Taking longer for glucose levels to come down

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jimmymumu

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Type 2
Hi. I've been diabetic for around 7 years and have managed to maintain it quite well till recently with 2 metformin twice a day and a fairly healthy diet. I've lost 14 lbs in the last 12 months. These last few weeks I've noticed slight differences.
1/ A water blister appeared on my leg without reason (no water retention)
2/ Increase in thirst

I've started monitoring my blood using an old Accu-Check Performa and I've noticed that it takes around 4 hours for my readings to drop after evening tea. In the morning it comes down fine. 2 hours after food tonight it was 10.7 after a further 2 hours it was 8.1.
Should I be seeing my diabetic nurse over this? Thank you
 
I've found it difficult to identify what is causing the slower reduction and higher readings. Sometimes it's obvious others not. I'm no expert but it should be a process of elimination. But I'm baffled sometimes.

To answer your question, I would think it's worth a call. See what others suggest. But that's my brief input.

I hope you make progress soon.
 
Thank you.
I'm normally really good at maintaining a healthy level, so I don't understand what's going on. I've not changed my diet recently.
 
jimmymumu said:
Thank you.
I'm normally really good at maintaining a healthy level, so I don't understand what's going on. I've not changed my diet recently.
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You're welcome.

As I understand it there are various possibilities.

Diet and portion size, exercise frequency and duration, before or after meals, medication, and health in general.

Off the top of my head. There's probably more.

Those can be broken down further. I haven't found it easy though, by no means.
 
jimmymumu said:
Hi. I've been diabetic for around 7 years and have managed to maintain it quite well till recently with 2 metformin twice a day and a fairly healthy diet. I've lost 14 lbs in the last 12 months. These last few weeks I've noticed slight differences.
1/ A water blister appeared on my leg without reason (no water retention)
2/ Increase in thirst

I've started monitoring my blood using an old Accu-Check Performa and I've noticed that it takes around 4 hours for my readings to drop after evening tea. In the morning it comes down fine. 2 hours after food tonight it was 10.7 after a further 2 hours it was 8.1.
Should I be seeing my diabetic nurse over this? Thank you
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What did you eat?
 
Over time your tolerance to certain carbohydrates can change so you may need to look more carefully at what you are eating. Maybe your portion sizes have crept up so weighting things to check would be a good idea.
Would you like to post what meals you are having and people may spot a potential problem food.
Those higher levels would explain the thirst but not necessarily the blister so worth getting that checked out as you don't want it to become infected. Although whatever has caused the blister could also have increased blood glucose.
 
jimmymumu said:
These last few weeks I've noticed slight differences.
1/ A water blister appeared on my leg without reason (no water retention)
2/ Increase in thirst
Click to expand...
You do need to see someone, so bloods can be done to see if you have an infection causing your problems. If this is the case then yes your numbers will go up.
So a simple health check will def help you get a solution a lot quicker.
 
Leadinglights said:
Over time your tolerance to certain carbohydrates can change so you may need to look more carefully at what you are eating. Maybe your portion sizes have crept up so weighting things to check would be a good idea.
Would you like to post what meals you are having and people may spot a potential problem food.
Those higher levels would explain the thirst but not necessarily the blister so worth getting that checked out as you don't want it to become infected. Although whatever has caused the blister could also have increased blood glucose.
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Hi. Yesterday's meal times consisted of:
Breakfast pre was 5.4 and i had 2 Weetabix with 2 cups of semi-skimmed milk, a cup of coffee with one sugar. Post-reading was 7.1
Lunch Pre-reading was 5.4 was a slice of roast pork with the fat trimmed and 2 regular slices of bread with low-fat spread, with a cup of coffee 1 sugar post reading was 6.8
Tea pre-reading was 5.6 and I had a chicken kiev weighing 102 grams with half a tin of spaghetti. Followed by some really weak dilute orange, with no added sugar. Post-reading was 10.1
In between meals I drink around 3 litres of water per day and no snacks.

The amount I eat is relatively small and most days run in a similar vein I go for walks when I can. I do have another condition )COPD) that limits my exercise
Thanks
 
jimmymumu said:
Hi. Yesterday's meal times consisted of:
Breakfast pre was 5.4 and i had 2 Weetabix with 2 cups of semi-skimmed milk, a cup of coffee with one sugar. Post-reading was 7.1
Lunch Pre-reading was 5.4 was a slice of roast pork with the fat trimmed and 2 regular slices of bread with low-fat spread, with a cup of coffee 1 sugar post reading was 6.8
Tea pre-reading was 5.6 and I had a chicken kiev weighing 102 grams with half a tin of spaghetti. Followed by some really weak dilute orange, with no added sugar. Post-reading was 10.1
In between meals I drink around 3 litres of water per day and no snacks.

The amount I eat is relatively small and most days run in a similar vein I go for walks when I can. I do have another condition )COPD) that limits my exercise
Thanks
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The foods you are having for breakfast and lunch although high carb seem to be tolerated OK but I suspect that the Kiev as they are usually coated in bread crumbs and the spaghetti which is high carb because of the pasta and the sauce is what is increasing the evening post meal reading. Keep a check on the carbs as the meal could well have been 50g carbs.
My other observation is you are not mentioning vegetables or salad so the kiev with veg or salad would be a better option and just 1 slice of bread with some salad or coleslaw for lunch.
 
I do have salads and love vegetables too, it just depends on the evening meal. As for carbs, I know very little about them. Is there a limit, what foods are best avoided etc?
Since I was diagnosed, I've concentrated on reducing portion sizes and removing sweet things from my diet. I eat fish on a regular basis too.
 
jimmymumu said:
I do have salads and love vegetables too, it just depends on the evening meal. As for carbs, I know very little about them. Is there a limit, what foods are best avoided etc?
Since I was diagnosed, I've concentrated on reducing portion sizes and removing sweet things from my diet. I eat fish on a regular basis too.
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If you are following a low carb approach which many do find successful then the suggestion is no more than 130g carbs per day, that is not just sugar as it is all carbohydrates which convert to glucose so foods like potatoes, rice, pasta, bread, pastry, breakfast cereals and tropical fruits are all high carb foods as well as the more obvious cakes and biscuits unless home make low carb ones and sugary drinks including fruit juice. Understanding what are high carb food is essential in managing blood glucose levels.
A good thing to do is keep a food diary of everything you eat and drink and estimate how many carbs are in what you are having to see how close you are to the 130g, that will help you see if you need to be making any reduction.
The information can be found as total carbs on packets etc, shop website and internet search for food X and total carbs, often given as per 100g so you need to work out for the portion you are going to have.
The book or app Carbs and Cals is a useful resource for giving the carbs for varuius portions of a whole range of foods.
Fish, eggs, cheese, meat, dairy are all good foods with salads and vegetables (non starchy are lower carb).
You may find this link useful for some meal ideas. https://lowcarbfreshwell.com/
Reducing portions of high carb foods but making sure you have enough protein and healthy fats as you have to get your energy from somewhere when reducing carbs.
One thing to be cautious of are prepared sauces and foods in them, as they can be high in sugars as in you tin of spaghetti.
 
Thank you for such helpful advice. I had some blood tests done 4 weeks ago and our Drs work on a basis of we'll contact you if there's a change. I've had no such call so I'll check tomorrow.
After my meal tonight which consisted of 2 small boiled potatoes, stewing steak, sugar snap peas and sweetcorn my sugars returned completely to normal at 6.0 after 2 hours
I never knew how bad the sauces could be so that is one change I'll be making.
 
So having spoken to the Dr He stated that my blood sugars were excellently managed at the time of testing, they were lower than last year.
I asked him about the spikes I'd been having and he's asked me to keep monitoring it for the next few days. He suspects an infection may be responsible.
As for the dietary advice in my post, I will be taking that on board and making whatever adjustments I need. The main ones I'm working on now are reducing my carbs and avoiding sauces.

Thanks to everyone who replied.
 
jimmymumu said:
Thank you for such helpful advice. I had some blood tests done 4 weeks ago and our Drs work on a basis of we'll contact you if there's a change. I've had no such call so I'll check tomorrow.
After my meal tonight which consisted of 2 small boiled potatoes, stewing steak, sugar snap peas and sweetcorn my sugars returned completely to normal at 6.0 after 2 hours
I never knew how bad the sauces could be so that is one change I'll be making.
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Looks like that meal suited you really well @jimmymumu 🙂

Well done on the tweaks and changes you’ve made. One of the frustrating things about diabetes is that it does tend to ‘change the rules’ from time to time, and you have to readjust and reset your approaches every so often.

Great to hear your Dr says your diabetes management is on-track, and hope the infection clears up if that was adding extra confusion into the mix!
 
Leadinglights said:
he information can be found as total carbs on packets etc, shop website and internet search for food X and total carbs, often given as per 100g
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Please be careful with this. The word “total” causes so much confusion for some people.

In the UK, Europe and Australia the word “total” isn’t used at all on our labels etc. Our labels make it easy. What is called “carbs” for us includes all carbs except fibre, even whilst specifying how many of those are sugar itself. I suspect this is what you mean. Fibre is an entirely separate listing.

In the USA they do use “total carbs” and for them that includes fibER as well. They then deduct the fiber to get what they call net carbs - same as our plain old “carbs” listing.

As many food and low carb sources are USA based it gets really confusing for those that don’t understand the difference. Either counting fibre when they needn’t for blood glucose reasons or deducting it twice and getting an artificially low count.
 
HSSS said:
Please be careful with this. The word “total” causes so much confusion for some people.
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On the forum folks generally use total carbs to separate from ‘of which sugars’ - which some newcomers arrive thinking is the only thing they have to worry about. Not really helped by the traffic light labelling focus on sugar.

While I take your point about fibre / fiber and differences in US/UK labelling, I personally think ‘total carbs’ is a reasonable and clear phrase in a UK context (and the difference with or without fibre is likely to be fairly modest when compared to the difference between ‘sugars’ and ‘carbohydrate’ content.
 
HSSS said:
Please be careful with this. The word “total” causes so much confusion for some people.

In the UK, Europe and Australia the word “total” isn’t used at all on our labels etc. Our labels make it easy. What is called “carbs” for us includes all carbs except fibre, even whilst specifying how many of those are sugar itself. I suspect this is what you mean. Fibre is an entirely separate listing.

In the USA they do use “total carbs” and for them that includes fibER as well. They then deduct the fiber to get what they call net carbs - same as our plain old “carbs” listing.

As many food and low carb sources are USA based it gets really confusing for those that don’t understand the difference. Either counting fibre when they needn’t for blood glucose reasons or deducting it twice and getting an artificially low count.
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Yes, i nearly did that (deduct it twice)...if you read US based books and read stuff online its easy to read the stuff on 'net carbs' and get confused
 
everydayupsanddowns said:
On the forum folks generally use total carbs to separate from ‘of which sugars’ - which some newcomers arrive thinking is the only thing they have to worry about. Not really helped by the traffic light labelling focus on sugar.

While I take your point about fibre / fiber and differences in US/UK labelling, I personally think ‘total carbs’ is a reasonable and clear phrase in a UK context (and the difference with or without fibre is likely to be fairly modest when compared to the difference between ‘sugars’ and ‘carbohydrate’ content.
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If the audience were only from the uk and only using uk sources I’d agree. But that’s simply not the case.

I get the appropriate intention is to include other carbs than just sugar in the advice. And I agree it makes a big difference, neither of which are the issue I raised. I’ve seen the confusion I describe over and over again though. Sometimes people have been unknowingly getting it wrong for years because they never saw an explanation or were mislead by something like this. The fibre in some foods is actually quite impactful to the count, particularly if you’re aiming for a pretty low carb count, less so if you’re more generous with the overall amounts.

Even using something like “all” the carbs wouldn’t be as confusing. That one specific word “total” has another meaning in the frequently encountered scenario of looking for diabetic food and carb info and could easily be avoided/altered, for the sake of clarity. Or we could continue to confuse people so we can carry on using the word we’ve previously used :confused:
 
HSSS said:
The fibre in some foods is actually quite impactful to the count, particularly if you’re aiming for a pretty low carb count, less so if you’re more generous with the overall amounts.
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Miscalculating carbs due to the fiber being included in the Total Carbs is also impactful to those with Type 1 using carb counting to calculate insulin dose regardless of whether we are aiming for a low carb count.
This happened to me a few years ago when I had some wonderful dates in my veg box. They were proper sticky with a wonderful treacle-like flavour. As a diligent Type 1, I weighed the dates and looked online for the carbs per 100 grams to calculate my insulin dose. I made a school-girl error: I used a US site and forgot to subtract the fiber. There is quite a bit in dates. As a result, my memory of those absolutely yummy dates is tainted by a hypo.
At the time, I was blogging for Diabetes UK. My post that week was entitled "My dates are trying to kill me". The title may have confused a couple of non-diabetic friends but it was a useful lesson for me to learn.
 
This makes my brain hurt. I'm in the UK and followed the above advice of counting all carbs, kind of overlooking the (of which sugars) Is that right?
 
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