Confused

[Rivki061]

Hello I am not exactly a newbie but I must confess to hardly ever posting-no idea why!

Anyway I've been diagnosed as type 2 for some time and I know I need to eat less carbs and I try but I'm confused as to what exactly is too much.

Is it ok for example to have a slice of toast for breakfast?
How about things such as pasta and potatoes how often are they allowed and in what quantity?

I avoid cake and pastry products such as sausage rolls and other such hot snacks but I do enjoy a pasta dish sometimes.

I limit the amount of chocolate I have but once again how much is to much?

My blood sugar levels are pretty well controlled and I want to keep them that way.


Many thanks in advance for any help.

 

[Northerner]

Hi, the simple answer is that you eat according to what your meter says you can tolerate well. People vary considerably in their tolerances, and at different times of the day. So, some people may find a big rise if they eat any carbs at all in the morning, but are fine later in the day - others may be fine with a small amount, such as a slice of toast, or a small portion of porridge or cereal.

A good approach is to follow a low GI or GL diet (glycaemic index/glycaemic load) - The GL Diet for Dummies is a good introduction. This involves choosing foods and combinations that will release their energy slowly and steadily, and therefore not cause a 'spike' in blood sugar levels. As you say your levels are pretty well controlled then the chances are you are eating about the right amount for you. I think the recommended daily allowance for non-Diabetics is around 230g. I personally eat around 150g. It can be useful to start a food diary, eat as you would normally, and note down the carb values of everything you eat and drink in a day - you can then look for areas where you might reduce or replace some of the carbs with other options e.g. more broccoli, less potatoes etc. 🙂

 

[Rivki061]

The thing is that I don't have a meter I was told that they are not necessary unless insulin is used that was by my GP and the Desmond group but other people say different.

I think the idea of sticking to 150 or so grams of carbs a day is good and I think that learning more about the best diet for people with type 2 is also a good idea as is the food diary!
As much as I like my GP I don't feel that he is all that knowledgeable of the finer details of type 2 diabetes.
Anyway thank you for that Northerner it was most helpful 🙂

 

[Northerner]

The thing is that I don't have a meter I was told that they are not necessary unless insulin is used that was by my GP and the Desmond group but other people say different.

I think the idea of sticking to 150 or so grams of carbs a day is good and I think that learning more about the best diet for people with type 2 is also a good idea as is the food diary!
As much as I like my GP I don't feel that he is all that knowledgeable of the finer details of type 2 diabetes.
Anyway thank you for that Northerner it was most helpful 🙂

You're welcome 🙂 Unfortunately, a lot of health care professionals are not up to date on the best care practice for people with diabetes This is a problem that is only now being recognised and many PCTs are having to review the care (or otherwise they provide - my own PCT among them. A huge percentage of people do not get the basic checks they are supposed to under NICE guidelines, and indifferent care, especially in the early months after diagnosis, seems commonplace. It's always worth challenging your nurse or doctor when you feel you are being dismissed or poorly treated - many of them spend very little time keeping in touch with the latest findings, unlike us who live with it and have to deal with it every day of our lives.

Good luck, and please do let us know how you get on - it's very helpful to others with similar questions to read how things go! 🙂

 

[DeusXM]

I would try to push your doc for getting a test strip prescription. If you're controlling your diabetes by diet, you need to know how individual foods affect you and you can't do that without blood sugar testing. Incidentally, how do you know your blood sugar levels are well controlled if you're not testing?

On the subject of 'how much is too much'....this really varies. I know a lot of T2s who would really, really struggle with 150g of carbs a day. I am not a habitual or intentional low carber but I certainly wouldn't eat that many carbs in a day, and I have a lot more direct control over my insulin levels than you. There is a particularly militant school of thought that suggests a good starting point is 12g for breakfast, 6g for lunch and 6g for dinner (ie no more than 24g per day) but if you can get good control and still eat more carbs, there's no need to be quite so restricted.

As Northerner also hinted, different GI/GLs will also have an effect. For instance, personally I've stopped eating baguette but will eat an equivalent amount in pasta because baguette seems to just land in my stomach and spill out glucose for hours and hours, whereas pasta doesn't. Again, you won't know this unless you test.

 

[Rivki061]

Thank you Northerner and DeusXM. I think I may well talk to my doctor about the blood test strips because then at least I will know exactly what diet changes to make;at the moment I'm trying to stick to 150g of carbs a day but of course that may or may not be ok for me.

The odd (or maybe not so odd thing) is that last year when I was in hospital after surgery and my sugar levels were checked regularly they rose more after I ate potatoes then they did after I had some chocolate.

 

[Northerner]

Thank you Northerner and DeusXM. I think I may well talk to my doctor about the blood test strips because then at least I will know exactly what diet changes to make;at the moment I'm trying to stick to 150g of carbs a day but of course that may or may not be ok for me.

The odd (or maybe not so odd thing) is that last year when I was in hospital after surgery and my sugar levels were checked regularly they rose more after I ate potatoes then they did after I had some chocolate.

Potatoes can be tricky for some people. New potatoes are better than mashed as they take longer to digest, even chips can be better for your blood glucose because the fat content slows digestion. Chocolate is similar, as it also contains fat. Good quality dark chocolate with a high cocoa content is probably the best option if you don't want to deny yourself completely - just a couple of squares after a meal can be quite satisfying and satiate the desire to binge at other times 🙂

 

[DeusXM]

The odd (or maybe not so odd thing) is that last year when I was in hospital after surgery and my sugar levels were checked regularly they rose more after I ate potatoes then they did after I had some chocolate.

That's perfectly normal. A potato is a lot bigger than a chocolate bar so it will probably have more carbs. Also, chocolate contains more fat, which means the volume of glucose it releases per minute will be less, which may be work better for your personal insulin response. Meanwhile, a potato usually takes longer to get going but once it does, you get the full hit.

 

[Rivki061]

Potatoes can be tricky for some people. New potatoes are better than mashed as they take longer to digest, even chips can be better for your blood glucose because the fat content slows digestion. Chocolate is similar, as it also contains fat. Good quality dark chocolate with a high cocoa content is probably the best option if you don't want to deny yourself completely - just a couple of squares after a meal can be quite satisfying and satiate the desire to binge at other times 🙂

Is it worth while buying sugar free chocolate or is something such as Lindt or Green & Black's 70% cocoa ok in limitation?

One thing I did find odd I was thinking of treating myself to a bag of sugar free Werthers (to have one now and again) and I looked at the carb content and the ones without sugar were higher in carbs than the ones with sugar.
So is it better to have the ones with sugar or the ones without?
My apologies if that is a daft question and of course I know I have to limit the amount I have either way.

I've likely got you thinking that all I eat is sweets and chocolates but it really isn't!
I do have quite a bit of fruit and I hope that isn't a problem 🙂

 

[DeusXM]

So is it better to have the ones with sugar or the ones without?

The ones with the sugar. Sugar means NOTHING when it comes to diabetes. Carbs mean everything. Also, sugar free stuff, aside from actually being higher in carbs sometimes, tends to also be sweetened with something like maltitol. If you want to eat maltitol, you need to learn two vital skills: how to break wind for a full minute without either laughing or drawing attention to yourself, and how to conduct the majority of your day from the toilet seat.

Is it worth while buying sugar free chocolate or is something such as Lindt or Green & Black's 70% cocoa ok in limitation?

As above. Go for the 85-90% stuff instead. You'll find after one or two squares that you're not really that keen on chocolate anymore.

 

[LeeLee]

Sugar free sweets do have their place, but treat with caution for the reasons stated.

I find extra strong SF mints (Fisherman's Friend do a good powerful one) useful when out shopping. One of those in one's gob has a magical effect on the shopping trolley - naughty stuff just doesn't seem to fall in! And they can be very useful to reduce the temptation from the smell of cooking burgers, sausages, sausage rolls etc., i.e the stuff that's really bad when trying to lose weight.

 

[DeusXM]

I do have quite a bit of fruit and I hope that isn't a problem

It can be.

Fruit juice and smoothies contain more sugar than regular soft drinks and probably should be avoided overall. Different fruits have different amounts of sugar - many people seem to be ok on small berries but stuff like bananas or apples can be deadly on the blood sugar.

What makes things worse is the type of sugar. Fructose, the main sugar in fruits, is particularly problematic. It needs to be converted to fat first before it can be properly metabolised (unlike other sugars), and a high fruit intake is related to insulin resistance. Simply put, there's a reason why hibernating animals eat lots of fruit in the autumn. Eating five portions of fruit a day is probably as bad for you (metabolically speaking) as eating a Big Mac. Have a look at the nutrition traffic lights on fruit things - they're red for sugar. And then they have the cheek to put a little star next to it and say 'these sugars naturally occur within the fruit', as if that makes a difference. It's like putting a red for fat on a pack of bacon and saying the fat is naturally occurring within the pig.

 

[Rivki061]

The ones with the sugar. Sugar means NOTHING when it comes to diabetes. Carbs mean everything. Also, sugar free stuff, aside from actually being higher in carbs sometimes, tends to also be sweetened with something like maltitol. If you want to eat maltitol, you need to learn two vital skills: how to break wind for a full minute without either laughing or drawing attention to yourself, and how to conduct the majority of your day from the toilet seat.

I know all about the more embarrassing side effects of sweeteners such as malitol!
It's interesting how things change because years ago I recall that people with diabetes were told no sugar which must have been highly restrictive.



As above. Go for the 85-90% stuff instead. You'll find after one or two squares that you're not really that keen on chocolate anymore.

I bought 80% cocoa Green & Blacks once and it made me feel sick but it didn't put me off chocolate. Maybe I will try the Lindt one and see what that's like.

Thank you DeusXM

 

[Rivki061]

It can be.

Fruit juice and smoothies contain more sugar than regular soft drinks and probably should be avoided overall. Different fruits have different amounts of sugar - many people seem to be ok on small berries but stuff like bananas or apples can be deadly on the blood sugar.


In the Desmond diabetes 2 group I attended they said that we could have one glass of fruit juice per day and if we wanted more it should be diluted;does that sound right to you? Personally I think that even when it's diluted it's still likely to be problematic.
I eat a fair amount of apples and bananas so that's a nuisance if they spike my blood sugars.
How about dates? I was told no more than 3 a day.



What makes things worse is the type of sugar. Fructose, the main sugar in fruits, is particularly problematic. It needs to be converted to fat first before it can be properly metabolised (unlike other sugars), and a high fruit intake is related to insulin resistance. Simply put, there's a reason why hibernating animals eat lots of fruit in the autumn. Eating five portions of fruit a day is probably as bad for you (metabolically speaking) as eating a Big Mac. Have a look at the nutrition traffic lights on fruit things - they're red for sugar. And then they have the cheek to put a little star next to it and say 'these sugars naturally occur within the fruit', as if that makes a difference. It's like putting a red for fat on a pack of bacon and saying the fat is naturally occurring within the pig.

I'm just looking at a bag of dried apple I have it's just plain apple with preservative and the carbohydrate content is 24.2g higher than a bar of 72% cocoa chocolate I have and there was me thinking that fruit was fine!
So how many portions of fruit and veg should a person with type 2 diabetes be aiming for daily.

Thanks so much for your help and your patience🙂

Sorry about all the questions but the health professionals seem to give rather conflicting advice.

 

[Rivki061]

Sugar free sweets do have their place, but treat with caution for the reasons stated.

I find extra strong SF mints (Fisherman's Friend do a good powerful one) useful when out shopping. One of those in one's gob has a magical effect on the shopping trolley - naughty stuff just doesn't seem to fall in! And they can be very useful to reduce the temptation from the smell of cooking burgers, sausages, sausage rolls etc., i.e the stuff that's really bad when trying to lose weight.

Fisherman's Friend that takes me back some years,my late father used to have them and that was longer ago then I care to remember.
I shall have to buy some for old times sake and to avoid the temptation of putting naughties in the shopping trolley!
I don't buy burgers,sausage rolls from the supermarket in fact I avoid pastry products such as sausage rolls and pasty's,I actually don't remember when I last had one.
I'm off out to buy myself a packet of Fisherman's Friends.

Thank you Lee Lee 🙂

 

[LeeLee]

I'm T2 and only on Metformin/diet/exercise. My diabetic nurse told me I could have as much veg as I want (within reason, taking care with spuds) but to limit fruit to 2 per day, NEVER grapes because they are little portions of sugar, and never fruit juice. Mostly I comply.

 

[Rivki061]

I'm T2 and only on Metformin/diet/exercise. My diabetic nurse told me I could have as much veg as I want (within reason, taking care with spuds) but to limit fruit to 2 per day, NEVER grapes because they are little portions of sugar, and never fruit juice. Mostly I comply.

I don't have a diabetes nurse.
I think I can stick to two portions of fruit a day it's just a shame that my favourites are the ones highest in carbs.
Ok so no more fruit juice.It's a good job I like water.
Is Pepsi Max ok?

 

[DeusXM]

I'm just looking at a bag of dried apple I have it's just plain apple with preservative and the carbohydrate content is 24.2g higher than a bar of 72% cocoa chocolate I have and there was me thinking that fruit was fine!
So how many portions of fruit and veg should a person with type 2 diabetes be aiming for daily.

It varies. One thing that fruit does have in its favour is fibre - with carb counts, you should subtract the fibre from the carb amount to get the total digestible carbs.

I also am definitely not saying 'never eat fruit' - I think fruit is an important part of diet but only to the extent that you can metabolise it. The important thing to remember is that fruit is not a 'free' food ie. you can't just eat it and not think about it, it requires the same thought you'd out in when you're eating bread or pasta or sweets.

In terms of fruit and veg portions per day, I would recommend as many portions as you can manage. The 'five-a-day' thing is largely a compromise based on what the FSA believes is an achievable target for a population that invented fish-and-chips and the Cornish pasty. And that includes fruit purely on the grounds of acheivability. So I would eat as many leafy green vegetables as you can (cauliflower, cabbage, broccoli, runner beans etc.). You should also probably be eating things like peas and carrots (but in smaller quantities as these are more carby). Potatos don't count as veg, and frankly I personally don't think parsnips should either. Then in terms of fruit, it's whatever you can manage in terms of blood sugar control but I would always pick veg over fruit where possible.

There are also no hard and fast rules over which fruits are good and bad - it can be highly individual. Also, with fruit I am prepared to make more compromises but then again I also have a more flexible insulin regime. For instance, I love fresh lychees but they are very sweet, so I will bolus for them. However I also love raspberries and blueberries, which I find have very little impact on me. As for juice, I drink 'light' cranberry juice -this is extremely low carb (2g per 100ml) and gives me a good fruit 'hit' without the sugar. It does have to be 'light' though, the other versions are sweetened with sugar, rather than sucralose or aspartame.

For drinks, water is the best. But any diet/zero soft drink should have minimal impact on your BG. You can also get sugar-free squashes as well if you're looking for a fruity taste, I get through a bottle of sugar-free Ribena every week. Those flavoured waters can also be good too provided you get the sugar-free versions.

 

[LeeLee]

My pet hate is soft drinks displays in shops - most of the time, the no-added-sugar choice is limited to water (boring) or cola (caffeine can raise BG). When I can be bothered, I raise the issue with the most senior member of staff available - but have rarely achieved anything. I wonder if anyone has considered taking action under the Disability Discrimination Act? Must look into this at some point.

 

[DeusXM]

I don't think you can really claim disability discrimination on this one - no-one is actively or purposely preventing you from anything important because you have diabetes. It's hardly the store's fault - blame the market. Rightly or wrongly, the majority of people prefer to buy regular soft drinks. If the store puts more diet stuff on display, they lose sales. It also goes down to stock availability - far fewer cans of Dr Pepper Zero or Diet Lilt are manufactured than Diet Coke (because they don't sell as well) and of course some soft drinks don't even come in diet versions anyway (Tango, Mountain Dew, Tizer etc.) These companies have no legal obligation to manufacture these things any more than a supermarket has an obligation to sell turkey ham.

Your best bet isn't the legal route; it's to convince soft drink manufacturers that there's a market for more diet versions of their drinks.