Diagnosed Type 2 - Tablets And Overwhelmed

[Quirkybee]

Hello everyone

I am a 48 year old female and have had a glucose intolerance for 10+ years, slowly losing weight and glucose reading after a fasting test being around 7.2.
I've lost a further 3 stone since 2014 controlled by following Slimming World and moderate exercise. This past year where I've lost a stone of this 3 stone weight loss, I've taken up cycling and tried my best to control my sugar through diet.

However the past 6 months have revealed that my HbA1C was firstly 79, then 6 weeks ago it went up to 113. I don't know what units these are measured in and find that my surgery has not been very informative, unless i ask questions. I was just prescribed Metformin, beginning with 1x day for week, increasing to 4x daily.

I have had a numbness in left leg which is ok, it's bearable and often goes very quickly, I've not had it this past week. Though my left ankle has swolken more than my right and this has only happened the the past 2 weeks since taking 4x tablets daily.
My ankles have been slim the last few years, despite being prone to slightly puffy feet when carrying extra weight.

I am just so confused now regarding my diet, which has been a very good diet, whilst following Slimming World. I've never been a big person, my weight was always around 9.5 stone for my 5'5 height, until it topped the higher range many years ago. Still, I'm 12st 10 currently and very pleased that I am too, even though I need to lose probably another 2.5 stone in order to reduce my BMI.

I just need help and guidance with my meals which I am now beginning to feel paranoid about. I started following the Carbs/grams way of monitoring my intake ie 80g per meal, but over 2 weeks, I gained about 6Ibs, I limit my wholegrain bread intake to about 2-3 slices over 7 days, but found doing the carbs way, it gained weight. I was eating a decent salad and a sandwich and although it kept me full, it put weight on me.

I eat fruit throughout the day and take one of those split Sistema flat containers with a blueberrie, satsuma and 4 strawberry mix in. One half only for 11am and the other about 3pm with a pear and yogurt. I nibble on walnuts, almonds and macadamia nuts throughout the week during work.

I have eaten a Magnum lolly on a weekend, not every weekend, enjoyed the odd piece of cake or treat in work, together with an Indian take away etc. These are treats and I have not cut them out, but beginning to wonder where I went wrong in the last 6 months for my reading to shoot to 113.
I know that is extremely high, but what I don't know or am not familiar with is the technology of these readings and wonder if I should start testing my blood sugars, but worried that it will make me paranoid or more worried.

I have a diabetic/hypertension review soon, one that I have had over the last 5 years or more, so I guess I can ask the nurse questions. I've asked to be referred to the dietitian and also to a management course which I understand is carried out every 6 months. My employer has allowed me to attend this course.

Any help is greatful, I am glad to be part of this forum, especially now as I need all the help I can get. Since I've been diagnosed, despite having this problem for so long, the true diagnosis has frightened me and I want to have a long happy and healthy life with diabetes and need all the help I can get.

Sorry for the very long message, but I just wanted to provide a picture of what has happened to date and just give some information in order for any help to be offered.

Thank you so much.

Beth

 

[urbanracer]

Hi @Quirkybee ,

I see that @Brunneria has given you some advice on blood glucose readings in another thread so I will not go over that again.

@daisy1 might be able to give you some advice with your diet but 80g of carbs per meal seems quite high. Whilst it sits comfortably in the gov.uk daily recommendation for a non-diabetic (260g), you will probably have more success if you cut this figure down. Bear in mind that many T2's on the forum consume less than 50g of carbs per day, and this might be OK for you, it might not, you need to see what you feel comfortable with.

 

[Daibell]

Hi. I think the important thing about diet is to think carbs and how much you can reduce them. I'm not a fan of branded diets like SW as they try to be all things to all people and don't focus on the approach needed for most people to lose weight and that is to keep the carbs down. Set yourself a daily limit of perhaps 150gm or even a lot less. Some people of these forums have less than 50gm/day of carbs! Can I also say to beware of dieticians as too many talk rubbish; there are good ones but not enough. Don't worry about proteins, fat or even salt - just focus on those carbs. Veg and fruit of course are fine but control the tropical fruits. Exercise is always good but it isn't enough. Do get hold of a glucose meter if you haven't already got one and this will guide you on which foods affect your blood sugar.

 

[Bluetit1802]

Hi,

All I can say is "goodness me"! 80g carbs per meal is far too many carbs, for any diabetic. Indeed, it is for many non-diabetics too. Eating that amount gave many of us diabetes in the first place! Firstly, it is carbs that cause weight gain, and secondly it is carbs that cause elevated glucose levels. Doubly whammy.

All carbs (wholemeal and otherwise) convert to glucose once inside the system, so the more you eat, the higher your levels will be. I lost all my excess weight and gained control of my BS levels by cutting down drastically on the carb intake and increasing my fat consumption. I am not alone in this - the vast majority of us here have done this. I eat around 30g carbs per day, normal protein, and fill up with fats. Slimming World/Weight Watchers and so forth are not designed for diabetics. You may well lose weight initially as that is their aim, but your BS levels will deteriorate and eventually you will gain back all that lost weight..

Bread, rice, pasta, potatoes, cereals and flour are the worst culprits. We also need to be extremely careful with fruit. Berries or an odd apple or pear are usually OK but tropical fruits are not, and neither are real fruit drinks or smoothies - they are worse than the actual fruit. If you do have fruit it is best not to have it as a snack. It is best to have it as part of a meal as a dessert with cream or full fat plain yogurt.

Do you have a glucose meter? If not I strongly urge you to buy one. Meters tell us which foods we can cope with and in what quantities. Test before you eat and again 2 hours after first bite - the rise in levels will show you what that meal has done to you. I would imagine your bread and fruit will not be doing you any good I'm afraid, but you can test this out for yourself. You may have a shock.

It will take a while to get your head round all this, but it is your diet that is causing you problems I'm afraid. Please have a good read round, and ask about anything you don't understand.

 

[luceeloo]

Hi,
Eating that amount gave many of us diabetes in the first place! Firstly, it is carbs that cause weight gain, and secondly it is carbs that cause elevated glucose levels. Doubly whammy.

I couldn't agree more with this. @Quirkybee, the diet you mentioned is very similar to the diet I followed from when I was in my late teens until I was 33 and diagnosed with T2. The commercial diets have this idea that we should all be eating salads, fruit, and plenty of whole grains. Unfortunately though, the excess carbohydrates convert to glucose, and then excess glucose is stored as fat. Resulting in High BG' and weight gain.

The best way of finding out what you can and can't eat is to test... you soon get used to your limits.

 

[Quirkybee]

Thank you all so far for replying. This is very confusing and I'm having trouble and probably beginning to have a little paranoia over what I'm eating. My worse time is in between meals and I think I nibble on far too much fruit during my working day.

My typical day's meals would consist of:-

Breakfast:
40-50g serving of shredded wheat bite size with half chopped banana, milk and sweeter (don't fancy anything savoury for breakfast)
Cup of tea with s/'s milk and a sweetner

Mid morning:-
A small (half of a split flat Sistema container) of blueberries, satsuma, 5 grapes,

Lunch:-
Portion of salad, drizzle of 30% fat salad cream with tin of mackerel or the vaccum packed peppered mackerel from Aldi
Low fat Greek style yogurt

Mid afternoon:-
The other half of the split fruit and a cup of tea, maybe a few nuts

Tea/supper:-
Anything from a homemade shepherds pie with veg
Low fat sausages with rice, salad
Bacon, egg, beans and few oven chips (chips twice a month)
Bolognese with wholewheat pasta etc
Salads
Fresh smoked haddock with tinned pots that I've fried with onion, and other veg

Then it's later during the evening that I fancy something sweet with a cup of tea, so either have an apple, orange or satsuma, or pear, sometimes a blue riband wafer bar.
I feel all if this may be wrong now and am really frustrated as to what is the best.

Do the GP surgeries issue testing meters free or do they have to be purchased? Again which would I choose, as not very good with decision making lately either, haha

Can anyone tell me if the Metformin will have a positive effect on my BG since I started them 6 weeks ago and reduce from 113? I realise I will need another HbA1c test soon.

Thanks in advance, very appreciated and I need to make a change in what I eat etc.

 

[ParkeyBaykis]

Hi

I think you are eating too much fruit - you're probably having 3 portions each time you snack. Whilst fruit is good for us, it is quite high in sugar so that may not be helping. Have you considered replacing your carbs at dinner with lower carb options eg courgetti for spaghetti, sweet potato instead of potato?

As for metformin, it makes you more receptive to your own insulin so it should help but it has to be at the effective level for you. I had a glucose meter when I had gestational diabetes which I kept fortunately as I don't believe that meters are routinely prescribed.

Hope this helps

 

[daisy1]

@Quirkybee

Hello Beth and welcome to the forum As suggested above, here is the information we give to new members and I hope you will find it useful. Ask as many questions as you want and someone will be able to help, in addition to the replies you have already had.


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 210,000 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.

 

[Avocado Sevenfold]

Hi @Quirkybee I did SW green days for a long time and lost weight. Every breakfast I would eat porridge with skimmed cow's milk, banana and grapes. Wholemeal sandwich and fruit for lunch and pasta and veg for dinner. This was ok then, but now I am T2, that is the worst kind of food. I wouldn't touch that with a barge pole now.

I think you may have to rethink your diet to remove the low-fat products, fruits that don't have the letters "berry " in them, pasta, bread, rice, cereals and potatoes. It may sound a bit of a dramatic overhaul, but it is the only way you will get that number down - metformin cannot do it. As a SW girl, you will be good at making tweaks and substitutions. Have a look around the forum at what others are eating.

The Codefree meter is a popular option as the testing strips are cheapest.

 

[Avocado Sevenfold]

@Quirkybee this link has info about the Codefree meter

http://www.diabetes.co.uk/forum/threads/left-to-it.106231/#post-1228065

 

[Quirkybee]

Thank you for your info, it all helps. Just getting a bit frightened over what to eat. Had 35g of shredded wheat bite size and half small banana for breakfast and gave Brough 2 pieces peppered mackerel, the kind from Ali in vaccumed pack, I love those, together with 2 eggs. I know I may be hungry, after. Have a yogurt too and 2 satsumas and a pear for throughout the day, rather than my usual pile of mixed fruit and berries.
I'll check out the link, thank you

 

[Avocado Sevenfold]

@Quirkybee Try not to be scared as fretting will only put your blood glucose levels up. Your numbers will have been high for a while so a day or two more won't make much difference while you wait for your meter to arrive. You will feel better and more energetic if you start to reduce your carbs today.

Have a read of this thread, see if there are meals you would fancy and start planning

http://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/

 

[Bluetit1802]

This thread will help you I hope:

http://www.diabetes.co.uk/forum/threads/a-new-low-carb-guide-for-beginners.68695/

The best way to start, in my opinion, is to empty your food cupboards of anything high in carbs. Start with your breakfast cereals and fruit bowls, Breakfast cereals are not a good choice. Fruit is not a good choice - berries have the least sugar but should only be eaten with fats such as cream or full fat yogurts, and only in small portions. I eat strawberries, but my meter tells me I can only have 2 medium ones. Blueberries have the most sugar of the berry group. Raspberries are good. Once your cupboards are clear, go shopping and stock up on low carb food, meat, oily fish (not in a sauce), eggs, vegetables that grow above ground (avoid root crops), and good fats. Ditch all the low fat varieties and eat the real thing. Bacon is excellent. Sausages should be the high meat content ones. I buy 97% Black Farmers but supermarkets usually have their own brands.

Cutting carbs right down could lead to potential fatigue and hunger, so you need to aim to replace this lost energy with good fats. Butter, cream, cheese, eggs, full fat varieties of yogurt and mayonnaise (Helmans Real Mayo is a good choice, or make your own), olive oil, avocados, Fat won't make you fat (unless you also have high carb) and will stop any hunger. With the right balance of low carb and increased fats you may find you don't need to snack between meals.

Check the nutrition labels on packaging for the "total carbohydrate" content and keep it as low as possible.

Your meter will be your best friend if used alongside a food diary. Eat to your meter and you can't go far wrong!

 

[walnut_face]

Hi @Quirkybee and welcome! All those fears and anxieties will soon evaporate, honest! I am only 8 months ahead of you, but for the first time I feel in control of my body, knowing what different foods do. Having looked at what you eat you seem to have followed the advise of the Health Care Pros almost to the letter. So how unfair that you have T2D?
I note that you eat a lot of low fat variants of food. Can I urge you to spend a few moments comparing the labels of full fat and so called 'healthy' low fat alternatives? Look at the sugar content of low fat, it is more likely than not to be higher than in full fat versions. This is how the food industry restore the taste good factor when fat is stripped out. For a T2D sugar is far worse than fat. Also if you eat higher fat you will find it more filling and may not need to snack (so much) between meals. Again if you do need to nibble try nuts instead of fruit.
This is a long haul and as the days go by you will gain more and more knowledge. As other have said get a meter, a meter will tell you what is good for YOU to eat, and no one or nothing else

 

[neety41]

Not everyone struggles with bread etc, i had seed toast for breakfast, ham salad for lunch with berries and greek yogurt then fajitas for tea, a juicy pear, mango and raspberries and my blood sugar is lower than it was yesterday, i dont find that bread is a problem with blood sugars. What i will say is, make sure ur cholesteol is ok cos quite often it isnt in diabetics, then u have to be careful with saturated fat, cheese wouldnt be ideal, u would need to up the healthy fish oils instead

 

[Quirkybee]

What I'm confused about (amongst other things haha ), is how can a high fat low carb.diet work, moreso, the high fat? If I started changing my yogurts to full fat, by using butter and rating other foods high in fat etc, I know I'd pile the weight on, so I just don't understand this ratio. Plus, having high BP, then how can high fat do it any justice? Unless I am misunderstand it somewhere.

 

[chalup]

@Quirkybee go to the atkins website and read the background information on why low carb diets work. There is also a lot of information in daisy1's welcome post here on the site. I eat extremely low carb and always high fat. I am steadily losing 4-5 pounds a month and my cholesterol is normal as is my blood pressure. I know it is hard to wrap your brain around as it goes against all you have been taught over the years but think of it this way...... Eating the way you have been taught has brought you to diabetes..... so is the way you have been taught right? Give LCHF a good one month chance without second guessing everything or yourself and if it is not right for you you can always change to something else.

 

[Quirkybee]

Thank you, I will read the info on the Atkins site and daisy1's post, thank you.

 

[bulkbiker]

What I'm confused about (amongst other things haha ), is how can a high fat low carb.diet work, moreso, the high fat? If I started changing my yogurts to full fat, by using butter and rating other foods high in fat etc, I know I'd pile the weight on, so I just don't understand this ratio. Plus, having high BP, then how can high fat do it any justice? Unless I am misunderstand it somewhere.

No you wouldn't and that is the whole point. You eat a lot less because fat fills you up so you don't need the snacks or so much to eat. You are eating so much more every day than I do on your high carb low fat diet.

 

[bulkbiker]

Please read Daisy's post and some of the posts on the success stories forum. You will be amazed by what we can achieve.