With an hba1c at the level yours is you almost certainly have a large degree of insulin resistance (ie it’s not doing its job very well despite likely having a good amount being made). Insulin is made in response to glucose levels rising. Having constant high levels of insulin circulating adds to the amount of resistance to it (you become desensitised as it were). Also type 2 often comes along with non alcoholic fatty liver which means regulation of how much glucose the liver adds to blood becomes dysregulated. One way this often shows up is in high morning fasted readings.
As you address the problem these things can and will improve. Maybe even to the level they become normal so long as you continue your management strategies but at the very least a good improvement.
An awful lot of us find that lowering carbs is key to reducing glucose and lowering circulating insulin to more normal levels and becoming more sensitive to it again.
So that means ALL grains like cereal, breads, pasta, pastry etc (brown, wholemeal, whole grain etc have almost identical carbs even if they have a little more fibre), starchy veg like potatoes, sweet potatoes, parsnips and any sugars need reducing. Fruit can be high carb so best to stick with a few berries or a little melon maybe. It also has fructose which a meter can’t record so look ok on the face of it but, in excess, can add to fatty livers as described above. Pulses like beans and peas have variable effects. They aren’t particularly low carb but some do ok with them.
130g a day is the recommended maximum. Many of us with high levels of insulin resistance need to have far fewer than this. Anything down to 20g a day for some. Testing will tell you.
Now that’s quite daunting for some so a step at a time is best. Some find focusing on a meal at a time (testing before and 2 hrs later for a 2mmol or lower rise ideally to mimic a non diabetic response). Others replace one food type at a time. Getting used to that then making the next change so it’s not overwhelming. Also testing and learning to read labels helps a lot. Look for food with a low carbs per 100g unless you’re only having tiny amounts.(eg under 10g carbs per 100g of product, under 5 even better). For type 2 pretty much ignore the “of which sugars” bit. It’s the carbs that matter. At least for a week or two count how many you eat at each meal and each day to get an idea where you are and which choices are better for your body.
Finding alternatives helps. Using vegetables instead of rice or pasta etc and having more of the protein elements on the plate help even if it looks a bit different. Experimenting with nut flours instead of grain. Using natural sweeteners (without maltodextrin found in many supermarket type granulated options) like stevia, erythritol, xylitol or monk fruit. Not being afraid of natural unprocessed fats is key. Full fat dairy has been proven in recent years to have great health benefits provided it’s not in ultra processed forms and doesn’t have added sugars. Eggs can be used many different ways. Proteins and fats keep us full far longer than carbs do and won’t raise glucose levels in anything like the same way. You don’t need to starve or feel hungry and you need to fuel yourself still. Google recipes with search terms like “low carb shepards pie” or “keto lasagne” for loads of ideas.
This page give free general advice about low carb eating.
https://www.dietdoctor.com/low-carb The same website has lots of recipes, guides, visuals and links to medical research papers. They do have a paid menu option but it’s totally voluntary and unnecessary if you don’t want that.
