Need advice

What's your diet .... and your weight

You're going thru the wars, so let's start with the easy ones first and then a process of elimination.

The arthritis must be really bad.

Then you know what to do .... take a hard line and witness the benefits. NO more bread and you got 24 hours to make a 2019 promise to get well below 100 kg.

I take a no prisoners approach, so DO IT.

And "good luck" means nothing without a decent intent.

Hi @Martynhsmith and welcome

I'll tag in @daisy1 for the intro to low carb eating that a lot of use to get better after diagnosis.
In fact some of us get so much better we are almost grateful for the condition.
Cut out as many carbs as humanly possible. The bread addiction will pass after a few weeks of cold turkey (believe me I know where you are with that one) but you need to cut it out completely or you'll stay addicted forever.
Try bacon and eggs and lots of meaty things for the first month and carry on monitoring your blood sugar levels and you'll be amazed at how quickly they normalise and how soon you start to feel a whole lot better. And we might even be able to get you off your meds too!

One book you might like to read is "Dr Bernstein's Diabetes Solution" By Dr Richard K. Bernstein revised 2011, available in hardcopy or e-book.

People here have given you good advice, but you also need to get your depression treated. With you getting home and not cooking, is it because you cannot be bothered?, and sleeping most weekend's is a sign of depression. You say that you are tired, that also can be caused by depression. Depression will also make your pain worse. Your weight will also contribute to your joint pains. Have you seen a doctor about your depression? If not it is best that you do. Do what people have suggested here, but you must get help with your depression otherwise you may not succeed, as you need to be in a good state of mind to stick to the low carb way of eating. Good luck

Thanks for the tag @DCUKMod
Hi Martyn, sorry to hear about your struggles. I do have arthritis but mine is osteoarthritis, so different but with similarities.
Before my Type 2 diagnosis my mobility was compromised as my feet and hips were badly affected. On being diagnosed Type 2 I embarked on low carb eating primarily to get my blood sugars under control but it had the happy side effect of weight loss, I started at just over 18 stone same as you but I’m guessing you are, as a man, taller than my 5’4”! I have to date lost 6 stone 4lb without really having to try. My feet and hips have obviously benefitted from the weight loss but my non weight bearing joints, neck and fingers have improved too, due I believe to the anti inflammatory effect of low carbing. I was on high doses of codeine, (I don’t tolerate Tramadol or Morphine long term), but now I only have a small dose of codeine at night. My type 2 diagnosis has been a blessing in disguise.
I suspect that the combination of chronic pain, Morphine and high blood sugars are not only affecting you physically but also making you feel tired and down.
You’ve taken the first step reaching out for help here. In your position I’d give low carbing a go with careful monitoring in view of your Gliclazide. As @Mike D says, New Year, a perfect time to resolve to turn things around. I wish you all the best.

Martynhsmith said:

First Some Information
I was diagnosed type 2 December last year
I was started on Metformin, which if I take more then 2 a day I get diarrhea.
It came to a head in July when my diabetic nurse said - You look terrible
My blood sugar was 25 and blood pressure was 150 over 105.
Im now on 80 mg of Gliclzide and 1 tablet of sitagliptin (Januvia) and 2 Metformin
I'm now testing my blodd sugar and I'm regularly below 10mg.

Sounds good so far except My life is a misery.

I was diagnosed with zero negative rheumatoid arthritis about 15 years. I've been bumbling along surviving with this. I'm on morphine tablets for the pain and other pain killers.
The symptoms are stiffness and pain when moving, if I ignore the pain and force myself to go on, I just tire myself out.

Changing to gliclazide made me realise how much I relied on ibruptohen.
My life consists of going to work, coming home, eating and going to bed because I'm too tired to do anything else.
Weekends consist mainly of sleeping.
(I'm amazed how my partner puts up with me because I'm just too tired to do anything but I try and end up making a mess)

Anyway, I've just spoiled a family holiday in Florida as I got a cough/Cold and it has wiped me out.

So I'm going to the doctors next week and try to sort this out. (I know I'm hovering round the edges of depression too)

So advice, what do I ask for?
What other medications are there?

Thanks in advance

Martyn

Click to expand...

Hey Martyn,

So sorry life's been so rough... These illnesses are all related to one another, you rarely see someone with reumatism who doesn't have something like an underactive thyroid or something as well. For me, I'm a T2, with amonst other thing's Sjögren's (rheumatism), PCOS (ovarian cysts) and Hashimoto's (hypothyroidism). And a clinical depression and introverted borderline personality disorder on top of that. So it's a bit much, all in all... And I'm hearing something similar coming from you, though how you manage to hold a job with the pain and fatigue, I don't know. You must be very, very strong.

Carbs are inflammatory. Not just bad for your bloodsugar levels, but for your RA too. You're on a lot of bloodsugar lowering meds, so if you want to change your diet to tackle it all, you do need to test all the time.... Make sure you don't hypo. But seeing that for me, going low carb made some difference, but going further and going keto made ALL the difference... I mean, I couldn't eat dairy/eggs for years because within two hours my fingers would swell up and the nerves in them became just burning wires of pain, and now I can have cream, 3-egg omelets and milk, and butter, and cheese... A few months after starting keto I didn't have an adverse reaction to dairy anymore. My HbA1c is 34, I lost 25 kilo's in weight. My energylevels are up, even my hip is okay now, (no more limping!) and the depression is much, much better. I can walk nice distances carrying camera equipment, while I used to collapse just walking around in my own home.

But it's not just straight sugars that are the culprit here. Fructose, starches... They'll all aggrivate your conditions, including the depression; high bloodsugars will influence your mood and behaviour, making you sad, irritable, angry, hopeless, all the time... Normally I'd say, go for moderately low carb, high fat to start off with, but in your case, I'd say, try keto. It'll make you feel flu-ish for a week or two as your body gets used to it, but let's be honest, you're not in a good place as it is anyway... Might as well give it a shot. Keto is less than 20 grams of carbs a day, meaning your body shifts its energy burning as it goes into ketosis (not to be confused with ketoacidosis!).... It then doesn't use carbs for fuel anymore, but fats.

Meals could look like this:
Scrambled eggs with bacon, cheese, mushrooms, tomato, high meat content sausages
Omelet with cinnamon and erythritol, unwhipped cream, and a side of berries and coconut shavings.
Leafy greens with a can of tuna (oil, not brine!), mayo, avocado (I cheat and get mine from the frozen aisle), pepper, salt, capers and olives
Leafy greens with slightly warmed soft goat's cheese and a nice vinaigrette
Meat, fish or poultry with broccoli- or cauliflower rice, where I usually add bacon and cheese to bulk it up some. Add herbs for additional flavour.
Snacks? Extra dark chocolate (85% Lindt's is good), olives, cheese, pork scratchings, nuts...
For meal ideas just check dietdoctor.com , see what's low carb and what isn't. But try to cut out bread, potatoes, pasta, rice, cereal, fruit (berries, tomatoes and avocado are okay, and apparantly, starfruit too)... They will affect your bloodglucose adversely. And your RA. And your fatigue. And your depression.

If you try this for a few months and you're still feeling low, consider getting onto antidepressants on top of the diet.

Just remember that with all the meds you're on, you could likely hypo when going ultra low carb... Keep an eye on your bloodsugars and maybe discuss a change in diet with a nurse. I know, bread's a thing... But would you rather have bread, or the feeling life's worth living?

Hugs,
Jo

PS: Are you on statins? Because they made my Sjögren's go nuts as well. I don't need statins anymore on the diet I'm on now, even if I am having dispropotional amounts of fats. (Basically, bacon twice a day. )

Hi and sorry to hear of your problems. The medication you have been prescribed appear to be the 'right' ones and the same as I had before insulin. As you have some excess weight you may have insulin resistance which the low-carb diet should help with. The Gliclazide may need to be adjusted as you lose weight as it stimulates the pancreas to produce more insulin and insulin resistance can affect insulin take-up. There are one or two other newer tablets that may be relevant? Does Ibuprofen need to be stopped when taking Gliclazide - I wasn't aware of that? BTW Sitagliptin reduces BS spikes after meals by extending insulin production.

@Martynhsmith
Hello Martyn and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it interesting and useful.

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.