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Questions

rhubarb73

Well-Known Member
Messages
709
Location
West Yorkshire
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Dislikes
aubergine
So I have a few questions that I would be really grateful for the perspectives of others on. Please direct me elsewhere if you think that will help.
Before I start though I just need to share a minor victory that I went out for a massive 3 course meal (low carb, fish starter, roast chicken and veg, cheese without biscuits for pudding) - I was absolutely stuffed and 2 hours later my mmol reading was 5.2, almost the lowest it has been since diagnosis. Low carb is working for me, and I'm really happy tonight - I'm sure there are harder days ahead with this...it leads me to my first question

1) Will weight naturally level off?
I'm pleased with the weight loss so far and still have some way to go to get back into the green zone, but after 5 weeks I'm half way there from my start position. As well as low carb, I think I am also running a calorie deficit given I've also upped my exercise regime. However, I'm eating more than ever: I used to skip breakfast almost every day, now I am eating eggs or porridge every day. I'm full after every meal, I don't have an appetite problem, I'm eating plenty, and occasionally snacking on a handful of nuts. I've lost 7kg in 5 weeks. I know this seems like a nice problem to have but will this rate of weight loss level off when I get towards a healthier weight? Or will I need to find a way a replace the calorie deficit (without adding carbs)? I hope this isn't a stupid question - I've never been in this position before.

2) How often to test?
My GP wa ambivalent about the test regime but I've read enough on this site to know it is useful, but how often to people test?
Every day? Before and after every meal? Right now I'm a kid with a new toy but I'd be interested in what others are doing / have done in terms of test regime?

3) Metformin and alcohol
Official advice = don't mix them. I know what the risks are, and I'm not asking for medical advice, just perspectives, observations and experiences. I don't really want to give up wine altogether - I like it. I need a better relationship with it and I'm already on the way there. I also know that a glass or two will add to the carb intake but what have others done?

Thanks to anyone who's happy to share their experiences on these points
 
Hi @Chris / Yorkshire sounds like you’re really doing well and you’re a new member but you’ve been low carbing and getting good results but tagging in @daisy1 for a new members information pack for in case you hav3nt seen it.
Re weight loss - I lost three and a half stone and started out just low carb to start with but I did find I needed to switch things around over time to keep a regular good loss. I went very low on my carbs to less than 20g a day after the first month so I went into ketosis. I did this initially by just eating one meal a day for a month and this produced for me the biggest bit of my weight loss and drop in bg. Now my bmi is low20 I’m maintaining on three meals a day - low carb of course which keeps my bgs steady- last months hbaca1 was 30. I do have to be careful as easy to lose weight for me on this way of eating
Good place to look if you want more info on keto and also Fasting is
Www.dietdoctor.com
Testing I think minimum is on waking, just before meal and two hours after especially in early days while you’re working out which foods suit you.
I’ve been off the Metformin now for six months but personally I carried on drinking wine in moderation throughout including the time I’ve been losing weight. As my bgs reduced luckily I was able to give up the Metformin but didn5 give up the wine! Unless special occasion I generally have a glass of red with my main meal.
Good luck keep going and asking questions a good way to learn
 
shelly262 thanks - if I understand correctly you are doing c6 tests a day (assuming waking = pre breakfast).
I'm currently doing 2-3 tests per day on basis that direction of travel is good. Maybe I need to test more when I reintroduce some carbs to see what works and what doesn't.
Still surprised my GP didn't think testing was necessary.
 
shelly262 thanks - if I understand correctly you are doing c6 tests a day (assuming waking = pre breakfast).
I'm currently doing 2-3 tests per day on basis that direction of travel is good. Maybe I need to test more when I reintroduce some carbs to see what works and what doesn't.
Still surprised my GP didn't think testing was necessary.
Our HCPs will tell us that testing is not necessary mainly for two reasons, the first of which is that the NHS annot afford the cost of meters/strips for all those with Diabetes and secondly because they think we will become anxious or obsessed by the readings.
 
Good news is that red wine is very low in carbs. The weight loss will taper off because your daily kJ ( or calorie if you prefer ) requirement becomes less as you lose weight. If you are losing weight then by logical extension you are running a deficit in calories. If you eat less than the daily requirements you will tap into the stored energy.

Now that my BG has been under control for quite a while now I don't test that often. Usually only test meals that I haven't tried before.
 
@Chris / Yorkshire

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 want 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.
 
shelly262 thanks - if I understand correctly you are doing c6 tests a day (assuming waking = pre breakfast).
I'm currently doing 2-3 tests per day on basis that direction of travel is good. Maybe I need to test more when I reintroduce some carbs to see what works and what doesn't.
Still surprised my GP didn't think testing was necessary.
Hi I don’t test now after breakfast or lunch - both small very very low carb meals for me _ unless I introduce something new in which case I would. I just continue to test as I wake up and before and after my main meal as that’s when I eat more and sometimes experiment a bit more but I’ve been doing this self testing stuff for 11 months now and did test 6 or 7 times a day until fairly recently. My hbaca1 in November 2017 was right down to 33 (97 on diagnosis) and last month 30 so not as much need for me. As you know it’s expensive too! I also enter my results on the free mysugr app which gives an hbaca1 prediction based on your readings and this is more accurate the more readings you put in and can be encouraging to see this.
 
Maybe I need to test more when I reintroduce some carbs to see what works and what doesn't.
I don't quite understand when you write about possibly re-introducing carbs. Earlier you wrote that you sometimes eat porridge for breakfast. You do realise that porridge is wall to wall carbs? But maybe you have already tested after eating it and, lucky you, it doesn't affect your bg?
 
yes thanks - I know oats are carbs. They don’t cause me big problems (currently)fortunately - I’m having it 2-3 times a week.
I didn’t say reintroduce, but “without adding carbs.” (more carbs).
What I meant was if I get to a point where I don’t want a calorie deficit but don’t want to cut exercise. Eating more is hard because the low carb diet is filling me up.
 
yes thanks - I know oats are carbs. They don’t cause me big problems (currently)fortunately - I’m having it 2-3 times a week.
I didn’t say reintroduce, but “without adding carbs.” (more carbs).
What I meant was if I get to a point where I don’t want a calorie deficit but don’t want to cut exercise. Eating more is hard because the low carb diet is filling me up.
Come on Chris, you did say "reintroduce": "Maybe I need to test more when I reintroduce some carbs to see what works and what doesn't."
 
Hi Chris welcome to the forum. Great that you are loosing weight and have a Blood glucose meter. This is great asset when starting to get use to low carb eating, so that you can see what foods affect you.
I Started Low Carb High Fat (LCHF) on 30th April after my visit to Dn for bloods. HbA1c was 82, weight 157Kg and Bg 16.6. I went on 18/6 fasting, no food from 20.00 till 14.00 next day, with only black tea, coffee and water during fast. I also reduced my carbs to between 15 -20%. After first month I had lost 8.4Kg and got my Bg down to 7.0 (averaged over 7 days).
I use to drink red wine but lost my taste for it during low carb eating. I gave up drinking alcohol all together a month ago.
I have now reduced my carbs to less than 5% per day and my average bg this week is 4.3. I still have a way to go with the weight loss and find LCHF so easy and positive thing, I'm never hungry!
You are in the right place for help, advice and support Chris, so any other questions ask away. Good luck on your journey.:)
 
I too for a while was drinking one glass of red wine nightly and also taking Metformin, with no apparent problems.
yes thanks - I know oats are carbs. They don’t cause me big problems (currently)fortunately - I’m having it 2-3 times a week.
I didn’t say reintroduce, but “without adding carbs.” (more carbs).
What I meant was if I get to a point where I don’t want a calorie deficit but don’t want to cut exercise. Eating more is hard because the low carb diet is filling me up.
You could look at higher healthy fat lower carb stuff - like more nuts or adding more olive oil to your diet will fill you up, maintain your weight but give you energy from the fats for your exercise schedule. Now I’m trying to stop losing I’m eating more nuts as reduced them before as so moreish and stalled myvweight loss at an earlier stage when I was working at helping my body burn its own fat stores rather than too much fat from food. Hope this helps
 
So I have a few questions that I would be really grateful for the perspectives of others on. Please direct me elsewhere if you think that will help.
Before I start though I just need to share a minor victory that I went out for a massive 3 course meal (low carb, fish starter, roast chicken and veg, cheese without biscuits for pudding) - I was absolutely stuffed and 2 hours later my mmol reading was 5.2, almost the lowest it has been since diagnosis. Low carb is working for me, and I'm really happy tonight - I'm sure there are harder days ahead with this...it leads me to my first question

1) Will weight naturally level off?
I'm pleased with the weight loss so far and still have some way to go to get back into the green zone, but after 5 weeks I'm half way there from my start position. As well as low carb, I think I am also running a calorie deficit given I've also upped my exercise regime. However, I'm eating more than ever: I used to skip breakfast almost every day, now I am eating eggs or porridge every day. I'm full after every meal, I don't have an appetite problem, I'm eating plenty, and occasionally snacking on a handful of nuts. I've lost 7kg in 5 weeks. I know this seems like a nice problem to have but will this rate of weight loss level off when I get towards a healthier weight? Or will I need to find a way a replace the calorie deficit (without adding carbs)? I hope this isn't a stupid question - I've never been in this position before.

2) How often to test?
My GP wa ambivalent about the test regime but I've read enough on this site to know it is useful, but how often to people test?
Every day? Before and after every meal? Right now I'm a kid with a new toy but I'd be interested in what others are doing / have done in terms of test regime?

3) Metformin and alcohol
Official advice = don't mix them. I know what the risks are, and I'm not asking for medical advice, just perspectives, observations and experiences. I don't really want to give up wine altogether - I like it. I need a better relationship with it and I'm already on the way there. I also know that a glass or two will add to the carb intake but what have others done?

Thanks to anyone who's happy to share their experiences on these points
In regards to Q1 my experience is that yes weight loss levels off at what your body thinks is a good weight. Not quite where I want it to be but hey a lot lighter than I was.
Q2 I test first thing in the morning then before eating and 2hours after first mouthful.
As I tend these days to OMAD then that’s 3 times a day. Sometimes I may do a before bed test, but usually that’s because I forgot the 2 hours after meal one.
Q3 I hated Metformin so gave it up after 3 weeks and cut carbs instead. Also don’t drink so can’t help you with that one.
 
You could look at higher healthy fat lower carb stuff - like more nuts or adding more olive oil to your diet will fill you up, maintain your weight but give you energy from the fats for your exercise schedule. Now I’m trying to stop losing I’m eating more nuts as reduced them before as so moreish and stalled myvweight loss at an earlier stage when I was working at helping my body burn its own fat stores rather than too much fat from food. Hope this helps
Yes, sound stuff, but Chris says, "Eating more is hard because the low carb diet is filling me up."
 
Yes, sound stuff, but Chris says, "Eating more is hard because the low carb diet is filling me up."
I was thinking more along the lines of when the OP was maintaining his weight loss and exercising a lot - that substituting some things in his diet with higher healthy fat may work but still keep him full alongside still having energy for exercising rather than going down the route of higher carbs to fuel exercise!
 
I was thinking more along the lines of when the OP was maintaining his weight loss and exercising a lot - that substituting some things in his diet with higher healthy fat may work but still keep him full alongside still having energy for exercising rather than going down the route of higher carbs to fuel exercise!
Yes, this is a real dilemma for me, and I have not been able to find any good advice for those of us who are not on insulin, whereas there is lots for the insulin dependant athlete.
 
On the question how often to test question, in early days for me it was before/2 hrs after every meal. And then I kept a food diary as I couldn’t keep it all in my brain :) And if I’m having something where I know what happens, I now feel confident (after 4 months!) that I’ll get similar results so I give my poor little fingers a break from being stabbed.

Time of day does make a big difference for me on same foods, though. I know eggs and various no-carb things alone are fine in my mornings, but adding one slice of HiLo bread makes a difference depending on when in the day I have it. It’s a no-no for breakfast, but fine for dinner.
 
I know this seems like a nice problem to have but will this rate of weight loss level off when I get towards a healthier weight? Or will I need to find a way a replace the calorie deficit (without adding carbs)? I hope this isn't a stupid question - I've never been in this position before.

All I can say is you are wise to plan well ahead. I lost all my excess weight on LCHF and then just kept on losing. I also wanted to lower my carbs to please my blood glucose. So I had a dilemma. It was all back to basics - cutting more carbs and adding extra fats and protein bit by bit, using my bathroom scales, a detailed food diary, and my meter. It took a while to find the right balance ... which is why it is a good idea to plan ahead and not leave it till the weight has gone. I added extra eggs and started eating cheese, which I hadn't eaten previously, plus extra mayo and extra butter. I also went back to a previous habit of a glass of red every evening. It did work, and I stopped losing. It was harder than losing it all in the first place!! I have maintained this weight now, give or take a few odd pounds, since about November 2014.
 
Thanks for the responses - lots of useful and reassuring things in there. (and thanks Alexandra100 for pointing out my lack of attention to detail...I'll blame it on the meds, lol)
I've taken to the low carb diet well as I really enjoy the foods - in fact I feel silly for not eating more healthily before because I'm enjoying my food much more now. It is hard to count calories though as many of my meals include a mix up of salad, veg, pulses and other protein goodies. So it's a bit of this, a bit of that rather than nice blocks of countable data. I think I'm using 3000-3500 calories a day with my exercise routine.
Bluetit1802, thanks for the advice re planning ahead - reassures me that this wasn't a silly question. I'm still overweight on the BMI measure and another 6-7kg to go to get in the green zone, and then plenty of scope before it becomes a problem.

I'm going to up the testing, although I need to improve my technique as a couple of digits are feeling quite sore and bruised.
Will treat myself to a glass of wine at the weekend. Going to miss my beer but that is completely off the menu for a while.

Thanks again and any further perspectives still very welcome.
 
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