Hello. Newly diagnosed T2 and very confused!

[Choosy]

Hi all
I was diagnosed in March with T2 and my HbA1c was 96. I was put on 1000mg Metformin, due to having chronic kidney disease. I was told to cut back on refined sugar and associated products. For 3 months I cut out all added sugars, cut out bread and reduced other carbs, a total lifestyle change. I've tried to educate myself and went further than my GP suggested as I was, understandably, very scared. I feel awful most of the time, so insanely exhausted and with low mood and anxiety.
I had my second HbA1c in June and was called in to see the diabetic nurse the next day. My HbA1c was 99! 3 higher than the previous reading. I had lost 7kg, which backed up the lifestyle change I told her about, and I was really confused. I asked her if I definitely had T2, as I have 2 autoimmune diseases and no risk factors forT2 other than being overweight. She said I'm overweight and in my 40's, therefore it's definitely T2.
She was adamant that I follow a standard low fat diet like everyone in the world should and said sugar is not the enemy. I'm not a nurse but even I knew I should be limiting my carbs! She told me my plate should be 1/3 full of starchy carbs!
My question is, does anyone know why my blood sugars are higher after 3 months in medication and with a huge lifestyle change? My GP gave me a prescription for gliclacide (sp?) yesterday so I'll be taking that alongside metformin. I have a few other health issues: Graves' disease, chronic kidney disease, fibromyalgia and anxiety/depression.
Thanks for anyone who gets to the end of this novel! And thanks in advance for any replies

 

[Pinkorchid]

As you do have more health issues besides the diabetes it would be difficult for us to say how you should be eating. Many here do the low carb high fat diet but as you have found out that is not the recommended one by the NHS for diabetics and may not be suitable for you. Perhaps other members here if they have any of the same conditions as you will be along to tell you what they do. Well done on loosing the weight

 

[sally and james]

Very high sugar levels, which don't respond to a drastic reduction in carbs, sound more like Type 1 to me, but hey, what do I know, no medical training at all. It should, at least, be ruled out. Saying you are in your 40's and overweight isn't good enough, in fact it's a disgrace.
Sally

 

[leslie10152]

Hi all
I was diagnosed in March with T2 and my HbA1c was 96. I was put on 1000mg Metformin, due to having chronic kidney disease. I was told to cut back on refined sugar and associated products. For 3 months I cut out all added sugars, cut out bread and reduced other carbs, a total lifestyle change. I've tried to educate myself and went further than my GP suggested as I was, understandably, very scared. I feel awful most of the time, so insanely exhausted and with low mood and anxiety.
I had my second HbA1c in June and was called in to see the diabetic nurse the next day. My HbA1c was 99! 3 higher than the previous reading. I had lost 7kg, which backed up the lifestyle change I told her about, and I was really confused. I asked her if I definitely had T2, as I have 2 autoimmune diseases and no risk factors forT2 other than being overweight. She said I'm overweight and in my 40's, therefore it's definitely T2.
She was adamant that I follow a standard low fat diet like everyone in the world should and said sugar is not the enemy. I'm not a nurse but even I knew I should be limiting my carbs! She told me my plate should be 1/3 full of starchy carbs!
My question is, does anyone know why my blood sugars are higher after 3 months in medication and with a huge lifestyle change? My GP gave me a prescription for gliclacide (sp?) yesterday so I'll be taking that alongside metformin. I have a few other health issues: Graves' disease, chronic kidney disease, fibromyalgia and anxiety/depression.
Thanks for anyone who gets to the end of this novel! And thanks in advance for any replies

Welcome to the forum @Choosy. When the body is under great stress it can retain or be flooded by liver dumps with glucose. I am no stranger to depression and other problems, so It is plausible to think this is part of the problem. But don't take my word as gospel. Keep up with what you are doing. This is the right path to take. We will help as much as we can. Keep us informed of your progress. Good luck on your journey.

 

[Jaylee]

Hi @Choosy ,

Welcome to the forum..

If you don't already? Get yourself a blood test meter.. (Your nurse probably won't like that one either!)
But a meter is the best weapon you have on how your diet is affecting the BS day to day, which in turn should help lower your A1c.

Tagging in @daisy1 & @AM1874 with some info.

Ask any question you like!

Good luck.

 

[DCUKMod]

Hi all
I was diagnosed in March with T2 and my HbA1c was 96. I was put on 1000mg Metformin, due to having chronic kidney disease. I was told to cut back on refined sugar and associated products. For 3 months I cut out all added sugars, cut out bread and reduced other carbs, a total lifestyle change. I've tried to educate myself and went further than my GP suggested as I was, understandably, very scared. I feel awful most of the time, so insanely exhausted and with low mood and anxiety.
I had my second HbA1c in June and was called in to see the diabetic nurse the next day. My HbA1c was 99! 3 higher than the previous reading. I had lost 7kg, which backed up the lifestyle change I told her about, and I was really confused. I asked her if I definitely had T2, as I have 2 autoimmune diseases and no risk factors forT2 other than being overweight. She said I'm overweight and in my 40's, therefore it's definitely T2.
She was adamant that I follow a standard low fat diet like everyone in the world should and said sugar is not the enemy. I'm not a nurse but even I knew I should be limiting my carbs! She told me my plate should be 1/3 full of starchy carbs!
My question is, does anyone know why my blood sugars are higher after 3 months in medication and with a huge lifestyle change? My GP gave me a prescription for gliclacide (sp?) yesterday so I'll be taking that alongside metformin. I have a few other health issues: Graves' disease, chronic kidney disease, fibromyalgia and anxiety/depression.
Thanks for anyone who gets to the end of this novel! And thanks in advance for any replies

Choosy, as the others have said, if you're cutting your carbs and not getting anywhere with your HbA1c, it certainly needs needs looking at.

I'm absolutely not doubting you have done as you have stated, but personally, when I became diabetic, in the early days I was astonished what impacted my blood sugars. It wasn't all as obvious as I thought it was.

Do you have a blood glucose meter that would allow you to test at home, to see how your diet might be impacting on things? If not, if you drive, you should have been given one, as your new medication can sometimes bring the blood numbers down a bit too low (for several reasons), so it can be important to keep an eye on it, especially if you drive.

It might be useful to give us a quick example of the things you routinely eat on a day to day basis, just to see if there's anything that could be negatively influencing your bloods unknowingly.

Another thing worth considering is whether you are taking or have recently taken any steroid medications. Unfortunately, they can have an unhelpful impact on the blood sugars, although clearly they can be absolutely necessary for an individual's wellbeing.

Should you be taking steroids, it it very important you do not alter your dosages without medical supervision or instruction.

 

[AM1874]

Hi @Choosy .. and welcome
Your experience with your nurse and the "starchy carbs" line is, sadly, what happens to many people .. but there is a simple way to deal with this. When you are with Nursie (or other HCPs) try this simple strategy:
# Listen
#Nod
# Smile and say thankyou
# Ignore

Putting that to one side for now, though, you have certainly made a good move coming here. Since joining this forum, the folks here have given me so much info, advice and support that I am now much more confident about the journey ahead. There will be plenty of folk on here who will be able to offer specific advice about your various medical issues .. so ask your questions and be assured that you will receive the answers that you need. It can all seem uphill to start with but, in my experience, it gets easier .. very quickly.

At this stage, a key point to take on board is that managing and controlling your diabetes (or pre-diabetes) through exercise, diet and testing your Blood Glucose seems to be the best way forward for many people. For me, committing to an LCHF (Low Carb High Fat) lifestyle and testing 3-5 times a day seems to be working and you'll find that there is a wealth of info, relevant advice and positive support about LCHF on the forum ..

I see that @Jaylee has already tagged @daisy1 for you and I suggest that you read up on the Low Carb Program in the information that she will soon be sending you. You might also find the discussion on the Low Carb Diet forum helpful .. and the following Diet Doctor websites ...
Low Carb Intro and Information
Low Carbs in 60 Seconds

It is a top priority that you get yourself a meter for testing your blood glucose and, for this, the following websites might help:
https://homehealth-uk.com/product-category/blood-glucose/
for the SD Codefree meter, which costs £12.98 or:
http://spirit-healthcare.co.uk/product/tee2-blood-glucose-meter/
who distribute the TEE 2 meter, which is free.
I have both which I alternate for comparative purposes and I have never found any significant difference between them.

Unless you are prescribed a meter and test strips by your doctor (unlikely), the costs of testing comes down to the ongoing charges for test strips and lancets. Make sure that you tick the appropriate box on the on-line order form and you won't pay VAT on the cost of your meter or strips.
For the SD Codefree, the strips are £7.69 for a pack of 50 and there are discount codes available for bulk purchases:
5 packs x 50 use code: 264086 .. cost is £38.45
10 packs x 50 use code: 975833 .. cost is £76.90
For the TEE 2, the strips are £7.75 for a pack of 50 .. there are no discount codes currently available for bulk buys
I'm testing 3-5 times a day which works out at around £10 to £12 per month for either of the two packages above but, more importantly, I know what my BG levels are .. and I can now manage them

Hope this helps

 

[Daibell]

Hi. Although being overweight is a strong pointer to T2 rather than T1, your high HBa1C and other auto-immune conditions could point to T1. My wife has CKD and her consultant confirmed this week that what you eat is largely irrelevant for the condition. Your nurse is wrong ref low fat being bad and eating loads of carbs being good; that is dated NHS advice and will not help BS or weight reduction. It's your choice but I would continue with the low carb and have enough proteins and fats to keep you feeling full. I'm assuming your nephrologist hasn't advised any specific diet advice. You should note that Metformin may not be advisable with CKD so do check that with your GP and/or nephrologist. Having the Gliclazide will hopefully help with your blood sugar. Once your weight comes down see where your blood sugar is. If it's still high you may want to ask the GP for a GAD and c-peptide test.

 

[theoldfunker]

Hi all
I was diagnosed in March with T2 and my HbA1c was 96. I was put on 1000mg Metformin, due to having chronic kidney disease. I was told to cut back on refined sugar and associated products. For 3 months I cut out all added sugars, cut out bread and reduced other carbs, a total lifestyle change. I've tried to educate myself and went further than my GP suggested as I was, understandably, very scared. I feel awful most of the time, so insanely exhausted and with low mood and anxiety.
I had my second HbA1c in June and was called in to see the diabetic nurse the next day. My HbA1c was 99! 3 higher than the previous reading. I had lost 7kg, which backed up the lifestyle change I told her about, and I was really confused. I asked her if I definitely had T2, as I have 2 autoimmune diseases and no risk factors forT2 other than being overweight. She said I'm overweight and in my 40's, therefore it's definitely T2.
She was adamant that I follow a standard low fat diet like everyone in the world should and said sugar is not the enemy. I'm not a nurse but even I knew I should be limiting my carbs! She told me my plate should be 1/3 full of starchy carbs!
My question is, does anyone know why my blood sugars are higher after 3 months in medication and with a huge lifestyle change? My GP gave me a prescription for gliclacide (sp?) yesterday so I'll be taking that alongside metformin. I have a few other health issues: Graves' disease, chronic kidney disease, fibromyalgia and anxiety/depression.
Thanks for anyone who gets to the end of this novel! And thanks in advance for any replies

Hi to Choosy. There is a lot of good advice here and a BG meter is a good guide to help control your diet and I only bought one 6 months after being diagnose as the Nurse said I don't need one.
Just to say it took six months for the effect of the change in diet to take effect on me.

 

[librarising]

it took six months for the effect of the change in diet to take effect on me.

But surely not to reduce your blood sugar levels ?
Geoff

 

[daisy1]

@Choosy

Hello Choosy and welcome to the Forum Here is the Basic Information we give to new members and I hope it will be useful to you. Ask as many questions as you need to and someone will 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 well over 245,000 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 free 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. They're all 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.

 

[theoldfunker]

Th

But surely not to reduce your blood sugar levels ?
Geoff

is

But surely not to reduce your blood sugar levels
Geoff

This refers to the overall effect of a complete change to life style and diet, now just one metformin with evening meal.

 

[librarising]

This refers to the overall effect of a complete change to life style and diet, now just one metformin with evening meal.

I don't understand your reply. I'm suggesting that a T2 shouldn't take 6 months for their blood sugars to go down if they're cutting down carbs. I suspect the OP is possibly T1. His blood sugars were his concern.
Geoff

 

[Choosy]

Thank you everyone for your replies, I am more than grateful!
I have purchased a BG monitor and will do as you have suggested and keep a detailed note of results before and after meals plus notes/photos of what I have eaten. This will give me a better understanding.
I'm going to hold off on the gliclazide until my monitor arrives, also from what I've read it shouldn't be given to people who are as overweight as I am. I think I need to focus on strict lchf and daily exercise and see if I can help myself before taking other meds.

The GP also wants to put me on statins. When I said I'd rather try to reduce my cholesterol myself - tc is 5.7 - he told me that everyone with diabetes had to go on statins. I think I'll leave that fight for another day!

Thank you all again