Diagnosed This Week - Minimal Info Given - Not Sure What to Do

[jcwebguy]

I am 39 years old. About a week ago I suddenly noticed I had to get up 3+ times per night to urinate and noticed it seemed foamier than usual. I've never had to get up before. That was on a Friday night. I had a meeting with my doctor on Tuesday for a physical anyways, so I waited until then and told her. Have been under some very high stress the past few months with my company (I am partner with some guys in a business that is close to taking off).

On Wednesday this past week I got a call back from a nurse that my blood test showed a glucose level of 350 and was told I was diabetic. I was also told to get another appt with my doctor, but she was going on vacation, so it would be the Tuesday after next before she could see me.

I was freaked out. I called back and asked if she could see me sooner as I didn't know what to do. She had the nurse call back and tell me not to worry, everything would be fine, it would be fine until she saw me, and not to add more stress to my life.

I own a software development company, so having a plan always helps, but right now I have no strict plan from a health pro. Instead I have had to decide what to do on my own. I felt like my choices were to continue as normal the next two weeks knowing there is an issue or to start trying to do something about it.

Since then I have cut way back on carbs and overall portions. I have been using the elliptical every day at a decent intensity for 20-30 mins.

On Friday I had an appt with my nephrologist (I had a potential kidney issue a couple of years ago that turned out to be nothing but have seen the nephrologist annually since to be sure) as he had received a copy of my urine work from the physical and wanted to check some things. He ran a new test - no kidney issues - the issue he was worried about ended up being dehydration - but he mentioned my blood levels show 250 or so for glucose. He ran an a1c but won't have the results until tomorrow. If my regular doctor ran an a1c (I assume she did) I have not been given the results yet.

I found a copy of some lab results from May when I got some additional life insurance, and at that time it showed a glucose level of 139.

Other than two nights ago when I had to get up once in the middle of the night, that hasn't been a problem short of maybe having to get up around 5:30-6a to go. Last night I was fine all the way through to my alarm. Overall dehydration has decreased but I continue to drink lots of water.

I have continued to eat far less portions, minimize carbs, and work out. I've done some reading on Type 2 diabetes and have been trying to follow the standards I have seen there, but I am very frustrated not having any doctor guidance yet. You can fall down a pretty scary rabbit hole online reading about things.

I have been very fatigued all day today. Not sure if that is due to blood sugar or the smaller portions, or the not-great sleep since finding out. I'm worried whether I've cut back too much, not enough, or just right. I'm trying to keep the stress down, but the whole prospect of this thing is just there, lingering in the background at all times, and I'm not sure what to do.

 

[Enclave]

Hi, welcome and you are in the right place for advice .. I am tagging @daisy1 who will be along soon with a lot of information that will help you to understand your diabetes

Could I just ask if you are eating good fats to make up for your low carbs ?

 

[BrianTheElder]

Hi. Welcome to the site, this is just the place to find answers to all your questions.
By chance, I used to run a software house, so I know what you mean about planning and worrying about possible outcomes.
I'm afraid your response from the docs is pretty typical, but don't worry, you're still at the early stages of sorting yourself out.
The good news is that a lot of people have had great outcomes from following guidance here, just look at the success stories.

 

[jcwebguy]

Hi, welcome and you are in the right place for advice .. I am tagging @daisy1 who will be along soon with a lot of information that will help you to understand your diabetes

Could I just ask if you are eating good fats to make up for your low carbs ?

Not sure about good fats?

I've been keeping sort of a log to tell my doctor when she is back. Here is what I have:

2/24/17 - Friday
-breakfast - baby carrots; 1 piece string cheese
-exercise- 22 mins elliptical
-lunch - whole wheat English muffin with peanut butter; carrots
-dinner - salad bar with light ranch, chicken, ham, minor shredded cheese

Hard day - nephro appt- turned out ok though
bad sleep - up 3x overnight (including early morning)

2/25/17 - Saturday
-Breakfast - hard boiled egg; 4 baby carrots; string cheese
- hard morning / coping with diagnosis
-exercise- 23 minutes elliptical
-Lunch - blue apron chicken and broccoli (skipped couscous)
-snack - orange
-Dinner - 2 slices blaze pizza - thin crust, red sauce, mozzarella, 1/2 normal pepperoni, chicken,1/2 normal bacon, roasted red peppers, sautéed onions - 360cal/32 carb; half (shared) side Caesar no croutons - 4-5 carbs
(Blaze is a pizza place where they make individuals on the spot and have a great nutrition calculator)
Hard morning; better afternoon
Cold feet in am; better in evening

Good sleep - up 0x overnight

2/26/17 - Sunday

-breakfast - hard boiled egg; 4 baby carrots; 1 slice whole wheat toast with a bit of peanut butter
- exercise- 22 mins elliptical - hard push
- Lunch - 2/3 grilled chicken breast; 4 wheat thins; 6 baby carrots; dallop hummus; laughing cow cheese wedge
- 40 minute walk with family

 

[jcwebguy]

One thing I worry about - am I crashing my system by cutting back so much so quickly? Is that why I am so tired today? I don't want to do nothing, but am I doing the wrong thing too? I'm sure I'm currently on about 1/2 the calories I was one even last week.

 

[BrianTheElder]

One thing I worry about - am I crashing my system by cutting back so much so quickly? Is that why I am so tired today? I don't want to do nothing, but am I doing the wrong thing too? I'm sure I'm currently on about 1/2 the calories I was one even last week.

You have to make sure you eat enough calories to supply your energy needs. All you need to do now is cut out sugars, starches, bread, pasta or anything with flour in, rice, beer. Then look at all the helpful advice on what you can eat, there's lots of enjoyable food that will really help you.

 

[Enclave]

Sorry, thought you was going low carb high fat way of eating .. it really works for reducing blood sugar. The high fat part is just eating no low fat foods swap them for high fat foods .. when/if you do go low carb you will need the fat for energy.. Carbs are addictive and when you start to cut them down you will feel a bit off for a few days

 

[jcwebguy]

Sorry, thought you was going low carb high fat way of eating .. it really works for reducing blood sugar. The high fat part is just eating no low fat foods swap them for high fat foods .. when/if you do go low carb you will need the fat for energy.. Carbs are addictive and when you start to cut them down you will feel a bit off for a few days

Honestly, I'm not sure what I'm doing. My biggest concern is what is most sustainable in the long run - at 39 years old I have a long ways to go (hopefully).

 

[jcwebguy]

Just found my A1C result from Tuesday - it was 8.6%.

 

[Art Of Flowers]

Being tired, depressed and constantly hungry are symptoms of eating too little fat in your diet. Carbs cause high blood sugar, so you need to cut these out as much as possible, but to compensate you need to increase the amount of fat you eat. Butter, cheese, cream is good as are avacodos, olive oil.

To reduce carbs you should minimise on things such as bread, potatoes, rice, pasta, cereals etc, and stop drinking fruit juice. If you want some low carb recipes, take a look at diet doctor.com.

 

[Enclave]

Honestly, I'm not sure what I'm doing. My biggest concern is what is most sustainable in the long run - at 39 years old I have a long ways to go (hopefully).

I can only tell you my experience with T2 .. I cut down to 20g of carbs a day .. took a few weeks to get that low and upped my good fats like olive oil, coconut oil, nuts, cheese you get the picture .. I lost a bit of weight and after about 2 years of eating 20g of carbs a day I realised I have gone into remission and can eat what I want now .. but finding my low carb way of eating is the way I enjoy my food now. I am vegetarian and think that may make LCHF eating easer .. I never counted calories

 

[Energize]

Hi @jcwebguy
Welcome to the forum. Lots of good advice, knowledge and experience here which is readily shared, as you've already discovered. Ask questions and someone will surely have excellent answers

I wouldn't worry too much about not seeing the NHS 'professionals' as soon as you think you should. You might be lucky and be given good advice by them but, generally, the advice is poor, I'm sorry to say.

It seems you have made good inroads to your diet and realised it's carbs that are responsible for glucose levels. Well done. Your Diabetes nurse will surely tell you to eat enough carbs, as per the Eatwell Plate but may I suggest you just pay lip service to that advice

Also, you will undoubtedly be told you, as Type 2, don't need to test. Well, I think everyone here disagrees with that advice! How can you be in control and improve your health if you don't know how your body is reacting to foods you eat? It's like driving a car with no speedo but expecting to keep within speed limits etc (poor example, sorry)

So, I recommend you get yourself a glucometer and test, test, test. There are loads on the market but the strips will often be expensive, especially as these are on-going costs. Two meters and strips that many use, with reasonable costs for test strips are the SDCodeFree
https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/
and the Tee2 (free meter)
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/
It's up to you as to which meter you eventually get. Some others, greater expense, may have bells and whistles so it's up to what you feel is right for you.

Well done for a good start

 

[Liam1955]

Hello @jcwebguy and Welcome to the Forum .

 

[Resurgam]

You don't need to worry about eating a low carb diet for a long time. I have consistently eaten far lower amounts of carbs for decades. My son, now 34 years old was a low carb baby. Even during times when I was ordered to alter the foods I ate, in order to try to slow down the huge weight gain it caused I had to eat small amounts of the dense carb foods. When my doctor changed I always went back to low carb and always felt such a relief but had to go through the process of losing weight all over again.

 

[daisy1]

@jcwebguy

Hello and welcome to the Forum Here is the Basic Information we give to new Members and I hope you will find it useful. Ask as many questions as you need to and someone will be able to answer.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 147,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.

 

[Prem51]

Hi @jcwebguy and welcome to the forum. Don't stress about not being able to see your GP immediately. Stress will raise your blood sugar levels. My GP only asked me if I ate grapes and told me to avoid sweet things. I learnt far more from this forum than I have from HCPs. A lot of us on here have reduced our bs levels by adopting a Low Carbohydrate High Fat (LCHF) approach to eating. The meals you gave details of sound good. Your low energy levels are possibly due to the diabetes. Increased 'healthy' fats like dairy, oily fish, avocados, nuts and olive oil can replace the energy you got from carbs.
Have a read round the threads to see how LCHF works and ask any questions you want to, the people on here are friendly and supportive.

 

[Pinkorchid]

One thing I worry about - am I crashing my system by cutting back so much so quickly? Is that why I am so tired today? I don't want to do nothing, but am I doing the wrong thing too? I'm sure I'm currently on about 1/2 the calories I was one even last week.

That could certainly be the reason for the way you are feeling you are probably doing to much to soon and even maybe not eating enough take things more slowly and eat a little more there is no need to panic. Waiting two weeks to see your doctor is not going to do you any harm things will not change for the worse in that time just wait and see her to explain your blood results then decide what you want to do .

 

[ME_Valentijn]

Since then I have cut way back on carbs and overall portions. I have been using the elliptical every day at a decent intensity for 20-30 mins.

Exercise is a bad idea if your blood sugar is too high. You might be producing excessive ketones, which could be dangerous. I'd suggest dropping the exercise until you have a blood glucose meter or a way to test for ketones. The cheapest way to test ketones is with urine sticks, such as Ketostix. Your local drug store should have glucose meters and urine ketone strips.

One thing I worry about - am I crashing my system by cutting back so much so quickly? Is that why I am so tired today? I don't want to do nothing, but am I doing the wrong thing too? I'm sure I'm currently on about 1/2 the calories I was one even last week.

You don't need to cut back your calories, but it can help a lot to minimize carbs. Nutritionally speaking, carrots are more of a starch than a vegetable. It's a good idea to read the package and measure your portions to determine how many carbs are in them, or check an online site such as CalorieKing.com (subtract fiber from carbs).

And again, a blood sugar monitor will be a great help in seeing how you respond to different foods. You can test right before a meal, then 90-120 minutes afterward. It's also a good idea to test routinely in the mornings, to get a fasting baseline for the day and see how you're progressing from day to day.

 

[jcwebguy]

Hello all,

Thanks for the encouraging words.

Found a copy of my results of blood work from last April when I got some life insurance, and my a1c was 5.8 back then. Wish I had known what it meant then.

Exercise and ketones - I bought some ketone strips, and my ketone level shows as 15 (low) which is the same it was at my dr appt 6 days ago.

With low carb, how low is low. I presume no carb is impossible as some veggies have carbs, etc, but not sure what to target. I read some things that say 45-60 per meal but others say that is way high. I've been trying to keep it under 30 if not more, but that seems like a shot in the dark. Carrots are one of the few vegetables I can eat without going ... bleh ... but I'm trying to work more in. But if 4-6 baby carrots is too much and is reversing any good, I can try and cut them out too.

I'm worried that my doctor will want to put me on meds, and that once on I will never get off. Do people reasonably ever get on some diabetes medication and then get off - not sure how that works? If I try to push off meds for a while will that cause irreparable harm to my system with higher glucose levels? How quickly should I see my glucose levels drop from the change in diet and exercise?

For every question there seems to be about 100 different answers out there, so just trying to sort it all out and stay positive when I can (which is not easy right now).

 

[jcwebguy]

How difficult is it to get started on a blood glucose monitor? Is it something I need a professional to show me how to use or are they safe enough I can just go buy one and use it?