New... trying to do the right thing but struggling a bit this week

[john.101]

Hi,

I have recently been told i have type 2 and have started on metformin 10 days ago. I am also trying to follow a diet which was suggested by 2 doctors but i really dont think it right for me.

Starting off with me... I'm 40years old. I am over weight (148kg and 6'2) but have lost 20kg in the last 12 months and in the last 6 months i have been far more active, walking 8-10k steps almost every day; going to the gym 4 times a week... its a real conscious decision to be more active and to lose weight. My bloods (not sure the what test its called) was 54 in december and had been creeping up over the few months prior.

I was told to try a total meal replacement diet with very little consultation or consideration. 3 meal replacement shakes a day for 3 months. thats around 800kcal a day. Which i not possible for me, i think its dangerous personally. So for the last 2 weeks i have been on a kind of hybrid where ive been on low fat and around 1200 kcal a day.

Then there is the medication. Started on metformin and was ok for a few days but today i have been feeling rubbish.

I dont really know what im asking to be honest... Just feeling like its alot! to start on long term meds; to cut down on food; trying to stay active; focus on my weight all on top work/life etc.... I read a while back that people get overwhelmed and i didnt really think much about it but i really know how that feels. I dont know if im feeling sick because im not eating enough, or the meds. i dont know if im eating too much/too little; i have no energy so cant exercise effectively... it goes on and i'm being a total grump about it.

So i thought i would try joining on here and seeing what happens. 🙂

 

[ianf0ster]

Hi @john.101 and welcome to the forum.
The 800 calorie diet thing is probably the most favoured method ( by Diabetes UK and the NHS) to control Type 2 Diabetes. But it doesn't suit everybody- no single approach does suit everyone. They say that this diet is safe for 8 to 12 weeks, but no longer than that. It is supposed to contain enough protein that you don't starve (which would mean your body starts consuming your own muscle as well as your fat) for up to 12 weeks.

Personally as a slim Type 2 it didn't appeal to me, especially since I was aware that any substantial reduction in calories means that the resting metabolic rate also reduces - so your body learns to live with fewer calories - meaning (you feel fatigued, weaker, colder, less able to concentrate). I didn't think I had much weight to lose, so I chose to use the method probably most preferred on both this and the other UK diabetes forum , which is Low Carb.

All 4 approaches have similar success rates of between 40% and 60%. The other 2 methods are longer term Fasting (for several days at a time) and finally Bariatric Surgery.

You have probably been told to cut down on sugars, but the truth is that all carbohydrates including starches as well as sugars) raise). Blood Glucose when digested (starch is like a long chain of glucose molecules holding hands. And digestion of refined sugars and starch starts in the mouth!

The idea of Low Carb is NOT to reduce calories, just reduce all carbohydrates and increase both Protein and fat in order to make up for the calories you would have been having in those carbs you stop eating. Protein and Fats are known as essential macro-nutrients meaning we humans must eat them , but Carbohydrates are non-essential macro-nutrients meaning we can make what we need from other food - both Proteins and Fats. Carbohydrates include lots of food considered 'healthy' like whole grains including oats, fruits and starchy veg like potatoes, parsnips. Fruit Juice is just like liquid sugar. Instead eat more fish (especially oily fish), meat (even fatty meat), eggs, cheese and full-fat dairy, nuts, and low carb veg like cauliflower, broccoli, avocado, celery and leafy greens. Of fruits you can eat berries and other low carb fruit such as rhubarb.

Some of us need to cut down more than others, and different Type 2's react differently to the exact same food - for example many can eat a whole carrot or apple - but for me they spike my Blood Glucose too much.
So the best tip is to use a Blood Glucose meter in order to test which food your body can cope with and which ones are best either avoided or only eaten in reduced portions. Test just before a meal and then 2hrs after first bite looking for a rise of 2.0 mmol or less (if you can).
Popular (cheaper) meters in the UK are the SD Gluco Navii and the Spirit Healthcare TEE2, they have cheaper test strips which is the main expense for the first few weeks because of the amount of testing required.

 

[ianf0ster]

Digestive tract problems are the most common side effect from Metformin. There is a slow release version if your body can't tolerate the normal version. Though some find they can't tolerate any version of Metformin. It isn't a big deal if you find that you can't tolerate Metformin provided you change what you eat so that your food doesn't spike your blood glucose too much..

 

[richardmillar11]

Hi John

You have done the right thing. I was diagnosed type 2 back in October and I completely know how you are feeling. I couldn't believe it felt I wasn't going to be able to go into work. The thought of how I was going to cope with a complete change in diet and lifestyle whilst holding down an existing very stressful job and trying to do it all on my own the shopping cooking etc. Plus once I got the news it was as if I was scared to eat and also I didn't know what I could eat. I got the diet sheet but found there was more on it than what I would have eaten in a day I just eat a lot of stuff in between meals and at night after my dinner. Loved eating out and all the wrong stuff but I also like healthy food just the bad stuff was quicker and easier when you are under pressure and of course its easier to go out than cook. Totally get how you are feeling. Let me reassure you that there is light at the end of the tunnel. It took me about 7 weeks to get my head around it all but once I did it wasn't as bad as I first thought. It just takes a little more preparation and I lost about 2 stone.

I was referred to a dietician which was really helpful and you should ask your GP about getting a referral sooner rather than later. I have an excellent service here. I even have a number I can contact them on to ask any questions at any time. After my appointment I felt really assured and really what they told me was I could eat loads more than what I was eating and that I was able to go out and have a meal and occasionally the odd treat. Of course I am still in the mind set of not eating anything sweet and that's no issue so no treats for now.

I was started on the same medication as you for 1 week then told to stop. I had no issues with it but lots of people have. It can make you feel pretty off and give you quite an upset stomach. The one thing I noticed was to take it during food so in the morning I would eat half my breakfast and then take the tablet and then eat the rest. Don't know if this will make a difference or not.

On diagnosis my Hba1c was 115 in 9 weeks it was 55!!!! So let me encourage you that diet can make the biggest difference. Although today I have learned that it is not a good idea to cut carbs completely and lower it too quickly. It sounds like you have hit the diet as I did and exercise and maybe you can be a little less tough on yourself in that regard.

Did you have any weight loss prior to diagnosis?

Hope this is encouraging - I understand how you feel I felt like mentally I just could not cope at all but that had changed. You are in the right place you will get lots of information, help and support on here.

R

 

[john.101]

Thanks everyone!

Just writing my post and reading your responses has already made me feel far less anxious about this all.

@richardmillar11 YEah i have hit the diet really hard... its kind of a mental thing that made me feel like i needed to do something drastic but i think i do need to get some more sight of what is the right thing.

I had weight loss all last year. I worked hard in the gym for 6-8 months and have been more active which has really helped. But i still had a bad diet and drank a fair bit so it was weight loss but i could have lost more... but i guess that will still have made my blood sugars go up.

The gym and excersize is now just part of my life routine, i love it so thats not going anywhere but this week i have felt so drained i have found working out a struggle. Guessing the really low cals plus a change in mediaction and mental stress have all contributed to that.

I have never tested my bloods. do you think i should get a meter and start tracking it? If so i think that and trying to speak to a dietician could be my next jobs

 

[janw]

Most of us T2s find a BG meter invaluable, especially at the beginning of our journey on the diabetes path - it puts YOU in control. You can see what carbs do or don't give you a spike, then you can try a smaller portion or use one of the low carb alternatives instead. Currently the SD GlucoNavii is the cheapest for the starter kit (£9.99) and the test strips. Available on Amazon or their HomeHealth website. Don't forget to click that you are diabetic so you don't pay the VAT. The starter kits only come with 10 test strips and lancets a-piece, so order more at the same time. You can ask you GP to prescribe a sharps box for the used lancets and find out where to take it once full. Hope this helps.

 

[Leadinglights]

Losing weight will make a big difference to both your ability to exercise and also to help get your blood glucose under control. Your HbA1C at diagnosis was not very high at 54mmol/mol and I would have expected that as you seem to be motivated to make changes you would have been given the opportunity with dietary changes only. People often cope with the metformin initially but when the dose is increased they then get problems.
But many people find success with a low carb dietary regime so reducing their intake of carbohydrate to less than 130g per day but increasing protein and healthy fats which with vegetables, salads, and fruits like berries will still enable you to have tasty filling meals.

Have a look at the thread in the Food forum, What did you eat Yesterday for ideas of what Type 2 folk have, be aware some people will have less carbs than others either because of any meds or because they have found what they can tolerate by a regime of testing with their home monitor.
Keeping a food diary and noting how much carb you are having then look to reducing it by one third for a couple of weeks, then another third until you get to where you need to be,
Your blood glucose level although in the diabetic range is not far over the diagnosis level so no need to go at it like a bull in a china shop, slow and steady is better as you are less likely to get eye or nerve issues, but good to have a goal to aim at.

 

[Mrs Mimoo]

Hi,

I have recently been told i have type 2 and have started on metformin 10 days ago. I am also trying to follow a diet which was suggested by 2 doctors but i really dont think it right for me.

Starting off with me... I'm 40years old. I am over weight (148kg and 6'2) but have lost 20kg in the last 12 months and in the last 6 months i have been far more active, walking 8-10k steps almost every day; going to the gym 4 times a week... its a real conscious decision to be more active and to lose weight. My bloods (not sure the what test its called) was 54 in december and had been creeping up over the few months prior.

I was told to try a total meal replacement diet with very little consultation or consideration. 3 meal replacement shakes a day for 3 months. thats around 800kcal a day. Which i not possible for me, i think its dangerous personally. So for the last 2 weeks i have been on a kind of hybrid where ive been on low fat and around 1200 kcal a day.

Then there is the medication. Started on metformin and was ok for a few days but today i have been feeling rubbish.

I dont really know what im asking to be honest... Just feeling like its alot! to start on long term meds; to cut down on food; trying to stay active; focus on my weight all on top work/life etc.... I read a while back that people get overwhelmed and i didnt really think much about it but i really know how that feels. I dont know if im feeling sick because im not eating enough, or the meds. i dont know if im eating too much/too little; i have no energy so cant exercise effectively... it goes on and i'm being a total grump about it.

So i thought i would try joining on here and seeing what happens. 🙂

Hi John my diagnosis was in November and I was told my HbA1C was 55. I am a 1.68cm woman and weighed 101kg.... I had got lardy. I went on the Newcastle diet with minimal input from my GP and have lost 9kg now in 64 days.... my HbA1C went down. I find the diet easy (800 calories a day) as I have two meal replacements for Breakfast and Lunch with a bag of salad with the lunch soup meal, and then for supper I have a 280 calorie real meal of either Salmon, a small steak or a small chicken breast with a side of cooked hot green vegetables. I have felt so much better since I did this and will carry on till I have lost 15kg. My blood sugar is now almost normal. Sorry you are feeling rubbish, I have abandoned the metformin for the moment as my tummy could not cope. Are you on modified relase or the cheap and nasty? I am told taking it in the middle of a meal does help. This forum will help you. If you find 800 calories too little, do 1000 calories a day but low carb, not low fat, you will do well I think? I am told alchohol is a bad idea as it's liquid calories so you might want to cut down a bit or change from beer to gin and slim? I don't drink at all but this was the advice on the Newcastle diet page.

 

[richardmillar11]

Thanks everyone!

Just writing my post and reading your responses has already made me feel far less anxious about this all.

@richardmillar11 YEah i have hit the diet really hard... its kind of a mental thing that made me feel like i needed to do something drastic but i think i do need to get some more sight of what is the right thing.

I had weight loss all last year. I worked hard in the gym for 6-8 months and have been more active which has really helped. But i still had a bad diet and drank a fair bit so it was weight loss but i could have lost more... but i guess that will still have made my blood sugars go up.

The gym and excersize is now just part of my life routine, i love it so thats not going anywhere but this week i have felt so drained i have found working out a struggle. Guessing the really low cals plus a change in mediaction and mental stress have all contributed to that.

I have never tested my bloods. do you think i should get a meter and start tracking it? If so i think that and trying to speak to a dietician could be my next jobs

I think you are doing really well and just like me having a melt down. Looking back there was no need I say keep doing what you are doing until you can have your hba1c done again in three months time I think you will find a big difference.

I really understand the mental aspect of it. It was and still is really hard to deal with and I found friends didn’t really get it. They just thought o well take the tablets what’s the big issue but it was a massive one for me. The lack of energy could be lack of food or I found that my lack of energy can also come from my mental exhaustion. Yesterday I was in a bad place about it all and it really bothered me to go for a walk. Tonight was a breeze but I am in a much better place mentally today and it makes all the difference. Try and get to a dietician they will confirm and reassure u that u r on the right track. In regards the alcohol I’d give it a miss completely until u get your hba1c repeated.

The blood testing thing is helpful but I did find it causes more stress mostly because if the readings r high then I panic but then after chatting on here I discover my readings r good. It is helpful as it helps u find out what foods cause or don’t cause spikes in sugar. For me it’s wheetabix which was on the diet sheet I was given but it’s not an option for me. I don’t like it anyway so it’s no big loss lol

Hang in there when it gets bad message someone on here I find the chat and information u can get from others really helps.

 

[NotWorriedAtAll]

Everybody is different in how much they can change all at once.
I am very much a 'one thing at a time' person and also not great with changes in routine or habit.
Which is why I decided to focus on food choices from the beginning and not worry about anything else to start with.
I haven't lost much weight at all and I am quite portly to put it kindly. I have been controlling my blood sugars very well for around three years now purely by making different ingredient choices and frankly eating more and 'naughtier' food than I used to before my diagnosis!

That said I haven't gained any weight either - which is a big change because prior to my diagnosis my weight was creeping up every year no matter how many diets I went on and no matter how much I tried to exercise - I even tried hypnosis at one point!

I am also not organised enough to be testing food stuffs to find out which ones may or may not spike my blood sugars. As well as being a 'one thing at a time' person I am also an 'all or nothing' person as i find simple decisions easier to stick with.

It was easier for me to just decide that digestible carbs were a no-no and to go straight onto a very low carb way of eating. I was not bothered about weight loss to begin with so I didn't worry about fats (which turn out to be very helpful in keeping you full and also feeling like you've eaten something delicious and wonderful) and neither did I bother about proteins. People who use keto as a weight loss strategy work out something called macros which are the allowed number of grams of protein and fat and carbs they can have per day and lose weight. I just eat whatever I want as long as I don't go over 20g of carbohydrates per day. That keeps my blood sugars at a steady level of between 5.5mmol/L and 7.0-ishmmol/L through the day and I have plenty of energy to do anything I want to do.

I eat meals that look and taste pretty much exactly the same or better than the ones I ate before diagnosis but they are not made with starchy flours or sugars and I choose vegetables and fruit that are very low carb and eat them sparingly and instead of potatoes I eat celeriac (which does everything a potato does but at a tiny fraction of the carb content) and I use konjac rice/noodles because they have zero carbs and make my own keto bread with a bread machine.

I never used to eat cakes or bread before diagnosis but now I eat home made keto cakes two or three times a week and I eat my home made bread often and even have fried bread for breakfast sometimes.

I have started exercising in the last year since I got an Oculus Quest 2 VR headset.

So just to say you can have a lovely future with nice, filling meals and be healthy. It may take a little time to work out how to achieve that but it is achievable without spending loads of money and with a bit of planning you can even do it so it isn't massively time consuming. The more exercise you do and the bigger a person you are - the more carb grammes you can eat in a day without it causing you problems. The one thing I've found is short bursts of exercise ideally after eating work better to keep levels stable through the day than one massive work out.

I used to do exercise and then eat as a reward which wasn't as good as eating first and then exercising and then after exercising drinking plenty of water or a nice mug of decaf tea and watching a film or something.

Sorry if this is a bit long winded. Hope you are feeling better about everything now. Remember stress is also another thing that spikes blood sugar so chilling out if you can and feeling better about stuff is helpful all on its own.

 

[ianf0ster]

Perhaps I missed a question about alcohol.
I saw @richardmillar11 say he would advise avoiding alcohol. For the majority of Type 2's even those Type 2's who are in remission, if they drank alcohol before diagnosis, then they still drink alcohol!
It's just like food - they still eat, just eat smarter.
What I mean is that unless you are desperate to lose weight or cut calories rather than just to get your Type 2 diabetes into remission, thee is no need to avoid alcohol, just avoid the carbohydrates in (for example sweet wine, most beers and normal high calorie mixers etc.) This means you can still drink spirits (bit only with a low calorie mixer), dry white wine, most red wines and some low carb beers.
I gave up my favourite beer, but I can still (and do) drink red wine or vodka, gin, scotch, brandy etc. Though not all at once .

 

[Drummer]

I suspect that the advice to do the low calorie diet is down to your weight.
Why do you think it is dangerous to be having full meal replacement shakes? They contain all the vitamins and minerals plus some basic food to keep you functioning.
Watch out for low fat foods as they often get loaded with carbs to make them palatable. We do need fats to stay alive and well, it is the carbs which are dispensable.