new member needs some advice

[Niall R]

Hi All.
I have been T2 for about 7-8 years now, but just recently (a week ago)began testing myself at home at the request of my diabetic nurse. i am 6ft and about 93 kg, so not massively overweight (lost about a stone in the last year). i normally run 3 times a week and about 10K each time - although that has slipped a bit over the past 2 weeks.
when testing myself i am regularly over 18 and have been as high as 24 this morning. Never been less than 15!
what more can i do to get this number down

 

[khskel]

Hi There,

What meds if any are you on and what's your diet like?

 

[Bruce Stephens]

when testing myself i am regularly over 18 and have been as high as 24 this morning. Never been less than 15!

What was your last HbA1c?

 

[rebrascora]

Hi and welcome from me too.

Sorry to hear you are getting such high readings. That is a concern.
Can you give us an idea of the sort of things you typically eat and drink for breakfast, lunch and evening meal and any snacks?..... Just to give us a rough idea of the amount of carbohydrate you are eating.

You may not be aware but diabetes isn't just about sugar but all carbohydrates (starches and sugars) which are converted to glucose by our digestive system and absorbed into the blood stream, where as diabetics, we are not so efficient at accessing it for our metabolism, so it builds up in our blood stream. That may be because we are not producing enough insulin or we have become resistant to the insulin we do produce. I sometimes think of it like a production line at a factory where there is a shortage of staff at the packing end.... the product keeps coming along on the conveyor and piling up in the packing area swamping them and the more that piles up, the less they are able to cope with it. The production line needs to be slowed down to enable them to clear the packing area so that the system can work more smoothly again.
Putting less carbs into your body should enable it to process the backlog of glucose in your blood and get back into better balance.

 

[Niall R]

i have a fairly 'normal' diet - probably not normal for a diabetic!
porridge in the morning with honey rather than sugar
sandwich at lunch time
meat and 2 veg at dinner
i think my biggest problem will be snacks. 1 bag of crisps a day plus some biscuits with tea
while i love sweet things i try to limit that to once a week, and try to have fruit during the week
probably not the best diet
i currently take 2 x 500mg metformin twice a day
body mass 28.1
HbA1c - 76.0 (7th April 2022)

 

[rebrascora]

OK, well there is certainly room for carb reduction in that menu. Porridge is high carb and despite the NHS recommending it for diabetics, many of us can't get away with it. Honey is just a different form sugar. As a beekeeper myself, I am keen to promote honey for it's micro nutrients, but not for diabetics. Unfortunately fruit is also not a great choice of snack and needs to be restricted, particularly tropical fruits like bananas, mango, pineapple and oranges and grapes although clearly not a tropical fruit. Most of us restrict ourselves to a small portion of berries (rasps, blackberries, blackcurrants, gooseberries, strawberries and to a lesser extent blueberries) as they are lowest carb or at the moment I am having rhubarb (technically a vegetable rather than a fruit) stewed with ginger and a little artificial sweetener.

Obviously you realize the crisps and biscuits are not a great idea. The bread in your sandwiches is high carb. The way I think about it is that one medium slice of wholemeal bread is about 15g carbs which breaks down in the digestive system to the equivalent of 3 teaspoons of sugar, so a 2 slice sandwich is the equivalent of 6 teaspoons of sugar to my BG levels. There are some low carb breads on the market like LivLife or HiLow which have about 5g carbs per slice or less at various supermarkets but I tend to just avoid bread. I know that is really radical and it certainly takes a bit of getting your head around I can tell you, but after a few months you don't even miss it, except sometimes for the convenience. Potatoes are the same.... assuming you have potatoes with your meat and veg. I do still eat potatoes occasionally but I have significantly reduced my portion size and frequency of eating them. I don't bother with pasta anymore and have a couple of spoons of rice maybe once a month.
It may seem like there is nothing much left to eat, but actually, it is all the tasty stuff rather than the white/beige stuff which just bulks out our plate.
Usually I have creamy Greek natural yoghurt for breakfast with berries/rhubarb and mixed seeds for breakfast or bacon eggs and mushrooms maybe on a bed of savoy cabbage cooked in the microwave with a knob of biutter or an omelette and salad.... usually with a big dollop of cheese coleslaw.
If I have a big breakfast, I usually don't need any lunch but today I had ham and pickled beetroot or I may have a chunk of cheese or egg or tuna salad usually with coleslaw/mayonnaise. Evening meal might be high meat content sausages with cauliflower cheese and green beans or broccoli or steak, mushrooms and salad (and coleslaw) or halloumi and cauliflower curry (but no rice) just the curry or a big bowl of ratatouille. I might serve that with burgers (meat patties no bread bun) or meatballs or gammon or lamb chops or chicken or with mozzarella or halloumi cheese.

Anyway, I hope that gives you some ideas of where the carbs are in your current food and where/how you can reduce them. Cauliflower works really well mashed with a dollop of cream cheese and a teaspoon of mustard instead of mashed potato or can be grated and used to replace rice/couscous. It takes a bit more thought at first but once you get into a routine of low carb cooking and eating it isn't particularly difficult to maintain.

 

[Niall R]

OK, well there is certainly room for carb reduction in that menu. Porridge is high carb and despite the NHS recommending it for diabetics, many of us can't get away with it. Honey is just a different form sugar. As a beekeeper myself, I am keen to promote honey for it's micro nutrients, but not for diabetics. Unfortunately fruit is also not a great choice of snack and needs to be restricted, particularly tropical fruits like bananas, mango, pineapple and oranges and grapes although clearly not a tropical fruit. Most of us restrict ourselves to a small portion of berries (rasps, blackberries, blackcurrants, gooseberries, strawberries and to a lesser extent blueberries) as they are lowest carb or at the moment I am having rhubarb (technically a vegetable rather than a fruit) stewed with ginger and a little artificial sweetener.

Obviously you realize the crisps and biscuits are not a great idea. The bread in your sandwiches is high carb. The way I think about it is that one medium slice of wholemeal bread is about 15g carbs which breaks down in the digestive system to the equivalent of 3 teaspoons of sugar, so a 2 slice sandwich is the equivalent of 6 teaspoons of sugar to my BG levels. There are some low carb breads on the market like LivLife or HiLow which have about 5g carbs per slice or less at various supermarkets but I tend to just avoid bread. I know that is really radical and it certainly takes a bit of getting your head around I can tell you, but after a few months you don't even miss it, except sometimes for the convenience. Potatoes are the same.... assuming you have potatoes with your meat and veg. I do still eat potatoes occasionally but I have significantly reduced my portion size and frequency of eating them. I don't bother with pasta anymore and have a couple of spoons of rice maybe once a month.
It may seem like there is nothing much left to eat, but actually, it is all the tasty stuff rather than the white/beige stuff which just bulks out our plate.
Usually I have creamy Greek natural yoghurt for breakfast with berries/rhubarb and mixed seeds for breakfast or bacon eggs and mushrooms maybe on a bed of savoy cabbage cooked in the microwave with a knob of biutter or an omelette and salad.... usually with a big dollop of cheese coleslaw.
If I have a big breakfast, I usually don't need any lunch but today I had ham and pickled beetroot or I may have a chunk of cheese or egg or tuna salad usually with coleslaw/mayonnaise. Evening meal might be high meat content sausages with cauliflower cheese and green beans or broccoli or steak, mushrooms and salad (and coleslaw) or halloumi and cauliflower curry (but no rice) just the curry or a big bowl of ratatouille. I might serve that with burgers (meat patties no bread bun) or meatballs or gammon or lamb chops or chicken or with mozzarella or halloumi cheese.

Anyway, I hope that gives you some ideas of where the carbs are in your current food and where/how you can reduce them. Cauliflower works really well mashed with a dollop of cream cheese and a teaspoon of mustard instead of mashed potato or can be grated and used to replace rice/couscous. It takes a bit more thought at first but once you get into a routine of low carb cooking and eating it isn't particularly difficult to maintain.

thank you! that's all incredibly useful advice.

 

[Christy]

You might find the Carbs and Cals book useful 🙂

 

[DouglasXKR]

If you’re testing with a finger prick blood test get some ketone test strips. Anything over 1, get some help.

 

[snowball12]

Crisps are definitely a no no. They are the only thing I miss. Lots of info here about low carb. I am not a fan of no carb i.e.Keto but have a look at that too. Good luck

 

[Leadinglights]

You certainly are having a lot of carbs for being able to keep blood glucose within a good range so no wonder you are seeing such high readings.
Low carb is one route to go, that being less than 130g per day so if you were to keep a food diary and tot up the carbs in everything you eat and drink then you could see how far from that you are.
You might find some ideas for modifying your meals in this link. https://lowcarbfreshwell.co.uk/

 

[everydayupsanddowns]

Welcome to the forum @Niall R

Well done on your impressive running and fitness! But sorry to hear you are seeing some above-range readings on your BG meter

Do you take any meds to help manage your glucose levels?

Hopefully a little carb moderation and some tweaks to your menu will help bring your levels back into range. When you’ve been running above range for a while it’s best to make changes to your menu gradually - partly because they need to be sustainable long term, but also because very rapid and sudden changes to blood glucose levels are harder on the fine blood vessels, and changing things more gradually will give your body time to adapt, reducing the risk of short-term nerve or eye damage. This s a marathon, not a sprint 🙂

If you were to reduce portions by a proportion (eg if lunch is sandwich + crisps + apple, first ditch the crisps, then after a week maybe switch out the apple for something else, then possibly go for a wrap rather than 2 slices of bread…) you may find that your levels begin to come down.

Don’t get too grumpy about the numbers you are seeing. They are just information to guide you, not a measure of how ‘good’ you are being. Many members find it helpful to take a reading just before a meal, and again 2hrs later. Ideally you'd want your BG to be no more than 2-3mmol/L at the 2hr mark. In a sense to begin with the numbers are less important that the differences. If you reduce the ‘meal rise’ then your overall levels will gradually reduce.

Good luck, and let us know how things go 🙂

 

[Niall R]

I'm struggling running. I'm not sure if its in my head or not, but over the past couple of weeks i have found it very difficult to finish the 10K. i seem to run out of energy - like i said it might be in my head.
Is there anything i can take to give myself a bit more energy - obviously nothing sweet, but are there any fruits or anything i could take

 

[rebrascora]

With levels mid teens and above you really should not be running as that is putting a strain on your body. I know when my levels hit 10 I can feel it starting to make things more difficult.... like lead weights in my arms and legs. Gentle aerobic exercise like a brisk walk will do you more good than running at the moment, but if you are running low on insulin it may be that you need to start injecting.

Can you tell us a bit about how your initial diagnosis came about? Did you have symptoms and if so, did they come on suddenly or was it just a gradual thing..... or perhaps it was picked up by a routine blood test?

Just wondering if perhaps you are not Type 2 but a slow onset Type 1 ie. Latent Autoimmune Diabetes in Adults (LADA).

Are you able to contact your GP or nurse and get an appointment to discuss your diabetes and ask for Type 1 testing. The two tests involved are a GAD antibody test and a C-peptide test. These will determine in you have antibodies which indicate that your immune system has attacked your insulin producing beta cells in your pancreas and the second test will how much insulin you are currently able to produce. They may also want to test your urine for ketones and if they don't mention it, ask them to. With BG levels persistently that high, you are at risk of developing Diabetic Ketoacidosis (DKA) particularly if you are a type of Type 1 diabetic. It is much less of a risk with Type 2. You should also push for them to prescribe Ketostix so that you can test for ketones yourself when your levels are consistently mid teens or above.

Please make an appointment and go into it with a list of questions and tests that you would like doing and if they cannot do them, then ask for a referral to a specialist diabetic clinic. Explain that you run 10k 3x a week but you are really struggling with your levels that high.... and please knock it down to a brisk walk for now as you are putting a huge strain on your heart.