Accelerating Diabetic Complications

dolby · 10-11-2009, 16:58

I am male, 45 years old (5-10/200 lbs), diagnosed with T2 Diabetes just this year in May: HbA1c=8.4; fasting BG=210; Microalbumin=40; protein(1+), glucose(2+), ketones (trace)through random urinalysis. This suggests I've had T2 for a while. My BG 2 years ago was 129. 4 years ago, it was 105. Let's say I've had this for 4 years or so. My hypertension (140/100 without Lisinopril; 110/90 with) was probably longer. And I've always had high cholesterol (250s) and triglyceride (300s).

Since June 2009, I've been taking 500mg of Metformin 2x a day, 20mg of Lisinopril, and 20mg of Simvastatin (just switched from Crestor due to side effects). In August, after taking these drugs for 3 months, my latest testing shows HbA1c=7.2 and fasting BG=115. Also, excellent cholesterol numbers (154) that are within normal. I seem to be making some progress.

Yet, my diabetic complications have progressed and I'm experiencing symptoms that seem more advanced for someone at my stage:

- Hands that go numb at night. Both hands.
- Cold fingers and hands: I mean, really chilling, icy hands. After sitting still for a while, when I put my fingers on my face, it's like putting ice. My clients have remarked how cold my hands are after a handshake.
- My feet are a tinderbox. Electric and tingling sensations all over. Literally, some kind of mini electric shock therapy is going on down there. My feet also go to sleep while exercising (being on an elliptical for more than 20 minutes). No coldness however.
- Sporadic fevers (though never above 100) accompanied by the feeling of being in a fog.
- Constipation; also what seems to be very slow digestion by stomach of food. I've always been a very slow eater.
- Foamy and ammonia-smelling urine that does not void completely (incontinence)
- Dry skin that seems to have really "thinned out." I'm very easy to bruise and cut. I believe I had a thicker skin when I was younger.

Just saw a nephrologist who ordered a 24h urinalysis for me to assess my kidney damage. I also recently started seeing an endocrinolgist to monitor BG throughout the day. So far, I notice my BG between meals to be around 110-150 and after meals, 220+.

Even with these numbers, I should not be experiencing these symptoms? What do you think is going on here? Is my after meal BG spiking? Perhaps my hypertension did the damage before the onset of BG elevation?

diabetes709 · 10-13-2009, 00:49

What do you eat, when you get those high BG numbers? Your normal numbers are already too high, so what little I know, tells me your meds are not working in the first place, and anything you eat with carbs, will increase your numbers past the so called 'safe point' of 140 as you are nearly there to begin with.

Sounds like you eat a lot of carbs, aka starch, to elevate from low 100's to over 220. More info about what you eat would help those of us who enjoy playing doctor, and not getting paid for it, try to help. lol!

John

dolby · 10-13-2009, 03:03

I used to eat a lot of starch. Spaghetti and all kinds of pasta, rice, pizza, sandwiches. I couldn't get enough of sourdough bread. Panera Bread and Au Bon Pain are my best friends.

My lunch used to be an Italian hoagie or ham & cheese sandwich. Or slices of pizza with toppings. Or a Subway sandwich.

Now I've replaced that with a small salad and a slice of whole grain bread, and a light yogurt. I'm trying to stick to this but honestly, I don't know what I can have for dinner. Some more salad, I suppose, and that's what I had today. But all I can think of will have carbs which will skyrocket my BG. So it's TBD.

For breakfast, I'm now eating Fiber One with skim milk. I'm giving myself some snacks: one apple between lunch and dinner and a banana after my dinner. Perhaps some dried apricots, too. This is my proposed diet plan! Of course, I have a feeling I may still score pretty high even with this: then what?

Quote:

Originally Posted by diabetes709

What do you eat, when you get those high BG numbers? Your normal numbers are already too high, so what little I know, tells me your meds are not working in the first place, and anything you eat with carbs, will increase your numbers past the so called 'safe point' of 140 as you are nearly there to begin with.

Sounds like you eat a lot of carbs, aka starch, to elevate from low 100's to over 220. More info about what you eat would help those of us who enjoy playing doctor, and not getting paid for it, try to help. lol!

John

diabetes709 · 10-13-2009, 04:28

Quote:

Originally Posted by dolby

I used to eat a lot of starch. Spaghetti and all kinds of pasta, rice, pizza, sandwiches. I couldn't get enough of sourdough bread. Panera Bread and Au Bon Pain are my best friends.

My lunch used to be an Italian hoagie or ham & cheese sandwich. Or slices of pizza with toppings. Or a Subway sandwich.

Now I've replaced that with a small salad and a slice of whole grain bread, and a light yogurt. I'm trying to stick to this but honestly, I don't know what I can have for dinner. Some more salad, I suppose, and that's what I had today. But all I can think of will have carbs which will skyrocket my BG. So it's TBD.

For breakfast, I'm now eating Fiber One with skim milk. I'm giving myself some snacks: one apple between lunch and dinner and a banana after my dinner. Perhaps some dried apricots, too. This is my proposed diet plan! Of course, I have a feeling I may still score pretty high even with this: then what?

I am with you on the sandwiches. Man do I miss those things, and the pizza and pasta. I could cry. Heck, I do. I was all those things, ice cream, cookies, and brownies as well. Not to any great excess, but too much, now that I look back.

I am T2, and think I have my numbers under control, but I have no idea how I do it, because I love to eat, and I love to eat simply, like sandwiches, and fast breakfasts and dinners. Heck, all I ever drink anymore, is water, and that is booooring. (oh, and non-fat milk every other day on the cheerios)

Anyway, apples are way high in sugar, bananas too, in fact the riper they get, the more sugar they provide, so you may want to watch how they affect you. Don't know about apricots, but CalorieKing - Diet and weight loss. Calorie Counter and more can tell you. Fiber one is 25 carbs in just one half a cup. That's a lot if you eat a full cup of it.

I had to give up cereal, but I do eat a 1/2 cup of cheerios every other morning with a few strawberries cut up on it, because I think there are good things in it to offset the carbs, and I only use non-fat milk.

I can't eat any yogurt. I thought it was low in carbs, but I haven't found one that qualifies as such.

No one should tell you that you can't eat something, because we all react differently to different foods. There is no "diabetic diet" but its a good idea to isolate some things, test with the old meter, and see what it does to you. Check out what each of those fruits are doing to you. Fruits are sugar, and usually kick up the BG.

Even whole grain bread is something to look at. What I can find, is 35 carbs for two slices. That's a lot, for me because one sandwich is like trying to eat just one potato chip. <g>

I found tortillas that are only 9 carbs at Wally Mart. Still want bread, but I can't, so I am working on the tortilla in its place. Some people use lettuce for bread, but I am not that far along yet. :-)

Deli meats, as well as tuna or canned white chicken, essentially no carbs, made with mayo, no carbs, on the 9 carb tortilla keep my carb intake pretty low, and my BG numbers don't even move when I eat that stuff.

I don't know if it helps, but I eat bacon and eggs, salads with hard boiled eggs and tomatoes in them, and dinner is usually something like a piece of chicken, steak, pork chop, cube steak, or some other meat on the bbq, never fried, as there are no carbs there at all. Then I have a small potato, boiled, along with boiling some frozen vegetables like green beans, or brochili. I never call them veggies since that implies I like them, which I don't, but I know they are good for me, so I eat them. Light salad dressing helps.

Hot dogs, Brats, and other sausages are zero, or nearly zero carbs. Its always the bread issue that kills those for me, but I am getting used to bbq'ing the brats, and eating them without a roll. Heavy sigh.....

The disclaimer here is that this is what I do, not a critique of your choices, or even a suggestion of "do as I do" only that I arrived at these things by using my meter to see what each part of every meal does to me. I was so upset to realize that bananas are a no no for me, as they made breakfast more palatable, and I had two apple trees, and two peach trees in my yard that gave me infinite supplies of great tasting fruit for years. I have cut them all down, since I can never eat them again.

CalorieKing is a really good site, and their software is very good as well, although most think its a bit high priced. I use it tho,as they have so many foods in their database, even restaurants and fast food places, so you can either plan a meal and see the carbs and other nutrients, or just plug in the ones you ate, and see for real what you just ate. That was a big key for me, because at first, I thought I was "low carb" but I was no where near where I thought I was.

Probably more than you wanted or needed to hear :-)

Also, as long as I have said so much already, .......I am getting by so far with my sweet tooth, having instant, no sugar, chocolate pudding (again, walmart brand) with non-fat milk, and light whipped topping. Very low carb, and chocolate enough to help me when I am craving it. Unsalted nuts, or walnuts, and I can even get by with Quaker granola bars now and then, between meals.

Oh, and cinnamon is known to lower BG levels in many people. Try to get a tsp of it in every day if you can. It helped me.

Hope I didn't bore you with the ramble <g>

John

P.S. Its really hard. I hope you can get the numbers under control with just diet, exercise, and meds. I find it almost intolerable, but there are no other options. I wish you all the best, and the inner strength to make it through this. Lots of help around here if you need it, or just want to vent, or as in my case, ramble. lol!

dolby · 10-14-2009, 05:34

I've been writing down what I'm reading when I test. I'm realizing that to test between 120-140, I have to literally starve. I get those numbers when I haven't had my breakfast or lunch, just a cup of coffee and a glass of V8. But if I even touch a modest lunch, my BG shoots to 200.

Today, for example, all I had for lunch was 4 carrot and celery sticks, and a mini bagel with nothing on it. That shot my BG to 197! Later tonight, when I worked out at 2 gyms and burned 800 calories, I tested 125. I mean all I had today were some carrot sticks, celery sticks, 1 slice of bread, 1 mini bagel, some green peppers, a cup of coffee and V8. That's all I had and I'm still getting elevated numbers!

Should I be on more Metformin? I'm taking 500mg 2x day.

Richard157 · 10-14-2009, 15:01

I have had all those symptoms in the past except for the somewhat high temperatures. Even with an A1c below 6.0 I had some mild retinopathy in my eyes and some nerve damage and neuropathy. It has been found that a good A1c is not enough to prevent complications. A low A1c is very necessary but a roller coaster type of control can still cause those complications. We really need an A1c below 6.5 (ideally below 6.0) and a stable control with few highs and lows. That stable control is very important. After cutting my daily carb intake to 130g per day, greatly increasing my amount exercise, and losing weight I reduced the frequency of my high blood sugar numbers. I now stay in the range 70-130 about 90% of the time. All my complications have disappeared. It has been that way for two years now.

Your 200+ numbers after meals are definitely causing you problems. If you are overweight or eat too many carbs or do not exercise enough that can be adding to the complications you are experiencing. If you can fine tune your control to the point that you have much fewer highs and lows with no numbers over 160 or so, and your A1c stays below 6.5 then your symptoms should gradually disappear.

dolby · 10-14-2009, 19:36

Thanks, Richard. It's encouraging to hear that those symptoms can disappear. That's what I"m shooting for. But how can I get the BG under control if I'm testing 200 with 4 carrot / celery sticks, a cup of coffee w/skim milk and a whole grain mini bagel? I have been on 500mg 2x per days since June 2009. Do you think I may need higher dosage or perhaps another drug? I won't be seeing my endo for another 4 weeks.

Richard157 · 10-14-2009, 23:39

I started using a chart in the 1980's and kept track of all my tests, carbs eaten, insulin used, exercise, etc.
I in the new century I have added more to my chart and I learn valuable things from it. I now list everything I eat and test frequently to see how carious foods affect my BG levels. I then determine what foods I should eliminate or eat in smaller portions. This is part of what I do to avoid highs and lows. It is difficult for me, a Type 1, to advise you, a Type 2 but still, in some ways, we can both profit from the same type of control. You need to observe how each kind of food you eat affects your BG. That might mean eating only one kind of food at breakfast so you will know that only that food has affected your BG two hours later. I test at 2 and 4 hours after each meal. Many diabetics expect less than 140 two hrs after a meal and very close to 100 four hours after the meal. Foods that will not meet that criteria should either be avoided or eaten in smaller portions. I can use insulin to compensate but you can only use exercise and food choices and portion control. It is really hard for me to give you more advice since I do not understand Type 2 diabetes as well as I understand Type 1. I think you should join a site where there are many active Type 2 diabetics who can advise you.

dolby · 10-20-2009, 07:16

After many experiments, a breakthrough. I tested 98 and 97 today 2 hours after my dinner consisting of cottage cheese, Mescalun salad, and some poppped rice. 1 hour after dinner it was 145. This is a breakthrough since I never tested below 100. Heck, my lowest number ever prior to today was 115.

So I seem to be doing something right. I seem to have some tolerance for cottage cheese. And I'm only having a slice of whole wheat bread in the morning. Now, if only my spikes go no higher than 140, where nerve and organ damage supposedly occurs.

Richard157 · 10-20-2009, 14:10

Those are good numbers, keep up the good work.