# Type 2, Diet controlled, Playing football spikes



## eddymyers (Nov 29, 2022)

Hey there,

I am still struggling to get my head around how to deal with my diabetes. I don't really have a specialist from the NHS to rely on for any help guidance or advice.

I recently purchased the Libre2 freestyle sensor and downloaded the app. I have set my 'range' to 4 and 9. I cna spend most of my time in that range, but then i play football on the weekend and i end up at over 24 for about two hours and then the coming down time of about another hour - So i am out of range for about three hours....Is this bad as it is sports and an adrenalin spike rather than a foody sugar/carbs spike?

I also have been having a salad for my lunch - lettuce, tomato, cucumber, cheese, olive oil, salt/pepper and have been fine - but today I also had an apple - not a massive one, and my BG rose to 9.7 1 hour after eating and just now down to 8.7 2 hours after eating.

My questions are many! For now - is there a way to stop my BG rising so much when playing football or should i consider stopping playing?

Can an apple really be 'unsafe' to eat with a salad?

Am i micro analysing everythng too much? I am looking at pre eat, 1 hour poost eat and 2 hour post eat. I keep trying to get rid of things that put me out of range after the 1 hour mark as it is a 'spike' and therefore will count negatively towards my A1c and future health concerns...

Still learning, trying and getting frustrated...Eddy


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## travellor (Nov 29, 2022)

What's your hba1c?
Are you normally on a low carb diet?


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## eddymyers (Nov 29, 2022)

travellor said:


> What's your hba1c?
> Are you normally on a low carb diet?


My last HBA1c was 50 on 21/11/2022
i have been trying low carb for last couple, maybe three months or so - trying to keep BG under 9. I do not need to lose weight though, i am close to being under weight so i am also trying to add weight!


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## travellor (Nov 29, 2022)

Anaerobic exercise does push up BG's short term.
But low carb also has an input as well.
Personally I'd keep playing.
Exercise makes a good difference to insulin resistance.
Watch the trends, watch the hba1c, and see how it goes.


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## eddymyers (Nov 29, 2022)

Does low carb make my body worry about not getting enough energy so therefore overproduces during exercise? Should i re-introduce carbs? even if it makes my general BG levels higher?


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## travellor (Nov 29, 2022)

Aerobic (gentle) exercise lets your body use oxygen to fuel the muscles.
So it great for a cardiac workout.

Anaerobic is when your muscles have to work overtime, and your body can't sustain the oxygen requirements.
(So brief sustained dashes in football)
The muscles switch to burning their own glycogen reserves.
This needs replacing, so your liver dumps glycogen to start to replace it.

(There are other energy systems in play as well, but this is the one that matters)

If you keep doing it, it will normally improve your insulin resistance, (but not guaranteed to), which is why you need to watch the trends.
It's also the way to build muscles, which again helps insulin resistance.

I used to go to the gym, and start aerobic, doubling my resting heart rate, but then did a stint of anaerobic, tripling my resting rate. (I don't even vaguely recommend this to anyone)

But, it has to be a personal, and educated choice, and you need to find a way that gives you a sport you enjoy, balanced against a BG you are happy with.


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## rebrascora (Nov 29, 2022)

Have you double checked these high BG levels that Libre reports with a finger prick? If they are genuine then I would be concerned particularly as they are sustained for several hours.

Personally I would not do any exertive sport/exercise if my levels were mid teens or above. Your body is under a lot of stress in that situation, particularly your heart and you are clearly not producing enough insulin to cope, I would be looking to ensure you drink plenty and go for a walk to try to reduce those high levels.

If you are slim and struggling to maintain your BG levels in range with a low carb approach and an apple is spiking you several points and explosive exercise sending your levels this high, then I wonder if it is possible you may not be Type 2, but a slow onset Type 1..... Just going to read your previous posts to see if there are any clues there...


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## eddymyers (Nov 29, 2022)

rebrascora said:


> Have you double checked these high BG levels that Libre reports with a finger prick? If they are genuine then I would be concerned particularly as they are sustained for several hours.
> 
> Personally I would not do any exertive sport/exercise if my levels were mid teens or above. Your body is under a lot of stress in that situation, particularly your heart and you are clearly not producing enough insulin to cope, I would be looking to ensure you drink plenty and go for a walk to try to reduce those high levels.
> 
> If you are slim and struggling to maintain your BG levels in range with a low carb approach and an apple is spiking you several points and explosive exercise sending your levels this high, then I wonder if it is possible you may not be Type 2, but a slow onset Type 1..... Just going to read your previous posts to see if there are any clues there...


My niece and sister are type 1 and they immediately thought maybe i was MODY or LADA type of diabetes - due to the weight, non-smoker, active(ish) lifestyle etc etc.


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## travellor (Nov 29, 2022)

rebrascora said:


> Have you double checked these high BG levels that Libre reports with a finger prick? If they are genuine then I would be concerned particularly as they are sustained for several hours.
> 
> Personally I would not do any exertive sport/exercise if my levels were mid teens or above. Your body is under a lot of stress in that situation, particularly your heart and you are clearly not producing enough insulin to cope, I would be looking to ensure you drink plenty and go for a walk to try to reduce those high levels.
> 
> If you are slim and struggling to maintain your BG levels in range with a low carb approach and an apple is spiking you several points and explosive exercise sending your levels this high, then I wonder if it is possible you may not be Type 2, but a slow onset Type 1..... Just going to read your previous posts to see if there are any clues there...



Good call.
Glad we have such a good mix of good people on this site.


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## eddymyers (Nov 29, 2022)

before eating my salad i took a freestyle Libre scan at 8.3, then an hour later i was up to 9.7, then an hour later again i was 8.4, an hour after that one i was 8.6...

I generally seem to wake up at low/mid 6 then before breakfast i rise to 7ish, then after lunch up to 8ish with the possible spikes of up to 9/high 9 before coming down to 7s again until tea time when i will go back up to 8ish with a low carb meal (recipe says roughly 30g or less of carbs).

I do feel as though 7/8ish throughout the day is high baring in mind i have salad for lunch and a less than 30g carbs for tea. I used to have full fat greek yoghurt with strawbs, rasps, blues and blacks for breakfast but that made me go from 7.3 to 9.2 after 1 hour and then 7.4 after another hour. This was with a black coffee - I have since read that caffiene can make you go high so i have changed to decaf coffee now.

So many different variables it is so difficult to get my head around!!!

Thank you every one who takes any time to read let alone reply! hahahaha


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## rebrascora (Nov 29, 2022)

I see you have family members who are Type 1 but your Dad was diagnosed Type 2 decades ago. Is your Dad on insulin and is he also slim..... Just wondering if he may be a misdiagnosed Type 1 and there is a predisposition to autoimmune diabetes and perhaps other autoimmune conditions in your family? 

Seriously, I would be very careful if those levels of 24 during and after football are genuine and not some "quirk" of the Libre system, so do double check them with a finger prick to make sure they are accurate. Levels that high during explosive sport are putting your system under way too much strain in my opinion. I know you probably really enjoy it and exercise and keeping fit is very important but maybe do something less exertive for a while and discuss it with your GP.  I think you need further investigation of your diabetes because those levels are unsafe.


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## eddymyers (Nov 29, 2022)

thank you for your words of advice - my dad is not on insulin and he has an old man beer belly worthy of his 70-odd years drinking the occasional guiness!!!

I have a phone appoitment tomorrow with specialist gp about going for a blood test to see whether MODY is likely. I will also be asking about LADA. 

What is the likely treatment if i am diagnosed with MODY - do you know?


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## rebrascora (Nov 29, 2022)

MODY is quite rare and I believe it is usually managed via oral meds, but as with everything diabetes related there is a lot of variability. 
Do mention to the specialist that your levels are going this high during and after football. They do really need to know that and they are the best person to advise you whether it is safe to continue.

Obviously, if you are LADA, you will eventually need insulin and I think this is the more likely scenario in my non medical opinion. Generally it is better to start sooner rather than later with small doses of insulin to try to preserve your remaining insulin producing beta cells. You should not be frightened of insulin and it will certainly enable you to eat a more varied diet as well as curb those high levels during football but it will take time to find the right balance with doses.


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## travellor (Nov 29, 2022)

eddymyers said:


> before eating my salad i took a freestyle Libre scan at 8.3, then an hour later i was up to 9.7, then an hour later again i was 8.4, an hour after that one i was 8.6...
> 
> I generally seem to wake up at low/mid 6 then before breakfast i rise to 7ish, then after lunch up to 8ish with the possible spikes of up to 9/high 9 before coming down to 7s again until tea time when i will go back up to 8ish with a low carb meal (recipe says roughly 30g or less of carbs).
> 
> ...



That certainly shows there is some insulin at work, but I'm freely going to admit I'm way in over my head now.
I would certainly say it needs more investigation, but always be upfront that you are low carbing.
It slews the BG, not bad, not good, but it's a curve ball you HCP needs to take into account.
Let us know how you are getting on, and keep enjoying that football!


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## Drummer (Nov 29, 2022)

@eddymyers  - you list the carbs you eat, but not the protien and fat - are you trying to eat just the foods which would elevate blood glucose, or actively avoiding meat fish eggs etc?
I know that my first meal should be the lowest in carbs but should have some to stop my liver being helpful.
Usually I have two normal meals, so it could be steak and mushrooms or a chop and stirfry early on, and I eat again 12 hours or so later and might have the yoghurt and berries for dessert in the evening.
Exercise elevates my BG but not as much as it used to - but I have slowed down quite a bit in the last few years.


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## Kreator (Nov 29, 2022)

@eddymyers all I'd say is I tried Freestyle Libre as a free trial in the summer - just to see what was happening (In Remmision by the way)

My BG spiked after exercise, but then dropped to normal levels again - I did notice also that every time I'd check and I didn't like the number, this would start to stress me out...which would then naturally inrease by BG due to stress!!

After a few days, I relaxed with it and took it all with a pinch of salt - the main thing is trends - not the actual figure at any one point - that's how I viewed it in the end...

It helped me understand a little more overall too..

Keep up the football tho!


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## eddymyers (Nov 30, 2022)

Drummer said:


> @eddymyers  - you list the carbs you eat, but not the protien and fat - are you trying to eat just the foods which would elevate blood glucose, or actively avoiding meat fish eggs etc?
> I know that my first meal should be the lowest in carbs but should have some to stop my liver being helpful.
> Usually I have two normal meals, so it could be steak and mushrooms or a chop and stirfry early on, and I eat again 12 hours or so later and might have the yoghurt and berries for dessert in the evening.
> Exercise elevates my BG but not as much as it used to - but I have slowed down quite a bit in the last few years.


Drummer - I didn't have any protein with my salad lunch - in the original post, what i wrote is what i had.


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## eddymyers (Nov 30, 2022)

travellor said:


> That certainly shows there is some insulin at work, but I'm freely going to admit I'm way in over my head now.
> I would certainly say it needs more investigation, but always be upfront that you are low carbing.
> It slews the BG, not bad, not good, but it's a curve ball you HCP needs to take into account.
> Let us know how you are getting on, and keep enjoying that football!


I am only low carbing as i saw that as the best/easiest/quickest way to reduce my A1c??? If carbs elevate it....reduce carbs...right??? I don't necessarily WANT to low carb - it is tricky to work out what to eat all the time rather than pasta/rice/potatoes. I don't see the point in reducing the amount of/portion size of these...unless it is unhealthy to stop them altogether?


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## eddymyers (Nov 30, 2022)

I am still unsure whether to continue with football? 

@rebrascora as you say - at 24mmol/L it is stressing my organs etc.

But i thought exercise was good. I have been playing for months now, before getting Libre freestyle - so god only knows how many times i have een spiking up over 20mmol/L .

Is it dangerous to keep playing and putting this much stress on my body?


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## rebrascora (Nov 30, 2022)

eddymyers said:


> Is it dangerous to keep playing and putting this much stress on my body?


Have you double checked those high levels with a finger prick because Libre can exaggerate at higher levels?

You said that you have a phone appointment with the specialist today, so they are the person to ask about this, so write down a list of questions and make this a priority because it is a safety issue.

Personally I would not do high intensity exercise if my levels were that high because I know it puts a strain on my body.


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## eddymyers (Nov 30, 2022)

rebrascora said:


> Have you double checked those high levels with a finger prick because Libre can exaggerate at higher levels?
> 
> You said that you have a phone appointment with the specialist today, so they are the person to ask about this, so write down a list of questions and make this a priority because it is a safety issue.
> 
> Personally I would not do high intensity exercise if my levels were that high because I know it puts a strain on my body.


Thank you agian - it is difficult to finger prick at football. I have done a couple of finger prick versus Libre and they were within 0.5 of each other - albeit pre-breakfast the finger prick was lower and after eating the Libre was lower!


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## rebrascora (Nov 30, 2022)

eddymyers said:


> Thank you agian - it is difficult to finger prick at football. I have done a couple of finger prick versus Libre and they were within 0.5 of each other - albeit pre-breakfast the finger prick was lower and after eating the Libre was lower!


Once you get well above range the Libre is usually less accurate. 
It only takes a minute to do a blood test and if I can do one whilst I am sitting on a horse then I am sure you can do one at half time or when the game ends. I usually just wipe away the first drop of blood and test the second if I don't have access to hand washing facilities.
It does need to be a priority question for the specialist though.


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## eddymyers (Nov 30, 2022)

rebrascora said:


> Once you get well above range the Libre is usually less accurate.
> It only takes a minute to do a blood test and if I can do one whilst I am sitting on a horse then I am sure you can do one at half time or when the game ends. I usually just wipe away the first drop of blood and test the second if I don't have access to hand washing facilities.
> It does need to be a priority question for the specialist though.


will do - so long as dr says its ok for me to play this weekend


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## rebrascora (Nov 30, 2022)

I take it, you have a big match on this weekend!


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## eddymyers (Nov 30, 2022)

rebrascora said:


> I take it, you have a big match on this weekend!


They are all big games at my age! Running around after young 20 year olds.....God i feel old!


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## Drummer (Dec 1, 2022)

eddymyers said:


> Drummer - I didn't have any protein with my salad lunch - in the original post, what i wrote is what i had.


Perhaps try regarding plant foods as subsidiary to the protein and fat of what is often the basic diet for type 2s, meat, fish seafood, eggs, cheese and full fat dairy seem to provide me with long lasting nutrition - I eat every 12 hours or so, and even on days when I go out to do a lot of work I seem to manage just as well as when pottering about at home.
In the morning I often have no more than 10 gm of carbs, but I eat a meal, and that keeps my BG from rising.


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## rebrascora (Dec 1, 2022)

Hi Eddy

How did you get on with the phone appointment yesterday?


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## eddymyers (Dec 2, 2022)

rebrascora said:


> Hi Eddy
> 
> How did you get on with the phone appointment yesterday?


Hey Barbara,

It weasn't the most brilliant to be honest! It seems there is no real advice for 'normal' weight people with type 2! The phone call turned into a face-to-face yesterday. I showed her my graphs on the Libra 2 and she said it was all perfect - that is with me on a pretty restrictive low carb diet. This is something i wanted to address as the diet (meaning way of eating rather than lose weight diet) is the difficult part of trying to reduce my BG levels through the day and balancing it with the previous norms of eating (such as bread, pastry, pasta etc). There is little to no research/evidence as to advice for normal weight people and how to turn type to into remission - she told me. 

She is having a word with our specialist diabetic clinic about testing for genetic forms of diabetes but doesn't think so as really, the only history is my dad with type 2 controlled by diet.

I have come away from the meeting with a diabetic specialist GP not really knowing what I am aiming for or indeed whether it is even possible for me to turn my type2 into remission - ie get my HBA1c below....well whatever!

I am going to be less strict with my diet, eat some carbs and have fun. She said it wil lnot be dangerous if i continue to play football - she encoraed me to due to the other health benefits of the exercise. She told me to eat banananas as the other health benefits outweight the fact that they can make my BG rise be 2.0mmol.

It is quite discouraging when the advice is well, there isn't really anything i cna tell you to do or not do. I asked what my 'range' should be - she couldn't tell me, I asked her what sort of 'spike' i should be avoiding/allowing - she couldn't tell me. I asked whether there was any advice - if i didn't have the libre (self funded) for me to try and reduce my HBA1c----not really! The only advice they give is to lose 12-15lb of weight quickly - because most of their newly diagnosed people are obese, but she defo doesn't want me to lose any weight!!!!

It is hard, again, to work out exactly what i should be doing or aiming for or indeed if there is any point in my doing anything at all!!!

Thanks for reading and showing interest in little old me


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## eddymyers (Dec 2, 2022)

Drummer said:


> Perhaps try regarding plant foods as subsidiary to the protein and fat of what is often the basic diet for type 2s, meat, fish seafood, eggs, cheese and full fat dairy seem to provide me with long lasting nutrition - I eat every 12 hours or so, and even on days when I go out to do a lot of work I seem to manage just as well as when pottering about at home.
> In the morning I often have no more than 10 gm of carbs, but I eat a meal, and that keeps my BG from rising.


I think i do need more meat/fish etc. 

You eat every 12 hours? I have breakfast (purely to keep my weight up) 8am, lunch 12pm, tea 7pm but then i don't really eat anything after that.


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## rebrascora (Dec 2, 2022)

Sorry to hear you have come away from the appointment without any real answers. That is very frustrating and demotivating I imagine. Was this a GP at your practice or a specialist consultant at a diabetes clinic? I am assuming the former as she seems to have very limited knowledge and not able to think outside the box. My gut feeling is that you are a slow onset Type 1 and your very restricted diet and exercise is keeping it at bay for now, but I really am concerned about your levels going so high during football. It would have been better if she was going to refer you for Type 1 testing rather than MODY, which is very rare and the testing expensive. 

I think it is a good idea to be less strict with your diet because I think it is preventing you from getting a correct diagnosis. It seems wrong that you need to let your body get to crisis point in order to get the help and support you need but we see it quite frequently on the forum, particularly with slim people who are doing their best to control it through diet and exercise. I was lucky that my nurse was open to the possibility of me not being a straightforward Type 2 from the start and thankfully after 6weeks I was started on insulin and referred to the diabetes clinic for a consultant appointment. 

Please keep a close eye on your BG levels and if they start to go really high as you loosen up your diet and eat a few more carbs, go easy on the football and if your levels hit 30 or above or you start to feel unwell, get yourself to A&E.


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## eddymyers (Dec 2, 2022)

Barbara - i think she is asking the diabetes clinic to look into all sorts of types of diabetes due to my not typical situation for type 2. I am going to keep an eye on my BG levels and not go crazy with the carbs - we actually liked a lot of the evning meals we have been doing without the pastas rices etc. so they will ocntinue. 

I am concerned about the range i should be setting for myself. I currently have it at 4-8.5 but even an apple will push me above 8.5! A banana makes my BG rise by about 2.0mmol! So i am thinking i should be raising my range to 10???


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## harbottle (Dec 2, 2022)

I think she may be correct, I don't think they know what causes T2 in slim people with no visceral fat. The work in Newcastle did show that slim T2s could lose weight and improve it, though, in a recently published paper. It seems to be more common in certain ethnic populations.


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## rebrascora (Dec 2, 2022)

Yes, absolutely raise your range to 10. You have to remember that the 8.5 guideline is for finger pricking 2 hours after food when your levels would generally be coming back down from a higher spike. Non-diabetic people spike higher than 8.5 and occasionally a bit higher than 10, so 10 as an upper limit is reasonable as long as you accept that occasionally you will go above 10 and that is OK as long as you come back down promptly. Going up to 24 during exercise is absolutely not OK in my book and I believe potentially dangerous. I think that will be putting a lot of strain on your heart and vascular system in general.


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## eddymyers (Dec 2, 2022)

rebrascora said:


> Yes, absolutely raise your range to 10. You have to remember that the 8.5 guideline is for finger pricking 2 hours after food when your levels would generally be coming back down from a higher spike. Non-diabetic people spike higher than 8.5 and occasionally a bit higher than 10, so 10 as an upper limit is reasonable as long as you accept that occasionally you will go above 10 and that is OK as long as you come back down promptly. Going up to 24 during exercise is absolutely not OK in my book and I believe potentially dangerous. I think that will be putting a lot of strain on your heart and vascular system in general.


When i put my range up to 10 - my time in range is 97%


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