Dietetic meeting - disappointment

[Krafty sue]

i was diagnosed with type 2 diabetes last October. Prior to diagnosis I was having extreme reactions to bites and stings...also I was having episodes of instant need to sleep, feeling confused, headaches, the shakes, lethargy...I was told that all this led to suspicion of diabetes and to be tested...and yes I was type 2. 55 years old and I am 5’1” and weighed 79 kilos, so yes over weight...
My hbA1c to start was 56...it is now 44 and I weigh 74kilos. And I take 1 metformin tablet daily.
The diabetes nurse at our surgery has been fabulous, and supportive. And loves what I have achieved in short time,
BUT my experience with dietetic staff was not so positive. I left feeling fat and almost as ‘what did you expect’? You are Fat = diabetes......
I had hoped for support in finding food alternatives, advice on labelling, what foods will certainly spike sugars, etc etc. Instead I got the standard food plate images! The ‘low fat’ is always better, you can eat all the things you ate previously but in moderation etc etc etc.. instead of talking diabetes I felt this was all about just weight Loss!
I wanted to know which yoghurts would be better (only suggestion was weight watchers and muller lite) ideas for meals... I have changed my eating habits, embarked on couch to 5k, Walk more, drink lots more water, cut out biscuits and treats. Constantly look at labels...I needed to know more about the carbs...example when looking at a label how high would the limit be for carbs? Low fat and low sugar options are not always best....I have discovered that labelling needs to Be read.
I know I am doing well, I know that I must be getting things right BUT I am so frightened of what I have already done to my insides...I want to do what I can to not shorten my life...
I have waited for the appointment, hoped for advice as a diabetic not advice because I am deemed just fat! Apologies for my rant...

 

[Krafty sue]

Ps I forgot to say. ..... when I mentioned carrying jelly babies around with me for ,those shaky moments...
I was told ‘if it helps...but it doesn’t do anything...your diabetes is not that sort that needs them...it’s more in the mind... but as I say...if it helps’. Soooooo, I am fat and silly.... my diabetes had been explained differently to me and the use of something sweet had been explained too..........so who is right? And a more I indeed silly

 

[SueEK]

Sorry to say it Sue but sadly this is an all too familiar story. My friend recently diagnosed was told exactly the same but thankfully she knew of my ‘journey’ and just ignored most of what her DN said and asked me. What my friend did actually say to her comment, ‘well you are very overweight’ was ‘no **** Sherlock, I didn’t realise’. Sorry but I found that hysterical.
On the flip side to that I was diagnosed just over a year ago as a side to a completely unrelated matter. I am 5ft 9” and have always been slim, no family history and no sweet tooth. When I saw my DN she said ‘well you have got a bit of a belly on you’, I couldn’t believe it, I had a teeny bit of weight on my tummy, normal I would say after 3 pregnancies and no gym freak.
Most of us seem to be given the standard rubbish of low fat and carbs are fine. We have to ignore it and listen to others, such as on this forum, who are living with it, the results of it and the best way to manage it. You certainly seem to understand it and what you need to do and that really is all you can do. None of us know if we have any damage due to our past eating habits but certainly we can help ourselves now and our bodies are very good at renewing themselves, though not with everything of course, so I wouldn’t waste too much time worrying about it. Just go forward as you are.
As for jelly babies etc, really this is more for T1’s or those on insulin who suffer from hypos, most T2s don’t get this, though having said that I had one, whilst on medication which is unusual, but have not had one since.
Sorry for the long reply but you are doing great, just continue being great x

 

[Ljc]

Hi. I am wondering if when you get those shaky moments if you are having what we call on here false hypo’s,
This is when your brain has got used to higher BG levels and as they start dropping down but are not at real hypo levels, your brain panics and send out desperate signals .
If this is the case, then eating carbs may delay the cessation of the unnecessary panic signals, instead try snacking on a less carby option,
Do you self test ? If so check your BG levels when you have those symptoms.

I do understand when you say about dietetic staff , thinking it is all to do with being fat, I get similar from some medics/nurses believing I am a bad T2 because I am on insulin , that is till they spot my Hb1ac figures.

As for the low fat yogurts etc, I don’t eat yogurt now but I would him for the normal fat versions without the fruit flavouring, I’d add a few berry’s myself
Personally if something that’s been deliberately made to be low fat , I don’t touch it, I go for the normal version instead as it usually has fewer carbohydrates, yes I am afraid it means lots of label reading ,

To be honest I believe in eating to your glucose meter, ie if you meter likes it then it’s fine
This way you are not only cutting out /down on things your body cannot handle well you are also not cutting down on things your body does handle well.

 

[rebrascora]

I am so sad to read of your disheartening experience with the DSNs, especially when you are doing so well. Good to hear that your practice nurse is supportive though. She is probably the important one for you as a Type 2 diabetic as she is the one who will mostly oversee your treatment.

Unfortunately the NHS is still stuck with the "old school" scientific and government advice of the past 50+ years regarding fat being the root of all evil when it comes to health and therefore advocating low fat. There is now a growing wave of doctors and diet experts who believe that this low fat advice may be at least partly responsible for the epidemic of diabetes we are now suffering from, but after a whole career of telling people to eat low fat to improve their health, you can hardly blame them for continuing to do so. There are some who are catching on but the general official guidance is sadly still low fat, moderate carb, even for diabetics whose bodies convert those carbs very rapidly into glucose, but do not have the insulin response to deal with them.

Almost all low fat products are higher in carbohydrate as a result of having the natural fat removed, because fat does not contain carbohydrates. It therefore makes sense for diabetics to opt for the full fat version, which not only reduces the blood glucose spike they get but also makes them feel fuller for longer and therefore helps them to eat less and lose weight.... fat takes longer to be digested than carbs, so it keeps hunger at bay and it also slows down the release of glucose from any carbohydrates which are eaten. Therefore, creamy natural Greek yoghurt is a much better choice for you than Muller Light or any other similar low fat option..... Lidl do a large litre bucket of it under the brand name Milbona which is the lowest carb I have found and tastes delicious. Make sure to get the creamy one though and not the low fat version as they are both packaged similarly.

As regards the jelly babies, this is what people who inject insulin would call a hypo treatment. Insulin and some other diabetic medicines like Gliclazide (but not Metformin) can result in you having too much insulin in your system.... in fact a relatively tiny amount of too much insulin can render you unconscious or even potentially kill you, so those people need to carry jelly babies or other sweet sugary items with them to counteract that insulin if they make a mistake with their dosage etc. You body might have a bit of a wobble because it is not getting as much sugar as it has been used to, but it is not at risk of the very serious implications I have mentioned above. Unfortunately, by giving yourself jelly babies when you feel a bit wobbly, you are just pandering to that urge for sugar. Instead you would be best to carry a few nuts and eat a handful of those when you feel wobbly and give yourself a bit of time to adjust. Your own body will not produce too much insulin to cause a hypo unless you have a very rare disorder called Reactive Hypoglaecemia and you would almost certainly know about it if that was the case, so try eating a few nuts or a boiled egg or a chunk of cheese when you get that wobbly feeling rather than something sweet.

You have talked a lot about giving up sweet stuff but are you also aware that you need to reduce your intake of starchy carbs like bread, pasta, rice, potatoes and breakfast cereals as well?

 

[Krafty sue]

Sorry to say it Sue but sadly this is an all too familiar story. My friend recently diagnosed was told exactly the same but thankfully she knew of my ‘journey’ and just ignored most of what her DN said and asked me. What my friend did actually say to her comment, ‘well you are very overweight’ was ‘no **** Sherlock, I didn’t realise’. Sorry but I found that hysterical.
On the flip side to that I was diagnosed just over a year ago as a side to a completely unrelated matter. I am 5ft 9” and have always been slim, no family history and no sweet tooth. When I saw my DN she said ‘well you have got a bit of a belly on you’, I couldn’t believe it, I had a teeny bit of weight on my tummy, normal I would say after 3 pregnancies and no gym freak.
Most of us seem to be given the standard rubbish of low fat and carbs are fine. We have to ignore it and listen to others, such as on this forum, who are living with it, the results of it and the best way to manage it. You certainly seem to understand it and what you need to do and that really is all you can do. None of us know if we have any damage due to our past eating habits but certainly we can help ourselves now and our bodies are very good at renewing themselves, though not with everything of course, so I wouldn’t waste too much time worrying about it. Just go forward as you are.
As for jelly babies etc, really this is more for T1’s or those on insulin who suffer from hypos, most T2s don’t get this, though having said that I had one, whilst on medication which is unusual, but have not had one since.
Sorry for the long reply but you are doing great, just continue being great x

Thank you for such a fabulous and supportive reply.. made me feel far more positive. Here is to the best forum.

 

[Krafty sue]

I am so sad to read of your disheartening experience with the DSNs, especially when you are doing so well. Good to hear that your practice nurse is supportive though. She is probably the important one for you as a Type 2 diabetic as she is the one who will mostly oversee your treatment.

Unfortunately the NHS is still stuck with the "old school" scientific and government advice of the past 50+ years regarding fat being the root of all evil when it comes to health and therefore advocating low fat. There is now a growing wave of doctors and diet experts who believe that this low fat advice may be at least partly responsible for the epidemic of diabetes we are now suffering from, but after a whole career of telling people to eat low fat to improve their health, you can hardly blame them for continuing to do so. There are some who are catching on but the general official guidance is sadly still low fat, moderate carb, even for diabetics whose bodies convert those carbs very rapidly into glucose, but do not have the insulin response to deal with them.

Almost all low fat products are higher in carbohydrate as a result of having the natural fat removed, because fat does not contain carbohydrates. It therefore makes sense for diabetics to opt for the full fat version, which not only reduces the blood glucose spike they get but also makes them feel fuller for longer and therefore helps them to eat less and lose weight.... fat takes longer to be digested than carbs, so it keeps hunger at bay and it also slows down the release of glucose from any carbohydrates which are eaten. Therefore, creamy natural Greek yoghurt is a much better choice for you than Muller Light or any other similar low fat option..... Lidl do a large litre bucket of it under the brand name Milbona which is the lowest carb I have found and tastes delicious. Make sure to get the creamy one though and not the low fat version as they are both packaged similarly.

As regards the jelly babies, this is what people who inject insulin would call a hypo treatment. Insulin and some other diabetic medicines like Gliclazide (but not Metformin) can result in you having too much insulin in your system.... in fact a relatively tiny amount of too much insulin can render you unconscious or even potentially kill you, so those people need to carry jelly babies or other sweet sugary items with them to counteract that insulin if they make a mistake with their dosage etc. You body might have a bit of a wobble because it is not getting as much sugar as it has been used to, but it is not at risk of the very serious implications I have mentioned above. Unfortunately, by giving yourself jelly babies when you feel a bit wobbly, you are just pandering to that urge for sugar. Instead you would be best to carry a few nuts and eat a handful of those when you feel wobbly and give yourself a bit of time to adjust. Your own body will not produce too much insulin to cause a hypo unless you have a very rare disorder called Reactive Hypoglaecemia and you would almost certainly know about it if that was the case, so try eating a few nuts or a boiled egg or a chunk of cheese when you get that wobbly feeling rather than something sweet.

You have talked a lot about giving up sweet stuff but are you also aware that you need to reduce your intake of starchy carbs like bread, pasta, rice, potatoes and breakfast cereals as well?

Hi ya,
I have been very good with carbs too. Made changes and am an avid label reader for sure.
The jelly babies are not a staple, but I had had advice from diabetes nurse and was told that the shakes do not mean that I have low sugars but more that the cells feeding our muscles etc are a little hungry for the glucose, the little sugar/food boost will stimulate insulin and get it doing it’s job of feeding cells with glucose. I do eat nuts, cheese etc if I feel the shakes, but the jelly baby is in my bag for those out moments. Since I have been on metformin and made diet changes etc, I don’t need the boost..... prior to diagnosis I would be close to passing out and desperate to eat... thankfully those moments are very rare now.

Have pretty much cut out bread, but do have seeded bread pockets, being in halls at uni means if I buy bread for me, it goes off quicker than I can eat it. Jacket spuds and new potatoes and sweet potatoes are my main carbs and porridge for breakfast........ making myself hungry just talking about food. Xxxx

 

[PhoebeC]

As @rebrascora has said better to go full fat and reduce the other bad stuff that avoid fat.
Same with butter, go full butter, its has like 3 ingredients in it only, nothing added, and just have less of it. All of these low fat versions need things adding to make them taste and look the same. It's better for you in the long run just have less of it.

You are doing well keep it up!

 

[Docb]

Slight diversion but met a skinny T2 diabetic this morning who is on a course and is finding it useful, in particular with gaining an understanding of carb control as a means of blood glucose control. The other comment she made, made me smile. It was to the effect that she felt a little out of place because everybody else on the course "could obviously do with loosing a pound or two".

 

[ianf0ster]

Slight diversion but met a skinny T2 diabetic this morning who is on a course and is finding it useful, in particular with gaining an understanding of carb control as a means of blood glucose control. The other comment she made, made me smile. It was to the effect that she felt a little out of place because everybody else on the course "could obviously do with loosing a pound or two".

Most skinny T2D's could also do better losing a few lbs on LCHF. I was a TOFI, so not overweight - I had been slim all my life, but that just meant that instead of in fat cells just under the skin my excess Blood Glucose was being stored away in and around my Liver, pancreas, kidneys etc. And THAT is NOT GOOD!

 

[zoombapup]

Have pretty much cut out bread, but do have seeded bread pockets, being in halls at uni means if I buy bread for me, it goes off quicker than I can eat it. Jacket spuds and new potatoes and sweet potatoes are my main carbs and porridge for breakfast........ making myself hungry just talking about food. Xxxx

Just be aware that potatoes are very carby. Porridge will also contain a ton of carbs. Just in case you weren't aware.

 

[Ralph-YK]

Welcome to the forum Sue from a fellow T2
Glad things are good with the nurse. Unfortunately, as you have found, there often isn't for support for changing diet as a diabetic.

 

[Drummer]

Hi ya,
I have been very good with carbs too. Made changes and am an avid label reader for sure.
The jelly babies are not a staple, but I had had advice from diabetes nurse and was told that the shakes do not mean that I have low sugars but more that the cells feeding our muscles etc are a little hungry for the glucose, the little sugar/food boost will stimulate insulin and get it doing it’s job of feeding cells with glucose. I do eat nuts, cheese etc if I feel the shakes, but the jelly baby is in my bag for those out moments. Since I have been on metformin and made diet changes etc, I don’t need the boost..... prior to diagnosis I would be close to passing out and desperate to eat... thankfully those moments are very rare now.

Have pretty much cut out bread, but do have seeded bread pockets, being in halls at uni means if I buy bread for me, it goes off quicker than I can eat it. Jacket spuds and new potatoes and sweet potatoes are my main carbs and porridge for breakfast........ making myself hungry just talking about food. Xxxx

Oh dear - you seem to be another one with the wrong idea about all those 'healthy' carbs we are told to eat or we are doomed - potatoes are really something to avoid, sweet potatoes, well the clue is in the name - higher in carbs than the ordinary ones.
The advice from your nurse is total tosh - feeding cells with glucose by eating sweets to release insulin - what nonsense.

 

[Neens]

@Krafty sue Sorry you have had this experience. I was going to write about false hypos - I see you have had the advice already - I know I have them occasionally - especially at the beginning when my body was only getting about 1/4 of the carbs it was used to - I used to eat a few almonds. My DN (who is a good one) talked to me about them and agreed that if nuts worked that was the right sort of thing, she wanted to make sure I wasn't using sweets or biscuits. A few times they have left me unable to move off the settee, perspiring, flaky, faint, dizzy and when I have recovered I tested BG and it was in the 5s and no problem.
I also worry about what could have happened already to my insides, but I will never know, a bit like I will never know exactly when I tipped over the range into Diabetes. However, the bloods for kidney function and eye screening etc. have all come back clear and that's good. You will reach a point where you will stop worrying about these things. The good thing is now these possible complications are monitored and action can be taken straight away to prevent damage which otherwise may have happened.

This is a great forum and there are lots of knowledgeable and supportive pages/threads and members. Welcome.

 

[Grannylorraine]

Sorry you had a bad appointment, but well done on how well you have improved your HbA1c.

 

[Quizzical]

I’ve been a T2 diabetes controlled diabetic for years, but started on insulin (Lantus) just under a week ago. I saw my GP yesterday and he told me to up the units from 10 to 14. However, my fasting bg this morning was 6.2, so I decided to leave it at 10. I had my usual low carb breakfast, but an a hour or so later had what I think was a false hypo with shaking. Checked bg which was 5.7. It would normally have been around 9. My question is: should I eat more carbs at breakfast, and is it OK to fast after supper (at about 6.30pm) until morning or should I have a snack later in the evening.

Sorry if this is all a bit confused!

 

[Leadinglights]

I’ve been a T2 diabetes controlled diabetic for years, but started on insulin (Lantus) just under a week ago. I saw my GP yesterday and he told me to up the units from 10 to 14. However, my fasting bg this morning was 6.2, so I decided to leave it at 10. I had my usual low carb breakfast, but an a hour or so later had what I think was a false hypo with shaking. Checked bg which was 5.7. It would normally have been around 9. My question is: should I eat more carbs at breakfast, and is it OK to fast after supper (at about 6.30pm) until morning or should I have a snack later in the evening.

Sorry if this is all a bit confused!

You have posted this in a very old thread so you may not get too many answers but hopefully someone in the know will respond.

 

[Quizzical]

Thanks. I’m a bit new to fora!

 

[Dave W]

I’ve been a T2 diabetes controlled diabetic for years, but started on insulin (Lantus) just under a week ago. I saw my GP yesterday and he told me to up the units from 10 to 14. However, my fasting bg this morning was 6.2, so I decided to leave it at 10. I had my usual low carb breakfast, but an a hour or so later had what I think was a false hypo with shaking. Checked bg which was 5.7. It would normally have been around 9. My question is: should I eat more carbs at breakfast, and is it OK to fast after supper (at about 6.30pm) until morning or should I have a snack later in the evening.

Sorry if this is all a bit confused!

I think the answer to all your questions is try it and see. Start keeping a written log of your carb intake and pre and post-prandial glucose readings and see how these correlate with any adjustments to your Lantus.
Your fasting BG is fairly good, though maybe a smidgin on the low side, and I would guess that increasing lantus will push it lower. It does sound like you had a false hypo as 5.7 isn't even close to a real hypo. As far as having more carbs with breakfast goes, it's another case of try it and see, as is having a few carbs before bed. If you are not experiencing night-time hypos you probably don't need carbs before bed.
Did your GP give a reason why he was telling you to up your Lantus?