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Type 2 diagnosed last week

T

Tootse

Well-Known Member
Messages
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Hi everyone, was told I had diabetes a couple of weeks ago, but just got results from my gtt last week (I was 9.4 at my initial bt after fasting for 12 hours and before I drank the glucose drink) for the life of me i can't remember what it went up to 2hrs after.

As you can imagine, my head's all over the place. Wondering what I should be eating etc, downloading lots of ebooks and getting more confused. I decided to wait until I have my appointment with the diabetes nurse this coming Friday.

I am so glad I've found this site which I will take time to read over the coming weeks, however I wonder if anyone can answer a couple of quick questions for me (I know I should have asked the doctor at the time and I will when I see them after my 6wk monitoring bt)

I noticed that a lot of people are taking the same medication as myself, Metformin 500mg, but have been prescribed 1 or 2 daily. I have been told that I need to take 1 a day for first week, increased to 2 in second week then 3 from 3rd week onwards. I am currently suffering from mild but 'urgent' diarrhoea from 1 a day I dread to think how my body will cope with 3! Can anyone tell me what to expect?

My cholesterol stands at 4.6 and although the doctor has said it's at slightly high end of normal, I have still been prescribed 40 mg of Simvastatin to be taken each night. Is this really necessary, and at such high dose (I read the leaflet and noticed that there are 10 & 20mg doses available)?
 
Welcome to the forum. Daisy will be along shortly with some advice.

If you have questions, ask away. I'm sure there someone here who has an answer or suggestion for you.

-M
 
Hi Tootse and welcome.
Your metformin is being increased slowly to a normal dose to allow your body to get used to it. This is common practice. If the diarhhoea continues, go back to the GP. There is a slow release version of metformin that doesn't cause this common side effect, but they give us the normal stuff first because it's a bit cheaper!
Regarding what to eat, here's a few ideas:-
In general terms you will need to reduce the total number of carbohydrates you eat per day. All carbohydrates turn to sugar when we eat them, and no type 2 diabetic on diet only, or on diet and metformin only, can control their blood sugars (BGs) without controlling their carb intake. Even those on strong medication normally choose to control their carb intake to keep the level of medication they take down. The total number of carbs per day you can eat depends on how advanced your diabetes is. It’s perhaps worth starting at about 50% of normal levels for a non-diabetic then adjusting up or down according to how you get on. So that means eating 150 grams of carbs per day for a man, 125 for a woman. You can read the total carb content of food under “nutritional info” on the packet or wrapping, or look it up on the internet for loose food. Just google “carb content..”
You also need to stop or reduce the bad carbs; that is the starchy ones that make your BG go up quickly.
So obviously no sugar or glucose! But also no white bread, white rice, pasta, flour products like pastry, cake and batter. You can eat a little basmati rice, wholewheat pasta or the tri-color pasta fusilli ones in small quantities. Boiled new potatos (again not too many) are OK but not old pots mashed, boiled or in their jackets. (Roast is not so bad, the fat slows their absorption and conversion to glucose in the blood) Amongst other veg, parsnips are about the worst for BG, and carrots not great but ok in smaller amounts.
Multi grain bread (not wholemeal) is not SO bad, but lots of us eat Burgen soya and linseed bread from tescos and sainsburys, although all bread should be in limited amounts.
All fruit has carbohydrates, and needs to be included in the amounts of carbs you eat in a day. For most people, bananas are about the worst for pushing our BG up and berries (like strawberries, raspberries etc) are the least bad.
No sweeties!
Exercise is important. I tend to exercise about an hour after eating when I know my BG will be peaking. This helps to bring it down quicker and further. I do ten minutes hard work on an exercise machine, but you could run up and down stairs for ten minutes or go for a brisk walk.
Returning to types of food and quantities of carbs - you can only find out how many you can eat by testing. Most type 2’s are not given access to testing equipment, so you should get your own – although try arguing with your Doc that you want to manage to NICE guideline blood sugar levels, and can’t do that without testing! If you have to buy a meter, they are cheap and most manufacturers will give them away for free. They make their money on the strips you have to use! So go for the meter with the cheapest testing strips. The SD Codefree available on the internet is about the cheapest at the moment. Some people test before and after eating, on waking (fasting test) and before bed. But if you have limited strips because of cost, the key to me is testing 2 hours after eating. If your BG is above, say, 7.8 at that stage, you need to cut down on the carb content the next time you have that meal. Test after various different meals and you soon get to see a pattern of what you can and can’t eat, and in what quantities. Keep careful records of what you ate and when, together with the result, so you can refer back at a later date. You can then reduce your testing. I said “below, say, 7.8” because NICE guidelines are below 8.5 but most of us think that’s a little high. 7.8 is the max. level at 2 hours after eating that a non-diabetic normally gets to so is perhaps a better target. Some then set progressively lower targets.
Do ask lots of questions; there is normally an answer on here. The more you get to learn about your diabetes, the better it will be.
Good luck!
 
Hi Tootse and welcome to the forum :)
Here is the information we give to new members and I think this will help you. Ask all the questions you like as there is always someone who will be able to reply.

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 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.
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Hello Tootse and welcome :)

Thought I'd tell you what I did. I was diagnosed in December last year and using the advice I found on the forum 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 nearly 4 stone in weight too. My doctor is very pleased how I am getting on and has advised me to keep doing what I have been doing since it's obviously working really well. You can normalise your blood levels but that isn't the same as a cure I'm afraid. What it means is that you will need to be very careful about what you eat from now on.

What you should eat diet wise is 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 regime 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 is different to what your are told is a good diet for you follow.

Next most members would recommend you test your own blood sugar levels. Did your doctor give you a meter and strips? Some do and some don't. It's a bit of a post code lottery and we find some progressive surgeries are pro testing and others anti. I'll warn you the anti ones can sometimes be very vocally anti! If you ask and get told no then if you can afford to most members will get a meter and test themselves anyway. A meter that many people are buying at the moment is called as SD CodeFree. The meter and 50 strips will cost under £20 then new strips are just £5 per 50 which is a lot cheaper than most other meters. The cheapest place to buy is the healthcare.co.uk shop on eBay but make sure you get a UK mmol/l model and not a US mg/dl one or the numbers it shows will be confusing.

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 get into it all and read around the forum you may see people talking about carb counting. If you want to understand what that is just ask. It is a powerful weapon that a diabetic can use to control their condition and one that many of us use to great effect.

Good luck and keep asking questions.

Regards

Steve

PS Here's two 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
 
Thank you for your responses.

I'm sure I'll get to grips with it eventually. My doctor never mentioned anything about checking my blood at home. In fact she said very little really. Apart from describing how to take the medication, that I should make an appointment to see the diabetic nurse and I need to have my blood tested again in 6 weeks.

I just cannot imagine losing the carbs. I rarely consume sweet things, no sugar in tea, diet drinks, I don't buy biscuits or cakes, so giving up sugary foods no problem. But carbs! I love my pasta, rice and spuds.

What makes me scared is that I may cheat. I have been dieting since childhood. Losing the weight then putting it back on with a little more added. You know that little voice that says 'oh go on, just this once, who would know, it's not really that bad'. If I couldn't ignore it then how can I resist temptation now. I know this is a potentially life threatening situation but...

I suppose this is what's called the denial phase eh?

Anyway does anyone know Simvastatin? My cholesterol stands at 4.6 and although the doctor said it's at slightly high end of normal, I have still been prescribed 40 mg of Simvastatin to be taken each night. She didn't really say why this is necessary, and at such high dose (I read the leaflet and noticed that there are 10 & 20mg doses available)? I have read others having problems with the drug which has put me of taking it yet. I was going to hold off until I have spoken to the diabetic nurse. Am I doing the right thing?
 
Hi. Regarding Simvastatin, the NHS is obsessive about diabetics taking a statin even with low cholesterol. It's you decision so be prepared to stand your ground. A cholesterol level below 5 does not indicate a real need for a statin. If 40mg does not result in any muscle pains or other side effects then you may want to continue. If you do get these side effects, stop the statin and tell the doctor. Asking for a lower dose is another option.
 
Tootse said:
I just cannot imagine losing the carbs. I rarely consume sweet things, no sugar in tea, diet drinks, I don't buy biscuits or cakes, so giving up sugary foods no problem. But carbs! I love my pasta, rice and spuds.

What makes me scared is that I may cheat. I have been dieting since childhood. Losing the weight then putting it back on with a little more added. You know that little voice that says 'oh go on, just this once, who would know, it's not really that bad'. If I couldn't ignore it then how can I resist temptation now. I know this is a potentially life threatening situation but...

I suppose this is what's called the denial phase eh?
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Tootse there are a number of different ways to treat your db but all of them require you to adopt a healthy lifestyle. The problem with thinking its just about sugar is its not! Carbohydrates are what make blood sugars rise and sugar is just a type of carbohydrate. Sugar is a carbohydrate that is counted as being dangerous as it makes levels rise quickly but other carbohydrate foods also act nearly as quickly especially the starchy ones like rice, pasta, bread, potatoes and cereals which is why many of us and many other countries health services tell you to restrict how much of them to eat.

In reality this is why most of us think getting a meter and testing is so important as it will tell you what level of carbohydrate you can tolerate. There is a lot of research that has been done that says to keep your level below 8 two hours after eating. Regularly exceeding that level does lead to complications such as blindness and amputations. It may take a while but that is pretty much what happens to many people who don't control their condition. To be blunt the worse thing you can be is an overweight uncontrolled diabetic as that can knock somewhere between 10 and 15 years off your lifespan

Effectively there maybe a balance between how much carbohydrate you want to continue to consume and how much and how powerful the medication you are willing to take. The normal route is to start a diabetic off on diet only or diet only plus a safe drug called Metformin then re evaluate in three months to see if you have responded. Unfortunately for many people the answer is they don't respond even through no fault of their own and are then put on more and more powerful medication to try and counteract how much carbohydrate they are continuing to consume. If that doesn't work or your pancreas simply gives up the ghost because those drugs work by over stimulating it then you will end up like so many people in this country as an insulin dependent T2 and as such you will need to inject insulin each day to survive. Insulin can theoretically cover the amount of carbohydrate that you consumed as you just have to inject enough. The insulin option is always there for diabetics but of course it comes with its own set of risks such as weight gain, hypos and the high risk of losing your driving licence when you legally have to report if you have had a hypo etc.

The alternative that many of us have chosen is not to enter this drugs escalator and simply cut out as much carbohydrate from our diets that is required until by testing we see our blood levels run safe. This seems entirely sensible and yes its hard work for the first few weeks but pretty soon you find loads of nice things to eat to replace the starch. I run my levels at those of an average non diabetic person so the theory is if I do that then firstly I run very little risk of any of those blindness, amputation or other complications and secondly I can stop or drastically reduce the rate of progression of the disease. Many forum members have done this for years. They are not cured by any means as if they ate a plateful of pasta or rice or sugar their levels would sky rocket. The best way of describing it maybe as my doctor does and says I've put my T2 into remission and so long as I continue eating my carbohydrate restricted diet it will likely stay there. As I mentioned in my first post my GP actively supports the way I control my T2.

Hope this hasn't been too blunt for you!
 
Not at all xyzzy, I need blunt if I'm to be woken up to the seriousness of my condition.

I am very much overweight and with having undiagnosed diabetes for a while I have not had any energy to exercise (I thought my tiredness and lack of energy was related to age and menopause), so moving around, let alone work up a sweat walking is a tad painful.

I was hoping that once I get my metformin up to the 3 times a day (2.5wks time) I would have a little more get up and go, but it seems I have to shake off my lethargy and take control sooner than my brain or body wants me to.

Thanks again for all the advice. I'll have to start planning my meals. Are there any good type2 diabetes or low carb recipe aps that someone could recommend?
 
Tootse said:
I just cannot imagine losing the carbs. I rarely consume sweet things, no sugar in tea, diet drinks, I don't buy biscuits or cakes, so giving up sugary foods no problem. But carbs! I love my pasta, rice and spuds.
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Yeah but who doesn't love pasta, rice and spuds? It's not like the rest of us "didn't really like chips" anyway. Not only are these things the staple of the modern western diet, but they also trigger the same brain receptors as opiates. They are literally addictive.

On the bright side, although diabetes is a serious life-limiting condition, you can probably make it go away with a few small dietary sacrifices.

You'll soon come to realise that pasta, rice and spuds, don't really taste of much anyway.
 
Update. I went to see the nurse for the first time today. She took my blood pressure (normal) and gave me booklets. Recommended that I book myself onto a 3hr a week class that runs for 6 weeks (earliest start dates are in September). Tickled my feet, all ok there. She had a suitably comical shock/horror face when I told her that I haven't started my statins yet. I told her that my cholesterol read 4.6 and i feel that being given a full 40mg daily dose was a bit too much. I asked her why the doctor hadn't started me with a lower 10 or 20mg dose to see how i got on with them first. She simply said the doctor would not prescribe tablets if I didn't need them. Yeah right.

I asked for a bg tester, and she gave me one! (My Life Pura X with 10 test strips and lancets) Stating that I should only test about twice a week before I have breakfast. And then only for about a month. Didn't explain how to use, where to get additional test strips and lancets, how to understand or what to do with the readings etc.

I was then handed over to the diabetic dietician. He told me to cut down the fats, grill my food instead of frying and fill half my plate with vegetables - no really? I told him I wish to cut down my carbs. He didn't dissuade me, but didn't give much advice. I asked what websites he recommended, he said diabetes.org. I was then given booklets about eating healthily, clearly stating that I need to eat starchy carbs.

I feel a little let down. I was hoping to come away with a clear guidelines of how to cope with type2. Well may the classes in September will help.
 
Tootse said:
I feel a little let down. I was hoping to come away with a clear guidelines of how to cope with type2. Well may the classes in September will help.
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It's a shame you feel let down, but not suprising. You already HAVE clear guidelines - those given to you on this thread by people who succesfully control their diabetes. Don't expect too much from the classes in september either - they'll probably just repeat what your dietician just said because they have to. Follow the dietary and testing advice given previously here and you'll soon see what happens to your BGs!
 
Hi Tootsie, I have been low carbing now for about a month after 2 years of following doctors guidelines and my diabetes getting worse. I am truly a convert, low carb is life changing! I feel great, I'm losing weight, my BG is coming down and I have bags of energy. Just a couple of days ago I noticed that I no longer get after meal dips in energy, I used to feel very sleepy after lunch of a sandwich and crisps, but now I have a cheese omelette or chicken salad and just stay feeling normal with balanced energy all day.

Exercise is important too, I try to go out for a walk after dinner, instead of flopping down in front of the telly. Especially now when the weather is nice and there is rubbish on the telly. I walk for about 40 minutes and get a bit sweaty and out of breath. One day this week 2 hours after dinner and just back from my walk my BG was 4.9!! Previously unheard of when I was following the 'carbs with every meal' advice.

Keep reading on here, there are recipes. I learned a lot from XYXXY's link http://www.dietdoctor.com/lchf

I still cook normal meals for my family like spag bol but I have brocolli instead of pasta, or cauliflower mash with a hand full of cheese - delish!!

Good luck, keep asking questions.
Jane
 
Thanks. I will continue to read the various threads on this site with interest and will follow, as best I can, the advice given. I imagine it will take me some time to stick to a low carb diet but hopefully I will get there.

Visiting in-laws this weekend and already resolve slipped. When I told them I was diabetic mother-in-law right away decided that she would do a salad for dinner. She was going to cook a large jacket spud for me but I said no. She got out the pork pies and I said no thanks. Mini sausages and scotch eggs were presented, I shook my head. She suggested pasta or rice and I said erm, more salad please.

When I was given dinner it was covered in ready salted crisps with a couple of slices of buttered white bread and a custard tart for afters. I didn't like to look ungracious so I ate it. Crisps were a very tasty touch and custard tarts are my favourite.

I did a bg test for first time this morning and the mmol reading was 5.4. Had a couple of boiled eggs for breakfast will take test again after 2 hours. Not sure what the readings will mean or what I'm looking for.

I have no doubt that we will find somewhere to eat in Great Yarmouth later and I can't imagine there will be a great choice of low carb meals to choose from. Any suggestions of what I should go for if available?
 
All day breakfasts without the beans and toast are a standby for me when I am out during the day. If I have a choice then a nice steak with salad is very good. I do find desserts and starters a challenge to my will power but sometimes have the cheese board and leave the crackers.

Most restaurants seem quite happy to substitute extra vegetables for potatoes, if they are not on my plate I know I won't be tempted. I also always ask for any dressings or sauces to be served in a side dish so that I can control how much I add to my meals.

I have also found that saying I am carbohydrate intolerant is far better than mentioning I have diabetes as it saves having to fend off helpful suggestions from those who have preconceived notions on what a diabetic "should" eat.
 
I was diagnosed 2 wks ago. Complete shock, no warning from blood test 6 months ago. Type 2 with vitamin D deficiency, high liver enzymes, and raised cholesterol. So far lost 4lbs but the charts I'm doing still show I overdo on sugar. Don't know how many calories a day I should be eating. I'm on a waiting list to join a group and have no one close with this. I'm on metaformin 500mg twice a day and have also been suffering with diarrhoea. Also on Atorvastatin 20mg and blood pressure tablets for nearly 10 years. I feel stressed and can't cope with work as well. Always love sweets and biscuits. Can't stand fish or eggs so really don't know where to start. Don't know how many calories I should be eating. I love pasta too Basically I'm confused. Don't have a monitor either. Help required .
 
Hi JoD and welcome to the forum :)
Have a read of the beginning of this thread as you will find a lot of information there which should answer your questions. Any more questions, just ask, and someone will be able to answer.
 
I have been given a Mylife Pura X bg monitoring system from the diabetic nurse.

Ok. So I have had a go of testing my bg. However, I'm still only on my second week of Metformin (taking 2 a day which will be increased to 3 in my 3rd week)

So I imagine that I should really start doing the tests in earnest once I'm taking the full medication regularly, so I can keep an eye on what works and what doesn't in relation to keeping my bg levels in check.

However, my diabetic nurse advised that I should only test first thing in the morning twice a week for four weeks. The 10 test strips and lancets supplied with the kit would be sufficient if I was to follow the advice, however I have already used 4 and the 6 I have left aren't sufficient if I plan to test regularly once fully on the meds.

I have looked on the net inc eBay, amazon etc to see if I can purchase the test strips and lancets. I noticed that there seems to be lancets that can fit many types of lancing devices, so maybe I can buy in bulk cheaply. But the test strips seem to be a different shape to the ones that come with my monitoring system (mine slides into the meter sideways). Is there anyone here that has the same meter that can tell me where I can purchase the above for a reasonable price, or would I be better off discarding the meter and buying the one that this site seems to recommend?
 
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