels that I am eating now I don't think about food and am never hungry - a huge improvement for me. I take vitamin + mineral supplements, along with cod liver oil and glucosamine (have done for years) and aim to drink at least 2 litres of water per day in addition to any other fluids.
     
  4. emerald0

    emerald0 · Member

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    Oh, the meter - I only test glucose in a morning cos my gp limits the number of test strips you can ask for,
     
  5. TeddyTottie

    TeddyTottie Type 2 · Well-Known Member

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    I would definitely test for the effects of all that milk - milk is one of the things that spikes me quite badly. I use double cream instead, you need much less of it. I dilute it with water before steaming it to make latte and it’s delicious!
     
  6. emerald0

    emerald0 · Member

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    Thank you. I hadn't thought of that. The cream sounds like a great idea.
     
  7. emerald0

    emerald0 · Member

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    Thanks to xfieldok and TeddyTottie for your helpful advice.
    Looking around on this forum it seems as though the numbers I have been working to are not good enough. In another thread in this forum I found a post from BriantheElder which informed me that the recommended level of protein intake is 0.8g/day/kg of body weight. Working on the basis that you should eat for the weight you want to be (whether that is above or below your current weight) it works out that I should be eating no more than 60g carbs per day - not the 114g I was using as my max!!! Does that sound about right to you more experienced and knowledgeable people here?? I also have learnt that measuring ketones via uristix is not a useful indicator of ketosis but have yet to discover what might be the better alternative.
    Sorry to sound like a moaning minnie but my stash of psychological resources for keeping me afloat mid-pacific, as it were, is dwindling to almost nothing and there is still no clear land in sight!! I desperately need a lifeboat and am hoping that this forum might provide one.
     
  8. TeddyTottie

    TeddyTottie Type 2 · Well-Known Member

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    I think.... is there any particular reason why you are so concerned about achieving ketosis? Is it possible you may be overthinking it? It seems to be making you quite anxious. It may be helpful to step back and focus on your goal(s) - lowering the BG and maybe losing weight, perhaps.

    I do very lazy keto, I do not count my macros at all. I just try to avoid all carbs except those in green veg (and the occasional treat of a home-baked low carb scone) and then eat a good variety of low carb food which I have tested for using my meter and know does not spike me. And I guess I am in ketosis most of the time, my pee smells of ketones anyway. I don’t test for that either.

    If money is tight, could you possibly buy some extra strips for your meter rather than ketone test strips? There may be more going on with your diet than you know because everyone has individual reactions to different carbs. Bread and milk are my personal no-nos. Those pecans, for example, are 14g carbs per 100g. That’s a large part of a daily carb allowance at the sort of amounts you mention. Limiting the time window in which you eat can be very helpful too, it gives you insulin levels time to subside. So try to avoid snacking and perhaps adopt a window in which you eat your 2 or 3 meals - so 12 to 6, or whatever suits you.

    But really, only a meter, with testing immediately before and then 2hrs after you eat, can show you what affects you personally. Testing for carb tolerance is not forever - most of us eat a fairly limited range of stuff, so once you know how you react to something there is no need to keep testing for it. I sorted out my good and bad foods within a couple of months, and now only test for new items (like stewed plums, rhubarb and gooseberries this summer) coupled with general testing every now and then.

    But as long as my BG is low, which I personally like to be between 4.5 and 5.5 most of the time and no higher than 6.5 after meals, I don’t worry about the ketosis. I have lost a lot of weight this way, although weight loss has plateaued over the last couple of months and I’d really like to shift that last stone so I need to think about that! But the key for me is the blood sugar - anything else is just icing in the cake. Or perhaps I should say, cheese on the burger, to keep it keto! :cat:
     
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  9. LaoDan

    LaoDan Type 2 · Well-Known Member

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    IMHO, you should focus on the goal of keeping your BG low. If your BG is low, your probably burning some fat. If you’re converting protein into glucose, you’ll probably see this when you’re measuring.

    IMHO measure your meals, cut the stuff that causes spikes. Get your levels low., safely.. taking into consideration your medication.,, most likely you’ll Get into ketosis

    BTW, i eat about equal portions fat/ protein and I stay low, but you need to measure you.
     
  10. MrsA2

    MrsA2 Type 2 · Well-Known Member

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    What about IF and exercise? Its not all food alone for most of us.
    IF is just limiting the times you eat and having longer pauses between food. Can really help if you snack a lot, even if its healthy snacks
    Exercise too helps bg push around the body faster. Even a 30 minute walk after a meal is supposed to help

    I say all this because I suffer frustration too. There's too many variables in all this diabetes lark so all I can do is find soemthing that fits with my life and lets me have semblance of being in control even if I'm not!
     
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  11. Flora123

    Flora123 Type 2 · Well-Known Member

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    @emerald0 why do you put milk in scrambled eggs? Skip the milk as it just makes them watery. Add another egg if you need a larger portion.
     
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