Type 2 newly diagnosed nurse visit pending

[Grillpan]

I was diagnosed type 2 a week ago and I have my first visit with the nurse this Thursday. The doc said that my blood sugar level was 23.7 having had the blood test at the hospital. They are not sure how long my blood sugar was as high as it is at the moment. I don’t drink all that much so my liver was ok but apparently my kidneys are declining more than they should be, I am not sure what that means in the long term.

I was put on 500mg Metformin tablets 3 x day and was told that I should start on them immediately. A guy at work who is type 1 diabetic and has been for most of his life told me that if his blood sugar was as high as mine he would be in hospital.

At the moment after about 30 minutes of eating a substantial meal I feel like I am fighting to stay conscious.

Up until about 3 years ago I was super fit, exercising everyday, I stopped because of the birth of my second son because things were getting ontop of the wife and just as paternity leave ended I was knocked off my bike by a van (I actually wrote the van off which I take some pride in) and so it was an easy excuse to drop everything in favour of the family.

Even though I had hung my trainers up and put on some weight I still had the feeling that I was indestructible, then this came along. Scary stuff, Xmas made it harder. I was very confused and a tad depressed about the whole situation but I put on the brave face for the wife and kids. I am 39 and until now I have been very lucky in never having to deal with any think that a paracetamol would fix in 30 minutes.

Before I go to the nurse I really want some advice from the people that have gone through it and what are reasonable questions and what I should expect from the first visit, my doctor said that I should write down everything that springs to mind so that I can take it in but right now, I have nothing at all.

 

[Sadnessnormal]

I have been there am new as well 3 months diagnosed with type 2 so I know what you going through. Don't do what I did. I panicked. If you have a good Gp service you'll be fine. I did. I struggled with eating I struggled with metformin and its side effects I got depressed because of it all. But when I did my 3 month blood test I was actually doing great. I lost 1 and a half in one month. So I short I telling you take it easy don't allow your self to get down. That's one of the problems with metformin it gets you depressed and feel more tired than when you where off it. Take it ones step at a time don't push yourself too much just do what you can and include a lot of positive thinking in you diets yes in your diet. It's is more important than picking which foods to eat.
Exactly what you wrote here is exactly what you tell your nurse. Your worries how you feel and what you would like from them as your nurse.
Don't despair am here if you need me and am sure plenty of friends here you shall make to give you confidence to carry on.

 

[Totto]

I'll tag @daisy1 for you, she'll give you the starter pack info.
Have a look around the site and see if any questions pop up. Ask away.

 

[daisy1]

@Grillpan

Hello Grillpan and welcome to the forum To answer some of your questions, here is the information we give to new members and I hope you will find it helpful. Ask more questions when there is something you need to know and someone will be able to 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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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.

 

[Grillpan]

Thanks guys,

I am a little confused though the Doctor gave me a book that said I should have a balanced diet but that I should go high on Carbs, it read complex carbs like Potatoes and pasta and rice being the main thing to eat and to avoid simple carbs, which I guess is a bag of Haribo. I have read through some of the forum posts and it seems to be that people are generally against carbs and I see links in signatures for "low carb programs"

Did my doctor get it wrong?

 

[Totto]

Have no idea really, apart from the unfounded fear of fats. Bad science, basically. I got the same advice but being third generation diabetic in my family, that I know of, I found it easy to go very strict low carb and also being old enough to have grown up with the full fat, original versions of dairy and stuff I never really could believe fat was bad. Fat is nice, filling and have only a marginal effect on BG, if any.

 

[Brunneria]

Thanks guys,

I am a little confused though the Doctor gave me a book that said I should have a balanced diet but that I should go high on Carbs, it read complex carbs like Potatoes and pasta and rice being the main thing to eat and to avoid simple carbs, which I guess is a bag of Haribo. I have read through some of the forum posts and it seems to be that people are generally against carbs and I see links in signatures for "low carb programs"

Did my doctor get it wrong?

The current fashion in the NHS is to recommend a diet high in whole grains and starchy carbs.
It doesn't seem to dawn on them that while this diet is considered healthy for most people, telling a type 2 diabetic with high blood glucose that they should eat 7-9 portions a day of foods that drive the blood glucose higher, is a bad idea.

There is some strange sort of brain disconnect going on there, I think.

All I can suggest is that you read as much as you can on here, and get yourself a blood glucose meter.
If you test your blood glucose levels before and after eating, you will quickly learn which foods are sending your glucose too high.
Then you get to choose whether to carry on eating those foods, take the NHS drugs, and slowly develop the expected diabetic complications.
Or you can stop (or reduce) eating those glucose raising foods, keep your blood glucose under control, and delay those diabetic complications for decades.

I chose to test and adjust my diet. Works like a charm. And I now feel better, with more energy, than I have for years.

Welcome to the forum!

 

[Southbeds]

Seems strange to go against your Doctors advice , but I stuck with @daisy1 and that changed the direction my health was heading for which was down hill

 

[Daibell]

Hi and welcome. Yes, the GPs book needs to go into the nearest bin. I'm afraid it is ridiculous but for diabetes, NHS diet advice will make it worse unless that advice comes from someone who has updated their knowledge. As and when you have a meter it will prove the point that carbs are bad for blood sugar so you don't have to take our word for it. Can you let us know your BMI/weight as you are quite young to be T2. Has anyone suggested the possibility of gestational diabetes?

 

[Mick1952]

Hiya.
I am about 8 weeks ahead of you. I am not medically qualified but feel I have some support to offer. I was diagnosed with a BG of 20.5 during a routine blood test. The last time the GP had a record of BG was 2009 so I have no idea how long this was brewing. I did have an unquenchable thirst for a few weeks prior to the tests, so had an idea that all was not well. I was given some handouts and put on Metformin 500mg 3 times daily, starting at 1 tab per day increasing weekly. I had an extended holiday abroad booked to start 2 days later so really had to get to grips on my own. I too was given the standard go low on sugars, fats, and salts talk. I found it all daunting, and just like you, I was having to hit the bed every afternoon feeling lifeless and just wanting to curl up and sleep.
After a day or so it dawned on me that diabetes is all about sugar and carbs. Fats and salt reduction are to help prevent the longer term complications of cardiovascular disease. However, if you don't get control of your sugars short term, you are less likely to survive long enough to worry about the long term.
So, I went on a very low carb diet, mostly salad and chicken kebabs, cut out all sugary drinks, and tried to walk a little every day. After 10 days my BG was down to 7.2, and after 14 days it was below 6.0
Sadly the Metformin played havoc with my stomach and I could not tolerate 3 per day, so I dropped back to 2 until I got home and saw the GP who has just switched me to the SR version. After only 5 days of this I am now feeling much better, and my BG is absolutely fine. My cholesterol levels although not very high to start with or now normal too. So my advice to you is don't panic, stay low carb until your BG comes down, then focus on fats, salts, weight loss and healthy lifestyle once you have the immediate problem of blood sugars under control.
By the way, I am 63 years young male, was diagnosed type 2 on 9th October. I hope this gives you some positive encouragement and helps you to see through the first few weeks of ****.
Mick

 

[Mick1952]

Sorry about the predictive text quirks in my post, I hope it is clear to you?

 

[Grillpan]

Doc said I was quite young for a type 2. At the moment I am 19st and 6ft. I have never put any stock in BMI as at 30 I was 15st with a 34inch waist and able to do a ten mile run in under an hour and was still classed as overweight. I am not the type of build that is ever going to be 11st.

Mick - Thank you for your post, you pretty much summed up exactly what happened to me last week when I got the diagnosis. I have a real problem with low carb diets, low fat and low sugar seems easy to me I guess that is how I was educated. I would be happy to live on pasta for the rest of my life.

The nurse visit is tomorrow, I am looking forward to it now. I am going to ask about getting a testing meter and low carb diets, I have read about a lot of fad low/no carb diets but I don’t think I would be able to cope with that so I know that I am looking for something that's not cutting out but controlling. If it wasn't for you guys i would have been happily shoveling in the rice and scratching my head why it was still going wrong.

Does anyone know of a good app that I can use to make a food diary that records the amount of carbs I have had in a day?

 

[Mick1952]

Hi again. Just to clarify on the low carb issue. I haven't had to go to a meal plan that doesn't suit. I eat plenty of pastas but, firstly switched to brown type spaghetti which I find I actually prefer to white, and go for fetuchini or strong versions of others, and just cut down on portion sizes. If you haven't discovered it yet, check out glycemic (not sure I spelled it correctly) index tables and go for the pastas and rices at the bottom end. Basmati rice and brown pastas have little effect on my BG. Stopping all sugary drinks was by far the single most important change for me.

 

[Daibell]

Hi again. Yes, added sugar is the worst culprit for carbs so remove as much of that as you can. You need to bear in mind that the Western world has been trained to have loads of low cost carby food for the last century or two. You can train yourself away from the worst of it and indeed as a diabetic you have no choice. As Mick1952 says, have low-GI carbs where you can to minimise spikes but they are still carbs. Set yourself a daily limit of, say, 150gm, but use the meter to guide you on what works for you. Now that the damage excess cabs can do has been found out you will find the supermarkets will produce fewer low-fat foods and more low-carb meals e.g. M&S Balanced For You range.