If I were recovering from a toe amputation, like Traceymac23 was, knowing what I know now, I might take medication for a couple of weeks, but only to enhance recovery from the surgery and to reduce the risk of infection. It's a tricky business though. When medication works, it's great, but if there are side effects, such as diarrhea, I'd continue on medication temporarily, but switch to a different medication. That said, Metformin would be what I'd try first. Glad medication worked out for Traceymac23.
With that said, I also believe you made right choice to delay taking medication and to begin with the low carb diet!
My A1c was 9.9% (US) or 84.7 (UK) when I was re-diagnosed with T2DM 50 months ago. Within three days I started the low carb ketogenic diet in the 30 - 42 carb a day range. And with five days, I found my way here. Lucky me. Lucky you. I can think of no better place to begin your diabetes education.
[Edited to add]: It took a full 4 weeks to get my glucose levels down with further improvements over the next year. I graphed my levels daily with graph paper. Had good and bad days. Give the diet the time needed for it to work.
So here's what you need to know now before your body begins the transition from "sugar burner" to "fat (and sugar) burner"...
- Stay hydrated throughout the day. Water is best, but I typically alternate drinking hot tea (black for breakfast; green after lunch; coffee and herbal teas are okay too) - with a cup or two of water. I actually take filtered hot and cold water with me to work, or when I'm going to be away from the house for an extended period of time.
- As your body begins releasing your "water weight" initially, you'll begin to lose sodium, so depending on what you're eating, you may start craving salty foods - (in my case it was corn chips topped with grated cheddar cheese, the former definitely not low carb!) - or you may begin to have headaches. When that happens, take in some salt. I experimented with different ways to do that. Ultimately what worked best for me was to grate sea salt into a cup of hot water and drink it - (I was trying to avoid all the food additives that are in many of the bouillon cubes and powders). I started with a 1.25 ml (1/4 teaspoon) and worked up to 2.5 ml (1/2 teaspoon). I continue to do that as needed to this day because I greatly limit processed foods and keep forgetting to add salt to the meals I prepare from scratch from real, whole foods.
- Magneisum. If you begin to have muscle cramps because you're like me and not able to get enough from the foods you're eating, be prepared to take a daily magnesium supplement. Avoid magnesium oxide even though it's cheap. I suggest magnesium citrate if you tend toward constipation or magnesium glycinate if you develop diarrhea on the magnesium citrate. There are other forms of magnesium too. Members here may be able to suggest specific brands available in the UK. That said, not everyone needs to supplement this mineral. It's highly individual.
- Constipation. I eliminated grains from my diet almost from day one on the low carb ketogenic. Not sure why, but I tend toward constipation even though I eat above ground leafy greens and/or vegetables with all meals. I have two strategies: take magnesium citrate, 150 mg with breakfast (or lunch if I'm skipping one meal a day) and 300 mg with dinner (but initally I only took 150 mg with breakfast and then 150 mg with dinner; it's best to work up slowly). Another strategy that works is taking 500 - 1000 mg or more of vitamin C with each meal. Or a combination of both.
- Raw nuts are an excellent source of protein, healthy fatty acids, minerals and fiber. I enjoy alternating between raw almonds, pecans, hazel nuts, also referred to as filberts I believe, and walnuts. Macadamia nuts are popular too. They're great on salads or if I have to delay a meal and just need something to keep me going until I can eat again. Roasted and flavored nuts are so tasty, but I reserve eating those as a special treat on holidays because I don't know how heat affects the fatty acids and I avoid eating anything made with highly processed and damaged omega-6 seed oils - (corn, canola, cottonseed, soybean, sunflower, saffola, peanut).
- Healthy oils and fats. Extra virgin olive oil for the vinaigrette I add to my salads (or cooked vegetables just before serving); mayonnaise made with eggs and avocado oil for my chicken or tuna salad; butter, ghee, avocado oil, possibly coconut oil, or animal fats for sauteing vegetables or preparing stove top meals made with meat, poultry, fish or seafood with vegetables, herbs, and spices.
- Eggs. I eat 1 to 2 eggs a day. They can be boiled and refrigerated as a grab and go food or used to make a frittata with your favorite combination of butter, egg, vegetables, cheese and seasonings. My favorite meal any time of the day when I have time to cook in the morning, or as a quick and easy dinner when I arrive home late, am starving, and just want something simple before I go to bed.
- Soup and stovetop meals prepared ahead and frozen in individual servings. Almost everything I eat is prepared fresh from scratch, but sometimes I need grab and go meals. Soups are frozen in glass jars, meals are frozen on a small plate, then removed and bagged frozen. Before work, I just grab a frozen jar of soup or a frozen meal and bring a glass container with lid to thaw the meal at work.
- Deli meats and cheeses. If I'm out with friends who don't eat the way I do, and I need a grab and go food that doesn't require thawing or any food prep, I find a grocery store with a deli, and have them slice meat and cheese for me to roll up and with some cut up raw vegetables.
- Above ground leafy greens and vegetables. I include generous servings, raw or cooked, with every meal. Keep your microbiome fed and happy.
- Grains, tubers, and sugar. Greatly limit or eliminate. I sometimes will eat a very, very small portion as a treat though rarely sugar.
- Low carb fruits and berries. Strawberries, raspberries, blueberries, black berries, lemon, lime, plums, apricots. Enjoy in small amounts. When I reintroduced them to my diet after 4-6 weeks on the low carb ketogenic diet. I started with six blueberries. Oh my gosh. They tasted so good. While I can't eat a whole orange any more, I do tolerate a 1/2" (13 mm) slice of orange with the peel. I enjoy a similar slice of grapefruit too, but halved, without the peel though. Yum.
- The other "fruits". Whole green olives, avocado, and coconut are all low carb and additional sources of healthy fats.
- Beans and Legumes. I do eat small amounts of these in soups or salads. Taco salad is one of my favorite ways to eat whole beans.
- Meat, poultry, fish, or seafood. Greatly enjoyed with most meals.
- Alcohol. Beer has carbs. Red wine and spirits without sugary additions are okay for many of us.
[Edited to add] - Dairy. Cheese and unsweetened, full fat yogurt are good sources of protein and fat. I tolerate hard cheeses, cream cheese, and heavy cream well. Sour cream not so much. Milk not at all, it's too high in sugar. One of my favorite snacks when I first started the diet was rolling sliced ham and cream cheese or provolone cheese, around a slice or two of a dill pickle. So good.
How much whole food starches and sugars we're able to tolerate varies greatly. What isn't tolerated well initially, may be tolerated better as insulin sensitivity improves with the diet over time. "Eat to your meter" is excellent advice.
When I have a high glucose level or eat a food that I know will spike my glucose level, I try to make time to walk it off an hour or so after I first sat down to eat the meal. Some day I'll get an exercise bike. As you gain more experience you'll come up with your own strategies that work best for you. I'm certain I'm forgetting something, but hopefully you find the above helpful.