blood sugar monitoring

[CanadianJohn]

I've been diagnosed with T2, and I am getting conflicting information. My family doctor (not the sharpest knife in the drawer) says I don't need medication, but my internist said that I definitely should be on medication.

The Canadian diabetes support group says "At the outset you already understand it’s imperative for you to monitor your blood glucose (sugar) levels at any given time", and even offers a free glucose monitor (you have to buy the test strips). The diabetes instructor at the Local Health Unit said that having a A1C test every three months is sufficient, and home glucose monitoring is overkill.

I have been referred (by the internist) to a diabetes specialist, but my appointment is not till the end of March.

In the meantime, I am watching my weight, and trying to exercise more, but conflicting information from professionals is really puzzling. I should tell you I am almost 77, and in generally quite poor health.

Any thoughts?

You will only learn about your own personal blood sugar response to various foods by regular monitoring, it can be counterintuitive (eg bananas are worse for me than a Mars Bar, because fructose in fruit is more bioavailable than glucose in chocolate, and the fat in chocolate slows down the rise). Yours may differ, you will only know by testing.

In the UK, you can buy a monitor or a Libre 2 continuous glucose monitor and download the app, this will give you 2 weeks of data about your response to food, exercise etc

Our diabetic nurses don’t give everyone glucose monitors because it can cause people real anxiety and isn’t necessary in all cases. They go off HBA1C readings and well control diabetics are only on annual recall, some on 6 monthly, new diabetics are on 3 monthly blood tests.

Google diabetes diet plan, lots of info will come up

in the U.K. for example

https://www.diabetes.org.uk/guide-to-diabetes/enjoy-food/eating-with-diabetes

Thanks for your comments; I'm new at this diabetes business.

I like the ideas on the food website given above. The "new to type 2" website I've been going looking at is all about egg whites and chopped spinach for breakfast... much too restrictive for my taste, and seems a bit punitive.

You do need to radically rethink your idea of breakfast though ( sorry!) but toast and cereals are really off the cards.
For type 2 you need to be low carbing permanently
my DH has managed to stay off insulin and remain on tablets by us just ( both) low carbing - no bread, rice, pasta, potatoes, oats etc in this house. The odd carrot passes the exam.

I went ultra low carb and no sugar after a high glucose reading in March and became a bit obsessed with constantly measuring, basically gave myself an eating disorder and could barely eat at all. However, it did kick start an improvement and I increased my carbs to a low carb diet and my latest reading is normal, high end normal, but shows my insulin resistance is improving. I've never been on medication and if I get another normal reading in 6 months they'll remove the diabetic marker from my medical record and consider that I've reversed diabetes.

It is possible to improve the outlook with a decent diet/exercise regime. I'm 57 so not the youngest either. Good luck OP. I'd concentrate on your diet for now and not worry about measuring. If diet isn't helping then closer monitoring might help identify any specific triggers.

Best changes would be to cut out sugar, reduce carbs and stick to small amounts of brown rice, wholewheat pasta and bread when needed. I now do have potatoes but will just have small amounts and try to have with skin e.g. small or half a baked potato but the world doesn't come to an end if I have a few chips occasionally. Best to eat carbs with fats or after fats.

Type 2 diabetes doesn't always need medication. The key to reversing it is weight loss. Medication especially insulin can make weight loss very hard.

Type 2 diabetes is a disease of too much insulin which is a hormone produced by the body in response to sugar.

So your options to decrease blood sugars is to stop eating them, that includes potatoes, bread, pasta, rice, flour, biscuits, cereal, chocolate etc. A diet of meat, fish, eggs, cheese, and mainly vegetables that grow above ground are all good. Eating low carb will mean your insulin levels fall so you can burn fat. I found after a week I was never hungry even though I was eating much less than before. The first few days we're tough and I definitely felt rough.

Alternatively you can fast. When you fast your body has no choice but to burn it's fat for energy. You can skip a meal, some people just eat one meal a day, some do alternate day fasting. When you fast insulin will fall and again you will burn fat. When you do eat you should just eat a normal meal. This can be easier for some people who don't want the faff of changing their diet.

My DH was recently diagnosed and three months on a low carb diet and his blood sugars are now in the pre-diabetic range. We're hoping he'll have reversed it by 6 months.

Look up Dr Unwin as he's a GP in the UK using low carb to treat his patients. He's produced the following sheet that helps guide patients in low carb eating.

https://phcuk.org/wp-content/uploads/A_5_page_low_carb_diet_leaflet_Unwin_2021-converted.pdf