Newly Diagnosed Type 2

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

1973Magpie said:

Hello


I am 40, and am in the overweight bracket (5' 9" and 77kg) and am quite lazy exercise-wise 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.

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Glad to see you are trying to pare off the carbs, Great Re exercise and ditching the "fags"

1973Magpie said:

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?

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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!

1973Magpie said:

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:

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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

1973Magpie said:

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 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.

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Keep going!

1973Magpie said:

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?

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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!

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.

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