It's So Noisy at the Fair: The Diabetic Thread

Diagnosed Type 2 in 2003 or so. It came on suddenly; I went to the doctor because I had lost a lot of weight in a matter of a couple of weeks (from 205-210 I dropped to about 175), was dying of thirst all the time, and almost passed out in a couple of meetings at work (TBF they were very boring meetings).

For many years I struggled, because I don't like to exercise — I fucking hate to exercise, honestly — and I like to eat what I like to eat. I don't have much of a sweet tooth, but a low-carb diet is out of the fucking question. I do try to eat less bread, less pasta, and less meat than I might if I was feeling super self-indulgent, and that's helped a little bit. Switching from Coke to Coke Zero, and from Snapple to unsweetened iced tea (Pure Leaf or Arizona) has helped, too. I was never a big drinker, so giving up alcohol immediately upon diagnosis (my first doctor told me it would interfere with my medication) was no sacrifice at all.

A couple of months ago I had a genuine breakthrough. I'd been taking 1000 mg of Metformin with breakfast and 20 units of injectable Toujeo insulin with dinner, and my numbers were OK but not great. So I asked my doctor if we could add 25 mg of Jardiance to that, and we did, and all of a sudden my numbers are normal to even below normal. When I test in the morning my glucose is in the 60-75 range, sometimes below that. As I said on another thread recently, it's gotten to the point where sometimes I need to eat carby garbage for dinner in order to make sure I don't wake up with the shaking sweats. But in general, I'm feeling pretty good and optimistic.

All very helpful, thank you.

i think the worst part is all the conflicting info online & bored doctors leaving you to your own devices

Big yes on both counts. As I said above, my doctor is useless.

Because I only want good news, I do my one self-reading a week at 9:30 in the evening, three hours after dinner. I know a morning reading will be higher, so I don't do one. Right now, because this is all new, I'm inordinately focused on these readings--I'm sure that will pass soon enough.

My eyesight has been as issue since grade 4; I hope this doesn't hasten bad stuff, but I was probably headed in that direction regardless.

I will ask my doctor about Jardiance, but I suspect I already know what the answer will be: "Let me look that up in my book."

re readings: it helped me not to think of them as an accusation (which i did for the longest time). this will sound corny but now i try to treat it as a compass? like, this reading is where you are ~right now~ and just make your course corrections accordingly. let it help you

sorry that sounds so dumb out loud

sounds like good thinking to me

it’s just, like i found my first 6 months so stressful bc of fluctuating readings, plus my blood pressure was high & i was struggling with those as well and it just felt like every test result & reading was just there to tell me i sucked

i couldn’t cope but the stress of that feeling was also helping to keep those readings out of whack

it’s so easy to drown in the microfocus & lose sight of the bigger picture. how you ARE getting better, you ARE making changes, you can just get up out of your chair & still live life regardless of whether your reading was high or low.

give yourself permission to fluctuate, to course correct, and to just try to do our goddamn best. that’s all we need to do.

Type 1 over here. Got diagnosed about 5 years ago, it sucks.

xp yes it's important to realise there is a very direct link between stress hormones and blood sugar level! That's one of their main immediate effects.

Went to the doctor on Wednesday; he actually wants me to get my numbers up a little (aiming for a morning glucose number around 90 rather than 60-75) so I've cut my dose of Toujeo in half, from 20 units to 10. Which means I no longer get to/have to eat cookies after dinner but I am waking up in the target range.

Good to hear. I'll be doing another three-month reading on Tuesday; my last one, my fourth, was down to 7.5 from 10.1. My home readings have levelled off in the ~5.5 range. I'll have to fight against complacency; I do find myself eating the occasional extra Keto cookie and such now that the initial panic has subsided. The one thing that's going great is weight loss; down to 164 this morning.

all encouraging news, good stuff!!

The one thing that's going great is weight loss; down to 164 this morning.

Nice! Once I got my medication dialed in properly, and made the accompanying mental adjustments, weight control was and has remained pretty easy. I've weighed roughly 175 (at 6'2") for 20+ years.

One thing I'm just becoming aware of--who even thinks about these things until you have to?--is the extra sugar in regular 2% milk. It's like all the fruit juice I've been guzzling the past 20 summers: "Isn't that great for my health that I don't drink pop?" As soon as I finish the milk I have on hand, I'll probably switch over to Joyya (knowing full well I'll over-pay for it).

my fourth A1c test today since March 2022 diagnoses (initial was 8 - and subsequent results were 6.1 and 6)

today I’m at 5.7 which was a welcome surprise

i expected it to higher but honestly i am still learning what does/doesn’t affect it, still a bit mystifying tbh

i thought maybe since I wasn’t able to exercise at all the past couple of months due to back problems that that might put me higher, plus christmas brought inevitable carbs that I couldn’t avoid & felt like my diet got a bit lazier

anyway, with these results it feels encouraging to finally get something like a win, and i am taking it as a sign to keep doing what i’m doing

will f/up w doc to see what they say

Good job. I was worried about Christmas too, but got through with good levels (5.3 - 5.5 at home; last three-month was 7.2 but before the holiday) and my weight's down to 162 some mornings, the lowest it's been in three decades. And I'm not as panicky about everything I eat now.

hi-five :D

the not-panicky about eating the wrong thing is huge, it’s like you want to go back & hug yourself for all freaking out you did, i can totally relate to that

Yeah, getting over food panic was a major step for me. I try to eat healthy but I refuse to eat joyless flavorless food just because it's theoretically better for me.

Perhaps it will help to consider a diabetes anti-role model: Lemmy. When he got diagnosed (which included spending a week in a coma), he took his pills, but other than that his only lifestyle change was switching from Jack Daniels & Coke to Jack Daniels & Diet Coke. I don't think he even gave up speed.

lmao <3 u Lemmy

As long as I can still shoot speed, I'm happy.

I feel like I haven't given up anything in terms of regular meals--or at least I'm loving everything I'm eating, and not thinking about the pizza/cheeseburgers I've given up. With snacks, I've given up a little. The Keto/Good Fats/Good Eats stuff I'm buying does lose a bit, but I've found one really good yogurt (Two Good vanilla) that tastes great and only has 3g of carbohydrates per 1/3 cup.

I've been eating a lot of Healthy Choice microwave dinners — they're meat and vegetables with maybe a little bit of pasta, with optional sauce/gravy that I almost always skip.

There a couple of those I like, and I always add extra vegetables. I cook lots of fish and chicken, and I found a Thai soup I really like.

Had my last two bi-weekly blood tests, won't go back for three months now. In view of how engaged my doctor is--not at all--I'll be on my own till the spring.

Readings are good: 6.7 then 6.5 for the three-month levels, 5.2 at home last night (lowest yet). Had my first cheeseburger in almost three months to celebrate, probably the worst thing I could do--but added chick peas to my nightly salad as penance.

lol yeah my doctors office called after my lab results came in & they’re like “yep everything looks stable ok bye”

last 3-month visit i waited in the exam room for 30 minutes for a pointless 5 min “keep doing what you’re doing” consultation

so i guess no visit at all is an improvement

My doctor's receptionist retired a couple of weeks ago, and she was an intermediary I had some rapport with. Typical: I didn't realize that when we'd been communicating via e-mail, it was her address, not the office's. ("I've just retired...please contact Dr. _______ at the office.) Wouldn't be shocked if my doctor doesn't even have an e-mail address attached to the office.

Buses cancelled where I was today, so a lot of absent students; it was pizza day, and there was extra for any teachers who wanted some. So I had my first pizza since getting the diagnosis in October. Plain cheese, two small slices--I was fine with that, though there was a little guilt about not limiting myself to one. I probably should have self-tested tonight to see if there was a spike, but it would have been nine hours later, so I doubt it would have shown up anyway. Plus I only like good news.

sometimes not knowing is more manageable than knowing & not being able to do anything abt it.

i had a work dinner last week at a thai restaurant. except the catch that i didn’t learn, that no one knew until we all got there, was that my boss was ordering for everyone! for 25 of us. unhinged. random dishes would get passed around unannounced so it was like a game of telephone trying to establish what any dishes were - not great for me but worse for ppl with serious food allergies

i just ate like 12 random scoops of various curry & like a teaspoon of rice …. and then made a protein bowl when i got home.

not ideal

if i could have ordered an actual dish for myself like i had expected, it would have been fine! grr

Yeah, I wasn't totally happy with the restaurant (pub, really) my sister chose for her birthday last night--the fish was good, but nothing in the way of vegetables except salad. But you don't want to end up being a drag when it's her night (what I ate was fine)...I've been eating this Thai soup once a week and the food-label numbers are really good.

Just to be clear, I wasn't ambushed like you; we both thought the mains were okay from the online menu, and I think just assumed there'd be a vegetable option on the side.

i had a work dinner last week at a thai restaurant. except the catch that i didn’t learn, that no one knew until we all got there, was that my boss was ordering for everyone! for 25 of us. unhinged. random dishes would get passed around unannounced so it was like a game of telephone trying to establish what any dishes were - not great for me but worse for ppl with serious food allergies

Ugh, this sounds like a nightmare. "Welcome to the mandatory meal! Here's your slice of cake!" "Uh, thanks...?"

yeah it was quite stressful

Well, the one thing I've learned over the last 20 years is that one bad meal won't kill you. There are definitely times when I've eaten really poorly and felt it (I remember once at work having a bowl of macaroni and cheese, with bread crumbs on top, for lunch and being basically in a coma for the rest of the afternoon) but I can always stabilize my system pretty well by the next day. I've even had days where my sugar spiked for no reason at all — I was eating healthy, getting an acceptable amount of exercise, and it just shot into the 300s for no reason at all, like my pancreas had just decided to take the day off. So, you know, do your best. It'll work out.

Which is actually something I've been wondering: if your level spikes and then returns to normal, is it like it never happened, or does every spike weaken your system a little more. (And I'm not even sure what I mean by "system.")

No question mark, but there is a question in there.

Based on my own experience, while diabetes does weaken your system over time, the process can be very gradual (like "river water wearing down a stone" gradual), especially if you are doing your best to be healthy. If you're disregarding the disease and eating pizza and snack cakes all day, drinking a lot, etc., etc., then sure, it'll progress faster than it otherwise might — that's just logical. But getting the right medication, eating as healthy as you can whenever you can, exercising (without even being a nut about it), all helps a surprising amount.

Mr. Jaq who has been trying to manage type 2 with oral meds for quite awhile (with occasional very long spates of denial and bursts of keto) is now on a small amount of insulin overnight. Hoping he takes it seriously and is consistent with it. Kudos to all y'all for dealing with it.

keto as an idea offers some useful recipes for me like when i am experimenting w desserts or baking or looking for a no carb option here or there but there is no way i’d ever go down that road as a whole lifestyle

rolling the dice on ketosis seems so scary to me & anecdotally v hard to achieve without encountering some p serious complications?

After a day of Peg-Lyte and more or less fasting--if you know what I mean, you'll know what I mean--had a reading of 4.9, first one under 5.0.

with occasional very long spates of denial--this is what I worry about most. With me it would be complacency, brought on by good readings like that one, more than denial.

Which is actually something I've been wondering: if your level spikes and then returns to normal, is it like it never happened, or does every spike weaken your system a little more. (And I'm not even sure what I mean by "system.")

― clemenza, Saturday, February 18, 2023 6:08 PM (three days ago) bookmarkflaglink

as a type 1, the thing the doctor checks these days (which they can now monitor) is 'time in range' and therefore it seems like the spikes don't matter as much? i'm guessing type 2 would be the same

I had my first eye exam in three years this month and the optometrist said it's still not possible to tell from the close up pics of my eyes that I'm diabetic, so good result there. And my PCP checks sensation in my feet at every quarterly visit. Otherwise my A1C still hangs around 6.3-6.5, fasting sugar around 110, and the doc is not too worried about it. Steady diet of metformin and glipizide as usual. (Actually she may have taken her eye off my diabetes recently as she made a big error in my thyroid meds, raising my dose when she should have lowered it, and she's been focused on those getting those numbers back in line the last 2 visits.)

(xpost) Thanks, that's how I've been approaching this--home-testing once a week, and picking an opportune moment. I figure if that number's good, then the whole week's good.

Thanks for the link Wm - Well hello this thread. Like clemenza I knew I'd end up here eventually, but what triggered it was a perfect storm of other shit - a fall causing a knee scrape that got weirdly infected, which I took antibiotics for which trggered a UTI, which they gave me too-weak 2nd antibotics for, so I ended up in hospital yesterday with a kidney infection.

My finger prick tests were as high as 18 yesterday morning (fasting), and didnt drop below 15 all day. I still dont understand all the accucheck tests vs actual blood tests stuff. I guess I will see my GP asap next week and get started!

Are those A1C levels? Because, uh, holy shit.

Best of luck.

Those do seem high for Accu-chek--maybe it's a different calibration or something? If you feel fine, though, I'm sure it's something you can bring down.

I went through a month where because my weight stayed low, I wasn't concerned about blood sugar. But it did slowly creep up, from a low of 4.9 to back over 6.0. The next week, though, it was back to 5.0. Complacency continues to be a concern--I find I snack a lot, have a bigger breakfast out once or twice a week, and am back to the occasional cheeseburger or piece of pizza--and I thought about asking the doctor for more of the appetite suppressant I was using at the beginning and then stopped. I'm hungry constantly. Otherwise, though, still doing well.

yeah I am still untreated at this point. I *do* feel very sick, but I think thats the kidney infection. Only symptoms prior really was INTENSE thirst/peeing cycles that were getting me up twice a night. Water has never tasted so good.Thats calmed down a bit since I had IV saline yesterday.

Only symptoms prior really was INTENSE thirst/peeing cycles that were getting me up twice a night. Water has never tasted so good.

That was my first symptom. That and passing out in meetings at work after lunch, and losing something like 20 pounds in about six weeks.

I still dont understand all the accucheck tests vs actual blood tests stuff.

I think--correct me if I'm wrong--the finger-prick at home is a snapshot of that moment, whereas the more formal blood test is a three-month average.

Which helped me not be so panicky at the beginning. My blood test started high, around 10.0, but my home tests right from the beginning were progressively lower, so I was confident they'd converge eventually.

Yeah previous tests were around 9. I'm not sure why it was so high yesterday. Combo of stress and fasting and illness I guess?

lol hell yeah!

Disappointed. From 11/11/22 to 8/31/23, I had 29 home readings between 4.9 and 6.1; my last two have been 6.4 and 6.5. I don't know if I'm splitting hairs or if something's changed...I feel like more or less doing everything the same.

I used to eat Siggi's all the time in NJ but haven't been able to find it in Montana.

They do a plain one - I managed to find some the other day and it is really good. Sadly not low fat but I think I'm resigned that low fat yog is just garbage anyway.

The Ozempic is making me struggle to eat. Not sick exactly, just completely lost interest in food. And I'm a foodie! Its quite unnerrving.

sounds terrifying imo lol

Thanks, Trayce. The fat/no fat yogurt thing is a conundrum, and in general. Some fat is okay theoretically because of the way it interacts with carbs, but then there are Chet Atkins diet types who just load up on it. Something I just read says no more than 20% of your calories should come from unsaturated fat, but I dunno still seems kind of high.

Sorry, saturated fat.

i try to walk somewhere down the middle btw non fat tastelessness vs keto full fat craziness

and try to favor fats like avocado, peanut butter etc

but i’m not putting butter in my coffee or making cakes out of cream cheese lol

In general I wouldnt say an old school Atkins diet is good for diabetics, because as you say they go a bit ham on the fats and Type 2 is all about trying to lose weight and even out the insulin resistance.

Keto diets seem a bit better. I'm not following any "diet", I just cut out the things they said were bad immediately (white bread, any white rice aside from basmati, sugar, fried potato) and reduced my portion sizes strictly (easier now on the meds due to aforementioned appetite loss). I think portion size control is a major one for me anyway. I've lost 10kg since I first started getting ill just before being diagosed. And that was in June, so thats not too bad.

xpost yes, I am still eating a lot of dairy fo the protein! Lo fat cheese mostly, plus some yog and eggs. And yeah going for olive oil esp when I mightve used butter before (except like, on a sandwhich lol I'm not gonna spread oil on my sammich).

But yeah no one can sit here and tell me 4 bacon rashers layered with cheese on a grill is a good thing to eat.

yeah overall balance & reduced portion sizes has worked p well for me

Thirded

Type 2 is all about trying to lose weight and even out the insulin resistance

Not for everyone, mind you. I'm 6'2" and weigh ~165. I'm trying to up my protein intake but also balance out my carbs just enough so that I don't get the shakes between meals. As it is, I often wake up literally weak with hunger in the morning; going 12-13 hours without food (dinner at 6 PM, breakfast at 7 AM) is a real fucking problem. Back in NJ there were a few times before I left that I'd wake up at 3 or 4 in the morning, eat a cup of peanuts and raisins, and go back to sleep for another 3 hours.

I've started exercising lately, using a resistance band and small weights (10 pound hand weights, 15 pound kettlebell) and doing standing pushups off the wall, squats, stuff like that. I'm not trying to get big, obviously, just tightening my muscles up a bit. The hardest part so far is getting to the point where it's habitual, or even where it's something I want to do rather than something I have to remind myself to do every day.

Struggling a bit lately. Increased Ozempic dose has completely destroyed my appetite/ability to want food. Like, so completely, I have to *force* myself to eat anything. As a result I am headachy and tired all the time (well, I assume thats why). And the clinic/hospital team want me to go up to the full dose!? Farrrk no. My sugars are sitting around 6, so I dont see the need. But I hope this settles, or I get to go back off this shit at some point because this really sucks.

Day to day, the diabetes doesn't affect my life much, except in what I eat. So mostly I just post blood-prick numbers here. After two bumps in a row back to the mid-sixes, I was definitely nervous doing a test tonight (first one in 19 days--kept putting it off). Back down to 5.8, so that was a relief. I'm due for a three-month in the next week or two, so we'll see where that's at.

Isnt mid sixes still ok? I'm around there and I'm happy with that!

I think it's fine, it's just that I had gotten things as low as 4.9, and spent months in the 5.0s, so back into the sixes was a step back and in the wrong direction if that continued. But that's just relative to me; I think mid-sixes is a perfectly good place to be.

Also: I over-worry everything.

Oh for a value of trending upward, yeah that makes sense.

Latest HbA1c - 5.3 awww yis.

But unfortunately, Im continuing to have other baffling increases in my liver enzymes despite having cut right back on alcohol (to once a week, tho admittedly on that once a week I still have a few more than I should) and cutting my paracetamol consumption down. The doc really doesnt know why. Could be the ozempic, or the statins, or gall bladder issues or fuck only knows. I'm so tired of all the blood tests and ultrasounds. Can I just be less broken pls.

<3 hang in there. congrats on the 5.3 tho, that’s great news

That's really low--good job.

Had a stupid workplace thing a couple days ago where I was putting away hollow blocks in a kindergarten class and let one drop on my thumb. A little pain, very discolored at the base of the nail. Because of the diabetes, I decided during the night that for sure this meant amputation (I wouldn't even look at it till the next morning), but the doctor I saw the next day said I'll lose the nail, it'll come back, and that'll be it. No pain at all now, but still discolored four days later.

I'm never sure if I should continue to extra-worry these things because of the diabetes.

6.0 last night. I'd been holding off because I've had this sinus thing, and I figured any kind of sickness might affect a reading. As always, I'm just blindly guessing.

Spoke to my endocrinologist last week who agreed with my GP that the Statins were prob the cause of the weird liver enzymes so told me to stop taking them - my cholestorol is ridiculously normal again now anyway and was not that high to begin with.

Placebo or not I cant say but I am feeling better, all the nagging joint aches I'd been having have gone, so maybe statins were messing me up?

Something I was thinking about yesterday. My three-month reading was 5.8; it was 5.7 in July, 5.7 in March. So my home tests bounce around a bit, but the three-months have levelled off there for half-a-year.

I was 10.1 last November. I'm starting to wonder if I was somewhere between 6-10 for the three-four-five years before being diagnosed. I didn't go to 10.1 all of a sudden--that must have taken time. Just not sure how much time. If I'm right, that's calming in a way. Life was normal before the diagnosis, reinforcing the idea that it's just a number. Keep it under control, but 6-7-8, it's all the same.

I had my 3 month checkup a couple days ago and was surprised I was at 6, thought it’d be much higher.

Thats awesome J! Well done! x

I've hit a plateau where weight isnt dropping much, sugars are good but not quite low enough. I cant eat less, I'm already only doing 2k calories a day, but the diabetes nurse today suggested meal replacement shakes like wtf no. Theyre full of artificial sweetners and weird crap.

I know booze is the last sticking point, and its not one that'll disappear. so I dunno.

It’s good but not through much effort on my part. I’ve been eating like shit - too high a deficit and way too much sugar when I do bother to eat. But I got a full blood panel done because I don’t feel anything different than before all this, and almost everything is great. For someone who eats as badly as I do, and never sees the sun, my vit d and b are great, calcium is great, iron is great, etc etc. But I feel like shit. I’m pretty bummed, since I thought the diabetes diagnosis was gonna be a turning point.

Trayce, that sounds so sketchy - a diabetes specialist shouldn’t be recommending meal replacement shakes if you’re eating at a normal level. I could understand it if you were underweight and needed to add the shakes to your existing diet, or at a weight that was so high it was negatively affecting your health directly, but otherwise that is the kind of nutrition advice that triggers disordered eating.

yeah agreed

I'm not eating terribly well tbrh. Some days I'm lucky if I manage one proper meal. I just never get hungry.

Something I was thinking about yesterday. My three-month reading was 5.8; it was 5.7 in July, 5.7 in March. So my home tests bounce around a bit, but the three-months have levelled off there for half-a-year.

can I ask you: the “three month” reading you’re referring to must be the hemoglobin A1c? the daily readings I assume are glucose readings in mmol/L? if so these are two completely separate units

You can also do a GMI which is an instantaneous measure similar to A1c.

huh…I work exclusively in the hospital these days so obviously I’m out of step with these sorts of things… I just looked that up and had honestly never heard of that! the usefulness of a daily A1c surrogate seems a bit dubious to me, gonna read some more about that

Kevin: I don't know...I thought my three-month averages were literally that, an average of all those home tests I do every couple of weeks. Maybe they are completely different.

i dont know the science

over time it has seemed to me that they are def 2 different things

home glucose testing is (to me) just so that you learn how lows & highs feel physiologically to keep you mindful of it, i really do think doctors recommend it pedagogically as sort of busywork so that ppl don’t ignore their symptoms

but it isn’t as good of a long term indicator bc it is incredibly variable

and then the a1c hemoglobin is the longterm indicator, measuring something different over a longer time period
basically the practical uh truth of what is actually going on, is the medication /diet/ etc ~working~

lol the other day I was just taking the piss, I ate a bowl of pasta and then a small bowl of reggular-sugar icecream (made from coconut whats worse) and boy did my levels shoot up. HIghest theve been since before I was treating this haha but they went back down overnight. I really need to stop being cavalier, but this weird sugar craving I never ever used to have, is creeping up. Prob from me cutting back on booze I reckon.

i find that sugar-free/zero sugar stuff that still tastes sweet makes me crave sugar more