Another newbie

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Devondumpling

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Relationship to Diabetes
Type 2
Hi all
Ive just been told that I have type 2 diabetes and have been prescribed Metformin.
I’ve an appointment to see the diabetes nurse in a couple of weeks but in the meantime I don’t really have a clue what this diagnosis means, how long I’m likely to have had it and what damage it might have already done.
I was actually expecting to be told my cholesterol was high and to go back on statins!
It’s the kick up the backside I need to overhaul my diet. I’m 64, a couple of stone overweight but reasonably active as I do a fair bit of walking. My blood pressure was fine too.
If I get the weight off is there any chance the diabetes can be reversed? When the surgery phoned, the doctor said that my second blood test results were better than the first ones but still not good enough. I hadn’t done anything different as I didn’t know this was what they were testing for, and the appointments were both first thing in the morning. She did mention trying to control it myself with diet etc but then said she’d like me to start the medication in the meantime. She also said that I’d start on one tablet a day for a week and then two a day, yet my prescription says to take one with breakfast and one at dinner.
Are there varying degrees of diabetes or is it a case of once you’ve got it you’ve got it? I am not sure what to expect when I meet the nurse to discuss what’s happening.
Sorry for all the questions!! Any advice as to what I should be doing / not doing etc. gratefully received!
 
Hello and welcome from another Devon girl.
Initial diagnosis can be quite a shock but you sound like you are ready to embrace lifestyle changes. First thing you need to do is ask what your HbA1c was. That's the blood test used to diagnose diabetes, and you need to know where you are starting from. A result of 48 mmol/mol or more is what diagnoses diabetes. As it was suggested control by diet, I would guess you are just in the diabetic range, and will just need tweaks to get out of the diabetic range. Hopefully it means you have been diagnosed before any damage is done. You will see many people on this forum have successfully reduced their HbA1c and are considered in remission. Some had a level over 100mmol/mol when they started. It can be done.
I was 57 mmol/mol when diagnosed and given 3 months dietary control to reduce my blood glucose. Be aware, dietary changes are for life, as it is so easy to slip back. An unrelated illness put my level back up and I was put on medication.
Metformin is the standard medication, but it can came with nasty side effects, cramps, diarrhoea, queasy. There is a slow release version which is kinder on the tummy. It is best taken in the middle of a meal - a pill sandwich! I started with mine at night, then morning and night when I went up to 2. I had the bad side effects, and have 2 other different medications now.
You will have lots of tests initially, then regularly for the rest of your life. These will include diabetic eye screening to test for retinopathy, foot test (tickle test) for nerve damage to the feet, blood pressure, weight, blood tests for glucose and organ performance. You should also be offered a training course about managing your diabetes and offered dietary advice. I was diagnosed 5 years ago, and sent on an Oviva course (that is what is offered in Devon, rather than the more common Desmond course). Things have changed with lockdown, so it might now be an online course. In the meantime, the Learning Zone - orange tab above - is the best place to start. I suggest one module a day, so you can take everything in.
The most important thing is your diet. From what I have read here, the quality of advice offered by dietary nurses varies. Some are more up to date than others, some still too heavy on carbs). But every body is different and you will have to find out what suits your body by trial and error.
I managed my food intake 2 ways. First thing is to keep a food diary. I got an app to do the hard work for me (there are several - I use NutraCheck). I recorded everything I consumed, by item, meal and day. It showed calories, total carbs, of which sugars, fats, sat fats, protein, salt, fibre. In the UK the carb total on packaging includes sugars. The measure you need to look for is total carbs. It is suggested Type 2 diabetics aim for less than 130gm carbs a day (including all your drinks and snacks). If you are currently consuming more you should aim to reduce slowly, as too quickly can affect the eyes (temporarily). I experimented between 50gm and 130gm, settling on 75fm +- 15gm. Others go far lower as they are more sensitive to carbs. But low carb does not mean no carb.
The second thing I did was to get a blood testing monitor. (I'm sure someone will advise on what is currently the best option.) I finger pricked first thing, immediately before eating, 2 hours after first bite, then last thing at night. That way you will see what foods affect your glucose levels. You should ideally be 4mmol - 7mmol and not rise by more than 2mmol or 3mmol, staying under 8.5mmol after food. (This finger pricking is different from the HbA1c. It is the immediate result, whereas the HbA1c is a 3 month average). I tested religiously for several weeks until I worked out foods were affecting me and adjusted accordingly. Again everyone is different. Now I just test for new foods.
There are different approaches. Some follow a Newcastle style diet (shakes), others reduce their carbs, some follow a keto diet which is very low carb. The foods you should look at include bread, potatoes, rice, pasta, cereals, most fruits, processed foods, below ground vegetables. It's not just the obvious things like sweets, cakes, biscuits, pastries. Some nurses suggest swapping to brown bread, pasta, but they are just as high in carbs as the white variety, just a bit slower acting.
My testing revealed I can eat a couple of new potatoes, or a medium slice of wholemeal from a 400gm loaf, but pasta and apples are lethal for me. But that's me. I was told a fruit portion is 80gm, and no more than 2 a day. I buy frozen fruit so I can measure it out. I keep digital scales and a clear bowl on my kitchen top and weigh everything except above ground vegetables and salads. No guesstimating.
There are plenty of substitutes, for example roasted squash instead of chips or roasties, low carb breads, courgetti or boodles instead of pasta, cauliflower mash or rice. I get soy bean pasta, but there is also black bean pasta. I make a lot of soups (in winter) and have salads (in summer). I also use my slow cooker a lot. This way I know exactly what I am eating without the processed food additives. In fact I had great fun trying out different foods and recipes. There is part of the forum with Food/carb queries and recipes to give you ideas.
You should find that by reducing your carbs and filling up with more veggies the excess couple of stones with start to shift. Weight loss is good for overweight diabetics! You say you are already active which is good. Walking, cycling, aquafit, swimming are suggested. I took up aquafit.
This is a very long post, but I hope the suggestions are helpful. No one way is right, it's just finding out what is right for you. Best wishes
 
Felinia said:
Hello and welcome from another Devon girl.
Initial diagnosis can be quite a shock but you sound like you are ready to embrace lifestyle changes. First thing you need to do is ask what your HbA1c was. That's the blood test used to diagnose diabetes, and you need to know where you are starting from. A result of 48 mmol/mol or more is what diagnoses diabetes. As it was suggested control by diet, I would guess you are just in the diabetic range, and will just need tweaks to get out of the diabetic range. Hopefully it means you have been diagnosed before any damage is done. You will see many people on this forum have successfully reduced their HbA1c and are considered in remission. Some had a level over 100mmol/mol when they started. It can be done.
I was 57 mmol/mol when diagnosed and given 3 months dietary control to reduce my blood glucose. Be aware, dietary changes are for life, as it is so easy to slip back. An unrelated illness put my level back up and I was put on medication.
Metformin is the standard medication, but it can came with nasty side effects, cramps, diarrhoea, queasy. There is a slow release version which is kinder on the tummy. It is best taken in the middle of a meal - a pill sandwich! I started with mine at night, then morning and night when I went up to 2. I had the bad side effects, and have 2 other different medications now.
You will have lots of tests initially, then regularly for the rest of your life. These will include diabetic eye screening to test for retinopathy, foot test (tickle test) for nerve damage to the feet, blood pressure, weight, blood tests for glucose and organ performance. You should also be offered a training course about managing your diabetes and offered dietary advice. I was diagnosed 5 years ago, and sent on an Oviva course (that is what is offered in Devon, rather than the more common Desmond course). Things have changed with lockdown, so it might now be an online course. In the meantime, the Learning Zone - orange tab above - is the best place to start. I suggest one module a day, so you can take everything in.
The most important thing is your diet. From what I have read here, the quality of advice offered by dietary nurses varies. Some are more up to date than others, some still too heavy on carbs). But every body is different and you will have to find out what suits your body by trial and error.
I managed my food intake 2 ways. First thing is to keep a food diary. I got an app to do the hard work for me (there are several - I use NutraCheck). I recorded everything I consumed, by item, meal and day. It showed calories, total carbs, of which sugars, fats, sat fats, protein, salt, fibre. In the UK the carb total on packaging includes sugars. The measure you need to look for is total carbs. It is suggested Type 2 diabetics aim for less than 130gm carbs a day (including all your drinks and snacks). If you are currently consuming more you should aim to reduce slowly, as too quickly can affect the eyes (temporarily). I experimented between 50gm and 130gm, settling on 75fm +- 15gm. Others go far lower as they are more sensitive to carbs. But low carb does not mean no carb.
The second thing I did was to get a blood testing monitor. (I'm sure someone will advise on what is currently the best option.) I finger pricked first thing, immediately before eating, 2 hours after first bite, then last thing at night. That way you will see what foods affect your glucose levels. You should ideally be 4mmol - 7mmol and not rise by more than 2mmol or 3mmol, staying under 8.5mmol after food. (This finger pricking is different from the HbA1c. It is the immediate result, whereas the HbA1c is a 3 month average). I tested religiously for several weeks until I worked out foods were affecting me and adjusted accordingly. Again everyone is different. Now I just test for new foods.
There are different approaches. Some follow a Newcastle style diet (shakes), others reduce their carbs, some follow a keto diet which is very low carb. The foods you should look at include bread, potatoes, rice, pasta, cereals, most fruits, processed foods, below ground vegetables. It's not just the obvious things like sweets, cakes, biscuits, pastries. Some nurses suggest swapping to brown bread, pasta, but they are just as high in carbs as the white variety, just a bit slower acting.
My testing revealed I can eat a couple of new potatoes, or a medium slice of wholemeal from a 400gm loaf, but pasta and apples are lethal for me. But that's me. I was told a fruit portion is 80gm, and no more than 2 a day. I buy frozen fruit so I can measure it out. I keep digital scales and a clear bowl on my kitchen top and weigh everything except above ground vegetables and salads. No guesstimating.
There are plenty of substitutes, for example roasted squash instead of chips or roasties, low carb breads, courgetti or boodles instead of pasta, cauliflower mash or rice. I get soy bean pasta, but there is also black bean pasta. I make a lot of soups (in winter) and have salads (in summer). I also use my slow cooker a lot. This way I know exactly what I am eating without the processed food additives. In fact I had great fun trying out different foods and recipes. There is part of the forum with Food/carb queries and recipes to give you ideas.
You should find that by reducing your carbs and filling up with more veggies the excess couple of stones with start to shift. Weight loss is good for overweight diabetics! You say you are already active which is good. Walking, cycling, aquafit, swimming are suggested. I took up aquafit.
This is a very long post, but I hope the suggestions are helpful. No one way is right, it's just finding out what is right for you. Best wishes
Click to expand...
brilliantly summarised...
 
Thank you for the fantastic advice Felini! I was pretty blasé about the diagnosis to be honest but didn’t really know much about diabetes and I think I have underestimated how damaging it can be!
I’m going to have to spend some time reading up on the foods to avoid, which look to be almost everything I enjoy! No more Devon cream teas for me!!!
If I put my mind to it, I can lose weight. I’ve done it in the past when my cholesterol was high, but I’m useless at sticking at it and as soon as I stop dieting, I revert back to my bad habits and pile it all on again.
I wish they had told me what my blood results showed. I’ve no idea if I was borderline or way over.
You’ve definitely given me lots to follow up on and I’ll have a good browse of the site.
Many thanks again
 
Devondumpling said:
I wish they had told me what my blood results showed.
Click to expand...
Yes, I've been in the same boat and have had to phone up and ask for my results. Even then the response is sometimes "There is no action" so I have to specifically ask for the measurement results as returned from the lab. It is frustrating to have to do this, but the GP surgery does have to give your results unless they think there is a reason that you knowing might be harmful to you (unlikely). I wish my surgery made the results available online like some do...would save the back and forth.
 
You are entitled to know what your HbA1c results were, so if I were you, I'd ask when you see the nurse. I suggest you also prepare a list of questions to ask at the meeting. That way you won't forget anything you really wanted to know.
I believe in moderation not abstinence, once you have a handle on things. So I do have the occasional treat. For example I went for a Chinese meal on my recent birthday, but had beansprouts instead of rice with my sizzling king prawns and veggie stir fry. If I go for an Indian meal, I'll have tandoori chicken, but with salad and mushroom bhaji. I do miss jacket potatoes though!
 
Devondumpling said:
Thank you for the fantastic advice Felini! I was pretty blasé about the diagnosis to be honest but didn’t really know much about diabetes and I think I have underestimated how damaging it can be!
I’m going to have to spend some time reading up on the foods to avoid, which look to be almost everything I enjoy! No more Devon cream teas for me!!!
If I put my mind to it, I can lose weight. I’ve done it in the past when my cholesterol was high, but I’m useless at sticking at it and as soon as I stop dieting, I revert back to my bad habits and pile it all on again.
I wish they had told me what my blood results showed. I’ve no idea if I was borderline or way over.
You’ve definitely given me lots to follow up on and I’ll have a good browse of the site.
Many thanks again
Click to expand...
I think the problem is often people regard it as A DIET when really it has to be a new way of eating for life as when you get into normal range if you then go back to old habits you will be back at square one or worse.
Hence whatever way you choose has to be enjoyable and still allow you the occasional 'treats'
 
Devondumpling said:
Thank you for the fantastic advice Felini! I was pretty blasé about the diagnosis to be honest but didn’t really know much about diabetes and I think I have underestimated how damaging it can be!
I’m going to have to spend some time reading up on the foods to avoid, which look to be almost everything I enjoy! No more Devon cream teas for me!!!
If I put my mind to it, I can lose weight. I’ve done it in the past when my cholesterol was high, but I’m useless at sticking at it and as soon as I stop dieting, I revert back to my bad habits and pile it all on again.
I wish they had told me what my blood results showed. I’ve no idea if I was borderline or way over.
You’ve definitely given me lots to follow up on and I’ll have a good browse of the site.
Many thanks again
Click to expand...
If you can get online access it shows on there. My surgery uses system online. You normally need to register first with ID at the surgery but I’m in East of England.
 
My Devon surgery also uses system online, so you might be lucky!
 
Hi Devondumpling, welcome to the forum.

I think most people felt overwhelmed when first diagnosed as there are a lot of unknowns but you're in the right place.

You've had some great info above so I'd just echo the need to get your HbA1c number so you know where you're starting from and what to work towards.

If you've improved your health before then there's a good chance you can do it again. The trick is making things a lifestyle change and finding things that you enjoy whilst being good for you.

Do have a look on the forum as there are many who have managed their health with diet alone so have a read and let us know if there's anything we can help with.
 
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