Advice needed

[Beadysmum]

Hi

I visited my doctor last Monday after having classic diabetic symptoms. I was called back to see a nurse and had a fasting blood test the following day. The nurse had a brief chat with me about a healthy diet. However I feel that I have had very little support. I was very confused about what I should and shouldn't be eating so spent the week listing my diet. I had another appointment today. I felt that the nurse knew very little about dietary matters.Rather than discussing the list with me and telling me which things were better avoided, she seemed very quick to give me a prescription for Metformin.
I guess my questions are.should it be possible to control type 2 Diabetes by diet alone, and if so how long should it take to get it under control? I do feel a lot better in myself than I did last week but my eyes are still a little blurry. I will take the tablets if I really need them but am loathed to take them unless I really need to.

Any advice gratefully received

 

[Beadysmum]

Just as a PS I wonder if other viewers to the forum can tell me what support I should expect from my GP?

 

[Anonymous]

Welcome to the forum - someone will be along in a minute with a proper welcome message but I was just passing..

So have you not spoken to your doc about the diagnosis yet? The sort of advice and support you get can be very patchy. Many on here have to fight for the right help, but some like me have docs and DSN's who are more switched on and actually interested in learning about what suits you (me).

There are people on here who do it all on diet and there are some who reduce their medication by changing or controlling their diet. Metformin is generally regarded as a good medication - it's absolutely standard to be put on it, often with a dose that increases over the next few weeks as you get used to it.

There's lots of info on here and it's worth having a plough through old threads and reading the new ones that arrive - I lurk here quite a lot and have learnt tons.

S

 

[xyzzy]

Hello Beadysmum and welcome to the forum.

Daisy should be along soon with some useful info but in the meantime here's what I did. It worked for me and got my blood sugar levels back to normal within around a couple of months or so. Not a cure as I still have to be careful what I eat but am now feeling great! I am really happy that I have minimised the risk of all those nasty complications. I was diagnosed in early December last year so just 4 months ago and have now lost 3 stone in weight as well.

A quick bit on Metformin. Most newly diagnosed are put on Metformin. It is an effective and safe medication but you shouldn't treat it as a magic bullet. It will help with your sugar levels but nothing like as much as getting what you eat sorted out. Some people find it has some sides effects (running to the loo and such like) but in most this goes away after a few days. If it doesn't for you then go back and ask for the Slow Release (SR) version instead. If your doctor or nurse only prescribed you Metformin then you don't need to worry about telling the DVLA about having diabetes as the way Metformin works means it doesn't cause hypo's so you run the same risks as a non diabetic.

Diet wise its really easy. Just drastically cut down or better cut out all things with plain sugar, so biscuits, cakes, sugar in tea and coffee, pure fruit juices, non diet versions of soft drinks. Next try halving starchy foods like rice, pasta, potatoes, bread, cereals and any other flour based products. Replace what's now missing with extra meat, fish, eggs, cheese and especially vegetables. Vegetables that grow above ground are best although most of us find carrots fine. Things like yoghurt are fine as is a small amount of fresh fruit. I find the ones that end in "berry" are the best. If you don't mind artificial sweeteners things like Diet Coke are fine to drink. On the starchy foods that are left swap try brown basmati rice instead of white and brown or tri-colour pasta. The bread that most recommend is actually Bergen soya bread but some do ok with wholemeal as well.

The above diet is close to one you would be one recommended to try by the Swedish Health service. It was introduced in that country last year and the American health service and several other countries health services recommend something very similar. You may find it conflicts with advice given to you in this country as we have yet to update and still use older dietary recommendations. In fact we use diet guidelines that are over 30 years old. If you want to read more about the modern ways there is a thread discussing it with some useful links here http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=2&t=28402

Next most members would recommend you test your own blood sugar levels. Did your doctor give you a meter and strips? Some do and some don't. It's a bit of a post code lottery and we find some progressive surgeries are pro testing and others anti. I'll warn you the anti ones can sometimes be very vocally anti!

The reason testing is important is you should try and keep your blood sugars below 8ish two hours after eating any meal. Above the 8 value is where the dangers of complications do begin to occur according to diabetic experts. So if you can't test how will you now if what you are eating is keeping you safe? The problem is every diabetic is different so my earlier advice to halve starchy foods is just a rough guide. You may find you need to eat less than half (like me) or that you can eat more than half like others.

As you get into it all and read around the forum you may see people talking about carb counting. If you want to understand what that is just ask. It is a powerful weapon that a diabetic can use to control their condition and one that many of us use to great effect.

Good luck and keep asking questions.

 

[Beadysmum]

To be honest I have never felt SO alone in my life.my husband just tells me that I'm not the only person feeling ill. I am not attention seeking just scared because this feels like the end of the road

 

[daisy1]

Hi Beadysmum and welcome to the forum There are a lot of people who want to be your friends here and you have seen the welcome they have given to you already. Do not feel you are the only one. Here is some information which I hope will help you to get good levels and either not need Metformin or take it for a little while and maybe not need it any more after a while. It depends on the person as we are all different. It will help you anyway as it has other good effects including benefits to your heart. I take it. Ask as many questions as you like as there is always someone here to help.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS


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 30,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

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

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.
-------------------------------------------------------------------------------------------------------------------------------------------------------

Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.

 

[xyzzy]

To be honest I have never felt SO alone in my life.my husband just tells me that I'm not the only person feeling ill. I am not attention seeking just scared because this feels like the end of the road

You are not seeking attention but are just confused and frightened about what it all means. All of us were like that to start with. Some partners do have problems accepting the diagnosis but they usually come round in the end. If you continue having problems with the other half just ask for advice and you'll get loads!

 

[borofergie]

I guess my questions are.should it be possible to control type 2 Diabetes by diet alone, and if so how long should it take to get it under control? I do feel a lot better in myself than I did last week but my eyes are still a little blurry. I will take the tablets if I really need them but am loathed to take them unless I really need to.

Can you control T2 with diet alone? Possibly.
Can you control it with diet plus metformin? Probably.

It all depends on your will power and (to a larger extent) on the state of your pancreas. Try doing as Daisy and xyzzy suggest and work out how you can reduce your carbohydrate intake. I managed to get my BG under control in about 2 weeks, others struggle for longer, but the great thing about Diabetes is that you can see your progress as you make it using a BG meter.

I wouldn't worry about metformin, apart from some upset tummy type side effects when you first start, it really is a great drug with lots of benefits. I can't remember who, but someone on the Forum was told by their GP that (s)he would prescribe metformin to everyone (diabetic and non-diabetic alike) if the NHS budget would allow for it.

If that doesn't work and you end up needing more drugs and least you'll know you tried.

 

[Grazer]

Just as a PS I wonder if other viewers to the forum can tell me what support I should expect from my GP?

Hi and welcome! Really not as bad as you might think. Take charge through diet and exercise with the advice you've had above. In terms of support from the doctor - it does vary immensely, but one thing you should know is the detail of your diagnosis. That is, the results of your blood test that led to diagnosis, including the "units" of the measurement to avoid confusion. It might not mean much to you now, but you MUST know it so you can track progress in the future when you get follow up tests. Just ring the doctor's surgery, ask for the results and "what TYPE of test was that?" and "In what units?" (was it a %age, a number in mmols/l....) You are entitled to know by the way.
Good luck and keep talking to us.

 

[catza]

Hi Beadysmum, I know you have been given lots of information already and, if you are like I was when I was first diagnosed and stumbled upon this forum, you will be feeling a tad overwhelmed. Well you have taken the first step so now read as many threads on here as you can, ask any question, no matter how silly it may seem. and it will start to make more sense.

Never feel alone, you have us here to talk to and we all know how you are feeling as we have all been in the same situation.

catza

 

[Beadysmum]

Many,many thanks for all your comments. They really are helping but I feel very confused. I spent yesterday printing out a whole load of recipes. I love cooking and baking and really want to find recipes that the whole family can enjoy. I seem to have found conflicting opinions about carbs (unless I have read it wrong,which is more than likely. Is pasta and rice good or bad and should I be avoiding the white versions (which I prefer).
Can I run a menu past everyone and can someone tell me if it's good or bad........please!
Spicy tomato soup recipe from support forum
Soda bread
Cheese

Pudding - pear and raspberry crumble

I make this with no sugar just a little canderel
and white flour.

I usually make my own soda bread.It's really easy and has no sugar but obviously loads of flour.I usually use white but open to suggestions?

So many questions but am trying to do this one day at the time.

 

[Grazer]

Hi!
To answer your questions:-
Pasta is not so good, but a small amount might be ok. I have wholewheat pasta rather than white, once a week
Rice is not good, but if you have a little now and again, use Basmati rice.
Flour is BAD. White flour very bad. People on this forum often use almond flour as a substitute. There are recipes using it on the low carb diet forum.
In general, try these things but test your blood 2 hours after eating them. If your readings are over 8, then don't have them again, or have a smaller portion.

 

[Beadysmum]

Hi

Thanks for that. What does every one have in stead of bread because flour kind of rules out pastry too. I am a little shocked because I had actually presented my diabetic nurse with a list of all the things that I had eaten during the week. It included macaroni cheese,pasta and curry with rice!

One more question? How do I test my blood? I assume this is the pin prick test but my nurse has not even suggested giving me one. I haven't seen a doctor since my initial visit and the nurse doesn't want to see me for another 2.5 weeks. Should I be asking for more help?

 

[Ann19]

Hi, most of us can tolerate Burgen, Soya and Linseed bread. It's a lot lower in carbs than white or wholemeal bread and low GI.

You need to test your blood as in the information posted by Daisy. Your Doctor may give you a meter and strips, but most refuse so we buy or own. There is NO way you can tell what effect a food has on you unless you test.

I avoid potatoes apart from 1 roast, the fat slows down the digestion so I found by testing that 1 doesn't effect me. I also avoid rice , pasta and anything with flour in it. Most cereals will send my levels up, but I can tolerate a small amount of porridge. Usually I have about 30g of Lizi's granola, half a total yoghurt, a bit of milk and some raspberries with a few spoonfuls of seeds(sunflower,pumpkin and linseed).

The NHS seems to push a diet that includes a lot of carbs, but any carb you eat turns to glucose in your blood and that is what as diabetics we can't process.

If you test and don't understand what the readings show then ask, there's always somebody around that can help. It's a minefield at first till you get your head around it and then it will all fall into place for you.

Ann

 

[hanadr]

Beady'mum,
there's a lis of thee monitoring you Should be receiving on the Diabetes UK website. there are 15 points on it.
Download and take with you to appointments.
Some GPs cannot give good support, they don't know enough. Sadly that's also true for some diabetes Specialist Nurses.
they tend to rpeat what they learned on "The Warwick Course" It's regarded as the highest level of training, but is actiually sadly out of date.
Most nurses and many doctors just don't know the molecular biology required to understand diabetes prroperly.
Hana

 

[borofergie]

T2 diabetes is a disease that could just as easily be called "carbohydrate intolerance". If you want to control it then you need to resign yourself to managing your carbohydrate intake (whether by portion control, GI or carb-counting). The best description of a diabetic diet is from our Swedish friend xyzzy:

The diet consists of meat, fish, shellfish, eggs, vegetables, legumes and vegetable proteins and fats from olive oil and butter. The diet includes less sugar, bread, cereals, potatoes, root vegetables and rice than a traditional diabetes diet.

By a traditional diabetic diet they mean the stupid "eat starchy carbs with every meal" and "half of your energy intake should be from carbohydrates" rubbish that the NHS is likely to advise you to eat. Have a listen to the news today if you want to find out how effective that is at controlling diabetic complications.

The good news is that with a few dietary adjustments you should be able to reduce your Diabetes to a mild inconvenience.

If you don't want to manage your intake of carbohydrates then the only other choice is more medication (which has consequences all of its own).

Hi, most of us can tolerate Burgen, Soya and Linseed bread. It's a lot lower in carbs than white or wholemeal bread and low GI.

Most of us can tolerate it in small quantities (one or two slices max), large rounds of toast and sandwiches are still going to cause a big old spike.

 

[the east man]

As usual all good advice. My only conern is the NICE results 2 hours after a meal. It has now been proven that complications start when your BG levels are over 7.8, so I would always aim for that target after a meal. Again, it's not for everyone, but I eat a Low Carb High Fat diet. I know it's hard for some people to get their head round eating lots of fat after years of being told not to, but lots of experts are starting to think we have got it wrong over the last 30 years. check out these websites bloodsugar101.com and dietdoctor.com. Good luck and keep the head up, we all have went through the desperation stage, now I just take as part of my everyday life.

 

[xyzzy]

I know it's hard for some people to get their head round eating lots of fat after years of being told not to

Yes that got me for a while. How can it possibly work I thought? Yet 4 months after diagnosis I'm sitting here with the blood sugar levels of a healthy non diabetic and for the first time in years my Cholesterol levels are in the normal safe range. Oh and I'm 3 stone lighter. All a coincidence?

What's not recognised is that this low carb high fat (LCHF) regime (it is not a diet) is what diabetics were told to eat prior to the introduction of the high carb low fat (HCLF) guidelines in the 1980's. There is nothing inherently wrong with a healthy balanced HCLF regime for the normal non daibetic population but recommending it for diabetics, especially T2's is like recommending alcoholics drink vodka. It is madness. As borofergie says I state and show in many of my posts that countries such as Sweden, America, Germany and others are increasing promoting LCHF for diabetics. Sweden even promotes LCHF for its general population as well! Just remember Sweden is thought to have the most progressive state run health system in the world. I would like the UK to follow their excellent lead as we are increasingly looking outdated.

 

[Beadysmum]

Hi

I invested in a burgeon loaf which I love. I made a moussaka from a recipe I found on the forum. being a veggie I had to swap the beef for quorn.I assume that quorn is ok? I must admit that apart from my fears,I am really enjoying trying new foods and recipes. Can I possibly just ask you all about a few more food stuffs. Is low calorie hot chocolate ok once in a while, what about honey,diet yogurts and weight watchers jellies(the only ones I usually eat as they are vegetarian?

 

[cteld]

Hi Beadysmum,

I'm a prediabetic who has reduced her blood sugar rises by quite a bit through low-carbing. At first I called it eating lowish-carb, but then when I kept reducing and reducing the carbs, I finally and shamefacedly had to admit I was on the low-carb bandwagon - driving it sometimes, even.

If you're a vegetarian, cutting carbs enough to control blood sugars is harder but still possible. You may want to focus on getting your protein from dairy, nuts and eggs rather than beans and grains, which are MUCH higher in carbs.

You ask about forbidden foods...pretty much EVERYTHING is okay (if in very small quantities) once in a while if your control is good. If it's sketchy, best to be stricter. How do you know if it's okay? Testing is the ONLY way.

Spending a day checking your blood sugar before and after meals (right before, then 1 hour afterwards, then 2 hours, then every hour until it's back at fasting levels) is VERY educational. You use up a lot of test strips but get a LOT of information you can use to modify your diet. Without that, I don't even know if long-term blood sugar control is possible. You learn SO MUCH, and the more you test, the more you learn.

One paradigm that helped me enormously was offered by Jenny Ruhl of BloodSugar101. She said to limit your carbs to those you most value. I gradually began to realize that grains were not what I most valued, either for taste or health. Yes, I loved rice and oats and wheat and potatoes. But I can live without them, after being a mostly-grain person for all my four decades of life, if that means making my last four (hopefully) complications-free. So now I don't eat a carb food unless it's something I either LOVE the taste of or has significant nutritional qualities.