Diabetes behaving oddly

Type 2
1

I am trying to get a handle on what makes my blood sugar do what it does. I am on 17 different medications, 3 of which are diabetes-related: 1,000 mg Metformin BID, 4mg Glimiperide QD and 5mg Byetta BID. My sugar HATES to be low (I have never actually experienced low blood sugar) and tends to hover around 130-160 with an A1c of 7.4. Often my morning sugar is high (nearly 200) and goes DOWN after eating.

One interesting experiment I performed was taking my BS (130) and then eating a pint of Ben & Jerry's Cherry Garcia. 30 minutes later, my BS was 154. Later on, I had 3 Werther's SUGAR FREE caramels, which made me feel crappy and shot my sugar to 220. I am mystified as to why the ice cream did virtually nothing, yet the sugar free candy drove my blood sugar up. Anyone with a solution to this mystery?

2

As for the meds, Let's just say "a nice assortment" - I really don't want my complete medical history on a public forum. But it is a fair question and I certainly don't mind you having asked it. I was uncomfortable enough saying anything about the condition online at all. I have already noticed that many employers have the misconception that a diabetic employee is somehow "defective."

I'm not on any particular diet yet. In fact, I just had my first visit to an endocrinologist a couple of weeks ago. Been treated by a GP before then and just felt that his skills were becoming insufficient to address my condition. I've only been on Byetta for 2 weeks and have a feeling that 5mcg BID is not a theraputic dose for me. I have had NO side effects AT ALL and that's usually a sign for me that we have not yet hit an effective dose.

It's not so much the control that concerns me here, it's more the counterintuitive effect that small quantities of sugar-free candy would significantly raise my sugar when a pint of ice cream barely budges it. Once I understand the condition and the effects that various substances have on it, the better decisions I can make. Both then Endo and I believe that going to insulin now might be jumping the gun.

3

I think it is the icecream , that delayed the rise in your BS level . Icecream has fat , which does delay the rise; similar if you were to be eating pizza( crust is high in fat unless you choose the Italian style ) or the hidden fats in ( North American way prepared ) Chinese foods .And yes ,a meal plan lower in carbohydrates may address your overall concerns as well .Are you including regular exercise in your daily plan ?
A hearty welcome to TuD and be well .

4

I would echo nel the fat in the ice cream probably slowed the digestion of the sugar in the ice cream. For some people this may mean a spike at a later time say 4 or 5 hours later. You may have just missed the spike. Sugar free candy usually contains sugar alcoholics which spike some and not others, or again spike at unpredictable times.

Many T2s can benefit from a substantial reduction in carbs, often beyond the levels recommended by many dieticians. For me I found the raw carb number is only part of the story, the source of the carbs is just as important. I have found I cannot tolerate grain, potatoes, fruit and legumes as well as sugar. The only way to find out your tolerance for various foods is an extensive testing program. Check out the bloodsugar101 website for an explanation of how to "eat to your meter"

Your numbers will cause further deterioration, so I'm glad you are here asking questions, that's the first step. Spend some time here reading old posts, you will get ideas on formulating a plan, as well as inspiration from people who have successfully confronted their condition.

5

I agree with Super_Sally you are not where you need to be with your numbers. As for the Byetta the 10 mcg dose is probably in you near future. Most people start with 5 mcg in the beginning to allow their body to adjust and then move on. Not everyone has side effects with Byetta, I never did but it was very effective for quite sometime.

You may benefit from insulin in the future but you need to give diet and exercise a try first.

Gary S

6

Lots of good advice here!

How often are you testing your BG? If you really want to get control of your diabetes, most people find that testing 8-10 times a day is one of the most helpful things they can do. Test when you wake up in the morning. Test before you eat every meal and snack. Test one and two hours after you eat, each time. Test when you go to bed. Keep detailed notes about what you've eaten, when you've exercised and for how long. Counting the carbohydrates in everything you eat is essential and will help you decide what foods do or don't raise your BG.

After a few days, you should notice some patterns. One is that if you eat a meal that's mostly protein and fat--say you have bacon and eggs for breakfast--your BG won't elevate by much at all in the first hour or two, but it my slowly rise over about four hours, sometimes a bit longer. It shouldn't rise to a dangerous level, though. If you eat something that's full of fast-acting carbohydrate, like many kinds of fruit, fruit juice, white or brown table sugar, etc., your BG will usually go up dramatically and pretty quickly, too! Some things like pasta may spike your BG considerably, but may take as much as 5, 6 or even 8 hours to do so.

While it's possible to make some broad generalizations about what most of us can or can't eat without raising our BG, everyone is different. Only you and your meter can find out what different foods do to your body.

BadMoon recommended the Blood Sugar 101 site. It's excellent! You might also get a copy of Dr. Bernstein's Diabetes Solution, which is available in most bookstores. You can read much of it online at his website. Dr. B gives an excellent, detailed, clearly-written explanation of what diabetes is, what it does to us and ways to manage it with exercise, diet and medication. He also includes a detailed diet that has been very effective for thousands of people. Even if you don't follow his way of eating forever, trying it for a couple of weeks will bring your BG down to normal--normal, that is, for someone who doesn't have diabetes! A few weeks of that will transform the way you feel, I promise! Even if you feel well right now, when your BG is consistently lower, you will be amazed by how much better you feel. Your pancreas will get a good rest, your mental clarity will improve and you'll likely sleep better than before, all while not being hungry! Some people don't stay on Dr. B's diet forever, but still benefit from it occasionally.

Keep asking questions here. People are incredibly helpful and resourceful.

7

Welcome,

I have actually been doing better with 2000 mg met. The big thing was to get my morning BG down and the rest of the day seems to follow a little better pattern. I coupled this upped dose with moderate carb (60 grams per day) diet. I have been testing often trying to figure out what is causing spikes and when. I always thought I did good on pasta until I discovered my delayed spike.

I once had a dietician tell me if I'm going to junk out do it on real cheesecake, the fat slows down the sugar. I haven't tried that in a long time and will need to see if that ends up being an acceptable way to get my readings to stay low.

You may be one of those unfortunates that can't do sugar alcohol.

I would start by trying to get the morning reading down. For me, I seem to do better if I eat something high fat right before bedtime like cheese, summer sausage, nuts (depends on what my bs is since they have some carbs). I also take a dose of met ( for me 1000 mg) right before bed.

How we react to different foods seems to vary from person to person. I don't think there is any hard and fast rule as to what diet works best. We each have to experiment on ourselves until we hit on the right combo of diet and exercise and whatever drugs the drs. think we should try. I'm not very daring and don't change my doses without talking to my dr. but changing the time you take it may help.