Advice needed please

Newbie777

Newbie777

Well-Known Member
Relationship to Diabetes
Type 2
Hello,

I need some advice please.

Sorry I could not workout where to add my meds in the profile.

Been type 2 for over 20 years.
Taking Invokana 100mg (was 300mg before today)
Metfirmin 1000mg (was 2000mg 2 weeks ago)
Glicizide 240mg
Trajenta 5mg (started today).
Last Hba 1c 117, previously 120 and 122!
I have now have an Freestyle CGM
Kidney eGFR now 58 (was 43, 2 weeks ago)

My blood sugars has always been very high, don't eat too much cakes but processed food and also being Asian eat wholemeal floor chapati (which has about 200g of carbs).

However went on Keto diet and my blood sugars were much better 4.5 fasting, 9 to 10 after two hours of food and about 8 at night, in fact I experienced hypos for few nights first time in mnay mnay years, so would have a snack before bed. So all good.

However, subsequently my kidneys were getting worse dropped from 60 plus to 43, went to A&E suspect acute pancreatis/kidneys stones but it wasn't, metformin reduced from 2000mg to 1000mg, this has led to my diabetes going up and an average around 14 after meals and 8 or 9 fasting reads.

So now been given a fourth diabetes medicine (Trajenta) as I don't want to go on insulin ( my body still produces it and there are many other disadvantages to insulin), usually you are only 3 types.

Also as of today i am trialling out a reduction of Invokana from 300mg to 100mg (GP not happy) as I suffer from high blood pressure ( was taking Lisonipril 10 mg, reduced to 5mg a day and last few days not been taking any) but still seem to get low blood pressure and it is the drop of 40 plus units that is a concern. The low blood pressure is a concern as I want to go the gym but sometimes my head spins even when I am walking a few yerds or going shop!
I have read up that Invokana can give low blood pressure so will see if improves if ovet 4 weeks, if not will go back to 300mg daily. I know I risk my blood sugars spiking!

My issue is the keto diet is great, but it is not sustainable and also I am worried about keto acididosis, are there any other diets I can try and still keep my blood sugars in control?

Anybody else have experience of reducing Invokana from 300mg to 100mg?

Thanks
Niaz
 
Welcome @Newbie777 🙂 Yes, there are various diets you could try. For example, you could try a low carb diet (not keto, up to 130g carbs a day) or a Mediterranean Diet with lowish carbs or a very low fat plant-based diet. Diabetes U.K. also has some meal plans:

Meal plans and diabetes

Eating nutritious, healthy and downright delicious food is that bit easier with our meal planners. We've created multiple different weekly meal plans to suit all types and tastes. They're nutritionally balanced, are calorie and carb counted, and can help if you want to lose weight. They also...
www.diabetes.org.uk www.diabetes.org.uk

It’s what works for you as an individual 🙂
 
Thanks inka,

I think I am on a low carb rather than keto, but do love my chicken, fish and kebabs with salad. I eat boiled eggs and have surreal for breakfast and heylo low carb bread with butter, I have switched to almond flour for chapatti now, for snacks I eat strawberries and blueberries with full fat yogurt and also have nuts all day, really off processed food now.

But I miss my carbs, especially potatoes, jacket potatoes, mash etc.
 
Yes I have and although good still not the same love raist potatoes too. I also miss rice, my wife makes a mean biryani.
 
I'm afraid you have to think of a low-carb diet rather than a specific diet type. Try to stay below 150gm/day and possibly a lot less. I know it may be difficult if you are used to Asian food. Apart from the carbs you can eat almost anything else.
 
Thanks sticking to 150g I can do, just need to work out alternatives to cravings I have
 
There is a difference between keto acidosis and ketosis - the first is associated with low insulin and usually with high glucose, the second is a natural response to eating low carb and burning fat for energy. The first is bad news, the second is of little concern, if any.
There can be keto acidosis at normal glucose levels, but that is fairly unusual.
From my own experience with type 2, lowering carb meant lowering blood glucose.
I hope that you can reverse your problems with low carb eating.
 
Thanks Drummer, Forvm the keytones in my urine was a key test Andover 3.0 would be bad. GP confirmed that I have little or no key to es in my urine, so not worried about keto acididosis, will carry no but need to control my diabetes via low carb rather than keto diet, thanks
 
Newbie777 said:
Thanks Drummer, Forvm the keytones in my urine was a key test Andover 3.0 would be bad. GP confirmed that I have little or no key to es in my urine, so not worried about keto acididosis, will carry no but need to control my diabetes via low carb rather than keto diet, thanks
Click to expand...
The 'flozin' medication you are taking has the potential to cause euglycemic ketoacidosis if people follow a very low or Keto dietary regime to it is wise to be cautious.
A couple of resources you may find useful are the book or app Carbs and Cals as there is a World Food version which gives the carb values of a whole range of foods. Also this link to a low carb approach which has different menu plans so you may find some which will suit you. https://lowcarbfreshwell.com/
 
Thank you very much, that's makes sense and am glad am not paranoid🙂.
Yes will check it out and hopefully being better informed will help.
 
Newbie777 said:
Thanks Drummer, Forvm the keytones in my urine was a key test Andover 3.0 would be bad. GP confirmed that I have little or no key to es in my urine, so not worried about keto acididosis, will carry no but need to control my diabetes via low carb rather than keto diet, thanks
Click to expand...
Low carb or keto, its all much the same idea - you reduce your carbohydrate intake until you see good results.
 
Thanks and I now have a plan.. I think Keto for e me is not good at all, I need to move to a low carb diet say 100g to 120g a day, the ridicouls keto diet is hard to keep to and expensive (low carb cereal, low carb bread, almond flour, oat milk etc).

I think to reduce carb intake is good, I will lose weight but also keep my sugars within 2 or 3 mmol target range. Will focus on Hba 1c reducing to less than 70 for now, then later 0 etc etc, needs to be a marathon and not a sprint. Thanks
 
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