Extremely frustrated!

[Bamboo]

I've learned so much from visiting this community. I hope someone can give me some insights into what is happening. First some background:

My mother is a type 2 diabetic. My A1C had been creeping up in the past few years; eventually it reached 6.5. My doctor gave me a meter and sent me to the diabetes educator. I was given a diet, a monitor and told to check twice daily. Things were going very well: I lost about 35 pounds and my A1C fell to 6.1. I had a brush with renal cancer (a surprise find: tumor on my kidney), but since they removed my kidney and the tumor, I've needed no other treatment. That was at the end of 2006. I continued monitoring and was doing well.

Then, in January and February of '07, my sugars began to rise slowly. At the end of February '07 I was diagnosed with an autoimmune disorder very similar to lupus. (I have many of the markers but not enough to actually have a lupus diagnosis.) To treat that I was given prednisone, and to protect me from increased blood sugars, I was given 1 mg. glimeperide (Amaryl) to take once a day and told to test my blood sugar four times a day. I continued to stick to the diet but have gained all the weight back in the past year that I'd lost prior to going on prednisone. I don't have to tell you how demoralizing that is!!

Everything was going well otherwise until about the past month, when my blood sugars have begun to rise. My morning sugar reading used to be around 80; now it's 115. My evening sugar at bedtime was below 140 (except when I could account for a treat now and then). Now it's over 160.

Tonight before dinner it was 181. I thought, "That can't be right!" I recalibrated my meter and it read 206. All I had eaten was a mid-afternoon snack was a small amount of dry-roasted almonds and 1 tablespoon of dried cranberries. (I had eaten two pieces of low carb chocolate very soon after lunch, but that had never affected me before). 2-1/2 hours later I did my pre-dinner testing and had those high readings.

Is this something I did wrong? Has my weight gain from the prednisone caused this? Do I have to cut my carbs lower than what I've been told? I'm feeling like I'm not trying hard enough, or I should be trying harder to keep from gaining weight. I just haven't had this kind of bad results before now!

Help, please!
Ann

[DibeticAthlete]

Eating properly can be tough. You should book another appointment with a dietitian and tell him/her this. They are a great resource. You need to keep in mind as well that dried fruit (your cranberries) are a very concentrated source of sugar. Drying the fruit means that for something so small it often times has more sugar.

You need to make sure you get enough food. I know that sounds odd but if your starving your body the liver will kick out extra sugar to feed the body and prevent a hypoglycemic reaction. Depending on your other health problems one thing that might help you (it works really well for me) is to eat whole grains. I know most people on this board fear carbs but whole grains take longer to digest and will keep you feeling full...and will help stabilize your sugars through the day.

Make sure to eat correct portions. I use very small plates which visually looks like a ton of food. My dietitian told me to use my hand as a reference. A fist is the maximum amount of carb you should eat, your palm (not your whole hand just the palm) is a measurement for meat. Veggies are always great but again peas are like cranberries, super sugary, so learn to read labels so you know what you are eating.

Another thing is to make sure you eat around the same times every day. Obviously life will throw you some curves but it helps to get your body into a routine.

[Coravh]

There are several possible things going on. First off, T2 is a progressive disease and sometimes no matter how hard you work, you still end up needing more meds. In addition to that, given the auto-immune disorder, it is possible that you actually have T1. When it occurs in adults, sometimes it can take years before insulin is required.

Talk to your doc about the numbers, maybe getting some testing done to determine or rule out T1, and then maybe make some adjustments re med changes.

Best of luck.

Cora

[Bamboo]

Thank you for your insights!

I got in to see the diabetes educator (she's a nurse practitioner in my doctor's office). She told me the same things you both did, although she didn't mention the possibility of my having Type 1. She told me the the autoimmune/inflammatory process may have notched things up, and that the weight I've gained from being on prednisone could have contributed to it. She recommended I use Metformin but wanted to run it past my doctor first.

My doctor's other nurse called a bit later to say that because I have only one kidney and the autoimmune situation, she wanted me to add one milligram of Amaryl (now I'll take a total of 2) rather than use Metformin. I'll be checking in with them in two weeks.

By the way, when I took my sugar reading before lunch (having eaten nothing during the morning), it was 181. I guess I have to quit responding like that for now.

I agree about the whole grains. The educator is the one who got me on an eating plan that was working beautifully (see the second paragraph of my original post). I told her I'm sticking to that plan and she agreed. Some years ago I used to follow a low carb way of eating, limiting my intake to 60 carbs. My plan now is a limit of 150. I usually stick between 120 and 140, so I'm doing what I'm supposed to in spite of a temptation to cut the carbs way, way down.

Again, thank you for your help! This is a wonderful community, and I feel lucky to have found it.

Ann

[DibeticAthlete]

Ann,
I know it's frustrating. You can eat the same thing every day at exactly the same time and get different readings each day. I do have one more suggestion and this is the best way to lower blood sugars.....sweat until you want to cry! I just finished a cycle class at my gym and pushed myself for an hour. There is no way around it, walking won't do it, you need to really sweat. I find that if I don't work out for 3 days my sugars are out of control...super high. Once I go to the gym everything goes back to normal. I don't workout for weight loss...I work out to stay alive, if I don't I know I'll die. Think I'm being dramatic? Well after two seizures due to hypoglycemic reactions I'm not taking any chances anymore.

My best advice is to find a friend who is already going to the gym, who is already fit, and have them drag you there. And going 3 days a week isn't going to help....you need to go 5 days and sweat! Just make sure to keep a close eye on your sugars because they will drop due to exercise. There is no easy way to get healthy you literally have to work your butt off. Set a goal for yourself such as a 10km race in June, or a triathlon, that way you will continue to workout because you need to be ready for the race. This isn't hard to do, I did it by just deciding to start. It's that easy, you just need to start working out. The sugars will get under control, weight loss will happen after months. You can do this!