Type 2 Diabetes Advice

[bigpurpleduck]

Hi all,

My mother-in-law has just been diagnosed with Type 2. She's been advised to lose weight, eat a healthy diet and exercise. Of course, all good advice.

However, she hasn't been given a meter to check BG with - is this normal? Would it benefit her if she could use my meter (with new lancet of course!)? Or is there a reason she hasn't been given one? I can't see how not knowing what your BG is and how it reacts to food can help...

She's also been given some diet information which I think may not be particularly good, i.e. lots of carbs such as white pasta & rice, potatoes (including baked potatoes!), bran flakes... I know all of these things have fairly high GI and for me cause a quick spike. I've also noticed some Type 2s on here saying they actually find limiting carb intake works better.

Can anyone offer advice? I'm hoping to have a chat with her tonight so if I could have a few responses before 7pm I'd really appreciate it.

Thanks in advance!

 

[Northerner]

Hi Emma, a meter would certainly help, in fact I think it's essential when newly-diagnosed for the reasons you state. After the effects of regular meals have been ascertained, then testing can be reduced for more unusual circumstances, like illness, new foods etc. and to keep an eye on things like fasting/waking levels.

Ideally, she should have her own meter as otherwise the readings would interfere with yours if you download them to monitor software.

Have a look at the 'Useful links' sticky in the newbies section:

http://www.diabetessupport.co.uk/boards/showthread.php?t=10406

This will give some good links for Type 2 advice, the Gretchen Becker book (highly recommended!) and GL diet books. 🙂

 

[everydayupsanddowns]

I'm sure the T2s will wade in, but your MIL seems to have been given the 'standard' advice which several T2 posters I've come across find actually seems to makes them worse!

Don't test - we'll do your HbA1c once or twice a year you you don't need to...
As you point out this is hardly helpful if trying to work out what happens when you eat different foods!

Eat lots of starchy carbs at every meal. Hmmmm... I'll let Wallycorker loose on that one (he got progressively worse on the std advice, but by carefully managing diet has since come off meds) 🙂 As you say, moderation/test-and-review seems to work much better for many here.

Luckily you will be on hand to offer some advice, hints and tips. Hope your MIL copes OK in those rocky few weks after dx trying to come to terms with it all.

M

 

[Northerner]

p.s. tell her to join the forum! 🙂

 

[bigpurpleduck]

p.s. tell her to join the forum! 🙂

I intend to suggest this, but she barely knows how turn a computer on, bless her 🙂

On the meter issue: is it possible to buy a meter and then strips separately? Or do the strips need to be on prescription? If prescription is needed, I could buy her a meter the same as one of mine and just order extra strips on my repeat? I test a gazillion times a day anyway and never have issues getting strips so doubt they would notice the difference!

 

[Northerner]

I intend to suggest this, but she barely knows how turn a computer on, bless her 🙂

On the meter issue: is it possible to buy a meter and then strips separately? Or do the strips need to be on prescription? If prescription is needed, I could buy her a meter the same as one of mine and just order extra strips on my repeat? I test a gazillion times a day anyway and never have issues getting strips so doubt they would notice the difference!

The strips can be bought seperately and without prescription. 🙂

 

[bigpurpleduck]

The strips can be bought seperately and without prescription. 🙂

Just from any chemist? And how much, roughly?

Sorry for all the questions, the NHS have always been good to me and I don't know a great deal about Type 2!

 

[Northerner]

Just from any chemist? And how much, roughly?

Sorry for all the questions, the NHS have always been good to me and I don't know a great deal about Type 2!

I believe they are in the region of ?25-?30 for 50 strips. Most pharmacies should stock the more popular brands from Bayer, Roche and Abbot.

 

[Cliff]

T2s, particularly those that are D&E controlled, will not be told anything about testing by their HCPs. If you find out about testing on your own, you will likely be discouraged from doing it - it might frighten you (as if the big D isn't frightening enough on its own). If you go ahead and test, you will not get strips on prescription unless you have a GP who is an absolute star, like mine - but I did have to show him my BG logs and explain how testing helped me refine my diet. He took the time and trouble to look at my data and agreed that I should avoid the starchy carbs because they were very obviously causing me difficulty. So, a nod and a wink towards low carb from the GP and nursey - "whatever works for you", which is good advice in many fields of life.

Northerner, as ever, is spot in my view with his recommendation of Gretchen Becker's book - it's an essential read. I have the rest but wouldn't have bothered buying them if I knew then what I know now - they tend to follow the "base all meals around starchy carbs" advice which certainly doesn't work for me or for many other D&E T2s. If low carb is too hard core - and I know some find it unsustainable - try low GI/GL - that works for some. Whatever you do, learn the role of carbohydrates and their effect on your body and BG levels.

Don't bother buying a meter. You can get loads for free from the manufacturers. You usually get a little pack containing the meter, lancets, pricking device and control solution, with a few free strips thrown in. I entered a so-called competition from Bayer to "win" a meter - but I suspect everyone's a winner! If not, it might help to tick the box that says you test oodles of times a day - they make their money from selling the strips. Bayer Contour strips are about ?25 for a tub of 50, about half that on e-bay although there are ethical issues around buying what might be other people's prescribed strips.

 

[Andy HB]

I'm wondering whether they give out the standard healthy eating leaflet that is available to non-diabetics? The reason I say that is because the Diabetes X-Pert course doesn't say anything of the sort (about eating plenty of carbs etc).

However, when I was in the Diabetes/Liver clinic a couple of weeks ago, I noticed a leaflet on a table in the waiting area which said to base meals around starchy carbs. That leaflet was a general one and was not specifically directed towards people with diabetes (but being in the waiting room may well have been mistaken as such).

Andy

 

[Cliff]

Andy - I've not been on the X-Pert course, my PCT don't do it - they do one called HEIDI which I have been on. The dietary advice was standard food pyramid stuff - the role of different foods groups did not get a mention but we were advised to base all meals on granary bread, brown rice, wholewheat pasta, that sort of thing, which suggests they were pushing a low GI approach. Those foods give me unacceptable numbers except in very small quantities.

 

[Andy HB]

Andy - I've not been on the X-Pert course, my PCT don't do it - they do one called HEIDI which I have been on. The dietary advice was standard food pyramid stuff - the role of different foods groups did not get a mention but we were advised to base all meals on granary bread, brown rice, wholewheat pasta, that sort of thing, which suggests they were pushing a low GI approach. Those foods give me unacceptable numbers except in very small quantities.

Ho hum! I'm just glad I did X-Pert and not HEIDI then!

Andy 🙂

 

[Cliff]

Ho hum! I'm just glad I did X-Pert and not HEIDI then!

I've just had a look at the syllabus on the x-pert website - we didn't get a fraction of what's on there. HEIDI is two and a half hours at a local GP practice run by a nurse and a nutritionist - it's the Janet and John guide to diabetes. Why do standards of care vary so much? Another postcode lottery?

 

[bigpurpleduck]

I'm wondering whether they give out the standard healthy eating leaflet that is available to non-diabetics?

I think this is exactly what my MIL got. The doctor hasn't actually said, "You have diabetes". They've just told her her BG is a bit high and if she loses weight, exercises and eats well she can bring it down.

I think the lack of info and clarity is shocking.

 

[trekpole]

My advice is not to rely too much on the NHS (Not Helpful Service) and see a herbalist. I'm going to do this as they also give dietary advice. It will probably cost about ?40 for a consultation but rather that than heartbreak from the GP and NHS.

 

[Northerner]

My advice is not to rely too much on the NHS (Not Helpful Service) and see a herbalist. I'm going to do this as they also give dietary advice. It will probably cost about ?40 for a consultation but rather that than heartbreak from the GP and NHS.

You do need to be cautious about herbalists too - there are a lot of unfounded claims about 'natural' ways to manage diabetes knocking around so do your research thoroughly before acting on their advice.

 

[BigMalc]

sounds like I am in the minority here but if she is brand newly diagnosed, I would not rush to get a meter, just get used to the shock of it and start trying to do the exercise and healthy eating gig.

I would assume they will be monitoring her quite closely for the first few months, so would start to push for personal monitoring say 3m after diagnosis, when she has some idea of what her new 'normal' routine is.

I would now be lost without my kit and strips, but initially there was too much to think about and as it can take a while to get under control, being faced with continual high readings could make for a very depressed person.

That and to say 'chin up, there is plenty of support and advice here' to her.

Good luck

 

[Northerner]

...I would now be lost without my kit and strips, but initially there was too much to think about and as it can take a while to get under control, being faced with continual high readings could make for a very depressed person.

That and to say 'chin up, there is plenty of support and advice here' to her.

Good luck

This is the argument that many GPs put forward Malc, that the high levels can be demoralising and demotivating. I think it needs good judgement on the part of the doctor or nurse, but some just seem to have a blanket refusal, disregarding the patient's desires. It's very much down to the individual, I think - some may be encouraged by seeing numbers improve and starting off with testing may speed the process to establishing a diet that is healthy and well tolerated. For others it may be a painful and worrying reminder of their ill health.

It is different for Type 1s though, as you need to know your levels right from the start to know if you're going hypo or need more insulin - even before you learn carb-counting - so my experience probably weights things in favour of testing asap.

 

[Jill]

I've bought my own meter and buy my own strips/lancets at the chemist and it's very expensive to start with but will hopefully be less expensive as I learn which foods are not to be eaten. I attended the DESMOND programme on my doctor's advice and it was helpful but I now know that the NHS recommendations made by DESMOND are definitely too 'carb-heavy' for my liking (although I love and miss carbs!). I can't understand why the NHS are giving these guidelines. Jill

 

[Andy HB]

sounds like I am in the minority here but if she is brand newly diagnosed, I would not rush to get a meter, just get used to the shock of it and start trying to do the exercise and healthy eating gig.

I would assume they will be monitoring her quite closely for the first few months, so would start to push for personal monitoring say 3m after diagnosis, when she has some idea of what her new 'normal' routine is.

I would now be lost without my kit and strips, but initially there was too much to think about and as it can take a while to get under control, being faced with continual high readings could make for a very depressed person.

That and to say 'chin up, there is plenty of support and advice here' to her.

Good luck

From personal experience, I was given a meter from day one. I found it extremely helpful. But, as I've said elsewhere, maybe my science background helped me make sense of it all (hopefully that doesn't sound patronising! Apologies if it does).

Andy 🙂