Trouble interpreting my data!

Status
Not open for further replies.
C

Carnivaldan

New Member
Relationship to Diabetes
Type 2
Hi there: first time on a health forum.

I want to reverse type 2, through mainly diet, and doing more exercise.

So I was pre-diabetic for a few years and ignored it. Went to a couple of the NHS group sessions and found them patronising and fell asleep!Just before lockdown my HPA1C measure went to 50, so I decided to do something. Since April I've been speaking to a nutritionist who specialises in Type 2 diabetes. He said that when you eat is as important as what you eat. So I've basically been fasting from 8pm to midday. I then have a protein shake + veg + yogurt. I have a hummus & veg snack in the afternoon. In evening zero carb dinner. I've lost over a stone in weight and feel pretty good on it (slightly frazzled by 6pm). I've amended the diet slightly (e.g I do have milk in tea & coffee before midday). I went back for a HPA1C test on June 1st and it had gone down to 46. Not bad. I then went back end July and it was up to 47. Disappointing.

I also bought the Abbot prick test - and have been measuring my blood sugar levels. They ranged from 5ish to 13. I then also bought the Freestyle Librelink which is a patch on my arm with an app. The problem I'm having is interpreting the data, and making any useful conclusions from it. So yesterday for example it trundles along at about 6, then went up to 8 after and eggy lunch. Went down to 3.5 in the pm (lowest ever) and back up to 8 after a hummus snack at 6. Trundled along at 6 ish with no spike after a seafood salad dinner. A more typical day was 6 waking up. Spike to 9 after shake lunch. Spike again at 10 at 8.30pm after dinner.

Basically I'm disappointed my HPA1C score hasn't come down more, quicker, sooner. My BG scores seem quite low. And I want to start eating eat more! Especially at breakfast. My usual breakfast (oats, original crunchy, milk, fruit) seems to send huge spikes. Shall I start experimenting with other breakfasts? Or carry on fasting?
 
Morning. Firstly I would say dump the oats, milk and fruit. All full of carbs. I can’t eat cereal of any kind without giving myself huge spikes. I eat eggs, bacon, salmon, sausage ( good sausage not cheap ones) for breakfast, don’t worry about fat. A diet like you’re on is very restrictive and not sustainable, you’ll crack and binge. Have a look at the Food thread we have, it’ll give you some great ideas. Re the HbA1C tests, it’s unusual to have two just a month or so apart as the test works by measuring your BGs for up to the last 12 weeks. Is your GP doing these or are you going privately? You will hear this a lot on here, diabetes is a marathon not a sprint. You are just on the borderline and by adjusting your diet it will hopefully stay there and you won’t need to join the club that no one wants to join.
PS a nutritionist isn’t the same as a dietician, anyone can call theirselves a nutritionist, whereas a dietician has qualifications. Read our threads you will learn loads more from us, and it’s free! Good luck in your quest.
 
You don't want to reduce your hba1c too much too quickly either, trust me, it can do damage so would never advise it although you don't have much to drop I still wouldn't suggest it xx
 
Hi @Carnivaldan and welcome to the forum and the strange world of blood glucose monitoring.

A HbA1c of 50 is just into the diabetic range and yes it is a good idea to get it down but there is no need to panic. Whatever you are doing at the moment has brought it down to 46/47 ( they are the same number as far as I am concerned) and a bit of work over the next couple of months should get it down to under 42, the trigger value for "pre diabetes"

The blood glucose measurement you get from a prick test has a margin of error. Your blood glucose readings go up and down during the day for many reasons most of which you have no control over and my suggestion is that you use your meter to get some idea of how your system is working. This means organising a testing regime. My suggestion is test first thing in the morning and last thing at night and before and two hours after a meal for a few days. One day do breakfast, another day lunch and another day evening meal. Keep a diary of all of the readings together with what you ate for the meal.

When you have got that information you can begin to see what is going on and begin to look to interpret it and use it to modify your diet to reduce the peaks which are almost always associated with meals and their carbohydrate content.

Take it slowly and methodically and you will get there in six months or so. @Kaylz makes the point that dropping it too quickly is not a good idea.

PS, might suggest a different approach if your HbA1c was 80+!
 
Welcome to the forum @Carnivaldan. I am glad you have found us. There is loads of useful advice from people who are living with D every day on here, as you have seen above .

Well done on making the decision to tackle this head on. It is hard to be patient but it will take time for things to change. Focus on the amount of carbs in each meal and use your Libre data to show you the impact on certain foods. I was surprised by my reaction to porridge when I started using the sensors. Use this information you gather to make changes to your diet or to reduce portion sizes.
Whatever you choose to do needs to be sustainable. We went for a fixed target for the number of carbs at each meal. It took some time getting used to the (much) smaller portions but it seems normal now.

Keep in touch and fire away with any questions.
It will take time.
 
Remember too that an Hba1c test is subject to error (in the same way that every test is never 100% accurate). No need to be alarmed if it does not show the expected change, when the changes are small.

A number of BG teadings are actually a better guide to cobtrol and Libre's "time in target" is even better. This is my view and I am sticking to it.
 
I personally find that the predicated HBA1c from the Libre for me is not close to the laboratory results.
 
Hba1c measures glycosolated haemoglobbin in your red blood cells. Red blood cells are replaced by the body after around three months, so it will take around three months for the glycosolated haemoglibin to replaced by the less glycosolated haemoglobin.
 
Hi, also just to note - everyone's blood sugar goes up and down a lot throughout the day - diabetes or no. My husband who does not have diabetes wore a libre for a week as my daughter who is recently diagnosed was getting upset by the ups and downs and wanted a straight line. His blood sugars ranged from 3.5 to 9 and went up if he ate a really carby meal. The main difference was his went down quickly to normal range from the higher numbers. My daughter actually achieved more time in range than he did!
 
I think you may find some of the foods you are eating are higher carb than you think. Not only that but the body is able to break down about 40% of protein and 10% of fat into glucose in the absence of enough carbs, so that will probably be why you got a spike from the eggs.... it usually happens about 2 hours after I eat protein.
Hummus is made from chick peas which contain about 45g carbs per 100g ie 45% carbs which is quite high and vegetables also contain carbs so depending upon which veg you had... for example carrot is much higher in carbs than celery, so depending upon how much hummus and veggies and which veggies you had, that would account for a spike following that snack. A Zero carb diet is nigh on impossible.
A very low carb diet of 20-30g carbs a day is possible but you need to eat a lot of fat to make it sustainable (you need to get calories from fat because you are not eating carbs) and enjoyable. Don't be frightened of eating more fat. It provides slow release energy to keep you going all day and evening.... I certainly don't run out of steam at 6pm. Fat doesn't spike your BG and it keeps you from feeling hungry because it takes longer to digest.
I worked outside all day yesterday until 10pm on just one meal.... a cup of coffee with cream in the morning and a quality quarter pounder Aberdeen Angus burger (no bun) with green beans and ratatouille made with lots of olive oil and a couple of dollops of creamy Greek Yoghurt with a few blackberries and mixed seeds for afters. Then I had a large chunk of cheese (actually 2... a mature cheddar and a blue stilton) and a small glass of red before bed.

How quickly does your BG return to normal after these spikes? That might be more of a measure of how well you are doing? As @stephknits says is normal for BG to vary throughout the day and spike not only from food but also exercise and stress. The recovery time to more normal levels is probably more relevant. For instance, before I was started on insulin, porridge would spike me into double figures for about 8 hours.... a sure indication that things were not functioning properly.
 
Thanks everyone. Useful. I realise that I am still cusp pre-diabetes / diabetic but I think it is already having impact on my health (e.g. got a cataract operation in a couple of weeks - I'm only 54) so I really want to crack it. My thinking today since exploring the site is:
- speak to my GP and really get them on the case and on board with what I'm trying to do (and see if they can help). I need continuity of care.
- get to grips with my patterns on Librelink (does it really only last 2 weeks? For £50!)
- try a more sustainable, smaller portion, v low carb diet that works for long term.
- do more exercise and measure the results of this on BG
Thanks everyone - glad I found you!
 
rebrascora said:
I think you may find some of the foods you are eating are higher carb than you think. Not only that but the body is able to break down about 40% of protein and 10% of fat into glucose in the absence of enough carbs, so that will probably be why you got a spike from the eggs.... it usually happens about 2 hours after I eat protein.
Hummus is made from chick peas which contain about 45g carbs per 100g ie 45% carbs which is quite high and vegetables also contain carbs so depending upon which veg you had... for example carrot is much higher in carbs than celery, so depending upon how much hummus and veggies and which veggies you had, that would account for a spike following that snack. A Zero carb diet is nigh on impossible.
A very low carb diet of 20-30g carbs a day is possible but you need to eat a lot of fat to make it sustainable (you need to get calories from fat because you are not eating carbs) and enjoyable. Don't be frightened of eating more fat. It provides slow release energy to keep you going all day and evening.... I certainly don't run out of steam at 6pm. Fat doesn't spike your BG and it keeps you from feeling hungry because it takes longer to digest.
I worked outside all day yesterday until 10pm on just one meal.... a cup of coffee with cream in the morning and a quality quarter pounder Aberdeen Angus burger (no bun) with green beans and ratatouille made with lots of olive oil and a couple of dollops of creamy Greek Yoghurt with a few blackberries and mixed seeds for afters. Then I had a large chunk of cheese (actually 2... a mature cheddar and a blue stilton) and a small glass of red before bed.

How quickly does your BG return to normal after these spikes? That might be more of a measure of how well you are doing? As @stephknits says is normal for BG to vary throughout the day and spike not only from food but also exercise and stress. The recovery time to more normal levels is probably more relevant. For instance, before I was started on insulin, porridge would spike me into double figures for about 8 hours.... a sure indication that things were not functioning properly.
Click to expand...
Just seen this: my spikes are usually quite "spikey" so go say from 6 to 9 then go down to 5 after 30 mins - 1 hour and then back to 6. One last week after oats & crunchy went from 5 to 17 and then back down to 6 all within 90 mins. Is that good?? Or do I want flatness?
 
5 to 17 and back to 6 in 90 mins tells you that you need to avoid Oats and Crunchy big time. Does that contain a lot of sugar as well as the carbs from the oats as that is a huge spike and definitely not good for you. Was that Libre readings or finger prick? Just wondering if you had something sticky on your fingers which compromised a finger prick reading and gave you a falsely high result... I'm not familiar with that product, but if it is high in sugar as well as starchy carbs that may be why it took you so high. You could play around with reducing the portion size and bulk it out with creamy Greek natural yoghurt and seeds if it is something you really like, but it may end up that only a tiny portion is what your body can tolerate. Using digital kitchen scales with things like breakfast cereals is important because we are so used to eating larger than recommended portions. I can usually manage 25g of a low carb Granola but it is a piddly amount and you then need to bulk it up with other things like chopped nuts and seeds and yoghurt..... It is also important to recognise that yoghurts can be quite high in carbs, particularly flavoured ones and low fat yoghurts are almost always higher in carbs than full fat versions. This is why I mention Creamy Greek natural Yoghurt. It is lowest carb, minimally processed, substantial, will keep you feeling full for longer and provide you with slow release energy. It is a better choice than milk on a Low Carb diet.

6-9 is good since you are back down to 6 within 2 hours.
 
Yes, Libre only works for 14 days and then the firmware shuts it off. As a T2 perhaps you do not need the sophistication of the libre, you might consider using it for 14 days and then a gap of, perhaps a few weeks, once you have discovered how things work for you. Use the libre to experiment with new foods for example.

You may find that finger pricking is good enough to fill the gaps.

Most T2s reduce the amount of testing that they do as they become more confident of what does what.
 
Status
Not open for further replies.
Back
Top