Type 2 Diabetes and Ileostomy makes it hard to find a balance for healthy eating

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Jax1

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I'm stuck in limbo trying to find a healthy diet that works with type 2 diabetes and having an ileostomy. My colorectal team tend to focus on the ileostomy as a priority as it dominates daily life due to high output, recommending stodgy foods white rice/potatoes/bread as a means of slowing down output.
My diabetic nurse is more about managing diabetes, and my gp ums and ahs when I try to explain the difficutly in managing both. I've gained weight and find it hard to shake it off. I don't know if it is relative to ileostomy or diabets but I am always hungry. All the healthy things that I used to enjoy are now off the table due to how they impact on stoma output. I feel like I'm fighting a losing battle that honestly, is quite depressing.
 
Welcome to the forum @Jax1

Sorry to hear you are caught between the competing needs of 2 conditions with quite different requirements :(

Would it work to switch to stodgy / bulky options that have fewer carbs? Like celeriac and swede instead of potato, and cauliflower rather than rice?

How does your stoma deal with high fibre foods like leafy greens? And how about fats to slow digestion? What about protein?

There are other threads with discussion around ileostomy here which may help
forum.diabetes.org.uk

Search results for query: ileostomy

forum.diabetes.org.uk forum.diabetes.org.uk
 
everydayupsanddowns said:
Welcome to the forum @Jax1

Sorry to hear you are caught between the competing needs of 2 conditions with quite different requirements :(

Would it work to switch to stodgy / bulky options that have fewer carbs? Like celeriac and swede instead of potato, and cauliflower rather than rice?

How does your stoma deal with high fibre foods like leafy greens? And how about fats to slow digestion? What about protein?

There are other threads with discussion around ileostomy here which may help
forum.diabetes.org.uk

Search results for query: ileostomy

forum.diabetes.org.uk forum.diabetes.org.uk
Click to expand...
Hi there, thank you for taking time to respond to my post. Unfortunately, stoma does not respond well to high fibre foods as they cause output to be more watery and gaseous that can make the stoma leak and fill continually. I can't eat pulses, or anything with seeds/pips/skins/peels as they can potentially cause blockages. I do eat a lot of chicken for protein. It really is a minefield of trying to maintain a decent diet whilst keeping a balance with the stoma.
 
Jax1 said:
Hi there, thank you for taking time to respond to my post. Unfortunately, stoma does not respond well to high fibre foods as they cause output to be more watery and gaseous that can make the stoma leak and fill continually. I can't eat pulses, or anything with seeds/pips/skins/peels as they can potentially cause blockages. I do eat a lot of chicken for protein. It really is a minefield of trying to maintain a decent diet whilst keeping a balance with the stoma.
Click to expand...
There is a link here but I would treat with caution as it says bananas are low carb which any of us here avoid as they are too high carb for many to tolerate. As with many things I suspect peoples' experiences with what they can tolerate with a stoma will vary.
It may give you a few ideas.
 
@Jax1 It may be that if your ileostomy needs these foods to enable you to get nutrients from your food before it passes out of your body, then the answer would be to provide you with medication to help you balance those foods. It may be something like Gliclazide which stiulates the pancreas to produce more insulin to cope with these carb rich foods or perhaps insulin itself. You need to talk to your diabetes nurse about supporting you to manage your diabetes with these foods if these are the foods you need.

These foods may be causing the hunger because they will likely spike your BG levels high and then your own insulin production kicks in too little and too late to bring them down and it is going high and then dropping which makes you feel hungry usually about 2 hours after a meal. If you can stabilize your BG levels better then the hunger should ease.

If you are diagnosed diabetic, then you could apply for a free 2 week trial of the Freestyle Libre 2 Constant Glucose Monitoring (CGM) system which might help you to see what is happening with your levels and experiment to try to improve the timing of any medication you get to manage your diabetes. You are in a special situation so please make sure to point out to your diabetes nurse that you are unable to change your diet, so need something "stronger" medication wise to help you manage your levels, rather than go through the NICE guidance route of first and second level medications
 
Last edited by a moderator:
rebrascora said:
@Jax1 It may be that if your ileostomy needs these foods to enable you to get nutrients from your food before it passes out of your body, then the answer would be to provide you with medication to help you balance those foods. It may be something like Gliclazide which stiulates the pancreas to produce more insulin to cope with these carb rich foods or perhaps insulin itself. You need to talk to your diabetes nurse about supporting you to manage your diabetes with these foods if these are the foods you need.

These foods may be causing the hunger because they will likely spike your BG levels high and then your own insulin production kicks in too little and too late to bring them down and it is going high and then dropping which makes you feel hungry usually about 2 hours after a meal. If you can stabilize your BG levels better then the hunger should ease.

If you are diagnosed diabetic, then you could apply for a free 2 week trial of the Freestyle Libre 2 Constant Glucose Monitoring (CGM) system which might help you to see what is happening with your levels and experiment to try to improve the timing of any medication you get to manage your diabetes. You are in a special situation so please make sure to point out to your diabetes nurse that you are unable to change your diet, so need something "stronger" medication wise to help you manage your levels, rather than go through the NICE guidance route of first and second level medications
Click to expand...
Thank you for your response. I was diagnosed type two diabetic in November 2022. Within weeks I was rushed into hospital with a perforated bowel and learned later on I had colon cancer, hence the ileostomy. I relapsed earlier this year and noted that at the time of original diagnosis and relapse, my diabetes was uncontrollable despite increased medication. I am currently on gliclazide and I am due a review with diabetic nurse soon as I am 3 months post surgery. I am seeing a diabetic dietician tomorrow and will discuss stoma friendly foods with him to see if a plan can be pulled together
 
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