Diabetes (type 2) Query

[Verbena17]

So for the past 3 months I’ve been trying to lower my HCA1C test of 49. Had my retest, having been really good, cut out almost all processed sugar and lowered carbs, walked more when my feet aren’t painful etc.

Got my results back and it’s literally gone UP to 50 😩.
What does this mean?
In the past week, I’ve been feeling shaky when exerting myself/dog walking, feeling like I need to eat to stop that ‘low blood sugar’ feeling but actually I just took my blood sugar 3 hours after brekkie and whilst having symptoms before I ate lunch, and it was 6.4.

Does this likely mean I’m diabetic? In addition I I’ve requested another blood test to check if my iron is still low (was 10 a year ago) because low iron can obviously affect the A1C test- making readings higher. My shaky/weak/no energy/slight cough symptoms are also the symptoms of having low iron….as well as being the same for low blood sugar.
Im overweight and losing any weight is really hard even though my diet is really quite good.

Really this won’t be full blown diabetes but I had a 2 week course of dexamethasone in 2021 and you can get steroid induced diabetes, either temporarily or long term. There is new research from the Recovery Trial saying patients who had dexamethasone whilst in hospital were prone to acquiring diabetes. When I was on it, they had to give me insulin injections to regulate my blood sugar.

Hmm - but compare that with the info on this website where they suggest 30-45g carbs per meal. This is why it’s all so confusing!
There are no set rules or advice.

https://www.everydayhealth.com/type-2-diabetes/low-carb-diet-mistakes-to-avoid-when-you-have-diabetes/#:~:text=Left%20unchecked%2C%20going%20low%2Dcarb,t%20produce%20as%20much%20insulin.

Maybe trial and error, see what works for you?

Diet advice on the UK can be sketchy, and much of it is based on bad science from 70+ years ago. I’d be wary of any diabetes diet advice suggesting as much as 45g of carbs per meal. Going lower (I think no more than 50g per day) is much more helpful and more effective.

Theres a website called Diet Doctor that’s worth looking through. It’s run by a Swedish Dr, who’s work has seen Sweden change their national diet advice for those who are diabetic or need to lose weight.

I got my pre diabetes down in 4 months from 44 to 38-- been sticking to no more than 75g a day and it is hard as I've always built meals around rice, pasta, sandwiches etc . I still eat porridge 3 or 4 times a week but if I have porridge I will eat cottage cheese with ham wrapped round it for lunch and a small salad and then something like chicken breast with garlic broccoli and carrots at night - no potatoes - im still trying to stick roughly to this

I was advised by my diabetes nurse to low carb as well. I aim for less than 30g per day.

I do agree that information regarding it varies wildly though.

If you’ve reduced your processed sugars and carbs the shaky weak feeling could be your body detoxing. Stick with it, I was diagnosed type 2 with a hba1c of 50, I refused medication and reduced my carbs. In total I’ve lost over 6st and am now in remission.

Thank you @Crikeyalmighty that’s really useful. I will try cutting bread and potatoes. And try to bump up my protein but as a former vegan I still don’t eat lots of meat.

Its so tricky - any limited (by food type I mean) diet is really stressful at the start!
In addition my son (18) has ARFID and so I’m always thinking about what I can make him or offer him so he will eat something. More food planning is not what I needed! 😩

That’s brilliant @IggyAce well done! You’ve inspired me now.

If you get a spare 5 mins, could you tell me a typical day of meals you’d have?
but honestly only if you have time. 😊

@Verbena17 im not as strict these days but I tend to have the following:
breakfast: slice of wholemeal toast spread with peanut butter or guacamole and scrambled or poached eggs.
or Greek yoghurt, couple of teaspoons of protein granola, berries & chia seeds.
porridge with chia seeds & berries.

lunch: omelette with ham & cheese.
crisp breads spread with soft cheese.

Dinner I tend to have the same as family but watch my portion size and swap pasta and rice for alternatives. For example I have courgetti instead of pasta and cauliflower rice instead of rice.

I still enjoy chocolate, I’ve just swapped to dark. I snack on nuts.

You would be wise to look at the UK diabetes forums (https://www.diabetes.org.uk/ and https://www.diabetes.co.uk/) , where many long term diabetics will be able to share with you their own experiences and offer suggestions. Carbs affect different people in different ways. Some people are ok with low GI carbs, others will have blood glucose spikes after a teaspoon of porridge. (I am one of the latter - an apple and dates would push my 2 hr blood glucose up to 15 or so).

I have to keep my carbs below 75 a day, and no more than 35-40 in one meal. Having a moderate amount of fat in a meal does help to prevent spikes for me, so, for example, strawberries on their own push my 2hr blood glucose up quite a bit, but if I have a generous portion of whipped cream with them, my blood glucose is ok.

If you are overweight, losing weight helps a lot. The fat around your pancreas causes pressure which makes it harder for the pancreas to produce insulin. When you lose weight, it doesn’t just make your bum and waist smaller, it actually gets rid of some of the fat around your internal organs, which helps the pancreas.

If you feel shaky when your BG is 6plus, it’s not low blood sugar that is making you feel shaky. A normal pre-meal reading for a non-diabetic would normally be 4 - 5.9.

I'm limited by needing to eat gluten free too - it all came on for me post covid- I found tinned fish or smoked salmon PAYE etc on gluten free crisp bread a good option as they are quite low carb- so even 4 was only 20 grams. One thing you didn't mention was alcohol, mine dropped a lot when I stuck to 2 medium glasses of wine twice a week only

The days I don't have porridge I have scrambled eggs and mushrooms and 1 slice of toast or sliced hard boiled eggs and ham and 2 gluten free crisp bread (10g for 2)

Also my favourite , dry fried raspberries and blueberries with a teaspoon of cinnamon on top of a crumpet with a dolllop of thick Greek yoghurt

@IggyAce yes my diet is similar

@Verbena17 unfortunately the current nhs diabetic diet info is not very helpful. I have been told it encourages small reductions and variety in carb types as this will result in some small change for most patients. Whereas telling people to aim for say low carb 50g per day would have zero benefit for most patients as they simply wouldn’t bother doing it.
Have you tried a cgm, continuous glucose monitor. You will very very clearly see that all the carbs are causing (cumulative) spikes. You will also see that cutting carbs back every day will give you a lower average reading (ie Hba1c).

The other thing I was told was to go for a 10 minute walk after eating and ditch snacks

All really helpful replies - thank you.
@Crikeyalmighty - no I barely ever drink alcohol. I can’t remember the last time I drank alcohol - probably March when I had a little Belgian lager.

I’m going to make a meal plan.
Can I just ask…..the number of grams thing - is that literally dry weight of food or cooked weight or ? Anyone got a carb calculator they’d recommend?

Oh one thing I forgot to mention….
I don’t have a gall bladder, which is why until now, I’ve not tried full keto. I’m not supposed to eat much saturated fat so having a full keto diet really would make it even more tricky.

@Verbena17 I have the same issue which is why I'm not eating keto

That’s good to know. I feel a bit better seeing all the helpful replies 😊

Have you had your thyroid tested? I had pins and needles foot pain with it before I was on levothyroxine. I also tested as pre-diabetic and then back to normal with no diet change once medicated for my thyroid.

Yes I eat veggies - those foods were just a few examples of stuff I eat for different meals.
However, for people without gall bladders, any type of brassica like cauliflower/cabbage/broccoli etc aren’t great. But I do eat them - just not loads.

That’s also very interesting. My last T4 result (last year) was normal within range. I’m having bloods tomorrow but not sure they’ll test thyroid. Will check with them.

I had Gestational diabetes. It was ridiculous literally anything carb and my readings were too high.

Look into pairing. I could manage some brown pasta if I had a shit load of cheese on it (just the way I like it).

Also keep a good diary and your readings. You will work out what your body specifically can handle. Was a nice surprise for me I could manage pasta but one slice of brown bread was never ok. Yet the diabetes diet sheets I was given had loads of "one slice of brown toast" on it.

I also found I had to walk for like half an hour after meals. Exercise makes a big difference.

Trouble is now having followed the diet I worked out for the diabetes I've found out I have high cholesterol so need to refuse cheese and cream (I have a teaspoon of cream in my hot drinks to avoid the milk carb). Literally don't know what to eat now. Just veg I guess