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Fluffkin

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Hi there.
I've just come across this forum and I'm really looking for advice re diabetes.
I was diagnosed with type 2 in 2008 and haven't done anything since. I get my blood sugar checked but otherwise it is diet alone. I did see a nurse when I was first diagnosed who gave me some diet advice. I was offered metformin but refused it because it gave me diarrhoea and I have a lot of that anyway. I didn't want to spend my life on the toilet! (Plus I kept messing myself)
Anyway, fast forward a bit and now my latest reading was 94 (I don't understand these new numbers, but I gather this is Very Bad) and the doctor has said he wants to refer me to a hospital team to go on insulin.
I'm just a bit confused about diabetes really, because I have mental health problems no one has ever really talked to me about it, and for a long time I thought that because I am fat I should just take my punishment (diabetic complications) and also, I worked as a HCA once and I remember our treatment-compliant patients with diabetes who came in with missing feet and blind and thought, well what's the point?
I'm a Bad Patient. But I think perhaps I should start being a better one.
 
Fluffkin wrote
I'm a Bad Patient. But I think perhaps I should start being a better one.
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Welcome Fluffkin :D

I'm guessing your 94 is an HbA1c in new measurement numbers. Gives 10.75 under the old system. Which gives you an average blood sugar of 17, which is far too high.

You don't say how you've been trying to control your diabetes with diet alone. Standard NHS advice pushes far too high carbohydrates levels for many Type2s.
We usually advise all T2s to test themselves (often using a self-funded meter and strips) to find out which foods are causing high blood sugar levels.
Usually anything sugary, potatoes, white bread, white rice and pasta, anything white-flour based. Some fruit and some veg is to be avoided.

This is the ONLY way you're going to take control of your diabetes.
Also losing weight will help, since it affects your insulin sensitivity.
One way used by a number on here is to follow a low-carb diet.

Our ethos here is that complications are NOT inevitable, but that following standard NHS advice is often not helpful.
My brain is now tiring, so I'm off to bed.

Please ask all the questions you need to, and someone will pop up to answer them :D

Geoff
 
Hello Fluffkin and welcome to the forum.

Certainly not the case you should just take the punishment you just need to know what to do! It does take a bit of hard work to start with but its well worth it. Here's some info I usually give to the newly diagnosed but you should be able to use a lot of it yourself to get you going.

I was diagnosed in December last year and using the advice I found on this site I got my blood sugar levels back to normal within around a couple of months or so and I have also normalised my cholesterol levels and blood pressure as well. I have now lost over 50lbs in weight too and 10" off my waist measurement. Not a cure as I have to be very careful what I eat but I'm feeling loads better now I'm back in control. My doctor is very pleased how I am getting on and has advised me to keep doing exactly what I have been doing since it's obviously working really 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 and really importantly 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 try 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 for Type 2 diabetics. In the UK the diet guidelines are now over 30 years old and are only gradually being updated. As the UK is lagging behind you may find what I and other forum members recommend will be different to what your are told is a good diet for you follow.

Did your doctor mention giving you a meter and strips to measure your own blood sugars?. Some do and some don't. It's a bit of a post code lottery and we find some progressive surgeries are pro testing and others anti. I'll warn you the anti ones can sometimes be very vocally anti!

The reason testing is important is you should try and keep your blood sugars below 8ish two hours after eating any meal. Above the 8 value is where the dangers of complications do begin to occur according to diabetic experts. So if you can't test how will you now if what you are eating is keeping you safe? The problem is 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.

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.

PS Here's three good links about what's good to eat.

First is the lady doctor who's low carb / low GI recommendations seem to form the basis of what's recommended in Sweden

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

Second is a good beginners guide to low carb regimes that are excellent for reducing blood sugar levels and losing weight.

http://www.dietdoctor.com/lchf

There are also loads of brilliant recipes on the forum. You can find them here http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=18&t=4871. My favourite is Cheeseburger Pie which you'll find near the end.

Good luck and keep asking questions.
 
Hi Fluffkin and welcome to the forum :) To help you to get back on track, and in addition to the advice you have already received, here is the information we give to new members and I think this should help you. Ask all the questions you like as we all want to help you.

BASIC INFORMATION FOR NEW MEMBERS


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.
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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.
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