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New diagnosis for husband.

When my husband first came out of hospital, we got excited that his blood sugars were in the low "teens". It will settle down, but yes you have to look after his diet and yours, so that you can maybe wade through the mud together. Good luck.
 
@welshgirl2228 I may be way off whack here, but considering your husband has an existing autoimmune condition (my husband has RA too) has his medical team run the tests for the possibility of type 1 rather than type 2?

I don't know the ins and outs of these but @catapillar might be able to explain.

:)
 
@welshgirl2228

Hello Welshgirl and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you like and someone will be able to help.


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 276,000 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.
  • 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.
 
welshgirl2228 said:
He has high cholesterol too so have cut right back on fat in his food but he has treats on the weekends.
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Not really.. a lot of people report lowered cholesterol when they cut carbs..
Also the total cholesterol number that our doctors obsess over is not a good indicator of anything so is best ignored but thas something for later.
On my journey and were I in your position now I would cut out as many carbs from my diet as possible.
Instead eat eggs and bacon,, meat and green veg.. butter.. cheese. All the things your husband will probably enjoy eating will be more beneficial at the moment. Also I do believe that a few have reported better rheumatoid arthritis when carb cutting so it may even be a win-win-win situation eat good food, reduce blood glucose, loose weight and maybe get a bit of RA relief.
 
Rachox said:
Welcome! I'm now six months from being diagnosed type 2. Once I was over the initial shock, I saw it as the proverbial kick up the bum to get healthier. I was started on Metformin and tolerate it well now after a bit of stomach upset in the early days. I wasn't advised to eat low carb by my GP or Diabetes education course, but stumbled on this forum by chance and took up a low carb life style with self monitoring. I started by eating less than 100g carbs/day to begin with and then after 6 weeks reduced it to 50-70g/day, that’s what I continue on now. Caution needs to be taken on certain drugs going low carb but on just Metformin it’s ok. The best way to see what foods suit him is to test right before a meal and then two hours after the first bite, you’re looking for a rise of no more than 2 mmol/l and to be within these recommended ranges http://www.diabetes.co.uk/diabetes_care/blood-sugar-level-ranges.html
This has worked for me, to date I've lost 4 stone (still more to go) and got my HbA1c (blood test for 2-3 month average blood sugar) down to a non diabetic level, all due to the fantastic support and advise I got here. I have arthritis so exercising is difficult for me too, I just try and walk more. Read around the Forum and encourage your husband to join too and I'm sure you'll both find a way to do it too! I would encourage him to start as soon as possible to get rid of the nasty symptoms he’s feeling.
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Beautifully put - just what you need when baffled and overwhelmed .
 
with your hubby having those readings you need him to start reading upon the condition, first he needs to take that medication now. he is damaging his body with blood glucose levels that high. he must understand the risks of a badly controlled as a priority i would urge you to get his ketones checked. at those levels he has a risk of ketoacidosis the symptoms match.

now to day no suger none. he does not need it. depending how he chooses to control his weight and food intake he needs to reduce his carb intake. at the minimum bread, pasta, rice and starchy root veg need reducing or removing. bread you dont need. if he must eat the rest reduce sizes and switch to brown whole meal, but there are thousands of folks on here that are able to cut them out control there bloods and lower there weight plus multiple other health improvements. just as important no fizzy drinks unless they are 0 cals

your going to feel overwhelmed but try not to panic. once your into the swing of the lifestyle changes its dead easy. your husband needs more support. so try to get him online. if you join him on this diet you will be helping him and even saving money. anddont panic if they start to talk about other medication. once sorted your hubby will feel way better.
 
welshgirl2228 said:
......I LOVE baking and recently have baked once a week (bread, cakes, pastries) so obviously thats not a good thing even if it's just on the weekend but in general his diet is very high carbs, SOOOOO much white bread! But pretty much everything I cook is high carb- curry n rice, Bolognese with pasta, cottage pie, sausage n mash not to mention my baking! All of these I use as little fat as possible during the week, all 5% or less fat meats, lots of veg......
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You say you love baking, so you have a huge advantage already. Since my diagnosis I’ve become much more interested in cooking from scratch and I am enjoying creating tasty low carb meals. There are loads of alternatives to be made. I substitute cauliflower rice for rice, butternut squash for lasagne and spaghetti for example. There are loads of low carb recipes on the internet. Here are a few websites to browse through to inspire your culinary skills:
https://www.dietdoctor.com/low-carb/recipes
https://www.ditchthecarbs.com/
https://www.ibreatheimhungry.com/
And here are a couple of my favourite low carb discoveries:
My favourite breakfast:
https://www.dietdoctor.com/recipes/keto-coconut-porridge
And a couple of sweet treats (still low carb):
https://www.dietdoctor.com/recipes/low-carb-chocolate-peanut-squares
https://www.ibreatheimhungry.com/lemon-almond-shortbread-cookies-low-carb-gluten-free/
And even a low carb Xmas pudding, I have not tried this yet but I’m going to!
http://thelowcarbdiabetic.blogspot.co.uk/2013/11/the-best-low-carb-christmas-pudding.html
And custard:
https://www.dietdoctor.com/recipes/keto-dairy-free-vanilla-custard
Amazon is a good place to get some of the more unusual ingredients. Happy Baking!
 
@welshgirl2228 while one autoimmune disease (rheumatoid arthritis) increases your risk for another autoimmune disease (type 1) simply because your immune system has got form for attacking perfectly health bits of you body, it's still pretty unusual for antibody testes to be run to distinguish between types of diabetes.

The antibody tests won't be run/ offered / thought about unless there is a reason to suggest the type 2 diagnosis is incorrect.

From what you have posted so far there is nothing to suggest the type 2 diagnosis is incorrect. Your husband is 18st and trying to lose weight, unlike a type 1 who often has dramatic weight loss before diagnosis. Being overweight also increases the risk of type 2 and points to type 2.

How old is your husband? The younger you are the more unusual a type 2 diagnosis is and that suggests investigations into type of diabetes should be done.

What was your husbands blood sugar on diagnosis? For type 1s it is usually over 20 or 30. So very high blood sugar on diagnosis suggests type 1. Did you husband have ketones on diagnosis? It's very unusual for type 2s to get diabetic ketones, so if so, that points to type 1.

As I said, there's nothing from what you have posted so far that suggests type 1 or a requirement for antibody testing. Rather, it seems your husband has been diagnosed type 2 for a few months treated with metformin only and made no diet changes, so he has poorly controlled type 2, explaining the high blood sugars and symptoms he is experiencing.

If you are concerned it could be type 1, ask for antibody testing. Things that would raise a concern about type 1 would be an inability to control blood sugar even with diet modifications and oral medication and continued untried for weight loss.
 
catapillar said:
@welshgirl2228 while one autoimmune disease (rheumatoid arthritis) increases your risk for another autoimmune disease (type 1) simply because your immune system has got form for attacking perfectly health bits of you body, it's still pretty unusual for antibody testes to be run to distinguish between types of diabetes.

The antibody tests won't be run/ offered / thought about unless there is a reason to suggest the type 2 diagnosis is incorrect.

From what you have posted so far there is nothing to suggest the type 2 diagnosis is incorrect. Your husband is 18st and trying to lose weight, unlike a type 1 who often has dramatic weight loss before diagnosis. Being overweight also increases the risk of type 2 and points to type 2.

How old is your husband? The younger you are the more unusual a type 2 diagnosis is and that suggests investigations into type of diabetes should be done.

What was your husbands blood sugar on diagnosis? For type 1s it is usually over 20 or 30. So very high blood sugar on diagnosis suggests type 1. Did you husband have ketones on diagnosis? It's very unusual for type 2s to get diabetic ketones, so if so, that points to type 1.

As I said, there's nothing from what you have posted so far that suggests type 1 or a requirement for antibody testing. Rather, it seems your husband has been diagnosed type 2 for a few months treated with metformin only and made no diet changes, so he has poorly controlled type 2, explaining the high blood sugars and symptoms he is experiencing.

If you are concerned it could be type 1, ask for antibody testing. Things that would raise a concern about type 1 would be an inability to control blood sugar even with diet modifications and oral medication and continued untried for weight loss.
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he has not started the meds and obviously not altered his diet, i feel for this lady if hubby is avoiding reality. o suppose denile id part of the grieving process.
 
welshgirl2228 said:
All the nurse said was to lessen his carbs etc but we're new to all this.
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I very impressed with his nurse, most NHS staff don't understand about carbs. By reducing my carbs I got my BG back to normal levels from 33 within a few months. I did nothing that other people have not already told you about.

Rheumatoid arthritis often improves when people stop eating grains (floor, breakfast cerea etc), thererfore if I was him, I would begin by removing all grains along with suger from his diet.
 
Hi again, @welshgirl2228 .

I appreciate it's all a bit bewildering at first, in terms of what to do and how it all works, but could you clarify if he has started on his Meformin, but hasn't started the additional meds yet. It would also be very useful to know what the new medication is, as that can impact in his next steps.

I imagine with his RA, he might be on other meds, in addition to the Methotrexate? Methotrexate isn't a pleasant drug to be on, but some people have found, once they rein their diabetes into some sort of shape, that other conditions also improve and their meds can be reduced a bit.

I can see you're feeling if you give up the bread, potatoes, rice etc., that there'll be nothing let to eat except grilled meat and the odd lettuce leaf. That's quite a common reaction, but honestly, there are still loads of things for us to eat, and in my mind, not having rice with curry just means I can have more of the really flavoursome stuff, and not bother with the higher carb padding out stuff.

Clearly the foregoing is only an example, but if you could let us know the sorts of things your husband (and you) like to eat, then maybe we can give you a few examples of how those of us who have already cut our carbs down would go about replicating as much of those meals as we can, but in a lower carb way.

Maybe if you gave us an example of what a typical day looks like, or if it's easier, what he ate yesterday, would could help with some really relevant suggestions.
 
catapillar said:
(asked for husband's age)
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I learned a lot from your informative post, thank you! Her husband is 46 (and 18st weight), from the OP.

paulus1 said:
he has not started the meds and obviously not altered his diet, i feel for this lady if hubby is avoiding reality. o suppose denile id part of the grieving process.
Click to expand...

To be fair to the OP and the OP's husband, post #1 says he was diagnosed a few months ago and has been taking Metformin since then. It is unclear whether he was given any useful dietary/lifestyle advice at the time (the OP says nothing about it).

"This morning" (which is yesterday morning, at the time that I post this) he had a new meeting with the nurse at which he was, indeed, asked to lower his carbs. He also got a prescription for new drugs, which the OP had apparently not checked (or filled?) yet but we are still talking less than 24 hours. His wife acted almost instantaneously by posting here.

I mean, if the nurse had read the Riot Act at the time of diagnosis several months ago (and maybe she did) but the OP's husband had ignored the advice, then I would agree about "avoiding reality." It is all water under the bridge now anyway, what matters is going forward, and perhaps we can help support the OP and her husband in figuring this thing out.
 
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