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A bit of a shock !!

M

MadMat

Well-Known Member
Messages
129
Hi all!

I'm a newly (3 weeks ago) diagnosed type 2 and feeling a little left in "limbo" right now

I was diagnosed while attending a group 2 driver medical as part of an application for a new job, when the urine sample showed high glucose. test on the DSN's meter showed a reading of 24! I was sent for a blood test to confirm the diagnosis which duly did :cry:

I was prescribed 500mg Metformin, two tablets twice a day straight away due to my need to pass the medical, rather than ramp up the dosage slowly as I understand is the more common. and advised to cut as much sugar and carbs as I could from my diet. (the side effects of that were fun!)

Saw the surgery's DSN again a week later, and another test on her BG meter showed a reading of 8, so the Metformin seems to be working! Thankfully the Dr has now signed off on my medical so I can start my new job soon!

After that I was told to book another blood test for 6 weeks after I started the metformin and go back to see the DSN again a few days after that to get results.

I'm told I've been referred for both dietician and optician appointments, but 3 weeks later I'm still waiting, and feeling like I've been left to figure out the changes needed to my diet - nearly every meal I used to eat was heavy on spuds rice or pasta, and I'm also a bit of a fruit lover too!

So I'm now 3 weeks away from my next DSN appointment, and wondering exactly what I can eat to replace all my favourite carb loaded foods!

Although on the plus side, I've lost around 5 kilos since diagnosis, although I could do with losing a fair few more!!

Mat
 
Hi Mat and welcome to the forum :) Once members arrive onto the forum this morning you will get loads of diet advice. You can also look at the Food and Nutrition forums accessible from the Board Index. In the meantime, here is the general advice we give to new members which you will find useful. Ask as many questions as you like as there are always members to help you.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 30,000 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 ... rains.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 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.
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Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.
Click to expand...
 
Hi. Congratulations on achieving such a reduction in your Blood Sugar so quickly. Although Metformin will have helped the main reduction in your sugars will almost certainly have been due to diet. There are many references to diet on this forum and Daisy has suggested some links. Go for low-GI carbs where you can e.g. multi-grain bread or Soya/Linseed such as Burgen. Avoid any highly refined flour products or have them in small quantities. The good news is alcohol is not a problem and you can eat meat and fats which have little effect on your BS; I've just had egg & bacon for breakfast together with home-made muesli. Keep to unstaurated fats where you can to help keep the circulation clear. Fruit is good in sensible quantities, but avoid the high GI ones such as melon and ripe bananas. Vegatables are generally good, particularly raw. So, good luck and keep up the good work and do ask if you have any questions.
 
Hi and welcome! As others have said, the metformin would have had only a minimal impact - they reckon a reduction of about 2 from the scores you had. The diet did nearly all of it. So well done. Here's a few things you may find useful, in addition to Daisy's excellent post. DO NOTE:- when you finally get to see the dietician you've been promised, you may, like a lot of us here, get different (sometimes bad) advice on what to eat. All I can say is, what we do here works! Your choice.
In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. That’s 150 grams of carbs per day for a man. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reduce the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk. There's a programme on BBC2 at 9pm tuesday about short but High impact exercise and it's effect on blood glucose levels which looks interesting.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. Level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Do ask lots of questions; there is normally an answer on here. The more you get to learn about your diabetes, the better it will be.
Good luck!
 
Is to normal for a newly diagnosed to be given tablets and then told to go away for over a month ? I've not seen a Doctor at all about the diabetes, I was sent directly to the DSN.

I did ask if I needed a BG monitor, the DSN said that as I was not at risk of a hypo I don't need one! Maybe it'd be easier and quicker to buy one myself ?

Having read some of the info on this site I'm guessing the best thing for me now is to start reading up on low carb diets, I really need to get this under control quickly, as I'll loose my Job should I need to go on insulin in the future.

On the subject of insulin, one thing I was wondering is what are the long term prospects, how many type 2 people end up on insulin eventually? should I be thinking about a change of career? It was pretty much made clear to me that I will not pass my medical if I'm using insulin.

Mat
 
The way you've been dealt with is pretty much the norm. One visit, diagnosis, no info, go away and come back later. Straight onto metformin is normal and okay; some do, some don't. However, it's a good safe drug and it's a good preventative against future heart problems so go with it. Also helps you lose weight if you need to.
Most doctoers don't issue testing kits: the "no risk of a hypo" is a typical excuse. Real reason is cost of testing strips. You need a meter not because of hypos but because you need to find out what food you can and can't eat.
Regarding insulin; some never need to go on it. A sensibly controlled diet (see my post above, doesn't neccesarily mean ultra low carb) will do wonders for your BG, and you could certainly avoid insulin for many years with any luck and some effort. So don't rush into a career change just yet!
Good luck.
 
MadMat said:
Is to normal for a newly diagnosed to be given tablets and then told to go away for over a month ? I've not seen a Doctor at all about the diabetes, I was sent directly to the DSN.

I did ask if I needed a BG monitor, the DSN said that as I was not at risk of a hypo I don't need one! Maybe it'd be easier and quicker to buy one myself ?

Having read some of the info on this site I'm guessing the best thing for me now is to start reading up on low carb diets, I really need to get this under control quickly, as I'll loose my Job should I need to go on insulin in the future.

On the subject of insulin, one thing I was wondering is what are the long term prospects, how many type 2 people end up on insulin eventually? should I be thinking about a change of career? It was pretty much made clear to me that I will not pass my medical if I'm using insulin.

Mat
Click to expand...

If you are a group 2 driver you will need to notify DVLA. They may ask you to test before and during periods of driving depending on your medication. (You should be okay with Metformin but I was initially on Gliclacide too and it s a hypo inducing drug and I had to sign a form to say I would test before and during driving periods else they would take my group 2 licences off me).
I bought a meter, (then my nurse said she would have given me one if I had asked) and ever since diagnosis have kept a food diary complete with meter readings all the time. Consequently my surgery (so far fingers crossed) have issued me with strips so I can test before I drive.

The rules have now changed regarding insulin and you can still hold Group 2 licences on Insulin if you have good control. When you first go onto it though you have to have 3 months off to prove first that it is well controlled and then DVLA will consider whether you are safe for your licences to be re-instated. So best to try and stay off it if possible.

Follow the wonderful advice from everybody on here and you won't go far wrong.....there is a wealth of help on here and everyone is great if you have a problem.

Regards from a fellow driver.
Angie
 
Thanks for that Angie, I'm not actually a group 2 driver, I'm going to be a private hire driver, and need to be licensed by the local council, who insist on the same medical as "real" group 2 drivers.

The actual driving licence required is a standard car one. As I understand it I don't have to notify DVLA at this stage, only if I do go onto insulin

Seems a bit daft to me, I drove a 3.5 ton van around for years with no medical or checks, but now I'm switching to driving cars I have to get a regular medical and criminal record check!!

Mat
 
Mat,

If your local council is anything like ours (I have private hire badge too) they still have the blanket ban on insulin. At least they did when I renewed mine last year anyway, don't know if they now amended it in light of the DVLA changes.

I believe you are okay as far as DVLA go on that score then. Make sure that your employer knows though for the vehicle insurance, the insurance companies aren't usually bothered about it but in case of an accident if they already know they won't use it as a get out clause.

The criminal record check is to 'make sure' you are a suitable person for carrying folks about, especially if you happen to get a school contract run. I have to have a check done for our County Council too so I can have an identity badge to be able to drive coaches on school contracts. Very often they both need renewing at similar times but each council won't accept the other's CRB check so it has to be done twice!!

Good luck.
Angie
 
Thanks for your help Angie!

The CRB thing is a bit of a farce isn't it, I already have a current one (helped out on a camp for my Son's cub scout pack last summer) but as you say, the council won't accept that, I've got to wait 4-6 weeks for them to run another one before I can start work!

Mat
 
I've been doing a lot of reading since finding this site, and have come to the conclusion that I really would like a BG meter and to test regularly

Should I wait for my next DSN appointment (nearly a month away) or simply buy one and start using it on my own.

Can I do any damage to myself? and how do I safely dispose of the used sharps if I'm not testing under the "supervision" of the DSN or Doc ?

Mat
 
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