CRASH COURSE

It seems your sister has been given similar advice to most of us type 2's as regards diet.

Carbs will raise BS levels.(potatoes, bread, rice, pasta, cereals) Fats will not. Protein does have some affect on BS levels, but not so much as carbs, and we all need protein to build up and protect our muscles, so cutting that is not wise. If she needs to gain weight you need to increase her calories, and best to do this with increased fats such as cheese, butter, eggs etc. Have you read this thread? http://www.diabetes.co.uk/forum/threads/a-new-low-carb-guide-for-beginners.68695/

She can eat any meat, any fish, some oily fish, eggs cooked any which way, cheese, above ground vegetables, salads, butter, olive oil, bacon and eggs with tomatoes and mushrooms. Cheese is very calorific, as are other dairy foods.

Hope this helps a bit, and good to see her infection has subsided. Now that has gone her levels may improve on their own.

Good luck, and let us know how your sister gets on.

@SallyH

Hello Sally and welcome to the forum

Have a read of this information we give to new members as you will find advice which will help your sister. Ask all the questions you need to and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

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 over 130,000 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-and-whole-grains.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 bloodglucose 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.

Also take a good look round the main website. There is a lot of information that I'm sure will help now and in the future.

Hi and welcome.

It seems like a tremendous amount to take on board, to start with, doesn't it?

But don't worry, it all becomes clear.

If you want to know what sort of meals people actually eat when they reduce the carbs (sometimes it is easier to imagine meals, rather than do s and don't s), then have a look at these three threads:

This is full of low carb recipes
http://www.diabetes.co.uk/forum/threads/low-carb-recipes.4871/
Then this is what people are eating on a daily basis (and quite a lot of chuntering about how they feel about it )
http://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.36803/page-218
And this has lots of vegetarian recipes, including puds and cakes
http://www.diabetes.co.uk/forum/threads/vegetarian-vegan-low-carb-recipe-index.61859/

Your sister may not want to go as low carb as many of the meals on these threads, but she could always add a controlled amount of carbs, if she likes.

Hope this helps.

Hi. I agree with the posts so far. Yes, increase calories from proteins and fat but keep the carbs down. No diabetic can eat anything. They can eat almost any food but the quantities of things like carbs must be kept down. The meter will help guide you as we are all different. If your sister does not put weight back on having increased the overall calorie intake then do come back and let us know.

Pleased to hear your sister is so much better.
We'll look out for your update.
BeeGee

As a novice I would hazard a guess that night sweats might be part of carb flu (which I haven't had but others can give details), and I would persevere with low carb as explained on this forum (no oats, root veg, pasta or bread) and increase the fat intake in the form of double cream, cheese, good quality (grass-fed) butter etc if these can be tolerated. Plus green veg and some meat, including fat of course. The "low fat leads to health" mantra is hard to shake off, I know.

SallyH said:

Daisy, I am indebited to your site and the help offered to me during my present predicament.

As you have probably gathered, I do not have a great interest in food, and really, I only eat to stay alive. I do not have any interest in it whatsoever, hence my complete lack of knowledge of what does what so to speak.

However, I am gaining in knowledge each day, and I'm sure by the time I've finished, I will be a qualified Diabetic Nurse . I have made my sister a file, and I am copying all the information being offered, so at least when she is strong enough, she will have a good idea what is required. Who knows, I may need it myself one day, so I will be armed and ready.

Thank you everyone for all your help.

Sally

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Alternatively you could refer her to www.dietdoctor.com
Hope this helps!

SallyH said:

Hello All,
I have been waiting to post until after the 7th January when my sister had her appointment with the Diabetic Nurse, but I’m afraid it has thrown up more questions than answers.

The appointment was initially made by the GP when she was very ill over the Christmas period – it was with a view to her being put onto insulin. However, her levels have dropped considerably now and the nurse advised that she wouldn’t dream of putting her on insulin with levels that are so ‘good’.

My sister explained that she had been watching the carbs, but was advised that she needs carbs to ‘keep her warm’, particularly during winter. The nurse then went on to advise that she should be eating porridge and baked potatoes with their skin on. I am really baffled by this, as this doesn’t seem to be the correct advice for someone who has had chronic diarrhea for over twelve months.

What is worrying me more than anything though is the fact that the weight isn’t really going back on, and this last week has fallen back again. We have wondered if this is down to the low carbs.

I also think her levels may be a bit too low, but what do I know – for several mornings now it have been around 3.9 rising to 6.8 around bedtime.
Since being on low carb, she doesn’t appear to have had the diarrhea much, one or two occasions that’s all, and she thinks that may have been down to fresh cream, so she has knocked that off for the time being.

Do you think she should be trying a few more ‘higher carb’ foods in an effort to increase her weight, whilst of course, keeping an eye on her sugar levels. As I have mentioned before, may be on another thread, she has been tested for Crohn’s etc., and everything was showing clear.

I would be grateful for any suggestions as to the best way forward at this stage.
Sally

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I regularly have blood scores in the 3s and I'm quite happy with that. Whilst T1s have to watch very closely if their bloods drop under 4, for those of us in the T2 and not on hypo inducing meds, pre-diabetes or non-diabetic camps these lower numbers are much less significant, unless we feel unwell. Some people feel off at those numbers, but many don't. Non diabetics also spend time in the 3s, but mainly never know, because they're not testing. Please don't be alarmed by the number, in isolation. On the odd occassion I have dipped to the very low 3s or into the 2s, and felt a bit rough, I just have a cup of tea, with milk, and that brings me back up enough to help me feel better, but not give me a spike.

I appreciate your sister lost weight due to her urine infection a few weeks ago. Does that leave her medically under weight, or is the concern just to regain the weight lost to fill out her clothes again?

The advice given by her nurse is sadly incorrect for diabetics. She is pushing the Eat Well plate the NHS want everyone to eat, but it really isn't suitable for us. Jacket spuds are not a wise choice and neither is porridge for most of us.

If she is still losing weight it could be because she is having insufficient calories from either fats or protein. It is a fine balance, but needs to be addressed. Maybe extra cheese or meat/fish/eggs?

I would be reluctant to increase the carbs by too much, but of course you could try this and keep testing to make sure her levels aren't increasing. Is she testing her meals, ie before and 2hrs after to see what the rise is? This is a good way of adding back a few carbs in small portions and seeing if they are OK for her. A rise of 2mmol/l is acceptable, although up to 1.5mmol/l would be better.