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Hello

I would be very sad if I had to give up cheese. I have given up pasta and jacket potatoes. I sometimes have cheese with an oatcake or on scrambled egg. Today I bought some Norfolk Pinkfoot and will have some as a side dish with cauliflower and yoghurt. Obviously you need to factor in salt and calories but it isn't high carb.
 
I try and keep my breakfast, lunch and evening meals to around 30g max carbs each, leaving me with 30-40g spare for snacking, although it doesn't always work out that precisely. I still end up under my 130g per day target on the majority of days.
 
I like Ian Marber's basic formula for every meal. One third of the plate each for protein, vegetables and carbs - and you can always swap more veg for the carbs
 
Ian Robinson said:
Do you lot spread your carbs out equally between you meals?

I don't have carbs for breakfast now I just have two hard boiled eggs and coffee, it lasts me well until lunch. So I have the carbs for lunch and dinner
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I try and spread them evenly across 3 meals. I rarely snack these days so the only extra carbs I have is a small amount of milk in tea or coffee.
Breakfast is a bit more difficult as I don't like strong flavours early in the morning so it's invariably yoghurt with berries or poached/scrambled eggs on toast.
 
Another thing. I'm on this Dapagliflozin and the nurse told me I would lose a couple of pounds which I did 5lb in the first 3 days. My wife said you can't keep loosing weight at that speed. Today I didn't lose any so it has slowed down. How exactly does this pill work? I am going to toilet loads so I'm drinking more water. Anyone on the same med?
 
Flozins make your kidneys excrete glucose in urine, so you'll need to drink enough to stay hydrated.

Because you're losing calories via urine, they can cause a bit of weight loss.
 
The flozin medications work by encouraging your kidneys to remove glucose from your blood at a lower level than usual.
When it comes to diabetes, I tend to think of the kidney's as being a bit of an overflow safeguard mechanism, like the overflow on a sink or reservoir, in that once the glucose levels are consistently at a certain dangerously high level the kidneys allow the excess to "run off" into your urine and the kidneys will kind of pump that excess out into your urine until the glucose is below that threshold. Without the Flozin medication, the threshold is usually about 15mmols, but with the flozin tablets it reduces it the threshold and encourages the kidneys to kick in and pump that glucose out into your urine at a much lower level, but still generally not below normal baseline levels, so they will stop being effective if your blood glucose levels are consistently in the normal range and therefore I expect the weight loss will also stop once your levels are consistently in range. Hence they don't cause hypos.
 
Yes but how is the glucose taken from your blood and sent to your bladder?
 
Your blood is filtered through your kidneys so it is removed from your blood and dumped into your urine at the kidneys and from there it goes into your bladder and gets weed out.
 
If you didn't drink enough water, you will become dehydrated and also put pressure on your kidneys, because they need plenty of fluids in order to make urine and the glucose in your urine will become more concentrated which risks a UTI and thrush, so it is really important to drink plenty although usually you will get thirsty if you don't.
 
Thanks mate. How many glasses is the norm for people in the same situation as me. I've added 3 pints to my daily intake as well as other drinks like coffee do you think that will be enough?
 
Leadinglights said:
Google says 2 litres or 6-8 glasses per day.
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That is total fluids though not on top of normal consumption of fluids and it doesn't all have to be plain water.
 
Ian Robinson said:
Yes but how is the glucose taken from your blood and sent to your bladder?
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Kidneys 'recirculate' glucose in the blood instead of removing it by reabsorbing it back into the bloodstream. The medication inhibits the protein (SGLT2) that causes this reabsorption so some of the glucose ends up coming out of your pipe (In your case.).

As an aside, when glucose levels are too high, the SGLT2 transporters can't handle it, so the glucose spills out into pee. Flozins effectively lower this threshold.
 
Hi Ian, I found that an easy way to up my fluid intake was to have a glass of water each time I had a tea or coffee. I worked in quite a warm office with no air-conditioning. Keeping hydrated stopped me getting headaches.
 
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