Confused newly diagnosed Type 2

[gwalmsley]

Hi everyone,

I am a newly diagnosed type 2, and I have been trying to get my head around the avalanche of contradictory information I have been provided with and the information on the various web sites and forums. Lots of different information on what you can and can't eat, and if I read "in moderation" without any guide as to what the author considers 'moderate' I will scream. 🙂

From what I can work out, if you are trying to control your diabetes with diet only it boils down to 2 rules:

• Get my weight down into the approved BMI range of 20-25
• Limit Carb intake to 200-300g per day spread as evenly as possible to prevent spikes

Does that seem right, or am I missing something fundamental/life threatening?

Thanks

Graham

 

[Ralph-YK]

Limit Carb intake to 200-300g per day spread as evenly as possible to prevent spikes

I don't know the quantity to have. You do have to manage carbohydrates. I gather it also depended which carbs you have and what you have with it.
You at least have something to start with, see how it goes.
Self testing can help. It allows you to see what affect food has on your BG.

 

[gwalmsley]

Thanks for your reply.

"I gather it also depended which carbs you have and what you have with it" is part of the problem. You can quickly vanish down the rabbit hole of GI, GL, interactions between different foods altering the GI etc. etc. It is all too overwhelming. Just trying to get it down to some simple rules to live by that stops be spending 2.5 hours in one isle of the supermarket trying to work out what I can actually eat.

I don't know the quantity to have. You do have to manage carbohydrates. I gather it also depended which carbs you have and what you have with it.
You at least have something to start with, see how it goes.
Self testing can help. It allows you to see what affect food has on your BG.

 

[Ralph-YK]

I know what you mean. This is where the self testing helps. Do before and after food. See what happens.

 

[pav]

Welcome to the forum, When I did the EXPERT course a couple or so years ago they recommended the daily intake of carbs was 135g. The thinking is even among health care professionals that even 135g of carbs is to much, if I eat that many carbs a day I certainly would have bigger weight problems than I already have.

With carbs it is best to eat the foods that release carbs slowly rather than ones that normally produce rapid spikes like white bread is out for most people as it causes very rapid spikes. Other foods like rice, pasta and breakfast cereals can cause rapid spikes.

This is where testing ones levels with a meter comes in use, though probably your GP practice will have said that you don't need to test and the GP will monitor you. Most if not all on here agree the only way forward is to monitor ones levels. In that you take a reading before you eat and then 2 hours after eating, keeping a note of what you have eaten. In this way you can build up a pattern of what foods you eat and how they react with you.

There is no definitive list of foods that you avoid, what you can eat and what you might have as a treat once in a while if luck in that one.

Those that can't get test strips on prescription and can self fund tend to use the SD code free meter available from Home Health or Amazon the starter kits only come with 10 strips to get you started and a pot of 50 strips is around £8 where as most of the strips for the bigger names can be around £25+ for a pot of 50.

If you feel you would like to test your levels the first port of call is the GP practice as some type 2's are lucky to get test strips on prescription if they they are not on any meds that cause hypos, but may be limited to the test strips they can have. If you you feel you would like to self fund and test the UK uses the mmoll method of measuring ones levels. If you order from Home health on the link below remember to select the I am a diabetic option as that removes the VAT off the purchase and the mmoll meter option

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/

There are quite a few on here that follow a low carb diet and will be able to explain better than myself what they eat.

If you can reduce weight, depending on what your current weight is can improve ones levels, it not true that type 2's fall into the overweight group of people.

 

[Northerner]

Hi everyone,

I am a newly diagnosed type 2, and I have been trying to get my head around the avalanche of contradictory information I have been provided with and the information on the various web sites and forums. Lots of different information on what you can and can't eat, and if I read "in moderation" without any guide as to what the author considers 'moderate' I will scream. 🙂

From what I can work out, if you are trying to control your diabetes with diet only it boils down to 2 rules:

• Get my weight down into the approved BMI range of 20-25
• Limit Carb intake to 200-300g per day spread as evenly as possible to prevent spikes

Does that seem right, or am I missing something fundamental/life threatening?

Thanks

Graham

Hi Graham, welcome to the forum 🙂 Sorry to hear about your diagnosis, and the experience of confusion that greets many people when faced with vague and impractical advice Hopefully, we can help change the situation so you feel better informed and can set about getting your blood sugar levels under good control 🙂

The first thing to bear in mind is that there is no one-size-fits-all solution to this, although there are some general guidelines you can follow. You have mentioned two of them above - weight loss (if you need to lose weight, not everyone does at diagnosis) will help your body handle your food intake better, making your cells more responsive to the insulin your pancreas is producing. Another big factor to consider in this respect is regular exercise - this will also improve your body's capacity to take up and use the glucose in your blood and thus keep your levels under better control. Is there any particular activity you enjoy? It doesn't have to mean running marathons or spending long sessions in the gym, just a regular daily walk will really help 🙂

Secondly, as you mention, is limiting your consumption of carbohydrate to the amounts it can tolerate well. I would say straight away that 200-300g daily of carbs would be considered very high by most people looking to manage their diabetes well, you really need to be looking at a low to moderate carb intake of 80-150g daily to begin with, depending on how you react to your different food choices. How will you know how you react? The only definite and practical way is to follow a regime of testing your blood sugar levels before and after eating, using a home blood glucose monitor. Your GP/nurse may supply you with this and test strips on prescription if you explain how you intend to use them to learn about your diet and tolerances. Have a read of Test,Review, Adjust by Alan S in order to understand the process. If you are refused a meter then it is worth funding your own initially whilst you gather information and then return to the GP with the evidence that it is helping you actively manage your condition. The cheapest option we have come across is the SD Codefree Meter which has test strips at around £8 for 50 (High St brands can charge £30+ for 50 test strips 😱).

I'd recommend starting a food diary initially, writing down the amount, in grams, of carbs in everything you eat and drink - this will provide you with a good template, not only of your current intake, but also to find areas where you might reduce your carb intake by substituting items with lower carb alternatives or reducing portion sizes (more green veg, fewer potatoes, for example).

For a good overview of diabetes and a practical approach to selecting food items that are suitable, have read of Maggie Davey's letter. I'd also recommend getting a copy of the excellent Type 2 Diabetes: The First Year by Gretchen Becker - these are trusted, reliable resources that have stood the test of time and are free of the myths and misconceptions you have no doubt already encountered!

Please feel free to ask any questions you may have - there will always be someone here happy to help! 🙂

 

[gwalmsley]

Thanks for you detailed response.

What kinds of food are you eating to only taking 135g of Carbs per day? At the moment it feels like just reading the label adds carbs to your total 🙂

I did stop having potatoes but having visited the dietitian yesterday she said potatoes were fine 'in moderation' (that wonderful phrase again). I have swapped over to brown/wholegrain/basmati rice, wholemeal bread etc. and I do like meat so can eat a lot of that (but of course then you have the 'don't eat too much protein' warnings). Veg is fine, but not a great fan of nuts (not allergic, just don't like the taste).

The other issue appears to be eating out.. absolutely no chance of knowing any of the numbers for what you are eating.

Graham

Welcome to the forum, When I did the EXPERT course a couple or so years ago they recommended the daily intake of carbs was 135g. The thinking is even among health care professionals that even 135g of carbs is to much, if I eat that many carbs a day I certainly would have bigger weight problems than I already have.

With carbs it is best to eat the foods that release carbs slowly rather than ones that normally produce rapid spikes like white bread is out for most people as it causes very rapid spikes. Other foods like rice, pasta and breakfast cereals can cause rapid spikes.

This is where testing ones levels with a meter comes in use, though probably your GP practice will have said that you don't need to test and the GP will monitor you. Most if not all on here agree the only way forward is to monitor ones levels. In that you take a reading before you eat and then 2 hours after eating, keeping a note of what you have eaten. In this way you can build up a pattern of what foods you eat and how they react with you.

There is no definitive list of foods that you avoid, what you can eat and what you might have as a treat once in a while if luck in that one.

Those that can't get test strips on prescription and can self fund tend to use the SD code free meter available from Home Health or Amazon the starter kits only come with 10 strips to get you started and a pot of 50 strips is around £8 where as most of the strips for the bigger names can be around £25+ for a pot of 50.

If you feel you would like to test your levels the first port of call is the GP practice as some type 2's are lucky to get test strips on prescription if they they are not on any meds that cause hypos, but may be limited to the test strips they can have. If you you feel you would like to self fund and test the UK uses the mmoll method of measuring ones levels. If you order from Home health on the link below remember to select the I am a diabetic option as that removes the VAT off the purchase and the mmoll meter option

https://homehealth-uk.com/all-products/codefree-blood-glucose-monitoring-system-mmoll-or-mgdl/

There are quite a few on here that follow a low carb diet and will be able to explain better than myself what they eat.

If you can reduce weight, depending on what your current weight is can improve ones levels, it not true that type 2's fall into the overweight group of people.

 

[gwalmsley]

Thanks for responding.

This is part of the confusing... Diabetic nurse says one thing, Dietitian says something else, forums say something else, it makes you feel you can't eat anything.

First thing I did was to start to keep a food diary, so I could see what I was eating. Just looked at the figures and carb intake for the last 8 days is 137, 161, 113, 206, 161, 111, 185,160 which is a lot lower than the target of 300 I have, so 150 probably isn't a stretch 😎

You are the first person to actually mention why I should exercise more, I thought it was just to help lose weight (current BMI of 30 and heading down to 25) rather than use up the glucose in my blood. Certain exercise is difficult due to problems with my knees, but I can walk a few miles and enjoy cycling and kayaking.

Thanks for the reading recommendations, I will get on those straight away.

I have another appointment with the diabetic nurse tomorrow morning, so I will ask about the testing.

Graham

Hi Graham, welcome to the forum 🙂 Sorry to hear about your diagnosis, and the experience of confusion that greets many people when faced with vague and impractical advice Hopefully, we can help change the situation so you feel better informed and can set about getting your blood sugar levels under good control 🙂

The first thing to bear in mind is that there is no one-size-fits-all solution to this, although there are some general guidelines you can follow. You have mentioned two of them above - weight loss (if you need to lose weight, not everyone does at diagnosis) will help your body handle your food intake better, making your cells more responsive to the insulin your pancreas is producing. Another big factor to consider in this respect is regular exercise - this will also improve your body's capacity to take up and use the glucose in your blood and thus keep your levels under better control. Is there any particular activity you enjoy? It doesn't have to mean running marathons or spending long sessions in the gym, just a regular daily walk will really help 🙂

Secondly, as you mention, is limiting your consumption of carbohydrate to the amounts it can tolerate well. I would say straight away that 200-300g daily of carbs would be considered very high by most people looking to manage their diabetes well, you really need to be looking at a low to moderate carb intake of 80-150g daily to begin with, depending on how you react to your different food choices. How will you know how you react? The only definite and practical way is to follow a regime of testing your blood sugar levels before and after eating, using a home blood glucose monitor. Your GP/nurse may supply you with this and test strips on prescription if you explain how you intend to use them to learn about your diet and tolerances. Have a read of Test,Review, Adjust by Alan S in order to understand the process. If you are refused a meter then it is worth funding your own initially whilst you gather information and then return to the GP with the evidence that it is helping you actively manage your condition. The cheapest option we have come across is the SD Codefree Meter which has test strips at around £8 for 50 (High St brands can charge £30+ for 50 test strips 😱).

I'd recommend starting a food diary initially, writing down the amount, in grams, of carbs in everything you eat and drink - this will provide you with a good template, not only of your current intake, but also to find areas where you might reduce your carb intake by substituting items with lower carb alternatives or reducing portion sizes (more green veg, fewer potatoes, for example).

For a good overview of diabetes and a practical approach to selecting food items that are suitable, have read of Maggie Davey's letter. I'd also recommend getting a copy of the excellent Type 2 Diabetes: The First Year by Gretchen Becker - these are trusted, reliable resources that have stood the test of time and are free of the myths and misconceptions you have no doubt already encountered!

Please feel free to ask any questions you may have - there will always be someone here happy to help! 🙂

 

[pav]

Thanks for you detailed response.

What kinds of food are you eating to only taking 135g of Carbs per day? At the moment it feels like just reading the label adds carbs to your total 🙂

I did stop having potatoes but having visited the dietitian yesterday she said potatoes were fine 'in moderation' (that wonderful phrase again). I have swapped over to brown/wholegrain/basmati rice, wholemeal bread etc. and I do like meat so can eat a lot of that (but of course then you have the 'don't eat too much protein' warnings). Veg is fine, but not a great fan of nuts (not allergic, just don't like the taste).

The other issue appears to be eating out.. absolutely no chance of knowing any of the numbers for what you are eating.

Graham

Most of my carbs come from wholemeal bread or on occasions granary a fair few on here like burgen bread of various types, big supermarkets in my area have it though the ones I have tried are not to my taste. Other carbs are potatoes not to many when having baked spuds it tends to be the home brands frozen ones which are around the medium size (smaller than my clenched fist. I don't like rice, pasta or pizza so they are an easy to put on my avoid list. I avoid breakfast cereals as the ones I like spike me way to much. Meat wise it's mainly Turkey, Chicken and pork with the odd bit of beef.

I did have a treat the other night and have some plain naan bread with a curry very high in carbs, but was lucky as for some strange reason they were ok on this occasion, other times no way I would get away with them, I do tend to snack on nuts.

 

[Northerner]

Thanks for responding.

This is part of the confusing... Diabetic nurse says one thing, Dietitian says something else, forums say something else, it makes you feel you can't eat anything.

First thing I did was to start to keep a food diary, so I could see what I was eating. Just looked at the figures and carb intake for the last 8 days is 137, 161, 113, 206, 161, 111, 185,160 which is a lot lower than the target of 300 I have, so 150 probably isn't a stretch 😎

You are the first person to actually mention why I should exercise more, I thought it was just to help lose weight (current BMI of 30 and heading down to 25) rather than use up the glucose in my blood. Certain exercise is difficult due to problems with my knees, but I can walk a few miles and enjoy cycling and kayaking.

Thanks for the reading recommendations, I will get on those straight away.

I have another appointment with the diabetic nurse tomorrow morning, so I will ask about the testing.

Graham

Looks like you may not have to struggle too much with your carb intake, from those numbers 🙂 Good luck with your appointment 🙂 If they are reluctant to prescribe strips, stress that you wish to take an active role in your diabetes management, not wait for a 3 or 6 monthly test which may only tell you that you haven't made good choices, but not identify the culprits. It's possible to manage your levels with the information from testing, but only if you are willing to limit your diet on a more or less permanent basis - testing allows you to retain flexibility so you can eat more normally, enjoying the things that you tolerate well that you might otherwise drop. What many healthcare professionals fail to grasp about Type 2 (and Type 1, so some extent) is that it is very much an individual condition that requires individually tailored knowledge. It's thought that each person's unique biome - the bacteria that lives in our gut - has a big influence on determining our tolerances 🙂 If you're interested, this was investigated on a BBC show a while ago:

http://www.bbc.co.uk/programmes/art...on-weight-and-not-others-and-can-we-change-it

 

[pav]

Thanks for responding.

This is part of the confusing... Diabetic nurse says one thing, Dietitian says something else, forums say something else, it makes you feel you can't eat anything.

First thing I did was to start to keep a food diary, so I could see what I was eating. Just looked at the figures and carb intake for the last 8 days is 137, 161, 113, 206, 161, 111, 185,160 which is a lot lower than the target of 300 I have, so 150 probably isn't a stretch 😎

You are the first person to actually mention why I should exercise more, I thought it was just to help lose weight (current BMI of 30 and heading down to 25) rather than use up the glucose in my blood. Certain exercise is difficult due to problems with my knees, but I can walk a few miles and enjoy cycling and kayaking.

Thanks for the reading recommendations, I will get on those straight away.

I have another appointment with the diabetic nurse tomorrow morning, so I will ask about the testing.

Graham

One problem is some nurses are stuck in the olden days saying you must eat so much of this and that, which in turn is not always suitable for diabetics.

As for exercise I am limited to what I can do due to arthritis and back problems, but do go out to meet some ex work mates and other friends, and even a gentle stroll around in the fresh air brings my levels down quickly, on more adventurous days it can catch me out some times and carry hypo treats.

 

[gwalmsley]

SD Codefree meter, lancets and strips purchased, should be here Friday.

No point even trying to fight my local doctors surgery over it.

 

[gwalmsley]

Hi Pav,

You mention carrying hypo treats. I thought hypos was only a type 1 issue because type 2 was too much sugar in the blood rather than not enough? Nothing has been mentioned to me about it from the various healthcare professionals. A few times since my diet change I have been dizzy on standing up, but just put it down to 'one of those things'. This may be a silly question, but how do you recognise a hypo?

Thanks

Graham

One problem is some nurses are stuck in the olden days saying you must eat so much of this and that, which in turn is not always suitable for diabetics.

As for exercise I am limited to what I can do due to arthritis and back problems, but do go out to meet some ex work mates and other friends, and even a gentle stroll around in the fresh air brings my levels down quickly, on more adventurous days it can catch me out some times and carry hypo treats.

 

[pav]

SD Codefree meter, lancets and strips purchased, should be here Friday.

Your quick off the mark 🙂 , still worth asking the the nurse or doc for a meter and tests strips, you could be lucky. Another point is if they put you on any medication like metformin (normally the first one they start people on) and you are in England and under 60 you are entitled to free prescriptions, though to get them you need to apply for a prescription exemption certificate which lasts for 5 years the docs will normally have the form and will need to be signed by a doctor.

 

[Ljc]

Hi Graham Welcome. It is so confusing isn't it. You're told one thing by one and something total different by another. and that's just the professionals.
On here you'll get advise based on what has worked for us, it's up to you to decide which is best for you, but I strongly suggest you monitor your own blood glucose as has already been suggested.

I'm going to give you two bits of advise. At first Don't go mad on the dietary changes , what I mean is do what is achievable as this is a marathon not a sprint.
Their is a book called ,Type 2 diabetes the first year. By Gretchen Becker which I believe you will find helpful . She's a fellow T2 who goes through month by month her first year after diagnosis
https://www.amazon.co.uk/gp/product...fm-21&linkId=0fe91e54d4071470ef950412cbbd7e95

 

[pav]

Hi Pav,

You mention carrying hypo treats. I thought hypos was only a type 1 issue because type 2 was too much sugar in the blood rather than not enough? Nothing has been mentioned to me about it from the various healthcare professionals. A few times since my diet change I have been dizzy on standing up, but just put it down to 'one of those things'. This may be a silly question, but how do you recognise a hypo?

Thanks

Graham

Type 2's can get hypo's if they are on meds that can cause hypos like glicazide or if they are put on insulin at some stage. Normal starting off meds of metformin do not cause hypos.

What you may be getting is what's called a false hypo, to your body it is a hypo, but in medical terms of a hypo it's not a hypo where your levels are below 4.0. The reason for the false hypo your body has become accustomed to high sugar levels and that has become the normal for you, when you start dropping your levels towards normal then your body reacts to this as a feeling of a hypo even though your level are above the hypo level.

 

[gwalmsley]

...
Their is a book called ,Type 2 diabetes the first year. By Gretchen Becker which I believe you will find helpful . She's a fellow T2 who goes through month by month her first year after diagnosis
https://www.amazon.co.uk/gp/product...fm-21&linkId=0fe91e54d4071470ef950412cbbd7e95

Bought and downloading to my Kindle as I type 😉

Graham

 

[gwalmsley]

Great explanation, thank you.

The level of sugar and carbs I am taking in has massively reduced compared to what I was eating. When you don't have to think about it that meal out at the Chinese, or pizza on the way home is just easy and delicious! Once I started to look at what I was eating I was shocked at the level of calories and sugars I was taking in. Even things I thought were healthy like fruit juice, or those small bags of dried fruit you get, all landmines in the battlefield of sugar intake 🙂

I am also finding that come the revolution people who design food labels are up against the wall along with the estate agent photographers 🙂 Packets that give the numbers per 100g that they are required to do, but then don't put an overall weight on the packet! or give an amount per 'serving' without saying how much that is.

I made a big mistake the other day. I was going to the cinema (cineworld) and thought I would be sensible and downloaded the nutrition information sheet from their web site to check what I could eat. I found to my surprise that the hot dog would be fine so had one of those. It was only later that I smelt a rat and went back to double check.... the numbers given were for the hot dog itself, the roll it was on was listed 2 pages away and was a totally different problem. I am not aware of a 'can I have the hotdog without the roll' option on their menu, so I think is is bad that they split the listings of the items.

Sorry for going on, but one more question, how do people deal with eating out? Obviously you have no real idea how something was cooked, or what is really in it (i.e. 'fish pie' covers a lot of options) so how do you cope?

Thanks

Graham

Type 2's can get hypo's if they are on meds that can cause hypos like glicazide or if they are put on insulin at some stage. Normal starting off meds of metformin do not cause hypos.

What you may be getting is what's called a false hypo, to your body it is a hypo, but in medical terms of a hypo it's not a hypo where your levels are below 4.0. The reason for the false hypo your body has become accustomed to high sugar levels and that has become the normal for you, when you start dropping your levels towards normal then your body reacts to this as a feeling of a hypo even though your level are above the hypo level.

 

[PinkGrapefruit]

Personally, I have taken the low-moderate carb path, and it's helped me get my numbers down and shed the weight.

Normal day:

breakfast few berries (10 carbs)
coffee with milk (5 carbs)
snack 9bar peanut (8 carbs)
lunch - prepacked salad (7 carbs)
lunch - tuna / chicken bites (6 carbs)
coffee with milk (5 carbs)
snack 9bar peanut / handful of nuts (8 carbs)
dinner - meat & veg (15-30 carbs depending on sauce) i like curries, stir fries, cauliflower cheese etc.
occasional late night snack of nuts or berries (10 carbs)

Looks like I'm hitting around 75-90g of carbs a day; sometimes less, sometimes more.

 

[pav]

When I eat out I find many of the pubs where I have meals are small on the portion size like chips you get like a dozen and normally select meals where additional carbs are not an added item like gammon is a nice treat when out for me as I don't very often have it, One pub I used to go to did a Sunday lunch, the potato content was not a lot but where generous on the chicken, I just did not eat the skin. On the odd occasion I had a small fish in batter but the fat from frying the fish tended to slow the carbs absorption down. The biggest headache was going to an Indian restaurant and did a compromise had the curry with naan bread but no chips or vice versa not having the two together helped, I am not perfect in what I eat due to the foods I like and dislike, when I do go out I try to eat a bit lighter meal earlier instead of the normal one, some times I get it right.