NEWLY DIAGNOSED

Hi Raione and welcome to the forum Here is some information for new members which should get you started. Keep reading as much as you can and ask questions when you need to as there is usually someone here 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 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.
-------------------------------------------------------------------------------------------------------------------------------------------------------

Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.

Click to expand...

Raione said:

Hi im newly diagnosed as a type 2 diabetic and for the past two weeks have been reading most of the posts and have found it very encouraging and informative

Click to expand...

Hi Rainoe

Welcome! This is really a mine field of information!! And people are really helpful when it comes to questions etc.


Good luck

Hi My name is Yvonne.I am 55yrs old.I was diagnosed with Type 2 Diabetes 2 months ago.I regulary go to see a health trainer where i'm learning about diet and exercise.

Hi and welcome to both raione and jezcrazy. Any questions, just fire away. Jezcrazy, I'm sure your health trainer is great, but just remember that what's healthy for a non-diabetic can be decidedly unhealthy for a diabetic. Do read about diet on this forum as well.

Hello Yvonne and welcome

Grazer makes a good point as usual. Just make sure your health trainer understands what is a safe diet for diabetics. In the meantime here's what I did.

I was diagnosed in December last year and using the advice I found on the forum got my blood sugar levels back to normal within around a couple of months or so and I have also normalised my cholesterol levels and blood pressure as well. I have now lost nearly 4 stone in weight too. My doctor is very pleased how I am getting on and has advised me to keep doing what I have been doing since it's obviously working really well. You can normalise your blood levels but that isn't the same as a cure I'm afraid. What it means is that you will need to be very careful about what you eat from now on.

What you should eat diet wise is really easy. Just drastically cut down or better cut out all things with plain sugar, so biscuits, cakes, sugar in tea and coffee, pure fruit juices, non diet versions of soft drinks. Next and really importantly try halving starchy foods like rice, pasta, potatoes, bread, cereals and any other flour based products. Replace what's now missing with extra meat, fish, eggs, cheese and especially vegetables. Vegetables that grow above ground are best although most of us find carrots fine. Things like yoghurt are fine as is a small amount of fresh fruit. I find the ones that end in "berry" are the best. If you don't mind artificial sweeteners things like Diet Coke are fine to drink. On the starchy foods that are left swap try brown basmati rice instead of white and brown or tri-colour pasta. The bread that most recommend is actually Bergen soya bread but some do ok with wholemeal as well.

The above regime is close to one you would be one recommended to try by the Swedish Health service. It was introduced in that country last year and the American health service and several other countries health services recommend something very similar for Type 2 diabetics. In the UK the diet guidelines are now over 30 years old and are only gradually being updated. As the UK is lagging behind you may find what I and other forum members recommend is different to what your are told is a good diet for you follow.

Next most members would recommend you test your own blood sugar levels. Did your doctor give you a meter and strips? Some do and some don't. It's a bit of a post code lottery and we find some progressive surgeries are pro testing and others anti. I'll warn you the anti ones can sometimes be very vocally anti! If you ask and get told no then if you can afford to most members will get a meter and test themselves anyway. A meter that many people are buying at the moment is called as SD CodeFree. The meter and 50 strips will cost under £20 then new strips are just £5 per 50 which is a lot cheaper than most other meters. The cheapest place to buy is the healthcare.co.uk shop on eBay but make sure you get a UK mmol/l model and not a US mg/dl one or the numbers it shows will be confusing.

The reason testing is important is you should try and keep your blood sugars below 8ish two hours after eating any meal. Above the 8 value is where the dangers of complications do begin to occur according to diabetic experts. So if you can't test how will you now if what you are eating is keeping you safe? The problem is every diabetic is different so my earlier advice to halve starchy foods is just a rough guide. You may find you need to eat less than half (like me) or that you can eat more than half like others.

As you get into it all and read around the forum you may see people talking about carb counting. If you want to understand what that is just ask. It is a powerful weapon that a diabetic can use to control their condition and one that many of us use to great effect.

Good luck and keep asking questions.

Regards

Steve

PS Here's two good links about what's good to eat.

First is the lady doctor who's low carb / low GI recommendations seem to form the basis of what's recommended in Sweden

http://blogg.passagen.se/dahlqvistannika/?anchor=my_lowcarb_dietary_programe_in

Second is a good beginners guide to low carb regimes that are excellent for reducing blood sugar levels and losing weight.

http://www.dietdoctor.com/lchf

Hi I was diagnosed 3 weeks ago and still don't know what type I am, can anyone tell me how long it takes to find out which type you are and how they do it?

Grazer said:

Hi and welcome to both raione and jezcrazy. Any questions, just fire away. Jezcrazy, I'm sure your health trainer is great, but just remember that what's healthy for a non-diabetic can be decidedly unhealthy for a diabetic. Do read about diet on this forum as well.

Click to expand...

Hi Grazer,yes i will do.I need all the advice i can get,it's all very confusing to me.I'm trying to control my Diabetes with watching my diet.The tablets i am on are Ramipril for my blood pressure and Simvastatin for my cholestrol.

Hi all.

Recently diagnosed in the last 3 months to Type 1 and have been put onto Insulin injections. Lantus at about 20 units in the morning and then Novo Rapid of about 8-12 units before Breakfast, Lunch & Dinner. Blood Sugar is stupidly high all day (15 at 6am through to 30 around 3PM) and I am naturally tired and losing focus with my work - My Vision is getting slightly worse on the VDU also to a noticeable level.

My Diet is not too bad. Cereal for breakfast, Ham Salad on Granary and a banana at lunch and usually chicken or fish with spuds and veg for dinner (very repetitive I must say). Lots of Tea and Coffee, some water and say 1.5 pints of beer a day (averaged).

I have a check up on 27 July but wanted some comfort as to whether it is within my control to increase the Lantus to reduce the overnight reading. I have so many questions and find that exercise is a great source of reducing the suagr levels, but when they get below 5 I really get the shakes, run for a slice of bread and jam and the sugar levels spike instantly. I dont veen have to be that active. Simple tasks like housework or a round of golf has me in bits.

Who is the best person to discuss next steps with - Diabetic Nurse, Consultant or perhaps just a Dietician ??

I am committed to doing as I am told...

Thanks in advance
Shaun

Last HBA1C = 13.2 / 14d Ave BG = 18.2

Hi shaun and welcome to here.

First of all, having symptoms of hypoglycemia is normal at slightly higher blood levels if you have been running high for a while. If you can avoid over-doing your 'treatment' to get the symptoms to go away, you will get used to it in time. If you have symptoms, try with half a slice of bread with ham instead of jam for instance.

Your diet is not too bad for a type 1 - your insulin should be able to cope with it, that is, if your insulin dose is correct for your meals. Do you test before eating and afterwards so you have a basis for telling whether the dose you inject is correct for your amount of carbohydrates in your food? Ideally, you would want to see your levels before eating rise by 2-3 mmol at the two hour mark after the meal. If it goes up by more than this, you would need another unit or two for that meal.

If you have excess blood sugar in your blood from the meal time insulins not working enough (determined by method above - testing it), I would not touch the basal first, but rather try to make a better guess of your meal. In this situation you may find your basal is fine but your body 'accumulates' meal time sugar.

However if your after meal readings are in the 3 mmol range, I would talk to the diabetes nurse about adjusting the basal.

It is normally recommeded to adjust only by about 5-10 percent, which for you means 1-2 units of Lantus adjustment, then wait 3-4 days to see the full effect and then assess from there. If you are not entirely comfortable with this on your own, that is understandable and I would discuss it with the health care pro that you're most comfortable with who also has a sensible knowledge. It could be the Diabetic Nurse or your GP.

Really though, you need a few tests.

The other way to test your basal is to not eat anything from you wake up till lunch and not take your NovoRapid. If your blood glucose rises more than about 2 mmol in this interval this indicates you need to adjust your basal. If it falls, your basal is too high. If it stays around 1 mmol from where it was, the level will be right. This test is only really good if your starting level is somewhat sensible though, so I would discuss it with them - and get the meter and pen and paper out and jot down what you ate, what you injected and how the blood sugars were.

Good luck.

Thanks Mileana - greatly appreciate your advice

You're welcome.