Diabetic and angry!

[sueturnersmith]

I was diagnosed Type 2 and given Metformin - 2x500g 3 months ago.

I still can't get my head round it all, and haven't got a clue what I'm supposed to be doing! I was given a BG meter, after I said I wanted to be pro-active, and was told to test once a day at varying times - ie, day 1 - before breakfast, day 2 - before lunch, day 3 before dinner, day 4 - 2hrs after dinner, day 5 - before bedtime, and rolling onwards. This didn't seem to give me any clue as to what was happening, so I bought another meter and some strips (which I can barely afford as a low income pensioner), and my readings vary up to 12.9 after some meals.

I was told I would be given an appointment with the Diabetic Nurse every 6 months, who would test my levels then. I feel that I am being left to my own devices, and am totally lost! I am 63 years old, have heart failure and Ischaemic heart disease, and am very worried. I don't know what diet to follow - high carb, low carb, low fat, whatever? I'm overweight, but have lost 1.5 stone recently, and due to my heart problems and previous ovarian cancer I am mostly wheelchair bound and cannot really exercise.

I really need help, and hope that someone can point me in the right direction - please?

 

[cugila]

Sue.
Was slightly puzzled by your post as most newly diagnosed are pointed in the direction of the Basic Advice that another Sue and I regularly post here. After checking out your posts it seems your very first post was in the Food Forum...... It got missed out because we were both on Holiday and were not around much. Shame it wasn't picked up earlier, we might have been able to save you 3 months of angst !

Anyway, as you are still having problems, here is that advice which you should read as there is stuff there that may help you get to grips with things. BTW, there is no 'high carbs' diet, that is a myth put about by some of those who severely restrict carbs, they really mean it is just higher than what they do ! The amount of carbs you consume will vary from individual to individual and is that person's choice. Your diet should contain only the amount that is needed to give you good control and nutrition. I consume about 40-50g per day just now, at other times it has been no more than 80-90g per day. I use low fat, low salt, low GI and GL. Forget about a particular 'type' of diet, it is a lifestyle.......for life.

As for your testing advice. That's not a great deal of use to someone newly diagnosed. The advice we give here is far better and once an understanding is gained then the regime can ease off after a while.

Here is the advice we usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, Diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

The main carbs to avoid OR reduce are the complex or starchy Carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of Insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause Insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting Carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total Carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a Diabetic.


As for a tester, try asking the Nurse/Doctor and explain that you want to be proactive in managing your own Diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try !!

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l........(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l.....( Type 2)

2hrs after meals....... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.


Ken / Sue.

As for exercise........for someone with mobility problems Resistance Bands are a good thing to use. You can use them whilst sitting and they are also very cheap. Once you can move more freely then the exercise can be stepped up to a level that is more intensive. As a CABG (2004) survivor I used them myself and they vastly improved my health and fitness levels.

 

[cloverly]

This has been really useful info for me too, i was told diabetics need to eat carbs with each meal. I really wasnt given any dietry advice either, just some leaflets.
I'm going to try the testing levels before and after meals etc and see how it goes x

 

[the_anticarb]

I don't believe you have to eat carbs with every meal (some do, some don't ) but what you need to do is make sure that you have the ability to process whatever carbs you eat - either through eating the right kinds of carbs that won't spike your blood sugar levels (low gi approach) or by taking the right amount of medication to process the carbs (this is more common in type 1s on insulin). Yes it can be very confusing! The metformin will make the insulin you do have in your system work better, by increasing cells sensitivity to it, but you won't go hypo if you eat a low carb meal with metformin (unlike some other tablets). I used to low carb, but found that it got too restrictive after a while, so now I use the approach that I'll eat what I think I need (and sometimes even - what I want) but test afterwards to make sure I don't go too high -12.7 as I'm sure you're aware is way too high after a meal you should aim to be below 9. You may find a low GI approach works for you -everyone is different so unfortunately it's not as easy as saying 'do eat this/don't eat that'.

Best of luck

 

[Daibell]

I can only add to what others have said ref carbs i.e. you must measure how they affect you and adjust accordingly. This evening I had an average piece of raspberry tart; just fresh raspberries (no sugar covering) and average pastry but guess what - 13.7 on the meter 2 hours later! Carbs really do hit me hard so I have to keep portions quite low. They may have a different effect on you but testing is the only way to find out. In general carbs are a problem for many type 2s so I ignore comments like 'eat starchy carbs with every meal' as poor advice; there is no medical evidence that you have to do that - just be sensible and get to know your own body response to food types.

 

[Sid Bonkers]

This evening I had an average piece of raspberry tart; just fresh raspberries (no sugar covering) and average pastry but guess what - 13.7 on the meter 2 hours later!

I think that average is a funny word as it will mean different things to different people, I read on here all the time people saying "I ate an average sized piece of (insert carb rich food stuff) and my bg went through the roof so I cant eat that any more"

In most health service/dietitians leaflets it talks about portion sizes as being "the size of your fist" or "what you can hold in your cupped hand" .

I still think there are many people, even some of the good people on this site, who still eat larger portions than perhaps is good for them. Let me qualify that, I have found that recently I can eat cornflakes for breakfast, now for over a year even an average amount of breakfast cereal would have put me into double figures and I used to just have a half a grapefruit. Now if I eat what I would call an average portion of cornflakes it would still put me over my target numbers but 20g I can get away with. I read in another thread recently someone saying "all they had was 40g of cereal" well this morning I thought I would do an experiment and I poured cornflakes into my cupped hand and guess what 18grams was the maximum I could hold and although I dont have hands like shovels I dont have small hand either. So I can't eat what I would call an average sized portion but I can eat what the NHS suggests is a portion.

Other portions that I regularly eat are 2 table spoons of basmati rice, about a handful I would guess, 3 small roast potatoes or 4 very small new potatoes, again about a handful.

I very occasionally eat fish n chips and I eat about 6 to 12 chips depending on the chip size, roughly what I could cup in my hand, I could not eat even half of what the average chippy calls a small portion of chips let alone an average sized portion :lol:

 

[josie38]

Hi,


i agree sid it is all about portion control. As you say most people have what they class as average size but it is not that way. I was advised to eat portions that you could fit in you hands with carbs and with meat a piece that is the size of your palm and fish the size of your whole hand (from thumb to fingertips) and unlimited veg


Josie

 

[hanadr]

If despite taking medication, the blood glucose readings don't come down, there are essentially only a couple of things you can do
1] with your doctor's help change your dose or your medication
2] Controll your carbs
Increasing your exercise can help a bit too, but only if the problem isn't too big. in this cold weather, turning down the heating can make a difference.
to the people who have been told that you NEED carbs. That is NOT true. If you never ate another carb in your life, you wouldn't come to any harm. Your liver can make all that you need from protein. If anyone tells you carbs are essential, ask them to show you the scientific study that proves it. You'll wait a LONG TIME.
Hana

 

[noblehead]

to the people who have been told that you NEED carbs. That is NOT true. If you never ate another carb in your life, you wouldn't come to any harm. Hana

Oh dear! :roll:

Nigel

 

[jaykay]

Does anyone know, is the hand thing a realistic measurement? I only ask because I'm 5'9" and have huge hands! :shock: From my thumb to my little finger, I can stretch 11 notes on a piano ( some people struggle with an octave i.e. 8 notes) and my hands are bigger than those belonging to my 6'2" son. So if I use a handful of anything it's not necessarily a small amount.

 

[MegaMan]

to the people who have been told that you NEED carbs. That is NOT true. If you never ate another carb in your life, you wouldn't come to any harm.
Hana

Not a 100% correct

 

[Gazhay]

You need to be very careful.

Things stated as 0 carbs, are often using polyols (sugar alcohols).
They *can* and *do* effect some people as much as carbohydrates.
Other people they have no effect, as usual, it's a try it and see thing.

If you do go for total carb eradication, you need to pay careful attention to your protein intake.

 

[smidge]

Does anyone know, is the hand thing a realistic measurement? I only ask because I'm 5'9" and have huge hands!

Hey Jaykay, I'm hoping not, because I'm only 5' and have tiny hands - I'll starve :lol:

 

[jaykay]

:lol: Smidge! Maybe you'd have to cheat and use 2 hands! I just wondered if it was just a 'convenient' measure or if there was some kind of correlation between hand size and ability to metabolise...ever hopeful me

 

[Keith from Bath]

Diagnosed in August with all clasic symptoms
Went on a a Desmond course and still ended up confused.
Told to eat Basamiti rice rather than Brown and multi seeded bread...which luckily I really like!
After losing 2 and half stone , I have stabilised at 12s4lb and have mainly avoided all sweets, pastries etc.
My gripe is the refusal to supply test strips and have to buy from Abbots at £14.50 for 50
Cant rwally afford it...certainly cant do regular tests which nurse says isnt necessary....but how can i check how I am doing without a test?
typically 6.6 before breakfast, 6-7 before evening meal and 8-9 at bedtime. Last 3 month check was 7.1
My biggest problem is painful feet. Baking hot and throb at night. Painful to walk on . Balls of feet feel swollen. But no one seems to care or offer any advice!
Such a misconception that Diabetes is no big deal! typical is my daughter who says @ my boss has diabetes and She eats cheese and cake and drinks red wine etc etc!
feel better for sounding off but feet still hurt and are stopping me from sleeping!
keith from Bath

 

[daisy1]

Hi Keith - your boss (your daughter's boss? not sure) isn't doing too badly 2 out of 3! The cakes are a no-no but cheese has no carbs although if you still need to watch your weight (after weight loss it's quite easy for it to go back on again) it's not advisable as it contains lots of fat. Now for the good news - red wine actually lowers your levels so you can go ahead and have some Of course if you still need to lose weight don't overdo it - well don't overdo it anyway 8) I am not giving your daughter's boss advice - this is for you.

 

[hanadr]

Mega Man
Please show me the EVIDENCE that any carb at all is necessary or that someone was harmed by not eating them.
I've been looking for years and failed to find it.
Hana
That doesn't mean that some carbs are not nice, but you DON'T NEED them

 

[MegaMan]

well if any cystic fibrosis person who also has diabetes stopped eating carbs, they would loses weight at a dramatic rate become very ill end up in hospital and if they still refused carbs then they would die.

When I was in hospital once, they were not giving me the right diet because they didn’t have any CF team so didn’t understand what to do. I dropped from 55 to 44kg as soon as my carb intake went back the weight started going up.

So I don't think I will cut the carbs out It would have been better to say some people can cut carb out but others must have carbs. I've been diabetic for 7 years and I've always had a high carb diet and as hard as I try my weigh has never gone above 60kg I know I'm a special case but I still don't think people should cut carbs out 100%

 

[HLW]

Well personally I'm a human, and I assume everyone else posting here is too, so our ancestors have evolved to eat carbohydrates (fruit, vegetables, wheat, milk etc), they are a part of our normal diet. I (and many of my fellow humans) are part of a select group of adult mammals that can digest milk, we have evolved to do this, it isn't some fancy modern invention. Eating fruit/plants in general isn't some fancy modern thing either, most if not all primates do (there might be some that eat just meat, I don't know).

 

[Happyyo]

Some advice for 'Diabetic and Angry': Make sure you have three filling good meals a day and record the results from your blood sugar monitor. After a couple of weeks take the results to your Diabetes Specialist/Doctor and he/she will help you adapt your insulin doses to suit you and hopefully make you feel better. Hows that for keeping it simple!

Best Wishes