What Next?

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Duane Charles

Duane Charles

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Relationship to Diabetes
Type 2
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Since I started taking readings and the various dosages of Metformin, I have asked lots of questions and have had a lot of answers and I thank you.

As I’ve said previously I’m struggling and feel confused by what I’m trying to achieve. I also know that nothing is going to happen overnight and the possibility of maybe not being treated correctly is also playing on my mind. My working hours don’t help as most days I’m there, I’m not leaving until midnight. I’m conscious of what I’m eating and believe me when I say I have taken great strides to cut down my sugar intake. I have an extremely sweet tooth and I know it’s not just about the sugar. I’m looking at carbs, I’m trying to understand what is good etc.

I’m sure that in time I’ll have more questions and I hope that you'll continue to offer advice and answers. I apologise for going on like this but I feel like I’ve overloaded on info right now but want to be doing the right thing and at times feel like I’m not. I’m also sure that I’m not the only person who has gone through this.
 
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Don't worry about coming here and expressing your frustrations. It is often more complicated to manage a condition when the possible reason for it is not clear and you are juggling multiple things. All you can do is your best and try to be logical in the decisions you make about what food to have when and when to test. But hopefully by collecting the information which may seem like a faff, it will enable your GP to see what might be going on.
It is always more difficult to diagnose and sort out a problem when people get erratic and inconsistent results, trying to fix a washing machine with an intermittent fault is a nightmare (may as well throw it away 🙂) but on the other hand a good engineer can say 'Oh I know exactly what it is' and is able to fix it.
 
@Duane Charles There might be more going on than you can tell - we are complicated and do not have simple levers - I reduced my intake of carbs from under 50 gm maximum per day to under 40 gm, as my HbA1c did not drop down into the 30s. A whole year eating fewer carbs and my HbA1c was unchanged. I was feeling a lot better though. The effects of type 2 had crept up on me so gradually that I did not realise how bad it was. Only when I began to feel that years were slipping off me did I find it amazing that I'd been coping with being unwell for so long.
There are several different conditions all labelled as type 2, I am sure, as people find that different things will or won't work for them. The time after diagnosis can be difficult as some, like me, alter their diet and it all comes right whilst others could eat the same thing and still not see the results they'd like.
If you have a sweet tooth you can always create a dessert.
I just ate something I made after dinner. It set quickly because I used frozen berries.
I get a bag of frozen berries, Lidl do a 4 berry mix which is cheap, sometimes I splash out on 'Summer fruits' - I get a big bowl and put in cold water and a sugar free jelly, 4 desert spoons of powdered gelatine, then dissolve it in boiling water. I add some sugar free squash, orange or red depending on the jelly, a teaspoon of artificial sweetener as the berries are a bit tart without and then pour in the berries, stirring so they do not clump together. It sets in minutes. I eat it with cream.
I use so much gelatine so that the berries do not go to mush in the firm jelly.
 
Drummer said:
@Duane Charles There might be more going on than you can tell - we are complicated and do not have simple levers - I reduced my intake of carbs from under 50 gm maximum per day to under 40 gm, as my HbA1c did not drop down into the 30s. A whole year eating fewer carbs and my HbA1c was unchanged. I was feeling a lot better though. The effects of type 2 had crept up on me so gradually that I did not realise how bad it was. Only when I began to feel that years were slipping off me did I find it amazing that I'd been coping with being unwell for so long.
There are several different conditions all labelled as type 2, I am sure, as people find that different things will or won't work for them. The time after diagnosis can be difficult as some, like me, alter their diet and it all comes right whilst others could eat the same thing and still not see the results they'd like.
If you have a sweet tooth you can always create a dessert.
I just ate something I made after dinner. It set quickly because I used frozen berries.
I get a bag of frozen berries, Lidl do a 4 berry mix which is cheap, sometimes I splash out on 'Summer fruits' - I get a big bowl and put in cold water and a sugar free jelly, 4 desert spoons of powdered gelatine, then dissolve it in boiling water. I add some sugar free squash, orange or red depending on the jelly, a teaspoon of artificial sweetener as the berries are a bit tart without and then pour in the berries, stirring so they do not clump together. It sets in minutes. I eat it with cream.
I use so much gelatine so that the berries do not go to mush in the firm jelly.
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I do much the same but use a sachet of sugar free jelly with a selection of berries (usually home grown frozen because I have them).
 
What I find is that I can have the same meal two days on the trot and on one day there’s a jump of over 3mmol and the next day the change is 0.1mmol. Yes my BG is high but I’m trying to find foods that don’t have too big an effect on me. It also gets me to wonder if the Metformin is doing what it should? I have been on the increased dosage for a week now, would it have kicked in by now?
 
Duane Charles said:
What I find is that I can have the same meal two days on the trot and on one day there’s a jump of over 3mmol and the next day the change is 0.1mmol. Yes my BG is high but I’m trying to find foods that don’t have too big an effect on me. It also gets me to wonder if the Metformin is doing what it should? I have been on the increased dosage for a week now, would it have kicked in by now?
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I have the same meals on a regular basis but my post-prandial readings are sometimes widely different, so much so that I long ago gave up trying to figure out why.

For example:-

Chilli Con Carne with Cauliflower Rice - average 6.0, range 5.3 - 7.1
Hunter's Chicken & Salad - average 5.7, range 5.2 - 6.4
Cajun Chicken & Salad - average 5.7, range 4.7 - 6.8
Mixed Mushroom Stroganoff with Cauliflower Rice - average 5.9, range 5.2 - 6.7
 
Metformin usually takes a couple of weeks to build up and if I remember correctly you are just on 500mg twice a day when I have seen it suggested that 1500mg is the minimum effective dose, but you have to build up to it slowly.
Also I think some of your meals you weren't testing just before eating as well as 2 hours afterwards, so now that you are hopefully getting into a better routine of testing you should start to see more useful results, but yes, we all understand how frustrating it is when you don't get consistent results with the same meal. There are at least 42 known factors which impact BG levels and we are only in control of a small number of them, so whilst the meal and your medication might have been the same and you may have done roughly the same amount of activity, there are many other factors which can also have an impact. This is why the test immediately before eating is so important to try to rule out other things affecting your levels between when you last tested and 2 hours after this meal. Most of those other factors will have minimal effect during that 2 hours, but if you went for a walk or had a glass of wine or a shot of spirit or had sex, or didn't sleep well the night before, or went for a long walk the previous day, that can have a significant impact. It is quite surprising how things can affect your levels, which is why looking for longer term patterns is helpful, because the other variables become background noise. Keeping a diary and noting activity and food and BG levels gradually helps you to see those patterns, but 2 tests on a particular meal sometimes isn't enough to draw any conclusions and it might take 3 or 4, to start seeing a pattern. The more consistent you can be with the other factors the clearer the patterns will become.
 
rebrascora said:
Metformin usually takes a couple of weeks to build up and if I remember correctly you are just on 500mg twice a day
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Hi @rebrascora , I was on 1 x 500mg twice a day but was actually taking both at the same time, usually with breakfast. Just before Christmas (21st) this was upped to 2 x 500mg twice a day, but again I’ve been taking these at the same time with breakfast. I may need to be a bit more patient with the medication and time allowed for it to work.

My sleep patterns are quite erratic as there are nights where I can be awake for hours and my energy levels during the day are non-existent apart from when I have to get ready for work. Breaks at work are almost frowned upon, so trying to grab a few minutes to have something to eat can be a bit of a luxury. My immediate manager is aware of my D diagnosis, but does little to find out about how it’s affecting me. I’m almost positive it hasn’t been mentioned to our Head Office until just before the Christmas break. This too does add to the stress and anxiety I feel.
 
Duane Charles said:
Hi @rebrascora , I was on 1 x 500mg twice a day but was actually taking both at the same time, usually with breakfast. Just before Christmas (21st) this was upped to 2 x 500mg twice a day, but again I’ve been taking these at the same time with breakfast. I may need to be a bit more patient with the medication and time allowed for it to work.

My sleep patterns are quite erratic as there are nights where I can be awake for hours and my energy levels during the day are non-existent apart from when I have to get ready for work. Breaks at work are almost frowned upon, so trying to grab a few minutes to have something to eat can be a bit of a luxury. My immediate manager is aware of my D diagnosis, but does little to find out about how it’s affecting me. I’m almost positive it hasn’t been mentioned to our Head Office until just before the Christmas break. This too does add to the stress and anxiety I feel.
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As the metformin you have is modified release they are meant to be taken at the same time.
 
Leadinglights said:
I do much the same but use a sachet of sugar free jelly with a selection of berries (usually home grown frozen because I have them).
Click to expand...
I can't take the amount of sweetener it would take to make all those berries into a sturdy jelly. My tastes have changed and I can make an ice cream using peas and a little salt and it tastes like peanuts - I think the clue might be in the name and they always did taste the same but I just never realised.
 
Drummer said:
I can't take the amount of sweetener it would take to make all those berries into a sturdy jelly. My tastes have changed and I can make an ice cream using peas and a little salt and it tastes like peanuts - I think the clue might be in the name and they always did taste the same but I just never realised.
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I suppose the fruit I put in the jelly is quite sour, gooseberries, jostaberries, redcurrants, sour cherries, blackberries so it never seems too sweet using the sachet of sugar free jelly.
 
Duane Charles said:
What I find is that I can have the same meal two days on the trot and on one day there’s a jump of over 3mmol and the next day the change is 0.1mmol.
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Given home testing meters have a tolerance of 15%, if your levels are high, this may not be much difference.
 
Drummer said:
'Summer fruits' - I get a big bowl and put in cold water and a sugar free jelly, 4 desert spoons of powdered gelatine, then dissolve it in boiling water. I add some sugar free squash, orange or red depending on the jelly, a teaspoon of artificial sweetener as the berries are a bit tart without and then pour in the berries, stirring so they do not clump together. It sets in minutes. I eat it with cream.
Click to expand...
Good afternoon @Drummer i was looking at your recipe above, I’ve only found sugar free jelly as a powder. Also, can gelatine sheets be used in the absence of it in powder form?
 
i agree you can do good on one food one day and it is bad. If you are on metformin I am thinking type 2. You are insulin resistant and have some insulin sometimes it works sometimes it doesn't. There are so many possibilities that may cause this, sleep, exercise, the amount of fluid in your body, how hot, or cold, or even something like how your metabolism or hormones are working. It is as easy as a+b= c but we don't know what a is one day b is another and therefore c can be anything. So you just need to plod on and make good choices we are all different. I'd keep going is what is next. Sorry no better advice.
 
Would it be an idea to ask my DN about Insulin Resistance and if they’ll arrange to find out if I am and by how much? Also, would it vary on the day of the test?
 
Duane Charles said:
Good afternoon @Drummer i was looking at your recipe above, I’ve only found sugar free jelly as a powder. Also, can gelatine sheets be used in the absence of it in powder form?
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I buy a large bag of gelatine powder, the 'strongest' set I can find, as it is cheaper in the long run. It lasts me around a year. Any sort of gelatine will do, it is just that the amount of flavoured sugar free jelly sachets to create a strong enough set for a whole bag of berries is too much artificial sweetener for me these days.
The gelatine powder means I can make posh looking dishes such as mixed vegetables in gelatine, a layer of chicken then steamed cauliflower, more gelatine and when set turn it out onto a steel tray with salad stuff all around it and be thought a proper chef at events where my morris dancers are performing.
 
Drummer said:
I can't take the amount of sweetener it would take to make all those berries into a sturdy jelly. My tastes have changed and I can make an ice cream using peas and a little salt and it tastes like peanuts - I think the clue might be in the name and they always did taste the same but I just never realised.
Click to expand...
peas and peanuts are both grown in the ground as opposed to most nuts that grow in trees.
 
Duane Charles said:
Would it be an idea to ask my DN about Insulin Resistance and if they’ll arrange to find out if I am and by how much? Also, would it vary on the day of the test?
Click to expand...
 
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