The sad irony of a beekeeper with Diabetes!

[Docb]

Reinforce Drummers point. When I started gliclazide and began to reduce carbs, monitoring stopped me going hypo. In my case the GP was happy for me to keep reducing the gliclazide until it balanced the carb intake. I suspect that I could drop the gliclazide altogether and still keep BG under control by carb conrol alone suggesting, at least for me, the gliclazide is not particularly effective in promoting insulin production.

 

[Jojo catwoman]

I have been told that driving only becomes an issue when you are taking insulin. Obviously it would be foolish to say the least, to drive if you felt unwell, whether diabetic or not.
Of course if in doubt, always test.

 

[Robin]

I have been told that driving only becomes an issue when you are taking insulin. Obviously it would be foolish to say the least, to drive if you felt unwell, whether diabetic or not.
Of course if in doubt, always test.

You only need tell the DVLA if you are on insulin, but anyone taking, eg, Gliclazide is supposed to undertake 'appropriate monitoring' to make sure they aren’t hypo. This is taken from the guide for medical practitioners.

 

[rebrascora]

Hi again guys.
Thanks for all the additional comments and information. I was given the guidance regarding monitoring and driving whilst using gliclazide by the practice nurse but I don't drive very often and since I am trying to increase my exercise levels, I'm driving even less and by BGs are still way too high with no sign of them dropping to normal levels yet.

After my telephone consultation with the senior GP at the practice yesterday, we have compromised on me increasing the Gliclazide to 2 a day, but he is very reluctant to prescribe insulin just yet. The consultant is having a case conference with my practice nurse and Dr tomorrow though regarding my situation and he will have the final say.

My fasting BG this morning was 11.2 and went up to 18 by noon having had only a tiny amount of porridge this morning with a spoon of Fromage Frais and no berries (or sugar obviously)...... @Drummer I am still experimenting via blood testing with my breakfast porridge and additives to see if it is the berries, the dairy or the oats themselves that may be the problem. I am open to changing and may try egg and beans tomorrow but want to be sure the porridge is a problem before walking away from oats as they have digestive/gut benefits and since there is so little going through my system right now I would prefer to keep porridge if I can.

I had salmon, broccoli and a small portion of wholegrain mix for dinner last night and a half a nectarine but fell asleep an hour later so didn't get a blood test reading for last night but it was 19.1 before I started cooking dinner at 8pm having not eaten anything since 2pm and that was scrambled eggs on low GI toast.

I have had a wholemeal pitta with red pepper hummus and salad leaves and half a tomato for lunch at 2pm with a fat free, no added sugar yoghurt. My BG at 2 hrs after lunch is 21.7
Yesterday for lunch as mentioned above I had one slice of low GI wholemeal seeded loaf (toasted with a little spread) with 2 scrambled eggs, half a tomato and salad leaves. My BG was back up to 19 last night before I had my evening meal despite having been out and had gentle exercise for a few hours prior.... mucked out, groomed and rode my horses and bedded up for the night etc.

Tonight I am intending to have a homemade mousakka (with aubergines not potatoes) and salad.

I have one cup of tea with a little milk on a morning and then drink only plain tap water the rest of the day.

I am open to suggestions about what might be better for me or if these meals are reasonable in attempting to lower my BG. I would add that the fromage frais is a recent addition and I have been extremely low fat up until the last couple of days of using that. I am taking a Gliclazide morning and night plus 4 Metformin a day. I appreciate any guidance.

 

[Pumper_Sue]

Those numbers are ridiculously high with the amount of exercise and limited food intake. My personal opinion is your GP is nuts. But then it's not his sight or life at stake is it?

Can you get someone to smell your breath? If it smells of pear drops then please get yourself to the hospital as you are in DKA which is fatal unless treated.

 

[rebrascora]

Reinforce Drummers point. When I started gliclazide and began to reduce carbs, monitoring stopped me going hypo. In my case the GP was happy for me to keep reducing the gliclazide until it balanced the carb intake. I suspect that I could drop the gliclazide altogether and still keep BG under control by carb conrol alone suggesting, at least for me, the gliclazide is not particularly effective in promoting insulin production.

Thanks for your response. How high were your BG readings to start with and how quickly did you see them drop when you started the Gliclazide and how much medication were you taking? Metformin and Gliclazide or just the latter? I'm 5 weeks on Metformin and 4 days in with the Gliclazide and not seeing any downward trend and have drastically reduced carb (particularly sugars) intake already, so just wondering if I am being impatient or my body is just resistant to the medication..... My BG is currently 21.7 two hours after lunch of a wholemeal pitta with hummus and salad leaves

 

[rebrascora]

Those numbers are ridiculously high with the amount of exercise and limited food intake. My personal opinion is your GP is nuts. But then it's not his sight or life at stake is it?

Can you get someone to smell your breath? If it smells of pear drops then please get yourself to the hospital as you are in DKA which is fatal unless treated.

Thanks Sue

My GP is very well respected both by other medical professionals and his patients, including myself, but he is very conservative. I am sure the consultant will override if he feels there are significant concerns when he reviews my case tomorrow, although I would really like them to have my up to date readings for that meeting/discussion and that is where I feel a bit left out of the loop because no one is asking for my readings and I am not attending the surgery regularly for checks. The nurse did ring me after the doc was on the phone and I think it is her view that I will need insulin but they are hoping the tide will turn before they take that step.
I don't believe my breath smells of pear drops but I know my urine smells weird.... like dried marrowfat peas when they have been soaked overnight with a bicarbonate tablet?? The nurse wants me to take a urine sample in next week when I go for another blood test and she mentioned testing it for ketones. I appreciate your concerns and I will mention to my partner to be aware of my breath smelling of pear drops but I don't feel like I am able to challenge my medical professionals further at this point and my BGs have been consistently this high for at least 6 weeks now, so hopefully a few more days will not cause too much damage. The nurse has stressed that if I feel unwell I should contact the surgery or a hospital..... whilst I don't feel great and I do have short spells when I feel unwell with palpitations and just want to lie down, it passes after 15 mins with no other treatment, so I don't feel like I can push things further just now. You know what professional people can be like when you suggest that a lay person like yourself is concerned and thinks I need more proactive treatment.... much as I appreciate that you are very experienced with diabetes.... I was as diplomatic with my doctor as I could be but I felt his hackles go up even over the telephone when I explained your concerns!
I will keep you updated.

 

[Drummer]

So pitta is bread?
Beans are - for me - a high carb food - you are still not eating a low carb diet so it is difficult to decide if you are not responding to eating like a type two and so more tests should be done or other treatments tried.
The short periods of feeling off could be 'false hypos' from your reduced intake of sugars, but if you are topping up with starches - but you have your meter.
If you do continue to see high readings and feel unwell for longer periods then the hospital A & E might be the best place for you.
If you are wrongly diagnosed and require insulin then the situation, going into DKA is a very serious one.

 

[Docb]

Thanks for your response. How high were your BG readings to start with and how quickly did you see them drop when you started the Gliclazide and how much medication were you taking? Metformin and Gliclazide or just the latter? I'm 5 weeks on Metformin and 4 days in with the Gliclazide and not seeing any downward trend and have drastically reduced carb (particularly sugars) intake already, so just wondering if I am being impatient or my body is just resistant to the medication..... My BG is currently 21.7 two hours after lunch of a wholemeal pitta with hummus and salad leaves

I started in the high teen's low twenties, not too dissimilar to yours. Found at annual review after a HBA1C of 82. I started by increasing meformin but I reacted badly to it so went back to 500mg a day and started to add the gliclazide. Stared with 1 pill (40 mg) which did very little. Went to two (80 mg) and then to three (120 mg). I then totally confused the issue by starting on a low carb diet whilst upping the gliclazide - told the DSN and she was happy because it was obvious I knew what I was doing and if anything went squiffy I would shout for help. After three weeks or so my BG was down to a range of 5-10 with occasional drops to low 4's. Spoke to DSN and agreed to cut back to 80 gliclazide. Kept this up for a couple of weeks and again had a bunch of low 4's so, again after consultation, dropped to 40 gliclazide which is where I am now.

When originally on 1 gilc and just starting on low carb I was ranging 11 to 17. Now, with 1 glic I am ranging 4.5 to 8. The difference is that I have got control of the carb intake.

A couple of thoughts on what you have said. Egg and beans for lunch? Check the total carb on the side of the tin or if it is some other bean weigh them out and look up the carb content. TOTAL CARB NOT JUST SUGARS. I'm aiming for about 80 g carb (total) per day - half a tin of beans will give you a big chunk of that. Given up wheat based stuff ( bread, pizza, pasta) again because I would have to have tiny amounts to hit my target - four slices of bread would do it. I eat a lot of veg but need to keep potato portions very small to hit my carb target. Stuff you think ought to be insignificant might not be. For example, I had an apple today with my low carb lunch and that gave me an 11.1. Had a cappuccino the other day and that gave me a 10. Had a 13 the other day which could be explained by my having had more dried fruit than I bargained for in a badly mixed museli. Small amounts of carb can have a big effect on me, maybe it is the same for you, maybe not.

My standard top tip is to get a diary and write things down. Write down everything you eat, weighing things if necessary and work out the carb content of each meal. Check that against your blood glucose readings and look for patterns. As I say I aimed for a total carb intake of around 80 g/day. When you realise you can get that from a decent portion of chips, it gives you a real marker on what you might have to do.

 

[rebrascora]

I started in the high teen's low twenties, not to dissimilar to yours. Found at annual review after a HBA1C of 82. I started by increasing meformin but I reacted badly to it so went back to 500mg a day and started to add the gliclazide. Stared with 1 pill (40 mg) which did very little. Went to two (80 mg) and then to three (120 mg). I then totally confused the issue by starting on a low carb diet - told the DSN and she was happy because it was obvious I knew what I was doing and if anything went squiffy I would shout for help. After three weeks or so my BG was down to a range of 5-10 with occasional drops to low 4's. Spoke to DSN and agreed to cut back to 80 gliclazide. Kept this up for a couple of weeks and again had a bunch of low 4's so, again after consultation, dropped to 40 gliclazide which is where I am now.

When originally on 1 gilc and just starting on low carb I was ranging 11 to 17. Now, with 1 glic I am ranging 4.5 to 8. The difference is that I have got control of the carb intake.

A couple of thoughts on what you have said. Egg and beans for lunch? Check the total carb on the side of the tin or if it is some other bean weigh them out and look up the carb content. TOTAL CARB NOT JUST SUGARS. I'm aiming for about 80 g carb (total) per day - half a tin of beans will give you a big chunk of that. Given up wheat based stuff ( bread, pizza, pasta) again because I would have to have tiny amounts to hit my target - four slices of bread would do it.

Thanks for your reply. I was advised to go wholemeal/wholegrain etc with carbs, so wholemeal bread and pasta and brown rice etc but to cut down the portion size of those which I have and cut all the added sugar as well of course. So I haven't had a cake, biscuit, scone, pizza or anything like that for weeks let alone sweets or chocolate and only the occasional slice of wholemeal bread.
I was thinking egg and beans for breakfast if the porridge is spiking me as @Drummer suggested. They are Heinz no added sugar baked beans and maybe some mushrooms with that and the eggs. Just eggs on their own seems so unsubstantial.

"Given up wheat based stuff ( bread, pizza, pasta) again because I would have to have tiny amounts to hit my target - four slices of bread would do it" ..... 4 slices of bread is a huge amount to me! What do you eat if you don't eat wheat products? Can you give me an idea of what you have for breakfast and lunch and dinner? I thought I was doing right by substituting sweet potatoes for potatoes and reducing portion size.... if I can't have either, then what do I put on my plate?? .... green veg and lean meat?

 

[rebrascora]

So pitta is bread?
Beans are - for me - a high carb food - you are still not eating a low carb diet so it is difficult to decide if you are not responding to eating like a type two and so more tests should be done or other treatments tried.
The short periods of feeling off could be 'false hypos' from your reduced intake of sugars, but if you are topping up with starches - but you have your meter.
If you do continue to see high readings and feel unwell for longer periods then the hospital A & E might be the best place for you.
If you are wrongly diagnosed and require insulin then the situation, going into DKA is a very serious one.

Can you give me a rough idea (ie examples) of what you eat for breakfast lunch and dinner because I cannot comprehend a diet with no carbs and yes a wholemeal pitta is a flat bread. I think of baked beans as protein and fibre....yes it will also contain carbs but so does almost everything. I also appreciate the oats in my porridge are carbs but also protein and fibre.
Feeling a little lost right now!

 

[Ljc]

Their is around 9g of carbs per 100 g of no added sugar Heinz baked beans.
I don’t know if you eat meat, if so how about some very high meat content sausages with eggs cooked anyway you like, you could add in some mushrooms. I’m making myself feel hungry here lol.

Sadly diabetes is very individual in what carbohydrates our bodies can and can’t tolerate , I am afraid to say that many HCPs (heath care professionals) in the NHS don’t seem to understand this and continue to tell us to eat wholemeal varieties instead of white varieties and unfortunately some people who are unable to test themselves never find out that that wholemeal something or other is spiking them up into double figures that’s why earlier I said eat to your meter, some even have to avoid porridge.

 

[Pumper_Sue]

@rebrascora how about doing a 24 hour fast with just drinking water? Do your bloods every 2 hours and see what results you get.

 

[Madeline]

Baked beans, even the reduced sugar, spike me badly. I know they say wholemeal bread and pasta, brown rice, sweet potatoes etc, but if it’s a grain it’s a carb. If it’s fruit, it’s a carb, if it’s a root veg, you guessed it, it’s a carb. And carbs are carbs, they ALL break down to glucose. Some can get away with a certain amount, others can’t. I can’t manage any.

Breakfast for me is full fat greek yoghurt, or skyr, plain only though, the fruit ones may not have added sugar, but the fruit itself is full of it. Or eggs and bacon/sausage if I can stomach it. If I’m feeling unwell I’ll just have some kefir.

Lunch is a salad, no tomato. I’ll have fish, eggs, or cheese with it, some sauerkraut (proper raw, not vinegar pickled shop stuff) or maybe a little kimchi (kimchi is a bit more risky because of the paste used)

Dinner is meat or fish with carb free vegetables - Wikipedia has a brilliant list. Pudding, if I have one, is yoghurt again, or a sugar free jelly, or a slice of watermelon - that’s literally water held together by plant cells, and isn’t too heinous.

Occasional carbs - Burgen bread is great, have it with butter as the fat will slow down the carb uptake. I’m also ok with a small amount of good quality, made with cream, ice cream, but only a couple of spoons.

I’m sensitive to carbs, it’s worse because I’m on steroids, and you’ll hopefully not have to be as strict, but I hope this helps and maybe gives you some ideas for meals.

 

[Docb]

@rebrascora. My meal pattern is a bit like Madelines. Breakfast... about 20g of museli or granola choosing those with nuts but minimal added fruit, slice of bergen toast with butter and a hint of marmalade and a brew. Carbs, 10 from the cereal, 10 from the toast, total 20g. Lunch typically soup (maybe home made or lowest carb ready-made), and bits and pieces (salad, cheese, cold meats). Carbs, 20g or so from the soup. Tea, today, piece of cod done in the oven in a parcel with lemon and butter, stir fried leafy veg with peppers and onions and small portion of oven chips. Carbs only from the chips 25g. Evening brew with a biscuit another 17g carb. Total for the day, 80g carbohydrate. Developing a few different recipies but generally minimise or eliminate flour based stuff or root veg. One thing I am working on is thin sauces, more broth than gravy cos you thicken sauces with starch, a carbohydrate.

 

[Madeline]

Almond flour or konjac powder are your friends @Docb

Naked Noodles stuff, we don’t digest konjac, and it’s great for the gut microbiome.

BULK POWDERS Pure Glucomannan Powder, Konjac Weight Loss, 100 g https://www.amazon.co.uk/dp/B00IZD2MLE/ref=cm_sw_r_cp_api_i_cZRKCbACGP43J

 

[Drummer]

I only eat twice a day - but for my first meal I might have eggs with cheese and tomato, or a salad - a bag of green salad, tomatoes radishes celery coleslaw, plus a tin of tuna in brine or eggs and cheese, or some left over meat from the previous days dinner, or some seafood or fish, or bacon and eggs, mushrooms sweetcorn and courgette or aubergine - so not something insubstantial. I would have coffee with cream either before or after.
In the evening, some sort of protein meat or fish usually but sometimes shellfish - and a stir fry of low carb veges, then frozen berries with sugar free jelly and cream - and more coffee.
I do not eat a dessert every day as I am not hungry enough, but two or three times a week I do, maybe don't have veges with dinner just the meat or fish. I would usually have a second cup of coffee around dinner time.
I do not eat high carb fruit or veges, grain is out usually, but I do make bread from time to time, with lots of high fibre additions, and then freeze it and ration it out. That seems to be only a few times a year though. I thought I'd be making some each month, but find that I do not crave it as much as I thought.

 

[rebrascora]

Many thanks for all the suggestions. I really appreciate you guys taking the time to give me some input because last night I just wanted to crawl into a corner and cry or shout and scream and rant..... I did a little of both because I was feeling pretty frustrated and just didn't know what I was supposed to do for the best.
I'm not sure how much more carbs I have been ingesting than 80g in the day but I doubt it is much if any over..... do you ignore the carbs in eggs and dairy? After I bought the Fat Free, No Added Sugar yoghurt and ate one I realised that it was still very sweet and the ingredients listed potato starch and maize starch which are obviously carbs \\(as well as the fruit and sweetners and overall carbs as 7.9g per pot. Even with reading glasses on, trying to see this info when it is printed in white lettering on an orange background is incredibly difficult, especially as my sight is not great at the moment..... shopping becomes really frustrating when you can't see this stuff and get home to find that you have bought things that seemed to be just what you needed and then find that they are not ideal after all..... I have felt a bit conned by the labelling and with so many people with Diabetes these days there is surely a market for these products to have clearer labelling!!
@Pumper_Sue
I did try breakfast and dinner with nothing in between the other day and BGs went down to 10.2 (my lowest reading so far) but then came back up towards the end of the day before I had dinner, but I may try a full 24 hr fast in the next few days.
Fasting BG this morning was 16.4. I had 2 eggs, baked beans and mushrooms for breakfast and 2.5 hrs later it was 16.3, so whilst I started the day off with a higher reading than the past couple of days, I have not had a spike after breakfast, so perhaps the porridge has been causing a problem. I guess it will be tuna salad for lunch and see how that goes.
I assume they wanted me to go low fat and low salt and no processed meats to protect my heart and help reduce my weight but now that I am down to a normal BMI, is it OK to increase fat intake in moderation to give me a few more calories. I am still losing weight at a rate of 3-4lbs a week and as I am pretty active through the day, I probably need more calories than the average sedentary person..... OR ..... is my heart still at risk with my BGs being so high and I need to keep the fats low until they come down..... OR.... am I reading correctly that some people find fats actually help to lower their BG by slowing the release from the carbs they eat.... ie full fat yoghurt may be better than low fat?

 

[Docb]

Yep its a right old balancing act but it looks like you are beginning to get a grip. I keep saying it but write everything down and if you can, plot a graph showing how things are changing over time.



I have put a copy of my data over the last couple of months above showing how blood glucose has varied over time. I don't have to rely on memory when trying to work out how things are progressing but I can see the trend and can see that over the last couple of weeks things have been pretty good. The spikes are best treated as blips and focussing on them can be misleading in terms of judging the direction of travel. I'm pretty sure what caused each of the recent spikes and those foods have gone on my do not eat list. Again, keeping an honest food diary has helped in that. It has also meant that when I have seen GP/DN I have been able to show them what has been going on rather than trying to describe it through memory recall. That has helped with their decision making.

 

[rebrascora]

@Docb
Many thanks. I think you are right that I may have just turned a corner with this and perhaps the complex carbs are the big problem.

My sister just very kindly researched and then talked me through downloading "The Sugar Diary" app and how to use it and I have already back logged yesterday and today's readings and meals and even for someone like me who is not tech savvy, it seems to be quite simple to use and I already have a graph taking shape.
I am feeling much more upbeat today seeing a glimmer of hope that if I cut the carbs right out, I may be able to manage this via diet after all and perhaps then experiment with bringing one or two back in to see if I can tolerate some but not others. I really don't want to go on insulin if I don't have to. Fingers crossed my readings continue to come down today with the new dietary knowledge that you have kindly provided me.
Can't tell you how much I appreciate everyone's help here. I was desperately despondent last night and now feel like I have the tools to deal with this today and the sun is shining!
Cheers everyone!