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Eating Less / Smelling More...

T

TPO

Active Member
Messages
31
Hello,

This is my first visit to any diabetes related website despite being diagnosed with type 2 about 3 years ago. Im 26 and about 25 stone so a pretty big lad. Im just looking for a bit of reassurance about what I am experiencing at the moment. Apologises if this is the wrong forum to be posting this.

I dont want to give you all my life story so I'll give this brief. When I was first diagnosed, my blood sugar was at 21 and my HBA1C at 11.6. My blood sugars are now about normal and my last HBA1C was 6.7 so I think I have done relatively well with regards to controlling my diabetes. Now, I want to lose weight.

About 2 weeks ago, I started eating less. I wouldnt really call it a diet although I suppose it really is. Im eating three meals (10.30am, 1.30pm and 5.30pm) with no snacking and my calorie intact is roughly about 1800 a day. ROUGHLY. What I am basically doing is cutting down what I eat at first and then I will diet (properly) later. I just want to get used to eating less first - does that make sense?

Anywayyyyyyyyyy, sorry for all the waffle. My question concerns my breath. Although no one has mentioned that I have bad breath, I have that taste in my mouth that I know my breath probably isnt the freshed. I am always chewing sugar free gum to try and combat this. I have looked into the cause of this and it would seem that the explanation concerns keytones. Am I right in thinking that my body is eating away at the fat because it isnt getting enough food and this burning of the fat is causing bad breath? Is this healthy (keytones)? Also, I am still eating carbs. A typical day looks like so :

Breakfast : Three slices of toast with butter.
Lunch : A roll with filling.
Dinner : Chicken and potatoes / pasta and sauce.

If someone/anyone could maybe give me some advice, that would be much appreciated.

Thanks x
 
TPO,
Welcome.
Re diet, my suggestions would be as follows:

Breakfast : Three slices of toast with butter.
Ditch the toast and try some egg ( if you must, have ONE slice of Toast)

Lunch : A roll with filling.
Try a nice salad (no potato salad/rice) or put the filling in lettuce leaf.

Dinner : Chicken and potatoes / pasta and sauce.
Chicken/meat fine but cut back on potato/pasta and make sure not too much carbohydrates in the sauce.

I my suggestion may be a bit harsh but you could cut the carbs gradually. Th reduction in carbs will be important.
I WOULD ADVISE TO TEST YOUR BLOOD TO FIND WHAT MAKES YOUR BLOOD SUGAR RISE TO TAILOR YOUR DIET TO YOU.
P.S. I'm a big guy too (looks like I've eaten a bear (or two) and left the a*se hangin' out!) like Dougall in Braveheart!
 
Hey man,

Cheers for getting back to me.

Thanks for the advice :-) So is keeping carbs to a minimum the best way to go? Like I said at the moment, Im just cutting down but I will eventually be looking to properly diet.

I dont suppose you have any knowledge about keytones and whether they are healthy?
 
Hi TPO, so well done so far. For me personally I eat a low carb diet which I know helps to lower my blood glucose levels as I test and I now know what I can and cannot eat. I have had to give up bread, pasta, rice as they send my B/G levels soaring, as Fergus Crawford wrote you personally will need to see what makes your B/G levels rise.
So now for breakfast I eat eggs and bacon or bratwurst from Aldi or Lidl, omelletes, scrambled, kippers, smoked mackerel. I eat plenty of salads and protein in the form of meat, beef, chicken, pork, lamb, cheese ( I do try to limit this as to too want to lose weight), all types of fish and vegetables. Instead of bread I now make savoury MIM's as a substitute and julienned courgettes instead of pasta and cauliflower mash and cauli rice instaed of mashed potato and white rice. The bad breath you mentioned is associated with the bi-product of ketones when in ketosis on Atkins diet although your are still eating carbs
I have bought books on the subject (not expensive from Amazon) i.e. "New Atkins New You",
"Protein Power" b Dr's Michael and Mary Eades and "What they don't tell you about DIABETES" by Jenny Ruhl. I have found these books excellent explaning not only diabetes but the relation to weight loss, ketones and a more energised way to live. Hope this helps and best wishes, Debra x
 
Thanks for the reply :-)

When I first got diagnosed, I was on one Metformin tablet twice a day but that got upped to two twice a day and that seems to work get things under control. Since I have been eating less, I have reduced the tablets to one twice a day again as I found the side effects (toilet problems) of two twice a day unbearable. But I have been keeping an eye on my BG levels and they are all OK.

What is the best way to find out what causes my BG levels to rise? Like when is the best time to test myself after eating? How long with the tablets take to begin working etc.

Why are carbs so bad for diabetics?

I might go and look into buying one of those books but in the mean time, does it sound like I have keytones? And is this healthy?

Thanks again x
 
Hi TPO, you asked why carbs are so bad for diabetics well it's all to do with reduced insulin or I should say insulin resistance so the insulin isn't working properly to convert glucose so it rises read the section "Ask a Question" by SugarlessSue showing when to test, I test on rising, and 1 and 2 hours after eating something new. Spend time in this forum looking at all the threads and the answers will be revealed, Debra x
 
Your questions regarding ketones seems to been lost amongst the advice being given ref food.....

Ketones and ketoacidiousus (sorry can't spell) are two different things. I have never had eithe one, so I can't give any advice on this, I wish I could.

As for breath, the first thing I would check out is the dentist, as it is these persons that can help, as there could be something else that is causing this. After the dentist I would be going to GP.

YOu don't say whether this has been a long standing problem or just recent...
 
donnellysdogs said:
Your questions regarding ketones seems to been lost amongst the advice being given ref food.....

Ketones and ketoacidiousus (sorry can't spell) are two different things. I have never had eithe one, so I can't give any advice on this, I wish I could.

As for breath, the first thing I would check out is the dentist, as it is these persons that can help, as there could be something else that is causing this. After the dentist I would be going to GP.

YOu don't say whether this has been a long standing problem or just recent...
Click to expand...

Thanks for the reply. I was at the dentist last week and everything was OK with my teeth and mouth so I think we can rule that out :-)

The problem of bad breath only occurred when I started eating less (dieting). It happened when I ate less before - I had a relapse into bad habits, oops - and now its bad so I have to presume that it is connected.
 
Hi TPO, sorry didn't reply to ketone question. If yoy are type 2 then the ketones on your breath should be because your body has switched to burning fat instead of glucose which prevents it rising, you can buy ketostix from pharmacies which you pee on and they will tell you if you have ketones present around £5.
Ketoacidosis is a very serious medical condition which happens to type 1.
As to what ketones mean and when to test refer to "Type 2" section of this forum for all your answers but as I agree with donnellsdaog to see a dentist as you may be wrong about it being ketones as you do seem to eat alot of bread but then you said that you are a big guy so that may be the reason, regards, Debra x
 
Hi TPO

There's some advice called 'Information for Newbie' which I believe is a sticky thread on the Board Index. Have a look at that - it's excellent advice, and tells you all about testing etc.

As for your bad breath - at the moment I don't think you're low-carb enough to be in ketosis (ie, burning fat instead of glucose) so it will probably be something else. Did it coincide with an upset stomach or the high dose of Metformin? That sort of problem can sometimes cause bad breath.

Do you drink plenty of water? 2 litres a day is advised, just of plain water. Also - eat plenty of raw green leafy vegetables. The chlorophyll in the leaves can help with breath smells. Parsley is great for that, if you can eat it. Just a sprig or two!

I have a diet called 'Viv's Modified Atkins Diet' on the Low-carb Forum which will certainly help with your weight loss. Have a read of it and see what you think. The whole thread covers many questions, but if you have any more, just ask! That diet will also lower your cholesterol and BP - at least, it does for me!

Hope that helps

Viv 8)
 
diadeb said:
Hi TPO, sorry didn't reply to ketone question. If yoy are type 2 then the ketones on your breath should be because your body has switched to burning fat instead of glucose which prevents it rising, you can buy ketostix from pharmacies which you pee on and they will tell you if you have ketones present around £5.
Ketoacidosis is a very serious medical condition which happens to type 1.
As to what ketones mean and when to test refer to "Type 2" section of this forum for all your answers but as I agree with donnellsdaog to see a dentist as you may be wrong about it being ketones as you do seem to eat alot of bread but then you said that you are a big guy so that may be the reason, regards, Debra x
Click to expand...

I think I definitely need to do a bit more reading on Type 2.

Are ketones bad? If I am trying to lose weight then do I not want to burn fat?

viviennem said:
Hi TPO

There's some advice called 'Information for Newbie' which I believe is a sticky thread on the Board Index. Have a look at that - it's excellent advice, and tells you all about testing etc.

As for your bad breath - at the moment I don't think you're low-carb enough to be in ketosis (ie, burning fat instead of glucose) so it will probably be something else. Did it coincide with an upset stomach or the high dose of Metformin? That sort of problem can sometimes cause bad breath.

Do you drink plenty of water? 2 litres a day is advised, just of plain water. Also - eat plenty of raw green leafy vegetables. The chlorophyll in the leaves can help with breath smells. Parsley is great for that, if you can eat it. Just a sprig or two!

I have a diet called 'Viv's Modified Atkins Diet' on the Low-carb Forum which will certainly help with your weight loss. Have a read of it and see what you think. The whole thread covers many questions, but if you have any more, just ask! That diet will also lower your cholesterol and BP - at least, it does for me!

Hope that helps

Viv 8)
Click to expand...

Thanks for the reply. I definitely dont drink enough water. Does it need to be plain water as opposed to adding no added sugar squash?

I'll head over and have a wee look at your diet now :-)

Thanks.
 
Plain water is best, I think. I fill a 2 litre jug with fresh water every morning, and make sure it's empty before I go to bed.

Ketones are bad if they are caused by high blood sugar levels. If your BG readings are high - I think in the teens and twenties, but there's probably a thread on here somewhere - and you feel nauseous and unwell, test with the glucose urine testing sticks mentioned above; if they show high sugars, get to A&E quick! you may have diabetic ketoacidosis (DKA).

If your sugars are low (for you), and you've been eating low-carb, you should be in ketosis, which is when your body is using your fat for fuel. It's perfectly natural, and harmless. Search on here, or Google for both of them - the wikipedia articles are quite good, for once.

Type 2s don't usually get ketoacidosis, but we can. Don't let it worry you unduly; you really feel ill with it, as well.

Viv 8)
 
I don't know enough about ketones so can't add to that but I have recently been losing weight, by cutting down and exercising more. I cut out bread quite a lot, and at the gym I increased my cardio work. Ask your doc nicely and sometimes they can refer you to a gym at heavily reduced rates for a period of time. And as you start seeing results you'll probably want to stay on after that time anyway, seeing results and receiving compliments feels great so it's worth making the effort
 
Hi TPO and welcome to the forum :) This is the "Information for Newbies" that diadeb and viviennem referred to earlier in this thread. It was written for new members by Ken and Sue, former monitors and you will find in here a lot of information that will help you to look after your diabetes as well as possible.

Here is the advice that Ken and I, as Forum Monitors, usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091



Sue/Ken.
Click to expand...
 
viviennem said:
Plain water is best, I think. I fill a 2 litre jug with fresh water every morning, and make sure it's empty before I go to bed.

Ketones are bad if they are caused by high blood sugar levels. If your BG readings are high - I think in the teens and twenties, but there's probably a thread on here somewhere - and you feel nauseous and unwell, test with the glucose urine testing sticks mentioned above; if they show high sugars, get to A&E quick! you may have diabetic ketoacidosis (DKA).

If your sugars are low (for you), and you've been eating low-carb, you should be in ketosis, which is when your body is using your fat for fuel. It's perfectly natural, and harmless. Search on here, or Google for both of them - the wikipedia articles are quite good, for once.

Type 2s don't usually get ketoacidosis, but we can. Don't let it worry you unduly; you really feel ill with it, as well.

Viv 8)
Click to expand...

My BG levels have generally been low recently but I have just done a test with carbs. I was 5.6 before eating. I then had three slices of toast and a metformin tablet and tested again 2 hours later and I was at 12.6. Im glad I joined this forum as I had no idea that carbs were so bad for diabetics. I think Im going to give your diet a shot and see how I get on.

Thanks x
 
daisy1 said:
Hi TPO and welcome to the forum :) This is the "Information for Newbies" that diadeb and viviennem referred to earlier in this thread. It was written for new members by Ken and Sue, former monitors and you will find in here a lot of information that will help you to look after your diabetes as well as possible.

Here is the advice that Ken and I, as Forum Monitors, usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=20&t=17091



Sue/Ken.
Click to expand...
Click to expand...

Thanks for that :-)
 
It's important that it's know that Type 2's can ALSO go into DKA (Ketoacidosis)

Ketones are the end product of your body burning fat instead of using immediate energy from glucose.

Type 2's are less likely to get DKA because they still produce insulin, the problem is in the body using the insulin or the body not quite making enough, or a combo of both. So the body is still able to use glucose stores, which it will do FIRST, if the body needs more energy then it will THEN break down fat resulting in ketones being present in urine and as you mention in breath too as the body will expel this in any way possible because it's an acid.

In Type 1's there is no or very little insulin production, therefore the body goes immediately to fat stores to convert to energy, because this is the only source, the ketones build up very quickly and become very acidic in the bloodstream which can be a life threatening illness, which is also the reason why Many type 1's will experience weight loss before being diagnosed with type 1 diabetes.

Back to type 2...

If the blood glucose is high, this indicates too little insulin or the body showing an extreme lack of being able to use the insulin already produced, hence the need for medication to either allow the body to use the insulin that it present better, or meds to encourage more insulin production from beta cells...

Because the body is clearly struggling to make use of the glucose present, the same thing can happen that commonly happens to Type 1's and ketoacidosis can also become a major problem, because the body cannot process the glucose in the same way Type 1's can't which is evident in high blood glucose.

Ketoacidosis may be quite rare in Type 2's but it DOES happen!!!

Ketones when on the atkins diet closely monitored is a way to indicate weight loss. If you are thinking of starting such a diet, please consult your doctor before making any drastic changes to your diet.

When producing ketones through diet and safely controlled you body will still want to get rid of these, so it's best you drink lots of water as suggested already if you go down this route and confirm your body is making ketones.

hope this sums things up about ketones a bit better.
 
TPO asked: Why are carbs so bad for diabetics?
Click to expand...

Please don't jump on me, those that know better, unless I'm totally wrong!

Basically (and very simply), diabetes occurs when the body has a problem with metabolising glucose.

All the carbohydrate we eat gets turned to glucose, quickly, and goes into the blood; some protein is also turned to glucose, more slowly; fat doesn't turn into glucose.

As we eat, the Beta cells in the pancreas start to produce insulin, which processes the glucose into fuel for the cells, and puts some into store in the liver for emergency use. If there's any glucose left over, some stays in the blood and the rest gets stored as fat.

In Type 1 diabetes, the pancreatic Beta cells fail, no insulin is produced, and the glucose stays in the blood. None is used for fuel; none is stored as fat. Type 1s lose weight rapidly, their blood glucose gets very high very quickly, and if it gets too bad they can - will! -die. So they inject insulin, or maybe use other medications, to get the glucose used correctly.

In Type 2s, either the pancreas isn't producing enough insulin, or the cells are becoming insulin resistant, or both, so the blood glucose isn't used properly and remains high. No matter how much insulin the pancreas produces, the muscle cells can't use all the glucose. With insulin resistance, unfortunately, the fat cells do not get insulin resistant, so the glucose gets laid down as fat! :shock:

Yes, Type 2 diabetes can make you fat! :roll:

If the body can't get enough glucose, it starts using stored fat, which is when ketones are produced (see Ebony's post, above).

Some medications stimulate the Beta cells to produce more insulin; others, like Metformin, help reduce the insulin resistance of the cells (among other things).

Exercise helps your body use the glucose more efficiently and speeds up your metabolism. I can't exercise much at the moment, so I'm concentrating on diet.

The above description is very simple and basic; there are more than 2 types of diabetes. I hope it's simple and accurate enough to be going on with (it's as much as I need to know!), but there are some very knowledgeable people on here who will correct it if I've gone wrong. Keep it simple, folks, please! :D

My personal approach to Type 2 diabetes is to limit my intake of carbohydrates to give my poor overworked pancreas a rest, so I eat a low-carb diet. I take Metformin, 1 x 500g 3 times daily, because it helps lower insulin resistance, it helps reduce appetite, and it protects a bit against stroke and (I think) cardio-vascular disease.

I was diagnosed in April 2010; after a period of denial, I accepted it, and went on to the Atkins diet. As of today, I have lost just over 3 stones; I have not had a bg reading outside the non-diabetic range for 2 months now - but this does NOT mean I can relax my guard. I still eat carefully, and I still test, though I do have the occasional treat.

My bg readings were not exceptionally high when I was diagnosed, because my GP was expecting it and I had a fasting blood glucose test every 6 months. I am thankful that I was caught so early, and very glad I like my low-carb diet - 'cos I'm on it for life, now. :D

Sorry if I'm teaching my grandmother to suck eggs, but I hope this helps.

Viv 8)

PS if you talk to your doctor about a low-carb diet, please do not mention Atkins! When you say that word many of them imagine you're going to lie about all day eating nothing but butter and cheese. Many haven't read the book, and won't listen. Maybe best to start by talking about "reducing carbohydrates". V
 
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