Hello, and some questions :)

[pabr25]

Hi Everyone,
Apologies if this seems a lot🙂
I am on week 4 since my confirmed T2, 1st test 109 - 2nd test 106. first 2 weeks taking 1 Gliclazide 80mg a day increased to 2 a day and 1 Metformin 500mg a day along with some major changes to my diet (still needs some adjusting) Is it normal to feel totally drained ?. I have another week before I see a nurse, so I decided to trial a freestyle libre 2 plus. on second day and I am getting readings of between 5.8 and 10.1 mmo/L and I fully understand what is causing the higher readings and how to manage it. What I am not sure of is how these readings compare to my blood tests. Any advice would be appreciated

 

[gail2]

ur doing well you need to test b4 meals and 2 hours after meals to see how what ur eating effects your bg levels.the libre will show your short term bg while the long term will show you longer levels

 

[Drummer]

Hi Everyone,
Apologies if this seems a lot🙂
I am on week 4 since my confirmed T2, 1st test 109 - 2nd test 106. first 2 weeks taking 1 Gliclazide 80mg a day increased to 2 a day and 1 Metformin 500mg a day along with some major changes to my diet (still needs some adjusting) Is it normal to feel totally drained ?. I have another week before I see a nurse, so I decided to trial a freestyle libre 2 plus. on second day and I am getting readings of between 5.8 and 10.1 mmo/L and I fully understand what is causing the higher readings and how to manage it. What I am not sure of is how these readings compare to my blood tests. Any advice would be appreciated

You might have got a reading in mmol/l, the actual blood glucose level from the bloodtest, but there is no exact conversion factor between that and the HbA1c level.
With any luck you should see the levels dropping as your metabolism begins to recover thanks to lower blood glucose levels, but when taking Gliclazide you do need carbohydrate in small amounts throughout the day to stop your blood glucose going too low.
Your diet might be too meagre or lacking in some essential component. We do need protein and fat to survive and live well.

 

[pabr25]

You might have got a reading in mmol/l, the actual blood glucose level from the bloodtest, but there is no exact conversion factor between that and the HbA1c level.
With any luck you should see the levels dropping as your metabolism begins to recover thanks to lower blood glucose levels, but when taking Gliclazide you do need carbohydrate in small amounts throughout the day to stop your blood glucose going too low.
Your diet might be too meagre or lacking in some essential component. We do need protein and fat to survive and live well.

Hi Drummer,
Thank you for your reply 🙂
Sorry, But being new to this I don't understand what you mean by the conversion factor, I thought both tests were in mmo/l ??

 

[pabr25]

ur doing well you need to test b4 meals and 2 hours after meals to see how what ur eating effects your bg levels.the libre will show your short term bg while the long term will show you longer levels

gail2,
Thank you for your reply 🙂
I am not going to pretend for one minute this is easy, but once I was given the news I made some very big changes to my diet and have to be truthful, I am far from enjoying my food at the moment but I know the changes will have a big impact on my health. My carbs are still a bit high ranging from 200 to 400 a day so still some work to do on that.

 

[gail2]

My carbs are still a bit high ranging from 200 to 400 a day so still some work to do on that.

thats a very high amount of carbs ou o have some work to do yet

 

[Drummer]

Hi Drummer,
Thank you for your reply 🙂
Sorry, But being new to this I don't understand what you mean by the conversion factor, I thought both tests were in mmo/l ??

No - they are measuring different things and have different units.
The mmol/l test is the level of glucose in the bloodstream at that particular time. The HbA1c number is a reflection of the continuity of exposure to glucose of the surface of blood corpuscles.
I was a bit shocked by the amount of carbohydrate you are eating - I need to keep to under 40 gm a day to have almost normal numbers. It does give you a lot of things you could change in order to reduce levels though.
I avoid grains, high starch veges and tropical fruits, limit medium carb fruits.
It is very pleasing that after a lifetime of increasing weight, I don't even need to think about it any longer.

 

[Leadinglights]

gail2,
Thank you for your reply 🙂
I am not going to pretend for one minute this is easy, but once I was given the news I made some very big changes to my diet and have to be truthful, I am far from enjoying my food at the moment but I know the changes will have a big impact on my health. My carbs are still a bit high ranging from 200 to 400 a day so still some work to do on that.

Welcome to the forum, it can be overwhelming at first but it can sometimes be a relief as it explains symptoms you may have been having.
Having the Libre can be helpful as long as you understand it's limitations and bear in mind it is not measuring quite the same as a finger prick test, but yes those results are in the same units of mmol/l. Some people can overreact to the information that the Libre gives. When first diagnosed then people opt for finger prick tests and test before they eat and after 2 hours to get an idea if they tolerate the meal OK by looking for an increase of no more than 2-3mmol/l or no more than 8-8.5 mmol/l after 2 hours. More than that indicates the meal is too carb heavy and even with medication reduced carb intake is needed as the medication can only do so much.
I look upon it as an overflowing sink (too high blood glucose) where you can bail out water (take medication) but it will still overflow unless you turn off the tap (reduce carb intake) and from what you say you are still eating too many carbs, a suggested amount is more like 130g per day.
This link may give you some ideas for modifying your diet and reducing those carbs, it is based on real food and about 130g carbs per day.https://lowcarbfreshwell.com/
The readings from Libre and finger pricks are in mmol/l and are essentially a moment in time and the aim is to be 4-7 before meals and fasting/morning readings and no more than 8-8.5 2 hours post meal but with an HbA1C of over 100 mmol/mol you will probably not be there yet as it takes time to reduce blood glucose and indeed it is better done gradually as a rapid drop can cause issues with your eyes and nerves.
The relationship between HbA1C is very loose in that the higher it is the higher finger prick readings will be, there is no direct conversion between the two./

 

[pabr25]

thats a very high amount of carbs ou o have some work to do yet

Hi gail2,
It actually scares me to think of what my carb intake was previously, if i was to hazard a guess i would say i have reduced them by about 90% so far which is probably why i'm finding it so difficult reducing anymore at the moment. i have lost 2 kilos in four weeks so that is a bonus

 

[pabr25]

No - they are measuring different things and have different units.
The mmol/l test is the level of glucose in the bloodstream at that particular time. The HbA1c number is a reflection of the continuity of exposure to glucose of the surface of blood corpuscles.
I was a bit shocked by the amount of carbohydrate you are eating - I need to keep to under 40 gm a day to have almost normal numbers. It does give you a lot of things you could change in order to reduce levels though.
I avoid grains, high starch veges and tropical fruits, limit medium carb fruits.
It is very pleasing that after a lifetime of increasing weight, I don't even need to think about it any longer.

Hi Drummer,
Thank you i understand, Re the carbs, It's nothing compared to pre diagnosis and yes i still have a way to go and i will get there 🙂🙂.

 

[pabr25]

Welcome to the forum, it can be overwhelming at first but it can sometimes be a relief as it explains symptoms you may have been having.
Having the Libre can be helpful as long as you understand it's limitations and bear in mind it is not measuring quite the same as a finger prick test, but yes those results are in the same units of mmol/l. Some people can overreact to the information that the Libre gives. When first diagnosed then people opt for finger prick tests and test before they eat and after 2 hours to get an idea if they tolerate the meal OK by looking for an increase of no more than 2-3mmol/l or no more than 8-8.5 mmol/l after 2 hours. More than that indicates the meal is too carb heavy and even with medication reduced carb intake is needed as the medication can only do so much.
I look upon it as an overflowing sink (too high blood glucose) where you can bail out water (take medication) but it will still overflow unless you turn off the tap (reduce carb intake) and from what you say you are still eating too many carbs, a suggested amount is more like 130g per day.
This link may give you some ideas for modifying your diet and reducing those carbs, it is based on real food and about 130g carbs per day.https://lowcarbfreshwell.com/
The readings from Libre and finger pricks are in mmol/l and are essentially a moment in time and the aim is to be 4-7 before meals and fasting/morning readings and no more than 8-8.5 2 hours post meal but with an HbA1C of over 100 mmol/mol you will probably not be there yet as it takes time to reduce blood glucose and indeed it is better done gradually as a rapid drop can cause issues with your eyes and nerves.
The relationship between HbA1C is very loose in that the higher it is the higher finger prick readings will be, there is no direct conversion between the two./

Hi Leadinglights,
Thank you for your reply, it is very informative. Re carbs see my reply to gail2.
I have found with the libre that having the exact same breakfast 2 days in a row and on the second day going for a short walk 30 minutes after eating made a difference to the readings - day 1 hit 13.4(no walk) and day 2 10.4(20 minute walk), i understand its not an exact science but gives some guidance especially as breakfast seems to be the biggest spike all other meals are approx 6-7.

 

[Leadinglights]

Hi Leadinglights,
Thank you for your reply, it is very informative. Re carbs see my reply to gail2.
I have found with the libre that having the exact same breakfast 2 days in a row and on the second day going for a short walk 30 minutes after eating made a difference to the readings - day 1 hit 13.4(no walk) and day 2 10.4(20 minute walk), i understand its not an exact science but gives some guidance especially as breakfast seems to be the biggest spike all other meals are approx 6-7.

Many people are more resistant to insulin in the morning so having a low carb meal helps with that increase, also morning readings are often the last to come down especially if people suffer from either dawn phenomenon or foot on the floor syndrome when the liver releases glucose in the absence of food to give you energy for the morning activities and for organs to function.
For many breakfast cereals are not a particularly good choice and many have full fat Greek yoghurt and berries with seeds or nuts and maybe a very small portion of a low carb or keto granola or eggs in any form with bacon, mushrooms, tomatoes and a small slice of toast.
You sound to be making progress in the right direction.
A meal may give the same increase in blood glucose but you may get a higher reading after 2 hours after the meal because it was higher in before eating.

 

[everydayupsanddowns]

Sounds like you are making great progress @pabr25

Hopefully as your body adjusts and adapts to being more in-range your feelings of being drained will subside.

High BGs in themselves can be very fatiguing, but sometimes it feels to me like the body has a sort of ‘running range’ that it’s used to working at. With T2 diabetes this can have gradually risen very slowly over time, so that for some people they can “feel fine” at pretty extreme levels, even levels which ae likely to cause damage over time. Then when action is taken, and the body is confronted with glucose levels that are more in the healthy range, it can get a bit of a surprise, and give off “this isn’t what I’m used to” warning grumbles.

There’s more information about HbA1c here

What is HbA1c?

HbA1c is your average blood glucose (sugar) levels for the last two to three months. If you have diabetes, an ideal HbA1c level is 48mmol/mol (6.5%) or below. If you're at risk of developing type 2 diabetes, your target HbA1c level should be below 42mmol/mol (6%).

www.diabetes.org.uk

That’s your longer term measure which reflects glucose levels over 3-4 months, and is measured in mmol/mol.

Fingerstick checks are a snapshot of glucose levels right now, and are measured in mmol/L.

Such a lot of alien terminology to get used to with diabetes! If you get befuddled by forum acronyms and shorthand, there’s a little glossary here:

Thread 'Common Acronyms and Abbreviations'

Mar 29, 2011

Here is an alphabetical list of acronyms and abbreviations you may come across on the forum:

Health-related

A1c - Shortened version of HbA1c the blood test that checks average BG over previous 6-12 weeks
ADA - American Diabetic Association

Basal - 'Background', long acting insulin (eg Lantus or Levemir)
BDA - British Diabetic Association (aka Diabetes UK)
BERTIE - Bournemouth Intensive Type 1 Education (see DAFNE)
BG, BM - Blood glucose measurements
BI - Basal Insulin
Bolus - Rapid acting insulin for meals/snacks
BS --> Blood Sugar

C:I or CIR - Carbohydrate to Insulin Ratio...

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Hope your levels continue to improve as you make more tweaks and changes. Keep going!

 

[pabr25]

Hello Everyone,
I cant thank you all enough for the replies, they have been a great help.
So a bit of an update, i had a terrible weekend with constant drops in levels, after checking my food log realized a cup of coffee was being recorded as 140 carbs m-).
Had my appointment with nurse and with all your help i had the confidence and information to explain how i was feeling and the circumstances around my drops, so much so she didn't need to ask any questions 🙂
The nurse was very happy with my attitude and progress 🙂
I have had my Gliclazide reduced to once a day and if things continue as they are i can reduce to 1/2 a day.
I realize it's not a quick fix and will always have to manage my levels, but seriously your replies really gave me a lift from my dark place and i hope that anyone else who is struggling (Please just ask) can find the support they need.