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New and looking for some advice

Discussion in 'Type 2 with Insulin' started by my_mate, Nov 20, 2013.

  1. my_mate

    my_mate · Newbie

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    Hi

    I am a 57 year old male type 2 diabetic and have been for some considerable time now. At the outset I was prescribed gliclazide (1 tablet per day) but as time has passed I have been prescribed all manner of drugs including metformin, ramipril, atoravastin, candesartan, pioglitazone, saxagliptin until ending up about one year ago being put on insulin injections and building up to what is now three injections a day of novorapid (30 units at a time) and one injection of insulatard at night time. This has controlled my sugars very well and although I suffered a series of low blood sugars at first these have now steadied themselves and I tend to hover around the 5.5 to 7.5 mark. However the one side effect that I have found is weight gain and I believe that I have put on two stone over the last year. This brings about a problem insofar as I have to increase insulin doses to cater for the gain in weight which, in turn, puts more weight on. I do have a very sedentary job, sat down for most of the day with little chance of exercise. My joints/muscles are such that I cannot walk for long and certainly can no longer run for any more that 50 metres. I really do need to get my head around this and end up with a self treatment plan, firstly to reduce my weight and secondly to try to improve my diabetes to a greater extent with an ultimate goal of not having to take injections any longer and rely on tablets only. The problem is that my doctors offer little or no support in this, I have never received any dietary advice from them let alone a care plan. If fact things are so bad that when I responded to their request to book a yearly review the best that they could offer was a nine week wait for an appointment. Any advice would be gratefully received...
     
  2. dawnmc

    dawnmc Type 2 · Well-Known Member

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    Buy Dr Bernsteins Diabetes Solution. It sounds like most of us you have been left to your own devises. Not good.
    Have you been told about carb counting. Do you test? You need a meter and strips to see what food does to your blood.
    Others will be along soon to give more advice.
     
  3. Weens12

    Weens12 Type 2 · Well-Known Member

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    Welcome!. You've come to the right place. This forum has lots of members who can help and advise on diet and exercise based on real-life experience.

    First off, think about changing your doctor if possible! GP Support varies enormously from practice to practice. You should have received some dietary advice, and support, and it's appalling that you have just been left to drift, with increasing medication.

    The best advice you'll get on this forum is to change your diet and exercise. That way you may be able to reduce or eliminate your use of insulin, which is causing you weight gain. You may even be able to reduce or eliminate the need for oral meds, if you can stick at it.

    If you have a meter for testing your blood, you can use it to find out what foods you eat give you high blood sugar. Test before eating and again 2 hrs after eating. This is to help you build up a picture of good and bad foods. Daisy will be along soon to give you information on the level you should aim for. You will quickly find out which foods cause you problems then you can reduce the portion size, or eliminate that food from your diet. After a while you will know all you need to know about the foods you eat, and you will only need to test the occasional new food, that you want to try.

    If you can reduce the amount of carbohydrates (carbs) in your diet, you can gain much better control of your blood sugars with lower amount of medication. You will need to adjust your insulin accordingly. There are many folks on insulin who will be able to advise you on how to safely reduce it, while lowering the carbs in your diet, until you find a level which works and is acceptable to you. Carbohydrates are converted to glucose in the blood, and cause blood sugar levels to rise. Refined carbs are the worst offenders, they will raise blood sugar faster and higher than any other foods. You will need to reduce the carbs in your diet somewhat to reduce your blood sugars. This will also help with excess weight. Your insulin requirements will reduce, and instead on increasing, you should find your weight going in the other direction.

    First start with the obvious, if you haven't already, and cut out sugary things including drinks. Cut out or cut down on the so-called refined carbohydrates such as white bread, potatoes (except a few new potatoes ), white rice and pasta. Anything white really! :D You can also try switching to versions of these foods with a lower GI -i.e wholemeal bread, brown rice, and wholewheat pastas, but in smaller portions. If you had been given any advice by an NHS dietician, it would have been to each lots of starchy carbohydrates at every meal, as illustrated in the NHS Eatwell Plate. This advice might be ok for the general population but is completely stupid advice for a diabetic. Diabetics cannot properly metabolise carbohydrates.

    Fats and protein, are not really a problem, so plan your diet around meat, fish, eggs, cheese and vegetables that grow about the ground. (the green leafy stuff), mushrooms. Root vegetables such as carrots, turnip, swede etc., can be eaten, but in smaller amounts. Nuts and seeds, cubes of cheese, salami, olives, eggs are good low-carb snacks, and small amounts of fruit - berries tend to be the lowest-carb fruits, and bananas the highest. I used to love bananas, but they don't love me anymore :cry: Bacon and egg is a good low-carb breakfast :shock: or Yoghurt with a small amount of fruit and tops with nuts & seeds.

    If you like bread, you could switch to a lower carb bread, such as Livlife Seriously Seeded, which you can get in Waitrose, or in some areas in Morrisons supermarket. Or try Burgen Soya & Linseed bread from any supermarket.

    You might be able to tolerate porridge or cereal for breakfast, but unless you test, you won't know. Everybody is different, and the difference is partly due to how advanced the diabetes is at diagnosis.

    How low carb you want to go is up to you ... some people choose very low-carb 30g per day. Some are more moderate (up to 100g or 150g) - It all depends on what you want to do and the results you get testing.

    What you should aim for is a daily level of carbohydrates that you are comfortable with, and that you can sustain over the longer term.

    As for exercise, if you can't walk far at the moment, why not start with some swimming? Then move on to walking, as you lose weight.

    Meantime, have a read of Daisy's post when it arrives, and keep asking questions. And browse the forum and the rest of the site for information to get you started. This all might sound daunting at first, but you'll soon grasp it.

    Best of luck!
     
  4. daisy1

    daisy1 Type 2 · Legend

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    Hi my_mate and welcome to the forum :)

    Here is the information which we give to new members (which Weens mentioned here) and I hope you will find it useful. You have already had a lot of very good advice and if you have some questions then go ahead and ask and you will get more 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 70,000 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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