type 2 and sugar control

Hi. An HBA1c of 62 is quite high and needs action. If you are morbidly obese then I assume you are including a fair amount of carbs in your diet? These must be reduced if you are to reduce weight and avoid medication. I expect the doc wants you to start taking Metformin which is a good safe drug but will not by itself solve the problem. So, the right diet and portion control are essential if you are to avoid or minimise medication; an HBa1c of 62mmol could well be damaging your body. Note that snacks are not a good idea (for anyone?) so not needed other than small non-carb things like nuts.

Have a look at Viv's Modified Atkins Diet, which is a Sticky Thread in the Low Carb section. It's a good base for any low-carb diet; if you stick to my version you will be eating about 25g - 30g of carbohydrate daily. If you want to eat more carbs than that, add them in carefully, using a carb counter book, from Low GI foods. As you increase the carbs, so you decrease the fat.

Following this diet I have lost 4 stone (BMI now 38, down from 48), my blood pressure has dropped, my cholesterol is fine, and my blood glucose levels are never normally outside the non-diabetic range. My last HbA1c was 37.

On your present diet, your carb intake is as follows:

30g oats 45g carb
60g cooked rice white = c 14g carb; brown c 13g carb (both cooked).
15g nuts/seeds c 7g carb
Pear 10g carb

That gets you up to 75g carb, which is about the level when my weight stalls or even starts to increase. You certainly won't be in ketosis (fat-burning) on that amount of carbs. I get there at around 30g daily.

That leaves a few further questions - what fruit do you use in your muesli? dried fruit is quite high in carbs, and so are some fresh fruits.
Which chicken & mushroom soup do you have? How many carbs on the packet/tin?
Which veg are you eating? and which beans?

There could be a further 20g carb at least sneaking into your diet with those 3 questions. Then, what do you drink? how many carbs in it? many diet foods/drinks are stuffed full of carbs.

I would suggest that you get a carb counter book (search on Amazon) and just check what you're eating; also, always read the labels. Do a week of a strict food diary and be completely honest with yourself about how many carbs you are taking in.

As for eating patterns - some people go for 3 meals a day; others graze, and eat maybe 5 smaller ones. It's whatever suits you best. I would always recommend breakfast; I have a 2-egg omelette cooked in butter every morning. This barely raises my blood glucose because it has minimim carbs. Fat doesn't affect blood glucose; about 20% of protein slowly turns into glucose and does affect your blood.

Finally; do give Metformin some consideration. I take 1 x 500g 3 times a day. It lowers the blood glucose by a little (1 or 2 mmol/l), works against insulin resistance and can suppress the appetite. It helps with weight loss. It also give some protection against stroke and CVD, and has recently been found to give some protection against some cancers. On the other hand, it can have side-effects - wind and upset stomach. This usually passes off quickly; if not, there is a slow release version which is gentler on the system.

This is completely your choice; no-one can make you take meds, but Metformin is in general a safe drug. If you decide to take it, make sure you go on to it gently - 1 a day for a week; then 2 a day for a week; and so on. Some people find that taking it in the middle of eating minimises side-effects. I had side-effects for a short time, but quickly got used to it and can now take it at any time.

I hope this helps. Let us know how you get on.

Viv 8)

Vicki, I really feel for you on a limited food budget because since I have been diabetic I have spent much more on food . There may be way to include meat more cheaply, though, if you could fancy it: liver is very,very cheap (my husband loves it. He buys it for 30p and there is enough to feed him for two meals and the dog also). If you don't fancy liver, you could also try cheap cuts of beef from the butcher and cook them *really* slowly in a casserole type meal (we bought some beef shin the other day, the butcher told us to cook it for four hours). Fish is harder, but you can get smoked salmon trimmings in ASDA, fine for putting in scrambled eggs, can't remember exact price but in their Smart Price range, not very high. Or tins of tuna you can get fairly cheaply especially if there's a special offer.


Type 2 on Metformin, diagnosed Jan 2013, ultra low carber, Hba1C at diagnosis 8% (11mmol), now between 5 and 6 mmol. 13kg lost so far

Finzi said:

Vicki, I really feel for you on a limited food budget because since I have been diabetic I have spent much more on food . There may be way to include meat more cheaply, though, if you could fancy it: liver is very,very cheap (my husband loves it. He buys it for 30p and there is enough to feed him for two meals and the dog also). If you don't fancy liver, you could also try cheap cuts of beef from the butcher and cook them *really* slowly in a casserole type meal (we bought some beef shin the other day, the butcher told us to cook it for four hours). Fish is harder, but you can get smoked salmon trimmings in ASDA, fine for putting in scrambled eggs, can't remember exact price but in their Smart Price range, not very high. Or tins of tuna you can get fairly cheaply especially if there's a special offer.


Type 2 on Metformin, diagnosed Jan 2013, ultra low carber, Hba1C at diagnosis 8% (11mmol), now between 5 and 6 mmol. 13kg lost so far

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YES YES YES OH YES THERE IS SOMEBODY ELSE IN THIS WORLD WHO USES SHIN BEEF!!!! THANKYOU:grin::grin::grin:

Low budget is certainly a problem - I have to be careful, but not as low as you, and food is my main expense once bills are paid and a tank of fuel put in the car! Clothes come a poor 4th - good job I'm scruffy by nature! :lol:

The diet you call your ideal would suit me too - except too many nuts for me (I have no willpower and if they're in the house . . .!), and too much fruit. I don't even eat fruit every week.

Can you eat salad-y things once they are in season and cheaper? Or is there any chance you can grow any, even in big tubs? Root veg tend to be highest in carbs and above-ground lowest, with the obvious exception of eg sweet corn. Sweet potatoes aren't too bad, nor are lentils or chickpeas in small portions. I follow the Atkins list; I avoid peas and beans, but eat green beans; mostly I live on them with broccoli, cauliflower, leeks, courgettes and mushrooms. Occasionally I'll have a carrot.

I've had a vegetable stew 4 times this week- 1 large carrot, 1 onion, a fennel bulb, a stick of celery, a sweet potato (left over from Christmas :shock: - still okay), 1 tin tomatoes, 1 red pepper, 1 orange pepper, lots of mushrooms, 3 garlic cloves, pepper, mixed herbs and mixed spice. It's the sort of thing I might put red lentils in, too. Instead I oven-cooked 6 low-carb sausages at the same time and then bunged them in. It tasted quite sweet from the potato and the peppers, and was delicious!

If I buy a chicken I have it hot the first day, almost by itself sometimes; then I will make a 2-portion leek, courgette and mushroom casserole and have that twice, once with cold chicken and then with cold chicken mixed in to warm. By the time I've had a couple of salad lunches off it as well, it will have done me 5 or 6 meals. I buy big chickens! . Then stock for soup. I also stock up with turkey legs at Christmas - they often go quite cheaply, now many people don't want a whole bird, just a crown. I've got one defrosting now.

Can you get rabbit? One butcher round here (I'm in the middle of the country) does jointed wild rabbit for £2.50. At least 4 portions, it makes cheap meals. Or I can get a whole one, naked and empty, for the price of some cartridges, they are such a pest. I'm lucky enough to live next to a gamekeeper, who gives me the odd game bird which has been too mangled to be sold. He skins them for me and just gives me the "crown" - the 2 breasts on the bone. If your butcher sells venison, there is a good cheap cut called venison flank, which casseroles brilliantly and is so healthy! Shin beef is great, cooked long and slow it's very tender and thick. Goes well cooked with onions and lentils, or with shallots.

Did your dietitian say anything about which fruits? Plums and apricots are best for low-carb and low GI, followed by any berries - all of which are too expensive at this time of year. Some tinned fruit is okay, provided it's in juice not syrup, and you have small portions. I go for apricots, peaches and pears in tins - but not often, and small portions. Avoid oranges, grapes and pineapple - or try them and test 2 hours after eating, as different people can tolerate different things. I can cope with a small apple, and I have to confess that I do sometimes have a banana - a child-size or "fun-size" one, as they call them in Tesco. I buy sugar-free jellies - they aren't expensive and eke out the fruit.

I would hate to be lactose intolerant, so you have my sympathy. Do let us know what sort of "dairy" you're eating - I like sheep and goat cheese and yoghurt, but I suppose they must contain lactose too?

Anyway, at least the dietitcian is paying attention to your problems, which must be a relief in itself. Let us know how you go on.

Viv 8)

I'm lovin this, on Bury market we have a fish and meat hall, you can get rabbit in there.:grin:

Ifyou are T2 on diet control only, you DON'T have to eat 3 meals a day if you don't feel like it.
It's as important what you eat as whenand how much. It sounds like you are trying to be low carb an doing it fairly well. Keeping to it will be good.
If your Doctor offers Metformin,don't worry. It's a very safe medicine, although it can upset some people's digestion.
Hana

You've got to be creative and also be willing to eat things twice or 3 times - unlike a friend of mine's husband who won't eat "leftovers" no matter what! :roll: .

Only one other thing to add - it is possible to eat too little. Your body can go into starvation mode and hang on to everything you give it, making it impossible to lose weight. I hate calorie counting, but you should be aiming to eat between 1200/1500 cals per day - I think. Anyone care to comment further on that?

Keep warm!

Viv 8)

Four keys: Diet, Exercise, Medication and Food Supplement. If you are really to lose weight, control carbo intake. If you are type 2, it will be easier for you to implement diet. For type 1, it will be harder for often times, sugar control is really in their insulin.

I strongly suggest that you take meds as what the doctor recommended. When you have lost some weight and you think it is already workable for you to maintain it without the meds, then you can probably do that. Again, do what the doctor said first and take control of blood sugar as soon as you can.

Hi Vicky.
Best of luck with the dieting, it is worth the work involved. Do you exercise? I often used to see people who were far too large (my size) trying to run, it worried me because of the damage they could be doing to their joints and their hearts. I have arthritis in far too many joints to try running! but walking has worked very well, just don't forget that wherever you walk to, you have to walk back again. I joined a walking club with a friend and we used to walk with them once a week. We also walk around my friends village and on Portreath beach. Walking on sand is much harder work. I only joined this forum yesterday and I have already taken some of the advice on board. I had never been too concerned about my carb intake, being a vegi, carbs were a good source of energy for me. I am now lowering my carb intake to protect myself in the future. Instead of 60 grms of porage in the morning I am having 30g. Only 1 slice of bread with my evening meal, not 2. I had already cut down on rice and spuds, I will now take this a bit further. I appologise if all this sounds a bit me, me, me. I am just trying to help in the only way I know which is to tell you what works for me. My one true weakness is biscuits, I used to think it was chocolate, it isn't, it's bikkies! (3 a day, max, honest!)
Lee.

Liver is a good cheap option as suggested above. As is shin beef. If you like them tinned pilchards are pretty cheap.

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A couple of months ago I thought there was a connection between sugar &me falling asleep! I was falling asleep walking down the road& still sometimes:-/ I've tested my theory out over this time period.. It really DOES!! That's why being diabetic we feel tired a lot the sugar makes us sleepy not the other things like meds... I don't take any meds for my diabetes or test my blood sugar levels either, because my doctor says I don't need to as am borderline diabetic type 2.. I know I'm lucky, though this is a struggle for me as I eat healthy most of the time..


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