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1st appointment with diabetes nurse

C

Cavvycuddler

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Hi all I've had my first appointment with the diabetes nurse today. It went well and she was really nice and spent a lot of time with me, about 35 mins I with her so didn't feel at all rushed.

She has referred me for a test on my eyes (I can't remember the name) to check the vessels and to do the Xpert course for type 2s. I was also offered free gym membership but declined at the moment as I've not had great experiences in the gym previously (the last time I went I was actually laughed at by ADULTS standing outside) and I do already exercise very regularly, albeit mild, walking my dog so I'll focus on the diet and losing weight before braving a gym again!

The nurse went through a handy book showing me the carb values and portions of certain foods, such has how high grapes are compared to something like blueberries etc and told me to try to eat 40-50g of carbs per meal. I've not had chance to look into what that means size wise so not sure if that's a lot or not as it sounds a lot!

The question I forgot to ask about carbs though is when I'm looking at a food packet, what figure am I actually looking at? Total carbs or the 'of which sugars' number? I've been trying to be more aware and make better choices so was going along with the traffic lights on food packets when I could looking for green for sugars but I've noticed some actually show quite a high total carb but low sugar values so I'm a bit confused as to what I need to be looking at. For example, total carbs 16g of which sugars 0.5g

Sorry if I sound totally stupid but I've spent my whole life purely looking at fat and calories and have no idea about counting carbs ‍
 
You look at total carbs since the body is capable of turning them all into sugar unless it's fibre.
 
Hi @Cavvycuddler there is no such thing as a stupid question around here so please keep on asking, I'm glad to see you being so proactive about all this and because in my flurry of work I didn't see your first post to welcome you so... Welcome! I hope you can get on top of all this!
 
Cavvycuddler said:
and told me to try to eat 40-50g of carbs per meal. I've not had chance to look into what that means size wise so not sure if that's a lot or not as it sounds a lot!
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Do note that many of the T2's on these forums can't eat nearly that many carbs and keep good blood sugar levels, in other words you may have to go a lot lower than the nurse said.
 
Thanks so much! Everybody is so welcoming and friendly, the support here is priceless. I'm feeling confident I can manage this and looking forward to a new lifestyle
 
Glad your nurse spent time with you. As for the carb amounts she has suggested, I feel that they are too high, I only eat 30 - 50g carbs per day! I did start for the first few weeks after diagnosis just keeping under 100g per day, but to keep my levels non diabetic I gradually reduced to the 30 - 50g mark. Testing is the best way to see what level is best for you.
Oh and btw the eye test is called a retinal scan.
 
Ah yes that's what it is!

I thought it seemed high after hearing people talk about keto at less than 20g per day. I'm not sure I can go full keto yet so I'm just going to start decreasing and monitor my levels for now and see how I get on.
 
Cavvycuddler said:
Ah yes that's what it is!

I thought it seemed high after hearing people talk about keto at less than 20g per day. I'm not sure I can go full keto yet so I'm just going to start decreasing and monitor my levels for now and see how I get on.
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we are all different. I have around 80-100g carbs a day. Getting a meter and testing to see how foods affect you is a great way to find your own level of carbs.

paging @daisy1 for her excellent advice.

If you go to your profile page, there should be a drop down menu for you to put what type of diabetic you are, and a box to fill in what diabetes meds (if any) you are on. This will help people who reply to you to tailor our non medical advice to your needs. Welcome : )
 
Thanks for the info. I've just ordered a meter so hopefully I'll be able to start testing next week

I've tried to update my profile but I dont seem to have the option and can't view what type others are on the mobile forum app so I'll update it when I can on the main website as it seems to be struggling loading pages for me at the mo!
 
Welcome @Cavvycuddler . As others have said you may well find that the recommended levels of carbs aren’t low enough. But you don’t have to get there all,in one go. Personally I jumped right on in there and cut almost all but others find it better to go more gently and take it a step at a time. So long as the direction is the right way all is good, just keep going.

Don’t forget if you are dropping carbs you need an alternative energy source and that is fats. Don’t be scared, it works without turning you into a blob. You may well find you eat less often as fat keeps you fuller for longer so it all equals out. Avoid low fat foods as they are often full of sugar and chemicals. It goes against everything you are used to I know. But take a look at this
https://www.diabetes.co.uk/forum/blog/jokalsbeek.401801/ as proof. And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation and https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ for food ideas. And https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy.

Carbs hold water and if you eat less carbs you need to increase fluid intake to compensate. If you eat fewer processed foods and increase water you’ll also need to make sure electrolytes don’t drop, particularly magnesium and potassium. So add a little salt too.
 
Thanks for all the info. Yes I am a bit scared of increasing fat because I'm already a blob ha ha
 
Cavvycuddler said:
Thanks for all the info. Yes I am a bit scared of increasing fat because I'm already a blob ha ha
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For type 2......
Toss out everything you 'know' about diet and nutrition.Fats are your new friend.You can decrease glucose and weight by cutting way down on the carbs and replacing them with fats.Lose weight with fat? YEP! Crazy but TRUE.

There are three basic nutritional needs...protein,carbs and fat.Weve come to find out carbs are not essential,the other 2 are.

Carbs are sugars....we dont want sugars....simple enough.As you cut the bad carbs you will have to increase fats and proteins.Simple math.

The 'experts' still cant say low carb/high fat after 50 years of bad advice,but it isnt just low carb as they begrudgingly say,you are replacing those carbs with something.And thats fats.If you ate just protein and no fats you would get ill and maybe die.So embrace fats,your new dietary friend on the diet that puts diabetes in remission.Low carb/High fat (LCHF). Not cure it,but in remission,important point.

Also,all carbs arent bad,things like broccoli,green beans,cauliflower just for some examples are very low carb and have a place yet in your new nutritional reset.

Read about low carb diets and see all the great things still allowed,and the 'what did you eat/what is your glucose level' threads to see very effective dietary control and level of results people have achieved.
 
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If you are eating from home and don't want to think about whether or not there are carbs to worry about, have up your sleeve a couple of 'safe' meal ideas that won't spike your blood sugar. For example, I love eggs so pretty much every morning I make scrambled eggs with cheese melted through it, at the moment it's 2 boconncini cheese balls and 3 eggs, fried in butter, and on the side I have avocado and tomato. Mushrooms and bacon when I'm in the mood. This is my 'safe' breakfast. If I want to add carbs, I have a half slice of my husband's homemade sourdough rye or spelt bread. It's lower GI than anything you can find in the supermarket. If I eat bread, I would test my blood sugar, but for my 'safe' meals, I don't test anymore.
A 'safe' lunch or dinner would be either a steak with broccoli or cauliflower, maybe mushrooms. If you're in the mood to cook, make a cauliflower bake with cream and cheese melted over it. Just avoid potatoes and carrots unless you want to add carbs and test what they do to you.
Another meal idea is a fresh fried salmon with a green salad, cucumber, capsicum etc on the side.
A "safe" snack might be a handful of walnuts and almonds. A piece of cheese.
I find that is a good enough base as a meal plan that I know won't spike my blood glucose levels. You could test after them yourself and see and make your own "safe" meals so you don't have to count carbs all the time.
 
@Cavvycuddler
Hello and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it both interesting and helpful.

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 well over 600,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.
 
Hi thanks for all the info
 
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