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- Thread starter kathy s
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trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
Well, clearly whatever these doctors advised you to do to change your lifestyle and diet etc to avoid your HbA1c increasing, assuming you followed this advice, hasn't worked - so I'm a bit baffled as to why they are unable to understand that! I've had no medical training and I can understand. So - what have they now advised you? and, have they now prescribed you any medication and if so, what?
rebrascora
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
Hi and welcome.
Can you tell us a bit about yourself and what if any dietary changes you made since last year? Do you have much/any weight to lose?
If you made significant dietary changes last year (particularly if you reduced your carbohydrate intake) and your levels have gone up significantly instead of down, then the Dr should be considering that you might not be Type 2 but perhaps there is something else going on and be referring you for tests.
Diabetes Types are categorized by the cause, so....
Type 2 is metabolic, usually caused by fatty deposits in and around the pancreas and liver affecting their ability to balance your Blood Glucose (BG) levels effectively. Usually at diagnosis Type 2 diabetics are producing plenty of insulin but their bodies have become resistant to it.
Type 1 Diabetes is caused by an autoimmune attack on the insulin producing beta cells in your pancreas, meaning you are no longer able to produce enough insulin to balance your BG levels. This usually comes on quite quickly and Hba1c will be high and they will usually experience the 4 T symptoms or Tiredness, thirst, toilet visits ie. weeing lots and thinner ie losing weight very easily or unexpectedly. There is a slower onset of Type 1 called LADA (Latent Autoimmune Diabetes in Adults) which sometimes happens in more mature adults and often exhibits like Type 2 initially and may even respond to Type 2 medication and dietary changes to start with, but as the immune system continues to slowly attack and kill the beta cells, their body reaches a tipping point where the remaining beta cells which have been battling to maintain balance, can no longer cope and levels suddenly rise dramatically. This is what may be happening in your case if you have taken steps to manage your risk of diabetes through diet and exercise and it has still got noticeably worst instead of better. Only you will know how much effort you have put into managing your diet since last year. Once you reach that tipping point you will generally need insulin for the rest of your life. If you have other autoimmune conditions, then Type 1 is more likely.
There are tests for Type 1 diabetes but they are not routinely performed and are best carried out through a specialists diabetes clinic rather than a GP practice. These are antibody tests looking for the antibodies which indicate that the immune system is targeting the beta cells and C-peptide which measures the amount of insulin you are still able to produce.
Type 3c diabetes is caused by damage to the pancreas either through inflammation or disease like pancreatitis, cysts or tumours or surgery to remove part or all of it or trauma from a bad accident. If this is suspected, you are probably going to need a scan.
There is also MODY which is a very rare genetic form of diabetes and you would generally have other family members also diagnosed.
Anyway, if you can tell us a bit more about yourself (BMI, activity levels) and what dietary changes you have made over the past year, we might be able to point you towards the tests you should be pushing for.
Can you tell us a bit about yourself and what if any dietary changes you made since last year? Do you have much/any weight to lose?
If you made significant dietary changes last year (particularly if you reduced your carbohydrate intake) and your levels have gone up significantly instead of down, then the Dr should be considering that you might not be Type 2 but perhaps there is something else going on and be referring you for tests.
Diabetes Types are categorized by the cause, so....
Type 2 is metabolic, usually caused by fatty deposits in and around the pancreas and liver affecting their ability to balance your Blood Glucose (BG) levels effectively. Usually at diagnosis Type 2 diabetics are producing plenty of insulin but their bodies have become resistant to it.
Type 1 Diabetes is caused by an autoimmune attack on the insulin producing beta cells in your pancreas, meaning you are no longer able to produce enough insulin to balance your BG levels. This usually comes on quite quickly and Hba1c will be high and they will usually experience the 4 T symptoms or Tiredness, thirst, toilet visits ie. weeing lots and thinner ie losing weight very easily or unexpectedly. There is a slower onset of Type 1 called LADA (Latent Autoimmune Diabetes in Adults) which sometimes happens in more mature adults and often exhibits like Type 2 initially and may even respond to Type 2 medication and dietary changes to start with, but as the immune system continues to slowly attack and kill the beta cells, their body reaches a tipping point where the remaining beta cells which have been battling to maintain balance, can no longer cope and levels suddenly rise dramatically. This is what may be happening in your case if you have taken steps to manage your risk of diabetes through diet and exercise and it has still got noticeably worst instead of better. Only you will know how much effort you have put into managing your diet since last year. Once you reach that tipping point you will generally need insulin for the rest of your life. If you have other autoimmune conditions, then Type 1 is more likely.
There are tests for Type 1 diabetes but they are not routinely performed and are best carried out through a specialists diabetes clinic rather than a GP practice. These are antibody tests looking for the antibodies which indicate that the immune system is targeting the beta cells and C-peptide which measures the amount of insulin you are still able to produce.
Type 3c diabetes is caused by damage to the pancreas either through inflammation or disease like pancreatitis, cysts or tumours or surgery to remove part or all of it or trauma from a bad accident. If this is suspected, you are probably going to need a scan.
There is also MODY which is a very rare genetic form of diabetes and you would generally have other family members also diagnosed.
Anyway, if you can tell us a bit more about yourself (BMI, activity levels) and what dietary changes you have made over the past year, we might be able to point you towards the tests you should be pushing for.
Thanks for replying, i know my diet needs work.
I'm beginning to think carbs are my enemy! To be fair they sent me on a prediabetes course, over a couple of months I went from 47 to 45.7, but now sky high, I did cut out red wine for a while and switched to diet lemonade and berries. But in recent months stress at work has meant I've gone back to it and was having a glass a night so I've now stopped again. I'm 4tf 10 and 9 st, I'm physically active at work and walk the dog an hour at a time. I cant do strenuous stuff anymore as I'm waiting for a consult on my knee which causes constant pain( the other knee was operated on 12 years ago and has been great, this time they say it can cause more damage to joints and are reluctant and live with it!) It has made be upset at times as i don't tolerate painkillers! Think projectile vomiting)
The docs gave me a low dose of metformin 1x 500mg to start but I had side effects of bloating, stomach pain, nausea etc, then two days ago I started with dizziness, actual vomiting and a rapid heartbeat so was told to stop the metformin. Now I am struggling and will see the nurse next Thursday. Even after my course I didn't understand carbs and as I don't have a sweet tooth I don't think these are helping however my hbac1 had gone down a little and my diet hasn't really changed since then. My doctor has said that he thinks my type 2 is hereditary and this scares me as dad went on to need dialysis, this led to a stay in hospital ( with complications) were he caught covid and died.
The optician picked up my need for a blood test as within 10 months my eyesight had completely altered and i was having issues with vision. The doctor so far hasn't done much other than tell me the news and say I will in time see the nurse and dietician at some point. Most of our services are still by phone and the nurse was due to ring on Tuesday, however after the reaction I'm now seeing her face to face on Thursday. Sorry post is so long!
I'm beginning to think carbs are my enemy! To be fair they sent me on a prediabetes course, over a couple of months I went from 47 to 45.7, but now sky high, I did cut out red wine for a while and switched to diet lemonade and berries. But in recent months stress at work has meant I've gone back to it and was having a glass a night so I've now stopped again. I'm 4tf 10 and 9 st, I'm physically active at work and walk the dog an hour at a time. I cant do strenuous stuff anymore as I'm waiting for a consult on my knee which causes constant pain( the other knee was operated on 12 years ago and has been great, this time they say it can cause more damage to joints and are reluctant and live with it!) It has made be upset at times as i don't tolerate painkillers! Think projectile vomiting)
The docs gave me a low dose of metformin 1x 500mg to start but I had side effects of bloating, stomach pain, nausea etc, then two days ago I started with dizziness, actual vomiting and a rapid heartbeat so was told to stop the metformin. Now I am struggling and will see the nurse next Thursday. Even after my course I didn't understand carbs and as I don't have a sweet tooth I don't think these are helping however my hbac1 had gone down a little and my diet hasn't really changed since then. My doctor has said that he thinks my type 2 is hereditary and this scares me as dad went on to need dialysis, this led to a stay in hospital ( with complications) were he caught covid and died.
The optician picked up my need for a blood test as within 10 months my eyesight had completely altered and i was having issues with vision. The doctor so far hasn't done much other than tell me the news and say I will in time see the nurse and dietician at some point. Most of our services are still by phone and the nurse was due to ring on Tuesday, however after the reaction I'm now seeing her face to face on Thursday. Sorry post is so long!
When I was diagnosed I didn't know how much carbs I was eating. Biscuits, cakes, sweets I knew were sugary so it was easy enough to stop eating those things. When I started to research it I found that foods which I had previously thought were ok actually were not ok for me because they were high in carbohydrates:
- fruit juices
- many cereals are very high carb
- rice, pasta, potatoes, bread
So much of my diet included these foods so by removing them and swapping them for other foods in itself made a difference:
- fruit juices (now only have water, tea and coffee plus the odd diet fizzy drink)
- cereals (instead only have Greek yoghurt or eggs for breakfast)
- rice (now have cauliflower rice), pasta (not found any really decent substitute but tried courgetti), potatoes (mashed cauliflower is s surprisingly good substitute), bread (found a low carb bread in the supermarket with 3g carbs per slice so I have one slice of that with my eggs)
Over the last two years I have gradually been finding more foods but it took time and getting used to taking note of the carb content of foods which I'd not previously done. I now don't feel too restricted with my diet but changing my diet was the thing that helped most.
Felinia
Well-Known Member
- Relationship to Diabetes
- Type 2
I agree with Barbara that you might not be Type 2, but another type, due to the rapid increase in such a short time.
One thing that can cause a sudden rise is an infection. I shot up to 88mmol/mol after a persistent kidney infection, despite losing 11kg, so have you had any illness or COVID since being pre-diabetic?
Also could you tell us a typical day's diet, including snacks and drinks, so we might be able to suggest tweaks? Also do you watch your portion sizes? Diablo T2 has made good suggestions.
Failing being unable to identify anything in your diet, you might wish to ask your GP for the tests for Type 1
One thing that can cause a sudden rise is an infection. I shot up to 88mmol/mol after a persistent kidney infection, despite losing 11kg, so have you had any illness or COVID since being pre-diabetic?
Also could you tell us a typical day's diet, including snacks and drinks, so we might be able to suggest tweaks? Also do you watch your portion sizes? Diablo T2 has made good suggestions.
Failing being unable to identify anything in your diet, you might wish to ask your GP for the tests for Type 1
Typical breakfast is 2 slices of seeded white toast do will switch to brown and have Greek yogurt and fruit some days instead.
Lunch , when I'm being really good is salad but includes a small portion of pesto pasta/ potato salad or coleslaw, so I guess I can cut the pasta and potato out. I also have this with feta cheese.
Dinner varies but will usually contain the most carbs be it over chips, New potato's, pasta or rice. So think.the evening meals need to change. Sometimes I'm so tired I just have toast in rhe evening. The bread I use is low in sugar ( I've been usingbtje traffic lights to help) but I haven't taken much notice of carbs( until now)
This is very similar to the way I was eating in my prediabetes days when i managed to lower my readings slightly , I think I need to make evening meal adjustments.
Oh I have fruit for snacks and sometimes rice cakes, again I was checking the sugar not the carbs.
Lunch , when I'm being really good is salad but includes a small portion of pesto pasta/ potato salad or coleslaw, so I guess I can cut the pasta and potato out. I also have this with feta cheese.
Dinner varies but will usually contain the most carbs be it over chips, New potato's, pasta or rice. So think.the evening meals need to change. Sometimes I'm so tired I just have toast in rhe evening. The bread I use is low in sugar ( I've been usingbtje traffic lights to help) but I haven't taken much notice of carbs( until now)
This is very similar to the way I was eating in my prediabetes days when i managed to lower my readings slightly , I think I need to make evening meal adjustments.
Oh I have fruit for snacks and sometimes rice cakes, again I was checking the sugar not the carbs.
Felinia
Well-Known Member
- Relationship to Diabetes
- Type 2
I think from your reply, you can see your diet is currently very carb heavy, and have now realised it's carbs, not sugars, you need to check.
What might help you understand your food composition is to get a food diary app, like NutraCheck or MyFitnessPal and enter everything you eat and drink. It will show you carb values by item, meal and a daily running total, amongst other nutrient values. You will need to weigh all your portions (no guessing) and that will surprise you just how small recommended portion sizes are. I keep digital scales and a clear bowl on my kitchen top and after 4 years still weigh most items except above ground and salad vegetables. It just takes a matter of seconds each meal and you will soon remember portion sizes and carb values.
I also have crockery where I know what portion sizes fit. For example, my bowl takes 275ml home made soup, and my "dinner" plate is actually a 10" side plate, so I can't get too much on it.
I've posted a few pictures of recent meals using this crockery, so you can see I don't starve!!
A poached egg, grilled rasher, tomato and a large chestnut mushroom for breakfast. Home made vegetable soup for lunch. Roast beef with cauliflower (instead of potato), carrots, runner beans and cabbage for dinner. Alternative lunch of prawn and cottage cheese salad. You can get lots of ideas from the Forum Food/carb recipes and queries.
What might help you understand your food composition is to get a food diary app, like NutraCheck or MyFitnessPal and enter everything you eat and drink. It will show you carb values by item, meal and a daily running total, amongst other nutrient values. You will need to weigh all your portions (no guessing) and that will surprise you just how small recommended portion sizes are. I keep digital scales and a clear bowl on my kitchen top and after 4 years still weigh most items except above ground and salad vegetables. It just takes a matter of seconds each meal and you will soon remember portion sizes and carb values.
I also have crockery where I know what portion sizes fit. For example, my bowl takes 275ml home made soup, and my "dinner" plate is actually a 10" side plate, so I can't get too much on it.
I've posted a few pictures of recent meals using this crockery, so you can see I don't starve!!
A poached egg, grilled rasher, tomato and a large chestnut mushroom for breakfast. Home made vegetable soup for lunch. Roast beef with cauliflower (instead of potato), carrots, runner beans and cabbage for dinner. Alternative lunch of prawn and cottage cheese salad. You can get lots of ideas from the Forum Food/carb recipes and queries.
Lucyr
Well-Known Member
- Relationship to Diabetes
- Type 1
No need to drop the red wine, it doesn’t generally increase blood sugars, though it is advised to have a couple of days off alcohol per week
Tdm
Well-Known Member
- Relationship to Diabetes
- Type 1
- Pronouns
- She/Her
A few ideas of swaps to help you. Some have already been mentioned
If you want to stick with bread, large sainsburys have a loaf called 'high low' that has about half the carbs but tastes the same. The slices are also smaller which helps futher.
Grated cauliflower is a great rice replacement and has a lot less carbs.
Grated / sliced courgette is an ok replacement for pasta.
Plus the above two help increase your veg count and have lots of fibre.
Whilst going wholemeal is a good idea in general, it doesn't really effect carb count that much.
Eggs and mushrooms, cheese and meat are very low carb, perhaps you could replace potato and pasta salad with items like boiled eggs, chicken breast, lettuce, edam, sun dried tomato? Mayo is fine too. Crustless quiches are a good salad item
Low carb isn't low taste.
Start looking at the carb count on food labels and you will soon get an idea of foods to avoid/minimise, and what to have in their place
You CAN do this...the thing to aim for is making taking lower carb choices a habit. And not having high carb stuff in the house will also mean there is less temptation
If you want to stick with bread, large sainsburys have a loaf called 'high low' that has about half the carbs but tastes the same. The slices are also smaller which helps futher.
Grated cauliflower is a great rice replacement and has a lot less carbs.
Grated / sliced courgette is an ok replacement for pasta.
Plus the above two help increase your veg count and have lots of fibre.
Whilst going wholemeal is a good idea in general, it doesn't really effect carb count that much.
Eggs and mushrooms, cheese and meat are very low carb, perhaps you could replace potato and pasta salad with items like boiled eggs, chicken breast, lettuce, edam, sun dried tomato? Mayo is fine too. Crustless quiches are a good salad item
Low carb isn't low taste.
Start looking at the carb count on food labels and you will soon get an idea of foods to avoid/minimise, and what to have in their place
You CAN do this...the thing to aim for is making taking lower carb choices a habit. And not having high carb stuff in the house will also mean there is less temptation
DianeS
Well-Known Member
- Relationship to Diabetes
- Type 2
My reading at day 1 was 75, and it took nearly a year to get back to levels everyone is happy with. Last reading was 43. I followed a Keto diet, and used the app on my phone to gear myself in. I lost 3 stone, and feel so much better..... It was the carbs that are still my enemy. I will now have a little bit of potato, or a max of 6 chips on a plate. Rice sometimes but rarely (and not much) pasta not at all...... Once you get in the swing of a new diet, it becomes second nature, and you think about it less...... In the end, food is food, and you have to change what you eat.... all food is diet of one kind or another. Keep the faith, and as has been said, keep the carbs out of the house.
I believe for certain people on certain types of medication there are questions about it...
Lucyr
Well-Known Member
- Relationship to Diabetes
- Type 1
Such as? Alcohol is fine with the vast majority of diabetes medications and the OP isn’t taking any.
trophywench
Well-Known Member
- Relationship to Diabetes
- Type 1
If I am in pain for more than about half a day, it definitely increases my blood glucose level. If I have to have an operation for anything - actually having the operation to cure the effects of whatevers wrong with me, also increases my levels. I've had 3 operations in my life - first was a hysterectomy, nowt sinister but I had fibroids and it turned out I also had shedloads of endometriosis which nobody knew anything about until the surgeon opened me up and then she had to spend a lot more time sorting that out instead of it being a relatively quick procedure. Last two were my left knee, when I fell over one Saturday walking out of a carpark to go to a shop, tripped over the speed bump just before said carpark gate, and smashed the kneecap. God - that hurt! and they had to open it up, clean out all the useless little bits and do a jigsaw of the bigger ones, pinning and wiring em all back together. All healed OK but about 12 months later knee was still giving me gyp and it turned out one of the pins had broken off and was attempting to escape via my kneecap skin, owwww. So opened up again along the same scar (which had almost disappeared by then) to sort it - which it did. All these increased my BG and involved an increase in the amount of insulin I needed until I was healed, the knee, I had to multiply my usual dose by 3. I wasn't 'ill' with any of these things.
So - your knee problem could be the thing increasing your BG level on it's own, without much else - BUT you do seem to be having rather a lot of carbohydrate so whatever happens from now I also think you need to pay a lot more attention to your diet. One basic thing to understand is that absolutely anything containing flour, whatever it happens to be - contains carbohydrate - so if it's got pastry round it whether it's a sausage roll, a mince pie, a profiterole or a steak & kidney pudding - we need to pay attention to the carbohydrate in the pastry before even considering the carbs in the mincemeat!
So - your knee problem could be the thing increasing your BG level on it's own, without much else - BUT you do seem to be having rather a lot of carbohydrate so whatever happens from now I also think you need to pay a lot more attention to your diet. One basic thing to understand is that absolutely anything containing flour, whatever it happens to be - contains carbohydrate - so if it's got pastry round it whether it's a sausage roll, a mince pie, a profiterole or a steak & kidney pudding - we need to pay attention to the carbohydrate in the pastry before even considering the carbs in the mincemeat!
Whilst loosing a few pounds is always a bonus my weight isn't that much of an issue, even the doctor said that.
From reading all your wonderful replies I now know that carbs are my problem! I've just been reading sugar content up to now. Hopefully have a good discussion with the nurse this week. Also someone mentioned the reason my levels might have raise so quickly is illness, I had covid in February 2 years after 1st having it .
From reading all your wonderful replies I now know that carbs are my problem! I've just been reading sugar content up to now. Hopefully have a good discussion with the nurse this week. Also someone mentioned the reason my levels might have raise so quickly is illness, I had covid in February 2 years after 1st having it .
- Relationship to Diabetes
- Type 1
- Pronouns
- He/Him
Will be interesting to see how cutting back on total carbs goes for you (not just ‘of which sugars’)
The traffic lights are pretty hopeless when it comes to glucose control unfortunately.
If you aren't able to find a lower carb bread (brown and white versions have pretty much the same carb content) you may find it helpful to reduce portion size (eg one slice where you would have had two) and possibly go for multiseeded versions as some of the seeds will pass through undigested.
Do you know when your next check is due?
The traffic lights are pretty hopeless when it comes to glucose control unfortunately.
If you aren't able to find a lower carb bread (brown and white versions have pretty much the same carb content) you may find it helpful to reduce portion size (eg one slice where you would have had two) and possibly go for multiseeded versions as some of the seeds will pass through undigested.
Do you know when your next check is due?
- Relationship to Diabetes
- Type 1
- Pronouns
- He/Him
Veg crisps are readily available, with varying carb counts (depending of which mixes of root veg they have chosen)
You can make very acceptable ‘kettle chips’ from celeriac I think. use a peeler to get thin slivers and then
Edit: it was another member with a green avatar! And they are shallow fried, not baked! @NotWorriedAtAll
https://forum.diabetes.org.uk/boards/threads/no-low-carb-snack-ideas….98683/#post-1148997
As for what constitutes ‘low carb’ I've never been convinced that going by labels or nutritional carb percentages (per 100g) is a great tactic - because you need to factor in weight and portion size.
Many folks here start with 130g total carbs per day as an initial opener. Then adjust from there based in the results they get.
Even just starting a ruthlessly honest food diary with what-you-eat-now, where you calculate / estimate total carb content of your current menu can helpfully show you which meals and ingredients are your ‘big hitters’ and prompt you to look for swaps / portion adjustments / alternstives.
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Leadinglights
Well-Known Member
- Relationship to Diabetes
- Type 2
Do check out the carbs of any of the alternative crisps as I have been very surprised that some which you would imagine would be lower carb i.e cauliflower crisps were just a bad.
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