Advice Required - Type 2 - Managing and Living with

Hi Neil and welcome to the forum
Here is the type of advice you need, which was written for new members. I hope you will find this helpful. Ask as many questions as you need to as there is always someone who can answer you.

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 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.

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Hi Neil and welcome! :wave:

I'm fairly new here myself and newly diagnosed - about 2 months ago.

I've had very similar results when asking for help from doctors/nurses, etc... for help or advice.
The nurse only gave me a blood glucose meter because the diabetic clinic at the hospital said I need one. She wasn't overly happy about it and told me I didn't need to worry about using it.
This same nurse didn't listen to me when I told her that I didn't feel the Metformin (I was on the exact same dose as you and I feel your pain regarding running to the loo all day!) was working for me. Instead of talking me through other options; so told me that the next medication they try is "much more expensive so we'll keep going with the Metformin because it usually works very well." :?

I was told by the diabetic clinic dietician that I had to eat MORE carbs, less protein and low fat and that I had to strictly count calories. She also told me I was eating too little calories and I needed to eat more. I'm struggling there, I admit!!

I did finally find someone that listened to me and told me that I needed to be on a different medication and just gave it to me then and there. The relief I felt was unreal!
I think that's the hardest part - getting people to HEAR you and HELP you.

Personally, diet wise, I am (like many people here) following something of a low-carb eating plan. I've cut out all wheat, bread, pasta, rice, potatoes and other highly starchy vegetables (and very high carb fruits) and of course I've cut out processed foods, sugary foods, etc...

You're definitely in the right forum though - everyone here is awesome and really supportive.

Hi Neil welcome aboard :wave:

neilwalt said:

...nor am I to test my own bloods etc.

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That's incorrect Neil, testing your own bloods daily is essential, you need to educate yourself as to how different food types effect your BG, if you don't have a meter I would buy one asap, a meter is an essential first step towards the end goal of 'control'.

Once you have an understanding of the effect that different foodstuffs has on your system, then and then only, does testing your own bloods take a lesser role.

Hi Neil and welcome to the forum.

The advise (or lack of) that you are getting is not that uncommon I'm afraid. The best thing you can do is take control yourself.

Thought I'd tell you what I did.

I was diagnosed in December last year and using the advice I found on this site I got my blood sugar levels back to normal within around a couple of months or so and I have also normalised my cholesterol levels and blood pressure as well. I have now lost over 3 stone in weight too. My doctor is very pleased how I am getting on and has advised me to keep doing what I have been doing since it's obviously working really well. Not a cure as I still have to be very careful what I eat but I feel loads better than I did.

Diet wise its really easy. Just drastically cut down or better cut out all things with plain sugar, so biscuits, cakes, sugar in tea and coffee, pure fruit juices, non diet versions of soft drinks. Next and really importantly try halving starchy foods like rice, pasta, potatoes, bread, cereals and any other flour based products. Replace what's now missing with extra meat, fish, eggs, cheese and especially vegetables. Vegetables that grow above ground are best although most of us find carrots fine. Things like yoghurt are fine as is a small amount of fresh fruit. I find the ones that end in "berry" are the best. If you don't mind artificial sweeteners things like Diet Coke are fine to drink. On the starchy foods that are left swap try brown basmati rice instead of white and brown or tri-colour pasta. The bread that most recommend is actually Bergen soya bread but some do ok with wholemeal as well.

The above diet is close to one you would be one recommended to try by the Swedish Health service. It was introduced in that country last year and the American health service and several other countries health services recommend something very similar for Type 2 diabetics. In the UK the diet guidelines are now over 30 years old and are only gradually being updated. As the UK is lagging behind you may find what I and other forum members recommend will be different to what your are told is a good diet for you follow.

See you surgery is one of the anti ones. It's a bit of a post code lottery and we find some progressive surgeries are pro testing and others anti. If you can't persuade them to give you a meter and , they do get £2000pa for you being a diabetic on their books, then the alternative is to get one yourself like many of us have done. You can get a meter plus an initial 50 strips for around £20. The one most people are buying at the moment is called an SD Codefree and you can get it from the healthcare.co.uk shop on eBay. Make sure you buy an English model that measures in mmol/l rather than a US on that measures in mg/dl or you will find the numbers what appear t make a lot of sense. Extra strips for that meter then cost £5 / 50.

The reason testing is important is you should try and keep your blood sugars below 8ish two hours after eating any meal. Above the 8 value is where the dangers of complications do begin to occur according to diabetic experts. So if you can't test how will you now if what you are eating is keeping you safe? The problem is every diabetic is different so my earlier advice to halve starchy foods is just a rough guide. You may find you need to eat less than half (like me) or that you can eat more than half like others.

As you get into it all and read around the forum you may see people talking about carb counting. If you want to understand what that is just ask. It is a powerful weapon that a diabetic can use to control their condition and one that many of us use to great effect.

Good luck and keep asking questions.

Regards

Steve

PS Here's two good links about what's good to eat.

First is the lady doctor who's low carb / low GI recommendations seem to form the basis of what's recommended in Sweden

http://blogg.passagen.se/dahlqvistannika/?anchor=my_lowcarb_dietary_programe_in

Second is a good beginners guide to low carb regimes that are excellent for reducing blood sugar levels and losing weight.

http://www.dietdoctor.com/lchf

hi i was dignosed in sept 2012 am also confused as i was told to do it with diet with no diet sheet or help i dont know what foods to eat so im up and down btween 3to 9 0r 10sbut great 5s when i wake up i think ive cut out all my sugurs his maybe the problem what does any one eles think thanks ive joined today and its opened my eyes and am not so scared thanks to all of the posts kim

Hi Neil, I was diagnosed 10 years ago but controlled it with diet alone. Last year, after a cut on my toe leading to blood poisoning and a stint in hospital, my sugars were way out of control and I was put on metformin, glicazade, victoza and ramipril. Over the past year, my weight has steadily increased, I have felt more and more poorly and the doctor just wants to increase my medication and offered me anti depressants when I explained how down I was feeling about everything.
Last week, I was planning on changing my doctor and coming off all my medication. Then I came on here. I was absolutely gobsmacked at the amount of people who had also struggled with their weight, medications and advice ( or lack of it) from the doctor. I read so many stories about people who had lost weight, reduced their medication and generally felt massively better having gone on a low carb diet and decided to give it a go. My fiance said she would follow the plan too and we have both now been on it for 5 days. To be honest, it hasn't been too difficult - the hardest part is re training your brain because everything that you have been taught in the past goes out of the window!! My blood sugars are dropping and we both feel better in ourselves. Hopefully the weight will start to come off soon too but I can honestly say that this forum has been a real eye opener and people seem to be willing to help and give advice and share their experiences. Its a relief to know that you are not on your own.
Good luck!!