Just diagnosed with Type 2

[Lynne888]

Hello Everyone

My name is Steve, I'm 39 and have just been diagnosed with Type 2 diabetes with an Hbac1 level of 52. I am very overweight.

Since diagnosis two months ago I have lost two stone 2Ibs by making changes to my diet and cutting down certain things.

My GP gave me the chance to get the level down without any medication and I will go back again next month and hope its worked.

I know everybody is different but I was just wondering as a sort of rule of thumb what grams of sugar and carbs should I aim for in a day?

Also one of the things that's got me through my sweet cravings so far is diet or zero sugar drinks but I've seen somewhere the sweeteners in them are still bad. Should I avoid these too as I feel I’ll really struggle with that?l

I’m the same as you with Coke Zero. I rarely have hot drinks so it’s my drink of choice. I wouldn’t worry too much personally. There’s no sugar or carbs in it so that’s the least thing you need to be concerned about at the moment. I started having some flavoured water as a substitute for some of the cola. Just start small and substitute one drink a day and then maybe two.

 

[Steve1984]

I’m the same as you with Coke Zero. I rarely have hot drinks so it’s my drink of choice. I wouldn’t worry too much personally. There’s no sugar or carbs in it so that’s the least thing you need to be concerned about at the moment. I started having some flavoured water as a substitute for some of the cola. Just start small and substitute one drink a day and then maybe two.

Thanks for the advice Lynne. Have you tested your sugars after coke zero before does it tend to have little or no effect if so?

 

[Lynne888]

Thanks for the advice Lynne. Have you tested your sugars after coke zero before does it tend to have little or no effect if so?

Has no effect whatsoever Steve.

 

[Proud to be erratic]

My understanding is that some people have strong concerns over the artificial sweeteners that are added to various foods. Not just because they perpetuate the wider ranging concerns about the extent of processed food products, but some people simply can't tolerate some of the sweeteners.

Personally I am concerned about the extent of processed foods and while I recognise they can't be totally excluded because they bring some convenience to my lifestyle I try to stay with fresh foods where possible. But I don't seem to get any obvious reaction to artificial sweeteners. I drink a fair amount of no-carb flavoured water and heavily diluted no-carb squashes; I don't much like the taste of our tap water.

 

[Steve1984]

Hello Everyone

My name is Steve, I'm 39 and have just been diagnosed with Type 2 diabetes with an Hbac1 level of 52. I am very overweight.

Since diagnosis two months ago I have lost two stone 2Ibs by making changes to my diet and cutting down certain things.

My GP gave me the chance to get the level down without any medication and I will go back again next month and hope its worked.

I know everybody is different but I was just wondering as a sort of rule of thumb what grams of sugar and carbs should I aim for in a day?

Also one of the things that's got me through my sweet cravings so far is diet or zero sugar drinks but I've seen somewhere the sweeteners in them are still bad. Should I avoid these too as I feel ill really struggle with that?

I've read lots of different things and obviously it's all a bit overwhelming. I haven't been testing my blood levels myself as of yet and will have lots of questions when I go for my first official review next month.

I'm hoping the changes I've made already will help the level reduce and stop the need for any medication moving forward.

I also have hypertension and take 20mg of ramipril for that so really need to sort it all out!

Thanks in advance for any help

Steve

Hi guys further to the above I just wanted to ask for some more help/advice if you dont mind. I ordered a freestyle libre sensor after some great recommendations and have been monitoring after certain foods to see what affects my levels etc.

I can confirm diet drinks and a Sweetener in my coffee have little to no effect which I thought might be useful info to some. Also raspberries and Strawberries good when I need a sweet hit.

As I'm a complete novice with the numbers I was wondering if someone could help me interpret the data in a little more depth.

I've attached my time in range. Does this look fairly good for type 2?

I'm also averaging a mmol of 6.4. Is that a safe level for type 2? The highest I've been straight after eating dinner is 11.9 so far but I am always down to below 7.8 by the two hours after mark (so far).

As mentioned in my first ever post I've got until end of Feb to have made a difference for my doctor to keep me off medication. I have my review and blood tests then.

My hbac1 was 52 at my first blood test then 50 two weeks later I've since lost 2 stone 12 Ibs.

If I stayed at an average of 6.4 mmol is there a way of a calculated guess what my hbac1 may be when I go back?

I have noticed in the mornings I be around 8 but go down quite fast sometimes to a low level when I wake (around 3.8) so not sure what I can do to stop that.

Thanks in advance for any further support and guidance.

Steve

 

[Lucyr]

Does it give you a number on the estimated a1c tab of the libre?

 

[everydayupsanddowns]

Well done on your terrific weight loss @Steve1984

And those glucose levels look really good to me. General guidance for T2 is 4-7mmol/L before meals and back down below 8.5mmol/L by 2 hours after the first bite.

For T1 anything above 70% of the time between 4-10 is considered ‘excellent’ and would very likely be consistent with an HbA1c around 48mmol/mol.

It’s never straightforward to estimate HbA1c from average glucose (because the 2 numbers measure very different things), but some CGM apps offer a “GMI” (glucose management indicator).

If it offers any reassurance, my Dexcom 90-day average is 6.7mmol/L, and Dexcom’s estimate is an equivalent of approx 44mmol/mol or 6.2%

 

[Steve1984]

HI Lucy, not yet it still says not enough data but I've only had it on a week as I'm newly diagnosed. Not sure how long I'll need to wear one before that displays?

Does it give you a number on the estimated a1c tab of the libre?

 

[Steve1984]

Many thanks Mike. Yes I'm trying my very best as want the diagnosis to be a turning point in my life of all the things I kept putting off ie eating healthy, losing weight, drinking less alcohol etc.

Thanks for the info if I could go back to the docs and be in the pre diabetic hbac1 range I would feel like I'd really achieved something in the three months.

I complety understand it's impossible to say and everyone is different.

I'm slightly concerned that it fluctuates so much in the mornings before I've eaten anything. I can be 8.4 mmol and then ten minutes later 3.8 but as I'm just getting used to things and learning I don't know what is cause for alarm and what isn't.

I know blood pressure can change minute to minute so am just hoping its similar and no cause for alarm.

One good thing is I've noticed it does seem to come down quickly after eating ill spike maybe 30-45 mins after but after 90-120 mins I'm always down under 7.8 which hopefully shows my body is doing what it's supposed to?

Thanks

Well done on your terrific weight loss @Steve1984

And those glucose levels look really good to me. General guidance for T2 is 4-7mmol/L before meals and back down below 8.5mmol/L by 2 hours after the first bite.

For T1 anything above 70% of the time between 4-10 is considered ‘excellent’ and would very likely be consistent with an HbA1c around 48mmol/mol.

It’s never straightforward to estimate HbA1c from average glucose (because the 2 numbers measure very different things), but some CGM apps offer a “GMI” (glucose management indicator).

If it offers any reassurance, my Dexcom 90-day average is 6.7mmol/L, and Dexcom’s estimate is an equivalent of approx 44mmol/mol or 6.2%

 

[everydayupsanddowns]

I'm slightly concerned that it fluctuates so much in the mornings before I've eaten anything. I can be 8.4 mmol and then ten minutes later 3.8 but as I'm just getting used to things and learning I don't know what is cause for alarm and what isn't.

You might find these pages helpful in understanding the levels and variability you are seeing.

This thread features a report on glucose variation in healthy non-D people

https://forum.diabetes.org.uk/boards/threads/bg-profiles-in-healthy-non-diabetics.99521/

And this outlines some precautions it can be worth considering when CGM data seems a bit ‘off’.

CGM limitations and precautions

Moderator Note: This helpful reply was copied from another thread as it details some of the commonly experienced limitations of continuous glucose sensors. My blood sugar has been in perfect range for days now, but although I haven't changed anything, I'm starting to get very short periods of...

forum.diabetes.org.uk

Personally I find keeping well hydrated, and being cautious about sensor compression (especially overnight) are two of the most important things for me.

 

[rebrascora]

Well done on your fantastic weight loss and the great reading you are getting on the Libre.
If you are not on any medication then levels below 4 are not a concern and for many of us, Libre reads a bit lower than actual BG so a 3.8 might actually be nearer 4.8. If these sudden drops in reading occur whilst you are still in bed, it is important to know that Libre is prone to what we call compression lows. Basically, if you apply pressure to the sensor like lying on it, the sensor compresses the tissue underneath it that the filament is monitoring and that causes the sensor to register a false low. It happens mostly in bed, but could also happen if you leaned heavily against a door jamb for a while or other similar situation, or if you were to wear an arm strap that was too tight. So if you get any unusual lows usually where levels drop suddenly and then bounce back up to their previous level, particularly during the night, or if you wake up with the low alarm going off and you are lying on that side, that will likely be the cause. Just something to keep in mind, but it is not unusual for non diabetic people; 's levels to drop below 4 occasionally, particularly during the depths of their sleep. The only reason those of us on insulin or BG lowering medication like Gliclazide take action when our levels drop below 4 is
a) to prevent them dropping dangerously low (below 3.5) because we took too much medication or
b) to preserve our hypo awareness which is our safety net to warn us when our levels are getting a bit low BEFORE they get dangerously low.

If you are not on medication like that, then your liver will usually release glucose to rebalance your levels, so being between 3.5 and 4 should not be a problem, but if you are only going off Libre and not double checking sub 4 readings with a finger prick I would suggest it is likely that Libre is exaggerating and you are likely not quite that low.

 

[Steve1984]

Well done on your fantastic weight loss and the great reading you are getting on the Libre.
If you are not on any medication then levels below 4 are not a concern and for many of us, Libre reads a bit lower than actual BG so a 3.8 might actually be nearer 4.8. If these sudden drops in reading occur whilst you are still in bed, it is important to know that Libre is prone to what we call compression lows. Basically, if you apply pressure to the sensor like lying on it, the sensor compresses the tissue underneath it that the filament is monitoring and that causes the sensor to register a false low. It happens mostly in bed, but could also happen if you leaned heavily against a door jamb for a while or other similar situation, or if you were to wear an arm strap that was too tight. So if you get any unusual lows usually where levels drop suddenly and then bounce back up to their previous level, particularly during the night, or if you wake up with the low alarm going off and you are lying on that side, that will likely be the cause. Just something to keep in mind, but it is not unusual for non diabetic people; 's levels to drop below 4 occasionally, particularly during the depths of their sleep. The only reason those of us on insulin or BG lowering medication like Gliclazide take action when our levels drop below 4 is
a) to prevent them dropping dangerously low (below 3.5) because we took too much medication or
b) to preserve our hypo awareness which is our safety net to warn us when our levels are getting a bit low BEFORE they get dangerously low.

If you are not on medication like that, then your liver will usually release glucose to rebalance your levels, so being between 3.5 and 4 should not be a problem, but if you are only going off Libre and not double checking sub 4 readings with a finger prick I would suggest it is likely that Libre is exaggerating and you are likely not quite that low.

Thanks Barbara that could be it then as I do sleep on the side I've put the sensor on this time as didn't think of that . I suppose I'll only find out for sure when I go for the hbac1 test at the end of the month so I'll keep my fingers crossed.

 

[Steve1984]

Also I've seen the ranges that the mmol should be when fasting and also 2 hours post-prandial and the ranges for diagnosing but is there a sort of good range it should stay in. I know on the monitor that's between 3.9-10 which is the target range but would there be a perfect level as such. For example sometimes I sit at 6.4 sometimes 7.9 etc? Or is it OK as long as in the target range?

 

[Lucyr]

HI Lucy, not yet it still says not enough data but I've only had it on a week as I'm newly diagnosed. Not sure how long I'll need to wear one before that displays?

Ah that should turn up soon but this is the formula the libre website says it uses

The formula is based on the published reference, which compared average Sensor glucose and laboratory-measured A1c:
A1c% = (Avg SGmmol/L + 2.59)/1.59

So your 6.4 mmol average bg would be an estimated a1c of 5.7% or 39 mmol/mol, if you kept the average at 6.4 over 3 months

 

[Steve1984]

Ah that should turn up soon but this is the formula the libre website says it uses

The formula is based on the published reference, which compared average Sensor glucose and laboratory-measured A1c:
A1c% = (Avg SGmmol/L + 2.59)/1.59

So your 6.4 mmol average bg would be an estimated a1c of 5.7% or 39 mmol/mol, if you kept the average at 6.4 over 3 months

Thanks Lucy that's really helpful. I hope 39mmol is correct that would be great news for my next review but understand its only a loose calculation

 

[Leadinglights]

Thanks Lucy that's really helpful. I hope 39mmol is correct that would be great news for my next review but understand its only a loose calculation

The general guidance is that if your levels when testing with a monitor are consistently between 4-7mmol/l before meals and fasting and less than 8mmol/l 2hours post meals then you would expect a normal Hba1C i.e. below 42mmol/mol, that is for the 3 months prior to the test.

 

[Jinty2001]

@Steve1984 well done on your fantastic weight loss. I’ve did it without medication. Your doctor can give you a referral to either SlimmingWorld or WeightWatchers if you feel you need further support. Using the foods on the learning zone on diabetes UK is a good guide combined with an eating plan from one of the clubs and the support of other members Is a great help. You get 12 weeks free and you have to lose 5% of your bodyweight to get another free 12 weeks should you choose to go that route. Keep up the good work!

 

[Steve1984]

@Steve1984 well done on your fantastic weight loss. I’ve did it without medication. Your doctor can give you a referral to either SlimmingWorld or WeightWatchers if you feel you need further support. Using the foods on the learning zone on diabetes UK is a good guide combined with an eating plan from one of the clubs and the support of other members Is a great help. You get 12 weeks free and you have to lose 5% of your bodyweight to get another free 12 weeks should you choose to go that route. Keep up the good work!

Thanks Jinty yes all without medication so far. Diagnosis was the kick up the backside I needed (to put it in polite terms)

 

[Steve1984]

The general guidance is that if your levels when testing with a monitor are consistently between 4-7mmol/l before meals and fasting and less than 8mmol/l 2hours post meals then you would expect a normal Hba1C i.e. below 42mmol/mol, that is for the 3 months prior to the test.

I seem to be averaging about 7mmol now I've been wearing the monitor a bit longer so appear to be at the higher end but I am normally down below 8mmol 2 hours post meals. Does this suggest I will be in the pre diabetic range hbac1 wise?

 

[Leadinglights]

I seem to be averaging about 7mmol now I've been wearing the monitor a bit longer so appear to be at the higher end but I am normally down below 8mmol 2 hours post meals. Does this suggest I will be in the pre diabetic range hbac1 wise?

It would need to be about that for most of the 3 months before your test. If the early weeks in that three month period were very high, they would need to drop off the time period otherwise it will push the average up, however I believe the test result goes through some sort of algorithm which weights the test to the more recent weeks. Don't second guess just wait for your result.