Newly done

Hi Michael and welcome to the forum
It is all very confusing to start with but you have done the right thing in joining this forum as the members will answer all your questions. To help you, here is the information we give to new members and I hope you will find it useful.

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.
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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...

Hi Mick

Welcome to the forum.

Mary x

Hi Mick and welcome to the forum.

All a bit of a shock when it happens and can be very confusing but try not to worry as there's loads you can do to sort things out.

On the hypo thing. It is strange your doctor has put you straight onto Gliclazide as that is a medication that is normally prescribed after another called Metformin has been seen not to work. The main difference is that Metformin will not cause hypos and would not require you to report your condition to the DVLA where as Gliclazide can in some cases (like taking it without eating) cause hypos and will mean you have to report any uncontrolled hypos to the DVLA BY LAW and run the very real risk of losing your driving licence. Read the section called Hypoglycaemia in this doc http://www.diabetes.org.uk/Documents/catalogue/Driving_and_diabetes.08.11.pdf Given your work I'm not sure if this is important to you.

Another reason many of us newly diagnosed T2's do not like Gliclazide is that it works by stimulating your pancreas to produce more insulin. In most T2 diabetics our pancreas is still producing insulin, in fact it is probably working flat out. The initial issue with T2 is one called insulin resistance where the insulin we produce is not working effectively to reduce our blood sugar levels. Gliclazide works by "turbo charging" your pancreas to produce even more insulin and while in the short to medium term this helps long term it is thought it may shorten the life of the pancreas and once gone the ONLY thing that will keep you alive is going on insulin injections.

Metformin works in a different way by attempting to stop your blood take up sugar so it doesn't stimulate the pancreas and doesn't run the risk of causing hypos. On Metformin you would have no additional risk of a hypo than a non diabetic. That's why the DVLA don't worry if you are a T2 just on Metformin. Metformin also is good for protecting against heart disease. I would ask your GP why you have been put straight onto Gliclazide rather than Metformin.

In any event many of us find that changing what we eat to "safe" foods works ten times better at controlling blood sugar levels than any diabetic drug. That has certainly been the case with me. Here's what I did. I was diagnosed in December last year and using the advice I found on this site I 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 over 3 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. I have normalised everything and just take Metformin to help a bit. Not a cure as I still have to be very careful what I eat but I feel loads better than I did.

Diet wise its 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 diet 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 have already seen what I and other forum members recommend is different to what your are told is a good diet for you follow.

Did your doctor give you a blood meter and strips as some do and some don't? It's a bit of a post code lottery and we find the progressive surgeries are pro testing and others anti. I'll warn you the anti ones can sometimes be very vocally anti! If you find your surgery is really anti then many of us would recommend getting a meter and strips yourself. If that turns out to be the case then just ask and lots of members can help.

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