Plan of action for who?

[Jual]

This seems to be the only place I can access where I am getting any help at the minute and I am getting anxy and stressy whereas when first diagnosed I was like...OK...just another thing to add to the growing list.

I had my first appointment after being diagnosed as type 2 with the nurse at my GP practise...everything I'd read said this would be the start of a close relationship which would put me on the path to having a PLAN! Plus I'd have a medical, be told lots and have my questions answered.I couldn't wait.

I was weighed,given a pack the local Diabetes Uk rep had made up ( apparantly a wonderful man who did it in his own time)told my levels were not hugely out as I wasn't in the 20's, given a diet sheet which I told her I already followed...and then was asked to come back in a couple of weeks so she could do my blood pressure and have a look at my feet.She was rushed and had 2 people waiting.

Before I left I managed to say I wanted to attend DESMOND course which I'd found out about and after making sure I wouldn't want her to take the blood and that I'd go to the hospital, then I had 2 forms written out to get my blood results so I could be referred to DESMOND if they came back in time.

Is this how it's going to be from now on, as if it is I feel like not bothering. I've just phoned up for my results and HBA1c is 13.4. Is that good? I haven't a clue and no one has commented.

How do you all just go from day to day if you have to put up with this all the time?

Sitting here sad with my mouth turned down...

Jual :cry:

 

[sami]

hi jual
sorry to hear that your nurse did not have time for you next time you go make a tripple appointment so she has time
a HbA1c of `13.4 is not good it is very high do you have a monituor and test strips are you following the nhs high carb diet as that will not help :cry:
try to lower your carb in take and see if that helps it does for moist type 2's
do you do any exerise as that also helps to lower your bg

 

[Ebenezer]

Is this how it's going to be from now on, as if it is I feel like not bothering. I've just phoned up for my results and HBA1c is 13.4. Is that good? I haven't a clue and no one has commented.

Below 6.5 is good. Have they advised on medication? If the Dr & nurse aren't bothered, find a new practice.

When I was first diagnosed, the HbA1c was 11. I immediately gave up sugar, & a confirming test a few weeks later was 8. To get that 2nd result, I was called to the surgery where the Dr spent 1/2 hour with me explaining all the problems that might occur, & all the help that was available. Attention to diet brought the reading down below 7, but I found I needed help as diet alone left me short of energy & hand/eye coordinarion & am now taking Metformin.

9 years on I am still well & strong, apart from a muscle problem that had a cause & is now cleared again. I still play a good game of tennis at 69.

The diabetes diet of low sugar/salt/fat with lots of fresh vegetables & fruit gives no problems, & when my wife had a heart attack, no changes to diet were necessary.

I agree with Sarah. We go to the hospital gym twice a week for Ann's heart rehab exercises.

IanD

 

[Administrator]

Hi Jual, picking up on what Sarah said, if you write a list of questions that you would like answered and post them here, I'm sure the community will do their best to answer them. Hope you are feeling ok and your day gets better.

Regards,

Admin

 

[Jual]

Thankyou to all of you taking the time to pass comments on to me. I really am confused about it all.
So here are a few questions to start.....

* The nurse told me bg monitors weren't a good idea as they can be out by 2 above or below the
reading. How else do you know how food affects you if you don't use one? I thought maybe your
ears glowed or something if your bg was up and no-one had told me!

* Do different foods affect everyone's bg differently?

* If they do then does that mean I need to start taking bg before I eat anything then just eat one item and test 2 hours later so I can get a list of foods that work for me?

* Is shops own sugar equivalent the same as Canderel etc or do I need to change? Tended to just go for cheapest for years.

* What do I need to be looking at on labels? I know I need to check the carb as of sugars to make sure they're low ; but what is low? Under 3%, 5%,10%?

Have loads more but don't want to bore everyone.

I'm really grateful for any advice.

:| I have a neutral face now but with a hankie attached to my nose as I have a horrid cold and croupy cough. I'm officially sic!

Thankyou in advance....

 

[Dennis]

Hi Jual,

Lets see if we can resolve some of your confusion.

* The nurse told me bg monitors weren't a good idea as they can be out by 2 above or below the
reading. How else do you know how food affects you if you don't use one? I thought maybe your
ears glowed or something if your bg was up and no-one had told me!

It is true that BG monitors can be inaccurate, but generally they are at least consistently inaccurate, so if your monitor tells you that your BG is 12mmol/l then it doesn't matter whether it is 2 high or 2 low, the BG is still very high. You could always try asking your nurse on what authority she is able to ignore the new NICE guidelines that say diabetes patients must be encouraged to self-test.

* Do different foods affect everyone's bg differently?

To an extent they do. Generally the things that are highest in carbohydrate (rice, bread, pasta, potatoes) will raise your blood sugar. In some people they seem to create a bigger raise than in others.

* If they do then does that mean I need to start taking bg before I eat anything then just eat one item and test 2 hours later so I can get a list of foods that work for me?

It certainly is a good idea to understand which foods affect your blood sugar levels and by how much, and that will take a bit of experimenting over time. You will gradually come to learn which foods are ok for you and which you need to avoid - and that doesn't mean never eat, just use them more sparingly.

* Is shops own sugar equivalent the same as Canderel etc or do I need to change? Tended to just go for cheapest for years.

Own brand sweeteners are exactly the same as the branded products so nothing to worry about.

* What do I need to be looking at on labels? I know I need to check the carb as of sugars to make sure they're low ; but what is low? Under 3%, 5%,10%?

The most important information on the label is how many grams of carbohydrate the food has. All carbohydrate converts to sugar in your blood. How much of the carbohydrate is already sugar doesn't really matter because sugar is just another form of carbohydrate. There is a topic "General Links for Diabetics" that has a lot of information on carbohydrates and is a good place for you to start your learning process! Also highly recommended is a book by Dr Richard Bernstein that explains better than any of us ever could exactly how diabetes works and how the different food types (carbohydrate, protein and fats) affect you. The book is called Dr Bernstein's Diabetic Solution. (Dr Bernstein does advocate a very low carb diet and that may not be what you want or need, but the book is so informative it should be made compulsory reading for every new diabetic.)

Hope that helps, but if you have any more questions just fire away - all of us on this forum are here to help each other if we can.

 

[IanD]

the Glycaemic Index

Do different foods affect everyone's bg differently?

That is not your immediate worry. A lot of research has been done on the rate of digestion of a wide range of foods resulting in the "Glycaemic Index" (GI) system. This book is no doubt typical of many:-
Easy GI Diet: Use the Glycaemic Index

You can build up an eating pattern using the recommended foods (e.g. basmati rice, multigrain bread, wholemeal pasta - all low-medium GI) which are slowly digested so giving a slow buildup of glucose as you work if off as energy. White bread & potatoes (high GI) are more rapidly digested & give a rapid increase in BS.

Once you've understood the system, you won't think you're dieting. Don't buy "diabetic foods" as they are sweetened with bulk laxatives. The GI diet allows normal eating but of selected foods - all aiding BS control. A bonus is that the diet is suitable for heart patients, & so protects you from the risks of heart attacks. Also I use a lot of oat bran to help control my cholesterol as I can't tolerate statins. The special margarines also help cholesterol reduction.

 

[Jual]

It's just beginning to make sense now, thankyou. I shall sleep on it and probably have 10 more things to ask on the morrow. :?

 

[Maria]

hi all
does the HbA1c always come out higher than the normal bg moniter reading?..as the former is the lab result isnt it? isit possible that bg readings can be around 3.7 to 7/8 thru out the day..then the HbA1c result be a lot higher?like in the 14,s.
Maria.
still after all this time still dont know weither i need meds or not..been told i was sent on blood test and didnt need it..and then the nurse saying we have known you had diabetis just before xmas?
and my bloods are not that high (i think) to be diabetic? im confused now!.due to go for test this month to see if im put on meds,,nurse did say dont take blood to often but try controle it?..how..if im being told just to do readings twice a day at no paticuler time? yet i have diabetice she says..she thinks i could get it lower tho..the HbA1c i think.
.

 

[IanD]

Maria

If your own measurements are in the 4-7 range, you would not get a high HbA1c. BUT although the numbers may be similar, they are not measuring the same thing. Your meter measures glucose in the blood, HbA1c measures combined sugar in the blood cell structure.

If you are measuring twice a day, overnight fasting should be one (4-7), & two hours after a meal the other (below 10) - vary which meal.

 

[sugar]

Hi Jual,
Still smiling at the thought of glowing ears! I think that the others have given you excellent advice. As a general point, now that you have your HbA1C result, your nurse can not ignore the fact that you need to do something to control you blood sugars. I would go for the "I got my result, and clearly this is really bad...so how are YOU going to help me control this thing?? Clearly, it will take a bit of time....it takes a while to learn how your body reacts to carbohydrates...but don't take any nonsense about not needing a meter. Maybe, once you have a perfect HbA1C result, there is an argument for noot testing so often...but in the early days, and for many of us, for ever, there is every reason to test!

As for HbA1C's and the results you get from the meter...as Ian says, they are different things. Personally, I have found that the HbA1C result, is usually slightly lower than my ave meter reading....but this could merely reflect how often, and when I test! I would (guess!!!!!!!) that if your meter readings are genuinely between 4 and 7...all the time, and not just a couple of times before meals, then your HbA1C would be in the region of 6. This is a guess based on my limited experience though...not a scientific fact! :lol:

 

[Russ]

Hi Jual,

You've got a lot on your plate. This is a good place to start sorting things but it will take time. Some of us (certainly me) still get confused but things become clearer more quickly for some than for others

I do think you should see if there is a better practice in your area, one where there is a good diabetic nurse.

Also, while this can be a good place to get your info, you might also like to get in touch with Diabetes UK (http://www.diabetes.org.uk) - they are the biggest organisation in the UK for diabetes, although they don't get it all right either. You will get a great deal of solid information from them and you can subscribe and go to meetings if you like.

Keep asking questions.

Good luck

Russ

 

[Russ]

I've given serious consideration to your recommendation of Dr. Bernstein's "Diabetic Solution", Dennis. I've read glowing reviews but worry a bit about the severe carb restriction and suggestions that the book (diet) is not for the feint hearted. Does this mean that it leans towards the Atkins Diet? I know some swear by the Atkins diet because undoubtedly it suits them but I've read various posts that advise us to steer clear of it and I'm rather mindful to heed that advise.

May I ask if you personally follow Dr. Bernstein diet and if so how you've found it? It is a question of being sensible about it and as best we can, find a balance? I'd be glad to know your thoughts.

Regards,

Russ

 

[Dennis]

Hi Russ, The Bernstein diet is not quite as low on carbs as Atkins, but not far behind it. I personally find Dr Bernstein's recommended carb levels a bit too low for me, so I tend to follow principles (and occasionally some of the recipes) but will add something that will give a small amount of extra carb, for example I will add a two or three small new potatoes to one of the recommended main courses. Or along with bacon and eggs I will have a single slice of wholemeal or linseed bread.

Dr B recommends around 30g carb per day, around a sixth of what the US govt recommends. I find that for me around 80 to 100g carbs per day gives me good control. But as has been pointed out many times, we are all different so what works for me may not be sight for someone else.