It's been a struggle

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wildmonk

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Relationship to Diabetes
Type 2
Hi Everyone, I was diagnosed with type 2 diabetes in mid January 21, my HbA1c was 68, my fasting glucose was 18.9 so not very good. It came as a bit of a shock although I had an inkling that something was wrong for a while. I'd put on around a stone and a half over 10 years taking me to 16 stone even though I was active and fit teaching and training in martial arts 7 days a week 3-5 hours a day, although the rest of my day could get very sedentary running my business and home-schooling my eldest and my meals were (although mostly good) sporadic and with late night binges... wine also became a stress reliever but I was still taking in far less calories than I was expending (I had between 1200-3000 calories per day but was using between 3000-5000). Ultimately I was working 14 hour days and not looking out for myself the way I should at 50 years old.

So I was put on metformin 500mg 1 tablet twice per day and told (this is literal) to eat less and exercise more and we'll have another blood test in 3 - 4 months. I immediately cut out all sugars and processed food which wasn't a big deal because my diet didn't have much of it in anyway (apart from the binges). I suffered from lack of energy which was a problem with my work so was told by my doctor to eat more carbs (although he couldn't tell me how many), so that's what I did through steel cut oats and fruit. I was taking in 100 - 200g of carbs, 70 - 80gs of fat and 90 - 120g protein and between 1600 and 2200 calories. I was still tired and my mood was affected, I was checking my blood sugar as of February (although my doctor didn't want me to) which was always around 11 - 13 through February and March and when I mentioned this to my doctor I was told to wait for my next blood test, it then went up to 15 - 18 all through April, I also lost 3 stone in this time without any good reason, I was worried but my doctor again fobbed it off as a good thing that I was losing the weight even if it was so quickly. I also started to cut down on carbs through April and increase fat: Carbs 60-90g, fat 100-120g protein 100-120g.

Sorry this long winded... so at the end of April feeling ill for a while and not being able to speak to my doctor for another week I phoned 111 and went to A&E with Blood sugar of 15.5 and ketones 2.9, I was dehydrated so was given fluids and sent home because other than the above I wasn't dying. When I did manage to speak to my doctor I was put onto a higher dose of metformin 500mg 2 x 2 per day. After 5 days I hadn't had any changes to my blood sugar and was then put onto Jardiance which had an immediate effect of dropping my blood sugar to a range of between 6 to 8. And so from May, through June and July my diet was: carbs 40-60g, fats 100-130g and protein 100-130g and I have felt a lot better, although it did take until the end of July before I started to feel anything like I did before my diagnosis. Unfortunately I seem unable to have more than 20 - 30g carbs per meal, only 20g of wholemeal bread, or some fruit affects me negatively, I also only really feel normal when I haven't eaten for a while. My blood sugar in the mornings is always high 7 - 9 (even though this is when I feel the best) but tends to be lower 2 hours after breakfast (even though I will sometimes feel wiped out after it). My blood test on 21st of July 21 came back with a HbA1c of 51, so much better even if I still don't feel very good.

Last week I paid to see a diabetic specialist to see if I could get some of the questions that I have answered, questions that my doctor just ignored or fobbed off and so I'm having more blood tests to see if I'm producing enough insulin, which is where I am today. My Blood sugar is still too high and my ketones are quite high too.
The specialist took me off of Jardiance due to my low carb diet and the risk of ketoacidosis and my blood sugar immediately jumped to 9-12 the next day and so I am now starting on Gliclazide 40mg 1 tablet per day, (my first day today so will see how it goes).

Beyond that I'm waiting on the test results and checking my blood sugar more regularly to see what foods affect me and if my exercise regime is affecting my blood sugar.

I'm a pretty positive person and my aim is to beat this (if I can) or have it as a part of my life that I can control a little better, so I guess my questions to you wonderful people are: is my story normal? Are these the kinds of struggles most of you have gone through and what worked for you?
 
Although I know I am more sensitive to carbs than most, I'd be advising to go for lower carb foods, as bread and fruit are a high carb option and they are digested so quickly and cause a spike in levels. The drop after a spike can certainly leave you feeling shattered.
As you are taking Gliclazide you will not be able to go as low carb as some, as you will need to have some carbs spread through the day or you might go hypo, but a wide variety of low carb foods might be more easily managed than small amounts of higher carbs more frequently.
 
Welcome to the forum @wildmonk

Sorry to read of the difficulties that you have had, but well done on achieving the reduction in your HbA1c.
I hope that the changes that you have made to your medications will help you to continue to reduce your levels.

From reading your account I am assuming that you have a Blood Glucose meter to use at home . If so this can give you the chance to find out how you react to specific carbs. We all react in different ways to certain foods, and by testing both before and again 2 hours after a meal you can find find out hiw much your glucose levels change. This can then help you to make swaps to lower carb option and/or reduce portion sizes, although these decisions need to be made in the light of your medications.

Keep in touch and let us know of your further progress.
 
The high ketone results you’re seeing are perhaps because of your very low carb diet rather than anything to worry about. Your bg levels are slightly high at 9-12 but would usually be much higher with keto acidosis (though some medications like empagliflozin can cause this with normal bgs). If you would prefer not to have ketones, increasing your carb intake and drinking more water would likely flush them out.
 
Hi wildmonk, welcome to the forum.

Well done on the progress you've made so far, it's not easy to get your head around things at the beginning but you'll get there.

As you can se, there are many approaches to managing diabetes as there are a number of contributing factors to our BG levels.

It might be worth keeping an honest food diary for a week including any medications you take plus your BG readings when you wake up and 2 hours after each meal. Then you can assess the impact your meals are having on you and what the correct approach may be.

It's an ongoing journey which may take to time to get adjusted to but it's a matter of course correcting as you go instead of striving for perfection.

We've got lots of info on the site so do ask as many questions as you'd like and let us know if we can help in any way.
 
Thank you everyone for the advice, it certainly helps to have the input to help make more sense of what's happening. I have just convinced my doctor to allow me to have the test strips on prescription so I will be testing more often and I have a linked food diary. I will stick to the low carb, I also need to see the impact of my teaching/exercise on my blood sugar as I suspect it may not be helping. Do any of you find that eating late 21:00 - 22:00 o'clock gives you high blood sugar in the mornings? Or do you stop eating earlier? I have the problem of working from 16:30 - 21:00 and struggle to eat enough before this time.
 
Do any of you find that eating late 21:00 - 22:00 o'clock gives you high blood sugar in the mornings? Or do you stop eating earlier? I have the problem of working from 16:30 - 21:00 and struggle to eat enough before this time.

Things can vary a lot from person to person. Some people find eating late actually helps keep their liver happy overnight, so that they experience less ‘dawn phenomenon’ (where the liver releases glucose in the early hours to prepare the body to take on the day).

Others find intermittent fasting, or limited-time eating (eg just 1 or 2 meals per day with long gaps).

Still others find their metabolisms much prefer a little-and-often ‘grazing’ approach.

There’s no one size fits all method that works for everyone. Diabetes is too fickle and annoying for that. But it sounds like you have an enquiring mind and a systematic approach to try to work out and tweak your strategies as you go along.

Hope you can find a range of options that work well for you 🙂
 
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