Hello from a newbie novice to the site - looking for advice!

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Grumm

Grumm

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Relationship to Diabetes
Type 2
Hi there, new to this site.
I have been diagnosed with type 2 for about 4 years. Taking Metformin and Dapagliflozin.
Have now been advised that I am 'borderline' to be prescribed insulin!! (Arghh). This I do not want to have to do. I've been a bit lax in the past following any sort of diet. I know that my previous eating habits have got me where I am today!. I blame that sweet tooth!
Anyhow, I am where I am! I'm looking for advice as to try and somehow get to a level where I am not 'borderline. I've altered my diet to reduce the carbs I'm eating. Taking brown bread and not white. (which used to be my downfall)! plus reducing potatoes. The dog doesn't know what's hit him as I'm now walking him more! (poor blighter). Is there anything I'm missing? There seems to be a vast array of advice (which is causing me reading blindness 🙂 ) but I'd love for some guidance from fellow people who are in the same position.
Also I'm developing Sore finger syndrome from the 9 self inflicted tests each day! I see there are some wearable type monitors. So also looking for thoughts on those such as costs, durability effectiveness etc.
Sorry for the missive. Hoping that some of you might take pity on me and reply (or whatever is protocol) after you've got this far and not been put to sleep.
Cheers
 
Hi @Grumm and welcome to the forum.
Sorry, I've lots of experience of finger-prick blood testing ( when to do it and which places on the fingers etc. ; but none with a Continuous Glucose Monitor since I was only ever interested in choosing meals to avoid blood glucose spikes, rather than longer Blood Glucose trends.

It's highly unlikely that you notice a different Blood Glucose response to brown bread than from white bread since they contain almost the same carbohydrates per slice. The amount of extra fibre in brown bread makes hardly any difference, so I'm afraid you need to look into either 'Low Carb/Keto bread ' which is expensive if bought; or to make your own bread. Lots of recipes on the internet, including keto mug bread' which you can make in a microwave.

I'm not in your position because one of those irritating people who took action straight away when diagnosed - so diet only, no medication. I discovered a Low Carb way of eating (against the Diabetes UK advice at the time), verified that it worked by using my BG meter to test meals; and then had normal BG levels within weeks leading to remission which I've maintained for the past 3 yrs.
So please feel free to ignore me!
 
Grumm said:
Hi there, new to this site.
I have been diagnosed with type 2 for about 4 years. Taking Metformin and Dapagliflozin.
Have now been advised that I am 'borderline' to be prescribed insulin!! (Arghh). This I do not want to have to do. I've been a bit lax in the past following any sort of diet. I know that my previous eating habits have got me where I am today!. I blame that sweet tooth!
Anyhow, I am where I am! I'm looking for advice as to try and somehow get to a level where I am not 'borderline. I've altered my diet to reduce the carbs I'm eating. Taking brown bread and not white. (which used to be my downfall)! plus reducing potatoes. The dog doesn't know what's hit him as I'm now walking him more! (poor blighter). Is there anything I'm missing? There seems to be a vast array of advice (which is causing me reading blindness 🙂 ) but I'd love for some guidance from fellow people who are in the same position.
Also I'm developing Sore finger syndrome from the 9 self inflicted tests each day! I see there are some wearable type monitors. So also looking for thoughts on those such as costs, durability effectiveness etc.
Sorry for the missive. Hoping that some of you might take pity on me and reply (or whatever is protocol) after you've got this far and not been put to sleep.
Cheers
Click to expand...
Unfortunately brown bread is no better than white - I don't eat grain at all to keep control close to normal.
Swede has replaced potato, I eat quite a lot of courgettes, cauliflower, cucumber, celery, aubergine, celeriac - also mushrooms and Lidl frozen stir fry - the two lowest carb versions.
Dapagliflozin actively reduces glucose so you need to make any changes gradually and try to keep a regular routine if you are not to have hypos or spikes. Carb counting will be essential, I suspect.
I only needed to do four tests maximum, as I ate twice a day, then could stop testing after breakfast as it was always good, used the evening meal to test reaction to foods.
 
Hi and welcome from me too.

The important thing is what you do from now on, not what you did or didn't do before.
Finger pricking shouldn't make your fingers sore and I went through a phase where I was testing 16+ times a day at oe stage to get the information I needed. I wonder firstly if you are using the same finger for all your testing? If so, alternate. Then you should be pricking the side of the finger not the pad itself which is usually a little more sensitive. Thirdly, make sure your lancing device is dialed down to the minimum depth you need. Also ensure your hands are warm so that blood flows easily, so you need a lower depth setting. Some people find running them under warm water or hugging a mug of tea helps. Some lancing devices are better than others too and generally the Accu-Check Fast Clix is considered the best on the market.

Going on from there, can I ask what it is about insulin which you are concerned about? I am Type 1 so I have no choice but I can assure you the prospect of injecting insulin is far more intimidating than the reality. Needles are absolutely teeny tiny....not much thicker than a human hair and only 4mm long, so very very short indeed and the pen injectors are easy to use. If you are unable to manage your BG levels well without insulin, then it is far better than the alternative of risking damage to the blood vessels and nerves in your eyes, feet and kidneys and the associated risks of damage and pain and loss of independence. It is however a pain having to think about all the ways that the insulin can affect your body and lifestyle and do quite a lot of planning and mental juggling to keep yourself safe. Hypos are scary at first but for me now that I am used to them and confident in dealing with them, they are mostly more of an inconvenience than anything else, but it does take time and trial and improvement to learn how to manage your diabetes with insulin, so if you can avoid that step then it is worth investing some effort into doing so.

I was actually misdiagnosed as Type 2 initially so I learned to go low carb from the start and despite going onto insulin later whch would allow me to eat a normal diet, I continue with low carb as I have found other health benefits from it. The key thing for me in making it sustainable was to introduce more fat because fat provides slow release energy and keeps you feeling full and in fact the low fat products that we have been encouraged to consume over most of our lifetime may actually have lead us to eat too much because the fat wasn't there to sate our hunger and the carbs release glucose fast to give us a surge of glucose and then a lull. I know I had got to the stage that I wanted food every couple of hours because I was hungry between meals despite eating far more than I do now. I cringe that I used to eat 4 slices of wholemeal toast with a whole tin of baked beans and think that was a healthy meal and then be hungry 2 hours later and be eating chocolate like it was going out of fashion! 1 slice of wholemeal toast is about 15g carbs which releases the same amount of glucose as 3 spoons of sugar, so 4 slices of bread would be like 12 spoons of sugar without considering the carbs in the beans and the sauce which is also very significant! I very very rarely eat bread now and I don't eat baked beans at all. It took time to get my head around not eating bread particularly as it is a carrier for so many foods, but also potatoes and pasta and rice and all those other grain products on a regular basis and drastically reducing my portion size on the odd occasion when I do have them. Porridge was the last grain product to go from my daily diet when I saw what it did to my BG levels, even the best jumbo oats made into porridge with water. Now I have creamy full fat Greek natural yoghurt for breakfast with mixed seeds and a few berries and usually a sprinkle of cinnamon and perhaps just a very small sprinkle of nutty granola to improve the crunch. That works really well for many of us here as a low carb breakfast option..... or eggs however you like them. I prefer omelettes as they don't have a runny yolk which begs for bread to soak it up or as a carrier like with scrambled eggs. You can also add lots of different filling to give variety and I serve it with a large side salad and a big dollop of coleslaw and that will keep me going until tea time without needing to think about lunch or maybe just have a few nuts or cheese at lunchtime.
You can still have steak and ships, but ships are made with celeriac or swede instead of potato and cauliflower makes a great substitute for mash. No pealing, boils quicker and mashes easily. Add a good dollop of cream cheese and a teaspoon of mustard and serve it with a sprinkle of grated cheese and some high meat content bangers and green beans or broccoli and you have a tasty filling meal. I am having a halloumi and cauliflower curry tonight served on a bed of shredded cabbage (instead of rice) sweated in the microwave in a little butter. Yum! You might not like these meals but it gives you an idea of eating normal meals with with the high carb foods substituted for lower carb options.
 
ianf0ster said:
Hi @Grumm and welcome to the forum.
Sorry, I've lots of experience of finger-prick blood testing ( when to do it and which places on the fingers etc. ; but none with a Continuous Glucose Monitor since I was only ever interested in choosing meals to avoid blood glucose spikes, rather than longer Blood Glucose trends.

It's highly unlikely that you notice a different Blood Glucose response to brown bread than from white bread since they contain almost the same carbohydrates per slice. The amount of extra fibre in brown bread makes hardly any difference, so I'm afraid you need to look into either 'Low Carb/Keto bread ' which is expensive if bought; or to make your own bread. Lots of recipes on the internet, including keto mug bread' which you can make in a microwave.

I'm not in your position because one of those irritating people who took action straight away when diagnosed - so diet only, no medication. I discovered a Low Carb way of eating (against the Diabetes UK advice at the time), verified that it worked by using my BG meter to test meals; and then had normal BG levels within weeks leading to remission which I've maintained for the past 3 yrs.
So please feel free to ignore me!
Click to expand...
 
Sadly many people don't realise that is is all carbohydrates which convert to glucose so continue to have those things and then they require more and more medication. A bit like an overflowing sink (high blood glucose), it will still overflow despite bailing water out (taking meds )unless you turn the tap off (reducing carbs).
I know I am a bit of a fan of the low carb approach so suggest you look at this link for some good explanation and ideas for modifying your diet. https://lowcarbfreshwell.com/
 
ianf0ster
Thanks for the reply.
Interesting about bread. My diabetes nurse was specific about having brown over white. Perhaps I should have paid more heed when first diagnosed. I'd probably not be where I am now.
I'll look up low carb/Keto bread. Appreciate that advice.
As for ignoring people.. not in my nature.
All the best.
 
Drummer said:
Unfortunately brown bread is no better than white - I don't eat grain at all to keep control close to normal.
Swede has replaced potato, I eat quite a lot of courgettes, cauliflower, cucumber, celery, aubergine, celeriac - also mushrooms and Lidl frozen stir fry - the two lowest carb versions.
Dapagliflozin actively reduces glucose so you need to make any changes gradually and try to keep a regular routine if you are not to have hypos or spikes. Carb counting will be essential, I suspect.
I only needed to do four tests maximum, as I ate twice a day, then could stop testing after breakfast as it was always good, used the evening meal to test reaction to foods.
Click to expand...
Drummer,
Thank you for that information.
I'm going down the more veg less carb type foods. I go to Lidl and look for that suggestion. A case of re-education for me.
Thanks for taking the time to reply.
Cheers
 
rebrascora said:
Hi and welcome from me too.

The important thing is what you do from now on, not what you did or didn't do before.
Finger pricking shouldn't make your fingers sore and I went through a phase where I was testing 16+ times a day at oe stage to get the information I needed. I wonder firstly if you are using the same finger for all your testing? If so, alternate. Then you should be pricking the side of the finger not the pad itself which is usually a little more sensitive. Thirdly, make sure your lancing device is dialed down to the minimum depth you need. Also ensure your hands are warm so that blood flows easily, so you need a lower depth setting. Some people find running them under warm water or hugging a mug of tea helps. Some lancing devices are better than others too and generally the Accu-Check Fast Clix is considered the best on the market.

Going on from there, can I ask what it is about insulin which you are concerned about? I am Type 1 so I have no choice but I can assure you the prospect of injecting insulin is far more intimidating than the reality. Needles are absolutely teeny tiny....not much thicker than a human hair and only 4mm long, so very very short indeed and the pen injectors are easy to use. If you are unable to manage your BG levels well without insulin, then it is far better than the alternative of risking damage to the blood vessels and nerves in your eyes, feet and kidneys and the associated risks of damage and pain and loss of independence. It is however a pain having to think about all the ways that the insulin can affect your body and lifestyle and do quite a lot of planning and mental juggling to keep yourself safe. Hypos are scary at first but for me now that I am used to them and confident in dealing with them, they are mostly more of an inconvenience than anything else, but it does take time and trial and improvement to learn how to manage your diabetes with insulin, so if you can avoid that step then it is worth investing some effort into doing so.

I was actually misdiagnosed as Type 2 initially so I learned to go low carb from the start and despite going onto insulin later whch would allow me to eat a normal diet, I continue with low carb as I have found other health benefits from it. The key thing for me in making it sustainable was to introduce more fat because fat provides slow release energy and keeps you feeling full and in fact the low fat products that we have been encouraged to consume over most of our lifetime may actually have lead us to eat too much because the fat wasn't there to sate our hunger and the carbs release glucose fast to give us a surge of glucose and then a lull. I know I had got to the stage that I wanted food every couple of hours because I was hungry between meals despite eating far more than I do now. I cringe that I used to eat 4 slices of wholemeal toast with a whole tin of baked beans and think that was a healthy meal and then be hungry 2 hours later and be eating chocolate like it was going out of fashion! 1 slice of wholemeal toast is about 15g carbs which releases the same amount of glucose as 3 spoons of sugar, so 4 slices of bread would be like 12 spoons of sugar without considering the carbs in the beans and the sauce which is also very significant! I very very rarely eat bread now and I don't eat baked beans at all. It took time to get my head around not eating bread particularly as it is a carrier for so many foods, but also potatoes and pasta and rice and all those other grain products on a regular basis and drastically reducing my portion size on the odd occasion when I do have them. Porridge was the last grain product to go from my daily diet when I saw what it did to my BG levels, even the best jumbo oats made into porridge with water. Now I have creamy full fat Greek natural yoghurt for breakfast with mixed seeds and a few berries and usually a sprinkle of cinnamon and perhaps just a very small sprinkle of nutty granola to improve the crunch. That works really well for many of us here as a low carb breakfast option..... or eggs however you like them. I prefer omelettes as they don't have a runny yolk which begs for bread to soak it up or as a carrier like with scrambled eggs. You can also add lots of different filling to give variety and I serve it with a large side salad and a big dollop of coleslaw and that will keep me going until tea time without needing to think about lunch or maybe just have a few nuts or cheese at lunchtime.
You can still have steak and ships, but ships are made with celeriac or swede instead of potato and cauliflower makes a great substitute for mash. No pealing, boils quicker and mashes easily. Add a good dollop of cream cheese and a teaspoon of mustard and serve it with a sprinkle of grated cheese and some high meat content bangers and green beans or broccoli and you have a tasty filling meal. I am having a halloumi and cauliflower curry tonight served on a bed of shredded cabbage (instead of rice) sweated in the microwave in a little butter. Yum! You might not like these meals but it gives you an idea of eating normal meals with with the high carb foods substituted for lower carb options.
Click to expand...
Holy Moley!!
Wow, what a reply!
There is so much information I'm going to print this off to read and (pardon the pun) digest. I don't know enough about the insulin but I know there are many people such as yourself who inject. I'm not afraid of needles. My comment about them and finger pricking was meant to be a light hearted. Guess it never comes over well when written.

Thank you so much for your time.
Cheers
 
Leadinglights said:
Sadly many people don't realise that is is all carbohydrates which convert to glucose so continue to have those things and then they require more and more medication. A bit like an overflowing sink (high blood glucose), it will still overflow despite bailing water out (taking meds )unless you turn the tap off (reducing carbs).
I know I am a bit of a fan of the low carb approach so suggest you look at this link for some good explanation and ideas for modifying your diet. https://lowcarbfreshwell.com/
Click to expand...
Hi,
Thanks for the link. I will take a look at it. I think I've been looking at things the wrong way. I'm so glad that there are people willing to share.
Kinda restores my faith in human nature.
Cheers
 
I cut out high carb foods the day after I was diagnosed (hba1c 83) and switched to food from books by Caldesi - check them out on Amazon - and I lost 3 stone in three months and got a hba1c of 36 and was told to cut the Metformin to one tablet a day. They said I could stop it last year, but I decided to keep on it as I get no side effects (Halving the dose made no difference.)

My diet consists of mainly fish/white meat, vegetables, fruits, nuts, peas, tomatoes, greek yoghurts and other low carb foods. Sometimes in Winter a nice daal, and lots of eggs and omelettes with mushrooms and onions in. We also make curries, but I use cauliflower rice instead of rice. I bulk buy almonds and eat quite a bit of dark chocolate - I've always liked dark chocolate, so I have no problem with the high cocoa content bars (> 75%). It's fabulous with peanut butter! (Pure peanut butter.)

I've made bread using almond flour, which is OK, but not the same. I recently made some low carb bread using Spelt and Bran flour with Almond flour that was quite nice, about 9g of carbs per slice, which is pretty low.

Sometimes for lunch at work I just buy some chicken and a pre-packed salad from Aldi and have it with a homemade dressing... nice a quick.

I am perhaps lucky in that I never really had much of a sweet tooth, and developed T2 due to being overweight, and going through a period of extreme stress (Plus maybe genetics, as my Dad had it.) I do have the occasional small portion of carbs (And on the odd occasion a large one!) and also a lot of exercise - tend to go for a walk about a hour after eating lunch.

This is my favourite book:

The 30 Minute Diabetes Cookbook: Eat to Beat Diabetes with 100 Easy Low-carb Recipes – THE SUNDAY TIMES BESTSELLER (Diabetes Series) : Caldesi, Katie: Amazon.co.uk: Books

The 30 Minute Diabetes Cookbook: Eat to Beat Diabetes with 100 Easy Low-carb Recipes – THE SUNDAY TIMES BESTSELLER (Diabetes Series) : Caldesi, Katie: Amazon.co.uk: Books
www.amazon.co.uk

The recipes are generally quite simple, and quite tasty. Sometimes *too* tasty, as I did develop a bit of craving for Salmon baked with orange and fennel and eat it twice a week!

(The author himself got T2 diabetes and reversed it by going low carb and losing weight.)
 
Hope you find some of it helpful.

Sadly we get a lot of people who come to the forum really anxious about starting insulin, so unless the humour is really obvious, we need to be reassuring and supportive, especially as some doctors and nurses "threaten" patients with the ultimatum of insulin if they "don't pull their socks up", like it is something to be frightened of, so people often get really uptight about that prospect, even those without a needle phobia and there are plenty of the latter.

You are clearly doing plenty of self testing which is great. Do you have a testing strategy as that is really important in order to gain useful data from it, so generally testing just before a meal and 2 hours after eating it is what is recommended and you are looking for a rise of no more than 3mmols between start and 2 hors post meal. If you can adjust your meals to keep that rise under 3 gradually your background levels should start to come down until your levels are mostly in range.

I note that you are on Dapagliflozin, so you need to be careful about reducing your carbs too low as that can lead to a risk of a form of Diabetic KetoAcidosis which is very serious, so do take it steady with reducing your carb intake. Slow and steady is kindest for your body and in particular the small blood vessels in the eyes which are susceptible to sudden, dramatic changes in HbA1c. A low carb diet is a very powerful tool in managing diabetes and most Health Care Professionals (HCPs) have no idea of just beneficial it can be, mostly because the NHS promotes wholegrains, which are still high in carbs. Basically setting many Type 2 diabetics up for failure by recommending wholegrains. This may be why many HCPs view Type 2 diabetes as progressive, because people have not been given the right dietary advice and so their HbA1c does gradually increase and need progressively stronger medication. Of course there are other types of diabetes which may not respond to a low carb diet and sadly many people are still misdiagnosed, so a low carb approach won't work for all, but if you are a standard Type 2 then it should.

Learning how to eat low carb is the key and it is difficult at first because culturally and traditionally our plates have been bulked out with carbs, which are cheap and filling. Potatoes and bread were my staples and it was mind boggling to contemplate meals without bread particularly because it is so quick and convenient to serve food on bread or in bread.
I am 4.5 years down the line and I really don't miss it anymore and the odd occasion when I have some I am not overly impressed. I do still sometimes miss the convenience but you find ways around it.

Anyway, just really wanted to say that food doesn't have to be bland or boring on a low carb way of eating but you do have to put a little thought and effort into it. There are lots of ideas for meals on the forum. Some or more low carb than others.
 
Welcome to the forum @Grumm

Your idea of reduced portion sizes and increasing veg seems like a really positive way forward.

Some folks on the forum opt for a hard stop ‘cold turkey’ approach, but it has always seemed more viable to me to make a series of staged changes over time. I think that would be the approach I would find easier. Plus, a more gradual change in BG levels towards a healthier range allows the body to adjust, and is easier on the eyes and nerve endings.
 
I used glucose monitors briefly, but found them of limited use as my blood sugar doesn't really do much - sort of gentle rolling hills. I found them quite inconsistent over their lifetime and expensive, but they are superb for people on insulin. I would suggest getting the free trial of the Libre from Abbott so you can spend two weeks checking out what is going on, although as has already been said, the medication means you might not want to go low carb without advice from the professionals.
 
Wholemeal in whatever form is not much lower in carbs than the white varieties - bread, pasta, rice - but it is a healthier choice, whether diabetic or not, and is generally recommended because the carbs are said to take longer to digest than refined carbs. However, the advice also comes with the caveat to reduce portion sizes. I have Weetabix for breakfast most days, for example, but only one.

Another option is to try alternatives to the starchy items. I eat red lentil pasta (there are other non-grain types too), riced cauliflower instead of rice, mashed cauliflower or mashed celeriac instead of potatoes, and celeriac chips instead of potato chips. I also help myself to a couple of slices of my wife's gluten-free bread on the odd occasion that I make a sandwich or have some soup as it has not much more than half the carbs of regular bread.
 
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