I usually post in Type 1 & parents of Type 1 kids, but my friend's mother was recently diagnosed Type 2. She has been asking me a lot of questions about how to control her blood sugar, but I am used to caring for my Type 1 daughter and I know there are some differences in Type 1 & 2.
She was told by her visiting nurse that if she is 80 or 106 in the morning, that she is low and she needs to drink juice. So, she has been drinking 4 oz. of juice, then eating breakfast and later she is 180'ish and doesn't feel well. This seems off to me because I don't consider 80 or 106 low for my daughter, but we just need to get some breakfast into her before she does go low. The juice seems overkill to me. (??)
She is not on medication yet and was told to test her BG twice a day. She sees the visiting nurse 3 times a week.
Does anyone have recommendations I could pass along to her?
The juice is most certainly overkill. Type 2 Diabetics are the most insulin resistant in the morning, and should not have extremely carb ladden meals or snacks in the morning, unless they’re gonna go do some brisk or strenuous exercise right afterwards. (To me, a heavy juice with 15 g of carb per serving before a breakfast, with likely more carbs, IS extremely carb ladden for a morning meal.) She will need to be proactive, from now on, and join sites such as this one… look up information online, etc. And do NOT rely for her control on a nurse. (Sometimes, I wouldn’t even rely on a doctor…) You can refer her to such sites as Blood Sugar 101: http://www.phlaunt.com/diabetes/index.php, which is very good at explaining the concept of controlling her carb intake, and using her glucose meter to know how meals affect her. This is the most important part in Type 2 control (whether she does any meds, insulin, or not). Seeing how badly carb content in a meal is going to affect her, and testing pre and postprandial. She can test pre, keep a log of what she ate and the carb amount, and then test postprandial… this will help her know if she needs to cut back on carb grams/servings or eliminate a carb portion in a meal. Blood Sugar 101 will also help teach her what is a normal blood sugar level, because those morning sugars she is having are NORMAL. They are NOT lows, and she does not need to treat them with anything. It’s such a frustration when ignorant medical professionals try to act like they know everything, and pass on this flawed knowledge to people! Thanks so much for asking, and trying to help her…
Thanks so much for your response Lizmari. She isn’t very computer savvy, but I will pass the info on to her daughter and maybe together we can help to get her up to speed.
How often do you test…about 6-8 times a day? Before/after each meal and before bed?
I think she’s also having a hard time giving up her old favorite foods and her husband being able to still eat it is a struggle for her. She’s going to need a lot of support as it’s a big change for her.
Well, I test only twice a day because I don’t have more strips, and even if I had insurance, for most Type 2’s… insurance restricts you to just twice a day, sometimes just once a day… unless you’re on insulin. I rotate what meal I test pre and post prandial… (and some days I only test fasting, and before bed, to make sure I am doing well in that area, too). lol She may not necessarily have to give up old favorites, just cut back on her servings, or change the way she prepares dishes… Example: I make a pizza on a “Flat Out” flat bread flour tortilla now, since they have varieties decently low carb and with tons and tons of fiber… It helps control my spike a lot. So… a lot in this game is about getting creative. dLife also has recipes that are low carb, for a lot of favorites, which she can try out… I think maybe even South Beach or Atkins have good recipe books in this aspect, too.
I am so sorry to hear about your friend & daughter!!
Anyway, not all treatments are the same for T2s. You see, I am a T2 (not your typical one though) – test 4x a day and my endo would like me to stay with 90 - 140 mg/dL. I start feeling my lows when I am at 85 mg/dL and my highs at 156 mg/dL – this of course will be different for everyone.
My advice is for her to physically go and see an endocrinologist – they can give her the correct treatment she needs to follow. Of course, she would also need to do some legwork of her own. She would need to do a little research about Type 2 Diabetes and do an entire life change — counting carbs, excersizing, documenting, etc…
However, I am concerned about the nurse telling your friend that 106 is too low (which in my book, I’d be freakishly joyful for a 106) and she would have to remedy her lows with juice. That seems ackward… drinking juice alone can make your sugars sky rocket!!!
Does she have those typical low symptoms? Shaky? Cold sweats? Nausea? If she feels any of those symptoms, especially if she is fasting, then she should be documenting these symptoms, along with her fasting bloodsugar numbers – by documenting them, she would be able to determine what her low numbers are, same for any high numbers she comes across ( I get nasea and dizzy for my highs) AND very beneficial when she sees her PCP or Endo.
Jessica, I hope these will help your friend out, but she really needs to see her doctor. A nurse cannot give a definitive diagnosis - actually they cannot and are not suppose to… I should know, I have a Bachelor’s Degree in Nursing =)
A few points. I test 4 times a day, morning and night, and before and after one meal. I twisted my Dr’s arm to allow me to test 4 times a day. He agreed. Most insurance companies will not dispute the Dr so the least your friend can do is ask. This helps to keep one on track. As to blood sugars she has likely had high sugars for along time and coming down into the 80’s and 90’s will feel very uncomfortable.
My advice work into it and dont try to get there all at once. It took me three months to feel comfortable for my fasting to be in the low 80’s and I was not guilty about upping my BG if I felt really uncomfortable. For fasting she should be between 85-95 should be her goal. Unlike a type 1 she will not go hypo as she is not on medications right now.
Eat to your meter and know what is high and what is low. Set your meter for the warning bell to go off too. Most meters your can manual set them.
If she spiked to 180 and didnt feel well she likely has damage to her pancreas now and medications may not be far off if not needed now. She should not be spiking above 130-140 and should be below 100 after two hours. If not she ask for medications to normalize her sugars. Diet cannot always help and the meds really help.
Also encourage her to do the yearly foot care, eye check, and dental checks just like you do for a T-1. Very important…
Yes, the key is working into feeling comfortable into the new numbers, because they are NORMAL numbers. Just because one starts feeling shaky, and uncomfortable does NOT make that a hypo… It makes it that the body has gotten so used to high blood sugar that now lower, normal numbers, feel odd. This is NOT a license to go treat normal numbers as if they were a hypo event all the time… But something we need to work into… and if one feels fine, why fix it? It’s fine.
I believe she does have an endocrinologist and has seen him/her but also has a visiting nurse for the time being. I know she has had BGs in the 200’s as well. She loves eating carbs, so I was showing her yesterday how to fill up her plate with half veggies, a little bit of carbs and then protein. She did mention feeling shaky and nauseous and was about 130 at that point.
I do remember my daughter having shakiness at lower numbers because her body had been so used to being High, so perhaps that’s what’s happening with this lady.
Jessica,
I agree with Lizmari and would like to add only that symptoms change as bodies get used to lower numbers.
A new type 2 may feel symptoms of hypoglycemia at 80 - and that may be what the visiting nurse was reacting to.
If she isn’t on a medicine, she’s not going low/hypoglycemic, no matter what the nurse said. Unless she’s got something else.
If 4 oz juice is sending her high, her pancreas is not sending out enough insulin to cover it; her body is reacting to swinging, and that results in not feeling well at all.
Fruit and juice may be something she needs to take one berry at a time! lol
I second the recommendation to read read read, keep records in writing, and go to an Endo to keep track of what happens in the next few months.
Hi Jessica, I haven’t read the previous posters but I would recommend the book Dr. Berstein’s Diabetes Solution to her. It is a great reference book and she will be able to control her blood sugars in no time by using his approach . If she is between 80 and 106 in the morning she is in the normal range. By drinking the juice she is spiking her blood sugar and starting a rollercoaster for herself and opening herself up to potential complications. Testing is important to know what the impact of food and activities like walking and other exercise have on her blood sugar. I have read on other sites that walmart has a cheap meter called relion and that their test strips are fairly reasonably priced and that they often have sales where you can stock up.
How old is this person? My dad was dx’d last year at the age of 89. His CDE told him that he needs to eat 4 carb items at every meal. He was also told that if he goes below 130 that might promote a low . So now he is afraid he will go into a coma if he falls below 130. I tried to explain to thim most people that are normal are in the 70-90 range most of the day with no problem. But at the age of 90 he really doesn’t want to listen. I think with senior citizens they are more afraid of lows, but he is on Januvia which doesn’t usually promote lows. Since your friend is not on medication unless she has frequent hypo attacks , I would tell her she only need to treat a low below 75 or so and usually glucose tablets are better than juice. Most juices are 25-35 carbs per glass and can easily spike you to 200+ with a rebound high.
dLife also has recipes that are low carb, for a lot of favorites, which she can try out… I think maybe even South Beach or Atkins have good recipe books in this aspect, too.