Advice wanted please?

[chrisgod]

I am a Diabetic and have been so now for several years. My sugars have never been exactly stable! My first meeting with my "consultant" ended with me having a bit of an argument! He "Stated" that a normal blood sugar level was 5.0! End of story. I said no sorry that has to be the ideal and possibly the average. NO it is what EVERYONE should be at! I still disagree and say he is wrong! 5.0 is an ideal and an average for all Diabetics and I certainly am NOT right at that level! If I get a reading of anything approaching 5.0 it is accompanied with extreme nausea and shaking etc! So HOW can I be different to everyone else? And how does everyone manage to maintain an IDEAL level of 5.0?

I am now age 53 and my blood sugars are more increasingly running at around 12/12.5 after a meal and approaching 6/7.5 when I feel at my most comfortable. My highest recorded reading I remember was 23.5!! And lowest was 2.3!! But these are VERY rare indeed and I am usually between the two figures above but more normally at the higher end of the scale. For instance while in the UK this last week I had a low of 4.3 (Felt GHASTLY!) and an early morning reading of 11.5?? My diet is most likely NOT ideal! But as there are NO Fish and Chips or Curry Houses in France to speak of? (Well there is actually a Chip shop opened in our village last month (the only one for hundreds of miles!!)but one visit was enough for me!) But I can control my weight and whilst overweight am not too bad? Certainly I weigh less than I was in the UK and that gave no cause for concern......well perhaps the comment may have been "You could do with losing SOME weight Mr Goddard"

I take Metformin and a whole other regime of other tablets but do not feel this is controlling my diabetes. Problem is I am in France and so feel a little bit like a fish out of water!

I have just returned from the UK and what has finally prompted me to take action? Is I have just met my fourth grandson and would REALLY like to see him attain at least his teen years! At present I doubt I will? And as my Daughter is also diabetic and has been on Insulin for a number of years and still is she absolutely insists she would NOT go back to tablets again!

So what should I do next? The Healthcare I get here is I am sorry to say FAR superior to that I enjoyed in the UK, UNTIL it comes to my diabetic care? That is as good as none existent. yes my doctor does make the right noises and all but seems to have no intention of referring me for a diabetic assessment? Is there anyone out there able to offer me some advice as to the way to proceed please? For instance I was of the opinion that it was either Metformin or Insulin and THAT was it till I recently found this site and now realise there is a LOT more choice than that! But it is specific advice with France in mind I need, anyone please??

 

[cugila]

Chris.
Whilst you may have been Diabetic for several years I think the advice we usually give out to newly diagnosed Type 2's might not go amiss here ? Have a read and see if there are things there that you might not have thought of which will help you get better control of your Bg levels. If you need anything clarifying then fire away.

We have several members who post from France and they may be able to help with the choices available to you there. I am sure they will show up eventually.

Here is the advice we usually give to newly diagnosed type 2 diabetics.This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different .

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

The main carbs to avoid or reduce are the complex or starchy carbohydrates such a bread, potatoes, pasta and rice also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating then two hours after eating you will see the effect of certain foods on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.

As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try !!

As a Type 2 the latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l.
2 hrs after meals......no more than 8.5 mmol/l.
If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

 

[chrisgod]

Many thanks for that! Straight away I can say I have NEVER EVER been advised about carbohydrates in any way shape or form!! And the BG levels make a LOT more sense when put like that! Bye gum he DID annoy me!!! :lol: :lol: :lol:

 

[cugila]

Chris.
I spent 12 years on a diet that included all the things they told me were healthy.......it nearly killed me. Came here early last year and followed the advice, haven't looked back since.

Best of luck and let us know how you get on.

Ken

 

[kateincornwall]

Hello and welcome Chris . My experience was that due to the wrong dietry advice from the HCP , I went from a Pre Diabetes stage to full blown Diabetes within two years, if I had only known then about lowering the carbs , I might not be diabetic now . The advice I was given was to eat plenty of starchy carbs, oh my Lord , what was all that about ? Once diagnosed , I decided to research and began to cut back on carbs and walk a lot more , it worked for me, my controll of BG is really good but I am never hungry . Loads of luck from me , there is so much you can do to help yourself once armed with the right information .

 

[Synonym]

Hi Chris and welcome to the forum.

Follow the advice posted by Ken and you will be better controlled and have much better BG levels - which will mean you will be much more likely to see your grandchildren grow up.

You are obviously testing so keep a food diary and note against the food eaten the self test results before and 2 hours after eating, you will soon see what your food is doing to your BG levels and can adjust accordingly. Many of us use a Carb Counter book by Collins gem or similar which shows the values of a wide range of foods so will also help you to make wise food choices. 8)

You will find the Food Forum interesting as it has many different ideas.

I no longer eat any of the starchy carbs as my body just does not tolerate them - we are all different so we will be interested to hear how you get on.

 

[scoots]

Hi Chris,
As your body has been used to running with slightly higher blood glucose levels, it is not unusual to get signs of hypo at a higher level as it is in effct a lot lower then the body is expecting. Once your blood suagars start to come down in general, it is likely that the signs of hypo will be less dramatic and at a lower level. We're all different - it's certainly not one size fits all!
Good luck with your docs - knowledge is power.
Jen

 

[phoenix]

Hi, I'm not sure I've understood correctly about your diabetes care, whether in fact you see a consultant or not.
If you are not seeing a diabetologue you can ask for a referrel from your medecin traitant. If you don't like your medecin traitant you can change him also.
The guideline seems to recommended you see a specialist if you are not well controlled, have complications or are about to go onto insulin. You can (as with any specialist) choose who you see. You could refer yourself , normally this would result in a lower than normal reimbursement ( I'm not sure what happens if you refer yourself for something ALD related.)
From the figures you give I would think that you have a good argument to see a consultant as as the target HbA1c for someone on metformin is actually less than 6.5%
I know my own specialist normally sees type 2s on a shared care basis with the GP. I would suggest you look for hospital/ site oriente en diabetologie and if you know anyone with diabetes ask who they see and what they think of them.
These are the equivalent of NICE guidelines in France.
(for the doctor, whats covered under the ALD, and for the patient)
http://www.has-sante.fr/portail/jcms/c_419389/ald-n8-diabete-de-type-2
At the very least the guidelines say you should be having regular visits to the GP or specialist, regular HbA1cs (4x a year), yearly lipid and kidney checks, yearly visit to the opthalmalogue, yearly tests for kidney function and a yearly ECG.

You should also be able to access a course or visit a dietitian (they prefer courses)
From what I know ( though I have type 1 so my courses are a bit different) the diet advised is similar to that advised in the UK but with rather more emphasis on the balance of each meal, portion control and using the glycemic index when choosing carbs. The type 2 course presented locally is a 4 day in patient course They have their 'victims' as a captive audience, lots of info, but also shared meals and practical sessions doing the exercise! If by any chance you live in the Midi Pyrenees I can give you a website which lists available courses.

 

[HLW]

Wow your consultant sounds great, telling you the truth like that! I got lied to at first by doctors who, when I asked what my blood sugar (hba1c) should be, said below 7! I looked it up on the internet, and saw that 7 was far above the normal range, so went back to the doctor and asked again what my hba1c should be. He said 7. I said 'no really, what should it be?'. He said below 6! They say 7 because some people find it's too hard work to get it lower than that, so if they are given a target of below 6 they just give up totally.

As scoots said, it's probably not a 'real' hypo, it's just that your blood sugar is at a healthy level after being high for so long. I've just started insulin, and for the first few days felt odd (shaky etc) when my blood sugar was at a normal level, I assume that was for the same reason.

 

[chrisgod]

WOW :shock: Thanks for all the info people! I would like to say I DON'T think that the lows are anything unusual! I have always been shaky shall we say at anything approaching 5.0 or under! My lowest low was within a week of being diagnosed and I was I remember something around 3.2 and I was I reckon nearly in coma, well were it not for the nausea and shaking?! I simply could not believe I could suddenly feel so BAD having just been diagnosed. But have always thought that was the medication???

I was of course pretty sure I was diabetic some months/weeks before I was actually diagnosed! My Ex. Wife was a nurse and I have had quite a lot of medical training so was not shall we say totally gobsmacked! But had I seen a poster that was posted in the doctors surgery a week or two after I could have self diagnosed a lot earlier! But no I am always "rough" at anything under 5.0 hence the discussion with the "Consultant" But not at ANY time has Carbs been mentioned by anyone and I saw the dieticians at Halifax early on quite a bit. I am an "eat some bread with that Chris" type of person! (Dad told me this from a VERY early age!) And I have to be truthful and say I find it hard now to resist sweet things! things I have NEVER liked! But to cut out Bread in particular? Never mind taters and rice!

@ Pheonix, I am resident in France and am also 100% funded because of the diabetes and wonder why you are not? I was fully funded in the UK for ALL medicines and am also here. OK I am also a war pensioner and so get free treatment for my accepted conditions (Arthritis in the main) but I can assure you I get no or have had no offers of any real help over diabetes treatment from my GP since for ever! He does get a little "UP" when I say my levels are at say 215/12!! But I always reckoned that was quite normal after a meal (of bread and pomme de terre!) But I have my monthly meet with him next week so will ask him about all you have very kindly mentioned. Thanks! I do incidentally still have an eye screening, but this is done in the UK at Specsavers! Anyway time will tell and I will keep in touch now and have a look for this little book you so kindly recommended!

And as I now record ALL my testing and so have a record. Mind it would help had I not gone to the UK without my tester!! That and the fact I cannot seem to get anything up to date as regards testing in France?? I had to toss my newest machines away when I arrived here as I simply cannot get test strips for them! I have a Accu-Check Active machine and luckily my daughter had a spare machine she lent me, otherwise I would have been stuck! And at £27.50 for 10 test strips in the UK?? Sorry but I would have missed a weeks testing! So again if anyone has managed to get anything more up to date in France? It used to be so easy! Simply point the machine at my PC and press the button and BING all downloaded to a Graph and all! Now I have to plot my own graph and all with the aid of a UK company as well! France is good at 90% of things but like Sausages and bacon and blood testing it is sadly lacking!

 

[phoenix]

Hi again,
I obviously wasn't clear, I get all my diabetes care at 100% and as I have a pump thats a lot of money.(what I wasn't sure of is if you self refer to a specialist rather than going through the GP, I know that they have been trying to curb this)

I have had excellent diabetes care here and know a number of people with type 2 who have also had no problems. Indeed I know someone on a pump who is a type 2, something almost inconcievable in the UK,

I know what you mean about meters, my first one was out of the ark but they have improved.
You are entitiled to one on prescription every 4 years. This is what produces the problem, the manufacturers don't have to compete, they get a fixed price and the person is locked in with the company for 4 years.Moreover the fixed price is very high, if you try to buy a meter at a pharmacy it will cost you between 70 and 90 euros!

The models available now though are similar to those in the UK. These are from some of the manufacturers.
Lifescan, One Touch
Vita ; quite high spec but I think this uses specific strips
Ultraeasy (in several colours) and Ultra2, as available in the UK . (these use the same strips as in the UK so in an emergency you can buy them there,)
These meters download via a cable to software available from the manufacturers site. The cables are free in the UK but cost in France. I use this and find it useful as I can download from an Ultrasmart meter bought in the UK (using French prescription strips) and change the units from mmol to mg/l for my doctor. I also have an Ultra 2 obtained on prescription.

Accuchek
Nano Performa and Performa: As fas as I can see these have the same specifications as the Nano Avia and Avia in the UK (I don't know if the strips are compatible).
These download to the computer via an infra red port.
Sadly you can't get the compact or get the strips here.
I use one every so often for testing on the run in long races, but have to buy the strips in the Uk myself.

Abbott
Optimum exeeed. looks like and has same spec as the one in the UK including ketone testing (though I doubt that would concern you)
Freestyle Papillon lite looks the same as the Freestyle lite in the UK
Again downloads via cable (35euro ) in France, I don't know about UK cost.
(again don't know if strips are the same)

 

[sue32]

Chris, you've received the most excellent advice from all the guys here. I too was struggling with high BM's and insulin resistance. The I went on Byetta. I am considerably overweight but since changing my diet and reducing my portion size and following the glycaemic load diet I have lost 21kgs in 2 months!!! My BM's are now between 4 and 5.5. My last HbA1c had reduced from 8.3 to 7.2 in 2 months. So good luck - you'll only get the best advice here.

 

[chrisgod]

Wow! Great news Sue, keep it up gal1 And yes it really IS good advice!! In fact as I have said better advice than ANY health professional has given me in what 12 years now??? :lol: :lol: :lol:

 

[hanadr]

Chris
the average BG of a non-diabetic is about 5, so why not set that as a target? there are quite a few diabetics who achieve this regularly. In a number of ways. Different methods of dietary control and for some, by use of medication.
to me here's no sense in having targets above 5, because that's where the complications start to raisse their heads.
Why set a "special" target for diabetics?
Hana

 

[HLW]

My lowest low was within a week of being diagnosed and I was I remember something around 3.2 and I was I reckon nearly in coma, well were it not for the nausea and shaking?!

Don't worry that's not nearly a coma, but it does need to be treated. In non-diabetic people, the lower end of the blood sugar range is 3.5, I think anyone would feel hungry and shaky at those levels though.
My levels went down to 2.7 last night (I know the meters aren't that accurate so it might have been higher) and although I felt terrible I was still conscious and able to talk normally, neither of the dr or nurse I spoke to on the phone at NHS direct or out of hours seemed that worried, just said drink sugary drink etc.
What I'm trying to say is don't panic if it's that low, but do treat it!

 

[Louiseswann1]

Hey guys I've recently been diagnosed with t2. I am currently using my one touch vita glucometer that I was given 4.5. Years ago when I had gestational diabetes. Will this still be correct