newbie from france

[libbyM]

Hi I was introduced to your forum this evening from someone on another forum in France.
I am 73 overweight and have been told just today I am forbidden to eat sugar. Great Chrissie present Have been living in France for 9 years after having spent more than half my life in Australia. I love cooking especially anything spicy but fortunately I don't particularly have a sweet tooth although must admit I adore mince pies Diabetes runs in my family but my mother, who lived to 98, controlled hers by diet. She was so good :clap: Other members, some now dead from old age (I hasten to add!)
suffered with the insulin controlled type and lost feet and limbs, cousins still with us, developed diabetes around the age of 60. So it didn't come as a great shock but disappointing nevertheless to get thus far. I am really encouraged by the low carb diet and hopefully over time my weight will drop.
However, am totally confused with the jargon and have really no idea where to start. No clinic here and even if there was I would have trouble understanding what they were saying. So your forum was just what I needed. Please be gentle with me as I'm a bit thick at times and need time to understand all that is necessary 8)

 

[daisy1]

Hi Libby and welcome to the forum The jargon is confusing but if you read here a lot you will pick it up like we all had to at first. You are on the right track with the low carb diet. That is the best way to control your levels. Like you I adore mince pies but I am limiting the number I eat and only up to Christmas. This is a very special treat and during the year I don't deviate from my diet very much. It's possible to have treats, but not too often. This information should help you both to learn the vocabulary, as I had to too, but also to control your diabetes as well as possible. Ask as many questions as you like as we are all here 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 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.

 

[phoenix]

Hi from me, I also live in France though I have T1 diabetes.
You can referred to a specialist if you feel you need to, you need to talk to your medecin traitant. They don't have clinics per se but I know my hospital conducts courses for people diagnosed with T2. (but they will be in French.)
You will read most people advocating that you test the effect of what you eat by testing your glucose levels before and after meals. You will probably want to ask your doctor for a prescription,

A meter is called a lecteur de glycemie, the strips are called bandelettes .
Your doctor may be reluctant to prescribe a meter, since the regulations say that

La prescription de l’autosurveillance glycémique ne doit pas être systématique chez les diabétiques de type 2.

However it is allowed if it is

afin d’améliorer l’équilibre glycémique lorsque l’objectif n’est pas atteint,
comme instrument d’éducation permettant d’apprécier l’effet de l’activité
physique, de l’alimentation et du traitement. Une autosurveillance
plusieurs fois par semaine à heure variable est recommandée dans ce
cas.

in other words so you can see the effect of activity and food.
I understand that new regulations also only allow T2s to be prescribed a maximum of 50 strips per year.
Unfortunately if you decide to buy them yourself then they are just as expensive as in the UK ) and buying a lecteur at the pharmacie is extremely expensive (average 79€) .

If you can't get prescribed a French one but decide you want to test for yourself I would advise getting one in the UK as they are far cheaper (If you decide to do this, give a yell, as I can tell you which types you can buy, you won't be able to get strips in France for some meters sold in the UK

If you do manage to get a meter in France, it will display different units to those in the UK . The French use mg/dl meters. To convert mg/dl to mmol/l you divide by 18 and to convert mmol/l to mg/dl you multiply by 18.
To make it even more confusing most French doctors actually use g/l so you have to put in the decimal point!
I've put in the figures for the targets quoted by Dasiy. The first, in blue is what the meter in France would read,(ie mg/dl) the second in red is what (most) doctors write.(ie g/l) (lab tests tend to use both mmol/l and g/l)
Blood glucose ranges for type 2 diabetes

Before meals: 4 to 7 mmol/l [72-126mg/dl] [0.72-1.26g/l]
2 hours after meals: under 8.5 mmol/l [153mg/l] [1.53g/l]

If you have been diagnosed with T2 after 2 fasting tests above 1.26gl, then you can apply for it to be treated as an ALD and any treatments/visits/lab tests are reimbursed at 100%. You need to speak with your doc about that.
As diabetes is an ALD you have various entitlements to care (at 100%). These are to be found here in the patient's guide http://www.has-sante.fr/portail/upload/ ... ars_08.pdf
Better stop, this is becoming far too long.

 

[daisy1]

Hi phoenix
Do you know of any site or paper that converts diabetes "jargon" from English to French or talks about diabetes care in the two languages? I have learnt all the words from this forum but have trouble talking with my endo because I don't know the French words even though I speak French. This would be useful for Libby too. I haven't even been able to find any information about diabetes and its care in French which I'm sure must exist somewhere. Thanks

 

[phoenix]

Hi phoenix
Do you know of any site or paper that converts diabetes "jargon" from English to French or talks about diabetes care in the two languages? I have learnt all the words from this forum but have trouble talking with my endo because I don't know the French words even though I speak French. This would be useful for Libby too. I haven't even been able to find any information about diabetes and its care in French which I'm sure must exist somewhere. Thanks

Sorry, we could write one!

 

[daisy1]

Thanks phoenix. I believe there is something in Canada if I could only find it. The trouble is that Canadian French is different from how it is spoken in France or Switzerland. The French spoken in France which is the "proper" French, has evolved differently in Switzerland :roll:

 

[libbyM]

Hi thank you so much for all the information. I am seeing mydoctor tomorrow for a discussion and am writing myself a whole list of questions. Bless him he does speak a little English but am never quite sure whether he= really fully understands what I say. Difficile. He has mentioned me taking tablets but would rather see if the diet does the trick. Obviously nothing is simple but now I've got over the shock I am determined to stick with whatever is correct. Once I understand what is correct that is I want to have another blood test instead of waiting until January as he suggested. He is very layback and even when my bp rocketted earlier this year 190/200 his comment was "I am not frightened for you". BP normal now but am on tablets. It was me who rang him yesterday suggesting we had a chat as I was uncertain just how serious my count was. His comment "sugar is forbidden".
Now that I have read as much as I can in the time I've had on this extremely informative forum, plus I have a sight problem which doesn't allow me to read for any length of time but that's another story, I feel more in control and informed. Still much to know and learn of course but at least I feel I'm on the right track.
I'm so thrilled to meet you all via this platform and thank you for your help so far. Hope I can contribute positively in the future.

 

[libbyM]

Well do I give you the bad news or the good news first Had a long chat with the doctor yesterday, took my husband in with me as I tend to forget things, and came away slightly depressed but not down.
I certainly have to stop all sugar but the count is not bad enough to be monitored monthly at the moment but to be careful and can have a treat or two over Christmas My weight is not of great concern to him but I prefer to lose a stone at least so the GI diet will be my guide. What I am teetering on is too much protein in my urine which came as a bolt out of the blue. He said, smilingly and not unkdinly, you are an old woman and can expect numbers like this. I obviously now have not only to watch sugar but protein. For a person who adores food and enjoys cooking it is a blow but there you are and I have get on with it. Better to know now and be observed than the kidneys go haywire or whatever much later on.