Newbie...

[peejay]

Hi all, my name is Paul, I was only diagnosed with type 2 diabetes in December 09. It was a bit of a blow as I already have Atrial Fibrillation and COPD. I've been on Metformin for the last 3 weeks, 1 a day for the first week, and now 2 a day so far. I have also had results of a blood test back this week (Wed) and have a cholesteral level of 8.1 and am now taking 10mg Simvastatin daily also. I am having trouble with my bg levels, it's ranging from from 12.2 to 19.8 and even once reaching 20.2. I don't think I've yet fully grasped the "can eat" and "can't eat" and would be really grateful for any advise on this issue. I also take a fair amount of other meds:

Daily....
Metformin 2 x 500mg
Simvastatin 1 x 10mg
Verapamil 2 x 40mg (hence 10mg Simvastatin)
Flecainide 2 x 100mg
Fluoxetine 1 x 20mg
Aspirin 1 x 75mg
Omeprazole 2 x 20mg
Seretide inhaler
Salamol inhaler...

Chin up is always best!! Happy New Year to all...

 

[pavlosn]

Hi Paul

Happy new year to you too!

Welcome to the forum and sorry to hear about your recent diagnosis as a T2 diabetic in addition to your other health conditions.

As you probably know by now, having diabetes means that our bodies are no longer able to manage our blood glucose levels on their own.

Most of the food we eat, is converted by our metabolic system into glucose, a type of sugar which is our main body fuel. Glucose is transferred in our bloodstream to our various body cells where it is absorbed through the action of a hormone released by our pancreas called insulin. In type 2 diabetics such as you and I, our cells become insulin resistant and are no longer very efficient at taking in glucose. As a result unabsorbed glucose remains in our bloodstream resulting in increased blood sugar levels.

In some T2's, as well as all T1 diabetics, the pancreas may lose its ability to produce insulin, in which case the diabetic becomes insulin dependent and has to inject insulin in order to keep his glucose levels under control.

Diabetics manage their blood glucose levels in order to stay within target levels and avoid short term problems such as hyperglycaemia (too high blood sugars) and hypoglycaemia (too low blood sugars), both of which could be life threatening if present in extreem levels. Another aim of good glyceamic control is to significantly reduce the risk of long term diabetic complications such as cardiovascular problems (the number one cause of death amonghst diabetics), kidney failure, gangrene, neurological problems and blindness.

There are two main measures of glyceamic control:

Blood Glucose Level - This is the usual reading one gets through self testing using a home blood glucose monitor and is expressed in the UK as mmol/l.

HbA1C - This measures how much glucose attaches to a specific type of molecule in our blood called heamoglobin and effectively is measure of the average level of glucose in our blood over the three months immediately preceeding the test. This is expressed as a percentage.

According to the latest UK guidelines, T2 diabetics should aim for a maximum HbA1C score of 7.5% and blood glucose levels between 4 - 7 mmol/l. for any reading taken first thing in the morning before any food is taken (fasting blood glucose level), and blood glucose levels of no more than 8.5 mmol/l for any reading taken two hours after any meal.

Some of us on this site believe that these targets are insufficiently tight to prevent long term diabetic complications and aim for targets which are much lower and as close as possible to non diabetic. However as a newly diagnosed you should aim to reach the above guideline targets. Once you have achieved these, you could consider a more aggressive approach if you wish.

So what should you do to achieve these glucose targets. You need to adopt lifestyle changes that will assist you in the long term to gain control over your diabetes.

Diet and Nutrition. What you eat,how much you eat and how often you eat will have a direct bearing over your blood glucose levels. In particular the quantity and type of carbohydrates you eat will be particularly relevant. Carbohydrates are divided into sugars and starches such as rice, pasta, potatoes, and cereals. Both types of carbs are converted into glucose when consumed. You should try to avoid sugars (only have sugar as a rear treat not as a regular indulgunce) and limit your intake of starches to quantities that will keep your blood glucose levels within the above limits.

In order to limit your carbs effectively you will need to learn how to count them and you will also need to start self monitoring your blood glucose level and keep a food diary. By testing before and two hours after a meal you will be able to educate yourself on what foods you should avoid or restrict in order to keep your glucose under control.

If you give as an indication of a typical day's diet, people here may be able to make constructive suggestions on how you could change it to improve glucose control.

You should increase your level of physical activity. Walking is very good in this respect and you should aim for about half an hour per day.

If overweight, you should aim to lose weight. Fat is much more insuline resistant than muscle so reducing weight and increasing body muscle has a beneficial effect on glyceamic control.

You should also try to avoid highly stressful situations as stress also causes glucose levels to rise.

With regards to drink, this should not be taken in excess as alcohol lowers blood glucose and in excess could cause hypocglycaemia. I believe that a couple of glasses of red wine per day, especially if taken with food, is meant to be an antioxidant and good for you.

As diabetes is not the only condition you have to manage, and as most of the people on this forum will probably not be familiar with your other conditions, you should take care that in following advise to manage your diabetes, you do not adversely affect these other conditions. You will need to discuss this with your doctors.

Once again wellcome and best wishes for the future.

Regards

 

[totsy]

hya and a warm welcome to the forum,
for starts as already said ,what is a typical days food for you? see if we can help,
also some of the meds u take can higher bloods too(i take some of the same) but obviously u need to take these,
have a good look around and ask anything u like

 

[peejay]

First of all, thanks for the replies..

In the morning I'll have either 2 x wheetabix, 2 x shredded wheat, musli or scrambled egg on 2 toast with a cup of tea.
mid day would be a sandwhich, brown bread with either paste or cheese (low fat), onion or tomatoe and another cup of tea.
evening meals normally consist of normal family meals, ie chips, mash, boiled potatoes or roasted, fish or fish fingers, lots of veg, spagetti bolognaise, chicken etc... but usually about the size of a childs meal, and a cup of tea.
I do have tea inbetween meals which maybe I should cut down on - I forgot to mention that I do have some sugar in tea, a level tea spoon. I have tried sweetners in tea and found it disgusting as with having no sugar, but I have gone from 2 spoonfulls to 1 level spoonful, so I'm slowly getting there..

If anyone could give me an idea of their daily intake would be appreciated....

manny thanks..

 

[pavlosn]

Hi again Paul

As stated earlier the main foods leading to a rise in blood sugar levels are carbohydrates, both sugars (simple carbohydrates) and starches (complex carbohydrates). I have identified foods in your diet which are high in carbohydrates in bold below.

"

First of all, thanks for the replies..

In the morning I'll have either 2 x wheetabix, 2 x shredded wheat, musli or scrambled egg on 2 toast with a cup of tea.
mid day would be a sandwhich, brown bread with either paste or cheese (low fat), onion or tomatoe and another cup of tea.
evening meals normally consist of normal family meals, ie chips, mash, boiled potatoes or roasted, fish or fish fingers, lots of veg, spagetti bolognaise, chicken etc... but usually about the size of a childs meal, and a cup of tea.
I do have tea inbetween meals which maybe I should cut down on - I forgot to mention that I do have some sugar in tea, a level tea spoon. I have tried sweetners in tea and found it disgusting as with having no sugar, but I have gone from 2 spoonfulls to 1 level spoonful, so I'm slowly getting there..

If anyone could give me an idea of their daily intake would be appreciated....

manny thanks..

Reducing your intake of carbohydrates should, all other things being equal lead to reduced blood sugar levels. Most of the people on this site choose to pursue such a reduced carb approach to controling their diabetes, reducing their intake of both sugar and starches, even if this is contrary to the advice "to eat plenty of starchy food" often given to diabetics by the medical profession in the UK. In fact some here (the low carbers), though certainly not all, even choose to eliminate such foods completely from their diets.

We are all different and are bodies vary in the amount of carbohydrates and the type of carbohdrate intake they can cope with. For instance, I find that eating cereals causes my blood sugars to spike while fruit has no such effect. The only way tofind what works for you is to experiment with food, testing your blood sugar before and two hours after each meal, to find out more about how diferent food affects it.

As you ask here is what a typical day's diet is like for me but be warned that it probably contains more carbohydrates than a lot of other people's I have seen listed on this site.

- Breakfast: 1 slice of toast with a small piece of cheese and a glass of milk, a couple of black olives and a cucumber and tomato.
- Morning Snack: 1 Fruit (apple, or orange ,or 12 grapes or 15 strawberries or half a small banana) or one crispbread
- Lunch: 1 Small piece of lean chicken pork or othe meat or fish (size of a deck of cards), plenty of salad (about half my plate) either two tablespoons of rice or two small (walnut size) potatoes or two tablespoons of pasta or six tablespoons of bulgur wheat or six tablespoons of beans or other pulses. One fruit
- Afternoon Snack: 1 Fruit (apple, or orange ,or 12 grapes or 15 strawberries or half a small banana) or one crispbread
- Dinner: 1 Small piece of lean chicken pork or othe meat or fish (size of a deck of cards), plenty of salad (about half my plate) either two tablespoons of rice or two small (walnut size) potatoes or two tablespoons of pasta or six tablespoons of bulgur wheat or six tablespoons of beans or other pulses. One fruit.
- Evening Snack: 1 Fruit (apple, or orange ,or 12 grapes or 15 strawberries or half a small banana) or one glass of milk

I would normally advise any diabetic to control his diabetes through controlling/reducing their carbohydrate intake. Although I believe that this should help reduce your blood sugar levels too, I hesitate to recomend it in your case as I know nothing about the other medical conditions you list and what effect, if any, such a carbohydrate reduction would have on them. Still I think that the above information should be good for you to know if nothing else to allow you to discuss treatment options with your doctors.

Regards

Pavlos