Worsening condition

[Camera_chris]

Hi. I'm new to the forum. I was diagnosed type 2 about 8 years ago. Initially I was diet controlled which was fine until about a year ago when I was prescribed Metformin. Whilst my hba1c wasn't very high I was also prescribed trajenta to help keep the blood sugar under control. Whilst I always took Metformin in the morning I often didn't remember to take it in the evening but I've recently felt some odd symptoms and been checking my blood quite regularly to find it around 13 most of the time. My diet hasn't changed but despite now taking Metformin morning and evening as well as trajenta I can't seem to get the blood sugar readings down. I'm becoming concerned

 

[bulkbiker]

What kind of stuff are you eating to get sugars that high?

 

[Winnie53]

@Camera_chris I wish I could tell you that diabetes can be managed with medication alone, but that's not the case. Diabetes, treated with medication alone, progresses...which is perhaps what's happening. Sounds like you've come to a fork in the road.

I looked up Trajenta...

"It works by blocking the breakdown of ‘incretin’ hormones in the body. These hormones are released after a meal and stimulate the pancreas to produce insulin. By prolonging the action of incretin hormones in the blood, linagliptin stimulates the pancreas to produce more insulin when blood glucose levels are high. Linagliptin does not work when the blood glucose is low. Linagliptin also reduces the amount of glucose made by the liver, by increasing insulin levels and decreasing the levels of the hormone glucagon." https://www.drugs.com/uk/trajenta.html

I don't feel comfortable with medications that force the pancreas to work harder. Nor do I think it's a good idea to increase insulin levels in type 2 diabetics because I assume that will worsen insulin resistance over time. But that's me.

Let us know if you'd like help with your diet. Many, many have learned how to eat low carb here. The diet restored my health, and I have severe insulin resistance. I crossed over to type 2 diabetes twelve years ago, and didn't start the low carb diet until two years ago. I love the food, though it's a bit of learning curve. We're here to support you by answering your questions.

 

[kokhongw]

It would help to have some idea of your current diet. That would give us some clue on what dietary adjustments may be helpful in your current situation.

 

[AM1874]

Hi @Camera_chris .. and welcome
When you say that you were "diet controlled" up to about a year ago, and that your HbA1c "wasn't very high" .. what diet were you following and what changed to make your Doc prescribe Metformin?
As others have said, it would be helpful if you could let us have some idea of your current diet .. there are plenty of folk here who could advise ..

 

[Enclave]

It would be a good idea to return to your Dr and maybe get your medication changed. As others have said .. what are you eating as a diet controlled T2
Am tagging @daisy1 who will be along with your welcome info

 

[Camera_chris]

Hi. Thanks for all the replies. When first diagnosed I was obsessive about not eating sugars and carbs. As I don't much care for lots of vegetables it was tricky but I think I ate a lot of salads and eggs, fish and meat. As I've got high bp and high cholesterol I sometimes felt that I could only eat steamed vegs (which is never going to happen). My current diet is pretty good. I avoid sugar where possible and eat a fairly balanced diet. I eat brown bread when I have bread. I could be disciplined with what I eat, provided I like it and I can avoid being hungry.

 

[purplepenguin]

Hi @Camera_chris
I tried Low carb Higher Fat and have seen excellent results in a very short time. Have a look at www.dietdoctor.com for more information especially with cholesterol. I would also suggest you don't touch bread again, unless it is home made low carb. Brown bread is no better than white bread for me and shoots my sugars sky high just by looking at it.

 

[Camera_chris]

Hi @Camera_chris
I tried Low carb Higher Fat and have seen excellent results in a very short time. Have a look at www.dietdoctor.com for more information especially with cholesterol. I would also suggest you don't touch bread again, unless it is home made low carb. Brown bread is no better than white bread for me and shoots my sugars sky high just by looking at it.

 

[Bluetit1802]

Hi @Camera_chris and welcome to the forum,

As everyone else says, diet is the key, with medication as an aid (if necessary). If you really want to lower your blood glucose levels and avoid future problems then you need to look at what you are eating. It seems you already know about carbs causing the problems, and maybe this is where you are struggling. All carbs convert to glucose once inside the system, whatever their colour.

There are plenty of foods you can eat, it isn't all about vegetables and salad. You have a meter I assume, so you can use it to help you find a better way of eating. Test immediately before you eat, then again 2 hours after first bite. Look at the rise from before to after. This will tell you if there were too many carbs in that meal for your body to cope with. A rise of above 2mmol/l tells you the carbs were too many and gives you the chance to either eliminate some or seriously reduce the portion size. If you also keep a food diary including portion sizes and record your levels alongside, you will soon see patterns emerging and be able to learn from this. It is called Eating to your meter, and is an excellent way to find that better way of eating. The aim is to keep any rises as low as possible, preferably under 1.5mmol/l.

As your Trajenta (Lipigliptin) is a drug that stimulates the pancreas to produce more insulin, you do need to test regularly to make sure you don't go too low. Carbs cause the production of insulin. The less carbs you eat the less insulin is required.

If you have any questions, just ask.

 

[Camera_chris]

Thanks. I could previously eat bread without a problem (my Bs stayed between 7-8 for years) I guess things may have changed. I had a botched prostate cancer op in Nov 2015 which resulted in 18 months of serious infections, hospital admissions and pain. Beginning to recover now. Thanks for the link to the diet information , I'll check it out for ideas. I get given a hard time if I go much outside a normal balanced diet as my wife thinks I'm just being fussy and strangely can't seem to distinguish between me not eating stuff because it's bad for my health and not eating stuff because I don't like it (I would actually eat pretty much anything if it was healthy for me).

 

[Camera_chris]

Hi @Camera_chris and welcome to the forum,

As everyone else says, diet is the key, with medication as an aid (if necessary). If you really want to lower your blood glucose levels and avoid future problems then you need to look at what you are eating. It seems you already know about carbs causing the problems, and maybe this is where you are struggling. All carbs convert to glucose once inside the system, whatever their colour.

There are plenty of foods you can eat, it isn't all about vegetables and salad. You have a meter I assume, so you can use it to help you find a better way of eating. Test immediately before you eat, then again 2 hours after first bite. Look at the rise from before to after. This will tell you if there were too many carbs in that meal for your body to cope with. A rise of above 2mmol/l tells you the carbs were too many and gives you the chance to either eliminate some or seriously reduce the portion size. If you also keep a food diary including portion sizes and record your levels alongside, you will soon see patterns emerging and be able to learn from this. It is called Eating to your meter, and is an excellent way to find that better way of eating. The aim is to keep any rises as low as possible, preferably under 1.5mmol/l.

As your Trajenta (Lipigliptin) is a drug that stimulates the pancreas to produce more insulin, you do need to test regularly to make sure you don't go too low. Carbs cause the production of insulin. The less carbs you eat the less insulin is required.

If you have any questions, just ask.

 

[Bluetit1802]

@Camera_chris

You seem to be having problems quoting a post. To get it right, you need to make sure your tab is underneath the quoted part, and best to have a line space before you start to type.

 

[daisy1]

@Camera_chris

Hello Chris and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it helps you. Ask questions if you need to and someone will reply.


BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why.
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.