Hello thread

[42istheanswer]

Hi I just had a routine NHS health check and have been told over the phone today that I'm diabetic and have high cholesterol. Last HbA1c about 3 years ago (done at my request) I was told was normal though not told what exactly the reading was. I have an appointment next week to see practice nurse for medication prescription and advice.

Feeling quite a bit of shock atm. I knew it was a possibility at some point as I'm clinically obese, my grandad had type 2, I was suspected of possibly GD during pregnancy (had 2 x GTT in second pregnancy, routine at 28 weeks due to large first baby and one at 36 weeks due to positive routine urine tests but "passed" both) and my twin was prediabetic a few years ago (hence my previous request for an HbA1c check) - twin successfully reduced his HbA1c to no longer show as prediabetic. But I still didn't think it would happen now/had already happened to me, I've not had any particular symptoms. Though the health check showed I've lost a stone without having particularly tried to, so I guess that's now explained...

Anyway, thought I would join the forum and learn my way around while I adapt to the idea...

 

[nonethewiser]

Like your twin wife reversed her prediabetes by losing weight, 5 stone in total, so you can but give it a try.

Have search around for Newcastle Diet for info.

 

[42istheanswer]

Like your twin wife reversed her prediabetes by losing weight, 5 stone in total, so you can but give it a try.

Have search around for Newcastle Diet for info.

My twin lost a little bit of weight but didn't have much to lose. There is a significant gender component to weight gain in my family and his weight as a young adult was classed as underweight and when he was told he was prediabetic I think his BMI was about 21.... He really really dramatically cut his sugar intake and adjusted his diet to lower GI foods.

 

[42istheanswer]

In any case I have no intention of undertaking anything like the Newcastle Diet. Artificial sweeteners trigger my IBS. I have always wished that companies would cut sugars by reducing sweetness rather than put artificial sweeteners in products.

 

[nonethewiser]

My twin lost a little bit of weight but didn't have much to lose. There is a significant gender component to weight gain in my family and his weight as a young adult was classed as underweight and when he was told he was prediabetic I think his BMI was about 21.... He really really dramatically cut his sugar intake and adjusted his diet to lower GI foods.

You can be slim on outside fat inside, visceral fat around organs can lead to type 2 diabetes, could be your twin was one.

Anyway good luck with whatever you choose to do.

 

[everydayupsanddowns]

Welcome to the forum @42istheanswer (what really DO you get if you multiply six by nine anyway?!)

Sorry to hear about your diagnosis with diabetes. It feels like it’s been waiting in the wings for you for a while - and there is a strong genetic component to the development of diabetes in some people (some can be just as overweight, and even insulin resistant and never go on to develop T2, while others can be normal weight and develop it).

Feeling shock, anger, sadness, and all the stages and emotions associated with a process of grieving is quite common following a diagnosis if a long term condition like diabetes. So be kind to yourself, and give yourself time to adapt. Try not to sink into coulda-woulda-shoulda self recrimination. You didn’t do this to yourself deliberately, and you can’t change the past. What matters far more is how you are able to respond to it, and what you decide to do next.

While it gets a lot of attention, the ‘Newcastle’ diet is by no means the only way to respond to a diagnosis with T2. It’s effective for some people, but not workable for everyone.

Many members here have found a path to remission of their diabetes through a slower, steadier, moderate or low carbohydrate way of eating, and for many this has resulted in weight loss they found difficult to achieve and maintain through other means.

One of the biggest questions when trying to get to grips with your diabetes is often ‘what can I eat’ and while there are obvious things like cakes, biscuits, sweets and sugary drinks that you will want to cut out straight away, you might be surprised how much *all* carbohydrate affects your BG levels, including rice, pasta, potatoes, bread, pastry, grains, cereals and many fruits. Finding swaps and alternatives, or simply reducing portion sizes of these foods can allow folks here to have a satisfying, varied and enjoyable menu, but one which also reduces their average glucose levels.

Increasing activity levels helps too, of that is something you are able to consider.

Good luck and let us know how you get on.

 

[42istheanswer]

Well this is a fun little extra before my appointment... my parents have now told me that dad is diabetic.... apparently he was diagnosed 18 months-ish ago. I have no memory of being told this....

He says he was diagnosed as type 2 but is on no medication, just "blood checks every now and then" and watching his diet a bit more carefully that he was before.

 

[42istheanswer]

Going to update here with my full stuff so it's somewhere to refer back to easily:

HbA1c 54

Total Chol 7.6
HDL 1.1
LDL 5.06
Tri 3.26

Thyroid OK. FBC OK. LFTs deranged (ALT, AST and GT high).

Diagnosed Type 2 - discussed with her whether slow onset Type 1 is possible, but she felt that due to my history of possible GD in pregnancies and my LFTs "not being deranged enough" that was unlikely. (And there's the added factors tbf that my maternal grandfather was Type 2 and as I've now discovered my father is Type 2, so potentially I may have inherited increased tendency from both sides).

Lost about 1lb so far with reduced carb diet. Practice nurse was lovely and we had a good discussion about options. She wanted really to put me straight on meds, I said I'd like to do 3 month trial of low carb diet. We had a discussion about my weight and dietary history and she is concerned whether I can maintain low carb long term - which I understood but said that actually testing diabetic will hopefully help with long-term willpower to maintain changed way of eating. Compromise agreed of 3 further weeks of low carb eating (have already been doing for a week apart from eating up some foods I already had and didn't want/couldn't afford to waste), discussion about meals vs snacks etc. She has issued me a BG meter **and a repeat prescription for strips** (and a "lifetime supply" of 200 lancets) and wants me to take fasting blood glucose first thing and one 2 hour post meal glucose for next 3 weeks. If I can keep fasting below 7 and post-meal below 11 then she'd be happy for me to continue trying diet only (but warned even if I put into remission then would need to maintain low carb diet at least 5 days a week indefinitely). She said not to stress if numbers are higher than targets as that won't help.

Regarding first line meds, she is willing to offer me a choice of metformin (side effects may not be great for me as I already have IBS), flozin or Trulicity.

She said that she is supposed to advise weight loss but she is less concerned with whether I lose weight (BMI 39) than with my overall health.

She has referred me for retinopathy screening, and "education group" - apparently 90% chance that will be online.

Next appt in 3 weeks, bloods in 3 months.

 

[Leadinglights]

Going to update here with my full stuff so it's somewhere to refer back to easily:

HbA1c 54

Total Chol 7.6
HDL 1.1
LDL 5.06
Tri 3.26

Thyroid OK. FBC OK. LFTs deranged (ALT, AST and GT high).

Diagnosed Type 2 - discussed with her whether slow onset Type 1 is possible, but she felt that due to my history of possible GD in pregnancies and my LFTs "not being deranged enough" that was unlikely. (And there's the added factors tbf that my maternal grandfather was Type 2 and as I've now discovered my father is Type 2, so potentially I may have inherited increased tendency from both sides).

Lost about 1lb so far with reduced carb diet. Practice nurse was lovely and we had a good discussion about options. She wanted really to put me straight on meds, I said I'd like to do 3 month trial of low carb diet. We had a discussion about my weight and dietary history and she is concerned whether I can maintain low carb long term - which I understood but said that actually testing diabetic will hopefully help with long-term willpower to maintain changed way of eating. Compromise agreed of 3 further weeks of low carb eating (have already been doing for a week apart from eating up some foods I already had and didn't want/couldn't afford to waste), discussion about meals vs snacks etc. She has issued me a BG meter **and a repeat prescription for strips** (and a "lifetime supply" of 200 lancets) and wants me to take fasting blood glucose first thing and one 2 hour post meal glucose for next 3 weeks. If I can keep fasting below 7 and post-meal below 11 then she'd be happy for me to continue trying diet only (but warned even if I put into remission then would need to maintain low carb diet at least 5 days a week indefinitely). She said not to stress if numbers are higher than targets as that won't help.

Regarding first line meds, she is willing to offer me a choice of metformin (side effects may not be great for me as I already have IBS), flozin or Trulicity.

She said that she is supposed to advise weight loss but she is less concerned with whether I lose weight (BMI 39) than with my overall health.

She has referred me for retinopathy screening, and "education group" - apparently 90% chance that will be online.

Next appt in 3 weeks, bloods in 3 months.

A general rule of thumb is that testing before and 2 hours after your meal that an increase of no more than 2-3mmol/l means the meal is tolerated and as your level starts to come down a 2 hour post meal of no more than 8-8.5mmol/l is what you want to aim at.
11mmol/l sound rather high, single figures would be better.
The aim is 4-7mmol/l fasting /morning and before meals.

Good that you have been referred for all the screening and have a follow up planned. Even with metformin you still need to make the dietary changes.
I have been doing low carb approx 70g per day for 2 years now and find it is just the new normal way of eating now.

 

[42istheanswer]

A general rule of thumb is that testing before and 2 hours after your meal that an increase of no more than 2-3mmol/l means the meal is tolerated and as your level starts to come down a 2 hour post meal of no more than 8-8.5mmol/l is what you want to aim at.
11mmol/l sound rather high, single figures would be better.
The aim is 4-7mmol/l fasting /morning and before meals.

Good that you have been referred for all the screening and have a follow up planned. Even with metformin you still need to make the dietary changes.
I have been doing low carb approx 70g per day for 2 years now and find it is just the new normal way of eating now.

I know the fasting blood glucose ranges (I'm actually a registered nurse and still remember those from my ward days). I'm not sure if she would be happy with 11 post meals long term (though she said that's "non-diabetic", presumably the guidelines she was given go alongside https://www.nhs.uk/conditions/high-blood-sugar-hyperglycaemia/ which says high is above 11), but that's the target she has set for the next 3 weeks

 

[Eddy Edson]

Going to update here with my full stuff so it's somewhere to refer back to easily:

HbA1c 54

Total Chol 7.6
HDL 1.1
LDL 5.06
Tri 3.26

Thyroid OK. FBC OK. LFTs deranged (ALT, AST and GT high).

Diagnosed Type 2 - discussed with her whether slow onset Type 1 is possible, but she felt that due to my history of possible GD in pregnancies and my LFTs "not being deranged enough" that was unlikely. (And there's the added factors tbf that my maternal grandfather was Type 2 and as I've now discovered my father is Type 2, so potentially I may have inherited increased tendency from both sides).

Lost about 1lb so far with reduced carb diet. Practice nurse was lovely and we had a good discussion about options. She wanted really to put me straight on meds, I said I'd like to do 3 month trial of low carb diet. We had a discussion about my weight and dietary history and she is concerned whether I can maintain low carb long term - which I understood but said that actually testing diabetic will hopefully help with long-term willpower to maintain changed way of eating. Compromise agreed of 3 further weeks of low carb eating (have already been doing for a week apart from eating up some foods I already had and didn't want/couldn't afford to waste), discussion about meals vs snacks etc. She has issued me a BG meter **and a repeat prescription for strips** (and a "lifetime supply" of 200 lancets) and wants me to take fasting blood glucose first thing and one 2 hour post meal glucose for next 3 weeks. If I can keep fasting below 7 and post-meal below 11 then she'd be happy for me to continue trying diet only (but warned even if I put into remission then would need to maintain low carb diet at least 5 days a week indefinitely). She said not to stress if numbers are higher than targets as that won't help.

Regarding first line meds, she is willing to offer me a choice of metformin (side effects may not be great for me as I already have IBS), flozin or Trulicity.

She said that she is supposed to advise weight loss but she is less concerned with whether I lose weight (BMI 39) than with my overall health.

She has referred me for retinopathy screening, and "education group" - apparently 90% chance that will be online.

Next appt in 3 weeks, bloods in 3 months.

FWIW, I would have thought there'd be more concern about yr non-HDL than the moderately high HbA1c. "Low carb" probably wouldn't do much to much to improve that by itself, except if it meant big reductions in *refined* carbs & restricted satfats & overall restricted calories => weight loss (which "low carb" by itself wouldn't achieve, despite the Internet), together with increased fibre. But even with that I'd have thought starins or whatever should be recommended.

 

[Leadinglights]

I know the fasting blood glucose ranges (I'm actually a registered nurse and still remember those from my ward days). I'm not sure if she would be happy with 11 post meals long term (though she said that's "non-diabetic", presumably the guidelines she was given go alongside https://www.nhs.uk/conditions/high-blood-sugar-hyperglycaemia/ which says high is above 11), but that's the target she has set for the next 3 weeks

It is a good thing you have a good bit of knowledge and can therefore make your own good decisions.
Bringing down your levels slowly is often a good idea to avoid issues with your eyes and nerves that can happen in some people.

 

[42istheanswer]

FWIW, I would have thought there'd be more concern about yr non-HDL than the moderately high HbA1c. "Low carb" probably wouldn't do much to much to improve that by itself, except if it meant big reductions in *refined* carbs & restricted satfats & overall restricted calories => weight loss (which "low carb" by itself wouldn't achieve, despite the Internet), together with increased fibre. But even with that I'd have thought starins or whatever should be recommended.

Going straight to statins might well have been what she suggested if my QRisk (risk of heart attack or stroke in the next 10 years) was higher.

Low carb for me very much means fewer refined carbs and more vegetables (and therefore more fibre). I haven't intentionally restricted calories, but I have been eating an average of under 1300 calories the past week just by doing that. I'm not certain how much I've reduced saturated fat, though it has to be some from having lighter dressings (not had any salad cream which used to be my go to dressing) and less butter from not having as much bread! (And will probably have even less in the way of bread and similar this week as I used up the bread I already had open pre-diagnosis. My eldest will eventually eat the white bread that is in the freezer if I don't buy more, so I don't feel the need to use that up).