Just won a BG meter.. Update

[daisyduck]

I've just had a call from the Mail.. I've won one of 200 meters and consultation courses. I also get the Carbs and Cals book which is a bonus. I wonder how the telephone consultations will go ?
https://www.pressreader.com/uk/the-scottish-mail-on-sunday/20180211/283442076929161

 

[Guzzler]

Well done, what did you have to do to win?

 

[daisyduck]

Well done, what did you have to do to win?

Just fill in name and email and address . and tick to confirm I am type 2

 

[Guzzler]

Just fill in name and email and address . and tick to confirm I am type 2

Money for old rope, as they say. Well done.

 

[hankjam]

It's always nice to win things. I would make the observation that the meter itself is probably the cheap bit, buying the test strips is where the manufacturers make their dough and taken a customer away from their opposition.
I wouldn't say I won my Contour Next, they were giving them away but at the time I was not having much consistency with my Coda-free device, it had a mind of it's own. The strips for the Contour are a bit more for each 50, which I am happy to pay as I think the device is a lot better....
Rambling is over... sorry.

 

[lindijanice]

Awesome. daisyduck!! You need a little unexpected surprise Good luck with the interviews - maybe you can teach them a thing or two!! Cheers/L

 

[daisyduck]

It's always nice to win things. I would make the observation that the meter itself is probably the cheap bit, buying the test strips is where the manufacturers make their dough and taken a customer away from their opposition.
I wouldn't say I won my Contour Next, they were giving them away but at the time I was not having much consistency with my Coda-free device, it had a mind of it's own. The strips for the Contour are a bit more for each 50, which I am happy to pay as I think the device is a lot better....
Rambling is over... sorry.

Yes, I don't expect that they will supply many test strips but the article looks promising in that is encouraging people to test for control. I'll be going in with an open mind

 

[daisyduck]

Update. This is actually looking promising. This is one of the teaching modules. The app is not working well at the monent but they have linked me to an online course. Meter hasn't arrived yet but I'm supposed to read all the info and receive that before I talk to my "coach"



What is a low carb diet?
When we consume carbohydrate our body breaks it down into glucose, fructose and galactose. Our body releases insulin, in order to clear the glucose out of our blood and into the cells where it can be converted into energy. Insulin also promotes the storage of fat, so when insulin levels are high our body is in fat storage rather than fat burning mode. Consuming fats does not directly affect blood glucose levels, and as a results does not lead to an elevation in insulin. So, by replacing some of our carbohydrate intake with fat, we can reduce insulin levels and increase our body's ability to utilise its own fat stores for energy.

What foods are encouraged?

"Low" carbohydrate is defined as less than 130g per day, whereas "very low" carbohydrate is less than 50g per day. You may also be familiar with the term 'nutritional ketosis'. Ketones are a by-product of fat breakdown and become a primary energy source if people become fat adapted by adopting a very low carbohydrate diet. Different people have varying tolerances to carbohydrate, so will be able to consume different amounts whilst still achieving their goals.

The image above gives an overview of how many portions of each food group are recommended when following a low carbohydrate diet. Contrary to what many people think, most low carb high fat (LCHF) diets are not high in protein. Protein can be converted into glucose in the body, and can even cause a direct increase in insulin. Therefore having too much protein will undermine what a LCHF diet is trying to achieve. Moderate protein consumption of 2 to 3 portions per day is therefore recommended. This is only a guideline however, and some people can tolerate more protein - especially if they are physically active. Protein can also increase satiety, so including a portion of protein with a meal may help you feel fuller for longer.

When carbohydrate is restricted it is important to increase the levels of fat consumed. People often make the mistake of having a low carbohydrate AND low fat diet, which inevitably leads to hunger. Fat should be consumed to satiety, so eat as much as is required to make you feel full. You should however consider if you are actually hungry, and make sure you aren't simply eating due to stress or as an emotional response. Healthy natural sources of fat include olive oil, butter, coconut oil and the fats in grass-fed meats, eggs and dairy products. There is no need to be afraid of fats, including saturated fats and cholesterol - although trans-fats, partly hydrogenated vegetable oils (often found in junk foods) and refined vegetable oils should be avoided!

A LCHF diet should also include a lot of green-leafy vegetables, though consumption of starchy vegetables (such as potatoes and other root vegetables) and fruit should be limited due to their higher carbohydrate content.

Practical advice

• Hunger: Some people experience increased hunger on a LCHF diet. As stated above, this shouldn't be the case if people actually follow the "high fat" part of the diet; i.e. they eat fat to true fullness, as suggested. Lowering insulin levels and reducing insulin resistance can actually reduce hunger:
  
  
  
  
  
• Including a portion of protein and some high-fibre green leafy vegetables with meals can also increase feelings of fullness.
  
• Lack of variety: This is often a concern, as people worry they'll be eating the same thing all the time. This does not have to be true however, as there are a wide variety of meals and foods suitable for a LCHF approach. You'll find an article of low carb recipe suggestions in Learning 3: Strategies for Weight Loss.
  
• Nutritional deficiencies: It's also been suggested that following a LCHF approach can lead to deficiencies of certain vitamins and minerals. However, intervention trials have found no evidence of this. This is likely in part because "real" foods are more nutrient-dense than processed ones.
  
• "Low carb flu": Some people report feelings of lethargy, headaches and genuinely feeling unwell when starting a LCHF diet. This is simply because your body is used to using glucose as a primary fuel source, and needs some time to adapt to using fats. For most people in 7-10 days these symptoms pass as they become more fat adapted. Making sure you consume a sufficient amount of fluid and salt can help to prevent these symptoms.
  
• Cramping: As many foods that are high in carbohydrates also contain relatively high levels of salt, it is not uncommon for cramping to occur when you eliminate them. Insulin also causes sodium (salt) to be retained in the blood, so when insulin levels drop you also excrete more salt from your body in your urine. So as well as taking in less salt, we also lose more. This problem can be solved simply by adding some salt to your food.

 

[daisyduck]

Still talking a lot more sense than I've experienced from the NHS


Blood glucose, blood pressure, height and weight - your care team collect lots of different data when they monitor your health. But do you really understand what your health results mean?

Knowing and understanding what these numbers mean can be an important step towards better self-management of your health. Here's a beginners' guide to what those terms mean and why they're important:

BMI [kg/m2]

'Body Mass Index' or BMI is an assessment of your weight relative to your height. It gives an indication of whether you are underweight, normal weight, overweight or obese. You can calculate yours here: http://www.nhs.uk/tools/pages/healthyweightcalculator.aspx

If you're overweight or obese, there are major health benefits to be gained from losing even a small amount of weight. Excess weight makes it hard for your body to use insulin properly, so losing weight will also help you to control your blood glucose levels. BMI is limited though as it doesn't tell us anything about where on the body any excess fat is stored, which is important in relation to our health.

Waist size [cm]

Waist size is a measurement taken midway between your lower rib and hip bone. A waist circumference of 88cm or more in women, and 102cm or more in men, can indicate serious health risks. Carrying excess weight around your middle makes it harder to control your blood glucose levels, and increases your risk of developing heart disease.

Blood glucose [mmol/L]

Blood glucose levels give an indication of the amount of glucose in your blood – but only at the time when the blood sample is taken. Readings can be taken when fasting, pre-meal or 2 hours after a meal in order to monitor blood glucose in the absence or presence of food. A level of 7.0mmol/L or over when fasted, or of 11.1mmol/L or more after food, is the diagnosis criteria for Type 2 diabetes.

HbA1C or 'glycated haemoglobin' [mmol/mol]

This blood test measures the amount of glucose that's being carried by the red blood cells in the body. This gives an indication of the average level of glucose in your blood over the last 2-3 months. It can be a good indicator of how well your diabetes is being controlled.

An HbA1c level of 42-47 mmol/mol (6 – 6.4%) indicates pre diabetes whereas 48mmol/mol (6.5%) or above is diagnostic of diabetes.

Blood pressure [mmHg]

Blood pressure (BP) is the amount of force your blood exerts against the walls of your blood vessels. The first and largest number (systolic BP) is the pressure when the heart pumps the blood into the vessel. The second and smaller number (diastolic BP) is the pressure when the heart is at rest. Ideal BP is considered to be between 90/60 and 120/80 (as in the figure below). High blood pressure is 140/90 or higher, and low blood pressure 90/60 or lower.

Cholesterol [mmol/L]

Cholesterol is a waxy, fatty substance that is essential to life. It's made in the liver but can also be found in some foods. Cholesterol cannot mix with the blood, and so it is carried through the body by protein transporters called lipoproteins. If the levels of these transporters become unbalanced your risk of heart disease and stroke increases. Cholesterol can be measured through a simple blood test, but total cholesterol on its own is not a useful measure of health and it is more important to assess the levels of cholesterol in the different transporters (LDL and HDL described below).

HDL or high density lipoprotein [mmol/L]

HDL are particles that mop up excess cholesterol in the blood and carry it back to the liver, where it's either broken down or passed out of the body as a waste product. Having more HDL is therefore better, and the ideal level is 1mmol/L or above. Lower levels can increase your risk of heart disease. HDL levels increase with regular physical activity, consuming natural fats and through reducing carbs in your diet.

LDL or low density lipoprotein [mmol/L]

LDL carry cholesterol to where it is needed in your body. When these particles become small and dense, they become unstable and can drop their load (the cholesterol) causing a build-up of fatty deposits in the blood vessel walls. This increases the risk of heart disease and strokes. Large LDL are less harmful, as they are more stable transporters of cholesterol. There is no standard UK test to measure LDL size, but raised triglyceride levels and low levels of HDLs are thought to cause the problem.

Triglycerides

Triglycerides are a type of fat. Having raised levels of triglycerides in the blood can increase your risk of heart disease. Consuming too much carbohydrate and alcohol can increase your levels of triglycerides – but losing weight can help to reduce them.

Kidney function tests [ACR, eGFR]

Your kidneys filter blood, removing waste and water to make urine. There are two main kidney function tests conducted to judge how well your kidneys are working. The first test, known as the 'Albumin to Creatinine Ratio' (ACR) test, assesses how much protein is leaking into your urine.

The second test, known as the 'Estimated Glomerular Filtration Rate' (eGFR), measures how much blood your kidneys are filtering. The normal value is 90-120ml/min. A value below 60ml/min suggests there may be some kidney damage.

Liver function test [GGT]

Gamma-glutamyl transpeptidase (GGT), an enzyme found in the liver, is a marker for liver disease or excess sugar or alcohol consumption. This test provides a good indicator of the presence of diseases like fatty liver. Recommended levels of GGT are 11-50iu/L for men and 7-32 iu/L for women.

CVD disease 10 year risk score

The CVD risk score is a short questionnaire that uses a number of factors to calculate your risk of having a stroke or heart attack in the next 10 years. You can try this for yourself online here: https://qrisk.org/2016/

In summary...

You and your healthcare team may use some or all of these tests to help them monitor your health and wellbeing. Remember – the results they collect are your health results! Don't be afraid to ask what the numbers mean to you, and feel free to write them down and ask questions

 

[daisyduck]

Wow, these people must have been on this forum. They are actually telling me everything I've learned from here over the last few years

Today there are so many sources of information that it can be hard to sort fact from fiction. Here are some of the top food 'myths' that may be influencing your diet choices, along with the truth behind the tales…

MYTH 1: Losing weight is just about eating less

THE FACTS: Losing weight isn't as simple as eat less, move more - if it was, then everybody would be able to successfully lose weight and maintain their weight loss through willpower alone! The amount we eat is based largely on our hunger levels, which are controlled by our hormones. We can't overpower these hormones long-term just through determination, so it's important to make dietary decisions that help us to control the levels of these hormones in our body. This means that changing what we eat is more important than just changing how much we eat. If you simply try to eat less without considering these factors, then your will body respond by increasing hunger and reducing the amount of calories it burns. It's then only a matter of time before you lose that battle and start to regain any weight you may have lost.

MYTH 2: People with Type 2 diabetes should have regular meals and snacks

THE FACTS: Eating regularly increases the amount of time that blood glucose and blood insulin levels are raised, so having frequent meals and snacks is counter-productive when it comes to managing Type 2 diabetes - unless you've been prescribed medication that increases your risk of hypos. A better strategy is to maximise the amount of time you spend in a fasted state, to allow insulin levels to remain lower. Having consistently high insulin levels leads to increased insulin resistance. Also, your body isn't able to burn fat when your insulin levels are high. Avoiding snacking between meals is one way to achieve longer periods of time with lower insulin levels, whilst for some people intermittent fasting may be a suitable option.

MYTH 3: Low-fat dairy options are more healthy than high-fat dairy options

THE FACTS: The fats in dairy products like cheese, yoghurt and milk have been shown to be beneficial for health - so choosing low fat dairy products means you miss out on these health-promoting effects. The rate at which carbs in dairy products are absorbed into the body is also slowed down by the fats and proteins they contain - so choosing low fat dairy options will actually cause your blood glucose to raise quicker than it would from eating higher fat dairy products. This slowing down of glucose absorption helps you to feel fuller for longer, too. Another reason to avoid low-fat dairy products - particularly yoghurts - is because the fats in them are often replaced with sugars to improve the taste.

MYTH 4: All cereals are good for you

THE FACTS: There are a wide variety of breakfast cereals in supermarkets, and many are promoted as being healthy. However breakfast cereals are often highly processed, meaning they can cause spikes in blood glucose levels and contribute to insulin resistance. It's not essential to have breakfast, despite what many people think - but if you do choose to have breakfast then better options to help you manage your blood glucose levels include low/lower carb foods like avocados, eggs, or full-fat yoghurts (perhaps with a few berries or some seeds). If you do still want to have breakfast cereal, then non-processed options such as steel cut oats are a better choice.

MYTH 5: Red meat is bad for you and should be avoided

THE FACTS: Meat is a good source of protein, and contains lots of nutrients – including essential nutrients like iron. It contains an excellent balance of saturated and monounsaturated fat. In addition, meat from grass-fed cattle can also provide you with beneficial omega-3 fats. It's best to avoid eating meat from animals that have been factory farmed, as they are often raised in confined spaces and given antibiotics and steroids. Eating up to 500g, or 5-6 portions, of red meat a week can be part of a balanced diet.

MYTH 6: Eggs will raise your blood cholesterol levels

THE FACTS: While eggs do contain cholesterol, dietary cholesterol has never been shown to increase our risk of heart disease and strokes. Every cell in your body makes cholesterol – if you eat more, your body make less. So eating eggs does not make the level of cholesterol in our blood rise. And even if the cholesterol in our blood did rise, this has not been shown to increase our risk of cardiovascular disease anyway!

MYTH 7: Fruit juice provides lots of vitamins and is fat free, so it's very healthy

THE FACTS: Fruit juice is a concentrated source of carbohydrate that can result in high blood glucose levels. When you drink too much fruit juice, the fructose and glucose it contains is converted to triglycerides in the liver. These can lead to obesity and fatty liver disease. This also applies to unsweetened fruit juice. Although whole fruit is healthier than fruit juice it still contains glucose and fructose, so too much whole fruit can also negatively affect your blood glucose control and other aspects of health.

MYTH 8: Vegetable oils are good for your heart

THE FACTS: Most people believe vegetable oils are healthy, because they're made from vegetables! However, they are usually highly processed. Processed vegetable oils contain large quantities of omega-6 fats, which can cause inflammation in the body and cause cell damage. Vegetable oils can also be damaged by cooking with them at high temperatures, which increases their potentially harmful effects.

MYTH 9: Chocolate is full of sugar and should only be eaten to treat hypos (low blood sugar)

THE FACTS: Chocolate is not the best treatmentfor hypos, as the fat it contains can slow down absorption. The carbs in chocolate are sucrose, which contains fructose as well as glucose. Fructose has to be broken down in the liver rather than going straight into the blood, which means chocolate's effect on blood glucose is not as fast as the effect of a food that contains only glucose. A 20g bar of chocolate contains 12g of carbs and 7g of fat, and is fine to eat on occasion for people with diabetes. However dark, bitter chocolate is the best choice – as it contains much more fibre, less carbs, and additional beneficial nutrients called polyphenols.

MYTH 10: Avocados are unhealthy because they are loaded with fat

THE FACTS: Most fruit consists primarily of carbohydrate, while avocado is loaded with healthy fats, fibre and other important nutrients. Avocados and avocado oil are high in monounsaturated oleic acid, a 'heart healthy' fatty acid that is believed to be one of the main reasons for the health benefits of olive oil.

Discover any surprises? There are lots of things people believe about food which are not true. This can have a big impact on what we choose to eat, so it's important to understand what the truth is so you can make informed decisions on what to eat.

 

[Brunneria]

This is wonderful.
And astonishing.

Congratulations on winning!

 

[daisyduck]

This is wonderful.
And astonishing.

Congratulations on winning!

I must say the course is really pleasantly surprising me. It seems to be a pre launch app as they are having lots of problems getting it to work properly. They have been great in keeping in touch and have already taken on board my suggestion of linking it to Fitbits etc as at the moment it relies on the phone pedometer.. which, if you are like me.. I do not walk around with my phone all day.

 

[DJC3]

Really informative and useful. Thanks for sharing it @daisyduck

 

[Kentoldlady1]

Wow!! This is so much better than the xpert course I have just finished. Wonder if it will get taken up by the nhs? I am guessing not, as it doesn't seem to agree with current nhs advice or the useless eatwell guide.

 

[Glenmac]

@daisyduck This is really informative and useful,I think they've been on our site.Thankyou for posting.

 

[Bluetit1802]

This looks to me like a Dr. Trudi Deakin inspired app. and indeed the logo at the top says X-Pert Health, which makes this even more likely. It could be straight from her book Eat Fat. She is a member on this site, (@Deakint ) and is the founder of the X-Pert courses, but in addition to her own ideas she has to accommodate the NHS stuff in order to retain the contract to conduct them.
https://www.xperthealth.org.uk/

 

[daisyduck]

Here's some more info on the app

https://www.digitalhealth.net/2017/03/million-pound-diabetes-app-rolled-out-to-ccgs/

I'm a little further through it now and it also mentions intermittent fasting ( time controlled eating ) and the Mediterranean diet.

 

[daisyduck]

The Mediterranean approach is based on the traditional diet followed in countries such as Italy and Greece, where the rates of cardiovascular disease and obesity were typically lower. Research has confirmed that the Mediterranean diet can be effective for reducing cardiovascular disease risk, for helping to manage blood glucose levels, and helping to reduce weight.

As well as a focus on certain types of food this approach also centres on being physically active (a good recommendation for health whichever dietary approach you choose) and seeing meals as enjoyable, social occasions. These factors are thought to contribute to the positive effects on health associated with the Mediterranean diet.

What foods are encouraged?

The Mediterranean diet consists mainly of natural, homemade, unprocessed foods. It is lower in carbs than a typical Western diet, and the carbs it does contain have a lower glycaemic index or GI. This means that they slow down digestion and help prevent surges in blood glucose. This diet also tends to contain more fats, with a similar amount of fats and carbs consumed. There's no 'right way' to follow the Mediterranean diet, but here are some general guidelines to follow. Eat a real food diet incorporating good quality protein from fish, seafood, nuts, seeds, beans, grass-fed meats, eggs, cheese and yoghurt – along with some whole grains and whole fruits. Eat plenty of vegetables and flavour your food with herbs, spices and generous amounts of extra virgin olive oil. Avoid sugar-sweetened drinks, added sugars, processed meats, refined grains, refined oils and other highly processed foods completely.

The image above gives an overview of how many portions of each food group are recommended when following a Mediterranean diet. Although the foods commonly included as part of a Mediterranean diet are reasonably well known the actual breakdown of macronutrients involved (i.e. how much fat, carbohydrate and protein to eat) is a more controversial topic. A rough guideline would be that the amount of fats and carbohydrates consumed would be similar (40-45% of total energy intake respectively) with the rest of the energy coming from protein (about 15%). For people with Type 2 diabetes it is important to consider the total amount of carbohydrate consumed, and for some people this amount of carbohydrate may still be too much and could result in poor glycaemic control and weight management.

The Mediterranean diet is sometimes promoted as a low saturated fat diet, but this isn't really the case - as it commonly includes full-fat milk and dairy products and meals often finish with a cheese board.

 

[daisyduck]

More about intermittent fasting


The main reason for following a fasting diet, of which there are lots of versions, is to improve regulation of insulin levels by balancing times of feeding and 'fasting' (or 'not eating').

Insulin is an anabolic hormone which promotes the storage of nutrients in the body, including fat. When levels of insulin are high, such as after eating a high-carb meal or snack*, we are not able to burn fat. Fasting for extended periods allows our insulin levels to drop, resulting in periods where we are able to use our body's fat stores as energy. Fasting can therefore be beneficial for weight loss and for preventing insulin resistance; which is a key component of Type 2 diabetes.

The images below show how our eating patterns influence our insulin levels - and as a result, our ability to burn fat:

These images show how having frequent meals and snacks reduces the amount of time that the body is able to burn fat for energy - whereas in the bottom image, where only two meals are consumed, the fat burning opportunity is much greater!

Intermittent fasting is a dietary approach which cycles between times of feeding and fasting. Certain foods/macronutrients are not necessarily restricted - only the times when they are eaten. It is still not recommended to binge on low quality, low nutrition junk food in the non-fasting periods!

Some people have success with combining intermittent fasting with eating a low carbohydrate, high fat diet (LCHF). This is because the LCHF approach helps them adapt to burning fat, so they are better able to use their fat stores for energy during the fasting times.

There are many ways to undertake intermittent fasting, and ultimately the approach taken should be tailored to suit the individual's lifestyle (one again, one size doesn't fit all!). The main approaches are:

• Alternative day fasting: In this approach individuals alternate between days of fasting (having less than 500-600kcal) and days of habitual eating. Some choose to completely abstain from eating on the fasting days; e.g. they may have a final meal on a Monday evening, then not eat again until the Wednesday morning.
  
• The 5:2 Diet: On this approach you would eat as usual for five days and then fast (have less than 500-600kcal) on the other two days of the week. These two days are not normally consecutive, and can be changed from week to week to fit in with your schedule. There are other approaches similar to this, but with more (e.g. 4:3) or less (e.g. 6:1) fasting days.

• Time restricted eating: In this approach you select an eating window, usually between four (e.g. 2pm to 6pm) and eight hours (e.g. 11am to 7pm), and only eat during these times. This is commonly performed simply by skipping breakfast, which results in an extended fast between the previous evening's meal and lunch (or dinner if a longer fast is desired).

* Not all snacks and meals are equal when it comes to their effect on insulin levels. Foods with starchy carbohydrates (which are just chains of glucose) will cause a rapid rise in blood glucose and also insulin, whilst a high-fat meal with low or no carbs may cause a small increase or none at all.