Knee surgery

[marymurphy13]

I’m 67 and need a double knee replacement. I’ve been type 2 for 13years. Waited two years to see the consultant and although he doesn’t know how long the wait will be, he made it very clear that I have to reduce my blood sugars for the surgery to go ahead. My 6 monthly check had recently come back at 79. I had already agreed to drop a few bad habits as I didn’t want to be taking any more medication than I’m already on. She suggested I try to reduce my daily carb intake to 25gms!!! I don’t want or need to lose weight. All the low carb diets I look at presume I want to lose weight. Exercise is obviously a major issue now and between that and covid I’ve fallen into the category of artist and couch potato.

 

[Leadinglights]

Welcome to the forum
I sympathise with the knee issue as I have been immobile virtually for the last 3 months following surgery for a ruptured patellar tendon and tibial fracture, however by keeping to my low carb regime I managed not to put any weight on which I was gobsmacked about. I am a bit more mobile now but still restricted.
It depends on how many g of carbs you are currently having but a reduction to 25g in one go sounds pretty severe and could cause issues with your small blood vessels and eyes.
Reducing what you have by one third for a couple of weeks, then another third and so on until you get to where you need to be to get your levels down. Keeping a food diary will help you see where you are.
In general low carb diets will lead to weight loss but by increasing protein and healthy fats you can hopefully maintain your weight.
It would be a good idea if you haven't already got one to either ask your nurse for a blood glucose monitor or purchase yourself as that will give you a good idea of which foods and meals you need to be cutting down on. Testing before and 2 hours after you eat looking for no more than 2-3mmol//l increase otherwise your meal is too carb heavy.
What diabetes medication are you taking as that might influence how low carb it is safe to go.
If you want inexpensive monitors with the cheapest test strips are the GlucoNavil or TEE2 on line from Amazon or similar.

 

[marymurphy13]

Thank you for your response. You are not the first person to mention concerns about dropping to 25gms of carbs initially. I’m now questioning if I heard right. She was aware of my downfalls. Mostly carb loaded savoury snacks. Too much fruit. The wrong sort. And mostly eaten late evening. Might try and speak to her next week.
I’m taking 1g metformin twice a day, 5m saxagliptin and 40mgs gliclazide. I was originally (about 3 years ago) prescribed 80mgs but this dose at the time caused hypos. Really didn’t want to go there again.
I have a monitor and today had a fasting reading of 8.6, 2hrs after lunch (2 egg tomato and mushroom omelette with half a slice of whole meal bread) had a reading of 6.4 Having said that prior to seeing the nurse it was much higher. I’ve been following the 25gms carbs for about 2 weeks and I’m struggling.

 

[Leadinglights]

Thank you for your response. You are not the first person to mention concerns about dropping to 25gms of carbs initially. I’m now questioning if I heard right. She was aware of my downfalls. Mostly carb loaded savoury snacks. Too much fruit. The wrong sort. And mostly eaten late evening. Might try and speak to her next week.
I’m taking 1g metformin twice a day, 5m saxagliptin and 40mgs gliclazide. I was originally (about 3 years ago) prescribed 80mgs but this dose at the time caused hypos. Really didn’t want to go there again.
I have a monitor and today had a fasting reading of 8.6, 2hrs after lunch (2 egg tomato and mushroom omelette with half a slice of whole meal bread) had a reading of 6.4 Having said that prior to seeing the nurse it was much higher. I’ve been following the 25gms carbs for about 2 weeks and I’m struggling.

If you are taking the gliclazide then you do need to be careful about hypos with such low carbs so do make sure you have hypo treatments available.
If you must have snacks then nuts, berries, protein nut bars (Nature Valley. KIND or shop own are filling and 10g or less per bar)
If you are snacking is it because you are hungry or just habit, increasing healthy fats and protein in your meal should help if it is hunger.
There is evidence that eating high carbs foods actually makes you more likely to be hungry.

 

[marymurphy13]

I eat very little through the day and this is one of the things I need to change. I’ve never been really into chocolates and sweet things. My downfall is salty treats. Always after a substantial evening meal. The time when I get to si and chill. I would be looking for anything salty and greasy, crisps, cheesy buiscuits…just any savoury snack. It’s habit, greed, boredom. My favourite flavour of crisp is greasy salt!
The irony of this is I appreciate calories and at my last appointment I’d lost 4kgs. I was very honest and said it’s not how much I eat, it’s what I eat.

 

[Leadinglights]

I eat very little through the day and this is one of the things I need to change. I’ve never been really into chocolates and sweet things. My downfall is salty treats. Always after a substantial evening meal. The time when I get to si and chill. I would be looking for anything salty and greasy, crisps, cheesy buiscuits…just any savoury snack. It’s habit, greed, boredom. My favourite flavour of crisp is greasy salt!
The irony of this is I appreciate calories and at my last appointment I’d lost 4kgs. I was very honest and said it’s not how much I eat, it’s what I eat.

I think it a matter of trying to control how much you have, certainly if you are going to stick to anything like 25g carb per day and choose pretty low carb things, like cheese, a few nuts, make a yoghurt dip and have with carrot or celery sticks.
There are a few recipes for low carb /keto crackers which a few people have tried.
If you are wanting to snack in the evening then try to have a meal with more healthy fat and protein.