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Inconsistent advice

wozey

wozey

Well-Known Member
Hi everyone this is my first post so sorry if I’m not doing it right

I’m a 42 year old guy and been slowly working up my Metformin dose to 4 tablets a day for my Type 2 diabetes, I’m now on the 4 a day but I’m not happy at all. Problem is for about 15 years I’ve only eaten one meal a day in the evening however I’ve been told that I have to change to eating 3 times a day and the tablets must be taken after food, I’ve done my best to force myself to eat and all I seem to be achieving is weight gain! I’ve cut out all added sugar in drinks and I’m trying to be more active and following the advice of not necessarily cutting any food out just eating things in moderation. Now I was talking to someone at work about my diagnosis and he said “oh I’ve got a diabetes buddy” I had no idea he had it too so we got talking and the advice he got seems completely different to me, he’s got a list of foods to avoid a gym membership and a blood monitor to check his levels. I get everyone is different but why the difference in treatment and advice, it just seems like a minefield and the weight gain can’t continue however I have till the end of April till I see the specialist again. Any advice or thoughts welcome
 
Sadly inconsistent advice is more the rule than the exception.

Why and by whom were you told you must eat three times a day? Plenty in here only eat one or two meals a day. It’s called intermittent fasting and has good evidence for being helpful for diabetes. Outdated advice was 3 meals a day to “stabilise” blood glucose. It makes sense on fixed insulin doses to avoid hypos but not otherwise. All feeding yourself more often does is constantly stimulate glucose, insulin and potentially add weight. The only possible explanation that makes any sense to me is if you get too hungry you might gorge on rubbish as a result. If what you eat in that one meal a day is appropriate to diabetes (low carb, natural unprocessed fats and proteins) and meeting your nutritional needs for energy, vitamins and minerals then it’s not a problem.

They usually advise to take Metformin with food because it’s less likely to upset your digestive system that way. If it doesn’t then not an issue. Or take at least some of the dose with your meal. If that’s not working a smaller snack for the 2nd dose rather than full on extra two meals would be my next step.

Eating the right foods once a day will be more effective than any dose of Metformin can be.

A meter is highly unlikely to be provided on the nhs but it’s well worth the investment at least for a while if you can manage it.
 
HSSS said:
Sadly inconsistent advice is more the rule than the exception.

Why and by whom were you told you must eat three times a day? Plenty in here only eat one or two meals a day. It’s called intermittent fasting and has good evidence for being helpful for diabetes. Outdated advice was 3 meals a day to “stabilise” blood glucose. It makes sense on fixed insulin doses to avoid hypos but not otherwise. All feeding yourself more often does is constantly stimulate glucose, insulin and potentially add weight. The only possible explanation that makes any sense to me is if you get too hungry you might gorge on rubbish as a result. If what you eat in that one meal a day is appropriate to diabetes (low carb, natural unprocessed fats and proteins) and meeting your nutritional needs for energy, vitamins and minerals then it’s not a problem.

They usually advise to take Metformin with food because it’s less likely to upset your digestive system that way. If it doesn’t then not an issue. Or take at least some of the dose with your meal. If that’s not working a smaller snack for the 2nd dose rather than full on extra two meals would be my next step.

Eating the right foods once a day will be more effective than any dose of Metformin can be.

A meter is highly unlikely to be provided on the nhs but it’s well worth the investment at least for a while if you can manage it.
Click to expand...

Well it was the diabetic nurse that said I need to eat more meals but didn’t say what I should be eating or what I needing to restrict the consumption of in my diet she just said everything in moderation, I’m also confused as to why I’ve not been told to test my blood sugar like my friend does, the whole appointment seemed rushed and I didn’t get to ask a lot of the questions I had. I’ve seen a lot of people talking test result numbers but I’ve no clue what they were so no idea really how bad the situation is
 
wozey said:
Well it was the diabetic nurse that said I need to eat more meals but didn’t say what I should be eating or what I needing to restrict the consumption of in my diet she just said everything in moderation, I’m also confused as to why I’ve not been told to test my blood sugar like my friend does, the whole appointment seemed rushed and I didn’t get to ask a lot of the questions I had. I’ve seen a lot of people talking test result numbers but I’ve no clue what they were so no idea really how bad the situation is
Click to expand...
Again sadly common. Useless generalised advice without anything to back it up. Moderation wouldn’t work if you were allergic to nuts or gluten for example. Whilst this isn’t an allergy it is an intolerance in a way so the same should apply.

Mistaken, outdated, unscientific beliefs are rife still. Drs and nurses get next to no nutritional training and even less for specific condition like diabetes. And the nhs advice is we should eat the same as everyone else despite the effects carbs have on us. Makes no sense to me or most of us actually living with this condition and wrangling it into submission despite the nhs advice rather than because of it. Fortunately times are changing and more staff are updating their knowledge but it hasn’t reached them all yet.

As to why not test? Well the nhs can’t afford for the army of type 2 to all have meters and strips. If they advocate it they need to provide it so guess what? They say we don’t need to. Also historically testing was to avoid hypos and adjust insulin doses, neither of which apply the most type 2. What they don’t realise is testing before and after meals shows you how you cope with that food and what to limit. If they don’t know about it they can’t educate us how to benefit from it so I can become a waste of money because of that lack of patient education admittedly. There’s a long thread on here about being told not to test, which is worse that just not providing the equipment. @Rachox has a list of the more affordable ones to “run”. Once you have one pop back here and we’ll guide you through how to use it most effectively. If it isn’t teaching you anything or helping you manage then it’s not worth doing.
 
HSSS said:
Again sadly common. Useless generalised advice without anything to back it up. Moderation wouldn’t work if you were allergic to nuts or gluten for example. Whilst this isn’t an allergy it is an intolerance in a way so the same should apply.

Mistaken, outdated, unscientific beliefs are rife still. Drs and nurses get next to no nutritional training and even less for specific condition like diabetes. And the nhs advice is we should eat the same as everyone else despite the effects carbs have on us. Makes no sense to me or most of us actually living with this condition and wrangling it into submission despite the nhs advice rather than because of it. Fortunately times are changing and more staff are updating their knowledge but it hasn’t reached them all yet.

As to why not test? Well the nhs can’t afford for the army of type 2 to all have meters and strips. If they advocate it they need to provide it so guess what? They say we don’t need to. Also historically testing was to avoid hypos and adjust insulin doses, neither of which apply the most type 2. What they don’t realise is testing before and after meals shows you how you cope with that food and what to limit. If they don’t know about it they can’t educate us how to benefit from it so I can become a waste of money because of that lack of patient education admittedly. There’s a long thread on here about being told not to test, which is worse that just not providing the equipment. @Rachox has a list of the more affordable ones to “run”. Once you have one pop back here and we’ll guide you through how to use it most effectively. If it isn’t teaching you anything or helping you manage then it’s not worth doing.
Click to expand...

Yes I’ll definitely get one and test because different foods will have a different effect so worth knowing what foods cause the biggest problem, yeah it just makes sense. I’ll have a look at that other thread also
 
Hi wozey - I'm also one of those T2s who ignored NHS advice and had my blood glucose in normal range in four months as a result - since then I've lost 60+lbs and feel fine.


Here’s some info on UK meters collated by @Rachox, and to be clear I/we have no commercial connections with any of the companies mentioned. There are also Constant Glucose Monitors such as the Libre which are more expensive but you can sometimes find a free trial.

"HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews - if you use this link and select the meter plus 5 packs of strips, and then add the code dcuk (all lower case) at check out you may get money off. I’m not sure if this code is still valid.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

Links to the strips for future orders:

https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/

There are also discount codes for when you come to buy more strips - "navii5" and "navii10" will give you 20% off purchases of 5 packs of strips and 25% off 10 packs of strips respectively. Again I’m not sure if these codes are still valid.

Then they sell the older SD Code Free, details to be found here!

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/

Discount codes for the Code Free strips, again I haven’t used them in a while.

5 packs 264086

10 packs 975833

SPIRIT HEALTHCARE have a meter called the Tee2 + which is quite popular however I haven’t been able to find it on their website lately.

(Old link which doesn’t work for me now but maybe works for you, if it doesn’t try the phone number below

https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793 ) or Google it and you’ll find it’s available from other outlets.

The strips are to be found here:
https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097

Some members have got a free Tee2+ by phoning up to order, with a large order of strips they often throw the meter in for free: Phone number 0800 8815423

If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.
Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free (for all meters and strips)."
 
I’ve just found a new link which works to Spirit Health’s Tee 2 +:
shop.spirit-health.co.uk

TEE2+ Blood Glucose Meter – Spirit Healthcare

Reliable and easy-to-use The TEE2+ blood glucose meter provides all the necessary basic functions for blood glucose testing. Key features: Large screen Results in 5 seconds Stores 1,000 readings Small blood sample requirements SmartLog compatible Bluetooth functionality Auto coding Accuracy to...
shop.spirit-health.co.uk shop.spirit-health.co.uk
 
wozey said:
Yes I’ll definitely get one and test because different foods will have a different effect so worth knowing what foods cause the biggest problem, yeah it just makes sense. I’ll have a look at that other thread also
Click to expand...
Keep a food log. It helps to write down what you ate and what your glucose levels were before the meal and again 2 hours after the meal. This will keep track of what meals are good, and which ones need reduced portions or total abstinence. A rise of 2 mmol/l at the 2 hr mark is considered ok, but if higher then adjust or avoid.
 
KennyA said:
Hi wozey - I'm also one of those T2s who ignored NHS advice and had my blood glucose in normal range in four months as a result - since then I've lost 60+lbs and feel fine.


Here’s some info on UK meters collated by @Rachox, and to be clear I/we have no commercial connections with any of the companies mentioned. There are also Constant Glucose Monitors such as the Libre which are more expensive but you can sometimes find a free trial.

"HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews - if you use this link and select the meter plus 5 packs of strips, and then add the code dcuk (all lower case) at check out you may get money off. I’m not sure if this code is still valid.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

Links to the strips for future orders:

https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/

There are also discount codes for when you come to buy more strips - "navii5" and "navii10" will give you 20% off purchases of 5 packs of strips and 25% off 10 packs of strips respectively. Again I’m not sure if these codes are still valid.

Then they sell the older SD Code Free, details to be found here!

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/

Discount codes for the Code Free strips, again I haven’t used them in a while.

5 packs 264086

10 packs 975833

SPIRIT HEALTHCARE have a meter called the Tee2 + which is quite popular however I haven’t been able to find it on their website lately.

(Old link which doesn’t work for me now but maybe works for you, if it doesn’t try the phone number below

https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793 ) or Google it and you’ll find it’s available from other outlets.

The strips are to be found here:
https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097

Some members have got a free Tee2+ by phoning up to order, with a large order of strips they often throw the meter in for free: Phone number 0800 8815423

If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.
Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free (for all meters and strips)."
Click to expand...
I got my first Libre 2 as a free trial by ordering directly from the Freestyle libre website.
 
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