Prescribed Metformin but wondering I can do this on diet alone

[Nicole T]

Hi,

I'm recently diagnosed as Type 2 with a HbA1C of 76. My GP has provisionally prescribed Metformin (I have the prescription here) and we're waiting on results for kidney function tests before going ahead, since I have kidney issues from childhood, and there may be an interaction with other, unrelated medication.

For about 2 years, I've been working mostly from home, and developed some atrocious snacking habits. Having a chocolate bar when I was bored, excited, stressed, annoyed, lonely, or in response to just about any emotion, in much the same way that a smoker would light up a ciggy. I'd sit down to watch a movie and eat a whole chocolate orange on my own. I'd snack on Kit-Kats or the Aldi fake Mars/Snickers throughout the day, sometimes getting through a whole pack in 24 hours. I'd started getting up in the night to pee and waking up with a very dry mouth every morning, but hadn't put two and two together. The crazy thing is that I don't even have a particularly sweet tooth. I'm as happy with a crispbread and a smear of marge as I am with a chocolate bar. It's just laziness with regard to the prep that makes me go for the latter. I don't add sugar or salt to anything, or cook anything deep fried, and while I like the occasional bacon sandwich, I eat beef and other red meat less than once a week.

My meter arrived from Amazon today, and I got a reading of 6.1 after a 15 mile bike ride and about 4 hours since breakfast (2 slices of white toast and minimal low fat spread.) 90 minutes after a corned beef sandwich (yes, I know, but this stuff needs using up, I won't be replacing it) I'm getting 11.2. That first one looks good to me, though the second is high.

The million dollar question: does it look like I might be able to handle this on diet alone? I've gone cold turkey on chocolate (apart from sprinkles on cappuccino) and I'm really not missing it. I've stopped getting up in the night to pee, and my mouth no longer feels dry when I wake. I've had a couple of meals out, not being especially careful what I ate, but main course only and no dessert. And to reiterate, I haven't started on Metformin yet. I seem to remember my mum (who had Type 2, and was on a whole cocktail of drugs, including Metformin) not getting the least bit concerned until her figures were into the teens. I really don't like the sound of the side-effects of Metformin, except perhaps for the weight loss.

 

[Goonergal]

Hi @Nicole T and welcome!

If you’re keen to give diet alone a go I’d encourage you. Many of us here - me included - have done just that starting from similar, or higher HbA1c numbers than you (mine was 108 on diagnosis).

Sounds like you’re already making some changes to what you’re eating. The key is to reduce carbohydrates as they all turn to sugar in the blood. How far to cut them is a mix of personal choice and what your body can tolerate - testing your blood glucose immediately before eating and again 2 hours later will give you an idea if this. Ideally you’re looking for a rise of no more than 2 mmols.

There are a number of threads on here where people discuss what they’ve eaten - the what have you eaten today thread in the low carb section of the forum is very lively and chatty. I also like dietdoctor.com for recipes and food ideas.

Good luck and keep us informed!

 

[Antje77]

The million dollar question: does it look like I might be able to handle this on diet alone?

I think your cards are looking good. With all the sugary snacks you were having, a change in eating habits will have a massive impact

You might like to read our short introduction on diabetes: https://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/ , and @JoKalsbeek will have lots of useful tips as well.

It's great you have a meter, very useful in finding out how your body reacts to different meals. If you test before first bite and some 2 hours later you'll get a good idea of your body's capability in handling that particular food.

Good luck!

 

[HSSS]

I’d echo the above that I think you are a good chance of making serious improvements by diet alone. Definitely read the link to jo’s nutritional thingy. You’ll be in for some surprises. What you think is right and wrong to eat might well get turned on it’s head. Obviously the chocolate and sugary stuff is an issue. But it’s not the red meat, corned beef or bacon that a problem. They are all fine for type 2. It’s the bread, crackers and marge (use real fats Eg butter not chemicals). Have a read and give it a go. We’re all here if you need help.

 

[Nicole T]

Wow! I came back to see if there was a response, and I have three. Thank you all. I'd read the intro, but not the low carb higher fat advice. All good stuff to take on board.

Of course they've hit me with the triple whammy of worrying about cholesterol and blood pressure as well, though the latter's come out at a not too scary 144 over 80. Keeping everything crossed for the cholesterol results coming back as acceptable. I don't fancy statins, either.

I've just been shopping and bought the supermarket own brand wholemeal rather than the white I usually buy. Slower carb release, so less of a spike effect, if I'm understanding this correctly. Bypassed the snacks aisle completely (there'd normally be at least four packs of Toffifee in my trolley at this point) and bought some carrots to chop up and snack on, so I'm quite proud of myself there. I think my main issue is "if it's there, I'll eat it." Thankfully, living alone most of the time, I can just resist the temptation to buy junk food.

Upgrade to real butter? I think I could do that. Shame I've just bought a 2Kg tub of low fat spread, though.

Once again, thank you. With the information that's out there, it's hard to get any perspective on what's achievable. Everywhere just seems to want to talk hard figures of levels before and after food and make anything over 8.5 sound scary.

 

[bulkbiker]

Slower carb release, so less of a spike effect, if I'm understanding this correctly

Unlikely.. probably best to ditch bread altogether especially if you want to see relatively speedy results.
The colour of bread has little to no impact its just another of the many myths we have been fed.

 

[bulkbiker]

Keeping everything crossed for the cholesterol results coming back as acceptable. I don't fancy statins, either.

You're just about to start a major dietary change I wouldn't even be thinking of statins for a good 6 - 12 months (well in fact I'd never even consider them but that's another story..)

 

[Newlysweet]

I’m 6 weeks into a 12 week go at normalising my numbers (HBA1C 56 at diagnosis) by diet alone - I’ve gone low carb, aiming for 30-50g carb/day, and it’s been remarkably enjoyable. I replace bread with keto bread using almond flour (recipe on dietdoctor.com), pasta/rice with cauliflower/courgette imitation, egg/avocado breakfast instead of cereal, and no beer. I’m not going to start Metformin unless this doesn’t normalise my numbers. Here’s hoping....

 

[bulkbiker]

I’m 6 weeks into a 12 week go at normalising my numbers (HBA1C 56 at diagnosis) by diet alone - I’ve gone low carb, aiming for 30-50g carb/day, and it’s been remarkably enjoyable. I replace bread with keto bread using almond flour (recipe on dietdoctor.com), pasta/rice with cauliflower/courgette imitation, egg/avocado breakfast instead of cereal, and no beer. I’m not going to start Metformin unless this doesn’t normalise my numbers. Here’s hoping....

Are you measuring your blood sugar levels? Can be an amazingly strong motivator.

 

[Krystyna23040]

I do think that you can do this by diet alone. You have been given some really good advice here.

I was diagnosed in 2012 with an HbA1c of 125. Was immediately put on insulin and followed religiously the so called ideal diet for type 2 diabetes. Low GI carbs like wholemeal bread and pasta. No sugary stuff but plenty of starchy carbs and everything low or zero fat - exactly as recommended by my Health Care Professionals.

It didn't go well. after 4 years I was in despair as diabetes complications worsened year by year. I had lost significant feeling in my right foot and it was getting worse each diabetes check up. Diabetic macular oedema and retinopathy was a huge problem also.

I did exactly what you have now done. Joined this site and got some brilliant advice which I followed to the letter as it made so much sense I knew that I was in the 'last chance saloon' so completely ditched the wholemeal bread and pasta, brown rice, potatoes, low fat spreads etc. etc.

Came off the insulin quite quickly, went into remission and am now diabetes resolved. My right foot is now low risk and the feeling has come back. My eyes are on the mend.

I know that as long as I stay low carb the diabetes will not come back and I will.keep my feet and my eyesight. I was so lucky that I found this site.

 

[TriciaWs]

The good news is that going low carb can also help with cholesterol - especially triglycerides. Mine fell really fast as I got my blood sugar under control.

Before you go shopping again check out the low carb facts - any ordinary bread regardless of the colour is high carb as are most root veg, rice, pasta, cereals, etc.
Find a low carb/carb free breakfast you enjoy or do without and wait till lunch (coffee with double cream can keep you going)
I switched from bread to the occasional slice of a low carb bread or made my own 90 second bread with ground almonds, make cauliflower rice, largely gave up on pasta substitutes. Mash is a mix of well cooked cauliflower with a little butternut squash (I freeze the mashed butternut in an ice cube tray so the rest isn't wasted).
I have real full fat Greek yogurt with a few berries (the only fruit I eat apart from rhubarb) or make a 'crumble' with ground almonds. I eat loads of leafy salad greens or cooked greens - cabbage, broccoli, green beans, etc. with chicken, cheese, eggs or fish and make use of butter, herbs, spices or lemon juice to vary the taste.
And in additional to cutting down on coffee I switched to full fat milk but use less - sometimes mixing it with coconut milk or cream.

 

[JoKalsbeek]

Wow! I came back to see if there was a response, and I have three. Thank you all. I'd read the intro, but not the low carb higher fat advice. All good stuff to take on board.

Of course they've hit me with the triple whammy of worrying about cholesterol and blood pressure as well, though the latter's come out at a not too scary 144 over 80. Keeping everything crossed for the cholesterol results coming back as acceptable. I don't fancy statins, either.

I've just been shopping and bought the supermarket own brand wholemeal rather than the white I usually buy. Slower carb release, so less of a spike effect, if I'm understanding this correctly. Bypassed the snacks aisle completely (there'd normally be at least four packs of Toffifee in my trolley at this point) and bought some carrots to chop up and snack on, so I'm quite proud of myself there. I think my main issue is "if it's there, I'll eat it." Thankfully, living alone most of the time, I can just resist the temptation to buy junk food.

Upgrade to real butter? I think I could do that. Shame I've just bought a 2Kg tub of low fat spread, though.

Once again, thank you. With the information that's out there, it's hard to get any perspective on what's achievable. Everywhere just seems to want to talk hard figures of levels before and after food and make anything over 8.5 sound scary.

Good news: It's not a tripple whammey. It's just a single one: Metabolic Syndrome. Under that umbrella are diabetes, obesity, high blood pressure, high cholesterol, and non-alcoholic fatty liver disease. And the solution to the whole thing? Low carb eating. I had everything except for high blood pressure (that was normal, it is now low sometimes if I forget to add salt to my meal), and the change in diet fixed it all.

I have to say though, buying a lot of stuff right when you're on the cusp of a diet change? You want to eat it rather than throw it out, and I get that, but none of it is good for you. You wouldn't give a peanut bar to someone with a peanut allergy, right? Because that's practically what this is. Everything over 8,5 does do damage, and yeah, your blood sugars seemed alright after that 15 mile bike ride, but that was because of the 15 mile bike ride... They should've been that good without the burning-off.

All in all, I think you might've already hit the Nutritional Thingy, https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html <-- but just in case... There it is again, and yeah... It's entirely do-able to do this without medication. Just diet. But don't decide to basically poison yourself and do damage because a tub's still full or you went for wholemeal. A spike is a spike, white brown or wholemeal. Stay away from it and you will have this thing under control (the WHOLE metabolic thing, not just the T2) before you know it.

Good luck!
Jo

 

[Nicole T]

More concerning figures today. 9 when I woke, going up to 12.5 2 hours after 2 slices of wholemeal toast. The nurse at my GP advised me Shreddies were good, but looking at them, they seem pretty high carbs, too. She was also the one who recommended I switch to wholemeal bread. I did have a few beers last night, though I'm trying to switch that out for gin and slimline tonic, mixed to around 2% ABV. I suppose part of this is experimenting to see how different things affect this, and it looks like beer is a corker.

I'll be honest: while I don't consider myself to have a drink problem, and typically do 'dry during the week' (though that went out of the window for lockdown) the thought of never actually getting 'good time' drunk again, properly depresses me. I tend to do events about 12 nights a year where I and friends get properly drunk, and having done these events sober, I can't see me enjoying them as much on the permitted 'couple of glasses of wine.' A bottle of wine would be more like it on a night out. This is also one of the reasons why Metformin is scaring me. So if anyone has any real world advice about consumption of alcohol, I'm all ears. Everything online seems to want to play it extremely safe.

The other thing that's going to be difficult is travelling for work and eating healthily on the road. Sandwiches are the favourite fast food, but of course that's the dreaded bread. There's probably nothing on the McDonalds or KFC menu apart from the salads that's suitably low carb. Any thoughts on how to deal with avoiding carbs and sugar on the road?

 

[Daibell]

Hi. Your GP needs to go on a nutrition course. How about ordering a Big Mac without the bun? I now do this. It's one of the options on the menu screen. It's served on a plastic 'plate'.

 

[Bheki81]

I do think that you can do this by diet alone. You have been given some really good advice here.

I was diagnosed in 2012 with an HbA1c of 125. Was immediately put on insulin and followed religiously the so called ideal diet for type 2 diabetes. Low GI carbs like wholemeal bread and pasta. No sugary stuff but plenty of starchy carbs and everything low or zero fat - exactly as recommended by my Health Care Professionals.

It didn't go well. after 4 years I was in despair as diabetes complications worsened year by year. I had lost significant feeling in my right foot and it was getting worse each diabetes check up. Diabetic macular oedema and retinopathy was a huge problem also.

I did exactly what you have now done. Joined this site and got some brilliant advice which I followed to the letter as it made so much sense I knew that I was in the 'last chance saloon' so completely ditched the wholemeal bread and pasta, brown rice, potatoes, low fat spreads etc. etc.

Came off the insulin quite quickly, went into remission and am now diabetes resolved. My right foot is now low risk and the feeling has come back. My eyes are on the mend.

I know that as long as I stay low carb the diabetes will not come back and I will.keep my feet and my eyesight. I was so lucky that I found this site.

i love this story, hope is possible

I was diagnosed this year and am learning about the low carb diet

 

[Goonergal]

Any thoughts on how to deal with avoiding carbs and sugar on the road?

Ditch the carbs. Macdonalds will serve you patties without bread; add bacon/cheese. KFC isn't too bad in the scheme of things - pull the breading off, or even with it a couple of pieces won't do a whole lot of damage. Or go into supermarkets and buy packs of cold meat/cheese etc. It's easy once you identify a few staples in places you pass regularly, or what the 'big' supermarkets, main fast food places etc. offer.

 

[HSSS]

after 2 slices of wholemeal toast. The nurse at my GP advised me Shreddies were good

The bread of any type will be the cause of the higher numbers. Shreddies would do much the same. The nurse is trotting out the same old advice that keeps type2’s getting sicker and sicker.

Have some bacon and eggs instead. Scrambled egg with grated cheese is really quick too. Or don’t have breakfast or a large creamy coffee maybe to keep you going til lunch or even brunch.

 

[Dusty911]

Agree with all of the above. Cut out bread, pasta, rice and potatoes and see what happens. If you need alternatives there are low carb options out there. Sainburies does a high low loaf I enjoy but still sparingly. I cut it all out then added some back in which I felt I couldn't do completely without using the metre all the time to see what I could tolerate and what I couldn't.
Good luck

 

[bulkbiker]

There's probably nothing on the McDonalds or KFC menu apart from the salads that's suitably low carb.

Mcdonalds will happily sell you a burger without the bun and sometimes even provide a knife and fork to eat it with.
KFC is ok if you peel off the breading but that's kind of the point of KFC so probably best avoided..

 

[bulkbiker]

9 when I woke, going up to 12.5 2 hours after 2 slices of wholemeal toast. The nurse at my GP advised me Shreddies were good, but looking at them, they seem pretty high carbs, too. She was also the one who recommended I switch to wholemeal bread.

It's amazing that even Diabetes Nurses aren''t yet on the Low Carb band waggon but will happily inform you that you have a "chronic progressive disease" when this is often only the case when you follow their dietary advice. Anyone would think they want to keep their clients!