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Type 2 Possibly going onto insulin.

Getting your head around low carb eating is a challenge but one that I have found very worthwhile in terms of blood glucose control. I decided to base every meal around a protein source and to add in non-starchy vegetables etc. I try to have 3 different protein sources each day just so that there is some variation between meals. I really didn't want to give up toast so researched low carbohydrate breads. Initially I thought I couldn't have a curry without rice or naan but that really is just a question of mindset. Over time eating habits and tastes do change and now pasta, rice, potatoes etc just don't occur to me. The occasional cake is another thing!
 
sgm14 said:
I think I am in a similar situation, but I didn't get a c-peptide test done, so can't be 100% sure, but my official diagnosis is that I am Type 2. I was on metformin for three years and then moved to a Basal/Bolus insulin just over two years ago.

You don't mention what type of insulin you would be moving to, so if it is to a basal only regime then very little of what follows will apply.

One thing I have learnt about diabetes is that everyone is different in some way, so your experience with insulin might be completely different from mine.

Dis-advantages I found to using Basal/Bolus insulin.
  • I have to be more careful and when I eat otherwise I risk going low.
  • I have to inject before every meal.
  • I need to monitor my levels more to make sure I don't go low or high.
  • I need to know the carb content of everything I eat.
Advantages I found
  • It gives me more freedom in what I can eat (Although in practice that does not seem to matter much to me)
  • It works!
So in the end, it is the only last one that matters. Metformin stopped working for me, and insulin does work, so I'm happy to take it.

Re low-carbs - When I was first diagnosed I was underweight, and when I was switched to insulin even more so, so I wasn't on a low carb diet at that stage. My carb content is now around 100 per day, which I think is technically low-carb, but still considered a lot by the ultra-low carb followers. (I am aware that it is ironic that my carb content is lower now that I am on insulin than when I was on metformin). I did try lowing my carb content even further, but found that I still needed insulin even for a 4-carb meal and I started to loose weight again, so I went back to the 100-a-day level.

The other thing I that I found helped me enormously was the free-style libre which I have been using for about 15 months.
Click to expand...

Hi Sgm14,

I don’t know the type of insulin regimen that I’ll be started on. I’ll be qizzing the DN about this, so your experience and knowledge is much appreciated.

I kind of get the impression from yourself and others that keeping an eye on my carb intake will be a crucial part of better health and BG control - fingers crossed.

Regarding using modern technology ie ‘Freestyle Libre’ etc., this is something that I am, if possible, going to take full advantage of.

Thanks for your reply.

Kind regards, Alan.
 
Dr Snoddy said:
Getting your head around low carb eating is a challenge but one that I have found very worthwhile in terms of blood glucose control. I decided to base every meal around a protein source and to add in non-starchy vegetables etc. I try to have 3 different protein sources each day just so that there is some variation between meals. I really didn't want to give up toast so researched low carbohydrate breads. Initially I thought I couldn't have a curry without rice or naan but that really is just a question of mindset. Over time eating habits and tastes do change and now pasta, rice, potatoes etc just don't occur to me. The occasional cake is another thing!
Click to expand...

Hi Dr Snoddy,

Ha ha yeah toast, very tantalising specially when it’s not allowed, I love the stuff, with loads of real butter!

The general consensus is keep the carbs down, but they’re everywhere and ordinarily they’re good for us until we develop diabetes. I like your idea of having a pattern with your meals, thanks for sharing that and thanks for your reply it’s good to feel supported.

Kind regards, Alan.
 
Resurgam said:
There are low carb breads, or you can gather up recipes and ingredients and make your own - though toast might still be problematic, some of the breads are quite tasty and do not last long when fresh.
Click to expand...

Hi Resurgam,

I’m not very good at cooking, I can cook, but it’s all the carb laden traditional types of comfort food. I’ll have to re-educate myself and really find out how many carbs are in the food I’m eating, making sure it’s low carb. Thanks for the heads up on bread. I’ll give it a go.

Kind regards, Alan.
 
Hi Allan. What does a typical day's eating look like? What dietary advice were you given at diagnosis? I can't help with medication comments as I have only ever taken Metformin and weaned myself off that a couple of years ago. My blood glucose levels remain normal.
 
Dr Snoddy said:
Hi Allan. What does a typical day's eating look like? What dietary advice were you given at diagnosis? I can't help with medication comments as I have only ever taken Metformin and weaned myself off that a couple of years ago. My blood glucose levels remain normal.
Click to expand...

Hi Dr. Snoddy,

Breakfast:
100 grams mushrooms, 1/4 of a capsicum, 200 grams of tofu, 40 grams of ‘vio life’ vegan cheese, 5-10 grams of sun dried tomatoes, turmeric and himalayan salt to add flavour. This I fry in about a desert spoonful of extra virgin olive oil.

Lunch:
Salad of 1 medium tomato, 1/3 of a cucumber, 1/2 an handful of olives, lettuce, 2 small chopped gherkins (no dressing on the salad). 1/2 of white heated and sliced pitta bread, 200 grams of hummus.

Dinner:
Viv-era (pretend kebab meat), 1/4 medium fried onion, 50 grams of passata, fry heated. Steamed cauliflower and half a tin of butter beans. I’ll make my own cheese sauce using soya milk and violife cheese.

Drinks throughout the day are about 8-10 mugs of tea using soya milk. With glasses of water. I am a builder, so I’m reasonably active all day.

When I was first diagnosed with diabetes, I began to exercise aproximately 1 and 1/2 hours every day. I was only on ‘Metformin’ initially. I was not overweigh and have been a keen cyclist and swimmer all my life. Unfortunately I kept getting really bad bouts of fatigue, to the point of being bed ridden. However, my blood glucose levels kept on rising and therefore the need for more medication. I carried on monitoring carb intake and exercising, but I was unable to get my blood glucose levels down without added medication.

Many people (including hcp’s) have commented on how I don’t fit the diabetic profile. My nephew, auntie and I were all disagnosed with diabetes within 3 years of each other. I believe it’s genetic and I possibly have a compromised pancreas?

Regarding carbohydrates, I was told to eat more (by a dietician) and that would resolve the fatigue. I did eat more and it made me feel very ill, as in more fatigued.

A bit of a long reply there, but that’s the general picture.

Kind regards, Alan.
 
Hi Alan, how's it going? Thank you for sharing your food diary. You do seem to be eating a relatively low carbohydrate diet all ready and one which is nutrient rich. I wonder if it is supplying enough energy to maintain your active lifestyle? This is why a dietician thoughtlessly suggested more carbohydrate - not a good idea for someone who is carbohydrate intolerant! Could you incorporate more healthy fats into your meals e.g. add avocado and an olive oil based dressing into your salad? Nuts and seeds could also be useful additions.
before I was diagnosed I was also getting incredibly tired and would think that I needed to have some extra carbohydrate for energy. And, like you, I would then feel even more tired. Having been fed the low-fat mantra for all of my life it took me some time to accept that it was a good idea to eat protein and fat as energy sources. Nowt wrong with a slice of HiLo toast (5g carbohydrate) and crunchy peanut butter!
 
Alan9009 said:
Hi Dr. Snoddy,

Breakfast:
100 grams mushrooms, 1/4 of a capsicum, 200 grams of tofu, 40 grams of ‘vio life’ vegan cheese, 5-10 grams of sun dried tomatoes, turmeric and himalayan salt to add flavour. This I fry in about a desert spoonful of extra virgin olive oil.

Lunch:
Salad of 1 medium tomato, 1/3 of a cucumber, 1/2 an handful of olives, lettuce, 2 small chopped gherkins (no dressing on the salad). 1/2 of white heated and sliced pitta bread, 200 grams of hummus.

Dinner:
Viv-era (pretend kebab meat), 1/4 medium fried onion, 50 grams of passata, fry heated. Steamed cauliflower and half a tin of butter beans. I’ll make my own cheese sauce using soya milk and violife cheese.

Drinks throughout the day are about 8-10 mugs of tea using soya milk. With glasses of water. I am a builder, so I’m reasonably active all day.

When I was first diagnosed with diabetes, I began to exercise aproximately 1 and 1/2 hours every day. I was only on ‘Metformin’ initially. I was not overweigh and have been a keen cyclist and swimmer all my life. Unfortunately I kept getting really bad bouts of fatigue, to the point of being bed ridden. However, my blood glucose levels kept on rising and therefore the need for more medication. I carried on monitoring carb intake and exercising, but I was unable to get my blood glucose levels down without added medication.

Many people (including hcp’s) have commented on how I don’t fit the diabetic profile. My nephew, auntie and I were all disagnosed with diabetes within 3 years of each other. I believe it’s genetic and I possibly have a compromised pancreas?

Regarding carbohydrates, I was told to eat more (by a dietician) and that would resolve the fatigue. I did eat more and it made me feel very ill, as in more fatigued.

A bit of a long reply there, but that’s the general picture.

Kind regards, Alan.
Click to expand...
Is that typical? Or your new carb aware day? Unless the vegan alternatives are high carb (I wouldn’t have a clue) then it looks much lower than the 150g you suggested was typical for you. It also looks very low in fats and protein so where are you getting your energy from? I assume you are vegan from this. I hope this is for reasons other than diabetes management as meat, eggs and dairy are extremely helpful in giving variety, fats and protein to a low carb diet. Without these I’m not surprised you’ve struggled to low truly low carb previously. There’s a vegetarian section in these forums that might help you with ideas though.
Eating more carbs would likely have been raising your bgl therefore that would have probably been the cause of the additional tiredness.
What levels have you seen with this menu? Have you been able to find out what testing was done to rule out LADA or MODY?
 
Dr Snoddy said:
Hi Alan, how's it going? Thank you for sharing your food diary. You do seem to be eating a relatively low carbohydrate diet all ready and one which is nutrient rich. I wonder if it is supplying enough energy to maintain your active lifestyle? This is why a dietician thoughtlessly suggested more carbohydrate - not a good idea for someone who is carbohydrate intolerant! Could you incorporate more healthy fats into your meals e.g. add avocado and an olive oil based dressing into your salad? Nuts and seeds could also be useful additions.
before I was diagnosed I was also getting incredibly tired and would think that I needed to have some extra carbohydrate for energy. And, like you, I would then feel even more tired. Having been fed the low-fat mantra for all of my life it took me some time to accept that it was a good idea to eat protein and fat as energy sources. Nowt wrong with a slice of HiLo toast (5g carbohydrate) and crunchy peanut butter!
Click to expand...

Hi Dr Snoddy,
Nuts are my go to snack, fortunately I like them anyway which helps. I do have a relatively varied diet and avocado is one of the things I’m fond of and eat reasonably regularly. It is hard keeping away from carbs, but it would seem it’s the only way to sensibly treat my diabetes, also with exercise and the necessary meds.

It certainly is a learning curve having diabetes. Adapt and survive is going to be my motto I think!

Thanks for discussing your experiences with me and passing on ideas, they’re much appreciated. It makes the journey seem a little less lonely.

Kind regards, Alan.
 
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