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Anji53

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Type 2
Diagnosed in August with type 2 115 mmol/mol. Received a phone call from my doctors while on holiday in Spain. Quite shocked as a bolt from the blue ( although I have yearly checks as hypothyroid no one mentioned possibility of diabetes)
told to go to doctors in Spain as I would be away 4 weeks which I did After testing prescribed xigduo.( combined metformin and dapagliflozin).
when I got home told xigduo could not be prescribed so given separate prescriptions for metformin and dapaglioformin
when retested in October my readings had dropped to 62 mml /mol
tested last week and on nhs app reading now 38 mml /mol
ive been cutting out nearly all carbs and have lost 20 pounds
Dont know what to do now, I’ve been so strict with myself but don’t think this is sustainable in the long run. Going out with friends isn’t easy Need to find a balance to maintain low reading
lots of conflicting advice on the web and so confusing
diabetic nurse at doctors gave me no advice , just checked my feet and a website link
should I be testing? I asked nurse but she said no. But how do I know what causes my blood sugar to rise ?
I should add I’m nearly 70 and finding it overwhelming
grateful for any advice
 
Hello and welcome. Firstly, well done on losing weight and getting your HbA1c down into the normal range.

You've asked a very important question about testing, as you do need to know what foods affect you. Everyone is different which is why testing becomes important. The NHS won't prescribe a testing kit for Type 2 unless they are on certain medications, so we have to fund them ourselves. I think the GlucoNavii is a popular model, available from Amazon and has one of the cheapest sets of testing strips.
You should test before eating and 2 hours after first bite. You should be looking for a starting value of between 4-7 mmol/l, a rise of no more than 2-3 mmol/l and ideally below 8.5 mmol/l. A process of recording, trial and error will soon show you what foods affect you more than others. For example, I can eat 2 small potatoes or 1 small slice of wholemeal bread, but rice, pasta and apples are lethal for me! I tested rigorously at first, until I worked out what suited me. Now I test for new foods. I do stick to portion control, keep digital scales and a clear bowl on my kitchen top, and weigh most things, except salads and vegetables. I also have an app to record cals and carbs, and enter my day's plan first thing each morning.
I believe (and it's only my personal opinion) that moderation is the best way to maintain. At home I mostly stick to around 1200 cals and around 75gm carbs a day, but I don't beat myself up if I occasionally have a treat and go over. (I'm still work in progress getting my HbA1c back down, after a nasty illness). Eating out can be tricky - I do look at menus before I go, try and make sensible choices, and keep an eye on what I have for the rest of the day. For example, this week I had Tandoori chicken with salad, I get stir fry vegetables or chop suey, with prawns and cashew nuts at my local Chinese, and look for omelettes and salads at other restaurants. Carvery's are good - you can miss the roasties and Yorkshire puds.
I hope I've offered you some useful suggestions. Best wishes
 
Last edited:
Anji53 said:
Dont know what to do now, I’ve been so strict with myself but don’t think this is sustainable in the long run. Going out with friends isn’t easy Need to find a balance to maintain low reading
lots of conflicting advice on the web and so confusing
diabetic nurse at doctors gave me no advice , just checked my feet and a website link
should I be testing? I asked nurse but she said no. But how do I know what causes my blood sugar to rise ?
Click to expand...

Welcome to the forum @Anji53

Congratulations on your weight loss, and the terrific reduction in your HbA1c!

I think you’ve highlighted a really important issue - and a frequent cause of frustration for forum members.

Many surgeries are only prepared to offer BG monitors to people with T2 who take medication that can cause hypoglycaemia (if you are still taking dapagliflozin you should be offered one!). But a BG meter can also be incredibly helpful and informative in terms of adjusting your menu to make it more flexible while still maintaining effective blood glucose management.

The method of pairs of BG checks before and 2hrs after meals that @Felinia describes can be a very powerful and impartial strategy. Different people react quite differently to the same foods, so it can be hard to just go by a food’s reputation alone - but your BG meter will simply show you how your body has reacted to a meal, and you can adjust portion sizes, or try swapping ingredients based on that information.

Another approach is to set yourself a limit of total carbs per day (not just ‘of which sugars’), but it can be difficult to be sure that you aren’t either overdoing things or being unnecessarily strict without checking, unless you are happy to wait for your HbA1c checks which may be every 6 months.

Hope you can find a way of eating that you feel is sustainable long-term, and which suits your tastebuds, your waistline, your pocket, and your BG levels 🙂
 
You have obviously made substantial changes to your diet and in combination with the medication has been very successful in getting your Hba1C back to normal. Testing would give you a good idea of what meals you can tolerate and that would give you more flexibility when eating out as you would know what to choose that would be safe and even if it was a higher carbs than you would have at home, it is not all the time.
I do low carb and usually find something enjoyable on the menu when eating out, but do leave some of the chips or half the bread. I sometimes ask for coleslaw or extra salad instead of chips or just say No chips please.
My low carb approach had just become my new normal and I don't miss anything.
I based my changes on the principals in this link. https://lowcarbfreshwell.co.uk/ but try for approx 70g total carbs per day.
I blotted my copy book yesterday by having a small wedge of birthday cake in celebration of my other half's Mum's 98th birthday and had fish and a few chips, but did have a delicious pear, stilton and walnut salad for lunch.
 
I used a BG meter to find out which foods were worst for spiking my BG - though I had to fund it myself (used a TEE2, but a Gluco Navii seems as good).
I have just come back from meeting a friend for a meal. I had a mixed grill and asked for no chips and no onion rings. When I explained my dietary control of my Type 2 diabetes, the waiter was only too happy to swap those higher carb (included a items on the menu as a standard part of that dish) for a very nice salad and an extra fried egg.

Many people think it's difficult to eat low carb, but I don't find it so. I check restaurant menus online before I eat there, choose something that is either completely OK for me or just needs a few items discarding or swapped out.
Then if I want swaps I explain my situation regarding Type 2 diabetes and I have always found the staff helpful (in lots of different restaurants).
.
 
I think it can also depend on how often you're eating out. If it's once or twice a month, then you might find that your HbA1c stays in range if you just have whatever you feel like at the restaurant and call it a treat meal. If it's 2 or 3 times a week then you might need to check menus more carefully for foods that fit with the dietary lifestyle you're trying to follow.
 
everydayupsanddowns said:
Welcome to the forum @Anji53

Congratulations on your weight loss, and the terrific reduction in your HbA1c!

I think you’ve highlighted a really important issue - and a frequent cause of frustration for forum members.

Many surgeries are only prepared to offer BG monitors to people with T2 who take medication that can cause hypoglycaemia (if you are still taking dapagliflozin you should be offered one!). But a BG meter can also be incredibly helpful and informative in terms of adjusting your menu to make it more flexible while still maintaining effective blood glucose management.

The method of pairs of BG checks before and 2hrs after meals that @Felinia describes can be a very powerful and impartial strategy. Different people react quite differently to the same foods, so it can be hard to just go by a food’s reputation alone - but your BG meter will simply show you how your body has reacted to a meal, and you can adjust portion sizes, or try swapping ingredients based on that information.

Another approach is to set yourself a limit of total carbs per day (not just ‘of which sugars’), but it can be difficult to be sure that you aren’t either overdoing things or being unnecessarily strict without checking, unless you are happy to wait for your HbA1c checks which may be every 6 months.

Hope you can find a way of eating that you feel is sustainable long-term, and which suits your tastebuds, your waistline, your pocket, and your BG levels 🙂
Click to expand...
Thank you so much that is really helpful. Clear when so much information is vague
 
42istheanswer said:
I think it can also depend on how often you're eating out. If it's once or twice a month, then you might find that your HbA1c stays in range if you just have whatever you feel like at the restaurant and call it a treat meal. If it's 2 or 3 times a week then you might need to check menus more carefully for foods that fit with the dietary lifestyle you're trying to follow.
Click to expand...
It's a personal choice, but I consider that high BG doesn't have to last 3 months to cause damage. So I take each day (and each meal) seriously.
 
Felinia said:
Hello and welcome. Firstly, well done on losing weight and getting your HbA1c down into the normal range.

You've asked a very important question about testing, as you do need to know what foods affect you. Everyone is different which is why testing becomes important. The NHS won't prescribe a testing kit for Type 2 unless they are on certain medications, so we have to fund them ourselves. I think the GlucoNavii is a popular model, available from Amazon and has one of the cheapest sets of testing strips.
You should test before eating and 2 hours after first bite. You should be looking for a starting value of between 4-7 mmol/l, a rise of no more than 2-3 mmol/l and ideally below 8.5 mmol/l. A process of recording, trial and error will soon show you what foods affect you more than others. For example, I can eat 2 small potatoes or 1 small slice of wholemeal bread, but rice, pasta and apples are lethal for me! I tested rigorously at first, until I worked out what suited me. Now I test for new foods. I do stick to portion control, keep digital scales and a clear bowl on my kitchen top, and weigh most things, except salads and vegetables. I also have an app to record cals and carbs, and enter my day's plan first thing each morning.
I believe (and it's only my personal opinion) that moderation is the best way to maintain. At home I mostly stick to around 1200 cals and around 75gm carbs a day, but I don't beat myself up if I occasionally have a treat and go over. (I'm still work in progress getting my HbA1c back down, after a nasty illness). Eating out can be tricky - I do look at menus before I go, try and make sensible choices, and keep an eye on what I have for the rest of the day. For example, this week I had Tandoori chicken with salad, I get stir fry vegetables or chop suey, with prawns and cashew nuts at my local Chinese, and look for omelettes and salads at other restaurants. Carvery's are good - you can miss the roasties and Yorkshire puds.
I hope I've offered you some useful suggestions. Best wishes
Click to expand...
Thank you
 
Felinia said:
Hello and welcome. Firstly, well done on losing weight and getting your HbA1c down into the normal range.

You've asked a very important question about testing, as you do need to know what foods affect you. Everyone is different which is why testing becomes important. The NHS won't prescribe a testing kit for Type 2 unless they are on certain medications, so we have to fund them ourselves. I think the GlucoNavii is a popular model, available from Amazon and has one of the cheapest sets of testing strips.
You should test before eating and 2 hours after first bite. You should be looking for a starting value of between 4-7 mmol/l, a rise of no more than 2-3 mmol/l and ideally below 8.5 mmol/l. A process of recording, trial and error will soon show you what foods affect you more than others. For example, I can eat 2 small potatoes or 1 small slice of wholemeal bread, but rice, pasta and apples are lethal for me! I tested rigorously at first, until I worked out what suited me. Now I test for new foods. I do stick to portion control, keep digital scales and a clear bowl on my kitchen top, and weigh most things, except salads and vegetables. I also have an app to record cals and carbs, and enter my day's plan first thing each morning.
I believe (and it's only my personal opinion) that moderation is the best way to maintain. At home I mostly stick to around 1200 cals and around 75gm carbs a day, but I don't beat myself up if I occasionally have a treat and go over. (I'm still work in progress getting my HbA1c back down, after a nasty illness). Eating out can be tricky - I do look at menus before I go, try and make sensible choices, and keep an eye on what I have for the rest of the day. For example, this week I had Tandoori chicken with salad, I get stir fry vegetables or chop suey, with prawns and cashew nuts at my local Chinese, and look for omelettes and salads at other restaurants. Carvery's are good - you can miss the roasties and Yorkshire puds.
I hope I've offered you some useful suggestions. Best wishes
Click to expand...
Thank you so much that is really helpful. Clear when so much information is vague
 
everydayupsanddowns said:
Welcome to the forum @Anji53

Congratulations on your weight loss, and the terrific reduction in your HbA1c!

I think you’ve highlighted a really important issue - and a frequent cause of frustration for forum members.

Many surgeries are only prepared to offer BG monitors to people with T2 who take medication that can cause hypoglycaemia (if you are still taking dapagliflozin you should be offered one!). But a BG meter can also be incredibly helpful and informative in terms of adjusting your menu to make it more flexible while still maintaining effective blood glucose management.

The method of pairs of BG checks before and 2hrs after meals that @Felinia describes can be a very powerful and impartial strategy. Different people react quite differently to the same foods, so it can be hard to just go by a food’s reputation alone - but your BG meter will simply show you how your body has reacted to a meal, and you can adjust portion sizes, or try swapping ingredients based on that information.

Another approach is to set yourself a limit of total carbs per day (not just ‘of which sugars’), but it can be difficult to be sure that you aren’t either overdoing things or being unnecessarily strict without checking, unless you are happy to wait for your HbA1c checks which may be every 6 months.

Hope you can find a way of eating that you feel is sustainable long-term, and which suits your tastebuds, your waistline, your pocket, and your BG levels 🙂
Click to expand...
Very interesting. When I asked at my doctors about testing I wasn’t expecting them to provide anything but was told nothing I was taking caused hypoglycaemia. I am still taking dapagliflozin and have an appointment with the diabetic nurse on Wednesday so maybe I should ask again.
 
Anji53 said:
Very interesting. When I asked at my doctors about testing I wasn’t expecting them to provide anything but was told nothing I was taking caused hypoglycaemia. I am still taking dapagliflozin and have an appointment with the diabetic nurse on Wednesday so maybe I should ask again.
Click to expand...

The NHS website is very clear that dapagliflozin carries with it a risk of hypoglycaemia.

See here (half way down):

www.nhs.uk

Side effects of dapagliflozin

NHS medicines information on side effects of dapagliflozin and what you can do to cope.
www.nhs.uk www.nhs.uk
 
Felinia said:
Hello and welcome. Firstly, well done on losing weight and getting your HbA1c down into the normal range.

You've asked a very important question about testing, as you do need to know what foods affect you. Everyone is different which is why testing becomes important. The NHS won't prescribe a testing kit for Type 2 unless they are on certain medications, so we have to fund them ourselves. I think the GlucoNavii is a popular model, available from Amazon and has one of the cheapest sets of testing strips.
You should test before eating and 2 hours after first bite. You should be looking for a starting value of between 4-7 mmol/l, a rise of no more than 2-3 mmol/l and ideally below 8.5 mmol/l. A process of recording, trial and error will soon show you what foods affect you more than others. For example, I can eat 2 small potatoes or 1 small slice of wholemeal bread, but rice, pasta and apples are lethal for me! I tested rigorously at first, until I worked out what suited me. Now I test for new foods. I do stick to portion control, keep digital scales and a clear bowl on my kitchen top, and weigh most things, except salads and vegetables. I also have an app to record cals and carbs, and enter my day's plan first thing each morning.
I believe (and it's only my personal opinion) that moderation is the best way to maintain. At home I mostly stick to around 1200 cals and around 75gm carbs a day, but I don't beat myself up if I occasionally have a treat and go over. (I'm still work in progress getting my HbA1c back down, after a nasty illness). Eating out can be tricky - I do look at menus before I go, try and make sensible choices, and keep an eye on what I have for the rest of the day. For example, this week I had Tandoori chicken with salad, I get stir fry vegetables or chop suey, with prawns and cashew nuts at my local Chinese, and look for omelettes and salads at other restaurants. Carvery's are good - you can miss the roasties and Yorkshire puds.
I hope I've offered you some useful suggestions. Best wishes
Click to expand...
Just wanted to let you know how helpful this has been
now my metformin has been stopped I keep coming back and re reading this
when I was first diagnosed I was just too shocked and confused to take it in but am now finding this so helpful. Thank you
 
So pleased that you are finding things easier @Anji53
Keep reading around and come back with any other questions.
 
Anji53 said:
Just wanted to let you know how helpful this has been
now my metformin has been stopped I keep coming back and re reading this
when I was first diagnosed I was just too shocked and confused to take it in but am now finding this so helpful. Thank you
Click to expand...

That’s so great to hear @Anji53 🙂
 
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