Hello

[DavideB]

Hello

We are living in Italy and I have just been told that I have diabetes SCARED OR WHAT!!

They have not told me if it is 1 or 2 just put me on Metrormina Teva 500mg twice a day

they just said watch what you eat and take more test end of may...

Thanks

Davide

 

[xyzzy]

Hello Davide and welcome to the forum.

I would hope if they don't what to see you until the end of May that they are pretty certain you are Type 2 especially if they have just put you on Metformin which is the normal start up treatment for Type 2. A blunt question! Are you an overweight adult? Even if only a bit overweight then if you are say 35 years or older then it is most likely you are T2. Were you losing weight unexpectedly prior to diagnosis? If you were that's an indicator of Type 1. Likewise if they tested your urine for ketones and it came back positive that's also a T1 indicator. If either of those to things ring true you need to get treatment now. High untreated blood sugar levels in a T1 can be very dangerous and can lead to a serious condition called DKA so you will need specific treatment as soon as possible.

A bit about Metformin. Metformin is a really safe and effective medication. It is not a magic bullet however and is best used when you change your diet as well. In fact changing diet is usually by far the best thing any T2 can do and in my opinion is ten times better than any medication. Metformin works by helping to keep your blood sugar levels lower after you eat. It can have some initial side side effect, stomach cramps, running to the loo etc. If these persist for more than a few days go back to the doctor and ask for the slow release SR version as that usually helps.

If you want to work out if you are overweight there are some simple ways of doing so. First is to work out your BMI. You can do that from lots of sites, one I found is here http://www.nhlbisupport.com/bmi/ Just type your weight and height in and cross your fingers! You should be aiming for a number less than 25. The second way is simply measure around the biggest part of you stomach. If that's over 38" (96.5cm) then its reckoned that its too big and you should also lose some weight.

What follows has worked for me and got my blood sugar levels back to normal within around a couple of months or so. It has also worked for very many other forum members. Not a cure as I still have to be careful what I eat but am now feeling great! I am really happy that I have minimised the risk of all those complications. I was diagnosed in early December last year so just 4 months ago and have now lost 3 stone in weight as well.

Diet wise its really easy. Just drastically cut down or better cut out all things with plain sugar, so biscuits, cakes, sugar in tea and coffee, pure fruit juices, non diet versions of soft drinks. Next try halving starchy foods like rice, pasta, potatoes, bread, cereals and any other flour based products. Replace what's now missing with extra meat, fish, eggs, cheese and especially vegetables. Vegetables that grow above ground are best although most of us find carrots fine. Things like yoghurt are fine as is a small amount of fresh fruit. I find the ones that end in "berry" are the best. If you don't mind artificial sweeteners things like Diet Coke are fine to drink. On the starchy foods that are left swap to brown basmati rice instead of white and brown or tri-colour pasta. The bread that most recommend is actually Bergen soya bread but some do ok with wholemeal as well.

The above diet is close to one you would be one recommended to try by the Swedish Health service. It was introduced in that country last year and the American health service and several other countries health services recommend something very similar. If you want to read more about this kind of regime there is a thread discussing it with some useful links here http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=2&t=28402

Did the doctor give you a meter and test strips to test your own levels? Most forum members would recommend testing your own levels. Not sure what the Italian policy is. Over here in the UK its a post code lottery with some progressive doctors handing them out and others not. In fact some doctors are really anti testing.

The reason testing is important is that every diabetic is different so my earlier advice to halve starchy foods is just a rough guide. You may find you need to eat less than half (like me) or that you can eat more than half like others. With a meter you should be aiming to get a reading below 8ish two hours after eating. The 8 number is where most modern research says the risks of diabetic complications DOES begin at so try not to exceed it regularly.

As you get into it all and read around the forum you may see people talking about carb counting. If you want to understand what that is just ask. It is a powerful weapon that a diabetic can use to control their condition and one that many of us use to great effect.

Good luck and keep asking questions.

 

[daisy1]

Hi Davide and welcome to the forum They certainly haven't given you much advice ! Here is some information which we give to new members which should give you some idea what to do. Some of this information applies only to the UK. Ask as many questions as you like as there is always someone here who can answer.

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.
-------------------------------------------------------------------------------------------------------------------------------------------------------

Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.

 

[DavideB]

Hello And thank you both for your answers,

1) question am I over weight....Well if i told you the council asked me if I could stand in as a mobile roundabout I think that answers that question...I am 109kl 5ft 10" Doc says needs be an 90kl

2) Doc never gave me any strips or any thing just said lose weight....

3) I think that it started a couple of weeks ago I was not well I had a bad bout of Gastroenteritis in bed for 6 days. That's when it started. Before that I never had any symptoms at all...

My mum has diabetes and has controlled it great and me and my brother always knew that one of us might get it. I am not fit and do not exercise a lot (into self blame now)

Many Thanks

Davide

 

[xyzzy]

Hi Davide

Yep like me you need to lose some weight!

Did they give you any test results like an HBA1c number or a fasting blood test number?

You may have only noticed the symptoms for a couple of weeks but normally T2 gradually builds up over a period of time usually several months or even years. Common symptoms you might not have realised are, getting up in the night to pee, blurry vision or deteriorating eyesight, thrush like symptoms (itchy in the groinal area!) plus others.

How much do you know about diabetes? Do you need some help understanding what it is and what the risks are? I take it you do realise now you've got it it isn't going to just go away even if you do drop weight. Losing weight will help lots but depending on how long it has been running the diet changes will need to be a pretty permanent thing or you will risk eye, nerve and even amputation troubles.

There are a number of ways to deal with T2 and it really is for you to choose so don't let a doctor dictate it to you.

First you can try and control by diet only or diet only + metformin. To do that successfully you really do need to accept you are going to have to restrict your carbohydrates considerably. Carbohydrates aren't just "sugar" but other things like the starchy foods I mentioned in my first post. It is just as important to restrict those. Daisy's post says exactly the same thing. If you don't do that restriction and don't cut the carbs you really are putting yourself at a lot of risk. Think of it this way if every time you ate a large portion of pasta or rice or biscuits etc you went blind for 10 minutes would you keep eating them?

If you really don't want to give up too many carbs then you can elect to go on stronger diabetic drugs. These will help but many can force your pancreas to work a lot harder to produce the insulin to process the carbs you eat. Some also have a tendency to make you gain weight. In the end you run the risk of your poor pancreas just packing up entirely and having no option but to go on insulin.

Finally you can just ask the doc to go on insulin straight away. This option will allow you very simplistically to eat whatever amount of carbs you want as you can inject enough insulin to cover what you consume. Sounds good but there are a number of downsides including a tendency to put on weight. The more weight you put on the more insulin you need so it can end up in a horrible spiral.

Which ever way you choose you should still try and lose weight and be healthy. Healthy in my book isn't doing loads of exercise unless you want to but getting out and just having a walk about is better than none. I just walk the dogs. Even as a non diabetic you would be at far higher risks of heart attacks and strokes etc if you overweight. What you don't ever want to end up being is an overweight uncontrolled insulin using diabetic as that is a very quick way to an early grave. That combination knocks around 10 to 15 years off your life span.

Keep asking questions

 

[DavideB]

Hello xyzzy

Great post thank YOU!!!

Well it looks like walking and a LOT less carbs....GOD I love my food I do not want to go on insulin and gain weight..

Can I have Pasta once a week? Sugar I do not mind I am sure that I can cut out, not a chocolate lover BUT i do (did) eat a lot of fruit..

Like weight watchers is there anywhere that does recipes for Diabetics? Just to get a start.

What Can I eat lots of...

I do not want to starve. I know that sill but you know what I mean, Can I munch a carrot, Coffee with milk, or Tea,

Blow (mild tone) this has knocked me for 6

Many Thanks for your help..

Davide

 

[MaryJ]

Hi Davide

Welcome

With regards to Pasta once a week - it depends on how it affects you - use this time for research. I can only handle 30g of dried pasta or rice. But if I wanted that amount for my evening meal every night I would have it. Any more sends my BG higher. (unless I have a glass of vino with it - but that's another thread).

At first I ate little (to test the carbs in the meal) but often (probably just over every 2 hours ) this kept me from too much hunger and focused on my readings and food diary.

Now a typical day is

Breakfast :

combination of (depending on time available and hunger)

1 or 2 egg omlette
bacon
mushroom
tomato
ham
philli

Lunch:

Chicken or tuna salad with coleslaw (lots of salad NO beetroot - that sent my BG up)

Dinner: generally from the following

Fish,meat or chicken with veg or salad
Spag bol - 30g pasta
Chilli - 30g rice
Sausage casserole (good quality sausage)
Roast dinner - 2 roasters and lots of non starchy veg

Don't now generally need snacks but if I do, I eat:

Peanuts or mixed nuts
Nairn oat biscuits with philli/cucumber

Fill up on the things which dont send your BG;s up, worry not about the fat content, by doing this for 4 months I've reduced my HBA1c from 7.1 t 5.99 and dropped just under 2 stone.

Good luck, keep us posted

Mary x

 

[cteld]

Davide,

You won't starve. I love(d) carbs, too, but the cravings really go away. You are not just left with indifferent and joyless eating, either...at least, I wasn't. I love food and love to cook, and still enjoy eating...just different foods. MANY more fats.

The main thing is that if you reduce carbs a lot, you should really replace them with fat, specifically fat that is satisfying and good for your body (not all fats are created equal) - or else eating this way actually IS hard to sustain. I'm not a fan of artificial sweeteners, and I'm also not able to eat processed or restaurant food, so eating lowish carb for me means eating lots of home-cooked meat and animal fats, eggs, low-carb veggies, coconut, cheese, yogurt, fruits and nuts. My sweets cravings, which I'd had all my life, pretty much went away instantly - far more easily than I expected they would - when I wiped out starchy foods and upped my fat intake.

Most low-carbers are not quite so rigid as I have to be (can't deal with most additives and preservatives because of cancer in the family, intolerance to free glutamates, and suchlike). It's a very livable lifestyle, AND very customizable to your likes and dislikes - and nowhere as scary as it seems at first. The best thing I like about "eating to your meter" is that nobody is telling you what's okay or what's not okay. It's all your decision.

 

[xyzzy]

Davide

The knack to this is at the start to not get hungry so when you cut down on the carbs like pasta and rice you MUST up other things like meat and vegetables and yes even fat (cheese and things like that). For the first few weeks after my diagnosis I just cut out as many carbs as I could and didn't particularly care what I replaced them with. Lunches were bacon, egg and mushroom fry-ups alternating with cheese and ham omelettes. Main meals I based around 250g of say mixed veg then added mince or chicken, half a jar of sauce to taste and very small quantities of either rice or pasta. For snacks I ate cheese, lots of cheese!. Now all that may sound remarkably unhealthy fat wise but it got my levels back to normal within around 8 weeks and I've just had the results back of a 3 month cholesterol test and for the first time in years my cholesterol levels are normal. I have lost 20kg on that diet in just 4 months and feel great. Nowadays after learning about low carb my diet is as varied as before I was diagnosed and not quite so extreme.

For more information on the kind of diet to aim for have a look here

http://blogg.passagen.se/dahlqvistannika/?anchor=my_lowcarb_dietary_programe_in

This is the good lady doctor that the Swedes took some of recommendations from

You should really try and get hold of a meter. If you can't get the doc to give you one the best bet is to buy one yourself. The one forum members are getting at the moment because its the cheapest to run is one called an SD CODEFREE. It's available from the health.co.uk shop on the UK eBay site. £20 (€25) will get you the meter plus an initial 60 strips. Additional strips will cost £5 (€6) / 50 which is by far the cheapest around. Have no idea how much it will cost to ship to Italy or even if you can get the same meter in Italy somewhere. If you buy the one I've mentioned make sure you order a UK / European model that measures in mmol/l rather than an American one that measures in mg/dl as the two numbering systems for blood levels are very different. If you get a meter then the magic number to aim for is to be under 8 two hours after eating. When you first start you may find you readings are very high, mine where in the 20's so what you should be looking for is for them to gradually come down day by day. It took me around 6 weeks before I could consistently get below 8 but in some people it can take just a few days. Also you may well find that you wake up with a far higher reading than when you went to bed. That's entirely normal. If that happens to you then just ask and someone will tell you why!

Like you I loved my carbs, especially rice. Never had a sweet tooth so sugar wasn't an issue but pastries and rice were a different thing. It's weird now as I don't miss them at all so what they say about "carb craving" is very true. For a few weeks I continued having a bit of rice here or a bit of pasta there but in the end it suddenly dawned on me that rather than spend by precious carb allowance on a small amount of rice I could spend the same amount on other things that I found I was enjoying even more!

If you want some low carb recipes there are hundred on this forum. I and the wife who is now a non diabetic low carb convert are gradually going through them!

One last thing. Just keep the questions coming, don't be afraid to ask anything. Everyone on the forum went through the same feelings and shock you are going through now so don't worry that you are asking too many questions.

 

[Defren]

Hello Davide, welcome to the forum. The best thing to do is ask questions, ask questions and then ask more questions. There is always someone who can help. Drink lots of water to flush out nasties, and reduce your carbs. Buy a meter and test, test, test. With each new food test before your meal and 2 hours later. You will soon learn what you can and can't tolerate. Good luck.

 

[BaliRob]

Dear XYZZY,

Are you absolutely certain that a sudden weight loss before diagnosis indicates Type 1? I lost a stone and a half in 2/3 months without trying, i.e., not dieting and I was in my 60's and, because I was getting out of breath during exertion, had blood tests and told I was Type 2. I posted here 3 days ago that I was suddenly having trouble getting my BG's down and asked for advice but have had no answers. Now I am starting to question my diagnosis even though it was 6-8 years ago.

 

[xyzzy]

Dear XYZZY,

Are you absolutely certain that a sudden weight loss before diagnosis indicates Type 1? I lost a stone and a half in 2/3 months without trying, i.e., not dieting and I was in my 60's and, because I was getting out of breath during exertion, had blood tests and told I was Type 2. I posted here 3 days ago that I was suddenly having trouble getting my BG's down and asked for advice but have had no answers. Now I am starting to question my diagnosis even though it was 6-8 years ago.

Hi Rob

Yes losing weight is one of the indicators of Type 1. Look here http://www.diabetes.co.uk/type1-diabetes-symptoms.html This certainly happened to my son. Many years ago now we sent him off to uni at a pretty normal weight. He came back one holiday a lot thinner and we just put it down to a student lifestyle. Luckily for us we had just moved house so the new doctors we joined did new patient checks on all the family and picked it up. The local HOSPITAL then phoned us to confirm an appointment that day about 5 minutes after we all got home!

Are your BG's still a lot higher? There are lots of reasons BG's can go high, illness, stress etc. If you are really worried you should go and see your doctor but I wouldn't have thought you have been misdiagnosed as T1 as a T1 has no insulin production capability so you would have needed insulin pretty soon after diagnosis. If its not a simple explanation like illness then it could be for whatever reason your pancreas is beginning to produce less insulin but it does seem strange that it happenned so quickly. If this is the case you should definitely see the doc as you may need to up your meds if you want to, alternatively lowering your carbs may help. If you try lowering carbs and do not see an improvement within a short while again go see the doctor and tell him / her what you have tried.

Sorry Bob that I can't help you more but the honest answer and why you probably got no replies is that yes, your sudden increase is a bit mysterious. I really would go to the doc's if it concerning you too much as better safe than sorry.

 

[phoenix]

Hi Rob,
There are many reasons that you can lose weight; not all related to diabetes, I note that you are using warfarin so you obviously have had other problems in the past. I think it's really something you need to discuss with your doctor.
I lost a great deal of weight before diagnosis and because I had a slow onset of T1 (LADA)it took some time; but not 8 years. My fasting glucose levels at the time were very much higher than the 8mmol/l you mentioned in your last post. This is still too high though and you may need a change in medication,

 

[DavideB]

I have noticed a lot on the forum people saying "strips" what are they and how do they work...Being In Italy I would not know what to ask for at the chemist..I would hate to go and ask the chemist strips and he takes his clothes of...anyone know another name please

Thanks

Davide

 

[daisy1]

Hi Davide
At this link I think you will find all the information you need:

http://www.diabete.bayer.it/ebbsc/cms/i ... T_uso.html

This link shows you, with pictures, how to test. There you will see the other words.

As far as I have been able to work out, with the help of my Italian speaking husband, the strips are called le strisce reattive. I hope you don't end up with the wrong thing :lol:

I hope this answers your questions.

 

[sdgray22]

hey are the little strips that go in the meters that we use to measure blood sugar levels. Different strips for different meters though so be careful. If you buy a meter at the chemist they should sell you the first packet of strips with it. Just take the packet from your first purchase from wherever you buy them to the chemist with you to ensure you get the right replacement ones. These strips are like the ones you use in chemistry to test liquids or the doctor to test urine. They suck up a small drop of blood from your finger which you prick, the test strip analyses the blood and your meter gives a reading. I am sure there are more scientific ways to explain it but thats what happens. If I was abroad I think I would buy my meter from the local chemist at least you can be sure of getting replacement supplies then. If you buy one here who knows if they have the supplies in Italy although there is always Ebay and international shipping!

 

[SweetHeart]

Hi Davide
At this link I think you will find all the information you need:

http://www.diabete.bayer.it/ebbsc/cms/i ... T_uso.html

This link shows you, with pictures, how to test. There you will see the other words.

As far as I have been able to work out, with the help of my Italian speaking husband, the strips are called le strisce reattive. I hope you don't end up with the wrong thing :lol:

I hope this answers your questions.

Add to Daisy's Italian: strisce reattive per l'monitoraggio del glucosio nel sangue

Ju

 

[daisy1]

Well done Ju, I tremble to think what Davide could have ended up with :lol: :lol: :lol: I hope the link is useful though.

 

[SweetHeart]

Daisy, your Italian was perfect, but there are so many monitors you can get now that it might be better to know exactly what you want to monitor! :wink:

Ju

 

[DavideB]

Thank you guys you have been great... :thumbup:

if you are thinking, this guys is always on or quick to answer it is because I am always on line, we have a web design business in the UK and run it from Italy and I go back every 3-4 weeks