Running out of ideas

domforr said:

I eat pretty well, cutting out carbs and sugar

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Do you have some meal examples ?
Also would suggest asking for a c-peptide test to check on endogenous insulin production if your doctor will do it.

As already mentioned, I'd look at checking out how much insulin you are producing. And as always, taking a look at what you'd eat for meals.

Stress is a big factor.

domforr said:

A typical breakfast would be greek yoghurt with a few blueberries and some flaxseed, a piece of low carb bread and peanut butter and a cup of tea. Otherwise a fried egg and tomato on a piece of low carb bread. Lunch is usually a salad, or maybe soup , but pretty light. Dinner would be some meat and maybe broccoli and green beans or salad. I'll snack on nuts and cheese in the day.

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Have you ever totted up how many carbs you are actually taking in?
Maybe try keeping a detailed food diary for a week and measuring everything.
Yoghurt, blueberries. "low carb" bread, peanut butter not especially low carb.
You might be surprised by how many you are eating.

domforr said:

Hi there,

I was diagnosed with type 2 diabetes 5 years ago when I turned 40 and am really struggling to keep things under control. I'm not overweight and I'm currently on 500mg TR metformin twice a day. Recently my levels have been really high when I test in the morning before eating. it was 14 today and is constantly between 10-14 in the morning.

I eat pretty well, cutting out carbs and sugar and I also exercise consistently, so I'm at a bit of a loss really. The doctors seem uninterested and the only suggestion has been increasing meds, which I'm reluctant to do as it makes me feel quite ill.

This has been a period of high stress, which probably isn't helping matters but I feel that somehow I need to change something to get back on an even keel.

Any suggestion gratefully received.

Best,

Dominic

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That sounds a bit like me at the moment. Over the last month or more I’ve been running high. I have recently cut back carbs as much as possible ( I’d normally be 20gpd but around 30g pd over Christmas) and absolutely no snacking and a brisk walk after my two meals and it is helping. Had 10g yesterday. I feel my body is becoming more resistant despite good control for 18 months.

Might be worth cutting out the LC bread and changing to a cooked breakfast and stop snacking and see how you get on. It’s very frustrating isn’t it. Good luck.

Hi. There is a hint of late onset T1 (LADA) from what you say. Do ask the GP for a C-Peptide test. If he/she shows little interest then consider having it done privately like I did when My GP was ignoring my situation. Are you on Metformin ST, the Slow Release version as it's much kinder if you are having problems with the plain version. Many of us in this situation without a clear T1 diagnosis would be started on Gliclazide or one of the other newer drugs. These can work quite well initially but if you are actually T1 then you will eventually need insulin and it's better to start it early. Your diet seems quite good so I would get your insulin levels tested.

domforr said:

Thanks - and to you too. You may be right about the bread - it’s the convenience that appeals.

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I know. It is just quick and easy... and delicious. I used to be able to tolerate the odd slice of LivLife bread but can’t recently. Not sure why but do feel a change in my body’s reaction to foods sadly.

I would suggest a few things:

What is "low carb" bread? Just cut bread out entirely. I did it. It's not easy, especially if you're used to being a sandwich eater, but it's possible. One thing I started to do is get butter lettuce and make sandwiches with that.

Beans are good and have fiber but also have carbs. Try to research different types of beans.

What type of tea? Although I think I will eventually add it back, I stopped drinking coffee and instead of green or herbal teas, I am drinking chamomile which has absolutely no caffeine.

If you are eating a lot of nuts, you are getting a lot of Omega 6. But that needs to be balanced out with Omega 3 so eat fish twice a week - and try adding am Omega 3 supplement. Also, take vitamin B-12. I take a complex which also has vitamins B6 and C. Also, some nuts are better than others. The best would be walnuts & pecans and followed occasionally with macadamia. Cashews and pistachios try to limit.

Lastly, as others have suggested, go to an endocrinologist (not your regular doctor who is probably NOT specialized in diabetes) and ask for advice as well as asking for additional blood tests. That's the first thing I did after my first A1C, to make sure I didn't have LADA or MODY or pancreatic problems which are sometimes misdiagnosed as Type 2. Essentially, Type 2 diabetes is a problem with insulin resistance (and maybe your body creating too much insulin that's causing cells to say "no" to it more often). The others are a problem of your body not creating enough insulin in the first place. That will take a different approach to deal with and it's best to test for this as early as possible - for example, if your pancreas is stressed and stays that way for a long time, it could at some point stop making even baseline levels of insulin which would require insulin shots.

It's your health, get all the tests you need to ensure you know what's going on with your body. Keep your doctors on their toes - they should not be treating your illness lightly and only prescribing more meds as the solution.

domforr said:

Hi, yes I think I need to get it checked as whatever I'm doing isn't really working and it's getting very frustrating. I'm on 500mg twice a day of the timed released version. I was on one tablet a few years back and was quite well controlled, but things have deteriorated since then and I'm back on 2. I have tried three a day, but just felt awful most of the time and the pharmacist said I shouldn't be on 3 a day as they then overlap, making you feel ill.

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Hi again. Thanks. Your pharmacist is wrong. Have a look at the leaflet in the Metformin (SR not ST my fault) pack. 2000mg is a valid dose which I was on for many years - 2 am and 2 pm. Metformin never does much so don't expect much of it. Yes, get a C-Peptide done and take it from there. Note that you may be offered a GAD antibody test. If this is negative it doesn't prove you aren't T1 as viruses etc can cause beta cell death as well as antibodies.

Hi Domforr,

I suggest that you do count up all the carbs you are eating. I occasionally (well semi-regularly) have a teaspoon of peanut butter- but I count the carbs. Nuts and low carb bread and peanut butter can all add up to a big amount of carbs. The other thing you may want to try is to have at least one of your meals no carb or to miss breakfast for a few days- just giving your body a break from carbs for a longer period.

However, I also agree with the suggestion to get the blood tests to rule out another type of diabetes. More information is never bad.

Good luck.

My Metformin dose is 2000mg, 4 tablets a day. Two in the morning and two in the evening.

You do need to build up to the full amount. You don't need to take before or after meals as how they work isn't linked with the food you eat. When I first took them I made sure it was after a meal but as I tolerate them well I just take them in the morning and evening without worrying about when I last ate. The after eating bit is more to do with being more gentle on the stomach.

Get your insulin levels tested... I was in the same boat a year ago...2000mg metformin and two gliclazide per day and still my BG barely went below 14 and constantly tired and losing weight...then after being referred to a specialist got diagnosis of slow onset type 1 and now on insulin...it’s worth a try...good luck

domforr said:

I haven’t, but I think I should just to get an idea of my real intake. I’m pretty lazy with this stuff, but I think I’ll have to be a bit more methodical

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It would probably help even if just a week. But you'll have to weigh everything and be honest!
That's why I find a carnivore way of eating so much easier.. when the vast majority of my food has zero carbs managing intake becomes a doddle.
I still weigh and record everything but that's just me..