Anyone with thoughts on this

I am a recently diagnosed Type 2. At first my glucose stayed around 120-130 simply with a few diet modifications and metformin. Now that is not the case. I am now unable to eat more than 20 carbs per meal or my blood sugar soars to around 160 or 170. Then in 2 hours it is down to 70 or 80 and I am struggling to keep it up. Lunch is not so bad because I am very active at work so I can handle a decent amount of carbs then. For Dinner…I do not get home from work until eight or so. IF I eat dinner it runs up to 160 or so again. My glucose is still to high at bedtime ( i crash soon after dinner) to eat a snack. So I wake up at 3 am with a glucose around 160-180 but it is always miraculously back to 113 when I wake up. Last night I really needed to sleep uninterrupted so I ate a snack and my glucose rose to 180…but it stayed low all night. SO what am I doing wrong. I have a dr appt tomorrow. It is always frustrating. My AIC is always low because I have so many hypo episodes during the middle of the day that it seems to offset the highs. I had to take several months worth of meter readings to the doctor before he would even diagnose me…as my AIC was 5.5. any sugestions>

I think maybe you need to find an endocrinologist and see what they say . I am sure no expert and maybe someone else might have some other suggestions for you . I would say though it is time for the endo for sure .

Unfortunately I cannot afford to see an edno…i can barely afford to see the family doctor

endo I meant…

Hi April I am sorry to hear about “the struggle” and will share a couple of my thoughts with you. I would STRONGLY ENCOURAGE you to get the book “Diabetes Solution” by Dr Richard Bernstein. He is both a diabetic and an Endocrinologist. It would appear that every diabetic almost needs a one year university course to understand that:

A- There is A LOT TO KNOW

B- There is A LOT WE DON’T KNOW

C-INSULIN REQUIREMENTS CHANGE, AND WE DON’T KNOW WHY

It is always very difficult to help people with diabetes with a short explanation because there is SO much involved. On first sight here it would appear that this current coping mechanism is not working the way you like. This either means that if you can adjust some of the variables for a better result that would be great, or you may need another kind of therapy. Food is a GREAT control point however we still always need the right amount of insulin in conjunction with your activity, all of which is determined by you.

It is posible that you may be better off injecting small doses of insulin through the day however, I AM NOT A DOCTOR and this is best determined between YOU AND AN ENDOCRINOLOGIST. Make any sacrifice possible to see an endo because what is happening is not working, and who cares how you keep things stable, as long as you do. The good news is that you are waking up with a normal reading and this indicates that you may still be producing insulin, because through the night everyones sugar goes up from a process called gluconeogenesis (amino acids in protein converted to sugar, see Dr Bernsteins book!!!). Dr Bernstein also suggests that another reason to run good sugars is so you don’t strain your pancreas and suffer a “beta cell burnout”.

I applaud your concern for the numbers, and congratulate you for wanting to make them better, AND YOU WILL!!! The question is, at what cost? This is up to you and I hope it helps. Like so many of us have discovered out of necessity for the most part we have become our own doctors because we live it.

Love Always
The Anonymous Diabetic.

P.S. I have written a bunch of stuff on Oprah’s Diabetes Support Board you may find interesting. It is a series of “chapters” (single pages really) entitled “Diabetes The Real Cost” and you can find it by going to www.oprah.com/community/community/health/diabetes

my doctor currently only has me on metformin and keeps telling me to quit focusing on the numbers,quit stressing over testing so much, and just focus on my diet

(1) Are you on oral medications, insulin, or diet only? (2) If you are on diet only, you may need to move from eating meals to grazing (“snacks” every 2-4 hours, no “meals”). If you are on medications (oral and/or insulin), their timing and/or dosage may need to be adjusted.

grazing is not a possibility with my job and schedule. I work 8-10 hour days with only a lunch break. It is very busy and we are not allowed to keep food in the pharmacy. SO if I eat a really low carb load to keep breakfast numbers down, then i end up hypo in a couple of hours and really struggle to make it unntil lunch at 3. Three months ago mu numbers were always in the 130 range and I could eat cereal in the morning and still eat pasta. THen after being diagnosed I started cutting carbs, gave up soda ( the previous numbers were with regular coke several times a day)…now taking 5oo mg of metformin in the morning and 1000 mg at night, my numbers are around 113 fasting and soar to up to 180 pp. I can now only handle around 10 g of carbs per meal. I cannot eat pasta, cereal, milk. Breakfast consists of two scrambled eggs ( I hate eggs). The problem is that is gone after about two hours and my numbers start dropping to around 70. Mu dinner numbers are always high also so it is never low enough for a bedtime snack. I do not get off until around 7 or eight so dinner is never before seven thirty and I am usually in bed no later than 10…many nights falling asleep over. There are many meals that I was able to eat 3 months ago and now cannot eat without a huge spike. THis is just so confusing.

I’d respectfully say that is nuts. The way to know what is good for your body to eat is to test. Yes, stressing over the result is not good for you in any way, just test, record, and adjust your eating to improve your meter readings.

8-10 hours with no breaks other than lunch? Most states have laws that for an 8-hour day you must have both a lunch break of at least 30 minutes and two breaks of 15 minutes.

What may be happening is that food from breakfast is combining with the rebound most of us get when we wake up (if you wake up low, the brain sends a signal to your liver to start converting glycogen, which raises your blood glucose), and then by the time your liver realizes your body’s being fed, the morning metformin kicks in and lowers you. This may also account for the 113 morning fasting readings. You may need to look at a lower-GI/longer-range carb for breakfast (think nuts, whole grains, etc.) to counteract a later low.

The long stretch of time between lunch and dinner is partly what is responsible for the after-dinner highs as well. The longer you go between meals, the higher you will rebound after a meal, and the longer it will take to get your numbers back down.

We are supposed to get breaks at work but we don’t. I don’t push the issue because in all other areas I can get by with murder where other people would get fired. My boss also has 3 kids and always insists that I go pick them up when the school calls and has no problem with I need to be off at the last minute. So I let the break thing slide. I am just at my wits end with the whole diet. I have tried all types of breakfast combos…eggs, omelettes, of course every cereal I have tried is out of the question. I am sick of eggs. If I add whole wheat toast or bagels, or any dairy I am high. I went to the doctor this morning and ended up in tears. I am still about 20 pounds too heavy but am by no means “fat”. He said I am just stressed and need antidepressants and it is a diet issue and does not want to prescribe meds. In the meantime I am supposed to have morning and evening sugars around 160-180 and then bottom out around lunch. This morning I splurged and ate a bowl of whole grain cheerios with skim milk and some strawberries. I of course had reading of around 180 but for the first time in forever…i made it until lunch without any snacks and was 100 at lunch. For lunch I had grilled chicken, 2 tbsp of brown rice, and steamed broccoli. The rice is already causing a spike…aaargh how can I change my diet much more

When you say your Bg goes up to 160-170 you are not saying how long after eating this is. If you are testing 2 hours after eating and these are the results then you are fine. 2 hours after eating your BG should be under 180-200. Fasting should be 90-120. This is the range we instruct our diabetic patients on. You may need to make sure you are dividing your meals into 5-6 smaller meals about 3 hrs apart. This may mean you need to pack snacks to take to work with you like some crackers, lunchmeat, and cheese, or yogurt, etc. something with carb and protein components.

Dear April.

I find it hard to fall asleep if the BG is not close to normal and even harder to stay asleep if it goes low or high so I sympathise. Your life style is not diabetic friendly except for the exercise you get at work. Try to get some almonds they are diabetic friendly and try to eat them evenly over the course of the day to stabilize your calorie intake and see if that helps.