# I need some advice!



## CarolA (Apr 25, 2022)

I decided to try to tackle my T2 diabetes by a low carbohydrate diet. Currently I am on 1g metformin twice a day, and they want to introduce more medication, which I am somewhat resistant to. Yesterday was day 3 or 4 of my new eating programme, and I mostly felt pretty good. When I went to bed last night I couldn’t get to sleep, and I began to feel very unwell. I felt very sick, but weirdly hungry, I was in a cold sweat and couldn’t think (perhaps because I was so tired). I got up and ended up drinking a small glass of milk. I eventually felt well enough to go back to bed, but I am totally wiped out today, with only about 4 hours sleep. I also had to get up to pee at least 5 times. Firstly, I do not know if I had low or high blood sugar….the symptoms seem to cover both, and secondly, I thought you only got blood sugar lows if you are taking insulin. Can anyone advise me?


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## Leadinglights (Apr 25, 2022)

As you say the symptoms are similar in both high and low blood glucose. The frequent loo visits point to high blood glucose. 
People sometimes get unpleasant symptoms when their body is getting used to lower glucose levels even if it does not show low enough on their monitor to be hypo. This situation highlights the wisdom of having a home blood glucose monitor to enable you to test if feeling unwell.
It would be a good idea also to get some ketone test strips to test for ketones in your urine when feeling unwell.
I wonder what you had had for your evening meal if high carb that could be a reason for feeling unwell.

If you still feel unwell today I would speak to your GP surgery.


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## CarolA (Apr 25, 2022)

Leadinglights said:


> As you say the symptoms are similar in both high and low blood glucose. The frequent loo visits point to high blood glucose.
> People sometimes get unpleasant symptoms when their body is getting used to lower glucose levels even if it does not show low enough on their monitor to be hypo. This situation highlights the wisdom of having a home blood glucose monitor to enable you to test if feeling unwell.
> It would be a good idea also to get some ketone test strips to test for ketones in your urine when feeling unwell.
> I wonder what you had had for your evening meal if high carb that could be a reason for feeling unwell.
> ...


I do not have a blood glucose monitor…the doctor said you only need one of those if you are T1. All my meals were low carb/no sugar. I am still getting to grips with what to eat, so have kept it very simple. Dinner was roast lamb with a big mixed leafy salad with oil and vinegar dressing, so not high carb. I have a lot to learn, and no local support to help. My GP is pretty useless, and doesn’t actually seem to see patients at all. I occasionally get a form for a blood test in the mail, and a phone call if the result is not ok. I will look into ketone test strips.


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## rebrascora (Apr 25, 2022)

Cold sweat is usually low BG but frequent weeing and thirst is high BG so could be either. Obviously, you are not on insulin or Gliclazide (yet) so unlikely to be a proper hypo but it could be that it was a false hypo particularly if you have cut your carbs quite dramatically and perhaps been quite active yesterday.... gardening for instance can be very effective at dropping your BG levels. It is also possible that it was low Blood Pressure which caused you to feel unwell if you are on quite a high dose of medication for that as low carb eating can drop your BP as well as BG.

I have looked through your other posts and I can't see any mention of your HbA1c result. Just the GP saying your levels were high and you needed more medication. Knowing your HbA1c is important in understanding where you are with your diabetes and taking control. My guess is that it may be very high, in which case dramatically reducing your carb intake may give you a false hypo. I would recommend getting a basic BG meter which will allow you to understand what is happening and make appropriate decisions about what to eat and what not to eat. Most of us find it an invaluable tool in enabling us to "see" our diabetes  in the numbers on the display. It can be helpful in discouraging us from eating the naughty stuff when we see a massive rise as well as motivating in seeing day on day and week on week improvement.... rather than replying on a 6 monthly or annual HbA1c blood test at the doctors which really doesn't tell us much about the individual things we ate during that 6 month/year period.

A basic BG meter kit is relatively inexpensive to buy at about £15 for the Gluco Navii or the Spirit Healthcare Tee2. These two meters are both well regarded on the forum by people who self fund for reliability and economy of use. The thing to take note of when buying a BG meter is the cost of the consumables and in particular the test strips as you go through a lot of these. Some manufacturers will give away the meter to lure you into using it but the test strips for that meter can make it much more expensive to use, which is why the above 2 meters are well regarded here. If you decide to buy a BG meter, do purchase at least 2 extra pots of test strips as you will go through a lot of them in the first few weeks and months of testing and you may also want to buy an extra box of lancets although most of us reuse our lancets (naughty I know as they are supposed to be single use, but the in joke on the forum is that we change our lancet annually on St Swithin's day... so a box of 100 will last well beyond a lifetime   .

Anyway, just to summarize, I would find out your actual numerical HbA1c result rather than a "high" and invest in a BG meter so that you have more feedback and control over your meal choices and an ability to see if any episodes like last night are related to BG or something else and if BG, to take appropriate action.


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## CarolA (Apr 25, 2022)

rebrascora said:


> Cold sweat is usually low BG but frequent weeing and thirst is high BG so could be either. Obviously, you are not on insulin or Gliclazide (yet) so unlikely to be a proper hypo but it could be that it was a false hypo particularly if you have cut your carbs quite dramatically and perhaps been quite active yesterday.... gardening for instance can be very effective at dropping your BG levels. It is also possible that it was low Blood Pressure which caused you to feel unwell if you are on quite a high dose of medication for that as low carb eating can drop your BP as well as BG.
> 
> I have looked through your other posts and I can't see any mention of your HbA1c result. Just the GP saying your levels were high and you needed more medication. Knowing your HbA1c is important in understanding where you are with your diabetes and taking control. My guess is that it may be very high, in which case dramatically reducing your carb intake may give you a false hypo. I would recommend getting a basic BG meter which will allow you to understand what is happening and make appropriate decisions about what to eat and what not to eat. Most of us find it an invaluable tool in enabling us to "see" our diabetes  in the numbers on the display. It can be helpful in discouraging us from eating the naughty stuff when we see a massive rise as well as motivating in seeing day on day and week on week improvement.... rather than replying on a 6 monthly or annual HbA1c blood test at the doctors which really doesn't tell us much about the individual things we ate during that 6 month/year period.
> 
> ...


Thank you, this is very helpful! I do take a big cocktail of BP medication, and I hadn’t considered this. My BP has been under good control for quite a while now, so I really don’t give it much thought…..I am very good at always taking medication at the correct times. If this happens again I will take my BP as a first step. I will call my gp and ask for a numerical value for my HbA1c so I can have a better understanding of where I am at. Just for guidance, what should I restrict my carbs to? I want to lose weight….I am 84kg and should be 70kg….but I don’t want to put more pressure on my kidneys.


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## rebrascora (Apr 25, 2022)

CarolA said:


> Thank you, this is very helpful! I do take a big cocktail of BP medication, and I hadn’t considered this. My BP has been under good control for quite a while now, so I really don’t give it much thought…..I am very good at always taking medication at the correct times. If this happens again I will take my BP as a first step. I will call my gp and ask for a numerical value for my HbA1c so I can have a better understanding of where I am at. Just for guidance, what should I restrict my carbs to? I want to lose weight….I am 84kg and should be 70kg….but I don’t want to put more pressure on my kidneys.


That sounds like a good plan. 
As regards carbs, it rather depends on how many you were eating before you started cutting them out. Low carb is under 130g a day but many people need to go a bit lower 70-90g and some people need to go much lower to maintain their BG in the normal range  Some people find very low carb too restrictive and need a mixture of lower carb and medication to manage their diabetes. I think it is safest to reduce your carb intake by about a third for a couple of weeks and then reduce by another third of that level at 2 weeks. In general, a BG meter tells you what level of carbs you need to reduce to to see normal BG numbers, but slow and steady reduction is best as it puts less pressure on the fragile blood vessels in the eyes and kidneys. I started by cutting all the sweets and sugar (I was a sugar addict so that was a big chunk) then I started whittling down my starchy carbs. I now average about 70g carbs a day and find that an enjoyable level, but I am not desperately fixed or organised with that. Some days I might have just 40g and other days I might have 100g. I see on my BG meter when I have had too many treats and need to cut back. The chances are, if you get the carbs level right to manage your BG levels, the weight will come off without focusing on it. For me the BG control was more important. The weight loss was an added benefit. 

I think I read on your other thread about less pain meds being needed since you changed your carb intake and that was interesting as my achy joints improved enormously as a result of changing to a low carb diet. Thought I was heading towards a knee replacement but now I can run down hills instead of cautiously hobbling. I hope you find the same benefits as I have from a change of diet. Sometimes a diabetes diagnosis can be the kick up the pants you need to make positive changes that were all too easy to ignore before. I appreciate that you have been diagnosed a few years but clearly this recent increase in levels has given you a bit of a wake up call to be more proactive in tackling the situation, which might just improve your overall health and perhaps reduce your need for other meds too.


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## Drummer (Apr 25, 2022)

CarolA said:


> Thank you, this is very helpful! I do take a big cocktail of BP medication, and I hadn’t considered this. My BP has been under good control for quite a while now, so I really don’t give it much thought…..I am very good at always taking medication at the correct times. If this happens again I will take my BP as a first step. I will call my gp and ask for a numerical value for my HbA1c so I can have a better understanding of where I am at. Just for guidance, what should I restrict my carbs to? I want to lose weight….I am 84kg and should be 70kg….but I don’t want to put more pressure on my kidneys.


You might need to reduce the blood pressure medication - there have been several reports of BP dropping too low on the low carb forum. Several people had falls and one had a very serious accident on stone steps after being told to continue with the tablets even though going dizzy and staggering when getting up from a chair.
Having a glucose meter will give you a good idea of the amount of carbs you can cope with and still be in normal numbers. It varies from person to person, and also with foods - I seem to extract more carbs from beans and peas than are listed, so I would spike if I ate a normal portion, as do some others, but not everyone, so it is something to check.


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## cockburn (Apr 27, 2022)

Hello Carol, I'm sorry to hear you are feeling poorly. Everyone else has given such detailed and good advice. This may be a red herring but one of the things that stopped me being diagnosed type two for a while was that the symptoms were very similar to the menopause which I was also experiencing! I thought I would put that here just in case it is true for you too (or anyone else reading this). There is another thread on this forum covering Roy Taylor's diabetes reversal diet so if the low carb doesn't work you could maybe ask your GP about that. I should also add that I had a GP who was struggling to provide a good service and never thought to change but then moved and got a much better GP so then wondered why I hadn't moved GP before! Best of luck with reclaiming your health.


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