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First post

Discussion in 'Greetings and Introductions' started by Fritter65, Nov 3, 2017.

  1. Fritter65

    Fritter65 Prediabetes · Member

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    Hi there

    Diagnosed as pre diabetic three months ago Gp sent me on NHS prevention programme.

    Low carb approach adopted and have lost 4 killos in weight but Hba1c
    Has only come down from 46 to 45

    Not got a lot more weight to loose as am now 64.5 Kilos with 77cm waist and Bmi of 21

    Do lots of walking but on the course have Been advised to incorporate more resistance training and exercise needs to push up heart rate

    Anyone else on Uk NHS prevention course?
     
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  2. Goonergal

    Goonergal Type 2 · Well-Known Member

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    Hi @Fritter65 and welcome.

    You may find that your diet will have a bigger impact on your blood sugar levels than weight loss on its own, particularly as you don’t want to lose much.

    I’m tagging @daisy1 who will be along with some helpful introductory information. Have a good read and ask as many questions as you like.
     
  3. Fritter65

    Fritter65 Prediabetes · Member

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    Many thanks for your welcome yes I think the weight loss is incidental due to low carb approach
     
  4. daisy1

    daisy1 Type 2 · Guru
    Staff Member Retired Moderator

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    @Fritter65

    Hello Fritter65 and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask questions when you need to and someone will be able to help.


    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 250,000 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.
     
  5. Grateful

    Grateful Type 2 · Well-Known Member

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    I am in America, but my understanding of the NHS policy is that it doesn't usually involve an explicit low-carb approach, but rather, a more conventional "balanced diet" or "eatwell plate." It might help if you could give us details of what you eat in a typical day. (If you don't mind.) Thanks!
     
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  6. Fritter65

    Fritter65 Prediabetes · Member

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    Breakfast

    2 hard boiled eggs
    Natural Greek yogurt three tablespoons

    Snack

    Salted peanuts 1 Packet


    Main meal

    Beef or chicken with green vegetables lots!


    Snack

    Soup and or cheese
     
  7. Grateful

    Grateful Type 2 · Well-Known Member

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    This is similar to what I do (details differ, but carb load similar) and is similar to others who have had success with the low-carb approach.

    Have you been following that approach for all of the three months since your diagnosis?

    By the way, the change in your HbA1C is statistically insignificant (because of the margin of error). It could have actually gone done more than the test indicated, or it might even have gone up slightly. If I were you, I would consider it "a draw" -- the lack of significant change in blood glucose, despite dietary change, is the issue.
     
  8. Fritter65

    Fritter65 Prediabetes · Member

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    Going to increase resistance exercises to see if this has an effect over next three months
     
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  9. Grateful

    Grateful Type 2 · Well-Known Member

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    Good idea, because there is some evidence that having more muscle and less fat can help. But, based on what I have read, unlikely to make a determining difference.

    Sorry to ask again: Have you been on that low-carb gig since your diagnosis three months ago? The reason I ask is that most of us who have tried it find it can take some months to work. Plus, some of us have a faster result than others. And, of course, some of us don't achieve sufficient control through diet alone.
     
  10. Fritter65

    Fritter65 Prediabetes · Member

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    Yes have been on low card since diagnosis however must admit 5here have been some occasional lapses when on a couple of holiday breaks! Think I need to think more in advance and look at restaurant menus more carefully with my low carb glasses on!
     
  11. Grateful

    Grateful Type 2 · Well-Known Member

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    If the lapses are occasional they are unlikely to have more than a tiny effect on HbA1c. I think you are probably doing all of the following things but just in case:
    • Decide what kind of "low-carber" you want to be: 150 grams per day? 100, 50, 30, 20? If you start at the high end of the range and the HbA1c doesn't budge, tighten up for the following months and see what happens. (The sample daily food list that you provided indicates that you are probably trying to be at the low end of the low-carb range.)
    • Double-check everything you eat and drink. Carbs lurk in unexpected places. Read the label on the packet, or Google "nutrition" for a particular food.
    • The labels need to be interpreted. Often, the grams of carbs listed are "per portion" or "per 100 grams" or whatever. Make sure you translate that properly to the portion sizes you are eating.
    • We have been conditioned to think that certain foods are "healthy" but they can be a minefield for anyone trying to go low-carb. Among the common "misleaders" are: fruit, certain kinds of vegetables, certain dairy products, and anything containing grains/cereals. The list is very long.
    • Yes, restaurants are minefields, although if the menu is large enough you can usually find something relatively safe such as meat or baked fish. Ask them to substitute garnishings such as potatos with spinach or whatever your favorite low-carb vegetables are.
    • Obtain a blood-glucose meter and "eat to your meter." Find out which foods "spike" you. Some people on this forum may advise that getting a meter is among the first things you should do, and they have a good point. (This is a personal decision. I don't use a meter.)
    • There is scientific evidence that moderate exercise helps lower HbA1c (slightly). The studies I have seen show that effect could be, perhaps, half of a percentage point (in the old HbA1c measuring system). That is nothing like as powerful as diet, but still helpful "at the margin." Personally, I have a brisk 3-mile walk every day, without fail. The resistance exercises you mentioned may help too. In my opinion, the most important thing is regular (i.e. daily) exercise rather than the total quantity of it.
    At this point you "only" have pre-diabetes so you probably have a little bit of time to sort this out. Well done for dealing with it now!
     
    #11 Grateful, Nov 4, 2017 at 10:03 AM
    Last edited: Nov 4, 2017
  12. Fritter65

    Fritter65 Prediabetes · Member

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    Many thanks for that detailed response and advice extremely kind of you to take the time to give such a considered and detailed piece of advice
     
  13. Fritter65

    Fritter65 Prediabetes · Member

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    Maybe someone could clarify this for me

    First Hba1c three months ago was 46 but this was after a 10 hour fast as doctor instructed

    Second one three months ago taken on NHS xpert prevention course was 45 but had not fasted

    Significance and the difference?

    Thanks
     
  14. Grateful

    Grateful Type 2 · Well-Known Member

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    HbA1c measures the average blood glucose level over the previous 8 to 12 weeks. It is not affected by anything that happens on the day of the test, or in recent few days.

    There is a "margin of error" too. The difference between 46 and 45 is not statistically significant.

    Edited to add full explanation, highly recommended: http://www.diabetes.co.uk/what-is-hba1c.html.

    Edited again to add: The reason your doctor requested the fast is probably because s/he was also running a "fasting glucose test." This is a separate test, nothing to do with the A1C.
     
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    #14 Grateful, Nov 5, 2017 at 11:24 AM
    Last edited: Nov 5, 2017
  15. Fritter65

    Fritter65 Prediabetes · Member

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    Thanks for that now I understand!
     
  16. Alison Campbell

    Alison Campbell Prediabetes · Well-Known Member

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    Just wanted to say hello and welcome to the forum
     
  17. Fritter65

    Fritter65 Prediabetes · Member

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    Cheers!
     
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