Newly diagnosed (T2D) and have to wait a long time to see a nurse. Anyone else had this and tips I'm not doing already?

[WaveyDavey123]

Hi Folks, posted a few times already but instead of dissipating my story here it is in one place. Already learned a lot here and looking to learn a lot more.

So... I'm kind of unsure if I'm actually T2 full blow yet. See the thread title. My HbA1c has been creeping up for years but no doctor or nurse ever mentioned that this was a problem. It went to 49 this time so I've had a letter telling me I'm type 2 and I've arranged an appointment with my GP surgery for .... 4th July (I did this Monday 12th June).

So, I'm a bit shocked at the time I have to wait for an appointment and am full of questions - many of which I've managed to answer (I think) reading various things and some leaflets I extracted out of a nurse I saw for an asthma review on Monday.
Much of the advice I saw on the internet said to not monitor with a blood glucose meter without talking to my health team first... but hey - I have to wait a MONTH(ish) so I came here and saw the opposite advice.

So I'm monitoring and certainly my glucose levels are high and I've already learned that large(ish) meals cause my levels to rise and not come down in 2h if I am not careful.
So already I've chopped my portion sizes drastically and am cutting out high carbohydrate foods.

I'm already quite active. I'm 52 and 5 ft 10ish but weight 123 kg. I used to be a prop forward when I was young though so I am wide naturally and hence I don't really trust BMI as a thing... but I do have too much around the middle - far too much. A couple of times in my life (post playing sports a lot as a young adult) managed to lose about 25 kg from my worst times - once by swimming about 1km a day on average in my mid 30s and once by long distance cycling about 10 years ago (I once did the Paris-Brest-Paris randonee race which is 1200 km in 3.5 days - in 2013 I cycled 20,000 miles in that calendar year). So I'm not averse to exercise but I am a chap of extremes. Between these feats I can also be quite sedentary. I'm an academic and get very very intensely interested in new things but once I've done them, I tend to lose interest.
I lost all that weight each time through exercise alone really and it took extreme effort and dedication as you can see above (if you're still reading lol). On both of those big efforts I bottomed out (plateaued) at 16 stone dead. With the cycling I was just getting into starting to diet a bit when it all fell apart (I had six months off for two operations - the first elective on an old ankle injury in 2015, the second was orthopaedic repair of my distal bicep tendon which I ruptured falling off my bike on some ice, not two weeks after getting back on it. I never recovered my cycling mojo.

So anyway, by the time of lockdown I was just cycle commuting and then that stopped too. I knew I was really unfit by last year and managed to get a hearth arrhythmia problem (atrial flutter). Possibly caused by the cycling as I have an enlarged heart it seems - that is something that extreme athletes can get. But also my otherwise unhealthy lifestyle probably also doesn't help. As far as I know I don't have an CVD but I do have medication for high blood pressure and cholesterol these days - for about the last 2 years. While I had the heart rhythm problem I was on beta blockers and blood thinners but I had an ablation last year and have come off those.

The heart problem was give the all-clear (remission) last Nov so since then I've decided to get my heart a bit healthier again.
The upshot of this is that I've been quite active since the beginning of 2023 - I now walk about 40 miles a week on average. I live 5 miles from my work and I mix just walking it with walking it and getting the bus in between (minimum 2 miles whatever). So I think I'm active enough.

So dieting it is. My diet has mostly been terrible really all my life - I always paid little attention to that, mostly because I had my head in the sand really and justified it by all the exercise I was doing was good enough. I was 13.5 stone when I was 18. Can't get below 16 stone since my 20s... I kind of knew it was diet I needed to change if I'm honest. So here we are.

I've tried to eat more healthily this year too. But I do have a penchant for beer and lots of it when I'm going for it. I've been eating mostly salad with tuna or falafel for most of the year but I do occasionally slip up - especially since discovering a Gregg's opposite my workplace not long ago.
Did I say I am a man of extremes... so maybe I buy a 4 pack o doughnuts.... yeah I'll easily eat them all at once. Maybe eat 2 or 3 croissants when I get in also. If I buy a chocolate bar... yeah that doesn't last more than one session. My wife at least has finally agreed not to have biscuits in the house, which I've been badgering her to drop for several years (yeah don't have a lot of self control with those either).

So, with 2 days down now, not one sweet treat has passed my lips. The weekend could be interesting as I do like a beer then... ho hum.

Wow, I like to start sentence with so, don't I.

Mostly I'm wondering here if others have had to wait so long to see a doc or nurse and what did you do in the meantime?
Also any fine tips would be good though I seem to have most of the basic ones down already. Not eating rubbish and monitoring what foods work and what don't. Dropped portion sizes drastically. Numbers.....? Average blood glucose concentration is 8.4 over last couple of days - highest reading has been 11.6, lowest 6.6 which was my last reading. I think I can keep it down at that level with some effort... I think this is a reversible situation at least.

 

[MrsA2]

You're going to do just fine @WaveyDavey123 . I've seen your other posts and you have the attitude, and learning ability to together this licked.
Just remember it's been years in the building and won't be resolved over night. Indeed it will be a lifelong control/ adaptations rather than a short term fix. (Assuming t2)

also, as much as exercise can help there's a saying that you can't out run a bad diet, it catches up in the end, but few of us realised what has been touted as "healthy" diet for years is in fact proving not to be so for those of us with diabetic tendencies or insulin resistance.

As to your specific questions -
I've never seen a medic of any sort. Was diagnosed in lock down and under control by time restrictions lifted so they won't classify me as I didn't have 2 tests over the limit. But my meter and my reactions to carbs tells me daily that I am. Each year I ask for and receive hba1c tests, but always have to chase for them and cope with many cancellations by them.
Overall the % population with t2 is rising so dramatically (think its nearly or very soon 50% in US) that NHS just doesn't have resources or interest. It's easiest (cheapest) for them to delay, prescribed a cheap drug and give in to belief its progressive... ie push all it all off to the future.
I'm not unhappy being ignored by system, I'm a much better manager of my own health than any HCP.
With a long wait for your next appointment you might decide ide to just make small changes so you get that high second tests and are formally diagnosed to get into the system.

As to food, cutting down is good, but don't get hungry. Eat sufficient protein and good fats (those from animals and dairy) to keep satisfied.

Hope this helps

 

[WaveyDavey123]

Thanks for that MrsA2, wow, I feel I have lots of attention from the medics now. I hope you do get one as - well checks for complications etc... but up to you of course.
They diagnosed me via an HbA1c score, I'm thinking that won't drop within a month and it's more important to deal with it anyway I think, as you say. My appointment, I believe, is a first 'managing diabetes' appointment with a nurse. I don't know if it's a formal diagnosis or not yet, but my letter says 'you are diabetic' so...

Reading above, it looks like I only eat falafel, salad and tuna fish - haha, that's just lunch - which is where I used get most naughty. I didn't mention other meals. I have porridge for breakfast most days and the evening meal varies, plenty of decent nutrients there, fret ye not. I appreciate the advice nevertheless.

 

[Resurgam]

Thanks for that MrsA2, wow, I feel I have lots of attention from the medics now. I hope you do get one as - well checks for complications etc... but up to you of course.
They diagnosed me via an HbA1c score, I'm thinking that won't drop within a month and it's more important to deal with it anyway I think, as you say. My appointment, I believe, is a first 'managing diabetes' appointment with a nurse. I don't know if it's a formal diagnosis or not yet, but my letter says 'you are diabetic' so...

Reading above, it looks like I only eat falafel, salad and tuna fish - haha, that's just lunch - which is where I used get most naughty. I didn't mention other meals. I have porridge for breakfast most days and the evening meal varies, plenty of decent nutrients there, fret ye not. I appreciate the advice nevertheless.

Hello and welcome.
You might be surprised at how quickly you can get back to normal - my Hba1c altered from 91 down to 47 in 80 days and I wasn't even trying all that hard. At 6 months down to 41.
I don't eat grain though - I am one of those with a digestion which can break down anything, so beans and peas - I get almost twice the carbs listed for those, and I don't touch porridge.
If you have been stashing away the carbs for a while then it might be best to reduce gradually so it is not such a shock to the system. Lowering gradually week by week will give you time to pick out those foods to avoid.
There are a number of websites with recipes for low carb baking, so you don't have to give up cakes and biscuits. I like lowcarblondoner as a source.
I found that once I was under 8mmol/l after eating I felt a change, and although I stuck with the same meals I saw my numbers continuing to fall and my Hba1c has remained normal except for one blip, but I was not told about it and was back to normal by the time I was - I suspect that an illness caused it.

 

[WaveyDavey123]

Hey, thanks for the welcome. Very interesting and good for you. I hope my story can be anywhere near as successful as that in future. Yes I’ve seen the low carb cakes, looking forward to trying them out as I’m quite a keen cook.
One thing there I’m definitely going to have to drop though. Recently I’ve been experimenting with the 5 classic French sauces- particularly veloutes and espagnole derivatives - yeah they’re very naughty calorie- wise. Got to go

 

[Antje77]

I have porridge for breakfast most days

Just wondering, how do you feel about bacon and eggs for breakfast?

I've already learned that large(ish) meals cause my levels to rise

It's not the size of the meal, it's the amount of carbs in the meal which affects your blood glucose. So a small portion of porridge is likely to raise you more than an enormous portion of bacon and eggs.

Recently I’ve been experimenting with the 5 classic French sauces- particularly veloutes and espagnole derivatives - yeah they’re very naughty calorie- wise. Got to go

Sounds very interesting, and I'm not at all sure they'll have to go!
Yes, there are carbs in the flour, but likely less than in your porridge. You're only just over the diabetes threshold, and you may find that just cutting back the carbs a bit is enough to get you in the safe zone again. Calories do not raise BG.
Being interested in cooking will be very helpful in adapting meals too!

Have you encountered this bit of information written by one of our members already? I think it's very informative as to how T2 works: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html

They diagnosed me via an HbA1c score, I'm thinking that won't drop within a month

With your hba1c at only 49, and the cut-off being 48, I think it's very likely you'll be at prediabetic levels again in a month.

 

[Antje77]

I am struggling with the low carb recipes I'm finding online, I sometimes feel sick for ages because the ones I've made aren't very nice.

You might like this thread, where we share what we eat. https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today-low-carb-forum.75781/page-2819

 

[ianf0ster]

Hi @WaveyDavey123 Many/most of us find that most grains are a problem - even whole Oat porridge!
Eggs are one of the best things for breakfast, have them any way you like, but without bread.
Fat doesn't raise Blood Glucose, so tends not to make you fat or raise Blood Glucose nearly as much as carbohydrates do.

If you have a BG meter then you can test how your body reacts to different foods/meals. Some highly refined carbs will spike your BG very quickly so that you get such a insulin spike that it also comes down very fast - so don't be fooled if such a meal or snack shows unexpectedly low BG after 2hrs. Mashed Potato (without butter which slows down its digestion) has a higher GI than does Table sugar as does ordinary wheat flour, so it's a good idea to check common foods by google asking how many carbs in ...

Fruit juice is just as problematic as high sugar soft drinks - not healthy at all for a T2 Diabetic, whole fruits are much better (except the sweet tropical ones like banana, mango, pineapple), but the lowest carb fruits are mainly berries - a good reason to eat seasonal strawberries, raspberries, blackberries.

Beer (and sweet wines) are a problem unless you find a low calorie (not low alcohol) beer. I didn't bother, just switches to red wine or spirits with low calorie mixers.

 

[WaveyDavey123]

Really interesting Antje77! Thanks for the new reading. I feel fine about bacon and eggs for breakfast but I've already tested the porridge a couple of times and it's fine so far. Bacon and eggs... well we do like a cooked breakfast at the weekend. I do need to lose weight anyway though so reducing calories is a major goal and this is a very good kick in the butt to get going. Yeah French sauces might not necessarily be high carb but the base is all butter otherwise for those two, even without this I've felt a bit guilty about cooking them at all

Good food for thought, I will be trying some of the recipes I've seen here, they look nice, diabetic friendly or not.

Good luck to you too Lisa and thanks for the chip in, good to know I'm not alone.

It's also easy to talk now and be motivated.... six months, 1 years time etc... that's going to be the much bigger challenge.

5.4 mM before tea tonight... breaded fish, some boiled potatoes, peas and a bit of parsley sauce (Schwartz packet stuff). 8.4 mM. 2 hours later...
Not bad but more than the 2 mM rise I've seen quoted... the learning continues...not sure what to make of that really.
(speculation really until I talk to a medic to see what I *personally* should be aiming for - but it's good to have some data ahead of that for now)

 

[Antje77]

5.4 mM before tea tonight... breaded fish, some boiled potatoes, peas and a bit of parsley sauce (Schwartz packet stuff). 8.4 mM. 2 hours later...
Not bad but more than the 2 mM rise I've seen quoted... the learning continues...not sure what to make of that really.

Less potatoes, more fish and veggies will likely give you a better result. And panfried fish in butter with pepper and salt, and maybe a little lemon tastes as least as good as breaded fish, but without the carbs from the bread.

(speculation really until I talk to a medic to see what I *personally* should be aiming for

Don't get your hopes up too high.
Many medics still believe that diabetes will simply get worse and worse, with more medication added over the years. And many of them will advise a low fat, high wholemeal carb diet. Your meter will be your best guide.

 

[WaveyDavey123]

Less potatoes, more fish and veggies will likely give you a better result. And panfried fish in butter with pepper and salt, and maybe a little lemon tastes as least as good as breaded fish, but without the carbs from the bread.

Yeah, that’s my secret plan but touchy feely, slowly catchy monky is needed with my better half. Will work on diet changes like that gradually as she’s quite resistant to changing everything suddenly currently. Which is understandable. 23 years we’ve been eating that regularly- old habits can die hard.

Don't get your hopes up too high.
Many medics still believe that diabetes will simply get worse and worse, with more medication added over the years. And many of them will advise a low fat, high wholemeal carb diet. Your meter will be your best guide.

Duly noted, thanks

 

[WaveyDavey123]

My blood sugars raised quite a bit after just 3 new potatoes. Was gutted, I love potatoes. Eggs, butter, cream, cheese and meat I seem to be ok with but I need to learn more about food. I've always had a basic carb heavy diet.

Yeah, same. I particularly like rice. Haven’t tested that one yet.
Potatoes- I’m not so bothered but my wife loves them.

 

[KennyA]

Really interesting Antje77! Thanks for the new reading. I feel fine about bacon and eggs for breakfast but I've already tested the porridge a couple of times and it's fine so far. Bacon and eggs... well we do like a cooked breakfast at the weekend. I do need to lose weight anyway though so reducing calories is a major goal and this is a very good kick in the butt to get going. Yeah French sauces might not necessarily be high carb but the base is all butter otherwise for those two, even without this I've felt a bit guilty about cooking them at all

Good food for thought, I will be trying some of the recipes I've seen here, they look nice, diabetic friendly or not.

Good luck to you too Lisa and thanks for the chip in, good to know I'm not alone.

It's also easy to talk now and be motivated.... six months, 1 years time etc... that's going to be the much bigger challenge.

5.4 mM before tea tonight... breaded fish, some boiled potatoes, peas and a bit of parsley sauce (Schwartz packet stuff). 8.4 mM. 2 hours later...
Not bad but more than the 2 mM rise I've seen quoted... the learning continues...not sure what to make of that really.
(speculation really until I talk to a medic to see what I *personally* should be aiming for - but it's good to have some data ahead of that for now)

One of the best bits of advice when you're diagnosed as diabetic is to forget what you think you know about healthy eating. The current fad for low-fat, high carb food was introduced in the 1980s and triggered the rise in obesity and T2 diabetes that followed.

Calories don't matter. Fats (natural fats) - butter, cream, meat - are good. Carbohydrate is the devil.

That 3mmol rise you had tells you that your system cannot handle the carbs in that meal. Not a surprise - the breadcrumbs on the fish, potatoes, peas (maybe) and packet sauce are all big carb items.

Three and a half years ago I was pretty much where you are now. BGs were back to normal in three months and I've lost over 25 kgs since 2021. It can be done, you won't ever be hungry. And there is zero-carb beer.

 

[MrsEee]

One of the best bits of advice when you're diagnosed as diabetic is to forget what you think you know about healthy eating. The current fad for low-fat, high carb food was introduced in the 1980s and triggered the rise in obesity and T2 diabetes that followed.

Calories don't matter. Fats (natural fats) - butter, cream, meat - are good. Carbohydrate is the devil.

That 3mmol rise you had tells you that your system cannot handle the carbs in that meal. Not a surprise - the breadcrumbs on the fish, potatoes, peas (maybe) and packet sauce are all big carb items.

Three and a half years ago I was pretty much where you are now. BGs were back to normal in three months and I've lost over 25 kgs since 2021. It can be done, you won't ever be hungry. And there is zero-carb beer.

It's hard getting my head around the calories bit. I'm struggling to get my head around having butter, cream, cheese, full fat Greek yogurt! It goes against everything I've been taught for years.

 

[MrsA2]

The diabetic nurse at my initial consultation gave me a handwritten sheet on what foods to avoid, what to include and what to have in moderation. She didn't want me to focus on calories at all but to focus on low carbs. She said have nuts and seeds for snacks, a bit of cheese if I'm hungry, to have cream on berries which I have been doing but not too often because I would like to get my weight down a bit. She said to have an "official" diagnosis of diabetes I need two readings 4 weeks apart that shows I've tipped into the diabetes range. As I said earlier, I'd taken on board some of her suggestions and my second reading was 44. So I was back into pre-diabetes. I was amazed it changed that quickly. I have given up rice, bread and potatoes which I love.

Wow, she's a rare good up to date one. You are so lucky, am envious

 

[MrsA2]

Yeah, that’s my secret plan but touchy feely, slowly catchy monky is needed with my better half. Will work on diet changes like that gradually as she’s quite resistant to changing everything suddenly currently. Which is understandable. 23 years we’ve been eating that regularly- old habits can die hard.

We're 2 and a half years in now. We started with separate tins, Hubby had his filled with carbs, I had mine filled with low carb and woe betide anyone who stole from the other. But once he saw my weight loss and my health gains he's slowly changed and we now as a family (have adult son at home too) mostly eat low carb. The boys have the occasional carby thing eg pizza or chips, mostly when I'm out, or we simply add carbs to their plates.
I now have to vigorously defend my low carb goodies from them. I have mostly lost my desire for carbs (not interested in bread, rice or potatoes at all but can still be tempted by the odd cake or biscuit) and hardly raid their carb stashes at all.

Slowly slowly wins the race

 

[Antje77]

Yeah, that’s my secret plan but touchy feely, slowly catchy monky is needed with my better half. Will work on diet changes like that gradually as she’s quite resistant to changing everything suddenly currently.

No problem, the secret is in the plating!
Simply drop most of the potatoes on her plate and more of the veggies on yours. And maybe accidentally wipe some of the breadcrumbs from your portion of fish on hers while plating too.

 

[KennyA]

It's hard getting my head around the calories bit. I'm struggling to get my head around having butter, cream, cheese, full fat Greek yogurt! It goes against everything I've been taught for years.

Human beings have managed OK for milennia on just those sorts of natural foods. It's only in the last 20 to 30 years that it seems food has had to have essential elements removed to make it "healthy". Unfortunately the media is still stuck on the idea that "calories (ie energy) makes you fat". It's a bit more complicated than that.

 

[WaveyDavey123]

Wow, lots of action since yesterday here. Losing track so can't thank individually but thanks all for all the helpful comment.

Y'all are pretty convincing and persuasive on the low carb thing. Not the first time I've heard some of this stuff either. Back in my cycling days there was lots of talk of low carb style diets though it was geared to cycling so that's where I get my penchant for oats from (slow release so very suited to long steady all day exercise). I changed to oats from wheat based cereals as one really eminent guy on the circuit lost about 30 years worth of middle aged spread and when he shared his experience it was much like this. 'It's all the wheat based products' I recall him saying. Never put anything into action myself though. He tried to break a long standing world record for miles cycled in a year and I was going to be one of his hosts before he had an accident and had to quit. The team's instructions for his food (hosts had to prepare it for him as he had a tight schedule) was lots of high protein stuff - particularly sausages. Though I shall steer clear of them and burgers I think as they have rusk or breadcrumbs in - at least the homemade ones I'd made anyway.
Time to go very much reduced carb at the very least.

Couple of questions.
I see around that dairy (cow) milk is frowned up because of the lactose. So can you use lactose free as an alternative? Oatmilk and such are not particularly environmentally friendly to my knowledge.
Also if milk is not good - how come full fat plain yogurt is? The one is made from the other.... the culture that makes the yogurt from the milk consumes the lactose I guess?

Chickpeas are bad then? Falafel and houmous are my current go-to for lunch...

 

[MrsEee]

Wow, lots of action since yesterday here. Losing track so can't thank individually but thanks all for all the helpful comment.

Y'all are pretty convincing and persuasive on the low carb thing. Not the first time I've heard some of this stuff either. Back in my cycling days there was lots of talk of low carb style diets though it was geared to cycling so that's where I get my penchant for oats from (slow release so very suited to long steady all day exercise). I changed to oats from wheat based cereals as one really eminent guy on the circuit lost about 30 years worth of middle aged spread and when he shared his experience it was much like this. 'It's all the wheat based products' I recall him saying. Never put anything into action myself though. He tried to break a long standing world record for miles cycled in a year and I was going to be one of his hosts before he had an accident and had to quit. The team's instructions for his food (hosts had to prepare it for him as he had a tight schedule) was lots of high protein stuff - particularly sausages. Though I shall steer clear of them and burgers I think as they have rusk or breadcrumbs in - at least the homemade ones I'd made anyway.
Time to go very much reduced carb at the very least.

Couple of questions.
I see around that dairy (cow) milk is frowned up because of the lactose. So can you use lactose free as an alternative? Oatmilk and such are not particularly environmentally friendly to my knowledge.
Also if milk is not good - how come full fat plain yogurt is? The one is made from the other.... the culture that makes the yogurt from the milk consumes the lactose I guess?

Chickpeas are bad then? Falafel and houmous are my current go-to for lunch...

I can't get on with plant milks, I've tried but not to my taste. I just have a splash of semi skimmed milk in my tea and single cream in my coffee although I don't drink much of either. I don't understand the full fat yoghurt thing either. I can have hummus, I love it. That seems to be ok for my blood sugar. I think chickpeas are fine but other more experienced folk may know better. I'd been having quinoa and couscous thinking I was doing good and I think the nurse said they were quite high in carbs so I've knocked them on the head now. I'm currently making a late breakfast of home made granola with mixed nuts, seeds, chia seeds, coconut flakes and coconut oil. I'm going to have it with full fat Greek yogurt.

I'll have to give falafels a go because I love them. I don't know how to make them though. If they involve breadcrumbs, they may be a no no for me.

I made a turkey burger last week and didn't use breadcrumbs but I can't remember what I used now (I recall pork rinds and an egg), they held together in the pan quite nicely.