Help! I don't want to medicate.

Help! I’m very confused.
After years of telling me I’m managing my diabetes well, there has been a change of staff at the diabetes clinic and all of a sudden they want to medicate me. I must say the old regime was pretty hands off, never calling me in unless I asked and not offering a HBA1c unless again I specifically asked.
A bit of background.
I was IGT in 1995 when aged 39 and told I had a model diet. I was an ex-racing cyclist and still very active although carrying 10kgs more than the 70kgs of 10 years earlier (too much beer!). In 2000 I was told I was not IGT after all and thus didn’t need an annual test.
In late 2004 (age 48), I changed career and had a health review. Two consecutive OGTTs of 7.0 and 7.1 gave me a diagnosis as a diabetic. Over the following year I lost 12kgs and did more exercise so that in early 2006 I was giving normal readings on the OGTT and told that I wasn’t diabetic after all – by this time I had not been offered a HBA1c and didn’t know the test was available.
In summer 2007, after my weight had crept up 6kgs (to74kg) I started to feel unwell. I was having dizzy spells, night sweats and one of my primary class said my breath smelled of sweets (ketones? after a mammoth weekend of endurance exercise). I asked the clinic for some tests including a HBA1c but they lost the results. I eventually got a repeat test a few months later which gave a HBA1c of 6.6. By March 2008 I had lost 4kg and got this down to 5.9. So the doctor again tried to say I should not have a diabetes diagnosis (but got overruled – hurrah sense at last!).
Since then, I have had a bad experience with statins (and don’t take them now) and my weight has fluctuated down and up by a few kgs and I have had sporadic HBA1c tests which have fluctuated along with my weight. After a naughty post xmas period my latest HBA1c is 6.5 (48 in new money). The clinics response was to suggest tablets (Metformin?) rather than doing any sort of lifestyle/dietary review. I was a bit disappointed and desperate not to go on medication until I really need to. Hence I found this forum.
Now aged 56, I currently exercise 4-5 days a week which consists of 2-3 runs of 40-90minutes, a weights session and a walk. A typical days diet is porridge or Museli for breakfast with a Benecol drink (lowest sugar variety). A wholemeal sandwich (eg cheese and tomato) for lunch, 3 dried figs with yoghurt for a ‘keep me regular’ snack, and an evening meal of pasta or rice with vegetables/meat sauce and a salad with French dressing and a glass of red wine. I’ll also have a piece of fruit and a few nuts during the day.

My immediate response to this is that I should lose a few kg and reduce my carbs intake. But I need to eat something. What could I replace breakfast with? Does anyone have suggestions for low carb snacks? Perhaps I need to start ‘testing’, but I don’t know anything about it.
Help! I don’t want to medicate (yet)!

Thanks Toots,
The whole carbs thing has been confusing as I was always told (and read on NHS websites) that my meals should be based around carbs, but now it seems that carbs are the enemy. I have started carb counting today but I really don't know what I should be aiming for. I had planned to have leek and potato soup tonight but now maybe it'll just be leek soup :?

You suggest toast for breakfast but isn't this even more carbs than 50g of porridge? I agree with the eggs bit. I don't eat many eggs but could have a few each week. Currently, I'm sitting here thinking about food. Ordinarily I might have an apple or crispbread to tide me over but now I'm thinking - wait, 11g of carbs in the apple, god knows how many in the crispbread... perhaps I'll have a... I really don't know.
At least I'll lose those kgs. Lets just hope I don't fade away to nothing.

Thanks Sketcher,
I'm also having to keep my cholesterol under control. Its up to 6.7, but the ratios are good, so I don't want to snack on anything that will raise it. I came off statins because I got muscle degradation which was stopping me from exercising and thus not helping my diabetes management. I'm currently avoiding cheese and taking benecol and garlic (1 clove per day) to try to keep this under control.
50g of carbs sounds really low. I reckon there's 2g in every cup of tea I drink, and I drink a lot of tea! 30g+ in my breakfast porridge. I'm a little worried how my body is going to handle exercise if I go really low on carbs.
I orienteer now which basically means a 60-90minute terrain run every Sunday (plus the training during the week). It's fairly demanding and I usually shove a fair few carbs down my neck to refuel after I have finished - i'll need to review how I do that. :?

Carol, you're right, I'm probably stuck in a breakfast cereal mindset.

However, what do people do to get fibre into a low-carb diet?
I currently rely on cereals and dried figs. Figs especially, but now I'm going to have to cut these out as they are about 8g of carb a pop.

Thanks for all the advice.
Well at the end of my first day carb counting I reckon I've had about 90g.
30g for porridge breakfast
20g sml tin pilchards in tomato sauce with handful of cooked bulgar wheat for lunch
10g for a dried fig & spoon of greek yoghurt
20g for beef with chickpeas, tomatoes and pepper stew
10g milk in various cups of tea/coffee

Is 90g ok? I have really craved a piece of toast. I might just have a nibble of cheese before I go to bed because I am hungry!
As for exercise, I was a bit tired and stiff after yesterday's interval running session (6km) and a couple of hours sawing up a fallen tree, so I just did 10mins on the cross trainer - long run tomorrow though.

Spendercat,
I'm intrigued by the glass of red wine for breakfast :wink: I'll give it a go. That doesn't look like a days worth of food though. I think I might fade away on that.

My numbers do seem to follow my weight though and although I'm already described as slim by my peers I reckon I have another 5-6kgs to lose from around my trunk. It'll help me with my hill running too, which has dropped off with age and the 'statins incident'.

I'm not sure I want to go no-carb but I certainly want to go less-carb. 90g was not too hard and I can see there are possibilities to shed another 20-30g. However, I have always been told that porridge is such a good breakfast, as the carbs are 'slow release' and also helps with reducing cholesterol. Have I got this wrong? should I actually be avoiding slow-release carbs too?
I used to be able to buy natural bran. If I can get it again, I was thinking of replacing 1/2 the porridge with this - has anyone used bran?
I'm also sprinkling cinnamon on my porridge as I'm told that it helps to regulate blood sugars - is this a myth?

I'm sure the red wine was just an amusingly accidental juxtaposition of phrases deliberately misinterpreted by me.
I do drink red wine but not every day and definitely not for breakfast. I shall attempt to limit myself to one glass in future.
I also hear that it is good for slowing down the conversion of a meal to blood sugars. Is this so? And is this why some people recommend that is should be drunk a little while (30mins-1hour) after a meal?

as for the porridge Sketcher, I use 30g of Jumbo oats with 1/2 water and 1/2 semi-skimmed milk. That gives less than 25g of carbs. Before trying to reduce the carbs I'd have twice that AND a handful of sultanas mixed in - I'm not even going to try to calculate how many carbs that was :shock: