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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?
 

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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
 

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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?

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
 

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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!
 

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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.
 

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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.
 

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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.
 

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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.
 

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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.
 

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Those are good numbers, keep up the good work.
 

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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.
Morning seems to be a very vulnerable time for T2's and carbs. I tried to eat a slice of bread at first, or toast, and finally realized that I could have that slice at lunch or dinner without any impact, but in the AM, it spiked me more than I cared for.

I am working hard now for zero carbs in the AM. Not a lot of choices, but I think that will help my A1c number a lot in the long term.

If it wasn't so serious, and took so much time, this would almost be a fun challenge :-(

John
 

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John I sometimes have ham or bacon with two scrambled eggs. That and a cup of coffee is only 5 carbs. If I had hot tea instead of coffee it would be 2 carbs. That fills me up rather well. I don't have any desire for bread in the morning. I have not eaten cereal for many years.
 

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John I sometimes have ham or bacon with two scrambled eggs. That and a cup of coffee is only 5 carbs. If I had hot tea instead of coffee it would be 2 carbs. That fills me up rather well. I don't have any desire for bread in the morning. I have not eaten cereal for many years.
Hi Richard,

Yea, my mornings are bacon and eggs, and its started to take a toll on me :) Just need to shake it up a bit. I don't drink coffee, and no juice on earth is any good for me, so I figured to try and turn my diet around and eat the more carbs, later in the day.

Sometimes, I just don't eat. I watch my numbers, and I know I need nourishment just like anyone else, but based on the position I am in, in life, its wicked hard to keep bothering to make meals. I am afraid that seeing my Ac1 number go down so well this last time, I have kind of lost my edge, and need to get it back. It never ends, as you well know :)

John
 

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Ahh, the struggle ...

The struggle of curbing carbs continues. I do have a bit of that "dawn phenomenon" that Dr. Bernstein discusses in his book. So I avoid eating any bread or cereal in the morning, now. I switched to bacon, eggs, some vegetables, ham, etc.

My lunch at work usually consists of cottage cheese, tuna fish salad or salad with some meat (like sliced pepperoni slices, salami, etc.). My numbers are good now. I can get as low as 100 2 hours after a meal. Premeal, I sometimes go under 90.

The problem, however, is the weakness that comes on later in the afternoon. It starts slowly, around 4pm. By 5pm, I'm completely exhausted. By that time, my carb intake for the day is probably only at 50g. So I come home and make my low carb dinner still: maybe a steak, sausage, or some fish, vegetables. Again, very low carb.
I'm still tired after the meal.

Finally, I can't stand it any longer and I grab a piece of bread. I eat only 1/2 a slice of whole wheat bread, toasted. I feel much better afterwards. I didn't eat a whole slice. But this low carb diet is continuing to make me feel weak later in the day. Do people feel this way: this is my 2nd week on Dr. Bernstein's diet and the afternoon fatigue comes on as strong as ever, and I have to run and get my emergency bread outta the fridger.
 

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Finally, I can't stand it any longer and I grab a piece of bread. I eat only 1/2 a slice of whole wheat bread, toasted. I feel much better afterwards. I didn't eat a whole slice. But this low carb diet is continuing to make me feel weak later in the day. Do people feel this way: this is my 2nd week on Dr. Bernstein's diet and the afternoon fatigue comes on as strong as ever, and I have to run and get my emergency bread outta the fridger.

Do you test before your dinner? I turned my meals around, going with as few carbs as possible and then adding as the day goes on. Maybe you can eat more than you think, in the evening? Only your meter knows for sure :)

Just as a comment to no one in particular, I have found that I started to obsess too much about not raising my numbers over 110 or so with a late meal, and frankly, that was a mistake and so I tend to eat a bit more, even toss in things that have too many calories, because I was hungry, and hating it. Still don't go past 130 max for dinner as the rule, but its been a long day, and I have to eat to make it through.

I don't think its how many carbs you eat during the day, so much as it is, the rate at which you take them in. That's why so many go with more, smaller meals, instead of the usual three. When I am hungry, and foraging :) I test, and if I am at a good number, I eat. I am not losing weight as fast as I would like because of that, but, good grief, life is for living, and if you are miserable, consider changing the weight goal and moving it out a bit.

P.S. Bread in the fridge is not good, as it dries it out. Bread should be frozen, and it will keep for a very long time, especially wheat bread, and then thawed a few slices at a time for when you break down. This is the only way I can have any bread in my house, as a loaf would go bad even in the fridge before I ever ate it all.

Keep reading that meter, and if you have "room" based on your numbers, eat something filling. Sounds like you are doing a pretty good job.

John
 

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Bagels?

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.
Hi Dolby

I'm new here and joined in order to make a suggestion to you and to hopefully interact with others and Especially Canucks because our issues can differ quite a bit from you south of the border types :D

I notice you are from NJ
Do you drive to the "City" (NYC) to get your bagels? We all know NYC bagels along with ones from Montreal and Winnipeg are the best on Earth but if you insist on eating them it would be better if you walked to Manhattan to get them rather than drive because of all the high density useless carbs you can eat bagels are on top of the list a little above Cheerios which is all the cereals is the same idea.

You mentioned that you had nothing on it? There is your big mistake. You will find if you have something on it in the way of protein, like Montreal Smoked Meat or Pastrami, and cheese as well then it will slow the release of sugars into the bloodstream but best just to look for regular sprouted bread not made with flour. It's easy to find this.

Carrots? Hey, same as apples, make sure you balance it with fat and protein. The worst fruits are apples, bananas and the worst veggies are carrots and a few others which escape my mind at the moment.

Lastly, if you take your reading just before you have a cup of coffee with milk and then take it half an hour later you are in for a big surprise because caffeine in the form of hot coffee releases adrenalin which ups your cortisol which spikes your numbers. Surprised? No, coffee is not bad for you but just so you know. I've heard all kinds of pros and cons about coffee but the best way to see is to test.

In summary, change your breakfast menu LOL

Bernstein is too strict on this bread thing. Yes bread is sugar and it would be better to get the energy you need from some other form but to go around feeling weak is no life and I have tried this and couldn't stand it either. Don't you think that balance is the key here? You may also find that your numbers in the morning are higher so maybe does up more in the a.m. and lesser in the evenings. I can get away with much more in the afternoon and evenings if I can drop my numbers by late afternoon. Then I can eat a cheeseburger and not notice any climb. Weird maybe its just me. I hate mornings
 
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