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M1cr0ft

M1cr0ft

New Member
Relationship to Diabetes
Type 2
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He/Him
I've just been diagnosed with Type 2, and as most of you new people know, it's quite overwhelming and confusing.

My doctor didn't give me any information, just sent me on my way, which made being diabetic even more scary and making me feel very alone, which I now know I'm not.

My initial reading was hbA1c at 110 mmol/mol. I think that translated to around 12.x or 14.x mmol/L. and my Ketone was 0.2. I was told I didn't need a glucose monitor. I bought one (a duel one) anyway, or how would I know what my levels are without waiting weeks for blood tests, especially if mine is so high and severe? I also have hypertension and elevated cholesterol. I must add that over the years, I have had no symptoms what-so-ever, unless they crept up on me and I just didn't notice. It looks like Ive had it for at least 10 years, with no treatment.

So, today...5 days later, my levels are 7.4 and ketone 0.1. So I think this is a good start? But boy am I hungry. I've no idea about portions or snacks. I did have a snack of a banana and peanut butter, and that seemed to help, another night I had Rivita, with peanut butter and banana, but my issue, what time can we eat up to? I've read no later than 6 or 7pm, another said between 8 and 9pm, so I am confused about what food to eat and when. Ive gone from 1 meal a day (with snacks) to a small breakfast, a tiny lunch and a few sandwiches for dinner. I've researched a lot and different websites seem to contradict each other. I (being dyslexic) get confused about all the proteins, carbs, fats etc. But what confuses me the most if the description on my medication. It states:

medsx.jpg


This confuses me to no end. I was back at the doctors this morning for another blood test, the nurse couldn't make sense of it either and the doctor that issued it wasn't in today She showed it around and other nurses and even a doctor, pulled confused faces reading it. If they're confused, that leaves me stuck as it reads like an internet puzzle.

I read this as take one for the first week. Then increase to 2 every 3 days, probably for a week, then 2 every day afterwards. I really don't want to take the wrong dosage.

Lastly, I read that you can't really take paracetamol, unless it's sugar free. I usually take 4 at a time within 6 hours if I have a headache. I also read that ibuprofen is good, but as I was fasting this morning, I have a headache and didn't want to take them on an empty stomach. Are these safe to have as a diabetic.

Please move this post if it's in the wrong place. But it's nice to be here amongst fellow diabetics.

Thanks, and I hope everyone has a good and safe diabetic journey.

Mike.
 
Welcome to the forum
There seems to be some confusing information on your medication. The tablets are slow/modified release so they release the active ingredient slowly and that is supposed to minimise stomach issues that some people get which is also why they are introduced slowly by increasing the dose over weeks but in any event people find they are better taken with food even mid meal to minimise the side effects. That said many cope with them perfectly well.
However it is also needed to make some changes to your diet as the meds alone will not be sufficient. You are starting with quite a high HbA1C so there is a long way to go, don't try to make conversion from HbA1C to the readings on your monitor as they measure something different. The monitor readings are a moment in time and are influenced mostly by what you eat. The correlation is only that the higher your HbA1C is the higher your monitor readings will be.
Have a look at this link for some ways of modifying your diet. https://lowcarbfreshwell.com/
Having filling meals is better than snacking on high carb foods.
 
Welcome @M1cr0ft 🙂 Unless you’ve been told otherwise because of your meds, I can’t see any reason why you can’t take paracetamol. Certainly being diabetic in and of itself wouldn’t mean you had to avoid them.

On to your medicine label, which is severely lacking in punctuation - hence the problem. I read it as:

Take one tablet a day for one week
Then take 2 tablets a day, one tablet 30mins before breakfast and the other tablet 30 mins before evening meal
After 3 days of the above 2 tablet regime, add another tablet to your breakfast OR evening meal dose so you’re now taking 3 tablets a day
Then after another 3 days, add another tablet to your breakfast or evening meal dose so that you’re now taking two tablets twice a day - a total of 4 tablets per day
 
Hi Mike,

Welcome to the Forum.

I agree the wording is confusing, I always take my tablets either with or just after a meal.

I have three meals a day, I think it is a case of picking the right meals for you and your blood sugar levels.

I take Paracetamol and Codeine at the moment, as I am in Hospital recovering from a Spinal operation with no issues.

Have you looked on the Diabetes UK website to see if there is a support group near you.

Regards.


Tim.
 
Hi and welcome from me too.

I agree with @Inka's interpretation of your instructions. Metformin are generally taken with or just after food to prevent digestive upset, but perhaps the MR (modified release) version can be taken before food. Personally I would play it safe and take it with or after food anyway. I wonder if the "before" breakfast and evening meal was a mistake and should have been "after".

As regards Paracetamol, I take cheap Lidl version occasionally and have no problem as regards BG (Blood Glucose) levels. If they do contain sugar, it will only be a very tiny amount and certainly significantly less than the amount of sugar in a banana, which is one of the fruits we generally suggest people are wary of, at least until they have tested to see how their body reacts. Bananas are one of the highest carb fruits.

There is no reason why you should go hungry even on a low carb diet but you have to learn which foods are high carb and which are lower and use your BG meter to test your body's response to foods by testing just before eating a meal/food and then 2 hours later. You are looking for a rise of no more than 2-3mmols which will tell you that your body coped with the amount of carbs in that meal. If it rises by more than 3mmols, then look at reducing the carb rich elements of the meal and adding more low carb alternatives.
Just to clarify, the 3 macro nutrients are protein, fat and carbohydrate. The latter consists of both simple sugars and more complex carbs like starches..... bread pasta, rice, potatoes, couscous, breakfast cereals etc even porridge which is often recommended for diabetics, is a high carb food and will significantly spike some people's BG levels but for others, it lives up to it's slow release reputation, so testing really is key to see how YOUR individual body responds.
There is also fibre to consider which is not a nutrient as such, because it doesn't provide nutrients to the body but it is important for gut and bowel health. I found that when I went low carb, and stopped eating wholemeal grains (grains are all high in carbohydrates), I lost a lot of the fibre from my diet and I needed to find alternative sources. I eat more seeds and veggies but I also use chia seeds and psyllium husk as additional supplements to my daily diet to provide soluble fibre and keep my gut happy....soluble fibre is also important for managing cholesterol.

Gradually you learn to recognise high carb foods and get into a routine of buying, cooking and eating lower carb alternatives, but it takes time to find a basic diet which works for you and then start to experiment to find new and interesting ways to cook and incorporate veggies into your meals. Bread was probably the hardest thing to turn my back on because it is so convenient and a carrier for so many foods and culturally, it is a staple part of our diet, but I no longer find it difficult to live without bread and I have become more inventive of different ways to serve food where I would have previously used it.

If you want suggestions for low carb options for breakfast, lunch and evening meals, just ask. We all have different tastes but I am sure you will be able to pick and choose from whatever suggestions we give you. Personally I found it easiest to just swap carb rich foods for lower carb alternatives but still have similar meals a lot of the time, rather than find new menus and recipes. I have plenty of low carb treats that I can dip into when I feel hungry but cutting carbs and eating more fat, protein and fibre has meant that I am actually rarely hungry, which was surprising because before diagnosis I was always hungry and 2 hours after a meal, I would be wanting a snack. I now know that this was because my BG levels were spiking and dropping. If I can keep my levels more stable with protein and fat which release over 2-10 hours after eating, rather than carbs which release within 2 hours of eating, I can often get away with just 2 meals a day, breakfast and evening meal, simply because I am not hungry in between.

As regards what time to eat, there are no hard and fast rules, but it is better to eat a while before you go to bed and ideally get active after your meals as this helps to burn the glucose released by the food. Some people find intermittent fasting helps, so keeping their meals within an 8 hour window during the day and fasting for 16hrs.but it isn't necessary to get good results for most people. Having a good testing strategy is what you need in order to figure out your own unique diet which caters to your diabetes and your tastes..... although there is often some modification of the latter needed because many of us have become far to attracted to sweetness in food, even savoury meals.
 
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The medication label is rubbish, slow release can just be taken once a day and don’t need to be a certain time of day. I take 2000 (4 of your tablets but 2 of mine as they’re twice the size) all at once at some point in the evening.

Basically take 1 a day for a bit, then 2 a day, then 3 (total per day) then 4. Wait a few days between each dose increase to make sure you feel ok and no side effects. If you get side effects give it longer between increasing the dose.
 
Hi @M1cr0ft

The explanation from @Inka seems the correct one to me. If you count the total quantity of tablets you were prescribed this may help to confirm it. Personally, I was started on 500mg once per day and I'm currently on 2000mg per day, half at breakfast and half at my evening meal time. I believe 2000mg per day is a typical 'high' daily dose for Metformin.

The reason Metformin is started on a low dose and increased slowly is to minimize side effects, the main ones being nausea and other stomach upsets. I was instructed to take the tablet with or immediately after food, so that's what I do, but again, taking it with food is all about minimizing early side effects.

As regards snacks, eating hours and mealtimes you'll find a huge variety of opinions and approaches to diet online. My personal approach has been to eat 3 meals per day with no snacks, and eliminating foods and meals that are particularly high in carbohydrates. I've eliminated bananas and tropical fruit like pineapple for example because they have so much sugar in them compared to other fruit. Berries are particularly good compared to bananas, when eaten in moderation.

Best of luck
 
M1cr0ft said:
I was told I didn't need a glucose monitor. I bought one (a duel one) anyway, or how would I know what my levels are without waiting weeks for blood tests, especially if mine is so high and severe?
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You wouldn't know. I, like you, got my own blood glucose monitor and even then was told I don't need to test as I am not at risk of hypos (low blood sugars) despite my making it clear it was to check my progress on reducing my high blood sugar. I found it invaluable in bringing down my HBA1c from well over a hundred to within the normal range so I think you were wise to get a monitor.
 
Welcome to the forum @M1cr0ft

Sorry to hear about your diagnosis. Have you seen earlier blood results that suggest your glucose levels were in the ‘diabetes’ range for all those years? A bit shocking that you were never told!

Hope that slowly building up the tablets over a number of weeks means you escape any stomach upset.

I hope you are able to find a way of eating that is satisfying, varied, flexible, interesting and affordable enough for you to maintain it long-term. And also one that you can tailor to give you the glucose results you are happy with.

Let us know how you get on.

One of our members @Docb may be able to give you some pointers about carer support and resources too.
 
Hi @M1cr0ft and welcome from me. Like you I am a CWD (carer with diabetes) and yes at times it can be a bit tricky balancing carer duties with the need to keep on top of your diabetes. Are you registered as your mum's carer? If so, what are carer services like in your area?
 
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