Type 2 Diabetes and KETO
kim_m_kk
Posts: 61 Member
Okay so I started Monday - I am three days in and woke up with blood sugar of 73 - as the morning went on it got down to 48. I ate my Keto Breakfast with some nuts but apparently that didn't help. at 48 I had to treat this with sugar - Lifesaver mints to be specific. Is it possible I need less meds already? I take metformin, Glyburide, and Jardiance. Not sure what to do - should I call and make a doctor appointment? I don't want her to just tell me to eat more carbs because I want to eat this way to hopefully get off all these meds.
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I'm a type 2 diabetic. I was taken off of Lantus about 6 months ago. I now only take Metformin twice a day, and my Dr is speaking of taking me off of that as well. AIC 5.3.. Going into Keto I had to feel my way through. I started checking my sugars very frequently. I quickly realized that I wasn't hungry when I woke up. So some days I don't eat right away, I'll go hours until I become hungry. That's when I'll take my first metformin. The same at night, if I'm not hungry I'll just snack and not take my metformin. We know our bodies better than the Drs. You just need to be monitoring your sugars faithfully. Because you definitely don't want to be wanting around with high sugars. 1 Month results from Keto - 17lbs down, and stable blood sugars that stay around 70-80. Don't allow anything to discourage you from trying keto, just come up with a plan that makes it work for you. Next time your sugar drops try some berries.2
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I was at work and lifesavers is all I had. And I felt like I was going to pass out - I think a 48 has to be treated. I don't always eat in the morning either and always hold my metformin until I do - I know that if I take it on an empty stomach it will make me sick. I have been on these meds for about 6 months - but I wasn't willing to change my way of eating until now. My first aic was 11. something and my last one was 7.3
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Wow! That's a huge drop in your A1C. I would definitely consult with your Dr.. sometimes the low blood sugars are caused by your meds. Also exercise helps with diabetes as well, which I'm sure you already know. But I just wanted to share as a person speaking from experience. Also, are you eating enough at night? Sometimes a snack before bed can help with not having lows in the am.0
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Since you just started, part of the balancing act you're discovering is that the body doesn't switch over that quickly to using ketones for energy. You have to deplete all stored glycogen, and even then, your body has to build new muscle mitochondria to use ketones instead of glucose...
That being said, do you have impaired liver function? Because if you'd previously been really high glucose and went low, the liver should have released some stored glycogen to help balance...
Metformin is supposed to improve the cell's receptiveness to insulin activity, but it should not cause blood glucose lows...
Jardiance has a whole load of warnings about low blood sugar, and it says it works by dumping excess glucose out your kidneys, contributing to dehydration.
Keto can be naturally dehydrating if you don't replace enough sodium - so make sure you're replacing the 3000 mg - 5000 mg a day that keto causes to be dumped...
Glyburide says it works by making your pancreas pump out extra insulin naturally. If you are doing keto, you'll need less insulin... This one also has low blood sugar warnings...
When you added meds, did you add them all at once? How you react to each med would probably determine course of action if this were my choices...
Maybe someone like @genmon00 or @2t9nty or @Sunny_Bunny_ might have a better idea...
Me, personally, LOOKING AT LONG TERM HEALING - I'd probably want to get off Glyburide first, then Jardiance, then maybe Metformin, but it has a number of benefits... But short term, I don't know if that is the order - nor do I have any idea how carefully you'd need to step the meds down, etc...
Just my 27 cents. I'm not a medical professional, nor a diabetic myself, though I'm pre-diabetic and have insulin resistance (and my mother and her father and sister have/had diabetes), so I've done research on the subject. Please be sure to make educated choices, have backup and safety plans in place, and the be careful!!! Meds like this are nothing to play with!0 -
Yeah I am pretty sure it isn't the metformin as I have taken it before for PCOS and fertility. I have really been low all day - I had some extra carbs with my lunch again as my sugar was in the 50s before lunch. Even now it is just 73. I guess I should probably make a doctor appointment.
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@kim_m_kk
When you go to your doctor, tell him you are not willing to eat more carbs to eat to your medication level. I'd tell him that you want the chance to address this through dietary, exercise, and lifestyle changes.
Admit that if you cannot remain compliant to dietary changes, you will contact him immediately so as to be put back on medications (this is the main reasons doctors want you to stay medicated - the majority of people cannot stay dietary compliant, because admittedly, it's really hard!).
Develop a plan together of limits - excessive readings for a few days in a row that don't respond to lifestyle changes. More than 2 weeks off plan. Any excessive readings over XYZ (set limits together) at your next appointment. Offer to check in with him by email once a month or once a quarter regarding your compliance, etc.
Any reasonable doctor should be willing to agree to this TYPE of scenario, if not exactly these things...
You seem to be on a good path back towards restoring your health. For your own success and safety net, you deserve to have these back up options for yourself if you decide down the road this dietary plan isn't right for you, etc.
Wishing you the best of luck! What you might do, too, if you're waiting long for an appointment, is ask which medicine you can begin reducing until he can see you, etc. Or get an appointment to be worked in to the schedule... This can be dangerous otherwise.2 -
My understanding of these things is that metformin does not produce blood glucose lows but Jardiance and Glyburide can. I have only taken Metformin. I would suspect that your doctor would want to reduce or eliminate one or both of the last two. Everyone is different, but I had great success with just Metformin and keto.
I had readings in the 80's from time to time when I was on the full dose of Metformin, but that was as low as it ever got.3 -
Yeah I will call and try to get in. Usually only takes a few days. I am over due for a bp check because I changed meds. I have had to eat more carbs today because it isn’t safe for by sugar to be so low and driving my kids around and such. Not what I wanted but had to be done.0
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It’s absolutely possible you need to stop the two glucose dumping and insulin stimulating meds already. As a T2D you already produce too much insulin so I don’t even know why a medication like that was ever created in the first place. Sounds super dumb to me. But what do I know.
Anyway, this I such a clear evidence that T2D is not the progressive condition that doctors are taught to tell patients. People only need enough meds for the diet they consume. Change the diet and the meds become unnecessary. At least most of them and at the very least the dosages don’t need to be as high and do not get progressively higher and higher.
It should be very clear now that your previous diet is the culprit in regard to your high A1c and while meds helped once you started, diet change you made now is really making a difference.
You definitely need to correct for a low below 60 I’d say. I personally would use either smarties or glucose tablets instead of lifesavers as they’re pure glucose without fructose which won’t help. That way you won’t need as much and with smarties you can sort of micro dose. I can’t remember how many carbs each individual smartie is but it’s easy enough to find out. I’d dose small amounts of pure glucose aiming to get up to 75-85 and just stay aware of how you feel after that.
I’d definitely eat higher protein meals as well. With high insulin levels you need to provide a substrate for the insulin to work on. If it’s not going to be glucose then it would be helpful if it were amino acids from protein. That way the insulin can be busy with amino acid uptake which repairs tissues and supports muscle and will be less likely to completely tank your blood sugar by shuttling away too much glucose or causing muscle wasting which would be terrible for someone that is already insulin resistant.1 -
What things do you snack on when sugar levels drop and you need a fix when you feel like your body is off but don’t want to do a Carb load?0
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Sunny_Bunny_ wrote: »It should be very clear now that your previous diet is the culprit in regard to your high A1c and while meds helped once you started, diet change you made now is really making a difference.
+1
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I was diagnosed as a Type 2 Diabetic at the end of July 2017. I had an A1c of 10. My BG reading at that time was around 230 mg/dL. My doctor told me to go on a low carb diet. I Google'd around and found keto. Doctor prescribed me Lantus, Metformin 1000mg, Glimepiride and Fenofibrate for my high triglyercide levels of 327. Lantus was expensive for a three month supply, so I told him if I could get Trebisa. He said okay, and I got it.
So I started to check my BG levels at least four times a day while on the keto diet. My blood sugar was steadily dropping. I even reached a low of 56 one day. Then I started reading that having that kind of level could be bad. So I started researching my medication. I found that Glimepiride could overwork your pancreas and can cause pancreatitis. I didn't even think twice of calling my doctor to ask if I can get off of it. I just stopped it myself, and told his nurse that always called me every week asking for my blood glucose readings. And the nurse said, "The doctor said that's okay that you stopped it." Then I find out that Fenofibrate can cause gallstones. I stopped that too. As for the Trebisa, I was taking 10 units every night before going to bed. As time went on, and as I was giving my results to the doctor, he said to stop the Trebisa. So...the scorecard so far reads: Stop taking Trebisa, Glimepiride and Fenofibrate. I was still taking the Metformin 1000mg.
But as I was finding out, every morning, I would spike up to 100-115 mg/dL in the morning, but in the evenings before dinner, I would get back down to 90-100. I was actually missing getting to 60-70 like I used to, but I was getting to those numbers with the Trebisa. Well, I told myself that I would never inject again. When I had my next doctor's appointment on Halloween, I told the doctor about my numbers and I told him about Metformin ER, which is a slow release version of Metformin. I asked him if I could go on it, and he agreed. So he prescribed it to me, and order blood tests. So, after being on keto for three months and just taking the regular Metformin, my blood tests were: A1c=5.5, Triglyercides=93. I told my doctor about my diet, and he started to warn me, but I told him it was working and the blood test results shows that it is.
Now, when I started at 267 lbs, and now I'm 198. My BG levels are now averaging 98 mg/dL. I'm taking the Metformin ER, Fish Oil pills, Vitamin D3, Magnesium, and a multi-vitamin. I have high blood pressure, so I'm also taking two meds for that, but on my next doctor's visit, I'll probably be weaned off of them.
I think you should research, and then make appropriate changes that you think is most beneficial to you. Then when you see your doctor, let them know what you've found, what your concerns are, and that you want to do what's best for YOU.7 -
Again a day of fighting low blood sugar. Got down to 43 at one point. I have an apt in the morning and took less meds tonight.1
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I would stop taking the Glyburide. It's almost the same medicine as the Glimepiride I was taking. That should bring up your blood sugar readings a little.3
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Doctor reduced my meds. Didn't really have a care in the world about why my blood sugar was suddenly lower or why I had lost weight. I think I need a new doctor. I also woke up sick this morning so that should take care of the lows for a few days. lol
I have been taking fenofibrate for my cholesterol it has not make any difference at all and my cholesterol is actually higher now than before I stared it. I think I am going to stop taking that too - a waste of money and it isn't working. When I get a new doctor I will consider my options.2 -
@kim_m_kk I don't know if that cholesterol medicine is a statin or not, but if so, I'd drop it like a lead balloon!
Keto and lowered carbs will drop your cholesterol too over time, you'll see the drops in your trigs the fastest. Remember cholesterol tests must be fasting for 12 hours, not 8 hours, in order to be anywhere close to valid...
8 hours fasting is sufficient for most other things, but not cholesterol...3 -
It is not a statin as I had a bad reaction to statins in the past. My problem is it has not done anything to help my cholesterol2
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@kim_m_kk
“I think I need a new doctor”
I think you do too. Not sure where you are but doing some Keto research I have come across a couple of sights that list pro-Keto doctors by city plus I know there is a website dedicated to getting rid of diabetes via the Keto diet. I believe they also have a list. Good luck!!!!!1 -
@kim_m_kk
“I think I need a new doctor”. - I think you do too.
Not sure where you are but doing some Keto research I have come across a couple of sights for on-line assistance and/or that list pro-Keto doctors by city. I posted three below as an idea. The last one is in Montreal, Quebec, Canada. I know there is one in Toronto, Ont as well. Probably loads around and maybe in your area if you look. Good luck!!!!!
https://www.virtahealth.com/about/inkinen
https://healclinics.com
http://nutriaclinic.com1 -
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I am in Dallas Texas I looked at a couple of those sights but really only found nutritionist and chiropractors. Those are good but I need a physician to help manage diabetes2
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@kim_m_kk I dropped fenofibrate because I wasn't keen on getting gallstones as a side effect. What I did do was substitute the fenofibrate with fish oil pills. Right now, I'm taking the Kirkland Fish Oil pills from Costco. They contain about 300mg of Omega-3. I take one in the morning after I eat breakfast, and one after dinner. I read that Omega-3 can help lower cholesterol and/or triglyceride levels.
I started the switch from fenofibrate to Omega-3 about 3.5 weeks before my blood test showed that my triglyceride levels were lowered from that 327 number to 93. Now, I'd like to think that taking those pills are helping, but it sure beats potentially getting gallstones.0 -
I am in Dallas Texas I looked at a couple of those sights but really only found nutritionist and chiropractors. Those are good but I need a physician to help manage diabetes
@kim_m_kk - here is one of the lists I found for Texas. I know some of these are nowhere near you, but I didn't want to delete any.
TEXAS
Dr. Vincent Bellonzi (Austin)
Dr. Gerardo Bueso (Houston)
Dr. Avery Carpender (Dallas)
Dr. William Curtis (Corpus Christi)
Dr. Daniel Flaming (Van Alstyne)
Dr. Lowell Brad Hays (Irving)
Dr. Steven Hotze (Katy)
Carrie Johnson (Katy)
Dr. Charles Mabray (Victoria)
Dr. Carlos Menendez (San Antonio)
Dr. Marlene Merritt (Austin)
Dr. Will Mitchell (Austin)
Dr. Luan Pho (Allen)
Dr. Amy Proffer (Amarillo)
Dr. Kota Reddy (Sugar Land)
Dr. Brian N. Sabowitz (San Antonio)
Dr. Jenny Seger (San Antonio)
Dr. David Simonak (Fort Worth)
Dr. Jason Venn (Frisco)
Dr. Dean Zincone (Seguin)
They are on this page: http://lowcarbdoctors.blogspot.com/
Right hand column by state. Most have a link...
And you want an Endocrinologist to manage your Diabetes, not just a primary care doctor... Endocrinologists who are trained in Diabetes Management will have more knowledge than a standard doctor.0 -
Thanks - I looked at that list but the one in Dallas is not a medical doctor and the one in Irving it seems is not longer at the practice. I have never been to an endo although I have thought I might should.0
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Well, that stinks, frankly. @kim_m_kk
It looks like Dr. Hays moved to Houston. I'm guessing the one in Fort Worth being off Beach Street isn't worth the hour or so drive?
I grew up in Irving, so I'm familiar with the metroplex, but I've been gone from Texas over 12 years now, so most of my doctor experience is outdated.
You should be able to make a list of doctors or Endos you are interested in, call up and ask to have a 5 minute phone interview where you can ask if they are low carb friendly, specialize in diabetes, and find out if you'll be compatible in how they approach you, make suggestions, etc... Good luck!0 -
@kim_m_kk - It looks like Dr. Hays still has an office location in Irving, but is primarily in Houston...
Might be worth calling the Houston office just to ask.
https://www.vitals.com/doctors/Dr_Lowell_Hays.html
EDITED TO ADD: It might be worth calling and talking to Dr. Carpenter, and ask her if she works with anyone else to manage diabetes, etc. in your area. It won't hurt to ask (or maybe doing an initial consult, if it's affordable). Also, you'd be surprised what Chiros choose to learn these days. My stepmother's brother is one, and he's a few steps short of a full functional medicine degree just to his own passion at doing things the more natural way when possible, etc.0 -
I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.0
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I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.
@2t9nty
@ralflott1
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