Hi My husband (he is 75 years old) has been told he is borderline Diabetic, GP said not too bad and no symptoms, diabetic nurse said to stop all bread, cakes biscuits pastry pasta potatoes fruit and fruit juice sugar etc etc the list was endless. Told to eat just vegetables and salad with fish or chicken, surely there must be somethings he can eat (which he actually likes!) He had necrotic pancreatitis 2 years ago (caused by a gallstone not alcohol) when we asked about type 3C the nurse said we would have to get in touch with the hospital and get a report? Since then he has given up alcohol, smoking and now eating! Help please so confused Many thanks
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- Thread starter Cosmic
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Have a look at the Harcombe Diet, well founded on proven principles.
Harcombe Diet article (scroll down to 7 added links to handy summaries and guides: https://diabetes-type2-remission.blogspot.com/2023/12/the-harcombe-diet-how-to-eat-your.html
Harcombe Diet article (scroll down to 7 added links to handy summaries and guides: https://diabetes-type2-remission.blogspot.com/2023/12/the-harcombe-diet-how-to-eat-your.html
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Docb
Moderator
- Relationship to Diabetes
- Type 2
Hi @Cosmic. Is your husband on any medication for his diabetes and do you have the HbA1c results?
As a fellow wrinkly I reckon that your DN was a bit over the top in her recommendations. My opinion, and it is my opinion, is that there is no need to STOP anything but it might be a good idea to look for a bit of carb reduction in his general diet. A bit of portion size reduction here and there when it comes to potatoes, bread and pasta, and maybe cutting out the "obligatory " cake or biscuit or two with a brew may be a good enough place to start with the aim of keeping around the diagnosis level and keeping his GP happy.
As a fellow wrinkly I reckon that your DN was a bit over the top in her recommendations. My opinion, and it is my opinion, is that there is no need to STOP anything but it might be a good idea to look for a bit of carb reduction in his general diet. A bit of portion size reduction here and there when it comes to potatoes, bread and pasta, and maybe cutting out the "obligatory " cake or biscuit or two with a brew may be a good enough place to start with the aim of keeping around the diagnosis level and keeping his GP happy.
Inka
Well-Known Member
- Relationship to Diabetes
- Type 1
Hi @Cosmic I’d contact the hospital as suggested and ask for the report (although surely his GP has access to something from the hospital?) Has he had any tests to check how his pancreas is since then?
In the meantime, I agree that the nurse’s advice sounds a bit extreme. I’d look at reducing his carbs not cutting them out entirely.
In the meantime, I agree that the nurse’s advice sounds a bit extreme. I’d look at reducing his carbs not cutting them out entirely.
Leadinglights
Well-Known Member
- Relationship to Diabetes
- Type 2
It does seem a bit extreme to suggest he needs to cut out all those foods especially if they have said 'borderline' diabetic. Some newer guidelines are that the diagnostic threshold should be more lenient for the more mature person and there should be a more personalised plan taking into account other conditions and risk factors.
However that is not to say it is not worth doing nothing to help bring his level down or at least stop it increasing as with the pancreatitis it may put more pressure on the pancreas so making some reduction in carb intake would be a good plan. But it needs to be a sustainable regime with foods he likes and which you can also enjoy.
I adopted a low carb approach following the principals in this link, fully supported by my other half so we essentially have the same meals. There are some menu plans to suit various tastes which may give you some ideas of the meals he can still have. https://lowcarbfreshwell.com/
Start with some modest changes as reducing carbs gradually is kinder on the eyes and nerves.
If you are into baking then there are recipes on the website sugarfreelondoner for low carb cakes and biscuits which would mean he could still have the odd cake or biscuit with his cuppa.
However that is not to say it is not worth doing nothing to help bring his level down or at least stop it increasing as with the pancreatitis it may put more pressure on the pancreas so making some reduction in carb intake would be a good plan. But it needs to be a sustainable regime with foods he likes and which you can also enjoy.
I adopted a low carb approach following the principals in this link, fully supported by my other half so we essentially have the same meals. There are some menu plans to suit various tastes which may give you some ideas of the meals he can still have. https://lowcarbfreshwell.com/
Start with some modest changes as reducing carbs gradually is kinder on the eyes and nerves.
If you are into baking then there are recipes on the website sugarfreelondoner for low carb cakes and biscuits which would mean he could still have the odd cake or biscuit with his cuppa.
Thanks all reducing sounds better than stopping. In answer to the above questions the only medication he is on is Creon for his pancreas and no nothing has been checked since he left hospital. Will have a look at the suggested diets and recipies
I missed the necrotic pancreatitis, still borderline appears to indicate the pancreas is still producing insulin. If your husband's waist is more than half his height, you have an indicator that losing some weight to get rid of excess visceral fat will be worth it.
Thanks he is actually trying to put on weight as he lost 4 1/2 stone in weight + loads of muscle while in hospital (3 1/2 weeks in intensive care then about 8 weeks + in wards with nothing to eat) and was seriously underweight put on a full fat diet with food drinks. He has now joined a gym goes walking and swimming class, so weight and excercise not a concern he has done really good up to now but thanks
Leadinglights
Well-Known Member
- Relationship to Diabetes
- Type 2
If he is trying to put on weight then that can be tricky as most dietary regimes which are designed to reduce blood glucose are also aimed at people who need to lose weight.
Reducing carbs without increasing protein and healthy fats can lead to just that.
I would ask for referral to a dietician as there may be implications for what Creon dose is needed.
I sounds as if he was pretty unwell but if he is feeling up to going to the Gym and doing exercise, then he must be on the road to recovery, still he shouldn't over do it.
Reducing carbs without increasing protein and healthy fats can lead to just that.
I would ask for referral to a dietician as there may be implications for what Creon dose is needed.
I sounds as if he was pretty unwell but if he is feeling up to going to the Gym and doing exercise, then he must be on the road to recovery, still he shouldn't over do it.
Yes thanks he is doing really well, Consultant said 2 years to recover from operation and its now just over that. A dietitian would be nice!!! When he left hospital we asked re diet and how much Creon was told 'how long is a piece of string' have to work out Creon dose yourself, start with 2 per meal if not enough increase (check poo!) Absolutely no advice re diet though
soupdragon
Well-Known Member
- Relationship to Diabetes
- Type 3c
Welcome @Cosmic (and husband!).
I'm also here due to necrotising pancreatitis. In my case I've had diabetes (treated with insulin) from the start and was told about it before I left ICU.
Many others have developed diabetes over a longer period of time, though.
Glad to hear that your husband is now doing well.
Sounds as though it would be worth contacting the hospital (or via your GP) about the pancreatitis. It's not relevant at the moment as his glucose levels are borderline but, if in the future he did end more treatment eg insulin, it would be helpful for that to be clear on his file. Type 3cs (if on certain insulin regimes) are treated as if Type 1 and so have access to diabetes technology.
I'm lucky enough to have the specialist pancreatic dietician as my point of contact on the HPB team.
Is there any way you can contact the HPB team and ask about dietary advice? It is a bit of a juggling act!
I'm also here due to necrotising pancreatitis. In my case I've had diabetes (treated with insulin) from the start and was told about it before I left ICU.
Many others have developed diabetes over a longer period of time, though.
Glad to hear that your husband is now doing well.
Sounds as though it would be worth contacting the hospital (or via your GP) about the pancreatitis. It's not relevant at the moment as his glucose levels are borderline but, if in the future he did end more treatment eg insulin, it would be helpful for that to be clear on his file. Type 3cs (if on certain insulin regimes) are treated as if Type 1 and so have access to diabetes technology.
I'm lucky enough to have the specialist pancreatic dietician as my point of contact on the HPB team.
Is there any way you can contact the HPB team and ask about dietary advice? It is a bit of a juggling act!
Thank you for replying we were told to look out for 3C on leaving hospital, he may have been told while in ICU but would not remember as he totally lost all time and memory of being in there, as it was during the lovely COVID I wasn't allowed in.
We are in the process of trying to get a group of survivors together to try and get the hospital in our area to provide some sort of post hospital support and information re diabetes etc. but at the moment have no idea who to ask re diet or anything, sorry to sound negative but struggling after him getting so much better then this
soupdragon
Well-Known Member
- Relationship to Diabetes
- Type 3c
It sounds as though you've both done really well with the recovery so far.
The GP's approach seems more reasonable than the nurse's. Gradually reducing carbs is certainly worth a try. After all he has been through making extreme changes doesn't sound a great idea.
Leadinglights
Well-Known Member
- Relationship to Diabetes
- Type 2
I don't know if this group will help you.
Also this one
Hi Cosmic
Sorry to hear of your husband’s pancreatitis.
I too suffered acute pancreatitis 10 years ago.
By the sounds of it his pancreas has been hammered and is struggling to function properly. He has some function ( hence borderline diabetes) but as others have suggested he should treat his pancreas with care as it may not produce insulin, lipase, amylase, protease, somatostatin and bicarbonate as it did in the past.
The main irritants to the pancreas are alcohol, smoking, spicy foods and fatty foods so he has done well to exclude the first two of these.
Creon is used to replace lipase (digest fats) amylase (digest carbohydrates) and protease ( digest proteins) . As you have found clear Instructions for Creon dosing is limited and most patients learn as they go along. The main aim is to avoid smelly grey/ yellow fatty stools that do not flush away easily within causing irritation to the anus. Sorry to be graphic but these are the facts. You cannot overdose on Creon so be bold with dosing, eg take more if high fat meals.
The fact he is borderline diabetic suggests he is able to produce enough insulin to use glucose produced by digestion. Somatostatin and bicarbonate normally take care of themselves so don’t worry too much about them. Often omeprazole is added to reduce acid reflux of abdominal pain and help Creon to function.
A dietician should be able to support Creon use and pre diabetes diagnosis, your GP can make a referral.
As he has lost so much weight in hospital then a high protein diet is normally recommended.
The fact he is exercising regularly is a good sign , I wish both him and you well for the future .
Chris
Sorry to hear of your husband’s pancreatitis.
I too suffered acute pancreatitis 10 years ago.
By the sounds of it his pancreas has been hammered and is struggling to function properly. He has some function ( hence borderline diabetes) but as others have suggested he should treat his pancreas with care as it may not produce insulin, lipase, amylase, protease, somatostatin and bicarbonate as it did in the past.
The main irritants to the pancreas are alcohol, smoking, spicy foods and fatty foods so he has done well to exclude the first two of these.
Creon is used to replace lipase (digest fats) amylase (digest carbohydrates) and protease ( digest proteins) . As you have found clear Instructions for Creon dosing is limited and most patients learn as they go along. The main aim is to avoid smelly grey/ yellow fatty stools that do not flush away easily within causing irritation to the anus. Sorry to be graphic but these are the facts. You cannot overdose on Creon so be bold with dosing, eg take more if high fat meals.
The fact he is borderline diabetic suggests he is able to produce enough insulin to use glucose produced by digestion. Somatostatin and bicarbonate normally take care of themselves so don’t worry too much about them. Often omeprazole is added to reduce acid reflux of abdominal pain and help Creon to function.
A dietician should be able to support Creon use and pre diabetes diagnosis, your GP can make a referral.
As he has lost so much weight in hospital then a high protein diet is normally recommended.
The fact he is exercising regularly is a good sign , I wish both him and you well for the future .
Chris
- Relationship to Diabetes
- Type 1
- Pronouns
- He/Him
Welcome to the forum @Cosmic
Having had necrotising pancreatitis, and needing Creon does make it sound like he more likely has Type 3c than Type 2 to me, so it would be worth following that up - not least because as @soupdragon says, some education courses and types of tech are not always offered to T2s because research tends to focus on what works / is cost effective for ‘classic’ T2 cases. So getting an accurate label that properly describes his condition can help ensure he gets access to the most appropriate treatment options.
There’s an overview of Type 3c here:
www.diabetes.org.uk
Having had necrotising pancreatitis, and needing Creon does make it sound like he more likely has Type 3c than Type 2 to me, so it would be worth following that up - not least because as @soupdragon says, some education courses and types of tech are not always offered to T2s because research tends to focus on what works / is cost effective for ‘classic’ T2 cases. So getting an accurate label that properly describes his condition can help ensure he gets access to the most appropriate treatment options.
There’s an overview of Type 3c here:
What is type 3c diabetes?
You may have heard of the more common types of diabetes like type 1, type 2 and gestational. But there are actually many other types of diabetes that aren't as well known. Type 3c diabetes develops because of the damage to the pancreas, which can happen for a few different reasons. And although...
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