Despite my extensive education and links with healthcare, I still have to look up diarrhoea every time I use it, to make sure the spelling is correct! But it became a very important word for me as I set about getting my HbA1c level down to something more acceptable than the 90 mmol/mol that I started at. The diabetic nurse told me this was double what it should be!
The diabetic nurse decided that I should take both metformin and glimepiride to help get my blood glucose levels down as I was making slow progress on metformin alone. I also decided that I would have to go on a really low carbohydrate diet get thing moving quicker. A particular concern for me was the situation with my eyes, discussed in more detail elsewhere.
So, little or no potato, rice or pasta to go with the no chocolate or sweets rules already imposed. Sunday roast without the roast potatoes just wouldn’t work but I was restricted to just the one rather than the several everyone else got. Sweet potatoes are much lower in carbs than the normal spud, so we got creative with them. Carrot and swede mash became more common and portions of rice and pasta got smaller if allowed at all. I made vast quantities of soup, freezing portions down, which became my staple lunch whilst at work.
Outcomes
The results were pretty dramatic with my weight dropping from around 73 kilograms to just over 65 (11st 6 lbs or 160 lb for non-metric readers) in a few short months. Work colleagues, friends and family all thought I must be ill and several were very concerned. My wife just thought I looked really unhealthy. My HbA1c however did come down to a very acceptable 47 mmol/mol.
The big problem for me was that the combination of drugs and low carb diet led to regular bouts of diarrhoea. I lost count of the number of times I had to make a dash for the toilets. At work this also meant praying that there was an empty cubicle. As an atheist, praying doesn’t normally happen but it is surprisingly easy when you feel that movement in the bowels! Fortunately, the bowel rumbling never happened during any of my lectures, but I did have to cut a couple of tutorial groups short. Definitely not something I wanted to discuss with my students. For a while I was almost convinced that metformin worked by making sure all food passed through as quickly as possible to prevent absorption of any carbs/sugars rather than being a GLP-1 agonist!
Hypos
The other problem that came up occasionally was hypoglycaemia. The NHS definition is when you blood glucose goes below 4 mmol/L. Common symptoms include shakiness, sweating, hunger, dizziness, and confusion. The first time it happened to me I was just finishing of a one-to-one tutoring session before heading home. I began to feel really odd and a bit shaky as I ushered the tutee out of my office. Suddenly I began sweating profusely. Definitely time to go home I thought. Getting home meant driving for about 20 minutes, fortunately the roads were not busy that day. By the time I was nearing home however, I was really struggling to concentrate and focus on driving. I definitely should not have been on the road but did manage to make it home without any mishap. I’ve had a few other hypos since but now always try to carry some chocolate or sweets with me for a quick glucose hit. The most bizarre hypo however, happened when I was out for a short walk with my wife. It being a short walk with a pub at the end I didn’t think it necessary to take any supplies with me. However, in less than 2 miles of relatively easy walking I suddenly felt the sweats starting and became very disorientated. I had to stop and sit down on a handy wall. My wife accosted a stranger passing by who turned out to be a good Samaritan, providing an energy bar for me to eat. I have no idea who it was, but they have my grateful thanks. Definitely a lesson learned. Bizarrely walking does bring my blood sugar levels down rapidly but, skiing, a more vigorous exercise doesn’t. I’ll be discussing this more in later posts.
Now, a couple of years on from my diagnosis, I’m managing to maintain pretty good control over my blood sugar levels whilst reintroducing some carbs into my diet. The key thing is keeping the portions smaller and being more active than I was. Retirement has got me away from a largely sedentary office based job into spending more time doing various projects around the house and garden. Not forgetting the ongoing range of pills I keep popping of course.
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Maintenance
Now, a couple of years on from my diagnosis, I’m managing to maintain pretty good control over my blood sugar levels whilst reintroducing some carbs into my diet. The key thing is keeping the portions smaller and being more active than I was. Retirement has got me away from a largely sedentary office based job into spending more time doing various projects around the house and garden. Not forgetting the ongoing range of pills I keep popping of course.
