Doubly whammy diagnosis

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befuddled

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Type 2
Hello all,
I am hoping that I can get some information and advice on here about my slightly unusual situation. I am hoping there may be some on here who have similar issues.
I have been unwell for the last 18 months with huge weight loss etc etc and was diagnosed with Crohn's of the small bowel in 2010. A major diagnosis which meant long hospital stays, and horrid investigations and treatment. This meant that initially I was on a fluid only diet for many weeks, initially tube fed and now have to follow a very low residue/fibre diet.
Because of the treatment I have had/am having and my family history ( 99% of my mothers side have type 2 diabetes - none follow a good diet and are overweight so can't help me out) I have developed steroid induced diabetes.
My problem is that I have to gain weight as my BMI is only 15. Due to crohn's I cannot have high fibre food as it could cause my small bowel to obstruct, I cannot tolerate too much fat and I can only eat really small portions.
And now I find I have diabetes so no sugar. AAAAgh

To say I am am gutted, fed up and bewildered is an understatement.

So my mission on here is to try and get some tips on food and diabetes, I know what I can have regarding my crohn's as I have seen a dietician regarding many times. I am not sure what I can and can't have as regard to diabetes though...I have a sweet tooth which isn't good and want to know what things I can have that are sweet and won't raise my sugars and won't mess with my crohn's..for example how much fruit juice, what about honey etc.

Very rambling post, sorry.
 
Hi befuddled, welcome to the forum 🙂 Very sorry to hear of your diagnosis, a real blow after your Crohn's diagnosis as well :(

I would recommend having a look at books on the Glycaemic Load Diet, some good examples here:

http://www.diabetessupport.co.uk/boards/showthread.php?t=7719

http://www.diabetessupport.co.uk/boards/showthread.php?t=7337

Hopefully, by reading the suggestions there you will be able to find food combinations that will help you increase your weight and still fit within your Crohn's requirements. The key thing with diabetes is to eat foods that are slow-release carbohydrates, so that the effects on your blood sugar levels are lessened. Unfortunately, a great deal of the literature on diets suitable for diabetics assume that weight-loss is desirable, rather than weight gain, and there are probably quite a few contradictory elements - like fibre is good for diabetics, but not for Crohn's.

It is possible, by using GL principles to combine sugary foods with other food in order to lessen the impact of those sugary foods on your blood sugar levels - for example, having a slice of cake with a main meal will have less impact than having it on its own.

Do you have a blood testing meter? If not, then do ask your doctor for one, as this will help you to work out what food you can tolerate, and in what quantities without having too great an effect on your blood sugar. If you can find some high calorie foods that don't affect your levels, then hopefully you will be able to bulk up your food in this way. There are links to extra reading matter in our 'Useful Links' thread.

We have quite a few members who have to juggle different dietary requirements, so hopefully they will be able to give you more advice. Is there any possibility of getting an appointment with a dietician who can advise on suitable diets for both conditions? I know we have a member at the moment trying to combine diets suitable for diabetes and gout and she is finding it difficult to find information too, plus we have many with Coeliacs disease too. It's not easy because most information around appears to be targeted just at diabetes.

Please feel free to ask any questions you may have and we'll try our best to answer them! 🙂
 
Welcome to the forum befuddled.

I'd have thought a good dietician would be able to guide you. Do you have access to one? If not, I'd suggest you get one organised through your GP (assuming it is done that way, hopefully someone can correct me if I'm wrong).

But, hopefully you'll get some pointers from the kind and helpful bunch of people that this forum contains as well.

Andy 🙂

p.s. I missed Northey's bit about dieticians, but as I wrote mine before I saw his, I'll be darned if I'm going to remove it! :D
 
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Andy HB said:
p.s. I missed Northey's bit about dieticians, but as I wrote mine before I saw his, I'll be darned if I'm going to remove it! :D
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Ha Ha - one day Andy you'll get there first.

Welcome to the forum befuddled - Andy and Northerner are correct - you need to see a good dietician, so that you are able to balance the requirements for diabetes and crons and still get all the nutrients you require. Some GP surgeries have their own dietician - though it may be better to get a referral to a hospital dietician as they are more likely to have come across balancing several conditions.
 
Welcome to the forum befuddled 🙂
 
Hi and a warm welcome to the forum.

Well, I am Diabtes Type 2 and my 19 year old son, Danni, has Crohns...But how the 2 would mix I imagine is difficult. Crohns I think is the more difficult to cope with.

My son was newly diagnosed this January after being rushed into hospital and had a long 2 week stay in hospital. He is on Pentassa and seems to be doing ok...I have been told to feed hom lots of Fibre Whilst he is in remission, and Low residue if he has a Flare or becomes unwell!...It is a minfeild, both Crohns and Diabetes!

I am sorry I cannot offer much advice...I am sure, with the help of Dietician and here that you may be able to find some useful information.

Best of luck, Ellowyne x
 
Welcome Befuddled - great name for anyone with combined problems of type 2 diabetes and Crohns and needing to gain weight. I can only reiterate the advice to seek help from a specialist dietician to help you with all conditions. Please keep asking to be referred (particularly any hospital based doctors who are probably best placed to make referrals) and don't take no for an answer.
 
Thanks everyone for your replies. I shall take a look at those books and try and get my head round the glycaemic index. I think I may have to recontact
my Crohn's dietician as it seems the diets are virtually polar opposites which is what befuddles me. Once I had come off the liquid only 'diet' and got high energy supplement drinks we didn't arrange to meet again. Now I can't have those drinks either as they are relatively high in sugar so perhaps I should recontact her.
@ ellowyne sorry about your son. Hope his Crohn's is under control. I am on azathioprine and prednisolone for my Crohn's which seems to be starting to work for me at last. My Crohn's is small bowel- jejunum/ ileum and I have narriwings there. They are hopeful these may resolve with the drugs in which case I can start to reintroduce fibre again but at the moment high fibre foods just make me sick.
From reading some of the replies it seems I may be able to have some sugar then - I thought sugar was just a no no. I may need to think about getting a blood glucose monitor as well.
 
befuddled said:
Thanks everyone for your replies. I shall take a look at those books and try and get my head round the glycaemic index. I think I may have to recontact
my Crohn's dietician as it seems the diets are virtually polar opposites which is what befuddles me. Once I had come off the liquid only 'diet' and got high energy supplement drinks we didn't arrange to meet again. Now I can't have those drinks either as they are relatively high in sugar so perhaps I should recontact her.
@ ellowyne sorry about your son. Hope his Crohn's is under control. I am on azathioprine and prednisolone for my Crohn's which seems to be starting to work for me at last. My Crohn's is small bowel- jejunum/ ileum and I have narriwings there. They are hopeful these may resolve with the drugs in which case I can start to reintroduce fibre again but at the moment high fibre foods just make me sick.
From reading some of the replies it seems I may be able to have some sugar then - I thought sugar was just a no no. I may need to think about getting a blood glucose monitor as well.
Click to expand...
Actually, I think you'll find they aren't polar opposites; partly because I disagree strongly with the high-carb low-fat advice that you will get for diabetes from the majority of dieticians.

I suggest that you look at it in stages. This is how I understand it (correct me if I'm wrong).

The primary and urgent need for you is to eat appropriately for Crohns.

The secondary need is to correct your weight loss and return to a healthy weight.

The long-term need is to achieve both of those without causing diabetes complications.

You already have advice from your medical advisors on the foods to avoid for Crohns. Working within those limitations, increase your intake of the allowed foods to start your return to normal weight. As you do that, test your menu to see what the effects are on your peak post-meal blood glucose levels and review that menu for better results.

On changing the foods you eat, whether increasing or decreasing, stop worrying about what you like. When I look back over the past nine years I am quite amazed at the foods I have come to like - and to dislike - once I finally accepted that my life literally depends on it. There is no food that I like more than I like my eyesight, my toes or my kidneys.

This will help you review your Crohn's menu for your diabetes: (click on it): Test, Review, Adjust

And a final very important point. Stop thinking diabetes is about sugar and start thinking it is about carbohydrtates. Treat sugar as just another carb.
 
I think Alan is right about the sugar. It is just another carb.

However, the main issue is that because it is so heavily refined, it hits the blood stream very quickly. It is also what they call empty calories because it has no fibre attached to it. I think that is why it is considered public enemy no.1 for diabetics.

But, there are some things that I still need a bit of sugar for (instant coffee being one!).

Andy 🙂
 
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