Feeling a little frustrated.....

@Grasscutters

If you need help with French diabetes terms, @phoenix should be able to help you. I know some but not all/enough.You will be able to find some French words on the web.

Here is the information we give to new members. Not all of this will apply to you in France. Ask as many questions as you need to 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 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.

Hi and welcome. Is you husband on any steroids as these can make any diabetes worse? There may not be much he can do about that but at least be aware. Diet is the highest priority. Do follow Daisy's advice. Reduce the carbs. Root veg are more of a problem than veg that grows above the ground. Raw carrots are better than cooked both due to the higher level of fibre and they are lower-GI i.e. absorbed more smoothly. Metformin can cause some stomach/bowel problems. If it does, then ask for the Slow Release (SR) version. Is your husband overweight? If so then the Metformin will help reduce insulin resistance. Any weight reduction will help with blood sugar reduction.

Hi,I also was diagnosed in France but with T1. It is really hard at first trying to get your head around a condition when you can't ask the questions you would like. You do learn but it takes time. Where I live diabetes care is excellent but as with everything it can vary.
People on here will give you their own experiences of how to cope with T2. I'll try and give you a few pointers to the French system.

First of all, the care you should receive is codified and published so in some ways you can know what to expect of your Medecin traitant and what tests/examinations you should receive each year. (hopefully, if you can read French well enough to find your way round the normal bureaucracy then you should be able to read some of the documentation.)

T2 is considered to be a chronic condition and as such is an ALD (affectation longue duree) Your doctor has to fill in a form (not entirely sure how it happens since mine was set up by the hospital) Having an ALD means that all treatments/medications for diabetes will be reimbursed at 100% (minus the normal franchises on each act and box of pills)

The aim of diabetes treatment is to keep your glucose levels under a certain level through diet/exercise and medication. The first drug used in France for T2 (as in the UK) is metformin , diet and exercise are stressed as important.
The target in France is an HbA1c (that is a blood test which shows how high your levels have been over the last 3months) below 7%. At the start you should have this test after 3 months .Hba1c tests should be every 3 months if you aren't achieving your target or every 6 months if your diabetes is stable. (referred to as l’hémoglobine glyquée


You will also have other checks. Your doctor should give you presciptions for
cholesterol checks, ( total/ HDL/LDL and triglycerides) lipides or bilan lipidique A blood test normally done fasting )
If HDL (that's the good one) cholesterol is low, LDL is high or if you have other CVD risk factors he will prescribe statins.
kidney function
checks for kidney function ( a blood test for plasma creatinine, and small particles of protein in the urine ) creatinine sanguine , microalbuminurie
Neuropathy. Your doctor should test feet for sensation using a monofilament (a bit like a bit of fishing line)
Blood Pressure should be taken

Heart . He should do or send you for a ECG and possibly an exercise stress test (you may have to make your own appointment with a cardiologue)
Eyes. He should direct you to get your eyes checked for retinopathy (again you may have to make your own appointment with an opthamologist; the ones where I live have very long waiting lists so you have to book at least 6months in advance)

self monitoring (autosurvellance glycemique) ie testing for glucose with a meter at home. This is no longer reimbursed for people with T2 on metformin alone. (you can get 200 testing strips a year if you are on other drugs but it isn't systematic) Meters are expensive in France and so are strips.
( most T2s on here find self testing invaluable and it is often difficult for them to be prescribed strips in the UK . Many buy a SD codefree meter and strips which cost less than many other makes. I believe they send to France)

You may be offered 'education' (ie a course at the local hospital or maison du diabete)

Here is a leaflet for patients from the health authorities about the ALD (2007 though and they have changed rules of self monitoring since then)
http://www.has-sante.fr/portail/upload/docs/application/pdf/bd-07-059-diabete_2_mars_08.pdf
Here is more recent but very much more technical
http://www.has-sante.fr/portail/upl...lis__3_juillet_07_2007_07_13__11_43_37_65.pdf


They also try to encourage people to join Sophia. This is a telemedicine service for diabetes. They have a website here with lots of info about the tests that you should have and their recommendations for diet and exercise . You can just join but of course speaking on the telephone is something that a lot of us find extremely difficult. https://www.ameli-sophia.fr/diabete/alaune-diabete.html


Oh one last thing, most blood glucose and some other tests in France use different units to the UK
Blood glucose is measured normally in g/l (in the UK they use mmol/l)
There is a converter on here that converts mmol/ to mg/dl (millimoles per litre to milligrams per decilitre ) http://www.diabetes.co.uk/blood-sugar-converter.htm
to then change to g/l you have to move the decimal point as here


Lab tests either use g/l or mmol/l but often include both on the report.
HbA1c is measured in percentage whereas in the UK they have changed to mmol/mol .There is another converter here.
http://www.diabetes.co.uk/hba1c-units-converter.html

Hello and welcome.

Yes, it is all very confusing at first, and must be doubly so for you in a foreign language.

Basically, the only way to control blood sugar levels for a type 2 is by diet and exercise. The diet isn't so much a diet as an eating plan that needs to be followed for life, not just a few months. Obviously he needs to cut out sugar, sweet stuff, fizzy drinks, cakes and so on. He also needs to be careful with carbohydrates. These little monsters convert to glucose once inside the system, especially the starchy ones. As we don't want too much glucose in our system we need to cut down on the major carbs. (Potatoes, cereals, pasta, rice, bread, pastry and anything with flour in it.)

If you get him a meter, and I strongly urge you to do so, you can use it by testing his levels before and after meals. This will tell you what that meal has done to his levels. By doing this over and over for the first few months at least you will learn which foods he can or can't tolerate. We are all different in this. He may find he can tolerate 2 small new potatoes for example, but no more. Jacket spuds and mash are really bad. New or roasted not as bad. Any dairy except milk is fine, so cheese, olive oil, butter, unsweetened yogurts are all OK. You have to be careful with milk and fruit as they contain a lot of sugar.

The good news is, red wine is fine (and a dry white).

Do have a read round and ask as many questions as you like.

Grasscutters said:

Thanks so much for all the info. I am very grateful! My husband is following LCHF diet as this definitely seems the way to go.
Have sent for the meter and should receive this soon. Feel much more confident in dealing with this now. He is drinking Almond milk instead of cows milk, and apart from a couple of roads potatoes on Sunday has not had any carbs.
I have seen a bread which is made old Flax and sunflower. Would anyone know if this would be ok?

Many , many thanks!

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If this is the mix that you order and make yourself it is ideal - only one carb a slice!
Here's the link http://www.sukrin.co.uk/sukrin-brea...t-free-sunflower-and-pumkin-seeded-bread-mix/
Good luck and ask any questions you may have.

Try the Burgen bread.
You can find it in most supermarkets and Iceland have for a £1 a loaf. It is soya and linseed. It doesn't spike me and I think it tastes better than most others!