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So confused by the readings

T

Thesootyshow

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Relationship to Diabetes
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Hi there. I’m trying to support my sister with her recent diagnosis of type two diabetes. She was diagnosed in September last year and was immediately given medication which made her ill. The leaflet stated that it was to be given if lifestyle changes hadn’t worked but she had not been advised to do so first. Anyway she was told that if she could work on her diet etc she could probably get away without having to take medication. She gave up salt, white bread and cut right back on potatoes, lost a stone in weight and seemed to be doing fine. However, we got a blood monitor (Sinotec) and the readings are so confusing. For example, a before breakfast reading of 5.1, before evening meal reading 6.8, but 2 hours later 14.2. She only had mushroom soup with sourdough bread, which we thought was ok! I took another reading half an hour later and she’d gone down to 13.6. I just don’t understand any of this.
 
The glucose level goes up after eating and then comes down.
It's speed at which it comes down that is important.
We prick test pre eating ..fasting test and again 2 hours later for the affect of the food on the blood glucose...it is that reading that will impact the HbA1c blood test.
Was the mushroom soup homemade? Commercial sourdough bread is still bread...still flour and flour is flour and is a carb in the starch group...a complex carb as opposed to sugar that is a simple carb; both impact glucose levels.
So it depends on how much bread and what the carbs are per portion in the soup.
 
Pollyanna said:
The glucose level goes up after eating and then comes down.
It's speed at which it comes down that is important.
We prick test pre eating ..fasting test and again 2 hours later for the affect of the food on the blood glucose...it is that reading that will impact the HbA1c blood test.
Was the mushroom soup homemade? Commercial sourdough bread is still bread...still flour and flour is flour and is a carb in the starch group...a complex carb as opposed to sugar that is a simple carb; both impact glucose levels.
So it depends on how much bread and what the carbs are per portion in the soup.
Click to expand...
Thanks for your reply, the soup wasn’t homemade, it was Bachelors! The bread was a couple of small pieces, and the diabetic nurse told us that sourdough bread was fine. What is HbA1c? Sorry for my ignorance
 
Blood glucose is dynamic, changing constantly. All sorts of things can cause this but the ones most within our control are food and exercise.

Readings before food are usually lower than those after. It’s normal,to rise and then fall. The key difference is how high it goes and how long it takes to go back down. Typically a non diabetic will stay below 11 most of the time and be back at the level they were at before the meal about 2 hrs later (or sooner). So it’s good to aim to mimic this as closely as possibly by choosing what food (and medication potentially) will help you achieve this. In type 2 the levels can be higher for longer. Test before eating and again 2 hrs later. Aim for no more than 2 ish mmol higher if you can by adjusting the food. Even if the actual numbers are higher than desirable that gap is important. Keep it up and the body gradually resets back to more healthy levels over time. It can be as fast as a few weeks or it can take some months. No one becomes tyoe 2 overnight and it’s a marathon not a sprint. Learning about the condition also takes time and this is a good place to do that from people who have walked the walk as it were.

The foods that raise glucose most are carbohydrates. All of them (except fibre). Some will do it more or faster than others. So that means not just actual sugar but potatoes, other starchy veg and grains too, so all grain based flour meaning breads, cereals, pastry etc. Sourdough might have some minimal differences, as might whole grains etc but even though the fibre varies (which is good and may slow things down a little) the carbs don’t by much at all. Ie many of us find most carbs are problematic and we aim to minimise eating them as much as our lifestyle and preferences will allow. If you don’t put the glucose in your body in the first place it can’t raise the levels. We replace those carbs with more protein and healthy fats so we don’t go hungry. We lose weight, control blood glucose and often improve things like high blood pressure and high cholesterol along the way as those things are all linked in type 2
 
Thesootyshow said:
Hi there. I’m trying to support my sister with her recent diagnosis of type two diabetes. She was diagnosed in September last year and was immediately given medication which made her ill. The leaflet stated that it was to be given if lifestyle changes hadn’t worked but she had not been advised to do so first. Anyway she was told that if she could work on her diet etc she could probably get away without having to take medication. She gave up salt, white bread and cut right back on potatoes, lost a stone in weight and seemed to be doing fine. However, we got a blood monitor (Sinotec) and the readings are so confusing. For example, a before breakfast reading of 5.1, before evening meal reading 6.8, but 2 hours later 14.2. She only had mushroom soup with sourdough bread, which we thought was ok! I took another reading half an hour later and she’d gone down to 13.6. I just don’t understand any of this.
Click to expand...
Welcome to the forum and brilliant that you are supporting your sister.
Whether people can manage to bring down their blood glucose without medication rather depends on how high it is in the first place and how committed they are to making dietary changes. There are some very obvious things that people need to cut out particularly cakes, biscuits, sugary drinks but other high carb foods like potatoes, rice, pasta, bread, pastry, breakfast cereals, tropical fruits, prepared sauces which really need to be regarded with caution and only had in small portions.
When taking blood samples it is essential to wash hands to make sure there is nothing on them as that can give a false reading. It looks like the before breakfast and before dinner readings look fine but an increase of so much with what she had for dinner does look a bit suspicious unless it was a huge portion of soup and lots of bread.
I would not be too concerned if this was just a one off.
I would just do some more before and 2 hour after meal readings to get a picture of what she is tolerating and what is perhaps best avoided.
If she was feeling unwell than that can cause increased blood glucose.
 
The bread was around 24-30gm of carbs
The soup seems to be around 7gm per half a tin with 1.5 sugars.
So about 37-40 for the meal so that's ok if aiming for 120 carbs per day so the question then becomes about about much insulin her body is producing.
I think you need more facts about your sister's actual condition??
Do you know how she became to be diagnosed in the first place last September?
 
An HbA1C test is done from a blood sample taken from the arm and is used for diagnosis and continued monitoring, a result over 47mmol/mol would give a diabetes diagnosis how high will determine the treatment, diet, diet and medication options. This is basically speaking an average of blood glucose level over the 3 months prior to the test. The finger prick tests are just a moment in time.
 
Pollyanna said:
The bread was around 24-30gm of carbs
The soup seems to be around 7gm per half a tin with 1.5 sugars.
So about 37-40 for the meal so that's ok if aiming for 120 carbs per day so the question then becomes about about much insulin her body is producing.
I think you need more facts about your sister's actual condition??
Do you know how she became to be diagnosed in the first place last September?
Click to expand...
She had high blood pressure (solved by giving up the salt) and the blood sample came back as possible diabetes, so a second test was done and she was diagnosed with type 2
 
Leadinglights said:
An HbA1C test is done from a blood sample taken from the arm and is used for diagnosis and continued monitoring, a result over 47mmol/mol would give a diabetes diagnosis how high will determine the treatment, diet, diet and medication options. This is basically speaking an average of blood glucose level over the 3 months prior to the test. The finger prick tests are just a moment in time.
Click to expand...
We are keeping a record of every reading, for what it’s worth. She is due for a check up next month and we’re hoping that she can keep on top of this so she doesn’t have to take the medication
 
Thesootyshow said:
She had high blood pressure (solved by giving up the salt) and the blood sample came back as possible diabetes, so a second test was done and she was diagnosed with type 2
Click to expand...
If that is the case I suspect she may not be all that far into the diabetic zone if the first one was 'possible'
Was she told the actual number as that is useful to know.
Losing weight must have improved her blood pressure and helped with blood glucose so well done on her.
 
Pollyanna said:
The bread was around 24-30gm of carbs
The soup seems to be around 7gm per half a tin with 1.5 sugars.
So about 37-40 for the meal so that's ok if aiming for 120 carbs per day so the question then becomes about about much insulin her body is producing.
I think you need more facts about your sister's actual condition??
Do you know how she became to be diagnosed in the first place last September?
Click to expand...
Those carbs might equate to one meal if the goal is 120 a day as often advised by the nhs. For some that’s a suitable level and achieve their goals. For others it might well be too high an amount for their bodies to deal with still so each meal needs to be less carby ultimately (or other help added).

It depends on so many factors what level is right for an individual (how much insulin and for a type 2 even more relevantly how much insulin resistance they have). And to a large extent it’s a process of learning as you go and checking results regularly. But it’s important to realise for some 120 a day is a stepping stone not the final destination. On that level I don’t do well at all and need to be having at least half of that ideally even less.
 
Pollyanna said:
The bread was around 24-30gm of carbs
The soup seems to be around 7gm per half a tin with 1.5 sugars.
So about 37-40 for the meal so that's ok if aiming for 120 carbs per day so the question then becomes about about much insulin her body is producing.
I think you need more facts about your sister's actual condition??
Do you know how she became to be diagnosed in the first place last September?
Click to expand...
We weren’t told how many carbs per day to aim for neither
 
Would you like to share some examples of typical meals as people may spot some problem foods.
Just to add a suggested starting point is to have no more than 130g carbs per day but as everybody is an individual it may be fine for some but too much for others.
Good explanation in this link so do have a look, https://lowcarbfreshwell.com/
 
Leadinglights said:
Welcome to the forum and brilliant that you are supporting your sister.
Whether people can manage to bring down their blood glucose without medication rather depends on how high it is in the first place and how committed they are to making dietary changes. There are some very obvious things that people need to cut out particularly cakes, biscuits, sugary drinks but other high carb foods like potatoes, rice, pasta, bread, pastry, breakfast cereals, tropical fruits, prepared sauces which really need to be regarded with caution and only had in small portions.
When taking blood samples it is essential to wash hands to make sure there is nothing on them as that can give a false reading. It looks like the before breakfast and before dinner readings look fine but an increase of so much with what she had for dinner does look a bit suspicious unless it was a huge portion of soup and lots of bread.
I would not be too concerned if this was just a one off.
I would just do some more before and 2 hour after meal readings to get a picture of what she is tolerating and what is perhaps best avoided.
If she was feeling unwell than that can cause increased blood glucose.
Click to expand...
She doesn’t bother about sweet stuff, but the bread and tatties were the problem. Ironically I can eat chocolate and all the evil stuff without it even putting weight on me. The nurse advised breakfasts of weetabix with berries, to cut out the potatoes and white bread, replacing it with wholemeal, rye or sourdough and limit to 2 slices per day. I think she’s just getting overwhelmed with it all.
 
Hi @Thesootyshow and welcome to the forum. Your sister is doing well with the weight loss but it seems the advice she has received from her healthcare team is a bit patchy.
Is she happy to share her initial HbA1c blood test result. This will help people to give her appropriate (non medical) advice, depending on how far she is on the diabetes scale.

The main culprits for raising blood glucose are carbohydrates. These include anything made from grains or flour as well as potatoes and sweet sugary foods and drinks.
Measuring blood glucose in a specific way will track the effect different meals have and also the longer term trend.
Test first thing on waking.(fasting bg test). If the figures reduce over weeks and months then the diet and exercise changes are working.
Test just before eating and 2 hours after first bite. These pairs of readings for each meal will show how the carbs in the meal affect the bg. Ideally the post meal reading should be no more than 3 mmol more than the pre meal test. If it's higher then reduce the carb content.
It will help if your sister keeps a food diary alongside the blood test results. She can then make changes that she can enjoy without spiking her bg.
Moderate exercise also helps lower bg. Just something as simple as a 20 minute walk after a meal.
You are obviously concerned for your sister and your support will help her manage her diabetes. It's unfortunate that the medication made her ill, but should she need medication in the future there are many options available.
Have a look at the pinned posts at the top of the Newbies forum. There is a lot of useful information there.
 
Pollyanna said:
And do you know those readings?
They are usually 90 days worth, occasionally 60 days.
It's measured in mmol/mol ...so my last one was 48 with finger prick tests averaging around 4.7 ish

The finger prick test is only as is at the time...it's a guide to the glucose rise at that moment in time.
Click to expand...
No, we weren’t told what they were.
 
silver minion said:
Hi @Thesootyshow and welcome to the forum. Your sister is doing well with the weight loss but it seems the advice she has received from her healthcare team is a bit patchy.
Is she happy to share her initial HbA1c blood test result. This will help people to give her appropriate (non medical) advice, depending on how far she is on the diabetes scale.

The main culprits for raising blood glucose are carbohydrates. These include anything made from grains or flour as well as potatoes and sweet sugary foods and drinks.
Measuring blood glucose in a specific way will track the effect different meals have and also the longer term trend.
Test first thing on waking.(fasting bg test). If the figures reduce over weeks and months then the diet and exercise changes are working.
Test just before eating and 2 hours after first bite. These pairs of readings for each meal will show how the carbs in the meal affect the bg. Ideally the post meal reading should be no more than 3 mmol more than the pre meal test. If it's higher then reduce the carb content.
It will help if your sister keeps a food diary alongside the blood test results. She can then make changes that she can enjoy without spiking her bg.
Moderate exercise also helps lower bg. Just something as simple as a 20 minute walk after a meal.
You are obviously concerned for your sister and your support will help her manage her diabetes. It's unfortunate that the medication made her ill, but should she need medication in the future there are many options available.
Have a look at the pinned posts at the top of the Newbies forum. There is a lot of useful information there.
Click to expand...
Thank you for your support, we haven’t been told anything about the reading, no idea what it was The pre-breakfast readings were originally around 6.8 and they’re down to 5.1 average ( none below that) She’s keeping a food diary and we hope that by recording everything we can try to make sense of it all
 
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