Diagnosed but not assessed yet

[livelee]

Hi.
I am newly diagnosed with type 1. I am 54 years old and until 9 years ago was a very fit and active man. After a series of throat viruses in 2005/6 I developed a chronic swollen larynx and vocal chords.

Over the intervening years I have had acute breathing attacks (physical or emotional stress being the trigger) and have then needed a course of steroids (prednisilone) to open my airway. Over the last 9 months I have had to have 5 courses of steroid and have now developed diabetes. I have lost 20lbs in weight in this period and am now under 10 stone (5ft 10)

I am a little confused about the conflicting dietary advice. I am not yet on insulin and I have just started taking Gliclazide and Metformin orally. My assessment won't be for another 4 weeks and in between I am visiting Spain.

Should I be reducing my carbohydrate intake? No sugar? Just a normal balanced diet? Advice on the main websites does not appear conclusive for my situation.

Any advice would be welcome

Many thanks

Lee

 

[Northerner]

Hi Lee, welcome to the forum 🙂 Sorry to hear about your diagnosis Diet can certainly be confusing, as people can have very different tolerances, and much may depend on the type of treatment you are receiving. However, the chief thing to bear in mind, as you have surmised, is the amount of carbohydrate you are eating, and also to some extent, the type. Some types of carbohydrate will release their energy slowly and steadily, others will have a much swifter effect on your blood sugar levels. There is a general way you can ascertain this, known as the 'GI' or Glycaemic Index of the food - the higher the number, the faster it will convert to glucose and raise your levels. It's slightly more complicated than that, because you don;t tend to eat foods in isolation (e.g. you don't just eat potatoes for a meal, you eat them with something else). To take account of this a more sophisticated method is the 'GL', or Glycaemic Load. It sounds complicated, but it's not really - I'd recommend getting a copy of The GL Diet for Dummies, which is a good introduction.

Basically, you need to keep your carbohydrate consumption low to moderate (I would say between 80-150g per day). Some people go very low carb, others consume more, but it is very much down to the individual and monitoring the effects, learning what you can tolerate whilst retaining flexibility in your diet. In order to discover what you can tolerate well, and what should be reduced or excluded, you use a blood glucose meter to measure the level before eating, then one or two hours after to determine the rise. Read Test,Review, Adjust by Alan S for an idea of how this works. Hopefully, since you have been put on gliclizide, you will have been given a meter and prescription for test strips? If not, you should ask your doctor for one because with gliclizide there is the possibility of your blood glucose levels falling too low (below 4 mmol/l) and you would then need to treat this with something sugary, like a couple of jelly babies. If you drive, then you MUST test before driving so you can be sure you are safe to do so.

Please let us know if you have any more questions 🙂

 

[livelee]

Thanks Northerner. I'll be on to my Dr on Monday. One question, if I reduce carbon how do I put on weight. I'm wasting away!

 

[Worcester_Matt]

Hi Lee,

I just wanted to say that I've been very recently diagnosed with type 1 diabetes, and I'm yet to see a dietician (next Wednesday hopefully), but I've found that the low GI Diet has been very helpful in reducing my glucose levels. A lot of dietary advice I've had so far is that normal levels of protein and fat are fine, and can actually help when eating carbohydrates, so it might just be a case of being careful about eating the right kind of carbohydrates, but not cutting down on your overall calorie intake, as you would if you were dieting to lose weight. It sounds like a careful balancing act when you need to put on weight, but something that a doctor can certainly help with I'm sure.

Matt

 

[Mark T]

Welcome to the forum livelee 🙂

 

[Northerner]

Thanks Northerner. I'll be on to my Dr on Monday. One question, if I reduce carbon how do I put on weight. I'm wasting away!

Don't be afraid of fat! It won't affect your blood sugar levels, in fact it can help to slow down the absorption of carbs so they don't 'spike' your levels so quickly. 🙂 Protein is fine also, so cheese, nuts, avocado etc. help yourself 🙂

One of the reasons you are losing so much weight is because your body can't use the glucose properly so it is turning to other sources of energy, which is body fat and to some extent, muscle fibre. The glucose gets peed away in your urine. Before I was diagnosed I lost about 20 pounds in the 18 months prior, then I got a virus and lost a further 17 pounds in 3 days - I weighed 8st 4 instead of the 11st I weighed before. It took a while, but once my levels were under better control I started putting the weight back on, so try not to worry too much about that aspect for now, the main thing is improving your levels.

In your case, you are not producing enough insulin in order to use the glucose properly - the gliclizide is intended to stimulate your pancreas into producing more.

 

[livelee]

Thanks Guys. I have come across Dr Bernstein and his recommended diet for my situation. It's helpful to hear of someone living it. Low carbon, hi protein and hi fat it is. I'll be seeing nutritionist and dietician after hols.for personal tuning. Cheers.

 

[Northerner]

Thanks Guys. I have come across Dr Bernstein and his recommended diet for my situation. It's helpful to hear of someone living it. Low carbon, hi protein and hi fat it is. I'll be seeing nutritionist and dietician after hols.for personal tuning. Cheers.

Do be careful with following Bernstein as I believe he promotes very low carb intake (by the way, it's short for 'carbohydrate', not 'carbon', just in case you need to google it!). This may mean that you end up consuming too little carb for the medication you have been on, possibly leading to your levels falling too low. Get a meter and monitor your levels to make sure you are safe 🙂

 

[trophywench]

Wouldn't it be easy to do a low carb diet if carb was carbon? I for one could give up eating charcoal dead easy! LOL (not that I ever have, you understand)

 

[DeusXM]

Uh, guys...aren't we missing something here?

Livelee, are you 100% sure you've been diagnosed as Type 1?

In Type 1, you don't produce insulin, which puts your body into what is known as diabetic ketoacedosis, which is fatal if left untreated. That means anyone with T1 must immediately be put on insulin. Until a T1 is on insulin, it is biologically impossible for them to store fat and impossible for them to use any energy source other than their own muscles and body fat, which is why T1s classically present as significantly underweight on diagnosis.

The good news is with insulin treatment, normal body weight is re-established fairly quickly...in fact, then the problem becomes inverted as insulin promotes fat storage.

If you are genuinely a T1, your diet is not not your immediate cause for concern, it's your treatment method you should be concerned with. That's why it is crucial you are 100% certain as to which type of diabetes you have. If it is definitely T1, you CANNOT wait four weeks for an assessment, you need to see a specialist NOW, as in you need to be at a hospital or GP surgery tomorrow morning whatever happens. I don't want to panic you but inappropriately treated T1 is acutely more dangerous than untreated T2, so if you are certain you have been diagnosed as T1, do not delay.

 

[Northerner]

DeusXM, Livelee's diabetes appears to have been induced by several courses of steroids. I think this is different to straightforward T1 as there may still be some insulin production, albeit reduced - the gliclizide may prompt more, and I think it's possible the pancreas can recover, as it's not autoimmune. I think we've had one or two members in this situation. Also, LADA can mean you may go months producing a reduced amount of insulin and not therefore getting DKA (this was me until I got a virus that pushed my pancreas over the edge, I was about 18 months with pretty pronounced symptoms that I ignored!)

 

[Mark T]

Well steroids generally cause insulin resistance, so DeusXM's suggestion that it may not be Type 1 per se (which by definition is autoimmune) is valid.

But it's probably not technically Type 2 either.

Really Livelee needs the checks for autoimmune markers to confirm.

 

[Northerner]

Ah yes, good point Mark, I got the steroid effect confused 🙄😱

 

[Robin]

I was initially diagnosed by my GP as Type 2, because of my age, and put on Gliclazide, even though I was losing 1-2 lbs a week. I couldn't take Metformin because my liver results were sky high. ( They returned to normal fairly quickly, Hospital later said my liver got angry because of the high glucose levels.)When I finally got a hospital appointment four months later, they tested me for anti-GAD antibodies which confirmed I was type 1, and I went on to insulin at that point. but in the meantime the Gliclazide plus a self imposed very low carb diet had lowered my A1c from 15 to about 8 or 9, so I obviously had a bit of residual insulin left. I think the older you are, the slower your insulin production declines, and you can still be walking round for months, albeit not feeling your best!