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Newly Diagnosed Type 2

Discussion in 'Newly Diagnosed' started by 1973Magpie, Jul 10, 2013.

  1. 1973Magpie

    1973Magpie · Member

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    Hello

    I have recently been diagnosed as Type 2, at the end of June, which wasn't too much of a surprise as I have had Gestational Diabetes in my last two pregnancies (6 and 4 years ago) and my Mother and Aunt and Uncles are all Type 2. Still feels a bit of a shock, even though I was half expecting it, I expected to be older before it happened! I was given a prescription for Metformin 500mg 3x a day, and told to come in and see the Diabetic Nurse on 18th July, I was also told I would receive appointments for Diabetes Education etc in due course.

    I am 40, and am in the overweight bracket (5' 9" and 77kg) and am quite lazy exercise-wise :oops: HbA1c of 6.9 (June 2013)

    I have had a read of lots of threads on here and elsewhere and as soon as I found out have started to reduce my carbs massively, I had to eat an extremely restrictive diet when I had GD as any carbs sent my BG rocketing and I was determined to have a home birth, (which if I was on insulin the Consultant wouldn't 'allow' - I had my home birth :lol:). I have also started increasing my exercise and have been walking children to school 3x a week (2 miles). Also gave up smoking (on day 12 so far). I was prescribed Metformin and have built up to taking 2x 500mg per day over the past week or so. I am struggling trying to do it all at once, giving up the smoking is the hardest bit atm.

    My confusion arises because I have just been to my Diabetes Education Course, and been given conflicting advice compared to what I have read and experienced personally when I had GD!

    I have been told to eat starchy carbohydrates with every meal (a minimum of 3x per day), that I must eat low fat at all times, that I need carbs for energy,and I will make myself very unwell if I expect my body to use fat for fuel. Also, that only carbs are converted into glucose, not fats/protein?

    The Diabetic Specialist Nurse also told me that I shouldn't be testing my own BG unless specifically told to by my GP (I challenged this and said that I was testing, at my own request, and that the information she was giving wasn't what the NICE Guidelines said...and was told that they are 'just' Guidelines NOT protocols... :x ) I was also told that my BG target readings were too low (I was going for under 8.5mmol/l at 2 hours after eating) and that as long as they were under 11mmol/l that was fine :shock:

    Anyway, I listened (and tbh dismissed most of what I was 'taught') had a think and decided to carry on with the low carb/highish fat diet I had started :eek: I have had a FBG of 5.6 this morning (these were 6.9-7.8ish two weeks ago) and after my breakfast I walked to school and back (4 miles) and BG was 5.6.

    So what I am asking really is, are my readings too low? Can they be too low? Also, do I need to take Metformin 3x per day if my readings are all ok, or can I stick at 2x per day?

    Thanks for reading, especially as that turned into a bit of an epic post!
     
  2. daisy1

    daisy1 Type 2 · Legend

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    Hi Magpie and welcome to the forum :)
    It sounds to me as though you are doing the right things for you and your levels are very good. Metformin has many other benefits other than just helping to control your bloodsugars. If you want to diminish your dose you need to ask your DN first. You are also doing a good thing to follow a low carb/high or moderate fat diet.

    I think testing is essential in order to see what certain foods do to your levels - test before and 2 hours after meals and compare - they should be about the same. I personally think that the levels given by NICE are too high and prefer to have levels below those. These are just my personal views. Other members will be along soon to give you their advice/views.



    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
     
  3. 1973Magpie

    1973Magpie · Member

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    Hi Daisy,

    Thanks for your reply.

    I am happy with the results so far with the lower carbs and higher fats, so will keep going with it I think. (In the back of my head I am having a little competition with myself to get my BG results as near 'normal' ie non-diabetic as possible) :D

    I have been prescribed the Metformin 500mg to build up to taking 3x per day over a few weeks, I am currently taking 2x per day. I will ask Diabetic Nurse whether I should take them 3x per day for other protective benefits, I was hoping I would get the other benefits without going up to 3x per day if that makes sense?

    Will have another read of the information provided, thank you.
     
  4. CollieBoy

    CollieBoy Type 2 · Well-Known Member

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    Glad to see you are trying to pare off the carbs, Great Re exercise and ditching the "fags"
    This is typical of the mis-education drivel peddled by some of the HCPs :evil:
    There is no real need to eat carbs as they are not an essential nutrient and can be synthesised by gluconeogenesis!
    They seem to be unaware of basic biology re fats/proteins as a fuel source!
    I disagree , I would be trying to aim for tightening up to below 7.5 @ 2 hrsfor most occaisions 8)
    anyway they are GUIDELINES and she needs to use them to guide unless she can give some valid reasoning for alternative guidelines

    Keep going!
    No, trying for BGs as near as "nomal" is admirable.

    What was the course? Xpert, DESMOND, or some local variant as the course designers may be interested in delivery so far from the course/NICE parameters!
     
  5. Daibell

    Daibell LADA · Master

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    Hi. Sad isn't it that diabetes 'professionals' peddle this rubbish about diet. As others have said you do not need ANY carbs at all if you choose as the body can produce the brain energy it needs from Ketosis i.e. the burning of fat. Fat is not the problem for diabetics in the diet but carbs, so do continue to low-carb to achieve the right meter reading. Yes, you do need to test your sugars with meter so get hold of one and take full control. Ref starchy carbs with every meal, the only justification for this is to smooth the intake but you don't need to have any, but most of us might have some stay below 150gm/day or less. BTW starchy carbs might be low-GI before processing, but the ones the NHS often recommends are in fact cooked/processed and become high-GI so how good is that? I agree the 2 hour mmol reading of 11mmol is too high and 8.5 is the NICE level. My otherwise superb DN also said 11 was OK which is obviously what they are trained to say but I follow NICE and the 8.5 level as my target but may go above trying to avoid having a hypo.
     
  6. 1973Magpie

    1973Magpie · Member

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    Fergus thanks for your reply, yes that was pretty much my thinking!

    I am quite 'anti-establishment' anyway, but it makes me so cross that they tell us 'facts' that, at best, are inaccurate, and at worst completely misleading. I don't think the Health Service like me much, I caused rather a stink at Ipswich Hospital when they decreed that I would 'have' to have a hospital birth with my second child, due to having Gestational diabetes....I questioned their protocols and it turns out they were based completely on ONE study of Type 1 diabetics having babies, which although similar in nature are much higher risk!

    I am pleased to say that after I had my (lovely) homebirth the protocols were changed to 'allow' homebirth to mothers with low risk pregnancies and GD!! So I am no stranger to standing up for my rights, and doing my own independent research, which it seems will hold me in good stead for dealing with my diabetes :)

    The course I attended was called 'Type 2 Diabetes Education Group' and was run by Norfolk and Norwich University Hospital. Appointment letter signed by Kate Gudgon BSc SRD Chief Community Dietitian, although the course was run by a Specialist Diabetic Nurse and a Dietitian.

    Diabell Thanks for your reply. I did wonder if she had mixed up ketosis and ketoacidosis with her assertion that carbs were essential for energy, and fats and protein didn't get converted into glucose ever by our bodies...I nearly asked her how the human race had survived up until 10, 000 years ago without grains...but she was already flustered by the carbs/fat for fuel questions! You'd think a dietitian would know how our bodies process food :roll:

    Off to do school run now, but will keep on keeping on with my self-improvement plans, thanks for all your comments, Magpie.
     
  7. NorthernPam

    NorthernPam · Member

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    Hi Magpie,
    If you haven't done so already then I suggest you take a look at http://bloodsugar101.com/. I was diagnosed T2 in March and, like you, decided to do my own research to get started as quickly as possible on getting the levels down. I also have family members with heart and eye problems as well as one who lost a leg recently so I am well motivated not to go down that road. I was really impressed with this site as it is informative and easy reading for a layperson ... I ended up buying the book too. This and other sites (including this forum) helped me to formulate my own strategy of reducing carbs. So glad I did as the 'educational session' was 3 months+ later and all about the eating well plate with almost no focus on diabetes. Not the dietician's fault; her presentation was professionally delivered and she will have been trained to deliver the official message. When I asked about reducing carbs I was told in no uncertain terms that it was not recommended but no alterative offered with the advice to eat to government GDA. It is worth noting that a few years ago I had a pre-diabetic result and was given the complex carbs/low GI advice at that time. I did introduce more carbs to my diet as instructed and not only put on 4 stone but also ended up with diabetes! I decided to ignore the dietician and continue with my own strategy. Vindicated 2 weeks later as A1c and cholesterol much improved. The extra weight has dropped off me and I feel better than I have felt for a long time. I'm still working on it and making adjustments as my goal is as near normal readings as I can get without meds but like so many others on this forum I plan to continue reducing carbs and have no intention of adhering to the guidelines. Good on you to fight your corner and keep up your reduced carbs approach. You'll get lots of support on this forum.
    Pam
     
  8. 1973Magpie

    1973Magpie · Member

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    Thanks Pam I will give that link a look later once the smalls are in bed :)

    Fantastic news on you managing to lose the excess weight caused by the 'healthy' diet, and on reducing your HBA1c and cholesterol too :) It's so helpful to read about others successes, especially when the official NHS line seem so bleak, a long slide through more and more medication into eventual insulin and complications!

    I haven't had my cholesterol tested yet, but am going to see the Diabetic Nurse next week for the first time, so will ask then about getting it tested as it would be handy to have a 'baseline' to work from. I have already been prescribed Metformin to take 3x per day, and started just over a week ago with 1x per day, and then upped this to 2x per day on Saturday, luckily don't seem to have had any side effects as yet, but I'm not going to go up to 3x per day until after I see the Nurse, a I'm not sure it'll be necessary with the BG results I'm starting to get!

    I don't seem to have lost any weight so far on my lower carb, higher fat diet, but my blood sugars are so much better, fasting BG was 5.6 this morning, and BG have been 5.6 2 hours after breakfast and lunch, quite a bit higher after tea, when I had a small portion of basmati rice, at 7.5.

    I have always pretty much followed the Eatwell plate model for diet since childhood, but have got a bit of a sweet tooth and will admit to eating more than my fair share of chocolate over the years! I am now in the process of retraining my palate to accept 3 squares of dark chocolate as a treat rather than a 200g bar of Dairy Milk... so hopefully I can get back down to 70kg (I did briefly weigh about this last year, when I was very unhappy, but as my mood has improved my waistline has expanded again) Last time I was really 70kg was pre-children, so almost 14 years ago, but I am hopeful reading others stories of success :)

    I only found this forum a couple of weeks ago, and joined this morning but already feel welcomed and amongst kindred spirits, so thanks everyone for making me feel welcome :)
     
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