Overwhelmed thanks to Dr Google

[Dippers83]

Not sure where to start with this one and I have so many questions!

So I received private blood tests back this week and among other things showed my Hba1c is 77. The doctor basically said this shows diabetes and cut out the refined sugar.

I’ve sent these results to my NHS gp and have a telephone consultation booked in a couple of weeks but I feel a bit in limbo in the mean time.

I should say as well that I have an under active thyroid, postural orthostatic tachycardia syndrome (PoTS), a BMI of 43 and vegetarian to boot (that’s more relevant from a diet point of view)

My main questions are below if anyone can help with any of them please?

1. I’ve seen through looking at this forum that a lot of people say that you need two results to confirm the diagnosis. So does this mean it’s possible I don’t have diabetes? (This is why I haven’t set my diabetes status)

2. Should I just be cutting out the refined sugar as suggested or should I start adjusting my diet more?

3. If I do adjust my diet is it simply a case of going low carb or is a low gi diet as beneficial? Or should it be a combination of the two?

4. Is it worth me getting a blood glucose monitor before I speak to the doctor?

5. Do I need to take any notice of the ‘of sugars’ on food labels I.e. should it be a percentage of the carbs? Or should I completely ignore this?

I have the added complication that if I don’t eat enough my PoTS gets worse so I really need to figure this all out so I can adequately plan and research everything so I don’t faint from not eating enough either but I need to eat little enough to lose weight. It just feels like a vicious circle.

Thank you if you got this far any advice is really appreciated. Even if it’s ’wait for the appointment’

 

[Antje77]

Hi @Dippers83 , welcome to the forum.
Let's see:

1. I’ve seen through looking at this forum that a lot of people say that you need two results to confirm the diagnosis. So does this mean it’s possible I don’t have diabetes? (This is why I haven’t set my diabetes status)

Very unlikely.
Mixing up of test tubes in labs is very, very rare.
Sometimes, when someone is only just over the diabetes threshold of 48 mmol/mol, they can have dropped below with the confirmation test. With a hba1c of 77 this isn't likely.

2. Should I just be cutting out the refined sugar as suggested or should I start adjusting my diet more?

3. If I do adjust my diet is it simply a case of going low carb or is a low gi diet as beneficial? Or should it be a combination of the two?

All carbs turn to glucose in your body, and refined sugar is just a carb.
A very small amount of refined sugar in an otherwise low carb meal will make blood glucose rise a lot less than a full plate of 'healthy' porridge.

4. Is it worth me getting a blood glucose monitor before I speak to the doctor?

YES!
If you use it to test before and two hours after meals, it can be a very powerful tool to work out what foods work for you. It will also answer question 3, without bias on one type of diet over the other.
Tagging @Rachox for information about meters in the UK to save you from spending more than you need to.

5. Do I need to take any notice of the ‘of sugars’ on food labels I.e. should it be a percentage of the carbs? Or should I completely ignore this?

I only look at the carbs, not the 'of which sugar'. It's all glucose once my body has dealt with it.

I have the added complication that if I don’t eat enough my PoTS gets worse

so I really need to figure this all out so I can adequately plan and research everything so I don’t faint from not eating enough either but I need to eat little enough to lose weight. It just feels like a vicious circle.

Not fainting sounds like a priority to me, and improving your blood glucose would be a close second in my book.
Losing weight is cool, and it will likely help with the diabetes as well, but for me, it would be a lot farther down the list of priorities.
Besides, many of our members have found they lost weight by lowering their carbs, and without lowering (or even watching) their calories.

and vegetarian to boot (that’s more relevant from a diet point of view)

Vegetarian low carb isn't a problem although it's a little more restrictive than eatig omnivorous. Bring reading glasses to the supermarket to check the carbs in commercial meat replacers, some are quite low carb, others very much not so.
Vegetarian low carb staple items to get enough calories are eggs, cheeses in all their glorious variety, cream, butter. All those items can be used to enrich any vegetable dish, both in calories and in flavour. And diabetes will be happy with those.

If you don't mind reading about meat, I find this piece written by one of our members very informative on how diabetes and food work, just mentally replace all the bacon mentioned with cheese and cream: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html
And again provided you don't mind reading about eating meat, here's a friendly thread in the low carb section of the forum where we share what we eat. Very good to get ideas: https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today-low-carb-forum.75781/page-2954

 

[OrsonKartt]

Hi @Dippers83 , welcome to the forum.
Let's see:

Very unlikely.
Mixing up of test tubes in labs is very, very rare.
Sometimes, when someone is only just over the diabetes threshold of 48 mmol/mol, they can have dropped below with the confirmation test. With a hba1c of 77 this isn't likely.

All carbs turn to glucose in your body, and refined sugar is just a carb.
A very small amount of refined sugar in an otherwise low carb meal will make blood glucose rise a lot less than a full plate of 'healthy' porridge.

YES!
If you use it to test before and two hours after meals, it can be a very powerful tool to work out what foods work for you. It will also answer question 3, without bias on one type of diet over the other.
Tagging @Rachox for information about meters in the UK to save you from spending more than you need to.

I only look at the carbs, not the 'of which sugar'. It's all glucose once my body has dealt with it.

Not fainting sounds like a priority to me, and improving your blood glucose would be a close second in my book.
Losing weight is cool, and it will likely help with the diabetes as well, but for me, it would be a lot farther down the list of priorities.
Besides, many of our members have found they lost weight by lowering their carbs, and without lowering (or even watching) their calories.

Vegetarian low carb isn't a problem although it's a little more restrictive than eatig omnivorous. Bring reading glasses to the supermarket to check the carbs in commercial meat replacers, some are quite low carb, others very much not so.
Vegetarian low carb staple items to get enough calories are eggs, cheeses in all their glorious variety, cream, butter. All those items can be used to enrich any vegetable dish, both in calories and in flavour. And diabetes will be happy with those.

If you don't mind reading about meat, I find this piece written by one of our members very informative on how diabetes and food work, just mentally replace all the bacon mentioned with cheese and cream: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html
And again provided you don't mind reading about eating meat, here's a friendly thread in the low carb section of the forum where we share what we eat. Very good to get ideas: https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today-low-carb-forum.75781/page-2954[/

- basic quorn pieces are around 3% carb which can make a good addition to a low carb diet.

 

[Guilty]

For a type 2 Diabetic vegetarian diet it helps me to keep in mind:

* Eat less ultra processed food
* Eat more non-starchy vegetables

And even gentle exercise can help (e.g. walking). Especially after meals.

 

[Dippers83]

Thank you - luckily quorn is my meat replacement of choice so that’s a good start!

 

[Dippers83]

@Antje77 Thank you so much! That’s all really helpful as I’ve felt like I’m going mad and going around in circles this week. I just had an overwhelming feeling that the advice to just cut refined sugar wasn’t enough for my Hba1c level and it led me down a rabbit hole! I’m so glad I found this forum as it seems like a treasure trove of information and so friendly.

 

[Dippers83]

For a type 2 Diabetic vegetarian diet it helps me to keep in mind:

* Eat less ultra processed food
* Eat more non-starchy vegetables

And even gentle exercise can help (e.g. walking). Especially after meals.

Thank you I’m going to have to dig my headphones out I think to motivate myself on walks.

 

[Rachox]

Hi @Dippers83 and welcome to the forum. Thanks for the tag @Antje77 , here’s some info on UK meters, and to be clear I have no commercial connections with any of the companies mentioned.



HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/



Links to the strips for future orders:

https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/



Then they sell the older SD Code Free, details to be found here!

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/





SPIRIT HEALTHCARE have a meter called the Tee2 + which is quite popular:

https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793



The strips are to be found here:

https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097



If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.



Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free. (for all meters and strips)

 

[Dippers83]

Hi @Dippers83 and welcome to the forum. Thanks for the tag @Antje77 , here’s some info on UK meters, and to be clear I have no commercial connections with any of the companies mentioned.



HOME HEALTH have the Gluco Navii, which is a fairly new model and seems to be getting good reviews.

https://homehealth-uk.com/all-produ...ose-meter-test-strips-choose-mmol-l-or-mg-dl/



Links to the strips for future orders:

https://homehealth-uk.com/all-products/glucose-navii-blood-glucose-test-strips-50-strip-pack/



Then they sell the older SD Code Free, details to be found here!

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/





SPIRIT HEALTHCARE have a meter called the Tee2 + which is quite popular:

https://shop.spirit-health.co.uk/co...e2-blood-glucose-meter?variant=19264017268793



The strips are to be found here:

https://shop.spirit-health.co.uk/co...py-of-tee2-test-strips?variant=19264017367097



If there is a choice of units of measurement then ‘mmol/L’ are the standard units in the UK, ‘mg/dl’ in the US, other countries may vary.



Don’t forget to check the box if you have pre diabetes or diabetes so you can buy VAT free. (for all meters and strips)

Thank you! That’s really helpful

 

[Paul_]

Not sure where to start with this one and I have so many questions!

So I received private blood tests back this week and among other things showed my Hba1c is 77. The doctor basically said this shows diabetes and cut out the refined sugar.

I’ve sent these results to my NHS gp and have a telephone consultation booked in a couple of weeks but I feel a bit in limbo in the mean time.

I should say as well that I have an under active thyroid, postural orthostatic tachycardia syndrome (PoTS), a BMI of 43 and vegetarian to boot (that’s more relevant from a diet point of view)

My main questions are below if anyone can help with any of them please?

1. I’ve seen through looking at this forum that a lot of people say that you need two results to confirm the diagnosis. So does this mean it’s possible I don’t have diabetes? (This is why I haven’t set my diabetes status)

2. Should I just be cutting out the refined sugar as suggested or should I start adjusting my diet more?

3. If I do adjust my diet is it simply a case of going low carb or is a low gi diet as beneficial? Or should it be a combination of the two?

4. Is it worth me getting a blood glucose monitor before I speak to the doctor?

5. Do I need to take any notice of the ‘of sugars’ on food labels I.e. should it be a percentage of the carbs? Or should I completely ignore this?

I have the added complication that if I don’t eat enough my PoTS gets worse so I really need to figure this all out so I can adequately plan and research everything so I don’t faint from not eating enough either but I need to eat little enough to lose weight. It just feels like a vicious circle.

Thank you if you got this far any advice is really appreciated. Even if it’s ’wait for the appointment’

Firstly, as others have suggested, your hba1c result suggests diabetes. I'd also add that it's well beyond margins of error on testing, so I would suggest it's best to proceed on the basis that you are diabetic and go from there.

Just to also reiterate previous advice, sugar is somewhat irrelevant, despite the NHS insistence on pushing the line that reducing sugar exclusively is beneficial. All carbohydrates are converted to glucose when digested, which in turn causes an insulin response. Type 2 diabetes is, in simple terms, caused by insulin resistance, and your cells can't absorb the insulin which carries the glucose from digested carbohydrate. As a result, the glucose stays in your blood longer, causing blood glucose levels to rise. For vegetarian specific advice, there's a section for that on the forum here - https://www.diabetes.co.uk/forum/category/vegetarian-diet-forum.71/

My last bit of advice at this point is to just stop, pause, and breathe. It's simple to say, but I really do understand the panic and urge to "fix" the problem immediately. Seriously though, try not to stress, it'll make things worse. You need to focus and make good decisions, stress and panic are counterproductive. Take some time, read the forum here, use a food tracking app to monitor everything you currently eat and the carbs in it, then take positive steps to improve the situation and reduce carbs. Sometimes that will mean avoiding foods, or food combinations, that are very high in carbs. Other times it will mean substituting high carb options for lower carb ones, e.g. brocolli is a better option than potato, as a basic example. However, until you track and find out where the problems are with carb intake in your current diet, you won't be able to make improvements and formulate a new diet.

You've found the most amazing resource in this forum. There's so many experiences and so much advice, it's worth taking some time to look around. Ask questions, don't think anything is too silly to ask. Everyone here wants to help, so don't worry about taking advantage of that. Most importantly, you can do this!

 

[jjraak]

My last bit of advice at this point is to just stop, pause, and breathe. It's simple to say, but I really do understand the panic and urge to "fix" the problem immediately

I'd second that.

I think for me, once I joined after DX, it was more akin to using the forums help as it guided me into taking a little bit of 'this' out & adding a little bit of 'that' to successive meals over those early days & weeks, (that with the aid of my meter) helped me turn a 58 HBA1c down to 42 HBA1c in just under 3 months.

And losing near on 3 stone, without even trying.

Good luck on your journey.

 

[Dippers83]

@Paul_ thank you so much. I’m definitely a carb ***** so this sounds like a good plan. I’m already snappy with trying to cut them down I think if I can find a couple of carbs that I can tolerate well I will find this all a lot easier.

 

[Dippers83]

I'd second that.

I think for me, once I joined after DX, it was more akin to using the forums help as it guided me into taking a little bit of 'this' out & adding a little bit of 'that' to successive meals over those early days & weeks, (that with the aid of my meter) helped me turn a 58 HBA1c down to 42 HBA1c in just under 3 months.

And losing near on 3 stone, without even trying.

Good luck on your journey.

Thank you so much, this really gives me hope.

 

[andromache]

@Paul_ thank you so much. I’m definitely a carb ***** so this sounds like a good plan. I’m already snappy with trying to cut them down I think if I can find a couple of carbs that I can tolerate well I will find this all a lot easier.

Don’t worry about feeling snappy and grumpy when you’re reducing carbs. Your body (and your gut microbes) are used to what they’re used to, and have ways of resisting change (even change for the better). That will settle when your new way of eating becomes established.

 

[saky]

You can add some nuts like almonds, peanuts, walnuts, brazil nuts along with salads and fresh non starchy veggies.....They are low carb and filling too...

 

[jjraak]

Thank you so much, this really gives me hope.

I'm glad

I too was all lost when I first got here (like far too many, I've since found)

I didn't know what to eat, and after trying the doctors advice (eatwell plan) I was starving AND desperate.

But I still couldn't convince myself such simple changes could be the answer (lchf)..so each day I dipped a toe in, and changed just a little, measured, and each time I improved, & before long I was convinced & fully immersed myself in lchf.

But I think for each of us, it's a tailored fit, to get it to a suitable fuel source for our daily life and any others ailments, we might have.


I like to tell a little story about back then.

I never took much notice of any blood works for doctors ..'fine' meant 'all is ok '

But I started backtracking all my old ones and match them to the DX ones

Seems my measures, pre dx, read more "omg ...how are you still alive" ...then was sensible.
Yep, they were poor, but no one had said.

6 months on lchf, got each metric (HDL,LDL,trigs & cholesterol )
Into "you'll live forever', NEXT' territory with the doctors .

Even got a "well done" text from the surgery.

The trigs, the one I now think of as the most important, but aren't they all.
I got from a 6..high danger
Down to 1.2..optimal using lchf

Hope is out there, amending the diet is the best way I think for many...and likely the easiest to boot.

Pre DX I use to eat 4 to 5 meals / snacks a day .

On the eatwell I barely ate anything, I was so worried

On lchf, once I got my head around it, I ate my fill .
Evening meal, plate full of food, big ol' fried breakfast ...missus was gobsmacked how well I ate AND how tasty it all was .

Pretty soon I began not getting hungry in between meals..

and the meal count dropped to one main meal a day sometimes , but most times it was just that one main evening meal a day plus a little snack (usually Greek yoghurt or a couple of boiled eggs) for breakfast as I aimed for 60 carbs a day .

Hope is out there aplenty, if we're willing to try , honest .

Good luck.

 

[jjraak]

You can add some nuts like almonds, peanuts, walnuts, brazil nuts along with salads and fresh non starchy veggies.....They are low carb and filling too...

A big fan of those .

I used to be gobsmacked at certain documentary's as they observed some "rare tribe in the Amazon", type of thing

As the hunters tracked an animal for days, and survived on a handful of berries or nuts.

But I now get it.

I take a couple of Brazil nuts as part of my daily intake (good for the brain, I personally believe)

Always surprised, that when I take them, if I'm honest ...I'm thinking what to have for breakfast after I've eaten them.

....and the amount of times I actually forget all about eating breakfast afterwards as I'm no longer hungry...two nuts, who'd a thunk it .

Nuts, a great choice for a snack.

 

[aylalake]

I agree about the nuts being a handy snack, although I personally cannot eat peanuts or cashew nuts as their carb count is too high for me.
Unfortunately my favourite Brazil nuts coated in chocolate are also on my naughty list although naked Brazils are of course fine. (Sucking the chocolate off to end up with a plain nut isn’t recommended )

 

[Dippers83]

I'm glad

I too was all lost when I first got here (like far too many, I've since found)

I didn't know what to eat, and after trying the doctors advice (eatwell plan) I was starving AND desperate.

But I still couldn't convince myself such simple changes could be the answer (lchf)..so each day I dipped a toe in, and changed just a little, measured, and each time I improved, & before long I was convinced & fully immersed myself in lchf.

But I think for each of us, it's a tailored fit, to get it to a suitable fuel source for our daily life and any others ailments, we might have.


I like to tell a little story about back then.

I never took much notice of any blood works for doctors ..'fine' meant 'all is ok '

But I started backtracking all my old ones and match them to the DX ones

Seems my measures, pre dx, read more "omg ...how are you still alive" ...then was sensible.
Yep, they were poor, but no one had said.

6 months on lchf, got each metric (HDL,LDL,trigs & cholesterol )
Into "you'll live forever', NEXT' territory with the doctors .

Even got a "well done" text from the surgery.

The trigs, the one I now think of as the most important, but aren't they all.
I got from a 6..high danger
Down to 1.2..optimal using lchf

Hope is out there, amending the diet is the best way I think for many...and likely the easiest to boot.

Pre DX I use to eat 4 to 5 meals / snacks a day .

On the eatwell I barely ate anything, I was so worried

On lchf, once I got my head around it, I ate my fill .
Evening meal, plate full of food, big ol' fried breakfast ...missus was gobsmacked how well I ate AND how tasty it all was .

Pretty soon I began not getting hungry in between meals..

and the meal count dropped to one main meal a day sometimes , but most times it was just that one main evening meal a day plus a little snack (usually Greek yoghurt or a couple of boiled eggs) for breakfast as I aimed for 60 carbs a day .

Hope is out there aplenty, if we're willing to try , honest .

Good luck.

Thank you! Positive accounts are really helping me at the moment, feeling a little negative to say the least.

 

[Dippers83]

I just wanted to say thank you for everyone for sharing your experiences and advice. Glucose monitor is on the list for next week when I can afford it.

Still struggling with the food but I know that’s a mental problem. All I want is a chip butty! I know the advice above about changing bit by bit is the best but I can’t help feel guilty and want to go as low carb as possible straight away. Which in turn is making me not want to eat which makes it all worse! I know this will pass but it’s so hard pushing through.