Yet another type 2 newbie

[Martywolfman]

Hi everyone.

So today I received a letter with type 2 diagnosis. it still has to be confirmed with another blood test in a couple of weeks, before I speak with a clinitian, but I'll be very surprised if it changes, as I have been pre-diabetic for several years now. But at least it didn't really come as any real surprise. I'm not shocked or upset by the diagnosis at all.

My HbA1c measurement was 52

However, I do know that will have a lot of difficulty trying to manage my blood sugar levels through dietary changes. I'm 54 years old, and clinically obese. I am also on the autism spectrum, with quite common ASD traits such as very little impulse control, and a quite limited taste palette. I live alone, so I don't have anybody to help me try to control my impulses when they take me over, and tell me to stop.

One thing is certain - I cannot add new things to my diet. If i don't already eat and enjoy the taste of something, I can't add it to my diet. Now that's not to say I don't like vegetables - Whilst there are a number of vegetables I will never eat, I do eat, and enjoy a lot of different vegetables too, but i get bored of them if i eat them too often. So the only thing i can do in terms of dietary changes is to cut things out of my diet. I just also happen to eat a lot of things that aren't so good for you too, and I have a huge appetite, I always have had, even before I became overweight. If I eat a regular size meal that would be a perfectly good meal for most people, I will feel more hungry when I finish it, than I did when I started. Losing weight will be extremely challenging for me. I have lost weight in the past. But I was permanently hungry, and I mean permanently. Every single waking moment for around a year, I felt hungry. and it just reached a point that I couldn't live like that any longer.

Exercise is also difficult. I have a number of other painful health issues which would make meanigful exercise very difficult for me - degenerative disc disease in 2 discs in my lower back which developed in my late 20s / early 30s, my knees are basically shot, i have arthritis in my hands and wrists, and to top it off I also had Chronic fatigue sydrome , starting around 20 years ago, which , whilst much improved these days compared to when it was at it's worst in my 30s, it has left me with permanent muscle pain / fatigue issues.

So yeah, my body is just a general mess

I've been looking though some of the info on the site here today, though obviously it's more of a quick read at the moment - there's a huge amount of info to get through. One thing that concerns me is the idea that I should avoid sugar altogther - as in white sugar. I'm a tea with milk and 2 sugars bloke. That's my go to drink at home. I do drink plenty of water as well though, i always have. But i can't imagine my life without tea, it would take away one of the few pleasures i have, hehe. I can't drink it without sugar - I've tried in the past, but i hate it when it doesn't have milk and sugar, so that's not an option. I would rather give up drinking tea, than drink it without sugar.

So all that being said, I know there's probably no definitive answer to this, and it's something I need to discuss with my doctor, but that is a month away yet before my appt, and my question is this. How likely is it that with limited dietary changes my blood sugar levels will be kept under control with medication? Hopefully not with insulin injections, as I'm a HGV driver for a living, and insulin brings problems with the DVLA and my license which would be very difficult for my continued employment in that field.

 

[Lucyr]

I would rather give up drinking tea, than drink it without sugar.

Welcome

If you’re not willing to try reducing the sugar or switching to sweetener then it sounds like you’ve got your answer on what to do with the tea.

You could stick to the foods you like but adjust portion sizes to eat a lot more of the things you like that are good for you and less of the ones that aren’t good for you. What’s on your list of safe foods?

 

[Martywolfman]

Thanks Lucy. Yes you're right, haha. I can't stand the taste of artificial sweeteners, in tea or other soft drinks. I hate diet coke and the like. Though that's not really an issue, I don't drink fizzy drinks on a regular basis or anything, so I can take them or leave them.

I'm horrified by the idea of giving up tea though. But it is what it is I guess. Have to try to accept that.

Safe foods as in healthy veggies, well, I love sprouts, cauliflower, broccoli and peas in particular, but there are plenty of others I eat regularly too - cabbage, carrots and kale are the ones that spring immediately to mind.

 

[Martin.A]

Sorry to hear that you have so many issues to contend with, and now this.

I used to take 2 sugars in my tea and also in my coffee but now I have both without sugar (or sweeteners). I cut back to one sugar and then after a while none and now I can't stand the taste of either if they have sugar in them. It was just a case of gradually weaning myself off it (and a load of other things that were part of my diet before my diagnosis).

From reading your post it seems to me that you already know what's needed to manage your T2 to prevent it progressing to the point at which your HGV licence might be at risk. Is that not a massive incentive to get a grip on things?

 

[rebrascora]

Hi and welcome from me too.

I was a sugar addict pre-diagnosis. I didn't spoon sugar into my coffee on a morning, I just tipped it in because it couldn't be too sweet, even with a sugar slurry in the bottom 😱. I always said that I would rather not drink it as drink it without sugar. I have experimented with sweeteners over the years but they all seem to have a horrid aftertaste and not as sweet as sugar, plus I don't think it is good for us to consume so much artificial sweetener either. When I developed diabetes I stopped the sugar altogether and went cold turkey and then cut the starchy carbs after that. I stopped drinking coffee as a result. Thankfully my partner had "adjusted me" to drinking tea without sugar a few years before, so I could manage that but it wasn't something that I enjoyed particularly. Now I drink my coffee with no sugar but real double cream instead and it is one of my daily luxuries that I really do enjoy. I also started drinking Rooiboos tea (Red bush) which is naturally not as bitter as black tea and that is pleasant without sugar. Unlike @Martin.A, I could go back to sugar in my tea and coffee very easily, but I simply can't afford to for health reasons (I am Type 1 and have insulin, but injecting for every cuppa you drink helps to discourage you.... plus I was getting really bad migraines which have pretty much stopped now that I have cut sugar and most carbs from my diet.

I appreciate that I am not autistic and that must make it a lot more challenging, but just wondered if there was anything in my story of moving away from sugar which might help you.

As regards your diet, I have two thoughts.
One is that perhaps you were not eating enough fat and protein and fibre when you were dieting and that was why you were constantly hungry. We have been encouraged to go low fat for the last 50+ years to lose weight, but fat provides both slow release energy and makes us feel satiated. ie it helps to stop hunger. Carbs even wholemeal low GI ones, can make us feel hungry. Cutting carbs right back and eating more fat and protein and fibre has really helped me to eat less overall and not be hungry. The fat intake particularly has been an important factor for me. So cream and cheese and full fat yoghurt and nuts and olives and pork scratchings. Basically foods which contain fat and protein but very little carbs.

Secondly, I wonder if you might not be a good candidate for one of the Semaglutide drugs like Ozempic or since that is in short supply.... Mounjaro, which is currently being prescribed on the NHS as it is new to the market. These drugs help you to feel like you have eaten too much and as a result they reduce your appetite. They can cause nausea and possibly vomiting if you eat too much, so it isn't necessarily a wonder drug and they don't work for everyone and I am very wary of mass use of such drugs as is happening almost worldwide for anyone (celebrity and non celebrity) who can afford to buy them privately, but I wonder if your situation might be one that would benefit from them.

 

[Leadinglights]

You could initially try using a smaller spoon to put the sugar in or try one and a half spoons rather than two.
All those vegetables you mention are very good choices, it is potatoes, rice, pasta which would be more of a problem. But making sure you are having protein and healthy fats as well will help with not feeling hungry.
Your HbA1C at 52 is not too bad only a little into the diabetic zone so you may only need to modest changes.

 

[Lucyr]

Safe foods as in healthy veggies, well, I love sprouts, cauliflower, broccoli and peas in particular, but there are plenty of others I eat regularly too - cabbage, carrots and kale are the ones that spring immediately to mind.

All those are fine to eat. You need protein too though, like meats fish eggs vegetarian alternatives like tofu or beans and peas too. Do you like any proteins? If you do then it’s sounding like you could improve your diet within the safe foods you already have, as I know trying to add new foods is not remotely easy.

 

[JITR]

At a glance, I'd say have a good look at your diet and change it for good:
- Target 1: HbA1C < 48 (borderline diabetic, aka remission)
- Target 2: HbA1C < 42 (borderline diabetic, getting back to normal)
- Target 3: HbA1C in the 30s (back to normal)

Here is a paste of some links which may help:
- Zoe Harcombe, What should we eat? how to lose and maintain weight eating nutritious food to satiety
- Dr David Unwin, diet sheet: easy to follow nutritious food diet
- Dr David Oliver, Freshwell GP: Introduction to Prediabetes and T2D: great content and graphics
- Roy Taylor, Achieving T2D remission (May 2023): all you need to know about T2D remission (to HbAic<42, normal)
- Roy Taylor, Information for Doctors: what GPs and DNs should know about T2D remission (to HbAic<42, normal)
- Newcastle Diet, leaflet: basis for NHS Path to Remission Soups & Shakes programme

I followed my own real food version of the Newcastle Diet, using the free Cronometer app to track nutrition.
If I were to lose weight again I'd follow Harcombe Diet principles (less demanding than Newcastle).

 

[Martywolfman]

From reading your post it seems to me that you already know what's needed to manage your T2 to prevent it progressing to the point at which your HGV licence might be at risk. Is that not a massive incentive to get a grip on things?

Thanks everyone for the welcome, commets and suggestions, I very much appreciate them

Yes Martin. You're right, it should be, and hopefully will be. But bear with me, I'd only had 5 or 6 hours to process things when I wrote my initial post, hehe.

But still, I just love my tea the way it is right now, it's one of my biggest pleasures in life. It's going to be a very, very hard thing for me to give up. I currently have no idea what I could replace it with for an enjoyable drink rather than just drinking water. I suppose I can try weening myself off the sugar, but I have tried that before, and just wasn't enjoying it at all. I can contemplate giving up sweet treats like chocolate and cakes etc, which won;t be easy, but it doesn't horify my. It's not like I eat them every day anyway. But losing tea is going to be very difficult for me. Or at least losing tea the way i drink it now.

I know I have to change things. I accept that. but that is going to be a real struggle, and taking my struggles with impulse control into account I think adds something extra to that difficulty.

Hi and welcome from me too.

I was a sugar addict pre-diagnosis. I didn't spoon sugar into my coffee on a morning, I just tipped it in because it couldn't be too sweet, even with a sugar slurry in the bottom 😱.

Yeah I get that. I have double sugared my tea, so 4 sugars, accidentally many times. I was alaways happy to drink it still, rather than just starting over making a new one.

I appreciate that I am not autistic and that must make it a lot more challenging, but just wondered if there was anything in my story of moving away from sugar which might help you.

No absolutely. I totally appreciate that. I mean, I can try to blame things on the autism, but I don't know what it's like to not be autistic, obviously. It may well be equally challenging for you and I. I don't for a moment think that it's not challenging for neurotypical people too. I appreciate the effort to help, no matter what.

As regards your diet, I have two thoughts.
One is that perhaps you were not eating enough fat and protein and fibre when you were dieting and that was why you were constantly hungry.

This is possible true. I don't know for definite. Though I was aware that we need some fat etc in the diet, and never ever tried to cut it out completely. I had learned before then that sugar was the biggest cause of obesity, rather than the fat as we were incorrectly taught for decades.

Cutting carbs right back and eating more fat and protein and fibre has really helped me to eat less overall and not be hungry. The fat intake particularly has been an important factor for me. So cream and cheese and full fat yoghurt and nuts and olives and pork scratchings. Basically foods which contain fat and protein but very little carbs.

This is acxtually mostly what I did to lose the weight at the time, cutting out most carbs. There were other things too, but this was the biggest change back then. But I also tried hard to reduce the overall amount of food I ate. I am well aware that i eat far too much.

You could initially try using a smaller spoon to put the sugar in or try one and a half spoons rather than two.
All those vegetables you mention are very good choices, it is potatoes, rice, pasta which would be more of a problem. But making sure you are having protein and healthy fats as well will help with not feeling hungry.
Your HbA1C at 52 is not too bad only a little into the diabetic zone so you may only need to modest changes.

Yeah I do eat a lot of bad carbs (potatoes, chips, rice, pasta, packet noodles) I guess reducing those will make quite a difference. Especially as you say that I'm not that my HbA1C isn't that high at the moment.

All those are fine to eat. You need protein too though, like meats fish eggs vegetarian alternatives like tofu or beans and peas too. Do you like any proteins? If you do then it’s sounding like you could improve your diet within the safe foods you already have, as I know trying to add new foods is not remotely easy.

Yes, absolutley. sorry I was just talking about vegetables specifically. I eat plenty of protein, though I have tried to reduce the meat i eat, purely for environmental reasons, in the last 5 years or so. But i eat chicken, beef, eggs very happily. Love all of them. Though I probably need to reduce the amount of processed food i eat. I'm a lazy cook. I don't enjoy cooking at all, so a typical meal for me would be grab a couble of southern fried breaded chicken steaks from the freezer, boil some of the veggies from my list, add some spuds, or rice, and that's dinner. But that's on a 'healthy meal' day. Egg and chips is one of my favourite meals, hehe

I know. I need to make changes to that. But as I'm sure you are very aware, we on the spectrum don't generally deal with change very well.

At a glance, I'd say have a good look at your diet and change it for good:
- Target 1: HbA1C < 48 (borderline diabetic, aka remission)
- Target 2: HbA1C < 42 (borderline diabetic, getting back to normal)
- Target 3: HbA1C in the 30s (back to normal)

Here is a paste of some links which may help:
- Zoe Harcombe, What should we eat? how to lose and maintain weight eating nutritious food to satiety
- Dr David Unwin, diet sheet: easy to follow nutritious food diet
- Dr David Oliver, Freshwell GP: Introduction to Prediabetes and T2D: great content and graphics
- Roy Taylor, Achieving T2D remission (May 2023): all you need to know about T2D remission (to HbAic<42, normal)
- Roy Taylor, Information for Doctors: what GPs and DNs should know about T2D remission (to HbAic<42, normal)
- Newcastle Diet, leaflet: basis for NHS Path to Remission Soups & Shakes programme

I followed my own real food version of the Newcastle Diet, using the free Cronometer app to track nutrition.
If I were to lose weight again I'd follow Harcombe Diet principles (less demanding than Newcastle).

Thanks I'll have a good look at those when I have time. I just had a quick look at the newcastle one. I might give that a try.

 

[Vonny]

Hi from me as well @Martywolfman. One question you asked was regarding insulin. I know @rebrascora mentions one of the newer drugs, and with a reading of 52 I think it's truly unlikely that your GP would start you on insulin. You are more likely to be put on metformin, which can cause tummy problems for a couple of weeks. Some people suffer for longer, and are better when they go onto the slow release version. Always take metformin with a meal to avoid the worst side effects. I've been on metformin for 4 years now and have no problem with it, but some people cannot tolerate it.

I had a little smile when I read that you get bored with certain types of food if you eat them too often. My son is exactly the same (he has Aspergers) and frankly is a nightmare to feed!!! He is in the process of buying a flat and I really worry that when he moves out he won't look after himself properly. It sounds like you are really trying to get your head around your medical issues, and that is a huge step in the right direction. And though you say you are a lazy cook, at least you take the trouble to boil up some veg to have with the rest of your meal.

One point, when you mentioned that you felt hungry after eating...once I gave up potatoes and bread I actually stopped craving them after a couple of weeks. It was a ghastly couple of weeks, but I'm so glad I did it.

Wishing you well x

 

[Drummer]

@Martywolfman I found that tea tasted really weird when I caught Covid, so I tried some alternative teas and really liked mint and liquorice, either as a mixture or one tea bag of each - and I did not need to add any milk or sugar. I drank them chilled in the warmer times (take out the bags after a few minutes) and warm in winter, so maybe starting off using them as a squash type drink might sort of ease you into using them?
Just stopping the high starch foods might make all the difference to your blood glucose - it is surprising how they can add up.
I make curry and eat it with chopped cauliflower rather than rice. Instead of mashed potato I cook swede in a pressure cooker, have some for dinner, then next morning have some as bubble and squeak, mixing in an egg or two, then either leftover veges or grated cheese and fried as bubble and squeak.
I get frozen stir fries from Lidl, and mixed veges too - they are so low carb you would not really need to limit portion size. When I have felt unwell these last few years - I have had Covid 5 times, or after a few days of painful feet when I could not get to the kitchen to cook properly, once I can get about again I have fried some chopped up beef with onion, tossed in a pack of frozen veges and added stock, then cooked it for ten minutes in the pressure cooker on high pressure. Several bowls full of that stew and I perk up considerably. I do stick to bare naked meat and fish though - the breading or other coatings add a lot of carbs to a meal, and they are expensive too.
I use various herbs and spices to make things more interesting - I have garam masala and tikka curry powders - I put soup or stew into a bowl, stir in a tiny pinch of one of the powders and put a plate on top to stop the volatiles escaping, and it is enough to make each serving different.

 

[everydayupsanddowns]

Glad you’ve found some of the thoughts and shared experiences from forum members helpful, interesting, or just confirming what you already knew.

Regarding the tea question… this isn’t something you have to change instantly. You could try a special (slightly smaller) teaspoon to spoon the sugar.

A classic teaspoon is approx 5g of carbs, so 2 sugars is 10g. If you had that at 8g for a few months perhaps you’d begin to adjust. Then notch down to 6g. Then one spoon not two (or use those baking measures and have 2x half-teaspoon sizes so you still get the activity of 2 spoons?

You might also consider adjusting brew-times as the sugars gradually reduce?

Or… Stick with your current system, but only have one cup a day.

You’ll find a way to make it work. I know you can.