I'd really like your honest opinion...

[Pip16]

Three very valuable nuggets of advice, if I may say so.

Like many (NOT ALL) diagnosed with T2 diabetes, I was extremely overweight (18st 8lbs and 5ft 8ins) and did not move around much. My diet was poor in the sense that I ate all that I should but ate and drank a lot that was unnecessary. I think that the modern day diabetes guru Prof Roy Taylor calls this *over-nutrition", I think that "gluttony" would be the old fashioned word.

On diagnosis (HBa1c 82 mmol/mol) I resolved to lose weight and to do this I would follow the diet recommended by the doctor (or strictly in the leaflet I was given by the doctor) and increase my activity levels by an hour or so brisk walking every day. I reasoned that I had been eating abnormally for several years and that the first thing to do was to bring my calorie consumption down to normal levels. I also resolved that I would review the question of diet when I had seen the effects of (hopefully) losing weight.

I had read on this forum the views of many who advocate a low carb diet, usually described as LCHF with the HF being high fat. Shortly after being diagnosed, the BBC Horizon programme "Fat v Sugar" was aired. The programme had twin doctors one of whom had a diet of almost exclusively fat based nutrients and the other whose diet consisted of sugar. The programme concluded that neither was a healthy diet but the glucose readings of the twin with the fat diet shot up more that the readings of the twin with the sugar diet.

I therefore decided that a balanced diet with carbohydrates was for me. I cut out white bread and potatoes, substituting wholemeal and sweet potatoes in their place. Red meat was also to go and replaced by fish. Vegetable (broccoli and beans) intake was increased. Some primitive form of portion control was introduced. I stopped eating as a form of recreation. The net effect of the above was that the weight fell off and and Hba1c likewise went south to 38mmol/mol) in first 3 months from diagnosis. I had decided that I would not take any medication until I had got myself down to a normal weight, so I have not taken any metformin although my diabetes team did want to prescribe it for me.

The upshot of the above is that I am now over 5 stones lighter than at diagnosis but still a few pounds over weight, I eat a normal diet and have normal blood glucose levels. I probably would have been in the same position if I had followed a LCHF diet, but who knows? The advantage of the NHS advised diet to me is that I feel that I can stick to it for the rest of my life, I do not think that I could say the same about a LCHF diet. So my advice to the original poster is to try the balanced diet advised by the NHS and other bodies around the world before embarking on a more restrictive diet, such as the LCHF advocated by many on here.

However, T2 diabetes is not a disease which is contracted overnight and in most (NOT ALL) cases is caused by many years over-nutrution/gluttony and that the main thing to do is to stop doing what one has been doing which has given you diabetes in the first place, which is overeating.

With respect to the original poster and to her DN, I do not think that the latter is advising to former to gorge on bananas and digestive biscuits. I think that the point the DN was making is that there is nothing out of bounds provided it is taken in moderation. I would also say that my diabetes team of a doctor, diabetes nurse and nutritionist (all NHS) have been conscientious, professional and knowledgeable. I have no doubt that they have been acting in my best interests.

Hi Syd Well done with your weight loss and lowering your HBA1C with your diet and exercise. As Brunneria has said you are very lucky in having such great support from your Diabetes team. With my comment i was merely pointing out that not only medical teams but also the general public have a perception that you must be overweight with no exercise and gorge on jam doughnuts to receive a diagnosis of diabetes.
The locum GP (telephone consultation on diagnosis) had never even met me. My medical notes i am sure had no details of my weight, height or my exercise regimes etc. Yet the advise given to me was to lose weight and do more exercise. When i did see the DN the only bit of advice i received was that our bodies do not need jam doughnuts.

Your Comment
......However, T2 diabetes is not a disease which is contracted overnight and in most (NOT ALL) cases is caused by many years over-nutrution/gluttony and that the main thing to do is to stop doing what one has been doing which has given you diabetes in the first place, which is overeating.


I was very first diagnosed? Aged 20, 31 years ago while 9 months pregnant and weighing 7.5 stone. I was working upto 8 months of pregnancy and was fit and healthy. When i gave birth i immediately went back to my pre pregnancy weight of 6.5 stone. The diabetes went? 2 More pregnancies, i put on same weight and back to pre pregnancy weight of 6.5 stone but no diabetes with those. I was running around after 3 young children all under 5. Plenty of trips to the parks and playing football etc and Still working, some days running to 3 different jobs. I was keeping house etc at home. Money was short, food was very healthy and all home cooked. Yes there was the occasional cake and sweet. Nothing to excess as we didnt have the money. Definately no burgers etc. Once again still weighing 6.5 stone i got an infection which showed raised sugar levels and my gp sent me for tests. Came back clear. My last pregnancy 10 years later, however weighing exactly the same before and after but i had diabetes again. This went once again after giving birth. I stayed at 6.5 stone for another 10 years. I was running around even more with my job. (i dont drive) and most days on the go from 6am to 12pm. If i was too busy i wouldnt eat. However my weight started creeping up on me when i reached 47/48 years. I was still eating the same, still some days not eating and doing the same if not more exercise than i had ever done but evenso my weight went up to 10.4 stone. All around the middle. I got a water infection last October and came back as raised sugar and have been tested monthly then 3 monthly until Sept when my HBA1C came back as 51. Diagnosed with type 2. I find it very hard, especially with my own history to believe that diabetes is solely caused by being overweight from eating the wrong foods and lack of exercise. My mother and her 3 siblings all have type 2 and as far as i know have always eaten healthily and not been overweight. Whose to know whether this went back further and my grandparents and even theirs suffered from diabetes.

Yes some people may be overweight, through being a glutton and lack of exercise, i know plenty of those and they do not have diabetes. Likewise i know of plenty who are overweight through a thyoid or other disorder, not caused by overeating or lack of exercise and also those who are of normal weight and do plenty of exercise and who all receive a type 2 diagnosis.

I have been on the lchf (although not too low) diet since around beginning of October and ive now lost just over 1 stone. I am now within the normal weight range for my height. As ive said previously there is no way i can do any more exercise than i already do. My meter readings are all between 4.3 and 6.8-7. I feel fit and healthy and looking forward to my next HBA1C in October. However i dont think that i could ever eat a jam doughnut or any other cake/pudding/sweet (unless i make my own) even in moderation as its not worth the risk to me.

Sorry that should be next HBA1C in December.

 

[Pip16]

This may well be the case. What about a glass of wine though?! How did you keep a straight face? As I read this, I had a sort of Hattie Jaques ooh matron image in my mind, delivering this po faced lecture!

Haha Hattie Jaques - I wont be able to look at her again with a straight face now. I didnt ask about the wine - well i didnt ask about a jam doughnut either - but arnt we told that a glass of red is good for us now!!

Julie

 

[Scandichic]

Three very valuable nuggets of advice, if I may say so.

With respect to the original poster and to her DN, I do not think that the latter is advising to former to gorge on bananas and digestive biscuits. I think that the point the DN was making is that there is nothing out of bounds provided it is taken in moderation. I would also say that my diabetes team of a doctor, diabetes nurse and nutritionist (all NHS) have been conscientious, professional and knowledgeable. I have no doubt that they have been acting in my best interests.

First of all, your weight loss is awesome! Well done! However, I cannot agree with the idea that nothing is out of bounds. If I eat a toddler size portion of rice, pasta or bread then my bs is in double figures! I have tried but to no avail. Small portion of chips (toddler size) ok but not great. 8.5 after 2 hours. Can get away with occasional ice cream though.
It would be nice if our HCP could show the same level of respect we show for each other here!

 

[daddys1]

Three very valuable nuggets of advice, if I may say so.

Like many (NOT ALL) diagnosed with T2 diabetes, I was extremely overweight (18st 8lbs and 5ft 8ins) and did not move around much. My diet was poor in the sense that I ate all that I should but ate and drank a lot that was unnecessary. I think that the modern day diabetes guru Prof Roy Taylor calls this *over-nutrition", I think that "gluttony" would be the old fashioned word.

On diagnosis (HBa1c 82 mmol/mol) I resolved to lose weight and to do this I would follow the diet recommended by the doctor (or strictly in the leaflet I was given by the doctor) and increase my activity levels by an hour or so brisk walking every day. I reasoned that I had been eating abnormally for several years and that the first thing to do was to bring my calorie consumption down to normal levels. I also resolved that I would review the question of diet when I had seen the effects of (hopefully) losing weight.

I had read on this forum the views of many who advocate a low carb diet, usually described as LCHF with the HF being high fat. Shortly after being diagnosed, the BBC Horizon programme "Fat v Sugar" was aired. The programme had twin doctors one of whom had a diet of almost exclusively fat based nutrients and the other whose diet consisted of sugar. The programme concluded that neither was a healthy diet but the glucose readings of the twin with the fat diet shot up more that the readings of the twin with the sugar diet.

I therefore decided that a balanced diet with carbohydrates was for me. I cut out white bread and potatoes, substituting wholemeal and sweet potatoes in their place. Red meat was also to go and replaced by fish. Vegetable (broccoli and beans) intake was increased. Some primitive form of portion control was introduced. I stopped eating as a form of recreation. The net effect of the above was that the weight fell off and and Hba1c likewise went south to 38mmol/mol) in first 3 months from diagnosis. I had decided that I would not take any medication until I had got myself down to a normal weight, so I have not taken any metformin although my diabetes team did want to prescribe it for me.

The upshot of the above is that I am now over 5 stones lighter than at diagnosis but still a few pounds over weight, I eat a normal diet and have normal blood glucose levels. I probably would have been in the same position if I had followed a LCHF diet, but who knows? The advantage of the NHS advised diet to me is that I feel that I can stick to it for the rest of my life, I do not think that I could say the same about a LCHF diet. So my advice to the original poster is to try the balanced diet advised by the NHS and other bodies around the world before embarking on a more restrictive diet, such as the LCHF advocated by many on here.

However, T2 diabetes is not a disease which is contracted overnight and in most (NOT ALL) cases is caused by many years over-nutrution/gluttony and that the main thing to do is to stop doing what one has been doing which has given you diabetes in the first place, which is overeating.

With respect to the original poster and to her DN, I do not think that the latter is advising to former to gorge on bananas and digestive biscuits. I think that the point the DN was making is that there is nothing out of bounds provided it is taken in moderation. I would also say that my diabetes team of a doctor, diabetes nurse and nutritionist (all NHS) have been conscientious, professional and knowledgeable. I have no doubt that they have been acting in my best interests.

Hi Syd, After reading this, I sort of thought that you may have really have been doing some low carbing without knowing it, I think everybody on here are doing the LCHF their own way & to different degrees. With me I would say I was doing the LCHF but would not eat all the fat on a piece of meat where I'm sure some would, but would do not worry as much about it as I did before. My veg has increased so that's about 50% of the plate and I may occasionally have a small potato & effeminately sweet potatoes. Will have 1 slice of wholemeal bread where I would have had 2 or 3 slices. If your are really saying that your plate continued to be 50% Carbs then good for you as it's worked, and losing the weight is the main aim anyway. Did you test during this period, was you able to see whether any foods you were having were having an effect on your blood sugar.
Ive just finished a book (excellent) 'Reversing Diabetes' He also stated that the way to help your diabetes was to have few carbs. Worth a read by David Cavan

 

[Sam72]

@Scandichic - I am absolutely the same with bread / wheat products. The smallest portion sends me into double figures too so it is out of bounds for me. I can tolerate boiled potatoes with no effect. Will try out porridge pasta and rice after my next hba1 c in mid December. Strangely a small amount of sugar in something doesn't affect me nearly as much as wheat. Sometimes has no real effect on BS really at all. I wouldn't have known any of this without my meter and advise from people on this forum. So... Sorry @Syd I stand by my first gut feeling that NHS advice was at best unhelpful

 

[Syd]

@Izzi Thanks for your comment. Alas the wonderful Vauxhall Velox in my avatar is not mine, but well done for not confusing it with the similar but far less prestigious Vauxhall Cresta (a common mistake).

 

[Syd]

Hi Syd, After reading this, I sort of thought that you may have really have been doing some low carbing without knowing it, I think everybody on here are doing the LCHF their own way & to different degrees. With me I would say I was doing the LCHF but would not eat all the fat on a piece of meat where I'm sure some would, but would do not worry as much about it as I did before. My veg has increased so that's about 50% of the plate and I may occasionally have a small potato & effeminately sweet potatoes. Will have 1 slice of wholemeal bread where I would have had 2 or 3 slices. If your are really saying that your plate continued to be 50% Carbs then good for you as it's worked, and losing the weight is the main aim anyway. Did you test during this period, was you able to see whether any foods you were having were having an effect on your blood sugar.
Ive just finished a book (excellent) 'Reversing Diabetes' He also stated that the way to help your diabetes was to have few carbs. Worth a read by David Cavan

Hi @daddys1 I certainly have cut the carbs from the level of my pre-diagnosis days. However a large proportion of my diet now consists of home made soup I am not precisely sure exactly how many carbs I am consuming. If I had to guestimate I would put it somewhere between 200 and 300 g per day, so to that extent I am lower than the GDA for an average adult male.

I did buy a glucose meter as in the early days I did not entirely believe that my Hba1c test was right. It was useful to the extent I could see my levels coming down. I still have it and occasionally test to see that all is ok, which it seems to be. The real test will be my next hba1c which should be some time next month, one year from diagnosis.

I was diagnosed after a routing blood pressure test which showed an abnormally high reading. I did not have any other symptoms and did not in any way feel ill, so I am led to believe that the diabetes was detected early which seems to be helpful. At the moment I keep a very careful eye on the weighing scales to make sure that either the weight is still coming off or at least not going back on.

 

[Syd]

Hi
@Pip16 I appreciate that there are those who are not overweight or obese and who contract diabetes T2. However it would seem that the NHS is being overwhelmed by people like me who have over indulged, got fat and got diabetes. There is a T2 diabetes epidemic which is caused by overeating and over-drinking.

The point which I hope I am making is that the first thing for a doctor or diabetes nurse to do is to put the patient onto a 'normal diet' and get them down to a normal weight. If this doesn't work then it may be time to move on to faddy diets, but in the first instance getting the weight off is the most important thing.

@Sam72 I don't know whether the advice which you have been given was the same which I was, if it was then we may have interpreted it in different ways. However, I wish you luck with which ever route you decide to go along to tackle your diabetes, if it works for you then that is all that matters.

 

[phoenix]

Hi

Hi Syd, After reading this, I sort of thought that you may have really have been doing some low carbing without knowing it, I think everybody on here are doing the LCHF their own way & to different degrees. With me I would say I was doing the LCHF but would not eat all the fat on a piece of meat where I'm sure some would, but would do not worry as much about it as I did before. My veg has increased so that's about 50% of the plate and I may occasionally have a small potato & effeminately sweet potatoes. Will have 1 slice of wholemeal bread where I would have had 2 or 3 slices. If your are really saying that your plate continued to be 50% Carbs then good for you as it's worked, and losing the weight is the main aim anyway. Did you test during this period, was you able to see whether any foods you were having were having an effect on your blood sugar.
Ive just finished a book (excellent) 'Reversing Diabetes' He also stated that the way to help your diabetes was to have few carbs. Worth a read by David Cavan

Actually, a diet that includes meals comprising by volume about 50% veg, a quarter starch ((bread, pot, rice, legumes even peas are starch) plus some dairy and a small piece of fruit actually adds to on average about 50% carbohydrate in the diet. I'm sure it's far more carbs more than LCHF aficionados eat, and is low in fat but it isn't huge amounts of starches either.
Here's how it looks. The plate represented is 9inches, calories about 1400 in a day.
http://www.extension.uidaho.edu/diabetesplate/planning/plate_lunch.html

It is the basis of the plate used both in the US , on the current ADA website, and is also what is used as a teaching tool by my diabetes dietitian in France. (though she would also emphasise the GI and quality of the starches chosen, would probably add a little more fat in the form of olive oil as a dressing and include 30-40g cheese in the dairy choices rather than as a protein element .)

 

[poshtotty]

@Syd

I very much agree with @Pip16

I've never been obese or hugely overweight and have always been quite disciplined with my food, although I am a bit of a foodie and love cooking and entertaining, but the food is mostly for the enjoyment of others rather than myself.

In the late 1990's while I was in my 40's I went down with acute glandular fever and was on the verge of being hospitalised, when I rallied enough to remain at home to recover. Not long after my recovery, I was diagnosed with rheumatoid arthritis, then T2. Both are auto immune diseases and I'm convinced there is a link to the glandular fever which weakened my immune system.

So I too object to being linked with the general belief that diabetes is caused by gluttony etc as in your comment below:

"However, T2 diabetes is not a disease which is contracted overnight and in most (NOT ALL) cases is caused by many years over-nutrution/gluttony and that the main thing to do is to stop doing what one has been doing which has given you diabetes in the first place, which is overeating."

Your own management of your condition is to be applauded, but there needs to be a much greater awareness of the other causes of the condition and understanding for those sufferers who did not bring it on themselves by neglecting their diet or refusing to exercise. In my case, diabetes could actually have happened, perhaps not overnight, but in a very short time of being hit with a disease which weakened my immune system. It is no co-incidence that the only two health conditions I have are both auto-immune diseases. Nor is it a coincidence that both conditions have improved significantly since converting to a strict LCHF eating regime, to the point that I have been able to give up all medications for RA and am pain free, with a decrease in the progression of this debilitating disease. The only item now on what was my 2 page prescription is Metformin. There have been no other changes in my life, except a change of eating

 

[Syd]

@dianagrace

I stand by my earlier comment that most (NOT ALL) cases of T2 are the result of overeating and poor diet. The words 'not all' are important as there are many cases of T2 in which the sufferer has not been guilty of the previously mentioned sins of over-nutrition/gluttony and yours would seem to be one of them.

I also stand by my earlier opinion that the doctors are right in the first instance to recommend what has been called the NHS diet (although it is one that BUPA also recommends http://www.bupa.co.uk/health-information/Directory/H/healthy-eating). If that doesn't work then move on and try something different, which you obviously have to your advantage.

 

[izzzi]

@dianagrace

I stand by my earlier comment that most (NOT ALL) cases of T2 are the result of overeating and poor diet. The words 'not all' are important as there are many cases of T2 in which the sufferer has not been guilty of the previously mentioned sins of over-nutrition/gluttony and yours would seem to be one of them.

I also stand by my earlier opinion that the doctors are right in the first instance to recommend what has been called the NHS diet (although it is one that BUPA also recommends http://www.bupa.co.uk/health-information/Directory/H/healthy-eating). If that doesn't work then move on and try something different, which you obviously have to your advantage.

@Syd Could not agree more, I am one of those that has not got a weight problem, yet I was guilty of a poor diet ,prior to my diabetes.
I follow a simple diet that works, so as you say if that does not work move on.
You have told us what works for you and that is a great boost for many on this forum, that is very important..
The main tool is control. as long as you use it..
Keep up your good work.

 

[daddys1]

Hi @daddys1 I certainly have cut the carbs from the level of my pre-diagnosis days. However a large proportion of my diet now consists of home made soup I am not precisely sure exactly how many carbs I am consuming. If I had to guestimate I would put it somewhere between 200 and 300 g per day, so to that extent I am lower than the GDA for an average adult male.

I did buy a glucose meter as in the early days I did not entirely believe that my Hba1c test was right. It was useful to the extent I could see my levels coming down. I still have it and occasionally test to see that all is ok, which it seems to be. The real test will be my next hba1c which should be some time next month, one year from diagnosis.

I was diagnosed after a routing blood pressure test which showed an abnormally high reading. I did not have any other symptoms and did not in any way feel ill, so I am led to believe that the diabetes was detected early which seems to be helpful. At the moment I keep a very careful eye on the weighing scales to make sure that either the weight is still coming off or at least not going back on.

Hi Syd, I think from your comment you have probably lowered the starchy carbs considerably and not eating the allotted NHS requirement of a balanced diet that being 30% starchy foods, I don't know only you know that, (these starchy foods are the ones that seem to spike a lot of people here), if you say you are having mainly soups now. You are also in a slightly different position to most here, being Pre Diabetic the main course of action for you is the losing of weight. The balanced NHS diet may have no effect on your sugars & providing you eat less & exercise it will work for you.

I am very marginal & my numbers are coming down to normal but the odd starchy carb does raise my levels so why would I eat them. The NHS isn't saying this is the recommended diet, but if your get a spike from some of these starchy carbs, remove them from you diet, they say carry on regardless but have them in moderation.

I have 2 friends both Type 2 both, suffering from some complications, one has nerve damage in the feet and legs now getting shooting pains in the legs, the other having some majors nerve damage in the feet and the blood sugars rising very high, Both follow the NHS diets religiously, i.e when I say to them you still have potatoes & bread yes but we are told we can have these these foods but in moderation. One of the guys occasionally tests and says I know these foods spike me but the NHS say its OK in moderation. Sorry that cannot be good for anyone..........

 

[sanguine]

@dianagrace

I also stand by my earlier opinion that the doctors are right in the first instance to recommend what has been called the NHS diet (although it is one that BUPA also recommends http://www.bupa.co.uk/health-information/Directory/H/healthy-eating). If that doesn't work then move on and try something different, which you obviously have to your advantage.

I used to eat something similar to the 'NHS' diet. Then I was diagnosed with T2. I stopped eating the NHS diet and went LCHF, so I 'moved on' immediately because it didn't work. There are many on here who successfully manage their BGs by not following the NHS diet, if you can do it by eating the amount of carbs they recommend and not having to take more drugs then congratulations.

 

[NoCrbs4Me]

I used to eat something similar to the 'NHS' diet. Then I was diagnosed with T2. I stopped eating the NHS diet and went LCHF, so I 'moved on' immediately because it didn't work. There are many on here who successfully manage their BGs by not following the NHS diet, if you can do it by eating the amount of carbs they recommend and not having to take more drugs then congratulations.

The problem is the health care professionals will not recommend a LCHF diet or any other diet if the standard diet doesn't work (except maybe a tiny, tiny minority of them). They will go straight to more meds. They are too hung up on the debunked theory that fat should be minimized in the diet and you need to eat lots of carbs. They don't know or don't believe that a LCHF diet is healthy, even though it will reduce blood glucose levels, lose weight, improve blood pressure, lower plasma triglycerides, and improve cholesterol numbers (or at least it did for me).

 

[jack412]

@Syd I would read up on insulin resistance and metabolic syndrome. as a prediabetic, it will stand you in good stead for the future.

 

[Daphne917]

My mother had T2 and she always seemed to eat healthily with no sugar, bnrown bread, pasta etc but was always told she needed to lose weight and finally ended up on insulin. I now realise why she had problems because she ate to NHS guidelines! Now the majority of us have the advantage of internet and forums and are, luckily enough, better informed than some of the professionals and can make our own judgement re what to eat and, to a certain extent, what is best for our own health. For example when I was taking Statins and my BS rose from 5.8 to 7.2 I found a causal link between diabetes and statins and informed my DN who promptly told me not to believe everything I read in the D Mail - she went quiet when I informed her I'd got it from the manufacturers own website. Luckily enough my new DN seems to know what she's doing to the extent that she suggested that I not eat too many carbs and have Low GI one if poss. I might even try the impossible and ask about being prescribed strips for my meter!!!