Hello Everyone

[Ian Brown]

Hi Folks,

I'm new to this forum but I've been a type 2 diabetic for 23 years. I've avoided insulin so far but maybe not for much longer.

My Hba1c is 9.0 reduced from 9.7 at the beginning of lockdown which is good as I've not been able to excercise much. I'm a Level 3 qualified Table Tennis coach and I reckon that activity knocks my Hba1c down about 0.5.

I've just been asked to up my glicazide up to 40mg from 20mg and the GP is considering Ozempic or Insulin, but we'll see what the extra 20mg Glicazide does.

I'd appreciate any ideas or advice as I'm not tookeen on the insulin as I want to keep my weight low as.my BMI is about 25 atm.

Thanks in anticipation.

Ian

 

[Bruce Stephens]

I'd appreciate any ideas or advice as I'm not tookeen on the insulin as I want to keep my weight low as.my BMI is about 25 atm.

We just had that argument elsewhere! Insulin doesn't, in itself, cause weight gain (or loss). Insulin allows you to eat more carbohydrates, and if you're stuck with specific doses might force you to eat specific amounts of carbohydrate.

So if you keep your current diet, start taking insulin, and then find you have to eat more carbohydrates too, then it's likely you'll gain weight. But if you get sufficient education so that you can adjust your insulin and diet, there's no reason why that would inevitably mean you'd gain weight. (Or be more likely to suffer from thrush or other UTIs, which was another (in my opinion dubious) claim.)

There are definite downsides to taking insulin but weight gain isn't an inevitable one, so long as you have good support from whoever's suggesting it. (A dietician, for example.)

(My BMI was around 25, and was rising very slowly largely as I aged, I think. I suspect it's a bit higher now just because I'm not doing so much exercise. Nothing to do with insulin, which I've been taking for nearly 40 years, and which my body produced before then, of course.)

 

[Ian Brown]

Thanks Bruce, that sounds like good advice. Hopefully it'll be a while before I have to get into the detail of the insulin vs. Ozembic argument. Ive just heard today that the GP will redo the hab1c in 3 months so we'll see what happens.

Thanks for the reply I appreciate it.

 

[rebrascora]

Hi Ian and welcome

Congrats on managing so long without insulin. I hope we are able to help you dodge it but if not, you should know that insulin in itself does not cause you to put on weight, it is the fact that you are eating too many carbs which causes you to put on weight when you start using insulin. If you start to reduce your carbs then not only will you be much less likely to put on weight if you do have to start on insulin but it may well reduce your need for medication so insulin or Ozempic is not necessary.

I very much doubt that the dietary advice 23 years ago for Type 2 diabetics was helpful and probably not that much has changed officially but many people here on the forum (and elsewhere) have found that a low carb higher fat way of eating has helped them to push their diabetes into remission and come off medication.
What many people don't understand is that all carbohydrates not just sugar cause our blood glucose levels to rise, so bread, pasta, rice, potatoes, couscous, breakfast cereals .... basically anything made with grains and even healthy foods like fruit and porridge and lentils and beans are high in carbs and are best rationed.

Here on the forum we advocate people use a BG meter to test their blood before and then 2 hours after each meal in order to see the effect that food had on their levels and then make adjustments to the carbohydrate content of that meal for next time if it caused too much of a spike (an increase of more than 3 mmols... but ideally looking to keep the spike less than 2mmols from any particular meal. This is referred to as "test, review, adjust" and hopefully someone will post a link which gives the details of the process. It enables us to tailor our diet to our tastes and our bodies (in)tolerance of specific carbs.... and it can be quite an individual response.... because some people can get away with a slice of wholemeal bread but potatoes send their BG rocketing whilst another person can manage a few pieces of potato but pasta is their nemesis. It can even vary with different times of day, so many of us find that breakfast time is when we are most insulin resistant, so any carbs eaten in the morning send our BG into orbit but the same food eaten later in the day has less of an effect.
Many of us opt for a low carb breakfast like creamy Greek Natural Yoghurt with a few berries and seeds and/or chopped nuts. Berries are the lowest carb fruits and tend to pack a punch flavour wise, so a few go a long way. Or a cooked breakfast with eggs like an omelette with whatever filling you fancy. I tend to have mine with mushrooms and onion and courgettes and ham and cheese and I serve it with a salad instead of bread and a good dollop of cheese coleslaw.... You will notice that cheese and creamy foods are mentioned because the fat in these foods will keep you feeling full for longer and provide slow release energy. This is contrary to NHS advice which is low fat, but there is a growing school of thought that this low fat advice is based on flawed research conducted 70 years ago and may even in part have contributed to the diabetes and obesity epidemic we are currently witnessing. Eating less fat means eating more carbs and the more carbs you eat, the more you want because they are digested quickly, spike your blood glucose and then 2 hours later your BG is coming down and your tummy is rumbling and you are looking for a snack. Following a low carb higher fat way of eating, I enjoy my food, but I eat less and I rarely feel hungry. Usually I just have 2 meals a day and sometimes just one. I eat natural fats like butter and cheese and olive oil and I have real cream in my coffee every morning (not Elmlea which has artificial fats added) because cream is lower in carbs than milk... (milk contains a sugar called lactose) and the fat helps to keep me feeling full and provides me with slow release energy and best of all it tastes gorgeous... and considering that I have pretty much given up a lot of my favourite foods like bread and potatoes (not to mention cakes biscuits and sweets) it is important to find other little food luxuries that don't cause my metabolism a problem. Interestingly my weight is stable in the normal BMI range and my cholesterol has reduced slightly since starting to eat more fat.... which is contrary to what we have been lead to believe and I am not the only one...

Anyway, I have rambled on quite enough for one post. I hope you find some of what I have written helpful.

 

[Ian Brown]

Thanks Barbara,

You're quite right much of what you mention is new to me. I had no idea that different types of carbs have different effects on different people. I feel a voyage of discovery coming on.

I did try the Atkins diet years ago and lost loads of weight to only put it back on, i had good BG results though.

I feel like a newbie again.

Thanks for your time I appreciate it.

 

[trophywench]

Well have a go at reducing your carbohydrate intake and keep using your meter to check your before and after eating levels.

Err, you do have a meter and strips?

 

[rebrascora]

I assume you have a BG meter and test strips on prescription since you are on Gliclazide, so at least you won't have to self fund.... unlike many Type 2s.
Keeping a food diary along with your readings will help you to make sense of it as you are looking more for trends than individual readings. If you have done Atkins before then you have an idea of what you are aiming for. Shame you didn't stick with it. Was there any particular reason why you stopped? I haven't done Atkins as such but find with a Low Carb Higher Fat (LCHF) way of eating I just need to be aware of the carbs and eat as much fat as I want and if I feel I need to lose a bit I cut back on the fat and increase exercise and if I need to gain a bit I have a second cup of coffee with cream on a morning and a nice big chunk of my favourite cheese with a small glass of red at bedtime. It is just small fluctuations and adjustments but it is holding me pretty steady in the normal BMI range and I am enjoying my food so see no need to change. Tonight it was lamb chops with cabbage and leeks cooked in a knob of butter and cauliflower cheese made with cream cheese and grated cheese rather than a cheese sauce made with milk and flour and a couple of tiny new potatoes.

 

[everydayupsanddowns]

Welcome to the forum @Ian Brown

There are all sorts of approaches to ‘ways of eating’ (rather than short term diets) on the forum. And the important thing to know is that there is no ‘one size fits all’, but folks here can help you on your voyage of discovery (great description!) to find a menu that suits your tastebuds, your BGs and your waistline

Just bear in mind that you will have to make adjustments slowly and carefully, partly because the meds you are in may need periodic tweaking, secondly because they need to be sustainable and going ‘all out‘ may mean you fall off the wagon rather than adapt to your new menu as a long-term solution, but also importantly because rapid changes to BG profiles are quite hard on the system, so it’s much easier for the body to transition over a period of weeks and months, allowing it time to adapt and adjust. 🙂

 

[Ian Brown]

I assume you have a BG meter and test strips on prescription since you are on Gliclazide, so at least you won't have to self fund.... unlike many Type 2s.
Keeping a food diary along with your readings will help you to make sense of it as you are looking more for trends than individual readings. If you have done Atkins before then you have an idea of what you are aiming for. Shame you didn't stick with it. Was there any particular reason why you stopped? I haven't done Atkins as such but find with a Low Carb Higher Fat (LCHF) way of eating I just need to be aware of the carbs and eat as much fat as I want and if I feel I need to lose a bit I cut back on the fat and increase exercise and if I need to gain a bit I have a second cup of coffee with cream on a morning and a nice big chunk of my favourite cheese with a small glass of red at bedtime. It is just small fluctuations and adjustments but it is holding me pretty steady in the normal BMI range and I am enjoying my food so see no need to change. Tonight it was lamb chops with cabbage and leeks cooked in a knob of butter and cauliflower cheese made with cream cheese and grated cheese rather than a cheese sauce made with milk and flour and a couple of tiny new potatoes.

Thanks Barbara,

The thing that stopped me on the atkins was there severly limited amount of fruit allowed. That was what I craved whilst on it, the root veg too.

I'm guessing I'm just gping to have to get used to it somehow. I had wholemeal toast this morning, with nothing sugary on it. The before reading was 10.5 after was 16.4 aaargh. Still I'm on the test and review cycle now. I may try porridge with cream tomorrow as I'm currently used to breakfast carbs and keep testing.

Thanks for the advice, i feel I'm on the right track even if the results aren't right yet.

Ian

 

[Ian Brown]

Well have a go at reducing your carbohydrate intake and keep using your meter to check your before and after eating levels.

Err, you do have a meter and strips?

Yes thanks Jenny. I have a background in research and intel so I like all the info I can.

Thanks for the reply

Ian

 

[Drummer]

I keep my Hba1c at the top end of normal, even though I am very sensitive to carbs - so bread and oats are not something I would eat unless it was a couple of slices of Livlife bread, which is 4gm of carbs per slice when I have kippers as they are too strong a taste without it.
I avoid grains, potatoes and high carb fruits as all sugars and starches cause spikes, even beans
I do have low carb stir fries, roast veges and salads and from time to time frozen berries. usually with cream and sugar free jelly on high days and holidays I make real custard or real icecream with eggs and cream.
From my day to day readings the Hba1c should be lower, but I think something broke with all the diets I was put on over the decades.

 

[rebrascora]

I am learning a new appreciation for other fruits like rhubarb and gooseberries and blackcurrants as well as rasps and strawberries and blackberries which I have always loved .... things packed with flavour and a bit of bite. I use a little Stevia to stew them with and having them swirled into creamy Greek yoghurt or whipped cream really gives you a nice dessert or breakfast especially if you add some chopped nuts and or mixed seeds. These are lower in carbs than other fruits but no reason why you cant have an occasional half a banana or half an apple one day and the other half the next as long as you don't make it a regular event. Testing before and after will show you what you can get away with...

Out of curiosity, how many slices of wholemeal toast did you have? Portion size of carb rich foods is important to log so if you had 2 slices, cut it down to one next time. Similarly, make sure to weight out your porridge oats before you cook them and then you can try halving the portion next time if it spikes you too much and bulk it out with other stuff like a few berries, seeds, nuts and yoghurt.

 

[brisr949]

The two things you craved are the problem, a lot of fruit are quite high in carbs and so are root veg..i think im right that ..if it grows underground its quite high, if it grows overground its medium and if it grows on the ground its quite low carbs..hope i got that the right way round.

 

[everydayupsanddowns]

.i think im right that ..if it grows underground its quite high, if it grows overground its medium and if it grows on the ground its quite low carbs..hope i got that the right way round.

That’s the rule of thumb I have heard @brisr949 🙂

 

[Ian Brown]

I keep my Hba1c at the top end of normal, even though I am very sensitive to carbs - so bread and oats are not something I would eat unless it was a couple of slices of Livlife bread, which is 4gm of carbs per slice when I have kippers as they are too strong a taste without it.
I avoid grains, potatoes and high carb fruits as all sugars and starches cause spikes, even beans
I do have low carb stir fries, roast veges and salads and from time to time frozen berries. usually with cream and sugar free jelly on high days and holidays I make real custard or real icecream with eggs and cream.
From my day to day readings the Hba1c should be lower, but I think something broke with all the diets I was put on over the decades.

Thanks for taking the time to reply. I'm on day 2 of trying to if I'm particularly sensitive to different groups of carbs, today was porridge. From the advice I'm reading from you all I might just try and reduce them to a minimum.

Thanks again

 

[everydayupsanddowns]

From the advice I'm reading from you all I might just try and reduce them to a minimum.

It‘s very much a ‘what works for you, works for you’ question really. There are several members for whom porridge is a very BG friendly and sustaining start to the day (alond with all the soluble fibre to boot!)... but for others a bowl or porridge may just as well be jam.

This is is the weirdness of diabetes and individual responses to food... there’s nothing for it but to experiment and see how things affect YOU, which will be governed by your gut biome, genetic makeup and metabolism far more than it will be by ‘what happens to 100 other people on average’ or opinions of strangers, be they forum members or HCPs.

Sometimes diabetes seems deliberately contrary with the way it reacts to food in different people, and while the experience of folks here might give clues and ideas... in the end, your bg meter will be the clearest indication 🙂

 

[Ian Brown]

Thanks for taking the time to reply. I'm on day 2 of trying to if I'm particularly sensitive to different groups of carbs, today was porridge. From the advice I'm reading from you all I might just try and reduce them to a minimum.

Thanks again

Interstingly a large bowl of porridge with sweetener and cream lead to an increase from 10.2 to 13.9... much lower.

Is this sort of info of use or interest to anyone?

 

[everydayupsanddowns]

Interstingly a large bowl of porridge with sweetener and cream lead to an increase from 10.2 to 13.9... much lower.

Is this sort of info of use or interest to anyone?

That’s great Ian, and I suspect if you reduced the size of the bowl slightly, you might hit that target of a maximum of 2-3 rise after meals.

Porridge is a weird one, because it has a reputation for being ‘slow release’ and many members over the years have found it works well for them, but it is very individual... and for others it acts like rocket fuel!

Just demonstrates how helpful self monitoring is - so you can check how things work for you!

 

[Ian Brown]

Thanks Mike,

Today shredded wheat ....10.9 to 17 aaargh...

On withthe experiments.

I appreciate your time and advice.

 

[Ian Brown]

After the wholemeal toast debacle i tried my own seeded bread..... 11.7 to 12.3! Yes the wholemeal bread was also home baked. Its the only way, it seems, to get a low sugar bread.

The variation of different carbs is a revelation to me. Im still testing. Then I will permanently change my diet.

Thanks everyone who's helped me I appreciate it.