Just diagnosed with Type 2

[Spacebard]

Hello everyone.

I'm 55 (male) and I have just been diagnosed with Type 2 diabetes, which I freely admit has been on the cards for a while. I was declared "borderline pre-diabetic" (or somesuch phrase) last year and given the usual advice to lose weight and get more exercise, but I failed to lose any weight and, in fact, gained quite a bit. I can only blame myself (although stress has been a major factor).

Currently, I'm waiting to see the local diabetic nurse for an advisory session. In the meantime, I've embarked upon a sensible weight loss diet. Although I've been overdoing it big time, I think I'm reasonably well informed on nutrition; I know that if I cut out certain things (bad snacks, alcohol), reduce my portion sizes, and eat little and often, my diet is quite good overall. I have lost significant amounts of weight before, but I always pile it back on. I'm sure this is a familiar story...

I'm wondering what else can I do, apart from losing weight and exercising more (which is a six-month+ project)? I have no idea what my blood glucose levels are from meal to meal - I'm not experiencing any indicative symptoms - so how can I know if my levels are under control? Will I have to monitor that and, if so, how often? I'm assuming drugs won't be involved at this stage.

I'm thinking out loud. I know I'll find the answers to these questions in time, but I thought I'd join this forum and introduce myself.

 

[Northerner]

Hi Spacebard, welcome to the forum 🙂 Sorry to hear about your diagnosis It sounds like you have tried to make a start, but are just not too sure about how to proceed. Probably best to start by learning a little about diabetes, how it affects you and how you can tackle it - the better your understanding of things, the easier it will be to get to grips with 🙂 I would suggest starting by reading Jennifer's Advice and Maggie Davey's letter, both long-established and well-regarded overviews. I'd also recommend getting a copy of Type 2 Diabetes: The First Year by Gretchen Becker, which is a positive and practical guide to these first few months.

There is a lot of negativity flying around about diabetes, particularly Type 2, with almost every article describing it as a lifestyle disease, with the consequence that many people blame themselves. However, there is a strong genetic factor at work, so any family history of diabetes may have been your first mistake - you should have picked better parents! 😉 It's also thought that, rather than diabetes being a consequence of weight gain, it may actually be the other way round, and the weight gain is due to the failure of your body to regulate your blood sugar levels properly.

I would suggest you start by writing a food diary. In it, record everything you eat and drink, and include the amount (in grams) of carbohydrate consumed. Carbohydrates, like bread, potatoes, rice, pasta, as well as obviously sugary things are what will raise your blood sugar levels the most. However, you will tolerate some things better than others, and the key to managing your diabetes well is doscovering what things you tolerate well and what you should be excluding from your diet. The food diary will provide you with a true picture of the kind of things you enjoy and your total carb intake, and once you have done it you can use it to identify areas that you might improve. Ideally, this will involve following a testing programme so you can find out how your blood sugar levels are affected by your food choices. Have a read of Test,Review, Adjust by Alan S to understand how to do this efficiently. If you don't have a blood glucose testing meter, it is well worth getting one so you can discover your tolerances, otherwise you will just be guessing and possibly continuing to eat things you don't tolerate well, or leaving out things you could safely keep in. The cheapest option we have come across is the SD Codefree Meter which has test strips at around £8 for 50 (high st shops sell strips at around £25-£30, and the strips are the main expense, so don't be taken in by a cheap meter with expensive strips! 😱).

Often, changing your diet so that it is better for your blood sugar control will result in you losing weight without really trying. If you are eating the wrong things (for your blood sugar control) then your body overproduces insulin which can then contribute to weight gain, whatever you do about calories etc. Stabilising your levels will help to normalise your insulin production so your body isn't constantly stressed in a battle with your food. If you want an idea of the types of food that can help, I'd recommend getting a copy of The GL Diet for Dummies which is a very good introduction to the 'Glycaemic Load' approach to selecting and combining foods so that they have a slow, steady impact on blood glucose levels.

That lot should get you thinking for a while! 🙂 Please let us know if you have any questions about all this, we have lots of friendly, well-informed people here who can speak from personal experience 🙂

 

[Spacebard]

Thanks very much for the welcome, Northerner. I particularly appreciate your reading recommendations, as it’s difficult to know where to start.

I am keeping a food diary. I use a site called SparkPeople when I’m trying to lose weight, as it records the amount of carbs, fat, protein, fibre etc. in foods and sets target ranges for each day. I recently reset my account, and included the fact that I’m diabetic, which has resulted in some changes to the target ranges (it now shows targets for each meal, for example). Also, I do have a family history of diabetes – my Dad and three of my cousins on his side have Type 2 and one uncle has Type 1 – but I’ve always assumed that I might avoid it if I could get back to a normal weight... which is why I blame myself. I’m interested to hear that ongoing poor regulation of sugar levels could have contributed to weight gain.

Having read a few other threads in this forum, and reading your advice, I realise that I need to get myself a blood glucose meter. The aforementioned SparkPeople site now gives me the option of recording daily glucose levels and periodic A1C levels, but it sounds like I should be testing more than once a day to establish the effect of certain foods and to understand how levels fluctuate throughout the day.

Thanks again!

 

[Northerner]

You're very welcome 🙂 The best approach with testing is to follow the advice in Test,Review, Adjust by Alan S - once you have established what your tolerances are you won't need to test anywhere near as often, so it may seem a lot to begin with but after you are familiar with your reactions to food you commonly eat you'll only need to test things that are new or for the occasional spot check. If you need any help interpreting the numbers, let us know 🙂

 

[Copepod]

Finding the right activity - something you enjoy - is key to maintaining adequate exercise levels, which often help reduce stress levels, too. Often integrating into normal life eg walking or cycling instead of driving or taking public transport, gardening etc, adding something to make walking / cycling more interesting eg photography, geoacaching etc, or running eg parkruns or orienteering. Obviously things depend on where you live eg rural / urban etc.

 

[Spacebard]

Thanks, Copepod. At the moment, I walk just about everywhere, as I don't have a car. A year ago, I moved from London back to my birthplace, a moderately large market town in the Midlands. I did join the gym, but didn't go often enough to make it count and ended up cancelling my membership. However, I've always enjoyed exercising on a fixed bike (and I used to attend spinning classes), so I've invested in an exercise bike to use at home. I also fancy joining a dance class, if I can find one locally that isn't aimed at small girls or elderly ladies.

Northerner: I ordered an SD Code Free meter and it arrived today, so I'll start using that soon (I've also followed up on all the other links you provided - extremely helpful - thanks again!).

 

[Northerner]

Thanks, Copepod. At the moment, I walk just about everywhere, as I don't have a car. A year ago, I moved from London back to my birthplace, a moderately large market town in the Midlands. I did join the gym, but didn't go often enough to make it count and ended up cancelling my membership. However, I've always enjoyed exercising on a fixed bike (and I used to attend spinning classes), so I've invested in an exercise bike to use at home. I also fancy joining a dance class, if I can find one locally that isn't aimed at small girls or elderly ladies.

Northerner: I ordered an SD Code Free meter and it arrived today, so I'll start using that soon (I've also followed up on all the other links you provided - extremely helpful - thanks again!).

Good idea to invest in an exercise bike, I have one and a rowing machine also - far better than having to hike off to the gym where I would often end up having to wait for equipment to come free. I think having the equipment there at home encourages you to use it more 🙂

Let us know how you get on with the testing, and if you have any questions regarding your readings 🙂

 

[Spacebard]

I've only done a couple of tests so far. I haven't quite got the hang of getting blood out of my fingers: I'm using the lancet device on setting '5' and attempting to take a sample from the side of a fingertip, but I only get a large enough sample about one time out of three. I guess I'll get the hang of it eventually.

Today, I took a fasting reading on first waking up and it was 6.6. I took another one two hours after eating breakfast and it was 7.4. Based on what I've read, I seem to be within the desired ranges, but it's early days yet. I plan to test before and after various meals and see how it looks over time.

 

[Northerner]

I've only done a couple of tests so far. I haven't quite got the hang of getting blood out of my fingers: I'm using the lancet device on setting '5' and attempting to take a sample from the side of a fingertip, but I only get a large enough sample about one time out of three. I guess I'll get the hang of it eventually.

Today, I took a fasting reading on first waking up and it was 6.6. I took another one two hours after eating breakfast and it was 7.4. Based on what I've read, I seem to be within the desired ranges, but it's early days yet. I plan to test before and after various meals and see how it looks over time.

Good results 🙂

You will get the hang of the fingerpricking 🙂 It can be helpful to run some warm water over your hands first (then dry them!) as the heat brings the blood more to the surface. Also, hanging your arm down and shaking it (believe it or not!) can also help. Prick the finger, then wait a second or two before gently squeezing - when you prick the finger it will react by trying to instantly close the wound, but if you allow it to relax for a second or two the blood usually comes out more easily 🙂

 

[pottersusan]

Welcome aboard. Lots of knowledgeable helpful people here🙂

 

[AJLang]

Welcome to the forum. I also live in a moderately large market town in the Midlands🙂

 

[Stitch147]

Hi and welcome to the forum.

 

[Spacebard]

Thanks all for the welcomes.

I finally saw the diabetic nurse today and got the full story on my diagnosis. I had an HbA1c level of 47, which puts me at the very top of the pre-diabetic range, and I had consecutive fasting blood glucose levels of 7.4 and 7.1, which, overall, is diagnostic of type 2 diabetes. I won't need any medication at the moment; the advice is to continue what I've started regarding weight loss and exercise, and to keep an eye on the carbs and portion sizes. The nurse suggested that regular home monitoring of blood glucose isn't going to be of much help to me, as my risk of hypo- or hyper- levels is low. In the absence of the full picture, I'd been monitoring my blood glucose on a daily basis (I'm now an expert at the finger pricking routine) and my fasting morning levels fall between 6.0 and 7.5. The highest reading I've had overall is 8.7, a couple of hours after a particularly bread-oriented lunch.

I don't need to tell anyone here that I will now be subject to regular checks on a number of body parts and fluids, but the main thing is that I'm aware of the diagnosis and able to keep it under control. The nurse said my blood pressure and cholesterol levels are probably more important at this stage than my blood glucose, due to the raised risk of heart attack and stroke. My blood pressure is fine and my cholesterol is in the normal range (although I take a statin, as I have familial hypercholesterolaemia). My kidney function is also normal. All in all, in terms of management, I think I'm in a good position.

 

[Stitch147]

Hi Spacebard, that all sounds not too bad. Its good to hear that you will still be self monitoring, knowledge is key afterall. Good luck with it all.