New type 2 member

[JohnR127]

I have an above knee amputation of my left leg and had been walking with a peg leg for about 6 months when I got a pain in my stump just around Christmas 2017. I assumed initially it was due to walking and working in the garden so eased off and waited for its to get better. It didn't and when my wife came back in the New Year from Christmas with her mother in California we went to a 111 walk-in centre as my GP was closed for the long break. They gave me a general antibiotic and a sticking plaster. The following night we dialled 999 when the skin on my stump ruptured and during the admission procedures at my local hospital I was diagnosed with type 2 diabetes with a BS level of 24. While dealing with my physical problem they put me on Metformin 500mg twice a day and told me to read a leaflet and change my diet.

That was my introduction to diabetes and while the doctors concentrated on saving my leg I concentrated on the aim of getting sugars and carbs out of my diet thanks to the information I found on the internet especially diabetes.co.uk. Eventually I had a meeting with the hospital's diabetes nurse but she had nothing to offer except to say keep taking the tablets. We had BS checks 6 times a day and as the default is sugar in drinks and porridge/rice/potato/pasta/sandwiches/biscuits for meals and snacks I had to concentrate on finding a way to eat a high protein diet to encourage regrowth of flesh to fill the 70mm hole in my stump which was left after an operation to clean out the infection. I did this by ordering meals from which I only ate the meat, cheese and during the day ate nuts and biltong (when sugar-free it is very high in protein) from home. When I was discharged after three weeks to the care of the district nurses my BS was steadily in the 6-8 range. The diabetes nurse said I no longer needed to test but should stay on the Metformin.

I had so many follow up appointments for my prosthesis, and a scan of my right leg, and clinics for my post-operative care that I only just got round to contacting my GP. Well, the practice receptionist actually who said their diabetic nurse couldn't see me for 2 weeks so I left my phone number and asked for a call back. When I got the call it was the receptionist who said I had already seen the hospital diabetes nurse so did not need to see theirs. I asked about getting a HbA1c and was told I have to wait 3 months from diagnosis so they will eventually get in touch.

I decided I would test for a while and having had my fill of stabs of my fingers for now got a FreeStyle Libre patch and downloaded the app onto my phone. I have been surprised how little I saw of my blood sugar levels with 6 more or less random tests dictated more by hospital routine than by my meals. It was also easier in hospital to settle into a routine which produced more consistent results than at home where I am still trying to fit the good foods I must eat into the household routine.

 

[Ross.Walker]

Good work on taking control, shame your dr/nurse is not as diligent as you

Testing is such a good way to find out what foods are doing to you, do you have a record of before and after you have eaten a meal and what that meal was?

@daisy1 can you add the standard wisdom please

 

[daisy1]

@JohnR127

Hello John 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 need to 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 235,000 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. Most of these are free.

• 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.
  

 

[JohnR127]

Good work on taking control, shame your dr/nurse is not as diligent as you

Testing is such a good way to find out what foods are doing to you, do you have a record of before and after you have eaten a meal and what that meal was?

@daisy1 can you add the standard wisdom please

Thanks Ross. At least they saw a message I left on their website and added Metformin to my repeat prescriptions.

I haven't been too diligent at recording everything as I tend to extemporise whilst cooking. I always check the carb content though and keep the total low.

I often get BS highs in the middle of a fasting period beyond the two hours after eating. Could my medication be guilty? I am on garbapentin and ferrous sulphate taken around 3pm as well as morning and night.

 

[archersuz]

Hi @JohnR127 and welcome.

 

[Guzzler]

Gabapentin raises my blood glucose levels, some people see fluctuations either way.

 

[JohnR127]

Gabapentin raises my blood glucose levels, some people see fluctuations either way.

Thanks. It explains a lot. I might have to shift the times I take the gabapentin so I can reliably test foods.

 

[Guzzler]

Thanks. It explains a lot. I might have to shift the times I take the gabapentin so I can reliably test foods.

Personally, I find it affects my fasting blood glucose levels the most but as you say, testing and tweaking will tell you more about how it affects you. Good luck.

 

[Ross.Walker]

Hi

I ask as I have a routine where I test a meal 4 or 5 times and if the result is close then I consider it good meal. you will always find external influences come into play but you have a tool chest of foods.

I am only on metformin so will defer the other medication questions to those who are experienced on them.

 

[Resurgam]

If you can get a good range of basic proteins as the basis of meals then having perhaps one other item for everyone, assuming that you have to fit in with a family, and then a higher carb addition for the others whilst you have another low cab choice.
I have been eating low carb for a long time, starting back in the 1970s, and once I got into the routine of it it was no problem.
I am eating the same foods now as when using low carb for weight control I was diagnosed over a year ago, but have had normal readings for over 7 months.