Blood Glucose - should I worry?

[Cheltonian31]

Since diagnosis, I've been following a very low calorie diet (meal replacement shakes + veg) for the past 12 weeks. Have managed to loose 25 kgs and HbA1c has come down from 88 to 37 - all that's good and reassuring. I am now introducing more regular (but smaller portioned) meals back into my diet. Over the past 2 days I have had one meal of home made vegetable soup (carrots. leeks, onions, celery, stock cube, thyme) with a slice of buttered home made wholemeal bread (I cant see that I had over 100g carbs in total on either day). The first day pre prandial BG was 5.1 at 6pm and 2 hrs later 8.9, falling to 7 by bedtime and 5.1 on waking the next day. The second day the same readings were 5.1 rising to 8.3, falling back to 5.3 and then 4.9 first thing this morning.
I don't know if I'm expecting too much to be surprised and disappointed that BG rises by over 3 after just a slice or two of bread. Am I wrong to be so worried? If that sort of reading/pattern is likley to be the norm when I am comepletely off of the meal replacement shakes is it likely to take my HbA1c back above 42/48?
I hope this is the right place to post this query? Please let me know if it should be somewhere else.

 

[LilyS]

Since diagnosis, I've been following a very low calorie diet (meal replacement shakes + veg) for the past 12 weeks. Have managed to loose 25 kgs and HbA1c has come down from 88 to 37 - all that's good and reassuring. I am now introducing more regular (but smaller portioned) meals back into my diet. Over the past 2 days I have had one meal of home made vegetable soup (carrots. leeks, onions, celery, stock cube, thyme) with a slice of buttered home made wholemeal bread (I cant see that I had over 100g carbs in total on either day). The first day pre prandial BG was 5.1 and 6pm and 2 hrs later 8.9, falling to 7 by bedtime and 5.1 on waking the next day. The second day the same readings were 5.1 rising to 8.3, falling back to 5.3 and then 4.9 first thing this morning.
I don't know if I'm expecting too much to be surprised and disappointed that BG rises by over 3 after just slice or two of bread. Am I wrong to be so worried? If that sort of reading/pattern is likley to be the norm when I am comepletely off of the meal replacement shakes is it likely to take my HbA1c back above 42/48?
I hope this is the right place to post this query? Please let me know if it should be somewhere else.

What meal replacement shakes have you been using? I am recently diagnosed so sorry I cant help with your question but I am looking into different diets to try and boost my weight loss TIA

 

[harbottle]

Are you on any medication?

So it was 8.9 two hours after eating, then 7 at bed time (How long was that?)

That's not actually *that* bad, as you didn't go into double figures, and the 8.9 is +-15% of a lab result, so it could be quite a bit lower, or a bit more.

Fasting levels are good.

 

[Cheltonian31]

What meal replacement shakes have you been using? I am recently diagnosed so sorry I cant help with your question but I am looking into different diets to try and boost my weight loss TIA

Hello Lily
I used Exante shakes (206 calories per shake, I bought them online) three times a day, occasionally swapping a shake for one of their meal replacement bars and very occasionally swapping for an M&S prawn and pasta salad pot. I also had a plate of veg (boiled or stir fried) or salad on an evening and 2 to 3 litres of water, plus black or green tea (I don't drink coffee). It was basically the approach recommended by Prof Roy Taylor at Newcastle University. There are a few You Tube Videos on the Newcastle studies/diet and on the Newcastle Uni Web site if you search on the Prof's name or "Newcastle Diet".
Weight loss started strong at 10lbs in week 1 and averaged 4/5 lbs each week thereafter, ranging from 2lbs to 7 lbs each week. I didn't do any new exercise beyond my normal dog walking etc. I started at 18st so I had plenty to loose. I stuck to the diet rigidly and found the rate of weight loss to be very motivational. I felt hungry sometimes for the first 48 hrs but adjusted to it thereafter.
I am now coming off the diet by swapping one shake for a "normal" meal, will swap out two meals next week, thereafter planning to try 16/8 hrs intermittent fasting to maintain the loss.
My hope is that all of this work means that my body can tolerate moderate carb consumption as part of a sustainable weight maintenance, balanced diet. But am worried (perhaps unnecessarily) about the blood sugar impact of reintroducing carbs like a small portion of rice, pasta or bread. Hence my initial post.
If you think you could cope with the short term rigidity of this approach, and your GP is supportive, it may be worth a try.

 

[Cheltonian31]

Are you on any medication?

So it was 8.9 two hours after eating, then 7 at bed time (How long was that?)

That's not actually *that* bad, as you didn't go into double figures, and the 8.9 is +-15% of a lab result, so it could be quite a bit lower, or a bit more.

Fasting levels are good.

Hello Harbottle
I was on Metformin 1x500g per day plus 1 atvorstatin until the latest HbA1c showed 37. My GP then stopped the Metformin but I'm still taking the statin. So the reading in the post are in the period just after stopping Metformin.

I also feel a little clueless about how to monitor blood sugar over the longer term. My GP said that finger pricking wasn't necessary, but I'm reluctant to just rely on the periodic HbA1c because it seems a fairly blunt instrument (even if very accurate). I also don't want to become obsessive. So I'd like to find a middle way that would highlight if my post weight loss diet was heading off course. Scales will tell me if weight is rising, but I don't know what's best (time of day, frequency etc) to monitor the blood sugars.

 

[Cheltonian31]

Are you on any medication?

So it was 8.9 two hours after eating, then 7 at bed time (How long was that?)

That's not actually *that* bad, as you didn't go into double figures, and the 8.9 is +-15% of a lab result, so it could be quite a bit lower, or a bit more.

Fasting levels are good.

Sorry should have answered your question about timings. First day pre food 5.1 was 6pm, post food 8.9 was 8pm, bedtime 7 was 11pm. Second day the measures were all 1 hr later.

 

[rebrascora]

The results are pretty consistent over those 2 days which suggests that they are right and your fasting levels are good, so it might be a question of the bread being a bit more than your body can handle. I know with homemade bread it is easy to cut a doorstep rather than a small thin slice and you mention one slice initially with the soup but then you say....

I don't know if I'm expecting too much to be surprised and disappointed that BG rises by over 3 after just a slice or two of bread.

...which makes it sound like it might have been 2 slices of bread rather than just one each day, which if they were 2 and both cut thick, it would certainly not be unreasonable for your levels to go up by that much, but the important thing is that they come down again and they are not going into double figures.

As regards testing, how about just monitoring your waking reading each day and keeping a record. Then do a weekly average and keep an eye on that for any obvious upward trend?

 

[helli]

Firstly and, in my mind, HUGE CONGRATULATIONS on your impressive weight loss and HBA1c reductions.
This is important to firstly celebrate and secondly appreciate what you can achieve.

I do not have type 2 and most of what I have learnt is from the amazing people with type 2 on this forum.
I know there is no point beating yourself or being judgemental about what you have eaten in the past ... whether that past was a year ago or yesterday. You cannot change the past. You can learn from the past which is why you often see mention of trial and learning.

One thing that I see people learning is what your body can tolerate which I see you have done with your testing of the bread and soup. You should not have to keep testing but you can learn - was the bread more than you can tolerate. Does it make sense to try different bread (sourdough, seeded, rye, ..) next time or maybe less bread.
This does not mean testing every time - once you have worked out the "best" for you in terms of what your body and mind can tolerate you know you should be ok with that in the future.
The same for other meals you want to eat.

For me, with Type 1, there are some foods that are easy for me to eat and manage my blood sugars but if I ate them all the time, I would miss some enjoyment so I think it is important to find the balance for me. I think it is probably the same for other types of diabetes - find your balance through testing for you and reading from others.

 

[Elektra]

Since diagnosis, I've been following a very low calorie diet (meal replacement shakes + veg) for the past 12 weeks. Have managed to loose 25 kgs and HbA1c has come down from 88 to 37 - all that's good and reassuring. I am now introducing more regular (but smaller portioned) meals back into my diet. Over the past 2 days I have had one meal of home made vegetable soup (carrots. leeks, onions, celery, stock cube, thyme) with a slice of buttered home made wholemeal bread (I cant see that I had over 100g carbs in total on either day). The first day pre prandial BG was 5.1 at 6pm and 2 hrs later 8.9, falling to 7 by bedtime and 5.1 on waking the next day. The second day the same readings were 5.1 rising to 8.3, falling back to 5.3 and then 4.9 first thing this morning.
I don't know if I'm expecting too much to be surprised and disappointed that BG rises by over 3 after just a slice or two of bread. Am I wrong to be so worried? If that sort of reading/pattern is likley to be the norm when I am comepletely off of the meal replacement shakes is it likely to take my HbA1c back above 42/48?
I hope this is the right place to post this query? Please let me know if it should be somewhere else.

 

[Elektra]

I kept a food diary every day and did my bloods 2 hrs after meals I ate most regularly to get an idea of what foods made my glucose levels rise sharply. I did this until an HbA1c test showed I was back in the prediabetic range. I found wholemeal sourdough bread - preferably freshly baked from a bakery - had the least impact - but eating more than one helping of carbs per meal made them rise. I strictly manage portions of potatoes and [wholemeal] rice. I eat pasta rarely because I find it sets off my carb cravings. But everyone is different in how they respond to different foods. I no longer keep the food diary and haven't tested my bloods for a while now, but my most recent HbA1c test put me at 42 - nearly back in the normal range. I also followed my diabetic nurse's advice and embarked on a fitness campaign. I now attend 3 exercise classes and 1 or 2 gym sessions per week at my local leisure centre, and I'm sure this has helped enormously in stabilising and reducing blood glucose levels.

 

[Drummer]

@Cheltonian31 Congratulations on reducing your HbA1c into normal numbers.
I found that even eating a very low carb diet I do not do more than bounce along at the very top of normal - but I struggled with an intolerance of glucose all my life and I am going to be 73 soon.
Although my type 2 is classed as in remission, I have not got rid of the intolerance of glucose, so I still avoid high carb foods. I eat anything else, except things made to be low in fat.
I changed what I ate so as to be under 8mmol/l at the 2 hour test, and that seemed to be the key.
I eat low carb veges and berries as my carb sources, nothing over 10% carbs except for a rare bit of high cocoa chocolate. That seems to work for me and it is reversing my change in shape gradually, just as a high carb diet removed the ) ( shape I was and I became ( ) over several decades, each year now I need to change my clothes to have a smaller waistline.
I do a bit of baking now and again, and if I make a bread dough after the first proving I add in lots of low carb seeds and fibre, quite gently, then wait for it to expand again. That seems to work, but I make small rolls and freeze them, so it is difficult to overeat them.
I find that I can cope very well if I stick to low carb foods, so that is my plan, rather than try to eat what is considered normal, which never really worked for me.

 

[Elektra]

You're right to do whatever works for you - and people like us will always have to be careful with the carbs. You are more disciplined on the carb front than I am. I was worried that I might have to go full keto which is too extreme for me, I'd never be able to stick to it as I love my carbs unfortunately. Luckily I seem to be ok without having to be that drastic.

 

[Drummer]

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Sorry not a clue what you mean.

 

[Drummer]

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This is weird.
I don't think I have eaten a Muller lite yoghurt, let alone recommended them as suitable for a type 2. I think the Options drinks are fairly low carb - but not something I would encourage the consumption of.
Is this some sort of mistaken identity?