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New and confused

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kerry66

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Hi I was diagnosed with type 2 this week, it wasnt a shock as I have been pre-diabetic for several years. I dont see the Diabetic nurse till May and I just think that she is going to send me away with a diet sheet and a magazine. That seems to be normal for my locality as its always about the money.

Anyway my main worries are about my blood results,
my hba1c was 53 - which I understand is 7.00 under the new scheme, will this trigger metformin or will this be handled with dietary advice,
I also had liver funtion tests and a thyrooid test, numbers as follows
serum tsh was 7.88 - the sheet says high but again is this going to trigger meds or dietary advice ,
liver tests were alt of 70 - again marked as high - is this purely due to me being overweight by several stones
other liver test ALP was 69 which was within the 'normal' range.

I know absolutely nothing really about how to handle this situation. I have tested myself for the last two years but have not really understood how to control my sugars, its very hard to find the really basic info.

If anybody can help me interpret the results so I know what to expect I would be grateful.
 
Hello Kerry

Welcome to the forum. Daisy will be along with her Welcome post in a while which contains lots of useful information.

A lot of peeps here find that counting carbs helps to control their sugar levels. Xyzzy has compiled a very useful post which has helped new members as well. Hopefully he'll be along in a bit as well.
 
Hi Kerry.

I may be able to help with the thyroid bit.I have an under active thyroid, and I am already on medication. After many tests and raises in thyroxin, my last result was 8.66. My GP is leaving me on my current tablets with a repeat test to be done in two months. I would imagine you will be asked to repeat your test in eight weeks or so to see if you have remained stable or gone up. I know at these numbers I feel pretty well, and the terrible fatigue has all but gone. I am low carbing though,and have my diabetes under extremely tight control, and I think this has gone a very long way to helping me in feeling so well.

I hope all this rambling is of some help to you.

Jeanne
 
Hi Kerry and welcome to the forum :) Some members who will be able to help you understand your blood test results will be along soon I expect even though it's Sunday. In the meantime, here is the information which we give to new members which I think you will find helpful. Ask as many questions as you feel you need to as there is always someone here who can help you.

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.
-------------------------------------------------------------------------------------------------------------------------------------------------------

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.
Click to expand...
 
Hello Kerry and welcome to the forum.

Here's the stuff that Didie was talking about in her post earlier it worked for me and got my blood sugar levels back to normal within around a couple of months or so. Not a cure as I still have to be careful what I eat but am now feeling great! I am really happy that I have minimised the risk of all those nasty complications. I was diagnosed in early December last year so just 4 months ago and have now lost 3 stone in weight as well.

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 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. You may find it conflicts with advice given to you in this country as we have yet to update and still use older dietary recommendations. In fact we use diet guidelines that are over 30 years old. If you want to read more about the modern ways there is a thread discussing it with some useful links here viewtopic.php?f=2&t=28402

Next most members would recommend you test your own blood sugar levels. Did your doctor give you a meter and strips? Some do and some don't. It's a bit of a post code lottery and we find some progressive surgeries are pro testing and others anti. I'll warn you the anti ones can sometimes be very vocally anti!

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.
 
Thank you for your advice everybody. I have cut and pasted some so I can get my head round it, I am just so confused regarding carbs etc. AS a matter or interest I did a bs test before dinner last night, 6.9, I was starving, it was 7.00 pm and I hadnt had anything since breakfast at about 10.00 am. I then took it again 2 hours after and it was 12.9. We had a roast chicken, roast pots, roast parsnips and other veg. Was it the roasts that put it so high.

This morning I had rice crispies (thinking they are only blowed up rice grains) with milk and a sprinkling of brown sugar, bloods before were 8 and after 2 hours were 12.5 so looks like they are on their way out as well.

I cant eat wheat so I need to really think about each meal I eat regularly (always rice crispies for breakfast) and see what I can do - apart from cutting out the sugar. How does porrige sit with most diabetics?

Cheers
 
Porridge is a bit of a mixed bag-Some people post that they can tolerate it well whereas others including myself can't tolerate it at all and will spike massively so it's worth testing 2 hours after to see where you stand with it.
 
I eat porridge with skimmed milk and a tiny bit of fruit sugar every morning. It doesn't spike my levels, but I do make sure that I religiously exercise 45 minutes to one hour after eating to reduce my levels.
 
kerryh66 said:
We had a roast chicken, roast pots, roast parsnips and other veg. Was it the roasts that put it so high.
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It would be the potatoes and the parsnips mainly. There will be carbs in the other veg as well, but nowhere near as much as in the spuds. Roast potatoes are better than mashed because the fats slow absorption (or something) but they're not going to help your numbers. Parsnips are quite high as well - celeriac, swede, carrot would be better.

kerryh66 said:
This morning I had rice crispies (thinking they are only blowed up rice grains) with milk and a sprinkling of brown sugar,
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Well they may be blown up rice grains :roll: but rice is not good for your numbers at all - some here can tolerate small amounts but I can't eat it at all and you really shouldn't be adding sugar to anything.

kerryh66 said:
How does porrige sit with most diabetics?
Click to expand...

Porridge is still high carbs but it's lower GI than most cereals, so the sugars hid your bloodstream over a longer period of time and should therefore spike you less. I make mine half and half with Almond Flour now (that's just ground almonds really) which cuts half the carbs. Remember that milk has carbs too - you can make porridge with water instead of milk, but only if you're wierd :D . (I am talking about real porridge by the way - not horrid instant out of a packet with a bunch of additives porridge).

Hope that helps

S
 
Good grief there is so much to take in. I have been ddoing my sugars before and after meals for a couple of days, they dont come back anywhere near normal, in fact the lowest before a meal has been 5.9. I dont snack, I have breakfast - today was porridge (not the instant stuff with additives swimmer, just oats and water) but since its not two hours afterwards yet I cant see how that has affected thigs.

As above i dont snack, but was told by a freind with thyroid problems that 6 smaller meals work better than 3 standard meals, does anybody know anything about that.

I see my gp in a bit and the DN in a week, I expect the DN to send me away with a magazine and a diet sheet. From what I have read on here there seems to be conflicting advice regarding carbs/starchy foods. My surgery is most likely to give the wrong advice if thats whats cheapest fot them. As I havent seen her yet I have no idea if they will script test strips, but I guess they dont. I dont know if the first line of defence is diet, then drugs, or if there is a cut off poiint where they say ooops, drugs for you missy!!

Would the general idea for meals to go for more proteins than carbs, are carbs in meat, god I just dont have a blooming clue.

Also does anybody have suggestions for breakfasts that dont involve wheat - or chillies, neither agrees with me!!

learning curve...steep...and some :(
 
kerry66 said:
I dont know if the first line of defence is diet, then drugs, or if there is a cut off poiint where they say ooops, drugs for you missy!!
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Kerry some of this is a bit blunt, I don't mean to offend just to inform.

The route you take should be up to you to decide not your doctor or nurse. If you want to control by diet only or diet only + metformin then most T2's have to accept they will need to really reduce their carbohydrate intake. If you don't want to make that choice then yes your option is to take more powerful drugs that will allow you to cope with a higher carb intake. You can of course always elect to go on insulin as simplistically that allows you to eat a normal amount of carbs BUT has several other downsides. Because of the way those more powerful drugs work a lot of T2's end up on insulin anyway. That's why T2 is seen as a progressive disease. Many forum members reject that it is a progressive condition BY adopting a diet only approach and aiming to keep the sugar levels close or even at those of a non diabetic. The theory then is if you have the levels of a non diabetic you run the same risks as a non diabetic.

Whichever way you choose the point is you will need to control your blood sugar levels so that they are mostly always in the safe ranges. If you don't do that then you DO risk troubles with your eyes and all those other horrible risks you probably don't want to think about. That ultimately is what in health terms being diabetic means.

So how restrictive on carbs do we mean? Well in my case once I got my meter I found (in dry weight terms) I could eat no more than 25g (1oz) of white rice, 25g of white pasta, no more than half a round of wholemeal bread or no more than 1 and a half average sized boiled potatoes in anyone meal. Anything more then BOOM my reading spiked well into danger. It might be worth you going and weighing out 25g of white rice to see how small a quantity that actually is. When I substituted brown rice and brown or tri coloured pasta I could just about double the quantity. When you weigh out 25g you'll see that 50g is still very small.

Now I was quite unlucky as compared to the average as I ended up being on the low side but even those T2's who are on the high side of average really are reducing carbohydrates by a large amount if they do the diet only approach. I admit like most have found accepting and giving up carbs is a hard thing to do. You do get cravings for them but it does pass. Apart from the very occasional meal I no longer eat any rice, pasta, potatoes or cereals. The quantity I can tolerate is so small it makes it pointless. Do you know what? I don't care! Over a period of a couple of months I've learned to enjoy all the foods I have substituted with instead and they taste better. I have never felt healthier. I don't feel hungry and feel alert and awake.

Whatever route you ultimately choose then if your are overweight you will need to adopt a better diet anyway as its not just diabetic complications but things like heart attacks and strokes that are also a concern. The combination of an uncontrolled overweight diabetic who has ended up on insulin is pretty lethal. If you read the front pages of this site those kind of diabetics end up on average taking somewhere between 5 and 15 years off their lives. Don't think those statistics can't apply to you. They do, that's the point. Those statistics are what made from the life spans of previous bog standard T2's like you and me.
 
Thank you xyzzy, blunt is fine, thats how it needs to be.

I am measuring before and after meals and have found some things are causing a massive spike, its a very steep learning curve. I have always been used to looking for fats, calories and wheat in food, now I need to shift the focus to carbs....its a complete turnabout for me but I am sure it will come together eventually.

As an overweight person I realise that this is something that needs to be addressed in no uncertain terms as soon as possible.

Interstingly xyzzy you mention that some ppl chose to do diet or diet + metformin - why would ppl actually chose to go straight to metformin rather than have a stab at diet control only - unless I am reading that wrong or misinterpreting it...?

As i suspected when I saw the GP earlier she went off and came back with a magazine for me, told me my thyroid and liver were fine (despite the bloods being high last week), told me to come back in a week to see the DN and away I came.

Gotta love south warks!
 
Kerry
one of the books I find useful on what to eat is Atkins made easy. the meal plans in the Atkins diet almost exactly mirror the ideal for diet control of T2D.
Hana
 
kerry66 said:
Interstingly xyzzy you mention that some ppl chose to do diet or diet + metformin - why would ppl actually chose to go straight to metformin rather than have a stab at diet control only
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Many people choose to go to metformin bcause it helps with weight loss, and it's a goo9d preventative drug against cardio vascular problems amongst other things; a common complication with diabetes. Also, it's been around for decades and is proven to be safe. So no real downside.
I got my Blood sugars well under control WITHOUT metformin, but when i read up on it I volunteered to go on it because of the above.
It doesn't actually do much for your blood sugars; your diet and exercise will do that.
 
Grazer said:
kerry66 said:
Interstingly xyzzy you mention that some ppl chose to do diet or diet + metformin - why would ppl actually chose to go straight to metformin rather than have a stab at diet control only
Click to expand...

Many people choose to go to metformin bcause it helps with weight loss, and it's a goo9d preventative drug against cardio vascular problems amongst other things; a common complication with diabetes. Also, it's been around for decades and is proven to be safe. So no real downside.
I got my Blood sugars well under control WITHOUT metformin, but when i read up on it I volunteered to go on it because of the above.
It doesn't actually do much for your blood sugars; your diet and exercise will do that.
Click to expand...

Grazer is correct but I would add even though Metformin doesn't do much to help reduce your levels, at most 1 or 2 mmol/l it does help reduce spikes when you eat things especially when newly diagnosed. I was put on 3 x 500g although at the level of carbs I eat it probably doesn't do much except stop a bit of spiking nowadays. I keep on it because of the other benefits Grazer says and I like to keep my levels as low as I can get them.

The shift from worrying about fat to worrying about carbs is quite a jump isn't it. The way I initially looked at it was to concentrate on getting my levels stabilised and to defer worrying too much about the carb / fat / protien balance at the start. That is a really important thing that some newly diagnosed people get confused about. What you are eating is a diet that will give you good levels first and do weightloss second. Most sensible diets you hear about will end up with you losing weight if you stick to them however you're primarily wanting a diet (better word is regime) that will sort your high blood sugar levels out. Happily for most people that level reducing regime will also get you to lose weight as well.

When I got diagnosed my wife who was diagnosed pre-diabetic a few years ago both decide to do this low carb high fat thing. I did it for blood levels, she did it as a diet. In those early days we had a steady diet of omelettes, cheese and celery and bacon egg & mushrooms fry ups! We would base a lot of meals around 250g of mixed veg / person then add chicken or mince plus some kind of Dolmino or Pataks curry sauce and have a minuscule amount of pasta or rice with them. Just make sure you make enough to fill you up! Got a bit boring but certainly got the levels sorted and my wife is very happy with the weight loss.

Four months in with my levels now normalised we have a far wider diet as we have added loads of low carb recipes we have found provided by the lovely people on this forum. I never had a sweet tooth so craving sugary things wasn't a problem. My issue was savoury things and rice!

Keep those questions coming...
 
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