New Diabetic with Type 2 - questions

[garyclark82]

Hi everyone, I was diagnosed last week with Type 2 diabetes (51 was my level - the nurse said 42 was normal - so is that my mmol?)

I am overweight and working on reducing that. I've been put on two metformin tablets a day (one with the morning meal, one with the evening meal) although for the first week, it was only with breakfast. I have not been testing myself - the nurse said that I wouldn't need to at this point (I have a further appointment next week so I can ask)

I'm on a low carb diet at the moment of 30g for breakfast, 45g for lunch, 60g for dinner and 15g for snacks and I'm getting on okay with this other than feeling pretty miserable and missing my previous foods (missing them incredibly in fact). I've been as strict as possible to keeping under the limits set, but I'm still feeling hungry at times. I know a lot of this is due to adjusting to my new life but it's still tough.

An average day so far would consist of:

Breakfast: 2 sausages (Be Good To Yourself although I'm hoping to get to my local butcher), 2 egg cheese omelette and a coffee.
Lunch: Mixed salad with chicken breast, a tablespoon of 70% reduced fat salad cream followed by some berries/unsweetened yoghurt
Dinner: Aldi Slim Well Chicken Saag, half a packet of cauliflower rice.
Snack: Fruit, a cheese oatcake, maybe (just maybe) a couple of squares of dark chocolate.

A few questions:
- How sustainable is eating like that going to be, long term?
- What sort of snacks would be recommended?
- If I were to have a particularly low breakfast/lunch, would I be able to use the carbs for later in the day?
- What advice would be recommended for cravings etc?

I'm sure I'll have more questions going forward but this is all such a change to my life

 

[Goonergal]

Hi @garyclark82 and welcome!

A few questions:
- How sustainable is eating like that going to be, long term?

Depends how much you enjoy it, whether it fills you up and how your blood sugars respond to the foods. Personally I eat very low carb - started at about 20g/day and now as close to zero as I can get, and have sustained it for 4.5 years. Enjoy it very much and am far healthier and more active than I ever was before.

- What sort of snacks would be recommended?

Long term, none. However, starting off I’d say things like a few nuts, a peperami stick or something else unlikely to raise your blood sugars.

Snacking isn’t generally recommended because for most type 2s, insulin resistance is a problem and every time you eat, you stimulate an insulin response. Ideally you want to limit this so that some sensitivity is restored and your body heals. Starting off this can be difficult and better to stay low carb and eat the odd snack than to go off the rails.

Have a look at dietdoctor.com for meal and snack ideas: https://www.dietdoctor.com/

- If I were to have a particularly low breakfast/lunch, would I be able to use the carbs for later in the day?

Possibly. It all depends how many carbs your body can handle in one go. For me personally, the answer is a resounding ‘no’, but you’re starting at a relatively low HbA1c of 51 (threshold for diagnosis in the UK is 48, with 42-47 pre-diabetic).

It’s for that reason - individual responses to food - that having a meter and testing is recommended here. Without that you have no idea what foods are doing to your blood sugars. The NHS will tell you it’s not necessary if you’re on diet only or diet plus metformin, but if they said otherwise, they’d have to pay for it. We can recommend the most cost effective meters for those self-funding.

- What advice would be recommended for cravings etc?

It’s not easy, but try and abstain - feeding the craving may lead to wanting more, rather than satisfying it. Unless you’re the sort of person who can moderate and just have one (I most definitely can’t). If you can, then there are many low carb substitutes.

 

[Antje77]

51 was my level - the nurse said 42 was normal - so is that my mmol?

That would be your hba1c in mmol/mol, yes.
A glucose meter would give your actual blood glucose level in mmol/l, so they're both mmol.

30g for breakfast, 45g for lunch, 60g for dinner

I'm a bit puzzled. How do 2 sausages, 2 egg cheese omelette and a coffee (your typical breakfast) add up to 30 grams of carbs? Sounds like a very low carb breakfast to me, and nowhere near 30 grams. The same goes for your lunch of mixed salad with chicken breast, a tablespoon of 70% reduced fat salad cream followed by some berries/unsweetened yoghurt. Even if there's a lot of sugar or starches in the low fat salad cream, how do you get to 45 grams of carbs? Can it be you're making a mistake in your counting?

 

[garyclark82]

Sorry, I meant that I was given a total of those figures to get to for each meal, not that those were calculated that way.

I'm still a newbie at all of this.

 

[Antje77]

Sorry, I meant that I was given a total of those figures to get to for each meal, not that those were calculated that way.

I'm still a newbie at all of this.

In that case it looks like you're a lot lower carb than you were advised. Mind, I think the advice to eat up to 60 grams of carbs in one meal isn't very sound advice for a diabetic so I'm glad to read you're quite a bit lower than that

A meter would come in very useful. You're only just over the diabetes threshold with your hba1c of 51 mmol/mol, so you may find you can handle a bit more carbs than you're currently having and still end up below 42
With a meter you can see what happens with different meals, and adjust them as you go instead of waiting for your next hba1c.

From your menu it looks like you're keeping the fats low as well as the carbs. If this leaves you hungry it will be harder to keep up eating this way.

 

[Daibell]

Hi and welcome. Do get hold of a meter; it is vital. Do have enough fats and proteins to keep you feeling full. Dark chocolate is fine but go for 85% Dark. For carbs think daily total rather than per meal.

 

[Mr_Pot]

Hi and welcome. Do get hold of a meter; it is vital. Do have enough fats and proteins to keep you feeling full. Dark chocolate is fine but go for 85% Dark. For carbs think daily total rather than per meal.

I think it is a combination of daily total and per meal. I don't think I am unique in being more affected by carbs in the morning than the evening. A CGM trial showed that my 10g of carbs at breakfast had the same effect on my BG as 4 times that at dinner. I would say set yourself a daily total, but the time when you eat it may be just as important as how much you eat. As always, experimenting and testing are the key to success.

 

[VashtiB]

Hello and welcome

I really recommend that you get a meter. We all vary in how our body responds to carbs- no one size fits all. So just given figures is not the complete answer.

As your starting point is quite low is it possible that the amounts you have b been given will do the trick but a meter will let you know.

You need to find a way to work out how to make your choices sustainable. This again will be helped by your meter. If you like many others find low carb difficult then being aware of your body's tolerances will help. Also some people react to some types of carbs disproportionately to the amount of carbs- again the meter can help.

I love carbs. I have found going very low carb- much lower than you actually helps lower the cravings. It also makes it easier mentally for me because there is no 'saving' carbs for a meter meal or trying to work out how to 'spend' my carbs. I also try hard to focus on what I can eat without worrying. This is what works for me. You need to work out what will work for you. The choices you make today are not necessarily the choices you will make tomorrow. We have all had a learning curve and journey working out what works for us. People here are really helpful and willing to give suggestions so keep asking.

Welcome.

 

[muzza3]

Hi and Welcome @garyclark82

The 1st step in my mind and many on here is to limit your carb intake and get a meter and test. Even if you need to self fund this will put you in control of your levels and will help you to shape your diet by being able to test meals to see how they impact your BG levels. From there you can make informed decisions on the best diet options for you . This is a great site and you can investigate the various diet options that have helped people on here and decide which is the best fit for you.Your meter will help you evaluate them.

Let us know how you are going and ask all the questions you have on here

Good luck on your journey

 

[LaoDan]

Hi @garyclark82

I’m only in to this a year and a half, while getting started was a little rough, after a few experiments with diet and exercise, I’ve found the right path. I feel fantastic.

Sometimes a little awkward, I prepare my own meals separately from my family. I have my little section of the fridge that’s my food lol. The family is happy, teevee time has been replaced with me dragging everyone outside to play around.

yeah, you can make it an awesome experience

 

[JoKalsbeek]

A few questions:
- How sustainable is eating like that going to be, long term?
- What sort of snacks would be recommended?
- If I were to have a particularly low breakfast/lunch, would I be able to use the carbs for later in the day?
- What advice would be recommended for cravings etc?

Good morning @garyclark82 ,

Good questions, and good start you're making. But I can see why you're hungry... There's three macro nutrients, and you're cutting out a lot of 2 of them... Better up the fats. That should keep you satisfied and give you something to run on, with carbs out of the mix. Just protein isn't going to cut it.

As for your questions, it's quite sustainable long term, once you find out what works for you. Your current diet isn't, as you're hungry all the time, but that's quite fixable! And I have to agree with the others, snacks aren't really that good of an idea, what with your pancreas needing as many breaks as it can get, and every time you eat something it has to shift gears again. If you do want to snack though, hard cheeses, pork scratchings, cold cuts/sausages, coffee with cream, or extra dark chocolate (Lindt's is great, and from what I hear, Aldi's Moser Roth is good too.). And maybe not think in terms of using carbs here and there... You don't actually need carbs to live, and you can't exactly bank them. If you'd had a meter, you would've already seen that if you have, say, 10 grams of carbs in the morning your blood sugars would react one way, and if you have 60 over lunch, you'd likely spike your blood sugars for a while. So do get yourself a meter with cheap strips, as you're going to need a LOT of them before you know exactly what foods agree with you and which don't.

Now, looking at your current diet, I see two things: Your carb count is well below what's been alotted, so yay, you! And secondly, the low fat stint... Fats aren't a diabetic's enemy, they're just about our best friend, second only to our meter. I know, it takes a bit of getting used to the idea after the low fat mantra's of the past decades, but.... It does make a difference in your hunger, and it'll give you something to burn for energy. So you might want to tweak your diet.

Breakfast: 2 sausages (Be Good To Yourself although I'm hoping to get to my local butcher), 2 egg cheese omelette and a coffee.
You might want to up the eggs. Maybe have 4 rather than two, add a little more (full fat!) cheese. You can toss in salmon, bacon, ham, that sort of thing, to bulk it up further. Or some chopped above ground veggies, spinach and such... Maybe throw some heavy cream into your coffee, makes it more filling and quite tasty!

Lunch: Mixed salad with chicken breast, a tablespoon of 70% reduced fat salad cream followed by some berries/unsweetened yoghurt

The tablespoon of reduced fat salad cream is the biggest red fag of the entire meal. You might want to go for proper mayo, (careful, some brands have put sugar in for heaven knows what reason), or olive oil and apple cider vinegar of a nice vinaigrette. You might also want to add some grated cheese, bacon etc to bulk it up further. Berries are fine, they're the lowest carb fruit out there, and the yoghurt should preferably full fat greek. Again, it's more filling and low carb.

Dinner: Aldi Slim Well Chicken Saag, half a packet of cauliflower rice.

I have absolutely no idea what Saag is, but the nutritional info says it's one gram of carbs per 100, so yay. It's low fat again though, so don't know how filling it is with just half a packet of cauliflower rice. (Good on you for using that though, good stuff!). If you can, or need to, you might want to bulk that up too some. I don't know whether it'd taste good with grated cheese or with a little butter tossed in, because I have no clue what it actually is, but you're the best judge of that.

Snack: Fruit, a cheese oatcake, maybe (just maybe) a couple of squares of dark chocolate.

...Yeah. The one thing you're most tentative about is the thing most likely to not spike you. Just a few squares of extra dark sounds fine to me, so enjoy! What fruits are you eating? Like I said, berries are the best thing for a T2. An average apple, for instance, contains 20 grams of sugar/carbs. A decent sides banana about 30+. One slice of pineapple over 20 as well... So basically, it all depends on what kind of fruit you're having. (And again, a meter would've warned you off the big hitters if you'd had one. See how useful it can be?). I can't tell how many carbs are in the oat cakes, but I personally wouldn't touch anything with oats with a 10 ft pole. For you, however, they might be just fine, as your HbA1c is lower than mine was at diagnosis and your insulin resistance at this point, is most likely nowhere near as bad as mine. Again, something your meter'd be able to tell you. Testing around meals can be very, very informative. (before you begin and 2 hours after the first bite. You're aiming for a rise of no more than 2.0 mmol/l)

Anyway, I hope this helps a little in solving the hunger issue. If you've got that licked, then yeah, you won't have any trouble keeping this diet up ad infinitum, and you should be feeling a lot better soon. https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ might help a little when it comes to adding some variety. But all in all... Meat, fish, poultry, most dairy and eggs are a free-for-all, and you can add on stuff from there.

Good luck!
Jo

 

[garyclark82]

Thank you so much to everyone who has commented so far. I have a tendency to hurl myself head first into big changes like this rather than trying to ease my way in, so something like this has been a real eye-opener. I am going to start adding more things with fat into my diet, along with additional meats so hopefully the hunger will dissipate and I can start working my way to my new and improved life!

I will be sure to post any further questions I have here, and welcome more thoughts/advice.

 

[garyclark82]

I have had a question from my partner which I could not answer so I thought I would ask:

"How do you incorporate a low carb diet into low fat family meals?"

 

[Bluetit1802]

I have had a question from my partner which I could not answer so I thought I would ask:

"How do you incorporate a low carb diet into low fat family meals?"

Why is your family on a low fat way of eating?
I am not surprised you are hungry with your current choices.
Do read the link @Goonergal gave you in the second post. Diet Doctor is a brilliant site, and you can get all the information you need without subscribing.

Buy yourself real fats, not highly processed chemical stuff. Swap the low fat salad cream for real mayonnaise. Your family doesn't need to eat it. Use proper butter, not low spread rubbish. Again, your family doesn't need to eat it. Eat proper cheese (hard cheese is best), eat fattier cuts of meat especially lots of bacon. Eggs are brilliant for us - as many as you like. Try bacon, eggs, a high meat content sausage, mushrooms and a tomato for breakfast or lunch. Anything fried is best fried in animal fats such as butter, goose/duck fat or lard, and avoid oils apart from olive oil. Avoid snacks, and if you want some fruit eat berries with cream as part of a meal, not a stand alone snack. If you must snack, try cheese, or a few lower carb nuts.

Protein is very important, so make sure you are eating enough. The fewer carbs you eat the more fat you need to balance things out.

As folk above have said, your first job should be to buy yourself a meter. The general advice is to test immediately before you eat and again 2 hours after first bite. The rise in levels should be under 2. Keep a food diary and record your levels next to the food. This way patterns will emerge and you will learn which foods are OK for you, and which are not. Once you are confident with matters, you can test at other times, such as 1 hour or 90 minutes after first bite, or even 3 hours.

Good luck, and ask questions.

 

[LaoDan]

I have had a question from my partner which I could not answer so I thought I would ask:

"How do you incorporate a low carb diet into low fat family meals?"

Focus on protein, even lean sources. Lots of greens leafy veggies. You can have an avocado on the side, macadamia nuts, olive oil. Maybe your partner likes sushi sashimi, or smoked salmon. I think it’s doable

 

[KennyA]

Hello and welcome to the club. You definitely need a meter - it gives you a snapshot of how things are , and what impact recent food, exercise, stress, illness etc has had. Change for the better can occur very quickly. This link
https://www.diabetes.co.uk/forum/blog/kennya.517579/
is my personal retrospective on what I found out in the first year. The difficult bit is the unlearning - most of what you think you know about "healthy eating" is wrong for a T2 like me. As we differ in how we react to carbs etc, my experience will be different to yours. The crucial thing is finding out how your own system works.

It's possible to combine a very low carb pattern with a normal pattern within a household - I just don't eat things like potatoes, pasta, rice etc. but that doesn't mean others can't. If I am eating plenty of protein and (especially) fat, I don't get hungry and snacking isn't an issue.

And - this forum is a very good source of advice and support.

 

[JoKalsbeek]

I have had a question from my partner which I could not answer so I thought I would ask:

"How do you incorporate a low carb diet into low fat family meals?"

Low fat isn't all it's cracked up to be, but if they insist on eating that way... My husband still eats carbs, so what I do is make meals that overlap. We have the same meat/poultry, so the basis is the same, but he'll have spuds and beans or something, and I'll have an extra chunk of salmon with mayo, chicken thighs,or some eggs with whatever. It's easier than making two entirely different meals. It's the same, just a few components in his that aren't in mine, and vice versa. So when you make something you all can enjoy, but you add some grated cheese, a bit of butter, an avocado, olive oil or whatever to yours, doesn't mean they have to. It's stuff you can add on later when it's plated. And you just leave out the potatoes or rice in yours. It's a bit of a mix-and-match, really. You'll get the hang of it as you go along.

Like you, I'm an all-or-nothing person. A word of warning though: There is such a thing as carb-flu. Carbs retain water, and when you cut carbs, you'll lose a lot of the stored water. And while you wee for England, you'll also flush out a lot of electrolytes. And that's something you might feel quite a bit when you jump in with both feet. The loss of water and electrolytes, -which will stabilise, by the way, in a few days up to two weeks- means you'll get dehydrated, and that can give you headaches, muscle and joint-aches, fatigue, nausea and whatnot. Like I said though, that will pass, and you'll feel better at the other end of it. Some of us choose to lower carbs more gradually because of this, but like I said, I'm like you... So you might want to do the same thing I did and get yourself an electrolyte supplement to tide you over until the dehydration is over with and your body normalises. Bone broth is an option too, but since that was a migraine trigger for me that was off the table, but it might be somethign you prefer over supplement-popping.

Good luck!
Jo

 

[ultradad]

I agree with what jokalsbeek said. I am about a month into being a diabetic and i am doing the LCHF diet. Anything over 8 grams of carbs saw a bigger rise than i wanted so i have ended up eating meats and veggies and 1 piece of 85-90% dark chocolate at night as a treat and bloods have been alot better.

Past few days i have noticed i am starting to feel abit hungry before next meal so i have started to increase my fats at each meal. I am finding over 20 grams of fat is keeping me full for longer. I have 3 eggs for greakfast but thats 18 grams of fat so i had scrambled egg this morning cooked with a spoon full of clover butter and hope that will push me over 20grams fat or its going to have to be 4 eggs. Looks like a few things i was eating like frozen pollock got no fat in it is going to have to go

Trying to work out what my body needs is new to me but keeps it intersting. Even though i am increasing fats i feel great and bloods were 4.8 this morning so thats good enough for me

ps this week i had my first peice of liver for 40 yrs and it tasted great. I had it with bacon and onions cooked in a frying pan and broccolli. Can get 1kg of it for £6 from butchers

 

[garyclark82]

Thank you for all of your responses. It does mean a lot, and even having a whole milk coffee topped with heavy cream last night was amazing and something I never thought I'd be able to have under these circumstances!

You have all been so helpful, and a very welcoming community.

 

[Daibell]

I have had a question from my partner which I could not answer so I thought I would ask:

"How do you incorporate a low carb diet into low fat family meals?"

As others have said, why go low-fat? It's best to largely ignore any diet advice from PHE and the other large establishments who rely on very suspect science. Remember it's your liver that decides how much cholesterol goes into your blood and it's depends very little on the fat that goes thru your mouth. Your body needs fat.