Questions, Questions and More Questions

[I_Hate_This]

As the title suggests, being diagnosed with Type 2 diabetes has created a fair amount of confusion for me. I wondered if anyone could help with my curiosity around a few things I don’t understand…

1) What determines whether someone is offered medication? I had assumed it was purely down to sugar levels but I have noticed others who have similar levels to myself being offered it whereas I haven’t.

2) I had a retinopathy appointment within 2 months of being diagnosed yet nothing from the diabetic ‘Xpert’ group which I think helps with diet and understanding food which I would assume would have been really helpful within the first few months of diagnosis… it’s now been almost 5 months and still nothing!?

3) Are sensors and home testing kits only beneficial when blood sugars are at a certain level or if you use medication?

4) Can you be diagnosed with T2 and successfully avoid medication for life?

5) At the moment all I’m doing is trying to keep calories and carbs below a certain amount (1500 and 130g) but is this enough? I often fall off the wagon with high sugar/carb meals but my Hba1c levels have come down slightly which I assume is down to sticking to a diet for the majority of the time but is this enough?

Thanks for anyone who managed to get through my long post. I just have so many questions and I don’t feel like I really know what I’m doing!

 

[Burylancs]

As the title suggests, being diagnosed with Type 2 diabetes has created a fair amount of confusion for me. I wondered if anyone could help with my curiosity around a few things I don’t understand…

1) What determines whether someone is offered medication? I had assumed it was purely down to sugar levels but I have noticed others who have similar levels to myself being offered it whereas I haven’t.

2) I had a retinopathy appointment within 2 months of being diagnosed yet nothing from the diabetic ‘Xpert’ group which I think helps with diet and understanding food which I would assume would have been really helpful within the first few months of diagnosis… it’s now been almost 5 months and still nothing!?

3) Are sensors and home testing kits only beneficial when blood sugars are at a certain level or if you use medication?

4) Can you be diagnosed with T2 and successfully avoid medication for life?

5) At the moment all I’m doing is trying to keep calories and carbs below a certain amount (1500 and 130g) but is this enough? I often fall off the wagon with high sugar/carb meals but my Hba1c levels have come down slightly which I assume is down to sticking to a diet for the majority of the time but is this enough?

Thanks for anyone who managed to get through my long post. I just have so many questions and I don’t feel like I really know what I’m doing!

A few points ...

1. New T2s are supposed to be given about 6 months on Diet and Exercise only so that they understand the absolute necessity of diet and lifestyle changes ...the Holy Trinity - lose weight, moderate carbs, increase exercise/activity. Some pen pushers just reach for the prescription pad straight away. In some cases immediate intervention is essential though.
2. Tve Xpert course is said to be one of the better ones for educating newbie T2s. Its provision is hit and miss though across the country.
3. Self testing is vital at any age,stage or duration of diabetes. Newbie T2s should be testing every carb, every portion size. Intensive testing to start with easing off to when necessary as you gain more knowledge. Get your own meter if necessary...E.g. Tee2 machine and strips at any pharmacy. Two mantra of Good Control , 'Test,Test,Test' and 'Eat to your meter'.
4. Unlikely you can avoid meds for life and not a realistic or credible goal. T2 is a life changing, life threatening chronic progressive condition. You Have to come out at it with all gins blazing. Your T2 will tell you what it needs at every stage of the journey.
5. The aim of the diet is to lose weight and find s routine that is workable and effective in the medium and longterm. It's a marathon not a sprint, you're the tortoise in the Hare and Tortoise race. You're planning a new lifestyle not a quick fix on a Fad diet. The 1500 cals and 130g of carbs sounds oK for starters. But T2 has to be managed by results. And that's down to you, don't expect too much of your so-called med 'team'.

 

[rebrascora]

1. There are no hard and fast rules as far as I can gather. It comes down to the GP/nurse or to a certain extent the patient if they can negotiate a medication hiatus to see if their dietary/lifestyle efforts will work. If your HbA1c was dangerously high, then medication would be prescribed but we have some members who have tried the medication found they had bad side effects and so ditched them and just used dietary changes to bring their levels down, some from very high levels, so diet can be a much more powerful factor than most medication if you get it right.

2. The Xpert course is I believe a contract and I am not sure if you have to self refer so it might be worth doing a search on that? Retinal screening is within the NHS in some places and contracted out in others. There is no real coordination as to when you get appointments for what, it is just a question of when they can fit you in. You should contact your nurse to chase up the Xpert course if it isn't a self referral.

3. Monitoring your BG can be an invaluable tool when you are managing your diabetes through diet. Sadly the NHS don't seem to recognise this and therefore don't generally fund BG meters unless you are taking specific medication which can drop your BG levels dangerously low, but many members here have found a huge benefit in BG testing and see self funding their BG meter as a wise investment in their health. The sensors are generally more expensive (£50 for 2 weeks) and give you a lot more info but my feeling is that it can sometimes give you too much info in the initial stages of understanding the rise and fall of BG. A basic BG meter kit will be about £15. Some manufacturers even give them away because they make all their money on the consumables for them.... namely the test strips, which are specific to each meter model, so not interchangeable. For this reason it makes financial sense to choose a BG meter which has the cheapest test strips. If you want suggestions for tried and tested ones by members here on the forum then please ask.

4. I am not sure that the forum has been going long enough to have amassed that sort of info and it depends on how long you are lucky enough to live (any of us could be knocked down by a bus tomorrow, so it is all relative) .... and if you were correctly diagnosed in the first place... rather than a mis-diagnosed Type 1 who will of course eventually need insulin .... and if the Type 2 patient was given appropriate dietary advice..... the NHS advice of the Eatwell Plate has not done people a lot of favours over the years.
We certainly have members who have pushed their diabetes into remission and remained so for several years without medication.

5. The fact that you fall off the wagon regularly is a bit of a concern and especially if you do so with sweet stuff. Everyone is different. Sometimes it really helps to test your BG and see what that sweet stuff is doing to your levels, but generally, I would expect you to be at your most motivated in these first few months after diagnosis, so if you are struggling to maintain your dietary changes, perhaps you may need help from medication too. Testing might help to motivate you or perhaps trying a different approach like the Newcastle diet which is a short term 8-12 week 800calorie shakes based diet, which might help to reset your relationship to food. Only you will know what you can sustain.
For me, low carb has become a way of life and I have found new foods to enjoy but very occasionally I will share a regular fish and chip supper with my partner or if there is an absolutely gorgeous cake being offered I will have a piece but mostly I need to stick to low carb because if I have treats too often, then it becomes a very slippery slope. Oddly, the lower carb I go, the less carbs I crave and the easier it is to say "No Thank you" when I am offered.
We are all different and you have to find the find the approach which works best for you and your lifestyle and your body.

 

[I_Hate_This]

Thank you both for these answers. The Xpert and Retinopathy referrals were made the same day but the response times have been very varied. I found it interesting as I felt the Xpert programme would be beneficial to have quicker but appreciate your points about coordination etc.

Can I ask, what is the benefit of testing so often at home if my Hba1c is coming down? I thought this would be more poignant if I was dieting and my levels were going in the wrong direction which would indicate a need for more specific food tracking? My nurse seemed to suggest this wasn’t beneficial when I said I had purchased my own testing kit? I am lost!

 

[Robin]

Thank you both for these answers. The Xpert and Retinopathy referrals were made the same day but the response times have been very varied. I found it interesting as I felt the Xpert programme would be beneficial to have quicker but appreciate your points about coordination etc.

Can I ask, what is the benefit of testing so often at home if my Hba1c is coming down? I thought this would be more poignant if I was dieting and my levels were going in the wrong direction which would indicate a need for more specific food tracking? My nurse seemed to suggest this wasn’t beneficial when I said I had purchased my own testing kit? I am lost!

The body's response to carby foods can be a very individual thing. Some people swear by porridge, because they find the slow release carbs give them a steady trickle of glucose into the blood stream, others say no, no, it gives me a huge spike of blood glucose, I never eat it. So by testing before you eat, and then a couple of hours afterwards, you can see how your system is coping with a particular food, and will then know whether it's something to put on the 'yes, eat this regularly' list, or the 'only on special occasions' list. This probably involves a lot more testing when you first start out, which you won’t have to repeat so often once you get a feel for what you personally can safely eat without a huge sugar spike.

 

[Deb_l]

As the title suggests, being diagnosed with Type 2 diabetes has created a fair amount of confusion for me. I wondered if anyone could help with my curiosity around a few things I don’t understand…

1) What determines whether someone is offered medication? I had assumed it was purely down to sugar levels but I have noticed others who have similar levels to myself being offered it whereas I haven’t.

2) I had a retinopathy appointment within 2 months of being diagnosed yet nothing from the diabetic ‘Xpert’ group which I think helps with diet and understanding food which I would assume would have been really helpful within the first few months of diagnosis… it’s now been almost 5 months and still nothing!?

3) Are sensors and home testing kits only beneficial when blood sugars are at a certain level or if you use medication?

4) Can you be diagnosed with T2 and successfully avoid medication for life?

5) At the moment all I’m doing is trying to keep calories and carbs below a certain amount (1500 and 130g) but is this enough? I often fall off the wagon with high sugar/carb meals but my Hba1c levels have come down slightly which I assume is down to sticking to a diet for the majority of the time but is this enough?

Thanks for anyone who managed to get through my long post. I just have so many questions and I don’t feel like I really know what I’m doing!

I am certainly no expert and have only recently been diagnosed myself but these are my ramblings:

1. It was recommended I take medication because my HbA1c was very high (96) and, when questioned, I had also been displaying and ignoring DKA symptoms, which in hindsight was ridiculous. The option to go with diet control wasn't really an option for me.

2. I'm currently in the middle of the Xpert course and it's been fantastic. Definitely chase up with your GP. I know waiting times will vary but it's definitely worth doing and the dietitian advice is bang up to date!!

3. I have found my testing kit invaluable for letting me know what foods I can tolerate. My diabetes nurse actively encouraged me to use it for this purpose.

4. I believe there are lots of people on this forum who have successfully managed their T2 diabetes with diet alone.

5. How often are you falling off the wagon and for how long? One piece of cake every 6 weeks isn't going to make much difference but a whole cake every week will make a massive difference. Believe me, I know it's hard. I LOVE food and use it for comfort, stress, happiness. Well, anything really but I know I have made myself REALLY poorly and I don't want to die just yet, or damage myself so my life changes dramatically and I can't to the things I want. Those are my motivators and I hope I can stick to them 🙂

Good luck and keep going - there's loads of helpful advice on here to keep you motivated.

 

[I_Hate_This]

Thanks everyone… I’m having a takeaway once a week and sticking to ‘plan’ 5 out of 7 days. I thought this was working for me as my weight and levels have come down but seems like there’s a whole host of things I haven’t considered… ‍♀️

 

[Leadinglights]

The more consistently you can keep the increase in blood glucose from your meals after 2 hours to 2-3mmol/l and aiming at no more than 8-8.5mmol/l post meal that will bring your HbA1C to normal level.
Looking at your starting HbA1C which was only 56 and the reduction to 52 it appears that you have made good progress with the approach you have taken.
The main thing is that whatever approach you take has to become your new way of eating not a short term quick fix which is why it is important that you enjoy the meals and food you have.
Have a look at this link for some ideas for meals and foods.

Freshwell Low Carb Project - Home

lowcarbfreshwell.co.uk

If you are into baking then sugarfreelondoner has loads of recipes for cakes, biscuits etc which are all low carb.

 

[I_Hate_This]

Thank you, I will look at this for some inspiration! It feels like a never ending learning journey!

 

[Lucyr]

1) What determines whether someone is offered medication? I had assumed it was purely down to sugar levels but I have noticed others who have similar levels to myself being offered it whereas I haven’t.

It’s a joint decision between you and your doctor. If you feel you can’t make many more diet and lifestyle changes and would like medication to bring your blood sugar down, then speak to your doctor. If you’d rather make more diet and lifestyle changes before trying medication then speak to your doctor.

 

[Lucyr]

2) I had a retinopathy appointment within 2 months of being diagnosed yet nothing from the diabetic ‘Xpert’ group which I think helps with diet and understanding food which I would assume would have been really helpful within the first few months of diagnosis… it’s now been almost 5 months and still nothing!?

I’m 14 years in and never been on an education course yet. If you have any specific questions you can ask here, but reading the DUK will give the same info I’d think.

 

[Lucyr]

4. I believe there are lots of people on this forum who have successfully managed their T2 diabetes with diet alone.

Fortunately though no one who is a current active poster on this forum has died, so having people on the forum not currently on medication doesn’t answer the question of whether they’d avoid medication lifelong. It depends how long they live… I’d rather live a long life with needing medication at some point than a short life with no medication.

 

[Lilsis]

I was diagnosed in November last year. My HbA1c was 49 and I was advised to loose weight and move more but no medication, which I'm happy with. Only time will tell if I need them in the future.
I test at home, although my Dr said there was no need but I could if I wanted to. I've followed the advice given by other forum members and test before my main meal and 2 hours after..
For me, lowering the amount of carbs I eat has been key in loosing weight.
Choose your Take Away wisely or you are going to undo any progress you've made.

 

[Lucyr]

Choose your Take Away wisely or you are going to undo any progress you've made

A takeaway as part of a balanced diet won’t undo months of progress. Takeaways tend to be high fat anyway which slows down the absorption of carbs to give the body more chance to match digestion with insulin