Diabetes Education Course

[Forgetful55]

Hi all

After being quite pleased after being told at the Diabetic Clinic I was no meds and diet only and come back in six months for Hba1c I was miffed to find out yesterday at the Diabetes Education Course that I was sent to that at the next session approx. one month from now we will all be given another Hba1c form and have to get our blood done so that at the third session in approx. 2 months from now they can see if we have taken their advice on board which included eating lots of carbs!? I asked how high did my blood sugar have to go before being put on metformin and the DSN said if it goes up at all. ( It is only 49) is this normal? She said then something about Metformin protects your heart?? How does it do that then? I would really like to try and do this with diet for six months at least but looking at me (as I am not overweight) she said .. well theres nothing you can do!! NOT encouraging at all very doom and gloom about progressive nature of disease and genetic and cant do much about it but not to worry as it would be treated and kept under control. Also given urine strips and told to pee on them every day at different times of the day and write on chart and take back next time. Well as far as I know if your blood sugar is under 10 it will be negative and as I have already been checking mine anyway and have had negative results all the time exept twice when it was light green that would appear to be good but I think the blood sugar monitor is a more accurate way to go as others have said and intend to get one soon.

Wondered if this was all normal procedure as I thought I was just going to learn about diabetes not to be managed by a nurse from the hospital as well as the one in my surgery.I The amount of carbs they are saying to eat was a lot I don't eat that many in my normal diet anyway at least not the amount they are suggesting. I just worked out that my carb intake is probably about a 130-150 max as I have to eat small portions anyway as I have a hiatus hernia and lots of carbs in one go don't do it a lot of good!! And that's including the one sugar I usually have in my tea..( still not getting on well with the sweetners).

Has anyone else had this happen at the courses? And does anyone know how high your blood sugar has to go to be put on metformin? Thanks .

 

[trophywench]

Well you don't eat a heck of a lot of carbs for a non-diabetic - but you haven't exactly cut back on them have you? LOL

Frankly - the total amount of FOOD 'they' say we should eat (D or not) is perfectly ridiculous for me unless I wanted to be twice the size I am. About 100g carb or preferably less is about right for me - and I've been overdoing it on a daily basis for months - nearer 130g a day plus of course all the protein and fats etc etc etc. Diabetically it isn't a problem - I'm T1 so I can just have more insulin to cover more carbs. But personally - it really is a problem. There's absolutely no pleasure in shopping for BIGGER clothes LOL

I think you will find t- when you get that meter and get testing that some of the things you eat have a shocking effect on your BG - so those are the things you probably need to limit. There are odd things my BG can't tolerate at all - eg a banana. So I tried sharing one with my OH. Nope, still too much. Well - less than half a banana is pathetic - decided Oh well I'll give em up then - and did. I should say this took me a long time - years - to finally stop trying but d'you know - that was 30 years ago and I haven't missed em! But sometimes, eating whatever at a different time of day you can have different results - so you have to approach it all with an open mind, and treat yourself as a scientific experiment!

So I say this - you are on the right track and 'they' aren't. So what I think you should do is this - get testing - have a read of 'Test, Review, Adjust' http://loraldiabetes.blogspot.co.uk/2006/10/test-review-adjust.html to see when to do it, how to learn from it and what to do next - get your A1c down and when they say 'See - you did well when you took our advice, didn't you?' answer 'No - I did well precisely because I ignored it!'

Finally - 'they' can prescribe Metfartin or anything they want to prescribe. However if they want you to take it - then it is necessary to get your agreement first !! - so there's no point in them writing the scrip if you won't.

Metformin was originally invented as a weight loss drug - it doesn't quite work like this in the strict scientific sense, but it stops too many carbs being absorbed by the gut - and if they aren't being absorbed, well where are they gonna come out again to get rid of themselves? Oh what a surprise! - upset tum, violent (and frequently smelly) wind and diarrhoea are the main side effects of the drug. It is alleged to be heart protective - but can't say I'm either convinced about that, or know how it's supposed to do it. If I knew, then perhaps I would be convinced LOL

 

[Forgetful55]

Hello Trophywench

Thanks so much for the reply.. I actually thought what you just said.. I thought crikey I have NEVER eaten that much food in my life not about to start now as I will be ginormous if I do. I just got down today to half a teaspoon of sugar in my tea.. (was a two sugars girl till recently) so I reckon I will get that sorted now within a few days without the dreaded sweetner. Regarding Metfartin If I have to take if the blood sugars go really high I would be prepared to give it a try but at the moment my fasting blood sugar is not even in the diabetic range I have been diagnosed only on the hba1c so I think I have a way to go with diet first. I do intend to get the blood sugar meter in the next week or so. So far the best advice I have had is on here and the David Cavan book called Reverse your Type Two Diabetes (he is advising about 30g of carb with each meal) and he was a diabetic consultant at the RBH (one of our local hospitals) for 17 years so he must know what he is on about. Why are the NHS so behind with the carb thing? I did ask the DSN regarding low carb and she said something about a study that had been done on 12 people who had shakes instead of meals.. ( that was not what I was meaning) but said that their diabetes came back afterwards ( well it would wouldn't it if they went back to high carb again) my lowering of carbs is a work in progress as I am very active (walk a lot and do aqua classes and swim) I cant go too low or I wont have much energy.. but I think I could still cut portion size a bit more.!

 

[DaveB]

Hi. Isn't it amazing how the NHS can offer advice that will definitely make your condition worse - it's scandalous. I assume you will not be stuffing yourself with carbs and will keep to your very sensible diet. Yes, urine sticks will merely show if your blood sugar is above around 11 mmol and nothing else. Do go and buy a meter and strips; the SD Codefree is one of the cheapest and available on the web. It is said that metformin helps the heart but like you I have never come across the evidence. It is, however, as very safe drug so don't be worried about taking it if you need it. You may want to look at the NICE Diabetes Pathways document on the web (Google it). It has a flow-chart showing the decision points based on your HBa1C etc.

 

[trophywench]

LOL - I 'know' Dr Cavan of old for certain reasons outside this forum (but not as a patient) - he's gone on to larger International things (in Brussels I think) - in the Diabetes bit of the European lot (it's not EU, it predates them like the EHIC agreement also does, so Brexit doesn't apply to it LOL) who decide things like what our BG should be before driving, Europe-wide, what drugs are good to have and should be licensed, etc.

As well as 'knowing' him as a fount of Diabetes knowledge that he's willing to share freely of course.

He'd be quite happy if folk lowered their carb as much as they wanted to, actually - but as he wanted the advice to be very widely accepted by both patients and NHS, decided not to go TOO far.

 

[grovesy]

Hello Trophywench

Thanks so much for the reply.. I actually thought what you just said.. I thought crikey I have NEVER eaten that much food in my life not about to start now as I will be ginormous if I do. I just got down today to half a teaspoon of sugar in my tea.. (was a two sugars girl till recently) so I reckon I will get that sorted now within a few days without the dreaded sweetner. Regarding Metfartin If I have to take if the blood sugars go really high I would be prepared to give it a try but at the moment my fasting blood sugar is not even in the diabetic range I have been diagnosed only on the hba1c so I think I have a way to go with diet first. I do intend to get the blood sugar meter in the next week or so. So far the best advice I have had is on here and the David Cavan book called Reverse your Type Two Diabetes (he is advising about 30g of carb with each meal) and he was a diabetic consultant at the RBH (one of our local hospitals) for 17 years so he must know what he is on about. Why are the NHS so behind with the carb thing? I did ask the DSN regarding low carb and she said something about a study that had been done on 12 people who had shakes instead of meals.. ( that was not what I was meaning) but said that their diabetes came back afterwards ( well it would wouldn't it if they went back to high carb again) my lowering of carbs is a work in progress as I am very active (walk a lot and do aqua classes and swim) I cant go too low or I wont have much energy.. but I think I could still cut portion size a bit more.!

I think the Nurse has got mixed up with the Newcastle Diet that was low numbers and shakes. Dr.Michael Mosley the 8 weeks book might be worth a read.

 

[Dollypolly]

You do know you can refuse metiformin or any drug they try on you. I refused because it doesn't help your heart and comes with side effects that are not pleasant or just down right nasty. I have IBS so felt it would make this worse much to the annoyance of the nurse I said no.
I then changed my diet completely as in cold turkey as I'm not a you can have in moderation as I'd just eat it all the same and spike my sugar levels. Some healthy foods spiked me too but we are all different so what spikes me might not spike you.
Oh by the way my levels where are at 8.7% but I've known others to be lower and the want them on it. I want to be proactive not reactive over my care is what I said. WhIch I have to say my care is poor sadly

 

[Forgetful55]

Thanks everyone for your help again.. I have the Michael Mosley book in my diabetes book pile downstairs.. its on the to read list after David Cavan (which I have nearly finished) and Gretchen Beckers book (dipped in and out of so far).. this Diabetes lark is becoming time consuming but once I know what I am doing it can take a back seat (she said hopefully) I wont be stuffing myself silly with carbs as I never have to a great degree anyway. You all seem to be doing well on the LCHF diet so that is good news and very positive.

 

[trophywench]

I always post the caveat that it isn't really HIGH fat. It's just fairly normal fat - but do not get sidelined by the 'eat low fat everything' brigade.

It's especially poor advice if you want to have nice skin and everything else Ladies of a Certain Age rather like to have LOL

By the way - what an absolutely gorgeous place you happen to live in. Spent a lot of time around there during one phase of my life - you know, when entry to the castle was completely free and they didn't have a proper car park down the road, if you cared to stagger up there on Sunday morning - before visiting The Pub ! Last time we went, we met the Sealed Knot coming back from battle to their camp in the field behind the carpark. Did you win Lads? my husband called. Yes thanks - but then, we always do! came the response !

 

[Andy HB]

Basically, you should tailor your diet to suit you. The level of carb in your diet sounds completely fine to me so long as your blood sugars are under control.

On the LCHF issue, I am very relaxed because, again, it is a personal thing. For me I was on a BCLF (balanced carb, low fat) diet and that really helped me lose weight and sort out my non-alcoholic fatty liver. But my point is don't let anyone tell you that one approach is the answer. Because it isn't! 🙂

The metformin does have a protective effect on the heart but that benefit pre-supposes that you are at greater risk of a heart attack (which, being diabetic, you statistically are). The view I took, when I stopped taking metformin was:
1) I did not need it to control my blood sugars any more. Seven years later, that is still the case and I remain off all meds for now.
2) There is no history of heart disease in my family and there is no problem with my heart either.

Lastly, metformin also prevents the liver from releasing glucose into the blood stream as well. So that is also quite handy for controlling your levels. But if your control is good without it and you don't want it, then don't take it.

Andy 🙂

 

[Ljc]

Hi. IMO we should do what suits our body best and what we can maintain long term. If you achieve good results and are happy with your diet and exersize regime ie not starving yourself and you are enjoying your food and chosen exersize with good BGs then that is the way forward for you.

Many of us T2s do eventually need to take Metformin etc but it is by no means inevitable, a few here have even been able to come off it.

It sounds to me that what you are doing is working well for you, if I were you I would continue with that and not be worried about having that Hb1ac they want you to have, then when it shows you've done real well, as I have no doubt it will, then you can have the pleasure if you wish, of saying "I did it my way" 🙂

 

[Forgetful55]

Thanks again everyone! Feeling cheered up. Today I had a brunch out with my friend but skipped the toast and just had a few small bits of fried potatoes then when I got home I had a bowl of strawberries with full fat plain yoghurt (yummy) did spoil it by having two ginger biscuits .. however I had been on five buses done some walking and have now cleaned the house from top to bottom so think I burned all that off!
Trophywench presume you are talking about Corfe Castle it is a beautiful area ( though its very clogged up in the summer) I live just outside Wimborne.

 

[trophywench]

Ah .. yes you do, don't you ! - I only registered 'Corfe' LOL