Confused/ worried by recent diagnosis

[Slonky]

Hi Everyone,

I've been getting a bit worried recently that my diabetes management attempts aren't working...

I was diagnosed in Feb 19 with an HbA1c of 48, then 51 - no symptoms. I was a bit surprised as I eat quite well and exercise and am slim and only 36 although there is a lot of diabetes in my family and I am South Asian.

Over the next few months I lost about 5kg to bring my weight down to 48kg, BMI < 21. I cut out carbs and snacking a lot - although would occasionally fall off the waggon - chocolate my real weakness. HBA1C in June was still 51, which I was disappointed by. My GP suggested Metformin but I am reluctant.

I bought a libre which shows a persistent fasting glucose of around 6 - 7.5mmol/L even when I haven't eaten for more than 12 hours. What I eat doesn't seem to make much difference! My blood sugar spikes but then tends to come down. Everything else is healthy - blood pressure, cholesterol, triglycerides, vit and min levels, liver enzymes. Most of the weight I've lost is from my abdomen which I thought would make a difference but hasn't.

The only other possible thing is my thyroid which I recently found out was underactive.

I really wanted to manage this with lifestyle changes rather than medication - I was aiming for Newcastle diet style reversal. But nothing seems to work.

Has anyone been in this situation or can anyone offer any advice?

Thanks

 

[Kaylz]

Hi and welcome to the forum 🙂 by saying you bought a Libre do you mean you are finger pricking? or scanning?

When you say you spike, what are your levels like pre meal? and then again post meal?

What is included in your diet at the moment?
xx

 

[Slonky]

Thanks for your reply. I am scanning. I'll wait a couple of days to post food and bg info. I stopped taking doxycycline only yesterday out of suspicion it was lowering my bg, and the last few days I have been experimenting with my very new libre with high carb foods - chocolate and crisps. So maybe this is causing my high fasting level. I think in a couple of days I'll be more stable. Today I had a cup of tea for breakfast. That 7 made me too scared to have anything more! I'm having blueberries and yoghurt for lunch and for dinner I'm planning to have a small wholemeal pasta portion with a sauce made with creme fraiche and peppers and kale. (I'm vegetarian btw).

 

[rebrascora]

Hi and welcome.

Is that all you had for breakfast... a cup of tea? There are no carbs in tea, so it is likely that your liver has dumped glucose into your bloodstream because you didn't have anything to eat, rather than the tea causing a rise. Do you eat eggs? They are a good choice for breakfast if you do. An omelette works well, I have mine with mushrooms and onions and peppers and cheese and courgette or aubergine or any combination of those and a side salad with lettuce, cucumber, avocado and 3 cherry tomatoes. It keeps me full all day without being heavy.

What type of yoghurt do you have? Low fat is higher in carbs than whole milk or creamy yoghurt and since it sounds like you do not need to lose weight, creamy natural/Greek yoghurt is probably better for you.

I would expect a spike from the wholemeal pasta but everyone is different and if you have a Libre it will let you see the full extent of how it effects you in graph form rather than the snapshot sample you get with a finger prick test. How long have you had the Libre?

Since those fasting readings are not bad I would ask what your pre meal readings are for the rest of the day?

It may be that Metformin short term will help your body to clear some of the blood glucose. Whilst the digestive upset side effects of it are a bit of a pain, they usually subside providing you take it with substantial food and you are not committed to it for life, so no harm in trying it and seeing how you get on in my opinion.

 

[Kaylz]

Thanks for your reply. I am scanning. I'll wait a couple of days to post food and bg info. I stopped taking doxycycline only yesterday out of suspicion it was lowering my bg, and the last few days I have been experimenting with my very new libre with high carb foods - chocolate and crisps. So maybe this is causing my high fasting level. I think in a couple of days I'll be more stable. Today I had a cup of tea for breakfast. That 7 made me too scared to have anything more! I'm having blueberries and yoghurt for lunch and for dinner I'm planning to have a small wholemeal pasta portion with a sauce made with creme fraiche and peppers and kale. (I'm vegetarian btw).

have you checked scans against finger pricks? if so what differences are they producing?

Blueberries are significantly higher carbs than other berries like strawberries, raspberries and blackberries, they have aroung 14.5g carbs apposed to strawberries out of the 3 I mentioned being the highest at 6g carbs per 100g, as Barbara has mentioned full fat Greek/natural yoghurt is generally lower in carbs as most low fat versions contain sugar to make it taste better

Pasta you may see a spike in but I've never put it to the test myself
xx

 

[Eddy Edson]

Thanks for your reply. I am scanning. I'll wait a couple of days to post food and bg info. I stopped taking doxycycline only yesterday out of suspicion it was lowering my bg, and the last few days I have been experimenting with my very new libre with high carb foods - chocolate and crisps. So maybe this is causing my high fasting level. I think in a couple of days I'll be more stable. Today I had a cup of tea for breakfast. That 7 made me too scared to have anything more! I'm having blueberries and yoghurt for lunch and for dinner I'm planning to have a small wholemeal pasta portion with a sauce made with creme fraiche and peppers and kale. (I'm vegetarian btw).

Hi Slonky! I'm also a new Libre user. FWIW, over the first four days, I'm finding that it generally reads a bit too high vs finger prick, some days by an average of around 1.0 mmol/L, other days much closer. Today it's been reading high by more than 1.5 mmol/L on some occasions. There doesn't seem to be any particular pattern, except that the amount by which it is reading too high will tend to remain fairly stable for several hours. [EDIT: Also, that it consistently tends to "overshoot" when BG is rising, but not when it's falling.] So anyway, I wouldn't really look to it for levels, more for trends.

 

[Slonky]

Thanks everyone - helpful dietary tips and good to know about the libre reading a bit high.

I guess I'm really keen to hear about people with my kind of profile - 'T2s' who are BMI < 21, physically active, south Asian ethnicity even - to know:
- if there are people for whom weight loss does not work so I should abandon that approach or
- if I need to persist and lose more weight to see the effects
- if there are particular weight loss and exercise regimes that help
- if might be misdiagnosed as an atypical T2, or are there lots of T2s with my profile?

My goal was Newcastle style reversal and I will lose and keep off whatever weight I need to achieve that, unless it is really not possible for some people.

 

[Kaylz]

good to know about the libre reading a bit high.

It isn't always though that's why we tend to compare to finger pricks for at least a couple of days first (I personally still do 4 finger pricks a day but that's as I'm on insulin and wouldn't use a scan to judge my insulin) but this was just a short while ago and spot on so always better to do a few finger pricks at least xx