# Hello



## TinaD (Aug 19, 2020)

An absolute newbie - final confirmation of Type 2 today. Last month test showed 51 - this month 69. Am on high dose steroids (COPD and pallindromic arthritis), have moderately high blood pressure (losartan) and AF  (Blood thinners). Am beginning to feel like a smarty tube. Very much want to address this by diet as I am overweight (just slip in under obese). Dr suggests it is steroid induced but I had pointed to massive oedema long before I was put on the steroids. Personally I suspect the weird diet induced by COVID19 lack of delivery slots: lots of lovely sugary baking as couldn't get my usual rather low carb provisions (I am a carnivore). Anyway here I am to learn from you experienced diabetics. Have Michael Mosley's book, BG monitor and about 100 questions. Firdt one being - how low carb can I safely go?


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## Deleted member 27171 (Aug 19, 2020)

Hi @TinaD 

I’m not sure about the carb question as it’s all very individual, but if you are able to test your levels at home you will be able to see how much you can sensibly tolerate with the least amount of impact on your bgl.

Steroid induced is certainly likely, but steroid induced or just Type 2, the treatment and aim of the treatment will be the same, so it doesn’t really matter which it is - unless you are likely to come off/reduce the steroid treatment at some point in which case your bgl would improve if the increase was caused by that.

I’m sure someone a lot more knowledgeable about low carb diets will be along to help you out with that soon, but welcome to the forum


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## TinaD (Aug 19, 2020)

Thank you for the reply Lucy. I was seeking to lose weight in the early spring and shed 2 stone on 20g carbs a day with no trouble. During lock down I was forced to abandon low carb and eat what was available: bread, focaccia, rice, and, I admit it, buns, cake etc as delivery slots from Tesco et al were impossible to obtain and I was isolated. I have solved the supply problem as Morrisons have started delivering here so I can fill the freezer and also my garden is producing mass green veggies. If I go that low again will I be risking ketouria or something equally unpleasant? 2 hrs after a zero carb lunch yesterday BG monitor said 16.4 which seemed to me pretty high.


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## Deleted member 27171 (Aug 19, 2020)

Did your doctor start you on any treatment for the diabetes? 16.4 is quite high, but on a high dose of steroids they will push up your levels even if you are eating low carb, losing weight etc. 
Of course that is not to say don’t do those things, as they may prevent even higher levels, and if you have weight to lose it is good to do so for your overall health, but steroid induce diabetes is of course caused by the steroids so they will increase your levels regardless.
If you have begun tablet medication to reduce levels then be aware that some may take time to build up in your system before you see an impact on your bgl, so if it’s only been a day or so they may not be working just yet.


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## Ditto (Aug 19, 2020)

TinaD said:


> how low carb can I safely go?



Hello and welcome to the forum.  Atkins Induction goes as low as 20 per day which I did for a while decades ago, but it is suggested you only do it for two weeks then increase. I was very surprised when I came on here and saw how many carbs people eat and consider low. Seems to work though, slow but sure and healthy.


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## TinaD (Aug 20, 2020)

Thank you Ditto for your response. Medic says today that the diabetic nurse will be in touch in a fortnight so they do not seem to be treating it as a serious matter. 6.2 fasting this a.m. I am eschewing bread,sugar, breakfast cereal, spuds, rice etc (and have been for the past week) so all I can do,I think, is wait but be careful meanwhile.


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## TinaD (Aug 23, 2020)

Over last 4 days Fasting blood has been between 6.1 and 6.4. Post-postprandial blood has varied between 8.4 and 9. Am I getting this right or is there more I should be doing whilst waiting for the NHS to get the diabetes's nurse out of bed? Am keeping carbs down to under 20 - a bit wibbly wobbly on the legs but otherwise OK.


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## Toucan (Aug 23, 2020)

Hello @TinaD and welcome from me as well.
Your fasting blood levels are in the 'good' range, but with the added complications of steroids, it is probably best to take medical advice on how low to go with carb intake.

The 'official' view of low carb eating is 130g per day, but many people on the forum find that this is too high.
As @LucyDUK the optimum amount is a very individual thing, and keeping a diary of how much per day, and correlating with meter readings will enable you to find out what works for you.
For me it is between 50g and 70g per day.

I hope you find a good solution, and also that you keep posting and let us know how it is going.


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## TinaD (Aug 24, 2020)

Nurse called today for the first time. Did I want any leaflets - I said "no" as I had found you and was doing low carb diet which she was happy with knowing I had done so before to shed weight (I am close to top of overweight but not obese). Is planning to send me a sample bottle to check for UTI as night peeing is a loud call to go and little to no product once at WC. Said test showed a slow increase in blood sugar over the earlier months - which rather supports my diet explanation than the steroids.Will repeat the HbA1C in 3 months and to ring if I am worried. "Try to keep BG in single figures and you won't be doing yourself much harm" was the basic advice. I explained I was a bit concerned about the oedema and accompanying petichiae together with the new spiders webs on legs indicating venous incapacity. Offered stockings but I have some and do not find them much use or comfortable - just seems to move the swelling north - and continue to use soft grip socks as anything else leaves a deep gutter by evening. Says kidney function is not brilliant and worse than a coupe of years ago. So I will keep digging the garden,eating above ground greens and other low carb foods and become a slimmer me in hopes of a remission. Thank you for your support and advice.


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## Toucan (Aug 25, 2020)

Hello @TinaD
Many thanks for letting us know how it is going.
It sounds as if the nurse was very helpful. 
Although there are some things to keep an eye on, as you say if you progress well with your eating and exercise plan things will improve,
If the weather with you as the same as it is here though, it won't be the day for digging the garden today!


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## TinaD (Aug 25, 2020)

A little windy to be sure but plenty to do in the polytunnel.


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## Toucan (Aug 25, 2020)

You may find some things of interest in our gardening thread








						In the Garden
					

I thought we had a gardening thread already but couldn't find it so thought I would start another one.  In my soggy garden February 2020  Lets see what's happening in yours?




					forum.diabetes.org.uk


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## SB2015 (Aug 26, 2020)

Welcome to the forum @TinaD 
Good to hear that your u have a supportive nurse at your Practice, and that you have found the advice on here so useful.

Keep us posted with you ur progress.


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## TinaD (Sep 4, 2020)

I have been religiously taking my fasting bloods each morning - they seemed to wander about a bit - sometimes 6.2, or 8.1, or 7.2 but the last 4 days look better (to me a complete tyro) 5.8; 5.7;6.1; 4.9. 2 hours after food 8.8; (I forgot); 7; 8.3........Have not been given any targets to aim for. Will ask nurse next time we speak. Suggestions please.   DIET: Not managing 16:8 (intermittent fasting) most days to give the pancreas a rest but usually managing on 2 meals a day, the calorie count isn't always hitting 800 but is below 1000cals and today a mere 606. Carbs 20 or less - scales will be worn out at this rate. STEROIDS: GPs trying to insist I lower steroid dose quicker but I am sticking to the Consultant's advice and digging my toes in. If they want an argument they should have it with him not me. We tried taking me off quickly originally and within a few days I was gasping for breath and unable to stand unaided. However, it looks as though I can get the numbers down notwithstanding the steroids so fingers crossed for a remission. PROGRESS/EXERCISE: I am busy building myself a disabled garden in case I lose the argument - 3 digs, puff, puff, puff, lean on spade, admire view, 3 digs... Oedema seems to be responding to pressure stockings and purple blotches on ankles, lower calves, fading. I've lost 8.94 kilos (19lb 11oz) since 9 August (when I found out I had failed first HbA1C test but had not had confirmatory second). 15kg more to go before I escape the overweight section of the NHS weight chart.


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## SB2015 (Sep 5, 2020)

Hi Tina

It is good to hear from you again.  

With regard to your diabetes it is the testing that will help you to monitor the impact certain foods have on your system.  This article has proved very useful for others 





						Test, Review, Adjust
					

Managing blood glucose levels for type 2 diabetes. Learning how to achieve long term control by testing and diet.




					loraldiabetes.blogspot.com
				



It helps to make effective use of the results that you get.

I am not familiar with any specific diet plans.  My only focus is to count the carbs that I eat at each meal and limit these to what I need.  All the carbs we eat will get converted into glucose once inside us and to avoid high glucose levels in the blood these need to match the insulin available.  That is why Diabetes management is so individual.  I know through testing I found that I couldn’t tolerate porridge, which I love.

I hope that helps.


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## Docb (Sep 5, 2020)

Hi @TinaD and welcome back from me.  Good luck with the garden and have you come across raised beds and "no dig" gardening?  That's what I have done and once the beds are built then you can forget digging and spend your time planting and harvesting.  

Must admit I am not sure about diet plans.  Like @SB2015 I like to watch the carbs and prefer to spread them out on the grounds I am not overloading my system at any time.  But as we keep on saying, everybody is different and everybody needs to work out what suits them.  If your method works for you, then carry on.

Like you, my morning blood glucose wanders about a bit as does the rise after a meal.  The DN suggested a range of 5-10 should be my target and that I should not worry too much about the wandering provided I kept in that range.  Now I have the hang of it, between the pills and what I eat it stays there.  Occasionally I get readings in double figures but when that happens it tends to come back down without doing anything.

Well done on the weight loss, will be helping all round is my guess.  Keep plugging away and the weight will continue to go down and we all look forward to seeing reports of your progress towards your 15kg target.


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## Toucan (Sep 5, 2020)

Hello again @TinaD 
Many thanks for letting us know how it's going, and your great success with weight loss and Blood sugar control.

Those blood sugar readings look very good. The range and general trend are, I think, the important things. Meter inaccuracies can be around 10% on individual readings. 
So don't be disappointed if a good days eating doesn't always get reflected in meter readings.
I went through a phase of ups and downs on this, and my husband used to work out what the day's mood was going to be dependant on the morning meter reading!  So I now tend to look at the trends rather than the every day ups and downs.

Very best wishes, and hope you will keep posting and let us know how it goes.


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## TinaD (Sep 5, 2020)

SB2015 said:


> Hi Tina
> 
> It is good to hear from you again.
> 
> ...


Porridge? In my dreams - my only carbs are from above ground leafy vegetables. Thanks for the link to the article - informative.


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## TinaD (Sep 5, 2020)

Docb said:


> Hi @TinaD and welcome back from me.  Good luck with the garden and have you come across raised beds and "no dig" gardening?  That's what I have done and once the beds are built then you can forget digging and spend your time planting and harvesting.
> 
> Must admit I am not sure about diet plans.  Like @SB2015 I like to watch the carbs and prefer to spread them out on the grounds I am not overloading my system at any time.  But as we keep on saying, everybody is different and everybody needs to work out what suits them.  If your method works for you, then carry on.
> 
> ...


Thank you - yes I do know a little about no dig and raised beds. I had some 9" raised beds and am now the proud possessor of 6 x 15ft by 4ft (height18") raised beds with 3ft paths between. Plan is to be able to kneel and weed easily. They have been easy enough to build although carting the wood was hard work. Filling them has taken days, as I am no longer quick with a shovel, spend more time gasping then digging,and I now await a man with a bobcat to fill the top 9" with the contents of the midden. Hellish job finding enough cardboard.
Good to know that somebody else has wandering numbers. I am not on pills for the diabetes, for which I am grateful, since I have to take a cocktail of the ruddy things for other conditions. I'll let you know when I hit target weight - got a pair of size 14 jeans in the bottom drawer which are calling to me from some years ago...


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## TinaD (Sep 5, 2020)

Toucan said:


> Hello again @TinaD
> Many thanks for letting us know how it's going, and your great success with weight loss and Blood sugar control.
> 
> Those blood sugar readings look very good. The range and general trend are, I think, the important things. Meter inaccuracies can be around 10% on individual readings.
> ...


Thank you - helpful to know that the readings are good. How nice to have an empathetic husband. I'm a widow so the old comment of "Say nothing, she hasn't had her second cup of tea yet" is no longer a morning feature!


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## trophywench (Sep 5, 2020)

I've never been a natural early riser since my senior school start time was 9.25am and I reckon I've been fighting that ever since - that's long been my excuse and I've stuck to it!


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## TinaD (Sep 6, 2020)

trophywench said:


> I've never been a natural early riser since my senior school start time was 9.25am and I reckon I've been fighting that ever since - that's long been my excuse and I've stuck to it!


I like your style! I have no trouble getting up early but find difficulty tolerating fools before 11 ish. No excuses available to me - I just bite...


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## everydayupsanddowns (Sep 6, 2020)

Glad to hear your update @TinaD 

And your levels seem great, especially given the continued steroids.

Huge congratulations on all the positive progress you have made.

Just remember that you ‘fail’ your HbA1c  , there is no failure, stigma or judgement to getting a high value. It is just information to inform what you might try next - and it sounds like what you have been trying is working really well for you


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## TinaD (Sep 6, 2020)

Thank you. I think I failed myself by not struggling harder for supplies and instead spending most of lock down baking scrummy breads, cakes, puddings etc and then there were all those lovely new potatoes in the garden that found a home...Back to the side of virtue - lettuce anybody? Pak choi? Time to add new seedlings to the hydroponics.


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## Docb (Sep 6, 2020)

Love your attitude @TinaD.  

Park the cakes and puddings but as for the new potatoes, the trick is not to eat a pile of them (especially the little ones that you can scoff in one go) but to take a couple of smallish boiled ones, slice them, and saute them in seasoned butter with chopped shallot and some sage.  That way you can savour them and the resultant portion looks 10 times bigger than the two measly spuds you started with fooling your brain into thinking you have had a generous amount.  Sneaky, eh?


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## trophywench (Sep 6, 2020)

Or take the same two new spuds, boiled then quarter them, leave, hidden in the fridge with door shut, whilst you prepare lettuce/pak choi, then add mayo to the cooled spuds and serve the resultant large dollop of potato salad with the leaves.  The fat in the mayo (Oh yes - full fat mayo!) slows down the absorption of the carb in the spud shed loads!


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## TinaD (Sep 6, 2020)

Get thee behind me Satan - 16g of carbs per 100g. 68 calories. A 100g of potato is so embarrassed it hides under the parsley. Next thing you and Docb will be advocating chips...I'm on 800 cals and 20 carbs a day - no sense in prolonging the agony.


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## stephknits (Sep 7, 2020)

I have really enjoyed reading this thread - well done TinaD for a fantastic effort.  I shall think of you whilst eating yet another courgette from the garden


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## TinaD (Sep 7, 2020)

stephknits said:


> I have really enjoyed reading this thread - well done TinaD for a fantastic effort.  I shall think of you whilst eating yet another courgette from the garden


Hello Stephknits - glad to meet another grower. I grew yellow ones this year but all my cucurbits have been poor this year. Sadly the spuds were superb and now all my neighbours are enjoying the fruits of my labour.


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## stephknits (Sep 7, 2020)

I feel your pain - I love new potatoes.  Lucky neighbours!


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## TinaD (Sep 7, 2020)

Freshly dug and just a modicum (well, lots) of good butter...bliss. Don't let me think about it...


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## rebrascora (Sep 7, 2020)

Pleased I'm not the only one who had a failure with courgettes this year. They have been so abundant previous years, not sure what I did wrong.
I have indulged in a few new potatoes this year having been very restrained last year. After all, new potatoes are lower carb than any other and I particularly like waxy ones (Arran Pilots or Nadines) which are lower carb than floury potatoes so I decided that I would have my annual portion of potatoes when they would do the least damage.... Of course I didn't eat the plateful that I would have pre diagnosis, but more than the piddly 3 little marbles I allocated myself last year.


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## TinaD (Sep 7, 2020)

rebrascora said:


> Pleased I'm not the only one who had a failure with courgettes this year. They have been so abundant previous years, not sure what I did wrong.
> I have indulged in a few new potatoes this year having been very restrained last year. After all, new potatoes are lower carb than any other and I particularly like waxy ones (Arran Pilots or Nadines) which are lower carb than floury potatoes so I decided that I would have my annual portion of potatoes when they would do the least damage.... Of course I didn't eat the plateful that I would have pre diagnosis, but more than the piddly 3 little marbles I allocated myself last year.


I doubt you did anything wrong. I think it was the weather. Depressing though to see so little return when last year total strangers who stood still long enough were given lots. I envy your self discipline. If its handy I eat it - hence denuding the veggie patch of the lovely murphies, clearing the pantry, and screening the grocery order for anything vaguely carb related. Man, could I eat a crumpet...well, no, I don't have any. Sobs into keyboard...


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## Docb (Sep 7, 2020)

I had no problems at all with courgettes up here in Lancashire but had stupid trouble in germinating almost anything else... beetroot a complete failure, carrots sporadic, salads poor. My spuds were hammered by slugs. Really weird.  Just put in some onion sets........


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## TinaD (Sep 7, 2020)

Docb said:


> I had no problems at all with courgettes up here in Lancashire but had stupid trouble in germinating almost anything else... beetroot a complete failure, carrots sporadic, salads poor. My spuds were hammered by slugs. Really weird.  Just put in some onion sets........


Peas, runners: excellent; asparagus OK, salads brilliant - but I do those in the hydroponics. Courgettes, butternut, cucumbers and spaghetti squash: dire.


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## TinaD (Sep 11, 2020)

Ok - a little advice please. Weight still going down nicely. FBG first thing seems mostly to be around 5 to 5.4. However finding when taking pre-meal test it seems to be around 9 to 9.9 although it doesn't go screaming up 2 hours after. Last night for instance it was 10.2 at 2 hrs post food. Ideas for squeezing that before meal figure down? I am taking a good deal of slow, steady, exercise (gardening) but cannot do speed because of COPD. Is this just the steroid effect as it is, apparently, an artificial cortisol which operates in flight or fight stress. Doing my best to avoid other stresses. 
Found some brilliant garlic on line and some elephant garlic. The great midden removal is booked for next week so will be able to plant out the over wintering strawberries and get the garlic in.


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## grovesy (Sep 11, 2020)

TinaD said:


> Ok - a little advice please. Weight still going down nicely. FBG first thing seems mostly to be around 5 to 5.4. However finding when taking pre-meal test it seems to be around 9 to 9.9 although it doesn't go screaming up 2 hours after. Last night for instance it was 10.2 at 2 hrs post food. Ideas for squeezing that before meal figure down? I am taking a good deal of slow, steady, exercise (gardening) but cannot do speed because of COPD. Is this just the steroid effect as it is, apparently, an artificial cortisol which operates in flight or fight stress. Doing my best to avoid other stresses.
> Found some brilliant garlic on line and some elephant garlic. The great midden removal is booked for next week so will be able to plant out the over wintering strawberries and get the garlic in.


Being on steroids can increase blood levels, and would think if you are going up into the 9's and 10's, then that is quite good for  someone on steriods.


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## everydayupsanddowns (Sep 11, 2020)

Sounds like you are doing really well @TinaD 

I suspect you may be right about the steroids


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## TinaD (Sep 12, 2020)

Thanks - very reassuring. I am on a massive dose of steroids which I am slowly reducing. Terrified the COPD will worsen and the palindromic arthritis will again confine me to bed with pain when the dose gets really low or ends. Can only take opiates for pain (which I won't do as no desire to be addicted but am on blood thinners which prevent use of NSAIDs\) Rather feel that diabetes is the last straw. On the good side I may end up a svelte and elegant figure as I ply my trowel - this keto lark is certainly working - I keep having to hitch up my trews.


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## grovesy (Sep 12, 2020)

TinaD said:


> Thanks - very reassuring. I am on a massive dose of steroids which I am slowly reducing. Terrified the COPD will worsen and the palindromic arthritis will again confine me to bed with pain when the dose gets really low or ends. Can only take opiates for pain (which I won't do as no desire to be addicted but am on blood thinners which prevent use of NSAIDs\) Rather feel that diabetes is the last straw. On the good side I may end up a svelte and elegant figure as I ply my trowel - this keto lark is certainly working - I keep having to hitch up my trews.


Good luck.


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## stephknits (Sep 12, 2020)

Don't like to boast, but we have had courgettes aplenty.  I'm rather sick of the sight of them.  Sounds like you are doing brilliantly, especially with the steroids.


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## TinaD (Oct 27, 2020)

After 3 days with Fasting BG improved to lower 4s, yesterday was a 5.7 and today a 6.1. So far as I have understood the research papers available on the web steroid induced diabetes is unlike Type 2 in that the effect of the steroids, by interfering with pathways, renders the liver deaf to the pancreas and also interferes with the capacity of cells to admit BG. It appears probable that they also damage cells in the pancreas.Since the steroids hit strongest effect 4 to 8 hours after consumption the liver goes on pumping out glucose at an increasing rate so the blood is well awash with it. It seems logical not to add to that effect so I am "doing keto" and have dropped from 96.7 to 82kilos since diagnosis in August. However the rise and persistence of the raised BG seems associated with the steroid effect profile rather than food. It goes up to around 9-10.5 and then very slowly declines. Oddly today it was 8.2 before I ate and then fell to 7.1 2 hours later.Is there anyone currently on here with steroid induced diabetes with whom it might be worth having a chat? Got a Hb1Ac booked for Friday and a telecon with the diabetic nurse on 3 Nov. Have a nasty feeling that the surgery has not seen this much before (if at all) since they are certainly not even attempting to follow the good practice guide published in 2014.


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## TinaD (Oct 27, 2020)

Should add highest spike was on 15th at 12.3.


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## grovesy (Oct 27, 2020)

I am not on steroids but I can sometimes be lower after meal levels than before meals. I also don't always have the same levels , even when eating the same foods.


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