newly diagnosed- advice please

I wonder if they get more 'points' for treating a diabetic than a not quite fully over the top one.
In a few weeks you could be back to normal, but when I did that - well my doctor seem to be sulking, I've not seen him since 2016.

Welcome to the forum @IPA, I would take action now to reduce your blood glucose levels so that you are in the pre-diabetic or possibly even in the non-diabetic range when you are re-tested.
You don't need a dietitian to tell you what you should eat. it's fairly obvious you need to cut out sweet sugary foods and drink.
But also you need to avoid or reduce as much as possible consumption of starchy carbohydrates which turn to sugar quickly in our bodies, so aren't good for Type 2 diabetics and pre-diabetics. The main culprits are bread, potatoes, pasta and rice (and beer if you are a drinker).
Have a read round the forums and ask any questions you want, the people on here are friendly and supportive.

Beer was tough for me too. I used to go to the pub most nights for a pub meal and 3 or 4 pints of 'real ale'. And that almost certainly contributed to my T2 diagnosis. I stick to red wine usually now.

Edit: I just realised your username 'IPA' might be beer related!
Beer is known to diabetics as 'liquid bread'.

IPA said:

Thanks for the all the advice. since the first test ive sort of cut back on carbs and added more protein but it gets confusing when it comes to fat. My thinking is a diet plan would take the stress out of it and id just follow it and keep things simple. that said beer is gonna be very tough.

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The fat is really to compensate for the calories you are not getting from carbohydrates so that you are not hungry. I don't have fat on purpose but meat with fat on, plenty of cheese, eggs, butter and cream seems to work. I certainly don't have anything labelled "low fat" but then I never did, as the taste always seemed to be inferior to the full fat version. I have a beer most weekday evenings (red wine at weekends) but I stick to one can.

If you choose to buy a meter here’s some info and to be clear I have no commercial connections with any of the companies mentioned. For a meter with cheap strips go for the Tee2 + found here:

http://spirit-healthcare.co.uk/product/tee2-plus-blood-glucose-meter/ with the strips found here:

http://spirit-healthcare.co.uk/product/tee2-testing-strips/


With more expensive strips is the Caresens Dual which I currently use, this one has the advantage of glucose and ketone testing in one machine, it’s to be found here:

http://spirit-healthcare.co.uk/product/caresens-dual-blood-glucose-and-ketone-meter/

With the strips here:

http://spirit-healthcare.co.uk/product/caresens-pro-blood-glucose-test-strips/


And to be totally transparent I used to use the SD Code Free which has the cheapest strips available. However I found it to be becoming less and less reliable. Here it is for anyone wanting to give it a go:

http://homehealth-uk.com/product-category/blood-glucose/blood-glucose-monitor/

and here for the extra strips

http://homehealth-uk.com/all-products/sd-codefree-test-strips-to-be-used-only-with-the-sd-monitor/

There are discount codes if you buy in bulk.

5 packs 264086

10 packs 975833


Don’t forget to check the box that you have diabetes if you do, so you can buy VAT free. (for all meters and strips)

Antje77 said:

This part might not work without a diagnosis...

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That’s why I put “if you do”

IPA said:

Hi Guys

My first test a few weeks back showed 7% and my recent hba1c test showed 48 which puts me just on the cusp between prediabetes and diagnostic diabetes. The doctor wants me to wait a few weeks then test again to see which one and when i asked about seeing a dietitian he suggested i wait to find out which one first.

is this good advice? id rather start making changes asap, as the way i see best case scenario is prediabetes so i should just crack on with lifestyle changes today rather than weight in limbo for another month.

should i wait as the doctor says or find myself a local dietitian or diabetes specialist myself?

Thanks for any advice.

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No time like the present, especially where your health is concerned.

@IPA
Hello and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it interesting and helpful.

BASIC INFORMATION FOR NEW MEMBERS

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.
  

IPA said:

ive transfered to brew dog nanny sate for week nights! i also brew beer for a hobby so not sure if i'll have to give that up? my drinking levels were/are similar to what your were. i like red wine but much more prefer ales. If i allowed myself just one night a week of 4 or 5 pints would that be allowable?

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Well I wouldn't consider drinking 4-5 pints even once a week. I do meet a couple of friends every 6 months or so and drink 3-4 pints then (I like London Pride). Actually when I've tested the next morning it hadn't raised my fasting blood glucose much.
I do think though that drinking beer regularly increased my belly fat which would have increased the visceral fat around and in my liver, which in turn would make my insulin resistance worse.
The only way to know how it affects you is to test. That might be difficult after drinking 4-5 pints, but test the next morning to see how it compares with your usual fbgs.
You could always adapt your hobby from brewing beer to wine making!

I don’t drink at all, never have, but has anyone ever seen what difference the non-alcoholic lagers make to fasting blood sugar when set against the “real deal” ?

IPA said:

If I allowed myself just one night a week of 4 or 5 pints would that be allowable?

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Hi, IPA, I'm T1 so the rules for me are different, as I can inject to deal with it.

As you'll have noticed, beers don't have a carb count on the bottles, but Carbs & Cals puts a pint of real ale at about 17g.

There's a few sites which report carb count for a range of beers, don't have the links to hand.

I have, ahem, a few pints on Friday and Saturday nights. I have to pre-bolus (inject insulin about 20 mins before first sip) and the first pint or two can still heavily spike me to about 8 or 9 before settling back down to a neater 5 to 7 with a bit of insulin stacking (repeated injections with each pint).

One of the things to be aware of is that the liver normally releases stored glycogen as glucose to fuel our energy needs between meals, but when alcohol is involved, it switches priority to processing the alcohol and shuts down releasing glucose.

For T1s, that can get messy in the early hours as our basal slow acting insulin continues to work dropping our levels in the absence of glucose from the liver, which is why a bit of cheese on toast before bed is a good idea for T1s after a night out.

For T2s, I suppose the liver shut down combined with the fact that T2 biology still has an operating insulin production system which notices bg levels could result in decent waking levels after a few drinks, but whether achieving that through regular drinking is questionable, and you'll likely still have the big spike while drinking but that depends on how well your beta cells are working and how "bad" your insulin resistance is.

So, like the others say, no way of knowing without testing.

As a T1, I don't sweat the occasional brief beer induced 8 or 9, but if it was putting me into the 12 to 15 range, I'd rethink that.

Spikes to 8 or 9 from fast carbs are normal even in non-Ts, so I'd be cautious about ruling out beer altogether - we're not machines and very often looking at the numbers alone misses the social/psychological aspects of the occasional treat - both T1s and T2s are having to do this for decades and it would be a miserable unsustainable way of living if we couldn't bend the rules a little every now and then.

PS: As you're a beer fan, thought I'd mention Pilot Brewery, couple of young lads got their degrees in brewing from Heriot Watt University, set up their own brewery on a shoe string budget just down the road from me, and are churning out an excellent range of unfined beers. Will be enjoying a couple later! We've got two Brew Dog pubs in town, but they're starting to become "mainstream" now!

https://pilotbeer.co.uk/our-beers-3/

I don't know if all this discussion of beer was triggered by my post where I said I have a can of beer most weekday nights. If it was, I should point out that I am not saying that it is a good idea and certainly not for everyone. In my case I can keep to a mid 30's HbA1c with a fairly liberal 70-80g of carbs per day and the beer is included in the count.