Need help re Carbs

[Welsh Wizard]

Although I have been a Type 2 diabetic for over 10 years I had always considered that I managed my diet fairly well however, following a Blood test ( for a Pre Op) in Oct 2020 the results were returned to my surgery and the Practise Nurse advised me that my average levels had risen to over 75 and that I should reappraise my diet to bring my levels back to where they were 12 months prior ie Average 50. I have kept a diary of meals that I eat since October and I have noticed that whenever I have a Sandwich (wholemeal bread) at lunchtime my blood tests, later in the day, are always raised. I am working hard to get to the levels of 2019 despite the fact that blood tests offered through the GP surgery have been put on hold and my 90 day av is currently 61, 30 day average 54 and 14 day average 51. Can any one suggest what I can do differently? Interestingly the Pre Op test was because I was due to have a hip replacement, which was subsequently cancelled again. The Practise Nurse suggested that I tried to do a bit more walking as exercise- they really do read the patient notes-NOT.

 

[Kaylz]

Possibly not eat bread and reduce your overall carbs so things like potatoes, rice, pasta etc

Telling us what you generally eat in a day may help us be able to help you more rather than us jumping in bombarding you with questions
xx

 

[Welsh Wizard]

Possibly not eat bread and reduce your overall carbs so things like potatoes, rice, pasta etc

Telling us what you generally eat in a day may help us be able to help you more rather than us jumping in bombarding you with questions
xx

Thanks for the reply. It's interesting that when you keep a food diary you begin to see trends and I have tended to try and eat a more varied lunch so, yes, when I swap a sandwich for soup or a light salad or even occasionally a slice of bacon with scrambled eggs I see a much lower Hba1c level later in the day. Whatsmore is if I have a larger portion at lunchtime and then a snack for tea the levels drop considerably

 

[grovesy]

Thanks for the reply. It's interesting that when you keep a food diary you begin to see trends and I have tended to try and eat a more varied lunch so, yes, when I swap a sandwich for soup or a light salad or even occasionally a slice of bacon with scrambled eggs I see a much lower Hba1c level later in the day. Whatsmore is if I have a larger portion at lunchtime and then a snack for tea the levels drop considerably

Do you have a sandwich with 2 large slices of bread , if so how about reducing it to just 1.
You seem to be also mixing your HBA1C levels with spot glucose levels, they are differnt things.

 

[Welsh Wizard]

Do you have a sandwich with 2 large slices of bread , if so how about reducing it to just 1.
You seem to be also mixing your HBA1C levels with spot glucose levels, they are differnt things.

Thanks, I'll give it a go. I might seem ignorant to the fact but I've never used a Blood test spot machine before to record information, but was told to get one and to monitor my sugar levels that way, so tell what do the readings on that relate to?

 

[AndBreathe]

Thanks, I'll give it a go. I might seem ignorant to the fact but I've never used a Blood test spot machine before to record information, but was told to get one and to monitor my sugar levels that way, so tell what do the readings on that relate to?

The readings on your meter are like snapshots, so what your blood is, at that moment. It's a different to to the HbA1c, which tests in a different way to indicate your average over around 3 months.

Your meter will likely be able to give you an average over 7, 14 30 days, or longer, but that is on the average of the tests you have taken, so you could be missing the best and/or worst scores.

What I used my meter for was to help inform me of the impacts of specific foods or meals on my bloods. I'd test before eating, then 2 hours later looking to see a rise of less than 2.0 from tthe before to the after test.

If it was 2 or under, that meal/food was fine. If it was more, I'd try it again, but in consistent, I'd eat less of that food, or not have it at all

 

[Welsh Wizard]

The readings on your meter are like snapshots, so what your blood is, at that moment. It's a different to to the HbA1c, which tests in a different way to indicate your average over around 3 months.

Your meter will likely be able to give you an average over 7, 14 30 days, or longer, but that is on the average of the tests you have taken, so you could be missing the best and/or worst scores.

What I used my meter for was to help inform me of the impacts of specific foods or meals on my bloods. I'd test before eating, then 2 hours later looking to see a rise of less than 2.0 from tthe before to the after test.

If it was 2 or under, that meal/food was fine. If it was more, I'd try it again, but in consistent, I'd eat less of that food, or not have it at all

I am really grateful for your response. Just shows the level of support that I've had over the years. My last full blood test was in March 2019. Of course last year it was cancelled because of Covid . I guess the Pre Op blood test was just a standard test and that's why I was told to get a Blood testing kit. When I phoned to book a blood test for this forthcoming March I was told that they are still being suspended so won't get it done. Nevertheless I suppose that the mere fact that I am monitoring my diet and the readings will at least help me control my diabetes to some extent. So much for the Diabetic health partnership working together!! I looks as if everything stops for Covid and I have to say it appears to be working far more efficiently in England than it does in Wales. My brother in law had an appointment booked for him only last week and he's just over the border from me.

 

[grovesy]

I am really grateful for your response. Just shows the level of support that I've had over the years. My last full blood test was in March 2019. Of course last year it was cancelled because of Covid . I guess the Pre Op blood test was just a standard test and that's why I was told to get a Blood testing kit. When I phoned to book a blood test for this forthcoming March I was told that they are still being suspended so won't get it done. Nevertheless I suppose that the mere fact that I am monitoring my diet and the readings will at least help me control my diabetes to some extent. So much for the Diabetic health partnership working together!! I looks as if everything stops for Covid and I have to say it appears to be working far more efficiently in England than it does in Wales. My brother in law had an appointment booked for him only last week and he's just over the border from me.

The pre-op test was an HBA1C and 75, is considered high for planned operations and most surgeons prefer it lower.
Testing blood sugars is not routinely recommended by all GPs, and even then mainly to those on hypo causing medication or Insulin, and strips may be restricted.
Everything is varied no matter where you are in the UK, even in neighbouring areas.

 

[AndBreathe]

I am really grateful for your response. Just shows the level of support that I've had over the years. My last full blood test was in March 2019. Of course last year it was cancelled because of Covid . I guess the Pre Op blood test was just a standard test and that's why I was told to get a Blood testing kit. When I phoned to book a blood test for this forthcoming March I was told that they are still being suspended so won't get it done. Nevertheless I suppose that the mere fact that I am monitoring my diet and the readings will at least help me control my diabetes to some extent. So much for the Diabetic health partnership working together!! I looks as if everything stops for Covid and I have to say it appears to be working far more efficiently in England than it does in Wales. My brother in law had an appointment booked for him only last week and he's just over the border from me.

How bloods are being handled seems pretty path at the moment. I've been fortunate to have bloods done, as required, but I appreciate that doesn't help you.

The pre-op test would have been an HbA1c, so that means your bloods have been running a bit rich for a while. Just FYI the guidance is that routine surgery shouldn't take place where the A1c is greater than 68, due to the increased risk of challenges around healing and infections.

Your blood sugar monitor will give you an idea of where your numbers are running, but don't hang your hat on your averages being a strong indicator of your A1c. Mine are always way off beam.

I don't know what the next steps are for you, and when you will be reassessed for your op, but if you wanted to have an A1c test, to ease your mind, or nudge you further in the right direction, you could always have one done "privately". There's an organisation called MonitorMyHealth who offer an HbA1c test for £29. It is done by a fingerprick test. You send off your sample and have the result, by email, in a couple of days. They send you everything you need.

MonitorMyHealth tests are done in the Exeter hospital's NHS labs, in quite times like the evenings. I use them for monitoring my thyroid function and just checked they're still offering the tests yesterday.

I don't have any commercial relationship with MMH. I'm just a satisfied customer, several times over.

Monitor My Health

Monitor My Health. Easy, safe home blood testing service conducted in our own NHS laboratory - results online

monitormyhealth.org.uk

(p.s. - I know COVID has got in the way of so much this past year, but your experience, in terms of support isn't dissimilar to my own, 7 years ago.)

 

[Jaxieb]

Can I ask what wholemeal bread you're using? From what I can gather a slice of wholemeal bread can be around 20g carb on average so a sandwich means a 40g carb hit from the bread alone.

I have a sandwich most days but I buy a low carb bread that's only 9.9g per slice.

Can I ask which bread has 9.9 per slice?

 

[Kaylz]

Can I ask which bread has 9.9 per slice?

I think @Anitram uses the Hovis Lower Carb and if memory serves me right the seeded variety is 9.9g per slice and the wholemeal is 9.8g per slice xx