Hi there not really sure what I’m doing

[TC40]

Hi, I’m 40 years old, I was diagnosed as diabetic about a month ago. Initially I went to the doctors for a UTI, they tested my urine and found glucose so gave me a blood test. My fasted blood test was 9.3 then my long term one was 71 so they said I was diabetic. This also happened to be the day I was moving house across the country. My doctor squeezed me in with the diabetic nurse who told me she had 8 minutes to talk to me. She told me I needed two blood tests before being diagnosed then decided I needed to be on metformin. She wasn’t very helpful just told me that I needed to lower my carb intake and not drink fruit juice and not eat to much fruit. She was pretty dismissive when she realized I was moving and said I needed to see the diabetic nurse in my new practice and gave me a list of things that would happen when I spoke to my new nurse. She gave me a prescription and sent me on my way after giving me a rather technical description of how metformin worked. Next I went to register at my new practice- receptionist said I couldn’t speak to a doctor or nurse until my registration was through (7-10 days) At this point I had a bit of a melt down but she did say she would try to speed it up. After a week I got registered, ended up with a phone appointment with a dr who told me to take the metformin and make an appointment with the diabetes nurse. My first appointment with the diabetes nurse is May 25th - earliest they could fit me in.

My sister is type 1 so has been supportive and gave me a blood tester. The metformin seems to be bringing my blood sugar down. But I don’t really know what I’m doing. I’m not overweight, and I’m pretty active so not sure what’s going on. Any advice on where to start on this journey would be great.

 

[IrvineHimself]

Hi @TC40, welcome to the forums.

What you describe sounds horrible. When it comes to medical matters, as I know only too well, travelling, (or in your case moving,) can be a real bitch.

Since you mention not having any of the normal lifestyle indicators, you really need to register with a new Doctor and get expert advice about the root cause of your diabetes. There may be other things going on.

With regard to carbs:
The general advice is to cut back on carbs, they all get converted to sugar. My Doctor gave me a target for a daily carb allowance. Since cutting back too quickly on the carbs can lead to complications, this initial target will, along with your medical history, depend on your previous eating habits. The most important thing to note is that you have to reduce your carb intake in stages.

Get into the habit of looking at the nutritional info on prepared foods, snacks etc and don't be fooled by labels that say: "Healthy Option". They may be healthy, but they can also have very high carb content. If, like me, you lack the discipline to just have one chocolate digestive, then it is probably best to avoid high sugar biscuits completely. Ditto with packets of crisps, tortillas and the like. Sugar is another no-no: Avoid sugary drinks and, if you can stomach them , use saccharine or some other sweetener in tea and coffee. If not, drink your morning cuppa unsweetened. With respect to soft drinks, note that there is a difference between "sugar free" and "no added sugar". It is the latter which should be your beverage of choice.

In general, you should only have very small, tiny daily portions of high carb veg, grains and cereals. Basically, cut back drastically on: pasta. potatoes, rice, bread... Another thing to avoid is "most" tropical fruits as they have a high sugar content. Apples and berries have a much lower sugar content, as does fruit which is not fully ripened.

For snacking, tree nuts:, almonds, walnuts, hazelnuts.... are all good. On the other hand dried fruit like raisins and sultanas are full of sugar. (That is why grapes are used to make great wine)

There is a meal planner here in the main DiabetesUK domain, which may be of use. Along with a search box, the page also has a navigation bar that will allow you to browse a large number of good quality articles on suitable foods, recipes ... etc, etc.

No doubt others will be along shortly to welcome you who will be able to relate their experiences with not having the normal lifestyle indicators

Good luck and welcome
Irvine

 

[Dave_Z1a]

I know your not panicking but don't panic, you have a diagnosis and some numbers which is good, at least its been picked up. I was in a similar situation before being diagnosed. Your sister will be a good source of advice to start with but you have some time to read up a bit about it, this forum is excellent, maybe jot down some notes to ask the db nurse when you meet her. Lots of other things will fall into place after the meeting like an eye check, general obs such as blood pressure, feet, weight, possibly more blood tests to establish a base line going forward etc and maybe NHS zoom course. In the meantime you could start cutting down, or cutting out, bread, rice, pasta, pastry, sugar, most fruits including juice (the worst!), confectionary, breakfast cereals except maybe oats if your lucky. Check out food labels before eating stuff, look for the carb content, in my case anything over 5g per 100g of product is a bit of a red flag, I either eat a tiny bit of it, don't eat it or eat it after having the main course. Eg full english fry up is fine, and I can have melon or yoghurts afterwards with little effect. Have a look at blood glucose meters they are very useful to advise you how your processing the foods you eat, your sister no doubt will know all about these little gadgets! Hope I didn't sound too patronising and your not alone, I seem to bump into type 2 diabetics on a regular occasion, a lot of us about! It will take time but you will manage the condition and it will become second nature. Big bonus is you will feel so much better in yourself with lower bs levels. Good luck at your first meeting, maybe you sister could go with you?

 

[Inka]

Welcome @TC40 You say you’re not overweight and your sister has Type 1. Has Type 1 been ruled out in your case? Type 1 comes on more slowly in adults and is often just assumed to be Type 2.

 

[TC40]

I’ve had 2 blood tests, that’s the extent so far. I’m hoping that when I finally see the nurse they will have some kind of plan. The first dr wanted to refer me so hopefully the next one will want to find out for sure. I think the lack of ketones made them want to treat me with metformin.

 

[Inka]

Hmm, I’d push for a C Peptide and the Type 1 antibodies test. You wouldn’t have had ketones at 9ish anyway, but you could be going higher than that at other times.

 

[ianf0ster]

Hi @TC40 and welcome to the forum.
Your situation isn't that unusual, even for those who aren't moving when first diagnosed.
An HbA1C of 71 (the long term measurement) is high (pre-diabetes in the UK starts at 42, and Diabetes at 48) but many were diagnosed with an HbA1C of over 100.
At least you have been given some good advice about Carbohydrates and Blood Glucose Meters.
GP's usually advise T2's not to do BG tests, but that is rather like driving by only looking in the rear view mirror - you can only see where you have been, not where you are in real time.
While Metformin does lower Blood Glucose, it does so by encouraging the liver to produce less of it, it does nothing to help with the processing of the glucose from the carbohydrates we eat - so most people need more than just metformin (either a dietary change such as Low Carb or more drugs).
For a Type 2, the best use of BG meter is for testing your meals in order to find ones you like which don't spike your BG too much. The way to do it is to test just before eating and then again 2hrs after first bite of that meal. Ultimately you should be aiming for spikes at the 2hr mark of 2.0mol or less, but due to your body being accustomed to high levels of BG, you can allow more (say 3mol spikes at first). The easiest meal to correct is breakfast (ditch the cereals) eat eggs and/or bacon, or cheese, or cold meat or Greek yoghurt with some berries an/or nuts - choose full fat dairy because that keeps you feeling fuller for longer than the low fat ones do (and usually contains fewer carbs).

Now the sting in the tail: Because you are slim (I am/was a slim T2 by now not classified as a diabetic because my blood tests are back in the normal range). There is a chance that you may eventually be diagnosed as a Type 1 or LADA (Late Onset Type 1). In which case you will eventually need to inject insulin daily, but with a low carb way of eating it's possible to need small amounts of insulin and the smaller the amount of carbs, the more accurate it is possible to get to the correct does of insulin.

 

[TC40]

I’ve been testing my blood now and again the highest I’ve found was 14.3. I’m hoping they will look at it. Thanks I will ask

 

[TC40]

Hi @TC40 and welcome to the forum.
Your situation isn't that unusual, even for those who aren't moving when first diagnosed.
An HbA1C of 71 (the long term measurement) is high (pre-diabetes in the UK starts at 42, and Diabetes at 48) but many were diagnosed with an HbA1C of over 100.
At least you have been given some good advice about Carbohydrates and Blood Glucose Meters.
GP's usually advise T2's not to do BG tests, but that is rather like driving by only looking in the rear view mirror - you can only see where you have been, not where you are in real time.
While Metformin does lower Blood Glucose, it does so by encouraging the liver to produce less of it, it does nothing to help with the processing of the glucose from the carbohydrates we eat - so most people need more than just metformin (either a dietary change such as Low Carb or more drugs).
For a Type 2, the best use of BG meter is for testing your meals in order to find ones you like which don't spike your BG too much. The way to do it is to test just before eating and then again 2hrs after first bite of that meal. Ultimately you should be aiming for spikes at the 2hr mark of 2.0mol or less, but due to your body being accustomed to high levels of BG, you can allow more (say 3mol spikes at first). The easiest meal to correct is breakfast (ditch the cereals) eat eggs and/or bacon, or cheese, or cold meat or Greek yoghurt with some berries an/or nuts - choose full fat dairy because that keeps you feeling fuller for longer than the low fat ones do (and usually contains fewer carbs).

Now the sting in the tail: Because you are slim (I am/was a slim T2 by now not classified as a diabetic because my blood tests are back in the normal range). There is a chance that you may eventually be diagnosed as a Type 1 or LADA (Late Onset Type 1). In which case you will eventually need to inject insulin daily, but with a low carb way of eating it's possible to need small amounts of insulin and the smaller the amount of carbs, the more accurate it is possible to get to the correct does of insulin.

Thank you that is brilliant information! An actual plan of action I really appreciate the time you have taken to write that down for me. I’ve always had a sweet tooth and enjoyed all the carbs so hopefully reducing these will make a difference.

 

[TC40]

I know your not panicking but don't panic, you have a diagnosis and some numbers which is good, at least its been picked up. I was in a similar situation before being diagnosed. Your sister will be a good source of advice to start with but you have some time to read up a bit about it, this forum is excellent, maybe jot down some notes to ask the db nurse when you meet her. Lots of other things will fall into place after the meeting like an eye check, general obs such as blood pressure, feet, weight, possibly more blood tests to establish a base line going forward etc and maybe NHS zoom course. In the meantime you could start cutting down, or cutting out, bread, rice, pasta, pastry, sugar, most fruits including juice (the worst!), confectionary, breakfast cereals except maybe oats if your lucky. Check out food labels before eating stuff, look for the carb content, in my case anything over 5g per 100g of product is a bit of a red flag, I either eat a tiny bit of it, don't eat it or eat it after having the main course. Eg full english fry up is fine, and I can have melon or yoghurts afterwards with little effect. Have a look at blood glucose meters they are very useful to advise you how your processing the foods you eat, your sister no doubt will know all about these little gadgets! Hope I didn't sound too patronising and your not alone, I seem to bump into type 2 diabetics on a regular occasion, a lot of us about! It will take time but you will manage the condition and it will become second nature. Big bonus is you will feel so much better in yourself with lower bs levels. Good luck at your first meeting, maybe you sister could go with you?

Thank you lots of good information.

 

[TC40]

Hi @TC40, welcome to the forums.

What you describe sounds horrible. When it comes to medical matters, as I know only too well, travelling, (or in your case moving,) can be a real bitch.

Since you mention not having any of the normal lifestyle indicators, you really need to register with a new Doctor and get expert advice about the root cause of your diabetes. There may be other things going on.

With regard to carbs:
The general advice is to cut back on carbs, they all get converted to sugar. My Doctor gave me a target for a daily carb allowance. Since cutting back too quickly on the carbs can lead to complications, this initial target will, along with your medical history, depend on your previous eating habits. The most important thing to note is that you have to reduce your carb intake in stages.

Get into the habit of looking at the nutritional info on prepared foods, snacks etc and don't be fooled by labels that say: "Healthy Option". They may be healthy, but they can also have very high carb content. If, like me, you lack the discipline to just have one chocolate digestive, then it is probably best to avoid high sugar biscuits completely. Ditto with packets of crisps, tortillas and the like. Sugar is another no-no: Avoid sugary drinks and, if you can stomach them , use saccharine or some other sweetener in tea and coffee. If not, drink your morning cuppa unsweetened. With respect to soft drinks, note that there is a difference between "sugar free" and "no added sugar". It is the latter which should be your beverage of choice.

In general, you should only have very small, tiny daily portions of high carb veg, grains and cereals. Basically, cut back drastically on: pasta. potatoes, rice, bread... Another thing to avoid is "most" tropical fruits as they have a high sugar content. Apples and berries have a much lower sugar content, as does fruit which is not fully ripened.

For snacking, tree nuts:, almonds, walnuts, hazelnuts.... are all good. On the other hand dried fruit like raisins and sultanas are full of sugar. (That is why grapes are used to make great wine)

There is a meal planner here in the main DiabetesUK domain, which may be of use. Along with a search box, the page also has a navigation bar that will allow you to browse a large number of good quality articles on suitable foods, recipes ... etc, etc.

No doubt others will be along shortly to welcome you who will be able to relate their experiences with not having the normal lifestyle indicators

Good luck and welcome
Irvine

Thank you I will check out the meal planner.

 

[Leadinglights]

I’ve been testing my blood now and again the highest I’ve found was 14.3. I’m hoping they will look at it. Thanks I will ask

As you are seeing quite high glucose levels anything you can do to reduce it the better even before you see the nurse. These days one has to become one's own expert in managing blood glucose levels. The diabetic nurses do tend to be bound by the standard NHS advice which recommends carbohydrate intake which is much higher than many can tolerate and foods that would cause high blood glucose levels. Metformin can only help the body cope with carbs slightly better by enabling it to use the insulin it is producing more effectively but can only make a small difference and dietary changes are the most powerful tool.
Many people find making a food diary of everything they eat and drink estimating the TOTAL carbs as it will help you see where some savings can be made. This can run alongside blood glucose readings of tests before you eat and 2 hours after your meal. This will indicate how your body is tolerating the carbs you ate, no more than 2-3mmol/l increase is what to aim at.
Many people find a low carb approach is successful and that would be less than 130g total carbs per day. You might find this link will give you some ideas. https://lowcarbfreshwell.co.uk/
This may change if it does turn out you are Type 1 or LADA so bear that in mind.

 

[Inka]

Be warned - if you’re actually a Type 1 and you reduce carbs too low, you’ll mask the symptoms and could delay your diagnosis. Early introduction of insulin in Type 1/LADA helps preserve the remaining beta cells so that’s important. A friend strugggled on for far too long. If you’re Type 2, obviously there’s no need to worry about that, but because you have a close relative with Type 1, I’d want that ruled out first. That way at least you’ll know and can then move forward in the appropriate way.

Contrary to what Ian has written above, for many Type 1s eating too few carbs just makes control harder in a different way. It can also cause a form of insulin resistance. The vast majority of Type 1s eat a normal diet with moderate amounts of carbs just as recommended for people without diabetes. People here eat all kinds of diets and varying amounts of carbs.

 

[everydayupsanddowns]

Welcome to the forum @TC40

Sorry to hear about your rollercoaster introduction to the world of diabetes. What terrible timing!

Hope things settle for you after your appointment on 25th, and you can begin to get some clarity/confirmation around your diabetes type given the T1 in your immediate family.

In the meantime you can keep asking away with questions on the forum, we have centuries of lived diabetes experience, and folks using all sorts of different management strategies for you to tap-into. No questions will be regarded as too obvious or ‘silly’ 🙂

 

[TC40]

Hi @TC40 and welcome to the forum.
Your situation isn't that unusual, even for those who aren't moving when first diagnosed.
An HbA1C of 71 (the long term measurement) is high (pre-diabetes in the UK starts at 42, and Diabetes at 48) but many were diagnosed with an HbA1C of over 100.
At least you have been given some good advice about Carbohydrates and Blood Glucose Meters.
GP's usually advise T2's not to do BG tests, but that is rather like driving by only looking in the rear view mirror - you can only see where you have been, not where you are in real time.
While Metformin does lower Blood Glucose, it does so by encouraging the liver to produce less of it, it does nothing to help with the processing of the glucose from the carbohydrates we eat - so most people need more than just metformin (either a dietary change such as Low Carb or more drugs).
For a Type 2, the best use of BG meter is for testing your meals in order to find ones you like which don't spike your BG too much. The way to do it is to test just before eating and then again 2hrs after first bite of that meal. Ultimately you should be aiming for spikes at the 2hr mark of 2.0mol or less, but due to your body being accustomed to high levels of BG, you can allow more (say 3mol spikes at first). The easiest meal to correct is breakfast (ditch the cereals) eat eggs and/or bacon, or cheese, or cold meat or Greek yoghurt with some berries an/or nuts - choose full fat dairy because that keeps you feeling fuller for longer than the low fat ones do (and usually contains fewer carbs).

Now the sting in the tail: Because you are slim (I am/was a slim T2 by now not classified as a diabetic because my blood tests are back in the normal range). There is a chance that you may eventually be diagnosed as a Type 1 or LADA (Late Onset Type 1). In which case you will eventually need to inject insulin daily, but with a low carb way of eating it's possible to need small amounts of insulin and the smaller the amount of carbs, the more accurate it is possible to get to the correct does of insulin.

Right I’ve started! I checked my BG this morning before breakfast- 7.8 then had porridge with chia seeds and blueberries, 2 hours later 7.8 - so that breakfast works then but I am feeling like I need to eat something- like I’m lacking in fuel … will my body get used to that feeling? My sister said I might feel a bit like this as that might be low blood sugar for me…

 

[Leadinglights]

Right I’ve started! I checked my BG this morning before breakfast- 7.8 then had porridge with chia seeds and blueberries, 2 hours later 7.8 - so that breakfast works then but I am feeling like I need to eat something- like I’m lacking in fuel … will my body get used to that feeling? My sister said I might feel a bit like this as that might be low blood sugar for me…

You could add a couple of spoons of Full fat Greek yoghurt as the extra fat will help you not to feel hungry.