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4 months in and going well (I think!)

Discussion in 'Newly Diagnosed' started by NorthernPam, Jul 6, 2013.

  1. NorthernPam

    NorthernPam · Member

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    Hi everyone,
    Just joined today and this is my first post other than introducing myself. I’ve been reading lots of posts on this site for the last 4 months so thought it was time to join in. It might be helpful to some people if I describe what has happened to me and how I feel about it.

    4-5 years ago I had blood tests for something else and glucose was a little high. Oral glucose test followed and told I was pre-diabetic but follow-on test was in normal limits as were later annual ones so I didn’t worry about it. Meanwhile practice nurse gave me a printed sheet of foods to avoid/eat and mentioned the GI Index. Not enough data so I bought a good GI book to learn more. Adopted many of the principles as it made sense even if not diabetic. Like others on this site ‘pre-diabetic’ was not explained enough to me or I would have taken it more seriously but I did introduce more complex carbs to my diet as instructed. Over the last 5 years I have gained 4 stone though lost 1 stone last year, became 'apple shaped', had puffy ankles most days, and needed the loo so often it was embarrassing! In addition I had become increasingly tired and the slightest physical exertion was an effort.

    Routine blood test this March and HBA1c at 60/8.8 with cholesterol 7 (1.1 HDL/4.2 LDL) so this time diagnosed diabetic. Initial disbelief and in denial but within hours realised I should take this seriously. GP gave me an information pack which I read all through. Like most people of my generation I knew that food played a big part in diabetes but had no in-depth knowledge of nutrition. I thought I had a healthy diet with lots of fruit/veg/salads, chicken, fish but low red meat, etc. but obviously not healthy enough. OK, so diabetes is the problem, where am I now, where do I want to be, what’s the gap, and what is the action plan to bridge it? Hmmm … don’t remember reading about that so read the pack again. The only food advice really is the pretty plate showing food type ratios but no specific guidelines so I knew then that I would have to develop my own strategy. I’d heard of GDA (Guideline Daily Amounts) so searched for those online. Interesting … GDA is the same for diabetics as non-diabetics. This didn’t make sense as to reduce weight you reduce calories, to reduce cholesterol you reduce saturates, and to reduce blood pressure you keep salts down so surely to reduce sugars you keep sugars (carbs) down?

    I started reading on various websites, including this one. I learned that the UK NHS advice is based on the UK Prospective Diabetes Study that was undertaken with just over 5,000 people between 1977 and 1997. NHS advice was slated by numerous people on this website but there were lots of good links to other sites related to later studies (Mayo and Kumamoto for instance) as well as other diabetes-focussed sites. Within 48 hours the overwhelming message was that the only food group of real significance related to diabetes was carbs. I started a spreadsheet to list the nutritional values of everything I ate and, as I am still learning, still do that today. This has enabled me to identify foods that are high sugar, saturates, salt, etc. and there were quite a few surprises along the way. Doing this has enabled me to make informed choices about what foods or what quantity of foods I now wish to eat. I also bought books recommended on this website including a quick calories/carbs/protein/fats reference written by Chris Cheyette and Yello Balolia (great for the supermarket or eating out) and ‘Blood Sugar 101 What They Don’t Tell You About Diabetes’ written by Jenny Ruhl. Do a search and you’ll find a website for the latter too. I strongly recommend anyone with diabetes/pre-diabetes to read this as it is very informative. I refer to this book regularly.

    When I added the nutritional values to the foods I had eaten in the week after diagnosis I was shocked that my healthy diet wasn’t as good as I thought … who would have thought that a famous brand no-fat yogurt contains 11.9 gms sugar or that cheese was so high in saturates? I decided to be drastic and cut my carbs to around 20 gms/day as outlined on some websites. I only did this for a few days as it was really restrictive, I was hungry, and I knew that I would not be able to maintain the motivation to do it long-term. Fairly soon I settled at around 150 carbs/day spread out over 3 meals/day (65-70% GDA). Within 2 weeks the weight loss was marked. I asked my GP for a blood monitor and morning bloods started coming in around 7.5 which encouraged me. This level of carbs is comfortable for me though I might have to adjust them in the future depending what progress I make. We are all different so although this level works for me a different level could be better for you if you decide to adopt this approach.

    About 3 weeks ago I attended the diabetes education session and was not impressed. Talking about future complications the phrases ‘when you get to that stage’ and ‘when the time comes’ didn’t exactly inspire me with confidence. When I questioned why GDA was the same for a diabetic as for a non-diabetic I was told that it was because these were government guidelines. I asked about reducing carbs and was told that was not recommended as carbs were needed for energy. The whole dietary section was about the ‘pretty plate’ with little focus on sugars at all and lots about saturates. This echoes what many people on this forum have said about this approach. Quite a bit of time was spent on alcohol too. Beer and wine does contain carbs but a spirit and low-calorie mixer doesn’t and even the dietician had to admit that such a drink did not affect sugars! The real alcohol issue is for those people on meds where getting tipsy can mimic a hypo. The only thing I learned from this session was the need to eat regularly to prevent the liver from releasing stored sugars so I continued my strategy although altered my mealtimes.

    The good news is that a week or so ago I had my 3-month check-up. HBA1c was 53/7% and cholesterol down to 5.5 (1.1 HDL/3.4 LDL). I have lost 25 pounds since March, got my face back with no double chin, no more puffy ankles even at the end of the day, sleep through the night most nights and if I do need a diddle it is once not 4 or 5 times. Morning bloods are more often in the 6 range rather than the 7 and 2-hour post meals vary from 4.7 to 11.2. (The 11.2 was after eating half an olive roll recommended by a neighbour diabetic! I’m learning.) I feel great and full of energy, am not hungry, and feel I am back to the person I was 5 years ago. I still have some way to go with weight loss and want A1c to be 6.5% or less with post-meal no higher than 7.8 so am at the stage of testing and ‘eating to the meter’ as so many people on the forum recommend.

    What I have found is that whatever % of carbs I eat then the % calories is pretty similar and as I am running at 65-70% this accounts for the weight loss. I’m keeping saturates etc. to similar levels and all combined this probably accounts for the positive progress. I am still eating a wide variety of foods and many of the changes I have made have been relatively small such as changing my salad dressings to much lower carb ones and buying naked chicken/fish rather than in breadcrumbs. I still eat butter in small portions and enjoy my scotch and low-calorie ginger in the evenings. I still eat bread, pasta, and potatoes but limit the quantity to match my target carbs quantity for the meal. A piece of cake or a biscuit is a very occasional treat. A square of 85% cocoa dark chocolate is good sometimes too (1.9 gms carbs/1.3 gms sugar). GP and nurses happy with me and even the dietician was interested in my charts and asked to keep them!

    I’ll be very interested to see what my results are in December and hope to see further improvement as I feel I am going in the right direction. Sorry this is so long but I hope that it is helpful to some of you. If anyone wants more detail then please feel free to ask. Suggestions for improvement also welcome.
     
  2. lrw60

    lrw60 · Well-Known Member

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    Fantastic story Pam! What type is your diabetes? I am type 2. I have been meds free coming up to a year now, my next test is in November. Most people who low carb find it difficult but do-able. What made it difficult for you? I have managed to get my carb intake down to about 150g a day. Not many here would call that low carbing!
     
  3. NorthernPam

    NorthernPam · Member

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    Hi Irw60,
    Thanks. I'm type 2 as well. I'd rather not go on meds of any kind if it can be avoided so am really making an effort to control this with diet. The most difficult thing was the first month as I only had a vague idea of what was in each food. It meant that every time I ate something new I had to look up the nutritional value and this was time-consuming. I've now got it all in Excel in an alphabetical listing so it takes just a minute or two a day to track what I have eaten. I only have to add a new line if I eat something that I haven't eaten over the last 4 months. I just copy and paste the lines from the master list into the one for the day. The eating part has been quite easy. I have never been one for dieting so thought I would be hungry all the time but I'm not. I am healthily peckish come evening time but not desperately hungry. Breakfasts and lunches I got sorted quite quickly and am getting much better now with evening meals where I want lots of variety so I don't get bored. I like to eat things with taste so use a variety of seasonings and dressings (all carb counted of course!) so that things like a stir-fry using 1-Cal spray doesn't always taste the same. I think I could go lower than the 150 gm. mark but I was losing weight rather too quickly so bumped up breakfast and lunch a bit. I have also read that balancing carbs fairly equally throughout the day is better than having them all in one larger meal and my bg's have been better with this approach. I'm still quite new to all this so big learning curve for me and no doubt I'll be making adjustments as time goes on. I've been reading more posts today and at least one person advocates eating a few carbs between meals to stop the liver releasing sugars and this makes sense so I might experiment with this idea. I want to be at the stage quite soon where I can go food shopping without having to think too much about it and where I am back in full control of my life.

    Are you getting good results with your 150 gms/day? I hope so.
    Good luck, Pam :)
     
  4. lrw60

    lrw60 · Well-Known Member

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    Hi Pam,
    Two and a half years ago I weighed nearly 18 stones and I was taking 10 pills per day for diabetes, high blood pressure and high cholesterol. I went on a diet and I have lost 5 1/2 stones. As I lost the weight my db nurse was reducing my meds. She knew that this should happen, but had never seen it happen. Last November I was taken off the diabetes meds and I had already stopped taking the statins to see if I really need them. I am now on 2 pills per day for blood pressure. I still hope I can lose the last 2 pills, but the damage may have been done.
    I stopped testing years ago when I was told that diabetes medication was for life, I couldn't see the point of testing several times a day and just accepted it as the way things were. Now I know better. How many of us type 2s are/could be taking meds we don't need. I still eat normal foods, for a veggie that is, but I am definitely eating better and of course, eating less (of the wrong thing). My weight stays fairly static, plus or minus 2 or 3 pounds which is fine.
    I am now wondering about getting some testing strips for my old meter, or even getting a newer meter? just to see how the foods I eat are affecting me.
    Like you I created a multi-page spreadsheet a few years back to keep track of my diet per day. One sheet has all the foods I eat with columns containg dietry information per item. I give the line a short name. BB for instance is 1/2 tin of baked beans. BBLC is the low sugar version. There are also sheets for each day of the month where I just type in the abbreviated name and either click on a button to play a macro, or press a key combination to do the same. The line is then automatically filled with the correct info for that item and the full name for the item replaces my short version. I must get out more!!
    It is very handy to be able to plan a days food in advance to see what my intake would be for that day. I know the foods I eat so well now that I can virtually plan a meal in my head and know what it will be values wise. I HAVE to get out more. :lol:
    You have done a fantastic job Pam. I think the way you have done things should be shown to newly diagnosed type 2s just to show them that there is a chance they might be able to control things. If they can't get the better of DB then they should at least be a lot healthier.
    One last request Pam. Please don't talk about biscuits! My downfall! I managed to give them up totally a few months back, I can even handle them without getting the shakes, but if I ever succumbed to even half a biscuit......
    Lee.
     
  5. NorthernPam

    NorthernPam · Member

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    Hi Lee,
    Seems like you and I have a similar approach. You have no idea how good this makes me feel as I was beginning to think I was being somewhat anal about this and taking it too seriously. When I saw the GP at my 3-month check-up he took a look at a selection of my charts with much head shaking, saying he couldn't do something like this. I think he thought I was a bit mad but must have been impressed as I blagged him into prescribing more tests strips for me so I could test more meals and also the effect of timings and exercise. I would love to see your charts please if you are willing to share as I think I could learn a few things and would also welcome some more tasty veggie meal options. Please feel free to send me a personal mail with them attached. I haven't tried this facility on this site yet but understand it is possible by clicking on the person's user name like on Ancestry.

    I have adopted the principle that no food is forbidden but that certain foods bring consequences. As I have said before I have never been into dieting as such but have watched family and friends dieting and having food cravings. This 'nothing forbidden' approach seems to be working for me as I haven't craved anything yet in 4 months. I have to say that I do miss a home-delivery Chinese but not to the point of fantasising about it. At some stage I shall indulge though. From various things that I have read including the 'Blood Sugar 101' book my understanding is that the occasional ... and I do mean occasional ... sugar spike will not result in excessive harm and that it is OK to eat off-plan occasionally. Luckily I do not have a sweet tooth so cutting out such things has not been difficult for me. I did have a small piece of cake with a friend on her birthday last month and have also had the occasional square of 85% cocoa chocolate (low GI) but very rarely and that little bit is enough to satisfy me. Interestingly the dietician said at the educational session that there was no such thing as a diabetic diet and if we wanted a piece of cake then to be aware that blood sugars would rise sharply and take longer to come down but also recommended that the best time to eat such a thing was with a meal. I am not convinced about this as surely this just makes the carb content of a meal higher overall? I have only tried the chocolate 2-3 hours from eating and tested before and after. Yes, sugars did go up but not much and came back down within 2 hours. More testing still needed though. We're all different and it seems that what works for one person sends sugars sky high in someone else.

    You have done very well indeed with your weight loss so well done on that. Well done too on getting off most of the pills. Personally I hate the thought of stuffing my body with chemicals as often meds bring their own problems. An old family friend takes 21 pills a day for various things and I would hate to be like that! I've read on the forums that some folk have been prescribed meds immediately even if their A1c was relatively low/pre-diabetic and I was quite relieved that my GP has not even suggested meds to date. I was quite amazed though by the lack of knowledge of other new diabetics at the educational session. The lady next to me had an A1c in the 20s and had been put on Metformin immediately. She didn't know why she was on the educational session as she had finished the prescription (not ordered more) and thought she would be cured now!

    I'm pleased with my weight loss to date although it has been incidental rather than premeditated. My aim was to get sugars down so I adopted the reduced carbs strategy and the weight just fell off as a consequence. I have 16 pounds to go now before I am back at the weight I was when I left school (a long time ago!) and this is the weight I have been most of my adult life. Clinically the NHS will still classify me as overweight (only just) but I have always been comfortable at that weight and looked and felt good. My weight loss is coming in at about a pound a week now which I am happy with. Already I have a waist again - 9 inches off that as of a month ago (not measured since) plus several inches off boobs and hips and it is noticeable. I really don't want to lose much more than this though so may need to look again at calories in due course.

    The first month I talked to a number of diabetic family, friends, and acquaintances in an effort to learn how they managed it and pick up some tips. I wasn't too happy with what I learned as by that time I had done a lot of research online and also read some books. A neighbour no longer has butter or any alcohol but still eats white bread and is under the impression that cutting out those things is good for his sugars. A cousin treats himself to a hot cross bun for elevenses every day and when I visited recently he produced puff pastry cheese and onion slices for lunch! I think this is a direct result of the lack of sugar focus in the educational sessions and the way diabetes is approached at government level. Such a shame as the cost to the individual as well as the health service is huge. What particularly saddened me is that both of these guys (and others I have spoken to) expect an inexorable decline in their health over time along with more meds as and when needed. I do not believe this is true and that those people who make the effort to look after themselves will not necessarily decline.

    I think you are so right to be testing again as your weight loss and being off meds will have resulted in a big change for your body. I've seen various posts about people not being able to get test strips prescribed and the NICE guidelines and think it is awful. How do you know what you are aiming for unless you know where you are? A good saying is 'if you do what you have always done then you'll get what you have always got' but how do you know if something has to change if you don't have the data to make that decision?

    I agree that the spreadsheet approach is great for meal planning, particularly just before a supermarket trip. The first month in this was a nightmare for me as it was taking so long - not just to meal plan but also looking at labels in the supermarket to make the best choices. I also went right through my food cupboards and freezer and got the values of everything in the house and that took time. Some things such as a frozen garlic baguette and a pack of dried fruit were immediately given away due carb content. Other things I kept and am eating in small portions from time-to-time. These days my shopping trolley is almost exclusively fresh stuff but that does mean more shopping trips! Luckily I have a large Tesco about 5 minutes drive away.

    Need to get out more? Sounds like you have this well organised now. I have to say that the first couple of weeks I spent a great deal of time both reading and setting up my spreadsheets. Thankfully it was a quiet work period for me so I didn't have to juggle time and could focus. Now I am back to normal activities and only think about diabetes at mealtimes. Hopefully as time goes on that will become second nature too.

    Thanks again for the support but I think you have the same approach so you are doing a fantastic job too. Not many people would have the time or the inclination to go into this much detail. There are many people who are not IT-literate and would not have the skill or knowledge to be able to create such a database anyway. For me it was essential to enable me to learn about content of different foods as no way I could remember it all in my head or keep a running tally of what I ate each day. I've got enough data now to start looking for patterns but shall continue to record everything until I feel confident enough to make good food choices without the charts. Already I do some in advance and others at the end of a day or even two days.

    I think it would be very helpful for newbies to have a bit more direction and knowledge when they start out even if it was only a list of items known to contain high sugars. The advice 'watch your sugars' was by no means adequate. The other 5 people in the room on my educational session clearly didn't have a clue as evidenced at the end when one guy asked what he could eat to fill him up if he couldn't eat 4 chocolate bars! Maybe a project for us?

    From your phraseology my guess is that you are UK based - correct? Whereabouts? I'm up in the northeast of the country.

    Thanks again for your support. I know I have a way to go and welcome both support and suggestions.

    It is really hot up this way today. My niece has just been to visit and we took my lab round the local woods. Since then I have cut the grass but come back in to finish this as it is too hot to do more garden work. Sam is now in the cool of my study at my feet panting from the heat so better for him to be indoors too. Hope you've had a nice day where you are.
    Pam
     
  6. lrw60

    lrw60 · Well-Known Member

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    Hi Pam,

    I never kept any of my old progress sheets, I used to delete it at the end of the month and start again. The only thing I kept is my weight record sheet that I have pinned to my bedroom wall. I write on this each Sunday morning. If I notice my weight creeping up then I know I have to get back on track.

    When I was diagnosed with type 2, 8 or 9 years ago, I was also told it would be for life. I believed them and I think they believed what they were telling me. I just lived with diabetes as a background illness. I had to make allowances for what I ate, but again, eating what the surgery thought was a good healthy diet. Lots of slow release carbs! It’s no wonder the hour after breakfast was one of the worst times for me, my breakfast would send many diabetics dizzy.

    Reading over this sounds pathetic. I had no control over my diabetes, I just lived as best I could. Now though, things are different. If I had known then what I know now I could have been off medication several years ago.

    What you are doing sounds as though it should become a self-help book, something recommended by the NHS as required reading.

    You refer to your weight loss as “incidental rather than premeditated”. That’s how I think of my diabetes. I didn’t “do” anything to lose it, it just went along with the weight. Like you I would be classed as still being overweight, maybe by as much as a stone. But the goalposts for a persons ideal weight seem to be quite wide. I thought I would be told at WeightWatchers that my ideal weight would be whatever, plus or minus a pound or two. It’s actually more flexible. Anyway, I am happy at the size and weight I am. I used to have a 40” waist, now it’s 32”. I went from an XL to M without buying new clothes as it would have cost too much! I still wear a working (paint spattered) cardigan from my XL days. When I was in a builders merchant recently that I hadn’t used for 2 years the woman behind the counter noticed my weight loss and complimented me! I am not used to that. I showed her how my cardie could now fold around me like a wrap. She said there was enough room in for her too! Much to her amusement, and the other customers, I invited her in. She declined, sadly!

    I must admit to still living with my head in the sand most of the time. I do plan my meals and plan them to be as low in carbs as I can. But, if I fancy a rice pud or fruit crumble with custard then I go for it. I usually have a low carb meal if I am going to have a high carb pud. My normal pud is grapefruit and low fat cream. I still find it difficult to lose the tendency to eat low fat instead of what other low carb’ers proscribe which is high fat. Full cream and proper butter are not on my shopping list. I lost my need for medication because I lost weight. My fear is that if I start to eat a low carb/high fat diet the weight could start to creep back and so would the diabetes.

    I looked back over the only old spreadsheet I could find a day or so ago. It was for January 2011. my carb intake was between 275 and 400 grams per day, averaging out at about 150 g of sugar. My carbs on the WW diet were about 200 g per day, more if I had a few bananas as snacks (bananas and grapes are classed as free foods on the WW diet, eat as much as you like).

    I am unemployed at the moment, well since December last year actually. I do get some jobs coming in which seems to keep the jobcenter people happy, but they find it very difficult trying to sort out the paperwork when I declare earnings as I am classed as self-employed. Due to other physical problems caused by work etc over the years I am trying to find something else to do rather than be a builder. If my education hadn’t been cut short by me leaving school aged 15 in 1968 then I might have a better chance of getting different work. I did wonder what my chances would be of retraining as a nutritionist. The requirements include O-levels etc. I left school before taking any exams. But I did well in the mock O-levels, 45 years ago! If you look to the right at my username etc you will see my location is Cornwall. I moved here in 2000 from Hemel Hempstead.

    I am writing this in MS word as the internet has been a bit slow of late. I will copy and paste it over. I enjoy working with computers and have taught myself simple programming skills. Not enough to get a job unfortunately, but I can write programmes to help me with work etc. I would prefer to remain self-employed, I have not been looking forward to having a boss, but needs must.
    Lee
     
  7. NorthernPam

    NorthernPam · Member

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    Hi Lee,
    Quick reply as just in from the dog walk and I want to log off soon. I've seen your name in other posts today - seen you have a cat in the pet forum (Sundi looks very laid back) and also saw you in a thread about cheese and onion pasties! Did you ever try making those and, if so, what were they like? They sound really good and could be adapted for other fillings too. I've been looking at other recipes on the site today including some sort of chocolate cake with raspberries and cream and a low-carb bread recipe which looks interesting. I had no idea such low-carb ingredients existed - told you I had a lot to learn. A task over the next few days is to go through the ones I fancy and make a shopping list then try to source the ingredients to give some a try. I'll be home a lot over the next 10 days as neighbour's lab, Poppy, is coming to stay while her family are in France. She doesn't like the car and I don't like to leave her too long when she stays so I have been doing my 'car' jobs over the last few days so I can do 'home' jobs next week. Not sure how much I'll be online tomorrow as I have my first retinal scan late morning and I understand that my vision could be blurred for a while. Not looking forward to it as I hate anyone touching my eyes. I know drops will be put in but just hope they don't use a clamp or anything otherwise I'm likely to freak out!
    More later, Pam
     
  8. lrw60

    lrw60 · Well-Known Member

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    Hi Pam,
    Sundi was incredibly laid back. But he died 25 years ago. I grew up with him around me as a kid. It wasn't the same when he went.

    I never managed any success with any of my attempts at low-carb baking. I couldn't get the flour to hold together. I have made my own vegetarian pies that are successful ('bout time for another batch!). I know that this sounds like a weak try at low-carbing, in a way it is, but I am trying to see how 'normal' my diet can be without starting the diabetes again. I judge that level by my weight, if I stay below 13 stones (12st 4lb today) then I am convinced I can live a fairly normal life. Quite soon I will be taking my friend Lorna out for a meal at our favourite pub in a small village, Bottalack, near-ish to Lands End. I will be having my usual meal of curried butternut squash with far too much rice! If that wasn't enough rice for one day, I will also be having their home made rice pud with clotted cream and jam! In the past this combination would make me feel as if my head was ready to burst, now the affects are quite mild. I will resume normal service dreckly, as they say in Cornwall.
    The eye drops only sting a bit, no restraints required. You will then sit somewhere to allow the drops to dilate your pupils before they call you in for the pictures of your eyes to be taken. They normally show you the pics on screen and give you the results there and then. Your doctor will get the full results and let you know. Have they told you not to drive? You won't be able to. You will find everything much brighter for a while so take strong sunglasses with you and either get someone to drive you home or take a taxi. Believe me, you probably won't even be able to look at the computer screen.
    Lee.
     
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