Newbie struggling

[Booroo]

Hi recently diagnosed type 2 hbalc 48 diet control at mo but I’m 52 this was genetic as have other kidney issues am on hrt and everything gone up the poo.
I told my nurse I though I was having hypo in nighttime so advised eat low carb supper but I have been up last couple nights peeing a good 6 times or more and felt rubbish ,managed t finally get blood out finger and it 8.4 at 1am! Because I’m also on bp tablets one is a diuretic I’m worried about potassium cos that’s variable with me but had bloods yesterday
Does anyone have a recommendation for which hrt is safe to use as I was on Evorel conti briefly and it says it can cause issues and need more check ups
Thank you x

 

[everydayupsanddowns]

Sorry to hear how difficult you are finding things @Booroo

Did you check your levels overnight when you felt the symptoms of a hypo? And what was the number?

8.4 is higher than you’d ideally want to be, but it’s not quite at the level which usually triggers the body to try to expel extra glucose in urine, that’s usually more like 10mmol/L sometimes called the ‘renal threshold’. Perhaps that’s different in your case because of the kidney troubles.

48mmol/mol is just over the line into a diabetes diagnosis, so you might fond some relatively modest tweaks to your meals to reduce your overall carb intake (alongside cutting out the obvious sweet and sugary things) helps a great deal.

Good luck, and let us know how you get on 🙂

 

[Leadinglights]

With an HbA1C of 48mmol/mol you are just over the threshold for diagnosis and usually at that level people will not get symptoms which is why their diagnosis is overlooked until their level is much higher so in some way you are fortunate in the early alert.
Many find a low carb approach is successful but it is a good idea to reduce carbs slowly to allow your body to adjust. For some people the carb reduction leads to weight loss which initially is fluid so that can explain extra loo visits. The other reason can be from a UTI.
Have a look at this link for a low carb approach which is based on the suggested no more than 130g carbs not just sugar per day as a good starting point, it is not NO carbs. https://lowcarbfreshwell.com/

 

[Booroo]

All very strange it was 8.4 in night last night as I said but felt c**p all morning after then fine and had a normal tea chicken one bacon veg 2 tiny potatoes and skyr yogurt then for supper had granary toast with flora been loo couple times not as bad so far feel ok but hungry just done bloods and it’s 9.7? My diabetic nurse is ringing me on Tuesday May have to start meds but don’t want metformin as I work in catering I can’t afford to be pooing all time uncontrollably,anyone have experience with the slow release ones is that better for the toilet?
Thanks

 

[Booroo]

Definitely no uti

 

[Booroo]

Also my bloods results for kidney function were totally fine so happy with that!

 

[silver minion]

All very strange it was 8.4 in night last night as I said but felt c**p all morning after then fine and had a normal tea chicken one bacon veg 2 tiny potatoes and skyr yogurt then for supper had granary toast with flora been loo couple times not as bad so far feel ok but hungry just done bloods and it’s 9.7? My diabetic nurse is ringing me on Tuesday May have to start meds but don’t want metformin as I work in catering I can’t afford to be pooing all time uncontrollably,anyone have experience with the slow release ones is that better for the toilet?
Thanks

Everyone 's experience of metformin is different so I can only give you mine. Started on slow release metformin at 500mg and slowly increased in fortnightly increments, I am now on 2000mg per day, dosage split between breakfast and evening meal. I always take it immediately after food. The digestive effects were quite mild and disappeared after a couple of days. Mild nausea and alternative constipation and loose bowels, but certainly not all day or uncontrollably. Happened each time dosage increased but milder and shorter term each time. I suggest drinking plenty of water and maybe keeping a pack of immodium handy just in case. I found I didn't need it but I understand your concerns working in catering. Hopefully if your hbA1c is not too high you may not need a high dose.

 

[Booroo]

Everyone 's experience of metformin is different so I can only give you mine. Started on slow release metformin at 500mg and slowly increased in fortnightly increments, I am now on 2000mg per day, dosage split between breakfast and evening meal. I always take it immediately after food. The digestive effects were quite mild and disappeared after a couple of days. Mild nausea and alternative constipation and loose bowels, but certainly not all day or uncontrollably. Happened each time dosage increased but milder and shorter term each time. I suggest drinking plenty of water and maybe keeping a pack of immodium handy just in case. I found I didn't need it but I understand your concerns working in catering. Hopefully if your hbA1c is not too high you may not need a high dose.

Thank you see what nurse says next week
Thanks for replying

 

[Leadinglights]

Really there is no need for medication if your HbA1C is only 48mmol/mol and making some dietary changes should be all that is needed.
Also if you are testing which is a good idea then a having a testing regime that will actually tell you something on which to base changes together with an estimate of the carbs in your meal.
So if you test before you eat and after 2 hours with nothing in between other than water, and the increase is less than 3mmol/l then your meal is OK otherwise you need to reduce the carbs in the meal. You should be aiming at 4-7 fasting /morning and before meals and no more than 8-8.5 2 hours post meal.
If you are reducing carbs quickly then you could be getting false hypos where your body need to adjust to lower level.
Everybody's blood glucose goes up and down throughout the day and night so random testing can be misleading.
Keeping a food diary with an estimate of carbs of everything you eat and drink and any before and after meal testing will help.
It is important to stay hydrated even though you are taking diuretics. That may be something to ask your nurse about.
Looking at the menu plans in the Freshwell link may give you some ideas.
Toast is probably not the best thing to be having as it is high carb but if you are hungry then increasing healthy fats and protein may help. Also having sufficient at your evening meal so you don't need more food after that would be less likely to give high reading at night.

 

[Booroo]

Really there is no need for medication if your HbA1C is only 48mmol/mol and making some dietary changes should be all that is needed.
Also if you are testing which is a good idea then a having a testing regime that will actually tell you something on which to base changes together with an estimate of the carbs in your meal.
So if you test before you eat and after 2 hours with nothing in between other than water, and the increase is less than 3mmol/l then your meal is OK otherwise you need to reduce the carbs in the meal. You should be aiming at 4-7 fasting /morning and before meals and no more than 8-8.5 2 hours post meal.
If you are reducing carbs quickly then you could be getting false hypos where your body need to adjust to lower level.
Everybody's blood glucose goes up and down throughout the day and night so random testing can be misleading.
Keeping a food diary with an estimate of carbs of everything you eat and drink and any before and after meal testing will help.
It is important to stay hydrated even though you are taking diuretics. That may be something to ask your nurse about.
Looking at the menu plans in the Freshwell link may give you some ideas.
Toast is probably not the best thing to be having as it is high carb but if you are hungry then increasing healthy fats and protein may help. Also having sufficient at your evening meal so you don't need more food after that would be less likely to give high reading at night.

Thankyou
I’ve only done couple of tests and not done any since. I think I tested when cortisol was high then had the drop as it were.
But last night was good so we have early tea then after couple hours went on treadmill for bit then had skyr yogurt after and was totally fine toilet normal amount of times for me ,just had hot flush but that’s another thing! Think I will do same again. I will b working my normal evening shifts soon which I finish at 10pm and as I’m in kitchen running round I usually grab a sandwich I make so to get me through to get home,then the fun of winding down which I used to struggle with bad but have a plan in place all being well.
Thanks