Yet another newly diagnosed Type 2

Devonbear

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Hi everyone.

My GP informed me on Friday (31st July) that I had an HbA1c of 59 and was therefore diabetic. It wasn't a huge surprise, I suppose, as I am overweight and have high blood pressure, gout (or at least elevated purine levels requiring medication) and possibly fatty liver as well. I'd had a previous blood glucose scare a couple of years ago, which went away with some weight loss, but of course I piled it all back on. I am under no illusions that this is anyone's fault but mine.

I am pretty familiar with the disease, as my mother lost both legs to it and then died aged 63. Now, of course, all I can think about is not going down the same path. She was a very heavy smoker, and I think that was probably a major ancillary factor (I've never smoked, and don't drink).

Like a lot of people I was heartened by the publicity around Professor Taylor's work in Newcastle, and since Friday have been eating a low calorie diet with minimal carbs. I don't think at 6'3" I can sustain myself on 600 calories a day, but I think I'm on about 800 or so. Professor Taylor himself said his rigid 600 calorie regime, with meal replacement shakes, wasn't in itself significant and that any low calorie diet would do. I've been further encouraged by reading one or two of the threads from people who've tried this approach. There also seems to be overwhelming agreement that the key is low carbohydrate intake, and that current NHS dietary guidance (eat mostly carbs) is dumb.

I'd rather expected my GP to make some referrals, but no. He's basically told me to lose weight and have another HbA1c in three months. No diabetic clinic or nurse, no monitoring, etc. Fortunately, my diagnosis coincides with me going on leave from work for a month so I have time to focus on getting the diet right. I'm hoping to lose at least a couple of stone in the 3 months, and preferably more (Professor Taylor recommends 1/6th of your body weight, which for me would be three and a half stone).

So, its meat, eggs, nuts and salad for me for the timebeing. I've also decided to start eating a small portion of oatbran porridge flavoured with cinnamon and stevia (borrowed from the Durkan diet) occasionally in the hope of staving off any digestive issues that the diet throws up. I am very lucky in that I have a wife who is both very concerned about my health, and experienced in caring for people with diabetes (OIC at an Care Home).

I thought it would be wise to register and declare myself, to share experiences and get encouragement when the inevitable obstacles come along. I'll keep you posted on how I get on, and fingers crossed I can be another success story (or at least a cautionary tale!).

Devonbear.
 
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ButtterflyLady

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Hi and welcome to our merry band :)

I will tag @daisy1 who will be along soon with an info pack for newbies.

It's not all your fault... some of it is genetics and bad luck... some of it is being overweight.

It's not usual to be referred to a specialist if your case of diabetes is straightforward and you don't have other health issues.

Advice to lose weight and have an HbA1c test in 3 months is sound, IMO. There are other blood tests the doctor should order at the same time, and a urine test. Your feet and eyes should be checked annually.

I'm surprised your doctor didn't suggest Metformin though... I think overweight diabetics should start with it and then once they have got their HbA1c down for a a few months they can come off it if they want to. Still, it would probably be ok to not have it, since you are low carbing and losing weight from the start.

Personally I'm not a fan of ultra low calorie diets. Rapid weight loss is a risk factor for gallstones. Calorie reduction is necessary of course, but you may be able to meet your goals with 1,000 or 1,200 calories a day. I don't know, we are all unique at the end of the day. Do what works for you and your lifestyle. Remember it's a marathon not a sprint :)

Good luck.
 
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JAY1JAY1

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Hi and welcome
Your right cut down on the carbs and eat more fat your weight will come off and your BG will drop , I can't be doing with diets and supplements all I've done is cut carbs and up my fat , lost over 1 1/2stone and my sugars are down to an average of 5.3 try it and let us know how you get on
 
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daisy1

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@Devonbear

Hello and welcome to the forum :)

Here is the information we give to new members and I hope you will find it useful. It is more important in our opinion to cut down the carbs instead of the calories. Ask all the questions you like and someone will 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

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.
 

DeejayR

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Hiya, welcome. All good advice above. Plus if you get a meter to test your blood sugar before and after meals you'll see what sends your level into the danger zone and how long it takes to come back down. The NHS doesn't usually supply T2s with meters and strips but I think it's a small price to pay for vital data, particularly if you're trying something like oatbran. I have a similar breakfast every few days and it doesn't hurt me. So far!
Your current diet overall looks pretty good.
 
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Brunneria

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Hi and welcome,

Please don't go down the blame-yourself route. It is such a waste of time, and the more you learn about this condition, and the more you get a grasp of how your body reacts, you will discover that your weight and general food/lifestyle is more a symptom of developing glucose intolerance, rather than the cause of it.

The good news is that we get to choose what happens next, even whether we want to go the diet/exercise med free way (my preferred option) or the drug way.

Have a good read of the forum, including some of the success stories, you may be pleasantly surprised. :)
 
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sanguine

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Hi @Devonbear , welcome :)

An Hba1c of 59 isn't too bad, it's lower than mine when diagnosed (65) and I'm now back at 38 with diet and exercise only. Have a read of my 1st year story below.
 

ButtterflyLady

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Hi and welcome,

Please don't go down the blame-yourself route. It is such a waste of time, and the more you learn about this condition, and the more you get a grasp of how your body reacts, you will discover that your weight and general food/lifestyle is more a symptom of developing glucose intolerance, rather than the cause of it.

The good news is that we get to choose what happens next, even whether we want to go the diet/exercise med free way (my preferred option) or the drug way.

Have a good read of the forum, including some of the success stories, you may be pleasantly surprised. :)
There's also a third (and other) ways, eg diet/exercise and a med. It doesn't have to be one or the other, just what works for you, Devonbear. We are all unique.
 

sanguine

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I'm surprised your doctor didn't suggest Metformin though... I think overweight diabetics should start with it and then once they have got their HbA1c down for a a few months they can come off it if they want to. Still, it would probably be ok to not have it, since you are low carbing and losing weight from the start.

My experience was that the GP didn't suggest anything (except the knee-jerk statins prescription, duly ignored). The OP's one hasn't even recommended a DN appointment, at least mine did that - and by the time it came I was already well on the way to weight reduction and BG control by low-carbing.

Your last sentence seems to contradict the sweeping generalisation of the previous one, would you not have given the OP the opportunity to try without first? Why step onto the slope of medication when it's not necessary?
 

Devonbear

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55
Type of diabetes
Treatment type
Diet only
Thanks everyone. Had a look at your presentation, Sanguine. Very encouraging!

My GP did actually mention that I'd probably have to go on metformin, and probably statins too. But he said first order of business was to lose weight (through diet and exercise) and see what happens. I have half an idea that he is fully aware of Prof Taylor's research but didn't want to actually tell me that rapid weight loss might resolve the problem (I assume doctors don't like unorthodoxy). The fact that he told me not to come back for three months rather fits the timescale most people who've succeeded in normalising their HbA1c have done it in.
 
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ButtterflyLady

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Thanks everyone. Had a look at your presentation, Sanguine. Very encouraging!

My GP did actually mention that I'd probably have to go on metformin, and probably statins too. But he said first order of business was to lose weight (through diet and exercise) and see what happens. I have half an idea that he is fully aware of Prof Taylor's research but didn't want to actually tell me that rapid weight loss might resolve the problem (I assume doctors don't like unorthodoxy). The fact that he told me not to come back for three months rather fits the timescale most people who've succeeded in normalising their HbA1c have done it in.
Yes, I suspect he is trying to strike the right balance between supporting the approach you want to take, because he agrees with it, while not looking too unorthodox in the eyes of his peers. A certain proportion of a doctor's files are routinely audited, and there is always a chance another doctor will have a reason to review a file in the future, so they are in the habit of doing and recording things that will look ok. It's a balancing act and I take my hat off to the ones who listen to patients and work as partners, while keeping the respect of their peers. I imagine it's not always easy for them.
 

ButtterflyLady

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Acceptance of health treatment claims that are not adequately supported by evidence. I dislike it when people sell ineffective and even harmful alternative health products to exploit the desperation of people with chronic illness.
My experience was that the GP didn't suggest anything (except the knee-jerk statins prescription, duly ignored). The OP's one hasn't even recommended a DN appointment, at least mine did that - and by the time it came I was already well on the way to weight reduction and BG control by low-carbing.

Your last sentence seems to contradict the sweeping generalisation of the previous one, would you not have given the OP the opportunity to try without first? Why step onto the slope of medication when it's not necessary?

If I said you had made a sweeping generalisation, would you think I was being courteous? I don't feel a need to answer your questions, and I'm loathe to participate in derailing a thread.

Devonbear seems to be doing well and has appreciated everyone's input. That's the main thing, IMO.
 
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Best of luck...I am newly diagnosed myself so in no position to give any time-served advice but I think taking on these changes wit your eyes open as you are will definitely be all to the good.
 

Devonbear

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55
Type of diabetes
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Diet only
Right... went to the GP today for the results of my three month period of trying to manage T2 with diet and exercise.

I have been sticking pretty well to a LCHF diet, although not particularly worrying about calories (at least after the first couple of weeks of shock wore off). Have discovered Lidl high protein rolls and start / finish the day with half of one toasted with a mixture of peanut butter and tahini. Eating lots of salads, but also bacon, salami, eggs, pork scratchings, and lots of roasts (sans potatoes). Carbs restricted to berries and nuts, plus some occasional root veg (carrots, suede - never potatoes or parsnips) and making food interesting like putting the odd apple or mango in a curry. No alcohol as I am a non-drinker anyway. My wife, bless her, has developed a range of low-carb, high fat recipes so I've been able to gorge on low carb cheesecake, low carb biscuits, low carb coconut macarons etc. I even joined in a "cream tea" on her birthday. Everyone else had scones, I had bits of Lidl rolls with clotted cream and a home-made strawberry jam (pureed fruit with stevia).

Net result. In 3 months, my weight has dropped from 121 kg to 110 kg. My waist has dropped by 5 inches (went from being on the first notch of my belt to having to trade it in for a new one). My HbA1c has miraculously dropped from 59 to 34 - leaving my GP wide-eyed and mumbling about whether he might have jumped the gun with the T2 diagnosis. My cholesterol, which was OK anyway, has improved further. Best of all, my unusual liver results (which are probably a result of a fatty liver) have returned to the middle of the normal range (they've been high for about 8 years). The only negative is that my blood pressure, which is controlled by quite a lot of medication, hasn't improved much (under control, but I was hoping for better and maybe stopping one of my meds).

All of that with basically no extra exercise (I walk the dog about 45 mins per day) and never once feeling hungry in 3 months. No calories counting - if I was peckish, I ate. A slice of mortadella. Some nuts. A bowl of strawberries and full fat yoghurt. Whatever I fancied so long as it was low carb. The only thing I didn't do was eat more than one Lidl roll per day - just because they're so delicious I might have gone mad with them and they are pretty high in calories.

GP says no meds, no follow up. Just another HbA1c in 6 months and if that's OK one every year from then on.

Next stage is to join the gym at work and take some light exercise (rowing, cycling, crosstrainer). Perhaps cut down on salt and caffeine a bit to try and shift the BP levels. Overall, feeling healthier than I have for the best part of a decade. I can actually get into size 34 jeans now (I was snug in size 40 in July) although when I say "get in" I mean in a "teenaged girl about to go to a party" sort of a way. With a bit of effort I think I can be comfortable in them by Christmas - and 34 is the size I wore when I was a svelte young police constable in my early 20s!!

A big thank you to everyone on Diabetes.co.uk for the LCHF diet advice and the sense of "the world isn't ending - you can easily sort this out".

Devonbear.
 
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Brunneria

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Absolutely brilliant. :D

I'm very jealous. :D:D

Well done. :D:D:D
 

JenniferW

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Type of diabetes
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Hi everyone.

My GP informed me on Friday (31st July) that I had an HbA1c of 59 and was therefore diabetic. ... I am under no illusions that this is anyone's fault but mine. ... I am pretty familiar with the disease, as my mother lost both legs to it ... '

Don't be too hard on yourself - you drew a genetic short straw. Regardless of 'lifestyle' you could well have ended up developing T2.
 

JenniferW

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561
Type of diabetes
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Hi everyone.

... No diabetic clinic or nurse, no monitoring, etc. ...

You might have to pester and then wait, wait, wait, but do ask to go on an X-PERT course. I've recently finished one. I started off thinking I knew as much as they were ever going to teach me, but hadn't appreciated what a difference the support of the group would make. The nurse at my GP's practice told me to contact them, and as far as I can see you self-refer. http://www.xperthealth.org.uk/contact/x-pert-centres