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stressed, worried and confused over diabetes situation

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I've been diagnosed diabetic for several years. I had another illness - a serious type of depression too - so I wasn't very motivated to take care of myself. I followed the recommendations through the doctors - which basically were minimal - just cut out refined carbs and eat more fruit and veg. I don't have an accurate record of my blood sugars but basically the fasting test went up over those years from around 6.5 to around 9. I take 2000mg of Metformin and I only realise now that this is a fairly high amount. I must admit that I stupidly didn't worry too much about having scones or chocolate occasionally as my nurse just said she would give me more tablets if I carried on eating that type of food - at no time did she say to me that I may be permanently damaging my pancreas, eyes or other organs. In addition, there was no provision of a blood glucose meter until I finally asked for one which I'm just trying to get the hang of.

Lately, I have been feeling really ill with thirst and weeing lots. I'm now so worried about the state of my body. I also have a lot of weight to lose. I'm trying to educate myself quickly but I'm stressed as it seems likely its too late to reverse things. I also watched my grandmother die after having a major stroke related to diabetes and it was very upsetting and worrying.

I am confused about what to eat with low carbing - because I have just been reading a book about reversing diabetes and the author says that you mustn't eat too much animal protein, or fat, either - the protein because it can damage your kidneys and the fat/oil because it can clog up your cells and lead to more insulin resistance. Is this right? This book also says to take portions of wholegrain carbs like brown basmati rice - but I've been reading here about people having just low carbs or cutting out carbs.

So, basically, is the most recent advice to cut out carbs completely or to reduce them to a limited number of grams/ or portion? Or can you have small portions of complex carbs? Do you have to cut out/down on animal proteins too because of your kidneys? Do you have to cut down on fats/oils because they clog up the cells in the pancreas?

Can anyone recommend a helpful book which has the most up to date information and guidance? I am trying to glean from posts the best thing to do but I'm not clear on where people are getting the best info from.

I'm meant to go and see the diabetes nurse again in several weeks time. I feel very let down by the advice given, but also realise I have been very foolish myself. I am scared of the future.

Thanks for reading :(
 
Hi Apple,

You could do with advice from a fellow T2 ( Im T1 )

Please dont worry with help and good advice I am sure you can sort it out. Read some of the success stories and they should help you to see the light at the end of the tunnel.

This should bump you up.....xxx

Lucy.
 
Hi Apple :) Maybe you will find this information helpful that we give to new members. Have a good read then ask as many questions as you need to as there is always someone here to help you.

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.
-------------------------------------------------------------------------------------------------------------------------------------------------------

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.
Click to expand...
 
Weeing lots is a symptom of high blood glucose.
I would advise any diabetic to cut back on the carbs. How much by is your choice.I personally keep very low; about 20 - 30 on a normal day.
In general, I avoid visible carbs. Sometimees I give in to temptation, but keep the portions TINY.
For me it works and it has become my habit. i've got so used to it, I almost never feel hunger.
Your choices might be cutting down, cutting out or substituting one food for a lower carb one.
Hana
 
Thanks for your replies. Thanks Hana for explaining what works for you as this is helpful to know.

To be honest I'm feeling extremely depressed. I just took my sugar level after a non carb lunch (tinned salmon, watercress and tomatoes) with 1000mg metformin and it was 7.2 which still seems high to me (I had accidentally missed my metformin at breakfast). I have had another illness so I'm finding it difficult to manage.
 
Hi Apple,

Just a thought! Do you need to get more help for your other illness. Have you spoken to your Doctor?

Lucy.
 
hi Lucy, thanks for your post. The other illness was diagnosed as psychotic depression - it was actually taking the antipsychotic over a number of years without my health being monitored that led to me becoming diabetic. The 'care' now is care in the community which means you are left on your own at home with a visit from a nurse every couple of weeks. There is no longer a local day hospital to visit as this was cut. I'm not psychotic at the moment, just very very low. If i asked for help it would inevitably mean that I would be given more drugs which I would prefer to avoid as they've nearly always led to weight gain. Sorry if this sounds negative - just trying to explain the situation.
 
Not at all! Just wanted to see if anything else could help you! It sounds if you get some help re the diabetes it may help. It can get frustrating trying to get your levels down and getting high numbers. We all have peaks and troughs. Try not to get too dispondent.

Sending a big Hug ((((x))))
 
I was diagnosed with T2 D around 5 weeks ago. The Doctor told me in hushed tones and I felt like I was on borrowed time!However when I met up with the Specialist Diabetic Nurse she reassured me that I was not about to fall off the edge of the page....such a sweetie, I'm lucky. Anyhow, my daughter bought me a book called 'Overcoming Diabetes' by Dr Sarah Brewer, its packed with clear down to earth really helpful information, I have told friends about it...a coincidence is that one of my best friends was diagnosed just days after me.I am still confused about what is safe and what to avoid when I go shopping.I avoid high fat and high sugar levels and frequently revert to the book suggested. I have lost 11 lb (I needed to..and more) and am eating much more healthily than before diagnosis. Good luck to you and all other T2s out there.
 
A book I would recommend is Atkins Diabetes Revolution, by M C Vernon and J A Eberstein. It's written for Type 2s, mainly, but is also useful for Type 1s wanting to low-carb.

The diet I use for weight loss (but it's brilliant for blood glucose levels too - and cholesterol and blood pressure levels) is on the Sticky Thread section on here. It's called Viv's Modified Atkins Diet. It's a basic list of foods for those that want to stick to a very low carb diet.

If you want to eat more carbs, get a carb-counter book and add in low-GI foods to the daily level of carbs you want to eat.

Don't be afraid to ask questions. We're all here to help! :D

Viv 8)
 
I have battled with depression all my life. I think the real issue here is that you need and deserve good quality health care for both the depression and the diabetes, with any meds for each not making the other one worse.

It's not about carbs and books and special diets - right now it's about effective medical care for a worsening depressive episode and what looks like hyperglycaemia or at least unstable BG levels.

Anti-psychotics are well known to cause or contribute to excessive weight gain. These days all psychiatrists are told to be careful with prescribing them to patients at risk of weight gain and diabetes. Some of the newer ones are better for diabetics than the older ones. Of course, they're more expensive for the NHS - but their own studies have proven that it's cheaper in the long run to stave off severe depression and/or diabetes complications.

Not having diabetes under control is known to contribute to depression, even in people who don't have a diagnosis of depression to start with. It's partly a chemical imbalance caused by the high blood sugar, and partly just the fact that living with this disease is hard. Some people can cope emotionally with diabetes, some people have good supports and resources (money, caring/fit partner and family, warm and comfortable home, access to transport, not living out in the country). Given your two conditions, and the fact that things appear really hard at the moment, the last thing you need is to have poor quality care for diabetes.

Your GP should be sorting out some proper services for you, possibly referring you to a specialist diabetes team for review. If your GP isn't interested, willing or aware enough to help, is there an advocacy organisation you can go to for advice? Someone to help you speak up and get the help you need, without your rights and wishes being compromised Seeing a nurse in a few weeks time does not seem like an adequate response to help you through this difficult time. I'm not sure she will be alert enough to your needs, and I think it would be good to see someone within a week.

I wish you all the best with this.
 
Thanks for your replies.

Viviennem - I will have a look at the thread you mentioned - thanks. However, I do have some reservations over having too much animal protein because of the affect on the kidneys - are you aware if this is something to be concerned about?

CatLadyNZ - thanks for your advice - but I'm not aware of any advocacy service here. I do have a community psychiatric nurse but to be frank she's been of little help over the past year (just wants to fill in lots of forms) and I have thought of asking if I could be with someone else. My experience of both doctors and nurses locally have been that they have been quite complacent and minimised any seriousness over health issues. I didn't realise that I was on a high dose of Metformin until I visited here and saw how many people were on so much less - and my local doctors surgery just seems to think that its fine to add more drugs into the mix. I really regret not properly investigating this for myself before now.
 
Apple
try contacting Diabetes Uk [they are not us].They have a lot of services and in some places there are groups, which might support you. In any case they have an advocacy service, which would support you in what your doctors say. All in all they provide an xcellent service [except in the matter of dietary advice]
Hana
 
2000 mg of Metformin is the maximum recommended dose per day and although you don't see it on here, I am sure there are many, many people on that sort of dose. Because I was diagnosed nearly five years ago, I'm on the old maximum dosage of 2550 mg per day plus 40 mg of Gliclazide.

I don't think I eat extra animal protein to what I did before, I just don't eat bread, pasta, rice or potatoes. This cuts the carbs nicely.

It is a balancing act between carbs and meds, but if your pancreas was already quite badly damaged before you were diagnosed (I'm sure I was diabetic at least five years before diagnosis and loved sweet sugary fizzy drinks), then no matter what you do, you will still need the meds, but you may be able to stave off the progression onto stronger meds by cutting the carbs.

Have you been tested for vitamin D deficiency, as it is quite strongly implicated in depression.

Edit: to mention vitamin D deficiency
 
Thanks Hana for your suggestion - I didn't realise that this wasn't Diabetes Uk.

Denise - thanks very much for posting - I am going to try and send you a PM.
 
apple123 said:
Thanks for your replies.

Viviennem - I will have a look at the thread you mentioned - thanks. However, I do have some reservations over having too much animal protein because of the affect on the kidneys - are you aware if this is something to be concerned about?

CatLadyNZ - thanks for your advice - but I'm not aware of any advocacy service here. I do have a community psychiatric nurse but to be frank she's been of little help over the past year (just wants to fill in lots of forms) and I have thought of asking if I could be with someone else. My experience of both doctors and nurses locally have been that they have been quite complacent and minimised any seriousness over health issues. I didn't realise that I was on a high dose of Metformin until I visited here and saw how many people were on so much less - and my local doctors surgery just seems to think that its fine to add more drugs into the mix. I really regret not properly investigating this for myself before now.
Click to expand...

Hi Apple

Unless you already have kidney problems, cutting carbs and increasing meat and fish, etc, won't harm your kidneys. You should get regular kidney function checks as a diabetic anyway. Mine are still functioning very well, which considering what I put them through . . . :roll: .

Similarly, increasing your fat intake, as long as it's good quality natural and unprocessed fat (in which I include vegetable oil eg extra virgin olive oil) won't upset your cholesterol levels either.

I've just finished a lovely low-carb supper of leek, mushroom, courgette and chicken, with olive oil, garlic, herbs, seasoning and a little butter. Nothing wrong with that! You'd be surprised how much veg you can eat even on the lowest-carb level of Atkins. It can even be done for vegetarians, though with a little more carb - Rose Elliott wrote a book a few years ago, should be available on Amazon if you're interested.

We're all different, and different levels of carb suit each of us. But if you need to lose weight (which is ongoing with me :lol: ) controlling your carb intake will show good results.

Viv 8)
 
viviennem said:
Unless you already have kidney problems, cutting carbs and increasing meat and fish, etc, won't harm your kidneys. You should get regular kidney function checks as a diabetic anyway. Mine are still functioning very well, which considering what I put them through . . . :roll: .
Click to expand...

I agree. The "high-protein" thing is a bit of a myth perpetuated by the Atkins bashers. A properly formulated low-carb diet doesn't need to have any more protein than a regular "balanced diet". Most people would find it difficult to significantly increase their protein intake (without taking protein shakes etc).

If you are going proper ketogenic (<<50g) you need to make sure that you eat the minimum amount of protein that your body will use to generate glucose through gluconeogenesis, which is about 1g per kg of lean body weight. I'm a big lad, and for me that'd only be 75g of protein per day.

As Viv says, unless you have existing kidney problems, I really wouldn't worry about it.
 
The main thing I have learned from this forum is take the old healthy diet advice and throw it away. The advice of high carb with protein and low fat, should really be turned on it's head. Cut carbs, up the healthy fat, so cut out all the processed stuff, ready meals, processed cheese, wheat, so no pies, sausage rolls, pasties etc. Eat a good amount of protein, spread throughout the day, and up the good fats. For diabetics dairy is GOOD! Eat cream, and cheese, mayo etc, but all full fat, not low or light. Lots of veg and salads. A diabetic diet is really quite a decadent one. One other thing, improvise. We can't have potato chips, so if you want chips, make celeriac chips, or swede chips. If you want mash or rice use a cauliflower. It's amazing the difference small changes can make, yet you never need be hungry, nor deprived.
 
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