That Old DP Keeps Rearing It's Ugly Head

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borisnatasha
Regular Member


Date Joined May 2009
Total Posts : 22
   Posted 4/14/2010 8:07 AM (GMT -7)   
I keep coming to these diabetes support groups complaining about the same old things. I am sorry but it is so discouraging.
My background is that I am a recently diagnosed (Mar 2009) Type 2. I am currently on Metformin-- 2X twice a day, and Diamicron MR--90 mg once a day. The Diamicron was prescribed after using Glyburide which was causing a lot of lows.
I have not been satisfied with the Diamicron at all. I feel there has not been a lot of control with it despite it being increased twice from 30 mg up to 90 mg. Plus it has been hard on my stomach. I had my lab work done recently and it came back with an A1C of 6.4 up from 5.9 at my last one. This is where the frustration comes in. My diabetic educator and I are not on the same page at all. In a nutshell she thinks my numbers are just great, and to top it off she belittles me and says I am too obsessive with my numbers and need to chill and just live with them as is. And she told me to test less. Maybe once or twice a day at random times and that is it. Now of course the obvious solution would be to part ways but I live in a small community and there are no other options available so I am stuck with her. I am just going to have to learn to ignore what she says and do what I think is best.

One of my biggest frustrations are my morning numbers. It doesn't matter what I do, they are just plain high. I have tried every kind of snack before bed.... carb and protein, just protein, nuts, no snack before bed, I have tried taking my Metformin before bed. Last night is a classic example. I had no snack before bed even though I was hungry. I was at 5.3 (95.4) before bed. Took 1 Metformin. I get up this morning, normal time and I am at 8.2 (147.6). If I were to share my concerns with the nurse she would tell me to just forget about and go about my business.
Since nothing I have done has worked anyway I guess I am going to have to take her advice on this one.

I am not looking for solutions because as I said nothing has worked. It is beginning to look like I am just going to have to accept things as they are. This is my problem and why I am so frustrated because after all my efforts and trying different things nothing is working. The worst part is when I was on the Glyburide I had gotten my numbers down to pretty reasonable in the morning and the rest of the day also and if it weren't for the lows I would still be on it.

I guess I just need to rant and have some kind words of support!

Thanks for listening.

LanieG
Forum Moderator


Date Joined Nov 2006
Total Posts : 5408
   Posted 4/14/2010 8:30 AM (GMT -7)   
Gosh, that's frustrating.  Can you write what you eat for meals and snacks in an entire day?  Let's look at the food you're eating first since that is probably the biggest impact on blood sugar.  (Then we'll deal with the surly diabetic "educator" after that!)
Lanie
 
forum moderator - diabetes
diabetes controlled so far by exercise and a low/no carb diet


borisnatasha
Regular Member


Date Joined May 2009
Total Posts : 22
   Posted 4/14/2010 8:46 AM (GMT -7)   
Hi Lanie....
Thanks for responding.

Here is my day....

I get up at 7 am.

Breakfast immediately
Two strips of turkey bacon
2 scrambled eggs
1 slice of low carb toast with margarine

Before I could not get away with having any carbs so that is improving somewhat.

about two hours later I have a granny smith apple with either cheese or peanut butter for a snack which seems to help lower my sugars before lunch.

My numbers before lunch after doing this are the best of the day... average 4.7

Then it is downhill or should I say uphill from there.

I have lunch which is most of the time a sandwich using low carb bread. Two slices are 13 gm of carbs. I sometimes have grilled cheese, sometimes deli meat. If I decided to have fruit with the sandwich I would have only half a sandwich. I try to keep my meal very small.

I go out for an hour walk after lunch and come home and my numbers are sometimes very high. When they are so high I will have a handful of almonds for a snack because if I don't they stay high right up to supper and the nuts seem to bring them right down. Most often they are in between 5.3-6.8 even with the nuts.

At supper I try to watch my carbs and try to keep them at 30 gm or less because if I don't they go super high and stay high. Again certain snacks might bring them back down again. Usually protein and or fat.

If they are reasonable before bed like in the 4s 9very seldom) and 5s then they go up at least 2 points by morning. If they were high before bed like in the high 7s or 8s then they will come down by morning but no lower than low 7s.

And that is pretty much my day. I have totally cut out bad foods because I can no longer get away with the occasional treat as I could before with the glyburide.

TVEditor
Regular Member


Date Joined Aug 2008
Total Posts : 481
   Posted 4/14/2010 11:59 AM (GMT -7)   
A suspicious culprit might be the low carb bread. I'm no saint -- I still have 2 slices of rye bread (low on the Glycemic Index) a day but at different meals. If I have a regular sandwich with 2 slices, I usually spike. You might try omitting the bread for a couple of days and see if that has any impact on your readings. I also switched from margerine to butter. The extra fat helps slow down absorption of carbs.

Have a look at Jeannie's message regarding eating fat at breakfast:

http://www.healingwell.com/community/default.aspx?f=20&m=1763249article

There is something to what the nurse is saying (I don't trust'em either :-) I was a testing fiend when I was first diagnosed but I determined that just the stress of waiting impatiently for the next test time and hoping for a low reading would sometimes bump my numbers up.

Although your last A1c is a little high, it's not all that bad. You might want to check your meter/test strips. You can buy (sometimes the pharmacy will give it to you) a solution that tests the accuracy of the strips. I had some high readings once and tried this. I found that I had a whole batch of strips that were out of the range recommended on the side of the container. I returned them and my readings went back to normal. Just a thought.


Chris - Forum Moderator, Diabetes

~ Diagnosed Type 2 in July 2008 ~ Dropped 53 or so pounds after following HealingWell advice ~
~ Diabetes under control / no meds - so far - knock on head

I used to eat 100% wrong -- now I eat 95% right

Post Edited (TVEditor) : 4/14/2010 1:27:46 PM (GMT-6)


borisnatasha
Regular Member


Date Joined May 2009
Total Posts : 22
   Posted 4/14/2010 1:43 PM (GMT -7)   
When I first started on the new med-- diamicron I absolutely couldn't eat any kind of carb at breakfast as my numbers would soar before slowly coming back down. After a while I tried a slice of the bread back in and found it worked okay and my numbers were decreasing right after breakfast as they were before when I was on the glyburide. So I don't think the bread is the culprit although I do try not to eat too much bread in a day.
I will try switching to butter though. Love the taste so this won't be too difficult.

I don't understand the so called expert's philosophy of testing only twice a day and at random times. How is this going to tell me how what I am eating is affecting my numbers? They almost make it sound as if what I don't know won't hurt me. That is pretty much what she said after I attended an Easter buffet and ate stuff I shouldn't have then tested afterward and was horrified at my numbers. She told me I shouldn't have tested at all. How else would I know how bad it was and how I better not do it again?

I know my A1C could be worse and it was at diagnosis (10%) so this is a vast improvement but still not low enough. I have tried to get the test solution for my meter only to find they don't sell it at any pharmacy in town and they can't get it from the company supposedly... I have no idea why that is since there was a bottle in with my meter when I first got it.

Thanks so much for all your very good ideas. I will keep plugging away and trying new things and hope I can get this figured out.

TVEditor
Regular Member


Date Joined Aug 2008
Total Posts : 481
   Posted 4/14/2010 4:11 PM (GMT -7)   
Yes, I agree about the random testing being maybe a waste of time. That may apply if your doctor suspects you of being diabetic and helpful during the diagnosis stages I think. Personally, I test if I'm trying some new foods or I don't feel the way I think I should. For example, if my BG is too high, I get sleepy. Not the expected, average symptom but that's the way it affects me. I have trouble keeping things in check (like you) mornings and after lunch so that's when I test. Since you're on medication, you should follow your doctor's advice on when to test and how often.

We've talked about this around here before; there appears to be no hard data on exactly how many spikes it takes to actually do damage but avoiding as many as possible would seem to be the way to go.

Consider: the A1c test is an average over 3 months of your BG behaviour so the really high and low spikes are ruled out.

The numbers, as far as I know, are guidelines so I've learned to not lose my head if I go overboard once in a while. A few of us here even leave our meters at home a couple of times a year ... when on vacation or just trying to relax. You'd be surprised at your own self-control, now that you are taking care of yourself (I was at mine). The point is, 'Live a little once in a while. Trust yourself.' Keep taking your meds though!

Be moderate in all things if possible -- especially the fats. I tried the turkey bacon for a while but it tastes like fried baloney to me. I like fried baloney (bologna?) but I don't like the turkey bacon so go figure :-) I went back to regular bacon but I have to watch my salt intake so I limit how much I eat.

PLEASE DON'T TELL THE THE NURSE THAT I'M KINDA AGREEING WITH HER! They are always right aren't they ;-)

P.S. I'm guessing you're in Canada -- click on my name at the left of the column to find my email address. Maybe I could help you find some test solution?
Chris - Forum Moderator, Diabetes

~ Diagnosed Type 2 in July 2008 ~ Dropped 53 or so pounds after following HealingWell advice ~
~ Diabetes under control / no meds - so far - knock on head

I used to eat 100% wrong -- now I eat 95% right


jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10392
   Posted 4/14/2010 4:44 PM (GMT -7)   
Hey! I was a nurse, buster. They aren't always right. I was, but not all nurses are.



nono mad tongue

TVEditor
Regular Member


Date Joined Aug 2008
Total Posts : 481
   Posted 4/14/2010 4:51 PM (GMT -7)   
No, no ... the nutritionist type ... the ones that .... oh, never mind. Seems like I got my foot stuck in my mouth. Can you help me with that Judy? Pleeeese? smilewinkgrin
Chris - Forum Moderator, Diabetes

~ Diagnosed Type 2 in July 2008 ~ Dropped 60 or so pounds after following HealingWell advice ~
~ Diabetes under control / no meds - so far - knock on head

I used to eat 100% wrong -- now I eat 95% right


borisnatasha
Regular Member


Date Joined May 2009
Total Posts : 22
   Posted 4/14/2010 4:55 PM (GMT -7)   
I personally have gotten used to the turkey bacon and kinda like it now. When I have eaten regular bacon I am shocked at the salt in it... it almost makes my hair stand up on end. As do most things that are processed. I am quite sensitive to salt now because I have been using No Salt for a couple of years. Turkey bacon tastes sort of salty too but not like bacon bacon.

I know it is not a crime to indulge occasionally but even when I do I am careful to not go too crazy but still my high numbers astound me. My husband agrees with "the nurse" and thinks I can afford to have a good time sometimes and it was for him that I went to the Easter buffet in the first place but I refused to have that waffle, even though I really wanted to! What control.... LOL

TVEditor
Regular Member


Date Joined Aug 2008
Total Posts : 481
   Posted 4/14/2010 5:17 PM (GMT -7)   
You're on the right track ... and there's a whole bunch of us on it with you wink
Chris - Forum Moderator, Diabetes

~ Diagnosed Type 2 in July 2008 ~ Dropped 60 or so pounds after following HealingWell advice ~
~ Diabetes under control / no meds - so far - knock on head

I used to eat 100% wrong -- now I eat 95% right


borisnatasha
Regular Member


Date Joined May 2009
Total Posts : 22
   Posted 4/14/2010 5:20 PM (GMT -7)   
I'm on the True Track! Which is the right track! I never feel alone on these boards.

Thanks Chris :)

LanieG
Forum Moderator


Date Joined Nov 2006
Total Posts : 5408
   Posted 4/14/2010 7:02 PM (GMT -7)   
I have to agree with you about the bacon bacon.  I bought some because of a recipe and the turkey type wouldn't do it as well.  And the salt was too much!  I also have to watch salt because of BP.  However, since we don't eat any processed food, the only salt I actually get is in cheese and what I put on my own food IF I use it.
 
Gosh, Borisnatasha, you have your food plan pretty much controlled but I would say the bread, low-carb or not, might be giving you the high readings.  On the other hand, that long walk after lunch is great and should help keep the blood sugar controlled instead of rising. 
 
It seems to me that testing 2 hours after a meal is important so you know what the food you're eating is doing to your blood sugar, despite the fact you're on meds.  Random testing is to see how your blood sugar is at any time during the day.
 
It's puzzling about the morning fasting readings.  Most advice for people with dawn phenomenon is to have a low carb snack at night.  I don't know.  Maybe give the meds a while to work?  Or, maybe have your doctor re-evaluate them.
 
confused
Lanie
 
forum moderator - diabetes
diabetes controlled so far by exercise and a low/no carb diet


borisnatasha
Regular Member


Date Joined May 2009
Total Posts : 22
   Posted 4/14/2010 7:16 PM (GMT -7)   
Can you taste all the salt in cheese too Lanie? I find anything with cheese in it is too salty, even if I don't salt for seasoning.

I think the answer here is to cut my carbs even more. I had a lower carb supper tonight and tested at 9 pm and was at 4.9! That was amazing to me. I haven't had such a good reading in a long time.
I guess if I have to eat really low carb then so be it. If that doesn't work then I guess I will have to get the doc involved and the next step will be insulin.

jujub
Forum Moderator


Date Joined Mar 2003
Total Posts : 10392
   Posted 4/14/2010 7:16 PM (GMT -7)   
We use the lower sodium bacon at our house. I cook the whole pound, then put it in a ziplock bag in the freezer. When we want bacon, I can take out a few slices and save the rest for later.
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