Conflicting advice

[Daibell]

Hi. Lots of good advice so far on this posting. It amazes me how many in the NHS still profer this bad diet advice since it's been known that carbs are the problem for many, many years. When I clap on Thursday to thank NHS staff for their work on Covid-19 I do remind myself that so many staff unwittingly through almost criminal PHE diet advice do harm to diabetics. Now isn't this the same PHE that has been 'managing' the Covid-19 crisis?

 

[KK123]

Thanks everyone I am going down the low carb route . Just wondered about the booklet ,
I have uploaded photos of it

Dear me. I wonder why their recipes actually seem to involve MORE carbs than an average person would eat normally, it's almost as if they are implying the carbs themselves are somehow the medicine for diabetes. Bizarre. x

 

[davd]

@David said he was on glimepiride, which is an insulin increasing drug, so the NHS have to supply a meter in case of hypos.
David, do you know your hba1c, as most doctors try diet and metformin first, so I'm guessing you may have had very high levels?
Be aware that the glimepiride acts by making your pancreas produce extra insulin, so low blood sugar may be an issue if you drastically reduce your carb levels while introducing the drug. Maybe call your nurse and tell her you are adopting a low carb approach and ask if you can delay taking the drug (though I think that is a pretty low dose). If you are taking it, make sure you always have some form of quick acting carbs with you (eg jelly babies, glucose tablets etc etc) in case of an unexpected hypo.

Generally T2s over produce insulin in a vain attempt to process the carbs that they can't tolerate, so taking a drug that makes you produce yet more insulin seems slightly counter productive to me, but that is pretty well all you can do if you don't reduce the intake of the food your body can't tolerate, carbohydrates.

If you're newly diagnosed you should also be aware that some T1s get initially misdiagnosed as T2s - ideally they should do GAD antibody and c-peptide tests to confirm the diagnosis but if you aren't young and thin many doctors don't bother. T2s outnumber T1s by a factor of 10 so the diagnosis is usually right. In case of T1 then low carb will only be a temporary cure for your condition, as the problem is a gradual destruction of all insulin producing cells, and insulin is the only long term solution. Luckily you have a meter so it should become obvious if that is the case.

Good luck.

My hba 1c , was 6 in December and 9 in April so an increase of 3 .
The GP put me on lowest dose of Glimepiride 1mg per day , but i am only testing first thing in the morning at the moment and struggling to get my mmol reading below 9 .
Starting off 6 days ago ar 13.7 rising to 15.7 day after then gradually reduced to 8.5 yesterday and back up to 9.00 this morning.
I am trying to keep to low carbs , for breakfast two rashes smoked bacon and one poached egg and one small toasted wholmeal slice of bread .
I don’t know if they will increase dosage of Glimepiride but until nurse rings me in 2 weeks time I will carry on as I am

 

[xfieldok]

Forget about fasting level, it will be affected by the dawn phenomenon and is usually the last number to come down.

By far, the most important testing is before you eat and 2 hours after. Stop with the toast!

 

[davd]

Forget about fasting level, it will be affected by the dawn phenomenon and is usually the last number to come down.

By far, the most important testing is before you eat and 2 hours after. Stop with the toast!

i don’t tend to eat breakfast much , so if I get up at 9.00am and have a cup of coffee Straight away .and eat Brunch at 11.30 is that a good time to do first test 11.30 and then test again 2 hours later

 

[xfieldok]

That would be perfect. Download the mysugr app and record your food and readings. I found invaluable.

I use double cream in coffee, lower carb than milk. And decadent

 

[Resurgam]

If you are eating bread then that isn't low carb - there are breads with small slices and just 4 gm of carbs - livlife for instance, but 'normal' bread is a lot higher.
I am more insulin resistant in the mornings so I have a tomato or small salad, or a low carb stir fry, but a maximum of 10 gm of carbs. Some people can eat more, but it would cause me to spike really high.
I then don't need to eat until evening, and I might have a dessert later on if I feel like it, though that isn't often these days.

 

[EllieM]

My hba 1c , was 6 in December and 9 in April so an increase of 3 .

That's a big increase for just 4 months. (from 42mmol/L to 75mmol/L) Many folk on these forums have started with higher levels and reduced them to normal by low carbing.

Good luck, and don't forget that T1/LADA has the same symptoms as T2, but needs different treatment. If your levels go down but then start going back up (without an increase in carbs) you need to push your GP to give you the c-peptide and GAD tests. (I am guessing he/she is fairly old fashioned because your hba1c was given to you in old style units (a %) rather than mmol/L (which has been used in the UK since 2011).

 

[Craigmartin]

Mentioned elsewhere that the appointment when they told me I was type2 the diabetic nurse whilst prescribing Metformin was very keen on weight loss alongside whilst week later the other diabetic nurse totally shot down not just low carb but any real benefit of weight loss and was insistent the tablets alone mattered.Told me not to get a meter and come back for H1 test early August.The fact id gone from 16.2 and 0.7 to 12.8 and 0.4 in just a week of under 50g carb she put down to the met.

 

[JoKalsbeek]

Mentioned elsewhere that the appointment when they told me I was type2 the diabetic nurse whilst prescribing Metformin was very keen on weight loss alongside whilst week later the other diabetic nurse totally shot down not just low carb but any real benefit of weight loss and was insistent the tablets alone mattered.Told me not to get a meter and come back for H1 test early August.The fact id gone from 16.2 and 0.7 to 12.8 and 0.4 in just a week of under 50g carb she put down to the met.

My endo believed a smidge of gliclazide got me back into the normal range, rather than my diet. Thankfully my GP *did* have her head screwed on straight and took me off of it, because I was having hypo's left and right.

 

[Craigmartin]

My endo believed a smidge of gliclazide got me back into the normal range, rather than my diet. Thankfully my GP *did* have her head screwed on straight and took me off of it, because I was having hypo's left and right.

This is a huge part of the conflicting advice received especially initially. The fact the 2 diabetic nurses within same practice give different guidance shows the problem.

 

[HSSS]

Mentioned elsewhere that the appointment when they told me I was type2 the diabetic nurse whilst prescribing Metformin was very keen on weight loss alongside whilst week later the other diabetic nurse totally shot down not just low carb but any real benefit of weight loss and was insistent the tablets alone mattered.Told me not to get a meter and come back for H1 test early August.The fact id gone from 16.2 and 0.7 to 12.8 and 0.4 in just a week of under 50g carb she put down to the met.

Well neither sound enlightened but I know which one I’d book for next time and which I’d avoid like the plague.

 

[davd]

That would be perfect. Download the mysugr app and record your food and readings. I found invaluable.

I use double cream in coffee, lower carb than milk. And decadent

Tried the double cream in coffee it all congealed in lumps not nice to drink .
Today i got up at 9.00 had coffee and at 11.00 tested 9.5mmol , took my medication Glimepiride and had 2 scrambled eggs with a small knob of butter in . At 13.00 retested and to my surprise it had come down to 8.3mmol I expected it to rise because of food . Would it be because of the Glimepiride kicking in.
Half expecting the nurse to increase the dosage if I can’t get it lower

 

[HSSS]

Eggs and butter have next to no carbs so no the food won’t raise your levels. It’s possible you have quite a dawn phenomenon and it simply wears off over the day so long as you don’t top it up with carbs. It’ll likely improve earlier in the day with time and start the day lower too as you stick with low carb eating

 

[xfieldok]

Never had that problem with double cream. Something similar happened when hubby bought extra thick cream, he thought he was treating me!

I wouldn't be looking at raising meds. Concentrate on keeping your carbs low. You had a low carb breakfast and saw the numbers improve.

You are starting out with a highish number first thing. This will be due to the dawn phenomenon and is usually the last number to come down. Ignore it for now.

 

[VashtiB]

If you are having trouble with the double cream you can add pure pouring cream- still lower than milk. You an also try unsweetened almond milk. Full fat milk is better than lower fat milk.

I use cream- haven't had that issue but it took some time for me to get used to it.

Good luck.

 

[Resurgam]

We have percolated coffee which the DH makes too strong for me, so I put the cream in first and add a small amount of cold water as I pass the sink, stir to combine the two and then add the coffee - if it looks really dark then I don't fill the mug and add more cold water on the way back.

 

[TriciaWs]

There is loads of research, mostly done in the last few years, proving that low carb works. Anyone who trained before that, or was trained by someone who hasn't heard of the new research will cling to the fat is the enemy line.
(Some of the research shows that a mix of processed fats and refined carbs is probably the worst thing for everyone - unfortunately that is the easy combination for businesses to run huge production lines and make more profit.)
My GP was OK with me trying low carb first instead of drugs, not supportive but willing to let me try it, but my diabetic nurse was not - she wanted my on metformin and statins - she was persuaded to look into the research once she saw my 3 month blood results as they confounded her expectation that my blood fats would shoot up, as my triglycerides actually fell.
The one person who wasn't convinced by the results was the dietitian who told me very firmly that I had to get more carbs.

About your finger test - did you clean both hands thoroughly first including rinsing off all the soap, and wipe off the first drop of blood to prevent contamination? I use a strip of clean tissue to dry my finger after washing rather than a towel.

 

[Daphne917]

Never had that problem with double cream. Something similar happened when hubby bought extra thick cream, he thought he was treating me!

I wouldn't be looking at raising meds. Concentrate on keeping your carbs low. You had a low carb breakfast and saw the numbers improve.

You are starting out with a highish number first thing. This will be due to the dawn phenomenon and is usually the last number to come down. Ignore it for now.

I have the same problem with cream in coffee - goes quite lumpy

 

[bulkbiker]

Tried the double cream in coffee it all congealed in lumps not nice to drink .

Stir it in.. was it "extra thick"? that can lump ..just get regular double cream and stir.