Yet another newbie

[Cliff]

Hello to everyone - another newbie here.

I'm 44 years old and was diagnosed with type 2 last week (FBG of 9mmol/l) and have my first appointment with the diabetic nurse next week. I also have high blood pressure (180/120) and cholesterol (can't remember the exact figure).

I've already started some necessary lifestyle changes - rejoined the gym, severely reduced my intake of saturated fats and salt, given up on sugary drinks and anything with added sugar, increased fruit and veg etc. I confess I still have to get my head around the whole carbs issue (I know the last point generates a lot of debate but I don't know enough yet to take a view) so I'm concentrating for now on what would be considered "normal healthy" eating with the intention of losing about 2 stone, which from previous diets I suspect I will do without too much difficulty.

My Dr seemed quite keen to get me on meds straight away, particularly statins to reduce the high cholesterol level. However, it seemed sensible to me to see if the lifestyle changes were capable of reducing my levels before taking the pills; otherwise how would I know if any drops in my readings were due to one or the other or both? We agreed to re-do the bloodwork in a month to see the effects, if any, of my increase in exercise and a more sensible diet. Does that seem like a reasonable approach? From other posts I've read I wonder if I should be making a fuss if the Dr takes the view that regular testing (via test strips) is not necessary? Is that correct?

I'll have many more questions I'm sure but thanks in advance for any responses to the above.

 

[Steff]

hi there cliff and a warm welcome to the site, firstly good luck with next weeks appointment with DN hope that goes well for you , and well done on joining the gym once again all these positive steps all serve in your favour have a browse around the place and you will see we are a great bunch , ask away anytime they will always be someone around to help

 

[bev]

Hi Cliff and welcome to the forum - your in the right place for help and advice.Bev

 

[Vanessa]

Hello Cliff and welcome to the site.

Good luck with your lifestyle changes - as you will see it has taken a number of us some time to work out what is the right balance for us in terms of diet. There is much debate re what we should eat and when and also re testing for Type 2s.

Your approach seems sensible to me but you may not see much change in your HbA1c in that time - simply because it measures your glucose levels over the previous 8-12 weeks. You might want to discuss with your GP/nurse whether he/she is willing to prescribe test strips or not and refer to the NICE guidelines that indicate you should be able to if you want to see what foods affect you particularly. In terms of your day-to-day blood glucose then Diabetes UK recommends we keep in the range of 4-7 fasting/pre-meals and 8.5 at the 2 hour post eating mark

 

[Viki]

Hi Cliff,

Sounds like you've made a fantastic start! Good luck - its great having you on board 🙂

Viki x

 

[HelenP]

Hi Cliff and welcome. I trust you're not as scarey looking as your avatar, lol.

Well done on making lifestyle changes, it's never easy, I've tried many times in the past but this time I have great motivation to stick with it!!

Good thinking to try the diet and exercise alone regime first, sadly I didn't have that option as my BG level was way too high and Doc said I needed meds to bring it down in a hurry!!

Good luck with your new lifestyle - we're always here for support and guidance, don't be afraid to ask.

xx

 

[wallycorker]

Hi Cliff,

I've been a Type 2 for nearly nine years and my situation got gradually worse by following the advice that it sounds as though you have been given. However, I've normalised my blood glucose levels over the last twelve months.

You can read my story here:

http://www.diabetessupport.co.uk/boards/showthread.php?t=3961

I recommend that you cut back on the starchy carbohydrates that you eat - e.g. cereals, bread, potatoes, pasta, rice etc. That usually leads to a big improvement in the blood glucose levels of Type 2s. Have you tried that?

The improvement comes along very quickly indeed for many Type 2s.

Testing is the only way that you will really know what is happening to your blood glucose levels. because of that, I recommend that you start testing even if your GP refuses to prescribe strips.

Best wishes - John

 

[Cliff]

Thank you all very much for your warm welcome - it's very much appreciated.

Vanessa - I haven't had an HbA1c test carried out yet so far as I'm aware; the most that's been done is FBG, cholesterol, triglycerides and BP, all of which are a cause for concern. I will ask the DN about HbA1c and see what she says. I've also had an ECG which came out fine. I will be having another FBG on Monday.

wallycorker - I found your story extremely interesting. My background is in the chemical, not biological, sciences but I have enough biochem to be able to get my head around the technicalities (mostly). As a newbie here, I hesitate to get too involved in the more contentious issues in my first few postings (experience of other forums indicates that that's never a good idea and, from what I've read here, low carb is certainly a contentious issue), but it seems to me that the metabolic conversion of carbs to glucose is scientific fact and on that basis it must have some effect. Regrettably, pasta and rice were my main pre-diagnosis staple foods - I will miss those.

HelenP - I regret that I do resemble my avatar!

With regard to test strips, I will see what my GP's policy is on that issue - I have the benefit of not being the shy retiring type and am quite prepared to put forward a reasoned argument - I also do browbeating quite well but will try reasoned argument first.

Once again, thanks for your warm welcome.

 

[wallycorker]

.......... from what I've read here, low carb is certainly a contentious issue), but it seems to me that the metabolic conversion of carbs to glucose is scientific fact and on that basis it must have some effect. Regrettably, pasta and rice were my main pre-diagnosis staple foods - I will miss those............

Hi again Cliff,

I wasn't advocating "low carb" in particular - I just said "cut back on starchy carbohydrate" - there is a big difference. I understand from what I read on these forums that "low carb" is considered to be a level of around 50 or 60 gms per day.

Personally, I've just started adding my daily carbohydrate intake up and I'm finding that I'm usually eating around 140g per day and quite often more. However, what carbohydrate I do take in a day these days is mostly in the form of complex carbohydrate from fruit spread out of the day.

In my opinion, looking back at what I used to do, I think the worst foods that I was eating, as far as my Type 2 condition is concerned, were the cereals, bread and potatoes. I eat only very, very small amounts of those foods these days.

John

 

[Cliff]

John - I suspect that the reduction in portion sizes that I'm attempting as part of my general weight loss programme will have the automatic benefit of proportionally reducing the quantity of carbs I consume (but maybe not the type of carbs) so to keep things simple I'll be sticking with that for now and monitoring progress. Can I ask what fruits you found particularly helpful and unhelpful?

However, the more I think about, the more I fail to understand how progress can be monitored without testing strips. We'll see what nursey says on Monday.

 

[wallycorker]

John - I suspect that the reduction in portion sizes that I'm attempting as part of my general weight loss programme will have the automatic benefit of proportionally reducing the quantity of carbs I consume (but maybe not the type of carbs) so to keep things simple I'll be sticking with that for now and monitoring progress. Can I ask what fruits you found particularly helpful and unhelpful?

However, the more I think about, the more I fail to understand how progress can be monitored without testing strips. We'll see what nursey says on Monday.

Yes Cliff - that is what happened to me originally, I was simply calorie counting to lose weight and because of that naturally reducing my carbohydrate intake - simply eating less bread. cereal and potatoes to lose weight. Once I started testing and could see what was happening then I cut fine-tuned things further by cutting back further on the quantity and type of starchy carbohydrate - e.g. I stopped having cereal for breakfast, moved to low GI/GL options such as brown rice, pulse spaghetti, Lizi's granola etc.

It would seem that I can eat almost any fruit without problems - I eat daily apples, pears, oranges and grapes - and on a fairly regular basis, kiwi, strawberries, bluberries, blackberries etc. Not been eating bananas recently but I think that is because I read so often about them causing problems for others rather than finding that they caused me any problems.

I do recommend testing even if you have to buy your own strips. However, it does soon become quite easy to operate without testing once you know what effects different foods do to your blood glucose levels. I've just been out for a pub meal of tomato soup, small amount of bread, gammon, chips and peas, carrots and cauliflower ("senior- citizen" portion) plus 250 mls of red wine - 5.3 before and 4.9 one hour after finishing eating - I was surprised that the post-meal result wasn't higher. However, in the first instance I do agree that it is essential.

If there is anything that I can do to help then just get in touch.

Good luck with sorting out your condition - John

 

[tracey w]

Hi Cliff and welcome, good luck with the lifestyle changes its great to have that king of committment. good luck with the blood tests, xx

 

[C*5_Dodger]

John - I suspect that the reduction in portion sizes that I'm attempting as part of my general weight loss programme will have the automatic benefit of proportionally reducing the quantity of carbs I consume (but maybe not the type of carbs) so to keep things simple I'll be sticking with that for now and monitoring progress. Can I ask what fruits you found particularly helpful and unhelpful?

However, the more I think about, the more I fail to understand how progress can be monitored without testing strips. We'll see what nursey says on Monday.

Dear Cliff,

Welcome to this forum, as you are now aware there is plenty of help and advice here. In addition to Whally, I am a controlled carber and have been so for over 12 of the 15+ years I've been a type2. For most type 2s, at least in the early years, controlled carbing is not low carbing, but when you start testing you will probably find that the carbs whally cuts out/down are the ones that will cause the most blood sugar problems, that's my experience. Anyway, you seem the type that will sort out what's best for you - you just have to do whatever it takes to achieve your targets. The most important study ever conducted in the UK for T2s, UKPDS, showed quite clearly that oral anti-diabetic drugs do not work well in the long term. Controlled carbing can give much better A1cs than anything except insulin.

Regards Dodger

 

[Cliff]

Hi guys. Just thought I'd let you know how things went with the DN yesterday.

You may recall that I was to have some blood taken for FBG, my previous reading being 9mmol/l. First thing I asked was if an HbA1C had been done the last time. Apparently not. Was it going to be done this time? Again, apparently not because "the lab don't like doing an HbA1C until they've done 2 FBGs". She then thought about it for a few moments and said she thought it had better be included because "we can compare it with a new HbA1C in January and see how your control is getting along". That seems sensible to me but I'm no expert yet.

We then got on to diet and she seemed quite happy with my plans for carb control/low GI. No pushing of the NHS diet.

She wasn't at all happy that the doc hadn't immediately put me on to high BP/high cholesterol meds. Her view was that even with an exercise programme, good diet and weight loss, I was very unlikely to reduce my BP or cholesterol to levels that would not require medical intervention so I really should start now. Last time I went to the clinic, the doc was a little bit more relaxed and was prepared to give exercise, diet etc a chance to work. So, a bit of a conflict of opinion. Any views? Have any of you who have needed to reduce BP/cholesterol from very high levels managed to do so without the meds?

We then got on to the subject of testing. I got the standard "no need to do that" answer. I then queried this and referred to the NICE guidelines which indicate that it can be offerred to Type 2s as part of a self-management regime. She didn't know this and said that NICE are always changing the rules and it's hard to keep up. Bottom line - no testing at this practice because the PCT say no. She then looked at me a little sideways and I responded in kind - "It's all about cash, isn't it?" I said and, to be fair, she didn't disagree. I can see some battles ahead but at the moment there are other things I need to concentrate on. So, as far as testing is concerned, I'm going it alone - fortunately the cost of strips is not an issue for me (and I'm now quite angry about the situation of those for whom it is an issue). With the variety of monitors/strips etc out there, some kit recommendations would be appreciated.

 

[AlisonM]

Some good stuff and some bad then Cliff. Have you had any hypos that you know of? If you have and/or you're on Gliclazide then you can use the possibility of hypos as ammo to get your testing strips. I'm using a Freestyle Freedom Lite, which is excellent but the cost of strips would be a huge issue for me, I'll find out on the 26th if I'm going to be able 'persuade' the new surgery to let me have them on prescription.

 

[Steff]

hi cliff ty for getting back with how it went as alison said some good and bad there then, i do hope you dont have constant battles on your hands nothing worse., regarding the testing monitor i have the same as Alison the frestyle lite and it is very good never let me down

 

[Cliff]

Have you had any hypos that you know of?

Not that I'm aware of. Still getting my head around the science but my understanding is that as a Type 2 who is trying to control by diet and exercise alone, my risk is going hyper rather than hypo. The meds the DN wants me on are for my high BP and cholesterol.

The reason I've decided I want to test is simple - if I cannot monitor my blood sugar level on an ongoing basis, how can I know if my control measures are working? An averaging test like the HbA1C seems too much of a broad brush approach. It doesn't let me know what foods are taking my levels up and, without that type of information, I cannot fine tune my diet to get things working optimally for me.

 

[Sugarbum]

Hi Cliff,

Welcome! I am sorry to hear of your new diagnosis but this is a great foum and area of support, especially in gathering some views and knowledge on subjects you are already finding are important in the realm of diabetes management! There is so much here, I expect you have already tracked back through a few threads but it is definately worth spending some time doing.

I hope you find your feet with all of this this, sounds like you are getting off to a good and balanced start. Anything we can do to help, just ask....otherwise, a BIG WARM welcome!

Louisa x

 

[AlisonM]

The reason I've decided I want to test is simple - if I cannot monitor my blood sugar level on an ongoing basis, how can I know if my control measures are working? An averaging test like the HbA1C seems too much of a broad brush approach. It doesn't let me know what foods are taking my levels up and, without that type of information, I cannot fine tune my diet to get things working optimally for me.

I'd make an appointment to talk to your doctor as soon as and explain that to him. Tell him you're not happy with the PCTs stance and ask who can make the decision to allow you to test if he can't. Someone mentioned PALS, whatever they are, I understand they may be able to go to bat for you if the doctor won't help.

I've been looking into this myself as I'm given to understand I may need to fight for testing strips myself soon and I want all my ducks in a row before I get to that appointment.