Husband newly diagnosed - I'm in charge !

[delphi]

This forum has been interesting and very helpful, so thought (with husbands permission) that I'd lodge some concerns/questions:

Husband recently confirmed as fasting glucose 8.2 ( blood tests first thing in the morning), then HbA1C (IFCC) 58mmol/mol hence Type II. I have more time than him and so committed to research, food shopping and ensuring we focus on the positives from this 'diagnosis' ie. this is a line in the sand in terms of weight and lifestyle (his BMI 32/ age 52 and intense work schedule sometimes from 8am through to late evening ). We're active (long working days aside), taking cardio-vascular exercise between 1-3 times a week, could describe our diet as mediterranean - probably too much olive oil and definately too much carbohydrate.

Anyway, he was handed a prescription for Metformin ( 1000 mg/SR 1 per day). Cholesterol: Overall 5.0, HDL 1.03 / LDL 3.37/triglycerides 1.43 - so statins also prescribed to bring this to the bottom of the acceptable range for someone with Type II. Told to come back in 3 months, see the nurse in the meantime, handed a magazine. Is that it ?

Questions:

(i) Metformin - is it absolutely necessary at this stage to prescribe - no symptoms other than the BMI ? Could this tablet help him with his required weight loss - would rather we concentrated on sensible eating, weight loss than tablets ? Should we talk to the nurse about this - I'd rather he/we were given the ultimate incentive to avoid medication wherever possible. Checked this out with occupational health at work and they suggest too ( without detailed knowledge of the patient) that medication would appear premature at this sort of blood sugar level.

(ii) BUPA: - do BUPA do anything on diabetes - dieticians ? We are fortunate enough to have this facility open to us, but not sure if it recommended. Slightly concerned that his most recent BUPA medical ( albeit 4 years ago ) fasting glucose was taken in the afternoon and fine. Judging by his blood glucose patterns (below) this could be massively misleading and if he'd had his medical in the morning quite a different result could have manifested.

(iii) Volatile blood glucose:

We ( I ) went out and bought a glucose monitor. Some very strange figures - but useful to know what impact different foods have ( we test together so it isn't cheap ). The morning peak is a concern:

Thursday am: we had a BG 9 last Thursday morning - he'd worked until 22:00 the day before - we ate chilli with a small portion of basmati rice and soon after went to bed).

Saturday am: BG of 6.0. On Friday evening, we ate steak/spinach/toasted sourdough at 21:00

Sunday: BG 7.8 Today ( Sunday morning ), we got up late and I sent husband out to the garden to do some 'hard labour' at 10.00 but before eating anything in the hope we could 'beat the peak'. I suppose we sort of expected as Saturday nights treat was a pint of bitter / glass of red wine, small portion of mushroom pasta followed by chicken (no skin) with spinach. However, this morning after the test, we then had brunch (toasted sourdough/grilled bacon/tomato) and 3 hours later blood had dipped to 3.6 :shock: . So cup of tea (spoon of sugar) and tomato salad, exercise and then BG went back to 6.0.

All very confusing. Any comments /input welcome - team effort achieves more ! :thumbup:

 

[daisy1]

Hi delphi and welcome to you and your husband

Here is the information we give to new members which should help you both. Ask more questions as you need to and someone will help. Members will be along soon to answer the questions you have already asked.


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.

 

[Chrispp]

I'm nearly 60 & diagnosed type 2 in 2010. I was first told about diet control & need to lose weight. I've never taken medications, not even aspirin. The message from my docs & diabetes specialist nurse was try diet come back in month and we'll put you on tablets :sad: I refused medication.
I changed my healthy style diet (same diet as type 1 wife) over night, cut back carbs severely, became close to vegetarian, even reduced already semi skimmed milk intake. Plus upping the exercise steaks.
I have to eat minimal quantity, & always feel slightly hungry to keep feeling fine, still on no medication & have a very clean bill of health now.
But no one else can do it for you, you have to live with your own choices & make the effort yourself. I now have a high chilli (should have bought Encona shares) content with my food as the hot chilli seems to help stem the appetite. My coffee addiction has been changed for green & mint tea & I also drink a lot of water. Biscuits, chocolates, snacks etc were easy to ditch as they were a minimal rare intake throughout my life. Fruit in salad at lunch time with chilli dressing covers any need for sweetness. Our home grown apples, pears and plums go into curries. For the odd treat I even bake healthy tasty chilli seeded bread that my wife has become converted to.
Swapping quantity for high spicy hot flavours & minimal quantity has suited me and keeps the docs very happy.


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[Daibell]

Hi. Metformin is a good safe drug. If reduces appetite and does help reduce glucose in the blood and helps reduce insulin resistance when overweight. It may not be essential for your husband but it's one of the better, safe, drugs. Test with the meter 2 hours after a typical meal. Don't worry too much about morning readings. Most docs at diagnosis will wait 3 months on the right diet with possibly metformin, then do an HBa1C test to decide what action to take next.