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New to the forum, saying hello

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Shugga

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Hello,
stumbled over the forum on twitter and thought I would sign up. I have been diabetic since 2002 and have managed to keep it under control using Metformin and Gliclazide until around mid 2008 at which point I was put on to Exenatide as the tablets seemed to stop working efficiently. 2 weeks ago I was taken off of Exenatide as it was not working (12 months seems to be some kind of limit if it is not doing what it says on the tin) and as of last week I have been using insulin (a mix of fast and slow release).
I am a little apprehensive about having to inject insulin but I am slowly coming to terms with it and am managing my dosage with the help of my local hospital, though at the moment my bloods are up and down like a fairground ride... so Ill be looking for advice from other people who have been through a similar experience, I am sure I'm not the first to be worried.
so that's me, pleased to have found you all...
Dean (Shugga)
 
Hi Dean.
Welcome to the Forum. Have a good look around and ask any questions you want. I am a Byetta user so am surprised it didn't work for you, however we have had some who have just not been able to tolerate it.

In an attempt to help you can you tell us what a typical days diet consists of, and also do you know what your Bg levels are throughout the day !

Ken
 
Hi Ken,
My diet generally does not change much, I start the day with either a bowl of porridge or 2 rounds of brown toast with marmite, mid morning I will have an apple and banana (or equivalent). For lunch I will have a sandwich, brown bread, with ham and salad or tuna and cucumber and maybe a pack of snackajacks, always an apple, banana and or clemantine. Dinner is normally something with little meat and lots of veg, chicken breast with boiled potato, carrot, cabbage, broccoli and cauliflower. I very, very rarely have an Indian or Chinese takeaway as these generally make me feel sick for days afterwards. It is very rare for me to have other fast foods, I cant stand pizza for the same reason I cant eat other take away food.
I don't drink or smoke, a case of 8 cans of beer can easily last me over a month and generally the Mrs gets fed up with them being in the fridge and drinks them before I get to them :)

Bloods have been between 13 and 19 for the last week and over the weekend, yesterday they started coming down to low teens and as of today I will be increasing my insulin from 12 units to 14 with a view to increasing again on Saturday by 2 more units if the levels have not dropped further. Ideally I need to get to a level consistently below 10 but this seems a million miles away at the moment, I think my sugars go up when I get stressed, then I stress more and start chasing my tail...

Thanks for listening,
Shugga
 
Thanks Shugga.
I know you are not newly diagnosed but can I ask you to take a read of this information, I think that some of it is very pertinent to you and it just might help you get better control of your Diabetes. Ask again if there is anything you are not clear about. The dietary advice I was given and followed would have killed me if I had stuck with it........it just wouldn't work for me.

Here is the advice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.

As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!
If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l........(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l.....( Type 2)

2hrs after meals....... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Ken & Sue.
Click to expand...
 
Hi Shugga

Do you test before and after meals? and test the effects of different foods? We are all very different and on this site you will find that people have very different effect to the same foods.

For instance: By testing I have found (that with the exception of the potato with your evening meal) I could not eat your diet without raising my BG significanlty.

Bread raises my BG's big style, as does fruit, oranges and orange juice spike my BG's - though I can eat a small banana, but only if I eat no other carbohydrate at the same time.

Most veggies, even pulses, I can eat fine, but carrots have to be raw and not cooked.

But I have found that if I chooses the right dishes and don't eat rice I can eat an indian takeaway.

Others here can eat some fruit and have found that they can eat certain types of bread but not others.

I can't touch beer but have recently found out trough testing that I can drink a glass of red wine.

And yes stress raises them too.

good luck

Annie
 
Annie,
I check my bloods 4 times a day, before breakfast, before lunch, before dinner and before bed. I don't test my blood after meals mainly because my nurse told me to test in the way that I do... that and I struggle to find a place on my fingertips that are not like a pin cushion!
I forgot to mention since I started Insulin I have stopped the Gliclazide and think I will be asked to increase the Metformin back to 4 500Mg tabs a day but have been told the slow release Metformin will not make me feel sick everyday (I did not manage well on 4 Metformin previous to injecting Exenatide)

When I went to the hospital for my clinic and was put on Insulin I did meet with the dietician, I got the feeling she was trying to find fault with my diet even though I don't eat fast food, crisps, mars bars etc. The best advice she had for me was to cut out the occasional packet of snackajacks and replace with another piece of fruit. Interestingly I had not even considered that my fruit consumption could be hiking up my bloods, it is something I will look at starting tomorrow, especially as the dietician was keen on me keeping that part of my diet up and replacing the occasional pack of snackajacks with another apple!

Over the last year I have lost over 1.5 stone in weight and I am gutted that now I am injecting insulin there is a very good chance I will put the weight back on again, I know fitness is a big part of controlling this but it is still a little disappointing to know the drug is going to be fighting against me in this respect.

I think I am already happier knowing that I can ask questions if I am unsure, the worst thing about all of this is the feeling of isolation.
Thank you,
Shugga
 
Shugga said:
I check my bloods 4 times a day, before breakfast, before lunch, before dinner and before bed. I don't test my blood after meals mainly because my nurse told me to test in the way that I do... that and I struggle to find a place on my fingertips that are not like a pin cushion!

Shugga
Click to expand...

What is the point of only testing before meals.......all that tells you are your fasting levels. It tells you nothing about what effect certain foods have on your BG levels. The only way you will know that is by testing at least 2 hours after your meals. The finger prick shouldn't be painful if the clicker is set properly. I test sometimes 6 - 8 times daily and have no problems. No pain, no soreness. I hope you are using the SIDES of your fingers and NOT the tips ??

That sort of advice from a HCP shows that there is very little knowledge about how the body metabolises foods, it is also the reason there are many Diabetic's out there who are struggling to control their Diabetes.

I recently gave some advivce to a Type 1 Diabetic about the issue of when to test, he is having difficulty controlling his levels. He has also lost part of his leg to Diabetes complications. He now realises that the levels he thought were good because he only tested before meals were in fact of no use as his post meal levels were terrifying, 17+ most days. This was down to his poor, so called healthy diet as given to him by an NHS Dietician.

Beginning to test 2 hrs after his meals he now sees that much of the food he eats is full of carbs which have elevated his Bg levels to a massive extent. Needless to say he is now eating much more healthily and Bg levels are continuing to drop all the time after he started to follow the basic advice we hand out there. It works for him, might just work for you.

Ken
 
I did meet with the dietician, I got the feeling she was trying to find fault with my diet even though I don't eat fast food, crisps, mars bars etc.
Click to expand...

That sounds like an expereince many people here will understand, we try and follow their advice and when it goes wrong they blame us anyway saying we are not compliant.

But we are all indivuals and so are our bodies, you need to work out what effects you, the general advice may fit some people, but it won't others, and yet we still get the blame when it goes wrong.

We had a converstaion on here a week or so ago about oven chips, I can't eat them but others had no problems. Yet a friend of mine was told by her dietician to only eat oven chips and not 'real' ones. How they can give such sweeping advice and not acknowledge our differences?

At least they seem to be giving you test strips, even if their testing advice was a bit strange,

Anniexx
 
I didn't really understand the relevance of the bit about test strips, maybe I'm lucky but I have always had them as a prescription item, as well as all of my diabetes drugs and anything else I need to boot (like antibiotics). I have an NHS prescription certificate and have had once since the day I was diagnosed... is this not the norm? If not it should be, there is no way I could afford to buy the stuff I use every day! Maybe I just have a really good GP?

I am going to start testing my blood levels after meals as well, as suggested by Ken, I didnt realise this was so important.... and have only been doing this for 8 bloody years, not once have I been told to test after eating. I have been testing using my fingertips, this was how I was shown to do it when I got my blood tester, again at the hospital..... it does hurt quite a lot and I tense up now as I press the button on the needle clicker.... my wife often says 'one day you will get used to that', I don't think I ever will. I'll do as you suggest and prick the side of my finger (I only use 2 of the 5 as it is... on each hand so 4/10) :)

Still learning, and thanks again for the advice, I'll let you know how I get on.

Shugga
 
Sadly not all diabetics, particulalry t2 get test strips from their doctors, they are frequently told that T2 don't need them. Some of us get some but have to top them up ourselves. My DN very reluctantly gave me the strips, but I get one box of 51 every 8 weeks, which works out at less that one a day

All medicated diabetics get free prescriptions but no they may not get their test strips on prescription.
 
Shugga said:
I am going to start testing my blood levels after meals as well, as suggested by Ken, I didnt realise this was so important.... and have only been doing this for 8 bloody years, not once have I been told to test after eating. I have been testing using my fingertips, this was how I was shown to do it when I got my blood tester, again at the hospital..... it does hurt quite a lot and I tense up now as I press the button on the needle clicker.... my wife often says 'one day you will get used to that', I don't think I ever will. I'll do as you suggest and prick the side of my finger (I only use 2 of the 5 as it is... on each hand so 4/10) :)

Still learning, and thanks again for the advice, I'll let you know how I get on.

Shugga
Click to expand...


I too have had a Nurse prick the pad of my finger, that is just because it is a one off test at that time.

They don't have to test frequently and that continuous testing on the pad of the finger will inevitably lead to soreness and also a possible lack of feeling in the figertips ! That is why it is far better to use the side of the fingers. I alternate 3 fingers on each hand weekly. No pain, no problems.

Ken
 
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