Doctor confirmed off the scale reading and need help with

Hi jziggy and Welcome to the Forum. I will tag @daisy1 who will provide you some basic information.

If you tap on FORUMS at the top, scroll down to FOOD and NUTRITION there you will see: Low Carb Diets, Low Calorie Diets, Weight Loss and so on. Hope this will be of some help to you.

Lots of us here find that cutting down the carbs helps reduce the blood sugar levels ..

Enclave said:

Lots of us here find that cutting down the carbs helps reduce the blood sugar levels ..

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Definitely

@jziggy

Hello and welcome to the forum Here is the information we give to new members which should help you on your choice of what to eat to keep your blood levels under control. Ask more questions and someone will be able 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 over 150,000 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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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.

Breakfast is easy: bacon and eggs.

jziggy said:

Hello this is my first time one here, I was diagnosed with Type 2 diabetes around 2 years ago but tablets were initially not necessary, My recent check has revealed I that I am now off the scale. My Doctor said I should be on insulin but he has given me 2000mg a day Metformin until May to see if insulin can be avoided. I have stopped my daily Cappucino's and sugar in tea, however, I am really confused as to what I should or shouldn't eat. Can anyone recommend a safe breakfast and Lunch to take to work as I find evening meals easier with help of the oven and microwave ? Thank you

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Hi. Firstly..what is "off the scale"? Can you let us know any test results or recent levels?
Secondly...Do you have a self-testing meter? Do you know the best times to use it?
Finally...what else are you eating/not eating? Reducing/avoiding completely simple carbs (bread, cereal, spuds, pasta etc etc) will result in lower blood sugar levels. Investigate low carb dieting..

and breakfast/lunch ideas -
boiled eggs, fried eggs, bacon dried bacon strips, smokes cheese slices cold meats (if low in carbs)
tuna fish john west tuna infusions avocados leafy salads brazil nuts

avoid milk and bread

Let us know how you get on. Good luck

jziggy said:

All I know is that I went from 48 to 59 and now I haven't a clue as all he showed me was a graph that disappeared off the page and said I should take tablets and he will call me in May. I don't have a self testing meter but I will get one and as you can probably tell, I have no idea what I will need to do. I am really confused as when people normally talk about levels they talk about 5's and 6's. So far I have eaten tinned fish, eggs, bacon, chicken, vegetables, salad and a little cheese....need to study more and go shopping myself

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This chart may help, since it has the standard measures all compared to each other.



The 5s and 6s are along the bottom - the finger prick numbers (the home test kit). I assume the 48-59 measure is the HbA1c (top blue) number - although it would seem odd to me to describe that as off the scale.

I'm from the US, so we use a different set of numbers (mg/dl and % for A1c) - so I still have to think way too hard to remember what a particular set of number mean here. Maybe someone else will recognize if there is still another set of numbers where 48-59 would be considered "off the scale"

In the US, I could call or email my doctor's answer if there is something I was too shell-shocked to think of at the time. (I did that with my diagnosis - which was a triple diagnosis of diabetes, Hashimoto's hypothyroidism, and vitamin D deficiency. I had him send me the lab results so I could go look things up.)

I'm on a small dose of Metformin (500 mg) and haven't had a bit of GI trouble with it. If the regular metformin doesn't work, ask about extended release. It is less likely to cause GI issues I don't drink much, but I had a glass of wine last night - no issue.

I control my blood glucose almost entirely by diet - I was in the normal ranges before the Metformin had a chance to kick in, so as near as I can tell it only helps the high readings I have in the morning. I log and test everything I eat, and cut back or eliminate anything that elevates my blood glucose. By testing, I mean that I test before eating and at 1, 2, and (if necessary) 3 hours after I eat. I have a personal cutoff of around 6.9 that triggers reconsideration of whether the food is something I can eat. That's pretty low and aggressive - but it was easier for me to make dramatic changes now while I'm really motivated by the diagnosis to fix this. Some people prefer to make much more gradual changes (like just cutting out the worst offenders - sugar, fruits other than berries, and white starches)..

The numbers are confusing as has been said. Charts like the one posted by Neohdiver help demystify things. The chart below will add to this hopefully. Basically, your 59 is an HbA1c test result (indicating the average over the last 3 months) and it equates to an average meter reading of 9.2mmols. When people talk about 5s and 6s they are talking about mmols (reading on their meters). The chart below will help you convert readings as a guide. While important for our own control of things, the meter readings are obviously in the moment and are not necessarily accurate representations of averages over time. So the HbA1c test from time to time clarifies that. Your earlier 49 would be 7.8 mmols on a meter. 5's and 6's are more normal range. (9.2 is kinda high - it is not "off the scale" as you can see from..the scale!...but it is too high and can and will come down with effort). Check people's details in their signature/footnotes to make comparisons. Don't worry about feeling overwhelmed..that's normal until you get a grip of foods etc...keep experimenting, testing and noting results after certain foods..you'll get there. Ask, ask ask! Paul

Hi @jziggy. Welcome to the forum. Hope the 2g of Metformin do the job.

Hi Ziggy I was diagnosed 4 weeks ago with a reading [ off the scale ] 19.3 now 4 weeks later with controlling diet 7.1 this morning. I eat bran flakes and blueberries for breakfast and alternate it with poached egg 1 slice of dry cured bacon, grilled tomatoes. Lunch rivitas with low fat cheese spread or cottage cheese lots of salad including red peppers Dinners chicken fish tuna mackeral etc with plenty veg. No sugar in tea drink coffee [black] everyone on here eats different things too, what suits one might not suit another but just giving you examples of what works for me. Hardly eaten any potatoes never eaten rice [ not a lover] eat melon regulary.

amgrundy said:

Hi Ziggy I was diagnosed 4 weeks ago with a reading [ off the scale ] 19.3 now 4 weeks later with controlling diet 7.1 this morning. I eat bran flakes and blueberries for breakfast and alternate it with poached egg 1 slice of dry cured bacon, grilled tomatoes. Lunch rivitas with low fat cheese spread or cottage cheese lots of salad including red peppers Dinners chicken fish tuna mackeral etc with plenty veg. No sugar in tea drink coffee [black] everyone on here eats different things too, what suits one might not suit another but just giving you examples of what works for me. Hardly eaten any potatoes never eaten rice [ not a lover] eat melon regulary.

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Well done @amgrundy your BG levels are fabulous! And all achieved in 4 weeks! you are a star. Hope that your story inspires @jziggy
I have a similar story once I started low carbing my blood sugar dropped into the normal range very quickly. Good luck @jziggy sounds like you're well on your way to low BG levels already. X

I think this 'off the scale' comment by medical professionals is highly UNprofessional. And dramatic. And nonsensical.

A reading of 19mmol/l is nowhere near 'off the scale', since home meters usually go up to 30 or 33 mmol/l as standard! Readings higher than that come back as 'Hi' and the manual recommends the user contact their doctor.

In the UK doctors regularly see people with reading in the high 20s, and send them home with metformin, or an appointment the next week. We see these people turn up on the forum regularly. It isn't ideal, but it happens.

What I suspect is that the medical professional in question was looking at a chart that stopped at lower figures. But that doesn't mean that higher figures are not possible, and often exist on other charts.

Such readings are not ideal, and they should be reduced by diet, exercise or medication. But there really is no need for such an absurdly melodramatic beside manner.

'off the scale' indeed.

*wanders off muttering indignantly at such ridiculous scaremongering*