not managed diabetes - best meal replacement shakes to buy?

Hi @Christina2 welcome to the group. I will tag @daisy1 to send you welcome info. We have all been where you are at the moment so you are not alone. Bit confused as to why the nurse said that you had to inject and strange her not knowing if you have had any tablets! What was your HbA1c? Do you have a Blood Glucose test meter? If not I would advise you get one then you can keep an eye on things. Do you need to loose weight? Please only answer what you are comfortable with. You have come to the right place for help, advice and support with your journey. Any questions ask away. Good luck

Hi Christine and welcome. First let me tag in @daisy1 for her useful welcome post.
Do you mind letting us have a bit more info so we can help you? Do you have an HbA1c result? If not is your nurse basing your diagnosis on one finger prick test of 15? Usually diagnosis is on the basis of two HbA1cs.
You may be able to get your blood sugar levels down by eating low carbs rather than using shakes, but if you do start taking the tablets you’ve been given you’ll need to be careful of hypos once your levels start to come down. Do you have a glucose meter at home?

christine 2 said:

I was diagnosed in 2012 and was very good for a few years. Then I sort of gave up. Chocolate/cakes, whatever I wanted. No side effects as far as I know. Had a medical and my blood sugar is now 15. I am sad to know that I was originally pre-diabetic but told I was diabetic. I think I might have been better but I wasn't and am now where I am. Nurse said I had to inject myself in stomach, then said had I had tablets? Disappointed she didn't know. Picked up prescription for competact on Friday. Looked on internet and now s.Scared to take them. pioglitazone has bad reputation for bladder cancer. would like to try meal replacement shakes instead. But what are best for low sugar/diabetes type 2 that I can buy?.

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Was 15 a fasting test or spot test in the clinic. I understand your concerns re competact. The pioglitazone component is actually banned in some countries. Are you overweight ?

christine 2 said:

I was diagnosed in 2012 and was very good for a few years. Then I sort of gave up. Chocolate/cakes, whatever I wanted. No side effects as far as I know. Had a medical and my blood sugar is now 15. I am sad to know that I was originally pre-diabetic but told I was diabetic. I think I might have been better but I wasn't and am now where I am. Nurse said I had to inject myself in stomach, then said had I had tablets? Disappointed she didn't know. Picked up prescription for competact on Friday. Looked on internet and now s.Scared to take them. pioglitazone has bad reputation for bladder cancer. would like to try meal replacement shakes instead. But what are best for low sugar/diabetes type 2 that I can buy?.

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I suspect you are heading along the right lines if you are cautious about taking medication and want to try a change of diet first. It depends on the detail of your circumstances of course.

The meal replacement shakes that are commonly available in supermarkets are usually high in carbs, about 25g once made up with milk as directed. They are far from ideal for diabetic people, but you often hear of overweight people with T2 using them to lose weight rapidly, and they are usually doing what they call the 'Newcastle Diet', and as well as 3 shakes a day, they have about 200 calories from vegetables. This forum is a good place to read up on the pros and cons of such an approach. I used them briefly and didn't die and found it fine after 3 days, but I wasn't sure that rapid weight loss was a particularly good idea, plus I didn't have the energy for my hobbies at the weekend.

A huge number of people on this forum do well on 'real food', where they control exactly what they eat, in particular the amount of carbohydrates in each meal. Using a blood sugar meter, you can start to learn what foods you can safely eat at each meal by testing when you start eating then 2 hours later and seeing if your blood sugar has gone too high. Generally this approach will lead to lowering the carbs a lot, and upping the fat to replace them. In spite of upping the fat, it also usually helps with weight loss, as your body gets used to burning fat both from your diet and your stomach, plus people tend to want to eat less of that type of food.

It is too easy to let the 'occasional' become the usual. Unfortunately it may be that your medical record has not been copied onto the computer system, so no-one will know whether or not you have had some treatments, including inoculations. What is done is done and it is important now to look to the future.
First of all get yourself a blood glucose monitor and learn how to use it, it may take a while to get the small droplet of blood out of the side of your finger even though a paper cut bleeds profusely. Use it on waking then just before eating and 2 hours after first bite, keeping a note of the numbers. If the later figure is more than 2 above the first then that meal is too heavy in carbs for you now. You may be surprised, I found that bread caused a spike which I was not expecting.
When you next shop read the nutrition labels and try to avoid anything that has more than 10g /100g of carbohydrate. It is a pain and takes time but after a couple of weeks you build a new routine. Try to keep to vege that grow above ground and fruit in the form of berries. By eating in this way I found that I lost weight, slowly but surely; my bg improved and it only took a few tweaks to find a food regime that I can keep for life.

@christine 2

Hello Christine and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful and interesting. Ask as many questions as you need to and someone will be able to help.


BASIC INFORMATION FOR NEW MEMBERS

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 235,000 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 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. Most of these are 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.
  

christine 2 said:

oh dear, just looked Weetabix, which is low in sugar is 69g in 100g. This is going to be a big change because it is so easy to eat cereal and it fills me up.

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Full fat plain yogurt with a few berries is quick.
Any leftover meat, cheese, olives, hard boiled eggs from the night before are easy.

christine 2 said:

Thank you for your replies. I did feel alone with nobody to talk to and these are helpful.

It was an hba1c that was 15. I am 90 kg (14 stone ish) so overweight but not too bad. I was 15 stones when I was first diagnosed in 2012. I lost 2 1/2 stone and have kept off 1 stone. The fat is around my middle, which I know is not good. I have a test kit that I am now using. I was 14.2 this morning at 8.30 am and had no food until 9.30, when I was 10.2. I'm hoping I can get the figures down without tablets. Do you think this is possible? I read that the pioglitazone is banned in some countries. Thank you. I know the sugar on packets should be less than 5 in 100 and I spent a lot of time finding Weetabix, which seems ok but I will now look at the carbohydrates in it.

"Avoid if has more than 10g /100g of carbohydrate" - that is very useful, I did not know this and will try it.

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Weetabix isn't a good food for diabetics it is going to be at least 2/3rds carbohydrate like most grain based foods - far too high for most people.
I was perhaps lucky to be able to reduce my numbers to normal simply by excluding high carb foods, nothing over 10 percent carbs seems to have worked well and I enjoy all the foods I can eat.

christine 2 said:

I was 14.2 this morning at 8.30 am and had no food until 9.30, when I was 10.2. I'm hoping I can get the figures down without tablets. Do you think this is possible?

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Yes I think this is possible. I was averaging about 16 in the middle of the day last year when it really hit me hard and I started to take action.

Without medication I can get a long run of morning fasting readings between 4 and 6. I'm not achieving that at the moment but I know why and am working on it.

A quick fix I used a few times was a few days of very low calorie eating. For a few days I tried the Blood Sugar Diet approach, and later on I tried the Newcastle Diet approach using the kind of shakes you mention. Either way it was about 800 - 1000 calories a day. I never did that for more than a week. On both occasions the readings dropped each day just like in the Newcastle experiments.

An alternative for relatively quick gains (i.e. blood sugar reduction) which may be better for the metabolism is fasting provided you aren't on blood sugar reducing drugs (I gather you haven't started taking them yet?) and start with short fasts e.g. skipping one meal a day.

A more long term approach for sustaining lower blood sugar is to eat normal amounts of real food but cut the carbs right down, ideally less than 50g a day, and replace with as much good quality fat as needed to stop you feeling hungry. While ensuring you have enough protein - a minimum of 50g a day seems to be a figure quoted for safety, and many people seem to end up having say 100-150g.

christine 2 said:

oh dear, just looked Weetabix, which is low in sugar is 69g in 100g. This is going to be a big change because it is so easy to eat cereal and it fills me up.

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Yes, it really was a big change for me. I don't think the new way of eating will ever feel normal to me and there is a huge amount to learn, and a lot of adjustment near the start. It definitely gets better and easier though, and most evidence suggests that it's the way we should be eating anyway for good health - the only reason it doesn't feel normal to me is because I was brought up for decades in an unhealthy food environment like most of us, and it's hard to unlearn what you've been doing every day since you were born.

When the whole idea of Weetabix seems preposterous to you, which may be in say six months time, then you know you are well established on the right path!

for a quick breakfast I grab whatever is in the fridge - but when I have time to cook I do omelettes, or kippers and cauliflower, even chops.
I was given a statin to take when diagnosed along with Metformin, it made me feel very ill indeed so I stopped taking them. My cholesterol went down which actually - being elderly and female isn't good - we live longer if our cholesterol is not reduced.

christine 2 said:

Do you have high cholesterol problems on the Atkins diet? I have been given a statin to take, which I'm not keen on either. My cholesterol is at 6.0. I do take high blood pressure tablets - Losartan.

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At the moment worry about your blood sugar levels.. once we get those down then we'll explain why higher cholesterol readings are probably beneficial/protective for women over 50.. you'll be amazed but for the minute in your shoes lowering blood glucose should be a priority. Good luck .. intermittent fasting say skipping breakfast can also be a great way to get sugars down but will be much easier after a few weeks on a very low carb diet.
Have fun and enjoy food again.

Hi @Christine 2 welcome to the group. There is a lot to take in but you will get there. My Bg was 16.6 a month ago. I went on the Low Car High Fat (LCHF) diet. I do 18/6 fasting, no food between 20.00 and 14.00 next day. Only black tea, coffee, water and vitamin water as needed. I also go for less than 15 -20% carbs. Have a look at the Low Carb thread for more info, its amazing what you can eat!! My Bg are averaging around 7.5 now so well pleased. You are in the right place for help, advice and support. Good luck