Please, can someone help me understand this?

Dear All, please help me understand why my management of T2 is failing.
I was diagnosed 6 years ago, and put on Metformin, and a very tightly controlled diet. My BS came down over a few months, and remained in control. I moved to London, where I slowly grew out of the habit of obsessing over what I ate, and would eat pretty much everything, with occasional binges on things like fries and cheesecake. My A1Cs were always below 7, and I guess this is because, while I didnt exercise consciously all that much, I walked everywhere, usually about 3-4 miles a day, 6-7 at the weekends.
I moved back to Delhi about a year ad a half ago, and my sugars have just gone haywire. There is much more stress ( I moved back to look after my mum, who has cancer, and my stepdad passed away suddenly two years ago), and less incidental exercise owing to the heat, dust, traffic, the general un-walkability of the city, but I do make it a point to do at least 30 minutes of cardio ( running, fast walking, cycling) everyday. i also watch what I eat like a hawk, and test before and twice after every meal.
What I cant understand is, how did a relatively lax management of diabetes a few years ago result in good control, and why am I unable to bring my BS down now? My doctor recently said my medication and diet/exercise regime was good, and that I should keep it up rather than use Byetta or insulin, but I cannot find it in me to live this restricted, obsessive life, not indefinitely. Do you think I will ever be able to be carefree about it again? is it a matter of a few months worth of very strict control/testing? How do you stay motivated and not swamped by it?
pep talk much appreciated.

I don’t think you can be carefree about diabetes. It is a progressive disease and as beta cells die off you become insulin insufficient and bgs tend to rise. You may need to raise dosage of meds or add insulin. I am able to control mine with metformin alone but I try to keep HbA1c under 6 and bgs under 100. I eat very low carb and rarely cheat on my diet. Diabetes is something that has to be managed every meal, every day. No more carefree days, sorry.

Tahira (beautiful name!), type 2 diabetes is usually progressive, and you have almost certainly lost a significant number of beta cells since you were in London. That means that what worked then won’t work now. I am surprised your doc hasn’t suggested an oral med, like Metformin, which helps many Type 2’s keep BGs down. Byetta is effective, as is insulin, and if you are not happy with your BGs, you should be able to try them. I think you need to be proactive with your doctor, and insist on better control.

And, no, I don’t think anyone who is serious about diabetes control is ever carefree about it. You were lucky for a while, but it doesn’t stay that way. But it’s better to be a bit obsessive and stay in good control than to suffer the horrible complications that can show up later. I have heard that Indians suffer complications sooner than those of European descent, and that medical care in India is not very good. So you need to work and and advocate for yourself that much harder!

Good luck!

Well, I was once on insulin and got better. I was off of insulin and became carefree also. After those carefree years my a1c was a 10. I got on metformin and januvia for about a year and I had a lot of stomach problems. I then worked out and stopped eating too many carbs and bad food to the point I cam back down to minimal metformin. So be realistic as to what you are eating and you may need to be back on metformin until the stress and exercise routines get better.

It is very good that you wish to be on top of your diabetes management. Stress, the weather, even the spices that is in our food may be some factors you can consider. The duration of time that you are a diabetic may also contribute. Maybe you can talk to your doctor regarding tying out other meds or increasing dosage of whatever is present?

i have a lot of coworkers that love Indian food. I stopped hanging with them for lunch because I could never find a good low carb Indian solution. All the stuff that I like had rice as a base so that was out of the picture for me unless I wanted to spend the rest of the day in the 200’s range. Food is good but I have the same issue with Indian as I do with chinesse and japanesse.

You’re entirely right, its hard to avoid rice and roti at meals. Am mostly living on salads and grilled things. The thing I miss most is bread though!

Thank you all, very much. I guess I was just feeling low about it yesterday. For the past two days I’ve completely cut out carbs and my BS has plummeted to the low 120s PP. Ha!
I know that ignoring my diabetes management was not the smartest thing, but I am on top of it now. I guess I hadnt given much thought to the fact that the disease can be progressive. No more slacking.
Thank you all for your support!.

Thanks Jeannie! I’m trying the low carb thing now, and it seems to be paying off. I just needed to rant, and thank you for replying!

Thank you Natalie! I am on Metformin, and my dose was recently upped, and my BS is coming back under control. I just wasnt sure why ignoring it had not led to high BS, whereas obsessing over it was not lowering the numbers. In retrospect I guess I was just really lucky, and that tight control is the only sensible way to live from now on. Thank you for replying!