(Another) newly diagnosed and confused

[endomorph]

Evening all. Well it seems I am joining a large community here and surprised at the number of "newly diagnosed" threads.

OK so this is me -

41, 38" waste, heart attack 5 years ago, on usual meds (asprin, artorvastatin, ramipril, amlodipine), fairly reasonable diet (grew up with father who has MS so lived on low-fat diet) although I love my bread and potato's

Diagnosed with T2 last week, doctor mentioned GTT was 4.7. Nurse appointment in 30 days time. Has stuck me on Metaphormine which my mother (retired nurse of 50+ years and has T2 herself) has advised I don't take yet because of the side effects, but advised to try and control through diet.

So a couple of initial questions -

1. Does the benefit of Metaphormine outweigh the side effects ? Should I start taking along with a managed diet ? Is it REALLY important ?

2. This is probably impossible to answer but what are "good" numbers for before and after breakfast, lunch, dinner and fasting ? What should I be targeting ? Got a tester and tested myself tonight - 8.9 two hours after dinner. Is that good, bad, or relative to before dinner test results ?

Guess I have a LOT to learn now and I refuse to rely solely on the NHS as I have been let down so many times in the past (prime example, no cardio rehab after attack !)

 

[susanmanley]

There is a lot to take in. I was diagnosed in may but manage diet only at moment [and diet is NOT boring I am pleased to say]

This site provides lots of support

I am going on a Desmond course tomorrow and will post about it after

 

[hallii]

Evening all. Well it seems I am joining a large community here and surprised at the number of "newly diagnosed" threads.

OK so this is me -

41, 38" waste, heart attack 5 years ago, on usual meds (asprin, artorvastatin, ramipril, amlodipine), fairly reasonable diet (grew up with father who has MS so lived on low-fat diet) although I love my bread and potato's

No more lots of potatoes and bread both are not good for BG (Blood Gluicose)

Diagnosed with T2 last week, doctor mentioned GTT was 4.74.7 would be OK so you must have that wrong. Nurse appointment in 30 days time. Has stuck me on MetaphormineThat is Metformine[/color] which my mother (retired nurse of 50+ years and has T2 herself) has advised I don't take yet because of the side effects, but advised to try and control through diet.

So a couple of initial questions -

1. Does the benefit of Metaphormine outweigh the side effects ? Should I start taking along with a managed diet ? Is it REALLY important ? Metformine is a useful drug for treating T2 it has few side effects apart from stomach upsets at the start, it soon settles down though

2. This is probably impossible to answer but what are "good" numbers for before and after breakfast, lunch, dinner and fasting ? What should I be targeting ? Got a tester and tested myself tonight - 8.9 two hours after dinner. Is that good, bad,It's not good not bad, ideally you should aim to be, say, 7 or 8 two hours after a meal. If you can achieve that sort of control then all the other times will come down slowly, maybe 6 fasting would be good, but early morning fasting results are very difficult to control, you have to accept whatever you can get or relative to before dinner test results ?

Guess I have a LOT to learn now and I refuse to rely solely on the NHS as I have been let down so many times in the past (prime example, no cardio rehab after attack !)

Yep, you have alot to learn, do it slowly, you will get there in the end, do not lightly ignore your doctors treatment advice, Metformin can always be stopped if you get things well under control

 

[Indy51]

Metformin is one of the oldest and safest drugs out there and apparently has many benefits beyond diabetes. Not everybody gets the digestive problems, especially if the drug is introduced very gradually. If you want to know more about it, you can find information here:

http://www.phlaunt.com/diabetes/14045911.php

Also, my understanding is that many people use metformin in the early stages to help their blood glucose control, but can come off it once normal BG levels and BMI are achieved.

The same site has a method for bringing BG under control and also the levels to aim for. You might find it helpful to also test before meals as well as after as you then get a 'before & after' idea of what foods affect your BG and how.

Daisy will likely post the introductory post for you, but in the meantime you can get the information here:

viewtopic.php?f=39&t=26870

Welcome to the forum

 

[daisy1]

Hi endomorph and welcome to the forum

I am glad to see you have already had answers to your post. Here is the information that Indy mentioned which is given to new members and I hope you find it helpful.


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.

 

[endomorph]

Thanks all for the words.

Tried my first Metaformin on Tuesday, 1 x 500mg. OMG ! Spent the best part of the afternoon on the porcelain throne.

Been food shopping over the last couple of days too. Still getting very confused.

I have been (and correct me if I am wrong) looking for low carb, low sugar foods.

Is there a rule of thumb of how many grammes you should consume per meal or day or is it relative to how your body is handling things and your blood tests ?

And should I be watching carbs or sugars ?

The recommended limit of sugar per day for men is 45 g for a non-diabetic person.

 

[Squire Fulwood]

Thanks all for the words.

Tried my first Metaformin on Tuesday, 1 x 500mg. OMG ! Spent the best part of the afternoon on the porcelain throne.

Been food shopping over the last couple of days too. Still getting very confused.

I have been (and correct me if I am wrong) looking for low carb, low sugar foods.

Is there a rule of thumb of how many grammes you should consume per meal or day or is it relative to how your body is handling things and your blood tests ?

And should I be watching carbs or sugars ?

The recommended limit of sugar per day for men is 45 g for a non-diabetic person.

Sugar is a carb so if you want to read labels just note the carbohydrate figure which includes the sugars as it usually says on the next line.

Carb counting is a good idea but not necessary for people who are only mildly diabetic. Buying a meter and using it to adjust your diet might mean that you can eat quite a lot of things but not everything that you have in the past. Just eat less of the problem foods.

Problem foods are most likely to be sugar, flour, potato or rice but not necessarily all of them. You need to cut out or cut down those that are a problem. A meter and a process of elimination is the way to go.

In my case flour was the major problem. The next problem was the foods that had flour in them. Many prepared foods are mechanically recovered meat mixed with flour and made into a cake. Only eating meat that clearly comes from animals is the answer to that. Steak, fillet, breast etc. not kievs, goujon, dippers or nuggets.

As for the Metformin. Ask you doctor for the SR (slow release) version and if that is a problem then go back to your doctor and say that the side effects are unacceptable. My nurse says she is not here to make matter worse.

 

[notafanofsugar]

Hi Endomorph - welcome to the forum... your photo looks a lot like CHris Moyles!

You've joined a great place - loads of people here to help and support! x

 

[endomorph]

The picture is Chris, I look like him (or so many people say)

 

[endomorph]

Interesting squire, never looked at it that way (testing and eliminating) .

What grounds do you eliminate on? Foods that raise levels for longer periods after eating?

 

[martin1914]

One of the reasons that the NHS gives such confusing advice is that there are very few people in diabetic clinics who actually know much about the disease. I was diagnosed with Type 2 after a coronary by-pass five years ago. On reporting to my local diabetes centre I asked what caused the disease, of which I knew little. I was told that it was caused by obesity, but having a BMI of 22-23 I was unconvinced. But the nurse insisted that obesity was the cause. I was still on a hospital insulin regime and the only dietary advice the centre offered me was to make sure I carried CocoCola and biscuits with me at all times to prevent a hypo. I was told that all my questions would be answered at my NHS hospital appointment. One was duly made for three months' time and promised seven minutes with Dr X "or a member of his team". I did some research from home, found a Diabetes Medical Consultant and paid him £150 for an hour of his advice: best thing I ever did. What he told me was that everyone will eventually get Type 2 diabetes if they live long enough and don't die of something else first: to that extent it is like old age. Some people get it younger, some people get it older. Obesity is a factor, but only to the extent that it is for other conditions. Genetics also comes into it, and so does diet: but the truth is that nobody really knows all the causes and how they work in concert. I was recommended to continue injecting because it is so much more effective and precise: anything taken by mouth is affected by the digestive processes which in turn are affected by what you have eaten recently. Five years later, taking my blood-sugars 3-4 times and injecting 2-3 times daily I feel in complete control and maintain blood sugars between 4 and 7. I have learned exactly what dose of insulin I need to reduce a high (or impending high) and in five years have only ever had two readings below 4. With the immediate cause and effect of eating/injecting being played out continuously I have learned what food to eat sparingly: but the only prohibition is no empty calories (sugar, wine gums, boiled sweets) – and no eclairs or similar without injecting first. Alcohol is an interesting one: the initial effect is to reduce the blood sugar whilst the liver processes the alcohol, but then increase it proportionately to the calories ingested. I now barely notice the regime that diabetes has imposed on me, and in some ways it is a blessing as it has made me more aware of my own health.

 

[Squire Fulwood]

Interesting squire, never looked at it that way (testing and eliminating) .

What grounds do you eliminate on? Foods that raise levels for longer periods after eating?

Two hours after eating I do a test. The NICE guidlines say the reading should be below 8.5 but like lots of people I am happier if it is a bit lower.

If it is significantly more than 8.5 I review what it was I ate. The next time I eat a similar meal I will reduce the portion size of the most likely candidate that caused the problem. I will repeat that process until I know how much of what I can eat.

You need to keep records in order to do this. A spreadsheet is helpful.