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Discussion in 'Prediabetes' started by Yellredder, Oct 12, 2017.

  1. Yellredder

    Yellredder Prediabetes · Member

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    Hi, so have been to see GP this morning as my hba1c was 47.

    "So, Diabetes is all about getting your weight under control," said this man who had never met me before and obviously only had had a cursory glance at my notes. "You need to cut out processed foods and walk for half an hour four times a week."

    "Yes, we mostly make home made meals and I am trying to cut down on my carb intake. I swim for an hour each week, I walk for at least half an hour most days and we're out and about walking in the countryside every other week." Says I.

    "You can only be walking slowly if you have a child though." Says he. "And these fad diets are useless."

    "We don't talk about diets in our house as there is a history of eating disorders within the family, so we're conscious of making healthy choices. And losing a lot of weight post op increased my HBA1C and it's been increasing each year."

    He then suggested I return to my post-op diet of about 700 calories a day and I had to push to get a referral to a dietitian. Not that the dietititan was any use when I had GD, nor indeed have they been able to help my mum at all with her diabetes.

    Fortunately, I bumped into the Diabetes nurse on the way out and she advised me to see the Diabetes lead, so I have an appointment in a couple of weeks.

    As a healthy, fairly active, slightly overweight (seriously, I blame my boobs for that!) person who's had GD and with family history of late onset, what should I be doing? What can I expect from the GP? Are there questions I should be asking?

    Thanks.
     
  2. Bluetit1802

    Bluetit1802 Type 2 · Oracle

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    Hi and welcome,

    It's clear something is pushing up your BG levels. All I can suggest is you keep a food diary including all the ingredients in each meal and the portion sizes. Really analyse exactly what you are eating. (amounts of carbs/fructose/calories/protein/fats and fibre) If you have a meter, use this to test before meals and about 2 hours after first bite, record these levels next to your food and look for patterns. This should show you what your danger foods are. The level to look at is the amount of difference between before and after. This needs to be as low as possible, and certainly under 2mmol/l. If it isn't, you have too many carbs in that meal for your body to cope with. If you don't have a meter, then you need to buy one, otherwise you are working blind.

    I'm afraid our GPs mostly live in la-la land as far as diabetes is concerned, along with dieticians and the rest of the NHS. Our expectations are low. Your best place for help and advice is this forum, from people that are actually diabetic. There are many knowledgeable members. Have a good read round and see how others are controlling matters, and ask as many questions as you like.
     
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  3. Resurgam

    Resurgam Type 2 · Well-Known Member

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    Fad diet are useless eh?
    My Hba1c dropped from 91 to 41 in six months from diagnosis and me going back to my fad diet aka Atkins.
    Min you though - my doctor hasn't spoken to me since diagnosis - I think he's sulking.
    Low calorie and more exercise did nothing at all to lower my weight whenever I was told to try them - with low carb I am full of energy, have non diabetic results and I am losing weight without any effort at all.
     
  4. Guzzler

    Guzzler Type 2 · Well-Known Member

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    Walking is said to be one of the best, easiest and cheapest ways to help in the control of blood glucose. Swimming, being resistive and low impact is also an excellent excercise. As diet and excercise are part of one's lifestyle then it is the change in lifestyle that is important not just 'fad diets'. You seem to be managing this part of your regime well, monitoring your bg by testing and recording will help you to make the decisions in regards to foods you can eat happily and those foods that are best avoided.
    Sadly, a lot of GPs are not quite up to scratch with the latest/ongoing research into Diabetes control. Have a read around the forum, you will see that many people manage their Diabetes with lifestyle changes that lower bg and (in some cases) lower the dosages of meds and in doing so lower the risk of complications further down the line. And welcome to the forum.
     
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  5. Yellredder

    Yellredder Prediabetes · Member

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    Hi, thanks all. I can monitor carbs, fat and protein on myfitnesspal, but wouldn't know how to monitor fructose and fibre? I do have to be careful not to eat too much fibre though, but I don't actively monitor how much of it I have. I know the low carb works for my mum, so I knew he was chatting bubbles! My old GP was amazing - he was always open to suggestions for various things. This was a locum who clearly could only go by the script! I do love the idea of a sulking GP! And, having mentioned to him about eating disorders - I really thought that telling me to eat that few calories each day was out of order.

    The nurse suggested I use the meter - I have two, my old one from the GD days and a newer one which has a cartridge in, which my mum gave me. So I shall give the latter a go as it's newer, just need to get a cartridge. My mum had been part of some study, I think with Leicester Uni, and they've helped get her Diabetes under control.

    Thanks all!
     
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  6. wiflib

    wiflib Type 2 · Well-Known Member

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    Are you in Leicester? I’m a recently retired Midwife who has been low carbing for 9 years to control my T2.
    If you fancy a natter over coffee, I’m yer woman.
     
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  7. Bluetit1802

    Bluetit1802 Type 2 · Oracle

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    You don't need to measure the quantities of fructose you eat, just make sure you don't eat much of the foods that contain it, which are mainly corn syrup and fruit, especially fruit juices and smoothies. Google can help with this. I mentioned fructose because unlike other foods it is dealt with by the liver rather than the stomach and can contribute to fatty liver issues, which we type 2s tend to have.
     
  8. Alexandra100

    Alexandra100 Other · Well-Known Member

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    I have found, to my disadvantage as I have a tendency to constipation, that reducing carbs automatically reduces fibre.

    My GP was worse than your GP!!! Like you, I saw one I had never seen before, who brushed my concerns aside, telling me that most of his patients have high blood sugar. (So that's all right, then!) Knowing that GPs usually worry about unexplained weight loss, I played the card of mentioning my BMI of 16.5, and that I am slowly but steadily still losing weight. He advised me to exercise LESS, in order to improve the ratio of calories in to calories out. I think this may qualify as the worst diabetic advice from a GP yet. Fortunately, as for you, the practice nurse is much more clued up.
     
  9. woodywhippet61

    woodywhippet61 Type 2 · Well-Known Member

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    My gp actually told me that I could manage my diabetes with diet and exercise suggested that I looked at the low GI diet and then wouldn't talk about it anymore as I had to see the DN and she would give me advice.

    Okay so the low GI diet wasn't really the best advice but the rest was. I agree about the low carb diet and constipation. As a sufferer of IBS for 30 years it's cleared that up a treat and then some. But I take 1 Magnesium Citrate tablet a day and that is now sorted out, thank you to whoever posted on here that little tip.

    Personally I've found that a nice walk at a steady pace i.e. not making me puff, helps bring down my bgl. If I have a strenuous uphill walk then it can go up.

    BTW IMO diabetes is not all about 'getting your weight under control' it's all about getting your blood glucose levels under control. I focused on that (whilst also weighing myself of course).
     
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  10. Phoenix55

    Phoenix55 Prediabetes · Well-Known Member

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    You may find that you react to grains in addition to the normal high carb foods. So porridge, breakfast cereal, some commercially produced sauces etc are all a problem as well as the usual breads and cakes. For some reason some of us have found that we can still tolerate the occasional Lidl high protein roll but that is about all. Salads and above ground vegetables sort out the fibre aspect of my diet.

    Not all DNs are up to speed. Mine clearly did not believe me when I told her that I had been eating the recommended 5 a day, hardly ever had a fizzy drink and had no diabetes recorded in the family ( and I have gone back several generations on both sides of the family) The advice to exercise more was about the only thing of any use that I took from the meetings I had with her. This website has been more use than the combined efforts of my local HCPs, I have had appointments with all of them trying to find one that I would want to see again, and they are not old waiting to retire nor inexperienced fresh out of training. I have always had a good relationship with previous practices when I have needed to visit on occasion, but this lot have brought out the determined non-compliant in me. I will continue to visit only when I have need, but avoid as much as possible.
     
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  11. Yellredder

    Yellredder Prediabetes · Member

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    Thank you all very much!

    Wiflib - no, not in Leicester, am oop north in Lancashire, as is my mum but she was part of a study so I guess they didn't stick to one location. A very kind offer, thank you!

    Bluetit - I have been making breakfast smoothies with avocado and whatever fruit is in the house! Not every day mind. I can only eat fruit in the morning, and had been trying to vary breakfasts a bit as I never know what I fancy in the morning, I just know I'm hungry!!

    WoodyWhippet - am also an IBS sufferer, hence my problem with fibre. I'm one of the ones who suffers if I have too much of the stuff!

    Phoenix - my fave breakfast at the moment is yoghurt with a handful of granola on top. I suspect the granola's not brilliant, but I don't have much.

    Thanks all so much! X
     
  12. Bluetit1802

    Bluetit1802 Type 2 · Oracle

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    I'm also in Lancashire. :)

    Have you stopped having fruit for breakfast? Avocado is fine and can be eaten at any time as it is very low in carbs/sugar. Other fruit isn't fine on the whole and we need to take care with it. It depends how you eat it, and which type you eat, and how much you eat. There is an awful lot of sugar in fruit, and when the fruit is squashed, like in juice or smoothies, it makes matters worse. The best fruits are raspberries and strawberries, or maybe a small apple or pear. The ones to be very careful of are tropical varieties such as bananas and grapes, plus dried fruits. It isn't wise to eat it as a stand alone snack. It needs to be eaten as part of a meal, and preferably with something fatty such as cream or full fat plain yogurts. Mmmmmm strawberries and cream. :)

    Have you got a blood glucose meter? If not, you will be helping yourself enormously if you bought one. With a meter you can test before eating and 2 hours after first bite to see at a glance what that food has done to your levels .... this way you will discover which foods are your personal danger foods. Keeping a food diary and recording your levels alongside is a good way to go about learning. We find our meters are essential tools.
     
  13. Alison Campbell

    Alison Campbell Prediabetes · Well-Known Member

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  14. Yellredder

    Yellredder Prediabetes · Member

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    Ooooh, hello fellow Lancastrian! I'm just on the border with North Yorkshire.

    I had been mainly having strawberries as my small person consumes vast quantities of them, so we always have them in. Plus I'd have a bag of mixed frozen berries and chuck some of them in. Not had a smoothie for a few weeks though, not the weather for them really!

    Yes, I have a couple of meters. I just need to get a cartridge for the newer one and start using that. And I record my food and exercise on myfitnesspal.

    Thank you Alison!
     
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  15. Bluetit1802

    Bluetit1802 Type 2 · Oracle

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    So am I, almost. I'm in the Ribble Valley. :)
     
  16. Guzzler

    Guzzler Type 2 · Well-Known Member

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    Hello and welcome to the forum. It sounds like you are getting on top of things already, good work.
     
  17. Yellredder

    Yellredder Prediabetes · Member

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  18. Yellredder

    Yellredder Prediabetes · Member

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    Sent that and forgot to say, I've been to see the Diabetic lead at the GP today. With the family history and my levels increasing when I lost a lot of weight post op, she has suggested Metformin. She's given me the prescription and told me to go away and think about it. So, I'm thinking about it!
     
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  19. Bluetit1802

    Bluetit1802 Type 2 · Oracle

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    Yay!!!! Which health centre/surgery do you use?
     
  20. Yellredder

    Yellredder Prediabetes · Member

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    I go to Barlick as it's closer to me than Clitheroe.
     
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