Why is diabetes so confusing?

[Trent_P]

Good Evening All

Firstly, I'd like to say how happy I am to have discovered this forum, it has helped me enormously improve my understanding of diabetes and I am already so grateful to the members who have posted in the threads I have read.

A bit of background: I'm in my early fifties and always been sporty (football, running, gym) and I believe my diet has always been healthy, certainly much better than average in my opinion. I don't have a sweet tooth, don't drink much alcohol and very rarely eat takeaways. I must admit I did take my 'eye of the ball' over the last couple of years and my exercise became less consistent (although I was still walking the dog 5 times a week even when I wasn't doing any 'activities') and the number of 'treats' started becoming an almost daily habit. The result was I did put some weight on especially around my belly area, although I still wouldn't have classed myself as 'fat'

I had a routine blood test as part of my 'well man check' at my doctors last November and the blood tests came back saying I was pre-diabetic (44mmol) and I must admit I hardly paid any attention to it (in my naivety) thinking a few tweaks to my lifestyle would reverse it. I upped my exercise and started cutting back on the treats although I never deprived myself of anything if I was out, on holiday etc. I didn't think I needed to, as most of the things suggested in the literature I was given, I was already doing. eg/ I have always eaten brown rice and wholemeal pasta, I very rarely had white bread, I was having 'healthy' cereals for breakfast. I went back to the doctors for a blood test at the end of July feeling very confident I had 'reversed it' so imagine my surprise when it came back as 48mmol and I was now type 2 diabetic.

I struggled to arrange a follow up appointment with my doctors (yes it is that hard to get in) to discuss my results and eventually gave up anyway after discovering this forum. I was shocked to read that a lot of the diet changes they were suggesting were not actually great advice; the meal plans shown in the literature were advocating weetabix and porridge as a recommended breakfast!

So after discovering this forum I made some big lifestyle changes. I have cut down drastically on my carbs; I still have them almost everyday but I'm making more informed choices and having less quantity. I'm also exercising more: going to the gym 6 times a week plus 4 or 5 hour long dog walks a week and most importantly I've purchased a blood glucose monitor.

So, this is where I'm starting to get a bit confused as I've tested 3 times a day for the last 2 weeks and my readings are always 'good'. My lowest fasting reading is 5.2 with a high of 6.4. I have also been testing just before and 2 hours after my main meal everyday and 'working my way' through various different carb based meals: brown bread, cereal, chips, pasta, lentils and even after a couple of pints of lager. These readings have been between 5.0 and 6.5 with the highest spike being 1.2 after a plateful of chips and scampi. I know its not a massive sample but nothing appears to be spiking my blood sugars significantly and all my readings are below (I think) diabetes range. I'm confused!! Do I have diabetes? Have I reversed it already? or isn't it as simple as that and I'm not understanding something.

Sorry for the long post

 

[MrsA2]

It was a good post. You've learned and implemented a lot. Finger pricking is good, but it has its limitations and by testing before first mouthful and at 2 hours after, one hopes to hit the peak. However our bodies are amazing complex things and your peak may be at different times after different meals and in different circumstances because, although food is the main trigger for bg, there are some 40 odd other things that may affect it eg
Exercise, duration and intensity
Sleep, duration, quality
Stress both good and bad such as excitement
Drugs and medications
Illness
Temperature (environment)
Etc etc.
And meters only have a 15% range of accuracy

So yes you might have seen big rises, or you might have missed them or your exercise is keeping them down, or maybe you don't have them on your current regime.

It would be worth you using a cgm for a while. That will show if it's timing, and I think your the sort of person who would find its data fascinating . There's usually a special offer if first one free, then it's £50 for each. Of course once you've learned what you need to you don't need to wear one any more.
I have one at Christmas and 1 for when on holiday for example.

Or you can extend your finger pricking to
Waking
Before and 1 and 2 hours after every meal. That might show you more of your pattern.

Hope this helps. It's a fickle beast is T2

 

[Melgar]

Hello and welcome @Trent_P . It’s definitely a learning curve. You will get to know how your own body deals with the food you eat. Yes, it is a shock when you first get diagnosed, but you seem right on it. We do tend to trust the medical community thinking they know best. As you see, not always. And diet is such a personal adventure. What spikes one person, barely lifts the next. What I can tell you is carbs are a universal blood sugar raiser. More Complex carbs like pasta, even whole wheat pasta can have your blood sugars up, over a longer period of time. A glass of fruit juice can see you spike right up there and just as fast come down because it’s a simple carb. Simple sugars are Less complex in structure so they get metabolized very quickly.

Carbs, regardless of whether they are plain white breads, or multigrain or some other healthy so called alternative will give you the same result, raised blood sugars. So ignore the so called healthy option of whole-wheat, or stoneground or multigrain, they all raise your blood sugars the same as if you ate a slice of white Wonder bread. Sad but true. Many people have great success reducing their carb intake. Basically, looking at the nutritional breakdown on food stuffs and looking at the total carbohydrate values . This gives you incite into how it’s going to possibly affect your blood sugars.

It is important to get to know your own body’s ability to deal with what you eat. As @MrsA2 suggests, a Continuous Glucose Monitor or CGM may benefit you in this respect. They are a bit pricey, but the information you gain from having your blood sugars monitored 24/7 over the 14 day life span ( if you are using a Freestyle Libra sensor they last for 14 days before you have replace it) will benefit you and give you incite. One of the many features of these CGM devices is a graph. The sensor makes a recording of your blood sugars, via the interstitial fluid, and plots it on a graph. So you can see if you ate a slice of bread how high it sends your blood sugar and for how long. I have added an example of one of my graphs over 8 hours. I know from looking at my graph that nothing I ate really spiked my blood sugars, but they were raised and did eventually come down just in time for dinner !
You are doing very well

 

[Outlier]

Just to add my congratulations at what you have achieved so far! This all takes longer than we think at first, so we need staying power, self-forgiveness when we meet ruts in the road, and always to keep our endgame in sight. You have such a good attitude and I am confident you will succeed. Welcome.

 

[Trent_P]

Thank you all for your replies.

Even though I have learnt a lot from this forum I'm still trying to fit all the pieces of the jigsaw together. Maybe I'm a bit strange but I'm almost seeing the diagnosis as a positive as it has made me take a closure look at my lifestyle and made me realise that as I am getting older I need to take better care of myself and just can't rely on doing what I've always done and assume everything will be OK moving forwards.

You have got me spot on MrsA2, I love statistics so I will definitely look to get a CGM to add another dimension to my data collection.

The graph looks very interesting Melgar (thank you) I think having access to continuous data like that will certainly give me a better understanding of how my body reacts to the many daily factors that could be effecting my blood sugars. It would be great to get a real handle on this so I I'm not constantly analysing every single decision and action against the effect it will have on my diabetes.