Insulin for Type 2 Yes or No?

[Drummer]

I found Atkins very close to the way I was eating, and I still eat the same way.
I only need to eat twice a day now, and it keeps my blood glucose under control.

 

[Catz63]

Well my Diabetic nurse got back to me last night. She wanted to know why I wanted to postpone the insulin. I told her I wanted to try reversing the insulin resistance first before taking on the insulin. She was obviously not a convert to the Low Carb Diet, this came across very clearly. She said if I continued to loose weight my numbers would come down and the insulin would help.
I mentioned to her that both the Liquid Diet and the Low Carb Program were available to people in our area and asked if she would refer me to the Low Carb Program. She said she would refer me to a dietitian and he would have a chat with me about what steps I wanted and would also refer me back to the hospital "to see if they have any more ideas" her words. She ended the conversation agreeing a pause to at least June giving me time to change my BG figures but stressed for me not to cut out all carbs as the drugs I'm on would put me in danger of hypo's. She wants me to have at least a small amount of carbs in every meal.

So there we go NHS holding back and offering little help to reverse my insulin resistance. With the time referrals take at the moment I will be lucky to get on a plan before June.

I am going to try reducing my carbs and start doing as much activity as my body will allow and see how this affects my BG figures.

Thanks for all the feedback

 

[rebrascora]

Sorry to hear your nurse was less than supportive but at least you have a few months to see what you can do.
Her point about hypos is valid in some respects as 2 other relatively new members here who had very high HbA1c results (in 3 figures I think) and were on Gliclazide have experienced hypos after adopting a lower carb diet and both have decided to cut their medication and stick with the diet after their Health Care Professionals were not overly supportive. @Bazzlejet and @Newbie777 might be able to offer some support or inspiration to you.
Your nurse's logic falls down a bit in that adding insulin to the mix increases your chances of having a hypo, so whilst your choice of treatment plan (ie diet and exercise) may risk hypos initially, it is working towards reducing the medication which can cause them, her plan is just increasing your medication to 2 lots of medication which can cause hypos.

It is nigh on impossible not to have "carbs with every meal", short of eating protein and/or fat and nothing else (think winter Inuit diet of seal blubber) and who wants to do that, because vegetables provide all the colour and variation to our food, but cutting out the high carb bulky beige/white stuff should make a big difference to your levels.

I should mention that if you are going low carb, you need to think about providing your body with an alternative form of fibre as most of us struggled with constipation when we cut out wholemeal bread and pasta etc. I have a fibre drink on a morning which consists of a glass of water with a tspn of chia seeds and a tspn of either psyllium husk or recentluy been using milled linseed. I also add a dash of balsamic vinegar and oddly a splash of diet cola to give it flavour but choose your own low carb flavouring. Give it a good stir and wait for it to absorb some of the water before drinking it. This will produce a bulk of gelatinous fibre which will pass through your digestive tract and keep it healthy and moving comfortably and easily 😉. Chia and linseed are also packed with lots of great nutrients. Chia seeds are one of the highest sources of Omega 3. One of our members has them in his morning coffee instead of my weird concoction. They can also be put in soups or stews and are available in most supermarkets. I also try to include other seeds like hemp, sunflower, pumpkin, sesame etc. I tend to sprinkle those in my breakfast yoghurt with my berries... just a tablespoon or you can sprinkle them on salads etc. If you find the seeds a problem either with getting stuck in your gums or IBS, then psyllium husk in some flavoured water works well. It is the basis of the Fibogel sachets which are prescribed to people with bowl problems, but can be bought from health food shops or online unflavoured and added to whatever low carb drink you like or just plain water. It all does the same job and a teaspoon of the stuff is all you need. Some people even incorporate it into their low carb baking and we have some inspirational members who bake all sorts of cakes and breads and cheese cakes etc using very low carb ingredients instead of grain flour. It is absolutely amazing what you can achieve once you get your head around the whole process and no reason why you shouldn't enjoy your food as much if not more on a low carb diet. Fibre is a very important part of the process though.

Anyway, I think I have waffled on even more than usual so will call a halt for now but just want to wish you good luck and please keep us posted with your progress and reach out if you need any help or support. Some days will be reasonably easy and other days will be challenging. If you fall off the wagon, don't beat yourself up, just get back on and use the forum to help with motivational ideas and inspiration like reading posts by the 2 members I mentioned above as both are doing fantastic and their BG meter readings are evidence to that.

 

[Catz63]

Sorry to hear your nurse was less than supportive but at least you have a few months to see what you can do.
Her point about hypos is valid in some respects as 2 other relatively new members here who had very high HbA1c results (in 3 figures I think) and were on Gliclazide have experienced hypos after adopting a lower carb diet and both have decided to cut their medication and stick with the diet after their Health Care Professionals were not overly supportive. @Bazzlejet and @Newbie777 might be able to offer some support or inspiration to you.
Your nurse's logic falls down a bit in that adding insulin to the mix increases your chances of having a hypo, so whilst your choice of treatment plan (ie diet and exercise) may risk hypos initially, it is working towards reducing the medication which can cause them, her plan is just increasing your medication to 2 lots of medication which can cause hypos.

It is nigh on impossible not to have "carbs with every meal", short of eating protein and/or fat and nothing else (think winter Inuit diet of seal blubber) and who wants to do that, because vegetables provide all the colour and variation to our food, but cutting out the high carb bulky beige/white stuff should make a big difference to your levels.

I should mention that if you are going low carb, you need to think about providing your body with an alternative form of fibre as most of us struggled with constipation when we cut out wholemeal bread and pasta etc. I have a fibre drink on a morning which consists of a glass of water with a tspn of chia seeds and a tspn of either psyllium husk or recentluy been using milled linseed. I also add a dash of balsamic vinegar and oddly a splash of diet cola to give it flavour but choose your own low carb flavouring. Give it a good stir and wait for it to absorb some of the water before drinking it. This will produce a bulk of gelatinous fibre which will pass through your digestive tract and keep it healthy and moving comfortably and easily 😉. Chia and linseed are also packed with lots of great nutrients. Chia seeds are one of the highest sources of Omega 3. One of our members has them in his morning coffee instead of my weird concoction. They can also be put in soups or stews and are available in most supermarkets. I also try to include other seeds like hemp, sunflower, pumpkin, sesame etc. I tend to sprinkle those in my breakfast yoghurt with my berries... just a tablespoon or you can sprinkle them on salads etc. If you find the seeds a problem either with getting stuck in your gums or IBS, then psyllium husk in some flavoured water works well. It is the basis of the Fibogel sachets which are prescribed to people with bowl problems, but can be bought from health food shops or online unflavoured and added to whatever low carb drink you like or just plain water. It all does the same job and a teaspoon of the stuff is all you need. Some people even incorporate it into their low carb baking and we have some inspirational members who bake all sorts of cakes and breads and cheese cakes etc using very low carb ingredients instead of grain flour. It is absolutely amazing what you can achieve once you get your head around the whole process and no reason why you shouldn't enjoy your food as much if not more on a low carb diet. Fibre is a very important part of the process though.

Anyway, I think I have waffled on even more than usual so will call a halt for now but just want to wish you good luck and please keep us posted with your progress and reach out if you need any help or support. Some days will be reasonably easy and other days will be challenging. If you fall off the wagon, don't beat yourself up, just get back on and use the forum to help with motivational ideas and inspiration like reading posts by the 2 members I mentioned above as both are doing fantastic and their BG meter readings are evidence to that.

Thanks for your help and ideas.I'll let you all know how I get on.

 

[stillgoing]

The only downsides to insulin that I’ve found are all the carbohydrate counting and the driving restrictions. You have to test before driving, if under 4 then you have to eat something, wait 15 minutes until over 4, then wait a further 45 minutes. Sitting in the car for an hour in the freezing cold, without being able to start the engine to put the heating on, late on a dark night, and all because of a bg of 3.9 when you just want to be at home is a total pain.

I was told 5 to drive. My target level is 5 to 8 so that I should always be fit to drive.

Driving when you have diabetes | Diabetes UK

Have a look at this well known site. In my opinion not really clear what you do between 4.0 and 5.0. It seems to say eat some carb and then drive. Below 4.0 wait 45 mins once back to target. Above 5.0 fit to drive

 

[Robin]

Have a look at this well known site. In my opinion not really clear what you do between 4.0 and 5.0. It seems to say eat some carb and then drive. Below 4.0 wait 45 mins once back to target. Above 5.0 fit to drive

The 'Horse's Mouth' so to speak is here, foot of page 2. If below 5 (but over 4) eat a snack.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/834451/inf294-a-guide-to-insulin-treated-diabetes-and-driving.pdf

My interpretation of it is that you only need to wait 45 minutes and until you’re over 5 before you drive if you were under 4, or had symptoms of hypoglycaemia (which I supposed some people might get if they are over 4) when you tested.

 

[Newbie777]

Hello,

Sorry to hear about the dilemma you are now facing.

Am glad that good advice has already been provided and hopefully this will help you.

You are on similar medicines to myself.

I am not an expert, so I can only mention my personal experience and may not be right for you, so please get medical advice as there may be other factors that only your GP can help you. I think, but not sure, Diabetic Nurses cannot prescribe medicine and would nees consult with the GP, so go straight to the GP.

I do not like the idea of going on insulin myself as I think it is a last resort and I don't like the dependancy on it.Medicine wise Glicizide can be increased to a max of 240mg, but not sure if that is suitable, one for your GP. Also, can I ask when do you take your Glicizide?

Yes, it's true that low carb is the way forward. However, I need to point out that I think slow steady change will be better, so keep some treats or hold on to some stuff for bad days, but start straight away with switching to almond milk and Brugen bread, that way you are replacing and not removing food, so it does not feel as bad. You will be amazed how changing to low carb eating will help you with.
1. Losing weight
2. Lowering your sugar (BG) levels
3. Help you feel fuller for longer.

Finally, it would be rude of me not to mention how well you have done on losing your weight.Well done and keep up the good work!

 

[grovesy]

Hello,

Sorry to hear about the dilemma you are now facing.

Am glad that good advice has already been provided and hopefully this will help you.

You are on similar medicines to myself.

I am not an expert, so I can only mention my personal experience and may not be right for you, so please get medical advice as there may be other factors that only your GP can help you. I think, but not sure, Diabetic Nurses cannot prescribe medicine and would nees consult with the GP, so go straight to the GP.

I do not like the idea of going on insulin myself as I think it is a last resort and I don't like the dependancy on it.Medicine wise Glicizide can be increased to a max of 240mg, but not sure if that is suitable, one for your GP. Also, can I ask when do you take your Glicizide?

Yes, it's true that low carb is the way forward. However, I need to point out that I think slow steady change will be better, so keep some treats or hold on to some stuff for bad days, but start straight away with switching to almond milk and Brugen bread, that way you are replacing and not removing food, so it does not feel as bad. You will be amazed how changing to low carb eating will help you with.
1. Losing weight
2. Lowering your sugar (BG) levels
3. Help you feel fuller for longer.

Finally, it would be rude of me not to mention how well you have done on losing your weight.Well done and keep up the good work!

If the Diabetic Nurse is a Nurse Prescriber they can can prescribe medicine. I not seen a GP for my Diabetes in nearly 15 years the nurses deal with everything.

 

[rebrascora]

If the Diabetic Nurse is a Nurse Prescriber they can can prescribe medicine. I not seen a GP for my Diabetes in nearly 15 years the nurses deal with everything.

And will almost certainly be more knowledgeable than the GP in relation to Type 2 diabetes and probably Type 1 too although the latter might not be saying a lot.

 

[grovesy]

And will almost certainly be more knowledgeable than the GP in relation to Type 2 diabetes and probably Type 1 too although the latter might not be saying a lot.

Yes , and when I was first diagnosed my then GP (now retired) said I will leave it to Debbie ( she has since retired too) . One of my current nurses used to be the Lead Diabetic Nurse for the next town.

 

[Newbie777]

If the Diabetic Nurse is a Nurse Prescriber they can can prescribe medicine. I not seen a GP for my Diabetes in nearly 15 years the nurses deal with everything.

Oh ok thank you for clarify this and that makes sense.

 

[Newbie777]

Yes , and when I was first diagnosed my then GP (now retired) said I will leave it to Debbie ( she has since retired too) . One of my current nurses used to be the Lead Diabetic Nurse for the next town.

Yes, I guess as the name suggest General Practioner, not an expert on everything, unlike a specialist like a Diabetic Nurse.

My experience with Diabetic Nurses has been slightly poor though, with recommendations made to the GP to increase my medicine, year upon year.
Of course all this is totally my fault for poor BG control.

 

[Drummer]

There seems to be a thing about 'needing fibre' to replace that from grains.
As I eat low carb veges, and it would have been my preferred menu all my adult life, I have never had any bother with constipation except when a well meaning HCP has pushed me to accept their print out diet sheet and to eat a low fat high carb diet.
I have never been able to understand 'feeling full' - I presume that it is the sensation of the stomach being stretched by the amount of food consumed. That would always, in my mind, be associated with having eaten too much 'eyes bigger than the belly' behaviour.
Having never stuffed myself it is not a sensation I would seek out as being a good thing. I do eat quite slowly, compared to me most people gobble down their food - I often wonder if they actually taste any of it. That might have something to do with it.

 

[Newbie777]

There seems to be a thing about 'needing fibre' to replace that from grains.
As I eat low carb veges, and it would have been my preferred menu all my adult life, I have never had any bother with constipation except when a well meaning HCP has pushed me to accept their print out diet sheet and to eat a low fat high carb diet.
I have never been able to understand 'feeling full' - I presume that it is the sensation of the stomach being stretched by the amount of food consumed. That would always, in my mind, be associated with having eaten too much 'eyes bigger than the belly' behaviour.
Having never stuffed myself it is not a sensation I would seek out as being a good thing. I do eat quite slowly, compared to me most people gobble down their food - I often wonder if they actually taste any of it. That might have something to do with it.

Wow that's control for you.

Sorry to say I am the complete opposite of yourself in everyway and wish I was so much like you.Regular carvery, eating quick, over indulging etc. I would use excessive carb eating to think it would reduce/control my stress, but is not true and no excuse. But was then and not now.

I recently have gone on a low carb diet and constipation is an issue, so more water, an apple and from today Weetabix with almond milk for breakfast.

 

[Drummer]

You might get more - er - benefit - from a big green salad or a stir fry than having carby foods.
I get a bag of ready made salad, add in beetroot, radishes, tomato, cucumber, celery, red sweet pepper, coleslaw, olive oil and wine vinegar dressing, - I need a big bowl, then add tinned fish, usually, or boiled eggs and cheese.
If I am frying something I might take the green sweet peppers, mushrooms, outer sticks of celery, courgette, any cooked veges left in the fridge tend to be tossed in as well, to make a stir fry.
I do have a very sensitive sense of taste, even at almost 70 - I used to work for Allied Lyons doing storage testing - picking up when things would start to go off by tasting. I often eat alone as I tend to exclaim at the different flavours as I eat - just can't help myself.
I think that most breakfast cereals are indistinguishable from their packaging.

 

[Newbie777]

You might get more - er - benefit - from a big green salad or a stir fry than having carby foods.
I get a bag of ready made salad, add in beetroot, radishes, tomato, cucumber, celery, red sweet pepper, coleslaw, olive oil and wine vinegar dressing, - I need a big bowl, then add tinned fish, usually, or boiled eggs and cheese.
If I am frying something I might take the green sweet peppers, mushrooms, outer sticks of celery, courgette, any cooked veges left in the fridge tend to be tossed in as well, to make a stir fry.
I do have a very sensitive sense of taste, even at almost 70 - I used to work for Allied Lyons doing storage testing - picking up when things would start to go off by tasting. I often eat alone as I tend to exclaim at the different flavours as I eat - just can't help myself.
I think that most breakfast cereals are indistinguishable from their packaging.

Yes that is true

I am on the right path, salad is once or twice a day and I experiment with the ingredients, my carb intake is now between 80g to 100g a day..

I had 1 Weetabix with almond milk and an egg for breakfast.
I do agree with what you are saying about cereals looking at the ingredients and there is a lot of stuff added.

 

[Drummer]

Oh - I forgot to mention herbs and spices. They can really add to the experience of eating salads and veges.

 

[JMyrtle]

Like Drummer I only eat twice a day and restrict carbs as much as possible.
One slice of Wholemeal Nimble is a good bet for breakfast as it's half the carbs of Burgan and Sheldon bottom cooked muffins are half the value of a bread roll.
It's s also worth testing and comparing the different kind carbs you have with your meals to find what you can tolerate yourself as everyone is different, For instance I am fine with baked or whole potato, chips and pasta but not white bread, mashed potato or rice.
I am also sorry to say this but you will have to get used to cooking two different meals for you and your husband, for example fish and chips, sausage and mash and Ulster fry are way off my menu but not his so I batch cook and keep my meals in the freezer for the days I need them when we don't eat the same thing.

 

[Cjoy]

Do you test regularly? I’m newly diagnosed, and it has been really eye opening what sends the blood sugar sky high. It has been trial and error, measuring glucose level before and 2 hrs after eating, ditching foods that change the level by more than 3. But once I know I can eat something I don’t tend to test before/after. I’ve certainly found it has really helped in reducing my blood sugar.

 

[JMyrtle]

I test four times day, on rising, before and after my main meal and before going to bed, provided my monthly average on the meter is below 7.5 I know I am in the normal range although its usually between 6.8 nd 7. 2
My GP said to keep a my sigle reading under 10.0 but I prefer to be below 8.0 so I know I'm still on track.