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Newly diagnosed looking for advice

T

T2 Woman

Active Member
Messages
25
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi everyone. I was diagnosed diabetic (I presume type 2 although nobody has actually said it yet) just before Christmas after an HBA1C test result of 101. I have long suspected I might be, due to having all the classic symptoms of diabetes so I asked to be tested when at my GP for a possibly related ongoing infection (still ongoing) which I’m told may resolve itself once I get my blood sugars under control. I’m 54 years old and overweight having had a very high carb and sugary diet previously. My GP started me on Metformin 2 x 500mg tablets daily with breakfast and dinner which I have just built up to gradually. I think they are causing major gastric issues but I have bowel issues usually anyway as I have bile salt malabsorption and IBS, so I’m trying to stick with the meds in the hope they will help in some way. Doc did say I can abandon them if I truly cannot tolerate. I’ve taken a lot of advice on board from extremely helpful posts and answers on here and I guess I’m just eager to find out more before I have an appointment with the practice nurse at the doctor in a few days time. Will this just be a general weight, bp, cholesterol testing appointment? Do I actually get referred to a specialist diabetes nurse/clinic? Or is this just a substitute for that due to NHS cuts? Will they advise me on how many carbs I can eat per day based on BMI etc and the HBA1C result and what my numbers post meal should be? or do I just have to guess at this myself until I get my own glucose meter? I have read up on low carb suggestions on the forums here and at the moment (after reading one persons experience here) I’ve been trying to stick to less than 180 carbs per day to start. I have cut out all “free” sugars (massive misnomer!) No cakes, biscuits, sweets, fruit juice etc which have made me feel quite hungry despite upping fats and protein. At the moment I am still having 2 weetabix (recommended on here as the least bad carb cereal) for breakfast with semi skilled milk and sweetener, usually eggs and 2 slices of whole grain toast spread with Benecol for lunch with protein either Steak/Chicken/Fish and veg/salad for dinner. Sweetener in tea with semi skimmed milk about 3 times daily and an occasional sugar free jelly or 5 carb yoghurt as dessert or snack. My indulgence has been 2 Rich tea biscuits of an evening around 12 carbs. So far I have managed to be under every day to varying degrees depending on how hungry I’ve been. Is this way too much carbs? I’ve started with this on the guess that I will have to reduce once I start testing, but I didn’t want to kill myself in the first weeks and lose motivation straight away. A friend diagnosed a year or two ago is heading for a bad outcome after going totally off the rails. I had spoken to him hoping for some hints and tips and he couldn’t give me any as he had given up and was carrying on with his old eating habits. I want to get a meter asap and have looked at recommendations here but was waiting till my appointment with the nurse to see if they also had any input for me. Apologies for the long and rambling post but I’d be most grateful if anyone can comment with how many carbs they are having daily and how much they can tolerate to stay within their limits so I can see if I’m in the majority or minority. I know I won’t get the full picture till I start testing. Just want to know if I’m heading in the right direction or I’m way off. Thanking you all so much in advance for any help you can offer me. I was hoping I could at least fit some carbs into my diet after hearing about someone sticking to within 45-60 carbs per meal.
 
Hi @T2 Woman and welcome to the forum.
Have you read this (Jo Kalsbeek's wonderful 'nutritional thingy' : The Nutritional Thingy. | Diabetes Forum • The Global Diabetes Community

You may be lucky and get good advice from your healthcare professional. It's not possible to predict either what diabetes specific knowledge they will have, or how up to date that will be. People still arrive here telling of absolutely terrible advice they got through their local GP practice.

Unless they prescribe Gliclazide or Insulin for you then you are very unlikely to be prescribed a Blood Glucose Test meter. Even if on is prescribed, most of the NHS doesn't know how to use it in relation to a lower carbohydrate way of eating. Notice I said 'way of eating' rather than diet. This is because it's best not to reduce overall calories - so increase Protein and Fat to make up for the calories in the carbs you are cutting out.

I consider a BG meter ( 2 most commonly used in this and the other forum are either SD Gluco Navii , or the Spirit Healthcare TEE2+ ) to be extremely helpful for anybody trying to reduce their carbs without going too hard which can cause psychological burn-out and giving up. But some can't afford to self fund them, or have too big a 'needle phobia' to be able to use them. Unfortunately those with such a large phobia of needles may inadvertently push themselves toward insulin injections to control their Blood Sugar. The main cost of a BG meter in in the test strips (of which you use many at first when testing before and then 2hrs after every meal. But after testing exactly the same food on different days and t different times of day and keeping notes, eventually you will be able to predict the glucose response to more and more meals and so no longer need to test (except periodically to check nothing has changed). Look for a 2 mmol rise (or less) from before eating to the 2hrs after first bite mark. Don't concern yourself about BG readings at other times because there is little you can do to influence them, while you have total control about what food you eat.

There is no magic formula for how many carbs a person can cope with because we are all different and we even have different carb sensitivity at different times of day. Despite having a much lower HbA1C than you, I found I was highly sensitive to carbs and so I had to cut down harder than most. So while 40gms per meal may be OK for some, for me it's 40gms maximum per day! But I only know that because my BG meter told me so.
 
Hi @T2 Woman , welcome to the forum and well done for taking the bull by the horns! You are certainly heading in the right direction.
Take it slowly at first but many on here go a lot lower with their carb intake. For example your two Weetabix at 26 gm carb is about my total for the day! For breakfast I have some berries and Creme Fraiche and a cup of coffee with milk and that sets me up until lunch time. Also be aware that bread of any colour are carby and will push up your BGs. Your meter will be your friend in finding out what you can eat, but don't worry too much at first, it's a Marathon not a sprint. Just keep up your determination and you will get there.
 
T2 Woman said:
No cakes, biscuits, sweets, fruit juice etc which have made me feel quite hungry despite upping fats and protein.
Click to expand...
Where have you upped the fats?
Your food list looks rather low fat to me, and considering you have cut out quite a lot of fats by cutting cakes and biscuits and the likes, you might actually be eating less fat than before, and likely less calories overall.
 
Hi Antje77 I am frying the eggs in a little olive oil and I did have butter on my whole grain toast, now Benecol as of yesterday. I am having tuna salad where the tuna is in oil. The jar of drained tuna is 10g fat approx. I’ve also had rib eye steak last night which is quite high in fat about 40g with salad side which I put some grated cheese on and fried the mushroom and onion in olive oil. I have had things like 2x low fat sausage with fried eggs and Benecol buttered whole grain toast as a lunch so I am having fat. How much fat do you think I should aim for per day bearing in mind I also need to lose a fair bit of weight? Thank you so much for your input.
 
T2 Woman said:
How much fat do you think I should aim for per day bearing in mind I also need to lose a fair bit of weight?
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I'd go for as much as is needed to not be hungry. Many of us found reducing carbs made us lose weight, and even if it doesn't, I think getting your blood glucose under control outweighs the losing weight part.
As long as you don't gain, you can always tackle that later.
Going hungry means a much bigger risk of not keeping up with the diet, which often leads to on and of dieting which isn't helpful.

Just curious: do you like benecol better than butter?

edit: could be worth counting your calories over a typical day to see where you are in relation to the general advice. Not because you should aim for a certain amount, but just to see if you are accidentally much over or under the advice.
 
I hate Benecol! Only put myself on it as I was worried that my cholesterol level will go up with eating more fat. Lurpak all the way for me normally! I’m going to try counting all the calories to see how I’m going with that. Good idea, thanks.
 
How many carbs? For me that’s not a straightforward question.

I try to aim for 50g max per day. But testing has told me that not all carbs are the same, and even the same carbs can cause different spikes at different times of the day. For example I can tolerate no more than about 5G carbs first thing in the morning usually in the form of Greek yoghurt. But I generally skip breakfast which helps. Bread spikes me tremendously at any time of the day, as does any form of crisps, crackers etc. potatoes depend on how they are cooked and when I’m eating them! Chips or new potatoes are best, with a meal in the evening. A medium sized portion usually has no effect at all.

of course your reactions to each of these will be different which is why people on here will tell you to test, test, test to begin with.
 
I am overweight (although a lot less so since I started eating low carb). My feeling about your food list is that I’d probably lower carbs a bit more, and up the fat. But you can do these things gradually, it’s a marathon not a sprint.

Thoughts for maybe lowering carbs: personally I’d ditch the weetabix (I haven’t eaten cereal of any kind since I was diagnosed). I’d maybe replace it with eggs (fried, poached, boiled, scrambled), smoked salmon, avocado, full fat Greek yoghurt with some berries.

Lunch sounds OK but I’d reconsider the two slices of toast, maybe cut down to one, but smother it in butter. And plenty of protein alongside. Your dinner sounds good, perhaps have the same sort of things that you’re having for dinner for lunch as well.

SF jelly is a great snack. To me, 2 Rich Teas sounds a bit bleak! If I was *going* to spend 12 carbs on a biscuit, I’d rather have a nice biscuit!

Also I saw you mention low fat sausages! No no no! Why would you want to eat a low fat sausage? Just make sure it’s a low CARB sausage. They do vary, generally the higher quality the better cos there’s more meat and less bready filler. But low fat - Nooo!

Also ditch the Benecol and eat butter. Plenty of olive oil on your salads.

These days I don’t eat very much cos I’m on Ozempic so my food intake probably wouldn’t really work for you, but before that, I aimed for under 30g carbs per day, didn’t count calories or fat but tried to have plenty of fat and protein.
 
T2 Woman said:
I hate Benecol! Only put myself on it as I was worried that my cholesterol level will go up with eating more fat.
Click to expand...
You might be pleasantly surprised on your cholesterol levels when eating less carbs and more fats.
All my lipids greatly improved over the last 5 years, and I eat more fat than before, including lots of butter, cheeses, pork belly, eggs, things like that.
And again, eating stuff you don't like is a good way of setting yourself up for giving up on your chosen diet.

If I were you, I'd focus on blood glucose first, and leave everything else for later, unless something unexpected happens like lots of weight gain or such.
For one, it's less overwhelming, an secondly, both weight and lipids may improve all by itself with the improved diabetes.
Please see if you can get the extended release version, many people report a lot less side effects!
 
Someone checked and a fried egg doesn't absorb fat, so it isn't high fat at all - adding butter and cheese to scrambled egg now - that counts as high fat for me at least.
I do not bother trying to eat grain, they need to be fortified to provide any actual nourishment anyway, so I eat my carbs as tasty veges, stir fries, salads, crunchy things with vitamins and minerals (with any luck) or even berries.
I thought Metformin was contra indicated when there were already existing problems with the gut - I had such dreadful side effects I threw out the tablets 5 years ago, and found that I never needed them.
 
Just say no ... to low fat anything. Many low fat products contain added carbs in order to make them taste better than cardboard ( natural fats in meats, fish etc contain most of the taste).
Just accept that the fat content of traditional whole foods like meat, fish, dairy were fine for people before the low fat fad started. Both heart disease and Obesity were much lower then.
Some people complain about the cost of a low carb way of eating, or that they feel hungry doing it. In both cases they are probably trying to eat low carb and low fat. Normal fat (high meat content) sausages are usually both cheaper and tastier as well as being more filling. The same applies to minced beef.
I don't add extra fat to food - I just don't try to remove what fat is naturally there in the first place.
 
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@T2 Woman
When I first started I used an app to calculate how much fat and protein and carbs I should eat. I used Carb Manager but I also hear good things about mysugar.
That, and a meter will soon show you what foods our body can tolerate and in what portions.


Don't expect much from your appointment. Supportive hcps who know low carb are few and far between
 
Hi Ianf0ster, Sorry to take so long in replying and thanks for your knowledgeable input.
I have indeed read the “nutritional thingy” I think I may have been in denial slightly about how many carbs I can safely eat judging by what’s on there and the low carb experiences on this post of other members. Knowing my local GP’s set up I highly doubt that I will get a specialist in diabetes with the practice nurse appointment I am going for so I’m going to try to keep reducing the carbs and as I go keep an eye on the calories count as I try to lose weight too. Hopefully I will lose purely with these low carb choices and not have to watch my fat too much when I up it. I have seen these meters you say recommended too and I’m going to have a read of the reviews to decide which one is best for me. I guess the sooner I get my hands on one the better regards the testing. I must admit I am not a fan of all the finger pricking I’m going to have to do but I’m hardcore and I’ll embrace it for my own good. I certainly do not want to end up further down the line having to inject insulin etc if it’s within my control. It’s the adjustment I’m having to make which I’m finding hardest but I will do whatever it takes although I’m aware it’s gonna be a rough ride. I have a husband and 2 adult children at home who loved my home cooking and baking so it’s going to be harder to have different meals from all of them. I just have to accept that my eating habits have to change permanently and there’s no going back.
 
Home cooking doesn’t have to mean entirely different meals. For example

a roast dinner I cook for all of us but I have fewer potatoes, carrots, parsnips, and more green veg. The meat is fine.

chicken breast, stuff with cheese wrap in bacon, serve with above ground veg for me, add potatoes for them

fajitas, normal wraps for them, low carb ones for me

bolognese, with pasta for them, I have the sauce on cauliflower. Sounds odd, but tastes great?

curry, I’m ok with one mini naan no rice, but add rice for them.

chilli, cauliflower rice for me, normal for them.

sausage and mash…potato mash for them, swede mash for me

there are lots of low carb baking recipes on line. Just google keto…..then whatever you want.
 
T2 Woman said:
I have seen these meters you say recommended too and I’m going to have a read of the reviews to decide which one is best for me. I guess the sooner I get my hands on one the better regards the testing.
Click to expand...
@Rachox , can you share your info on meters again? I think @T2 Woman will like it.

With meters, it's about the ongoing costs of test strips, wait for Rachox to share her information on meters before ordering anything!
 
Hi @T2 Woman and welcome to the forum. Thanks for the tag @Antje77

Here’s some info on UK meters, and to be clear I have no commercial connections with any of the companies mentioned.


HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews, links to the strips and the meter:

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/

There are also discount codes for when you come to buy more strips - "navii5" and "navii10" will give you 20% off purchases of 5 packs of strips and 25% off 10 packs of strips respectively.


Then they sell the older SD Code Free, details to be found here!

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/

Discount codes for the Code Free strips

5 packs 264086

10 packs 975833


SPIRIT HEALTHCARE have a meter called the Tee2 + found here:


https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793

with the strips found here:


https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097

Some members have got a free Tee2+ by phoning up to order, with a large order of strips they often throw the meter in for free:

Phone number 0800 8815423


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

https://shop.spirit-health.co.uk/collections/caresens-dual



If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.


Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free. (for all meters and strips)
 
Hi Lakeslover I did the roast dinner thing with less roasties etc on Christmas Day and had similar tonight to the chicken breast wrapped in bacon covered in cheese. They had baby roast potatoes, I had a side salad with lettuce, chopped red pepper, vinaigrette and more grated cheese. I’ve struggled to find any low carb wraps at a reasonable cost anywhere. Do you have any recommendations? Don’t know if I can stomach cauliflower rice but I might give it a go. I’ve just bought some Bare Naked Konjac rice substitute which I’m a bit put off trying by the reviews saying when you open the packet it smells fishy, but my husband says he will prepare it for me as apparently you have to pour the pocket water out then rinse it in a sieve with boiling water to get rid of the smell first, then boil or microwave. Some people love it, but many are saying it’s disgusting. They also do noodles substitute and spaghetti made from the same stuff. I’ll try the rice first with a homemade curry. Thanks for all your suggestions. I’ll report back with my verdict on these rice/noodle/spaghetti subs.
 
I read it was contraindicated too, but my doctor seems to have ignored this despite telling me on the telephone that she was going to put me on the slow release ones because of my bile salt malabsorption. I’m going to continue to cut down my carbs and up the fats and see if I can tolerate the extra gastric problems it’s giving me, but will ask my practice nurse to query it with her.
 
I was diagnosed just before Christmas with a hba1c of 98. At my appointment the nurse asked me my weight and took my blood pressure. She explained I would be referred to check my eyes and my feet/legs. I was also given a tee2+ blood glucose monitor which she gave me the choice of whether I wanted to use one or not. She touched on nutrition and I was referred to the DESMOND programme and the NHS digital weight management programme. I was advised that my next blood test would be March.
 
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