Recently diagnosed type 2 but given very little advice from my GP

KennyA said:

Hi @TrishMabey and welcome to the forum.

The standard way to find out what your BG is doing currently is through a fingerprick test using a glucometer. This gives a snapshot reading which can be subject to error of up to 15% either way (so a true value of 6.0mmol/l could be shown as anywhere between 5.1 and 6.9). Officially T2s not on insulin "do not need" to check BG levels - I found monitoring was essential to get control. One reading tells you very little because BGs change in response to many stimuli, not only food - your liver is constantly adjusting levels all the time. The metformin you've been prescribed hinders the ability of you liver to make new glucose, it doesn't affect the carb and sugars in your food.

Experience on the forum is that the best way to use fingerprick tests is in a structured pattern: you test before meals, to establish a baseline, and then again two hours later. This is NOT to see "how high you go" - in fact the peak blood glucose will probably be around 45 minutes after eating, as carbs are digested to glucose and enter the bloodstream, and before your natural insulin response has really tackled the rising levels.

Testing at the two hour point then shows you how well (or otherwise) your insulin response handled the carbs. If you're more than 2mmol/l above where you started, or above 8.0mmol/l, your insulin response is not currently able to cope with that amount of carb/glucose. So what it will tell you, over time, is the foods you can cope with and the foods that will tend to push your BG up.

The other testing method is a constant glucose monitor (CGM). These you wear constantly, and they monitor the level of glucose in lymph, rather than blood - but it can then estimate a value for blood glucose. The great thing about CGMs is that they give you a complete picture and you can see how BG levels vary over a day (BG variation is perfectly natural and happens to everyone, non-diabetics included). The downside of CGMs is the cost. T2s not on insulin won't get them, and many T2s on insulin don't get them either. The NHS is more concerned about LOW blood glucose for insulin users than it is about the rest of us managing our diabetes.

You're right to watch out for carbs and sugars. All carbs get digested to sugars anyway, so they end up as the same thing. As to levels to aim for - that depends on you. I saw two very clear things when I cut my carb intake. The first was a very quick drop in BG from 50mmol/mol (HbA1c test) when diagnosed in December 2019, to 38 by April 2020. Over the next few years I lost about six stone, all acquired while undiagnosed.

The normal "low carb" level is anything less than approx 130g carb/day. I went for 20g carb/day at diagnosis, which is exceptionally low, but suited temperament and style. This means no bread, pasta, pastry, rice, sugar, cereals, potatoes, fruit, beer, etc. It's therefore eliminating carb in both concentration and volume - eg a food might be quite low in carb in percentage terms (eg 7%) but if you're going to eat 400g of it that's going to be getting on for 30g carb.

I've largely kept to that since. The thing is that we are all different, and I'd suggest our T2 may well be different, and while I think carb reduction is the route well worth trying, unfortunately there's no firm guarantee. That said, if you look at the "Success Stories" section of the forum you'll find a quantity of accounts from people who've had a lot of success.

The forum is a great resource, and questions are encouraged. You'll find people here who've been down this road before you, and know where most of the bumps are.

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Mark Rawlinson said:

First of all very well done on what you have done cutting out the foods you like (It is very hard work) When ypou go to see GP ask for you results to the Hba1c test and also ask of a blood sugar monitor, testing strips etc. You should get them for nothing. You may be diet control only depending on your result.
Ask any questions you want we have all been there (me not that long ago) we will do our absolute best to help

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KennyA said:

If your GP follows the official line you will be told NOT to test. Main reason is that if told to test, you would need to be prescribed a meter and enough strips. They aren't that expensive but if all the T2s in the UK got them it would be a significant increase in cost. It also goes along with the notion that T2 is progressive, can't be reversed, will always and only get worse, all that junk - testing is irrelevant if that's your view.

As a practising T2 in remission for years, I think testing is essential in managing an eminently reversable condition, and is probably the single most important bit of information you can have. .

I have used a Gluco RXQ since diagnosis. It is an old model and doesn't (eg) link to your phone or anything whizzy. But it works, and Gluco will give you one free. The strips, which is where the real cost is, are also less expensive than some other makes.

@Rachox has an up to date list of machines - Rachox, can you oblige please?

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