Hi again Chris
A reading of 49 is only just over the Diabetes diagnosis threshold of 48 so it should not need too many dietary changes to push it back. That said, that was a year ago and a lot can happen during that time.... particularly in the current climate when many people are comfort eating more and perhaps exercising less.
Just to clarify, exercise doesn't mean anything overly exertive or formal. A brisk daily walk is pretty well ideal to help with diabetes management and as someone who also struggles with depression I can tell you that it also helps with mental health. I appreciate that COPD may limit you in how much you can do but it is important to do whatever you can and if you can push yourself to make an effort for a couple of weeks to make a habit of it, it will get easier.
Sounds like you may be a thin outside fat inside (TOFI) diabetic, where you are carrying a higher percentage of visceral fat around your organs rather than on your body in general. I am not sure if this might mean you need to be quite radical with your diet over a short period to force your body to metabolise it. Hopefully some TOFI diabetics will chip in. I believe
@ianf0ster and
@travellor are two such members who have taken different approaches to their diet for diabetes management.
As regards diet many people believe that it is just a question of cutting out sugar, but it is in fact all carbohydrates which cause us diabetics problems because our digestive system breaks them all down into glucose which is absorbed into the blood supply where it gets stuck because either we don't produce enough insulin (usually Type 1) or we are resistant to the insulin we produce (usually Type 2). Eating less carbs means that we have less glucose going into the blood stream in the first place and doing exercise like walking or cycling causes the muscles to suck the glucose out of the blood stream, but exercise alone is not enough to do it, even if you walked all day, so diet is the really key factor.
The options are:-
To go on a very strict very low calorie diet for 8 weeks to force your body to use that visceral fat as fuel. This is sometimes referred to as the Newcastle Diet or the Fast 800 where you limit yourself to 800 calories a day, often using shakes or meal replacement products. It had been on the news recently because the NHS are now supporting this approach for some people and getting it prescribed.
The option which most people here on the forum adopt is to significantly reduce their consumption of carbohydrates. This is a longer term approach essentially for the rest of your life and involves cutting back on bread, pasta, rice, breakfast cereals, potatoes and fruit as well as the obvious cakes, biscuits and sweets. It usually involves eating more fat which helps to keep you feeling full for longer so you don't feel the need to snack, provides slow release energy and makes it enjoyable and therefore sustainable. I appreciate that we have been advised for decades that fat is bad for us and makes us obese and causes Cardio Vascular Disease and gives us high cholesterol but there is a growing wave of scientific opinion that this advice was based on flawed data and our current obesity and diabetes epidemic is in part because we cut right back on our fat intake. Unfortunately there is a massive food industry invested in low fat products who are keen to maintain the status quo, so the low fat dietary advice is still being rolled out, but many of us here now choose to ignore it and have lost weight and lowered our cholesterol by eating more fat and less carbs.
So if you want examples of what might be a low carb menu
Creamy natural Greek yogurt (made with whole milk not low fat) with a few berries like rasps or strawberries or blackberries and a few mixed seeds and or chopped nuts for breakfast washed down with a cup of coffee made with real double cream.
An omelette or meat or fish with a salad for lunch
Gammon with cabbage and cauliflower cheese for dinner.
I often end the day with a small glass of red wine and a chunk of nice cheese. ... Dry wine and spirits are low carb so OK in moderation but beer and cider are higher carb so best limited or avoided.