Newly diagnosed. Type 2.

What type?

I'm type 1 and have the same problem if I don't eat in the morning. Doctor told me, if you don't eat in the morning your liver pumps a bit of sugar into your blood to keep you going. If you haven't eaten in over 12 hours it may be that?

Kayg said:

Oh right, yes it could be that. There's so much to learn, I had no idea. I will try eating then testing in 2 hours. Thanks

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No problem they didn't tell me either until I complained about it!

Hi @Kayg and welcome to the forum.

Have you been given any advice from your G.P.?

There is some basic information that is provided for newly diagnosed. I will tag @daisy1 and she will post it.

Hi,

I see you are type 2, diet only. Maybe your diet could do with tweaking? Under normal circumstances it is the food we eat that raises or keeps our BS levels up. Perhaps we can help you with this?

The morning sugar dump by your liver is known as the Dawn Phenomenon or Liver Dump. There is plenty abut it here on the forum if you have a search, or Google it.

I dare say @daisy1 will post comprehensive and very good info soon but the core of it is that many on here find the current NHS official dietary advice for Type2 advises eating far too much carbohydrate. In my case cutting out starchy foods like pasta, bread products any vegetable that grows underground made a huge difference, you have to replace the carbohydrate energy in your food with something and that is lots of fats and oils. This is called Low Carb, High Fats diet (or LCHF), it works, is really easy to follow and strangely in most cases cholesterol numbers will improve.

Eating a small amount before bed helps avoid the morning spike in readings.

@Kayg

Hello Kay and welcome to the forum

Here is the information we give to new members and I hope you will find it useful, in addition to the answers you have already received. Ask more questions and someone will help.


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 over 150,000 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-and-whole-grains.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 bloodglucose 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.

Welcome, Kayg. Yes, please be more pushy with your GP. I have a lot of other health problems and am on a lot of meds for those. It makes it complex, so it's more important for your health professionals to be fully engaged and involving you in your care.
I have chronic reflux, which is well controlled by medication. I've had an endoscopy to check for more serious issues and to confirm that medication not surgery is the best way to go. Are your symptoms under control? If not, let me know... I've had this for nearly 20 years and I have a few tips. One of them involved putting the head of my bed up on blocks so it is about 6 inches higher at that end. Before that I was being woken up with severe reflux pain, even thought I was having a heart attack one time, yikes. I hope your reflux doesn't cause too many issues for you.

Good luck and hope to hear you've gotten better help from your GP next time.

Kayg said:

Hi catlady, I've had endoscopy too but I've tried every medication combination and it's still not under control. Surgery would be the cure but because I'm now overweight due to being immobile, it's not an option as it wouldn't last long. My bed is already propped up but I get reflux while sitting up so really struggling at present. The worst part for me is the aspirating of acid and the following chest infections. Any tip would be great, thanks

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Sorry to hear it's so bad at the moment. I am on 40mg a day of omeprazole, but have also been on the max doses of ranitidine and domperidone as well, plus gaviscon at times. When you say surgery would be the cure, is that because they found a structural issue like hiatal hernia? I find if it gets really bad I lie on the floor over a bean bag, and it puts my body in a good position to reduce the flow of liquid upwards and reduce pain.

Another consideration might be obstructive sleep apnea, as it is linked to reflux... I have both conditions, and I have never been able to find out from the doctors which condition causes the other. In OSA the air pressure in the trachea changes as you stop breathing then gasp for air, and in this process there is pressure on the lower oesophageal sphincter, which is critical in reflux. If you have OSA, it could be making your reflux worse, as well as making you hungrier and it being harder to lose weight. An overnight sleep study, on referral from your GP, is the way to find out if you have OSA.

I can really empathise with you about the reflux, it's a tough condition to have. I hope things improve soon.

Kayg said:

I'm on lansoprazole and ranitidine. I was on domperidone but doctors can't prescribe it here any more. I'm physically disabled so definitely can't get on the floor, well if I did I wouldn't get back up lol. I don't have sleep apnea luckily. Thanks for your advice, it's good to talk to someone with similar problems.

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Sorry to hear about domperidone... I wonder if you can get it from overseas, or if there is another drug for delayed gastric emptying that you could use? Are you able to sit leaning slightly forward, instead of straight up and down, or leaning backwards? I love stretching out my torso like that when I have symptoms, it seems to help a bit. I'm sure you will be able to see an improvement in your diabetes, it just might take longer than it would for others. Slowly and surely wins the race. Best wishes.

Kayg said:

They took domperidone off as it can cause heart arythmia, I have a heart condition anyway so don't want to risk it. I'll try the stretches, I'll try whatever I can at present. Thank you

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A drug you could ask your doctor about is Ondansetron, it's an anti-nausea drug and very effective for that. It might give you some relief from reflux, I'm not sure. Another thing that helps me is taking sips of water, and I've even tried leaning forward onto a heated wheatbag around the middle of chest/sternum area. Gaviscon is good... Mylanta not so good because you have to time it so it's not close to when you take meds. Pain relief with paracetamol taken as 2 x 500mg up to four times a day might help too. I find it works well after a couple of days at that dosage. Not sure if you can take that with other meds you are taking, so best to ask your doctor.

Does anyone else with reflux, GORD, slow motility or other stomach problems have any suggestions?