Newly diagnosed type 2

[brianD14]

Hi - been dipping in and out of this forum for a few days now reading various bits of introductory information.

I'm newly diagnosed 47 yr old male after a routine NHS health check with an Hb1Ac results of 57 mmol/mol on 30 Jan and then 54 mmol/mol on 13 Feb. I understand those numbers for someone unmedicated are not terrible. I have a poor family history with a least one grandparent (dead), parent (dead) and younger sibling with type 2, so must be genetic factors in play too. My blood pressure was in the hypertensive range (now reduced) and my cholesterol was also high, but understand these are essentially all part of the same metabolic syndrome linked to obesity/insulin resistance.

I didn't wait for the second Hb1Ac test and began immediate lifestyle changes on 30 Jan (lots of brisk walking and big reduction in starchy / beige carbs / no booze) which seems to have had a slight impact with the 13 Feb test showing slightly lower. I'm averaging now around 12.5k steps a day. My weight is 11 pounds lower after 2.5 weeks which suggests to me that I have some blood sugar control when careful. My sleep is better and what I now believe were afternoon blood sugar crashes have stopped. Otherwise I don't seem to be obviously symptomatic with the listed classic signs (thirst, weeing a lot etc).

My understanding is the Hb1Ac test is a three month average of how 'sugary' my red blood cells as the average red blood cell has a three month lifespan before being replaced, so the tests so far will be picking up poorer diet and lifestyle since around mid-November '23 e.g. including Christmas time excess!

The NHS can't actually offer me a follow up appointment with the diabetes clinic to discuss treatment until 13 March, but it seems unlikely they will retest Hb1Ac until at least another 3 months so - is that right? - where I'd hope a continuation of lifestyle / dietary changes will have had further impact on the three month average. Might still be in the diabetic range of course, but I'm minded to see what can be done with lifestyle changes first before medication options. I'm sold on the low(er) carb approach - why would you eat carbs for a disease that is essentially one of excess carbohydrate malabsorption?

Does anyone think it is worthwhile getting a private Hb1Ac test done a bit before 13 March to see how that informs the diabetic clinic discussion?

Anyway, that's my experience so far - any thoughts welcome! Thank you.

 

[sgm14]

Does anyone think it is worthwhile getting a private Hb1Ac test done a bit before 13 March

Even 13th of March is still only half-way into the 90 day period since your lifestyle change and so I may not tell you much.

If I was in your shoes, I would probably try to get a freestyle libre trial which lasts 14 days and then you could buy another sensor for the cost of a Hb1Ac test and it would show you more information.

 

[brianD14]

Even 13th of March is still only half-way into the 90 day period since your lifestyle change and so I may not tell you much.

If I was in your shoes, I would probably try to get a freestyle libre trial which lasts 14 days and then you could buy another sensor for the cost of a Hb1Ac test and it would show you more information.

thank you, I'll look into that.

 

[shelley262]

I agree with @brianD14 that trying libre on free two week trial would be a great way of moving forward to help you judge what takes your numbers up and what the general direction of travel is now. I'd also recommend a blood glucose monitor to check especially particular meals - it's a cheaper route over time and will also give you valuable information.I
You've got some family history that hopefully will help give you the motivation to manage your health. It's good to have solid reasons to help you especially during initial habit changing days and weeks.
Keep asking questions and reading around on here so many success stories to inspire you and I'm sure you'll be one too.

 

[derekhansen]

Firstly well done for taking control to reverse your Diabetes T2. If you can stick with a low carb lifestyle there is a very good chance you will be able to get back to a much healthier Hb1Ac and possibly be able to ditch the medication.
One thing I would say about the exercise is beware of relying too much on it for losing weight. Maybe get used to losing the weight by restricting the carbs first, whilst exercising moderately and then increase the exercise when you have attained your weight and Hb1Ac targets. The thing is that intense exercise will obviously make you more hungry and you will need to be able to keep up that high level of exercise long term unless you reduce the carbs accordingly. Its a balance you will need to keep for the rest of your life.

Regarding another Hb1Ac test I think its a little early to worry. Three months between tests and reviews with a Diabetic nurse is the norm.

 

[MrsA2]

You've learned and implanted a lot in a short space of time!

The only thing missing seems to be finger prick bg tests (or cgm) which would give you instantaneous readings rather than waiting for 3 month averages.
Meters can be cheap.

 

[brianD14]

Around 6 weeks from diagnosis thought I'd just post progress:

BP now 117/78 - was sky high 170/110 on initial measurement at the end of January. I'm hopeful that as the BP has normalised, the blood lipid profile and blood sugars on the HB1AC will have come down when I have my next blood tests (end of April). They are all linked conditions. My first diagnostic readings were 57 and 54 mmol

I've lost 8kgs in weight. Clothes noticeably looser.

So, far it's just been lifestyle change and exercise - lower carbs (but not keto) and brisk walking. Averaging around 12k steps a day. Alcohol only a half bottle of wine a week now (there has to be some joy in life!)

I've refused meds so far for cholesterol, diabetes and BP whilst I see what the continued lifestyle change brings as I think come the end of April I will have a better 'no meds' baseline to make informed decisions around meds if needed.

I've noticed my BP is very sensitive to alcohol and stress and I suspect a proxy for glucose levels too.

Sleep is great at the moment. Very few blood sugar crashes in the afternoon when I used to get them.

So all feels currently very positive. Will update end of April when I get new information on progress.

 

[Paul_]

Around 6 weeks from diagnosis thought I'd just post progress:

BP now 117/78 - was sky high 170/110 on initial measurement at the end of January. I'm hopeful that as the BP has normalised, the blood lipid profile and blood sugars on the HB1AC will have come down when I have my next blood tests (end of April). They are all linked conditions. My first diagnostic readings were 57 and 54 mmol

I've lost 8kgs in weight. Clothes noticeably looser.

So, far it's just been lifestyle change and exercise - lower carbs (but not keto) and brisk walking. Averaging around 12k steps a day. Alcohol only a half bottle of wine a week now (there has to be some joy in life!)

I've refused meds so far for cholesterol, diabetes and BP whilst I see what the continued lifestyle change brings as I think come the end of April I will have a better 'no meds' baseline to make informed decisions around meds if needed.

I've noticed my BP is very sensitive to alcohol and stress and I suspect a proxy for glucose levels too.

Sleep is great at the moment. Very few blood sugar crashes in the afternoon when I used to get them.

So all feels currently very positive. Will update end of April when I get new information on progress.

You're making great progress, Brian. Really well done!

 

[MellyMell]

Like everything in life you think it wont happen to you, last year (early part of) I was diagnosed as Pre- Diabetic I though I was doing all the right things but come my doctors appointment and my blood test in October I was officially diagnosed with Diabetes Type 2. Although its been about 5 months since being diagnosed I am still struggling , I was put on Metformin but finding it difficult to take and I feel dizzy or light headed but trying to get a change of medication or any help is near impossible. i already suffer with my mental health and the stress of all this is not helping. I have been looking at the Freestyle Libre trial, but its expensive to buy as I cannot get any help with it, asked doctor got nowhere was told to speak to the local hospital diabetes department I did that but as they are not treating me they cannot help, so not sure what way to go from here......

 

[JoKalsbeek]

Like everything in life you think it wont happen to you, last year (early part of) I was diagnosed as Pre- Diabetic I though I was doing all the right things but come my doctors appointment and my blood test in October I was officially diagnosed with Diabetes Type 2. Although its been about 5 months since being diagnosed I am still struggling , I was put on Metformin but finding it difficult to take and I feel dizzy or light headed but trying to get a change of medication or any help is near impossible. i already suffer with my mental health and the stress of all this is not helping. I have been looking at the Freestyle Libre trial, but its expensive to buy as I cannot get any help with it, asked doctor got nowhere was told to speak to the local hospital diabetes department I did that but as they are not treating me they cannot help, so not sure what way to go from here......

Brian (the original poster) is turning things around quite well, and there's no reason you would not be able to. Mental illness and budget restraints throw a wrench in sometimes, but hopefully one can work around those. https://www.freestyle.abbott/uk-en/getting-started/sampling.html should, I think can get you a meter for 2 weeks for free, far as I've understood it. Never used one though, relied on finger pricks the entire time.

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html might help some get your blood sugars down, and maybe you can ditch the metformin if you manage on diet only. A meter'd tell you.

It's not entirely hopeless, you know. I have a whole lot of conditions, both physical and mental ones, and diabetes is honestly the easiest one to manage to date. So chin up, and ask any questions you may have. You don't have to do this alone.
Jo

 

[brianD14]

Like everything in life you think it wont happen to you, last year (early part of) I was diagnosed as Pre- Diabetic I though I was doing all the right things but come my doctors appointment and my blood test in October I was officially diagnosed with Diabetes Type 2. Although its been about 5 months since being diagnosed I am still struggling , I was put on Metformin but finding it difficult to take and I feel dizzy or light headed but trying to get a change of medication or any help is near impossible. i already suffer with my mental health and the stress of all this is not helping. I have been looking at the Freestyle Libre trial, but its expensive to buy as I cannot get any help with it, asked doctor got nowhere was told to speak to the local hospital diabetes department I did that but as they are not treating me they cannot help, so not sure what way to go from here......

I'm sure the feelings are normal and they will eventually pass. For me diagnosis felt like a kick in the stomach, especially with my family history. Think I was in shock for a few days.

But it is all fixable over time with the right approach for which there is good advice on here and elsewhere. I'm trying not to get too obsessive about the numbers day to day as I think that can affect mental health, although I'm am monitoring my blood pressure regularly as this is to me feels the most important aspect over the longer term as it's a related marker for the risk of future complications.

Instead I'm trying to focus on the bigger picture things that are likely to make a difference over time: diet, exercise, stress, sleep, quantity and type of carbs, weight etc. Medication (whether it be for BP, cholesterol or blood sugar control) is largely treating symptoms not causes, and its the causes that need most focus. If at some point I do need meds, they are not instead of fixing the other lifestyle related things that need sorting. I know some of the diet factors will be trial and error, but I'm pretty sure its fixable and manageable with the right approach and support. It's not all about meds. I think it will be fixable for you too even if it doesn't feel like at the moment. Stick with it!

 

[Outlier]

Also important - VITAL - to do your own research as not many dieticians and even fewer Dr.s or nurses, even so-called specialist diabetic nurses, are up to date on diet for us diabetics. Many are still promoting the "Eatwell" system, for instance. If you find one of the clued-up medics, they are gold dust.

 

[brianD14]

Also important - VITAL - to do your own research as not many dieticians and even fewer Dr.s or nurses, even so-called specialist diabetic nurses, are up to date on diet for us diabetics. Many are still promoting the "Eatwell" system, for instance. If you find one of the clued-up medics, they are gold dust.

Yes agree - I've not seen or spoken to the same clinician once since my diagnosis and I've had all sorts of mixed messages on carbs. Almost as if they know excess carbs are a big part of the problem but are a bit scared to offer any radical advice and go as far as they dare because of the worry about condoning higher consumption of fat.

My personal view is that I don't think low carb feels sustainable for me over the long term - it risks being boring, but accept it may well work for others especially those with worse blood sugar numbers than me. But it is very easy to cut out what are obviously a lot of the very bad carbs e.g. beer, white bread and other things made from white flour, sugar, processed foods etc

It does seem you need to also think positively about the fibre content of any carbs you eat (not going to raise blood sugar, and beneficial in other ways e.g the good bateria in your gut) and also resistant starch carbs ( e.g. greener unripe bananas better than ripe yellow ones) that also don't spike blood sugars to the same extent. And some carbs will have vitamins and minerals you need too e.g. raw carrots don't seem to cause me any issues. So agree about finding balance too.

In terms of research, I've found Robert Lustig's book 'Metabolical' very readable on the science of what's going on in your body when it consumes excess carbohydrate, sugar, other processed foods, and alcohol and how those cause metabolic disorders, of which diabetes is one. Has made me think about things differently. All very interesting, accepting that scientific research is always evolving.

 

[ajbod]

Please note Carbs have not one single vitamin or mineral that cannot be sourced elsewhere, ie No vital nutrients.

 

[Beating-My-Betes]

Please note Carbs have not one single vitamin or mineral that cannot be sourced elsewhere, ie No vital nutrients.

The same could be said of meat, but that's not a reason to not eat meat. These types of reductionist viewpoints aren't helpful when it comes to designing a diet that will have a much more varied and complete nutritional profile, that most people will enjoy and that will therefore potentially be more sustainable.

 

[ianf0ster]

The same could be said of meat, but that's not a reason to not eat meat. ...................................................

That could be said in theory, but in practice the greater bioavailability in animal foods makes a huge difference. That's why vegans need to use supplements for B12 and Iron. Studies still show most vegans are deficient in both.

 

[ajbod]

My comment was not meant to be an attack of vegetarianism, merely pointing out a fact, that newly diagnosed may not be aware of, and may worry about reducing carbs. It simply tells them, they will NOT be missing out on anything that carbs provide, should they go down that route.

 

[Beating-My-Betes]

That could be said in theory, but in practice the greater bioavailability in animal foods makes a huge difference. That's why vegans need to use supplements for B12 and Iron. Studies still show most vegans are deficient in both.

The greater bioavailability of animal foods is reductionist and also needs to be qualified.

b12 is an essential supplement for vegans. But it's also regarded as an essential supplement for omnivores, either directly or given to the animal destined to be eaten. And while vegans are perhaps more susceptible to issues with iron, it doesn't seem to pan out in reality. Issues with iron are multi-factoral, often quite easy to mitigate. and certainly not the sole preserve of meat-dodgers.

Lastly, depending on how one defines supplementation, most people, regardless of chosen WOE, are supplementing in one form or another.

 

[Beating-My-Betes]

My comment was not meant to be an attack of vegetarianism, merely pointing out a fact, that newly diagnosed may not be aware of, and may worry about reducing carbs. It simply tells them, they will NOT be missing out on anything that carbs provide, should they go down that route.

I didn't take your comment to be an attack of vegetarianism/vegansim. But the fact still remains, your position on carbs is at best reductionist. But I'd be more inclined to say it's just plainly incorrect.

 

[oldminer88]

Splashed out on a free libra this month was pre diabetes trying to sort with just diet and exercise. Found some of my results interesting , on low carb diet as it is. Found pizza sends my numbers crazy,plus one of beta blockers doesn’t seem to help.Helping me get a better idea of what I should be doing