Type 2 and Losing Weight

Hello srobertson06, welcome to the forum, personally, i have 10% carbs, 20%protein, and 70% good fats and keep my calories below 800 a daybut...we are al different so experiment as to your happy levels,clive

srobertson06 said:

I was diagnosed around 4 months ago, informed to lose weight, I was losing weight very slowly for the preceding year and have so far managed to lose a few more kilo's but now really struggling. I was informed to eat carbs with every meal, but no idea how many carbs to eat - even having to learn carb amounts in food as always worked on calories previously. I am on two 500gm Metformin tablets a day - one morning and one evening after meals - do suffer with occasional feeling sick, I am also on a statin once a day, taken late evening.
My question is carbs, how many in a meal or in a day, best way forward to losing weight and hopefully getting the blood sugar levels down as well.
I am about to do yet another fasting blood test as doctor not happy with last test and talking of doubling my Metformin following the next fasting blood test.
Any advice very much appreciated.
ps - I am attending the Desmond project at the end of the month where my doctor informs me I will learn a lot...

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Hi, In my experience the best number of carbs to have is as few as possible if you want to control you bg and lose weight. I find http://www.dietdoctor.com/lchf works for me.

Most of us were told to eat carbs with every meal. This is out of date advice. All carbs turn to glucose once inside the system, some faster than others, so it makes sense for diabetics to seriously reduce the amount of carbs they eat and replace the lost energy with good fats. (real dairy as opposed to low fat plastic rubbish as an example). Reduce or avoid potatoes, rice, pasta, bread and cereals.

Have you got your own blood glucose meter? If not I strongly advise you to get one. This will tell you what your body can cope with as far as carbs are concerned. We all have different bodies, different degrees of insulin resistance, different medication, so no-one can tell you what foods will cause your levels to rise, but a meter can.

Cutting carbs and going back to full fat products should see those pounds start to drop off you, which will also help with your blood sugar levels.

A very warm welcome to you @srobertson06 . I'll tag @daisy1 who will give you some initial reading that will help you.

@srobinson06

Hello and welcome to the forum

Here is the information we give to new members and I hope you find it useful. Ask as many questions as you want and someone will help.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 over 150,000 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-and-whole-grains.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 bloodglucose 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.

Hi. You were given bad advice to have carbs with every meal. Why would anyone advise you to make your diabetes worse (but I suspect it was good old NHS). You should have been told to reduce your carbs overall. Having them smoothed during the day is always good but you only need to have a small quantity and that is for the fibre and other nutirients. Reducing the cabrs will help with both blood suagr and weight. Many on this forum have less than 100gm/day. I would set a level of, say, 150gm/day to start with.

Hi there. If it is any help at all I thoroughly recommend reading Patrick Holford's "Say no to Diabetes". I found his explanations as to what is going on and how to control your diet totally enlightening. It also gives a clear guide as to which carbs are best, which worse and of quantities and limits. I've learnt more from this than anything the NHS has to offer. Good luck.

Have a look at this thread, which may help you.
http://www.diabetes.co.uk/forum/threads/a-new-low-carb-guide-for-beginners.68695/

If 10.5 was your lowest, you do need to start to take control yourself. Test before you eat and after 2 hours. Keep a food diary and record your levels alongside that meal. Patterns will emerge and you will learn which foods are causing the problem. Aim for a rise of less than 2mmol/l from before to 2 hours after to begin with, then aim for less as you get used to it all.

Ask as many questions as you like.

Hopefully you can start to lower your BS by eating to your meter. If you start to test 2 hrs after every meal you will be able to see which foods spike you and which you can tolerate. Even if you can start to cut down on the obvious carbs it should make a difference. Every one here strives for a different level of BS control so it is very much a personal choice, you have to decide for yourself what level you want to be at. Many here strive for non diabetic levels as it is the best way to minimize complications in the future.

Hiya. I'm lifting your post from another thread because a few points you made puzzle me.

srobertson06 said:

Belivta breakfast biscuits - could not eat breakfast before leaving the house to get to work - have yet to discover a breakfast I can take to work which does not include carbs.................. still learning how to deal with type 2 !
cheese (lactose free) with tomatoes, cucumber, lettuce and a little low fat mayo with some crisps...... Lunch
cooked chicken, new potatoes and cabbage for Tea.
One apple eaten between breakfast and lunch.
I know from testing myself (kit I brought as doctor does not support testing for type 2) that potatoes are not bad for me - all breads raised the bg levels.
So far I have only occasionally got bg readings below double figures and they seem to be from avoiding all carbs and usually occur during the afternoon!
Hoping my Desmond day will provide some guidance - attending this Friday.

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I don't understand why you're having Belvita biscuits. They are junk food and not likely to be tolerated by a diabetic. Have you checked out the meals and recipes on the forum? Lots of people find good solutions to eating on the go.

There's no need to have lactose free cheese. Full fat cheese is carb-free (almost) and provides the fat you need to replace carbs. Milk, however, is dodgy for many of us so we avoid it. Cream is good, double cream is better. Fat doesn't make you fat.

I don't understand how potatoes aren't bad for you if your BS levels aren't dropping below double figures.

Beware of apples. Eat with something else to slow down the digestion rate. Like full fat cheese!

I do hope Desmond explains how you can manage your diabetes.

srobertson06 said:

she did add no white bread and no dried fruit or any nuts..............

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I understand the white bread and dried fruit but really do not understand the nuts. I (and many others) live off nuts.

srobertson06 said:

Thank you to all of you who have posted a reply, I read them with great interest and yes I can confirm it was the NHS Diabetic Nurse who informed me to eat carbs with every meal, she did add no white bread and no dried fruit or any nuts.............. beginning to take her words with caution.
I have ordered the book that was mentioned and hope to have it to read very soon and I have been to the recommended website and will visit it again I am sure.
As for testing - again informed by the doctor I do not need to test, having read many comments on the forum I have purchased my own and have only tested up until today to find how low my blood sugar readings have got to and so far the lowest reading I have managed is 10.5 - so guessing my doctor will increase my Metformin dose next time I see him. I wait to get the 'feeling good' that I am told will happen when my blood sugar levels drop to a more normal range, this is what I was told will happen when I do the right things food wise with the aid of medication.
So I will keep reading comments and may post the odd question or two in the future. Thank you all once again.

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I would take the nurse's words with caution too, as there's nothing wrong with nuts, and there's no need to ensure you eat carbs with every meal. I try to eat as small an amount of carbs each day as I can, without going to extremes about it.

However, not everything the nurse (or doctor) says about diabetes management or other conditions is wrong. I have found it is helpful to have a healthy skepticism about what anyone says about food or health. Some of the suggestions you will read online or in books are not accurate and will not help you in your situation. The same is true for professional advice. Some of what the professionals say is accurate and helpful; the challenge is figuring out which parts are.

Given that you are working on getting your BG levels down through changing what you eat, to me it would make sense to delay taking a higher dose of Metformin, until at least 2 months after you start getting good numbers with your home testing. As I understand it, the HbA1c test covers the previous 2 months of BG fluctuations, so if you want to show the doctor how good your result is, it's only fair to start that 2 month period once you have better levels. If your doctor is a reasonable person and respects your autonomy he or she will agree to wait before reviewing your dosage. If not, just smile and get the extra pills but it's up to you whether you take them. I don't know how long it is until your next HbA1c... if it's too soon you might have to wait until the following test before you can show a good result to your doctor.

Where I live, no one does routine fasting blood glucose tests anymore because the HbA1c test is considered more appropriate. There may be some occasions where FBG is helpful. I had my HbA1c tested every 3 months until mine was under 40 (it's 37), and I get 6 monthly tests now.

My view on Metformin is that it's helpful if BGs are too high, and if they come down enough for long enough, then stopping it is an option, as long as BGs don't go up again. I choose to stay on Metformin along with low carbing as I believe these things together give me the best management of my condition. Basically if you don't need to take more Metformin at this time, don't. If in a few months you do need to take more then that's fine, too. The key is to keep BGs under control so you don't get complications.