After 2 years of pre-diabetic monitoring, my A1c jumped from 6.0 to 9.3 over just a few months and my BG was 271 at diagnosis. Six months later, I’m on 1000 mg Metformin and 1.8 mg Victoza and my fasting glucose has come down to around 115-120.
The problem I worry about most, though, is even though I’ve been following a strict LCHF diet since my diagnosis, my post-prandials still rise by 60-80 points and I see occasional numbers in the low-mid 200’s. I usually exercise twice a day after eating, but now I’m dealing with huge blood glucose swings all day long, which make me feel crummy. My doctor was pleased with my latest A1c of 6.8 and tells me I’m doing fine (I’m not). He’s worried about over-medicating and causing hypos, even though I’ve had only a handful of readings below 100 and my lowest-ever reading was 86. I make a real effort to eat to the meter to balance things out, but I’m still frequently surprised by out-of -kilter readings. Help!
I think your concerns are legitimate. Post-meal numbers in the 200’s are not good for you. If you’re not aware, you should realize that most doctors fear hypoglycemia, to a fault. Therefore their advice tends to drive blood sugar control in their patients well above the human-normal range. As medical practitioners, they’ve collectively decided that hypo-avoidance is job #1.
While our docs might sleep better knowing their patients’ BGs are nowhere near hypoglycemia, their advice, if followed, can mean years and years of well above average BGs. This is not good for us.
I am a T1D and my only insights about T2D is reading for many years their stories here. You’re already doing a great job limiting carbs and exercising. Good for you. Insulin may be an appropriate tool for you. It is potent and it works. Many doctors, however, try to discourage/delay T2Ds from using insulin. It’s unfortunate.
I’m sure you’ll get more responses here. You’ve found a good online community! Good luck.
Thanks for your input. I’m with you. I told my doctor that shooting for an A1c of only 7 didn’t feel strict enough, since I’m only in my early 50’s and have 20+ years to develop complications based on these numbers. I’m also not on medications that should drop me dangerously low, but mentioning this just annoyed him. I still have some weight to lose (I’ve lost 50 lbs), so I’d like to wait until I reach goal to think about trying insulin, but I made an appointment with an endocrinologist (six months out) because I don’t want to wait for more problems to develop before making appropriate changes.
Hi, I was on a LCHF diet for 2.5 years and it kept me off insulin for that time. There is a 3rd part to that diet and its moderate protein. If you eat too much protein your BG will go up, quite a bit sometimes. Do you check to see if you are in ketosis? I had to use a meter to check mine and I could never get it high but I was usually around 1-1.2 reading.
Towards the end of that diet for me I was having a hard time eating lower protein and my sugars went up, but I kept my carbs below 30g daily. I quit because for me insulin would not work at all while I was in ketosis. I would take 20 units to lower my BG 6-7 points so I gave up the diet and went back to insulin instead of drinking olive oil instead.
Bottom line it sounds like may be eating too much protein and or carbs, increase fat intake.
So far, I haven’t been counting proteins, except as calories. Overall, I’m eating around 1200 cals/day including carbs, protein and fats. I don’t really get why certain carbs, not just grams of carbs, spike me like crazy–I ate 1/2 an orange last week and numbers went through the roof!–but I’m tracking everything I eat and working to learn from my mistakes. I assume I’m in ketosis and never have carb cravings, but I don’t test for it. With exercise I’m always in calorie deficit and consistently losing weight.
All carbs are not equal. Some get in your bloodstream very quickly like fruits and grains. When I did that diet my carbs consisted of only leafy greens, avocado, broccoli,cauliflower,brussels sprouts, couple slices of tomato every now and then and cucumbers/pickles. I ate zero fruits because my body couldn’t handle it, I had spilkes. Also for a snack I would eat a small handful of nuts like almonds or walnuts. For the vitamin shortfall of not eating fruits I took a multivitamin and vitamin C and had no problems.
It is particularly important to track total carb consumption and fiber consumption (since most types of fiber don’t raise the BG of most types of diabetics). “Simple carbs,” and particularly the glucose and fructose in fruits and some veggies, are really quite efficient at spiking blood sugar after meals. I eat a “moderate” carb diet at this point (around 100g per day, with 30-40g of fiber) and have mostly eliminated the big spikes (occasionally travel catches me out), last A1c was 5.2. I found the combination which works for me currently (Metformin, 100g carbs per day, lots of exercise) through eating to my meter and keeping a lot of data.
It has also changed for me over the last year. The first three months were difficult and saw relatively little progress. Since then, I’ve pretty rapidly honed my management skills (although I do have some long-standing issues with barely controllable weight loss).
One thing I can share: my doctor was quite concerned about “going low” and didn’t want me to have an A1c below 6%. Nice guy, but he just didn’t know what he was talking about when it came to diabetes. It took me a while to figure it out, but I eventually changed GPs (and for my whole family, as well). My new doctor is smart enough to know her limits, and while supporting my target of a low A1c (I like to be 5.0 or below), she also has insisted I see an endocrinologist.
Thank you! I’m already careful about glycemic index of foods, but I’ve been more concerned with fiber affecting the total carb count than carb absorption over time. That makes so much sense! When I have 8 grams of carbs, for example, in a glass of V-8, it keeps me in balance, but the same 8 grams of carbs in a handful of grapes send my numbers soaring. There’s definitely a learning curve to this thing!
It does, thanks. I’ve been eating mostly veg and very little fruit, like you and that works well for me, but my doctor wanted me to moderate my carbs, going from 30-40 grams/day to more like 60-70 now that I’m on victoza, to ensure that I wouldn’t go low. Since I never go low, it feels like making that change just cancels out a lot of the benefits I should be seeing on victoza.
I have not been tested yet, since I had a fair amount of weight to lose, it was assumed that I was type 2. I will bring that up with the endo. Thanks for your input!
I always wondered about fiber and how it plays into blood sugar levels but couldn’t test it out while I was on the LCHF diet as I heard it breaks Ketosis. Since being off that diet for about a month now I tried a test last week. I bought some Bobs Red Mill wheat bran (only ingredient is wheat bran) and put 1/2 cup in a bowl with water and microwaved it 4 mins. I added 1/4 cup of unsweetened cashew milk and pinch of salt and ate it. My blood sugar was 110 fasting (thanks to Tresba) at 1hr after eating the wheat bran and nothing else it was 191. Take it for what its worth, each person may react differently.
