Newly Diagnosed with Type 2 Diabetes

[sandra1960]

Hi My name is sandra i have been diagnosed with type 2 diabetes at the moment it is being controlled by diet, nurse has told me that i will eventually be dependant on insulin. I am married with 2 grown up children and 4 grand children . I would appreciate any help with diet tips or any other tips that i might find helpful.

Thanks in advance

Sandra

 

[daisy1]

Re: Newly Diagnosed with Type 2 Diabete's

Hi Sandra and welcome to the forum. Here are some tips for you as requested! This is the advice we give to new members. Have a good read of this, read around the forum, and ask as many questions as you like - we would all love to help you

ice we usually give to newly diagnosed diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2010 NICE guidelines for Bg levels are as follows:
Fasting (waking).......between 4 - 7 mmol/l........(Type 1 & 2)
2 hrs after meals......no more than 8.5 mmol/l.....( Type 2)

2hrs after meals....... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do 30 minutes moderate exercise a day. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Sue/Ken.

 

[sandra1960]

Re: Newly Diagnosed with Type 2 Diabete's

Hi daisy

Thanks for replying so quickly, im a little confused now as the nurse told me to eat plent of carbs and im not able to test as i wasnt given a tester, i do have to see the doctor on friday so i will ask for 1 and tell him i also want to be in control.

Thanks

Sandra

 

[daisy1]

Re: Newly Diagnosed with Type 2 Diabete's

Hi again Sandra
Our advice does differ from what the NHS and DUK say but we find that this works better. You have to work out what foods you can tolerate by testing (2 hours) after meals and adjusting things accordingly. There is no set advice as far as we are concerned, just some basics which we post. That advice has helped many on here.

 

[sugarless sue]

Re: Newly Diagnosed with Type 2 Diabete's

Hi Sandra, welcome to the Forum.

here is something Ken and I thought up as an argument to get strips. Have a read and see if you can use any of these to persuade your Doctor to give you strips.

There is a trend amongst certain HCP’s to tell Type 2 Diabetics that they do not need to test their Blood sugar levels. This is mostly driven by the fact that the cost of test strips is a very large part of any surgeries budget ! There is an even more worrying trend to tell Type 1’s not to test too frequently!

Diabetes is a condition where glucose cannot be metabolised properly for whatever reason.

Carbohydrate is the chief source of glucose.

Telling someone on diet only to eat ” plenty of carbs” at each meal is not right as they have no way of correcting the highs if they occur.

Initially you need to test your blood glucose levels before and at least two hours after every meal to see what the foods you are eating are doing to your blood glucose levels. By two hours they should normally be down to pre meal levels. For about a month you should keep a detailed food diary with the foods you eat, number of carbs in each meal and the Bg( Blood Glucose) readings for that meal.
Once you get the hang of which foods you can eat then you can slowly cut back on the testing when you are confident to do so. Getting control of your Bg and therefore your Diabetes will make you more confident in dealing with Diabetes and may help to slow down or stop any complications developing thus saving the NHS money on further treatment ! Diabetes does not have to be progressive if well controlled.

The NICE guidelines do NOT say that Type 2’s should not test !

Below are the guidelines on testing and my thoughts on how to interpret them to the Doctor / HCP who tells you you do not need to test !

NICE Guidelines.

Patient education

● Offer structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review. Inform people and their carers that structured education is an integral part of diabetes care.

Ask about courses in your area. DAFNE for Type 1’s. DESMOND for Type 2’s. Many areas also have courses that are specific to the area as well with different names.


Dietary advice

● Provide individualised and ongoing nutritional advice from a healthcare professional with specific expertise and competencies in nutrition.

Therefore if a ‘normal’ Practice Nurse / Diabetic nurse gives you advice on diet ask to see a qualified Dietician !


Setting a target HbA1c

● When setting a target HbA1c:
– involve the person in decisions about their individual HbA1c target level, which may be above
that of 6.5% set for people with type 2 diabetes in general.


The key word here is ‘involve’ don’t be dictated to ! You may have to be assertive but always be polite !


– encourage the person to maintain their individual target unless the resulting side effects
(including hypoglycaemia) or their efforts to achieve this impair their quality of life
– offer therapy (lifestyle and medication) to help achieve and maintain the HbA1c target level
– inform a person with a higher HbA1c that any reduction in HbA1c towards the agreed
target is advantageous to future health.


How do you maintain your target without testing ? An HbA1c is only a guide to your blood sugar levels it does not show the highs and lows of everyday Bg readings.

If you run your Bg levels high for three months / six months you could be doing a lot of damage to your health. By daily testing you can keep control and levels down.


– avoid pursuing highly intensive management to levels of less than 6.5%.

This may be good enough advice for someone on Insulin etc but if on diet or some of the medications there is no reason why you cannot have a lower Hba1c than 6.5 % .This is providing there is no other medical reason why you should have a higher level.


Self-monitoring

● Offer 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. Discuss its purpose and agree how it should be interpreted and acted upon.


Self-monitoring of plasma glucose should be available:

● to those on insulin treatment.
● to those on oral glucose-lowering medications to provide information on hypoglycaemia.
● to assess changes in glucose control resulting from medications and lifestyle change.

( This is the one to use ! You are on a very big lifestyle change initially when you become diagnosed ! You need to learn about YOUR diabetes and the only certain way is by testing and trial and error ).

● to monitor changes during intercurrent illness.
● to ensure safety during activities,including driving.

( If you are a driver then you need to test to check your BG levels for the sake of safety on the road )

Assess at least annually, and in a structured way:
● Self-monitoring skills.
● The quality and frequency of testing.
● How the results are used.
● The impact on quality of life.
● The continued benefit.
● The equipment used.

You want to test because you want to be in control of your diabetes. You want to be complication free so need to keep your Bg down, you can only do this by testing regularly.

You want to control your Diabetes with diet to start with so you need to test to see what the foods you eat are doing to your Bg levels.

You will keep a food diary etc so that you can interpret the results and act on them, reducing portion sizes and avoiding foods that raise your Bg levels.

The “impact on your quality of life” is immeasurable ! It is keeping you from becoming an uncontrolled Diabetic.

The “continued Benefit” is keeping you on track with your management and being able to check you are still on track. You need to be able to test when you are not feeling well or if you eat something new.


Discuss urine glucose monitoring if plasma monitoring is found to be unacceptable .

If this is discussed as an alternative then please point out that glucose does not show in your urine until after about 12 mmol/L in the blood ! Therefore as you wish to remain a lot lower than this to control your Diabetes you need the proper blood glucose monitoring equipment!

Over the years we have seen a variety of HCP ‘excuses’ for not giving test strips to Type 2 Diabetics.
“ You will get stressed “ NO ! I would get stressed by not testing !

“We will tell you what your numbers are by doing HbA1c every 6 months “ Not good enough ! you need to know every day what your blood sugars are doing.

“ We will tell you what to do “ NO. YOU want to be in control ! It is your Diabetes not their’s. Are they going to be at the end of a phone 24/7 to answer your questions ? NO. They knock off at 5 o’clock and leave you to the mercy of NHS 24.

The worst one ? “ Don’t test as you will damage your finger tips and will not be able to read Braille when, ( not If, you notice !) you go blind !!!! The only answer to that one is to complain to the Practice Manager !

Sue / Ken.

 

[Sanober]

Hi Sandra

I've just joined too

My Diabetes nurse has told me they won't give out Glucose Meters as there has to be 'strong justification' for it, the metres are ok but it's the strips apparently because they're expensive.

She said they only give out metres/strips to people who have bad control so they can see for themselves what's happening to their glucose levels.

I was told I won't be getting a meter. Interesting but then I'm seemingly an anomaly at the moment and awaiting referral to a specialist because I'm not a standard Type 2 because of my age (I'm 34) and my already healthy eating/fitness regime.

Let me know if you're successful getting a meter. Because I agreed with Sugarless Sue how on earth am I to know what affect eating and exercise is having?

 

[lister]

hi sandra and welcome,
i agree with daisy and sue as i am in the same cat as you but finding lowering my carbs and self testing i am able to see what food trends are affecting me personally and have now lost about 1 and a half stone and got my sugar levels down we are all different and our bodies deal with different things in an individual way.
good luck.
Rob

 

[JUSTFOCUS]

Hi Sandra welcome
Enter the competition advertised on here Apparantly some people have won new meters :wink:
It's free

 

[viviennem]

I didn't 'win' the competition but nevertheless they sent me a meter! not the posh USB one, an ordinary Contour.

Still doesn't solve the strips problem, though. Keep pushing for them - testing, at the very least for a few months when you're first diagnosed, means you really get to understand what's going on and I'm sure saves lots of grief later. 'Learning what you're doing' is a good argument.

Good luck!

Viv

 

[Daz66]

Re: Newly Diagnosed with Type 2 Diabete's

Hi daisy

Thanks for replying so quickly, im a little confused now as the nurse told me to eat plent of carbs and im not able to test as i wasnt given a tester, i do have to see the doctor on friday so i will ask for 1 and tell him i also want to be in control.

Thanks

Sandra

Hi Sandra,

Sorry to read you have just been diagnosed, I too was told the same when I was diagnosed back in 2001. I had a nervous breakdown in 2004 and spent 8 days in hospital, 8 days of jacket potato and beans was not ideal! (esp in a confined space lol). I guess you need some carb for energy but then if you don't burn the carb by exercising, the bread, rice, pasta, potato etc will turn to sugar in your system and bump up your blood sugars. I'm new to this site too, plenty to read by the looks and lots of good advice/info, try not to worry, I think we are in a good place. take care, D x

 

[Daz66]

Forgot to mention about the test meter issue, if the doctor doesn't supply you with a meter there are other ways you can get one, either cheaply or for free. I was given 2 when I was diagnosed 10 years ago but the test strips are no longer available for the meter . I happened to be looking at one of the diabetesUK sites and there was a advert on there for a free meter, filled out the form and it came within a couple of weeks. It's a good one too, one handy unit that has the finger pricker connected to the side of the tester, it takes a 50 strip drum, comes in a nice wallet and has spare lancets included, all of these , the drums of strips, lancets , needles etc are available on prescription, just have to see your GP and tell them what you require.

My meter is a ACCUCHECK COMPACT PLUS, in black with a nice yellowygreeny digital display, shows time and date, has a memory so you can keep track of your blood sugar history and I think you can hook it up to your pc if you want to keep a record of your levels on there. You could always google the name of the meter and see if it comes up anywhere as being free, I bought myself one from Asda too, as I am on the road all day, now have one for the van and one for home. It think it was around a tenner in Asda, so not expensive. I cant understand why your doctor says you wont be provided with one, you need to keep a check on your sugars, also, you can feel low sugar and your reading will be high, so the only way to know for sure is to take a reading. Best of luck and all the best for now, D x

 

[sandra1960]

Hi all thanks for the replies.
I saw the doctor and it was a NO NO with a meter was told not necassary yet as im not insulin dependant so i went on ebay and bought 1 for just under a tenner, i saw the nurse again and im now told my blood pressure is too high and may have to go on more meds. Both myself and hubby laughed at this as we both said together i will be ratteling with all the tablets i take . I have got an appointment at the Desmond clinic so will go see what they have to say. Yesterday was a bad day was a little tearful as im only just recovering from breast cancer also i suffer from osteoporosis, the nurse wants me to go for a walk every day for at least half an hour erm i cant walk 10 yrds without having to stop cos of the pain in my hips and knees, so i have invested in an excersise bike and will do 10 mins a day and gradully build up the time im on it. Once again thank you all for the replies if i do not reply straight away you will no im having a bad day , Speak soon take care and as sue says at the bottom of her page i too wish to die with my feet on ,... :lol:

Sandra xxx

 

[Gappy]

I've only been diagnosed a short while but I have made small changes as I want them to be sustainable. So the exercise bike sounds a good idea for you, but put it in a room where it can be seen! My mum put hers in the spare room and now it's not been used for months!