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What to expect at first appointment

M

Mum23boys

Member
Messages
8
Type of diabetes
Type 2
Treatment type
Other
Hi, I am new here. I recently had an eye test as have noticed change in sight. The optician recommended I was investigated for diabetes due to what I described. I have a strong family history, so would not be a surprise. Long story short, it has taken 3 weeks and 2 raised HbA1c (100 & 92) and am finally seeing nurse tomorrow, so will get formally diagnosed then.

I was wondering what I might expect at this appointment (I have had to fight to get it as wanted to give appointment in 2 weeks time)?

I have read that they don’t recommend testing for T2 other than HbA1c. I have sourced my own meter whilst waiting for own peace of mind, and not had 1 reading in range despite changes in diet & increased exercise (been 2 weeks 4x a day). I am assuming that with this information, I will need medication of some kind as not really changing with diet alone.

I guess what I am wondering is if there is anyone else with HbA1c of these levels who could share their experience of management. I am happy to go with whatever the nurse recommends, but I want to go with realistic expectations if that makes sense?

Apologies for the long winded post, just wanted to give some context.

Thanks in advance for any advice/response.
 
Hi, and welcome to the forum,

While you wait for answers from other members you might find it helpful to take a look at some of the links in my signature below, in particular what to ask at a diabetic follow up.

It’s great that you have a meter. Can I ask how and when you are testing? To see how a particular meal affects your blood sugar the usual advice is to test just before you eat, and then two hours afterwards. That will show you how much that meal has raised your blood sugar. By comparing meals over time you will be able to see which are better for you.

If you are able to give us some idea of your diet/the meals you generally eat we might be able to give some pointers on foods to avoid.
 
Hi, thank you for your reply.
I will have a look.

I have been testing before meals & before bed.

There doesn’t seem an apparent theme. I can eat the same meal on different days and sometimes the reading has gone up, sometimes it’s slightly lower.
I have changed pasta/rice to wholewheat versions and tend to have a lesser portion than recommended (60g rather than 75g for instance). Majority of plate veggies/salad, trying to avoid potatoes. Most meals have been chicken/tuna/eggs.
I am eating so much broccoli/spinach/kale that I am surprised I have not turned green!
Breakfast I am having mostly Greek yogurt with berries & flaxseed or Chia pudding with berries (made with almond milk), occasionally weetabix.

I am almost feeling scared to eat anything!

Any pointers welcome.
 
Hi and welcome @Mum23boys . One thing to consider is that all carbohydrates and starches are turned into useable sugars by the body. So that means a pasta, whether it’s whole-wheat or plain white pasta will result in the body turning those carbs into sugars and likely increasing your blood glucose. Many foods contain hidden carbs as fillers such as wheat, rice , corn flour. Therefore, it is the carb content of foods that are important when trying to reduce sugars through diet.
 
@Mum23boys
I found the DietDoctor site invaluable when I was first diagnosed, don’t subscribe there’s no need, there’s plenty of free info, recipes, full week meal plans & articles to keep you going

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How do you start a keto or low-carb diet? We have delicious recipes, amazing meal plans, the best keto videos, and a supportive low-carb community to help dramatically improve your health. Welcome to Diet Doctor, where we make low carb simple.
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Mum23boys said:
I was wondering what I might expect at this appointment (I have had to fight to get it as wanted to give appointment in 2 weeks time)?
Click to expand...
Hello, and welcome @Mum23boys

At the appointment you should have blood pressure checked, be weighed, have your feet checked (lightly touched at various points to see if you can feel the touch). You will most likely be given advice on diet. This is often the standard NHS Eatwell Plate diet which is basically a low fat high carbohydrate diet. Though some more enlightened health care professionals are starting to advise on adopting a low carb diet. Many of our members with T2 decide to use a low carb diet and are able to manage their blood glucose very well using this method. This is fine, but caution is needed with some prescribed some medications that can reduce blood glucose levels to a very low level.

You will probably be told that it is not necessary to test your blood glucose, and if you want to do that you will have to fund the test kit yourself. Good that you have already started doing this, and if you use the advice from @Lakeslover on when to test, and keep a record of the numbers, and what you have eaten, it will help you understand how various foods are affecting your blood glucose.

You are likely to be prescribed medication. Don’t despair. Lots of members here have started with higher HbA1c readings , but have regained control, and been able to reduce or even stop medication.

You should be offered an appointment for retinopathy screening. A specialist eye test where images of the retina are taken to check for any changes to the retina.

Do take time to read around various sub-forums. You will, I am sure, have lots of questions. Ask away. Our members are willing to help and advice, based on their own experiences.
 
Dieticians recommend full fat yogurts, not the low fat versions. It's to do with the way your body metabolises them, I can't remember the details. If you join Diabetes UK their Balance magazine has healthy recipes, all carb and calorie counted. Blood testing before meals and two hours after meals is recommended as somebody else suggested. See if you can get a Libre 2 plus cgm on prescription. They check your blood sugar every 5 minutes and produce graphs showing exactly how food and exercise is affecting your BG. Your blood sugar rises automatically first thing in the morning. Dawn phenomena. Make a list of questions before you go. Everything affects your blood sugar, not just food and exercise. Good luck.
 
If you're diagnosed as a Type 2 there is a slim to zero chance of a CGM, however bothe Abbotts (Libre) and dexcom run free trials for their "basic" sensors If you sign up for both you can get about 3 weeks of free data
 
Hi. When I was diagnosed with T2, a few years back, the nurse gave me a finger-prick meter for free and put me on repeat prescription for test strips and lancets (I'm elderly and get prescription stuff free). You might ask if you can get that too but it might depend on where you live.

You should be given dietary advice but it may not be very good advice. I learned by experiment how much sugar and starch I can eat to keep the numbers in the right range, and you should be prepared to do that too. If you do, record how many grams of sugar and starch your meals contain (weight the portions and look up the data on the web) and correlate that with before and after readings on your meter (two hours after the meal - it takes that long for starch to be digested). I got down to 41 two years running (just below the magic 42) and the nurse admits that I know more about diet than she does.

Going low-carb will affect your weight. I'm chronically underweight (unlike many T2 patients) so I have to balance things - enough carb not to shrivel away but not too much for the diabetes to be of concern.

Good luck, and let us know how it goes.
 
Hi I'm a diabetic T2 of 40 years. I've found that using a constant blood glucose monitor (Libre 2+ or similar) for a month or so has let me understand how my body reacts to both food and medication. Jessie Inchauspé, also known as Glucose Goddess, is a French biochemist who has done a lot of research based on Libre 2 use, so watch her shows (Eat Smart: Secrets of the Glucose Goddess on Channel 4) read her book and sign up for her emails/website. They will teach you science based meal planning and eating to help you get control of your blood sugars. The Libre 2+ is offered free (on manufacturers website) for the first use then its £50-£60 or so for each new device ( lasts 15 days).

The main tips are start each meal with a salad or veg, eat meat/fish/eggs next, try and avoid simple carbs (potatoes, rice, pasta, wheat) use celeriac carrots, swede, butternut squash, beets instead. Try and avoid all cereals. I start most meals with cold slaw (which i bulk make every 3/4 days) and always have a chinese leaf head in the fridge as an instant/emergency salad. It's all a bit strange at first but I found the results amazing.

A little gentle exercise 40 minutes 3 times a week also helps get rid of internal fat and reduces insulin resistance, Tai Chi or Pilates is great

​

 
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Low carb is absolutely the best way. Also avoiding juice, which really puts your sugar up quickly. However if you are exercising hard, then its good to have a bit of carb beforre you start, as your body will burn it off. Something they don't tell you is that your menstrual cycle will affect how carbs affect your blood sugar. (Insulin is a hormone). I always had really high sugars when premenstual. (At last, an advantage to the menopause!)
 
Different types of exercise affect blood glucose differently. Aerobic (eg running, cycling) will cause a drop in BG where as anaerobic (eg weightlifting) will cause BG to rise. I learned this on a course on managing exercise with T1, where the possibility of hypoglycaemia deters some people from exercising; however, the effects on BG are the same for T2.
Good luck with finding your way through all this, @Mum23boys, sounds like you're already on the right track, and definitely in the right place on here - people are always ready to help.
 
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