Type 2 New here, advice please

[kingfisher2]

So, the sweet tooth finally go me into this club, darn it!

I have to say that the more I read the more confusing it gets, I realise it is a complex subject and everyone is different, so I would like to ask a few very basic questions to kick off with and make it easy for you experienced people to guide me please.

Blood sugar has historically been high (old scale) around 6-6.5 and Father and Grandfather were both type 1. Before Christmas A1c was new scale was 49. Doc said sugar is poison so I agreed to address the problem by lifestyle changes. I have never been into gym type activity but I get a fair bit of exercise doing manual work at age 73 that most 60 year olds could not do. I am trying to cut out the junk food things but it is not clear cut about what is and isn't good to eat. My weight is within the ideal body mass index for my height, my weight has been stable for at least 2 years, but I have lost 6 lbs since Christmas and recent stomach discomfort doesn't seem like good news, I did'nt eat that much junk.

I have been reading many threads here and I am staggered by the thread about whether to test or not. My doctor did not suggest testing but I could not see how I could understand what was going on without, so I do test but I don't really understand the implications of the readings. Seeing the specialist nurse in a week for 3 month A1c check.

My questions for now:
When is the best time to test? Should I test before and after every meal for a week to get a snapshot?
Are grapes good or bad?
Are apples good or bad?
Are raw porridge oats with a sprinkling of a low sugar malt based cereal for breakfast good or bad?
Is a small beer or glass of white wine with dinner good or bad?

I need to get into diet reading, but those are things I enjoy, so I want to know if they are good or bad, everything in moderation of course.

Thanks in advance.

 

[catinahat]

Welcome @kingfisher2
Testing
Don't get too caught up in the numbers, the industry wide accuracy standard for all meters is +/-15% so if your meter shows 6mmol for example your actual level is anywhere between 5 and 7 mmol. So getting uptight because one morning you are at 5.5 & the next 6.8 is pointless because both are in there same range.
Where the meters really become useful is testing around food, test immediately before you eat and again 90min to 2hrs after. The difference between the two results tells you how your body dealt with the carbs in your meal.
Grapes, probably not good, check with your meter
Apples, for me, big ones bad, the little ones are OK occasionally, for you check with your meter
Raw oats, i wouldn't, but for you, who knows, check with your meter
Beer, depends on the beer, some are lower carb than others, wine, red or white, no problem just steer clear of the sweet ones, spirits no problem jus be careful with any mixers..
Anything you are not sure about, just test, eat it, then test again, let your meter be the judge. But remember it's not the actual number we're too concerned with, it's the difference between the two tests that are important.

 

[kingfisher2]

Thanks for the reply catinahat.
I was not aware of the accuracy issue with the meters, that's helpful to know.
So I started the learning curve testing as you suggested, a good size bowl of raw porridge oats with milk and a sprinkle of a crunchy malt cereal only raised my before breakfast result by 0.8 mmol. It was 8.8 first thing anyway probably because we had a rare treat of a Chinese take away meal last night. I will try adding some grapes to my breakfast cereal one day in the week and see what that does. Not likely to be a good result I fear.
I always get that sort of number first thing in the morning, 7 or 8, which either means my main meal in the evening is all wrong or I am getting the early morning high from natural body function I read can happen in the early hours because of the bodies natural secretions of all sorts into the bloodstream. So much to learn. Thanks.

 

[catinahat]

I'm surprised that your oat and malt cereal breakfast had such a small impact on your levels. I know it would send mine high and probably keep them high for some time. But we are all different, that's why testing is so beneficial.
One thing I would check before making that breakfast a regular favorite is to extend the testing past the 2hrs.
Not all foods are digested at the same rate, oats are well known for releasing there energy over a long period of time, of course the energy they release is glucose, the very thing we have trouble with.
It could be worth your while testing at 2.5 and 3hrs just to see if you are missing the spike by testing at 2hrs.
The other thing I would urge you to have a think about is your choice of fruit, grapes are literally little sugar bombs. There are better lower carb fruits you could choose, strawberry, raspberries, some find blueberries acceptable although I can only manage a few without getting a spike.
As you reduce the amount of carbs you are eating eventually you will see a reduction in your morning levels, but it's not something that happens overnight. Our fasting levels are quite often the last to improve.
Every time we eat more carbs than our bodies can handle, that extra glucose has to go somewhere.
Our livers can store a certain amount but when that storage is full the remainder is converted into fat and stored that way.
Our bodies take every chance they get to use up that excess glucose, so the overnight fast gives it an opportunity to dump some of that glucose into our blood.
A simple way of looking at carbs is to realise that sugar is just another form of carbohydrate.
1 teaspoon of sugar is around 4 grams of carbs, if you divide the amount of carbs in whatever you are about to eat by 4.
That is how many teaspoons of sugar you are about to eat, so that healthy slice of wholemeal bread at 20g of carbs, would be the equivalent of 5 teaspoons of sugar, suddenly its not looking quite so healthy.
Keep testing and using yourself as a Guinea pig, you will eventually sort it out, but it takes time.

 

[KennyA]

So, the sweet tooth finally go me into this club, darn it!

I have to say that the more I read the more confusing it gets, I realise it is a complex subject and everyone is different, so I would like to ask a few very basic questions to kick off with and make it easy for you experienced people to guide me please.

Blood sugar has historically been high (old scale) around 6-6.5 and Father and Grandfather were both type 1. Before Christmas A1c was new scale was 49. Doc said sugar is poison so I agreed to address the problem by lifestyle changes. I have never been into gym type activity but I get a fair bit of exercise doing manual work at age 73 that most 60 year olds could not do. I am trying to cut out the junk food things but it is not clear cut about what is and isn't good to eat. My weight is within the ideal body mass index for my height, my weight has been stable for at least 2 years, but I have lost 6 lbs since Christmas and recent stomach discomfort doesn't seem like good news, I did'nt eat that much junk.

I have been reading many threads here and I am staggered by the thread about whether to test or not. My doctor did not suggest testing but I could not see how I could understand what was going on without, so I do test but I don't really understand the implications of the readings. Seeing the specialist nurse in a week for 3 month A1c check.

My questions for now:
When is the best time to test? Should I test before and after every meal for a week to get a snapshot?
Are grapes good or bad?
Are apples good or bad?
Are raw porridge oats with a sprinkling of a low sugar malt based cereal for breakfast good or bad?
Is a small beer or glass of white wine with dinner good or bad?

I need to get into diet reading, but those are things I enjoy, so I want to know if they are good or bad, everything in moderation of course.

Thanks in advance.

Hi, and "welcome to the club" and the forums.

I'd agree with catinahat's observations. In my early days I tested on waking, before eating, two hours after eating, and last thing at night. Plus I tested after doing anything different - eg last year I started playing football again and testing shows an hour or so of that will see a raised BG - as you'd expect, the liver keeps you topped up with plenty of fuel. Once I was happy I knew what was what, I scaled testing right back and just run checks every so often - I've just done a week of "first thing" tests, for example.

Your other questions: these are answered from my point of view - I'm on around 20g carb/day and usually in ketosis. You might well have a different experience.

Are grapes good or bad?
For me, they are right out.

Are apples good or bad?
Also out.

Are raw porridge oats with a sprinkling of a low sugar malt based cereal for breakfast good or bad?
I don't eat breakfast that often and I wouldn't eat this, much though I used to love porridge.

Is a small beer or glass of white wine with dinner good or bad?
It depends. Standard beer is fairly high in carbs - allow anything from 15 to 25g carb per pint. There are a few good low- and zero-carb beers - Marston's Resolution (about 3g per small bottle) Salute's Lager and IPA (zero carbs). Wine is not too bad for carbs - allow around 4g for 5 fl oz (approx one small glass of wine). A standard 750ml bottle of wine is roughly 25 fl oz so 20 or so grams of carbs per standard bottle. Dessert wines or fortified wines can have a lot more carbs than this. I've never found there to be much difference between carb content and impact as far as red vs white goes. Treat it like any other source of carbs and factor it into your daily intake.

 

[Resurgam]

Ouch @kingfisher2 that is very poor advice from your GP.
The problem for a type 2 diabetic is carbohydrate, not sugar, and you can't really give yourself diabetes as so much advice is to eat the wrong things.
My GP was hammering on about starchy foods for almost 2 years before my diagnosis, whilst for me things went from bad to worse.
After 80 days low carb I was no longer in the diabetic range.
There are, however, variations, and outliers in the collection of conditions all lumped together under the term diabetes, so particularly at the start there could be some uncertainty - the classic type 2 puts on weight easily, feels drowsy after eating carbs and responds well to their restriction.
The actual numbers on the meter are not so important as the difference before and after meals - but I am a bit uneasy about your GP's assumption that you are plain and simple type 2 so if you see your numbers climbing relentlessly even eating low carb that should ring alarm bells.

 

[RayCox]

Should all type 2 diabetic be on low or no carbohydrates. I love oats but they must be high in carbohydrates.

 

[catinahat]

Should all type 2 diabetic be on low or no carbohydrates. I love oats but they must be high in carbohydrates.

It depends on what you want to do, some people don't want to give up their favorite foods, so they put their trust in the NHS, take their medication and usually get progressively worse, just like their Dr's expect them to.

Others want to give themselves a chance of living a life free of meds and the health complications that diabetes can cause
Carbohydrates when digested will be converted to glucose and cause your blood sugar level to rise.
The less carbs in your diet, the lower your levels will be, and you will less likely to experience the health problems associated with high blood sugar.

 

[kingfisher2]

Thank you each for your contributions above.

I have never taken any real notice of the consequences of the food I eat, I eat and enjoy, but Catinahats' explanation about Carbs in relation to sugar is a great graphic illustration, and a whole new world to me.
I did not understand how the body processes food, the conversion of carbs; no wonder I am struggling to get any sort of pattern to the testing numbers. Whilst I have cut out virtually all the obviously sugary things I love, it is not just them that is/are the problem.
I need a complete rethink about what I eat. I always thought we ate a healthy diet, lots of fresh veg, and very few take-away meals etc. but it is not that simple.
I have not been doing much manual work for a week or so due to the wet weather; I got on a push bike today, I have not done that for many years. We live in an undulating landscape so it can be quite demanding on some of the hills. My mid morning reading was 10.3, after the bike ride 90 minutes later it was 6.1. That says it all, 'on your bike mate'.

Much more to learn. Thank you for the support.

 

[kingfisher2]

Just my ramblings!

NHS 'Patients know best' system had updates on my blood test of last week, but not A1c ??? they say that will be another few days before posting, makes no sense to me. My optimistic hope is that A1c was so far down from 49 that they had to re-check it, my realistic head says that the numbers I am getting daily from finger prick tests are not looking good I suspect, despite my efforts at 'being good'. My doctor did not say to test, just lay off the sugary things to get my A1c down, but until I know the latest result it is all pretty meaningless. (It will be a sad day when I have to chuck away the tubs of ice cream that have been in the freezer for 3 months because they are past their best)

Catinahat suggests that the basic numbers are less important than the spikes certain foods give, but my early morning tests are generally averaging 8 +/- which I assume to be not good. I am running a spreadsheet recording daily food intake and the numbers, hopefully a pattern will emerge. Must be basic carbs that are the problem.

I bought an exercise bike yesterday thinking that to get my night time numbers down a good workout after supper might help. I did 12Km on 80% resistance, but it made virtually no difference to my numbers this morning. In fact my usual breakfast of 50grms raw porridge oats with malt cereal sprinkle (ditched the grapes on top) - which contributors here expected to give me a high, normally doesn't, but this morning it was a full 7 whole digits higher spike 2 hours after!!!!! Bonkers !

This finger pricking routine is a faf, and I often forget; anyone got any advice/recommendations on the patches that can be read with an iphone app., seems like an easier test option, and with a phone alert reminder to do it, even when I am out working in a remote location?

My wife found a useful app called 'Neutracheck' which has calorie and carbs info for a huge range of foods anyone else using it? It is on subscription but if you only do 5 items a day it can be used for free, just click past the payment option someone pointed out.

 

[Outlier]

I found giving away the frozen foods that were what I used to be able to eat removed a lot of pressure in the early days. My lean non-diabetic husband hides his stash of sweetsbiscuitschocolatecrispssaltedpeanutscake so while I know it exists, it isn't shouting at me to eat it. I have strong ethics about eating other people's food, so no issues there. It's his not mine. So I suggest you either move the ice cream out of the house to a grateful recipient, or formally gift it to your wife with the instructions that she should eat it when you are not there, and immediately wash up any evidence.

Courage, mon brave. You'll ace this.

 

[pixie1]

Maybe have a re think on the porridge and try something different. Sometimes we have to strip right back on the carbs to begin with.
You maybe experiencing a condition called Dawn Phenomenon. This is were your fasting levels are higher than your bed time levels. This will rectify itself eventually on a low carb diet. Keep up with the cycling, as it all will help you., if you are T2 diabetic.

 

[kingfisher2]

I found giving away the frozen foods that were what I used to be able to eat removed a lot of pressure in the early days. My lean non-diabetic husband hides his stash of sweetsbiscuitschocolatecrispssaltedpeanutscake so while I know it exists, it isn't shouting at me to eat it. I have strong ethics about eating other people's food, so no issues there. It's his not mine. So I suggest you either move the ice cream out of the house to a grateful recipient, or formally gift it to your wife with the instructions that she should eat it when you are not there, and immediately wash up any evidence.

Courage, mon brave. You'll ace this.

Oooooh! that lovely long word above is so tantalising!!! Thanks for the encouragement.

 

[kingfisher2]

Hmmmm! disappointing result.
A1c only down from 49 to 47. I was a bit slow getting started with this diet change idea and did not really have a clue what I was confronting when I was confirmed A1c of 49 just 2 days before Christmas, but 3 months later and 7 lbs lighter ( when I was already just within the acceptable BMI ) seems contradictory.
The sudden weight change concerns me, my weight has been very stable, I was not eating that much sweet junk, possible too many carbs, but I did not understand carbs = sugar basically.

Any observations on the weight loss, have others experienced it when they started to address diabetes?
And will the A1c come down more significantly in the next few months now I am learning more and testing like crazy?
I also have a new symptom of an almost continuous stomach ache for the last 4 weeks, is this a common symptom, or are there maybe other things going on?
Thanks.

 

[catinahat]

Weight loss for most of us is a welcome side effect of eating low carb, initially I understand it can be due to the fact that carbs hold on to water.
If you would rather not loose any more weight, you need to increase the other macronutrients to compensate for the reduced carbs. How much you need to increase your protein and fat by is anyone's guess, you will just have to experiment.
Your HbA1c is merely a reflection of how well you are coping with the carbs in your diet, less carbs = lower HbA1c
When we change our diets it can often cause our stomach's to complain and quite often because of the carbs & water thingy, dehydration and lack of electrolytes can cause problems.
But if you are concerned about your stomach pain a trip to the Dr might be wise.

 

[kingfisher2]

Weight loss for most of us is a welcome side effect of eating low carb, initially I understand it can be due to the fact that carbs hold on to water.
If you would rather not loose any more weight, you need to increase the other macronutrients to compensate for the reduced carbs. How much you need to increase your protein and fat by is anyone's guess, you will just have to experiment.
Your HbA1c is merely a reflection of how well you are coping with the carbs in your diet, less carbs = lower HbA1c
When we change our diets it can often cause our stomach's to complain and quite often because of the carbs & water thingy, dehydration and lack of electrolytes can cause problems.
But if you are concerned about your stomach pain a trip to the Dr might be wise.

Thank you, another very helpful explanation of a further bit of this puzzle.
I don't mind losing a 'bit' of weight, it is just how comparatively fast that it is happening that concerned me. ( Ha! I always said one day I would get back into my 32 inch work jeans that I never threw away.)
I have an appointment with a dietician next week which should give me a bit more direction to better foods. My wife, bless her, is carbs and calorie checking everything we eat for every meal, and cooking accordingly. Occasionally I test out the odd item that is unlikely to be acceptable, more wishful thinking in most cases, but thankfully I am still getting away with my oats and cereal, with grapes occasionally, with under 2 points rise that you suggested is the target.

 

[catinahat]

I would be careful with grapes, they are basically just little sugar bombs, of course it depends how many you have but there are lower carb fruit options.
You should find this page informative https://www.dietdoctor.com/low-carb/fruits

 

[HSSS]

I have an appointment with a dietician next week which should give me a bit more direction to better foods.

Quite possibly not. The majority still advocate the Eatwell plate and 1/3 complex carbs as per their education and nhs standards. You’ll be told to eat oats and whole meal bread and sweet potatoes etc. All I can say is either don’t or test them thoroughly using a meter.

Some still believe carbs are essential (they aren’t - we can live without them entirely if need be) when the small amount of glucose required can be made in the body from protein and fat via a process called gluconeogenisis. They are still terrified of naturally occurring fats and want us to replace them with chemicals, processed seed oils and carbs.

This is the advice that has seen the nation get sicker and fatter in the last generation. Using a meter and assessing what those foods do for your body will remove any bias or “fad” claims and almost certainly show you the advice might be better than junk food but it’s a long way from the most effective advice. Even the American Diabetes Assoc recognises low carb is the single biggest thing we can do for ourselves to control type 2.

 

[kingfisher2]

I would be careful with grapes, they are basically just little sugar bombs, of course it depends how many you have but there are lower carb fruit options.
You should find this page informative https://www.dietdoctor.com/low-carb/fruits

Thank you yet again, that is very helpful to compare various fruits.

 

[kingfisher2]

Quite possibly not. The majority still advocate the Eatwell plate and 1/3 complex carbs as per their education and nhs standards. You’ll be told to eat oats and whole meal bread and sweet potatoes etc. All I can say is either don’t or test them thoroughly using a meter.

Some still believe carbs are essential (they aren’t - we can live without them entirely if need be) when the small amount of glucose required can be made in the body from protein and fat via a process called gluconeogenisis. They are still terrified of naturally occurring fats and want us to replace them with chemicals, processed seed oils and carbs.

This is the advice that has seen the nation get sicker and fatter in the last generation. Using a meter and assessing what those foods do for your body will remove any bias or “fad” claims and almost certainly show you the advice might be better than junk food but it’s a long way from the most effective advice. Even the American Diabetes Assoc recognises low carb is the single biggest thing we can do for ourselves to control type 2.

Thank you for this, it seems very sad that the NHS advice may not be the best, but I see the wisdom of testing everything for myself as Catinahat suggested as a good basis to work from.