Help please

[Gwynn]

Hi, I am new-ish to all this (a few months) and I have been trying really hard to understand and sort things out as best I can, but I have got myself into a muddle.

I was diagnosed as a type 1, then some weeks later as a type 2. I was overweight
, my HbA1c was 130, and cholesterol was high.

I was put on metaformin and insulin injections.

Using diet alone, having come off all meds, after about 3 months I got my weight down to a good figure having lost 25Kg, and my BMI was 25 ish, HbA1c 39. No result on cholesterol yet. My BG readings have all been in the 5's since I came off all diabetic meds too.

All good.

Now here's my problem.

I cannot seem to be able to work out how to increase my calories ( so that I can now maintain my weight) and at the same time keep my carbohydrates low and cholesterol low. Additionally, according to the guidelines I have read, I am trying to keep my saturated fats low too.

With that list of requirements I cannot get enough calories and my weight is continuing to fall too far.

Has anyone got any advice that can help me up my calories and yet at the same time keep the carbs low and not overshoot on the cholesterol and fats.

I need about 1500KCal per day.

Today looking at my food diet I get 1190KCal, 83g carbs, 77g protein, 21g fibre, 9g saturated fats, 4g salt, 230mg of cholesterol.

Breakfast cerial (20g all bran & 60g milk) & 1/2 banana
Morning snack nectarine & some peanuts
Lunch 1/2 prawn salad
Afternoon snack some peanuts
Tea 1/2 prawn salad
Evening snack a few strawberries & some peanuts
Night a few raspberries

I thought that peanuts might help me out but now I am not so sure, and I cannot live off peanuts

So what have I got wrong in my thinking. I must have got something wrong but right now I am just in a bit of a muddle and getting very worried.

Have I been stupid and just got it all wrong?

Help me please.

Oh, and just to cap it all I have had zero help from the NHS.

 

[Drummer]

I suspect that you are eating too little fat - we do need it, it is an essential part of our diet despite all that is said about it being a bad thing, our brain and nervous system, cell membranes, our hormones and many essential chemicals within our bodies rely on fats, and they have to be natural ones, not processed seed oils.
I could not maintain good levels with the amount of carbs you eat, so you must have done a good job reversing your diabetes.

 

[Inka]

@Gwynn I think you need to add a few carbs. Remember on your previous thread you were eating more than 200g carbs per day, weren’t you?

Think back to your unfounded concerns about hypos then and see this as similar. You don’t need to take things ‘to extremes’ or be so rigid in your thinking.

You could add some low GI carbs at both lunch and tea. Your daily diet there looks inadequate to me. I’m probably half your size but I’d starve on that.

 

[Gwynn]

Thank you for your replies

I was running on the assumption that some had successfully dropped their carb intake to zero or thereabouts. No way can I see a way of doing that. But if it were possible then surely that would take care of diabetes.

So what is a sensible level of carbs. Tricky one that because everyone is different and we are all not reacting well to carbs. I will try raising them but I am very nervous of doing so.

I had increased my carbs and fats over the last few days but my evening BG was slighly raised (and I mean, slightly). I was worried that I had gone too far and started to upset things.

So is less than 100g of carbs a stupidly small amount? Of course I worry that if I raise them then my BG will go crazy.

And

What amount of saturated fats is good. I have read so many conflicting pieces of advice on the internet. So some better, more solid advice here would really help me.

Thanks

 

[Inka]

@Gwynn If I remember correctly, you were told your high blood sugar was cause by the steroids and also by your ‘bad’ previous diet. You’ve also said you were overweight. Correcting all or some of those factors might have been enough to get your metabolism able to cope with things again. So perhaps a moderate diet and maintaining a healthy weight will be sufficient.

I don’t think zero carbs are a good idea and nor do I think a very low level of carbs is a great idea either. There are other ways to deal with Type 2 and eating zero/very low carbs isn’t compulsory. I would call very low carbs at being below 50g very roughly. So no, I wouldn’t say 100g carbs was very low - just low.

How high was your evening blood sugar when you say it had risen slightly?

You can stick to 100g carbs a day if you want, and add in extra ‘good fats’ and/or protein. So avocados, nuts, seeds, oily fish, etc. Adding those fats spread over the day consistently might be enough to up your calories. It’s easy to add peanut butter or other nut butters to things, sprinkle nuts and seeds on your salad or on your morning cereal. I don’t know if your prawn salad had an avocado in but if not you could add one or half of one.

 

[Gwynn]

Martin, what is your limit on carbs per day?

I have set 200g but rarely go over 100g and often down to 60g

But now I do need to increase but what is a safe and good level of carbs?

 

[Sally71]

Guidelines are 2500 calories per day for men and 2000 for women to maintain weight. Much less than that and you'll lose weight, more and you'll put it on, obviously. How to balance where you get them from is the tricky bit, but fats are not the evil demons they have been portrayed as for the last 30 years.

 

[everydayupsanddowns]

Martin, what is your limit on carbs per day?

I have set 200g but rarely go over 100g and often down to 60g

But now I do need to increase but what is a safe and good level of carbs?

I think its a very invividual thing (as you already know). Many forum members sit around the 100-200g mark, while others are more sensitive to carbs and go below 100g a day.

I think what matters most is balancing your weight goals alongside your BG aspirations. You also need your eating plan to be viable for you long-term.

So a little experimentation is very worthwhile. Don’t fear adding moderate carbs or fats from ‘good’ sources, and just keep an eye on the resulting changes to your BG levels and the balance of components in your blood fats / cholesterol (total cholesterol is not a very helpful indicator IMHO)

 

[Gwynn]

Thank you. The fact that others find it tricky to balance things helps me greatly. At least I'm not quite as stupid as I feel (I hope).

Anyway I have increased my carbs (to 130g) and saturated fats (to 18g) today, but still only get to 1625 KCal.

Interestingly, I have read guidelines on the NHS and elsewhere that say for a man of my age, height and lifestyle, I should be consuming about 1500KCals. No wonder people get confused with so much conflucting advice out there. And, yes, the demonised fats seems to be being challenged.

The only real guide is how I personally react and cope.

I will stick at that for now and see if that helps. Its heaps more than I have been consuming each day over the last few months.

I feel so well now too.

I really don't want to go back on medication! So this is very important to me.

 

[Inka]

You’re being sensible @Gwynn You’ve made some small changes and can now see how things go and adjust again if needed 🙂

 

[Drummer]

The amount of carbs to have is what you can cope with easily so your blood glucose is in the normal range after eating - it is different for each person.
I could only eat 50 gm of carbs per day when I was younger if I was to control my weight, and that is what I went back to on diagnosis but I reduced it to under 40 to try to reduce my Hba1c, but that didn't work, that is stuck on 42.
I do not feel that I have to balance anything - I eat the natural fat which comes along with the meat, fish, yoghurt, eggs or cheese - if I don't feel like eating the fat on my meat then I cut it off, but I do not even give it a second thought.

 

[Gwynn]

I will let you know how things progress.

Thanks for all of your help

Never give up! Never surrender!

 

[Leadinglights]

There is a lot of debate about the fat/cholesterol issue and what is put out to the public is often a very simplistic view. But the body actually need a certain amount of cholesterol to function as it is part of the digestion process and it is involved in tissue healing and the body makes cholesterol from glucose and fatty acids. Your genetics will determine how much the body makes and utilises the dietary fats so again everybody is different. The ratio of HDL and LDL and triglycerides is an important factor not just the total cholesterol level and what is an acceptable level will vary for people with different risk factors - so not an easy balancing act.

 

[trophywench]

Prawns being the only protein for a whole day wouldn't be enough for most of us. I mean I get saturated fat every time I have a hot drink from the full fat milk in it. I also spread butter on bread and then put the protein (slice of boiled ham, slice of corned beef, tuna and mayo, cheddar..... )with or without some salad, between the bread, accompanied by 5-10 cheese and onion crisps. This afternoon I had a cup of tea and a Tesco's Finest sultana scone, halved and buttered with about a teaspoon of Raspberry with Gin & Lemon jam (in an Xmas food parcel and it is nice!) between the two, with approx a teaspoon of clotted cream on each half. Could have had a buttered Hot Cross bun instead, so that's tomorrow, Tea is roast chicken left over from Sunday, a small amount of boiled spud (mashed & creamed with full fat milk and a dollop of butter) steamed frozen peas and gravy.

 

[Gwynn]

Thats very interesting. Todays cumulative protein is 87g, which, from what I have read is more than sufficient (assuming that what I have read is correct)

Todays meals totals ended up like this...
Cals 1624
Carbs 104g
Protein 87g
Fibre 24g
Saturated fats 17g
Salt 3.5g
Cholesterol 157mg

It looks like these are reasonable figures. Am I wrong?

If I am then please let me know. I am keen to correct things but can only do so if I realise I have got it wrong.

 

[rebrascora]

How much non saturated fat are you eating as you seem to have omitted that?
Dietary cholesterol is now believed to have little bearing on blood cholesterol, so I think you are confusing the issue even counting it or worrying about it and there are different types of cholesterol some good, some less so, so lumping it all together is not helpful in my opinion. It is a far more complex issue than most scientists can agree on so what hope do you or I have of fathoming it out. Do you worry about the constitution of the air you breath and monitor that?
I think you have to draw a line and for me keeping the carbs under control and maintaining a healthy weight and feeling fit are more important than looking at calories and other macro or micro nutrients. I know that I now eat a lot of fat and a high proportion of that is saturated fat, but I feel fit and well, in fact more so than I have for 30 years and for me that is more important than worrying about NHS dietary guidance which has already been proved to be unhelpful for Type 2 diabetics and the low fat advice has been brought into question and discredited by greater minds than mine but looking at the information which is available and my own family history I am convinced that dietary fat and saturated fats are not the threat to our health that we have been lead to believe.

 

[Gwynn]

I have to agree with you regarding cholesterol. I will keep going for now but the September test results will dictate whether it has been helpful or not.

There is so much confusion around.

 

[Drummer]

I would really encourage you to start to have some decent meals - the essential foods are protein and fat, and your diet seems rather lacking in them - and you are eating so frequently too.
Today I have only eaten once, but I had beef with a stir fry and coffee with cream, which seems more than enough to sustain me.

 

[Gwynn]

Not quite sure I understand your reply Drummer. My meals are well balanced across the day and, except for calories all aspects are within guidelines. The calories are just a tad short of guidelines but I am increasing them gradually daily to ensure that I don't over do it.

All this extra effort that I apply, I quite enjoy, and trying to understand as much as I can keeps me fascinated and engaged, which is essential (IMHO} to manage diabetes.

I am well and happy, full of enery and do not feel hungry. I am just trying to stop the weight loss in a controlled and manageble (going forwards) way.

I am hoping to learn any new secret any of you may have in regard to increasing calories but not carbs.

Today I am very very nervous, worried and on edge, as I have the added serious stress of attending a psychiatric appointment with my wife, who wants to stop her meds again. Last time a GP agreed and she ended up being sectioned, but not before causing terrible damage to the family. I really don't want a repeat of that for her or us. This time she has been referred to a consultant so the outcome may be better.

 

[Inka]

@Gwynn I hope the appointment goes well today for you both. It must be very stressful indeed.

Your diet changes are fine. You’ve made some sensible changes and can always tweak a little more if needed.