Trying to control my blood sugar through diet

I am 60 with lower weight and lower numbers. Metformin is helping. I don’t think you are doing anything wrong but it might be genetic. I am slim and swim etc. My HbA1c is borderline normal. But starving and get post meal highs that I am sure are damaging. Even on Metformin I need to eat low carb. Ugh. My doctor’s response was that I was ‘already doing everything’ and to try Metformin. I actually asked to go up on the Metformin after3 weeks and now am getting better readings.

Melgar said:

... sometimes it would go as low as 1.9, so night sweats, headaches and a pounding heart

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Melgar said:

My day time highs can reach around 14. Thoughts , thanks

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Hi
Sorry if I missed it, but have you now been diagnosed as type 2 ?
If so could I ask what your HBA1c was ?

I'm not on ramipril so unaware of its abilities or risk re low carb, but 1.9 is well below a safe level.

I'd be taking urgent advice if that was me.

And rising to 14, sounds too high


I've given a little thought, having seen so many who are pre-diabetic on the forum.

(I skipped straight to T2D )

It's a heads up that damage is being done, but changes made now can bring you back from the diagnosis of T2D .

for me, I simply picture my type 2 as pot on the stove.


over the years I've been adding glucose to it, and now it's spilling over (hello type 2 )

the route out is to
A. Lower & use up the glucose in the pot.
B. Avoid putting as much glucose into the pot as possible.

Point A forces our bodies to scavenge for fuel sources once the flow of carbs is reduced.
(Usually resulting in a bonus of weight loss )

And Point B, stops us topping up the pot in the meantime.
(And helps us find ways of eating better suited to a T2D's needs )

All of this I suspect is much easier before being diagnosed as Type 2 officially.
(Bearing in mind the fluctuating time frame of those being made aware versus how long they were unaware of any impending conditions ..presume like many T2D's, few being DX'd as prediabetic get told asap )

None of the above remedy is done over night & it takes time to lower the pot so we CAN get to more manageable BG levels.

But after 3 years I guess you would have a decent idea of what you tolerate if your testing

So if your diet is low carb, does it have enough fat & protein in it ?,

And with such a wide ange of scores, is it possible your DX was wrong ?

if it's correct, then one conclusion might be the Mediterranean diet may not be effective enough for you?

perhaps a few examples of what your meals entail.

And how many times you eat in a day, might let others offer practical advice to help alter & fine tune your diet, before you seek other alternatives

To answer your question lots of us control it with diet.

I see two possibilities here. It also depends if you are on any diabetes medication right now. It appears not but best to be clear. And how long you’ve been diagnosed.

The first is that the version of Mediterranean diet you are on (there is no one defined version) is too high carb for your body. most of it looks good but the thing that stands out to me is the pasta. How much of it are you eating and are there any other carbs in there Including oats, fruits and juices for example? Although you have olive oil in there a low carb diet need healthy natural fats to replace the carbs or else hunger might be an issue (therefore sticking to it) or weightloss might exceed what’s desirable.

The other option if you’ve not been diagnosed type 2 long is that you too are LADA like your brother and your mostly low carb diet has slowed that enough to allow your body to cope for a while on dwindling insulin. It can take. A few years to become clear in anyone and I’ve seen re diagnosis up to 5 yrs. According to some research many stay misdiagnosed and just get put on insulin early in type 2. This means in the nhs they miss out on the free tech like cgm and pumps. So if this resonates ask for the c peptide and antibody tests (remembering only positive antiGAD is conclusive and its possible to be negative and still type 1, which LADA is a slow onset form of)

Melgar said:

I have a FreeStyle Libre CGM

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With a CGM it should be relatively easy to see what is causing your high levels.
Keep a detailed food diary, with portion sizes and the time. Then compare your diary with the data from your CGM.
For example, if you know what you had to eat or drink in the couple of hours before your CGM recorded the level of 14, then you will more than likely discover the culprit.
If you add activity to your diary gardening, housework, exercise, etc you will also discover what affects your levels other than food.

Out of interest do you check you night hypo with a fingerprick? (Appreciate you do have some symptoms too) Libre is notorious for getting false lows when you lie on a sensor. I ask because going properly hypo when not on diabetic medication is rare unless you have an also rare condition.

I am agreeing with the majority of the advice, you are getting, fasting levels on or around normal, your hba1c is in diabetic levels, but I would imagine it could be reduced by more carb reductions.
My point is, to impress on your doctors, that you are probably having rollercoaster blood glucose levels and hypos.
Non diabetic, spikes of over 10 after eating, then Hypoglycaemia.
This needs to looked at by a referral to a specialist endocrinologist in hypoglycaemia, to find the cause.
I have Hypoglycaemia, a condition that is caused by carbs intolerance.
We have a forum on hypoglycaemia, if you want more information.
You need to lower your carb intake, it will lower the spike and that will help lessen the chance of a hypo.

Melgar said:

Thanks for your reply . I really appreciate the info. You feel so alone with it. I am waiting for an appointment with the diabetes clinic. I have not been that impressed with these clinics here in Canada. You get a bunch of fact sheets on diet and that is that, you are on your own. I will be returning to the UK in the not too distant future. I will definitely check out the discussions on carb intolerance . My aim is to stop these continuous spikes and what I think are few carbs . The sensors are a real eye opener. Because my morning fasting sugars have been okay I thought I was doing well until I decided to buy the Freestyle libre cgm. What an eye opener. And what I thought was me waking up with anxiety was low blood sugar!

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The problem in most countries is that Hypoglycaemia is not on the required list of subjects to be studied, and only certain doctors after leaving college take diabetes as a specialty. So the medical books or NICE advice for the NHS, is taken as orthodoxy.
hence the famous eat well plate examples.
this does not take into a count those who are glucose intolerance carb intolerance lactose intolerance and any other intolerance you have, never mind that an awful lot of T2 diabetes is caused by insulin resistance, hyperinsulinimia, high circulating insulin and the inability to control blood glucose levels.
Eating carbs in every meal regardless of so called healthy complex carbs, is definitely not healthy for someone like me who is more or less intolerant to carbs. It is often said and advised that all carbs are carbs! Also there are certain properties in certain carbs, for me , that are really bad for my health, the starch in potatoes, or certain vegetable oils, production foods containing the likes of palm oils or industrial sweetness
I only eat fresh food. Why?
I know what is going into my mouth and my food diary, reminds me, what happens to my health if I don't have control of my blood glucose levels.

Keep asking, keep learning. I have a feeling you are going to want to know what is going on.

best wishes

Melgar said:

I was first alerted to being pre-diabetic in September 2019 . I am
Lactose intolerant and have been so for about 20 years. I am just very careful with dairy. Other than watching out for dairy I have no digestive discomfort.

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I have been lactose intolerant since birth.
interesting!

Any intolerance is a great concern with modern industrial production food.

This is what gets me!
From young my doctors have told me to avoid dairy completely!
So why dont doctors advise avoidance from carbs if you are carb intolerant?

Go figure.

Lamont D said:

I have been lactose intolerant since birth.
interesting!

Any intolerance is a great concern with modern industrial production food.

This is what gets me!
From young my doctors have told me to avoid dairy completely!
So why dont doctors advise avoidance from carbs if you are carb intolerant?

Go figure.

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Exactly my thoughts, why recommend consuming carbs, when one cannot tolerate them. I have come to the conclusion that no one within the healthcare profession actually understand diabetes. except for those more enlightened. We do have those on the peripheral of the otherdox thinking

Melgar said:

I was a long distance runner for a chunk of my life. And for a short period I was a competitive runner. I am familiar with the use of complex carbs and would use them because of the distances I would run.. At 5'6.5" I was around 110lb or just under 8st. It was a real challenge to keep my weight on. I stopped running about 10 years ago due to my knees. Of course, my weight went up so I went on a low carb diet. Within a few weeks my breath smelt of pear drops. I increased my carb consumption and the sweet smell went away. Thus, I am leery of dropping my carbs too much. As I did not have diabetes in my family I never thought too much about my blood sugars but now they are dominating my life in a negative way. I had my sugars tested in the UK and was not pre-diabetic that was in April 2019, but in September of the same year the Dr advised me after a random blood panel I was pre-diabetic. It seems it happened all at once. I lost about a stone in weight to 10 st. modified my diet but it made no difference to my blood sugars. They have crept up slowly despite my best efforts. I did not think I had a carb sensitivity but I must have. Thank you all for your advice.

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There are a number of endurance athletes that use ketosis (very low carb) to provide sustainable long term energy as your body fat will keep you going far longer than glucose will without the need to eat on the run. And this metabolic state of ketosis is what produced your pear drop breath. It doesn’t last. And neither do many of the other other ”detrimental“ side effects when done knowledgeably that are so often touted as reasons not to do this way of eating.

Did you ever get the results in numbers from the U.K. test or just a vague “it’s normal”? Many of us have found prediabetic levels in our medical notes that were never conveyed to us. Some drs don’t bother, thinking it’s progressive so I’ll wait till it’s bad enough for drugs. Although at some point we all have to tip from being normal to prediabetic to diabetic as it’s a fixed point.

Losing weight alone won’t necessarily solve the issue depending on what you are eating still. Type 2 is fundamentally a carb intolerance. Most don’t know they are sensitive til they get diagnosed.

There are two ways of getting your energy levels.
The first is getting your energy from carbs.
the second is through ketones.

the first is normal due to the modern diet.
the second is a result of becoming fat adapted and a choice for many.

the first is for those who don't have an intolerance to carbs.
the second is a healthy option for those with an intolerance to carbs.

the first makes me really ill, tired, hypo and uncontrolled.
The second gives me great energy levels, great health and no hypos. And great control of my blood glucose levels.

I wonder what is best for me?

Melgar said:

I was a long distance runner for a chunk of my life. And for a short period I was a competitive runner. I am familiar with the use of complex carbs and would use them because of the distances I would run.. At 5'6.5" I was around 110lb or just under 8st. It was a real challenge to keep my weight on. I stopped running about 10 years ago due to my knees. Of course, my weight went up so I went on a low carb diet. Within a few weeks my breath smelt of pear drops. I increased my carb consumption and the sweet smell went away. Thus, I am leery of dropping my carbs too much. As I did not have diabetes in my family I never thought too much about my blood sugars but now they are dominating my life in a negative way. I had my sugars tested in the UK and was not pre-diabetic that was in April 2019, but in September of the same year the Dr advised me after a random blood panel I was pre-diabetic. It seems it happened all at once. I lost about a stone in weight to 10 st. modified my diet but it made no difference to my blood sugars. They have crept up slowly despite my best efforts. I did not think I had a carb sensitivity but I must have. Thank you all for your advice.

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Melgar said:

Yeah just a vague statement that my BG was normal. Of course, I never thought more of it until I had a random blood panel for something unrelated and I was shocked when the Dr told me I was pre-diabetic. It was just 5 months later. I got the advice to modify my lifestyle which i did. So it's frustrating that I did everything they advised me to do and still my BG went up. I will drop my carbs to the very minimum and see what happens. In the past I have had difficulty with being under weight and this has been the situation right up to 10 years ago when I stopped running. I am still active as we have a farm but not running 70 - 80 miles a week. I do have autoimmune issues in my family (As I said in my opening post my brother is LADA, but was diagnosed T2. After a few years on metformin his Meds stopped working and his blood sugar shot up to over 44.) My mother suffered from Rheumatoid arthritis but my Dr dismissed any link. So I'm diagnosed T2. I am determined to pull my BG down and stop these big sugar spikes but I want to do it safely, of course.

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Sadly the vague and inaccurate “normal” is all too common. If you can get the numbers you’ll find out if it was indeed a sudden change or a more gradual one.

Again depends how you modified your lifestyle how effective at blood glucose control it will be.

As I said above it’s possible that you too are LADA but til that’s ruled in or out lowering carbs further is imo a good option. Maintaining weight on low carb is achieved by eating more fat and protein not just cutting carbs and failing to replace them. You say about doing it safely. What concerns you?