Hello

Hi Linda and welcome to the forum You are right to think that you need to monitor your BGs as you cannot possibly control your levels without testing and just a yearly HbA1c. It is effectively a matter of cost and you may find you will have to fund your own testing equipment unfortunately. I hope you enjoy the Desmond course. Here is some information that we give to new members which I hope will be helpful to you. Ask as many questions as you want as there is usually someone who can answer them.

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 30,000 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 ... rains.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 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.

Click to expand...

Welcome Linda! Yes, purely money saving (the no-testing argument), although they'll say things like "don't want you worrying yourself" and "you can't do anything about it anyway"; but of course you can. You can stop eating the things that make your BGs go too high, or reduce the quantity.
If you have to buy your own strips, and can't afford to test too often, I'd say test 2 hours after eating as the main test. If your readings are over 8.5 at that stage, you need to cut down or cut out the carbs in that meal. After a while, testing after different meal types, you'll get to know what you can and can't eat. You'll also be able to set your targets steadily lowerwith time as you get to understand your body. Sub 8's, then sub 7's etc.
On this subject, you should sign our e-petition for free testing for all type 2's; here's the link:-
http://www.google.com/url?q=http://www. ... 3K8At9v8Ew

Do get your friends and colleagues to sign as well.
Good luck!

Welcome to the forum Linda

Grazer is right it's purely money saving. What you could do if you can't afford to test that much is to try and work out safe meal options for each of your 3 main meals so rotate what meal you test at 2 hours after for a while. Once you've got a list of good options then I'd do what Grazer says and simply test two hours after your main meal. Apart from testing to see what BS level you are it I find it is a very good psychological way of keeping you "good" especially if you write it down in black and white.

As to what to eat I'd offer the following advice. Apologies as it's just a copy of stuff I wrote to another new person yesterday.

Many of us on this forum find that we can control our blood sugar levels and even get them down to a non diabetic range by reducing the amount of starchy carbohydrates we eat. I realise this may be the opposite of what your diabetic nurse or dietitian may have recommended but it isn't some crazy fad and is what you would be recommended to eat in more enlightenned countries such as Sweden. The NHS diet recommendations were drawn up in the 1980's and have never been updated since. The Swedish health service bases its recommendations on modern studies carried out in the last few years.

You will discover when reading peoples comments on this forum that the vast majority recommend reducing starchy carbohydrate the only real debate we have amongst ourselves is by how much!

To start I would recommend you do the following which should still give you a reasonably varied diet and begin to bring your levels under control.

Firstly half what you are eating in starchy carbs (bread, potatoes, rice, pasta, pastry, cereals) and then so you don't get hungry replace the half you've given up with meat of any kind, fish, cheese and any vegetables that grow above ground (most of us can also get away with carrots so mixed veg is fine). Throw in a small amount of fresh fruit (ones ending in "berry" are the best) and some things like yoghurt and you'll soon start to notice the difference. Reducing drastically or better still cutting out any sweet things with sugar in them is taken for granted!

On the half of the starchy carbs you keep eating try to.

change white rice to brown basmati rice.
change white pasta to brown or green or the tri colour stuff
change white bread to wholemeal brown or best is burgen soya bread
never eat mashed potatoes and try and eat roast potatoes as they process slower.

Do not be afraid to eat "fat" at the start so cheese, eggs, a bacon egg and mushroom fry up are all fine. You can adjust your diet to lessen fat once you have controlled your levels. At this stage the mantra should be carbs are bad, fat and protien are good. Don't worry you won't put on weight.

You should see your blood sugar levels begin to come down and stabilise over a period of a few weeks. You should however begin to see that they "spike" a lot less pretty soon. I was diagnosed roughly two months ago with levels in the 20's and now have readings between 4.5 and 6.5 when I test at all times. You should be testing before eating and then two hours after each meal.

If after doing this for a while your levels stabilise but are still too high (I must say that simply halfing starchy carbs hasn't been enough for many of us) then you need to continue reducing carbs and replacing them with safe foods until you can constistently keep them in the safe range.

If you want to get really serious you can "count" how many grams of carbs you eat each day by working it out from the carbohydrate count found on the labels of foods. If you want help in how to do this just ask. Everyone is different so we all end up at differeing levels of carbs either based on what our blood sugars tell us or because of personal feelings about how much carbohydrate we want to eat. As an indication only my blood sugar stay in the ranges I've stated only if I eat less than 75grams of carbs / day. Some people end up being able to eat less and some more.

Good luck and keep asking questions.