New type 2 and a bit confused

[seamatt]

Hello!

I am a newly diagnosed (well end of August) type 2. For the first month I was left to my own devices and carried on with my weight loss. A couple of days before my first visit with the Diab nurse I found the forums and have been reading a lot since.

I told the Nurse and she said I was better off carrying on with a balanced diet, and to just have wholemeal bread, pasta etc and no artificial sugar. I had lost more weight as have been the model of fitness freak since diagnosis, so she was pleased. My BP was down as well, as it was quite high at diagnosis.

I managed to get a glucose meter and test strips, and have been doing some testing after meals to see how it affects me. I was told to do it 1-2 hours after food. This is what I have so far.

Date Time Food Time after eating Reading
22/09/2012 16:30 Turkey Sandwich x 2 1 hour 6.5
23/09/2012 14:25 stir fry 2 hour 4.6
26/09/2012 11:00 Porridge, Blueberries, Strawberries 2 Hour 6.2
28/09/2012 14:50 chicken, savoury rice 2 hour 5.5
02/10/2012 17:10 wholemeal pita - x1 Linda Mcart Sausage x 2 1 hour 5.7
04/10/2012 15:50 Wholemeal Sub roll, turkey, salad 2 hour 5.1

Now from what I have read this looks ok? So should I just keep on the way I am, or will I not know until I have my first HBA1C at the end of October.

Thanks

 

[Grazer]

They're good results. What about your other meals though? These look more like breakfast and snacky lunches; main meals?

 

[seamatt]

Hi Grazer, I tend to eat the chicken and rice quite a lot as my main meal, and also the stir fry. I have organic oats made with water with 80 grams of mixed blueberries and strawberries every day for breakfast.

I usually have a sandwich/salad or pitta for lunch and then chicken and rice or stir fry for dinner. I keep a full food journal on MyFitnessPal.com.

I tend to eat quite repetitive, as it keeps me focused on eating well. I do have wholegrain cracker breads and cheese as a snack most evenings, but they are quite low carb so can't see that being a problem.

Thanks again for the reply, I really appreciate it.

 

[seamatt]

I forgot to say in the original post that I want to keep my condition as diet controlled if possible, so am very keen to do all the 'right' things and see if my body can do it.

 

[daisy1]

Hi seamatt and welcome to the forum

Here is the information we give to new members and I hope you will find it helpful. Ask all the questions you like as there is always someone who can 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.
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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.

 

[Grazer]

Hi Grazer, I tend to eat the chicken and rice quite a lot as my main meal, and also the stir fry. I have organic oats made with water with 80 grams of mixed blueberries and strawberries every day for breakfast.

I usually have a sandwich/salad or pitta for lunch and then chicken and rice or stir fry for dinner. I keep a full food journal on MyFitnessPal.com.

I tend to eat quite repetitive, as it keeps me focused on eating well. I do have wholegrain cracker breads and cheese as a snack most evenings, but they are quite low carb so can't see that being a problem.

Thanks again for the reply, I really appreciate it.

Hi again. The sandwich/pitta is quite high in carbs, and rice is very high. Swapping the rice for salad or other veg fairly regularly would help a lot. Oats are also high in carbs, organic or not. If you get the results, then ok, but if you want to keep your levels even better on diet, you may need to adjust a little.

 

[seamatt]

Thanks both.

I know the carbs are a little high with the rice and bread, but with the levels I have are they OK?

My nurse says I should be aiming for 300g or under carbs a day. At the moment I am under that......I think this is why I am a bit confused, as my test levels seem to be OK, where some people say the food is high.

Sorry if I am coming across as a bit thick :lol:

 

[Fraddycat]

Hi Seamatt, You are right, your levels are pretty good and so there is no real need for you to change your right now. However diabetes is a progressive disease and there may be a time in the future that you would need to move those levels down a bit to maintain the same level of control.

Many of us have read Gary Taubes - Why we get fat, which discusses the unneccessary role of carbohydrates in our diet and there are many other books and articles on this subject and so we choose to live with a very low carb diet, excluding many of the foods that Grazer highlighted in his post. I personally eat similarly in that I choose not to eat rice, pasta or pitta, and even porridge, even though porridge doesn't have a significant impact on my BG, because then I don't get some other symptoms, like extreme tiredness, and rapid hunger sometime 2 hours or less later, which I feel is caused by carbs.

I sometimes treat myself to carbs but not to rice or pitta, maybe to a square of chocolate or a biscuit, or a glass of vino.

 

[seamatt]

Thanks Fraddycat

I am loosing a lot of weight as well and am exercising 6 days a week at the moment. My doctor gave me the impression that it does not have to be progressive and even mentioned reversibility? Is this an option?

 

[Fraddycat]

That's a tough question to answer Seamatt because every 'body' is different. Different bodies/pancreases (or whatever the plural is) respond in different ways. I personally followed my GPs advise for 2 years and got progressively worse, needing more and scarier meds. I was 'threatened' with insulin - seriously threatened if I didn't lose weight, but they were still pushing the carbs with every meal, balanced diet with 40 - 50% of nutrition coming from carbs.

I KNEW something was wrong with my diet, I went to the DN and asked for help but she had nothing except the same old song, she referred me to the dietician in July and I have just got an appointment through for November (!)

But then I found this place, after two unhappy years. Since July I have been following a very low carb diet, I feel FAB, have lost 2 stone in weight, have managed to increase my fitness level and feel 10 years younger. I am not saying to you that what I am doing by cutting out bread, pasta, rice and potatoes, is the only way to go, everyone has to find their own path by experimenting, testing and keeping a track. Many people have 'eat to your meter' as their signature and that is the way to find out what works for you. Test, test, test.

Good luck!

 

[seamatt]

Thanks again Fraddycat

I am quite lucky that I was already on a weightloss kick from the start of the year, and am now just cranking it up to 11. I was/am very overweight through enjoying too many sedentary activities and eating badly.

I am a bit wary of low carb as I did Atkins once for 8 months in a desperate attempt to loose weight (which I did) but suffered terrible migraines and tierdness for most of it. I am just now trying to burn my food/fat off with lots of exercise.

I don't know a lot about this condition, and have only see the worst of it with an uncle going through all of the 'complications' before it killing him, and I am terrified of it.

Thanks again for your replies, and I will just see what happens after my first HBA1C at the end of the month.

 

[Grazer]

My doctor gave me the impression that it does not have to be progressive and even mentioned reversibility?

Your doctor ought to know better, although many don't. People talk about "reversing" their diabetes because they get their BGs down to normal levels through diet and exercise, but that's not "reversing" it (implying a cure); it's managing it. Eat a mars bar and compare your Bgs to a non-diabetic doing the same and you'll soon see it's not cured. There is a school of thought that suggests a pre-diabetic caught early, just suffering from insulin resistance, can effectively "cure" their diabetes with an extreme short-term diet, but if you have full blown diabetes with a loss of pancreatic function, you're down to managing it not curing it, until thery find a magic pill to make beta cells grow again.
Your figures are good as I said before, but personally I'd still be cutting back on the rice etc to get them even better and closer to normal. You don't need to go Atkins if you don't have to, and you obviously don't, but swapping the starchy carbs like rice for healthier veg would help your next HbA1c a lot. Up to you of course, and if you're wed to rice, then go for it and well done on all the other improvements.

 

[seamatt]

Thanks Grazer

Appreciate all the advise. My diet is in a massive overhaul at the moment so I will keep an eye on what everything is doing to me now. It looks like I was very lucky to get a meter and test strips from what I am reading, so will make good use of it.

Are my levels the same as normal though? they were all under 7 after food, or do I need to be below another number.

Thanks again for all your help.

 

[Grazer]

Under 7 is good, although most non-diabetics would be below 5.5 two hours after eating. So I suppose that would be considered truly normal. We can't always get there, but some of us strive for it. 7.8 is the MAX a non diabetic would get to two hours after a very carby meal, so that's the other end of the target spectrum. Where you set your target is a personal thing.

 

[Defren]

Thanks Grazer

Appreciate all the advise. My diet is in a massive overhaul at the moment so I will keep an eye on what everything is doing to me now. It looks like I was very lucky to get a meter and test strips from what I am reading, so will make good use of it.

Are my levels the same as normal though? they were all under 7 after food, or do I need to be below another number.

Thanks again for all your help.

Your figures are good, but like Grazer told you, your GP needs his knuckles rapped. Diabetes is progressive, even some who keep very low tight BG find they get more and more intolerant to carbs, and end up having to restrict their diet or take more powerful medication. None of us can say for sure how our diabetes will progress, if at all, but to say it can be reversed is naughty. Once a diabetic, always a diabetic.

 

[seamatt]

Wow what a punch in the gut

I was told that it does not have to be progressive, and that it could be reversed or at least not get any worse. Worst nightmare is back

 

[Grazer]

Wow what a punch in the gut

I was told that it does not have to be progressive, and that it could be reversed or at least not get any worse. Worst nightmare is back

Don't panic too quick. Although you can't "cure" it, really tight control can mean many of us can slow any progression down so much that you can control it with diet and exercise for many years before you may need things like insulin - if you ever need it at all. That's why I said before that many of us try to get our BGs as near normal as possible to give our poor old pancreas a rest.

 

[RobsterinSheff]

My nurse says I should be aiming for 300g or under carbs a day.

Hi

That is standard DN/ NHS advice and for the vast majority of us T2s is really- and there is no better way to phrase this- utter garbage.

To begin with you should be aiming for a ballpark number of 150-180g carbs per day (medium carb approach). You should- at the start- be testing regularly, especially 120 minutes after eating a certain food type. That way you can begin to build up a picture of what food types give you horrible spikes and what types are more mangeable (its different for every person).

Have a deep search through the many threads on here- you will find many (as I did) started out only with the kind of information given to us by the NHS/ our medical practice. Those of us that were fortunate to quickly find this site had some erroneous perconceptions swiftly ended.

Depending upon your personal BG testing results and your subsequent HBA1c tests you may need to reduce your carb intake to nearer 100g carb per day or even lower. This often largely depends on how much of a pancreas you have left. If your GP practice is geared up for the expense (bit of a post code lottery here) you can request an MRI pancreatic scan.

Fasting glucose number (in mmol) should be 6 or under; 2 hour post prandial should be 7.8 or under. Though many on here argue that us T2s should aim for numbers achieved by non diabetics = under 5 and under 6 respectively. Though I personally disagree with this 'hard core' approach.

 

[RobsterinSheff]

I was told that it does not have to be progressive, and that it could be reversed or at least not get any worse

There is a lot of conflicting research out there on the 'inevitability' of progression. I've pressed my GP on this and he has tried to stay non committal but won't rule out "insulin at some point down the line". Especially as I am 46.

But it is an established fact that with tight BG control we can put our diabetes into 'remission' = though there is some disagreement on what HBA1c constitutes this. I've seen A1c of 6.5 or below defined as 'remission' whereas many on here swear by A1c of 5.9 or below (and some hard core assert its even lower than that- say 4.9 or below- to be 'real').

But as Grazer says don't lose heart. Its actually one of the few 'chronic' conditions where you have a major role in deciding whether it gets worse or not yourself.

OK its an absolute sh*tter that you have it- it took me over a month of tortured introspection to digest my diagnosis.

But you can control it it with your own dietary appoach and increased movement/ exercise. This also has beneficial impacts on other conditons- for the first time in 15 years I have BP below 120/80 and 'normal' cholesterol numbers: and I last weighed what I do now in 1998.

 

[seamatt]

Thanks everyone for the advice. I have been testing more today as I was told just to test once a week as I don't really need to be testing......seems like more NHS myths

I had my favourite chicken and rice this evening followed by some cheese and crackers which totalled 111 grams of carbs. 2 hours after I was 5.1

I have been looking at my carb intake over the last week and the daily totals have been...179, 171, 95, 191, 163, 184, 189, 190.

By the looks of it I am not too far off medium carb, and hopefully with a bit of tweaking could keep below the 180.

I think the key is testing a lot as you guys have all said to see what does it for me. I am hoping that they found it early with me as I was not presenting any signs and it was picked up when I had a Full blood count for another condition and they sent me for a fasting.

Thanks again everyone.