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Help please for a Newcomer

4528 Views 19 Replies 7 Participants Last post by  Nagesh Rao
Hi all,
I am starting a new thread, as adviced, in order to get maximum feedback.
New here and new to Diabetes type 2, diagnosed two weeks ago. I have been desperately trying to keep the BG under control and I dont think I have quite got the hang of it yet. So any help from you experienced people will help me. My fasting has for some time been at 14 mmol/L [which I think equates to 252 mg/dL]. Yesterday, I decided to take 1 Metformin in the morning with Amaryl 4 mg (glimepride). Blood sugars came down beautifully by 1400 hrs to 8 mmol/L (144) and then slowly started creeping up to 14 (252) by bedtime. I took 2 more Metformin at night and was hoping that my FBG will be normal. But it was 12 this morning (216). I am a bit confused by all this. Nothing so far is succeeding. I have oatmeal porridge for breakfast, a zero-carb high protein lunch and a high protein dinner. I do drink plenty of coffee. And yes, I do aerobic exercise [Lateral Thigh trainer] for half hour every day.
Should I be going on to Insulin? Should I be trying health food supplements? (I do take Omega-3 1000 mg every day) I wonder.
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Hi Nagesh and Welcome!

As I mentioned in that other thread, Metformin seems to be a drug that can take several weeks to get up to therapeutic levels so you may need to be patient before you see results and it also does not make much sense to take extra doses or miss a dose to try and make short-term Blood Glucose (BG) adjustments.

Insulin can be a useful tool for managing BG levels (I started on it early myself). There is a recent thread discussing this option...

Many (though not all) find (through home BG meter testing) that our tolerance to Carbohydrates (sugar) varies through the day with breakfast as the time of day when we can least tolerate carbohydrates.

Here is my usual spiel on diet (in this case it simply means "what I eat", as opposed to a drastic short-term weight-loss change)... I apologise if it crosses any religious/cultural dietary taboos...

Real whole food, is the order of the day... preferably local and in-season, grown/reared on nutrient rich land... grass-fed beef and pastured chickens for example. This means eat whole (unprocessed, unpackaged, unadulterated) food, which includes a natural balance of fat, protein and carbohydrates (as well as vitamins, minerals etc...) ...there really is no need to be afraid of natural fat... it's gotten a bad rap.

Those of us with Diabetes need to pay particular attention to the foods which have the most effect on our Blood Glucose (BG) levels. There are obvious things to watch out for like candy, cola, cakes and sweets (these are high in refined/concentrated carbohydrates)... next in line are the "white" foods like bread, pasta, potatoes, rice, breakfast cereal... but even something assumed to be healthy like orange juice has about as much sugar as a cola... fat reduced milk can have an higher proportion of lactose (sugar), especially in low-fat products such as yogurts which may have High Fructose Corn Syrup (HFCS) added to replace the fat... and so it goes on. That does not mean you need to feel deprived or hungry to eat this way, not by any means. You may even find you can work in an occasional family cake... for example. The keyword there being "occasional" as it used to be when our Grandparents baked cakes only for Birthdays etc... not everyday (muffins, donuts, pastries) for breakfast.

You may have heard the phrase "eat to your meter" and this deceptively simple message is very wise... test around your food and figure out what works best for YOU.

Learn to read nutritional labels AND ingredient lists. Be aware of hidden "sugars" -- mostly ending with "ose" -- and starches (such as Maltodextrin) which also quickly break down into sugars.

Some ideas for snacks: nuts, cheese, dark chocolate (70% cocoa or higher), pork rinds/scratchings, cold meats, boiled eggs, peanut butter.

While we are encouraged to eat "so many servings of fruit and veg daily", many of these can spike our BGs so test, test test... for many of us, green leafy vegetables seem to work best... but you may also help reduce/slow the BG spike by mixing foods... for example: instead of eating an apple by itself, try just half the apple in slices with some peanut butter or cheese... or have a few berries with some cream.

I'd suggest that BG control be your primary aim... while minimising the need for insulin which is the major fat storage hormone -- reducing excess fat mass, improving cholesterol/lipids, hypertension etc... all these tend to improve with more normal BGs.

I am not big on setting unrealistic "exercise" goals... flogging yourself at the gym... unless you feel especially motivated to do so. I think you are better off with something sustainable in the long term. There are many health benefits of activity but I'm not convinced that losing weight is a major one. I do believe in building activity into your daily routine (rather than finding excuses for missing the gym)... take the stairs, park further away, get off the bus a stop earlier... go for a walk at lunchtime... take "smoke breaks" at work where you walk around the block instead. Physical activity can help with your BG numbers as it tends to lower Insulin Resistance (IR) , as well as using up glucose but as with food, it is advisable to test and see how it affects you.
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Is it the Type 2 or the Metformin that is affecting your appetite? If it is the Metformin you might reconsider some insulin and a lower dose of Metformin. I really don't think starving is helpful to the body... we need to feed the machine and that includes more than simply energy... there are many nutrients essential for health.

As Metformin works on the Liver I suspect that it ought not to be mixed with alcohol... at the same time I know some who find a moderate intake (a glass or so most nights) of dry wine or spirits (like an aged single malt :cool:) beneficial in terms of BG control, not to mention lower stress levels.

A1c is a reflection of your average (mean) BG over the last 90 days or so (largely based on the 120 day average life-cycle of red blood cells), weighted to the last 30 days or so (it is not an exact science!)... so don't expect an huge change over 2 weeks of treatment... so long as it is heading downwards, then that is a good sign :)
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Sounds like a great start Nagesh and a fun party ;)
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