Scared of getting a dx and being able to make the potential lifestyle changes

[Graphista]

I'm 50, fat, sedentary and love my carbs though try to eat relatively healthily.

I had a load of bloods taken recently as I've had a rubbish winter health wise and wanted to get to bottom of it.

Drs just called me (how rare is that?!) to have me make another appointment to test blood again as showed raised blood glucose.

On day of test I hadn't eaten before testing which is what's really worrying me!

Also family history of type 2 and yes I am kicking myself for not being more sensible but I have a lot of other health issues to contend with too inc ocd.

I'm scared I won't cope with the dx, the changes I'll need to make (creature of habit), or even that with the ocd I'll go too far the other way and be too controlling with it all.

Can anyone relate? Been through similar and can reassure?

Appointment is in 2 weeks so not urgent response from them but still...

Also if you're doing low carb I've heard it's best to switch to full fat milk/butter/everything etc to help you stay feeling full. Low fat versions of foods can often be higher in sugars.

Soreen bars are horrific! Chuck them! They’ll spike you like nothing else.

The weetabix & soreen were on low/lower carb meal plans I read yesterday.

@Kerfuffler yea there's contradictory advice on that. Some say same as you others say needs to be low fat too plus from bloods looks like my cholesterol is also high (never had been before) although dr never mentioned it. So I've no idea what to do there! But I cannot stand anything but skimmed milk anyway. Other high fat I could manage if that's advisable for me.

See this is the problem so much contradictory advice/info

Gosh - what a lot to take in, I really feel for you.

In your situation I would prioritise a glucose monitor as we all deal with carbs/glucose differently and there may be things you regularly eat that really increase your blood sugars.

Michael Mosley does a vegetarian option for his FAST Mediterranean style diet. There are vegetarian shakes that might be good for breakfast and eggs are a great source of protein and filling for lunch for example.

I know if you felt ill you would probably find it much easier - but friends who have t2 have really struggled with vision and foot problems. You need to become your own very best friend in this, your own champion because ultimately you are the one whose quality of life will suffer.
Most of all be kind to yourself, you've had a big shock, give yourself time to digest the information. I wish you well

OK, suggestions for the future are in bold;

Lunch - sandwich with mayo & squeaky bean pastrami, low fat crisps & a mini soreen

Could you add lettuce, cucumber and tomato, maybe a sliced gherkin? The sweetness of the gherkin & tomato might satisfy the desire for sweetness.

Dinner - half pack whole grain rice with diced mushrooms and peppers and 1/3 pack stir fry sauce

Could you add half a block of tofu/quorn strips, add some aubergine/frozen peas/edamame beans/sweetcorn and use soy sauce and rice wine vinegar + five spice powder to give it all more flavour?

Supper - 5 whole grain crackers with cheese & mayo, small portion almonds and a skinny bar

How about some Greek yoghurt, almonds, frozen raspberries and 3 dates?

Today
2 weetabix (well supermarket own) with skimmed milk & sweetener

Fair enough, but scrambled egg on toast might make you feel more full for longer due to the protein.

Dinner I've a casserole defrosting - quorn, tinned tomatoes, carrots, peas, stock, marmite, herbs. Would normally have with mash or buttered bread, going to try and not have a carb see how I get on.

Sounds lovely - what about boiled potatoes or sweet potato if you need a carb? Could add chickpeas to the next one, spinach, courgette, that kind of thing?

Was your haemoglobin normal? If it wasn't you can't rely on the HbA1c

@Graphista

It's the low carb bootcamp threads

Hope you can see it from the attached.

Such a friendly and knowledgable group of people. Have a look at some of the older threads. There is a link to a spreadsheet which has all the information to get you started.

It's only fair to say that low carb high fat takes a bit of getting your head around, esp because it's so different from everything we have got used to being told about healthy eating.

Hope you find it helpful

Diabetes diagnosed with HbA1c now, not fasting tests

You said in your opening post you've had a winter of ill health so can't be feeling that fantastic even if don't have the tick box symptoms (the vast majority of t2 diabetics don't have symptoms until its too late and organ damage, the typical excess thirst and peeing is more common with t1)

103 is way over the diagnostic limit and it is an analysis of the last 3m worth of sugar in your blood so independent of recent diet

Gestational diabetes is a risk factor for getting normal diabetes later in life so that fits

Not having a diagnosis doesn't mean that the damage isn't happening (ignorance is bliss) etc you're far better off knowing so something can be done to prevent long term complications

If you're significantly overweight massive weightloss can reverse a t2 diagnosis

The drs know what meds you're on and will interaction check before starting new ones

patient.info/diabetes/type-2-diabetes

Have a read here this is what I directed many to when working as a gp. They'll refer you to a dietician and support classes. Dependent on bmi you can get exercise on prescription for free or reduced gym membership, and often 12wks free weight watchers/slimming World

What results did you not understand, I can try to explain?

Best of luck, information is power, believe in yourself and you'll succeed

Theyre totally different tests is why the numbers are so different

Random Glucose levels (your first test) is diagnostic if >11...this is literally how much sugar is in your blood at that time

Your 2nd test is looking at glycosylated haemoglobin ie how much cumulative sugar is getting stuck to your red blood cells over time, which given your red blood cells live for 3 months before they die, we use it to work out how well controlled diabetes is over the longer term, rather than an individual bad day.... to diagnose diabetes needs a hba1c >48

So albeit v different numbers they're well over the limit to diagnose you unfortunately (or more fortunately as now you know its something you can modify

www.diabetes.org.uk/professionals/position-statements-reports/diagnosis-ongoing-management-monitoring/new_diagnostic_criteria_for_diabetes

That's more detail

Low carb is not the same as low sugar. For example Soreen contains high sugar, even if largely derived from dried fruit. You also need to watch "low fat" or "light" labels as sweetener/fruit sugar maybe added to compensate. Do you drink fizzy drinks or juices?

It is about achieving a balance but diet is only part of the picture, are you as healthy a weight and active as you could be. Ask about Desmond courses www.desmond.nhs.uk or for a referral to a wellbeing service.

That'll just unfortunately be because that's when next slots are for diabetic nurse clinics (they're extended slots to allow more talk time)

Try cutting your carbs and increasing veg and protein is your starting point

The urine is unlikely to matter whether its fasting or not (can't say I've ever asking for a fasting urine as theoretically if your kidneys are functioning adequately no sugar should be able to pass into the urine...its only when you start getting kidney damage (often from diabetes) can sugar escape into the urine, it'll be to look for that and other kidney issues (like protein)

@ninjafoodienovice yea most of the low carb experts the veggie versions are VERY heavy on eggs. I like eggs but come on!

Been my own champion & my daughters health wise for a looooooong time don't even get me started on why!

This was actually my 3rd time this winter going to drs saying something is wrong and I had to push for the blood tests.

@NeverDropYourMooncup

Thank you

My responses

Only reason I hadn't added some veg to sandwich was I'd none in, was trying to not shop before asda delivery . Gherkins are high sodium and sugary so conflicting advice on whether suitable for diabetics, I like them in a sandwich so hoping I can have occasionally.

Stir fry I either have just veggies but a lot of or I add some quorn. Tofu is tricky as I live along as usually only comes in big packs which once opened have to be used within 24-48 hours. I can make my own sauces or just have with soy sauce I'll admit I've become lazy on that. I've ordered ingredients to make cooking sauces tomorrow.

Peas, beans and sweetcorn are all high carb and must be used carefully.

Got yogurt and blueberries today which I will have as a little dessert after the dinner I'm currently eating and for breakfast tomorrow - because bloody Sainsbury’s had NO EGGS 

For supper tonight and lunch tomorrow I grabbed some quorn picnic eggs.

Having the casserole with some butternut squash made into a mash (yellow label grab) and it's actually really lovely

Soups and casseroles I throw in whatever veg I've got that's needing used up usually, I do love my veg so I'm lucky there.

@ringoutsolsticebells haemoglobin was 145 (115-165 U)

@FinallyHere I'll check that thread out thanks

@ringoutsolsticebells that seems so counterintuitive to me

@Destiny123 I kept getting colds/coughs type things, when I didn't have bugs I felt fine but was getting a lot of bugs which really is unlike me.

The drs know what meds you're on and will interaction check before starting new ones

Not remotely my experience! I've been prescribed meds that were contraindicated with others I was on I've been prescribed meds I'm actually allergic to! Don't trust them on that at all. Last prescription they gave me a few weeks ago was for a med that had been discontinued several months earlier.

Thanks for link I'll take a look.

Exercise is problematic due to disability I'm not stable on my feet, already under physio and have a schedule for that plus seated/lying yoga. Walking & swimming I can do oh good days but that's not predictable/regular.

I'm concerned my AP is high, dad had genetic pancreatitis and we suspect grandad did too but it was never diagnosed.

Cholesterol is high, it's NEVER high, I don't usually eat high fat foods purely as I don't like them, don't like fried food, fast food that kinda thing. Haven't had a takeaway in years as they're a waste of money.

Was surprised not anaemic as I know I've not been as good on iron and vit c intake as I should be.

They also didn't test (as discussed) vit d and b12. I'd like to get this tested if poss as I have concerns there.

information is power

I totally agree but dr basically dropped the bomb said I needed to change diet didn't tell me how and has basically left me to just deal with the news until my appointment. Personally as the appointment was already in place I don't see how that was remotely useful.

Thanks for explanation re the different tests.

I've already halved the amount of carbs I have with meals, cut out all sweet treats, switched to sweetener where applicable if I hadn't already. Love my veg anyway, increasing protein where I can.

@LIZS yea I get low carb and low sugar aren't necessarily connected. Yea been told that about "low fat" products. I don't like to have caffeine because of the insomnia, so I mostly drink diet soda (ginger ale) or no added sugar Squash or flavoured water which I was told by dentist is not acceptable cos they are supposedly still too sugary but then on diabetes uk they're saying it's fine

Between disability and Mh I have not been active for a long time. This is not something I can easily change.

Diabetes makes you prone to infections (eg people with recurrent abscesses should always be screened for diabetes)

I can only speak for colleagues I know but thats not normal, the gp prescribing system has a built in interactions checker, albeit lots of stuff "technically" interacts but if you read into it, it often means just slight increase risk of side effects, hence I often prescribe stuff that technically interacts, that's where clinical knowledge comes into it rather than pure facts

The vast majority of people (millions nationally) have no side effects from metformin, don't forget only people with issues moan about stuff online, those with no issues taking it won't be wasting time raving about it online. Try it, if it gives you trouble ask for the slow release version it stops the gi side effects, but the vast majority are totally fine on the normal one

Swimming is great, even walking up and down in water is fab for cardio (it's what my mum was told to do when waiting for her hip replacements), it's actually a lot more hard work than I was expecting when did it with her.

Can you get a little pedal exerciser like this www.superdrug.com/health/independent-living/everyday-living-aids/aidapt-pedal-exerciser-in-white/p/729465 mum uses this sat on a chair

Sorry not sure what AP means?

Cholesterol is about 70% genetic your liver makes it (ive seen stick thin patients with high cholesterol), but it would be incredibly unlikely to not be high if you're overweight. By improving your diet this should improve

It's probably so you have some time to do some googling while the news sinks in rather than immediately call you in when it's still raw (after all your numbers suggest it's been the case for a while so a few weeks will have minimal impact...that and there's just no gp slots available due to overwhelming pressures

The vast majority of people (millions nationally) have no side effects from metformin, don't forget only people with issues moan about stuff online, those with no issues taking it won't be wasting time raving about it online. Try it, if it gives you trouble ask for the slow release version it stops the gi side effects, but the vast majority are totally fine on the normal one

This. I only had slight issues for the first couple of days. Then it was fine.

My GP referred me to a wellbeing counsellor who referred me to an diabetes group which included exercise and diet advice (over zoom). It was incredibly useful and I actually managed to lose weight in lockdown despite wfh. The advice has changed so much since I was diagnosed - it was all high carbs and starch back then 🤦‍♀️ I know so much more now - and your love of veg will stand you in very good stead.

Diabetes research has a lot of funding spent on research etc, don't dismiss the advice from your GP and remind the GP to check for contraindications etc.

@Destiny123 I can only speak from my own experience but it was pharmacists brought the meds issues to my attention and in every instance when I returned to dr they were  "you're quite right you definitely can't have that" so it wasn't minor issues at all.

I'm in Scotland not sure if systems different here.

Regarding side effects I've had major issues with them in recent years especially upset stomach problems. I have endo inc tissue on bowel, Ibs and with the ocd/toilet phobia plus the other meds I'm on especially the antidepressants I don't want to be in a position where I'm not absorbing them and getting ill that way.

In real life I know several people with type 2 I've been asking friends and family of course and every one of them was put on metformin first and had a horrific time stomach wise, certainly doesn't seem a rare or mild issue to me and I'm not willing to risk that.

Those still on meds are on gliclazide or sitaglaptin now.

Yes I have to do the waking in the pool when I can as recommended by physio. Used to swim a lot as a kid. Love it, just not always up to it.

Regarding buying things, I'm on benefits already and money is REALLY tight well actually I'm sinking into debt! That's just with cost of living! I'm already worried about I think I really need to get a monitoring meter and strips etc (frankly Fucking outrageous that diabetics have to pay for this - not a recent opinion)

AP - alkaline phosphatase

Sorry but I think the way the news was delivered and how I was dealt with was unprofessional, thoughtless, showed no understanding or concern regarding a vulnerable patient with Mh issues, he didn't even ask/consider if I had emotional support in real life. There's a reason why the best way to deliver such news is in person not on the phone! And a less than 3 minute call too.

@CharlotteStreetW1 I do remind of contraindications and allergies I had to do this last time he was originally going to prescribe penicillin that I'm allergic to, wasn't obvious from name of med so I asked based on previous experiences, that was when he prescribed the med that's been discontinued which I didn't discover until trying to fill the prescription the following day, a Saturday. With the asthma etc it was important I get started on antibiotics asap, again through experience I've found if I delay it can cause serious complications so I ended up going through nhs 24 to get the matter resolved.

I genuinely cannot risk non absorption of my other meds I'd be a mess! I do wish people responding would accept that.

Yoy can ask if your surgery can prescribe a meter and strips.

Had a look at bootcamp, it's too extreme for me and I don't need that competitiveness at the moment either.

I'll browse the recipes but otherwise not for me.

Is soup possible, if homemade you can control what goes in and even freeze batches.

Yea I need to get back to making soups, I've ordered items for delivery tomorrow with that in mind. Might hold off until maybe see what veggies I use for other things first though

Hi @Graphista . I was diagnosed with T2 a year ago. Started being really good. Panicked. Decided to ignore it. Stopped taking my meds. Didn't go back to my old ways of eating (high carb because it's cheap) but certainly eating more than I should.

Now I'm trying to be "good" again. But there's so much conflicting advice that I don't actually have a clue anymore.

I've been told to low carb.
Don't low carb.

My diabetes nurse said no more than 1/3 of the plate carbs.

Eat bread and potatoes.

Don't eat bread and potatoes.

Do Slimming world (which in my experience did lead to weight loss but was very carb heavy)

Eat high fat
Don't eat high fat

Fruit is good
Fruit is too sugary

Vegetables are good
Veg has too many carbs.

Complex carbs are OK
Don't worry about carbs, look at the GI number.

Anyway. I'm not sure that's even remotely helpful to you, sorry. But i reckon with a bit of support we can both do this!

Oh and definitely ask your Dr's if you can get a glucose monitor on prescription, I did.

Hey @Graphista , I have spinal disabilities, cPTSD & was diagnosed last year (exactly 1 month after my Dad died with type 2 on his death certificate, thanks Universe!).

With all the existing medications I’m on, adding metformin & Atorvastatin (standard protocol at my GP) hasn’t been too gnarly. I’ll be honest, I am having gastro effects still (but I have IBS anyway), luckily the opiates I have for pain relief do help to slow things down a bit.

Ask at your surgery if there is a dedicated diabetes nurse. We have a great prescribing nurse who the GPS defer to because she is the

Oh and I'm also on a low income, (benefits only due to ill health but not ill enough for lcwra/pip) and have a mixture of mh issues and potentially ND too. All in all its exhausting.

(Bloody sausage fingers & a 40kg doodle launched on my lap).

Anyway, our GP practice has a specialist diabetes nurse practitioner who is excellent. We are lucky that our surgery also has 2 full time pharmacists who have been great at handling the additional meds into my already packed regime.

I take a vitamin B supplement as advised by my nurse as metformin can cause some funky interactions & I'm feeling pretty good.

On glucose meters, talk to your surgery. It’s crap type 2s either have to manage without unless we buy our own (or are prescribed insulin), but some surgeries will provide test strips if you buy one of their advised glucose meters. This may be a Trust wide initiative though. But it’s always worth asking. I use a Sinocare Safe AQ, only because other friends had recommended it & to be honest, the reviews were better than the NHS recommended meters on Amazon.

Every type 2 I know has only achieved really good control with a meter, so it’s a bit of a false economy that we can’t get them on prescription or for free. Even more so for those of us with limited income due to benefits linked to our disabilities or illnesses. That instant blood feedback has been the best motivator to bringing my diet into check. My exercise can be limited (spinal collapse for the win) but I’ve used my diagnosis as a kick up the bum to get as active as I can within my own limits.

We can do this. X

I'm not in Scotland but most can get glucose meters on the nhs here, especially given your numbers are quite abnormal (the drug companies give them for free as they make the money from the test strips...especially if you see endo (I had some funny sugar issue they can't diagnose, asked me to do 3 wks of readings, when I tried to give them the machine back was told they didn't want it as companies give them for free anyway).

Ask for MR (slow release), there's a reason it's first line (my diabetic knowledge isn't super hot as I'm an anaesthetist /icu dr) but you'll probably need some medical therapy

Unfortunately patients have no clue how stretched the system is at present, lots of things are done in a less than ideal manner currently as gps are leaving in droves from poor working conditions/overwhelm/stress etc

A 20quid cycle device is probably cheaper than swimming on a cost utilisation basis if you have to choose

Ask the gp for exercise on prescription (again don't know if Scotland does it) and a slimming world type referral that'll help and be cheap

Oh sorry we use ALP as the abbreviation for alk phos, there's loads of reasons it can be elevated and needs to be looked at in combination with lots of other tests not isolation (can be liver related can be bone related).

Try to change your mindset to 'what can I do within reason to help myself' rather than focusing on all the limitations or issues in your way, it's a much more constructive approach and will be far more helpful to you

Have u looked at intermittent fasting? Michael mosley does a lot on it and there's a lot of strong evidence now for it in both obesity and t2dm