Newly diagnosed, by luck

[AlanC]

I have recently been diagnosed with Type 2 at the age of 61 (and my cholesterol was 7.2 ), and I have just had my first check-up. I only had a blood test after seeing my doctor for an unrelated problem (a lump in my armpit from a hair follicle problem). I am not happy that I only came to be diagnosed by accident - I think the NHS should give more routine test, especially to older people. I was surprised to be diagnosed with diabetes because as the nurse said, I am not a typical patient as my body mass index is 22.3. I also eat reasonably healthily, without being too religious about it, and I didn't have any obvious symptoms, although with hindsight they were there - slightly thirstier than normal, and occasionally itchy feet for perhaps a year, which seems to be a little-mentioned symptom that I had not been aware of. The only thing I was doing wrong was lack of exercise, but now I have bought an exercise bike and ride it while I watch Pointless on BBC1 - exercise is boring by itself.

I guess I am not alone in doing a lot of Googling for more info, and I am finding it all very complicated and contradictory. Also, some of the information is almost baby-talk, some is technical and esoteric, not much is pitched in the middle. The many different types of fat and their relevance is very hard to decipher. One thing that puzzles me is the map on Wiki for Type 2 diabetes, which shows that Spain, Portugal, Italy and Greece all have higher rates of T2 than most other European countries. Isn't the Mediterranean diet supposed to be healthy?

Another thing that I am unhappy about is the claims that it is caused by obesity, lack of exercise, etc. To me, a cause is something that is guaranteed to give you a disease. These so-called causes are really only risk factors that merely make you more susceptible, somehow.

So I feel I need to learn a lot more about this complicated and puzzling condition, hopefully this site will clarify things for me.

 

[librarising]

Welcome Alan !

Just off to bed, check latest posts, and there's yours !
So a quick reply. Hang around and you'll soon find there's a traditional NHS approach to diabetes, which involves basing meals around starchy carbohydrates. This doesn't work for many since carbs will push up blood sugar levels, and your future health depends on keeping them down. Quite a few adopt a low-carb high fat diet, either against a lot of HCPs advice, or it's done in their ignorance. Some HCPs are coming to see the benefits of a low-carb diet, but too few at the moment, sadly.

I'd recommend you get yourself a blood sugar meter, if you haven't already. This will let you identify which foods are the ones to avoid.

Have you been put on a statin ? Some here, like myself, are staunchly against them. Others are ok with them, and tolerate them.

We can point you towards whatever research you want. It's your diabetes, and your call about how you treat/control it.

Geoff (off to bed)

 

[MaryJ]

Welcome Alan

I was also diagnosed by 'accident', I ws 43 and shocked.

I consider it lucky I was.

Agree with Geoff re get yourself a meter, you need to know how foods affect you. It does all seem a bit daunting at first but it settles down

Mary x

 

[daisy1]

Hi Alan and welcome to the forum.

Here is the information we give to new members and I hope you will find it useful. Ask all the questions you want as there is always someone who can 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.
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Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.

 

[dawnmc]

Hi Alan, welcome to the club, I agree there doesn't seem to be anything pitched in the middle for people to understand. I'm still finding it confusing even 10 mths after diagnosis.

 

[AlanC]

Thank-you everyone for your replies!

To answer Geoff, I am on Atorvastatin (40mg per day), plus Gliclazide, Metformin and Ramipril. The only side-effect is a slight loss of appetite, which I am told is temporary.

I have to admit that I do not understand the need to modify my diet. My medication improves my insulin sensitivity and blood sugar levels, and also my cholesterol level and blood pressure, so what should I be trying to achieve by diet which the medication doesn't? Will I be able to eliminate some of the drugs if diet change improves my physiology? I have started to reduce my fat intake considerably as this is said to reduce total cholesterol and improve insulin sensitivity, but some kinds of fat are also said to improve sensitivity, so I don't know if this is the best approach.

 

[BioHaZarD]

Thank-you everyone for your replies!

To answer Geoff, I am on Atorvastatin (40mg per day), plus Gliclazide, Metformin and Ramipril. The only side-effect is a slight loss of appetite, which I am told is temporary.

I have to admit that I do not understand the need to modify my diet. My medication improves my insulin sensitivity and blood sugar levels, and also my cholesterol level and blood pressure, so what should I be trying to achieve by diet which the medication doesn't? Will I be able to eliminate some of the drugs if diet change improves my physiology? I have started to reduce my fat intake considerably as this is said to reduce total cholesterol and improve insulin sensitivity, but some kinds of fat are also said to improve sensitivity, so I don't know if this is the best approach.

Hi

The idea and need for changing diet is so you don't have any complications and can maybe lower the drug intake, I have now come off my medication and using diet only to control my diabetes. I am eating a low carb (no bread, pasta, rice or potatoes) though some eat a little, and a high fat diet. Eating fats (real butter, cheese, cream) gives you energy rather than getting them from carbs and I don't put weight on, in fact I loose weight. Low fat products contain more sugar and carbs. My cholesterol has also come done to normal levels.

The NHS will tell you to eat carbs with all meals and give you meds, which long term is not good and will lead to more meds and inventually insulin.

Please read this forum and take advice, you will improve for the better not like the advise from the NHS.

 

[librarising]

AlanC wrote
I have to admit that I do not understand the need to modify my diet.

Here's why many here don't follow NHS guidelines

Results for England. The National Diabetes Audit 2010-2011
Percentage of registered Type 1patients in England
HbA1c >= 6.5% (48 mmol/mol) = 92.6%
HbA1c > 7.5% (58 mmol/mol) = 71.3%
HbA1c > 10.0% (86 mmol/mol) = 18.1%

Percentage of registered Type 2 patients in England
HbA1c >= 6.5% (48 mmol/mol = 72.5%
HbA1c > 7.5% (58 mmol/mol) = 32.6%
HbA1c >10.0% (86 mmol/mol) = 6.8%

We feel diabetics should be aiming for HbA1cs in the 5s or low 6s. To allow nearly three quarters of T2s to have an HbA1c of 6.5 or over is, in our minds, scandalous.
We believe it's all caused because they hold on to their 'meals based around starchy carbs' line. Carbs push up blood sugar.
Reducing carbs reduces blood sugar spikes, and HbA1cs go down. There are loads of success stories on this forum from people using low-carb as a treatment option. They often reduce or eliminate their reliance on medication.
Carb restriction was used 100 years ago. Unfortunately saturated fat came to be demonised :

http://www.dietheartpublishing.com/diet-heart-timeline

and if fats were reduced something had to take their place - enter so-called 'healthy' carbs and vegetable oils, and the health crisis we have today.

The NHS line is that diabetes is progressive. Low-carbers believe that their dietary approach holds it in check, but that a carbs-based diet with its necessary medication will make it progressive, or harder to control.
Not all low-carbers are happy to go high fat, but there is little evidence to suggest that saturated fat is bad for you, and increasingly people are coming out saying that all the concern about cholesterol is misled.

I have researched current understanding virtually every day since my diagnosis (Nov '11) and can remember reading "saturated fat is good for you" and thinking that can't be right. I've now ditched vegetable oils, upped my fat intake, and
eat plenty of meat, eggs, animal fats etc.

As regards cholesterol, carbs are the worst thing for affecting them, and adjusting your lipid profile badly (HDL, LDL, triglycerides)

I'll end there before you suffer from information overload.

Geoff

 

[shazznay]

I have recently been diagnosed with type 2. My first appointment with the DSN was yesterday. I had hoped it would be a helpful consultation but I came out feeling confused and depressed. She spent a lot of the time describing what sort of complications I had to look forward to. Losing feeling in the feet and suffering scalding getting into the bath. She had seen some appalling burns apparently! Toes being amputated. Suffering a stroke or heart attack as I also have high blood pressure and the two go hand in hand. Renal problems, the list goes on.
I am not stupid, I had realised that this disease bought with it a lot of problems but I feel there was no reassurance whatsoever.
The info she gave me on diet was very vague. Eat healthily, more fruit and veg etc. I pretty much follow that sort of diet anyway. But having researched various advice avenues I have pretty much decided to go down the low carb route.
I am taking metformin and since I have been taking it I have found my appetite has decreased naturally so hopefully it will not be too painful.
I am so glad I have found this forum as I was feeling very down about the whole situation.

 

[Paul_c]

In olden times (pre low fat, all sat fats are bad days) type 2 was associated with old age as, basically, your pancreas had finally worn out.