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Great Desmond Course and Coping

Discussion in 'Newly Diagnosed' started by Courts_12, Jul 1, 2019.

  1. Courts_12

    Courts_12 · Well-Known Member

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    Would it be best to request my doctor to do more tests? Aha I am not a very assertive person but I will try. Thank you! :)
     
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  2. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    Hey Courtney,

    Okay, so what are you eating now? As you know, carbs translate to bloodsugars, so... How many carbs are you eating in a day? The medication you're on (gliclazide) can make you go hypo if you go very low carb, so keep an eye on that eh. You don't want to face-plant. Test your heart out. Going from the assumption that the T2 diagnosis is correct, you could just go low carb and discuss dropping the meds with your doctor as you're not happy with them. That'd mean eggs, meat, fish, poultry, above ground veggies and leafy greens, (no legumes or underground veggies for the most part), berries, heavy cream/clotted cream, full fat greek yoghurt, cheese, extra dark chocolate, mushrooms... That sort of thing. Stuff you want to steer clear of: Spuds, pasta, cereal/muesli, rice, corn, bread and anything else made of grain. If you keep your bloodsugars in range with low carb eating you could indeed be a T2. (Or, admittedly, a T1 in the honeymoon period). If that's not doing anything for your bloodsugars at all, and you're seeing double digits more often than not, then T1 becomes ever more likely. I'm not a doctor, I'm just a T2, mind... Just make sure you test before a meal and 2 hours after the first bite, see what happens. You shouldn't have a rise of more than 2.0 mmol/l in that time. (It'll spike at about 1 hour after eating, the 2 hour mark is you seeing whether your body is adequately tackling the glucose/carbs.).

    Go back to your doc and ask for a referral, name the specialist you originally saw. Hopefully that'll help you get back in touch with them. (I have at some point taken matters into my own hands and written to specialists myself. Usually got an answer too, but that was in the Netherlands and Canada). Something's going on and I can advise my head off, but if you're a T1 in disguise this advice is about as useful as a rake is to a cat. ;) And whatever people advise, be it here or on the Desmond course, go with what your meter tells you. Diabetics are all individuals with different needs, but your meter'll always tell you what yours are. Hold on to the 2.0 mmol/l rise maximum, 2 hours after the first bite, and that'll steer you right. If that's not do-able for you on a low carb diet, then other types are really an option. You could possibly need a basal and a bolus insulin. That's fine, loads of people do it. But you do have to know whether that's what you need.

    Hugs,
    Jo
     
  3. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    PS: I find it horribly hard to stick up for myself. For my health though, I've had to, on quite a few occasions. From your posts you sound like you can write just fine, and eloquently get your point across... If you can express your worries in a letter or e-mail, you don't have to feel pressured to voice your concerns in the alotted 10 minutes, and get it off your chest within a certain time frame. ;)
     
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  4. Courts_12

    Courts_12 · Well-Known Member

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    That is exactly what it is has been like I have just listened to the doctors and not questioned anything. Thank you, I think that would definitely be easier as I do not mind writing e-mails and letters. I never even thought of that! Hopefully they take it seriously :)
     
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  5. Energize

    Energize Type 2 · Well-Known Member

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    @Courts_12
    You've been given some excellent advice in the previous posts. Testing your blood glucose levels, both before and a couple of hours after each meal will be incredibly informative as to what foods your body can cope with and those your body doesn't cope with. It will help you, also, if you can keep a food diary.

    Being assertive is very difficult to many, so you have my sympathy. However, I have learnt to be a lot more assertive in many situations, but not all. As already mentioned, writing a letter to your GP outlining what your concerns are and what your expectations are, is excellent. Get it to the surgery before your appointment so s/he has time to read it. Take a copy of the letter, or the points listed, as a 'tick list', to the appointment, to help keep on track. If you don't understand, or think you're being told 'rubbish', just say something like "Could you explain further/in more detail, please? I want to understand this " Then, if s/he doesn't answer adequately, then just repeat it until you get what you need. It's called 'broken record' and is very effective - just keep repeating it, not answering other questions in order to distract you.

    The other thing to mention re when you go to a hospital clinic, you are entitled to see the Consultant, or specific doctor on that team, but you must request this at the reception when you book in on arrival. You may have longer to wait, though, or be offered another appointment if it's not possible to accommodate your request. However, you can only request this if the doctor is working for that particular consultant, ie on that team. The doctor you were hoping to see in clinic, who saw you in hospital, was possibly one of the more junior doctors or from a different 'team'. The more junior doctors are often not in clinics until of a more senior rank and I suspect that's possibly why you wouldn't have seen him there.

    Hope that helps ;) Well done for all you have already achieved :)
     
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  6. PenguinMum

    PenguinMum Type 2 · Well-Known Member

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    Hi Courtney
    If I were in your position I would definitely write a letter to the GP and copy it in to the Endocrynology Consultant (try and find a name) at the hospital. You shouldnt have to fight for a proper diagnosis. Best wishes.
     
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  7. Daibell

    Daibell LADA · Master

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    Hi and welcome. You are learning fast and do doubt realising that the subject is complex and many in the NHS only have part of the diabetes story and some of it wrong, The GAD test for T1 is not a final test as it only tests for one antibody although it's the most common. Viruses can cause T1 and the GAD test will show up negative - many GPs don't realise this. The knowledgeable ones will also do the C-peptide test which will tell whether your own insulin is low or high. Low implies T1 and high implies T2. Metformin can be used by either type but only has a very small effect. If you have bowel issues with it then the SR (Slow Release) version is better. Gliclazide stimulates the pancreas to produce more insulin and is sometimes given in the early stages of late onset T1 but insulin is the right solution longer-term and really does the job. For T2, Metformin and the right diet can often be all that is needed. As others have said you were given out-dated dietary information on the course; sadly it's become the standard mantra around the world. Carbs are our enemy as your meter will demonstrate. Fats are not a problem despite standard guidance and the fat you eat contributes little to your blood cholesterol - the liver does that. So, use the meter to guide you and if blood sugar control becomes more difficult, do ask for the C-Peptide test. Gliclazide dosage can be varied by the GP with quite a large effect but insulin is the right solution if T1.
     
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  8. Courts_12

    Courts_12 · Well-Known Member

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    Hey Jo,

    Sorry just seen this reply on the way home from work, I have mainly cut out a lot of carbs. I think I had my first hypo that I know of today I was really shaky, luckily had some sweets at hand and I tested at work it was 4.6 after. I am going to try keeping some carbs in my diet I think as I never want to experience anything like that again. Luckily I eat a lot of veg already although I have been having granola lately is that bad? Often when I eat it goes up by a lot so if I am in 7 before it spikes to above 10 or even higher.

    I am going to ring my doctors tomorrow completely forgot about their closing times today. But I will definitely pester them now. I just want a definite diagnosis aha but it seems far away to find out I hate needles but I am trying with this glucose meter so if it helps I will have to ignore my needle fear. Thank you for the advice though it has helped loads I will take on board what you have said

    Hugs, Courtney :)
     
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  9. TriciaWs

    TriciaWs Type 2 (in remission!) · Well-Known Member

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    I was lucky to be diagnosed fairly soon (my glucose and HbA1c were fine a year before), and I already knew that people might get into remission by going low carb instead. I refused to go on the old Desmond course (they have been very anti-low carb) but sat through an appointment with a dietitian telling me to eat more carbs even though my 3 month blood tests were good.
    £ months after I was in remission, all my BS results are in the normal range as long as I count my carbs. And in spite of eating more fat, including butter and cream, my blood fats are much better too and my liver test.
    I started on 100g of carbs a day then down to 85g - others find they need to go lower, and the longer since your BS went high often means it takes longer to reduce it.
    Good luck with this.
     
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  10. Courts_12

    Courts_12 · Well-Known Member

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    Hey Jo,

    Sorry just seen this reply on the way home from work, I have mainly cut out a lot of carbs. I think I had my first hypo that I know of today I was really shaky, luckily had some sweets at hand and I tested at work it was 4.6 after. I am going to try keeping some carbs in my diet I think as I never want to experience anything like that again. Luckily I eat a lot of veg already although I have been having granola lately is that bad? Often when I eat it goes up by a lot so if I am in 7 before it spikes to above 10 or even higher.

    I am going to ring my doctors tomorrow completely forgot about their closing times today. But I will definitely pester them now. I just want a definite diagnosis aha but it seems far away to find out I hate needles but I am trying with this glucose meter so if it helps I will have to ignore my needle fear. Thank you for the advice though it has helped loads I will take on board what you have said

    Hugs, Courtney :)
     
  11. Courts_12

    Courts_12 · Well-Known Member

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    At least they diagnosed you quite early on, are you type 2? I thought the Desmond course was good but drastically realised that things they were saying didn’t match what doctors said. I still went away happy but now I am not sure as so many people have said the information on carbs is really wrong. I have a dietitian next Tuesday really hoping they don’t do that!

    I really hope I can get to the same point I cannot wait to eat a bit normally again! My blood sugar is constantly high but I am trying to cut on fruit more now. Pineapple is my biggest enemy aha. Thank you :)
     
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  12. bulkbiker

    bulkbiker Type 2 · Master

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    Tropical fruits are unfortunately one of the worst enemies of decent blood sugar readings.
     
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  13. Courts_12

    Courts_12 · Well-Known Member

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    It is killing me not to eat it but I am trying my best. Is grapefruit any good? Just trying to find fruit that I can still eat to keep me sane :)
     
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  14. lucylocket61

    lucylocket61 Type 2 · Well-Known Member

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    can you give us an idea of what your previous usual daily/weekly diet was please? maybe we can help you tweak it?
     
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  15. Courts_12

    Courts_12 · Well-Known Member

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    Before I ate fruit salads mainly for breakfast with quite a lot of pineapple. My dinner was mainly sandwiches in white bread or pasta salads. And for tea it varied but before I was a bit bad at keeping to eating tea. It was things from pizza, to frozen meals or home cooked meals either from my mum when I want to hers or myself if I could be bothered after work to be honest. I know it was not the best although I rarely ate chocolate or sweets then either it is fruit that is my main bad habit eating.
     
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  16. HSSS

    HSSS Type 2 · Well-Known Member

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    Fruit, bread, pasta and granola are all highly likely to give big rises. Check them especially. Either cut them out or limit them to an acceptable rise amount. It may be so tiny it’s not worth it.

    Get some glucotabs in case of hypo and I’ve seen people mention small orange juice cartons. Maybe some type 1 can give better guidance.

    If you are confirmed type 2 then glicazide should match your chosen diet not the other way round and you should not be forced to eat carbs purely to allow a particular dose.
     
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  17. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    Hey Courtney,

    That would've been a hypo, yeah, if you're in the low 4's after sweets... That's what happens when you lower your carbs and still take gliclazide. With only metformin that doesn't happen. I've had a few, and yeah, they're no fun... But you did exactly what you had to do. So well done! As long as you're on glic, always have something handy. Like jellybabies or dextro. But if you cut carbs -and truly are a T2- you might be able to ditch the glic, and the metformin, in time. T2's don't hypo, usually. (Still... There are exceptions to the rule. I hypo when it's extremely hot, my bloodsugars bouncing up and down all through the day.). It's usually medication that'll make someone go hypo, either glic and it's bedfellows, or insulin. I was on gliclazide for a little while, but with the LCHF diet I could ditch it, three months after diagnosis. As well as the statins they put me on.

    As for granola, yeah... Not the best option. (Personally, I wouldn't go near it.) But your meter already told you as much. If you want to have breakfast-y stuff that's not eggs with bacon and whatnot, there's a keto porridge somewhere on dietdoctor.com, or you could just toss some crushed nuts (walnuts, pecans, macadamia's, bit of coconut flakes), and maybe some berries, into full fat greek yoghurt. Yum, and simple. :) And that shouldn't spike you. https://www.dietdoctor.com/low-carb/keto/fruits has the best and worst fruits listed for a T2. I know it's hard to let the bulk of fruit go, but after a while, you don't miss it so much. And then when you do have a bite of something, it's horribly, horribly sweet, because your palette changes. ;) It takes a little while, but it's a good change. For me, it made other, non-sweet food actually taste better. More lively, somehow. I really, really enjoy food these days. Where before it was just something I needed to sustain me.

    None of us enjoyed handling needles, it's not exactly anyone's hobby (well, maybe some, haha), but you get used to that too... When I started with the finger pricking the hairs in my neck used to stand on end and I'd feel tingly all over. Now it's just pull-out-my-kit, stabby-stab-stab, done. Took about a week or two to get to that point. It's surprising how quick you can get used to something. Good thing too. The good news? If you're a T2, and you know because you test a lot at the start, what foods do to your bloodsugars, you don't have to test all the time anymore. You'll already know eggs don't spike you, or that granola does, so you won't have to test those: you'll know your safe foods from your risky ones. These days I only test when something's up. If I feel off/ill, if the weather's really hot, if I get a steroid shot, or a flu jab... Or if I ate somewhere and I'm not too sure they listed all the ingredients properly. (Two weeks ago I was served a salad with apple and honey. That did not go well. I was halfway through before I figured it out, and I didn't have the heart to not finish the plate. I walked it off though). All in all... This is temporary. And even if you aren't a T2 but a T1, you could try going for an insulin pump and/or a continuous monitor. That's basically stuck on, and while you'd have to check every now and again to make sure it's all working properly, it would simplify things.

    Still... If you're seeing numbers this low on just metformin and gliclazide... I'm keeping my fingers crossed it's T2. That can be managed through diet-only, relatively easily. If that's the route you choose. I know it's what I went with, and I haven't had diabetic complications since. It's been 3 years since my diagnosis, almost, and I've spent most of it on a diet. And honestly, I don't feel like I'm missing out much. And I'm certainly a lot healthier and have more energy than I did before.

    In any case, read the Nutritional Thingy in my signature, and be careful with low carbing while on Glic. It's a bit of a balancing act. And you already know you don't enjoy hypo's. ;)

    You'll get the hang of this. Good luck with the doc!
    Jo
     
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  18. Lowcarb 2

    Lowcarb 2 Type 1.5 · Well-Known Member

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    Hi I was diagnosed aged 54 and like you attended a Desmond course and found it very useful now 56 i have had to progress to insulin 6mega ago but am still coming well
     
  19. Courts_12

    Courts_12 · Well-Known Member

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    Hey Jo,

    I have tried cutting carbs nearly completely but I am just going to see what works best from now on. Definitely not a good experience. They want to take me off gliclazide but when I ran out before I felt rubbish when I did not take them unless taking more metformin balances it out? If I am type 2 if I managed to feel fine without tablets I would go with just the diet control. Although since using these tablets I get headaches behind my eyes mainly every day nearly and constant dry mouth still which is annoying.

    That is crazy, did they not label it on the menu? I have not ate out at restaurants much since been diagnosed as I was worried about that. St least you managed to walk it off I need to start learning that exercise needs to be a bigger part of my life now. I just need to get into the habit of going to the gym or swimming. A pump stuck to someone? Ouch isn’t that painful? I hate needles so just picturing a bigger version of a needle!

    I am terrified of needles! Omg I was exactly the same I am still nervous when pressing the button it takes me a good few minutes to build up courage.
    I am hoping it is more towards type 2 although it is very rare that my sugars go below 10 after eating. I cannot wait to get more energy I have definitely felt more drained lately I have never relied on tablets before even when I got bad stomach pains I stayed away from tablets.

    Thank you so much, it has helped a lot just to talk everything over! I will have a look now I need to start focusing properly on my diet rather than just cutting out a lot. I never want to experience a hypo again I feel bad for people who get them often. I am praying the doc has the answers

    Courtney :)
     
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  20. HSSS

    HSSS Type 2 · Well-Known Member

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    If you are type 2 : then low carb will replace the gliclazide and in the long term probably be far better for you in reducing insulin resistance, the cause of the issue rather than just tackling the symptoms ie high glucose.
     
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