Blood sugar regulation

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NewdiabeticRo

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Hello so I've been diagnosed with type 2 diabetes fronjust over 15 days now. I maintain between 800-1000 calories in my diet and have not managed much weightloss due to lack of time for exercise but I have a whole routine scheduled to start in a week's time. Today my fasting blood glucose was high - 7.5 on waking up but I ate a regular meal last night and it was 4.5 before going to bed. 2 hours post breakfast it was 10.1 and I was having sedentary day so I decided to go for a 30 min walk. I came back and it's now down to 3.2. I've eaten a half a slice of bread to fix it and it came to 3.5 so I had a small coffee with almond milk and sugar and it's just touched 4. I've never realised but the feeling of a hypo is something I've realised I feel during the night sometimes and sometimes at work. My first meeting with my diabetes nurse was yesterday and she said to only test a random and before bed time and if the before bed was less than 4.5 then to eat 2 biscuits and go to sleep.
I'm a bit confused about how to regulate this. Any advice will be appreciated
 
I think it would be useful to let folks know what medications you are on to control your diabetes (if any). The replies will depends on the meds 🙂
 
gll said:
I think it would be useful to let folks know what medications you are on to control your diabetes (if any). The replies will depends on the meds 🙂
Click to expand...
Hi
I'm on 500gm Metformin sustained release twice a day - I'll be honest, I forget to take until an hour after meals. Last night I realised I did not take it until I did post dinner sugars which were 8.1 without taking the medication as the tablet marked for the evening was still in the strip
 
firstly don't panic about the timing of metformin. It is not a drug you see immediate effects from.
It builds up in your system over days.
Of course taking metformin mid meal can help with the side effects it can bring if you are suffering.
What metformin does is gets your liver to calm itself with the dumping of so much glucose back into your bloodstream and helps you to use your own insulin more efficiently.

Metformin alone typically doesn't cause hypos (the dangerous kind) so I wouldn't panic about that. If you feel crap, sure have a small snack but its not needed to stop any life threatening situations where folks on insulin or drugs that force insulin production. Your body is probably not very used to those low levels and you should acclimatise over time.

For meals and controlling the swings, what most people tend do is:
test on first bite of a meal
wait 2 hours
test again
if the difference is more than 2-3 mmol/l then the portion of carbs in the meal should be adjusted (decreased) and test again another time to see if the new potion is okay for you.
Its all an individual thing so what is fine for one person may not be fine for you.

Having a post meal reading of no more than 8.5mmol/l is ideal but secondary to the 2-3 rise (impossible goal if you are above that before you start eating)

When testing in the morning, there can be 2 factors in play which is where your body "helpfully" dumps a bunch of glucose into your body to get you setup for the day.
1) dawn phenomenon which happens while you sleep
2) foot on the floor which happens when you get up and move about, usually within 5-15 mins of getting out of bed

What most people do is test in bed for accuracy. Having something to eat when you get up usually sends a message to your liver to say "heeey chill on the dumping of glucose, we are good here"

fire away if you need any more elaboration or have any questions, nothing is too silly to ask 🙂
 
gll said:
firstly don't panic about the timing of metformin. It is not a drug you see immediate effects from.
It builds up in your system over days.
Of course taking metformin mid meal can help with the side effects it can bring if you are suffering.
What metformin does is gets your liver to calm itself with the dumping of so much glucose back into your bloodstream and helps you to use your own insulin more efficiently.

Metformin alone typically doesn't cause hypos (the dangerous kind) so I wouldn't panic about that. If you feel crap, sure have a small snack but its not needed to stop any life threatening situations where folks on insulin or drugs that force insulin production. Your body is probably not very used to those low levels and you should acclimatise over time.

For meals and controlling the swings, what most people tend do is:
test on first bite of a meal
wait 2 hours
test again
if the difference is more than 2-3 mmol/l then the portion of carbs in the meal should be adjusted (decreased) and test again another time to see if the new potion is okay for you.
Its all an individual thing so what is fine for one person may not be fine for you.

Having a post meal reading of no more than 8.5mmol/l is ideal but secondary to the 2-3 rise (impossible goal if you are above that before you start eating)

When testing in the morning, there can be 2 factors in play which is where your body "helpfully" dumps a bunch of glucose into your body to get you setup for the day.
1) dawn phenomenon which happens while you sleep
2) foot on the floor which happens when you get up and move about, usually within 5-15 mins of getting out of bed

What most people do is test in bed for accuracy. Having something to eat when you get up usually sends a message to your liver to say "heeey chill on the dumping of glucose, we are good here"

fire away if you need any more elaboration or have any questions, nothing is too silly to ask 🙂
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Thank you. This was very informative. I've realised I've been feeling the same feeling of hypos for a very long time now, pre diagnosis. I am going to try and see a diabetic team.
 
How did you come to be diagnosed with Type 2? It is possible aged 25 but not all that usual.
 
trophywench said:
How did you come to be diagnosed with Type 2? It is possible aged 25 but not all that usual.
Click to expand...
I was in hospital for pyelonephritis and under a lot of stress. Lots of family history (mum, maternal grandmother, 4 of dads sister's). I've always been fit and healthy but gained 10kgs since October 2019. My HbA1C in hospital was 110 on day 1, 109 on day 2 and 106 on day 3. And blood sugars were high and they kept pushing insulin and it had no effect but Metformin did. I have not yet been informed of the results of my anti-Gad antibody and c-peptide tests yet.
I was on the 800 calorie diet, upped it to 1200 basically because I've added soda bread and more berries as fruit but minimum physical activity is pushing me into a hypo. I was sendentry after dinner last night working at my desk and 4 hours after my meal, it was 3.4 jus - I don't know how to regulate it considering I'm going to start the 10000 steps a day and gym X3/ week from the 30th.
 
Its definitely an odd scenario.

From a common sense standpoint, I would consider deferring your steps and gym plans until you have had some more medical advice and possible investigation.

How long have you been on the restricted calories and were you experiencing the same symptoms before that or even if you were, to the same degree?
 
gll said:
Its definitely an odd scenario.

From a common sense standpoint, I would consider deferring your steps and gym plans until you have had some more medical advice and possible investigation.

How long have you been on the restricted calories and were you experiencing the same symptoms before that or even if you were, to the same degree?
Click to expand...
I started the restricted calories on the 4th of May
But now that I know what a hypo makes me feel, I've been feeling them for months. So I don't really know whats caused the A1C to be so high. A friend in the medical profession thinks the constant hypos may have caused excessive release of glucose into the system. But the DN won't listen to me neither will the GP. They want me to see through the Metformin till end of July
 
So is this a DN at your GP surgery or is she a DSN at a hospital diabetes clinic?

Whose idea was the 800 cal diet and is it being overseen by a hospital to ensure you are getting the correct amount of micronutrients as well as cals?
 
trophywench said:
So is this a DN at your GP surgery or is she a DSN at a hospital diabetes clinic?

Whose idea was the 800 cal diet and is it being overseen by a hospital to ensure you are getting the correct amount of micronutrients as well as cals?
Click to expand...
It's the DN at the GP buy the DSN and Consultant were the ones that recommended the 800 calorie with 10,000 steps a day and said to take multivitamin with it as well
 
Well I think you need to ring the hospital clinic and tell them you are constantly going hypo, and hence urgently need more input from them re your diabetes.
 
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