Steep learning curve for a newbie

[Millydance]

Hi everyone, 3 weeks ago I was diagnosed with type 2. I have been prescribed Metformin and have altered my diet to a low carb and low sugar one as advised by the diabetes nurse at my doctor's.
For the first 10 days I felt a real improvement in my fatigue level and my blood glucose but for the last several days I have been feeling just as exhausted as I did before the diagnosis. I am strict with my diet and the only thing that has changed is an increase in Metformin - first week @ 500mg/day, 2nd week @ 1000mg/day and now I'm up to 1500mg/day. The first 10 days my blood glucose level steadily declined from 19.9 to an average of 6. However, the last few days it has been between 9 and 10 when I first get up and then spikes after breakfast; today it is 14.6 I haven't changed what I eat for breakfast and I'm not snacking or eating anything I shouldn't.
I'd be very grateful for a few suggestions as to why I'm feeling worse after initial good progress and why my blood glucose is higher in the morning than it was during the first 10 days.
Many thanks to you all, Milly

 

[Tee G]

Hi and welcome. Illness/Stress can mess with BG. It may be necessary to have a FULL BT done to see if any other conditions have cropped up?? Anaemia, raised white cells (Illness/infection) etc etc - You have certainly done the right thing where carbs / sugar are concerned, but dont forget to read labels for hidden sugars and total carbs on all foods you eat, its not always the 'obvious' that causes problems for some people. and of course all veg (especially root varieties) hold difference levels of carbs.... this link may help you (I found it interesting). https://www.dietdoctor.com/low-carb.....

You say you havent changed your diet? You may have to! Now you have a diabetic diagnosis foods you may have enjoyed before may not be suiting you now. The only way to really find out is with a home testing kit (a Blood Glucose monitor - you will see posts on those throughout the forum) I think you may need to think about that avenue. Its vital you know what foods effect you levels, now you have a new way of living.

 

[Kaylz]

You say you havent changed your diet? You may have to!

i think you've misunderstood as it states in the first segment they have altered to low carb, I think they mean they felt great for 10 days on that but now not so great but haven't changed from the diet they changed to initially xx

 

[Kaylz]

Hi @Millydance and welcome to the forum, are you feeling unwell at all? more stressed this past wee while? xx

 

[rebrascora]

Hi and welcome

Can I ask how your diagnosis came about? Had you been prediabetic leading up to this or did the symptoms and diagnosis come out of the blue? Have you lost weight quite easily since your symptoms/diagnosis occurred? Do you know your HbA1c reading and how long had you been symptomatic before going to the docs?

It is possible that you are actually Type 1 and not Type 2 diabetic. An HbA1c result of 48 or more just gets you a diagnosis of diabetes and if you are not a child or young person, they often automatically assume you are Type 2, especially if you are carrying a bit too much weight or admit to a bad diet, but it is perfectly possible for older people to develop Type 1 diabetes and last year that happened to me at the age of 55yrs. I was also assumed Type 2 initially and like you I managed to reduce my BG levels by taking the medication and adopting a low carb diet, but eventually the pancreas starts to run dry of insulin production and BG levels start to rise again. It took 6 weeks for me before they realised that I was not responding to Type 2 treatment and started me on insulin and I was really resistant to the prospect of it, but getting a positive Type 1 diagnosis helped and a year down the line I know for certain that I would be dead without it and it is now just a part of my normal daily routine, albeit a frustrating one at times.

I would suggest that you get in touch with your GP or Diabetes Nurse and explain that your levels are rising again despite eating very few carbs and ask about Type 1 testing (GAD antibody and C-Peptide tests) and possibly starting on insulin in the mean time. This is by no means a failure on your part to manage your diabetes but a consequence of an assumed Type 2 diagnosis. I know I felt really bad when I wasn't able to control my BG levels with diet and oral meds, even though it seemed like I was eating cardboard by the end of the 6 weeks. Low fat, low salt, very low carb, no alcohol... a lifetime of such a diet was a pretty bleak prospect and still unable to keep my levels in range. Although I still eat low carb despite my Type 1 diagnosis, I have now increased my fat intake (LCHF diet) and food is so much more enjoyable since then but I still need insulin to survive and I think you may be in a similar situation, so please get back in touch with your health care professionals asap.

 

[Neens]

@Millydance welcome to the forum - sorry to hear about your BG levels - some good advice here - I would contact GP and get an appointment - you may already have one booked. The waking level (fasting) is usually higher - the dawn phenomena - and it is usual to increase after food (although perhaps by less - I am not an expert) and certainly the higher teen levels would make me want to get medical advice from my health team - my levels were 17 /18 on diagnosis - it wasn't tested again for a while (I didn't have monitor straight away) but 5 weeks after it was 6.9 and has continued to be 4.7-6.8 usually around 5s somewhere - it could be that it hasn't had time to settle/work yet?
I would try not to worry as stress will raise your BP and BGs. This is the right place to come for support but no-one can replace good medical advice from your team. They may adjust the meds to max dosage 2000mg. They did that for me.

Good luck, you seem to be doing all the right things.

 

[Tee G]

@Kaylz - Sorry i didnt put it very well, the point i was trying to make was even though we make changes to a more 'low carb' diet, (as instructed by clinicians) those 'low carbs' can still sometimes give us trouble. Its so complex, what activity you had the day before, what you ate last thing at night, how well you slept, the volume, hydration, all factor in. And we know some foods suit one person and dont suit another. Monitoring is the only way to see clearly. 😎 looking at overall averages is useful, we go up and down like yo-yo's

 

[ianf0ster]

Hi Millydance, It seems like there is more going on that is obvious in your first post.

1.Both quite a bit higher BG levels than your body is used to can make you feel rough, but so can BG levels that are normal/safe yet are quite a bit lower than your body has been used to.
2. You seem to have a high fasting BG level, which (in the absence of being caused by Stress, Infection or Medication) is likely to be either due to what you ate the previous evening, or due to the Dawn Phenomenon.

However you say you are doing a Low Carb way of eating, so if that is the case then you wouldn't eat anything which could raise your BG so high for so long.
I get DP too, but I find that if I have an almost zero carb breakfast (such as boiled eggs) then my BG reading 2hrs after first bite is always lower than the pre-breakfast reading.

What are you having for breakfast? - Not porridge I hope!

 

[Millydance]

Hi and thanks to all who have replied for your help and kind wishes. Kaylz - you are right - I changed my diet immediately on diagnosis and have kept to it since. I did feel much better for the first 10 days but not feeling so good now. Tee G - I have a glucose monitor which I use every day. I have always been careful about what I eat and am well-used to scrutinising labels but now I am taking extra care with regard to carbs and hidden sugar content. Rebrascora - I had a test done last June which came back positive for diabetes. Unfortunately the Dr's surgery failed to notify me. It was only when one of the nurses was doing an audit on old blood tests that she discovered nobody had contacted me. That was 5 weeks ago. I had an HbA1c test done on 28th Jan which came back as 99. I'm 58 years old. I wasn't symptomatic as such; I have had ME/CFS for over 30 years so didn't think anything of it when the fatigue got considerably worse. The blood test was routine. Neens - I have been told to increase the Metformin gradually over a 4 week period, starting on 500mg; by next Sunday I will be on the full dose of 2000mg. The info about waking levels is appreciated, thank you, as I wasn't aware of this. Thanks also for the tip that it could take a few more weeks for the BG to settle rather than it fluctuating as it is at the moment.
Thank you all for sharing and for making me feel so welcome. I will take everything on board! Hopefully this is no more than a glitch and it will settle down soon. Milly x

 

[Millydance]

ianf0ster.....oh lord, porridge! My diabetes nurse advised me to have porridge for breakfast. I did, once. It sat like a brick in my stomach and made me fall asleep.........needless to say I have abandoned that idea 😉

 

[Tee G]

Hi again @Millydance. It may be worth while speaking with your GP/diabetic nurse??, (maybe a telephone consultation, if your surgery offers this service) could put your mind at ease. Hope you get it sorted out, please let us know how you get on. All the best.

 

[Tee G]

p.s. @Millydance - (Unrelated to topic).....if you put an '@' sign butted up to the persons name you are responding to, we get an alert on our home page that you have spoken to us. It highlights in the text here too, easier on the eye to find when we come to read it. 🙂

 

[rebrascora]

Interesting that you have ME as that is also an autoimmune condition (like Type 1 diabetes), which might add a little more likelihood of your Type 2 diagnosis being incorrect. There is another less common form of Type 1 diabetes called LADA (Latent Autoimmune Diabetes in Adults) or Type 1.5 and this might be more appropriate since you were showing signs of carbohydrate intolerance in June but survived untreated until now. Well done the nurse for picking it up during audit and acting on it.
Diabetic dietary advice is often poor within the NHS, it is sad but not surprising that the nurse advised porridge as many of us cannot cope with it.
I do still think it is important to liaise with your Health Care Professionals and inform them of your progress reversal and make sure they understand how few carbs you are eating. If you start to feel unwell (stomach pain or difficulty breathing or your urine/breath smell like pear drops) and your BG starts to get mid 20s then drink plenty of water and get yourself to hospital pronto as you could go DKA (Diabetic Ketoacidosis). I don't mean to worry you but it can happen quite suddenly. Thankfully, you have the means to test your blood and perhaps a means of testing your urine for ketones.... if not ask the nurse for Ketostix, as with readings above 14 you should have the means to check for ketones.