Newly diagnosed and a little overwhelmed

Hi and welcome Hope your injury heals quickly....not a great start for you. Here on the forum you will find lots of useful advice and info that will help you on your way. I will @daisy1 and she will send you some great info to get you started...have a read through it and then come back with any questions. Loads of great people here to help so feel free to ask as many questions as you need to

Hi and welcome it can seem daunting at first but there are loads of great members here and as Gezzabelle said just ask as many questions as you need to

@rhedgehog

Hello and welcome to the forum. Here, as mentioned above, is the information we give to new members and I hope you will find it useful and helpful. Ask all the questions you like and someone will try and answer.


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 over 150,000 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-and-whole-grains.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 bloodglucose 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.

Hi and welcome. I'm worried that you had NHS diet advice as so often this is the opposite of what you should do. Follow Daisy'd advice and redcue the carsb way down. Set a daily max of, say, 150gm and even less if possible. You need to have enough protein and fats (yes, fats!) and veg to keep you feeling full. It's apity you can't exercise but diet is always the key. The Metformin will help a bit to reduce the insulin resistance you will undoubtedly have. A meter is essential for you to take control and see what foods affect you and by how much. If the weight doesn't come down enough, the GP can prescribe a weekly injection of something like Victoza which is targeted at those withe excess weight. Do discuss with him if needed to check it will suit you.

rhedgehog said:

Some background:

I have major weight issues (all self inflicted) and went to the doctor at the end of June (on my 35th birthday of all days) to check me up before i started a diet and hopefully to get some help and support. I'd got to a ridiculous 200kg and a BMI of 57 so after a few previous aborted attempts thanks to useless GPs, i got up the courage to try again.

Had a raft of blood tests including non fasting glucose and AC1. Glucose was high (wasn't told how much) but AC1 was 51 so was diagnosed with T2. When i last tried this in 2010, i only had some liver issues, so it's a recent development and they tell me they think they caught it early on.

Unfortunately, in the week between the blood tests and going back for the results, I ruptured my Achilles tendon and so was put straight on 1500mg of metformin a day and sent to the A&E to get my leg in plaster. Of course they wouldn't operate because of the T2 diagnosis, so i am now about 8 weeks into wearing the boot and waiting for about 6 months of physio to start.

I have begun my diabetes education meetings which are hosted at the local library, but I can't get onto any exercise classes or much else until I can walk again.

Once the final meeting is over next week, hopefully then I can discuss with the GP to get everything sorted out like BG monitoring rather than just the one a day urine strip, and all the rest of the things I need to start doing. Seems that so far, apart from a few specifics on diabetes, the meetings have mainly been with a dietician and all just basic good diet advise (which i need anyway, but I was hoping for more insight into diabetes specifically). I'm hoping once they are over and I can get some appointments with the DSN, i might be able to start understanding this a little more.

Somehow, despite being unable to walk or exercise, have managed to lose 8 kilos in 10 weeks and my last ac1 two weeks ago was down to 48, so not all bad, even though i haven't even really started to get my head around it all.

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Welcome to the club you never wanted to join. Glad you found the forum.

I was previously 140kg with a BMI of 46, so I feel I can relate a bit to being morbidly obese. Through low carbing, learned on this forum, I lost 55kg in one year and my BMI was 27. It felt amazing! Since then I let carby foods slip back in and have gained quite a few kilos... so got back on the wagon 10 days ago and have lost 2kg already. My target BMI is 27 then I might see if I can push through to 22.5

A doctor suggested bariatric surgery once... but I wasn't convinced the risks were worth it. I have since found that for people under say 200kg, it is possible, and safer, to lose weight by reducing carbs/calories.

Exercise makes very little contribution to weight loss. It does help with blood sugars, mood, building muscle and general wellbeing. If you are using a boot, you might be able to aquajog or swim? You can also do arm weights while seated. This is an excellent exercise for building muscle, which really helps with blood sugar management. You don't need to buy fancy weights, just use tinned food or something You can also get stretchy bands from a sports shop. Just moving about the house and doing housework is exercise; you'd be surprised how much that is helping. And carrying excess weight also burns calories.

Getting a blood glucose meter will really help you get your blood sugar down and lose weight. It's hard for T2s to get free testing strips in the UK, so you may need to buy your own meter and strips. The cheapest strips are with the SD Codefree meter, available here:
http://www.homehealth-uk.com/medical/blood_glucose_monitor_testing.htm
You may need a lot of strips initially. There is a discount code if you buy 5 or 10 boxes, which brings the price down to about £5 for 50 strips.
5 packs 264086
10 packs 975833

For many years I blamed myself for being obese and getting T2. But I was ignoring the genetic part of the equation. It's quite possible that our bodies developed insulin resistance then we gained weight then became diabetic. There is a theory that the process can take about 10 years, and it seemed to in my case. A person with diabetes who has done a lot of reading, and writing, about it, Jenny Ruhl, wrote about this at her website, Blood Sugar 101:
http://www.phlaunt.com/diabetes/14046739.php

One more thing... with your BMI you may have some obstructive sleep apnoea, so you might want to ask your GP to refer you for a sleep study. It's very common in people with a BMI over 40, especially those who have T2 diabetes. Getting it treated can make it easier to lose weight, and reduce fatigue and daytime sleepiness.

Welcome to the forum, it's an excellent resource.

Hi there and welcome.

I am fairly new here as well (everyone is great). Its all very confiusing and overwhelming at first but that feeling does get better. I too am morbidly obese and have played around with diets for years, all of them (apart from juice ones as I am too much of a pig)!. I have started low carbing and although its a bit hard at first as you feel a bit grotty whilst your system gets used to it, I can homestly say I feel so much better. I rarely feel hungry. I do miss the pasta as I was a great lover of it but if you look at all the recipes and food ideas on here it gives you lots of options. I have been doing this properly for about two weeks and have lost 4kgs, not a huge amount but not bad for me

Keep asking questions, they are a friendly bunch on here and nobody bites

Deb

rhedgehog said:

Thanks for all the replies guys, it's been very helpful.

I do tend to wake up frequently in the night, but it's very rarely a shock or uncomfortable, it seems to be every 90 minutes almost on the dot, so it just seems to be my natural sleep pattern. i was the same even before i put all the weight on, so i don;t think i am suffering from any apnoea, but it's certainly something to discuss with my doctor once this **** boot is off and i can start to discuss the weight loss properly with her.

....

I know i have a long way to go, and i'm getting conflicting advise locally on whether to concentrate on my diabetes first, or losing the weight, but i guess if the LCHF diet can do both, then that's my best bet. If i can somehow get back to my original weight of 90KG, i'll be over the bloody moon!

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Some people with sleep apnoea are aware of their awakenings but most aren't. Unless someone tells them they snore and stop breathing for short periods then gasp, they can go for years without knowing there is a problem with their sleep. Some of the common symptoms are excessive daytime sleepiness, fatigue, headache first thing in the morning, needing to get up during the night to urinate, increased appetite, and difficulty concentrating. There is a screening test, in the form of a short quiz, that many doctors use. If the questions don't ring much of a bell for you then you might be ok:
http://epworthsleepinessscale.com/1997-version-ess/

I too struggled with whether to focus on diabetes or weight at first. I have found that if I reduce carbs and see my blood sugars go down, the weight just falls off. I believe you can get back to 90kg. Probably lower if you want to and it's appropriate for your height. You can do it! You are on the right track.

GPs like to go for quick fix diets and weight loss.
Dr Asseem Malhorta a leading cardiologist states a longterm mediterean diet is best for weightloss. He was on TV a couple weeks ago.. Theres a couple of postings about it on the forum.

Hello and welcome to the forum,I cant add to the advice you have been given,but stick with us and ask all the questions you need,
You are not alone.

I hated mackeral and salmon and avocados and olives!! Now I eat oily fish 2 times a week-would eat more if the advice said we could.. But it says only 2 portions- less if pregnant..
I just started off with 3 olives cut in half. Made sure we bought ones with feta cheese. Avocado I tried 1/4 then built myself up. Fish too. First time hubby shredded it for me so it didn't still look fish shape. I put on a bit of chilli garlic ginger sayce initially to disguise the tastes...now with the llashings of oil dressing I make then I have now got used to the tastes and love all the salads. We have lits of variety with spinach and rocket leaves, home grown lollo lettuce, cucumber, onions, pepper, tomatoes (I never used to like them either unless they were in a bolognese. Then the other avocado, olives and fish with liads of dressing. Its so lovely. Hubby makes it everyday for me and leaves in the fridge for me to have in the evenings. Sometimes we have a few julienned carrots and I'm just trying out beetroot now as well.
There is no room on the plate for potatoes, coleslaw etc...
We used to sprinkle nuts over but nowadays I will sprinkle a few sunflower or pumpkin seeds over before I eat. Then you could make mayonnaise if you needed more fat...lovely too with boiled eggs. Always adding more feta cheese (goat or sheeps).

I have this 5 days a week the other 3 days I have with cod, haddock or plaice. May have to be 6 days a week now as my stomach n bloods don't seem to tolerate red meat Other food I love is duck wrapped up with same salad but small portions in lettuce wraps but I do have a but of hoisin sauce on this..


We have this in winter too!!

I cannot have any potatoes of any kind. I am finding that my tastes have changed since I went LCHF and am eating things I never liked before. I hated yogurt now I eat it at least three times a week, didn't like salads now I do. Weird.