Moderation

[Ccash]

Hi,

I was diagnosed type 2 earlier this year with an hba1c of 48 (so only just in range). I followed a strict low carb diet for 6 months, lost a stone in weight and got my hba1c down to 38 so really happy.

I have had a a couple of people in my life express concern that my eating had become disordered or express concern about my weightless. My BMI is 19 and I had already come to the conclusion I didn't want to lose any more weight. My cholestrol had gone up ever so slightly, still below 5.

I am now wanting to relax my eating a little to prevent further weightless and to avoid my cholestrol continuing to go up. I am reminding myself regularly that the odd high blood sugar reading is not a problem, it is persistently high sugars that lean to complications. How much time in a day should I be aiming for my blood sugars to be in a normal range to remain at low risk.of complications? If my hba1c next time is within prediabetic range is this still OK? I ask these because I know I was becoming very anxious if my finger prick test was above normal range.

 

[Leadinglights]

Hi,

I was diagnosed type 2 earlier this year with an hba1c of 48 (so only just in range). I followed a strict low carb diet for 6 months, lost a stone in weight and got my hba1c down to 38 so really happy.

I have had a a couple of people in my life express concern that my eating had become disordered or express concern about my weightless. My BMI is 19 and I had already come to the conclusion I didn't want to lose any more weight. My cholestrol had gone up ever so slightly, still below 5.

I am now wanting to relax my eating a little to prevent further weightless and to avoid my cholestrol continuing to go up. I am reminding myself regularly that the odd high blood sugar reading is not a problem, it is persistently high sugars that lean to complications. How much time in a day should I be aiming for my blood sugars to be in a normal range to remain at low risk.of complications? If my hba1c next time is within prediabetic range is this still OK? I ask these because I know I was becoming very anxious if my finger prick test was above normal range.

You should be able to prevent any further weight loss by including protein and healthy fats in your diet.
Keeping your finger prick readings 4-7mmol/l fasting /morning and before meals and under 8mmol/l 2 hours after eating for the majority of the time then that will usually mean HbA1C is in normal range.
As you say the odd higher reading will not have too much impact

 

[helli]

How much time in a day should I be aiming for my blood sugars to be in a normal range to remain at low risk.of complications?

How are you testing your BG?
If you are using finger pricks, it is not possible to know how much of your day is in normal range because you don’t know what is happening between pricks.
If you are using a CGM, the guidance given to people with Type 1 may give you some insight. To minimise risk of complications, we are advised to keep our BG within range at least 70% of the time. The range is larger than that mentioned for finger pricks. This may be to allow for short spikes after eating or maybe because doing the full time job of a human organ (injecting insulin and calculating the dose) has a mental impact which also needs to be considered. So, the recommendation is CGM readings to be in the range of 4 to 10 mmol/l at least 70% of the time.

 

[Ccash]

How are you testing your BG?
If you are using finger pricks, it is not possible to know how much of your day is in normal range because you don’t know what is happening between pricks.
If you are using a CGM, the guidance given to people with Type 1 may give you some insight. To minimise risk of complications, we are advised to keep our BG within range at least 70% of the time. The range is larger than that mentioned for finger pricks. This may be to allow for short spikes after eating or maybe because doing the full time job of a human organ (injecting insulin and calculating the dose) has a mental impact which also needs to be considered. So, the recommendation is CGM readings to be in the range of 4 to 10 mmol/l at least 70% of the time.

Thankyou for this, I use finger prick testing. I know it's not an entirely accurate picture as its in the moment but as its around meals which I guess is when you will see most variation I guess the info is still useful. The CGM guidance of within range 70% of the time is useful to know as it reassures me the odd finger prick test of 10-12 is not going to be a problem.

 

[harbottle]

I can relate to that. After I lost weight and hba1c got to 36 I got a bit obsessed with keeping BG down and started to do a lot of checking and carried on low carb and got anxious if I saw a value > 6.0. Nowadays I'm a lot more relaxed, sometimes eat normally and don't worry about carbs (Like this weekend) and hba1c still comes back around the same as it's been for 3 years. Some literature out there confidently states that BG quickly goes back to 5, but it's not really the case - different times of the day it can be slightly higher due to hormones and stress and the pancreas sensitivity changes during the day. A brief spurt of intense exercise can cause a rise, food can be unpredictable (As I found out with a CGM, lentils cause a rise after 3 hours!) and a meal can still have an effect far longer than 3 hours. I found using a CGM that just having a meeting at work would cause my BG to go up a little! As long as it comes down to the 4-7 mark I don't worry.

The two weeks before my last hba1c I went to a pub and had steak and chunky chips, and the result still came back in the same area as it had been for weeks.

 

[everydayupsanddowns]

The CGM guidance of within range 70% of the time is useful to know as it reassures me the odd finger prick test of 10-12 is not going to be a problem.

It certainly isn’t IMO. There’s a large study in the Links section which examined the glucose profiles of healthy individuals without diabetes, and showed that there were instances of time above 10 even with a fully functioning metabolism. For T1s, around 25% of time can be 10+ and still result in an on-target A1c (though not one as low as yours).

Are you keeping track of your daily carbohydrate intake? 130g of carbs a day still counts as low carb, but might give you a bit more room for manoeuvre?