Diagnosed T2 yesterday. A lot to take in.

[Janwel]

Hello everyone. Went to see Practice Nurse for a healthy heart check and was diagnosed T2. Advised to lose weight, be more active and take Metformin and go back in 12 weeks for new reading and will then be offered a statin. I was always aware that my weight was a risk factor for diabetes etc but struggled to give it priority it needed. Waiting to join hospital education programme too and also retinal screening. Out of the blue as no symptoms but with hindsight is not a surprise. Going to take this seriously from now on and appreciate support available here.

 

[Snowwy]

Hi @Janwel , welcome to the forum.
You WILL certainly get a wealth of support here.
Fairly new myself and it is a lot to take in.
There will be others who will point you to various other links to help you get to grips with it.
Ask loads of questions and take it one day at a time.
Someone said 'a marathon not a sprint'
Cheers

Snowwy

 

[Felinia]

Hi Janwel
Yes a lot to take in, but your surgery sounds on the ball with the information you have been given so far. Sadly not all GP surgeries are as good as yours or mine. What was your HbA1c reading, your cholesterol readings, and your Metformin dosage? It will help others advise you. I too was not surprised when first diagnosed, as I knew my eating habits were not as good as they should be, I was overweight, and inactive. But you can start to turn things around in 3 months, like I did.
Before your education course, I suggest you use this website for 2 things - Maggie Davies letter (I'm sure someone will post the link) and to work your way through the Type 2 Training programme, a couple of modules at a time, to take it all in. That way you can build up a list of questions and go prepared for the course. Like many 60+ year olds I had all the physical excuses under the sun not to exercise, but my Diabetes Specialist Nurse (DSN) suggested Aquafit. I hadn't been in a pool for years but have built up to 4 classes a week and it's made an enormous difference to my mobility and fitness, and so far I've lost 17 pounds.
As for food, the most important thing is to reduce carbs, not just sugar which is a type of carb. That means bread, potato, rice, pasta, cereals, fruit juice as well as the obvious cakes, biscuits, pastries, sweets. DUK recommends less than 130gm carbs per day, but most of us go much lower, some from need and some from choice. I experimented and settled on 75gm +- 15gm per day. We are all different and have to find what suited us best. There are suitable substitutes out there, like cauliflower rice, Bare Naked noodles, low carb bread. Lots of posts and suggestions on the food section of the forum.
I joined a website which measures the cals, carbs, sugars, protein, fat, sat fat, fibre and salt, for every item of food, and maintains a diary per meal, per day and per week. That way you know exactly where you are and I plan a day in advance. I also cook from scratch and freeze in individual portions. Today is typical: I had poached egg, grilled tomatoes and mushrooms for breakfast. Lunch will be home made vegetable soup, into which I will put some chopped chicken. Dinner will be baked fish (not breaded or battered), carrot and swede puree (instead of mash), cauliflower, runner beans. As a treat I have 80gm frozen berries and a dessertspoon of plain Greek yogurt. In addition I have 170ml milk for tea and a mini Benecol drink to lower my cholesterol (I'm severely allergic to statins). In total I've come out at 76gm carbs of which 43gm are sugars. I occasionally do have oats at breakfast, with unsweetened nut milk.
People will advise you to test yourself so I'll leave them to tell you about that. I did at first to discover what foods did or did not affect me. I learned potato and apples were lethal for me, but I could take a small amount of low carb bread or oats. Other people find different foods affect them - it's very individual. Now I just test when I have a new food.
Please ask as many questions as you like - we've all been there and I certainly asked plenty! Best wishes

 

[Jodee]

Welcome Janwel

Sounds like you are taking the right steps in the initial months of diagnosis.
Desmond educational course and the self referral Xpert course and both good. https://www.xperthealth.org.uk/

 

[Toucan]

Hello @Janwel, welcome and so pleased that you have joined the forum
As you can see from the messages already sent there are many of us here who have all had similar experiences to you, and are very willing to help you find your way through.

The link that @Felina mentioned is Maggie Davey's letter, what this lady did to control her diabetes.
There is no on-size-fits-all though and you need to work out what works best for you, and there are several options.

Many of us find that reducing carbohydrates has a very beneficial effect on reducing blood sugar readings and weight loss.
It will help if you can find out which foods cause your blood sugars to rise, and eventually arrive at a lists that lets you maintain good blood sugar levels, that you enjoy eating, and fits your lifestyle in terms of how much preparation and cooking you like and have time to do.

A glucose monitor is a way to find this out, and one of the most affordable meters is the SD Gluco Navii

There is a lot to take in and adjustments to be made, but be assured it will be well worth it, and many of us end up feeling healthier and more energetic than we have for years.

If you browse around the forum you will find help on all sorts of topics, and please ask any questions and there will be many of us here to help.

 

[Janwel]

Thank you for the helpful replies re my t2 diagnosis yesterday. Nothing at all was mentioned to me about testing - just the review in 12 months time. My Hba1c at diagnosis was 56. My cholesterol is 49. My metformin will start on 1x500mg for 7 days and then 2x500g thereafter. My bmi is high risk (over 30). I need to

 

[Janwel]

Thank you for the helpful replies re my t2 diagnosis yesterday. Nothing at all was mentioned to me about testing - just the review in 12 months time. My Hba1c at diagnosis was 56. My cholesterol is 49. My metformin will start on 1x500mg for 7 days and then 2x500g thereafter. My bmi is high risk (over 30). I need to

Manage weight loss while also controlling carb/sugar intake. 12 WEEKS not months

 

[Toucan]

Hello @Janwel,
Thanks for the update. 56 HBa1c, although in the Diabetes range is not too bad, but you will need to aim to get it down into the 40's. Many of us (including me) started much higher than that, so getting it down is well within scope.

Testing is purely optional, and unfortunately in many circumstances not funded by the NHS, so they often don't suggest it.
Personally I would find it quite difficult to manage without doing this, as I would not be able to measure what particular foods spiked my blood sugar, and also would have no idea of progress between annual blood tests.
There are many members however that don't use a tester and still get good results.

May be it is something to consider a little bit further along, as there are many other things to get used initially

 

[Felinia]

I am surprised in some ways that you were put straight on Metformin - some GP surgeries take a more conservative option and some go thundering in straight on medication when the reading hits 48+. My starting HbA1c was slightly higher than yours and I was given the opportunity to lower my level by diet and exercise alone. I took it and got my level down to 48 in 12 weeks. Also my cholesterol and BMI were higher than yours. I can't take statins but by diet and exercise managed to lower those as well. The side effects of Metformin are diarrhoea and cramps. You are best advised to take the Metformin in the middle of your meals. Alternative 2 is to ask for slow release Metformin, and alternative 3 is to ask for 3 months grace to see what diet and exercise alone can do.

 

[Tee G]

Hi @Janwel - welcome. You have had good stead advice here, not much else to say other than - dont panic! Allow yourself time to properly absorb all this new information. You will need determination and focus - we are all a little scared and nervous about this strange road ahead of us. BUT its doable. I never thought I could give up half the thing ive had to , but you know what....I would never go back. I enjoy what I eat, theres plenty of choice, (loads of good food idead here on this site, go poke around, its fascinating) - with just a little care and prep you can eat well and varied and love life. I think the the secret is, 'be mindful' - 'get moving' - and 'embrace change'. Good luck and please let us know how you are getting on. All the best.

 

[Martin9]

Hi @Janwel
it’s all a bit scary at first welcome to a club no one wants to be in, but follow the advice above from all those great advice posts above and your next HbA1c will be much reduced, remember Diabetes 2 just needs a lifestyle change, get on top of it and you might be able to get off meds..
best wishes
M.

 

[Neens]

Hello everyone. Went to see Practice Nurse for a healthy heart check and was diagnosed T2. Advised to lose weight, be more active and take Metformin and go back in 12 weeks for new reading and will then be offered a statin. I was always aware that my weight was a risk factor for diabetes etc but struggled to give it priority it needed. Waiting to join hospital education programme too and also retinal screening. Out of the blue as no symptoms but with hindsight is not a surprise. Going to take this seriously from now on and appreciate support available here.

Welcome to the forum - this is a very supportive group with lots of knowledge and experience. It seems millions of people have no symptoms. Looking back I had some but they were listed as side effects of other meds I was on after an operation so I didn't consider intervention. I did ask for my bloods to be done on the 3rd infection in 12 months as generally I'm fit/healthy. So was out of the blue - like you.
The DUK website is good - check out the Learning Zone - whilst you wait for education course (mine isn't until next month) - also lots of informative threads and recipes etc. And all those links and tips everyone else has posted.

 

[JMyrtle]

My understanding is that the N. I. C. E regulations don't recommend going onto medication until your b/g goes over 60.

On diagnosis with a reading of I think 58 I was told to change my diet and come back in six months by which time I gone down to normal levels.

 

[grovesy]

I don't think that is right I have never had a HBA1C over 60 and I have been on medication/medications a number of years. If I remember correctly I was put on medication when the HBA1C hit 7.0%(now the equivalent of 53).

 

[Drummer]

I would argue that you have not got the most important information about type two diabetes.
A type two cannot cope with carbohydrates in the diet.
Most can manage to deal with a few - many people start off eating around 50 gm a day, and monitor their recovery using a blood glucose meter.
Once the BG levels get close to normal the metabolism starts to improve and we begin to lose weight, feel more active and energised, so there is confusion about what causes which.
Metformin can cause drastic upsets of the gut, which was why my tablets ended up in the bin - combined with Atorvastatin I was only fit for a care home.

 

[Felinia]

I too was told by my GP surgery that they don't medicate until over 60. And I have to say my GP surgery is very much on the ball and up to date in all things - I'm so lucky

 

[NotWorriedAtAll]

Hello everyone. Went to see Practice Nurse for a healthy heart check and was diagnosed T2. Advised to lose weight, be more active and take Metformin and go back in 12 weeks for new reading and will then be offered a statin. I was always aware that my weight was a risk factor for diabetes etc but struggled to give it priority it needed. Waiting to join hospital education programme too and also retinal screening. Out of the blue as no symptoms but with hindsight is not a surprise. Going to take this seriously from now on and appreciate support available here.

Hello Janwel.

I was diagnosed a year ago or so and straight away cut carbs and felt loads better immediately.
I enjoy cooking so I enjoy the creative challenges of making delicious meals without carbs.

It is actually very easy to make amazing food that is a million times nicer than carb laden stuff and baking in particular is much easier because carb free baking can be done in the microwave in moments instead of having to use a convection oven. Also a lot of classic cooking involves using cream and butter and herbs and small amounts of garlic and other flavours so in some respects I've found keto food much nicer.

The downside is that while my health has improved and my blood sugars are fine, my blood pressure is better than ever and my cholesterol levels are good too - alas after the first six months of weight loss I've reached a plateau. Probably because I don't do enough exercise. So that's my challenge for this year but I will be losing weight for me and my own preference to be less of a waddler and not because it is needed for my health.

I hope you don't get too downhearted - the great thing is that type 2 diabetes is something you can conquer without meds if you cut the carbs, increase your water intake and fibre intake and don't get stressed - because stress makes everything including blood sugars worse.

 

[grovesy]

I have looked at the NICE guidelines and 53 seems to be level they are suggesting to aim to be below. Wether it be diet, or medication, and if that level is not achieved to add to the medication.

 

[Felinia]

I have looked at the NICE guidelines and 53 seems to be level they are suggesting to aim to be below. Wether it be diet, or medication, and if that level is not achieved to add to the medication.

Yes, I too looked up the NICE Guidelines and have copied them over. I'd be interested in other people's interpretations, because I read it that as soon as a person is Type 2, regardless of HbA1c, even 48, they should be put straight on standard release Metformin. If they go above an HbA1c of 58 the medications should be increased. They should aim to get below 53 but no mention of being taken off Metformin. From the posts I have read here some people are put on Metformin with an HbA1c of 48, so clearly some GPs have reached the same conclusion. I am SO GLAD my GP gave me the opportunity to try diet and exercise alone first.

It also explains why Type 2 are not routinely given monitoring equipment.

Blood glucose management

• Involve adults with type 2 diabetes in decisions about their individual HbA1c target. Encourage them to achieve the target and maintain it unless any resulting adverse effects (including hypoglycaemia), or their efforts to achieve their target, impair their quality of life. [new 2015]
• In adults with type 2 diabetes, if HbA1c levels are not adequately controlled by a single drug and rise to 58 mmol/mol (7.5%) or higher:
  
  • reinforce advice about diet, lifestyle and adherence to drug treatment and
  • support the person to aim for an HbA1c level of 53 mmol/mol (7.0%) and
  • intensify drug treatment. [new 2015]
  
  
• Do not routinely offer self‑monitoring of blood glucose levels for adults with type 2 diabetes unless:
  
  • the person is on insulin or
  • there is evidence of hypoglycaemic episodes or
  • the person is on oral medication that may increase their risk of hypoglycaemia while driving or operating machinery or
  • the person is pregnant, or is planning to become pregnant. For more information, see the NICE guideline on diabetes in pregnancy. [new 2015]

Drug treatment

• Offer standard-release metformin as the initial drug treatment for adults with type 2 diabetes. [new 2015]
• In adults with type 2 diabetes, if metformin is contraindicated or not tolerated, consider initial drug treatment[1] with:
  
  • a dipeptidyl peptidase‑4 (DPP‑4) inhibitor or
  • pioglitazone[2]or
  • a sulfonylurea. [new 2015]

 

[Felinia]

Further into the NICE guidelines I found this chart which I hope I have successfully linked. I also found buried further down in the guidelines, the suggestion that people can actually try and manage by diet and exercise. Reading guidelines can be a minefield of vagueness and confused advice!!

"For adults with type 2 diabetes managed either by lifestyle and diet, or by lifestyle and diet combined with a single drug not associated with hypoglycaemia, support the person to aim for an HbA1c level of 48 mmol/mol (6.5%). For adults on a drug associated with hypoglycaemia, support the person to aim for an HbA1c level of 53 mmol/mol (7.0%). [new 2015] "