Recently diagnosed type 2

[806cat]

Hi all,

I was diagnosed with Type 2 just under 6 weeks as part of an overall health check based on a HbA1c reading of 63. It did come as a bit of a shock. I'm 52, 6'2" and was hovering just under 14 stone so a bit overweight but not drastically. BMI also just above the average range. I generally eat pretty well and exercise fairly regularly but had let it slip a bit recently and was definitely starting to get the pot belly often associated with male middle age. My dad (RIP) developed T2D in his late fifties but he put it down to lifelong steroid use due to a lung condition he had. With hindsight, perhaps not and I have it due to genetic disposition.

So it has basically been the kick up the bum I needed to get back into exercise a bit more and have basically tripled my running and do more cycling. I have also tried to cut down on carbs especially anything with sugar in and I am slowly working my way around what is good and what isn't but it is a bit of a minefield. I have bought a blood glucose monitor and can say my readings have been within the NICE guidelines (although toward the top end) for about 4 weeks now. I have also lost over 6lbs and the pot belly is definitely shrinking .

The one dilemma I have is regarding medication. The doctor who originally diagnosed T2D suggested that upping the exercise and changing the diet would be enough to reverse it and said I would probably not need to go on medication. However, at a follow-up with the GP, she wanted to put me on it straight away and seemed to disregard when I told her about my blood glucose readings on the basis that not being particularly overweight, I would struggle through diet and exercise alone. I am reluctant to go on medication unless absolutely necessary and feel from reading here that I shouldn't have to if I keep to my diet and exercise regime. On the other hand, if the side effects are small and it doesn't really affect my day-to-day life, then perhaps it would be a better idea?

Any experience or advice appreciated.

 

[Bluetit1802]

Hi and welcome,

It is very pleasing to see your proactive approach and the way you are viewing your diagnosis.

Your first doctor was right to suggest upping your exercise and changing your diet could eliminate the possibility of medication. The NICE guidelines encourage this, and the normal time to see if this works is 3 months. You are only 6 weeks in, so I can see no reason why you shouldn't continue until at least your review HbA1c test. You and your doctor can then decide if diet and exercise are working for you. Your second doctor is not wanting to give you that chance.

You say you are testing and your levels are now within the NICE guidelines. Can you tell us exactly what sort of levels you see before and 2 hours after meals? Are you using your meter to learn which foods affect you the most? Keeping a food diary including portion sizes is a good idea so you can record your levels alongside and look for patterns. Just be aware that the NICE guidelines are a bit too generous.

 

[Squire Fulwood]

I didn't want to be seen as anti pills so I accepted them when prescribed. However, if they gave me side effects I was not slow in mentioning it which put the onus back on DN to do something about it. She tried lots of pills and I suffered lots of side effects and I am not on medication at all now.

My personal opinion is that the primary care attitude worsened my quality of life what with multitudes of pills in timers in case I forgot to take them, aching legs and a bad tasted in my mouth etc.

Not everyone gets side effects but don't suffer in silence if you do.

 

[Resurgam]

I don't understand what weight has to do with it - just another myth to contend with.
I had a very bad experience with Metformin and statins, and my memory is still impaired. I think I have lost it for good.
I suggest that you stick to eating low carb foods, with the normal amount of fat - normal before all the low fat misinformation was put out.
I have normal results for my blood glucose tests of all kinds, which I think is entirely due to what I eat. I have increased exercise a little now I am feeling better, but that happened after the drop in BG not before.
Although I have not lost a great amount of weight, even though I have been trying to do so, my shape has changed, my waist has shrunk significantly, so much so that I have had to buy or make/remake all new skirts and trousers.

 

[Heretic1]

For what this is worth, I was 'labelled' just over a year ago with hba1c of 97, so a bit more than yours!! I made it VERY clear at that time I did not want ANY medication, and was going to beat this ...., which in fairness the HCPs have respected. (See my recent post in testimonials - 'Thank You Diabetes'.

Still on no medication, hba1c now 34 - so completely 'non diabetic'. I eat healthily (and unhealthily occasionally), I love my 'phys' .... all the stuff you've listed.

It has worked for me, but we are all different, and the approach by HCPs equally differ!

The very best of luck to you, and very best wishes.

 

[806cat]

Thanks for the replies, which are all very encouraging and looks like you have all done a great job in managing it! It makes me want to stick with the diet and exercise and avoid the medication if I can. My readings are between 5.5 and 7 first thing in the morning and between 6 and 8 about 2 hours after eating, I went out for dinner on Saturday and eat a veggie burger with a brioche bun and got a reading of 9.8 2 hours after so seems to be a clear link there.

I'll reserve judgement re. GP but it's not too good at the moment. They did another blood test as well (results not in yet) and I was told minimum three months due to the lifetime of the red blood cells but she said 6 weeks. I am going on Thursday so it will be interesting to see what they say. Fortunately these days there is a wealth of useful information on the Internet so it is easier to make more informed decisions.

Going out for my usual 10K run later...

 

[Bluetit1802]

Going out for my usual 10K run later...

This is admirable, and will help. However, please bear in mind that exercise possibilities can be interrupted, or even cease completely. We never know when we are going to break a leg. Diet is the key and must be addressed in order to be able to maintain control when unable to exercise to this degree.

 

[Sam50]

Thanks for the replies, which are all very encouraging and looks like you have all done a great job in managing it! It makes me want to stick with the diet and exercise and avoid the medication if I can. My readings are between 5.5 and 7 first thing in the morning and between 6 and 8 about 2 hours after eating, I went out for dinner on Saturday and eat a veggie burger with a brioche bun and got a reading of 9.8 2 hours after so seems to be a clear link there.

I'll reserve judgement re. GP but it's not too good at the moment. They did another blood test as well (results not in yet) and I was told minimum three months due to the lifetime of the red blood cells but she said 6 weeks. I am going on Thursday so it will be interesting to see what they say. Fortunately these days there is a wealth of useful information on the Internet so it is easier to make more informed decisions.

Going out for my usual 10K run later...

Sounds like you have a very positive attitude and I think you should continue with low carbing and exercise-your readings are very encouraging. My hubby was diagnosed mid-June with an HBA1C of 98 ( bit more than yours !) and is also keen to avoid meds. He is doing well with the low carbing and aims to cut them further still. His post meal readings now are generally around 9.5 but he is also wrestling with stress which doesn't help the BG. Keep going as you are-medication is a weapon in the arsenal but one that you may not need to use x

 

[Nicksu]

Thanks for the replies, which are all very encouraging and looks like you have all done a great job in managing it! It makes me want to stick with the diet and exercise and avoid the medication if I can. My readings are between 5.5 and 7 first thing in the morning and between 6 and 8 about 2 hours after eating, I went out for dinner on Saturday and eat a veggie burger with a brioche bun and got a reading of 9.8 2 hours after so seems to be a clear link there.

I'll reserve judgement re. GP but it's not too good at the moment. They did another blood test as well (results not in yet) and I was told minimum three months due to the lifetime of the red blood cells but she said 6 weeks. I am going on Thursday so it will be interesting to see what they say. Fortunately these days there is a wealth of useful information on the Internet so it is easier to make more informed decisions.

Going out for my usual 10K run later...

Re the burger - that sounds about correct. Insulin resistance seems to be worse later in the day for most of us. If I'm going to indulge in a bit of bread I tend to keep it for lunch time and then no more than one breadbun at a time.

Regarding your morning readings - I remember the dietician (when I finally got an appointment) said they liked the levels to be about 5.0 so yours are a little on the higher side. Your next test will no doubt show a drop in your HBAC1 due to the change in diet and exercise. When I was diagnosed mine was 102 and then when I was next tested (2 months later) it had come to down to 75.

Unfortunately I do have to take meds (Gliclizade) which I have been okay with. I'm on steroids which unfortunately tend to spike your BS levels later in the afternoon irrespective of anything. Metformin - I couldn't take it - due to the GI effects. Personally I think GP's have a financial incentive when they put someone on medication for diabetes (or is that me being cynical?!). Either way, good luck for your results and keep going - I'm a year in since diagnosis and 4 stone lighter - nothing like a kick up the rump to change your attitude (and diet!). It's a wake up call but if we take charge of our lives its better than being led around by our GP.

 

[Liam1955]

Hello @806cat and Welcome to the Forum .

 

[Daibell]

Hi. I would try a low-carb diet and exercise for a while and see if you can keep your HBa1C within range. If you are already having a low-carb diet and taking exercise then meds may be needed. If you have a genuinely low-carb diet your weight will gradually reduce and so will your insulin resistance which will help with blood sugar. Metformin is what you will almost certainly be offered. In the plain form it can cause short term bowel issues for some people. If you insist on the Slow Release (SR) version you will almost certainly suffer no side effects. It's a good safe drug in any form but does not have big effect on blood sugar. You may be offered statins which have nothing to do with diabetes and you may want to check what your lipids breakdown is before taking them. Statins can have side effects.

 

[Guzzler]

I was diagnosed about three months ago and it was a bolt from the blue. My HbA1c was 98 and I was put on Metformin straight away. It was a couple of weeks later that I joined this group and I do wish I had found it sooner as I would have asked for three months grace before starting any drugs. It was a different story when it came to statins as I had had my doubts for a long time before dx. I now know enough to go to my DN/GP armed with a fairly sound knowledge base.
My second HbA1c four weeks later was 73, still too high but definitely going in the right direction and I had lost a stone. I had none of the nightmarish side effects of Metformin and that really is the only reason I still take them other than the benefit(?) to my liver. My ultimate aim would be to come off Metformin and be able to control my numbers with diet alone.

 

[Rachox]

I'm in the medicate camp (for now!). I was diagnosed in May with an HbA1c of 70 and was offered Metformin straight away. I agreed as I wanted to get my numbers down quickly. This is because it transpired, in my first conversation with my GP about my diabetes, that I'd had a borderline test four years ago, which I wasn't told about so didn't get the chance to act upon. I was worried what damage might have already been done to me. Anyway I achieved a significantly reduced HbA1c in nine weeks and I have lost 3 stone to date. I eat low carb and continue on Metformin for now, luckily I tolerate it well. Ultimately I'd like to reduce the Metformin but maybe just stay on a small dose for its other benefits.

 

[Heretic1]

This is admirable, and will help. However, please bear in mind that exercise possibilities can be interrupted, or even cease completely. We never know when we are going to break a leg. Diet is the key and must be addressed in order to be able to maintain control when unable to exercise to this degree.

This is true, and I might get hit by a bus tomorrow, or struck by lightening.... but will cross that bridge when I get there .... just as I did when I was first labelled.... but I now have the knowledge to do what I need to do when (or if) that happens.

For me the glass is half full .... not half empty!

 

[Heretic1]

Going out for my usual 10K run later...

Complete respect @806cat I wouldn't dare to suggest what you must or must not do .... we are all soooo different.

For me, hitting the phys has brought my numbers (and weight) well down .... I am no longer in the diabetes range. I find it had given me a degree of flexibility as to what I can still eat (and long may it continue) .... and am having a terrific time being fitter, stronger and such a better place than most my age.

10k is a respectable distance to go .... I'm happy with running 5-7k ..... although push it to 120+ on the bike! ‍

 

[AM1874]

Hi @806cat .. and welcome
You have certainly made a good move coming here. Since joining this forum, the folks here have given me so much info, advice and support that I am now much more confident about the journey ahead. So ask your questions and be assured that you will receive the answers that you need. It can all seem uphill to start with but, in my experience, it gets easier .. very quickly.

You have made a positive start but the key point (that you already seem to have taken on board) is that managing and controlling your diabetes through exercise, diet and testing your Blood Glucose seems to be the best way forward for many people. For me, committing to an LCHF (Low Carb High Fat) lifestyle and testing 3-5 times a day seems to be working and you'll find that there is a wealth of info, relevant advice and positive support about LCHF on the forum ..

I have tagged @daisy1 for you and I suggest that you read up on the Low Carb Program in the information that she will soon be sending you. You might also find the discussion on the Low Carb Diet forum helpful .. together with the following Diet Doctor websites, which will give you all the info that you need on what and what not to eat ...
Low Carb Intro and Information and Low Carbs in 60 Seconds

It is a top priority that get yourself a test meter and, for this, the following websites might help:
https://homehealth-uk.com/product-category/blood-glucose/
for the SD Codefree meter, which costs £12.98 or:
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/
who distribute the TEE 2 meter, which is free.
I have both which I alternate for comparative purposes and I have never found any significant difference between them.

Unless you are prescribed test strips by your doctor (unlikely), the costs of testing comes down to the ongoing charges for test strips and lancets. Make sure that you tick the appropriate box on the on-line order form and you won't pay VAT on your meter or strips.
For the SD Codefree, the strips are £7.69 for a pack of 50 and there are discount codes available for bulk purchases:
5 packs x 50 use code: 264086 .. cost is £38.45
10 packs x 50 use code: 975833 .. cost is £76.90
For the TEE 2, the strips are £7.75 for a pack of 50 .. but there are no discount codes currently available

I'm testing 3-5 times a day which works out at around £10 to £12 per month for either of the two packages above but, more importantly, I now know what my BG levels are .. and I can now manage them

Hope this helps

 

[daisy1]

@806cat

Hello 806cat and welcome to the Forum Here is the Basic Information we give to new members and I hope it will be useful to you. Ask as many questions as you like 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.

 

[Squire Fulwood]

My HbA1c was 98 and I was put on Metformin straight away.
My second HbA1c four weeks later was 73,

Here's an interesting sum. Remember that the Hba1c is an "average" of three months.

98 Assumed.
98 Was your first Hba1c and I will assume that the month before was the same.
23 This is what you would have to achieve in order to get an average of .....
73 after only one month.

 

[Bluetit1802]

I don't know why any of us bother with HbA1c tests. They are a waste of time in my opinion.

 

[Resurgam]

Oh I don't know - I'd have paid to see the look on my doctor's face when reading what my Hba1c was after 80 days on low carb.