Chemist tested me for diabetes - sent me to the Dr TODAY urgently...please come and talk to me...

[MyHeadWasInTheSandNowNot]

These are my questions

1: The reading the chemist got was 20 - can anyone tell me what this means (ie how 'serious' it is) and if they think it could be controlled and/or preferably gotten rid of through diet and exercise.

2: What will the Dr do today.

The rest is whittering background.

Also, I just wanted to say that I'll have to go in about an hour and wont be able to get back on line until tomorrow afternoon, but I haven't done a runner and will be grateful for any help/advice.

[I'm a regular - I've namechanged because I'm not sure yet if I want to tell anyone or not and I have a few RL friends on MN. It's not that I mind people knowing as such it's just that I don't want it to turn into A Big Deal]

I have been wondering for quite some time if I might have diabetes. A few things have made me wonder about it such as

• Excessive thirst (always having to have a bottle of water on me)

• Eyes a bit blurry at night (been blaming the overhead light and the small tv screen with tivo bright red background and only a problem at night and spending too much time looking at screens)

• Occasional 'shakes'

• I am overweight and struggle with feeling like my 'blood sugars' aren't right

...but what made me 'man up' to getting tested was that last week & yesterday I had a couple of episodes of light headedness/feeling faint when doing things such as changing a lightbulb, I had also been having them in the shower, but put that down to it being hot/steamy etc

I called the chemist about a year ago to see if they did the tests, but ended up not going

I also went to my Dr about 3-4 years ago with constant tiredness and no real reason for it.... he put it down to my weight (which although I'm overweight was not stopping me doing anything, being reasonably fit etc), he really wasn't interested in looking further. I haven't been back, but am and have been pretty much constantly tired since before then. I know I should have seen another Dr but it's hard when you are overweight and they don't seem interested in seeing past that and accept their might be something other excess weight causing the problem.

I wonder now how long I might have had it for and thus how much damage I might have done already to my body, especially my eyes, that's pretty scary.

I was already overweight, but I was pretty fit - then something quite lifechanging happened and I've put on more weight, stopped exercising and I am not unfit. I'm certainly not can't move off the couch unfit - I could still easily walk 4 miles, run for the bus (i'd be panting but I could do it and would recover pretty quickly) - but something else I've noticed (just yesterday I really 'thought' about it) is that I have been putting off doing stuff like walking places (now I take the car), running up the stairs (now only ever walk), kicking the ball about with the kids etc and I realised yesterday it's because when I do I feel awful - not just tired/worn out but light headed and a bit pukey - it's been a gradual thing.

I am totally committed to exercising - a minimum of 30 minutes every day without fail (have just been for an hours walk - about 3 miles) and to improving my diet (which I fully accept hasn't been great for a while, since this 'thing' happened and for a wee bit before then).

I'm not looking for any magic cure - I just want to know if I can get rid of the diabetes through diet and exercise.

Thank you if you made it this far - or even if you didn't wade through it all but can help.

Jailer! Happier !

MyHead I have just managed to catch up with your thread. I have type II diabetes, and was diagnosed in 2004. First of all I want to say, stop panicking and take a breath! It is a big shock to the system, googling and all the conflicting information you are given is difficult to sift through and you will need to find your own pathway through this. I was put on metformin straight away and I would recommend that if you have been prescribed this that you definitely take it, over time if you manage to lose weight and keep to a relatively low carb diet you may find that the dose can be reduced or stopped entirely. I also remember about a month after starting metformin when I had to put in my repeat prescription, have that moment of realisation that this is for life - previously every time you have been to the doctors and had tablet, you finish the course and are better. Now I had to come to terms with the fact that that wasn't going to happen.

As others have said, and as you youself can see through common sense, the official line of having to eat starchy carbs every meal doesn't seem to make much sense. When I do this, my blood sugars go up high then crash down. When following this diet I do at times need insulin to control my blood sugars which in turn leads to hypos, which in turn leads me to need sugar to bring back up my blood sugars, which in turn prevents me from losing weight and overall turns into one big mess as I struggle to stay within guidance for my bloods.

I think you have two choices - one is to go proper low carb (a la bootcamp stylee) where you keep your carbs to a minimum and keep your blood sugars very stable. You do have to commit to this though as you will need to up your fat and protein in your diet in order for it to work. If you read the low carb pages on mumsnet (there are some information pages unde the food section) this explains in simple terms the science behind needing to eat fat : protein: carbs in that order of importance when following this kind of diet. If you do choose this pathway you need to rewrite what 'breakfast' is - you can have anything you like for breakfast, I can recommend leftovers from the night before in general or your avocado and cheese sounds good.

The other choice is to go what I call medium carb. For me this was keeping my meals to a fist of carbs, a fist of protein and the rest veg on my plate at any meal. So for example if I had rice, pasta or potatoes then the appropriate portion size was the size of my hand when clenched in a fist, same for protein and fill up on veg the rest of the plate (generally this tends to be a quarter of a plate of carbs, quarter protein and half veg - assuming your plate isn't very big of course!). I tended to have porridge for breakfast, salad and a sandwhich filling or soup for lunch perhaps with half a slice of granary bread and then tea would be meat/fish, maybe a tablespoon or two or rice and then lots of veg (the greener the better).

My problem with the second woe is that I found I was getting hungry between meals, especially mid-morning and it was too easy to allow the carbs to creep back in, rendering my blood sugars unstable again. I also found that different carbs really affected my blood sugars completely differently and I found it hard to control as a result of this.

I have been doing bootcamp/low carb and have had much more success. I take metformin (850g twice a day) with my meals. When I first moved to completely low carb my blood sugars stablised almost straight away in that every time I tested I had a very similar result. However that result was still too high and I had to use my background insulin at nighttime to bring that number down, after only three days it was back down to normal levels and I have been able tor reduce my insulin dose at night to nearly nothing.

I am sorry this is so long and I hope it makes some sense to you!

IAGTBF - thanks for that :) I'll have a look at the website. 8g of carbs per 100g is higher than I really want at the moment though, I'm trying to keep under 4 for most things, up to 5 occasionally. I agree, I think truely low carbing as a vegetarian will be/is hard! I think it's OK for a couple of weeks, a month or whatever if you just want to lose weight, but as a 'forever' thing it's tricky. Still, I'll do my best for now, keep it as low carb as I can & hope to drop some serious weight. They say 10% really helps to lower your BGL, so I'll see.

BIWI - I rarely take anything, so hopefully wont need to for a while and when I do I can test with my new meter

Sazpops - you tease :)

SCOTCH - No, I really don't eat eggs at all. I might have the odd bit as an ingredient of something (when I'm out/at friends) like a cake (but I don't buy them, I use egg free recipes), but not in something like quiche etc or egg as an egg. The idea of it just makes me feel sick - I wouldn't be any jailer happier to eat them regardless of where they're from. I understand that is hard to understand :) But honesty, I feel the way about regular eggs as most 'normal' people would about eating cat.

wow you are certainly getting lots of input on this thead

just an answer to your questions to me .. I find that wholemeal granary or seeded is ok for me , just one slice usually at a time... its 14 - 18 carbs depending on the brand.

What I am finding is that it is not just as simple as counting the numbers and that if you have x number of carbs then your BG will move a set y points... oh nothing so easy , White bread seems to just escalate the numbers more than the equivelant amount wholemeal / seeded ( well that is the basis of GI count though isn't it )

This imo is why its so vital that we each understand our individual bodies reactions and tailor our diet accordingly.

Re not following nurses / nhs advice ........ well usually I would be in agreement that often / usally its not a good idea to ignore medical advice.

But there is a problem with the situation regarding diet / diabetes etc. Some of the studies that were done that shaped current advice are now being found to be seriously flawed ... there are many medics who have kept up with newer studies and will indeed support actions such as reducing carbs and not leaping immediately on all T2 diabetics prescribing statins and bG lowering medications. They have their ear to the ground and realising that there are indeed changes happening.

They are also realising that we MUST address this issue at a far ealier stage than the current cut off point for being officialy diabetic. Thing is that not all GP's NUrses ... or even the NHS as an organisation .... find it easy to change "habits". Its like trying to change direction in a huge oil tanker in the sea... takes a loooooooong time.

There has to be a realisation that maybe the advice thats has been given out for soooooo long is maybe flawed

... that maybe in the drive for a lower fat diet we have stuffed so much starch / carbs / sugar into "healthy" foods that we have contributed to high obesity levels not helped to lower them. We have become so used to that sweet taste we crave it and the situation escalates.

Oh its a huuuuuuuuge topic .... lets just say that if you hang around long enough there will be official changes and even complete U turns

i mean remeber when eggs were good for you (remember the catchphrase "go to work on an egg" anyone) .... then they were too high in fat / gave you salmonella ..... now they are good for us again !!!!!!!

and so is butter again. ... and marg according to the latest news is the "bad boy" now.

nothing like toeing the offical line eh

sorry I am do not mean any disrepect to anyone that has lost friends and family to diabetes ... but HCP ( and I am one) dont have all the "right" answers.. "right" changes according to research / evidence.

MrsHP - Hello :) Well done for making it through the whole thread - some of my posts are mammoth! Don't be sorry yours was long!! > the more people write the more it helps.

I would recommend that if you have been prescribed this that you definitely take it - Why? Based on what? (Blind faith in the medical profession, even those really not trained in diabetes?) It was simply prescribed because it's what she does for every single diabetes patient she has, no family history, no medical history, she thinks the NHS high carb diet is a good idea & inists that self testing is a waste of time - I can't see any good reason to blindly follow her.

you will need to find your own pathway through this I couldn't agree more and part of that is deciding whether I think metformin is something I need or not. I'm not saying I wont take it, I'm saying I want to make an informed decision.

As I said before, I have no problem with 'left overs' for breakfast, but at the moment dinner is the salad/coleslaw type affair and I cannot face that 3 times a day! I'm getting fed up of it twice a day and I'm finding it hard to think of other things to make (couldn't face Thai Green Curry for breakfast!) I need to check out the Bootcamp Recipe thread again!

I'm struggling to find vegetarian (no egg) sources of low carb protein, that's why I'm asking for suggestions.

You say there are two options - Bootcamp Low or (your) Med Carb. At the moment I'm much closer to bootcamp, but probably not in ketosis due to veg intake... I can't just eat avocado and cheese as sources of fat/protein, I need to find other things.

I'm really, really pleased that Bootcamp is working for you!! :)

I wish there were some D2, (non egg eating) vegetarians to say what they are eating! :/

I hope that makes some sense, I'm knackered!

Metformin is not just used in the control of diabetes, it's prescribed for PCOS and as a fertility drug. I know that when I don't take it regularly my blood sugars are higher over a period of time. In my experience taking it helps me to lose weight quicker and to keep my blood sugars lower and more stable. I csn't really see any reason why someone would choose not to take it as it can't possibly hinder the control of your condition.

Where does protein come from in your diet currently then? Do you eat fish? Sorry if you have answered that and I have missed it! I think tofu has less than 5g of carbs per 100g, but due to its make up (something to do with amino something's) it pushes people out of ketosis.

Some possible suggestions to differ between lunch and dinner - salads for lunches (different lettuces on different days to mix it up, cucumber, celery, cheeses, salad dressings - make your own from from different oils, vinegars (not balsamic), halloumi is brilliant as you can cut it up small and fry it, leave to cool slightly and it goes crispy like croutons!). Dinners different veg, roast lots of things green beans roasted are good, cauliflower rice is nice and easy, maybe some tofu here in small amounts. I know bootcamp rules say vegetarians should have some nuts so maybe small amounts of nuts made into stuff? I will see if I can think of anything else...

have pmd you the direction to experienced vegans with diabetes who might be able to offer you some support.

Protein in vegetables www.livestrong.com/article/394772-protein-rich-fruits-vegetables/

Tazzle - I just wrote a really long reply and the bloody laptop ate it!!

wow you are certainly getting lots of input on this thead - Yes I have and I'm really very grateful for everyone taking the time to post, it's certainly helpful having you all to talk it through with! Lots of different opinions :)

wholemeal granary or seeded is ok for me I look forward to trying it one day, a while from now :)

I am finding is that it is not just as simple as counting the numbers and that if you have x number of carbs then your BG will move a set y points... oh nothing so easy Yes, that's going to be very frustrating - I have a very logical/mathmatical type brain and so thing that don't 'conform' annoy me!

It's good that some medics are looking in this (Eenfledt for one!) and are admitting the advice given out has been wrong - though god knows how long that will take to hit mainstream thinking!! Very much like changing direction in a huge oil tanker!!

... yes, definitely the good egg/bad egg/good egg situation :)

I've never fallen into the marg trap - it's butter or nothing. All that added crap cannot be good for you! I know I've eaten worse in processed food, but I've never bought anything but butter to eat or use in cooking.

nothing like toeing the offical line eh - some people think that if the Govt says it, it must be right... nothing to do with funding or whatever, no... of course not!

HCP ( and I am one) dont have all the "right" answers.. "right" changes according to research / evidence and I'd have to add in capitals FUNDING.

MrsHP

Metformin is not just used in the control of diabetes, it's prescribed for PCOS and as a fertility drug I know that, but how does that relate to me? I haven't been prescribed it for either of those and don't need it for either of those??

I haven't said I wont take it, I just want to make an informed decision. I'm information gathering at the moment and I want to know what my readings are without metformin. I don't think spending a little time doing that is a bad thing - otherwise how am I going to have any idea if the woe is working or if it's just the metformin?

No, I don't eat fish, I'm vegetarian.

Before this my protein came from a lot more cheese, more quorn, milk, beans, lentils & vegetables. Now it's coming from less cheese, less quorn, less milk, far less beans/lentils & more vegetables

I think tofu has less than 5g of carbs per 100g, but due to its make up (something to do with amino something's) it pushes people out of ketosis yes, I seem to remember this as well.

It's not that I want to differ between lunch and dinner - it's that I need to add things back in, but I'm undecided as to which I'll add back in...

Yes - Haloumi is nice isn't it :)

I think what I was trying to say about the metformin is that Ivan see why you might not follow the nhs advice about eating carbs as try clearly ate going to push your blood sugar levels up and they is what you want to avoid. Metformin can't possibly have a detrimental effect on your blood sugars and so, seeing as your bloods have clearly been extremely high at times I just couldn't see why you wouldn't take it initially at least. As a type 2 diabetic your body doesn't produce enough insulin or the insulin it does produce is ineffective and metformin combats this. Diet doesn't, it just stops your blood sugars going as high as they might with large quantities of carbs. As I said only you can make your own decisions and I think I'll brownout of this thread now as I find it hard to know y

You might be causing yourself damage by not taking the metformin to control it. I have background retinopathy from poor control previously buy as you say your decision. I am not vegetarian and I eat eggs so I don't think there is much else I can say.

I hope you find you are able to control it in a way your are happy with. Good luck for everything.

Great posts from mrs hercule and tazzel, lots of good points made.

Metformin and pcos fertility issues as well as diabetes.. These issues are all part of syndrome x/ diseases of civilisation... And many people find all of these issues resolve on the grain free, lower carb higher fat and protein diet. Many, many medical conditions root cause is a disordered insulin response and all the knock on effects to the rest of a persons metabolism. There is plenty of science to back that up but it tends to be individual papers looking at individual diseases rather than looking at the whole body.

Headinthesand, I think you have a choice to make, or you will find it really hard to get the nutrients you need to stay low carb. I respect your choice to be vegetarian but I think you need to consider your choice in relation to your illness and what you are trying to do with your diet.
Is there any form of animal protein you are happy to eat (cheese is good I know you eat that, check labels as some has more protein than others!), prawns? Shellfish??? I know you don't eat these.... But could you?

"Great posts from mrs hercule and tazzel, lots of good points made."

I agree. One of my friends is a doctor who specialises in diabetes. She gets frustrated with patients who don't follow sensible medical advice or who don't take control and responsibility for their health because the effects of diabetes are insidious and aren't obvious until it is too late to do anything about them.

As someone with poor eyesight anyway I would be paranoid about losing it altogether.

Lol tho bunbaker I was not really meaning follow current medical advice... Far too many carbs to control bs by diet, IMO a much more radical diet such as paleo is needed to give good control without medication.

Now, the news you've all been waiting for - what was the cauliflower pizza like? Well, I wouldn't say it was an unqualified success - it tasted good, but I'd expected the base to firm up more (it was a bit soggy). I will try it again, but here's a link in case anyone else is brave enough to have a go!

www.irishtimes.com/newspaper/magazine/2013/0112/1224328642317.html

headinthesand - I had a thought, have you tried quinoa? We have it quite often as a 'filler' and it is lower carb than grains AND contains protein. It doesn't affect DH's levels adversely, I think because of it's make-up.

This thread has really moved on since I last posted - you must feel overwhelmed with information! Good luck with sorting it all out!

scotch I agree, to control with diet requires radical changes, not anything close to what diabetic nurses advise

MrsHP - Would you say that HbA1c of 9.3 & fasting of 10.9 is extremely high? I thought they were both definitely high, but not extremely??

I have read quite a few posts (on the various diabetes sites) where people with similiar and higher results have lowered them to an acceptable level with diet, weightloss and exercise (without drugs)?!

As diabetes is progressive, I just want to do what I can with diet/weightloss/exercise now so that metformin is the next step, rather than take that step now and then have to take a bigger dose/something else 'next' - does that make sense?

As a type 2 diabetic your body doesn't produce enough insulin or the insulin it does produce is ineffective and metformin combats this. Diet doesn't, it just stops your blood sugars going as high as they might with large quantities of carbs

I thought that weightloss would mean there could be enough insulin for my needs.
I thought that a low carb diet would mean less sugar in my blood so less insulin needed.
I thought that weight loss lowers your blood sugar.

Is that not right? and if it is right then why isn't it possibly enough?

How much damage can I really cause by monitoring my blood sugars for a couple of weeks before deciding whether to take the metformin or not? I've seemingly had this for quite a few years - will a couple of weeks make that much difference?

Please don't bow out - I am listening, I just need to understand and make my own decision.

But if you do - thank you for your help, it's certainly given me things to think about and thank you for your good wishes.

SCOTCH - No, I couldn't. I really couldn't. Honestly, I struggle with dairy and as I said, just before this I was looking at ditching that again as well.

Bunbaker - One of my friends is a doctor who specialises in diabetes. She gets frustrated with patients who don't follow sensible medical advice or who don't take control and responsibility for their health because the effects of diabetes are insidious and aren't obvious until it is too late to do anything about them

I am taking responsibility for my health. Medical advice (the nurse) to eat lots of starchy carbs and take metformin because she prescribes it to everyone with diabetes is hardly sound, personal, professional advice.

I am worried about losing my eyesight and all of the other devastating things diabetes can cause - if I wasn't, I wouldn't be doing all of this - I'd have just ignored it all and carried on as I was.

What diet does your friend advise?

Sazpops - thanks for the review :) What a shame is wasn't quite as you'd hoped/expected. Why don't you have a look at the one on the Bootcamp Recipe thread?

I used to have quinoa a lot, but haven't for ages. I was reading about it yesterday and thought I should get some, so funny you have posted that too!

isithometime - are you saying that you don't think my changes are enough? What else do you think I should change? (other than upping the protein)

I hadn't been on that thread before myhead, there are one or two things I might try, thanks. The cauli pizza on there is practically identical to mine, with different cheese.

Looking through a few of the recipes, I can see your problem with not eating eggs, as they are used in so many dishes. Racking my brains to think what you could substitute.

Yes I do thinking fasting of 10.9 is high. I would be concerned if my sugar level after eating was that high, let alone after fasting. As I said earlier I would take the metformin initially, if you manage to control bloods and lose weight trough diet you may well be able to come off this later. Controlling via diet alone is difficult. You have to be very strict all of the time, you can't have anything carby at all like rice, pasta, potatoes and you will find fruit and anything sweet probably sends you flying high. It is a life long commitment to eating this way. You are already thinkin about introducing higher carb foods in order to get protein and I am not sure realistically how well you can control via a vegetarian diet without eggs. Jus my opinion of course.

sazpops - It's a good thread isn't it :)

MrsHP - If I started taking metformin how would I know if it was that or the diet that was making the difference? How would I know I could come off it?

I don't know but realistically it would be a combination of both. Once your bloods/hba1c is stabilised and in acceptable levels then you could slowly reduce your metformin dose and keep monitoring it.

I think mrsH make a very good point I'm her post of 10.17am,

In order to get enough protein and fats to keep you healthy, while keeping carbs low enough to level your blood sugar is going to be almost impossible on an almost vegan diet... I think in your particular case because of those additional difficulties, going on the metformin initially might be a good idea - you would know when to reduce the medication, if you started to see very good fasting bloods (less than 4.8 to 5.0), you could then half the dose and keep eating the same and see what happened.

Unfortunately, the higher carb levels you are going to need to eat to get sufficient protein for good health might have been fine if you had impaired glucose tolerance, you might have still got good control of your bs levels but you have gone beyond that - those fasting levels are properly diabetic and I think at least initially you need the metformin to kick start things.

To be veggie is absolutely your choice but I do think you ate going to find it hard to stay off medication if you remain veggie... I know a few paleo people who were veggie and got really sick and had to make that decision - one has become a big meat eater but the others were happier to go down the prawns and shellfish route on the ground that they are not "higher" animals in the way that vertebrate fish, poultry and mammals are iykwim... Your choice of course and I understand why you wouldn't want to go down that route