Frustrated -- Could Use Some Advice

[Jill-O]

Hi, Everyone --

I was just diagnosed with diabetes on 1/23. I was put on 1000 mg of Metformin extended release at night. I saw the doctor again yesterday to find my fasting glucose was 244! Got a meter and tested per his instructions 3 hours after dinner. It was 151, when he'd said it should be 180 or lower for me right now. Didn't eat anything until this morning. Tested as soon as I got up -- 210! URGH. Did my 30 minutes of walking, took a bath, etc., then checked again BEFORE eating breakfast -- 225!

My doctor doubled my Metformin which I now will take 2x a day but at first he said do half the dose in the morning, which I'm doing. Also put on generic Ameryl 2mg but has me break the little pill in two and take one in the morning, one at night. This is new, before I was just on Metformin. I took the Ameryl last night and again this morning.

Just tested before a snack and a client appointment due in my office soon, and it was 212.

SO frustrated!!!

I've lost 7 pounds the past month, which is good, watching my calories and being so much better with carbs than before (and of course eating nothing at night when my body is doing me in apparently). And, I've been walking 30 minutes every morning and just recently added ankle weights.

If you all can maybe give me some advice, I would appreciate it it. I've felt so much better and was honestly shocked to get the news yesterday that sugar-wise, I am not doing well. And, until yesterday, I didn't have the meter to give me the head's up so that will help some but as far as what not to eat, it's at night that it seems to go on up there.

Thanks,
Jill

[soso]

Hi Jillo
It may take a few days for those extra meds to kick in...so dont panic for a few days... also, if I do not eat soon after waking, I see my bg rise..this is the liver giving you a little glucose boost to get you going most likely.... only other thing I would say is that I am surprised your doc said test 3 hrs and not 2hs, which is more normal for catching spikes....keep up the good work, it takes a while to get sugar levels down and you are newly diagnosed....
be well
ss

[princesslinda]

Jill, I can relate to how you feel when your readings just don't seem to make sense. I'm so glad you got your meter, as now you'll be able to see how it's going whenever you want. You'll feel more in control that way. I encourage you to check 2 hrs after starting your meals. My doc said it should be under 140 then, though others have said they have been told under 160.

Since you've started on the Amyril, you will probably notice a drop in your levels. I'd make sure I carried a protein bar or something in your purse in case you have low episodes while your out. My stepmom is only on Amyril and will occasionally have lows and she makes sure she has something she can eat on hand, just in case. She also had some swelling of her ankles on it as well, so watch for that.

Try not to get discouraged. Everyone responds differently to this disease. Do the best you can and continue regular f/u with your doc and you'll find what works.

For the higher fastings, you might want to try eating something high in protein just before you go to bed (piece of cheese, spoon of peanut butter, handful of walnuts or almonds). Sometimes you'll go low in the early am hours and your body will overcompensate and you'll have higher fastings. High protein snack just before bedtime can sometimes help.

I have just finished reading the "T2 Diabetes - the first year" by Gretchen Becker and it is great...you should get it, as you'll learn a lot about this disease, what the different meds do, the effect of exercise and diet on it..it was very encouraging to me.

Hang in there!
Linda

PS: It takes 3-4 weeks to get the optimal benefit from metformin..not sure how long before you see results on the Amaryl, but it does take time for meds to reach therapeutic levels in your body.
I can say that I noticed results very quickly with the metformin, but I pretty much eleminated breads, pastas, sugar, rice, potatoes and immediately started exercising, so i'm not sure whether the metformin worked for me that fast or if it was the lifestyle changes, as I had been very sedentary.

[Jill-O]

Thanks for the advice. It is so frustrating.

I wonder how long Amaryl takes to start having an effect?

And, I will eat right after I walk from now on.

Also, will try a "snack" just before bed, too. Frustated at the thought since I'm trying to loose weight.

[princesslinda]

I've lost 47 lbs since diagnosis 8/31/06, and I often will have a piece of cheese or nuts at bedtime. I don't think it will keep you from losing weight.

Found this info on Amaryl:
"The usual starting dose is 1 to 2 milligrams taken once daily with breakfast or the first main meal. The maximum starting dose is 2 milligrams.

If necessary, your doctor will gradually increase the dose 1 or 2 milligrams at a time every 1 or 2 weeks. Your diabetes will probably be controlled on 1 to 4 milligrams a day; the most you should take in a day is 8 milligrams. If the maximum dose fails to do the job, your doctor may add Glucophage to your regimen."

Sounds like it may take a little while to regulate your Amaryl dosage, so don't be discouraged. Glucophage is the brand name of metformin, so you already have it.

Again, don't be too discouraged, you're doing all the right things and things will level out for you in time.

Linda

[mzizgayle]

Hang in there, it does take time for the meds to start working and everyone is different...I have also heard that the 2 hour reading after a meal can be from 180 or less, or 160 or less, check with your doctor as to which goal he wants you to aim for. Mine at first had me aim for 160, now he has me going for 140 or less. Talk with a nutritionist and learn which foods trigger the high spikes

[FTW]

Hi Jill,

You're exercising. Your doctor is adjusting meds, and now you have your meter. This is all great! You're on your way to getting control and avoiding complications! Here is a link to advice used by hundreds if not thousands of diabetics to control their numbers:

Test, Test, Test (http://www.alt-support-diabetes.org/NewlyDiagnosed.htm)

As others have said, it may take some time for the metformin to become fully effective. I've read up to a month to get in your system fully.

Also, you might want to try a small snack before exercising, something like 1/2 cup cottage cheese is enough to prevent a glucose dump.

You can still manage a snack before bedtime and continue to lose weight. I do it on 1200 calories per day. My most common late night snacks are 1/4 cup of smoked almonds, (170 calories and 5 carbs), or an Atkins Caramel Double Chocolate Crunch bar, (150 calories and 10 net carbs).

I keep track of everything I eat on Fitday. (http://www.fitday.com) Eating to my meter has turned out to be the best motivator ever for me.

We all vary on the amount of carbs we can tolerate and still keep our numbers in control. Many of us find we can eat very few carbs for breakfast at all and can tolerate more later in the day. This might mean eggs and cheese for breakfast. Or I can eat one slice of Brownberry Carb Counting bread with a tbsp. of peanut butter or an egg, etc.

There are lots of low carb options in the stores these days. As you get started feel free to ask more questions. It'll be OK. You have some time to figure this out, and the fact that you're here posting tells me that you will.

FTW

[slipperyelm]

Jill-o, I bet you already have made some significant progress in getting your blood sugar down. You know why I say that? Because you say you FEEL better what with your efforts at excercise, eating better, and wieght loss.

If only you'd had a meter from day one so that you had something to compare your currents numbers to! Did your doctor atl least tell you an A1c from when you were diganosed last month? I just feel real sure you have already made some decreases in blood glucose, even if they seem disappointingly high for you now.

Hang in there, You are just at the beginning of this challenge. Do what you can each and everyday, but be assured that the improvements from all the things you do (including your meds) can be gradual.

[Jill-O]

Thanks again, people :)

My first A1C was done actually by my OBGYN. I was seeing him for my 4th pregnancy which soon became my 4th miscarriage. He noted the sugar in my pee and did a couple fasting glucose tests and an A1C (this was in January before seeing my internist). I am ashamed to say it was 11.7 :( :( :(

My internist will do another A1C on 3/20 and will see him 3/23 for a check up and the results.

I am going

C
R
A
Z
Y

I swear!

Before I left the office this afternoon, I had a cup of non-fat no sugar added yogurt, which I think has like 12 carbs and 7 milk sugars? Tested when I got home (about 2 hours after eating the yogurt) and my reading was 125. Which made me happy but just so confused.

I do have a few books so far and maybe I can get some additional information from them about this. I've been reading in them a lot but not having tested before yesterday, I did not realize what's happening to me at night and in the mornng.

A little scared to try the night time snack thing. I haven't built those calories into my schedule and maybe will wait a few days to see how the additional levels of metformin and the addition of the amyril (sp) helps? I could lessen calories elsewhere in the day if I need to and I have like 5 big jars of smoked almonds as I love them!!! I just haven't had that many in a couple of weeks trading off for some lower calorie choices.

[princesslinda]

Hey Jill:
I think timing of WHEN we eat has as much to do with BS levels as WHAT we eat. If I eat something with more carbs at lunchtime, my levels do not go up as much. If I have something like eggs/egg beaters and bacon/turkey bacon for dinner, my am BS levels are great! i'm also not as hungry.

I know you're afraid to gain weight...that's my greatest fear, as I have so much to lose, but you might want to try having a piece of cheese just before bed maybe for 2-3 days and just see what it does. And aren't nuts supposed to be good for you, the good type fats? You have to do what you're most comfortable with, but you will feel much more in control as your levels stabilize....which they should as your meds take better effect.

Hang in there!
Linda

[slipperyelm]

If your A1c was 11.7, then that means your average blood glucose over the last three months before diagnosis was somewhere in the range of 305-330. So you see, you already have brought your blood glucose down by your efforts and your meds. :)

As you stick to it, it generally gets better, too. How 'bout that 125 today!? Great! Take heart. You already are making progress; I'm sure of it. :)

[jvetter18]

Hey Jill-O.....you must eat to keep the BG's in check. It seems like reverse when you trying to lose wieght and keep BG's down but you'll spike if you don't eat. That's why it was so high after your walk. Your liver will dump glucose in a fight or flight reaction. Then eating adds more to the equation. Good times.

[Jill-O]

When I tested last night about 2 hours after dinner, it was 191 :( Blah. Then I tested as soon as I woke up this morning and it was 190. I wake up usually VERY early (4am or earlier usually), but also go to bed early (oh the life of a farm girl / financial planner). Before, I had tested in the morning just before eating which would be several hours after waking. So, I tested early and ate some cottage cheese an hour later and walked. Waiting to test around 7am and see what happens. Took my meds with the cottage cheese. Maybe starting to eat something earlier will help? I always eat something for breakfast, but it could be 4 hours after being awake and doing things so maybe it's more like lunch to my body???

[Jill-O]

191 at 7:05am... I ate the cottage cheese and took the meds at 5am and then walked 30 minutes before getting ready for work.

[mg_2204]

I've felt so much better and was honestly shocked to get the news yesterday that sugar-wise, I am not doing well.

I find that eventhough we're on the right track, sometimes our body doesn't necessarily respond straight away to the meds and the new lifestyle. The danger here is for you to get discouraged and give up. Don't!! :) You haven't felt better for no reason. There has been progress. Keep at it. And test! With a meter it's easier to see what foods and lifestyle changes really benefit us.

The very best to you :) :) :)

[Jill-O]

Man, am I ever obsessed! I had a protein shake after testing around 7am and tested just now a little before 11 and it was 115!!! So, I had a cup of no sugar added yogurt (which worked fine yesterday). It seems maybe I'm doing "good" during the day with eating, etc., and at night get totally out of whack. Going to eat a lighter dinner, walk tonight (usually only walk in the morning) and have some almonds before bed. I really want to figure the "why" off all this. It is driving me cah-razy!

[princesslinda]

Hang in there Jill....you'll see BIG improvements before you know it. Try a supper of "Egg-Beaters" or egg white omlette and see if your levels aren't lower. I'll bet you'll be surprised. You're doing great!