Help! I don't want to medicate.

[stuffedolive]

Help! I’m very confused.
After years of telling me I’m managing my diabetes well, there has been a change of staff at the diabetes clinic and all of a sudden they want to medicate me. I must say the old regime was pretty hands off, never calling me in unless I asked and not offering a HBA1c unless again I specifically asked.
A bit of background.
I was IGT in 1995 when aged 39 and told I had a model diet. I was an ex-racing cyclist and still very active although carrying 10kgs more than the 70kgs of 10 years earlier (too much beer!). In 2000 I was told I was not IGT after all and thus didn’t need an annual test.
In late 2004 (age 48), I changed career and had a health review. Two consecutive OGTTs of 7.0 and 7.1 gave me a diagnosis as a diabetic. Over the following year I lost 12kgs and did more exercise so that in early 2006 I was giving normal readings on the OGTT and told that I wasn’t diabetic after all – by this time I had not been offered a HBA1c and didn’t know the test was available.
In summer 2007, after my weight had crept up 6kgs (to74kg) I started to feel unwell. I was having dizzy spells, night sweats and one of my primary class said my breath smelled of sweets (ketones? after a mammoth weekend of endurance exercise). I asked the clinic for some tests including a HBA1c but they lost the results. I eventually got a repeat test a few months later which gave a HBA1c of 6.6. By March 2008 I had lost 4kg and got this down to 5.9. So the doctor again tried to say I should not have a diabetes diagnosis (but got overruled – hurrah sense at last!).
Since then, I have had a bad experience with statins (and don’t take them now) and my weight has fluctuated down and up by a few kgs and I have had sporadic HBA1c tests which have fluctuated along with my weight. After a naughty post xmas period my latest HBA1c is 6.5 (48 in new money). The clinics response was to suggest tablets (Metformin?) rather than doing any sort of lifestyle/dietary review. I was a bit disappointed and desperate not to go on medication until I really need to. Hence I found this forum.
Now aged 56, I currently exercise 4-5 days a week which consists of 2-3 runs of 40-90minutes, a weights session and a walk. A typical days diet is porridge or Museli for breakfast with a Benecol drink (lowest sugar variety). A wholemeal sandwich (eg cheese and tomato) for lunch, 3 dried figs with yoghurt for a ‘keep me regular’ snack, and an evening meal of pasta or rice with vegetables/meat sauce and a salad with French dressing and a glass of red wine. I’ll also have a piece of fruit and a few nuts during the day.

My immediate response to this is that I should lose a few kg and reduce my carbs intake. But I need to eat something. What could I replace breakfast with? Does anyone have suggestions for low carb snacks? Perhaps I need to start ‘testing’, but I don’t know anything about it.
Help! I don’t want to medicate (yet)!

 

[sassywriter43]

Pop along and have a look at our low carb forum. There are quite a few good ideas. I am sorry - but I have really bad brain fog this morning due to my M.E. :crazy: and I have only just skimmed your message. I am really certain someone will be along soon to offer some more concrete ideas.

 

[toots8298]

low carb breakfast idea - how about a couple of boiled eggs or eggs variety? or smoked salmon with small bit of wholemeal toast or something.

your diet and exercise regime sounds really good, i'm surprise that the clinic wants to medicate you if you keep your HBAC1 low, not sure maybe ask them to review again in 3 months and then ongoing on a 3 monthly basis?

Good luck

 

[stuffedolive]

Thanks Toots,
The whole carbs thing has been confusing as I was always told (and read on NHS websites) that my meals should be based around carbs, but now it seems that carbs are the enemy. I have started carb counting today but I really don't know what I should be aiming for. I had planned to have leek and potato soup tonight but now maybe it'll just be leek soup :?

You suggest toast for breakfast but isn't this even more carbs than 50g of porridge? I agree with the eggs bit. I don't eat many eggs but could have a few each week. Currently, I'm sitting here thinking about food. Ordinarily I might have an apple or crispbread to tide me over but now I'm thinking - wait, 11g of carbs in the apple, god knows how many in the crispbread... perhaps I'll have a... I really don't know.
At least I'll lose those kgs. Lets just hope I don't fade away to nothing.

 

[Sketcher]

Hello Stuffedolive. No time for an in-depth reply but for snacking, try nuts, cheese or meat; you could keep a stock in the fridge of boiled eggs, sausages (choose a low carb make, such as Black Farmer or most Frankfurters). If you cut down on carbs, then you'll need to increase fats for energy, with the bonus that fats help keep hunger pangs away for longer. I am controlling with diet and exercise only: I can't cope with potatoes, apples and crispbread (not to mention bread, pasta and all puddings, sweets & chocolate); I only have fruit (a very small amount) if I'm going to have an exercise session afterwards. Less than 50g carbs per day, but I've worked down to this gradually.

I won't mind too much when I have to go on Metformin (it has general benefits and no known problems once your guts get used to it) but I'll keep off for as long as I can.


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[stuffedolive]

Thanks Sketcher,
I'm also having to keep my cholesterol under control. Its up to 6.7, but the ratios are good, so I don't want to snack on anything that will raise it. I came off statins because I got muscle degradation which was stopping me from exercising and thus not helping my diabetes management. I'm currently avoiding cheese and taking benecol and garlic (1 clove per day) to try to keep this under control.
50g of carbs sounds really low. I reckon there's 2g in every cup of tea I drink, and I drink a lot of tea! 30g+ in my breakfast porridge. I'm a little worried how my body is going to handle exercise if I go really low on carbs.
I orienteer now which basically means a 60-90minute terrain run every Sunday (plus the training during the week). It's fairly demanding and I usually shove a fair few carbs down my neck to refuel after I have finished - i'll need to review how I do that. :?

 

[carty]

Hi there
Its a bit of a mine field at first but just try to think outside the box eg breakfast doesnt have to be cereal or toast it can be omelette or cooked ham and cheese dont be afraid of bacon and some sausages are low carb I eat black farmers .Also I have leek and celeriac soup which doesnt spike my BGs and tastes better than leek and potato especially with a clove of garlic and a little fresh chilli pepper(I put chilli in almost every thing)!
CAROL

 

[stuffedolive]

Carol, you're right, I'm probably stuck in a breakfast cereal mindset.

However, what do people do to get fibre into a low-carb diet?
I currently rely on cereals and dried figs. Figs especially, but now I'm going to have to cut these out as they are about 8g of carb a pop.

 

[Sketcher]

I'm with you on the chillies, Carol!

In answer to Stuffedolives question, my fibre comes from mountains of salad (watercress, rocket & spinach, tomatoes (not too many, they're a fruit, so a bit carby), radishes, spring onions, cabbage, chillies, etc.; also soluble fibre in the form of "Eat Water" noodles and rice from Holland & Barrett.


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[ian1968]

I actually think there's a really easy answer to your question.

Just drop the bread at lunchtime. Have a big salad instead - it'll fill you up as well as a sandwich, and will reduce your carbs.

For lunch, I have three veggie sausages - I'm a vegetarian - a boiled egg, a big pile of lettuce, two tomatoes, a few slices of cheese and sometimes a dollop of hummus. It's far more satisfying than a sandwich and fewer carbs overall.

 

[LesleyAnne2]

Hi stuffedolive
I have really gained control of my blood sugar by following Viv's Modified Atkins diet which is a Sticky Thread on the Low Carb section of the forum. Do have a look at it.
For breakfast I generally have a fry up, or greek full fat yoghurt with double cream and mixed nuts.. totally yummy...
You can read about my experience here viewtopic.php?f=43&t=36741
Hope this helps.
Lesley

 

[stuffedolive]

Thanks for all the advice.
Well at the end of my first day carb counting I reckon I've had about 90g.
30g for porridge breakfast
20g sml tin pilchards in tomato sauce with handful of cooked bulgar wheat for lunch
10g for a dried fig & spoon of greek yoghurt
20g for beef with chickpeas, tomatoes and pepper stew
10g milk in various cups of tea/coffee

Is 90g ok? I have really craved a piece of toast. I might just have a nibble of cheese before I go to bed because I am hungry!
As for exercise, I was a bit tired and stiff after yesterday's interval running session (6km) and a couple of hours sawing up a fallen tree, so I just did 10mins on the cross trainer - long run tomorrow though.

 

[misterdj]

Stuff, i really recommend the following book The Art and Science of Low Carb Living by volek and phinney. It gives you the science behind how to do low carb eg less than 50g a day. It all makes sense. They show how you will eventually have more energy and be able to do more exercise. It's not focused on people with diabetes but there is a section on type 2. They also use a lot of examples of sports people. I've been living on 50 to 70g a day and will shortly take the leap to under 50g. The change has been challenging but my blood glucose levels are down to normal regularly. So well worth the effort.

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[ian1968]

Thanks for all the advice.
Well at the end of my first day carb counting I reckon I've had about 90g.
30g for porridge breakfast
20g sml tin pilchards in tomato sauce with handful of cooked bulgar wheat for lunch
10g for a dried fig & spoon of greek yoghurt
20g for beef with chickpeas, tomatoes and pepper stew
10g milk in various cups of tea/coffee

Is 90g ok? I have really craved a piece of toast. I might just have a nibble of cheese before I go to bed because I am hungry!
As for exercise, I was a bit tired and stiff after yesterday's interval running session (6km) and a couple of hours sawing up a fallen tree, so I just did 10mins on the cross trainer - long run tomorrow though.

I think you've done really well. I changed my diet but didn't go lo carb and I managed to lose weight and get my BG levels down to normal. I really found that dropping bread was the biggest thing. If it's of any help, here's what I eat:

80g in weight of Shreddies, plus 250g of milk
Small orange
The lunch I described before - three sausages, lettuce, two tomatoes, boiled egg, slices of cheese
50g of peanuts
Child's packet of hula hoops
Pasta and veggie sauce
Weightwatchers yoghurt
50 g of peanuts

Plus cups of tea with milk throughout the day.

I lost 3 stone with that diet, and my latest h1abc is 5.4.

 

[spendercat]

I have to say it - Weight control is not the entire answer for diabetes. Nor is exercise. It helps, but that is all.
You have probably done phenomenally well to keep the illness at bay until 56.
There, I've said it.
There is no need for you to be hungry, that will simply discourage you and lead you along the road to medication, that you do not want to go down. If you can turn your attention and control to simply adopting a controlled carb diet, that satisfies your appetite, you will get the same or better HBs as losing weight has done for you in the past.
2 oatbakes with large amount cream cheese - 11gms carb
glass of red wine - 5gms carb
Large pot Alpro unflavoured soya yoghurt 10gms carb (That makes a good breakfast)
Litre of Soya milk (Light) 0.5gms carb
Celery stick stuffed with cream cheese 0.5gms carb
Salami with cream cheese and an olive 0gms carb
Irish coffee, unsugared 1gm carb

 

[stuffedolive]

Spendercat,
I'm intrigued by the glass of red wine for breakfast :wink: I'll give it a go. That doesn't look like a days worth of food though. I think I might fade away on that.

My numbers do seem to follow my weight though and although I'm already described as slim by my peers I reckon I have another 5-6kgs to lose from around my trunk. It'll help me with my hill running too, which has dropped off with age and the 'statins incident'.

I'm not sure I want to go no-carb but I certainly want to go less-carb. 90g was not too hard and I can see there are possibilities to shed another 20-30g. However, I have always been told that porridge is such a good breakfast, as the carbs are 'slow release' and also helps with reducing cholesterol. Have I got this wrong? should I actually be avoiding slow-release carbs too?
I used to be able to buy natural bran. If I can get it again, I was thinking of replacing 1/2 the porridge with this - has anyone used bran?
I'm also sprinkling cinnamon on my porridge as I'm told that it helps to regulate blood sugars - is this a myth?

 

[Sid Bonkers]

Spendercat,
I'm intrigued by the glass of red wine for breakfast :wink: I'll give it a go.

Intrigued? I'm horrified that anyone drinks a large (202ml) glass of wine and an Irish coffee for breakfast :eh:



I'm no prude when it comes to a drink but I genuinely thought that only alcoholics drank alcohol at breakfast time ...I'm obviously naive when it comes to low carb diets.

 

[Sketcher]

Hello Sid. I'm sure the wine-for-breakfast idea was a mistake or a joke; at least I hope so!

Stuffedolive - you'll just have to experiment and measure your BG before and 2 hours after porridge to see how it affects you. It's best to use traditional porridge oats and not the instant microwaveable sort. Personally, I couldn't cope with porridge, but you may be OK - you just have to try. I stick to sausages and eggs (pre-cooked by me) for quick weekday breakfasts; at weekends it might be smoked salmon and scrambled eggs or bacon, eggs & mushrooms. The red wine is definitely for the evenings!


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[stuffedolive]

I'm sure the red wine was just an amusingly accidental juxtaposition of phrases deliberately misinterpreted by me.
I do drink red wine but not every day and definitely not for breakfast. I shall attempt to limit myself to one glass in future.
I also hear that it is good for slowing down the conversion of a meal to blood sugars. Is this so? And is this why some people recommend that is should be drunk a little while (30mins-1hour) after a meal?

as for the porridge Sketcher, I use 30g of Jumbo oats with 1/2 water and 1/2 semi-skimmed milk. That gives less than 25g of carbs. Before trying to reduce the carbs I'd have twice that AND a handful of sultanas mixed in - I'm not even going to try to calculate how many carbs that was :shock:

 

[vicky_l]

Hi stuffedolive

I might have to shout

you arent eating barely enough no wonder you are hungry

ok the carbs are fine

drop the fig trust me you really want to

cholesterol in our blood isnt I believe due to eggs so up the eggs

try cream in your tea instead of milk Yes cream

try adding fat to your cooking people use butter lard and coconut oil and add some veg for fibre you seem quite low on veg

say make that massive salad up suggested earlier with that tin of fish and enjoy it

average day for me is

eggs with mushrooms or some veg like spinach or peas or egg and sausage/bacon and veg
fish and salad huge salad large dinner plate
meat and veggies and cooked in butter or butter on top of veggies
piece cheese (have up to 80g)
and if hungry still some pepperami/ham/cooked meats (cooked myself normally if you buy check for sugar added)

I am losing weight this is day 9 (although made some adaptions prior to this) for me and feeling good

I am upping meat and fish portions to deal with hunger

Oh and I have avoided meds this way too

My HbA1c went from 48 to 62 made docs want me on meds I asked them give me three months and had HbA1c done this week and it came back as 55 (not where it needs to be but shows food adaptions is helping already)

baby steps you will get it
xoxox