DianaMC

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Hello,

I've been looking at this forum for a while as a source of support after being told about a month ago that I'm prediabetic.

To put this in context - and apologies ahead that this will be quite a long post - I thought I might be at risk (because I have the body type and do have some knowledge of nutrition from work and study experience). However, because I wasn't showing up as diabetic on previous tests specifically for that, I had assumed I was in the clear. Unfortunately not!

The diagnosis would have worried me less if I had not been exhibiting some symptoms that are associated with blood sugar issues - eg vision problems, near-fainting episodes, feeling very tired, having whole days of no energy, feeling irritable, gaining a lot of fat around the middle - and more. Including a frozen shoulder for about a year, which reduced the amount of exercise I usually did. Result: more tiredness and weight gain! And before that I was told I might have SAD (seasonal affective disorder) or chronic fatigue - I'd have days where I just couldn't get out of bed and felt pretty low. I'm now thinking it may have been more related to blood sugar and diet issues!

I have done quite a lot of research on PD and diabetes generally in the past month, whilst waiting for an appointment with a diabetic clinic nurse (prior to starting a course that's intended to help educate people with prediabetes). I'm guessing that I might have found some of the information they're going to give me, already - which is fine. 3-4 weeks felt like a long time to wait for 'guidance'!

So I've done some 'homework', and have followed guidelines for cutting out added sugar foods, then moving to swapping out white carbs for wholemeal ones, and adding in many more vegetables in daily dishes. I've also looked into various low carb diets, including Keto - working on understanding the scale from a healthy approach to one that might be a bit problematic. I'm not someone who naturally eats a lot of fruit, so finding that a bit hard to fathom - as it seems to be the only ok 'dessert' type food for diabetics, but doesn't agree with anyone. I've read that bananas can be too high carb and melon has a lot of sugar in it, but berries are good. Part of the reason why I've kept away from fruit (and acidic foods like tomatoes and citrus fruits, in quantity) is that I tend to get a 'geographic tongue' problem (ie oral soreness). So I probably can only manage small amounts anyway - and tend to eat fruit with other foods. I wonder if other people here have problems with fruit...?

The good news is that the research has helped me calm down! And the food swaps are working, I would say - at least in terms of feeling more level within myself. But at first it felt like things were really hard to manage and I'd be sensitive to even the smallest amount of the 'wrong' food type. I imagine this is because my blood sugar was starting to adjust. Hard to explain all of this - but I suspect other people may know what I mean.

The bad news is that, recently I've been getting pain in my other shoulder, ie not the one that has recently healed after being frozen for a year. This seems like a red flag, confirming I need to keep taking this Type 2 diabetes threat seriously. From what I can gather, from records covering my family history, this might well be hereditary. And I might be predisposed in others ways, too, to Diabetes (Type 2), eg being born prematurely.

I now feel that I want more information on what's really happening with my blood sugar reactions to various foods and to when I don't eat for a while (which can sometimes happen due to quite a busy lifestyle). I have understood that stress can affect blood sugar, too. So I'm trying to reduce that. And to take more exercise again. But it's a bit tricky as the yoga I reintroduced, once I got the PD diagnosis, seems to be what has triggered another shoulder problem. I wonder if there's a better form of exercise that I can do at home (trying to drag myself out to go running or even walking in the morning feels too challenging!)

I am thinking about getting a blood sugar monitor - actually, it was advised by the chiropractor I've been seeing who has helped heal the previous shoulder problem, and who also spotted a chromium deficiency and told me about ALA as a more natural alternative to Metformin (which I'm not keen to take).

It would be great to hear from anyone who can recommend an up to date glucose monitor/meter, which is relatively pain free to use (I'm a cissy!) and ideally lets you know if BS level is too high or too low. I gather only Types 1 injecting insulin may be at risk of hypos? But my occasional episodes of near-fainting (which I used to put down to low blood pressure, as it was in the past, although is generally more normal now) make me wonder if my BS is dipping too low in my dietary and exercise efforts to ensure it's not too high!

Hope I can offer useful info to this forum at some point, too. But for now I'm a newbie more in need. And I'm nervous about my clinic visit on Friday. I want to be able to ask the right questions and hopefully get some useful information. I suspect getting a BS home testing kit might be pushing my luck there, but you never know....

My doctor was quite laid back about the diagnosis, based on my 43 mmol reading (I think its equivalent of 6.1 or 6.2), but I don't feel that way. It strikes me as a bit too close to Type 2 for comfort! She said that the NHS is rolling out more testing for prediabetes - maybe that is partly why I happened to get my HbA1c done now - which was suggested because I'd seen several doctors about eye problems and mentioned that I'd been told I might be in danger of diabetes (when I'd been for a general check up where they work out BMI, take body measurements, etc). My GP also said that the plan of action is a course offered to patients. So I gather that's going to be the next step, after visiting the nurse...

I would really welcome any advice, experience etc that you all may be able to share!

Many thanks - Diana
 
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EllieM

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Hi @DianaMC, and welcome to the forums. I'll just tag in @daisy1 so that she can post in the new diabetic welcome post, which has lots of useful information.

Most of the T2s on here go low carb, which allows many of them to achieve normal blood sugars without medication, which isn't quite the same as the diet that you appear to have been going for. (When you research on diabetic diets, remember that insulin dependent diabetics such as myself have a different condition to carbohydrate intolerant persons such as yourself, and the dietary advice doesn't always differentiate between the two.) In particular, aside from obvious sugary foods such as desserts and chocolate and fruit juice, T2s here mostly cut out bread, potatoes, pasta and rice. If you weren't eating fruit before, I don't see the point of adding it in. (Though berries aren't too bad). In any case, daisy1's post has a lot of info about diet, which will be better than what I can tell you.

As regards a meter, this is probably the only way you'll find out what's happening and what foods your body can tolerate (everyone is different on that one.) You'll almost certainly have to pay for your own meter and strips.

Here's some current info on meters which I've copied from @Alexandra100 (I've added a couple of comments in italics).

**************
These two are the meters many of us on this Forum who self-fund use. They have probably the cheapest strips.

(1) The TEE2 meter is free, but alas not the strips to use with it, which cost £7.75 for 50 ex VAT.

With your free meter you get a useful little carrying case, 10 free strips, 10 free lancets (which will last for ages if, like me, you re-use them) a free lancet gun and free bottles of testing fluid. Customer service is fantastic. You can speak directly to a REAL PERSON 24/7 on a freephone line (0800 881 542 whenever you have a question or if you prefer not to order online. Your order arrives pretty much by return of post. You can have a replacement gun, more batteries and more testing fluid all free. The meter works fast and it only requires a small drop of blood. It supposedly will transfer readings to an app by bluetooth, but only some phones and tablets are suitable. Mine aren't.

http://spirit-healthcare.co.uk/product/tee2-plus-blood-glucose-meter/

Alternatively you can buy a CodeFree meter starter kit for £12.89 here: (actually 15.47 as you have to pay VAT)

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/

The advantage of the Codefree meter is that the strips work out slightly cheaper than for the TEE2 if you buy 50 (£7.69 ex VAT), but much cheaper if you buy in bulk. (To do this you have to put in a special code, available here on the Forum.) One disadvantage is that the Codefree customer service is way inferior to that of the TEE2 and only available during working hours Monday to Friday. This is particularly important if one is new to testing, as it means with the TEE2 one can get advice at any time of the day or night. One's Codefree order arrives much more slowly than the TEE2. So if, like me, you have a tendency to forget to order until you are about to run out, the TEE2 is better. With the Codefree not only do you have to pay for the meter, you also pay for any replacement batteries or testing fluid you may need later.

Don't forget that as a diabetic you don't have to pay VAT on your meter or strips. You can sign up for this on the order forms. Unfortunately you'll have to pay VAT as you're (fortunately) not diabetic yet.

**********



There is another possibility which is a freestyle libre, which is a patch that you stick on your arm and gives you continuous glucose readings. It's probably something to consider AFTER you've done blood testing, because it's quite expensive and not accurate for everyone.


Good luck, I'm sure you'll get lots of support on here whenever you post. (I'm in NZ so I'm posting when many of the other members are asleep. :)).
 

daisy1

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@DianaMC

Hello Diana 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 help.


BASIC INFORMATION FOR NEW MEMBERS

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 235,000 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 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. Most of these are 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.
 
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Prem51

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Welcome to the forum @DianaMC . The cheapest strips to use, which are what cost most long term are the SD Codefree and the TEE2.
The bit you are worried about is the finger pricking. I was too, but you do get used to it. I use the Accu Chek Fastclix device which you can set to different depths. You don't see the actual needle which is an advantage for me. You can buy it online for around £13.

Screenshot 2018-08-23 at 08.30.36.png
 
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bulkbiker

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I wonder if other people here have problems with fruit
No need to eat it at all if you don't want to or if it has a negative effect. For a full on Ketogenic diet it's really only possible to eat a very little anyway so cut it out.
Do you eat meat/fish? I ask because you don't seem to mention much about protein in your post.
But for many of us carbs whatever the colour are quite bad in terms of blood sugar control.
 
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Guzzler

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Hello and welcome. You have already been given a lot of advice already and it can be a lot to digest at first (no pun intended). But I thought I would address your query on excercise, if you do not mind.
It is said by someone in the know that 'You can't outrun a bad diet'. As weight loss and good management of Pre D and T2 equates to 80% diet and 20% excercise or roughly thereabouts then it follows that addressing dietary changes are paramount. I would advise that you excercise within your comfort zone but without risking injury or inflammation. Many members find that walking the dog twice per day helps.
Carbohydrates can prove to exacerbate inflammation so lowering the carbs in your diet will in time aid your excercise levels. I will leave it there for now except for one thing, you mention ALA and just in case you are unaware, it is the r-ALA you may benefit from. The ordinary ALA may not have enought of the active ingredients to be of much benefit.
Good luck.
 
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Alexandra100

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I am thinking about getting a blood sugar monitor
IMO this is indispensable. Now that the TEE2+ meter is no longer free, I'd go for the Codefree https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/, which has marginally cheaper strips when you buy one tub, but much cheaper when you buy in bulk using a code: 5 packs 264086 10 packs 975833.

I have both meters and find it useful from time to time to check one against the other. They appear to me to be very similar except that the TEE2+ http://spirit-healthcare.co.uk/product/tee2-plus-blood-glucose-meter/ can connect by Bluetooth, but only if you can manage the rather complicated process (I failed). Another advantage of the Codefree is that the meter is quite a lot smaller than the TEE2+.

You can economise by not bothering to buy spare lancets at first, as you will get 10 in your starter kit and you may decide, like me and many others here, that it is not at all necessary to use a new one each time you test. I find I can go months before I feel the need to change mine.

I hope this is in time to be useful, good luck!
 
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DianaMC

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Thanks so much, EllieM! So useful, all that information and especially all the insight on meters, about which I know very little at all.

I like the look of the TEE2+ monitor, but couldn't figure out from that website where the strips are. And have I understood correctly that I need lancets as well as strips, to do the finger pricking and testing?

My understanding re the different diabetic issues might be simple, but it is that T1 diabetics have a problem with producing enough insulin in the body to cope with breaking down sugars in the blood. And that T2 diabetics have enough insulin but it doesn't work properly in doing the job of breaking down blood sugars, so they bank up in the blood. I see a craniosacral therapist for back pain, who also explained some of it in terms of the sugar molecules being quite large and that's where the breakdown is not able to happen easily (I think she meant for T2 diabetics), hence the arteries come under strain and that is why (some?) diabetics can end up with things like vision loss. I hope that's all a correct understanding...

With the food, part of the advice I've come across, generally, is to cut down portions of carbs, to move away from recipes that focus on carbs as the major part of the dish (eg paella, kedgeree, pasta dishes, pizza - and variations) - and also to focus on high fibre carbs because they slow down sugar in the blood and avoid spikes. Hence the focus on brown rice, wholewheat pasta, lentil-based noodles, etc. And to focus more on proteins, or at least a larger proportion of proteins to carbs. And include a great many vegetables (and some fruits - probably more fresh fruits). Obviously, I am still learning what works with my body. But so far the carb items that are meant to level out blood sugar (ie not create spikes, but be slow-release) along with getting proteins more involved, especially if there are to be any (savoury natural) carbs or fruits involved seem to be suiting me. I would actually like some fruits in my diet as they contain some fibre and make for snacks (I don't usually eat much fruit at a time even now). But I'm tending to favour nuts and seeds as snacks when on the move. When I say small amounts, I mean that in around 35-40g muesli I have maybe five dried sultanas or raisins and a wedge of chopped apple. I add a spoon of yogurt to the almond milk I have with it, as something sour is meant to help slow the digestion of the carbs. I know not all diabetics can eat cereals for breakfast. Of all the types I only eat Fruit n Fibre, muesli or porridge anyway. But I get that some people have to steer clear altogether.

I guess I should count myself lucky, because I've not found it especially difficult to wave goodbye to biscuits, cakes (especially buttercream cakes), ice cream or the odd sweets like marshmallows and fudge - except in that I feel like a social pariah at times because I can't join in certain 'traditional' rituals. That said, I haven't drunk any alcohol for about 10 years (because it stopped agreeing with me) and haven't eaten chocolate (barring the odd occasion of a bit of white chocolate if it was in a dessert) for about 5 years, because I found the versions with cocoa too addictive - and white choc on its own to be too sweet. So I'm sort of used to being the odd one out in some settings :) However, I do miss honey (especially on seeded toast and with porridge!) Before now I would have eaten far too many different things together at a buffet breakfast if away from home. So not really surprised if my BS ended up too high due to that sort of gamut of possible carbs.

As my nutrition education has emphasised to include all food groups - and because I've tried various exclusion diets in the past - I'm a little wary of completely removing carbs from my overall diet, unless that turns out to be the only way forward. I totally respect that it works for some people, though.

In my case, there was a time when I followed the Blood Type Diet - which was quite a lot like Atkins, but more wary of fats. And another when I cut out dairy products (also very popular at the moment, with vegans). Because, however, many of these approaches are so far untested as to long term effects, it's easy to think what the heck at the time, because it's working for the issue of the moment ... (or it was for me, in terms of weight loss and feeling better). But I now wonder if some of my exclusion diets had a bearing on later developing gallbladder disease, and immune system issues. With GB disease, I had to severely cut down on fats, but then I think that affected my immune systems as, for example, some fat based products do contain elements that can help with it. Hence I'm trying to go forward a little warily - whilst trying to keep with the general brief of a lifestyle that helps lower and then level out BS level. Just trying to gather info at the moment, to see what I think I can work with. I don't feel I have all the answers. so it's good to hear what has happened for other people.

I'm very grateful for your time and your help!

Diana
 

Prem51

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I like the look of the TEE2+ monitor, but couldn't figure out from that website where the strips are. And have I understood correctly that I need lancets as well as strips, to do the finger pricking and testing?
You are right, the spirit-healthcare website isn't showing the TEE2 strips. It's possibly because they have been out of stock for the last couple of weeks. You do get 10 strips with the meter (and 10 lancets).
When the strips are available again they are £7.95 for a tub of 50.
 
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Alexandra100

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I like the look of the TEE2+ monitor, but couldn't figure out from that website where the strips are. And have I understood correctly that I need lancets as well as strips, to do the finger pricking and testing?
Try here: http://spirit-healthcare.co.uk/product/tee2-testing-strips/
The Spirit Website is not the easiest to negotiate. However their helpline is 24/7 and you get to speak to a real person immediately, so you can order that way if you like. I think you may have missed an earlier post of mine where I mentioned lancets: "You can economise by not bothering to buy spare lancets at first, as you will get 10 in your starter kit and you may decide, like me and many others here, that it is not at all necessary to use a new one each time you test. I find I can go months before I feel the need to change mine". In the starter kit you also get a lancet "gun".
 
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Alexandra100

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I'm a little wary of completely removing carbs from my overall diet
A few people do follow the "carnivore" diet which does almost completely eliminate carbs, but for more than 99.99% of people even on this Forum eliminating carbs is impossible. Most people who start a low carb diet are shocked to find out how many foods do contain carbs. Even sardines!!! Even raw spinach! Carb-free foods are: fish but not all, and not sea-food, flesh, fowl and fats (but not all butter).
 
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Alexandra100

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You are right, the spirit-healthcare website isn't showing the TEE2 strips. It's possibly because they have been out of stock for the last couple of weeks. You do get 10 strips with the meter (and 10 lancets).
When the strips are available again they are £7.95 for a tub of 50.
They were out of stock for quite a while, but now appear to be back. The website is rather temperamental. The 24/7 freephone option might be an easier alternative. However, the fact that the strips were unavailable for so long, and Spirit didn't seem much concerned about the problem this might raise for their loyal customers, has rather dented the image of the TEE2 for me. At the same time, the last time I ordered Codefree strips from Home Health, their customer service and speed of delivery seemed much improved. If I were buying now, I think I would go with the Codefree for the cheaper strips and smaller size of meter, unless I wanted the possibility of a bluetooth connection which comes with the TEE2+.
 
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Alexandra100

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I'm tending to favour nuts and seeds as snacks when on the move.
I do this too, and also a small pot of cheese strips, but of course the nuts are less perishable in hot weather, if they don't all get eaten up.
 
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DianaMC

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ok, find the cheapest meter that the NHS is likely to give you and test once in a while when you wake up and 2 hours after dinner or another meal with carbs or when you are invesigating foods and how you react.

Wholemeal = pure carbs, so skip it

All your symptoms could also be a thyroid condition

A gentle style of Yoga sounds really good so does warm water therapeutic swimming

Look into Esmonde Technique?


Thank you, Contralto!

I've been checked for thyroid issues for quite some years - partly to do with a pituitary gland issue. But it always comes back as normal. I'm a tiny bit nervous about NHS approaches to treating thyroid hyper/hypo too, tbh as I know someone who was given that radioactive pill. It didn't solve the problem, just sent them in the other direction. Within a few years they suddenly died from a brain tumour. Maybe I'm joining too many dots there, but it made me feel a bit wary. They seemed perfectly fine, health wise, prior to that, apart from a burning sensation in the legs and weight gain to do with the thyroid problem.

Esmonde Technique sounds really good. Haven't come across that before. I looked on Amazon and Ebay for DVDs/blueray and they seem to range from 50-170 quid a go. Is it just me, or is that a bit steep for an exercise video?

I bought one of those Vibrapower plate things when I was out of action with the injured shoulder, but never quite got around to using it - it's quite heavy and really needs to be near the TV, so I can use the DVDs I bought with it (which were a lot less squids a go!) Sort of messes up the lounge ambience... But maybe I need to be more focussed on getting that set up, too.

So far, what I thought was a gentle style of yoga has ended up with back pain and another shoulder going wrong. So I'm definitely thinking about options. Difficult to get myself to a swimming pool, though, as can't drive at the moment due to cataract issue. Waiting for more tests - hopefully it can be operated on after Xmas (when I'll have had the second round of tests and follow up appointment).

Many thanks for your help!

Diana
 

DianaMC

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Prediabetes
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Thanks for the Intro info, Daisy1 :) Very helpful.

I'm especially interested in the bit about hypos - is it only Type 1s that get them, do you know?

Thanks for your help,

Diana
 

DianaMC

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Prediabetes
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Welcome to the forum @DianaMC . The cheapest strips to use, which are what cost most long term are the SD Codefree and the TEE2.
The bit you are worried about is the finger pricking. I was too, but you do get used to it. I use the Accu Chek Fastclix device which you can st to different depths. You don't see the actual needle which is an advantage for me. You can buy it online for around £13.

Thank you Prem51 :)

This Fastclix device looks really handy. Excuse the daft question, but, having looked at it on the Accu-Check site, have I understood correctly that the lancets go into this device and it works to set how far they lance into your finger, basically? If that bit is right, how does the rest of the business work? Do you then put the blood on a test strip. And then how does the meter read it? Does it have a special area for the test strip or something? Sorry to sound so dense!

If I've understood how to use the Fastclix device - I see that some folks are saying hey, you can re-use the lancets - do you put sterilising solution on the lancet before next using it - I guess this is a question to anyone, but if you happen to know, there it is!

Thanks again,

Diana
 
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Alexandra100

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I'm especially interested in the bit about hypos - is it only Type 1s that get them, do you know?
People injecting insulin or taking some meds that increase their insulin production can get hypos. The rest of us can get false hypos especially if we bring our bgs down from a high level rather fast. I have never had one, but I believe they can be really unpleasant but are not harmful. One of the benefits of having a meter is that one can check one's bg and not panic in this situation.
 
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