Fallen off the diabetes tightrope

[Derby Simon]

Hello everyone, I am Simon and back in I think it was 2018 my doctor did a blood test after I went with concerns about diabetes. My dad is type 2 and my dentist said I had a drier than expected mouth so I thought I better get checked out. My Hba1c result was 47 so obviously pre diabetes. I am not going to lie but I have a sweet tooth and my meals are likely carb heavy but by carrying out some tweaks which did not amount to any major changes my score dropped to 42 for a number of tests and I felt quite comfortable with that. Then Covid happened and ok I guess I let things slip a bit - it was not a good time for us was it! anyway in Jan 2021 I got tested again and levels had risen to 46 - so not going in the right direction but I got nothing from the doctors beyond a letter with the result - no follow up appointment (maybe because of Covid) and did not get a further test until Jan 2022 when it came as a shock that it was 57 so way off into diabetic territory. At the time I was recovering from a double stomach illness from the Christmas period and the diabetic nurse over the phone agreed that the level could have been thrown out by the illness so we agreed a further test for a few months later. Move onto recent weeks and the latest result is 66 so that blew my idea of the illness causing the spike out of the water and now the diabetic nurse has told me I have to go onto Metformin.
What has left me somewhat perplexed is how I got the levels down by a fair bit for a number of tests then all of a sudden the levels have gone up and continued to rise at an increased rate even though I had if anything returned to eating similar to what I had prior to the uplift to 46. Before I go onto the Metformin I wanted to get an idea of my actual blood glucose levels to see what is actually happening prior to starting medication and I see on the forums it is suggested a glucose meter is a good investment to help control the condition but for some reason when I have mentioned checking my bloods to my diabetic nurses (I wasnt asking them to give me a machine) they keep telling me I dont need to do it! I have got a machine anyway as I think its an important starting point for this journey. I guess also at the back of my mind I am concerned that the sudden uptick in my Hba1c results when I am eating similar to 2018/19 when my levels fell could be being caused by something else.

 

[Drummer]

Quite a few people have reported an upturn in Hba1c or glucose levels, and I saw my Hba1c go up after Covid - or rather I learned it had but a year later, as no one told me about it, and at the next test it was back to normal again.

 

[janw]

There are many things that could have caused your numbers to rise. Our bodies do change with time and it could be that something you tolerated well in the past, now gives you higher spikes. Have your portions enlarged? Are you still exercising as much as before? Have you changed your job or are life changes creating added stress? These are all things you can look at.
Yes, we are quite often "dissuaded" from buying a BG meter, but they really are a huge help with getting our BG under control - please also consider keeping a food/drink diary (online - lots of free ones around) as that will help you keep your carbs to no more than your elected number. Don't worry about calories, get plenty of good fats and protein.
I expect you know to check before a meal and to check again 2 hours after that first bite, looking for a rise of no more than 2-3 mmol/l. Cut the carbs slowly, do not rush it, take your time with one meal at a time to prevent other problems from happening.
Best of luck to you.

 

[ColinUK]

My baseline certainly seems to be a little higher post-covid than before. Whether that’s causation or coincidence who knows.
Like you I’ve certainly had periods where I’ve relaxed the diabetic mindset regarding foods and also exercise has been hard to maintain.
Stress is another factor. These past two years have been extraordinarily stressful for me and that’s also ticked up my BG levels a bit.

Having a monitor is a good thing as it does allow you to test pre and post food. If you keep an honest food diary you’ll soon figure out what you can tolerate and what you would be wise to avoid generally.

You mention being put on metformin. What’s the dosage and how are you tolerating any side effects?

 

[Derby Simon]

There are many things that could have caused your numbers to rise. Our bodies do change with time and it could be that something you tolerated well in the past, now gives you higher spikes. Have your portions enlarged? Are you still exercising as much as before? Have you changed your job or are life changes creating added stress? These are all things you can look at.
Yes, we are quite often "dissuaded" from buying a BG meter, but they really are a huge help with getting our BG under control - please also consider keeping a food/drink diary (online - lots of free ones around) as that will help you keep your carbs to no more than your elected number. Don't worry about calories, get plenty of good fats and protein.
I expect you know to check before a meal and to check again 2 hours after that first bite, looking for a rise of no more than 2-3 mmol/l. Cut the carbs slowly, do not rush it, take your time with one meal at a time to prevent other problems from happening.
Best of luck to you.

Thanks for your reply,
When I test at present I am doing when I get up, 2 hrs after lunch and 2 hrs after my tea. I currently work a 7 day week so am very active but do wonder if the mass activity in the day and how my body then handles the sugar as part of that confuses my body when later I have a meal but am far less active because it is evening time.

 

[AngelSprings]

My blood glucose readings shot up after having the three covid vaccinations, and they've not gone down since despite eating low carb.

 

[Derby Simon]

My baseline certainly seems to be a little higher post-covid than before. Whether that’s causation or coincidence who knows.
Like you I’ve certainly had periods where I’ve relaxed the diabetic mindset regarding foods and also exercise has been hard to maintain.
Stress is another factor. These past two years have been extraordinarily stressful for me and that’s also ticked up my BG levels a bit.

Having a monitor is a good thing as it does allow you to test pre and post food. If you keep an honest food diary you’ll soon figure out what you can tolerate and what you would be wise to avoid generally.

You mention being put on metformin. What’s the dosage and how are you tolerating any side effects?

The metformin are 500mg and I am to take one per day - not sure when to take it as it says with breakfast but I dont tend to have breakfast so wondering if its ok to move that to lunch time instead when I have a proper amount of food. I have not taken any yet as I have decided I want to test my bloods for a week to see where they are prior to doing so.

 

[Derby Simon]

My blood glucose readings shot up after having the three covid vaccinations, and they've not gone down since despite eating low carb.

That certainly sounds strange!

 

[everydayupsanddowns]

The metformin are 500mg and I am to take one per day - not sure when to take it as it says with breakfast but I dont tend to have breakfast so wondering if its ok to move that to lunch time instead when I have a proper amount of food. I have not taken any yet as I have decided I want to test my bloods for a week to see where they are prior to doing so.

Welcome to the forum @Derby Simon

Good to hear you have decided to take a more focussed hands-on approach to your diabetes management. Hope you find sharing your experiences with the friendly folks on the forum helpful and encouraging.

I don’t take Metformin, but I understand from reading posts from many of our friendly T2 members that taking it in the middle of a fairly substantial meal can help reduce the gastric upheaval. Some seem to find it helps if the meal is both substantial and has a fairly low carb count.

It’s not at all uncommon for nurses and GPs to say that home monitoring of blood glucose is not necessary. I think the feeling is (and it is backed by some research) that many T2s find it inconvenient, painful, confusing, and even slightly demotivating.

My suspicion is that perhaps, “You don’t need to do that” is a safe shorthand. Those who really want to will carry on and do it anyway, while others who may be anxious and worried about things (who might also be the sorts of people to find seeing high levels to begin with worrying and concerning) will be reassured that it isn’t necessary for them.

Having said that, many many forum members and newcomers have found a BG meter to be an invaluable part of their self-management and motivation toolkit. Being able to see exactly how you respond to different sources, portion sizes and combinations of carbs (and other foods) can be a very direct way of adjusting your menu to make it more BG-friendly for you as an individual.

‘Eating to your meter’ can take a lot of the uncertainty out of the questions, “Can I eat that” and “Is x better for my blood glucose than y”

 

[ColinUK]

The metformin are 500mg and I am to take one per day - not sure when to take it as it says with breakfast but I dont tend to have breakfast so wondering if its ok to move that to lunch time instead when I have a proper amount of food. I have not taken any yet as I have decided I want to test my bloods for a week to see where they are prior to doing so.

The advice is to take it with food but it’s doesn’t really matter if it’s morning or lunch as long as it’s part of your routine.
There’s no point really putting off taking them as they don’t start to work immediately. If you’re tracking bloods regularly you’ll see a difference but of course you’ll not know if that’s from the meds alone or a combo of factors.

Metformin can produce somewhat explosive side effects - it’s not nicknamed Metfartin for nothing after all - if it does, and you’ll certainly know if that’s the case, just mention it to the gp and ask for the modified release version. You don’t have to wait until you’ve finished a whole box before asking either.

 

[Derby Simon]

Welcome to the forum @Derby Simon

Good to hear you have decided to take a more focussed hands-on approach to your diabetes management. Hope you find sharing your experiences with the friendly folks on the forum helpful and encouraging.

I don’t take Metformin, but I understand from reading posts from many of our friendly T2 members that taking it in the middle of a fairly substantial meal can help reduce the gastric upheaval. Some seem to find it helps if the meal is both substantial and has a fairly low carb count.

It’s not at all uncommon for nurses and GPs to say that home monitoring of blood glucose is not necessary. I think the feeling is (and it is backed by some research) that many T2s find it inconvenient, painful, confusing, and even slightly demotivating.

My suspicion is that perhaps, “You don’t need to do that” is a safe shorthand. Those who really want to will carry on and do it anyway, while others who may be anxious and worried about things (who might also be the sorts of people to find seeing high levels to begin with worrying and concerning) will be reassured that it isn’t necessary for them.

Having said that, many many forum members and newcomers have found a BG meter to be an invaluable part of their self-management and motivation toolkit. Being able to see exactly how you respond to different sources, portion sizes and combinations of carbs (and other foods) can be a very direct way of adjusting your menu to make it more BG-friendly for you as an individual.

‘Eating to your meter’ can take a lot of the uncertainty out of the questions, “Can I eat that” and “Is x better for my blood glucose than y”

Thanks for your response which is one of many that has been useful for me to consider. I think having a glucose meter and getting some figures down for different times, 2 hours after a meal etc will be useful for me going forward. Only issue currently is the meter I purchased didnt come with a test solution so I am having to trust that the results are true otherwise its a bit pointless for me. I do have a sweet tooth and my meals are rather carb heavy but hopefully having a glucose meter may help me navigate those kind of issues in the coming weeks.

 

[Derby Simon]

The advice is to take it with food but it’s doesn’t really matter if it’s morning or lunch as long as it’s part of your routine.
There’s no point really putting off taking them as they don’t start to work immediately. If you’re tracking bloods regularly you’ll see a difference but of course you’ll not know if that’s from the meds alone or a combo of factors.

Metformin can produce somewhat explosive side effects - it’s not nicknamed Metfartin for nothing after all - if it does, and you’ll certainly know if that’s the case, just mention it to the gp and ask for the modified release version. You don’t have to wait until you’ve finished a whole box before asking either.

I like the term modified release version - is that an alternative name for sneaking out a fart! thanks for your warning - I note the pharmacy has included 2 different boxes with my prescription.

 

[rebrascora]

I like the term modified release version - is that an alternative name for sneaking out a fart!

HaHa! Not sure if you intended to joke or genuinely misunderstood, but the modified release version of Metformin has a special coating which helps to protect the digestive system from it's more inflammatory or explosive side effects.
Just to be clear..... with Metformin you can't always be sure it is just wind so do bear your circumstances/location in mind before you let rip..... or modified release ....as you might get more than you bargained for. 😱 Toilet is the safest place to release the pressure, at least in the first few days!

 

[ColinUK]

I like the term modified release version - is that an alternative name for sneaking out a fart! thanks for your warning - I note the pharmacy has included 2 different boxes with my prescription.

The pharmacy will not have given you a box of regular and of modified release at the same time because that’s not going to have been what you’ve been prescribed.
It’s probably just metformin from two different suppliers.

Modified release is more expensive hence why it’s not prescribed unless needed.

 

[Derby Simon]

The pharmacy will not have given you a box of regular and of modified release at the same time because that’s not going to have been what you’ve been prescribed.
It’s probably just metformin from two different suppliers.

Modified release is more expensive hence why it’s not prescribed unless needed.

Thanks for flagging this up to me Colin.

 

[Derby Simon]

HaHa! Not sure if you intended to joke or genuinely misunderstood, but the modified release version of Metformin has a special coating which helps to protect the digestive system from it's more inflammatory or explosive side effects.
Just to be clear..... with Metformin you can't always be sure it is just wind so do bear your circumstances/location in mind before you let rip..... or modified release ....as you might get more than you bargained for. 😱 Toilet is the safest place to release the pressure, at least in the first few days!

I am not going to fart anymore I am only going to do modified releases! having had salmonella and campylobacter at Christmas to be honest I am already careful when letting out modified releases!

 

[rebrascora]

I should clarify that of course my laughter is for the euphemism and not that you had an extremely bad stomach over Christmas. Blooming heck! That must have been tough! Great for losing some weight I imagine but I bet it makes the
harshest diet look like a walk in the park.

 

[harbottle]

Reading this reminds me of this song:

Warning: NOT SAFE FOR WORK OR MINORS due to lyrics.

I didn't have any of these issues with Metformin, thankfully.

 

[trophywench]

Simon - as Colin says, absolutely a price difference - but not like £1m a packet - we're talking under a £1 for normal Met and £2 or £3 ish for the 'slower release' one.