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Please help!

Discussion in 'Newly Diagnosed' started by Chris Sarantis, Mar 6, 2018.

  1. Chris Sarantis

    Chris Sarantis Type 2 · Newbie

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    Hi guys,

    I’m 36 and I was diagnosed with type 2 diabetes a couple of months ago and after seeing a consultant I’ve been on a gram of slow release metformin and one sitagliptin a day for just over a month in combination with a strict diet and exercise regime.

    Initially the thirst went away but just in the last week it’s come back along with the midnight trips to the toilet and the consultant now thinks I may have type 1?

    I have gone for the hba1c test again (my original result was 88) but I’m worried if there hasn’t been any change he’ll jump to conclusions prematurely.

    Is it possible that the medication simply isn’t strong enough and has worn off and needs to be increased? What tests completely verify the type 1 version? Does the thirst 100% imply high blood sugar or can it be a side effect of the medication?
     
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  2. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    Hi Chris and welcome! First let me tag in @daisy1 who post intro info for you.
    Next can you tell us a typical day’s diet, we may be able to suggest some improvements.
    Also do you monitor your own blood sugars at home?
     
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  3. Chris Sarantis 1

    Chris Sarantis 1 · Guest

    Hi! My typical diet is: porridge or weetabix with semi skimmed milk, blueberries, walnuts and pumpkin seeds for breakfast, yoghurt, nuts for snacks, salad, veg, chicken/tuna and sometimes wholemeal pitta for lunch, meat/fish grilled/steamed with brown rice/brown pasta and veg for dinner. Water only for drinks...
     
  4. bulkbiker

    bulkbiker Type 2 · Master

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    Thats a whole lot of carbohydrate for someone whose body has problems processing carbs..
    I would suggest cutting out all the starchy foods and seeing what that does. All carbs turn into glucose when ingested and your body has trouble dealing with glucose. Cut out the carbs and watch your numbers drop.
     
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  5. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    A lot of us Type 2s find that reducing carbohydrates in our diet improves things. Carbohydrates turn into sugar once digested. Brown varieties do too but are absorbed a little slower. In your diet I would point out the following as potentially problematic: porridge, weetabix, pitta and rice. Even milk and yoghurt have lactose which is a natural sugar. The only way you’ll know for sure is to test before and after meals.
     
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  6. Chris Sarantis 1

    Chris Sarantis 1 · Guest

    Thanks for the tips guys! So instead of all those carbs what would you have instead? Breakfast/lunch in particular? Is 0% fat yoghurt ok? What about unsweetened almond milk? Are pulses like beans and lentils ok? Any simple recipes/tips would be fantastic as I'm really struggling, thank you!
     
  7. bulkbiker

    bulkbiker Type 2 · Master

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    Are you worried about fat for a specific reason.. we have been misled that it is bad for us and in fact it can provide satiety where carbs provide only hunger. Personally my breakfast is tea or coffee with either lactofree milk (fewer carbs) or double cream. I find a couple of those keeps me feeling full until lunchtime.
     
  8. Chris Sarantis 1

    Chris Sarantis 1 · Guest

    What about your actual meals? Any combinations would be great thanks!
     
  9. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    Have a look at this website. There is a list of suitable foods, and plenty of lovely recipes.

    https://www.dietdoctor.com/low-carb/foods#foodlist
    https://www.dietdoctor.com/low-carb/60-seconds
     
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  10. bulkbiker

    bulkbiker Type 2 · Master

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    Well as I said I don't eat breakfast but if I did it would involve bacon, eggs, or full fat yoghurt. For other meals I have meat or fish and green veg as a main meal with ham, cheese, eggs, bacon for lunchtime.
    If you are looking for meal ideas then www.dietdoctor.com has loads of ketogenic and low carb meal suggestions.
     
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  11. bulkbiker

    bulkbiker Type 2 · Master

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  12. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    Unsweetened almond milk is fine, zero carbs in it.
     
  13. eggs11

    eggs11 Type 2 · Well-Known Member

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    As far as pulses and lentils go - I would recommend testing your blood sugars: https://www.diabetes.co.uk/blood-glucose/blood-glucose-testing.html after a meal containing them to see if your body can cope with them or not - we are all different in this respect, but they are quite starchy foods. I can cope fine with houmous, because of the fat content, but a 'healthy' lentil soup spiked me.
     
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  14. daisy1

    daisy1 Type 2 · Legend
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    @Chris Sarantis

    Hello Chris and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it useful. 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.
     
  15. Brunneria

    Brunneria Other · Moderator
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    Hi Chris

    You asked about how type 1 diabetes is diagnosed.

    Basically, most doctors seem to assume that if you are adult and overweight you will be a type 2 whereas if you are younger and slim, you will be a type 1.

    However, if we don't react typically to the meds and lifestyle changes they suggest, they may then do further tests to double check.

    In order to properly test for type 1, two tests are usually used. C-peptide and GAD. The results of these will distinguish between type 1 and type 2 diabetes. So if you doc has just ordered you another HbA1c test, then you may need to ask for those two additional tests.

    Diet is a brilliant weapon in the management of type 2, and it can help in type 1, but type 1s will also need insulin to manage their blood glucose levels, so it is very important that you keep asking until you have a definite diagnosis
     
  16. Oldvatr

    Oldvatr Type 2 · Well-Known Member

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    I am surprised no one has mentioned Metformin. It is the first port of call according to NICE guidelines, along with the lifestyle changes as you mention, So far the GP is adhering to the NHS checklist correctly.

    Metformin is not the panacea we might think. It is a diabetes med, but in actual real life it does very little to drop blood sugar levels. It is prescribed mainly as a general protection for your vital organs such as heart and kidneys, and is also a bit of an appetite suppressant. But you may need to take a second med to get high bgl down. This will happen when the second HbA1c is in.

    As some have said here, you may find that changing your diet to avoid the high carb intake especially from grains and starches will do better than the Metformin, and many of us here use Low Carb to control our conditions. Also try to avoid modern highly processed foods and ready meals since they often contain hidden sugars.
     
  17. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    Your diet looks good, except for the load of carbs in there. Drop the rice, bread, (and pasta, corn etc) wheetabix and you're halfway there. With kicking carbs out you'll have to replace them with either fat or protein, so you might want to consider full fat greek yoghurt for instance, as it's filling and still low-carb, or coconut yoghurt... Adding cream to your coffee? Or go for an english breakfast without the toast. And if you really want rice, mince cauliflower to the same consistency, it's surprisingly versatile! Meat, fish, salads, nuts and berries are usually fine. Best thing to do is get a meter, check what impact certain foods have (I'm fine with berries in the morning for instance, but they spike me later in the day). It's a learning curve. For me it's berries, nuts and tea in the morning, salad or stir fried veggies in the afternoon, and veggies and meat in the evening. For snacks I have nut mixes, olives etc, and extra dark chocolate (sometimes with a bit of coconut butter.), But if you have no issues with milk like I do, cheeses and the like are good. There's a whole lot you can eat without spikes, you just have to rearrange your plate some. Good luck!
     
  18. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    Was it never explained that diabetes is an inability to deal with carbohydrates?
    I can well believe that your HCPs neglected to give you that vital piece of information.
    If you cur out all those starches then you will - with any luck, see a change in your reaction to eating.
    Blueberries are high in sugar - they are the highest carb count of the fruits called berries, so best avoided, replace with something under 10 percent carbs and eat in moderation, and then swapping the low fat milk for cream - and anything else low fat should be changed for a lower carb original.
     
  19. There is no Spoon

    There is no Spoon I reversed my Type 2 · Well-Known Member

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    Hi Chris,
    I can see from your diet you have gone for a healthy option every single time, but those healthy options work best if your non-diabetic.:banghead:

    Sorry this is going to be long winded but by breaking every meal down for you, it might help.

    Breakfast.
    Weetabix is about the best cereal you can find, the least in sugar. Almost a healthy option. :banghead:
    • Cereal + milk = carbohydrate (with added sugar) + carbohydrate = bad.
    • Bacon & eggs = protein + protein = Good
    (I'm thinking of getting this printed on a T-shirt):woot:

    Semi-skimmed milk is lower in FAT and if your reducing your carb intake you need to replace the energy shortfall so full FAT is better. Porage the stir in a pot kind is better than microwave packets.

    Lunch.
    Yoghurt: has to be full FAT to compensate for the energy shortfall from eating less carbs.
    Wholemeal pitta: is a complex-carbohydrate so a much better choice than plain pitta (carbohydrate). But if your body is struggling to deal with carbs even though it feels like the healthy option it's not. :banghead:

    Dinner.
    Brown rice/brown pasta: Again complex-carbohydrate.
    meat/fish grilled/steamed: Remember the energy shortfall its better cocked in FAT coconut oil (for example) and butter.

    I completely understand where your coming from on all of these choices, every one of them like grilled/steamed is considered the healthy option but not the diabetic healthy option. :banghead:

    I hope this helps, a couple of tweaks to what your already doing should give you even better results. ;)
    :bag:
     
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  20. SockFiddler

    SockFiddler Type 2 · Well-Known Member

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    For breakfast this morning (6am) I had a 3-egg omelette (with butter in the pan), into which I chucked (I'm a free-styling sort of cook) a handful of grated mature cheddar and a few slices of salami trimmed into strips.

    Lunch (1pm) was olives and a leafy green salad with tuna mayo followed by a 25g bar of 86% cocoa mass chocolate.

    Dinner (7pm) will be 2 chicken breasts roasted in olive and walnut oil with some chargrilled peppers, aubergines and sliced courgettes, and my late night snack (I'm a night owl and like to eat around midnight) will be a head of brocolli with an aioli dip.

    This is a fairly typical day for me; my calories will clock in at about 2k, my carbs 50g - 60g.*


    *It's worth noting that I kept a food diary for around 3 months to get an understanding of what and when I eat. In it I recorded everything I ate, including carbs and calorie values, and my BG levels before and 2 hours after eating. Over time I learned which foods I could and couldn't eat, and which foods I wanted to eat but needed to be careful with.

    I occasionally still pick a day and keep a diary of what I eat that day to make sure I'm still on track, but I don't do it on a daily basis unless something exceptional is happening: I'm feeling stressed / poorly, attending a party or event, eating out. It just helps me to see it all laid out sometimes, but I don't feel I need that kind of mental process on a daily basis anymore.

    It's also worth noting that I used to be the kind of eater who could easily put away a ludicrous amount of food and still be hungry 2 hours later (the "I don't know where she puts it all" kind of eater), and the amount that I eat now leaves me feeling completely sated, but neither bloated nor sleepy (a la after Xmas Dinner kind of feeling).

    There is no magic trick to this; I do not feel I work hard or employ any willpower (after the first couple of carb-free weeks have passed). If this required a huge amount of effort and / or willpower I'd be the first to fail. There is, however, a forum filled with support, info and other people's experiences which you have already started to tap into. That and good-quality information is really all you need.

    Welcome to the forums: management of your illness is easily within your grasp.

    Sock x
     
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    #20 SockFiddler, Mar 8, 2018 at 3:35 PM
    Last edited: Mar 8, 2018
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