Worried about my sugar levels

[snowball12]

My last HbA1c reading in January was 76, what dose that mean, I know its higher than last time. My diabetic nurse is a bit scatty and said it was ok but I am not so sure. I have had Type 2 since 2011 despite no family history. I eat fairly well, porridge wholegrains fruit and veg etc. Exercise is limited as I have osteoarthritis in my knee. I am approx. 2 stone overweight and can't seem to shift it. My fasting sugars are never below 9 and have gone up later in the day to 15.I have had a stressful year with my mother dying suddenly but I do not know why my sugars are going haywire. Should I see my GP when this pandemic is over. I am on 1500mg of metformin and 120mg of Duloxetine anti depression/ anxiety medication. I am a chronic depressive for over 32 years now. Any help would be appreciated

 

[Kaylz]

Hi there and welcome to the forum

You say you eat fairly well but list mainly carbohydrates as a food source, have you tried reducing your carbohydrate intake to see if you can get your blood glucose down and in control? it isn't just sugar you have to be wary of it's total carbohydrates so maybe try reducing portion sizes of the carbohydrates
xx

 

[rebrascora]

Hi and welcome

Whilst 76 is a lot higher than is ideal it is not in the red zone but needs addressing and it should certainly be possible to reduce it relatively easily with the correct dietary changes. The problem sounds like you have been given erroneous dietary advice regarding what is healthy for a diabetic.
Carbohydrates are broken down by the body into glucose which then gets absorbed into our blood stream. Insulin is produced by the pancreas which enables the cells of the body to access the glucose. With Type 2 diabetes, the body usually becomes resistant to the insulin and the cells are not longer as able to access and remove that glucose from the blood. Metformin is supposed to help the cells to be more receptive to the insulin, so that they can remove the glucose, but it is far more effective to just cut the amount of glucose going into the blood stream in the first place and this is where following a low carb diet makes a huge difference.
Carbohydrates are both sugars and starches, so any food which is high in carbs is best avoided or significantly reduced, even the "healthy" low GI versions. So your diet of porridge and wholegrains and fruits is still very high carb and that is causing your body to become more and more resistant to insulin, hence your HbA1c has gone up.
If you cut right back on carbs, you will produce less insulin and your body may regain some of it's sensitivity to it but more importantly your Blood Glucose levels will reduce and you will almost certainly lose weight.

High carb foods are the obvious sweet stuff like cakes and biscuits, sweets and chocolate but also fruit and fruit juice, honey and maple syrup, but also starchy foods make from grains like bread, pastry, batter, pasta, couscous, rice, breakfast cereals including porridge and root vegetables like potatoes in all their forms and parsnips and carrots even.
Reducing or completely omitting these foods from your diet will make a huge difference to your BG and longer term, your HbA1c.
It may seem like there is nothing much left to eat but actually a Low Carb way of eating can be very enjoyable. It just takes a bit of time to figure out. One of the first things to realise is that fat is not the demon we have been lead to believe for the past 50+yrs. If you eat more fat, you feel satisfied. It takes much longer to digest than carbs so it keeps you fuller for longer and it provides slow release energy and it tastes good so you don't feel deprived. Having cream in my coffee every morning instead of milk is lower carb, tastes amazing and helps set me up for the day. Eggs are a good choice for breakfast instead of porridge or cereals or toast. I like a 2 egg omelette with onion and mushrooms and cheese and I usually have it with a salad and cheese coleslaw, but scrambled or poached or boiled are all fine, but steer clear of the bread/toast. Some people use asparagus as soldiers in their soft boiled egg instead of toast. Bacon, sausage egg and mushrooms is another low carb choice although perhaps not ideal for every morning. Sausages need to be good quality high meat content because cheap sausages contain rusk which is carbs. Many of us also enjoy Creamy full fat Greek natural yoghurt with a few berries which are the lowest carb fruits (or rhubarb stewed with sweetener) with some chopped nuts and mixed seeds like pumpkin and sunflower and chia.... the seeds are helpful to provide extra fibre which is lost when grains are removed from the diet. Exotic fruits like banana and pineapple and mango and oranges and even apples and pears are quite high carb, so a few berries are usually the safest option for a fruit portion.
Salads for lunch are good. especially at this time of year with meat or fish or eggs or cheese and coleslaw works well or full fat mayonnaise and avocado adds health extra fat as do olives if you like them.... one of my low carb treats is a pot of olives, or a chunk of my favourite cheese or if I am feeling really naughty, a packet of pork scratchings.

For dinner, cauliflower is a staple for me. Who doesn't love cauliflower cheese or you can boil it and mash with a dollop of cream cheese and a spoon of wholegrain mustard to replace potato mash or grate it and cook it to replace rice or couscous. I often have cauliflower cheese with gammon or high meat content sausages or pork steaks. Cauli mash works well to top mince for a cottage pie with a good dusting of grated cheese of course and I have seen recipes where it is cut into slices and cooked like a steak, but not tried that yet. Ratatouille is another favourite, with lots of olive oil and courgettes and aubergines and peppers and onions and tomatoes and garlic and mixed herbs. Topped off with grated cheese and baked in the oven is good. I could sit here and type all evening but hopefully you get the gist of what you are aiming for.

It sounds like you have a BG meter and that will make things so much easier. One the forum we recommend testing before each meal and then 2 hours after to see the effect each meal has had on your BG and that will guide you as to what carbs you can and can't get away with and we are all different in that respect. Some people can get away with a small portion or pasta once a week whilst others might be ok with a couple of small potatoes or a slice of bread once a day. If the rise in BG is less than 3mmols 2 hours after a meal then that meal was reasonably ok but ideally you are looking for a rise of no more than 2 mmols.
Many people find that their BG naturally rises in the morning even without eating anything. This is called the Dawn Phenonenon. Eating carbs for breakfast on top of this rise can make things significantly worse, so many people find it very beneficial to avoid eating carbohydrates in the morning particularly. A simple change in breakfast for you from porridge to eggs or yoghurt for example could have a huge impact on your daily readings, even without going too low carb for the rest of the day.

Anyway, if you haven't got bored and fallen asleep, hopefully some of what I have written above will be helpful.

 

[DaveB]

Hi. An HBA1C of 76 is far too high. You should be aiming to be 60mmol or less. Yes, you may not have had the right guidance about diet. All carbohydrates contribute to higher blood sugar and weight. For breakfast having eggs and bacon for example would be better than porridge. Wholegrain bread etc is better than white but would still be a Carb so go for proteins and fats rather than carbs where you can