Type 2 Diabetes and IBS

[Eleanor1960]

Hi out there. I'm new to this so bear with me please, however any assistance would be greatly appreciated.

I am currently on Insulin (Novorapid x 3 injections and Lantus x 1 at night). Does anyone have a problem with their diabetes/diabetes oral meds and IBS?? I have had IBS (diagnosed) since age 19 and have struggled but I generally have an idea what to eat now and am better not eating grainy breads/bran or high fibre foods and better with white bread (which is not the best for diabetes). Porridge/oats is a problem for me if I eat it everyday (causes heartburn).

I have also had problems with my IBS and diabetes medications. I have been Type 2 diabetic now for 10 years. I was on SR Metformin for years and suffered with IBSD terribly but just put up with it. However about 18 months ago I was referred to the hospital diabetologists who took me off Metformin because of the side effects above and they put me on Pioglitazone. This made my sugars go really high so I was advised to go onto insulin as the other medications would affect my IBS. At the time I was gutted as I was hoping insulin therapy would be further down the line of treatment. The medications I have tried so far are Metformin and Metformin SR, Gliclizide (stopped due to rapid weight gain), Sitagliptin (stopped by doctors when I went on to pioglitazone). I am now on a combination of the insulin above and Dapagliflozin which keeps my sugars OKish. However the Dapagliflozin causes bad constipation so my GP has also prescribed laxatives. Last week I went to see the DN who told me to tweak the Lantus insulin a bit to get better morning readings (which have always been a bit of a problem for me) and when I explained about the constipation and pain I was having she advised me to stop the Dapagliflozin for a month. This has however caused a big deterioration in diabetic control and so I have reinstated it and will check with the DN when I see her next. I was just wondering if anyone had similar problems and how to cope with it. PS the DN has said there is not that much more that can be offered to me, medication-wise due to my IBS.

Interestingly I've just read the item on the website in connection with ginger and some of the natural alternatives - does anyone have any experience of this in relation to their diabetes ????

 

[Indy51]

Hi and welcome to the forum. I'm tagging @daisy1 who will give you some basic information about diabetes.

As to IBS, have you looked into the FODMAPS diet? It works by minimises the fermentable fibres that cause gas and bloating. The Monash University in Melbourne, Australia have a mobile app and info on the diet: http://www.med.monash.edu/cecs/gastro/fodmap/

For me the key was cutting out all grains and losing weight. Helped with reflux, IBS and blood glucose levels. Sugar and artificial sweeteners are also a big trigger for me.

 

[daisy1]

@Eleanor1960

Hello Eleanor and welcome to the forum

Here is the information we give to new members and I hope this helps you, especially with reference to diet and carbohydrates. Ask more questions and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

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 over 150,000 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-and-whole-grains.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 bloodglucose 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.

 

[PatsyB]

Hi and welcome to the forum...I have suffered from IBS for many years and have taken movicol for this ....Hope all settles down for you soon

 

[))Denise((]

I've completely given up wheat and don't replace it with gluten free alternatives. I can now take metformin without terrible IBS-D,

Metformin doesn't actually reduce blood sugar levels that much, a low carb diet does more.

 

[Eleanor1960]

Hi and welcome to the forum. I'm tagging @daisy1 who will give you some basic information about diabetes.

As to IBS, have you looked into the FODMAPS diet? It works by minimises the fermentable fibres that cause gas and bloating. The Monash University in Melbourne, Australia have a mobile app and info on the diet: http://www.med.monash.edu/cecs/gastro/fodmap/

For me the key was cutting out all grains and losing weight. Helped with reflux, IBS and blood glucose levels. Sugar and artificial sweeteners are also a big trigger for me.

I will certainly look into the FODMAP diet and grains/sweeteners issue. I have always struggled to lose weight in the 10 years since being diagnosed with Type 2. I am 5ft 2in and 10st13, gaining around 6lbs since going on insulin. I exercise regularly (as much as my dodgy knees will allow) and find it an uphill struggle to lose weight and do get despondent with it. The diabetes team say I have a lot of insulin resistance and always make the point of stating that diabetes is a progressive condition. Thanks for the input - its useful to have contact with people with the same aim.

 

[Eleanor1960]

I've completely given up wheat and don't replace it with gluten free alternatives. I can now take metformin without terrible IBS-D,

Metformin doesn't actually reduce blood sugar levels that much, a low carb diet does more.

Thanks for your reply. Giving up wheat is difficult as it seems to be in a lot of products. With so much restriction on food, what sort of foods can you actually eat without it getting boring? My difficulty is when I am out and about or at work and its so easy to pick up a sandwich.

I have started with scrambled eggs in the morning, tuna fish, egg mayo, ham, pickles for lunch and something like chicken or steak with vegs, trying to cut out a lot of carbs - but it's early days. I never thought I had a lot of carbs but must have had too many for me. On first diagnosis in the past I had some not very good dietary advice from my GP about carbs advising that I should eat plenty, then when I did the SMART sessions a few years ago that was completely turned on its head. Its good to get the view of others in the same situation. Thanks

 

[BooJewels]

Good morning. I too am a long term diabetic and even longer term IBS sufferer and went on insulin in March. I couldn't tolerate Metformin at all and became pretty much housebound on it until I refused to take it any more. My Mum on the other hand gets constipated with it, but her diabetes consultant recommended eating a handful of fresh almonds every day as the oil in them keeps things moving and that has done the trick for her.

I don't know the other med you've been on, but wondered if there's a reason when you're already on insulin, why you can't drop the other meds and increase the insulin? I'm on a combination insulin twice a day which has suited me well - the DN said that she's using it more frequently these days as all of her patients on it do really well with it . They weaned me off the meds I was on at the same time as they gradually increased the insulin.

I was very worried going on it that I would gain weight as everything you read suggests that you will (and I'd be ecstatic to be your weight at 5'2", I'm only 5' and a lot heavier), but I started on [my version of] LCHF (Low Carb, High Fat) way of eating (lots of info here on the forum on it) at around the same time and have actually lost 13lbs on it to date. My BGs have improved significantly (was between 14 and 26 before, now between 6 and 11) and we're probably not up to my final dose yet.

My digestive habits have certainly changed on this regime - I still find odd new foods cause problems - but they're actually pretty settled. My remaining issue just now is wind. It seems to get trapped rather than passing, so I need to address that as I haven't figured yet what foods cause it or might rectify it. I might need to resort to medication.

So even as a long time and what I considered to be experienced diabetic, I've learnt a great deal in the last few weeks and have changed my regime completely and have found something that is working for me, so maybe some changes in your diet might work for you too. I'm becoming progressively convinced that it was actually the carbs upsetting me rather than the fat I thought it was. I have actually modified my regime gradually over the 2 months and it's still a work in progress with room for improvement, but I had a 2 egg cheese omelette for my breakfast today and that would have been unthinkable a few months ago, eggs had been a no-no for me. for over 20 years.

 

[donnellysdogs]

My gastro chap thought I may have IBS before doing a "shapes" test which proved I had slow colonic transit.

My stomach doesn't tolerate any jelly, and bread, pasta or rice...

I was given movicols and enemas to deal with my stomach.

Not needed any drugs at all since having flax seed and chia seeds daily. When I don't have them then I know it!!!

Completely natural assistance and has completely normalised my stomach.

 

[donnellysdogs]

My niece got hypnosis to deal with her IBS after suffering so badly as a child. She really suffered badly. After 5 sessions with hypnotherapist she could even travel to remote 3rd world places to help build schools and medical centres etc where toilets were not the best in the world!! She has remained good for the past 7 years and remains travelling and helping out in remote places lacking toilets!!