Total Newbie struggling with glucose levels

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KazG

KazG

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Hi all, I am totally new here, and to having diabetes. I have felt a total lack of support from my local GP and Diabetes nurse. I had an appointment today where she didn’t answer any of my questions, told me I didn’t need meds and to go away and follow the instructions in the booklet. Am I stupid to expect more? I want to lose my excess weight and try to put myself into remission…no advice. I asked if I could have my HbA1c checked after another 3 months to see if the changes I make are working….no it’s yearly! I asked why my glucose levels were high most of the times I have checked them…was told I shouldn’t be checking them. i have been following a low carb diet so results of 16mol/l an hour after food….is that normal? A level of 8.8 mmol/l 15 hours after a snack…is that right? Should I be on tablets? Can anyone point me in the direction of what I can expect to see in my blood glu results when following a restricted carb diet please. Should I be on tablets? Giving my a booklet and telling me to come back in 1 year feels like the GPs wash their hands of you when you get diagnosed. I want to lose weight and get into remission if possible, but want more support on the journey. Please any advice would be wonderful. Thank you x
 
Hi and welcome.

Sorry to hear that you are not being provided with the support you feel you need.

How long have you been diagnosed and do you know your most recent HbA1c test result?

If you are going to do home testing, and here on the forum we highly recommend it, then having a testing strategy is really important so that you can use the info you get. The general recommendation is to test immediately before a meal and then 2 hours afterwards. The difference between the before and after readings is what informs you about how your body responded to the food you ate at that meal. If your levels rose by more than 3mmols on two separate occasions, then you need to make some adjustment to the carb content of that meal and test again until you reduce the rise in BG due to that meal. Testing at 1.5 hours one day and 2 the next is not helpful. You need to be consistent with the timing of 2 hours post meal and also knowing what your premeal reading was. Everyone's BG levels rise after they eat, peak and then come down. With diabetes our insulin response is impaired so it will likely spike higher and take longer to come down again, but if you reduce the amount of carbs to keep the spike lower, then it has a chance to gradually start bringing your baseline levels down before the next meal sends them up again.
Some people also test first thing in the morning each day to give them an idea of their fasting levels and over weeks and months you should gradually see these levels coming down. There will be some day to day fluctuation, so you will be a bit higher one day and a bit lower the next depending on a whole host of factors but week over week and months over month, if you are keeping the meal rises low, the waking reading should come down into range.

Can you give us an idea of the sort of things you are typically eating at the moment, to see if we can spot anything which might warrant closer testing. Some things like lentils and chick peas and porridge can be fine for some people, but cause other people problems despite their so called "healthy" slow release reputation. The whole benefit of testing is because we are all different and finding these little idiosyncrasies helps to enable us to tailor our diet to our particular body's response and our diabetes.

It is worth investing in a couple of months of intensive testing so that you can develop a repertoire of meals/portion sizes which work for you as an individual and then just test any new foods/meals after that to see how you respond to those. Keeping a food diary along with your before and after test results is important, including the portion sizes of the main carb constituents.
 
It sounds like you have a particularly useless GP and nurse as most of the advise is pretty rubbish.
Most people will get an HbA1C after 3 months from diagnosis so you can check if changes you have made are being effective.
Whether you should be on medication rather depends on what your HbA1C is so if not too far above the diagnostic threshold of 48mmol/mol then dietary changes should be sufficient.
Many do find testing at home useful but it is only so if you adopt a strategy as described rather than something random.
I must say the readings you are getting suggest your carbohydrate intake is too much for your body to tolerate.
Many find a low carbohydrate approach successful in both losing weight and reducing blood glucose. This link may give you some ideas for a way forward if that is a way you could engage with. https://lowcarbfreshwell.com/
Low carb is suggested as being less than 130g carbs not just sugar per day, it is not NO carbs.
If you would like to post the sort of meals you have then people might spot foods which are potentially a problem. I think trying to make sure you have filling meals rather than snacking is more helpful.
 
Hard to fathom why your GP and DN should be so dismissive but at least you've done the right thing by signing up here.
I can't add to what @rebrascora and @Leadinglights have already said except to say welcome and we're here to help.
 
Thank you so much for your comprehensive and quick reply…you have already said so much more than my GP and the ‘booklet’ have said. My HbA1c at diagnosis on 24/10 was 59, and 58 1 week later. Breakfast has been 2 weetabix with unsweetened rice milk or about 100 calories of wholemeal bread with a scraping of butter or marmite. Lunch may be a sandwich thin with chicken and salad or a keto bar (v low in sugar). Evenings are fish or chicken with veg and potato, or chilli without any rice. I am logging everything with nutrachek and calories between 800-1200 a day on the whole. The problem may have come in with the fact my new diet (combined with co-codamol following nasal surgery) has left my constipated and resorting to syrup of figs. I couldn’t find nutritional info on this but it must be packed with sugar…started with just 5mls and ended on max dose of 30mls in one day (was getting desperate and the alternative…lactulose…is also packed with sugar!). I am going to start with the strict monitoring regime first thing in the morning and hopefully this will help me identify trouble spots. I am also starting my new exercise regime tomorrow as I am allowed to excerise 14 days post surgery). Thank you SO much for spending the time to respond, I really am very grateful. X
 
Is there a reason why you use rice milk? It is more highly processed than dairy milk and clearly you are not vegetarian. It also appears that, depending upon the brand it may contain more carbs than whole dairy milk. 2x Weetabix is probably pushing it too, but obviously some testing around that will let you see if you can tolerate them. Many of us have creamy Greek style natural yoghurt with a few berries and mixed seeds and or chopped nuts or peanut butter

As regards constipation, I use a fibre supplement drink to keep my bowels moving. The syrup of figs is definitely not going to be helping your BG levels. I use a mixture of whole chia seeds and psyllium husk mixed into a tall glass of water flavoured with whatever I like (low carb) and drunk down. Having it as a drink works best for me because it ensures that I get the extra fluids into me which is also important, particularly at this time of year when we are less inclined to drink so much water. Some people sprinkle it on their food or in soups and stews which I also do to thicken them, but my fibre drink (similar to Fibogel which is often prescribed to older people) works great and is not just important for my gut health but the high soluble fibre also helps to reduce cholesterol. Chia seeds are available in most major supermarkets. I get mine in Lidl. I buy the psyllium online. My sister finds just the chia seeds work well for her as do many others but I like the combination. Going low carb certainly caused me to become constipated at first, but now I have my fibre drink routine it is sorted.
 
The foods you mention you are having for breakfast are very high carb, weetabix, rice milk, bread so you will be starting the day with high blood glucose. Many find that having a low carb breakfast of Full fat Greek yoghurt with berries or eggs in any form is a better option.
Potatoes are high carb so more other veg with your fish of chicken.
Really it is carbohydrates you need to be taking account of rather than calories. The book or app Carbs and Cals is really useful as it has carb values of different portions of a whole range of food is an easy to see way. Also some scales on your work top to weight things until you get your eye in for what is a good portion as some things are very deceptive./
Hopefully once you are off the co-codamol the constipation will be alleviated, but you could try SenoKot as being less sugary or something like fibogel.
 
It makes me so cross when GPs and diabetes nurses are so dismissive when all people want is help to help themselves. That aside, you have come to the right place and this forum is jam packed with useful advice and help.

I’ve nothing helpful to add that hasn’t already been said, other than welcome and keep logging in. Everything will seem quite overwhelming at the moment but things will become much clearer over time and you will settle into a new way of looking at food and its affects on your blood glucose.
 
KazG said:
Thank you so much for your comprehensive and quick reply…you have already said so much more than my GP and the ‘booklet’ have said. My HbA1c at diagnosis on 24/10 was 59, and 58 1 week later. Breakfast has been 2 weetabix with unsweetened rice milk
Click to expand...
If the reason the rice milk because your lacatose intolerant(dont know weather you are but just thought that's a possible reason for it) then perhaps unsweetened almond milk would be better that has very little carbs in it. Weatabrix are also quite carby. I can't really advise much on carb intake as I'm a type 1 who doesn't limit carbs
 
rebrascora said:
Is there a reason why you use rice milk? It is more highly processed than dairy milk and clearly you are not vegetarian. It also appears that, depending upon the brand it may contain more carbs than whole dairy milk. 2x Weetabix is probably pushing it too, but obviously some testing around that will let you see if you can tolerate them. Many of us have creamy Greek style natural yoghurt with a few berries and mixed seeds and or chopped nuts or peanut butter

As regards constipation, I use a fibre supplement drink to keep my bowels moving. The syrup of figs is definitely not going to be helping your BG levels. I use a mixture of whole chia seeds and psyllium husk mixed into a tall glass of water flavoured with whatever I like (low carb) and drunk down. Having it as a drink works best for me because it ensures that I get the extra fluids into me which is also important, particularly at this time of year when we are less inclined to drink so much water. Some people sprinkle it on their food or in soups and stews which I also do to thicken them, but my fibre drink (similar to Fibogel which is often prescribed to older people) works great and is not just important for my gut health but the high soluble fibre also helps to reduce cholesterol. Chia seeds are available in most major supermarkets. I get mine in Lidl. I buy the psyllium online. My sister finds just the chia seeds work well for her as do many others but I like the combination. Going low carb certainly caused me to become constipated at first, but now I have my fibre drink routine it is sorted.
Click to expand...
Thankyou for the suggestions, I shall look at changing to maybe skimmed milk. I was using it as it was lower carb and fat than the semi skimmed my husband uses. I shall look at the husks and chia seed…Thankyou for the suggestion, very helpful. I love Greek yoghurt so that would be a good choice…thank you again x
 
rayray119 said:
If the reason the rice milk because your lacatose intolerant(dont know weather you are but just thought that's a possible reason for it) then perhaps unsweetened almond milk would be better that has very little carbs in it. Weatabrix are also quite carby. I can't really advise much on carb intake as I'm a type 1 who doesn't limit carbs
Click to expand...
Thankyou, I must admit I was looking at the sugar content of weetabix, which is low, but the carbs are high as you say. Time to change my breakfast I think…
 
rayray119 said:
If the reason the rice milk because your lacatose intolerant(dont know weather you are but just thought that's a possible reason for it) then perhaps unsweetened almond milk would be better that has very little carbs in it. Weatabrix are also quite carby. I can't really advise much on carb intake as I'm a type 1 who doesn't limit carbs
Click to expand...
No not lactose intolerant…I will rethink the rice milk, Thankyou for pointing it out. There was me thinking I was doing a good thing but I was getting it all wrong. Really appreciate the feedback x
 
rayray119 said:
If the reason the rice milk because your lacatose intolerant(dont know weather you are but just thought that's a possible reason for it) then perhaps unsweetened almond milk would be better that has very little carbs in it. Weatabrix are also quite carby. I can't really advise much on carb intake as I'm a type 1 who doesn't limit carbs
Click to expand...
Thankyou, I will revisit my choices x
 
Deb_l said:
It makes me so cross when GPs and diabetes nurses are so dismissive when all people want is help to help themselves. That aside, you have come to the right place and this forum is jam packed with useful advice and help.

I’ve nothing helpful to add that hasn’t already been said, other than welcome and keep logging in. Everything will seem quite overwhelming at the moment but things will become much clearer over time and you will settle into a new way of looking at food and its affects on your blood glucose.
Click to expand...
Thankyou, your stats you have posted are really inspirational, I hope my journey is as successful as yours, x
 
Leadinglights said:
The foods you mention you are having for breakfast are very high carb, weetabix, rice milk, bread so you will be starting the day with high blood glucose. Many find that having a low carb breakfast of Full fat Greek yoghurt with berries or eggs in any form is a better option.
Potatoes are high carb so more other veg with your fish of chicken.
Really it is carbohydrates you need to be taking account of rather than calories. The book or app Carbs and Cals is really useful as it has carb values of different portions of a whole range of food is an easy to see way. Also some scales on your work top to weight things until you get your eye in for what is a good portion as some things are very deceptive./
Hopefully once you are off the co-codamol the constipation will be alleviated, but you could try SenoKot as being less sugary or something like fibogel.
Click to expand...
Thank you, I shall shift to my bacon medallions and egg for breakfast tomorrow and stock up on Greek yoghurt. I have kept the potato portions small, and weigh everything at the moment, but wouldn’t miss them if I cut them out. The GP confused me by saying I should have bread, pasta, rice or potatoes with each meal…it didn’t seem like good advice. So glad I came to this site.
 
Leadinglights said:
It sounds like you have a particularly useless GP and nurse as most of the advise is pretty rubbish.
Most people will get an HbA1C after 3 months from diagnosis so you can check if changes you have made are being effective.
Whether you should be on medication rather depends on what your HbA1C is so if not too far above the diagnostic threshold of 48mmol/mol then dietary changes should be sufficient.
Many do find testing at home useful but it is only so if you adopt a strategy as described rather than something random.
I must say the readings you are getting suggest your carbohydrate intake is too much for your body to tolerate.
Many find a low carbohydrate approach successful in both losing weight and reducing blood glucose. This link may give you some ideas for a way forward if that is a way you could engage with. https://lowcarbfreshwell.com/
Low carb is suggested as being less than 130g carbs not just sugar per day, it is not NO carbs.
If you would like to post the sort of meals you have then people might spot foods which are potentially a problem. I think trying to make sure you have filling meals rather than snacking is more helpful.
Click to expand...
Thankyou for the info, I have changed my app from the low sugar target to low carb target which is clearly better. Thankyou so much. I am going to monitor closely for the next week and see how I get on. X
 
KazG said:
No not lactose intolerant…I will rethink the rice milk, Thankyou for pointing it out. There was me thinking I was doing a good thing but I was getting it all wrong. Really appreciate the feedback x
Click to expand...
It's okay to get it wrong sometimes it's just about learning from things. Also an important thing to remember with the old diabeties marlakey is what's wrong for someone else could be right for you and vise visa
 
rayray119 said:
It's okay to get it wrong sometimes it's just about learning from things. Also an important thing to remember with the old diabeties marlakey is what's wrong for someone else could be right for you and vise visa
Click to expand...
Thank you x
 
KazG said:
Thank you, I shall shift to my bacon medallions and egg for breakfast tomorrow and stock up on Greek yoghurt. I have kept the potato portions small, and weigh everything at the moment, but wouldn’t miss them if I cut them out. The GP confused me by saying I should have bread, pasta, rice or potatoes with each meal…it didn’t seem like good advice. So glad I came to this site.
Click to expand...
That is exactly why people don't manage to improve their HbA1C and end up with more and more medication. Those are the really high carb foods along with the obvious cakes and biscuits. They also say cut down on sugar which yes is needed but it is all carbohydrates that convert to glucose.
Cream is actually lower carb than milk but there is little difference between the other dairy milks so it is better to have just what you prefer.
 
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