What am I doing wrong?

[Sweetie G]

I want some advice, I am diabetic type 2 on gliclacide and piroglitrazone I have a weight problem and I am slowly losing weight but today my doctor told me either I was eating to much or getting no exercise.

I eat a diet of between 1400-1600 calories daily limiting it to under 40 grams of fat low carbs and slightly higher protein and of course plenty of vegetables and salad. My advised calorie intake is 1500-1700. I workout daily and walk 3 miles a day.

In the last 6 weeks I have lost only 1.5lbs so what am I doing wrong is the doctor right or was she just patronising me and not listening (unfortunately a common experience since diagnosis 7 years ago). From all the recent research I have done on my condition and weight loss I believe that I am on the right path and it will be a slow progression. But this has now put doubts in my mind though I dont think cutting my calories below 1400 a day for my current weight would be healthy.

Any advice gratefully received as I am now puzzled and doubting myself.

 

[daisy1]

Hi Sweetie and welcome to the forum It's carbs you should be reducing and counting - not calories. I know you say you are eating low carbs but do you know which foods contain the least carbs? Let us know what you eat in a typical day and we can see how your diet can be improved.

There are two books that can help you - Calorie Carb Fat Bible 2011 ( it is updated every year) which is a large book and smaller books (pocket sized) but less accurate are the Collins Gem Carb Counter or Calorie Counter (which includes carbs). You can find them on Amazon or in good book stores. These should help you to see what you can safely eat.

Perhaps you could give this a try and see if your blood sugar levels and weight loss improve. You don't say what your BG levels are like - have you been testing? This is very important. If they won't give you a meter (ask them first) then you can usually get one free from manufacturers or from a competition on this forum as they want you to use their strips. In the information below, written by the Forum Monitors, is some advice on how to persuade your doctor or nurse to give you test strips. If they won't prescribe you strips you can buy them on ebay. Don't go without testing - your health is at stake here. Only by testing can you work out which foods you can eat and which you either can't eat or eat only reduced portions of.

Here is the information which is routinely given to new members by the Forum Monitors (even though I know you are not newly diagnosed).

Here is the advice that Ken and I, as Forum Monitors, usually give to newly diagnosed Diabetics. We hope that these few ideas gained through experience help you to gain control and give you some understanding of Diabetes. This forum doesn't always follow the recommended dietary advice, you have to work out what works for you as we are all different.

It's not just 'sugars' you need to avoid, diabetes is an inability to process glucose properly. Carbohydrate converts, in the body, to glucose. So it makes sense to reduce the amount of carbohydrate that you eat which includes sugars.

For more information on CARBOHYDRATE see here:

viewtopic.php?f=3&t=20306

This is NOT a low carb diet suggestion, just a reduction in your intake of carbohydrate. You have to decide yourself how much of a reduction will keep your blood glucose levels in control.

The main carbs to avoid OR reduce are the complex or starchy carbohydrates such as bread, potatoes, pasta, rice, starchy root veg and also any flour based products. The starchy carbs all convert 100% to glucose in the body and raise the blood sugar levels significantly.

If you are on Insulin you may find that reducing the carb intake also means that you can reduce your dose of insulin. This can help you to keep weight gain down as Insulin tends to make you put on weight and eventually cause insulin resistance. This should be done slowly so as not to cause hypos.

The way to find out how different foods affect you is to do regular daily testing and keep a food diary for a couple of weeks. If you test just before eating, then two hours after eating, you will see the effect of certain foods on your blood glucose levels. Some foods, which are slow acting carbohydrates, are absorbed more slowly so you may need to test three or even four hours later to see the effect that these have on your blood glucose levels.

Buy yourself a carb counter book (you can get these on-line) and you will be able to work out how much carbs you are eating, when you test, the reading two hours after should be roughly the same as the before eating reading, if it is then that meal was fine, if it isn’t then you need to check what you have eaten and think about reducing the portion size of carbs.

When you are buying products check the total carbohydrate content, this includes the sugar content. Do not just go by the amount of sugar on the packaging as this is misleading to a diabetic.


As for a tester, try asking the nurse/doctor and explain that you want to be proactive in managing your own diabetes and therefore need to test so that you can see just how foods affect your blood sugar levels. Hopefully this will work ! Sometimes they are not keen to give Type 2’s the strips on prescription, (in the UK) but you can but try!!

For TIPS FOR STRIPS see here:

viewtopic.php?f=20&t=19002#p173253

If you are an Insulin user in theory you should have no problem getting test strips.

The latest 2011 NICE guidelines for Bg levels are as follows:
Fasting (waking and before meals).......between 4 - 7 mmol/l...(Type 1 & 2)
2 hrs after meals........................no more than 8.5 mmol/l.....( Type 2)

2hrs after meals......................... no more than 9 mmol/l ......(Type 1)

If you are able to keep the post meal numbers lower, so much the better.

It also helps if you can do at least 30 minutes moderate exercise a day, it can be split into 10 min sessions to start with. It doesn't have to be strenuous.

The above is just general advice and it is recommended that you discuss with your HCP before making any changes. You can also ask questions on the forum on anything that is not clear.

Finally a few QUESTIONS TO ASK AT DIABETES CLINIC.

viewtopic.php?f=20&t=17091



Sue/Ken.

 

[Sweetie G]

On the counter I am using I eat about 120g of carbs a day in total, an example is my carb intake yesterday which was 84g in total. My nutritionalist friend told me that I should aim to keep it under 220 and to count calories carbs and fat as well as ensuring low sugar. I also enter all my consumed food daily on to a food calculator to ensure I am not going over my self imposed limits. I am being so strict with myself and measuring everything. So I dont think I could cut out any more carbs either as the carbs I do get are mainly from eating oats at breakfast which are a food apparently beneficial to diabetics it is all so frustrating but I am going to see another doctor today with my printed 4 week food diary so hopefully he/she can advise me further.

 

[anniep]

Some of us would find those oats for breakfast a real problem, they can raise some peoples BG's very much. Also we are often more sensitive to carbs first thing in th emorning, and our bodies find then harder to processthem then, than it does if we ate them later in the day.

 

[Sid Bonkers]

Hi Sweetie and welcome to the forum

The information posted by daisy has some great information in it that has helped many members here get started on losing weight and controlling their diabetes. Definately worth reading IMHO

My nutritionalist friend told me that I should aim to keep it under 220 and to count calories carbs and fat as well as ensuring low sugar.

Your nutritionist friend will know that carbs are the same as sugar, they both turn to glucose as they are digested , what she/he may not realise is that for diabetics, especially those treated by meds and or diet, both sugar and carbs need to be tightly controlled to keep blood glucose (bg) levels down.

the carbs I do get are mainly from eating oats at breakfast which are a food apparently beneficial to diabetics

IMHO the carbs that are beneficial to diabetics are those eaten in small enough portions so as not to raise the blood glucose levels too much, and to know what they are requires frequent testing as no one can tell you what different foods and portions will do to an individual. Test, test, test and test again until you know what you can and cant eat safely. Many T2's do eat oats but many find them off the menu as they can raise bg levels above the N.I.C.E. recommendations. The only way to know if they are safe for you is to test

Most people find that if they reduce their carbohydrate intake and reduce portion sizes they not only reduce and control their blood glucose levels, they also lose weight too

The information often given here is not always the same as that given by many health professionals, but it has worked for many members here. Hope you find the forum useful

 

[Patch]

On the counter I am using I eat about 120g of carbs a day in total, an example is my carb intake yesterday which was 84g in total.

Although this is not an especially high level of carbs, it is enough to slow down or halt your weight loss. Have you considered cutting it right down? Try <30g per day, maybe?

I also enter all my consumed food daily on to a food calculator to ensure I am not going over my self imposed limits. I am being so strict with myself and measuring everything.

This is a GREAT habit to get into. And you'll know, from your own results, what kind of effect on weight loss your current diet is having. Try reducing your carbs for a couple of weeks, and monitor what you are eating, and how your weight is affected.

If you always do what you've always done, you'll always get what youve always got.

...I dont think I could cut out any more carbs either as the carbs I do get are mainly from eating oats at breakfast which are a food apparently beneficial to diabetics...

If you always do what you've always done you'll always get what you've always got. So if you want to get something different, DO something different.

...it is all so frustrating but I am going to see another doctor today with my printed 4 week food diary so hopefully he/she can advise me further.

It is frustrating - but we're with you! Most Dr's have got a real problem with lo-carbing for weight loss/diabetes management (but not all), so don't be put off if yours doesn't approve. It works.

Good luck!

 

[Dillinger]

Sweetie,

You are not doing anything wrong, other than perhaps listening to plainly idiotic advice from your GP.

Gliclazide acts to 'force' your pancreas to release insulin even when you have not eaten carbohydrate and it is being used with the pioglitazone which increases insulin sensitivity. The idea is that your (damaged) pancreas is forced to over produce insulin and that insulin is then made 'more potent' by the pioglitazone.

Obviously, you are not having trouble with your weight because you are over eating or under exercising; you are currently about 300 calories less than the Department of Health recommended daily amount for women of 1940 calories and you are doing a lot of exercise.

So why the trouble with the weight? It's the insulin - insulin is the key hormone for the laying down of fat, the less you have in your blood stream the less fat you deposit and the more fat your body will use for energy.

Essentially, your GP is giving you a drug that stimulates insulin production which will make you fat and then says; now lose weight. You are being thrown an anchor when you need a life buoy...

Drop your carbs as low as you can as suggested above and things will improve - the amounts you are eating now are too high.

Read these books if you feel unsure about this; 'Dr Bernstein's Diabetes Solution'. 'Gary Taubes - Why We Get Fat'.

Dillinger

 

[noblehead]

Sweetie,

Try increasing your daily exercise and this may increase your weight loss, personally I wouldn't be to disappointed at losing 1.5lb in six weeks as it's well know that weight lost slowly is much easier to keep off as opposed to losing it fast on a diet you don't particularly like or want and when reverting back the weight piles back on. It's taken me two years to lose 2 stone and I am more than happy at this slow weight loss, my diet will not change much when I reach my goal except I'll increase my portion size slightly to keep my weight steady.

BTW you right about oats, they are a great source of fibre and is said to be beneficial to cardiovascular health.

Nigel