BGM - complete numpty

[helli]

@Leadinglights I am curious why you have mentioned DKA with low carb and SGLT2.
My (probably ignorant) assumption is that "too low" low carb would lead to hypos rather than DKA. The risks you list are all things that cause BG to rise rather than fall.

 

[Leadinglights]

@Leadinglights I am curious why you have mentioned DKA with low carb and SGLT2.
My (probably ignorant) assumption is that "too low" low carb would lead to hypos rather than DKA. The risks you list are all things that cause BG to rise rather than fall.

People in the past have been anxious to point out that a low carb diet is unwise when taking that medication but exactly what constitutes low carb is very much up for debate in that context. @Lucyr had mentioned it from personal experience I believe.

 

[Lucyr]

@Leadinglights I am curious why you have mentioned DKA with low carb and SGLT2.
My (probably ignorant) assumption is that "too low" low carb would lead to hypos rather than DKA. The risks you list are all things that cause BG to rise rather than fall.

DKA is a known potential side effect of SGLT2 (the flozin drugs) and either the person prescribing or the leaflet inside the box will often warn against a low carb diet whilst taking it.

Here’s an example from this Diabetes UK website (on a page about low carb diets of under 130g carb per day) “If you have type 2 diabetes and take SGLT2 inhibitors like Dapagliflozin or Canagliflozin speak to your healthcare team first as you might need to stop taking them. This is because they may increase the risk of Diabetic Ketoacidosis when reducing your carbohydrate intake.”

Source: https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes/meal-plans/low-carb#:~:text=If you have type 2,when reducing your carbohydrate intake.

 

[saffron15]

I haven't properly sorted my diet. It can be a bit erratic. Having a plan of sorts I have often either woken up not hungry and left out breakfast or by 6pm know I don't want supper. This has only happened since I went on the SGLT2. The HCP warned against low carb. I asked to speak to pharmacist when I collected the drugs but she wasn't sure. I'm not interested in a keto diet but realised a few times by missing an anticipated meal I have been around 80. I'm now trying to add extra carbs. The leaflet with the drug isn't sufficiently helpful. Obviously I still want to lose weight. On Monday I had an hour of runs [ toilet I'm not an athlete) I don't know if it is something I ate or metformin having a little game. I've reduced to two tablets which when I first started bunged me up. I had had an incredibly stressful day on Monday. I will up carbs to over a hundred and try one of the keto sticks I've been given.
I've only been on medication for five weeks it is still a little bewildering.

 

[Lucyr]

The HCP warned against low carb.

If the HCP warned against low carb whilst on the SGLT2 medication (understandably as it’s a commonly known risk) then you either need to up carbs to around 130 a day which is considered more moderate carb, or go back to the HCP and say you’d prefer to stick to lower carbs can they swap the medication to one that is safe with that.

 

[saffron15]

I did check with pharmacist and also emailed the HCP who is a pharmacist. He hasn't responded. He didn't explain how low carb nor does leaflet or nhs site. Despite skipping supper Ive eaten some almonds on top of what I have had today and haven't yet added it up but as it includes a croissant stuffed with apricot, a small amount of humus and half a ciabatta with apple soup and fish fingers I will be OK. I have been adding more carbs every meal. I plan to eat a naughty cottage pie half for lunch half pm with lots of veg. However I visit a fishmonger on Fridays so will look for what to add to it. I have a cauli and could add yoghurt and cheese to it. I've still got carrot, fennel celery green beans and Swiss chard.
I still want and need to shift some fat. I've lost 10 kg which is enabling me to be more positive but I could do with losing another 10 and if to have an ideal bmi a bit more.

 

[Lucyr]

I did check with pharmacist and also emailed the HCP who is a pharmacist. He hasn't responded. He didn't explain how low carb nor does leaflet or nhs site.

This website Diabetes UK says that low carb is under 130g per day and that if you want to eat less than that whilst taking SGLT2 medications then you need to speak to your HCP first as you may need to stop the medications to be able to safely eat low carb, which is why I made the suggestion in my previous post.

You’ve also said your HCP has also already warned against low carb, and again as low carb is defined as under 130g a day and you’ve said you’re eating less than that then you need to reconsider the medication, or your diet, or at least understand the signs of DKA and be able to check for ketones.

Low-carb diet and meal plan

Eating a low-carb diet means cutting down on the amount of carbohydrates (carbs) you eat to less than 130g a day. But low-carb eating shouldn’t be no-carb eating. Some carbohydrate foods contain essential vitamins, minerals and fibre, which form an important part of a healthy diet.

www.diabetes.org.uk

 

[saffron15]

@Lucyr I remember reading it and thinking it was tied up in maybes etc. I have increased carbs and will test bg over next few days. It maybe to continue losing weight I will need to exercise more ( from a shaming very low base) I prefer the new medication and less metformin. Probably I read it too much like a lawyer.
I have an appointment on Monday where I could clarify.
Thank you

 

[Lucyr]

@Lucyr I remember reading it and thinking it was tied up in maybes etc

Well yes that’s how diabetes and medication works, maybe eating low carb with the medication will result in DKA and maybe it won’t. No one can give definites.