So confused

[tjs]

Hello all,
I have recently been diagnosed with type 2 diabetes at 42 years old, I have accepted the fact and have decided to look upon it almost as a plus as I now need to turn my former unhealthy life around but what is the best way? I am heavily overweight and my doctor has prescribed metformin and blood pressure tablets. I like to think of myself as reasonably intelligent but I am baffled by conflicting advice mainly around diet. I will be really greatful for anybody else's views on these questions. My blood sugar levels are normally around 5.5 upon waking, rising to 8 after meals and dropping down nicely again.

1.Due to me being overweight, weight loss is a must, what am better off cutting out at the moment- fat and sugars for obesity or carbs for diabetes?

2.The recommended daily carb limit for a healthy person is between 270-300 depending on what literature you read, is there a recommended limit for us chosen people?

3.Does everything need to be managed on a daily or short term basis or can a long term view be taken, i.e. have a celebratory meal Monday and live like a pauper Tuesday and Wednesday?

4.I have seen people alluding to an Atkins type diet, i.e. almost carb free but then others advising against removing a whole food group, I personally would have no problem eating lean steak and chicken every day but it doesn't seem right, if something seems to be to good to be true there is normally a catch.

5.Exercise? many years ago when I was younger slimmer and fitter I was advised to exercise at 60-75% of my maximum heart rate for at least 30 minutes a session for weight loss, now the advice seems to be higher levels but every piece of exercise equipment and websites all advise talking to my doctor before starting a fitness regime, he has told me to lose weight, has anybody got a GP whom they would feel comfortable discusssing a training regime?

6.I believe that Weetabix sent me a bit hypo, I had some for my breakfast, a couple of hours later I felt lightheaded and sweaty, I tested my blood sugar level and found it was between 3.5 and 4, I swiftly raided my kids sweety jar and was soon back over 5 but how can this be? I thought carbs raised the sugar levels not lowered them or was it a coincidence

That's all for now, I am sure I will be back soon.

Thanks in advance,

TJS

 

[Mileana]

Hi,

I am and certainly have been overweight too.

On the front of overweight and carbs and fat, I am of the firm belief that as carbs, or more precisely starch, is one of the reasons we will put on weight. The short version of that is because white bread, potatoes and so on offer you very little nutritients for their caloric value. No Atkins diet would rob you of 'carbs' as such. What they do, really, is rob you of starch - while giving you a smaller amount of carbohydrates and lots of insoluble fibre like you know from green leafy veggies etc, and along with that, they give you actual nutritients. When you look at grain, flour, potatoes etc, you find that they are mainly made of starch with is a di-saccharide ( a two component sugar), while table sugar is a mono-saccharide (mono for 1 chain). You want stuff that your body will break down into sugar slower so you get less peaks in your blood sugar. On a very low carb diet, you try to turn your metabolism into fat-burning only or mainly. On a moderate carb diet, you try to avoid the spikes from the fast acting carbs (starch) while being a bit less worried about the slower, more fibre packed options such as wholemeal and brown rice.

If you think about it, your body is struggling to process the sugar you eat (including starch). It pumps out tonnes of insulin to try to make your muscles wake up and 'eat' the sugar. However, that isn't really working, so you make more insulin. Which still doesn't work. Insulin resistance helps you keep on weight, and the more heavy you get, the less well your insulin will work.

That's why as a minimum, people will recommend to cut down to about half of the 'recommended' 300g of carb - so you get only 150 a day of starchy stuff. Some then go lower as they find it improves their control. That choice is one that you should make, and you can take a look at Viv's Modified Atkins which is found in the Low-Carb area if you want - that is very informative.

Also, you muscles will work better when they are used, so if you don't do a lot of exercise, you can improve that also by going for walks - 10 minutes now and then, 30 minutes a day would be good. Or swimming which is good for us big 'uns. The intensity of your exercise will to a degree be determined by what you are capable of, but also of your aim. If you do moderate exercise, you generally improve stamina. If you do vigorous exercise, you generally try to improve your fitness. The first form tends to lower blood sugar gently, the 2nd form while you are new to it, tends to see a quick rise in blood sugar in some, often followed by a rapid drop later in the day. Any exercise that you will likely do, is better than any scientifically perfect version that you won't do, so start slowly and with something you like doing.

Regarding the hypo on your breakfast, I am not sure. Maybe it would be a good idea with a bit of protein or nuts mid-morning. You may have thrown out a lot of insulin to deal with the breakkie, then when you started moving around, your body was suddenly able to use it and stuff went too low. Is possible.

 

[xyzzy]

Hello TJS and welcome to the forum.

It can be a bit confusing when you first start out. If you have recently changed what you're eating then its likely your blood sugar levels will be quite erratic for a quite a while. The average normal level for a non diabetic to have is in the low 4's so because its an average some people will run slightly higher and some people will run in the high 3's . Even as a T2 diabetic I try and keep mine less than 5.5 most of the time and am happy when I see a low 4 reading. While your levels are stabilising you can get dizzy and feeling sick symptoms but they are very unlikely to be a true hypo especially if you only take Metformin. Metformin is a medication that won't normally cause hypo's. It's for that reason you don't need to report you are diabetic to the DVLA. It's important to realise non diabetics can get those same hypo like symptoms too. An easy way would be to do a load of exercise when you haven't eaten for a while. Hypos are normally restricted to diabetics who inject insulin or occasionally those who take powerful insulin stimulating drugs. The simple maxim to remember is being diabetic doesn't cause hypos it's the insulin diabetics inject or the powerful drugs they take that can cause a real hypo.

Anyway here's what I did to sort myself out and you'll find its a similar story from lots of people on the forum. I was diagnosed in December last year and using the advice I found on this site I got my blood sugar levels back to normal within around a couple of months or so and I have also normalised my cholesterol levels and blood pressure as well. I have now lost over 50lbs in weight too and 10" off my waist measurement. Not a cure as I have to be very careful what I eat but I'm feeling loads better now I'm back in control. My doctor is very pleased how I am getting on and has advised me to keep doing exactly what I have been doing since it's obviously working really well.

Diet wise its really easy. Just drastically cut down or better cut out all things with plain sugar, so biscuits, cakes, sugar in tea and coffee, pure fruit juices, non diet versions of soft drinks. Next and really importantly try halving starchy foods like rice, pasta, potatoes, bread, cereals and any other flour based products. Replace what's now missing with extra meat, fish, eggs, cheese and especially vegetables. Vegetables that grow above ground are best although most of us find carrots fine. Things like yoghurt are fine as is a small amount of fresh fruit. I find the ones that end in "berry" are the best. If you don't mind artificial sweeteners things like Diet Coke are fine to drink. On the starchy foods that are left swap try brown basmati rice instead of white and brown or tri-colour pasta. The bread that most recommend is actually Bergen soya bread but some do ok with wholemeal as well.

The above diet is close to one you would be one recommended to try by the Swedish Health service. It was introduced in that country last year and the American health service and several other countries health services recommend something very similar for Type 2 diabetics. In the UK the diet guidelines are now over 30 years old and are only gradually being updated. As the UK is lagging behind you may find what I and other forum members recommend will be different to what your are told is a good diet for you follow.

I assume as you are measuring your blood sugar levels your doctor has given you a meter and strips? If that's the case you are one of the very lucky ones!t. It's a bit of a post code lottery and we find some progressive surgeries are pro testing and others anti. The anti ones can sometimes be very vocally anti!

The reason testing is important is you should try and keep your blood sugars below 8ish two hours after eating any meal. Above the 8 value is where the dangers of complications do begin to occur according to diabetic experts. So if you can't test how will you now if what you are eating is keeping you safe? The problem is every diabetic is different so my earlier advice to halve starchy foods is just a rough guide. You may find you need to eat less than half (like me) or that you can eat more than half like others.

As you mentioned how many grams of carbs are recommended then try and initially aim for around 130g / day. This is the figure that is recommended to Type 2 diabetic in America. Use your meter to then adjust that figure so that you keep safe. In the UK a non diabetic is recommended to eat 50% of their diet as carbohydrates so if you ate 2000 calories a day that would equate to eating 250g / day of carbohydrate. Here in the UK the SAME diet is recommended for T2 diabetics as well but most T2's especially those who want to control the condition by diet only or diet plus Metformin find 250g / day far to high to keep their blood levels safe. It for that reason I said the UK diet is out of date compared to a lot of other countries recommendations.

Good luck and keep asking questions.

PS Here's three good links about what's good to eat.

First is the lady doctor who's low carb / low GI recommendations seem to form the basis of what's recommended in Sweden

http://blogg.passagen.se/dahlqvistannika/?anchor=my_lowcarb_dietary_programe_in

Second is a good beginners guide to low carb regimes that are excellent for reducing blood sugar levels and losing weight.

http://www.dietdoctor.com/lchf

There are also loads of brilliant recipes on the forum. You can find them here http://www.diabetes.co.uk/diabetes-forum/viewtopic.php?f=18&t=4871. My favourite is Cheeseburger Pie which you'll find near the end.

Good luck and keep asking questions.

 

[daisy1]

Hi TJS and welcome to the forum In addition to the information you have already received, here is the information we give to new members and I hope you will find this helpful. Ask as many more questions as you need as we are all here 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 30,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes ... rains.html

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

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.
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Please sign our e-petition for free testing for all type 2's; here's the link:
http://www.diabetes.co.uk/petition/

Do get your friends and colleagues to sign as well.