Partner of newly diagnosed type 2

[Isi16]

Hello. My 62 yr old grump (partner) was diagnosed a few days ago and its been like an earthquake in our house. He was at the nurse for something else and she said she would just get his blood tested for diabetes while he was there (he's been borderline for 4 years). Apart from it not the usual glucose test he had annually (tested then drinking something, waiting an hour then tested again plus bloods) all she took was bloods-45 minutes after he had his fruit and fiber bowl of flakes. He was 48? Doesnt mean anything but all he was told was that he was just over the limit? Hes now trying to read through what he can on food-as am i to see what i can or cant cook for meals. Its a very steep learning curve!

 

[Docb]

Hi @Isi16 and welcome to the forum.

Let's start with the simple thing. The 48 number will be an HbA1c result. This gives a measure of his average blood glucose over the last couple of months and will not be affected by his breakfast. That might have affected a spot reading, but not his HbA1c.

The HbA1c result is a sliding scale on which there are a couple of fixed points. 48 is the main one because it is the level at which a formal diagnosis of diabetes is made. At that level the risk of getting any symptoms let alone complications is very low but it is saying that it is time to sit up and take notice because you don't want it to get a lot higher. To put it into perspective, things begin to get a bit of a problem when it gets nearer to 100 and real trouble when around 150.

So, it is time to get educated and work out a plan to keep things in check, but there is no need to panic. Read around the forum and check out the learning zone and ask questions about anything you do not understand. Somebody will be around to help.

 

[Isi16]

Thank you for explaining that. We were both a bit shocked that the nurse didnt do the usual fasting tests, she is known to be rather "matronly" (for avoidance of using a rude word) and its her way or the highway attitude so we wondered why blood was done as a check instead. He wants to loose weight, about 2 stone so a better diet was planned anyway for us both with snacks already gone and cakes etc too. He has a physical job, walks our dog 4 times a day too. Do i need to cut out potatoes bread pasta rice altogether, or would cutting frequency and portion control be okay?

 

[Felinia]

Hi and welcome
With a reading of 48 he is only just in the diabetic range, but he's been given the chance to get on top of things now, rather than later.
A 2 stone loss and the exercise he does will be a great start. I would say moderation in bread, rice, pasta and potato, not abstinence at this time. Bread, rice and pasta should be wholegrain. As for portion size, my nurse told me 2 new potatoes (about 50gm). I vaguely recall reading somewhere to have half portions of pasta and rice. You can use pasta substitutes like courgetti, or cauliflower rice instead. Bread is a tricky thing. Some people can eat more than others. I can have one slice (25gm) from a small (400gm) loaf, as anything more spikes my glucose.
Hopefully a couple of months will see you both slimmer and healthier. Best wishes

 

[Leadinglights]

Hello. My 62 yr old grump (partner) was diagnosed a few days ago and its been like an earthquake in our house. He was at the nurse for something else and she said she would just get his blood tested for diabetes while he was there (he's been borderline for 4 years). Apart from it not the usual glucose test he had annually (tested then drinking something, waiting an hour then tested again plus bloods) all she took was bloods-45 minutes after he had his fruit and fiber bowl of flakes. He was 48? Doesnt mean anything but all he was told was that he was just over the limit? Hes now trying to read through what he can on food-as am i to see what i can or cant cook for meals. Its a very steep learning curve!

I have not heard that the glucose tolerance test is still being used for diagnosis and the HbA1C is the more usual way, though that is normally sent to the lab rather than being done in 45 min at the surgery. But the result of 48mmol/mol is just in the diabetic zone so with some modifications to diet you should get a grip on it. My other half really got on board with my low carb regime and has also lost some weight. So we have the same meals but he just has a few extras.
I can recommend the book Carbs and Cals as it gives carb value of a whole range of foods and meals but some people use other more sophisticated methods of carb checking.
I would suggest you start a food diary of what you or rather he is eating and drinking and then you can see where some savings can be made. People suggest start by reducing carbs by one third for a few weeks, then more if you need to. This of course depends on self monitoring at home to test the effect of meals on blood glucose levels, they would be spot tests before and 2 hours after he eats where you would aim for no more than a 2mmol/l increase and no higher than 8mmol/l
Sadly G P don't recognise the value of this testing so you would most likely have to self fund the monitor and test strips.

 

[Docb]

@Isi16. If you look at the current guidelines you will see that the HbA1c test is now used for diagnosis. The fasting blood glucose, used when I was first diagnosed, is a bit "old hat" these days, and sensibly so. The fasting test, which was essentially a one off blood glucose reading, relied on too many things to be under control and said nothing about the highs and lows that occur with blood glucose levels. The HbA1c test smooths all of those things out and gives a more reliable overall picture. Your nurse might be a bit matronly but I think she was doing the right thing!

Loosing the weight will be a good way of starting to get things back under control. In terms of diet changes you will find lots of opinions but for what it is worth, I favour portion reduction rather than cutting things out altogether. Which way you go depends very much on you (and him). The important thing is to make changes which eventually become part of your way of life and only you can judge what is possible and what is not.

 

[Isi16]

Thank you for all the advice. He's not doing very well with cutting down the carbs-especially bread. He still eats too many slices for my reckoning. Its always been wholegrain and i have changed rice to brown. He does without potatoes when i make them and has upped his fruit. He has kept a diary of everything hes eating and drinking. No more diet drinks but water instead also going out for walks most days. He's at an angry stage and its very wearing on me but see what the near future brings in the hope he settles down. Its hard trying to think of what to cook! One thing i cant find is wholewheat pasta! Im in the country so not much choice. Thanks again

 

[Leadinglights]

Potatoes, rice and pasta even the brown or whole wheat versions (which have the same carbs as the white) are the things people do tend to cut out as the amount that would not increase the blood glucose level too much are not really worth bothering with and find having a bigger range of other vegetables instead is just as satisfying.
Have a look at the thread What did you eat yesterday for some ideas if the sort of things Type 2 folk have. You will see that most people have meals based on meat, fish, eggs, full fat dairy, veg and salads and find them very filling and satisfying.
Bread is often a problem for people but some are able to tolerate 1 slice but no more. Breakfast cereals are also something to be careful of as the suggested portion would be too carb heavy.

 

[Drummer]

Thank you for all the advice. He's not doing very well with cutting down the carbs-especially bread. He still eats too many slices for my reckoning. Its always been wholegrain and i have changed rice to brown. He does without potatoes when i make them and has upped his fruit. He has kept a diary of everything hes eating and drinking. No more diet drinks but water instead also going out for walks most days. He's at an angry stage and its very wearing on me but see what the near future brings in the hope he settles down. Its hard trying to think of what to cook! One thing i cant find is wholewheat pasta! Im in the country so not much choice. Thanks again

I'm afraid that wholegrain can often be no advantage at all - it still has the same amount of carbs - it made no difference to my glucose levels to have brown carbs so it might not be worth seeking them out.
Fruit should be reduced, not increased, particularly the high carb ones. Berries a couple of times a week seem to be OK even for me, I am very sensitive to carbs - but I really do advise getting to lower levels first, before adding in more than that.

Diet drinks shouldn't be a problem as long as they are not in excess. I have fizzy flavoured drinks or squash with no sugar, though not every day.
Are you testing blood glucose? I found it very rewarding to see my blood glucose going down week by week.

 

[everydayupsanddowns]

I think it’s important to make the changes sustainable and manageable long-term. It could be very disheartening for someone who is already feeling quite limited in what they are able to eat to hear that so many other things are to be avoided, when actually this may not be the case.

Better to gradually reduce portion sizes and make changes in a series of small steps perhaps?

Particularly if there os information from a BG meter to act as a guide?

Also it’s important to remember that everyone has a different tolerance to carbs, and while fruit other than berries may be problematic for some members, for others they can form part of a healthy, balanced and BG-friendly menu in the right proportions.