Hi!

[Waves]

I’m new to the group and looking for help and support with my daughter who has type2 diabetes and is underweight . Her blood sugar according to the diabetic nurse should be between 8-10 . I am struggling to keep her at a healthy weight and keep her sugar levels down . ( she has quite a lot of additional needs too) I need a list of snacks she can have and what is a definite no no . Please help x

 

[Drummer]

For an ordinary type two meat, fish or seafood, eggs, cheese, full fat yoghurt, are fairly standard foods. These tend to be very sustaining and so snacks are not needed.
For a swift meal I keep a mini wok and a cheese grater by the cooker and would make scrambled eggs, add cheese when the eggs were just not quite done, having turned off the heat, then I thinly slice a tomato and put it on top, cover with a plate, and then the tomato is just slightly warmed by the time I sit down to eat. Takes all of two minutes.
I should ask, though if there are any restrictions, and what medication your daughter takes.

 

[Waves]

For an ordinary type two meat, fish or seafood, eggs, cheese, full fat yoghurt, are fairly standard foods. These tend to be very sustaining and so snacks are not needed.
For a swift meal I keep a mini wok and a cheese grater by the cooker and would make scrambled eggs, add cheese when the eggs were just not quite done, having turned off the heat, then I thinly slice a tomato and put it on top, cover with a plate, and then the tomato is just slightly warmed by the time I sit down to eat. Takes all of two minutes.
I should ask, though if there are any restrictions, and what medication your daughter takes.

Hi
Thanks for your reply , she’s on allopurinol 100mg for gout
Alogliptin 25mg
Gliclazide 240mg

 

[Docb]

Hi @Waves and welcome to the forum.

My first thought is that your daughter being underweight and struggling to keep blood glucose levels down whilst taking what I think is the maximum dose of gliclazide does not easily fit into the "run of the mill" type 2 categorisation. I think you should be talking to her GP or diabetes nurse to see if they agree.

Are you monitoring blood glucose? You should be because of the gliclazide. If so, what sort of blood glucose levels does she have and what sort of rise does she get after eating?

 

[Waves]

Hi @Waves and welcome to the forum.

My first thought is that your daughter being underweight and struggling to keep blood glucose levels down whilst taking what I think is the maximum dose of gliclazide does not easily fit into the "run of the mill" type 2 categorisation. I think you should be talking to her GP or diabetes nurse to see if they agree.

Are you monitoring blood glucose? You should be because of the gliclazide. If so, what sort of blood glucose levels does she have and what sort of rise does she get after eating?

Hi ‍♀️
They tested her for type 1 and are adamant she is type 2 . I see the diabetic nurse on a regular basis but it’s not always helpful and conflicting dietary guidelines hence I’ve joined the forum .
blood levels have been up and down the last 6 weeks ( she’s had a chesty cough) but ranging from 11-20

 

[Docb]

My thought is that the dietary advice is easy to say, she needs more calories to keep her weight up but with less carbohydrate to get her blood glucose down, but not so easy to implement. It means cutting back on starchy things like pasta, potatoes, things made from flour and increasing meat, dairy, seeds, and the like. Discussion with the medical professions is made hard because it goes against the messages they normally put out, telling people to do the opposite.

In your position I would start to keep a diary of what she eats and to take blood glucose readings before and two hours after to get some information about what types of food cause the higher levels. I would be working out calories and carb contents of meals and start looking for ways of adjusting things to up the calories and to reduce the carbs. Don't worry if you do not know how to do that, it is not hard, and we can help.

A final thought, blood glucose levels in the teens and low twenties can make you feel a bit wretched. You might need to take that into account when working with your daughter.

 

[Waves]

My thought is that the dietary advice is easy to say, she needs more calories to keep her weight up but with less carbohydrate to get her blood glucose down, but not so easy to implement. It means cutting back on starchy things like pasta, potatoes, things made from flour and increasing meat, dairy, seeds, and the like. Discussion with the medical professions is made hard because it goes against the messages they normally put out, telling people to do the opposite.

In your position I would start to keep a diary of what she eats and to take blood glucose readings before and two hours after to get some information about what types of food cause the higher levels. I would be working out calories and carb contents of meals and start looking for ways of adjusting things to up the calories and to reduce the carbs. Don't worry if you do not know how to do that, it is not hard, and we can help.

A final thought, blood glucose levels in the teens and low twenties can make you feel a bit wretched. You might need to take that into account when working with your daughter.

Thanks very much for your help . I feel wretched at times because she can’t speak and it makes it doubly difficult. She’s 40 by the way would you mind if I sent you a typical days menu to see if I’m way off?

 

[Docb]

Of course put up a menu, you will get input not only from me but lots of others who all have lived with diabetes in all its forms. At the end of the day you have to find a way forward that suits your circumstances and the more you understand what is going on the easier that will be.

I was wondering if your daughter might be an adult. If she has other difficulties then that makes things very difficult indeed. Just keep telling yourself that there has got to be a way through, you have just got to find it.

Are you your daughter's carer? I ask because I am a carer myself and know the complications that can lead to.

 

[grovesy]

Thanks very much for your help . I feel wretched at times because she can’t speak and it makes it doubly difficult. She’s 40 by the way would you mind if I sent you a typical days menu to see if I’m way off?

I agree with @Docb she definitely sounds more like Type 1 did she have any further tests to rule out Type 1?

 

[Waves]

Of course put up a menu, you will get input not only from me but lots of others who all have lived with diabetes in all its forms. At the end of the day you have to find a way forward that suits your circumstances and the more you understand what is going on the easier that will be.

I was wondering if your daughter might be an adult. If she has other difficulties then that makes things very difficult indeed. Just keep telling yourself that there has got to be a way through, you have just got to find it.

Are you your daughter's carer? I ask because I am a carer myself and know the complications that can lead to.

That’s great thanks .
Weight : 36.2kg currently Height:1.4metres
Breakfast : bran flakes or rice crispies with full fat milk or scrambled eggs with butter and cream
Lunch : low carb wrap or low carb seeded bread with ham tuna or cheese . Crisps
Tea: chicken , sausage , mince dish, fish , salad , potatoes ( dr told me to use sweet potatoes but ??? , vegetables ( no carrots, no pasta, no rice . Pies occasionally but they cause an increase in levels. I make everything fresh as shop bought cottage pies etc seem to affect her as does sauces like bolognaise or chilli types.
All food has to be finely chopped or she’s sick.
Supper: Cheese and rice cakes
She drinks tea , zero coke and water , occasionally I give her a coffee made with cream and unsalted butter when she’s losing weight . ( she won’t drink anything else at all!)
She adores bread , Doritos ( they absolutely kill her)
Honest feedback please , I’m desperate to get it back on track so if I’m doing it all wrong tell me but in a kind way

 

[Docb]

Well, you are not doing it wrong, that's for sure. You have covered most of the things that we would normally suggest.

Some little things...

Bran Flakes and rice crispies. Both carb based and some of the brands add sugar. Next time you are shopping for them, check out the nutrition labels and head for brands with lower carbohydrate levels. When doing this compare TOTAL carbohydrate and not just the sugars. You need to assume that all carbohydrates will turn into blood glucose.

Bread. The amount of carbohydrate varies in different breads. Start reading labels and you will find that out. There are low carbohydrate breads around but what is available depends on where you shop. If your daughter likes sliced white then you may have to start weaning her off it and onto one of the low carb varieties. Don't assume brown bread will be lower carb - always check the label. OOPs just checked your post and you mention low carb bread so you know that.

You have worked out that a lot of ready meals are high carb and that the best way of controlling things is to make things your self.

Trouble with Type 2 is that all people with elevated blood glucose and do not fit the Type 1 profile as interpreted by your GP are all put in the same box as if there is only one cause and one way of looking at it. There are times when this is not a good idea and it sounds to me like your daughter is in that category.

Can I suggest you start keeping good records of blood glucose measurements and meals. The meal record should have portion sizes noted down. The reason I suggest you keep records is that it will help to focus your discussions with the Diabetes Nurse in an effort to get them to put their thinking caps on.

 

[Drummer]

On those medications there is a danger of going too low, so a really low carb diet is not appropriate, though reducing them, when a particular meal shows that it produces a high spike might avoid the really high numbers.
I don't understand the advice to use sweet potato as the clue is in the name - I use swede or cauliflower when I want to make a 'mash', mixing in cream. I have two mugs of coffee with cream each day.
The essential foods are protein and fats, so the food diary to record the amounts eaten and the subsequent blood glucose levels seems a good idea, and by reducing the carbs a little, balancing the medication, it might mean an increased intake of other food groups. Small adjustments might just tip the balance towards weight gain and away from higher blood glucose. Some help from the professionals would not come amiss, I think.

 

[rebrascora]

Hi and welcome from me too.

You must be very worried to be in such a situation.

I would be asking what tests they did for Type 1 and the results of those tests. The tests in themselves can sometimes be inconclusive and need to be interpreted by a consultant who has the knowledge and experience to look at them in conjunction with other factors, in order to come to a conclusion about diagnosis. It is not always straightforward.

The readings you are getting in response to the relatively lowish carb diet she is eating and the fact that she is on Gliclazide and underweight, all point to her not producing enough insulin rather than Type 2 where insulin resistance is the usual cause. I think you should be pushing for insulin regardless of her classification and I personally think it is likely she is Type 1 or LADA (Latent Autoimmune Diabetes in Adults) and misdiagnosed. Have you ever been referred to a consultant for diabetes?

I agree with the others that a detailed food diary with BG readings before and 2 hours after will give you more data to take back to your Health Care Professionals in order to push for different treatment or a referral to a diabetes clinic if that hasn't happened.

Can you tell us a bit more about how her diabetes diagnosis came about and how long she has been diagnosed?

 

[everydayupsanddowns]

Welcome to the forum @Waves

Glad you have found us.

I hope the ideas and suggestions from our members provide you with some useful strategies and ideas.

I’d be interested to know if they had taken a cPeptide test to measure how much insulin your daughter is able to produce - typically classic T2s with insulin resistance produce high levels of insulin while LADA and T1s where the beta cells have been killed off produce very low levels.