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SarahGell

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Relationship to Diabetes
Type 2
I'm Sarah, been coping/ignoring type 2 diabetes for a number of years. I became really depressed, thought that if I ignore it - it would go away... now I have a wound that won't heal so I know it's time to take action. I'd be grateful for any support or positive comments.

Thanks
 
Hello and welcome. We're a friendly bunch and happy to help where we can. It would help us if you could tell us a bit about yourself and your diabetes so we can tailor our replies. For example, your most recent HbA1c, medications you are on, any other medical conditions, your lifestyle (food and exercise). My history is in my signature below.
Do you have any specific questions or worries? I've found since being diagnosed I take longer to heal, so I just keep everything clean, bathe the injury in salt water and wait. A recent gash I also treated with Germolene on a dry dressing. You may need to contact your GP surgery and see a nurse.
 
Hi Felinia,

Thanks for reaching out to me - bear with me whilst I cut and paste my results:
'I undertook a telephone consultation with Sarah this morning. Unfortunately from a diabetes point of view things remain unchanged and her HbA1c checked in February was 87. This is despite Trulicity 4.5 mg weekly and Metformin which she can only tolerate at a maximum dose of 1.5 g daily. I understand that she has been prescribed alogliptin but I do not think that this would be very beneficial in combination with Trulicity and I would recommend starting Sarah on empagliflozin 25 mg daily. I be most grateful if you could provide her with a prescription. From a lipid point of view her latest lipid profile shows a total cholesterol 4.6 triglycerides of 5 (which I think is largely related to her hyperglycaemia) HDL cholesterol of 1 and LDL cholesterol of 1.7.'

That's an extract from the copy of the letter I got....
I don't really understand most of it. However, I'm determined to learn and change.

My wound is currently being treated with dressings twice a week. It's not massive but it just won't heal.
 
OK. You are on the maximum dose of Trulicity, and 3/4 maximum dose of Metformin.
Empagliflozin (which is from the same family as Canagliflozin that I take) reduces blood glucose through your urine. You have to drink a lot, so of course pee a lot!! I basically had to double my water intake once I started taking it.
I also take Linagliptin which is of the same family as Alogliptin. I would trust your diabetic specialist if they think Alogliptin taken with Trulicity would not suit you, possibly related to your other medical conditions.
I can only stomach (literally) 500mg SR Metformin.
Your total cholesterol is lower than mine! I believe medical practitioners would like to see total cholesterol lower than 4 in diabetics, but if you are not taking statins and have not been advised to take them, that's OK.
Your HbA1c (pardon me for saying) is high, and you are doing the right thing in thinking you need to take action. The best way you can help yourself is through looking at your food and exercise. It is suggested many Type 2 diabetics can lower their blood glucose by reducing their daily carb intake to less than 130gm a day.
I don't know what your diet looks like, but you can get an app which will record all your cals and carbs, by meal and by day. This is what I do, and have done since I was diagnosed. I keep digital scales and a clear bowl on my kitchen top and weigh most foods (except salads and above ground veggies) - no guesstimating.
Once you know where you are starting from, you can gradually reduce your carb intake (not too quickly as that can affect your eyes). Everyone is different so it's trial and error until you find out what suits your body. I experimented between 50gm and 130gm and currently have settled on 75gm, sometimes going up to 90gm. It may seem hard at first, particularly if you're a lover of bread, potato, rice and pasta, but it's amazing how quickly you can adapt to smaller portions or substitutes. I have a mixture of Tesco Slim shakes with water/almond milk, eggs in all forms with veggies (omelettes, crustless quiche, frittata), home made soups, salads. My evening meal contains at least half a plate of veggies with a protein source.
Exercise also helps. I started aquafit 4 years ago and go 2 or 3 times a week. We are all ladies of a certain age, all shapes and sizes! But it could be as simple as a daily walk (with or without dog). My 80+ neighbour cycles twice a week. I also have a mini exercise bike which I used in lockdown, or there are online videos (Joe Wicks).
People have said managing diabetes is a marathon, not a sprint, so it's best to take it one step at a time and build up. I hope this helps a bit, and I'm sure lots of other people will chip in. The Forum is a great place to get information, as is the Learning Zone, orange tab above. I post my food daily on the Food/carb queries forum, with lots of pictures.
Today's lunch and dinner: 250 ml homemade butterbean and sweetcorn soup: 115gm baked salmon, homemade ratatouille, 2 new potatoes

Butterbean and sweetcorn chowder.JPGSalmon with ratatouille.jpg
 
Last edited:
Many do find a low carb approach is successful at reducing your blood glucose as medication can only do so much, low carb being no more than 130g per day total carbs not just sugar.
When you have an overflowing sink (too much glucose) then you can bail out some water (take the meds) but unless you turn the tap off (reduce carbs ) then the sink will still over flow.
This link may help you with ideas for some dietary changes.
lowcarbfreshwell.co.uk

Freshwell Low Carb Project - Home

lowcarbfreshwell.co.uk lowcarbfreshwell.co.uk
 
Welcome to the forum @SarahGell

Sorry to hear what a difficult time you have had adjusting to your diabetes diagnosis. As you may have been told, elevated glucose levels can inhibit healing and restrict blood flow, which may exolain why your wound is slow to heal :(

I’m so pleased you’ve joined us though, and it’s great to hear that you have decided you want to get your diabetes to cooperate a little more. Diabetes can be a fickle and frustrating adversary, but with determination and a bit of experimentation, it is something that can usually be managed with a few changes and adaptations.

One of the tricky things is that it can be very individual - so there isn’t one single way that will work for everyone. You have to find a set of strategies that work for you, and which you can sustain.

Many members here find that gradually reducing their total carbohydrate content to a level that their body finds it easier to cope with (with the help of any medication they are advised to take). Do you have a blood glucose meter to check your levels at home?

Good luck! And ask away with any questions you have.
 
Hi and thanks for taking the time to reply.

I'm aware that I have not done anything to help myself in a long time. I had a bereavement and nothing else really mattered after that.

However, I'm determined to start looking after myself and take control.

I do have one of those little testing machines - can you tell me what the normal range is? I have just done a test and it's 11.4 but it has been as high as 17.8.

Thanks again.
 
Leadinglights said:
Many do find a low carb approach is successful at reducing your blood glucose as medication can only do so much, low carb being no more than 130g per day total carbs not just sugar.
When you have an overflowing sink (too much glucose) then you can bail out some water (take the meds) but unless you turn the tap off (reduce carbs ) then the sink will still over flow.
This link may help you with ideas for some dietary changes.
lowcarbfreshwell.co.uk

Freshwell Low Carb Project - Home

lowcarbfreshwell.co.uk lowcarbfreshwell.co.uk
Click to expand...
Hi and thank you for that information.

I have no idea how much carbs I should limit myself to. I have ordered a book... do I just look on the packet, or can you recommend an app? I will look at the link you sent.
 
Nutracheck is my favourite app. UK based with pictures of the packaging. I just paid about £24 for a year, there’s a 7 day free trial

Myfitnesspal is free but American

Carbs and cals has pictures of foods on plates, not sure of the cost

Or you can check k the packaging or somewhere like the Tesco app
 
Felinia said:
OK. You are on the maximum dose of Trulicity, and 3/4 maximum dose of Metformin.
Empagliflozin (which is from the same family as Canagliflozin that I take) reduces blood glucose through your urine. You have to drink a lot, so of course pee a lot!! I basically had to double my water intake once I started taking it.
I also take Linagliptin which is of the same family as Alogliptin. I would trust your diabetic specialist if they think Alogliptin taken with Trulicity would not suit you, possibly related to your other medical conditions.
I can only stomach (literally) 500mg SR Metformin.
Your total cholesterol is lower than mine! I believe medical practitioners would like to see total cholesterol lower than 4 in diabetics, but if you are not taking statins and have not been advised to take them, that's OK.
Your HbA1c (pardon me for saying) is high, and you are doing the right thing in thinking you need to take action. The best way you can help yourself is through looking at your food and exercise. It is suggested many Type 2 diabetics can lower their blood glucose by reducing their daily carb intake to less than 130gm a day.
I don't know what your diet looks like, but you can get an app which will record all your cals and carbs, by meal and by day. This is what I do, and have done since I was diagnosed. I keep digital scales and a clear bowl on my kitchen top and weigh most foods (except salads and above ground veggies) - no guesstimating.
Once you know where you are starting from, you can gradually reduce your carb intake (not too quickly as that can affect your eyes). Everyone is different so it's trial and error until you find out what suits your body. I experimented between 50gm and 130gm and currently have settled on 75gm, sometimes going up to 90gm. It may seem hard at first, particularly if you're a lover of bread, potato, rice and pasta, but it's amazing how quickly you can adapt to smaller portions or substitutes. I have a mixture of Tesco Slim shakes with water/almond milk, eggs in all forms with veggies (omelettes, crustless quiche, frittata), home made soups, salads. My evening meal contains at least half a plate of veggies with a protein source.
Exercise also helps. I started aquafit 4 years ago and go 2 or 3 times a week. We are all ladies of a certain age, all shapes and sizes! But it could be as simple as a daily walk (with or without dog). My 80+ neighbour cycles twice a week. I also have a mini exercise bike which I used in lockdown, or there are online videos (Joe Wicks).
People have said managing diabetes is a marathon, not a sprint, so it's best to take it one step at a time and build up. I hope this helps a bit, and I'm sure lots of other people will chip in. The Forum is a great place to get information, as is the Learning Zone, orange tab above. I post my food daily on the Food/carb queries forum, with lots of pictures.
Today's lunch and dinner: 250 ml homemade butterbean and sweetcorn soup: 115gm baked salmon, homemade ratatouille, 2 new potatoes

View attachment 24211View attachment 24212
Click to expand...
 
Wow Felinia!

So much useful information, thank you so much!

I am on Simvastatin (40 mg). My exercising is limited as I have a disability. I'm looking into 'cycling for the disabled', if I can pluck up the courage to go.

I don't want to come on this forum and just moan, but I have never had the opportunity to talk to others living with diabetes and even just these few posts have been brilliant.

Sarah.
 
Lucyr said:
Nutracheck is my favourite app. UK based with pictures of the packaging. I just paid about £24 for a year, there’s a 7 day free trial

Myfitnesspal is free but American

Carbs and cals has pictures of foods on plates, not sure of the cost

Or you can check k the packaging or somewhere like the Tesco app
Click to expand...
Thank you for the information, it's kind of you to reply. I'll check them out.
 
Morning Sarah. Just picked up your 2 posts.
First your blood prick tests. Yours are high at present. What you are aiming towards is 4-7mmol/l before eating, and no more than a 3mmol/l rise, up to 8.5mmol/l 2 hours after first bite. So please think of yourself as work in progress from today. But regular testing will help you learn what foods spike your glucose levels, so you can adjust. I can manage a couple of new potatoes or a medium slice from a 400gm wholemeal loaf, but rice, pasta and apples are lethal for me. Everyone is different which is why testing is important.
I use NutraCheck as it is UK based and I find very user friendly. So much easier than looking at all the packages or keeping paper or spreadsheet results and you can carry it around on your phone in the supermarket! Please Google their website as it is very informative. As Lucyr says, they have a free trial. As for the carbs, because you have quite a high level of blood glucose at present, it is VERY important to reduce your carbs slowly. If you go too quickly, it can affect your eyes, causing blurry vision. That does settle after a time so no need to see an optician.
Once you know what your current level of carb intake is, you can start to reduce it. The suggestion is to reduce it by a third for a couple of weeks, so your body can adjust, then keep chipping away until you get down to 130gm a day. After that it's up to you to find out what suits your body. I use my slow cooker a lot to make soups and casseroles, as I can control what goes into them. I then make up individual portions and freeze them. NutraCheck allows you to make up your own meal recipes and save them.
Welcome to a new healthier you!
 
A good starting point is to reduce your carb intake gradually to no more than 130g total carbs per day.
You can use a combination of looking at packets, tins etc, looking on shop websites at the nutritional information for total carbohydrates or on the apps people mention. I found the book Carbs and Cals really helpful and kept on my worktop with a digital scale as weighing everything (well anything carby) will give you a better idea of portion size.
But testing with your monitor will be the best way to see if you are tolerating that 1 slice of toast with your scrambled egg.
 
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