Getting confused the more I know!

[robbolondon]

Hi all
I was diagnosed with type 2 mid Jan. I think that my Xmas over indulgence, mince pies and roast spuds tipped me right over!
I found I had very high sugar levels, initially between 12 and 16. By cutting all sugar, booze, carby foods pretty much completely, sticking to low GI diet I got my level down to 6.7 and lost over 1 stone within a month. I'm on tablets 3 x a day. I feel so much better, more energy and a bit lighter too.
I then saw my surgery's diabetes nurse. She said I should be eating some carbs in every meal, what a relief.
I was getting fed up with almost none, and am not the kind of person to measure the content of every meal in detail. So since then I have had a little bread everyday, occasional sandwich, bran for breakfast, not much carb with meals, but some. Pasta sometimes, new pots, basmati rice etc which is what she advised and as most UK NHS diabetes advisors now say. I don't drink, I've not had any sugar, once or twice I've tasted a little bit of cake or desert, choc etc, as she says I should be able to have a tiny amount so I don't go crazy.
Today I heard Dr Briffa on radio 4 saying this is totally wrong.
I have not checked my levels for a few weeks, I have not felt the need to as I feel so much better, less tired, not thirsty, and the nurse agreed it was best not to go crazy monitoring too often.
I am now dreading taking a glucose reading, I watched the figure come right down, I felt good about it. I've actually lost my tester, but will buy a new one to see what's going on. I'm waiting to get onto a local hospital diabetes clinic list - that will be interesting to see what other peoples experience has been over a longer period.
I feel the information we are getting now is very confusing, especially online. It all sounds like they know what they're talking about but offer totally extreme advice, I don't know what to do for the best. I can't be the only one!
I don't want to ignore the advice I'm getting from my GP or local NHS clinic, as they should be my first and only port of call. But they also seem resigned to me probably needing more medication in the future, even when I see a rapid improvement in my glucose levels and a hoped that I can control it myself with the right diet and good exercise. I see some 'experts' think this is possible, mostly in the US. But the type of advice I see coming from the US totally contradicts the advice from here and I don't really trust doctors that have a book, website, diet to sell either. A website can make a nice income, do they never have ads? Dr John Briffa says Diabetes UK is sponsored by Kellogs so you can't really trust it, just as he has a book to promote, so who do I (we) turn to?
I am not a doctor and will never fully understand the detailed medical aspects of diabetes. I like many others have to accept and follow the advice we are given, as with many other illnesses - we should trust our experts. I expect as time goes on I will balance my diet and see my sugar levels stabilise and my lifestyle changes will be easier to live with. But I am very concerned right now that the advice I am given is quite possibly wrong and could cause my condition and related problems to get worse in the years to come.
What can I do for the best?
R

 

[Anonymous]

Hi Rob,

I know what a lot of people who are type 2 on here would say, myself included, but there's a simple way to determine what you should believe and what, ultimately, is best for you.

If you find your meter and take a few simple tests now, you'll find out whether you're running levels that are safe or are doing you harm. You don't need to change your diet to do this and you don't have to ignore the advice of your professionals.
Take a reading, eat a normal meal, wait two hours and take another reading. If a starting point of say 6.5, rises to something is well in to double figures, then your medication or diet is not sufficient to prevent you having complications at some stage.

Then d the same test, but with a low carb meal - same meal but without the spuds if you like. Do the test again at two hours and make a note of how much change you see. I suspect, because I already have a view and a lot of testing behind me, that you'll be surprised.

Everyone is different and we all have to deal with this our own way, but I have a diabetic nurse who thinks low carbing is the best approach - she is a senior specialist in the same NHS as your diabetic nurse. They can't both be right. So my advise s get some facts about YOUR condition by testing yourself.

 

[lozzark]

Robbo,
In a sense all are correct. Your condition requires you to moderate your carb intake. The extent to which you have to do depends on you. A diet without some carbs can be unattractive and boring. People are often misled by the term "sugar". They think of it as the white crystalline stuff you find in a sugar bowl. In fact that type of sugar is sucrose and it is half glucose and half fructose. Glucose is the sugar found in the bloodstream that requires insulin to metabolise. Starch on the other hand is all glucose. When digested it turns completely into maltose, which the body converts to two molecules of glucose. Yes that is right, a gram of sugar only contains half a gram of glucose, but a gram of starch contains a gram of glucose. The issue is how fast these processes happen. Locozade, which contains HFCS, a substance similar to sugar, will rapidly fill the blood stream with glucose. Nuts & beans, which contain some starch that enters the bloodstream very slowly, so slowly, you may not even notice it. Starches such as bead & potatoes arrive as glucose somewhere in between depending on the nature of the carb, how much you eat, what you eat it with and how much you eat. You can include some carbohydrate at every meal, but be careful of the type (choose low GI, non processed foods most often), eat with protein and fat (olive oil is good), limit the amount eaten to what your BG can tolerate. If it not much, have smaller meals more frequently to help your body metabolise the carbs. To do this you must have a meter, otherwise you will not know the effects. Standard advice is to have blood glucose below 8 within two hours of eating. You may choose to go lower than this to keep close to the normal range. Exercise also helps. You may have to ask your doctor to help you adjust your meds. One thing is sure: you will have to eat less carbohydrate than prior to diagnosis, but you can make smarter, more healthful, choices. I've been doing this for 10 years, and 12 years after diagnosis, no complications have yet arrived.

 

[paragliderpete]

Hi. I agree with what the others have said. Test yourself and see what the affects are . About two years ago I agreed to go along with the NHS advice on diet. Just for a trial to satisfy my doctor and diabetic nurse, although very much against my better judgment. At the start of the trial my average daily bm's were 6.5, with no readings above 7.5. I was still trying to reduce my bm's at the time.
Within 14 days my average bm was up to 14 and I was getting highs of 18 - 20. I stopped the diet , and returned to my low carb diet, and now have very good control within a non diabetic range.
For your info. My doctor also borrowed my American book to study it's doctorin. In simple terms It's carbs that are killng us so why consume 50% per meal , of the very stuff that is causing all the problems.
It's also interesting that the UK stands alone with it's advice on a high carb diet for diabetics. Indeed you have to remeber that all doctors have a code of practise that is set down by the NHS which they have to abide by.
The only way as said earlier is for you to test and test. You will soon establish which is correct for you

 

[IanD]

Take heart - if you are not confused, you haven't understood what you are being advised.

 

[Django]

All

I too am utterly confused by it all. I've been on Metformin for 7 weeks now for type 2 . No improvement at all in tested levels. I've cut out a lot of carbohydrate, taken more exercise....still no improvement. Each website seems to offer different advise on what you can/can't eat.
I can fast for 12 hours and have a higher reading on a morning than when I went to bed.
To be perfectly frank I'm wondering whether it's really all worth the bother. I'm on the verge of just letting nature take it's course and see what happens.

Django

 

[catherinecherub]

All

I too am utterly confused by it all. I've been on Metformin for 7 weeks now for type 2 . No improvement at all in tested levels. I've cut out a lot of carbohydrate, taken more exercise....still no improvement. Each website seems to offer different advise on what you can/can't eat.
I can fast for 12 hours and have a higher reading on a morning than when I went to bed.
To be perfectly frank I'm wondering whether it's really all worth the bother. I'm on the verge of just letting nature take it's course and see what happens.

Django

Hi Django,

Please do not despair. Nobody can tell you what you can and cannot eat as we all respond differently to foods. You have to rely on your meter and see what a meal is doing to your levels and then cut back on the carbs you included to see if that will make any difference. You need to keep a food diary for a few weeks and you will see a pattern emerging.

Have you read the advice for Newly Diagnosed? It is pretty basic and will help you get started.

This is also a great help. It is written by someone with diabetes and explains about the first year. It is called Taming the Tiger. An apt title really as this condition is a bit of a beast.
http://www.diabetesdaily.com/voices/fil ... iger11.pdf

If you are doing everything in your power to control this condition and your levels are still high then you made need more medication. There is no shame in this as some people cannot get the desired results on Metformin alone.

You may be suffering from Dawn Phenomenon with higher readings in the morning and these are difficult to control. Some people eat a high protein snack before bed but it doesn't work for everyone. It cannot always be controlled so do not worry too much but try and work out what is happening during the day as once your levels stabilize you may find those morning readings come down too.

Take care.

CC.

 

[IanD]

It seems the impact of a diabetes diagnosis is confusion - 12 years ago I thought I had the disease I would die from. That state of shock lasted months. For several years I followed the "official" advice, including carbs with every meal, & I felt well - the only consistent symptom was chronic tiredness.

BUT other complications were setting in including the beginning of retina damage & crippling muscle pain. I joined this forum, and reduced the obvious carbs. I wasn't expecting a "miracle cure" but just hoping for an improvement. It came! In 3 months I was out of pain & playing tennis without problems. That was 4 years ago & at 73 I am very fit & well - at the Ealing hospital gym "Olympics" & I won gold & bronze in 2 table tennis competitions. I would not dare go back to a high carb diet - I've got too much to lose.

You need to establish a diet you can stay with - diabetes is a long term condition we have to live with. There is no need to fast - that is not sustainable. Start keeping a food diary while you are sorting out your diet.

My b'fast is always a "porridge" made from ground almonds & coconut flour (2-3 dsp each) flavoured with coffee, NAS squash, sweetener or plain. I mix with boiling water. Dried milk can be added to the powder. I have the same thing in the evening, flavoured with low calorie drinking choc. It's very sustaining as it provides about 300 kcals provided mainly by fats that are much more sustaining than cereal. Sometimes I take out the dry mix for an emergency meal. Having it in the evening minimises teh "dawn phenomenon" whereby the liver releases stored glucose ready for the new day & gives a surprisingly high fasting reading.

I make a low calorie cake-bread using ground almonds, ccnut flour, crushed flax seeds, with baking powder, olive oil & eggs - & other ingedients - it's never the same, but always an acceptable cake texture that soaks up gravy, accepts spreads & can be taken out for snacks.

Otherwise I eat normal meals without the carbs. That allows eating out without difficulty - OK have the fish without chips, the burger without the bun ....

But please, don't give up, & be content with a slow response - all progress is good. My condition is now static at a BMI of 26.

If your response to significant diet changes is slower than you would like - over a month, say - post your diet here, there may be hidden calories creeping in, or other reasons for slow progress.