Seeking advice following T2 diagnosis

[rogpt51]

I was diagnosed with T2 around 7 weeks ago, straight onto metformin and built up to 3 x 500mg within a few weeks. At diagnosis my fasting BG was 17.3 (!) have been struggling with the meds from feeling really good part of day to awful at other times especially late morning. Dose increased from yesterday to 2 x 500mg morning then same again b4 eve meal. Nearly all of my morning readings are still double figs range 10 - 14. I have always been v active but took my eye off diet and weight leading up to diagnosis - now addressing latter and half a stone gone in 7 weeks plus maintaining my range of sport activities - nurse doesnt regard me as too overweight albeit a bit more still to come off prob another half a stone. Feeling in the dark as to what I should reasonably expect to see in way of lowering BG towards desired ranges - can anyone help?

 

[daisy1]

Hi Rog and welcome to the forum It is difficult to predict how your levels will come down as everyone is different and their levels do not behave the same. All you can do is look after your diet and exercise and watch the levels gradually come down. Metformin will decrease your levels by up to 2 mmol/l maximum. To help you to get going, here is some information written for new members by the former monitors and I hope you will see some results from following this advice. Ask as many questions as you like as we are all here to help.

Here is the advice that Ken and I, as Forum Monitors, usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. 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.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

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

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

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. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have 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!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091



Sue/Ken.

 

[rogpt51]

Thx Daisy - am seeing my doc next week for an earlier than anticipated HB1AC do you think they will let me persevere with the metformin for a while to see if things improve or should I be preparing for myself for other treatments being introduced??

 

[hallii]

Two weeks is a short time, you will need longer to see more changes.

The weight loss is good, that will help.

A change from 17.3 to 10-14 is significant, remember this is not s sprint, it's a marathon!

So keep up the good work, and keep testing; Make a chart of your results and try and see what food affects you most. You might try cutting down on the amount of carbohydrates you eat at any one meal particularly breakfast.

If you do not see continuing improvements in a couple of weeks then something needs sorting.

That is where your doctor ot DSN needs to be involved, they might change meds or suggest a different diet or any number of things.

10 - 14 in the morning is still to high, but not of any major concern, after all it should only be for a few more weeks and things should improve. I bet your BGs were a lot higher for much longer before you were diagnosed!

Have you set any targets? Has you doc./DSN suggested any targets to aim for?

I aim for a fasting BG in the morning of 7 or less and maybe 8 or less two hours after a meal.

Just to restate the obvious, the amount and type of food you eat and excercise are the biggest factors in bringing your Bgs under control.

Give it a few weeks more and then maybe go and see your Doc again.

H

 

[Sid Bonkers]

I have always been v active but took my eye off diet and weight leading up to diagnosis - now addressing latter and half a stone gone in 7 weeks plus maintaining my range of sport activities

Hi rogpt51 and welcome to the forum, your 7lb weight loss in as many weeks is great and should help to decrease your insulin resistance (IR) which in turn will help to lower your blood glucose (BG) levels.

It is quite common for T2's to put on weight prior to diagnosis so it probably had nothing to do with you "taking you eye off diet and weight" it is merely a symptom of T2 diabetes, so dont beat your self up over it. Read the info in Daisy's post and start cutting back on the carbs bit by bit till you find the right level for you.

 

[rogpt51]

Thanks H & Sid v helpful - ref H's question at diagnosis I was set a morning target of 10 and once MF dose went up to 3 a day target range advised to me was between 4-7. I am a tall guy 6 foot 2 in height and now weighing 15 and a half stone - finding intial change in diet pretty hard but I read that MF suppresses your appetite anyway ie moving to porridge for brekkie plus banana, snacking on fruit, one round healthy wholemeal sandwich, plenty of tea and coffee with skimmed milk but prob still need to find eve meal recipes that work for me and non diabetic wife! I am still enjoying a few glasses of wine and now odd beer but within limits so not sure if alcohol needs to be cut out completely to help progress or whether moderation within rec limits is ok???!!!

 

[Sid Bonkers]

Hi again, metformin at its max dose of 1000mg twice a day will only reduce bg by around 1 or 2 mmol/L so it is far from a magic bullet but it does have advantages and is considered a first line drug for T2's.

It works in three ways firstly it decreases the absorption of dietary carbohydrates through the intestines. Secondly it reduces the production of glucose by the liver. And thirdly and perhaps most importantly metformin increases the sensitivity of muscle cells to insulin.

In addition to these three main properties it helps suppress appetite and has also been shown to help prevent certain cancers.

Unfortunately it does have some side effects that can affect some people these may include stomach cramps, wind and or diarrhoea and is often referred to as Metfartin, I personally got cramps and wind but they went away after a few weeks, other people have worse experiences but there is also a slow release version Metformin SR which can be prescribed if the side effect bother you.

Porridge, some people find they can eat porridge others find they cant as it is quite high in carbs, I dont like porridge so for that reason I dont eat it, but testing before and 2 hours after eating it will tell you if it is OK for you or if you need to reduce the portion size or perhaps even not eat it at all, that said many diabetics find it a good breakfast. Bananas are also quite high in carbs and you may find that they are best eaten later in the day as a snack or after lunch rather than adding to an already carby breakfast, also most fruits are carby to a greater or lesser extent so again test, test and test again. I find I can eat a small apple for lunch and an orange after dinner but thats not to say it will be OK for you to do the same, everyone is different and you need to find your own diet plan that is OK for you.

Alcohol can have some strange effects on us diabetics beer can be quite high in carbs so will initially raise bg levels but when more than one or two are drunk and they fill the liver it stops regulating glucose while it is cleaning the alcohol from the blood at about 1 unit per hour so bg levels can drop quite fast, something to watch for if out on the

Sometimes it can be helpful to eat a snack while drinking or before bed after a few beers to help stabilise bg overnight although this is more of a problem for insulin users it is still good to know.

Wine is less carby and a glass or two of red wine has been reported by many, myself included to help reduce bg levels but obviously don't over do it

One last blah blah :lol: Bread, bread is often tricky and white breads of all kinds are often very bad for T2's who cant cover their food with insulin, wholemeal is not much better apart from having more fibre it is still very high in carbs but many find that wholegrain breads are kinder and are lower on the glycemic index (GI), Burgen linseed & soya bread is often tolerated well too again not by everyone so test, test, test.

I'm sure it all seems alot to take in but the more you read the clearer it will all become. Honest

 

[trand]

Hi rog, and welcome to the mine of imformation, you are in the right place for any help,and advice,and well done with the weight loss, it gets easier, once you get into a regime, sid and others mention Bergen bread, it is such a nice bread i have actually converted non diabetics over to it ( maybe a bad move as the shops have sometimes sold out ) a great crew on here, and good luck,

 

[jinstone]

Mine discovered just prior to operation. It was 21.3 on a Thursday, after overnight fast it dropped to 19.0. I was also put on Metformin and Gliclazide. It took six months to get down to acceptable levels for the operation SO as others have said don't panic or be panicked it is a long slow process and your doctor or nurse shouldn't rush you to switch to insulin. I have a very patient nurse and doctor fortunately who hae been very supportive. It sounds like you are very much on the right track. Keep up the good work.
Regards
Jeremy

 

[rogpt51]

Jeremy

Thanks for your comments - I am still getting morning readings first thing average around 11 for the last week and feeling more stable during day. Saw my doc this morning and he has put me on 80mg of Gliclazide twice a day to with my MF - told me they want to see single figs and has put a marker down at this early stage that I could need insulin once or twice a day to supplement the MF if the Gliclazide doesnt show a fairly quick improvement in BG readings, wants to see me again in around 3/4 weeks. Also warned me that if the Gliclazide works I need to be aware of poss lower BG especially as I do a fair bit of sport. Thanks for words of encouragement, trying to convince myself its one step at a time especially given what doc has foreshadowed today!! Regards Roger