Newly diagnosed with lots of questions

I was diagnosed February 10th with Type II. My doctor spent 45 minutes with me going over the results and the medication, but I left with a lot of unanswered questions.

Because of elevated liver enzymes, he put me on Victoza instead of metformin (which he said he usually starts patients with). I guess the Victoza is working ok; I’ve had no noticeable side effects and I’ve lost 5 pounds in the 10 days I’ve been taking it.

I’ve had gestational diabetes twice, so I’m familiar with testing my blood sugars. My doctor told me that I need to be testing a couple of times a day and that I could alternate times. Problem is, I have no idea what I should be looking for as far as blood sugars. What is normal? What do I do if it’s above or below normal? I have no clue.

When I was pregnant and dealing with GD, it wasn’t that big of a deal, because I knew that as soon as the baby was born I’d be able to go back to a normal diet. It wasn’t traumatic to think that I’d never be allowed to have birthday cake ever again. But now…I just don’t know. Can you not eat ANY sugar when you’re diabetic? Is the sugar in fruit or milk different than the sugar in a cookie as far as diabetes is concerned?

What should my goal be? To keep my BG levels as even as possible? Right now, they’re kind of all over the place. One morning they’re 143 and one morning they’re 99. Most of the time, they seem to be about 110-130 although twice after breakfast they were 170 and 183. My A1C was 6.6 at diagnosis.

Where can I get all this basic info?

I highly recommend Blood Sugar 101 by Jennie Ruhl. You can read it online or get the book. You’re asking good questions. This website is also a great resource for information and support. Welcome.

I was diagnosed the same day as you, so take what I have to say with a grain of salt, and if I say the wrong thing, someone PLEASE correct me.

I was originally told by my doctor to test before meals, but the more I read, it makes sense to feed the meter, which essentially means you are checking post meal sugars to see if you are eating correctly. At one hour after the FIRST bite of food, a good goal is below 140, and 2 hours after the FIRST bite should be below 120. This way you can also see what foods affect you differently. Generally speaking simple sugars will give you a higher rise in bs, but I’ve read an awful lot of conflicting information on that, some say a carb is a carb, and some others disagree. And of course the amount of fat and fiber in the meal will effect how fast it is digested.

So my approach over the last week or so has been one of overkill, I am eating every two hours and testing two hours later which conveniently is also a pre-meal. I have discovered that my tolerance level is between 20 and 30 grams of carbs. If I don’t eat every two hours my liver kicks in to high gear and starts making glucose. My Dr. refused to put me on meds, so I am doing it with diet, exercise and homeopathy.

Good luck to you!!! And I guess we share the same D-Day :slight_smile: Suz

Yeah, this two hour schedule takes A LOT of planning. I just went out and bought a bunch of snack food that had my 15 to 20 carbs in it like mini fig newton bags, and TLC bars and rice cakes, 5 triscuits with humus, or a peice of fruit with the Jif peanut butter that now comes in little indiviual to go cups etc… I keep a bag of raw veggies to have at every snack… I buy the big bags of baby carrots, pre-cut and washed broccoli or the cherry tomatoes. Then I went to Walmart and bought a bazillion smart ones, healthy choice etc frozen dinners with less than 35 carbs… so now my whole day is quick and easy… I have mobile snacks and dinners are preplanned. And the dinners at $1.57 are beyond cheap, and my kids love eating them too… which is a weird new twist for us because we never did frozen dinners, but until I have a better handle on this, or have better control when my weight is down, that is the season of life we are in :slight_smile:

TV dinners are tough. Most of them are high in fast acting carbs. There are only a few, VERY FEW, that are low in carbs. Read the labels carefully. Check the nutrition label EACH time they are purchased. The receipes change. That “delicious new receipe” may mean the carb count has changed. That 35 gram TV dinner may be causing a quick high spike in blood sugar. I suggest testing 1 hour after eating it to find out if this is happening.

Goldensun… so true… I have been very very picky about the carb count on them, and don’t buy if it is over 35 and even then, I don’t eat all the noodles. My post prandial bs have been very good! But I also take a Blood Glucose Defense and a cinnamon pill with all my meals. They have worked very very well for me.

For me and for many T2s a carb is not a carb. Sugar and starch are different from carbs found in non starchy vegetables (broccoli cauliflower squash etc) . Some people can get away with whole grains others, like me, cannot. If I eat any starch at all the quantity needs to be severely restricted, most of the time I figure it isn’t worth it considering the tiny quantity I can eat without a spike. As others have said we are all so different the best thing is to test extensively and figure out your individual reactions.

I was diagnosed on Dec of 2010 with type 2 and A1c was at 14.0. As of Feb 2011 my A1c is at 7.5. I realize that it is still high and I am working on it everyday, but, to cut it in half in a short amount of time is pretty good. My remedy in the beginning was to check bs when I wake up and 2 hours after every meal of the day. Like that you can see what food raises your bs and from there you make adjustments. I cut out all white products (bread,rice,etc) and switched to brown. I still have cake as a snack but not as much as before. My point is you can still have your favorite foods but in a smaller portion. Now, what worked for me might not work for you because it’s all trial and error. That is why it is important to test, test ,test your bs and adjust accordingly. As far as normal numbers go I see from 70 to 120 or 60 to 130 on the internet websites that I visit.You are not far off the “normal numbers”. There are plenty of websites to go to , my favorite ones are this one and Diabetes daily and the American diabetes website.

Control is a very individual thing and for some tight control comes easier than others. Dont beat yourself up if you cannot get it and miss your target goal as this can take a lot of work and time on your part. As others have mentioned carb counting is very important. Your carb counting is as important as any medication you take. Eat to ones meter is a good place to start and to test 1 and 2 hours after eating writing down what you ate. Remember the after meal spikes you get have to be made up with your own insulin and as a T-2 you likely are deficient now in insulin production and you are insulin resistant. Not stressing the pancreas is what I watch closely. In addition after meal spikes make up your A1C too so that extra sweet or carb at each meal will take its toll and eventually add up. Your fastings should be less than 100 and you should not be spiking above 140 2 hours after a meal. This can be easier said than done but having a goal is important. The Victoza will help and the met. Good luck.

Wow, well said Emmy! Wish I’d read your summary when first dx. It would have saved me a lot of time sorting out the lots of chaff you get online (and offline too!).

The only point I would disagree is about simple vs complex carbs. I think that is very much conventional wisdom. But my meter disagrees with conventional wisdom. I have great post-prandial numbers from 30g carb in French fries. Whereas 30g of carb in wholegrain bread sticks around spiking me for hours and hours.

I’ve been D for 4 years. It took me almost 3 1/2 years to finally get my bgs under 100 even though I ate very low carb and exercised. I have lost all the weight I can possibly lose. I am now 115 pounds and eat around 50 carbs most days. You have to find what works for you and it takes lots of trial and error and tons of testing. For me I have found eating a very natural, organic diet with no chemicals works for me. I eat lots of calories and lots of fat, just very few carbs. Since my bgs are now under 100 most of the day I have cut back to testing 2 x a day, but in the beginning I was testing 6-7 times a day. I think if you can keep bgs under 120-140 after meals and under 100 at fasting it is a good start.

Dear Emmy,

With all due respect, I’m afraid my meter disagrees re white vs whole grain flour. I guess everybody’s a little different in their own ways. In general I try to pick the low-carb versus the high-carb but I cannot avoid carbs entirely especially since I have to bolus for protein. If I do eat carb then I go with what I can better tolerate - and strangely enough, that means fries over wholegrain bread anytime.

If someone knows the explanation why GI is irrelevant for some PWDs, I’d be interested to hear it. My meter tells me I can metabolize croissants and baguettes (in small amounts of up to 20g) better than chickpeas.

I just want to point out how upset it makes me that so many doctors diagnose people with diabetes and let them leave their office so lost! When I was diagnosed about 7 years ago, a nurse told me over the phone that I was diabetic and that I should “just be careful what I eat”. If I wouldn’t have asked for another appointment they would have left it at that. This is a life changing disease and no doctor should ever treat their patient like that. I hope you get all the answers you need.

Test often and keep a log to start of what you are eating and your bg levels. Looking back at the written record will help you learn a lot about your own bg and what works best for you for types of food. Test before you eat and two hours after. You want to be coming back down at that two hour point or, even better, where you were right before the meal. Test before you exercise and right after. This I do as more of precaution because exercise can sometimes drop my bg too low. You also want to test right before bed and right when you get up. Ideally, you want to have a wake up bg between 80-100. But some people have what is known as “dawn syndrome” – it results in higher bg in the morning. A good bg is below 140 because many experts say that it is bg above 140 that causes damage. But remember that 80 -100 ideal range. The more time you can spend in that range the better. Anything below 70 is too low. Because you are not on insulin, your risk of lows is likely less – but it’s good to be aware that they can happen and be prepared with a sugar source (e.g., glucose tablets).

I will not discuss numbers here as we canadians have a different number system.
I was diagnosed in october 2010 so fairly new as well.
What I have done is this:
I bought myself a journal/daytimer one that gives me lots of writing space.
I tested 8x a day for the first 2 months… when I wake, before i eat, 2 hours after. and before bed.
I also wrote down every crumb I put in my mouth during that time.
Yes, I wont lie… it was a pain in the arse, however, I did find out much information/data on exactly how my body works, and what foods I react to and which ones I dont.
Type 2 D is very different for each person, so it is important to figure out what best works for you, and it also helps your care team figure out what if any meds you may need more accurately.

Congratulations on your progress!!

The Wal-mart Relion meter has strips for around $20 for 50. I use a WaveSense Presto. It’s nothing fancy but gets the job done. They also have software to download your meter readings to your computer. Then when you go to see you doc you can print out some nice charts instead of handing him or her a blood stained log book. I get my strips from here They give free shipping for a $100 order and you can get an additional 7% discount because you belong to TuDiabetes. Look under Resources --> member discounts at the top of the page. Figuring all this in my cost is around $32 per 100. They also have a free meter deal if you buy so many strips.

Testing frequently at the beginning will help you reach your goals faster. I still test 7+ times a day, because it helps me keep on the straight and narrow diet wise, but if you have a fairly stable diet many find they can cut back on the testing as time goes on.

Fat is slower to metabolize which may seem to slow your BG level. however if you test 3 hours post prandial you may notice that it will be higher.
That being said… everyone is diferent and if after 3 hours then perhaps thats just the way you are. check it oout, experiment and you will figure it all out.
good luck!