new to diabetes and forums!

[chocoholicnomore]

I have just been diagnosed with type 2 diabetes and started metformin last night (1 x 850 in morning and 1 x 850 in evening) after attending diabetic clinic for first time.
My hb1a reading was 9.5 and my meter readings are around 11.
I am a chocoholic and am worrying how to cope without chocolate in my life (obviously not my biggest worry but thought it was too trivial to ask at clinic). I have not attended dietician yet and was hoping for some advice from this forum. (This is my first time joining a discussion forum)
I thought that, like other diets, if I was really good all week then I could have a bar of chocolate at the weekend. But I also wonder if, to maintain regular sugar levels, is it better to have 1 square of chocolate per day and try cutting it down to every 2 days etc.
What about special occasssions too? If you are really good most of the time then can you have a wee bit extra at special times like birthdays, christmas etc.
I know people who are on insulin can adjust their dose to cover eating extra but how does it affect those on diet and tablets only.
Also had diarrhoea ( don't know if spelling is right!) about 1 hour after taking the tablet last night and again this morning. Can side effects work that fast? I have never experienced side effects of any medication in the past.
Another query. The leaflets from the clinic said to base all meals on starchy foods (bread, potatoes, cereal, pasta, rice etc) but I have read other things in the forum warning to keep away from starchy foods. I am overweight and do need to lose weight but I don't know which way is correct. I have been on all other diets (weightwatchers, slimming world etc) and I feel that I keep comparing to other diets instead of just thinking healthy eating. At the moment I have cut right down on carbs (I feel it's similar to atkins diet but with a little carbs added on)
Also, can skipping meals or having a longer time between meals cuase any adverse reactions while taking metformin. I work from 9am to 2.30pm and usually don't having anything to eat until I come home (apart from some toast about 7.30 am and a couple of chocolate bars during the day)
Sorry for rambling on and asking so many questions. Hope someone can help me with some advice.

 

[daisy1]

Hi chocoholicnomore and welcome to the forum

I will try to answer some of your questions. About chocolate - only you can decide whether you can eat chocolate or not, by testing before eating and 2 hours afterwards to see if your levels come back down to more or less the before level. (This is how you work out whether you can tolerate ANY food not just chocolate). This should help you to evaluate the quantity but one square a day is definitely better than one whole block at the weekend. Your tester will tell you. You can also help by choosing carefully the sort of chocolate that you buy. Choose preferably any of the brands that do a good dark chocolate - Lindt, Green & Black's, some supermarket own brands. Look for anything 70% cocoa solids or above, and check the amount of carbs on the nutritional information. Try 85% or 90% cocoa solids and you will find a small amount is enough. Keep away from diabetic chocolate though as it has a laxative effect :shock:

Most of us relax the rules (carefully though) at Xmas, birthdays, etc. then get straight back into routine afterwards and it doesn't do too much harm if you don't do it too often. Life isn't worth living if you can't have a little treat from time to time!

Metformin is well known for causing stomach upsets. Make sure you take it during your meal, not before or after. If you really can't tolerate it there is a Slow Release version which you could ask your GP/DN for which might help.

You are doing the right thing having cut right down on carbs. A lot of people here do not agree with the NHS advice to eat lots of starchy carbs.

I'm not sure about skipping meals but I'm sure someone will have some advice to give you.

Here is some general information that we give to new members - I hope it is helpful to you. Please ask any more questions you have as someone will usually have an answer for 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.

 

[chocoholicnomore]

Thanks. Your reply is a great help. At least I know the right chocolate to eat now. All your other answers were really helpful too. It's so confusing to get conflicting advice from professionals but if it works for the majority then I'll keep to what I am doing. I was advised at the clinic that I don't get a monitor as I am not injecting insulin. I have decided to buy my own so that I can keep an eye on how well I am in control. I had thought about testing once a week at the same time every week but your answer about testing before and after eating certain foods sounds worthwhile so I will definitely give it a try once I receive my monitor. Thanks again for all your help.

 

[Daibell]

Daisy has given you some good advice to get you started. I normally have Green & Blacks 85% dark chocolate and perhaps only 2 to 4 squares per day. I'm on Metformin SR and do ask your GP for this slow release version if your bowel problems don't fade away; it may calm down.

Beware the term 'starchy' carbs because everyone interprets it differently. You need to go for low-GI carbs which means they are absorbed slowly. Many carbs such as white bread start as starchy grain and end up higly refined, high-GI carbs. The NHS are wrong to describe bread as 'starchy' as a result. I personally buy low-GI bread and there are other good recommedations on the forum. Good luck and do come back with any more questions.