Control

[Northpart]

I am new to this Forum and have been avidly reading the posts and learning a lot. I have some questions I can't immediately find the answer to and would be grateful for any guidance.

I was diagnosed with Type 2 diabetes in 2003, and managed to control by diet up until this year. After not going to see the practice nurse for 9 months, not testing, and working away from home I suddenly started getting pains in my legs and feet. I booked an appointment at the surgery and bough my self some testing strips. My first reading was 10.2 mmo/l. I improved my diet and got put on metformin tablets. Since then I have been low carbing. I am 6 feet tall and my weight has dropped from 14st7 to 12st2.
I have some red marks on my feet, the nurse has inspected them, and I get some small pains but less than I did. I am 62. My readings are now highly variable from a low of 4.7 upto about 7.8 mostly around 6.0 mmo/l. There is a family history of late onset diabetes, my father got in his late 50s so did some of his siblings; some had amputations. Although my readings are better I find it very difficult to control and understand why sometimes they are high and sometimes lower, even with the same pattern of eating.

I believe the only way to avoid some nasty complications (given my family hsistory) is to have really tight control, more than I have now. I think it is hard to do much more with my diet, I am finding it difficult to keep weight on with a strict low carb diet.

So my questions: Are there any other meds I should be asking for? Can I have insulin to take with meals? Are there specialists I can see (my surgery is OK, but not what I would call cutting edge)?

Thanks in advance

 

[xyzzy]

Hi Northpart and welcome to the forum.

If you've been reading then you should have picked up that diet wise cutting out sugar then drastically reducing starchy food - rice, pasta, bread, potatoes, cereals and flour based products is the best way by far to control levels. If you get that right it is, in my opinion, ten times more effective than any medication apart from going on insulin.

As to meds I would recommend then I'd go on Metformin SR simply for the protection it gives your heart. I was worried after I got good control with low carb that the doc was going to stop mine but he luckily knew about the heart benefits as well so was quite happy I continued them. Depending on your blood pressure I'd also recommend you take an ACE inhibitor such as Ramapril. Again apart from reducing BP it has added benefits in protecting against heart disease, strokes and kidney problems.

As diabetics we rightly focus a great deal on blood levels but we shouldn't forget that most diabetic who die young do so from heart failure and strokes and that kind of thing not from purely diabetic complications.

On going on insulin then yes that's an option that any diabetic should have. It will certainly allow you to eat a wider diet but it does have its downsides. First it will tend to make you put on weight and the more weight you put on the more insulin you need so it can end up in a viscous spiral unless you control quite strictly what you eat. Going on insulin isn't a get out of jail free card regarding weight loss and healthy eating in fact it is just as important. There are of course other downsides such as the risk of hypo's and having to report you are an insulin user to the DVLA with the inherent risk of losing your driving licence etc.

Again welcome and keep asking questions.