Newbie Steve

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SteveDo

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Hi, all.

Steve here, in the Medway towns (Kent). Type 2 diagnosis received today following an NHS health check. Prescribed metformin and gliclazide, also atorvastatin for cholesterol. I've also been given a blood-glucose testing kit and an appointment with a clinical pharmacist. I think the only symptoms (which I didn't recognize as such) have been increased visits to the loo (especially overnight), and thirst (dry mouth leading to guzzling water): I thought I was just drinking too much booze! (Which I do, actually - that'll have to change.)
 
Welcome @SteveDo 🙂 Do you know what your HbA1C result was (the blood test that diagnosed you with diabetes)? It must have been reasonably high if you’ve been given Gliclazide, I presume?
 
Welcome to the forum, it can be a shock to get a diabetes diagnosis but also a relief as it can then explain symptoms you have been having. Diagnosis is made from the result of an HbA1C test where the threshold is 47mmol/mol. I assume your result was quite high if you have been given 2 medications, however diet is also important. It is good you have a monitor as the gliclazide has the potential to cause low blood glucose so you will be able to keep an eye on that.
Many find reducing carbs in the diet will be successful but it is better to reduce gradually especially with that medication and don't go too low on carbs but usually around 130g per day is suitable.
Have a look at this link which should help with some ideas for modifying your diet.
 
SteveDo said:
Steve here, in the Medway towns (Kent). Type 2 diagnosis received today following an NHS health check. Prescribed metformin and gliclazide, also atorvastatin for cholesterol. I've also been given a blood-glucose testing kit and an appointment with a clinical pharmacist.
Click to expand...

Gosh that must have come as quite a shock @SteveDo 😱

And yes, I remember from my own diagnosis how easy it is to put any symptoms you have noticed down to other things. I put everything down to ‘stress’ (even though I knew I didn’t feel very stressed!

Great news that you have been given a monitoring kit.

A blood glucose meter can be a very direct way of examining how you are responding to your meals and snacks, and then making small tweaks and changes to meals to try to improve your outcomes.

You can take a reading before a meal, and then again 2hrs after the first bite, to see what the differences are. This can help you identify any carbs that seem to be spiking your BG (initially in a way the numbers themselves matter less than the differences between them). Ideally you would want to see a ‘meal rise’ of no more than 2-3mmol/L at the 2hr mark. Once you can see how you respond to different meals you can begin experimenting with reducing portion sizes of the carbs where you see bigger rises. You might find that you are particularly sensitive to carbohydrate from one source (eg bread), but have more liberty with others (eg oats or basmati rice) - It’s all very individual! You might even find that just having things at a different time of day makes a difference - with breakfast time being the trickiest.

Over weeks and months of experimentation you can gradually tweak and tailor your menu to find one that suits your tastebuds, your waistline, your budget and your BG levels - and a way of eating that is flexible enough to be sustainable long-term. 🙂

Lots of members here have used frameworks similar to that to help tailor their menus to suit their individual metabolisms.
 
I don't know if this is still functional but if it is it may be of interest as it is in your area.
“Kent and Medway CCG, in partnership with Paula Carr Diabetes Trust, are currently offering free access to the myDiabetes app for people living with Type 2 Diabetes in Kent. This would give them access to expert advice, structured education, nutritional guidance, exercise programs and much more.”

The self-referral form is here https://mymhealth.com/resources/kent
 
Leadinglights said:
Welcome to the forum, it can be a shock to get a diabetes diagnosis but also a relief as it can then explain symptoms you have been having. Diagnosis is made from the result of an HbA1C test where the threshold is 47mmol/mol. I assume your result was quite high if you have been given 2 medications, however diet is also important. It is good you have a monitor as the gliclazide has the potential to cause low blood glucose so you will be able to keep an eye on that.
Many find reducing carbs in the diet will be successful but it is better to reduce gradually especially with that medication and don't go too low on carbs but usually around 130g per day is suitable.
Have a look at this link which should help with some ideas for modifying your diet.
Click to expand...
No, the GP didn't give me the actual figure. I might try to find out next week.
everydayupsanddowns said:
Gosh that must have come as quite a shock @SteveDo 😱

And yes, I remember from my own diagnosis how easy it is to put any symptoms you have noticed down to other things. I put everything down to ‘stress’ (even though I knew I didn’t feel very stressed!

Great news that you have been given a monitoring kit.

A blood glucose meter can be a very direct way of examining how you are responding to your meals and snacks, and then making small tweaks and changes to meals to try to improve your outcomes.

You can take a reading before a meal, and then again 2hrs after the first bite, to see what the differences are. This can help you identify any carbs that seem to be spiking your BG (initially in a way the numbers themselves matter less than the differences between them). Ideally you would want to see a ‘meal rise’ of no more than 2-3mmol/L at the 2hr mark. Once you can see how you respond to different meals you can begin experimenting with reducing portion sizes of the carbs where you see bigger rises. You might find that you are particularly sensitive to carbohydrate from one source (eg bread), but have more liberty with others (eg oats or basmati rice) - It’s all very individual! You might even find that just having things at a different time of day makes a difference - with breakfast time being the trickiest.

Over weeks and months of experimentation you can gradually tweak and tailor your menu to find one that suits your tastebuds, your waistline, your budget and your BG levels - and a way of eating that is flexible enough to be sustainable long-term. 🙂

Lots of members here have used frameworks similar to that to help tailor their menus to suit their individual metabolisms.
Click to expand...
Thanks. At the moment I've just been told to take readings twice a day - before breakfast and before bed - for at least two weeks so they can be reviewed (perhaps by the clinical pharmacist?). Still, I'm sure it can't hurt to take more readings.

I must say, I have been a bit shocked by my first two readings: 23.5 last night and 14.5 this morning. All the examples in the booklet are in single digits!


Steve
 
That indicates that your HbA1C is pretty high with those readings.
People find that testing need to be for a purpose so to guide you on food choices.
When readings are that high in newly diagnosed then a good testing regime is to test before you eat and after 2 hours when you would be aiming at no more than 2-3mmol/l increase, once you get a better grip on making meal changes then the guide is 4-7 fasting and before meals and no more than 8-8.5 2 hours post meal.
If you are seeing large increases from your meal then you know it is too carb heavy.
 
SteveDo said:
No, the GP didn't give me the actual figure. I might try to find out next week.

Thanks. At the moment I've just been told to take readings twice a day - before breakfast and before bed - for at least two weeks so they can be reviewed (perhaps by the clinical pharmacist?). Still, I'm sure it can't hurt to take more readings.

I must say, I have been a bit shocked by my first two readings: 23.5 last night and 14.5 this morning. All the examples in the booklet are in single digits!


Steve
Click to expand...

I've found the result in the NHS app.

HbA1c level (DCCT aligned): 13.5%
HbA1c level - IFCC standardised: 124 mmol/mol
 
Leadinglights said:
I don't know if this is still functional but if it is it may be of interest as it is in your area.
“Kent and Medway CCG, in partnership with Paula Carr Diabetes Trust, are currently offering free access to the myDiabetes app for people living with Type 2 Diabetes in Kent. This would give them access to expert advice, structured education, nutritional guidance, exercise programs and much more.”

The self-referral form is here https://mymhealth.com/resources/kent
Click to expand...
Thanks, I've submitted the form.

There are also supposed to be some free training courses locally, but I haven't quite figured that out yet.
 
SteveDo said:
I've found the result in the NHS app.

HbA1c level (DCCT aligned): 13.5%
HbA1c level - IFCC standardised: 124 mmol/mol
Click to expand...
That HbA1C is very high considering the diagnostic threshold is over 47mmol/mol so you do have a good bit of work to do. Your readings are consistent with that HbA1C.
You might want to try testing some of your meals to see where you can be making some impact, Test before you eat and after 2 hours, increase should be no more than 2-3mmol/l.
 
SteveDo said:
I've found the result in the NHS app.

HbA1c level (DCCT aligned): 13.5%
HbA1c level - IFCC standardised: 124 mmol/mol
Click to expand...

Based on the experiences shared by some other members, I’d suggest you aim to reduce your glucose levels gradually over a period of weeks and months, rather than trying to reduce your levels too quickly. If your fingerstick levels have been in double-figures for a while (which might give rise to an HBA1c at around that level) then reducing them too quickly can put quite a strain on fine blood vessels in eyes and nerve endings which can cause temporary changes in your eyes, or give rise to transient nerve pain.

Slow and steady wins the race 🙂
 
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