Ogtt

[Scotia]

Had my OGTT yesterday, already forgot what it means. However I suppose in a few days I will get confirmation if I am Type 2 or not. I don't think it will be the latter though.

I have been reading some posts on here and seeing references to low carb, and no carb. I am a bit puzzled, I thought a diabetics diet was mainly counting carbs not missing them out.


Thanks for reading.
Scotia.

 

[Cat1964]

Oral glucose tolerance test? I have just recently been diagnosed type 2. I am not counting carbs. My diabetes for now is to be controlled by diet and exercise. The nurse told me last week that she wanted me to keep 'background startches' in my diet, so I am still able to eat rice, potatoes etc just not lots.

 

[Scotia]

Background starches?

 

[Cat1964]

Yes I kind of thought that too. But when I told her I was cutting lots of stuff out of my diet she stopped me in my tracks. She said to me there are carbs and starches that are still important in our diets. She showed me a plate which gave me guidance on portions. Funnily enough it was on This Morning about half an hour ago too. Divide your dinner plate in half. On one half should be filled with greens/veggies, the size of your palm should be meat or protein on the other half and the remainder of the 2nd half should be rice, bread, potatoes etc. suppose that's what she was meaning. As it was my 1st appointment since being diagnosed there was so much to take in that I didn't question background starches.

 

[everydayupsanddowns]

Yes I kind of thought that too. But when I told her I was cutting lots of stuff out of my diet she stopped me in my tracks. She said to me there are carbs and starches that are still important in our diets. She showed me a plate which gave me guidance on portions. Funnily enough it was on This Morning about half an hour ago too. Divide your dinner plate in half. On one half should be filled with greens/veggies, the size of your palm should be meat or protein on the other half and the remainder of the 2nd half should be rice, bread, potatoes etc. suppose that's what she was meaning. As it was my 1st appointment since being diagnosed there was so much to take in that I didn't question background starches.

It's difficult because for *some* people that might be fine. But for many others that advice might be a complete disaster. Aside from a little vitamin C there is little in a potato apart from starch. A form of starch that breaks down to glucose in the bloodstream faster than table sugar or golden syrup in most people. It is unlikely that the nurse you spoke to would suggest that you ensured you sprinkled your meat and vegetables with a good few tablespoons of sugar and a squeeze of lemon, but in a sense that was the suggestion.

The 'eatwell' plate that I think you were shown is based in no small part on the 'food pyramid' which came out of America in the 50s as was driven by the USDA (that's department of agriculture, not health). This may be absolutely fine for people with a fully functioning metabolism, but raises some difficult questions for people who have a problem digesting carbhydrate properly. Part of the initial idea was that fat in the diet was directly linked to heart disease (a notion that is increasingly undermined more recent research). Many Drs and nurses still recommend very high carb intakes for people with diabetes despite knowing that this will have a disastrous effect on blood glucose levels. We can try to go for carbs which absorb more slowly, but almost all bread and breakfast cereals, for example, will absorb at a very similar speed to granulated sugar.

For my money 'everything in moderation' is the key. I have difficulty (not least practically/socially) with extremely low carb approaches. But moderate to low carb 'eat to your meter' methods seem absolutely logical.

It is recommended that as as adult I eat 250-300g of carbs a day. I could not eat that much with any regularity without gaining a significant amount of weight and having extremely erratic blood glucose levels, which would do my long term health no good whatever, no matter how little fat I was trying to eat at the time.

This page makes interesting reading too: http://www.drbriffa.com/2012/03/05/...y-advice-diabetes-uk-dishes-out-to-diabetics/

 

[Mark T]

Oh yes - that advice 🙄

Consider that starches (also sometimes called complex carbohydrates) are converted to glucose by your body. Glucose that you consume will directly raise
your blood glucose levels.

This is the reason that many opt for low carbohydrate or moderate carbohydrate diets. Personally I go for the "eat to your meter" approach which is outlined here: http://loraldiabetes.blogspot.com/2006/10/test-review-adjust.html


Every person is different, so one person might be able to cope with a quarter plate of potatoes, another might not.

 

[Cat1964]

I know what you mean but I wasn't given any type of monitor. That's another thing she said that she didn't think I needed to test my glucose levels. So I don't know what will be having a bad effect on glucose levels. I haven't eaten much of these 'background starches' she mentioned. I am happy enough with a big plate of veggies to keep me going.

 

[Scotia]

OMG, not going to think about this again until I get confirmation. Such a lot to know.

Thanks so far.
Scotia.

 

[trophywench]

So she wants you to (do the equivalent of) drive your car without looking through the windscreen, does she?

Do you think that's very good advice?

Cos I don't ....

 

[Cat1964]

So she wants you to (do the equivalent of) drive your car without looking through the windscreen, does she?

Do you think that's very good advice?

Cos I don't ....

I take it you are referring that last remark to me Trophywench?

Good question but being new to all this myself I don't know if it is good or bad advice. She didnt even do a finger prick test last week. She told me that when I go to the diabetic clinic appointment in 3 weeks time they would do a 'finger stab' then. She even went away and asked the doctor if I should be on Metformin but the doctor said no. I thought at that point if you don't know what my blood glucose is right now how do you know I need Metformin? I haven't been at all well since that appointment so have no real interest in eating as it all tastes of nothing whatever I eat or drink. I don't even feel bad or good when I haven't eaten anything at all. So my thoughts on it this week are how do I know how much being ill this week has affected me too. Only difference I noted today is I have been thirsty all day.

 

[everydayupsanddowns]

Only difference I noted today is I have been thirsty all day.

Many GPs resist giving BG monitors to people with diabetes, primarily down to cost unfortunately.

Unexpected thirst can be a sign of BG levels running high (as they often do during periods of illness). Just keep drinking lots of water. Hope you feel better soon.

Incidentally Diabetes UK have an advocacy pack to help people get access to self-monitoring, and if your GP/nurse still refuses to help you monitors can be purchased for which the ongoing strip-cost is more reasonable. Some of our self-funding T2s will know the right ones.

 

[Cat1964]

It just seems very confusing. Even at hat appointment it was obvious I was coming down with 'something'. My throat was scratchy and I kept apologising when my voice faded at times to nothing. I told her I had a sore throat. It was only through reading something on the net a couple of days ago that I found out being ill can affect your blood glucose. I seem to have been fine so far apart from the thirst that I noticed straight away this morning. I have been drinking a lot but the thirst hasn't yet gone away. I will keep drinking today. But as an after thought should I mention monitoring my blood glucose when I go at the end of this month to my 1st diabetic clinic.?

 

[everydayupsanddowns]

I would certainly ask for a monitor. Tell them that you want to actively use Self Monitoring of Blood Glucose to maximise the effect of diet changes, and to monitor things during illness. Tell them how worried you feel when you don't know what is happening, and that you don't see how a 3 or 6 monthly test can give you information on how your body is coping with different foods.

That post 'Test review adjust' is by someone who has been managing their blood glucose levels within very tight margins for 10 years or more without medication. That won't be possible for everyone, but without knowing what foods (and at what time of day, and in what portion sizes) your body can happily cope with - I really don't see how you can hope to control your diabetes.

Once you have done some fairly intensive testing in the early days, you'd be able to drop way back to a more 'maintenance' level. But until you know *by testing* whether potatoes are fine, but rice is a disaster (or vice versa) - you (and anyone who give you dietary advice) will be just guessing.

 

[Cat1964]

I would certainly ask for a monitor. Tell them that you want to actively use Self Monitoring of Blood Glucose to maximise the effect of diet changes, and to monitor things during illness. Tell them how worried you feel when you don't know what is happening, and that you don't see how a 3 or 6 monthly test can give you information on how your body is coping with different foods.

That post 'Test review adjust' is by someone who has been managing their blood glucose levels within very tight margins for 10 years or more without medication. That won't be possible for everyone, but without knowing what foods (and at what time of day, and in what portion sizes) your body can happily cope with - I really don't see how you can hope to control your diabetes.

Once you have done some fairly intensive testing in the early days, you'd be able to drop way back to a more 'maintenance' level. But until you know *by testing* whether potatoes are fine, but rice is a disaster (or vice versa) - you (and anyone who give you dietary advice) will be just guessing.

Thank you so much for this advice. As I said earlier being new to this all is quite daunting. You don't know what to ask or if you are going to seem really stupid. What worried me most about being ill was the thirst today. But I also had a headache from Thursday to Saturday that was when I think this illness was at its worst. I almost had a meltdown with it all on Saturday and was talking on FB to my friend. She is a nurse and suggested my blood glucose must be running fairly high if I was experiencing a 3 day headache too and painkillers were doing no good. She told me to up the fluid intake to help. The headache did go away. Hopefully after I see my GP tomorrow I will get better and with any luck it will be ages before I ever get sick again. My worry is if I don't know just how high my blood glucose goes in times of sickness, how much damage am I doing to myself. As well as being sick I was really stressed by Saturday as it was coming up for the anniversary of my dads death on Sunday. So stress and illness how do I monitor all that and what I'm eating. Should I be worried about what effects the weekend has had on me?

 

[everydayupsanddowns]

Sorry to hear that you've been having such a rough time. Stress also has a reputation for raising BGs, so you've had a real double whammy.

Thankfully though, pretty much everything I've read suggests that, no, there is no need to worry about a brief period of high BG levels - as unpleasant as it may be.

It's the long term picture that will better predict your chance of avoiding developing any d-related nasties. Once you have settled and have a handle on things (as you seem very likely to do with the questions you are asking) the occasional treat or celebration (birthdays etc) can be enjoyed without worrying that long term damage is being done.

And never worry about asking a question here - the only 'silly' ones are the ones you dont ask!

 

[Cat1964]

Thanks for your help and advice. You put my mind at rest. I will definitely ask at the diabetic clinic when I go about the meter.

 

[mcdonagh47]

Had my OGTT yesterday, already forgot what it means. However I suppose in a few days I will get confirmation if I am Type 2 or not. I don't think it will be the latter though.

I have been reading some posts on here and seeing references to low carb, and no carb. I am a bit puzzled, I thought a diabetics diet was mainly counting carbs not missing them out.


Thanks for reading.
Scotia.

The Oral Glucose Tolerance Test can give 4 results ...
- "normal
- IFG - Impaired Fasting Glucose
- IGT - Impaired Glucose Tolerance
- Type 2 Diabetes

 

[mcdonagh47]

That post 'Test review adjust' is by someone who has been managing their blood glucose levels within very tight margins for 10 years or more without medication. .

If you are referring to Alan S that is just untrue. He has been on Metformin for years. He was on 1000 mg for years and complaining that it wasn't doing much. AFAIK he is now on the standard dose of 2000 mg - like most of us T2s.

 

[everydayupsanddowns]

If you are referring to Alan S that is just untrue. He has been on Metformin for years. He was on 1000 mg for years and complaining that it wasn't doing much. AFAIK he is now on the standard dose of 2000 mg - like most of us T2s.

Thanks McD. My error - I'd thought he was tablet free. Still a pretty impressive achievement though.

 

[haz]

It's difficult because for *some* people that might be fine. But for many others that advice might be a complete disaster. Aside from a little vitamin C there is little in a potato apart from starch. A form of starch that breaks down to glucose in the bloodstream faster than table sugar or golden syrup in most people. It is unlikely that the nurse you spoke to would suggest that you ensured you sprinkled your meat and vegetables with a good few tablespoons of sugar and a squeeze of lemon, but in a sense that was the suggestion.

The 'eatwell' plate that I think you were shown is based in no small part on the 'food pyramid' which came out of America in the 50s as was driven by the USDA (that's department of agriculture, not health). This may be absolutely fine for people with a fully functioning metabolism, but raises some difficult questions for people who have a problem digesting carbhydrate properly. Part of the initial idea was that fat in the diet was directly linked to heart disease (a notion that is increasingly undermined more recent research). Many Drs and nurses still recommend very high carb intakes for people with diabetes despite knowing that this will have a disastrous effect on blood glucose levels. We can try to go for carbs which absorb more slowly, but almost all bread and breakfast cereals, for example, will absorb at a very similar speed to granulated sugar.

For my money 'everything in moderation' is the key. I have difficulty (not least practically/socially) with extremely low carb approaches. But moderate to low carb 'eat to your meter' methods seem absolutely logical.

It is recommended that as as adult I eat 250-300g of carbs a day. I could not eat that much with any regularity without gaining a significant amount of weight and having extremely erratic blood glucose levels, which would do my long term health no good whatever, no matter how little fat I was trying to eat at the time.

This page makes interesting reading too: http://www.drbriffa.com/2012/03/05/...y-advice-diabetes-uk-dishes-out-to-diabetics/

This is excelent advice. I am T2 and was automatically shoved on metaformin and tested only by the practice nurse, once a year! I was told to eat carbs every four hours whether or not i was hungry. the result was my weight went up along with my sugar levels and the metaformin. I got a test kit, and since Christmas (I had to stop the metaformin completely due to reaction), and I went on a carb by test diet. I eat something, test the result, keep it in the diet or chuck it out. I find that about 50grams of carb works best, for me, others will vary. A friend sticks to 25g another to 100g. My daily readings have come down from 10.5/16.5 to 6.5/8.5. I intend to check and test until I know exactly which food does what to my system. My weight has also dropped, by 12 pounds! Good luck Scotia, and others, stick with it (no pun intended) keep testing and checking, get to know your body and take control.