My first visit to the diabetes nurse

[Ottermoon]

Hi Everyone,

I was diagnosed a week ago and have been devouring information like you wouldn't believe. Well, maybe lots of people here would believe! LOL! :lol: I've been reading this forum, and joined it today.

So today I had my first visit with the diabetes specialist. I was prepared to have to argue for testing, but to my surprise, and relief, she was supportive and praised my attitude for wanting to take control.

I thought about the way the NHS is reluctant to prescribe test kits and strips to T2-ers. I think that if they do this across the board, it's been shown to not be cost-effective. Imagine how many peeps will get the expensive kit and not also track their food and activity levels, which basically means the testing doesn't help them learn anything. But if they prescribe the testing kits only to those that show a desire to be involved and proactive in changing their lifestyle, well, the cost benefits are probably pretty clear. They try to be supportive. At least, that's the case for me.

As I see it, the testing is a single or double loop feedback: learning if I need to adjust my actions (strike out some foods altogether, reduce the portion size on others), or re-think my whole approach (maybe I need medications to support this after all). If I can't get feedback on how the foods I eat affect me, I can't learn, and if I can't learn, then I can't manage this.

I was grateful the diabetes specialist agreed with me, and that I came home with a monitor and test strips.

All best wishes,
Ottermoon, who hasn't learned how to add a signature line yet.

 

[daisy1]

Hi Ottermoon and welcome to the forum First - to put a signature in you go to User Control Panel, then Profile, then Edit Signature and just type in what you want in the box. Simples. Second, the Forum Monitors have written some basic information for newly diagnosed members. You should find this very useful. You sound like you are already getting the hang of testing and there is a lot in this advice on testing too. Have a good read...

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS.

Postby sugarless sue » 02 Oct 2010, 17:49
Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091



Sue/Ken.

 

[ebony321]

Hi Everyone,

I was diagnosed a week ago and have been devouring information like you wouldn't believe. Well, maybe lots of people here would believe! LOL! :lol: I've been reading this forum, and joined it today.

So today I had my first visit with the diabetes specialist. I was prepared to have to argue for testing, but to my surprise, and relief, she was supportive and praised my attitude for wanting to take control.

I thought about the way the NHS is reluctant to prescribe test kits and strips to T2-ers. I think that if they do this across the board, it's been shown to not be cost-effective. Imagine how many peeps will get the expensive kit and not also track their food and activity levels, which basically means the testing doesn't help them learn anything. But if they prescribe the testing kits only to those that show a desire to be involved and proactive in changing their lifestyle, well, the cost benefits are probably pretty clear. They try to be supportive. At least, that's the case for me.

As I see it, the testing is a single or double loop feedback: learning if I need to adjust my actions (strike out some foods altogether, reduce the portion size on others), or re-think my whole approach (maybe I need medications to support this after all). If I can't get feedback on how the foods I eat affect me, I can't learn, and if I can't learn, then I can't manage this.

I was grateful the diabetes specialist agreed with me, and that I came home with a monitor and test strips.

All best wishes,
Ottermoon, who hasn't learned how to add a signature line yet.

Sounds like you really have been doing your homework :lol:

You seem to have got a pretty good grip on it all already and it's great you have an understanding specialist too