newly diagnosed with type 2 diabetes

Hello and welcome @davealan1962

Don't worry about when to take the Metformin each day. It is more important to take it with food than randomly without food. Which meal and what time of day doesn't really matter. Just do your best to space it out as best you can and always with a meal. Metformin has a tendency to give people tummy and bowel upsets, which is why it is necessary to take it with food. If you do get the tummy/bowel upsets take heart that it shouldn't last very long once your body becomes used to them. If it doesn't go away you need to ask your doctor for the slow release version (SR) as these are supposed to be kinder on the tummy.

I'm tagging @daisy1 as she has very useful information she gives to all newly diagnosed. Do read her post when it arrives.

Meanwhile, have a good read round all the forums, jump in and ask questions whenever you have one, and start making plans about dietary changes as diet is the key to controlling this disease, not Metformin (It only helps to a limited extent)

davealan1962 said:

Thank you for your reply. I have already started a diet plan and have got my glucose level down from 14.9 to 10.4 (if these figures mean anything to you) and have over the past week, lost 3lbs in weight. Also doing more walking, gardening and generally more moving about. I have not yet seen anybody like a diet nurse only just my GP who has told me to loose weight and take the tablet as per previous message. Certainly will look forward to reading more on these forums. Again, thank you for your reply.

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That is an excellent start. Well done.

I take it you have a meter, so you now need to use it to check your food choices. This will help far more than any advice you may receive from your nurse or GP.

You may know this already, but if not, this is the best way to achieve control:
Test immediately before you eat
Test again 2 hours after first bite
Keep a food diary of all ingredients in the meal including portion sizes
Record your before and after levels alongside the food
Try to keep any rise from before to after under 2mmol/l preferably less.
More than 2mmol/l and there were too many carbs in that meal.
You may have a few shocks!
This is called eating to your meter.

The only other advice that I would give is to get a book or an app on the carbohydrate values of foods.
When I started carb counting I was shocked at some seemingly inocuous foods that have a high number of carbs in them.
Welcome to the forum and to the learning curve you're about to experience.

Hi davealan1962 welcome to the forum you will learn loads on here from very friendly and knowledgeable people to help you on your journey with T2 diabetes

Hi and welcome...... Only been doing the LCHF way of eating for about 14 weeks now and at my last review I had lost two stone and bloods down to 37 from 48 with the guidance and advice from the guys on the forum. There's a lot to take in at first but it does get easier.

Bluetit1802 said:

That is an excellent start. Well done.

I take it you have a meter, so you now need to use it to check your food choices. This will help far more than any advice you may receive from your nurse or GP.

You may know this already, but if not, this is the best way to achieve control:
Test immediately before you eat
Test again 2 hours after first bite
Keep a food diary of all ingredients in the meal including portion sizes
Record your before and after levels alongside the food
Try to keep any rise from before to after under 2mmol/l preferably less.
More than 2mmol/l and there were too many carbs in that meal.
You may have a few shocks!
This is called eating to your meter.

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You need to test at the one hour mark after eating to see if there is a spike, then at the 2 hour mark you should be back to your original number.

Hi @davealan1962 and welcome to the forum. it is a shock when you get that diagnosis and takes a bit of time to get your head around it all. You have done well to get a bg meter which will be an essential tool in monitoring your progress and finding out which foods raise your bs level.
Many of the Type 2s on here have found that adopting a Low Carbohydrate High Fat (LCHF) approach to eating has reduced our blood sugars, and often our weight too. Have a read round the threads to see how this works and ask any questions you want. The people on here are friendly and supportive, and you will get a lot of good advice.

Hi @davealan1962 .. and welcome
You have certainly made a good move coming here. Since joining this forum, the folks here have given me so much info, advice and support that I am now much more confident about the journey ahead. So ask your questions and be assured that you will receive the answers that you need. It can all seem uphill to start with but, in my experience, it gets easier .. very quickly.

You will come across a lot of conflicting and sometimes confusing information but the key point to take on board is that managing and controlling your diabetes through exercise, diet and testing your Blood Glucose seems to be the best way forward for many people. For me, committing to an LCHF (Low Carb High Fat) lifestyle and testing 3-5 times a day seems to be working and you'll find that there is a wealth of info, relevant advice and positive support about LCHF on the forum ..

I see that @Bluetit1802 has already tagged @ daisy1 for you and I suggest that you read up on the Low Carb Program in the information that she will soon be sending you. You might also find the discussion on the Low Carb Diet forum helpful .. together with the following Diet Doctor websites, which will give you all the info that you need on what and what not to eat ...
Low Carb Intro and Information and Low Carbs in 60 Seconds

It's good that you are testing your blood sugar levels and I recommend that you test before meals and then again two hours after you started to eat .. some folk also test one hour after eating and take a fasting blood glucose reading first thing in the morning. You will soon develop your own testing pattern which will enable you to monitor trends over time and to spot any foods that cause your blood sugar to "spike" or fall ouside the normal ranges. The ranges that you are looking for are ..
# Before meals: 4 to 7 mmol/l
# 2 hours after meals: under 8.5 mmol/l
I've been testing 3-5 times a day since I was diagnosed in February, which means that I now know what my BG levels are .. and I can now manage them

Hope this helps

@davealan1962

Hello Dave Alan and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful in addition to the advice other members have given to you. Ask as many questions as you need to and someone will be able to 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 well over 250,000 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

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.

Over 145,000 people have taken part in the Low Carb Program - a free 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

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.

Take part in Diabetes.co.uk digital education programs and improve your understanding. They're all free.

• Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why
• Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.

slinkimalinki said:

You need to test at the one hour mark after eating to see if there is a spike, then at the 2 hour mark you should be back to your original number.

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I think this is too harsh a target for a new comer. I would advise leaving the 1 hour test alone for now until well in the swing of things and numbers are more clearly understood, and whilst still learning about danger foods being back where you started at 2 hours is probably unrealistic. Testing at an hour is useful once in the swing of things.

Bluetit1802 said:

I think this is too harsh a target for a new comer. I would advise leaving the 1 hour test alone for now until well in the swing of things and numbers are more clearly understood, and whilst still learning about danger foods being back where you started at 2 hours is probably unrealistic. Testing at an hour is useful once in the swing of things.

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I could not agree more. Nothing worse/more demotivating than being set what must to a newcomer appear an impossible target.

Achieving two hour after meal counts of no more than 2mmol/l higher than pre meal levels seems to me a more sensible initial target and even this will probably take a while and lots of trial and error to achieve.

Once this initial target is achieved consistently then, should one wish to, one could adopt the tighter limit suggested above.

Sent from my SM-G935F using Diabetes.co.uk Forum mobile app

slinkimalinki said:

You need to test at the one hour mark after eating to see if there is a spike, then at the 2 hour mark you should be back to your original number.

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That seems a bit fast - I am still up to 2 whole numbers higher at 2 hours after eating, and I have normal numbers. I tried to keep to under 8 at first, did not always succeed for some time, but gradually things were turned around and the foods which now sent me to 8mmol/l now barely raise a 7.

davealan1962 said:

Just thought I would let you know, that I tried a little test like what you said about certain meals. Well I was shocked to find out that one meal that I love made my bs 5.1 higher after 2x hours of eating the meal compared with what it was just before the meal. I am also finding out with the results I have been doing, that my bs is higher at the weekend then during the week. One question I do have and I don't know if you can answer it and that is, " is it best to have 3x meals a day, or more meals but less portions over the day to stop bs spikes?".

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I told you there would be some shocks! I hope you can learn from the shocks that some foods need to be taken out of your diet, and others may just need the portion size reducing.

My thoughts on meals are to have 2 or 3 a day, skipping one is good, adding more is not so good. The longer time there is between eating the longer our pancreases are able to rest and the less insulin we have floating about our bodies. Also, after eating there will be a rise and that rise needs time to come back down before we eat again, otherwise when we eat next we may still be higher than normal, and this has a knock on effect of making us even higher after we have eaten, and so on. Personally, I skip breakfast apart from a coffee with cream, eat lunch and evening meal, just eating in a 6 hour window and fasting for the other 18 hours. This is known as intermittent fasting, 18/6.

Bluetit1802 said:

I think this is too harsh a target for a new comer. I would advise leaving the 1 hour test alone for now until well in the swing of things and numbers are more clearly understood, and whilst still learning about danger foods being back where you started at 2 hours is probably unrealistic. Testing at an hour is useful once in the swing of things.

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Totally agree. I've been low carbing about 8 months and HbA1c is now in normal range, but it is rare for me to return to exactly where I started after 2 hours, even when eating a zero carb meal.

Goonergal said:

Totally agree. I've been low carbing about 8 months and HbA1c is now in normal range, but it is rare for me to return to exactly where I started after 2 hours, even when eating a zero carb meal.

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Same here, and I've been doing it for well over 3 years..