Just Diagnosed

Hi Andrew and welcome to the forum
Your doctor was telling you about possible complications you can get with diabetes, but if you look after your blood sugar levels very well, it may reduce the likelihood of getting them. It is definitely necessary to test, to see from your levels which foods you can eat, by testing before and 2 hours after meals to see the effect they have. Test strips may not be prescribed by your doctor but ask anyway. If not, try buying them on Ebay or Amazon.

This information which we give to new members should be helpful to you. Ask as many questions as you need to as there is always someone who will be able to help.

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.
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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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jacks1447 said:

Hi
I had a routine blood test in April and it came back 8.1 doctor at the time told me to wait until now as he wanted to see if I could control it.
So I had one the other day and it came back 8.3 even though I had fasted, I don't eat sweets, fatty food and don't drink booze lol
When I go to the gp surgery today he told me that I would be starting medication at once, 3 tablets every day what I did not realise is that I would also be given 2 other pills.

He gave me Atrvastatin 40mg, Metformin 500mg and Ramipril 1.25mg, he never explained to me what they are for and just told me that a clinic would be in touch with me soon.

I am a male just turned 40, 5'7 and weigh 12 stone 1, not really obese and do normal exercise daily, being diagnosed was not really a surprise as my Mum, Aunt and grandad all had Type 1.

I was trying to take in everything that he said but I was over whelmed, he mentioned heart attacks, Strokes, amputations so as you can imagine I am Bricking it right now.

Any sort of advice that can be given will be very appreciated, also I have a blood test kit that my mum had, do I need to test my blood?? if so are they the only item I can not get on prescription (uk).

Many thanks for help.

Andrew

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My sympathies - not particularly for the diagnosis, but for the shock of what the Dr "mentioned." My Dr did the same - only added more possibilites - even computing my PROBABILITY of a heart attack. I was in a state of shock for months. I was also told that even if I followed their diet & lifestyle recommendations diabetes was progressive, so I should not think I had failed as I progressed from diet/exercise to ever-increasing medication to insulin, with complications along the way.

That was 12 years ago - today I am fit & well, no complications, play tennis & table tennis at club standard - & I'm 73. With proper control, you too should be able to stay well.

I wish I had been given Daisy's advice when I was diagnosed. I had the standard Diabetes UK advice to base my diet on complex carbs - low sugar/low fat/low salt. I was afraid not to follow that advice - I was so frightened by the threat of complications. I did progress to medication (metformin & simvastatin) & suffered extreme tiredness, disabling muscle pains & the beginning of retinopathy. 4 years ago I found this forum - changed my diet to low carb & increased fats. Immediately my blood sugar control improved, & within 3 months muscle pains & tiredness had gone & 4 years on I am fit & well.

Ask your Dr for a printout of your blood test results - you will build up a portfolio over the years & will know yourself how you are doing. You become your own expert - it's your life. As newly diagnosed, my Dr prescribed nothing - he wanted to see how my system behaved with the modified diet/exercise regime.

Atravastatin is a cholesterol reducing drug - but what is your cholesterol aka lipid profile? It may cause side effects including muscle pains - I can't take any chol reducing drugs, but my heart is healthy at a chol level of about 5.3 instead of less than 4 which they think is necessary.

Metformin is a standard blood glucose reducing drug - it often cause digestive disturbance & is available in a slow release version which is more acceptable. I take 3x500 mg daily.

Ramipril in an ACE inhibitor that reduces blood pressure - but what is your blood pressure? It should be below 135/80.

Stay in touch on the forum, & ask your questions about everything your Dr & clinic advise.

Hi and welcome Jacks! See you had the normal poor intro to diabetes from your medical team. Just watch the carbs as Daisy has said and you'll be fine. No need to brick it. I'm healthier now than before I was diagnosed. Blood sugars near normal, cholesterol down, blood pressure good for a young man (which I'm not!), BMI 22. All is well. All down to avoiding everything with sugars and reducing my carbohydrate intake. Here's the route I took:-
In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. So that means eating 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reduce the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos (again not too many) are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. The SD Codefree available on the internet is about the cheapest at the moment. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. Keep careful records of what you ate and when, together with the result, so you can refer back at a later date. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Do ask lots of questions; there is normally an answer on here. The more you get to learn about your diabetes, the better it will be.
Good luck!

Welcome to the forum. Most of us who post are the diabetics, there are some partners, parents and friends, but mostly we are the actual patients, and guess what? We have our fingers and toes, and are not in imminent danger of a stroke or heart attack. Sure, some here have been unlucky enough to be victims of those, but they are still here to tell the tale. The moral of that? Stop "bricking it"!

Cut your carbs right down. Cut or curtail bread, pasta, rice, potato's, and wheat/flour based products along with ready meals and processed foods and you will see your numbers tumble. Lots of fresh veg, berry's (a lot of fruits spike diabetics, berry's are usually fine). Meat, poultry, game, sea food, dairy, game, are all fine. Read through the forum especially the low carb section, and I promise it does get easier. It all seems overwhelming, but in a short time, you will get the hang of it and it will become second nature.

Hello Jack and welcome to the forum.

I'm afraid many doctors don't seem to want to explain things so you many new people turn up on the forum with very similar stories. The three drugs you've been given are the standard ones that most GP's dish out to all newly diagnosed T2's

Metformin is the a very safe medication that will help control your blood sugar levels. It isn't a magic pill however, no diabetic medicine is. It will lower your background blood levels marginally but will help to stop you "spiking" high after you've eaten. The way it works means that it cannot induce diabetic hypos which is why so long as you don't progress to stronger and different medications you won't need to report your condition to the DVLA as you are seen to be no more risk as a non diabetic. That's also a good point to make, just because you are now diagnosed T2 does not mean you are suddenly likely to get hypos's. Being diabetic isn't the cause of hypos its strong diabetic drugs or injecting insulin that can cause hypos. As a T2 just on Metformin you have no more additional risks of hypos than you have ever had. Did you realise you are now entitled to free prescriptions because you are on Metformin? Metformin is also good for heart disease prevention in fact some of us who can maintain safe blood sugar levels just by adopting the right diet still take Metformin for that reason alone.

Ramipril is a drug who'd primary purpose is to lower blood pressure. Again I would say it's a very safe drug. The amount you are prescribed is based on how high your BP is. It has a secondary important effect of protecting your kidneys so again is very worthwhile.

Atrvastatin is a statin. They are prescribed to reduce cholesterol levels. While I take a similar statin there is a bit of a controversy over statins as they can undoubtedly have side effects such as giving you concentration problems, tiredness, memory loss and leg pains. My attitude is if you don't get any side effects they are probably ok but if you swap to a healthy diet and get your cholesterol levels normalised you should stop taking them. You will find other forum members say they are ok and others will not take them at all. Its one of those things where each of us has to make an individual choice.

Anyway the best way of controlling blood levels, losing any weight is to recognise you need to is to adopt a safe and effective regime over what you are eating. Most of us find that once we understand what is safe to eat and what is not safe then adopting the right diet is ten times more effective than taking diabetic medications.

Here's what I did. 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 3 stone in weight too. My doctor is very pleased how I am getting on and has advised me to keep doing what I have been doing since it's obviously working really well. I have normalised everything and just take Metformin to help a bit. Not a cure as I still have to be very careful what I eat but I feel loads better than I did.

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 is different to what your are told is a good diet for you follow.

Did your doctor prescribe a meter a strips for testing your own levels? Some do and some don't as it's a bit of a post code lottery and we find the progressive surgeries are pro testing and others anti. I'll warn you the anti ones can sometimes be very vocally anti! It worth asking but if you find your surgery is really anti then many of us would recommend getting a meter and strips yourself. If that turns out to be the case then just ask and lots of members can help.

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.

Regards

Steve

PS Here's two 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

Hi. The advice you have been given so far by others on this thread should help you get better control of your blood sugar. Bearing in mind that others in your family have had T1, that you are only 40 yrs old and not obese, there is a small possibility that you are in fact a T1 LADA. The initial treatment by tablets and diet is the same as for a T2 but if your sugars don't come down then your GP can do two tests for LADA if needed.