Hi there, and welcome to the board.
The first thing that you need to realize is that unless you are talking to a diabetes specialist, or an unusually enlightened GP or nurse then they probably won't know a huge amount about diabetes. I hastily add that I am not meaning to criticize GPs and nurses here - they can't be expected to have specialist knowledge in every area that they encounter. However, this does mean that the "standard NHS" advice that you usually get is what the medical textbooks say - and that is somewhat dated, to say the least.
This all means that you need to read a lot and become your own specialist. The only way that you will get really good healthcare is to be in a position to make your own informed decisions. This forum is a great place to start getting this knowledge - delve around through some of the old threads. There are also a number of good books out there (as well as some dodgy ones) - you will see many references to them on this forum, or post if you want advice.
MalcNascar said:
Met diabetic nurse for first time last Monday and prescribed Metformin because my diet was regarded as generally healthy.
Metformin is a widely used drug for T2s - it should bring your BG down quite quickly. However, it does have side effects and since many T2s manage to control the diabetes by diet an exercise alone that is probably something worth striving for. From what you have said, it doesn't sound to me like your diet is a very good one from the point of view of diabetes control. If you make drastic changes to your diet and start to exercise more, then you will quite likely find that you would be able to dispense with the Metformin quite quickly.
MalcNascar said:
I eat loads of fruit and veg, love meat, fish, cheese etc. However, I also eat a lot of carbs
Meat, fish cheese and veg are all good stuff. Fruit is OK in moderation, but you need to be a bit careful about it because it does contain a lot of sugar. However, I really think that you should try cutting down substantially on the carbs.
MalcNascar said:
I will have weetabix or porridge or shredded wheat for breakfast;
How about bacon or eggs (or both). Cereals, porridge and bread all contain a lot of carbs and certainly all do bad things to my BG!
MalcNascar said:
lunch is more often than not a salad cob with some meat and yogourt;
I suggest avoiding the bread. How about a mixed salad with meat and yoghurt. BTW check the ingredients of yoghurt, a lot of them contain a surprising amount of sugar. I make my own using one of the unsweetened
EasiYo bases - then I can be sure what goes in it!
MalcNascar said:
dinner is traditional uk meat and 2 veg with potatoes or pasta and sauce or rice based dishes.
Meat and 2 veg is fine, but I would cut out the potatoes, pasta and rice. I suggest that you generally get used to substituting a salad for these. You can make a surprisingly good virtually carb-free rice substitute by grinding a cauliflower until it is the consistency of rice and then microwaving it for about 5 minutes. You can then add an egg to make fried rice or use it as a rice substitute for most purposes. It goes well with curries.
MalcNascar said:
My BS was 17 at diagnosis, however, nurse is not advising I monitor at this time.
I am confused as to why she is not wanting me to monitor BS levels, is this normal for newly diagnosed? :?
:evil: :evil: :evil: This makes me very cross. Unfortunately it is quite usual these days for T2s to be strongly discouraged from self-monitoring, and this is something that I (and I think most people on here) will consider to be very bad advice. The charitable interpretation of why she doesn't want you to monitor is that there have been some recent studies that show that self-monitoring isn't cost effective and doesn't improve BG control or reduce the risk of complications. However, the cost-effectiveness argument is not a good one if it is
your health that you are talking about! The study that purports to show that it doesn't improve BG control is actually really badly designed and all that it really shows is that if people don't take any notice of their BG readings then they don't get any benefits from monitoring (as one wit commented - "this work deserves a Nobel prize for the blindingly obvious!").
The rather more cynical view on why you are being discouraged from monitoring is cost. If you are told to monitor then you will have to be prescribed strips, these are expensive and I have heard stories that PCTs are discouraging GPs from prescribing them to T2s. I quite strongly suggest that you get a meter and start monitoring - ideally persuade your GP to prescribe them, but I have never had any joy there and I buy strips off e-bay (the going rate is about half the high street price). Monitoring will allow you to track your progress, and it will also allow you to experiment with your diet and learn what you can and can't eat (everyone is different, and you need to learn what works for you). Eventually, when you are sorted out, you will probably need to monitor very occasionally, if at all, but while you are learning to adjust to your new lifestyle then monitoring will help a lot.
MalcNascar said:
Reading threads on diet, am I eating to many carbs and what on earth do I replace them with?, I cant afford to loose weight. :shock:
Eat low carb things that you like. Meat, fish and cheese are all good, as are eggs, nuts, green vegetables and salads. Fruit and yoghurt and milk are OK in moderation, and don't be afraid of fat (its dangers to health - still espoused by much of the medical profession - are dramatically overstated, and I can give you a
lot of references to the scientific literature on that if you are interested). In fact if you are concerned about loosing weight, then you could maintain or increase your energy intake by increasing the amount of fat and protein you eat.
What I suggest you do is the following (this has worked for me and, based upon my reading, I think that it will work for most T2s).
- Buy a monitor and learn how to use it. Initially just measure your BG once per day, before breakfast.
- Temporarily (probably just for a couple of weeks) go on an extremely low carb diet (i.e. absolutely no sugar, and as far as possible no obvious carbohydrate). Don't worry if this is going to be hard to maintain, it will only be for a couple of weeks until you normalize your BG.
- Once your morning BG is normalized (i.e. consistently well under 7mmol/l and preferably under 6) then you can start experimenting with food. Measure your BG immediately before eating and again one and two hours later. You need to look for patterns, and learn how various foods effect your BG - what you are aiming for is to keep it stable and low for as much of the time as possible, whilst eating as interesting things as possible. It is a trade-off, but gradually you should be able to learn how to create a personal diet that you can live with permanently.
- If you have a stable and normalized BG when you are on a low carb diet then you might like to try coming off the Metformin. If you do that then monitor carefully, and if your BG shoots up start taking the tablets again. However, unless your pancreas is really badly damaged, then there is every chance that you will be able to control the diabetes without it.
Lastly, don't forget to exercise. That is probably at least as important as diet, and you should aim to be doing at least 45 minutes of moderately strenuous exercise per day.