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Discussion in 'Prediabetes' started by gardengnome42, Oct 27, 2017.
Good that you are reading and seem well prepared. Keep posting and let us know how you are doing.
@gardengnome42 good that you are taking the situation in hand.
You mentioned the "really scary" factor that it is a "progressive disease." Even though I have no specialist medical knowledge, I am now convinced this is not always the case. Or at the very least, that some people can slow down the progression so much that it would have negligible effect on lifespan or quality of lie.
In strict scientific terms, it seems that "nobody knows." There is a mountain of evidence that it is progressive, and doctors, from their daily experience of treating people with diabetes who steadily get worse, understandably consider it to be progressive!
I was scared witless, at diagnosis, by the "progressive" label attached to the disease. For days, I was convinced I would never see my (future) grandchildren grow up.
Nine months later, I am still symptom-free and there are no signs of any diabetes complications, and because my BGs are under control at non-diabetic levels, there is close to zero risk of complications.
Anecdotally, hundreds, nay thousands of people are having the same experience. There isn't much hard science, but lots and lots of people on this forum are living evidence that it seems to work.
Who would have thought it! Have just read this about fatty liver and fructose. Oh dear it seems I certainly have been overloading on it, will have to stop that. What a shame as I do love it so! So much for the nanny NHS telling us to eat '5 a day' which I do in excess - somehow I don't feel that chewing on a carrot or celery stick will cut the mustard in the same way as a beautiful Victoria plum or a ripe pear, and don't mention mangoes.
Gosh, once again you are echoing my feelings from diagnosis-time pretty much exactly. I loved fruit, especially exotic fruits like kiwis. Although I do now eat fruit (but in very small quantities), the low-carb diet seems to have considerably changed my palette.
To give you an example. For various reasons, I have been eating one banana per day. This is a bit of a no-no on a strict low-carb diet, but bear with me. Although I still like the taste of a banana, it is quite different from the pre-diet days. Nowadays, it tastes almost like pure sugar. (And in fact if you look up the nutrition information, that is pretty much what a banana consists of.) In the old days it just tasted like ... well ... a banana!
I do have berries with my breakfast. They, too, have changed taste. They taste waaaay sweeter than they used to. So much that two small raspberries and two blueberries is enough for me. That's an infinitesimal quantity of fruit, but enough to satisfy my taste buds now. (And, for fruit, berries are low-carb.)
Edited to add another example: Coffee. I am pretty much addicted to it. In the old days, I always added milk and a teaspoon of white sugar. I would drink four or five cups in a typical morning. Well, that is something I did not give up, except that I now drink it black and unsweetened. To start with, this was hard because of the bitter taste. Nine months later, the black coffee actually tastes quite sweet. Even though coffee is actually zero-carb!
Hi Grateful, I see that you were only diagnosed this February and have managed to reduce the HbA1c to prediabetic levels in the 9 months since then. Well done you! Obviously with no meds you have done it by diet, did you do low carb?
You sound as though you had the same reaction at diagnosis to me [shock horror] yet your Hba1c was 8.9. That's high I think? Was the test given as routine for something else or did you have a problem? And how was the bad news broken to you?
My grandmother had diabetes but only when she was in her 70's, which is where I am at, and as she had osteoarthritis was unable to walk far, it eventually made her bedridden with dreadful ulcers and she died of a stroke at 90. I have OA too and am 75. I do wonder how long my glucose nos. may have been rising on the quiet before I had that NHS health check. that revealed hypertension 5 years ago.
Have you had the welcome post from @daisy1 yet? I have paged her, just in case you havent seen it. It has lots of helpful advice on diet and diabetes and blood sugar control.
I am British, but live on the East Coast of the United States. My HbA1C was 8.3% (67) at diagnosis in February of this year, which is high and firmly in the diabetic range, but not astronomical. This was a routine medical and the T2D was diagnosed in a blood test (I had no symptoms) so it was like a bolt of lightning out of the blue.
I am 6-foot-4 and have been thin and weedy much of my life, although over the past decade my waistline had expanded to 40 inches (nine months later, it is 35 inches) even though my BMI was "only" 21.7. I was someone who took quite a lot of exercise (and used public transport, and walked a lot) but it was irregular. I also spend much of my life anchored behind a desk.
Due to laziness, I had skipped my annual medicals for many years. The previous A1C test was in 2009, when it was 5.5% (37) which is just on the edge of pre-diabetes, but not in itself a cause for concern, and I was not given any kind of warning. It is only with the benefit of hindsight that one can see a "trend."
Then I had a huge stroke of luck. It turns out that my doctor, who is a mainstream American GP of almost exactly my age with no "alternative medicine" tendencies whatsoever, happens to believe in the benefits of trying the "low-carb diet, more exercise, no meds" option. The conversation went something like this:
I said that I had been reading up about diabetes and found it all quite scary. His response:
"It is what it is. Who knows, you may just have a genetic factor that predisposed you. We've made progress. I'm seeing less of the 'old days' when people went blind or had their limbs amputated."
I asked him how high my HbA1C was (by then, I had done some research).
"It's 8.3% ." (I winced!) "Let's try something. Look, if it had been 15%  or something, then, I would put you on drugs immediately. But I'd like you to try changing your diet instead. Stop getting your sugar from Domino's [UK translation: Tate & Lyle]. Adopt a low-carbohydrate diet. Exercise a bit more. Make another appointment for two months from now, we'll test it again and see how things are going."
Notably, he did not provide any specific dietary advice apart from the above paragraph. Not exactly a detailed prescription, eh? My wife, who was present at the consultation, asked if I should consult a dietician. The doctor said that might be a good idea, but he did not press the issue.
So: Wonderful doctor, as I now know. But a bit thin on the details, eh?
I then spent weeks figuring it all out for myself. I did not know about this forum, but I did quickly discover https://www.dietdoctor.com/ (thank goodness). I joined the American Diabetic Association and bought all sorts of ADA-recommended books about diabetic cookery (all of which are now being binned because it turns out they are all high-carb).
For the first two months, I was scared s***l*** I must admit. I was almost certain that the low-carb diet wouldn't work, or would have only a minor effect (because that is what my research into medical studies seemed to show). I was convinced I was going to an early grave, blah, blah.
For those two months: carbs fewer than 30g per day, coupled with strict portion control. I gave up booze. I made sure to walk five miles per day, every day, even in sub-zero weather. I lost 10KG. I was a pretty unpleasant, obsessive individual. I kept my diagnosis hidden from everyone except my wife (because I did not yet know "how things were going to go").
Then the big shock (as big a shock as the initial diagnosis): Two months later I had brought the BG to below diabetic levels. The doctor was chuffed and averred that this was an "excellent job." Six months after diagnosis, my A1C was even lower and the doctor's response (scribbled on the test result sheet) was: "Wow!!!"
My next A1C test is coming up (next week). At this point, I have relaxed a lot. I abandoned the portion control (I no longer need to lose weight). I reduced the walks down to three miles a day. After getting that shocking (in a good way) A1C result at two months, I resumed drinking alcohol, but in moderation (in the past, I was an immoderate drinker, including too much beer which may have been a factor in developing T2D).
The one thing I am still extremely strict about is keeping to the low-carb diet and three miles walking every day.
I don't even really care if my A1C creeps up a bit because I now have a good "cushion" -- I would only be concerned if it turns out to be an upward trend, over time.
I don't even self-test my BG levels (and never have). The sole indicator is an A1C test done at the clinic every three months.
So that's my story, and I apologize for being a bit of a windbag (for the numbers, see my signature below). I consider myself to be really lucky, and that is why I chose the user name "Grateful" upon joining this forum. But if I can do it, others (if their medical circumstances permit) can do it too.
I was about to write "good luck" but luck doesn't have all that much to do with it. You are already taking control, and that is what matters. Best wishes.
You say you suffer from high blood pressure. Have you not been having an annual "Complete Bloods" test? I do, I think because I suffer from paroxysmal AF. I now know that I had BbA1c tests in 2014, 2015 (both 37) and 2016 (40) but nothing was ever said. Maybe you too could delve back into your past tests and find some interesting info.
Just think of it as another kind of Fitbit! I do. Just as my Fitbit scores motivate me to walk, when sometimes I wouldn't have done, so too the hope of seeing a low bg score sweetens (or maybe I should say spices!) my lowish carb vegetable platter and gives extra purpose to my regular after-meal short walks. The day I temporarily ran out of strips I was aware immediately of some slippage, portions a little larger ... And think of the difference, taking control of your own health every day, every meal, rather than being dependant on seeing some ignorant health professional a few times a year. Rather than trying to follow some off the peg diet plan you will be able to tailor yours to suit your own precise needs and tastes. Believe me, I REALLY didn't want to do that first test and put it off for a whole week, but now I almost look forward to them, in the hope of getting a little reward for my good behaviour! (Sometimes I don't get the reward I think I deserve, but that's for another thread.)
I am really lucky because berries do not affect me at all. Maybe the cream stops that not sure
The fruit you have been eating should be fine berries are good as I am sure rhubarb is if you do not use sugar to sweeten it for yourself you can use sweetener like Stevia it is more the tropical fruits that are liable to raise BG more
Indeed, I am right now reading Dr Bernstein's book, and was delighted to see rhubarb on his "permitted" list. Not buckets of it, obviously, but still... Now I can't wait for the rhubarb season to come round again.
Derry, I am determined to find a place for berries in my diet, but I'm not sure where to fit them in. Do you think it's better to include them in a meal, or instead make them a snack with cream or, my preference, Greek yoghurt?
What an interesting story! I can see why you may have chosen the nickname "Grateful". OK, your doctor didn't do it all for you, but isn't it better that way? IMO this is one malady where it is essential that the sufferer him/her self learn and take control, as we see people doing all the time on this forum. The people who don't explore, but leave everything to their doctors, don't do so well (to put it mildly).
Grateful, would you mind revealing what else besides a very few berries you eat for breakfast?
Hello Gardengnome and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask more questions when you need to and someone will be able to help.
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 250,000 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
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.
Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.
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.
Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.
Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
Breakfast: You are homing in on my guilty secret. Breakfast is when I ingest much of my daily carb load, and I even include some grains. This is partly because I usually exercise immediately after breakfast. The amounts of each individual ingredient are very small, but nearly all of them have carbs.
One tablespoon homemade sugar-free granola (muesli), mixed with:
One tablespoon wheat bran (almost pure carbs, taken to cope with constipation which I suffered from badly when starting low-carb).
Four thin slices of banana.
Covered with a thin layer of fat-free milk.
After eating that, I have two tablespoons of fat-free Greek yoghurt.
Black, unsweetened coffee (about four cups during the course of the morning, ground from beans).
Salad with self-made vinaigrette (three parts olive oil, one part wine vinegar, pinch of salt).
Half of an avocado with same vinaigrette.
Nuts (macadamia, Brazil, pecans).
If feeling hungry, add a two-egg omelette. Typical filling is cheese and/or Herbes de Provence.
Large glass of fizzy mineral water with half a lemon squeezed into it.
After lunch: one cup of black, unsweetened coffee.
Dinner: This is where I (well, we, as my wife does three-quarters of the dinner cooking) get creative. Possibilities:
Spiralized food (celeriac, courgettes, butternut squash). For example, celeriac noodles with low-carb meatballs from the supermarket and low-carb sauce bought in glass jars also at the supermarket. Or, courgette noodles with shrimp. Or, lasagna made with butternut squash slices. All sorts of recipes, mostly from a book we bought about spiralizing.
Meat (typically pork, lamb chops, chicken, sometimes wrapped with bacon).
Fish (cod, haddock, sole, baked plain, squeezing lemon onto it).
All sorts of vegetables.
We cook a huge ratatouille once a week and slowly eat it in the following days.
For dessert, cheese eaten on low-carb keto crackers cooked using the dietdoctor recipe. Typically we have a spread of four to six difference cheeses. (Being "allowed" to eat cheese was a major revelation when I found out about the low-carb diet. I love cheese and so does my wife.)
Snacks: Outside meal times.
Nuts (same selection as the lunchtime ones).
Cheese with crackers (same as dinner dessert).
Late afternoon, one small glass (edited to correct size: 90ml, hard to find, but they exist) of dry red wine.
With dinner: another small glass of same.
About twice a week: I cheat and have twice that amount of wine (total of 360ml, or about half a bottle). Really debauched, I know. (Prior to diagnosis I was an immoderate drinker, mainly beer.)
About once a month (so far!): a pint of beer, making sure it is really good quality and really high in alcohol (for a beer).
Hydration: At least two liters of tap water per day in between mealtimes, and especially while exercising.
You know what, I enjoy it, and for some weird reason I am now enjoying food much more than I did pre-diagnosis. Occasionally I eat a forkful of the high-carb food that others have on their plates, just as an experiment, and it often tastes awful. So rich and overwhelming!
Edited to add: This is really a "low-carb, low-fat" diet mostly. I have upped the fat a bit (compared to pre-diagnosis) but not much. I am not sure why it works for me, but why tinker with something that works?