Bad advice on Diet?!?

[chew824]

Hi everyone,

I'm pretty new to this Diabetes lark having been diagnosed in February. The advise I have been given by the diabetic nurse at my surgery seems to contradict what I read on the forum. Many people are being told or are choosing to eat very low carb diets. However I haven't been asked to count carbs and have been discouraged from doing blood tests. The advice has been to swap to brown bread, brown rice, brown spaghetti etc, more pulses and beans, more green leafy veg... cut out sugars, be aware of the GI of foods. I have asked to speak to a dietician and have a referral to arrange but wanted to get people's opinion of this advice. My family who are medically trained but not diabetic experts are furious at the care I'm getting but I can't decide whether it's bad or not?!?!

For a little background I was BS of 15.1 which dropped to 8.7 using diet and has since dropped to 7.6 taking 1 x 500mg Metformin (which I have been asked to increase every two weeks by one until I'm on 4 a day, 2 for breakfast and 2 for dinner/tea).

Anyone have an opinion on it? I've seen a few comments about poor diabetic care and wondered whether mine was considered it bad? Help!!! It all seems rather confusing to me...

Added - Interesting I've just had my first hba1c result and it's 75 (9%)... eek!

 

[Tracey69]

Hi and welcome,
I am a typ1 diabetic. We all need some carbs, this keeps us from hypo's or dropping to a low level bs. Like you have said i would ask to speak to a dietician as they can give you alternative foods. If you can follow the low carb then it would be better for you.
Hopefully daisy01 will be along, she is a type 2
Sorry if i haven't helped much but i think you need professional advice to get you started.
Take care
Tracey

 

[daisy1]

Hi Chew and welcome to the forum The most important thing about choosing what to eat is by testing before, and 2 hours after meals to see what effect each food has on your levels in spite of the fact they tell you not to test. You don't necessarily have to do a low carb diet but you do need to reduce the carbohydrates you eat. This is a completely individual thing and everyone is different as we say on here. The guidelines are just guidelines and you have to find out for yourself. You may have seen this information I give to new members but you should try out what it says and see if it works for you. The standard NHS instructions are not the best advice you could receive. Carry on asking questions and there will usually be someone here to help.

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.

 

[xyzzy]

Hi chew824 and welcome to the forum.

Yes I was discouraged from testing as well but ignored it as I reasoned how else will I know what is safe for me to eat. Also the NICE guidelines state you should test as a Type 2 if you understand and react to the readings you get.

On the diet and carb / gi question.

There are a number of ways a Type 2 can treat their condition but basically it comes down to three things. Firstly the amount of carbohydrates you eat, secondly the amount of drugs you want to take and finally how much risk with your blood sugar levels are you willing to take.

If you want to get your blood sugars back into a safe range then the majority of forum members would tell you to reduce your carbohydrates especially the starchy ones like rice, pasta, bread, cereals and anything else made with flour. Its just taken for granted that you will restrict drastically or completely remove all straight sugary things from your diet.

You can think that the standard NHS diet puts more emphasis on starchy carbs but will then expect you to take drugs to compensate and expects that you wont mind a relatively low regard to blood sugar risks. For an informed view on safe blood sugar levels this link is good if a bit depressing. http://www.phlaunt.com/diabetes/14045678.php

A lot of us don't accept the standard NHS view and in fact neither do a growing number of other countries health services and will tell you to restrict your carbohydrates far more than the standard NHS dietary guidelines. You can restrict in a number of ways but the two most common are through carb counting where you actually count the number of grams of carbs you eat a day and through portion control. If you carb count you can get the grams of carbs off the backs of packets but be sure to use the total count and not just the "of which sugars" amount. If you do it this way a good place to start would be to aim for around 120 - 150g of carbs a day in total which is the same kind of amount you would be recommended to eat by the Swedish health service.

The other way is to not bother with the counting but to just use portion control where you just reduce the size of the portions you are eating.

In both cases testing your blood sugars is then highly recommended as it will allow you to adjust your carb intake up or down so that you can keep your blood sugars safe.

Effectively it can work out that if you are willing to go on a very low carb diet you may find after a period of time you can control your blood sugars with no medication what so ever. If you pick a slightly higher level (like me) then you may need to take a simple safe and effective drug like Metformin to help a bit. With Metformin you don't get the risk of hypos and it doesn't put additional stress on your already overworked pancreas. If you want to still eat more carbs then you may need to take stronger drugs. The key thing is testing to ensure you are keeping safe.

Hope that helps and keep asking questions.