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Good And Bad Results

@Sue2335

Hello Sue and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it helpfpul. Ask as many questions as you want 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 well over 235,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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 blood glucose 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.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
Hi @Sue2335 what an astonishing turn around, this has got to be in the top percentile!

When a successful change of eating takes places fat is literally being dumped from the fat in cells which can raise the cholesterol numbers. Dr Berg says there is no point in measuring for several months until (para phrasing) a homeostatic position is attained. The diet heart hypothesis is verbatim what I have placed in bold. Those who rely on this hypothesis are concerned with LDL which a low fat diet works well towards to reducing (as well as statins), those who take an alternative view (i'm in this camp), say broadly triglycerides in the blood (made from carbs) is a factor to be watched and that triglyceride to hdl(c) ratio is a more rounded proxy for potential atherosclerosis.

It may be worth you getting tested for the presence of the Apoe4, which is a protein concerned with the liver function. With this in mind if I were in your shoes I would immediately as advised, drop Metformin as this acts on the liver - with a HbA1c of 39 there is no technical reason for you to be on this, unless you have actively looked at some of the stated possible other benefits. In any event the effects of potentially having the Apoe4 protein has only been tested in carb eaters, so there is no evidence in low carb populations (citing Dr Berg).

Two big considerations for heart disease if you are super concerned. First if this were playing on my mind, I would save my pennies and get a CAC scan (https://www.nuffieldhealth.com/tests-scans/ct-calcium-scoring-or-cardiac-calcium-scoring), this will show the root disease if present rather than a guess which the Framingham measures used by the NHS and others does - (Ivor Cummins as mentioned in other posts lays out the evidence so well on this, but in summary when compared CAC scores wipe the floor with Framingham - it is not even close). Second Dave Feldman shows how easy it is to obtain completely different cholesterol markers in circa 3 days - don't blame me if your jaw hits the floor and cracks when you read this http://cholesterolcode.com/extreme-cholesterol-drop-experiment. His protocol has been used by persons to get favorable insurance just by manipulating what the fat they consume.
 
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No .. meat and cheese are great no/low carb foods.. Meat has no carbs (apart from some residual in liver) and most cheese is very low. Please don't mislead people. The information (in the UK at least ) is freely available on food packaging or supermarket websites.
I wasn't "misleading" anyone but thanks for your "input." It was a simple question, not telling anyone anything, and besides, Guzzler's post directly after mine noted there are carbs in both products. I've read many posts on the forum talking about the "little bit" of carbs in meat and cheese. One guy told me I was under-counting the carbs in cheese. When meat is cooked and goes brown, that is the caramelisation of the sugars, according to my chef friends. You seem really keen to correct some of the things I post, even when it's not remotely warranted. Why is that? Why not just live and let live?
 
Daily low dose aspirin may be more appropriate if you do opt for a drug to assist with lipid management, but as you know it carries some risk of GI bleeding. Always a trade off, these things.

You may wish to read the NICE guidelines on this.

1.5 Antiplatelet therapy
1.5.1 Do not offer antiplatelet therapy (aspirin or clopidogrel) for adults with type 2 diabetes without cardiovascular disease. [new 2015]

https://www.nice.org.uk/guidance/ng28/chapter/1-Recommendations#blood-glucose-management-2
 
Personally, I wouldn't be interested in adopting any medication without good scientific evidence to back it up. Again personally, I don't like taking aspirin for a headache, never mind every day, whatever the dose.

I've been taking daily medication for non-diabetes conditions for over 20 years and I don't like it either, but needs must. Some of them are keeping me alive and all are giving me a chance to have the quality of life we all wish for ourselves.

Aspirin is actually one of the milder medications people with significant CVD can take, and it may obviate the need for a statin, which I agree is much harder on the body. I always consider the quality of the evidence base before starting a new medication, too. In most cases the doctors I see don't have time to focus in on one drug like an informed patient can.
 
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Another thing that comes to mind is the little bit of carbs in meat and cheese... the latter would be higher I think?
No .. meat and cheese are great no/low carb foods.. Meat has no carbs (apart from some residual in liver) and most cheese is very low. Please don't mislead people. The information (in the UK at least ) is freely available on food packaging or supermarket websites.

Cheese is marginally higher carb than meat but even cheese doesn’t contain any significant amount, I always count meat and cheese as zero carb. Here’s a couple of examples of Tesco’s brilliant nutritional info
 
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Cheese is marginally higher carb than meat but even cheese doesn’t contain any significant amount, I always count meat and cheese as zero carb. Here’s a couple of examples of Tesco’s brilliant nutritional info
Goodness there is a lot of attention being paid to the tiniest of matters by a group of people today. I admire your determination to offer support to fellow diabetics.
 
Yes, I saw it eventually, hidden right at the top of your post, so I deleted my post!!! Sorry. :) I struggle to see this type of pic as they appear small and faded. It could be my machinery, chrome, or something. It isn't the first time I've missed one.
I should have clicked the larger option for the pic but that makes the pic huge and rather in your face!
 
I was diagnosed with type 2 in February 2018. This is my first post though this website has become my bedtime reading since my diagnosis. I'm a nurse for many years but I actually can't believe how much I didn't know about diabetes. Thank you for the very useful information on this website. So my diabetes story started in February but my feeling is, I had been diabetic for a long time. I come from a strong diabetes and cardiovascular history (my mum was diabetic, and 4/5 siblings are also diabetic).
I have been on a strict low carb since diagnosis after reading lots of success stories on this website. Had my first bloods post diagnosis this past Monday, I was very eager to know the results so this morning I went to the surgery for my blood results. The receptionist looked on the computer, the results were available but hadn't been seen by a doctor. She told me to phone back in the afternoon, I tried phoning all afternoon with no answer so decided to go back to the Gp at 415pm. So the receptionist said the Gp tried to ring me at 410pm according to their system, this worried me so I told her I will wait till she has spoken to the GP.
I was told the Gp said she will ring, with my very worried face I walked out of the surgery. Just when I started the car the Gp rang. Her first question was "what have you been doing with your diabetes"? I don't tell lies so I said I have been on a low carb diet since diagnosis. She said "oh thats why". I asked her my numbers, she said my HbA1c is now 39, from the initial diagnosis of 110 in Feb. This made my day as you could imagine but hey she went on to say, "we have a slight problem though". Immediately, I knew it was my cholesterol that I had self requested to be tested on Monday. She said my cholesterol has come back 6.8. She said it is high but didn't talk of statins. Didn't have pen and paper to write so didn't ask the ratios etc. I have my appointment with the diabetic nurse in week's time so will have print out of results. She said you have been working hard to reduce the diabetes so do the same with the cholesterol. She advised me to eat more fish. And also to stop metfomin. (I was on metfomin 500mg BD) I have told her I will reduce to one a day for now. I need your help, how do I balance these numbers? Don't tell me to live on greens! The cholesterol is also family related, obviously now activated by my high fat low carb diet. Please help.


maybe if you have lost a lot of weight in the same period your cholesterol could be raised initially from all the released fat in your blood , maybe it will lower by itself along your low carb journey
 
I've been taking daily medication for non-diabetes conditions for over 20 years and I don't like it either, but needs must. Some of them are keeping me alive and all are giving me a chance to have the quality of life we all wish for ourselves.

Aspirin is actually one of the milder medications people with significant CVD can take, and it may obviate the need for a statin, which I agree is much harder on the body. I always consider the quality of the evidence base before starting a new medication, too. In most cases the doctors I see don't have time to focus in on one drug like an informed patient can.

Jenny - Your choices are exactly that; yours, as are mine. I consider if aspirin were discovered/invented today it would struggle to achieve approval. Again, my view.
 
Jenny - Your choices are exactly that; yours, as are mine. I consider if aspirin were discovered/invented today it would struggle to achieve approval. Again, my view.
My post was more about your comment that you don't like taking meds at all. I don't take Aspirin and I wouldn't because of the bleeding risk. There are lots of drugs people could quibble over on a forum if they wanted to. I am coming from the angle of empathy for those who must take daily meds for anything. I'm happy for you that you don't need to.
 
My BG's have been good ranging from 4 - 6mmols. I use Ontrack app my average for the month on there was 4.9mmols.

That tells me your Iow A1c is not due to something being wrong with your red blood cells, these BG reading should be given to your GP and added to your medical records.

@Sue2335 As you are a trained HCP, it is likely you would benefit greatly from this book if you have not already read it. https://www.amazon.co.uk/Art-Science-Low-Carbohydrate-Living/dp/0983490708
 
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