Type 2 New here, advice please

[ajbod]

You need to get your wife to STOP calorie counting, just CARBS.
To help understand carbs and sugars try the below link.

Freshwell Low Carb Project - Dr Unwin’s sugar infographics

lowcarbfreshwell.co.uk

 

[ajbod]

The problem with dietitians is what they advocate is better, but in the way being beaten 1/2 to death, is better than beaten to death

 

[KennyA]

Thank you, another very helpful explanation of a further bit of this puzzle.
I don't mind losing a 'bit' of weight, it is just how comparatively fast that it is happening that concerned me. ( Ha! I always said one day I would get back into my 32 inch work jeans that I never threw away.)
I have an appointment with a dietician next week which should give me a bit more direction to better foods. My wife, bless her, is carbs and calorie checking everything we eat for every meal, and cooking accordingly. Occasionally I test out the odd item that is unlikely to be acceptable, more wishful thinking in most cases, but thankfully I am still getting away with my oats and cereal, with grapes occasionally, with under 2 points rise that you suggested is the target.

You are clearly doing very well so far. However - you may not be "getting away with" oats and cereal and grapes. Your A1c is around 49/47 over the last two A1c tests (which is within the error margin of the A1c test). It makes me wonder if your A1c reduction is stalling and whether you might need to think about the effect those carbs are actually having.

Yes, they may not be giving you a rise of 2 or more after 2 hours. But they are still going in and your testing might be missing a rise (possibly delayed because of the oats and cereal) which could be happening some time later than 2 hours.

Is it worth cutting out the carbs for a while and seeing what that does to your next HbA1c?

 

[ajbod]

Think of it as a sliding scale, the carbs you eat now put you on the scale at Hba1c at 48ish, eating fewer will move you down to a lower level. We are all different and your base number, where nothing else will work, it's where YOUR body wants to be, the maximum YOU can get down to will vary from what others can reach.

 

[kingfisher2]

You are clearly doing very well so far. However - you may not be "getting away with" oats and cereal and grapes. Your A1c is around 49/47 over the last two A1c tests (which is within the error margin of the A1c test). It makes me wonder if your A1c reduction is stalling and whether you might need to think about the effect those carbs are actually having.

Yes, they may not be giving you a rise of 2 or more after 2 hours. But they are still going in and your testing might be missing a rise (possibly delayed because of the oats and cereal) which could be happening some time later than 2 hours.

Is it worth cutting out the carbs for a while and seeing what that does to your next HbA1c?

Thank you for the encouragement; my reduction in A1c from 49 to 47 is just one 3 month test period, and being told 'sugar is poison' by my doctor 3 days before Christmas I was slow to really get into the process, I was in denial (at least until I had enjoyed my love of Christmas mince pies and the other goodies all around me) .... then I tried much harder for the next 10 weeks before my first re-test.
I thought just leaving out the chocolate, muffins, biscuits etc. was what was needed, but thankfully Catinahat gave me a graphic analogy that 4 grms of carbs is similar to a teaspoon of sugar - which really hit home. I have never thought about food nutrition, I have always eaten a balanced diet with lots of fruit and veg., and I had plenty of other of life's 'challenges' to worry about along the way.

The general consensus here seems to be that the raw porridge oats, malt cereal and grapes some times is not good. My daily tests spreadsheet and food record shows I am generally around 8-8.5 first thing before breakfast, average about 9.5 at 2 hours later, and around 6.5 before lunch, which surprised me having been told to watch out for that combination giving a spike; I think I will try something different for a while
The fact that both my father and Grandfather were type 1 suggested it was only a matter of time before I joined this club, so I am luck I have got away with it this long.

 

[ajbod]

Type 1 and type 2 are really totally different conditions, it would be perhaps easier if they weren't both called diabetes Mellitus. There is lots of crossover between them, but it also causes too much confusion to those who don't live with it.
even many health care professionals seem to misunderstand.

 

[HSSS]

The fact that both my father and Grandfather were type 1 suggested it was only a matter of time before I joined this club, so I am luck I have got away with it this long.

Type 2 does not become type 1. They are different conditions with different causes. Often people believe using insulin makes you type 1. This is not true and many type 2 using the medication route of treatment end up on insulin as their condition becomes more and more insulin resistant.

Theoretically it could be possible for someone with type 2 to then later get type 1 as well but to be honest it would likely be missed in diagnosis, not tested for antibodies or insulin production, and written off as type 2 getting worse. It happens because insulin can be used for both types so it’s seen as there’s no real “need” to differentiate. A problem as, in the uk currently, only type 1 get access to some much better tech to manage their insulin use. And a type 2 can improve by different management strategies mostly of diet.

 

[kingfisher2]

Think of it as a sliding scale, the carbs you eat now put you on the scale at Hba1c at 48ish, eating fewer will move you down to a lower level. We are all different and your base number, where nothing else will work, it's where YOUR body wants to be, the maximum YOU can get down to will vary from what others can reach.

Thanks for the observation.
Keeping a spread sheet of food consumed and the test results is starting to show patterns with some good lower numbers which I want to achieve.

As I replied to KennyA, I am going to give my usual (high carb) breakfast a miss and try something completely different for a while.
Even though the test results don't seem to show a spike, the fact that my first thing in the morning results are consistently high may be a consequence, (I am learning there are other factors come into play overnight) , but it is worth the change to see what happens.

 

[kingfisher2]

Type 2 does not become type 1. They are different conditions with different causes. Often people believe using insulin makes you type 1. This is not true and many type 2 using the medication route of treatment end up on insulin as their condition becomes more and more insulin resistant.

Theoretically it could be possible for someone with type 2 to then later get type 1 as well but to be honest it would likely be missed in diagnosis, not tested for antibodies or insulin production, and written off as type 2 getting worse. It happens because insulin can be used for both types so it’s seen as there’s no real “need” to differentiate. A problem as, in the uk currently, only type 1 get access to some much better tech to manage their insulin use. And a type 2 can improve by different management strategies mostly of diet.

Thank you, that dispels another bit of lack of understanding.

 

[KennyA]

Thank you for the encouragement; my reduction in A1c from 49 to 47 is just one 3 month test period, and being told 'sugar is poison' by my doctor 3 days before Christmas I was slow to really get into the process, I was in denial (at least until I had enjoyed my love of Christmas mince pies and the other goodies all around me) .... then I tried much harder for the next 10 weeks before my first re-test.
I thought just leaving out the chocolate, muffins, biscuits etc. was what was needed, but thankfully Catinahat gave me a graphic analogy that 4 grms of carbs is similar to a teaspoon of sugar - which really hit home. I have never thought about food nutrition, I have always eaten a balanced diet with lots of fruit and veg., and I had plenty of other of life's 'challenges' to worry about along the way.

The general consensus here seems to be that the raw porridge oats, malt cereal and grapes some times is not good. My daily tests spreadsheet and food record shows I am generally around 8-8.5 first thing before breakfast, average about 9.5 at 2 hours later, and around 6.5 before lunch, which surprised me having been told to watch out for that combination giving a spike; I think I will try something different for a while
The fact that both my father and Grandfather were type 1 suggested it was only a matter of time before I joined this club, so I am luck I have got away with it this long.

Type 1 and Type 2 are not different aspects of the same thing, and one doesn't become the other. It's like floods and droughts: they've both got something to do with water, but you can't expect to deal with them the same way.

 

[kingfisher2]

You need to get your wife to STOP calorie counting, just CARBS.
To help understand carbs and sugars try the below link.

Freshwell Low Carb Project - Dr Unwin’s sugar infographics

lowcarbfreshwell.co.uk

Thank you for that link, it really puts the various foods in perspective, quite scary actually. I can see why I like some of the things I like now.

 

[kingfisher2]

Well it is all a bit academic now!
Just been diagnosed with terminal stage 4 pancreatic cancer, inoperable, the prognosis is grim, couple of months maybe...... I guess my blood sugar is the least of my problems now.
Thanks everyone who gave advice, much appreciated.
All the best.

 

[ajbod]

Very sorry to hear your terrible news, i hope the time you have left can be peaceful and painless. I wish there was something i could say or do that would help. At least now you can perhaps enjoy the things that were lost out on to keep your sugar levels down.

 

[finzi1966]

Oh my goodness, that’s awful news. Certainly enjoy anything that you feel like eating, and peace and strength to you and your family xxxx

 

[Lakeslover]

Terrible news.

I don’t know if your medical team have mentioned it but macmillan run a forum similar to this. There are various subgroups there including for those with terminal cancer, and for the spouses of those with terminal cancer. You and your wife might find it helpful. It was a great help to me when my husband had terminal cancer, and after he died.

I wish you and your wife well and hope you are able to enjoy these weeks as best you can.

 

[Prince4]

Quite possibly not. The majority still advocate the Eatwell plate and 1/3 complex carbs as per their education and nhs standards. You’ll be told to eat oats and whole meal bread and sweet potatoes etc. All I can say is either don’t or test them thoroughly using a meter.

Some still believe carbs are essential (they aren’t - we can live without them entirely if need be) when the small amount of glucose required can be made in the body from protein and fat via a process called gluconeogenisis. They are still terrified of naturally occurring fats and want us to replace them with chemicals, processed seed oils and carbs.

This is the advice that has seen the nation get sicker and fatter in the last generation. Using a meter and assessing what those foods do for your body will remove any bias or “fad” claims and almost certainly show you the advice might be better than junk food but it’s a long way from the most effective advice. Even the American Diabetes Assoc recognises low carb is the single biggest thing we can do for ourselves to control type 2.

If carbs are not needed, then why do people Hypo? is it not because a lack of carbs???

 

[ajbod]

Hypo is caused by too much Insulin, Whether injected, or produced Endogenously due to drug stimulation. If you are taking neither, then a Hypo is all but impossible.

 

[HSSS]

If carbs are not needed, then why do people Hypo? is it not because a lack of carbs???

usually because of more medication (like insulin) than they need at that point in time (in relation to what they’ve eaten etc). Occasionally other medications or conditions can cause it but not lack of carbs on their own. As humans we all regulate homeostasis by dumping glucose from the liver into the blood when it’s required to avoid hypo. The above things can interfere in that process or override it and cause a hypo. We get that glucose not only from carbs but when they are missing we can make it from proteins (including muscles) and even fats. Otherwise all humans would go hypo within a short space of time without food and we can in fact go weeks in extremes.

 

[Prince4]

I know that I am New to this but the NHS website suggests otherwise....

Low blood sugar (hypoglycaemia)

Find out about low blood sugar (hypoglycaemia), including what the symptoms are, the causes, how to treat it and how to prevent it.

www.nhs.uk

It says that people can hypo even if they are not even diabetic??

 

[HSSS]

I know that I am New to this but the NHS website suggests otherwise....

Low blood sugar (hypoglycaemia)

Find out about low blood sugar (hypoglycaemia), including what the symptoms are, the causes, how to treat it and how to prevent it.

www.nhs.uk

It says that people can hypo even if they are not even diabetic??

And it goes on to, over simplistically, explain why that might happen. Pretty much all come down to a temporary inbalance in insulin and food or another medication condition/situation. All of which require something more than solely lack of carbs to be happening.