Help needed

Petrolhead276

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Hi all.

My name is David age 61 (Oct).
we live in SE Essex between Southend & Basildon.

I am not diabetic but my wife is Type 2 diabetic and I am overweight enough (BMI 46) to be in the diabetes risk category, whenever I see my GP this is mentioned.

My wife's medication has just been changed from a second tablet, can't recall the name of it, to a VICTOZA 6mg/ml (prefixed Liraglutide) in addition to metformin at highest dose.

For a number of years she had no meter from our GP just a blood test every 3 months.
Personally I find that approach stupid and an NHS cost saving excercise, whilst I get that it's the 3 month rolling values that are important, waiting 3 months between each means one cannot manage ones bloods on a timely basis and a monthly test with the GP reviewing the changes over a 3 month rolling timeline would be more appropriate, especially for newly diagnosed patients to get on top of the changes required to their lifestyle.

Therefore I got one of the free meters from the manufacturers and bought the test strips & lancets ourselves.

Even with this she was unable to adequately control her blood sugar levels.

She now has a meter from our GP, and I have obtained the free cable from manufacturer to be able to offload the results to a PC for us to review.

My wife is also obese and has never really eaten a lot, personally I believe she has a very low metabolic rate and this is part of her problem, I am constantly reminding her that she needs to eat regularly but she says she is not hungry and so goes the vicious circle with her blood sugars and eating.

To top it all, we have a severely physically disabled son, whilst he no longer lives at home, he still requires our support for financial & health management and he himself underwent bariatric surgery and my wife has been visiting him 3 days a week for the last year, spending all day wife him and motivating him, but it takes its toll on her and she then cannot motivate herself to manage her diabetes.

She has told the Diabetes GP, who happens to be at the other practice surgery and only sees my wife for her diabetic reviews, that she has read that "stress" can influence blood sugar levels and that we have a disabled son.
He just poo pooed this, until her last appointment when a young Asian doctor trainee was also present and my wife mentioned the age of our son (34) and his conditions and the trainee said you have had a lot to deal with over a long period of time.
She also has had asthma since a child and the nurse has changed her medication for this (NHS cost saving?) and that isn't working for her, adding more stress.

I went along to support her at one of her reviews (18+ months ago) with the diabetic GP, he had his jaw resting on his hand whilst talking to her looking at his pc screen, totally impersonal.
So I left it for a few minutes listening to his questions and her answers, I then interjected with "the reason I am here today is that my wife tells me you don't listen to what she is saying", this got his attention and he took his jaw off his hand and looked at us both.
I then explained the issues she had with his approach and why I had sought a private appointment with a consultant arranged by our usual GP and that he had best start listening to what my wife says as putting her on medication that gives her constant thrush is unacceptable regardless of whether it brings the BG levels down, as it's an unacceptable form of medication for my wife's needs.

She won't join a local diabetes group to talk with people who have been through this either, she hates opening up to strangers.

Hence this post to see what other options exist for me to try with her to provide support.

@daisy1 seems like you are the fountain of all knowledge on here from some of the posts I have read
 
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urbanracer

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Hi @Petrolhead276

I note that in another thread you have written that you don't understand the diet issues.

Arguably, diet is the most important thing for a T2. You have to recognise that all carbohydrates turn into glucose in the body. Therefore, reducing one's intake of carbs (potato, bread, pasta, rice, cereals) is likely to be beneficial. It's not just about sugar.

There are recipe and food ideas in the diet forum that will give you an insight into what to replace the carbs with if you decide to give it a go.

For many T2 forum members, low carb diets also lead to weight loss, so again, there are additional potential benefits for your partner.

Have a good look around the forums and ask as many questions as you need to.

Good luck and welcome to the forums.
 
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Guzzler

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Stress induces cortisol production and cortisol raises blood glucose so there is a physiological result of stress. A GP should never poo poo a patient under any circumstances but when the patient actually knows what is contributing to raised bg then he/she should take note and act accordingly. You did the right thing in making that doctor take notice of what you were saying, well done.
Diet, for me, has been the mainstay in my armoury. First thing I did was to give up sugar in my tea then all the starchy carbs already mentioned and then I looked further to reduce any carbs that I was unaware of that seemed inocuous like bananas, garden peas etc I bought a carb counting book although you can easily download an app or just google the carb count of foods and drinks. It is a real learning curve so don't expect an overnight change. I had a few wobbles but I've managed to lower my bg and lose weight but I'm still learning four months on from diagnosis.
It may be that high bg is causing your wife's thrush rather than medication so lowering the amount of carbs will help. It is a condition I have not suffered with since I started low carbing and I had been plagued by it before then.
Try to get used to looking at labels on the foods you buy, as a general rule aim for 10g of carbs or fewer for 100g of weight. Best of luck to you all and welcome to the forum.
 

Resurgam

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Messages
9,849
Type of diabetes
Type 2 (in remission!)
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Diet only
I am also one of the people who eat little yet put on weight, and can go without eating all day too.
Eating low carb can have a huge effect on people who considered themselves resistant to losing weight - I was shocked to find that I was just the opposite when I removed all the 'healthy carbs' from my diet. There was a lot of resistance to the idea back in the 1970s, and I have been persuaded to 'eat normally' on several occasions and then endured weight gain and ill health - a very serious incident of pre-eclampsia in pregnancy - and the diagnosis of diabetes after trying 'cholesterol lowering' for almost two years.
People often report they are eating healthily and list all the carbs they are eating in their brown or natural form - on low carb the brown is the meat.
There are some 'experts' who claim that there has been no research done on low carb - ignoring all the people who have found the Atkins diet to work for them. It has certainly made all the difference to me, as my blood tests show normal results now.
 

JackieCarroll

Active Member
Messages
26
Type of diabetes
Type 2
Stress induces cortisol production and cortisol raises blood glucose so there is a physiological result of stress. A GP should never poo poo a patient under any circumstances but when the patient actually knows what is contributing to raised bg then he/she should take note and act accordingly. You did the right thing in making that doctor take notice of what you were saying, well done.
Diet, for me, has been the mainstay in my armoury. First thing I did was to give up sugar in my tea then all the starchy carbs already mentioned and then I looked further to reduce any carbs that I was unaware of that seemed inocuous like bananas, garden peas etc I bought a carb counting book although you can easily download an app or just google the carb count of foods and drinks. It is a real learning curve so don't expect an overnight change. I had a few wobbles but I've managed to lower my bg and lose weight but I'm still learning four months on from diagnosis.
It may be that high bg is causing your wife's thrush rather than medication so lowering the amount of carbs will help. It is a condition I have not suffered with since I started low carbing and I had been plagued by it before then.
Try to get used to looking at labels on the foods you buy, as a general rule aim for 10g of carbs or fewer for 100g of weight. Best of luck to you all and welcome to the forum.

It's more than likely high BG causing the same effect as thrush as I believe excess sugar that the body can't deal with is excreted in the urine. I'm sure someone will correct me if i'm wrong. I seem to recall my GP diagnosing my husband with thrush when he had extreme thirst for over six weeks - before sending him a letter to correct the diagnosis to T1
 

Snapsy

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Messages
2,552
Type of diabetes
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It may be that high bg is causing your wife's thrush rather than medication so lowering the amount of carbs will help. It is a condition I have not suffered with since I started low carbing and I had been plagued by it before then.
I suffered constant thrush for a long period of time which I can link directly to when my diabetes was very much out of control due to a thyroid condition and its dramatic psychiatric side-effects.

Thrush likes a sugary environment, and that was precisely the problem as far as my own experience was concerned. I was able to finally eradicate it with Diflucan One (an oral capsule) and Canestan cream, but this only worked when I had finally stabilised my sugars - any attempts to get rid of it before I had lowered my sugars proved fruitless.

Sending hugs to you both, @Petrolhead276 .
 

Petrolhead276

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@Petrolhead276

Can you tell us what your wife eats and drinks in a typical day?
Is her asthma medication a steroid?

Yes at least one of her asthma meds' is steroid based.

Unfortunately I am unable to say what a typical days diet is as:

1) she doesn't note it, even though I have suggested it would be beneficial so that the BG values I extract from her machine periodically can be overlayed to the dietary intake.

2) she is more concerned about others than herself, e.g. our son. Despite me saying on occasion that not looking after herself could result in those people she cares about not having her around anymore. Whilst I know that is a bit shock tactics for some, I have known my wife for 45+ years and unfortunately sometimes this is the only way through her defence mechanisms.

Someone else mentioned talking therapies, my wife finds anything like this intrusive to her privacy, so I doubt she would entertain it, although personally it's what she needs, e.g. a local buddy of similar age and having beaten the condition or is also struggling with it so they can whinge together.

We both have a "sweet tooth" with chocolate being high on our hit list along with the sweeter wines (German kabinett, spätlese & Auslese plus French sauternes); but these are not a daily or even weekly occurrence, more once or twice a month or when on holiday.
 
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Petrolhead276

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Hello and welcome.
Just a quick question. Has your wife had her thyroid levels checked recently?
And yes, stress will most definitely act on blood sugar levels.

No she hasn't.

I have noticed a couple of people ask this question.

It would help me understand why this is important, one post said under active thyroid causes weight gain, is this the sole reason?

I just found this useful guide to uk thyroid tests
http://www.acb.org.uk/docs/default-source/guidelines/TFTguidelinefinal.pdf?sfvrsn=0
which may benefit others
 
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Kentoldlady1

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Messages
733
Type of diabetes
Type 2
Hello, hope that some of the replies have helped a bit.

The reason I ask about thyroid issues is not just about weight gain, although that is part of it. Thyroid problems are often found in people with t2d and the symptoms can be very similar. Having had both diagnosed very close together I feel that an untreated thyroid problem can be very tiring. It alters mood, body temp, appetite and just about everything else we need to live a good life.
Ask for it to be checked as rates rise as we get older

In any event the diabetes needs to be tackled. I hope you have both managed to have a read around this site and seen exactly what we can do to help ourselves. Sometimes though, I know that it really feels as though it is just too much and nothing much could possibly help. But it does not matter where you start, a lot can be done in a surprisingly short time to really improve health.

Diet is the single most important change we can make. I have used a low carb, high fat diet and it has worked for me. There is a site called dietdoctor and although you pay for some of it a lot of it you can read for free.
Jason fung (look on youtube) explains how diet can make a huge difference.
This site has a great recipe section and the forums have sections on food.
However, you and your wife really need to engage with this. I see that you say she will mot keep a food diary, so does that mean you eat separately?

If your wife needs to just vent she can post on here, or one of the other sites where she can be anonymous yet share how she feels. I found carers uk very helpful, where others really understand all the love, frustration, loneliness and sheer hard work needed when caring for another adult.

Good luck with it all. Please let us know what happens for you both.x
 
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Bluetit1802

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25,216
Type of diabetes
Type 2 (in remission!)
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Diet only
All I can suggest is a change in diet. Every carbohydrate we put in our mouth turns to glucose in the body. The fewer carbs we eat, the less glucose there will be. It is as simple as that. I know it isn't always simple to reduce the carbs, but it is a simple fact that this is the only way to reduce blood glucose levels without the aid of more and more medication and insulin injections. Carbs also cause weight issues, so cutting those right down should help both of you lose weight as a bonus.

Can you convince her that carbs such as rice, potatoes, pasta, bread, breakfast cereals, flour based foods and fruit should be reduced? Can you encourage her to use her meter to see what her meals are doing to her levels? If she tests immediately before she eats and 2 hours after her first bite she will see at a glance what that meal has done. The aim is to keep any rise from before to after down below 2mmol/ and preferably less. If the rise is more, then there are too many carbs in that meal. Some will need reducing in portion size. Some will need eliminating. Keeping a record of these levels alongside the food eaten will produce patterns, and will show her what her personal danger foods are.

I wish you both well, and your son, and hope this forum can be of help to you. Please keep posting and asking questions.
 

CherryAA

Well-Known Member
Messages
2,171
Type of diabetes
Type 2
Treatment type
Diet only
Hi all.

My name is David age 61 (Oct).
we live in SE Essex between Southend & Basildon.

I am not diabetic but my wife is Type 2 diabetic and I am overweight enough (BMI 46) to be in the diabetes risk category, whenever I see my GP this is mentioned.

My wife's medication has just been changed from a second tablet, can't recall the name of it, to a VICTOZA 6mg/ml (prefixed Liraglutide) in addition to metformin at highest dose.

For a number of years she had no meter from our GP just a blood test every 3 months.
Personally I find that approach stupid and an NHS cost saving excercise, whilst I get that it's the 3 month rolling values that are important, waiting 3 months between each means one cannot manage ones bloods on a timely basis and a monthly test with the GP reviewing the changes over a 3 month rolling timeline would be more appropriate, especially for newly diagnosed patients to get on top of the changes required to their lifestyle.

Therefore I got one of the free meters from the manufacturers and bought the test strips & lancets ourselves.

Even with this she was unable to adequately control her blood sugar levels.

She now has a meter from our GP, and I have obtained the free cable from manufacturer to be able to offload the results to a PC for us to review.

My wife is also obese and has never really eaten a lot, personally I believe she has a very low metabolic rate and this is part of her problem, I am constantly reminding her that she needs to eat regularly but she says she is not hungry and so goes the vicious circle with her blood sugars and eating.

To top it all, we have a severely physically disabled son, whilst he no longer lives at home, he still requires our support for financial & health management and he himself underwent bariatric surgery and my wife has been visiting him 3 days a week for the last year, spending all day wife him and motivating him, but it takes its toll on her and she then cannot motivate herself to manage her diabetes.

She has told the Diabetes GP, who happens to be at the other practice surgery and only sees my wife for her diabetic reviews, that she has read that "stress" can influence blood sugar levels and that we have a disabled son.
He just poo pooed this, until her last appointment when a young Asian doctor trainee was also present and my wife mentioned the age of our son (34) and his conditions and the trainee said you have had a lot to deal with over a long period of time.
She also has had asthma since a child and the nurse has changed her medication for this (NHS cost saving?) and that isn't working for her, adding more stress.

I went along to support her at one of her reviews (18+ months ago) with the diabetic GP, he had his jaw resting on his hand whilst talking to her looking at his pc screen, totally impersonal.
So I left it for a few minutes listening to his questions and her answers, I then interjected with "the reason I am here today is that my wife tells me you don't listen to what she is saying", this got his attention and he took his jaw off his hand and looked at us both.
I then explained the issues she had with his approach and why I had sought a private appointment with a consultant arranged by our usual GP and that he had best start listening to what my wife says as putting her on medication that gives her constant thrush is unacceptable regardless of whether it brings the BG levels down, as it's an unacceptable form of medication for my wife's needs.

She won't join a local diabetes group to talk with people who have been through this either, she hates opening up to strangers.

Hence this post to see what other options exist for me to try with her to provide support.

@daisy1 seems like you are the fountain of all knowledge on here from some of the posts I have read

If you are finding it hard to persuade your life to make the change, could you help her by taking over the food for a bit? there re lots of delicious Low carb recips here and on diet doctor.com. They are lovely for all, diabetic or not.

Once she got some of the good stuff inside her, you may find its easier to persuade her not to need the bad stuff, simply because her hunger pangs will start to go down. It does start to happen very quickly - so how about a whole renewed interest in cooking coming from you?
 

SimonCrox

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317
The victoza is a useful agent; it does not cause hypos, drops the glucose levels as much as insulin and decreases the risk of heart attack and stroke. Folk generally find it reduces their appetite so that they do eat less, and also, it seems to make folk eat less energy dense high refined carbohydrate foods. If mixing it only with metformin, there should not be a problem with hypoglycaemia if one eats less.
Best wsihes
 
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Petrolhead276

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I do not have diabetes
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If you are finding it hard to persuade your life to make the change, could you help her by taking over the food for a bit? there re lots of delicious Low carb recips here and on diet doctor.com. They are lovely for all, diabetic or not.

Once she got some of the good stuff inside her, you may find its easier to persuade her not to need the bad stuff, simply because her hunger pangs will start to go down. It does start to happen very quickly - so how about a whole renewed interest in cooking coming from you?

It's not a matter of good stuff v bad stuff, it's a desire not to eat that is the bigger issue.

She is an extremely good cook, managed our sons dietary needs including counting calories, GI balance etc.

Yes i could take over meal preparation, especially as i am shortly going to retire, which will give me more time for this.

But answer this, how if someone just losses interest in eating food in general does one turn it around? I try to face things in life head on, whereas she would rather avoid confrontational situations.

Like it or not tackling ones food intake to manage diabetes is a major confrontational issue, unfortunately it is a personal one.
Whilst People can help, be supportive etc etc, the ultimate choices are made by the individual with diabetes, at least anyone not under a mental health section.

The son of a friend of my wife had Type 1 and due to his emotions & relationships (girlfriend/others) ended up in a diabetic coma and suffered irreversible organ failure and the inevitable consequences of that.

Sorry for my rants, I am just concerned and can't say these things directly to her without things escalating in the wrong direction.

I am sure she is still at the denial stage of the change curve (aka grief curve) even though she was diagnosed in 2012.
 
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CherryAA

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2,171
Type of diabetes
Type 2
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Diet only
It's not a matter of good stuff v bad stuff, it's a desire not to eat that is the bigger issue.

She is an extremely good cook, managed our sons dietary needs including counting calories, GI balance etc.

Yes i could take over meal preparation, especially as i am short,y going to retire, which will give me more time for this.

But answer this, how if someone just losses interest in eating food in general does one turn it around? I try to face things in life head on, whereas she would rather avoid confrontational situations.

Like it or not tackling ones food intake to manage diabetes is a major confrontational issue, unfortunately it is a personal one.
Whilst People can help, be supportive etc etc, the ultimate choices are made by the individual with diabetes, at least anyone not under a mental health section.

The son of a friend of my wife had Type 1 and due to his emotions & relationships (girlfriend/others) ended up in a diabetic coma and suffered irreversible organ failure and the inevitable consequences of that.

Sorry for my rants, I am just concerned and can't say these things directly to her without things escalating in the wrong direction.

I am sure she is still in the denial stage of the change curve (aka grief curve) even though she was diagnosed in 2012.

It's not a rant ! - that is why the site exists, to try and provide some support and hopefully help people regain their health.

You mention that your wife is obese with lots of cravings , yet she doesn't eat a lot ? is that a fair summary?

That describes many of us in the early days, we feel so guilty about being fat, we try so hard to not be interested in food, so every day becomes a battle to try not to give into our cravings ( which we often fail at) and then not even getting any good nutrients, so we slowly starve ourselves into ill health with the best of intentions.

Obviously no one can put themselves in your wives shoes,so it would be very good if she could be persuaded to join here herself, she can be totally anonymous - its one of the lovely things about being able to speak to strangers on the internet.

If she can't be persuaded , then if you could educate yourself about a healthy diet for diabetics- which is often a very low carb but high fat diet - think of example - bacon and eggs sauteed in butter , just without the bread . it may be that you could prepare it, without mentioning anything about it in terms of a diet, and gradually allow her to actually fill up on the nutrients she needs but is possibly missing right now. You will probably find yourself very surprised at the wide range of foods that are recommended. For now your wife doesn't need to be on an actual diet, she simply needs to get the nutrients that are missing and gradually bring down her blood sugars - the weight loss will come after that especially if you try to steer her away from carb. heavy processed foods.

It is so hard when someone we love is in pain and we can't figure out how to help them. I hope you find a way.
 
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Resurgam

Expert
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9,849
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Type 2 (in remission!)
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Diet only
As your wife is often away from home and your retirement is imminent - I wonder if you could help by preparing breakfast for her before she goes out, or having something ready for her on her return.
It is fairly rare for someone to refuse food when it is there ready for them to eat, even if they claim to have no appetite. Get someone sitting at the table to have a cup of tea and it is amazing how much food vanishes over a drink and a chat.
It might be a good thing for you to be eating a low carb diet - I found that it was the only easy way to lose weight - on most diets I lost hardly anything at all except the will to go on living, but doing Atkins I bounce about like a Tigger.
 
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Jo_the_boat

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Messages
784
Type of diabetes
Type 2
Treatment type
Diet only
It's a difficult one for sure, particularly when your wife doesn't seem to want to help herself. You must be at your wit's end. YOU know that many suggestions on here are sound. It may be a bit off-the-wall, but how about showing her what can be achieved by doing it yourself?
Perhaps try a low carb diet yourself even though you are not diabetic.
If you have time perhaps you could also watch a video or two - they may give you, and through you, her, some inspiration.
There are a couple of links here..
http://www.diabetes.co.uk/forum/threads/a-doctor-awakens.127613/
http://www.diabetes.co.uk/forum/thr...-ivor-cummings-at-the-bacpr-yesterday.127479/

Good luck.
 
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Petrolhead276

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I do not have diabetes
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It's not a rant ! - that is why the site exists, to try and provide some support and hopefully help people regain their health.

You mention that your wife is obese with lots of cravings , yet she doesn't eat a lot ? is that a fair summary?

That describes many of us in the early days, we feel so guilty about being fat, we try so hard to not be interested in food, so every day becomes a battle to try not to give into our cravings ( which we often fail at) and then not even getting any good nutrients, so we slowly starve ourselves into ill health with the best of intentions.

Obviously no one can put themselves in your wives shoes,so it would be very good if she could be persuaded to join here herself, she can be totally anonymous - its one of the lovely things about being able to speak to strangers on the internet.

If she can't be persuaded , then if you could educate yourself about a healthy diet for diabetics- which is often a very low carb but high fat diet - think of example - bacon and eggs sauteed in butter , just without the bread . it may be that you could prepare it, without mentioning anything about it in terms of a diet, and gradually allow her to actually fill up on the nutrients she needs but is possibly missing right now. You will probably find yourself very surprised at the wide range of foods that are recommended. For now your wife doesn't need to be on an actual diet, she simply needs to get the nutrients that are missing and gradually bring down her blood sugars - the weight loss will come after that especially if you try to steer her away from carb. heavy processed foods.

It is so hard when someone we love is in pain and we can't figure out how to help them. I hope you find a way.

Cherryaa
Yes your first sentence is a fair summary. Thanks for the rest too.

However, with one crucial exception - It's not just since she became diabetic that she eats less, She has always eaten like a mouse, yet gained weight.
As a child (many years before I met her) she was even put on a diet after her mother who had taken her to the doctor about her weight, if I recall correctly it was salad after salad, strangely she still enjoys a salad now, but not for every meal (who would - rhetorical).

There is a rationale that I have heard many times:
whereby our bodies store fat from the good times for use in the lean times (caveman biology) and if one does not eat regularly then when foods does enter the body the body sends it straight to its energy store (FAT), so in reality eating too little can be equally as bad as eating too much.

One of our sons consultants summed up his weght gain very well.
"Stuart, you have to look at it like this, your body is very efficient and doesn't need much in terms of food (aka calories) to keep it going each day".

And my orthopaedic consultant who performed the surgery on the cam impingemt of my left hip was concerned about my weight (IMHO more that it might ruin his spotless reputation for no breaks of the femur post surgery), however, he said to me "you just need to stop eating"; and he wasn't joking either.
 
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CherryAA

Well-Known Member
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2,171
Type of diabetes
Type 2
Treatment type
Diet only
Cherryaa
Yes your first sentence is a fair summary. Thanks for the rest too.

However, with one crucial exception - It's not just since she became diabetic that she eats less, She has always eaten like a mouse, yet gained weight.
As a child (many years before I met her) she was even put on a diet after her mother who had taken her to the doctor about her weight, if I recall correctly it was salad after salad, strangely she still enjoys a salad now, but not for every meal (who would - rhetorical).

There is a rationale that I have heard many times:
whereby our bodies store fat from the good times for use in the lean times (caveman biology) and if one does not eat regularly then when foods does enter the body the body sends it straight to its energy store (FAT), so in reality eating too little can be equally as bad as eating too much.

One of our sons consultants summed up his weght gain very well.
"Stuart, you have to look at it like this, your body is very efficient and doesn't need much in terms of food (aka calories) to keep it going each day".

And my orthopaedic consultant who performed the surgery on the cam impingemt of my left hip was concerned about my weight (IMHO more that it might ruin his spotless reputation for no breaks of the femur post surgery), however, he said to me "you just need to stop eating"; and he wasn't joking either.

Unfortunately as a society we put more and more pressure on people to "lose weight " through eating less and exercising more ". Your wife isn't alone in dealing with the consequences of that. In my own case, many years of calorie restriction low fat eating did the same thing and resulted in my diabetes too. The human body needs proper nutrition , if you cana t least try a lower carb higher fat more nutrient dense way of and does not need to look like much food on the place, then maybe you can both find a way out of this logjam, like many of us have. Please give it a go. Sometimes when it seems like there is no hope, that one last try of something a little different can achieve something :)
goodluck