Type 2 Very confused partner

[0dd0ne]

Hi there,

Apologies for the long post. Feel free to grab a coffee before you settle to read.....

So, my partner has recently been diagnosed with type 2 diabetes and she's completely confused about what she can and can't eat. She's read a lot of posts on here and other forums, groups etc, and she tells me that they seem to be very contradictory. One will say one thing and another will say the complete opposite, or what seems to be the complete opposite to her. She also has absolutely no idea what her numbers should be pre and post meals, how often she should eat, when she should eat, and so on. She needs to lose quite a lot of weight, but at 62 and with a chronic pain/fatigue condition to boot, she can't really exercise at the moment to help achieve this. She also needs to keep to a diabetic friendly diet and keep her numbers within a good range but she has no idea how to do any of it. Her doctor has been about as much use as a windbreak in a hurricane, (she didn't even know she *was* diabetic until she received an appointment for the diabetic clinic! She was told she was pre-diabetic about 18 months ago, and had been going for regular blood tests since, but when she went from pre to full on, the doctor failed to tell her! She had to call and ask why she'd been referred to the clinic, and it was then that they said, "Oh yes, your last test showed you were now type 2" ‍). Anyhow, I'd really like to be able to point her in the direction of some good, plain speaking, easily understandable, advice. She can't get her head around carbs, sugars and fibre. She'll say things like, "So I can eat carbs, but not much sugar? But isn't sugar a carb? And isn't fibre a carb? But I'm supposed to eat fibre? And what about fruit, that's full of sugar, but it's supposed to be good for you? So I can't eat fruit?". And I can't explain it in a way she understands. I'm very worried about her, and really want her to be able to get this under control and get healthier. So any help or advice would be most welcome!

If you've reached this far.... thank you!

 

[Deleted member 475901]

My GP agreed I could try low carb first before any medication, and for me that was the right path. But it doesn't suit everyone.

I bought a meter and I tested before then 2 hours after every meal at first to check how many carbs my body can deal with. Based on that information I set my own carb limit.
I got down into the normal range fairly quickly but I still snack some days and still have a sweet tooth - I just restrict myself to 85% chocolate and low carb cake/desserts. I did find that thinking about my favourite carby foods and finding substitutes for them very helpful, plus celebrating the fact that I now have oily salad dressing, cheese, butter, etc.

Here is a link to the ranges for blood sugar:

Normal and Diabetic Blood Sugar Level Ranges

Normal blood sugar ranges and blood sugar ranges for adults and children with type 1 diabetes, type 2 diabetes and blood sugar ranges to determine diabetes.

www.diabetes.co.uk

 

[KennyA]

Hi there,

Apologies for the long post. Feel free to grab a coffee before you settle to read.....

So, my partner has recently been diagnosed with type 2 diabetes and she's completely confused about what she can and can't eat. She's read a lot of posts on here and other forums, groups etc, and she tells me that they seem to be very contradictory. One will say one thing and another will say the complete opposite, or what seems to be the complete opposite to her. She also has absolutely no idea what her numbers should be pre and post meals, how often she should eat, when she should eat, and so on. She needs to lose quite a lot of weight, but at 62 and with a chronic pain/fatigue condition to boot, she can't really exercise at the moment to help achieve this. She also needs to keep to a diabetic friendly diet and keep her numbers within a good range but she has no idea how to do any of it. Her doctor has been about as much use as a windbreak in a hurricane, (she didn't even know she *was* diabetic until she received an appointment for the diabetic clinic! She was told she was pre-diabetic about 18 months ago, and had been going for regular blood tests since, but when she went from pre to full on, the doctor failed to tell her! She had to call and ask why she'd been referred to the clinic, and it was then that they said, "Oh yes, your last test showed you were now type 2" ‍). Anyhow, I'd really like to be able to point her in the direction of some good, plain speaking, easily understandable, advice. She can't get her head around carbs, sugars and fibre. She'll say things like, "So I can eat carbs, but not much sugar? But isn't sugar a carb? And isn't fibre a carb? But I'm supposed to eat fibre? And what about fruit, that's full of sugar, but it's supposed to be good for you? So I can't eat fruit?". And I can't explain it in a way she understands. I'm very worried about her, and really want her to be able to get this under control and get healthier. So any help or advice would be most welcome!

If you've reached this far.... thank you!

There are many ways to manage this condition.

You've already bumped into the first problem, which is the conflicting information that's around. This is largely because up to around the 1980s, mainstream advice on losing weight had always been "reduce starchy foods and sugar" ie, eat a low carb diet. However before that time there was a huge scare about a coming potential "heart disease epidemic" and the need to do something about it. It was thought that a low fat high carb diet would help with heart disease (there was some debate about whether fat or sugar was the problem, but the problem fat people won) and this was recommended. In the end the heart disease issue never materialised, because people gave up smoking. See eg Dr Malcom Kendrick's book "The Clot Thickens" or Dr Verner Wheelock's book "Healthy Eating - the Big Mistake" for a far more detailed discussion of this. Both are well-written and very easy to read.

But we were left with the "carbs are healthy, eat lots" advice which has been the doctrine since. And we've had a large rise in obesity and Type 2 diabetes, not because people aren't following the official advice, but because they are.

"Normal" blood glucose as calculated by an HbA1c test is between 38 and 42 (as currently defined in the UK). This is "normal" because most people without diabetes have blood glucose levels in that range. Type 2 diabetes will automatically be diagnosed at an HbA1c level of 48. See the attached graph.

A further problem is that different countries use different definitions of "normal". There are currently five different definitions of pre-diabetes and a recent BMJ article (https://drc.bmj.com/content/7/1/e000794) couldn't find any benefit to setting the bar lower - that is, defining people who were "normal" yesterday as being "pre-diabetic" today, when the BG hasn't altered.

A lot of people on this forum, including myself, have had huge success with a low carb diet both as a way of lowering blood glucose and losing bodyfat. I'd recommend getting hold of a fingerprick blood glucose meter that will show clearly the impact of various foods on blood glucose.

Sugars (glucose, sucrose, fructose, and lactose for example) are carbs. Starch - eg from flour or potatoes - is carb. All digestible carb turns to glucose (fibre is undigestible carbohydrate) which ends up in the blood stream. It should be used for muscle fuel, but if your body has a problem with responding to your own insulin, the glucose will not be taken up by the muscle cells and instead will either stay in the bloodstream at higher concentrations or be converted to bodyfat. By definition, if you have insulin resistance you are diabetic. I am diabetic because I am insulin resistant, but because I restrict my carb intake I do not (currently) have high blood glucose. High blood glucose over time damages nerves and capillaries.

Carb-heavy foods include bread, potatoes and most other root veg, pasta, pastry, sugar, most fruit, and rice. Potato is for example around 60% carb, bread is about the same. This website is useful:
https://www.dietdoctor.com/low-carb/keto/foods.

That link will take you to the keto (ie very low carb ) section but there is a lot of basic info on the site about the carb content of various foods.

Wholemeal still has the same amount of carb but for some people it seems to be digested a bit more slowly. My view is that this makes no difference to me.

My personal pattern was to go extremely low carb from the outset - around 20g carb a day. That is the amount you'd get from one apple. I was (late 2019) somewhere well over 120kg, had numerous nasty diabetic symptoms, and a comparatively low (50) HbA1c. I was back in normal BG range within four months, and have since lost more than 25kg. I'm exercising now since last year but almost all of my weight loss happened before I restarted. I also go for long periods between eating, (you'll see people refer to One Meal A Day - OMAD) largely because I'm not hungry. I'd eat if I was.

That seems like a lot to take in - the best thing is for you both to read around a lot and find the style that works for you. Keep asking questions if something isn't clear. It always helps (well, it helped me) to have a supportive other half because it increases the chances of success if you make some overall diet changes as well.

 

[Outlier]

A small addition to that super advice - it's amazing how much hidden carbs and sugars there are in processed food, even only slightly processed, such as fat free yoghurt. It's helpful, rather than cracking your head over every meal, to shop round the perimeter of the supermarket and stick to plain easily-recognised fresh or frozen veg., fish, cheese, cream, full-fat plain yoghurt and meat.

What a lovely supportive partner you are. It's daunting at first, but knowledge is power, and what we think are mountains become foothills.