Diabetes I am confused please help!!!!!?

Question

Good morning everyone. Just a little history first. My husband has epalepsy and has been on siezure medication for about 5 years now. I did not know til yesterday that this medication causes high blood sugar. I found this by looking it up on the net... However as of yet we have not gotten even one doctor to admit this is true...

Anyways here is my question he is on 1500 mg of meformin a day 1 in the am 2 in the pm 500mg each. The first 500mg pill brought his sugar down from 400 to about 300 then they added the other 1000mg and non of this extra medicind didn't do anything.

We are very carefull about what he eats instead of a meat veggie and a starch at night we have a meat and 2 veggies, and we eat next to no bread and pasta when we do it is whole wheat version. Everyone tells me I am doing it perfect as far as diet goes.

Now when he takes his blood sugar after he eats it always drops down like yesterday he ate dinner before it was 320 then 2 hours after he ate it was 216 I thought the sugar should go up after eating.

I am very concerned about his has anyone had they sugar drop after eating. If so is there anything I can do to help him keep it down that I am not already doing. between the epolepsy and the diabetes he is now taking 20 pills a day I am worried he is in the middle of a circle that will kill him someday...

Answer 1

Blood sugar goes up after we eat.  In two hours after a meal, it is supposed to be back down to an acceptable range.  This is what his medications are supposed to do, help him lower his blood sugars.  His body is doing what it is supposed to do.  His blood sugars are still high, and it may take several months for him to get the results the doctor is after.   He needs to take his blood sugar readings, when he gets up in the morning, before each meal, and after each meal, and before bedtime.  It is not uncommon for other medications to lead to diabetes.  Get him an appointment with a nutritionist and sign up for some diabetes educational classes.  I think they would be beneficial to both of you since it sounds like you are somewhat confused about what diabetes should or should not be doing.  You will learn a lot, and you can ask questions and get good, accurate answers.  Most hospitals have them.  He needs to watch his intake of carbs, keep them on the low side, and learn about good and bad carbs.  The South Beach diet is an excellent diet for diabetics, many dietitians and nutritionists suggest it for their patients.  His meals need to be around 45 grams of carbs and he could have 2 snacks a day that are 15 carbs each.  Here is a list of the new blood sugar levels that was given to me by an endocrinologist.

Fasting  (when you get up in the morning)

110  Excellent

140  Acceptable

180  Fair

2 hours after a meal

140  Excellent

180  Acceptable

235  Fair

If your husband is having trouble keeping or bringing his blood sugar levels down, talk to the doctor.  It is very common to have to have medications adjusted or changed.  Your husband should also be getting some good daily exercise, like walking for 30 to 45 minutes each day.  This will also help to lower his blood sugar levels.

Answer 2

You might want to try reducing carbs a lot more than you have.  There is no need to have as many as 45 g of carbs per meal as posted above -- I don't have more than 15 g, because anything above that results in BG levels that are unacceptably high.   You mention that you have whole-wheat pasta instead of regular pasta, but I've found that there is almost no difference at all between the two.  They both raise my blood sugar too much.

If I were you I would try eliminating all pasta, bread, rice, cereal, potatoes,  crackers, etc. for a couple of weeks and see if there is an improvement.  Also eliminate starchy vegetables like peas and corn.  For veggies, stick to ones with high fiber and high water content.  Go for broccoli, cabbage, cucumber, spinach, etc.  Be very limited with fruits -- just a few berries or a quarter of an apple.  Nothing tropical.

Regarding his BG level going from 320 before eating and then 216 after: this is probably because you only checked it 2 hours after eating.  I have done lots of experiments on myself, testing every 15 minutes for several hours after eating and recording all of the data.  With the types of food I currently eat, my BG will peak at about 45 minutes after eating, and then start to drop back down.  It is back to normal levels (80's or 90's) well before the 2-hour mark.

(Other foods will have different peak times and peak levels.  If, for instance, I were to have a glass of orange juice -- which I never do -- the peak would be very high, and would occur about 15 minutes after I drank it.  If, on the other hand, I had a couple of slices of pizza -- another thing I don't eat any more -- The peak wouldn't be quite as high as with orange juice, but it would be very long and very delayed.  It would take about 4 hours to get back to normal.  There is some disagreement over which is more harmful: a short but very high spike, or a relatively lower but longer-lasting spike.  So I eat foods that attempt to minimize both the height and the duration of the spikes.)

EDIT: I agree with the target BG levels listed by the first poster, and completely disagree with the ones in the second post.  Levels like that lead to nerve damage, eye damage, and kidney damage, and are by no means "Excellent" or "Acceptable".  Your husband may have more difficulty than most people reaching good BG levels due to his other medical conditions -- I wish him the best of luck!

Another Edit:

My nephew, who has brain damage, suffers from frequent seizures.  His doctors have put him on a ketogenic diet to try to reduce the occurrence of the seizures.  It is a very high-fat, low-carbohydrate diet that has been effective at controlling epilepsy in children.  I don't know whether or not it is commonly prescribed for adults.  But since a lower carbohydrate diet is also effective at controlling type 2 diabetes, it might be worth looking into.  Try googling "ketogenic diet epilepsy", and you'll get lots of information.

Answer 3

Yeah, the blood glucose recommendations in the second answer should be disregarded.  They have nothing to do with the published guidelines of any diabetes association I'm familiar with.

The problem with giving advice for your husband is that his blood glucose levels aren't even close to the desirable range.  A 320 mg/dL reading is high enough to justify a visit to the emergency room.  I suggest that your husband contact his doctor to find out what he should do to bring his numbers down.  Readings that are consistently over 200 and frequently over 300 are sure to lead to serious complications if not corrected as soon as possible.

Answer 4

he needs to exercise if he can. is he on steroids? b/c steroids can cause major sugar problems. epileptic pt's are usually put on a steriod. a sugar of 320 and 216 is very high. he needs to exercise. that is the best thing for a diabetic. you seem to be feeding him ok. make sure he gets plenty of fiber and water. yes, the sugar usually does go up after eating. however, if it is really high b/c of medication to begin with, it could go down after a meal. and 320 is very very high!!

edit: I don't know what the person below me has been smoking... but I got this off of the american diabetic association:

Truly Normal Blood Sugars

Fasting Blood Sugar

A normal fasting blood sugar (also the blood sugar you'd see before a meal) is roughly 83 mg/dl (4.6 mmol/L) or less. Many normal people have fasting blood sugars in the mid and high 70 mg/dl (3.9 mmol/L) range.

Post-Meal Blood Sugar (Postprandial)

A truly normal person eating the high carb typical American diet does not go over 120 mg/dl (6.6 mmol/L) one or two hours after a meal and many are under 100 mg/dl (5.5 mmol/L) two hours after eating.