# Greetings and todays question.



## SadhbhFiadh (Nov 22, 2016)

Hi, I was diagnosed type 2 at the end of September, although it was a few weeks before I got the letter. My own GP met with me about 3 weeks ago to do the bloods and confirm it. There was a strong family history, so I was not surprised. My goal was to reach 60 without the diabetes, and I managed that (only just!) My question is about diet. I just want to know how many or in what percent to kcalories, of the macro-nutrients. I have read about spreading food evenly across the day, but even that I am unsure. We have three meals a day, about six hours apart. Is that ok? 

It will be some time before I will be able to attend the class, and in the meantime the advice I've been given matches up with what we already do. For a few years we have been going along with smaller plates, traffic lights, rainbow vegetables, 5 a day and exercise 150 minutes a week. We haven't been strict, but fairly consistent. Since I retired in 2012 I have lost 2 stone. 

I am worried that if I was following a reasonably healthy lifestyle, how will I improve it? I am on metformin and was already on blood pressure and water tablets. Yesterday she added an ace inhibitor because I had protein in my urine at 0.22 (and what does that mean?!) 

Many thanks, 
from Sunny Scotland


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## Northerner (Nov 22, 2016)

Hi Sadhbh, welcome to the forum  Sorry to hear about your diagnosis  You do sound well-equipped to manage things well though, as you are already following a pretty healthy diet and lifestyle, but it sounds like the diet may need some fine-tuning. Don't worry, this is perfectly achievable and doesn't necessarily require a sparse and limited diet to achieve! 

Diabetes is actually quite a complex condition, and this is largely because it can affect people in quite different ways. Chiefly, it is about our body's ability to process carbohydrates, so rather than concentrating on calories, focus on these. I'd suggest starting a food diary initially, and recording the amount, in grams, of carbohydrates in everything you eat and drink for a week or two. So, things like bread, pasta, rice, potatoes, fruit, sugary items or anything made with flour, such as pastries. This will give you a good picture of your current preferred intake. You can then look for ways to modify your meals so that they have an improved impact on your blood sugar levels - perhaps by reducing or replacing portions of carby items with lower carb alternatives e.g. less potato, more green veg, sweet potato instead of ordinary, lower carb bread such as Burgen Soya and Linseed or Lidl protein rolls - you get the idea, I'm sure, and anything you are not sure about, please just ask and someone will be able to help  

Ideally, you are aiming for a diet that will release its energy slowly and steadily rather than hitting your levels and then dropping them down quickly (the 'sugar rush' effect). I, and a lot of others, find that the GL (Glycaemic Load) diet can help with this - The GL Diet for Dummies is a very good introduction, so worth a look  Also you should ideally be able to monitor your tolerance for different meals by using a home glucose monitor - Test,Review, Adjust by Alan S  describes how to do this efficiently and effectively. If you haven't been given a meter and a prescription for strips then it's worth asking for them. Many GPs don't give them to Type 2 patients as they say there's no need to test unless you are on certain medications, such as insulin, but really it's the best tool for discovering your personal tolerances for things - what you can safely keep in your diet and what you should exclude, or only have in moderation or as a treat  It's worth funding your own if you weren't given one, as an early understanding of your responses will really help you get to grips with things - once you are more confident with your diet you won't need to test anywhere near as often as you might do initially. The cheapest option we have come across is the SD Codefree Meter which has test strips at around £8 for 50 (High Street brands can charge up to £30 for 50 strips )

As if I haven't given you enough to think about, I'd also recommend reading Jennifer's Advice and Maggie Davey's letter, and getting a copy of the excellent Type 2 Diabetes: The First Year by Gretchen Becker  There you go, you're all set! 

Please let us know if you have any questions and we will be more than happy to help


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## grovesy (Nov 22, 2016)

Welcome.


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## Northerner (Nov 22, 2016)

P.s. Sorry, I didn't answer your questions directly! I find that spacing my meals about 5-6 hours apart works well for me. I wouldn't worry about the kidney thing for now, it's fairly standard to be put on a pill to help protect them when you are newly-diagnosed. The tiny blood vessels of the kidneys (and eyes) can be affected by diabetes and 'leak' protein. This will be closely monitored and nothing to be alarmed about


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## SadhbhFiadh (Nov 22, 2016)

Thank you, Northerner, no- no one gave me the meter. My sister-in-law (in Kilkenny) said I should insist, but I thought I would wait a little to see how things evolved. I will speak to the Dr again in two weeks, so I may ask the nurse. 

I have read the two articles (I've been looking around at posts for a couple of days.) I looked for the First Year book in our library, but no luck. That will need to wait a short while. But I did find the one for Glycemic Index there, so I'll pop round tomorrow when it's open. 

You've been very encouraging.


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## Northerner (Nov 22, 2016)

SadhbhFiadh said:


> Thank you, Northerner, no- no one gave me the meter. My sister-in-law (in Kilkenny) said I should insist, but I thought I would wait a little to see how things evolved. I will speak to the Dr again in two weeks, so I may ask the nurse.
> 
> I have read the two articles (I've been looking around at posts for a couple of days.) I looked for the First Year book in our library, but no luck. That will need to wait a short while. But I did find the one for Glycemic Index there, so I'll pop round tomorrow when it's open.
> 
> You've been very encouraging.


Perhaps you can order the book from another library? My library allows you to search for a book in the library network, and they can borrow it from somewhere else if they don't have it, or even order it if it can't be found and they think there will be a demand for it  Worth asking when you go in for the GL book!


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## grovesy (Nov 22, 2016)

I would recommend buying Gretchen's book if you can as I found it useful to go back and revisit, it is also written in monthly chapters of diagnosis.


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## SadhbhFiadh (Nov 22, 2016)

grovesy said:


> I would recommend buying Gretchen's book if you can as I found it useful to go back and revisit, it is also written in monthly chapters of diagnosis.



Thanks.
I found a used copy on Amazon for under £3, but then postage so I ordered the kindle version. £7 is ok. 
Our council doesn't have inter-library loans unfortunately. We are glad the library is still open a few days a week, in the recent economic climate!


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## grovesy (Nov 22, 2016)

SadhbhFiadh said:


> Thanks.
> I found a used copy on Amazon for under £3, but then postage so I ordered the kindle version. £7 is ok.
> Our council doesn't have inter-library loans unfortunately. We are glad the library is still open a few days a week, in the recent economic climate!


That is good you have got. 
It is shame about the library services. We still have inter library loans here but the notification service is bizarre, my husband uses alot, he gets notification that it is at the library, but in fact 9/10 when goes in it is not, they send when it is sent out. We live in a city in Essex on a well established area, and had to wait over 30 years for a local library, that is only manned by volunteers a few days a week.


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## SadhbhFiadh (Nov 23, 2016)

OK, here's a question. Why do the kidneys throw off protein? I understand the technical aspects of how, but is it due to the Metformin? Or the poor uptake of insulin? Or the elevated BP? I am only concerned because my kidney function is closely followed, has been for 40 years because of another static condition, and I just need to understands the risks.


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## grovesy (Nov 23, 2016)

Kidney problems can be one of the complications of Diabetes.


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## Northerner (Nov 23, 2016)

SadhbhFiadh said:


> OK, here's a question. Why do the kidneys throw off protein? I understand the technical aspects of how, but is it due to the Metformin? Or the poor uptake of insulin? Or the elevated BP? I am only concerned because my kidney function is closely followed, has been for 40 years because of another static condition, and I just need to understands the risks.


This document (pdf) explains all about protein in relation to the kidneys:

http://www.nhs.uk/Livewell/Kidneyhealth/Documents/protein in urine.pdf


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## SadhbhFiadh (Nov 23, 2016)

Excellent, that's clear. Many thanks.


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## trophywench (Nov 23, 2016)

The infant school version of what the kidneys do is - they are a sieve, they filter stuff out.  The can't do anything with glucose, so they pass this and other stuff it can't process out in the urine.  Trouble is with glucose, the molecules are too big to pass through the teensy holes in the sieve.  I always imagine them as coarse granulated sugar - the grains are rough, right?  So - the glucose molecules keep abrading the surface of the sieve and eventually all the holes get bigger - hence they can now get into the kidneys and pass.  But - if the holes are big enough for the Glucose - then they are also large enough for all sorts of other baddies - which the kidneys should never be exposed to in the first place - in there too.  And that is BAD news ....... eventually they just pack up if it goes on long enough ......


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## SadhbhFiadh (Nov 23, 2016)

Thanks for that. I have had CKD for some time, but I'm hardly out of the starting gate with the Diabetes. I guess I thought it would take longer. I would not be able to have dialysis, so it's the kidneys damage of the Diabetes I fear. In fact, it was the specialist in Glasgow who raised the diagnosis to my GP. My visit to him at the end of September had the random blood sugar of 17. My GP had done one in April and it was 5. So I was unprepared for the news. I thought Diabetes was like the tide coming in - not jumping off the boat! ⛵ Well, I hope the lisinopril is effective! 

Many thanks for your word pictures.


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## Amigo (Nov 23, 2016)

SadhbhFiadh said:


> Thanks for that. I have had CKD for some time, but I'm hardly out of the starting gate with the Diabetes. I guess I thought it would take longer. I would not be able to have dialysis, so it's the kidneys damage of the Diabetes I fear. In fact, it was the specialist in Glasgow who raised the diagnosis to my GP. My visit to him at the end of September had the random blood sugar of 17. My GP had done one in April and it was 5. So I was unprepared for the news. I thought Diabetes was like the tide coming in - not jumping off the boat! ⛵ Well, I hope the lisinopril is effective!
> 
> Many thanks for your word pictures.



I've had a protein leak from my kidneys for at least 15 years and have been on lisinopril too. My kidney function which is regularly monitored is still doing fine despite the diabetes.


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## SadhbhFiadh (Nov 23, 2016)

Amigo said:


> I've had a protein leak from my kidneys for at least 15 years and have been on lisinopril too. My kidney function which is regularly monitored is still doing fine despite the diabetes.



Thank you. That is encouraging!


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## SadhbhFiadh (Nov 25, 2016)

Is there some recommendation in grams or percentiles for sugar? I know some foods are packed with sugar just the way God made them, but I have been drinking benecol in the mornings and that, on it's own, has over 3g. I think the recommendation for _added sugar _is 6 grams? but food by itself always goes over that mark. I think there is some difference between simple and complex carbohydrates. I am still waiting for the GI Index book I've asked for. 

All the best,
S.


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## Northerner (Nov 25, 2016)

SadhbhFiadh said:


> Is there some recommendation in grams or percentiles for sugar? I know some foods are packed with sugar just the way God made them, but I have been drinking benecol in the mornings and that, on it's own, has over 3g. I think the recommendation for _added sugar _is 6 grams? but food by itself always goes over that mark. I think there is some difference between simple and complex carbohydrates. I am still waiting for the GI Index book I've asked for.
> 
> All the best,
> S.


I would say that it's more important to look at the total carbohydrate content of things, as all carbs will convert to glucose and raise blood sugar levels. Things should become clearer when you get your GI book. It may surprise you to learn that white bread will generally raise your levels faster than table sugar, as there are fewer chemical processes to undergo during digestion!  

I'd suggest having a look at the Diabetes UK page 'Understanding food labels' to see how they need to be looked at a bit more closely than if you don't have diabetes - front of pack stuff isn't a lot of use to us, nor 'traffic light' symbols really, as we need to know the type and total of carbohydrates in the food


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## SadhbhFiadh (Nov 25, 2016)

Thanks. I'll check out the labels food page. Mostly we shop based on the traffic light codes, for processed things, but I haven't paid much attention to the numbers. I did order some Kingsmill high protein bread that is new. that one is half the carbohydrate from the ordinary brown loaf Kingsmill does. 
thanks very much.


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## SadhbhFiadh (Nov 27, 2016)

Hi, I have the 'first year' book, and it's really very good. Not over my head, not childish. Plain English, I guess - and reading it makes me feel like this is possible.   I'm up to day three and passed it to my husband to read. I'll get back to it tonight. I also received the glucometer on Thursday and I've done testing for fasting or pre-meal and 1 and 2 hours after meals for all of Saturday and Friday. So a pattern will hopefully appear soon. I think I'll cut the portion of rice (Basmati) in half, though. It was my highest reading at 12.8, but it was 6 when it came to pre-dinner test. Most of the numbers are 7's and 8's, so I'm a little less concerned than the bloods draw that was fasting at 16. Thank you for all the help. This is a grand website! 
All the best,
S.


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## grovesy (Nov 27, 2016)

SadhbhFiadh said:


> Hi, I have the 'first year' book, and it's really very good. Not over my head, not childish. Plain English, I guess - and reading it makes me feel like this is possible.   I'm up to day three and passed it to my husband to read. I'll get back to it tonight. I also received the glucometer on Thursday and I've done testing for fasting or pre-meal and 1 and 2 hours after meals for all of Saturday and Friday. So a pattern will hopefully appear soon. I think I'll cut the portion of rice (Basmati) in half, though. It was my highest reading at 12.8, but it was 6 when it came to pre-dinner test. Most of the numbers are 7's and 8's, so I'm a little less concerned than the bloods draw that was fasting at 16. Thank you for all the help. This is a grand website!
> All the best,
> S.


I also liked the fact that it was plain speaking and that some bits had been anglised. I don't often like American written medical books. I found it much better than one endorsed by Diabetes UK. I also find that alot of what she says about all being different is often borne out by posters on here.


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## SadhbhFiadh (Nov 27, 2016)

Yes, it was edited, clearly, for a British version: I was pretty sure a farmer in Vermont would not be hailing a taxi in London!


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## Northerner (Nov 27, 2016)

SadhbhFiadh said:


> Hi, I have the 'first year' book, and it's really very good. Not over my head, not childish. Plain English, I guess - and reading it makes me feel like this is possible.   I'm up to day three and passed it to my husband to read. I'll get back to it tonight. I also received the glucometer on Thursday and I've done testing for fasting or pre-meal and 1 and 2 hours after meals for all of Saturday and Friday. So a pattern will hopefully appear soon. I think I'll cut the portion of rice (Basmati) in half, though. It was my highest reading at 12.8, but it was 6 when it came to pre-dinner test. Most of the numbers are 7's and 8's, so I'm a little less concerned than the bloods draw that was fasting at 16. Thank you for all the help. This is a grand website!
> All the best,
> S.


Good news  It escapes me why there are so many healthcare professionals up and down the country who fail to see the logic of a testing regime to gain an understanding of personal tolerances (well, not really, it's down to misguided illusions of short-term savings ), and that book should be given to all newly-diagnosed people - or anyone struggling to understand what it's all about! 

Keep us updated on your progress, things sound to be going very well so far!


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## Ditto (Nov 27, 2016)

I  find it worrying that you seemed to have such a healthy lifestyle and you still got diabetes.  I read in a magazine years ago that if you take water tablets then it's a definite that you will eventually get diabetes so I refused to take mine. My doctor said I would get it anyway. So discouraging.


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## grovesy (Nov 27, 2016)

Northerner said:


> Good news  It escapes me why there are so many healthcare professionals up and down the country who fail to see the logic of a testing regime to gain an understanding of personal tolerances (well, not really, it's down to misguided illusions of short-term savings ), and that book should be given to all newly-diagnosed people - or anyone struggling to understand what it's all about!
> 
> Keep us updated on your progress, things sound to be going very well so far!


The book is not new either I bought mine over 13 years ago and I have just checked it was first published in the UK in 2001.


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## grovesy (Nov 27, 2016)

Ditto said:


> I  find it worrying that you seemed to have such a healthy lifestyle and you still got diabetes.  I read in a magazine years ago that if you take water tablets then it's a definite that you will eventually get diabetes so I refused to take mine. My doctor said I would get it anyway. So discouraging.


Unfortunately the media push it is caused by a unhealthy lifestyle. Researchers keep finding different genes that are implicated, so that is only one factor.


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## SadhbhFiadh (Nov 27, 2016)

Ditto- It can be discouraging, but I knew genetically it would happen, plus one or two other things that were beyond reasonable control. My goal was to reach 60 without the diagnosis. I did, but then got overconfident. I guess I shouldn't have had that big Do for my 60th!


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## SadhbhFiadh (Nov 27, 2016)

grovesy said:


> Unfortunately the media push it is caused by a unhealthy lifestyle. Researchers keep finding different genes that are implicated, so that is only one factor.



Don't forget the guilt, also promoted in the media!!


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## Northerner (Nov 27, 2016)

SadhbhFiadh said:


> Ditto- It can be discouraging, but I knew genetically it would happen, plus one or two other things that were beyond reasonable control. My goal was to reach 60 without the diagnosis. I did, but then got overconfident. I guess I shouldn't have had that big Do for my 60th!


Lovely picture Sadhbh!  I still have no idea how to pronounce your name!


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## SadhbhFiadh (Nov 27, 2016)

It's Irish. Sounds like sigh-ve fee-a, or sive fia. 
Sadhbh is anglisized as sally.


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## Ditto (Nov 27, 2016)

Cripes, Sally is easier.  My Da was Irish but the spellings are a nightmare. I've still not got over what should be Dun Leary.


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## Northerner (Nov 27, 2016)

We have a member called Aoife, and I had to look on Youtube to see how to pronounce her name properly before I met her!


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## Radders (Nov 27, 2016)

I use the dairy free Benecol as it has only 2.2g total carbs per portion.


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## SadhbhFiadh (Dec 2, 2016)

In another thread, Martin Canty posted:



Martin Canty said:


> Dietary cholesterol is a minor source of cholesterol in our blood, the body manufactures the rest from glucose, many of us have reduced our cholesterol by significantly reducing our carb intake. I think that many members of this board consume in the 50-150g a day for their carb intake.



My (shocked) question:

50g of carbs a day!?
How does one determine that? I mean, is there a formula? I have been testing for 7 days, fasting plus pre/post meals. I have been waking with 7s, spiking lunch time in the 9s, and after supper it's anywhere from 6-9. All week I have the food diary with meals starting around 300 calories each and about 30g carbs a day.

PS. That doesn't count the wee truffle after tea that spiked me to 15.3 two hours later! Blasted Christmas baking!!


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## Ditto (Dec 2, 2016)

Doing Atkins and trying to lose weight I'm sticking to 20g carbs a day...150g a day would be Henry VIII type feasting.


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## SadhbhFiadh (Dec 2, 2016)

Ditto said:


> Doing Atkins and trying to lose weight I'm sticking to 20g carbs a day...150g a day would be Henry VIII type feasting.



I have the Atkins book. My sister followed that briefly.


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## Ditto (Dec 2, 2016)

It does work if you read the book and follow the guidelines exactly. Plus it cures indigestion, acid reflux, heartburn etc. Well it cured mine!


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## grovesy (Dec 3, 2016)

I would have thought if you lost weight then it is more likely solved your digestive problems than the Atkins.


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## SadhbhFiadh (Dec 3, 2016)

grovesy said:


> I would have thought if you lost weight then it is more likely solved your digestive problems than the Atkins.



Yes, or eating smaller meals, less volume. 
But I'll bet the Atkins will have a great vegetables list, and recipes. I will check that out of the library!


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## Ditto (Dec 3, 2016)

grovesy said:


> I would have thought if you lost weight then it is more likely solved your digestive problems than the Atkins.


 Yes I should think so...my top weight was 18 3 and I'm around 16 now but it's the Atkins that cures my ills. Soon as I start to pig out again all the ailments come back! 

All vegetables are allowed on Atkins, but some sooner than others ie root veggies are higher in carbs so you have to be careful of those. Potatoes are all starch but have good vitamin C under the skin, carrots are sweet, my Mum once made gravy with carrots and hubby complained.


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