Older newly diagnosed type 2 vegetarian

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Chrsyc

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Type 2
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Yesterday, I was informed I am Type 2 diabetic. It was a shock as I have been receiving treatment for Long Covid. At the same time I’ve been told to lose weight (I’ve put on a stone in a year)
I’ve looked online about what I can & can’t eat but there’s sooooo much information. I also read that I must eat 4 meals a day - is this correct? I also read that you need a monitor to check your sugar levels. Do I need to buy this? Which one???
I just need a simple guide to help me get to grips with this.
I have signed up to DiabetesUK membership and await the membership pack. I go to collect my medication today and am hoping it has an information sheet with it.
I’m in my 70s and feeling very overwhelmed.
All help is gratefully received.
 
Hi @Chrsyc and welcome!

I'm sorry that you've had to join us, but please know you're at the right place - we've got a lot of users here who are always eager to help.
There are a lot of different options that people go for when it comes to food, but a general 'rule of thumb' as such is reducing carbs that you consume. Everyone tends to think that simply reducing sugar will do the trick, but carbohydrates are very important as they breakdown into sugar (glucose), so you need to watch them too. Think of what you usually eat day to day, have a look at how much of that are carbs and consider where you can reduce those. Remember that the changes that you'll be making need to be long-lasting, so there's no use in starving yourself or doing something and feeling miserable. Those changes will need to become your new 'go-to'.

Do you mind me asking what were your Hba1c levels? This would give Users a better understanding on what support you might be needing. And how's your mobility? I can only assume that with Long Covid it might be difficult?
 
Hello @Chrsyc , welcome to the forum. So sorry to hear you have been living with long covid and now finding out you have type 2 diabetes. It is a lot to take on board, but you don't need to do it all at once. Try not to scare yourself with looking on the Internet. Not all the information is up to date or accurate. This forum and the Diabetes UK site is very helpful. Ask as many questions as you like. If we can give you the answers and general advice we will. While we are not medical experts, there is a lot of experience of living with diabetes among our members. Hope your follow up appointments will help you understand how diabetes affects you. Everyone is different so you do what works for you.
 
Welcome @Chrsyc 🙂 Your aim is to find the right diet for you as an individual - ie one that controls your blood sugar and maybe also helps you gradually lose that little bit of weight if you need to do so.

I don’t know where you got the four meals a day thing from, but some people on certain diabetes meds do need a small bedtime snack. You could start off by looking at the Learning Zone (orange button at the top of this page). There are also Meal plans and Recipes here:

Meal plans and diabetes

Eating nutritious, healthy and downright delicious food is that bit easier with our meal planners. We've created multiple different weekly meal plans to suit all types and tastes. They're nutritionally balanced, are calorie and carb counted, and can help if you want to lose weight. They also...
www.diabetes.org.uk www.diabetes.org.uk

Recipe finder - Enjoy Food | Diabetes UK

www.diabetes.org.uk www.diabetes.org.uk
 
Hi and welcome.

Please don't feel your age has anything to do with it, we all felt incredibly overwhelmed at diagnosis. It is a very normal emotion, but I can assure you that with the right support and information it does get easier and can be an opportunity to actually improve your health rather than it being necessarily detrimental. I know I am not the only one here on the forum 0who has used my diagnosis as the kick up the backside I needed to make some changes to my lifestyle for the better.
The confusing bit is which changes do you need to make and this is where all the conflicting advice comes into it. The thing is that we are all different and what suits one person doesn't always suit another. Plus diabetes can be surprisingly individual and our metabolism and digestion and lifestyles in general as well as tastes are all different. This is why we often encourage people to experiment on themselves to see what works for them and the food they eat and the exercise/activity they are able to do and the medication they take and a whole host of other factors, that can affect Blood Glucose (BG). Having a BG meter can really help with that experimenting because it enables you to "see" your diabetes in some respects. After all most people don't really know or see any real symptoms of their diabetes when they are diagnosed, so it can sometimes even be quite hard to accept the diagnosis, simply because people don't see any real signs of it.

The first thing to do is to find out what your HbA1c is. That is the blood test at the GP surgery or hospital used to diagnose diabetes and track your management of it. It tells you how far into diabetes territory you are starting at and will show you over the years if you are making good progress to reduce it or if it is getting higher and perhaps needs a different approach. You are entitled to know the actual number and if you don't know it you can ask the nurse at your appointment, or look online if you have online access to your test results. Diabetes is diagnosed in the UK when your HbA1c reaches 48mmols/mol or more, but some of us were into 3 figures at diagnosis. The normal range is below 42, but there is an interim range of 42-47 when some people are diagnosed as being "at risk of developing diabetes" or sometimes referred to as pre-diabetes.

You mention medication. Do you know what you have been prescribed? If not, it may be useful to know that the right dietary changes can be more powerful than most diabetes meds, so sometimes it can be possible to negotiate a 3 month hiatus on medication, to give dietary changes and perhaps increased activity a try with a retest after 3 months to show if that is being successful. Usually an HbA1c between 48-60mmols should allow you this opportunity although people have brought their levels down from much higher through dietary means without medication, but the current advice is I believe to treat inflated HbA1c patients with medication combined with lifestyle changes at the earliest opportunity. It is possible to come off medication at a later stage if your HbA1c comes back down to more normal levels and can be maintained there, so it isn't necessarily progressive, as some doctors seem to think. Most people can do a lot themselves to manage their diabetes well.

Anyway, the thing to do is to draw up a list of questions for your nurse appointment and take it with you and cross the questions off as you get answers and note down any results. If you wish to negotiate a period of 3 months lifestyle changes before starting medication, ask about that option. As I said, if your HbA1c is too high, this may not be a sensible option, but in the 48-60 range it should certainly be considered, if you feel that you are motivated to make changes. If your levels are very high and you need certain medication like Gliclazide, you should be offered a BG test kit with a meter and strips, so I would wait until you see what the nurse offers before forking out for your own kit. Gliclazide (and insulin, which will almost certainly not be prescribed at this early stage) can cause your levels to drop a bit too low, so they have to prescribe you a meter with those meds, but sometimes, if they feel you are motivated to make the necessary changes they have some leeway to provide a meter and test strips when you aren't on those meds, so worth asking..... they can only say "No" as a worst case scenario.

Anyway, good luck with your appointment and when you have more info from that come back to us, but in answer to your question about having to have 4 meals a day, that is not standard advice, but may work for some people. Having just 1 or 2 meals a day works for others and 3 regular meals for others. None are right or wrong, just what works for any particular individual.
 
Thank you all so much for your information and wonderful advice. I really appreciate your help.
To answer a few questions:
- My Hba1c level is 51
- My mobility is generally good except Long Covid has left me with balance issues along with dizziness and headaches. The biggest problem is fatigue though.
- I collected my medication today. It’s Metaformin 500mg. A phased introduction.
- I asked at the Drs if I could talk to someone to answer a few questions but no-one was available to see me until the end of October!
- I also asked for an information sheet but they don’t do them
- I am booked in for another blood test beginning of November.
- I also asked about monitoring and they told me I didn’t need to at this stage. I was a little disappointed about this as I would feel happier knowing it wasn’t increasing! I’m willing to buy my own equipment but have no idea what to buy!
- I have been signed up for the Structured Diabetes Education Programme but don’t know when that will start.

Once again, thank you all. I’m adjusting already and having this forum is a great comfort.
 
The two BG meters most frequently recommended for those self funding both in terms of reliability and economy of use are the Spirit Healthcare Tee2 and the Gluco Navii. Both are available to buy online and will come with 10 lancets and 10 test strips. Most of us reuse the lancets multiple times without issue even though they are supposed to be single use and indeed we have a St Swithin's day club where those of us who are "seasoned testers" where we change our lancet (finger pricker) once a year on St Swithin's Day (15th July), so the 10 lancets in your test kit could potentially last you 10 years IF you only use them on yourself. I was prescribed a box of 200 and indeed have them on my repeat prescription, but that one box will obviously last me several lifetimes since I am a fully subscribed St Swithin's club member :D. They are however relatively inexpensive if you want to be scrupulous and use a new one each time. The test strips however are single use, so you will definitely need to order extra pots of test strips and generally an initial purchase of 2-3 pots of 50 test strips will get you started. They are specific to the test kit you buy, which is partly why we recommend those two meters, because they have reasonably low cost test strips and that is where the manufacturers make their money. Some other BG meters can have test strips which cost 2-3 times as much for 50 test strips. I think the two meters mentioned will be between £8 and 10 for each pot of 50 strips depending if you can find a multipack offer.

With an HbA1c of 51, I personally think starting you on Metformin at this stage is a bit of overkill and especially as it sounds like they are intending to build you up to full dose, when a few simple dietary changes alone should push you back into the normal zone in about 3 months with no appreciable risk in that time even if it doesn't. It doesn't sound like your medical professionals wish to engage with their patients to manage their diabetes and that is a real shame and self management is far more effective than just prescribing medication if people are motivated but you can't know or expect them to be motivated if you don't discuss it with them. As I said above though, there is no reason why you can't come off them at a later date if your levels come down into the normal range or if you suffer side effects. There are many people here on the forum who started on Metformin with much higher HbA1c than you and now manage their diabetes very effectively without any medication.
 
Thank you for this. I will get some testers . I like the St Swithins Day idea but hope to sort my weight and levels by my November blood test.
I must say, I was most disappointed by the lack of support from my surgery. I know they are busy but expected a little more support & guidance. However, I shall manage with guidance from wonderful people like yourself & others on this forum. Thank you again
 
One more question please…
Do I need to inform insurance companies (car/holiday etc?) What about DVLA?
 
Hi Chrsyc
I am now 5-6 months into my diagnosis, starting with a very high HbA1c well into 3 figures. But this forum put my mind at rest. But as most people have said this can be a very individual experience. Everyone will find their path that they are comfortable with. But with frequent visits to this forum you pick up on the experience of others and you will decide what you are comfortable with. However, with a figure of 51, this is a figure a lot of people dream of and as some people have said this is possibly manageable by just a few changes without the need of medication. Becasue of my high figure I was put on 1000mg of Metaformin AND Insulin. But withing 10-12 weeks I reduced my figure to 62. It is questionable that I need to be on Insulin or high levels of medication..... but I am an individual that has been given that advice. I am sur eyour Diabetics Team have your best interests and will guide you.... but this forum will be there as well.

As to the opportunity to lose weight (mentioned in your introduction), although, I am very sure this would be beneficial, but it may come naturally as your lifestyle changes. But you may get to a point where losing weight is not an option, and you may need to go the other way and PUT ON weight. Sadly, the support for this requirement is somewhat lacking. Most people think Diabetes = Lose Weight and you will get better. Ok, maybe I am over reacting here, but there does seem to be less information if you are in this predicament. BUT.... pester your Doctor and your medical team, even though they are over worked, they can be very helpful.

Regards to the testing kits, depending on your situation it may not be prescribed to you. If you are in this category, try and look at it positively, it means you do not require it. But like you, I would find it useful to "know" how I am progressing, rather than waiting months between blood tests. Sorry, I only use a kit given to me by my Diabetics team so can off no experience in commercially available kits.

Do you this forum, it is full of experiences and how people overcome difficulties, which is equally helpful as medical information.

Good luck.
 
No, you don't need to inform DVLA or car insurance, but I believe you need to declare it for holiday insurance.
 
Chrsyc said:
One more question please…
Do I need to inform insurance companies (car/holiday etc?) What about DVLA?
Click to expand...

You don’t need to tell the DVLA but you should tell your car insurance company as I believe it counts as a material fact.
 
A bit late to the party as I have been out all day but I have to agree that metformin is rather overkill with an HbA1C of 51 which is just a smidgen over the diagnostic threshold and some dietary changes should be sufficient to reduce your blood glucose and lose weight.
This link has a vegetarian menu plan but also some good information which make may things clearer for you in the absence of any help from your GP. https://lowcarbfreshwell.com/
There are some newer NICE guidelines that suggest that the diagnostic threshold for more mature people should be more lenient taking into consideration any other health risk factors. However if you need to lose weight it will do no harm to evaluate your diet and make a few changes.
I would discuss the real need for metformin and see what dietary changes will do to your HbA1C when you have the next test.
 
barnesd said:
Hi Chrsyc
I am now 5-6 months into my diagnosis, starting with a very high HbA1c well into 3 figures. But this forum put my mind at rest. But as most people have said this can be a very individual experience. Everyone will find their path that they are comfortable with. But with frequent visits to this forum you pick up on the experience of others and you will decide what you are comfortable with. However, with a figure of 51, this is a figure a lot of people dream of and as some people have said this is possibly manageable by just a few changes without the need of medication. Becasue of my high figure I was put on 1000mg of Metaformin AND Insulin. But withing 10-12 weeks I reduced my figure to 62. It is questionable that I need to be on Insulin or high levels of medication..... but I am an individual that has been given that advice. I am sur eyour Diabetics Team have your best interests and will guide you.... but this forum will be there as well.

As to the opportunity to lose weight (mentioned in your introduction), although, I am very sure this would be beneficial, but it may come naturally as your lifestyle changes. But you may get to a point where losing weight is not an option, and you may need to go the other way and PUT ON weight. Sadly, the support for this requirement is somewhat lacking. Most people think Diabetes = Lose Weight and you will get better. Ok, maybe I am over reacting here, but there does seem to be less information if you are in this predicament. BUT.... pester your Doctor and your medical team, even though they are over worked, they can be very helpful.

Regards to the testing kits, depending on your situation it may not be prescribed to you. If you are in this category, try and look at it positively, it means you do not require it. But like you, I would find it useful to "know" how I am progressing, rather than waiting months between blood tests. Sorry, I only use a kit given to me by my Diabetics team so can off no experience in commercially available kits.

Do you this forum, it is full of experiences and how people overcome difficulties, which is equally helpful as medical information.

Good luck.
Click to expand...
Hi @barnesd , I agree with your comments about lack of information and support for people trying to gain weight who also have T2. I presume that because it's less common the NHS haven't given it much thought.
 
Again, thank you all for your kindness and information. It is so reassuring ❤️
 
Chrsyc said:
Yesterday, I was informed I am Type 2 diabetic. It was a shock as I have been receiving treatment for Long Covid. At the same time I’ve been told to lose weight (I’ve put on a stone in a year)
I’ve looked online about what I can & can’t eat but there’s sooooo much information. I also read that I must eat 4 meals a day - is this correct? I also read that you need a monitor to check your sugar levels. Do I need to buy this? Which one???
I just need a simple guide to help me get to grips with this.
I have signed up to DiabetesUK membership and await the membership pack. I go to collect my medication today and am hoping it has an information sheet with it.
I’m in my 70s and feeling very overwhelmed.
All help is gratefully received.
Click to expand...
Hi Chrysc,
I was diagnosed in July with an Hba1c of 52. My diabetic nurse was happy for me to try 3 months of diet control before retesting.
I invested in my own monitor/strips etc as I'm a need to know sort of woman!!
Like you, I've been referred to the education course - no indication yet when that might be! However, in fairness, I've had my annual kidney screen, my feet check and I have my appointment for my first retinopathy screen in a fortnight so I am reassured that I've not been forgotten about.

It's overwhelming being diagnosed but the support on here is fantastic and I hope you find it case helpful as I have.
 
Thank you. I would like to try for 3 months too without medication but as I stated earlier, I can’t get to discuss my situation with anyone at the Drs until end of October!! I daren’t just not take the tablets.
Like you, I also ‘need to know’ so I’ve ordered a monitor and it arrives tomorrow
 
Chrsyc said:
Thank you. I would like to try for 3 months too without medication but as I stated earlier, I can’t get to discuss my situation with anyone at the Drs until end of October!! I daren’t just not take the tablets.
Like you, I also ‘need to know’ so I’ve ordered a monitor and it arrives tomorrow
Click to expand...
It is your decision not theirs as to whether to take the medication and if you are committed to making dietary changes and are getting yourself the tools to take control of your condition then I would just see how you go without the medication.
You can check your progress by using your monitor by testing your fasting/morning blood glucose and also test your tolerance to meals by testing before you eat and after 2 hours where you will be aiming at no more than a 2-3mmol/l increase. Your aim is 4-7mmol/l before meals and fasting. Those morning readings are often the last to come down and for some can remain stubbornly high.
 
Thank you. I am going to go back to Drs tomorrow and try to insist I talk to someone (not very hopeful)

So are you saying that I should test:
- first thing in morning before I eat & drink
- just before I eat
- 2 hours after I’ve eaten

Also, I’m not understanding what you mean by 2-3mmol/l increase or 4-7mmol/l
This is all a new language for me!
 
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