Just found out

[TriciaWs]

I had a mild scare a few years ago, when my blood sugar crept up a little after years of being fine and I was warned I might be pre-diabetic. But I managed to cut down on carbs and lost a stone and it settled down. Last week my annual blood test results call back and instead of the expected 'all normal' I was called in. My HbAC1 is up from 37 a year ago to 53 and, although I can't remember the figure, my triglyceride level is a bit too high as well.
In spite of knowing I was in a risk group, my mother and another close relative developed diabetes and my diet is not brilliant, it was a shock when it happened.
I moved house 20 mths ago, since then in spite of a list of disabilities and chronic conditions and 13 prescription items, I've only seen a practice GP once and locums 3 times.
But now, I've been told to cut out full-fat dairy in spite of my ongoing Vit D insufficiency (up from a serious deficiency a while ago) and 'do more exercise' although I'm disabled - it feels like my GP and nurse have never actually looked at me, wondered why I'm using a walking stick and mobility scooter, or read my file.
I have an appointment for a diabetic review next week. Am I going to be able to get the nurse to give me tailored advice that takes account of my other health conditions and the impacts of the drugs I take?
(Especially as I've found research to suggest one of the drugs they put me on last summer following a letter from a neurologist asking them to treat my migraines may have contributed to the high blood sugar problem?)

 

[Jenny15]

Hi, my diagnosis story was similar to yours and I too have multiple health and disability diagnoses.

I'm not overly optimistic your nurse will do an A+ job but hope he or she surprises me.

I have read the UK NICE guidelines on chronic fatigue syndrome and they literally tell doctors NOT to tell a person to exercise as it makes it worse. This may also be the case for your condition(s). When a well meaning random person online tells me to exercise more, I just ignore it because they probably do not understand my medical needs or what is now best practice. We exercise as much as we know our body can handle.

I suggest taking Vit D supplements (I get them on prescription) as disabled people are more likely to spend time indoors and not get enough sun. Vit D deficiency causes a number of problems we can do without.

I will tag in @daisy1 who has some excellent info for newly diagnosed people.

It should be relatively simple to get your BGs back down to a safer level, even given your other health issues. Feel free to ask any question, there are no stupid ones.

 

[Guzzler]

Hello and welcome. I have a ray of hope for you, I am a wheelchair user and suffer chronic pain which means that I cannot do any meaningful excercise and yet I have improved my HbA1c from a diagnosis result of 98 to one of 43 in just a few months. I did this with dietary changes and with Metformin. Excercise, in my opinion, is an aid but diet is the game changer.

As to whether your Diabetes Specialist Nurse will be able to take into account your multiple conditions I am afraid that is not something I have experienced. My DN looked bewildered when I asked how Type 2 would impact on my other conditions, a year down the line from diagnosis I am still learning of the effects. My GP seems completely uninterested in Diabetes except to push me onto statins which I have refused. I am on three drugs known to raise blood glucose levels but they are pain medications and I have had to weigh up the risks and benefits for myself. Sorry to sound gloomy and pessimistic and I hope that your experiences are different to mine, they possibly could be.

Now a few more positives. I have lost weight, improved my numbers which has improved my prognosis, managed to completely come off one medication that I had become addicted to (non Diabetes related drug), I have no signs of fatty liver disease and the pain I had from this has disappeared. Overall my pain levels have seen a small but significant fall and that means a corresponding rise in my quality of life. I have no Diabetes related neuropathy, at my first (and only) screening for retinopathy only a background level was found, my kidney function and my liver function has normalised. I am a happy bunny!

As an aside, joining this forum has taught me shed loads not only about Type 2 Diabetes but about drugs, nutrition and overall health. And to top all that I have found a group of people who are friendly and funny and, quite frankly, not a little Bonkers!

 

[JoKalsbeek]

I had a mild scare a few years ago, when my blood sugar crept up a little after years of being fine and I was warned I might be pre-diabetic. But I managed to cut down on carbs and lost a stone and it settled down. Last week my annual blood test results call back and instead of the expected 'all normal' I was called in. My HbAC1 is up from 37 a year ago to 53 and, although I can't remember the figure, my triglyceride level is a bit too high as well.
In spite of knowing I was in a risk group, my mother and another close relative developed diabetes and my diet is not brilliant, it was a shock when it happened.
I moved house 20 mths ago, since then in spite of a list of disabilities and chronic conditions and 13 prescription items, I've only seen a practice GP once and locums 3 times.
But now, I've been told to cut out full-fat dairy in spite of my ongoing Vit D insufficiency (up from a serious deficiency a while ago) and 'do more exercise' although I'm disabled - it feels like my GP and nurse have never actually looked at me, wondered why I'm using a walking stick and mobility scooter, or read my file.
I have an appointment for a diabetic review next week. Am I going to be able to get the nurse to give me tailored advice that takes account of my other health conditions and the impacts of the drugs I take?
(Especially as I've found research to suggest one of the drugs they put me on last summer following a letter from a neurologist asking them to treat my migraines may have contributed to the high blood sugar problem?)

People who don't see *you*, but just spew out general -and faulty- advice, are of no actual help... If the goal is to lower your HbA1c and lose weight, while inable to excersize, full fat dairy is your friend, not the enemy. Read up a bit on this site about lchf (low carb, high fat) check out the low carb program, and maybe dietdoctor.com too, (video's, recepies etc) as going full-blown keto might be an idea as well. It should keep up the vit. D, but supplements might be an idea. They give me migraines, but if you can take them without problems, it'd be a lifesaver.
I skip breakfast these days, unless I need meds that require a full stomach, but typically, I eat scrambled eggs with bacon, cheese (goat's, as cow's milk is a problem for me), mushrooms and a few cherry tomatoes. Or a salad with tuna or bacon & cheese, capers, olives and mayo. In the evening I go for cauliflower rice with bacon and cheese, and a good load of meat. (Chicken, cow, pork, fish). It's low carb, high in fat, and I'm losing weight. My HbA1c is now in the low 30's. (It was 38, but I switched from lchf to keto/intermittent fasting about a month ago, so my numbers have gone down even further.). Lost 8 pounds in little over a month... No particular excersize. It's just an idea, but since you mentioned having tried low carb before... Thought you might be interested. Take everything you hear with a grain of salt, do your own research, and don't do anything that doesn't sit right with you. It's your body, your life. You choose.

Best of luck!

 

[daisy1]

@scallywagger

Hello Scallywagger and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it helpful. Ask as many questions as 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 235,000 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 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. Most of these are 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.
  

 

[TriciaWs]

Thanks everyone. Good to know I'm not the only one facing standard diabetic advice that goes against my other conditions, this gives me more confidence.

As for Vit D I get it on prescription, but at the 2nd blood test in May the nurse told me I shouldn't get any vitamins on prescription even though one of my drugs, Pregabalin, lowers folic acid and Vit D and B12 levels - and that's why I get the supplements!

Anyway, I've been cutting carbs since Sat. Struggling with breakfasts but overall I'm doing OK so far. I'm using the lowcarbprogramme pages to record what I'm eating for now.

 

[ringi]

Remember to take the vit D with a meal that contains fat.

 

[Bluetit1802]

@TriciaWs Hello, and welcome to the forum,

You don't have to have multiple conditions to receive inappropriate advice from our diabetes nurses/doctors. In fact, it is a common occurrence, mostly involving diet. You will learn a great deal more on this forum from people that are themselves diabetic and who have masses of experience between them.

My piece of advice is to get yourself a blood glucose meter. This will help you with your food choices by testing before and after meals to see what that meal did to your levels. We can help you with this. They are essential tools.

I would also advise you to get a print out of your blood test results. These are important and tell you a lot. Not just blood glucose but also cholesterol, liver & kidney functions, full blood counts and anything else they throw in. If you are England you can ask if your surgery puts test results on line as they are supposed to do, and ask how to register for this. You say your triglycerides were high, so you do need to know "how high" and what the other lipids were - a print out will tell you this. Is this the reason you were told to cut out fats and dairy? If that is the only reason, it isn't necessary and is old outdated advice.

 

[Rachox]

I take my vitamin D with my breakfast, a low carb high fat coconut ‘porridge’, not real porridge, not a grain in sight! Here’s the recipe if you’d like to try it:
https://www.dietdoctor.com/recipes/keto-coconut-porridge