1 month into T2 diagnosis - struggling with meter numbers

Type 2 New to Type 2 diabetes
#1

I am new to T2, on Metforim 500mg 2x/day. Have increased my exercise and watch everything that I eat. Have reduced my initial BS from 350 to the 150's. I have read the blogs and have been eating to my meter. During the weekends, I am active and my before eating numbers have been in the 120's and after eating 140-150. My first thing in the morning numbers are in the 150-160 range even though I eat a healthy snack (veggies & a little hummus) before bed. However, during the week when working my morning numbers are in the 170's and after eating lunch have been in the 200's. When I started the Metforim I took one at 6am and one at 6pm. Then I read that high morning numbers can be a result of taking the Metforim too early in the evening so I started taking them at 11pm and 11am with my snacks.

I am very frustrated that I am eating per the meal plan for carbs designed for me by the diabetes educator and watching what I am eating to see if something isn't working well with me causing higher numbers. My numbers are good on the weekends but the week days are a mess. My exercise habits are basically the same during the week as the weekends, with the exception of household chores, laundry, etc. I know that I have only been at this one month, but I feel like I am doing something wrong. Am I just being too crazy and causing myself more stress? Any thoughts would be most helpful.

#2

"Eating to your meter" and eating per the meal plan designed by the diabetes educator may conflict. I have a few thoughts. Your weekend numbers don't look that bad. Have you tried skipping the bedtime snack to see the effect on your morning numbers? Does Metformin require it be taken with food?

Can you describe a little bit about what the diabetes educator recommends for your eating plan? How many carbs per day and per meal are built into this plan? Most diabetes educators don't believe in restricting carbs. What kind of meals is the educator recommending? Can you list a few sample meals?

The idea of eating to your meter is to identify your threshold of carb intolerance and which carb-heavy food are the worst offenders.

How many carbs are you eating for lunch during the work week? Eating to your meter means measuring your BG before you eat, write down what you eat, and then measure about 2 hours after you eat. If the result is not acceptable, then identify the offending food or quantity and adjust that meal for the next trial.

Don't blame yourself! You are in this for the long run, not for a few days or weeks. You are trying to learn and adjust and this process is not a straight line venture. It may be two steps forward, one step back. Your sustained effort to get this right will pay dividends, but you must persist! It's not easy but is so worth it.

#3

Thanks for replying Terry. To answer your questions:
- I was told to take the Metforim wuth food - no other direction
- When I skipped the bedtime snack, my morning numbers were in the 200's
- The meal plan by the diabetes educator included 15 carbs for snacks - mid morning, mid afternoon and before bed. 45 carbs at breakfast, lunch & dinner. An example of a meal was 1 scrambled egg, 1/4 cup of turkey crumbles, 1 piece of whole wheat toast with margarine, 8oz milk, & 1/2 banana, Lunch was a salad with lots of veggies, tuna & a low fat yogurt. Dinner was a grilled ground turkey burger (no bun), small based potato with 1 tsp margarine, 8oz milk.
- I do measure my BG prior to eating then 2 hours after eating. I hadn't kept a food diary prior to meeting with the diabetes educator, but am now so I can see what I am doing.

I think part of my problem is that I want immediate results for my actions and I have never had to deal with a chronic disease before. That is why I joined this group so I can learn.

#4

I couldn't possibly eat 45 carbs at breakfast and control my blood sugar! Those 8 oz glasses of milk are empty carbs; I don't think any adult really needs that much milk, and unless you are hungry, you shouldn't have to be eating so many snacks. No offense, but the diabetes educator is clueless!

Ok, first things first. Most important question is, are you sure you're Type 2? Many of us were misdiagnosed as type 2 solely based on age. If you are Type 1, the meds won't help you. did the doctor do antibody testing and c-peptide? Some relevant (but not conclusive) questions: Are you overweight? Have you lost significant weight lately (without really trying). Do you have any other autoimmune conditions such as thyroid? Do they run in your family? Only the tests are conclusive but your answers to those questions might set you on a path to clarify Type.

#5

Deb - Zoe’s point about getting a correct dignosis is very important. In general, we patients, put way too much confidence in doctors. They are not gods and they do make mistakes. Some T1Ds, like Zoe, were misdiagnosed simply because of their adult age.



T1D is an autoimmune disease and antibodies are usually present at diagnosis. If you are really a T1D you will lose valuable time, not to mention feel sicker longer, if you continue to follow advice appropriate for T2Ds. The typical T2D treatment path will take you down an ineffective path, starting with Metformin, and then adding one or more medications and finally insulin before you get any decent metabolic contol.



You will need to be forceful with your doctor to get the blood antibody tests. There are several and I don’t know all the names (one is GAD) but you can search for TuD member, Melitta, I believe, who has written extensively on this very topic of misdiagnosing T1Ds as T2Ds.



Getting this sorted out now is to your benefit. If you truly are T2, then you can go down that path with confidence.

#6

Here’s a link to one diary that explores the misdiagnosis topic:

https://forum.tudiabetes.org/topics/mis-diagnosed-as-type-2?commentId=583967%3AComment%3A3156153

#7

Congratulations you have made tremendous progress in a short time. I think the reason your numbers are better on the weekend is the extra exercise you get from doing housework. Your body is burning off the glucose stored in your muscles and liver. When this happens your insulin resistance goes down and the glucose from your food is used to restore the glucose it has burned off. The end result is better post meal numbers.

Your diet plan is similar to the one provided to me by a dietician on diagnosis. I routinely spiked to 180-200. For what it's worth there are several items in your meal plan that I can't tolerate even in small quantities. Toast, milk, banana, yogurt, hummus and potato. You might try eliminating these foods for a day during the week and see if it helps. For me breakfast usually revolves around eggs as they are less than 2g. each. I often have a veggie omelet made with eggs, low carb veggies and almond milk. Bacon or sausage and eggs works well too. Be careful to use unsweetened almond milk. I often have what I call a meat salad for lunch and dinner, low carb veggies with some meat and cheese on top.

Since your numbers are better on the weekend you can loosen up on your diet if you wish. I too try to take my metformin as late in the evening as possible, I think that makes for better morning numbers. I often have a glass of almond milk with cocoa powder and truvia added late in the evening. I think it has a modest positive impact on my morning numbers.

#8

Melitta chiming in here. The autoantibody tests are GAD, ICA, IAA, IA-2, and ZnT8. If a person has been diagnosed with diabetes (FBG greater than 125 mg/dl) and is positive for any one autoantibody, the person has Type 1 autoimmune diabetes. Here is a link to my blog on autoantibody testing. And Terry, that's a great summary of the "path of misdiagnosis."

#9

I'm pretty much in agreement with BadMoon. You are doing very well for a month in. You could continue along these lines & see results of your 3 month A1C.
I followed a very similar diet (ADA rec) initially. Over the years I have cut my average carbs per meal from 45 to 25-30. I avoid high-glycemic carbs (potatoes, rice, white flour). With almost daily exercise, I am getting by on only Metformin--last A1C was 6.5.

Following up on Zoe, I disagree that milk is "empty carbs"--a good source of protein & calcium. That said, I gradually have reduced my milk intake because it is carby. Nowadays, I get my calcium from low-fat cheese, Greek yogurt, greens, sardines etc. But I do enjoy 1-2 cappuccinos a week!

This is a process. Relax--you'll get on top of this D beast!

#10

Sorry, Deborah, you are of course right that milk has protein and calcium. What I meant by "empty carbs" was I personally don't want to "waste" 12-15 carbs on just a beverage. I drink 1-2 cappuccinos a day but I use unsweetened almond milk.

#11

Do you mean the pleasure to carb ratio, P:C, is too small??! ;-o

#12

You got it, Terry!

#13

Partly responding to Zoe . . .

I like milk. Really tried to keep in my daily diet for a year or after dx. I tried almond milk for 6 months--never got into it. I came to shudder at the thought of an almond milk cafe con "leche."
Many dedicated low-carbers would shake their head at my daily consumption of beans. Most mornings I have a half cup with breakfast. I like them, but furthermore the protein & fiber sustains me all morning.
I have found it relatively easy to reduce my fruit consumption. Twice daily I savor a couple grapefruit segments, a few pear slices etc. These tiny quantities would have been unimaginable to me at dx!

We're all different--bodies, tastes.

#14

We are indeed, Deborah. I was just responding to the OP's post that she was struggling with high blood sugars and has obviously been given the standard misguided high carb/low fat diet and wanted to suggest that there are alternatives that might work better.

#15

Excellent Zoe, this 30 year+ type 2 who almost wiped out agrees with your excellent comment.

Blessings and Thank you!

#16

Thanks to all of you who responded. I find it helpful to hear from folks that are doing the diabetes journey. I understand that each of us will react differently to food item. I was having a low moment when my numbers jumped to 201 after lunch. I have to take all of your advice, the info from the diabetes educator and my doc and develop what best works for me. At my next appt with my doc, I will discuss the additional testing. Thanks again for your assistance, this is a very confusing diagnosis to deal with so much information and the to-do's and the not to-do's but I know I will do ok as I am determined and I have assistance from all of you.