Hi Everyone, nice to be part of this

[Dinah Dyer]

Hi, I have had type 2 diabetes for about 8 years now, sudden onset in a few months. My hba1c was in the 30s and 6 months later it was 58. I'm a nurse so felt ashamed that i was 2 stone overweight and had bern dieting for years which may have caused it. I'm adopted so have no family background. I also have a mental health condition that causes me to be impulsive and quite obsessive too which doesn't help. 8 years later I'm on tresiba insulin 68 a day plus 2 gliclazide tablets and 2 metformin. I really have to get a handle on this as my recent hba1c was 77, it had increased since starting tresiba.
I have been on sick leave for 8months with stress and have decided to give up work to concentrate on my health. I'm looking at a new meal plan for the new year. I really don't like eggs for breakfast so think I will stick to porridge. I have had wholemeal toast today which always makes me feel sluggish. I think I'm in denial with my head in the sand . I would be really grateful for any suggestions . Apologies for the long post x

 

[Lily123]

Welcome to the forum @Dinah Dyer.What range of numbers are you getting before meals?

 

[Inka]

Welcome @Dinah Dyer 🙂 The first thing to ask is whether you test your blood sugar at home? That’s crucial if you want to get on top of things, as it will show you what foods/meals work for you.
Generally Type 2s have to watch the amount of carbs they eat. You say you felt sluggish after your toast. That could be high blood sugar or something else. Having a meter and testing will give you the answer.

As you’re on insulin, you shouldn’t make drastic cuts to your carbs without help.

 

[rebrascora]

Hi and welcome.

No apologies needed for long post. The more info you give us the better we can understand your situation and make more appropriate comments.
If you are on insulin then you will have a BG meter. What sort of readings are you getting and when do you test? Personally I think your insulin regime is not helpful to your situation. Tresiba is a long acting basal insulin and is not capable of dealing with the carbs from food. It is meant to be used in conjunction with a bolus insulin to deal with the glucose release from the food you eat. It looks like they are expecting the Gliclazide to stimulate your pancreas to cover your food but from your HbA1c something isn't working!

From a practical point of view, eating lower carb will give your Tresiba a better chance of coping.
Many of us find that porridge isn't a good breakfast choice but you could do some testing to see how your body responds, taking a reading immediately before eating and then 2 hours afterwards. Make sure to weigh your porridge oats and keep anything else you add the same so that you can test it for a few days and see what happens and hopefully get reproduceable results over a few days..... We always suggest at least 2 days of tests on any individual food before drawing any conclusions about a meal response, because too many other factors can affect BG levels. If you are seeing a rise in BG of more than 3mmols 2hrs after the meal then you ate too many carbs and need to reduce your portion size of porridge oats (which is where weighing accurately becomes important) and test again for another 2-3 days and if necessary, reduce portion size again or if still too much of a spike in BG then discard porridge and try something else.
Many of us like to start the day with full fat Greek style natural yoghurt with a few berries (rasps, blackberries, blueberries, blackcurrants etc) and mixed seeds and chopped nuts.
What many of us have found is that the low fat advice we have been following for years hasn't been helpful for losing weight and in fact the reduced fat has caused us to feel hungry which has made dieting difficult. Eating full fat products like blue top milk and creamy yoghurt and cheese and nuts, and less carbs has stopped the carvings and eating compulsion and we feel more satisfied. This is because fat takes longer to digest and provides slow release energy. I now have double cream in my morning coffee which I really love and that helps to sustain me throughout the day without needing carbs every few hours. I have struggled with comfort eating for many years, but I really love the control that Low Carb higher fat way of eating gives me, because I don't get those gnawing cravings that were so difficult to cope with.
Best of all, I feel fitter and healthier and slimmer than I have in years and my cholesterol levels very surprisingly are consistently reducing despite eating a lot more fat and most of it saturated.

Anyway, that would be my strategy for getting started and sorting out a good breakfast option for you could make a dramatic impact on your levels because we are most insulin resistant on a morning, so finding a breakfast which doesn't send your BG levels into orbit at the start of the day, gives you a better chance of keeping them in range during the rest of the day.

 

[Dinah Dyer]

Welcome to the forum @Dinah Dyer.What range of numbers are you getting before meals?

Hi, I'm only doing a morning fasting blood sugar at the moment but next week I have been asked to do before and after each meal as well and then contact my diabetic nurse. Thanks for your support and I will update with some readings next week

Welcome @Dinah Dyer 🙂 The first thing to ask is whether you test your blood sugar at home? That’s crucial if you want to get on top of things, as it will show you what foods/meals work for you.
Generally Type 2s have to watch the amount of carbs they eat. You say you felt sluggish after your toast. That could be high blood sugar or something else. Having a meter and testing will give you the answer.

As you’re on insulin, you shouldn’t make drastic cuts to your carbs without help.

 

[Dinah Dyer]

Hi, I'm only doing a morning fasting blood sugar at the moment but next week I have been asked to do before and after each meal as well and then contact my diabetic nurse. Thanks for your support and I will update with some readings next week

Hi and welcome.

No apologies needed for long post. The more info you give us the better we can understand your situation and make more appropriate comments.
If you are on insulin then you will have a BG meter. What sort of readings are you getting and when do you test? Personally I think your insulin regime is not helpful to your situation. Tresiba is a long acting basal insulin and is not capable of dealing with the carbs from food. It is meant to be used in conjunction with a bolus insulin to deal with the glucose release from the food you eat. It looks like they are expecting the Gliclazide to stimulate your pancreas to cover your food but from your HbA1c something isn't working!

From a practical point of view, eating lower carb will give your Tresiba a better chance of coping.
Many of us find that porridge isn't a good breakfast choice but you could do some testing to see how your body responds, taking a reading immediately before eating and then 2 hours afterwards. Make sure to weigh your porridge oats and keep anything else you add the same so that you can test it for a few days and see what happens and hopefully get reproduceable results over a few days..... We always suggest at least 2 days of tests on any individual food before drawing any conclusions about a meal response, because too many other factors can affect BG levels. If you are seeing a rise in BG of more than 3mmols 2hrs after the meal then you ate too many carbs and need to reduce your portion size of porridge oats (which is where weighing accurately becomes important) and test again for another 2-3 days and if necessary, reduce portion size again or if still too much of a spike in BG then discard porridge and try something else.
Many of us like to start the day with full fat Greek style natural yoghurt with a few berries (rasps, blackberries, blueberries, blackcurrants etc) and mixed seeds and chopped nuts.
What many of us have found is that the low fat advice we have been following for years hasn't been helpful for losing weight and in fact the reduced fat has caused us to feel hungry which has made dieting difficult. Eating full fat products like blue top milk and creamy yoghurt and cheese and nuts, and less carbs has stopped the carvings and eating compulsion and we feel more satisfied. This is because fat takes longer to digest and provides slow release energy. I now have double cream in my morning coffee which I really love and that helps to sustain me throughout the day without needing carbs every few hours. I have struggled with comfort eating for many years, but I really love the control that Low Carb higher fat way of eating gives me, because I don't get those gnawing cravings that were so difficult to cope with.
Best of all, I feel fitter and healthier and slimmer than I have in years and my cholesterol levels very surprisingly are consistently reducing despite eating a lot more fat and most of it saturated.

Anyway, that would be my strategy for getting started and sorting out a good breakfast option for you could make a dramatic impact on your levels because we are most insulin resistant on a morning, so finding a breakfast which doesn't send your BG levels into orbit at the start of the day, gives you a better chance of keeping them in range during the rest of the day.

Hi and thanks so much for your help and detailed reply. My diabetic nurse has asked me to do a full week of readings fasting and before and after meals next week so hopefully this will tell us more. I was having full fat yoghurt, nuts and raspberry for a couple of years so could definitely go back to that. I need to start anew and not go back to 'dieting' as it just messes with my mental health. I will have a good think about your suggestions and get back to you next week. Thanks and take care

 

[Dinah Dyer]

Welcome @Dinah Dyer 🙂 The first thing to ask is whether you test your blood sugar at home? That’s crucial if you want to get on top of things, as it will show you what foods/meals work for you.
Generally Type 2s have to watch the amount of carbs they eat. You say you felt sluggish after your toast. That could be high blood sugar or something else. Having a meter and testing will give you the answer.

As you’re on insulin, you shouldn’t make drastic cuts to your carbs without help.

Thanks so much for your reply and advice, I'm going to be doing a full week of testing before and after meals next week and will hopefully know more after that. I have had a few hypos and thought they were due to Tresiba but my nurse says much more likely to be gliclazide causing this. My appetite is low but I can tend to comfort eat. I made a big batch of veg soup today do that's a good base for me. Thanks so much and I will post more next week.

 

[Alan S]

Hi, I have had type 2 diabetes for about 8 years now, sudden onset in a few months. My hba1c was in the 30s and 6 months later it was 58. I'm a nurse so felt ashamed that i was 2 stone overweight and had bern dieting for years which may have caused it. I'm adopted so have no family background. I also have a mental health condition that causes me to be impulsive and quite obsessive too which doesn't help. 8 years later I'm on tresiba insulin 68 a day plus 2 gliclazide tablets and 2 metformin. I really have to get a handle on this as my recent hba1c was 77, it had increased since starting tresiba.
I have been on sick leave for 8months with stress and have decided to give up work to concentrate on my health. I'm looking at a new meal plan for the new year. I really don't like eggs for breakfast so think I will stick to porridge. I have had wholemeal toast today which always makes me feel sluggish. I think I'm in denial with my head in the sand . I would be really grateful for any suggestions . Apologies for the long post x

Your meter can be used to guide you to a better way of eating for healthy blood glucose levels. I suspect you will no longer be eating porridge or much toast or other breads at breakfast after you see the effects on your blood glucose an hour after your last swallow.

I used this technique. Start with whatever you eat now.

Eat, then test after eating at your spike time and if BG’s are too high then review what you ate and change the menu next time. Then do that again, and again, and again until what you eat doesn’t spike you. You will get some surprises, particularly at breakfast time. The so-called "heart-healthy" breakfasts are NOT for most type 2's. Similarly, you will find variations through the day - the same thing will have different effects at breakfast, lunch, dinner and supper. But I can't say how they will affect others - only how it affected me - which is why we all need to test ourselves.

As you gradually improve your blood glucose levels, review the resulting way of eating to ensure adequate nutrition, fibre etc are included and adjust accordingly.

Then test again.

Test, review, adjust, always towards better and better blood glucose levels.

One word of caution if you decide to give that a try. It works, but as you are using tresiba and gliclazide you should not make drastic changes to the menu. Modest changes made consistently will still work without risking hypos. You should discuss reducing insulin or meds with your doctor as you reduce the carbs. It works most efficiently if you do a little extra testing to discover when the peak occurs after meals and use that timing. If you are not sure use one hour after your last bite until you discover your peak.

And no - you won't have to test so intensively for the rest of your life. As time goes on and you build your knowledge you won't need to test as often because many of your results will become predictable as your numbers improve. You will be building your own personal Glycemic Load database. As that happens you can reduce the intensive testing to "maintenance" levels. I still do two or three fasting tests and several one-hour post-prandial tests randomly each week. Just to be sure that things aren't changing. I may do a few more if I am adding a new dish to the menu or trying a new restaurant. But I no longer need to test after every meal or snack.