# Insulin for Type 2 Yes or No?



## Catz63 (Feb 8, 2021)

I have been put forward by my specialist nurse for Diabetes to start Insulin shortly. I am still not sure this is the route I want to go. My Hb1ac is in low 70's that;s down from the last but still up from what it has been in the past. My blood glucose is tested 2 to 3 times daily some days its behaving and is 6.8 - 7.4 in the morning before breakfast other mornings it's 9 - 9.9 for no reason (but I suspect liver dump). My specialist nurse says my bloods are not super high but my meds don't seem to be coping. I've tried everything and reacted badly to a few. So I'm currently on :
Metformin SR 1g twice a day
Glicazide 160mg twice a day
Canagliflozin 300g once daily
She has now decided I need insulin to help bring my numbers down. I have looked into it - I am not convinced its the right path. 
I would rather try to reverse the insulin resistance causing the type 2 diabetes. I am prepared to try the Liquid Diet and start an exercise reigeme.
Does any one have any thoughts? 

BTW I've been labelled Type 2 since 2012, I've lost over 5 stone and am now 13st.


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## rebrascora (Feb 8, 2021)

Can we ask the sort of food you are eating as you make no mention of lowering your carbohydrate intake, which is by far the most powerful tool in lowering BG levels. Many people, particularly those diagnosed a long time and given standard NHS advice assume they just need to cut down on sugar and eat wholemeal bread etc but continue to eat quite a high proportion of carbs including plenty of fruit and this unfortunately will not help many Type 2 diabetics. Cutting a significant proportion of all carbs from the diet is much more effective and can result in some people pushing their diabetes into remission and coming off all medication. Weight loss alone will work for some people but not all, so for me cutting your carb intake would be the thing to do if you haven't tried that before starting insulin.
If you can give us an idea of a typical day's food and drink we might be able to see where carbs could easily be cut and alternatives suggested.


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## rebrascora (Feb 8, 2021)

I should say that the only medication as powerful at reducing BG levels as low carb diet, is insulin, so don't be afraid of it if you need it, but if there is room for dietary improvement as regards reducing carbs, then I would ask your nurse to give you 3 months to try that first. The draw back with insulin is that you have to get the dose just right and it can be a tricky business and obviously who wants to inject themselves several times a day if they don't need to.

If you are already following a low carb diet and your numbers are still stubbornly high then it may be that you are LADA (Type 1.5) which is a slow onset Type 1 rather than Type 2, so knowing what you currently eat will give us an idea if that is likely. If you are LADA then you will likely need insulin at some point, but you might want to ask for a C-peptide test to assess how much of your own insulin you are able to produce which should help indicate your Type and possibly a GAD antibody test. Most standard Type 2 diabetics produce a lot of insulin but their body is resistant to it and ignores it, so extra insulin injected can help along with Metformin which improves the body's responsiveness to insulin. If you have LADA or Type 1 then your pancreas is no longer able to produce enough insulin itself and taking gliclazide (which stimulates the pancreas to produce more insulin) is like flogging a dead horse. That is a very simplified version and it is of course much more complex but gives you an over view of the rough differences between types. With Type 1 and LADA the insulin producing Beta cells in the pancreas are attacked by the body's immune system and killed. In standard Type 1 that happens quite abruptly and people get very ill (Diabetic Ketoacidosis or DKA) pretty quickly, but with older adults the die off of beta cells can be slower and therefore appear to be more like Type 2 diabetes initially and even respond to Type 2 medication in the early stages.... which can last months or many years.


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## Catz63 (Feb 8, 2021)

Thanks for replying.
I have all my life tried to follow a low fat diet as I have always struggled with weight. I have reduced carbs but obviously not enough . I eat some fruit but am limited as I have allergies to a lot of fruit acids. I eat nuts as a replacement for snacks. My appetite in recent years has reduced considerably. My breakfast is my main meal, by tea time my interest in food is minimal. I still have wholemeal bread if I have bread but I am not drawn to bread as I'm having problems swallowing it. I have soups mainly vegetable with one grated potato to help thicken it. I still enjoys crisps at lunch time as I want to taste some flavour. My down fall is my sweet tooth I always want something sweet after lunch or tea. Usually a 66 - 99cal snack bar.
My drinks in a day:- start with a coffee with a dash of semi skimmed milk, sometimes a 2nd at eleven but more often I have a flavoured fizzy water low /no sugar or a no added sugar fruit squash. I regularly drink more than 2litres in cold drinks a day including water.
I also take a pro-biotic with breakfast.
My activity is limited, my knees are not good. I enjoy walking and will walk to PO or to the grocers when I can. I have lost a lot of muscle mass and as I have very loose joints this is very painful as I get nerve pain as the bones move about in their joints. I have found some exercises on line to help build the mussels so am going to give that a go. 
I have been self employed for over 12 years and since I closed the business I now have more time to look after me.


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## rebrascora (Feb 8, 2021)

Low fat diets are half the problem. Fat keeps you feeling full for longer so you don't need to eat so much and don't feel hungry in between meals and need snacks. It also helps to stabilise BG levels by slowing the rate at which any carbs you eat hit the blood stream, so having cream or creamy Greek natural yoghurt with your fruit will help to make it more filling... (edited to add.... and mean the fruit has less of an impact on BG.... it is a good idea to severely restrict the likes of bananas and other exotic fruits though as these are the highest carb fruits) 

*Can you elaborate on what you have for breakfast specifically,* as this is a time of day when we as diabetics, are often more insulin resistant so having a low carb breakfast is often more beneficial than any other meal and saving the majority of your carbs for later in the day can make a big difference as your body may well be able to cope with them better then.

With no added sugar fruit cordials, you need to look at the carb content on the nutritional info label (usually in small print on the back label.... same with all food labelling when looking at carbohydrate content, as some contain real fruit juice which of course contains sugar. 1 glass a day may not make much difference but if you are having several glasses a day then it all adds up. You may be surprised to know that semi skimmed milk contains more carbs than whole (blue top) milk and cream contains less than both of them so many of us diabetics have our morning coffee with double cream instead of milk... less carbs and the fat keeps us feeling fuller, so we don't feel the need to snack.

I know this will be contrary to everything you have been told about diet but for us diabetics we have to learn to think differently and eat things which our body can cope with, not the things it can't process any more. If we cut back on carbohydrates significantly, then we have to get our calories from somewhere else and fat has less impact on our BG levels than protein, which is the only other food group. It is even believed by some quite high level scientists that our low fat diet is in part responsible for the obesity and diabetes epidemic we are now seeing in the world, because that fat has been replaced by cheap carbs and those carbs create a glucose spike in our blood, which when it drops, triggers us to want to eat again to get another sugar high and gradually we eat more and more of them and our body gets immune to the insulin we produce to deal with it. Again, a simplification, but once you cut the sweet stuff and a lot of carbs from your diet and eat more fat, you don't crave the sweet, carb rich foods you did before and feel sated eating less food in general.


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## adrian1der (Feb 8, 2021)

And let's face it, who can complain at an eating plan that includes pork scratchings and cheese


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## rebrascora (Feb 8, 2021)

Adrian, we are so on the same page!!


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## Catz63 (Feb 8, 2021)

rebrascora said:


> Low fat diets are half the problem. Fat keeps you feeling full for longer so you don't need to eat so much and don't feel hungry in between meals and need snacks. It also helps to stabilise BG levels by slowing the rate at which any carbs you eat hit the blood stream, so having cream or creamy Greek natural yoghurt with your fruit will help to make it more filling.
> 
> *Can you elaborate on what you have for breakfast specifically,* as this is a time of day when we as diabetics, are often more insulin resistant so having a low carb breakfast is often more beneficial than any other meal and saving the majority of your carbs for later in the day can make a big difference as your body may well be able to cope with them better then.
> 
> ...


Hi, well Breakfast as I said I eat as my main meal and so I have some carbohydrate usually wholemeal toast from freezer with clover spread. I usually add a piece of fruit - small banana, small apple or a handful of white grapes. Occaisionally cereals Oat flakes with semi skimmed milk and sliced grapes along with my pro biotic and coffee with semi skimmed milk.
I read over the weekend about increasing the fat intake and I can see the logic but having lived two thirds of my life on a limited fat diet it will be a difficult change to make.

My no added sugar drinks - I have checked the lables the squash just says negligible amounts of carbohydrate -6 cals a glass. the fizzy water 0.8g carbs of which 0.5g sugar/100mls ,neither very accurate. In the summer I tend to drink more water. I have at least 1 litre of water a day at the moment. 
I have put a call into my diabetic nurse and I want to ask her to refer me to join the Low Carb Program as my chances of getting on the React trial is very unlikely at the current time.
Just thinking about what foods are in my house at the moment is mind blowing, they are protein high and carb not so high but I do still have to feed my husband who just balked at going to full cream milk when I mentioned it. When I met him he was using full cream milk, I was on skimmed so we compromised to semi-skimmed but now he cant face returning. He says he doesn't like it in his coffee. It is going to be a long hard journey unless he climes on board too.
Personally I only use coffee to wake me up in the morning and as something warm to drink on cold mornings I only started drinking coffee 8 years ago prior to this cold drinks or hot chocolate.


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## adrian1der (Feb 8, 2021)

Well, your breakfast is very carb heavy. Most people are more insulin resistant first thing in the morning so not a great time to load up on carbs. Wholemeal bread is no better for you than white bread. Carbs are carbs. Bananas and grapes are also very high in sugar and cereals are again high in carbs


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## Catz63 (Feb 8, 2021)

adrian1der said:


> And let's face it, who can complain at an eating plan that includes pork scratchings and cheese


Cant say I will ever enjoy pork scratchlings but I do like cheese but usually with poatoes but I could eat them more on veg instead.


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## adrian1der (Feb 8, 2021)

Catz63 said:


> Cant say I will ever enjoy pork scratchlings but I do like cheese but usually with poatoes but I could eat them more on veg instead.


Rather than potatoes how about a nice cauliflower cheese?


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## Catz63 (Feb 8, 2021)

adrian1der said:


> Well, your breakfast is very carb heavy. Most people are more insulin resistant first thing in the morning so not a great time to load up on carbs. Wholemeal bread is no better for you than white bread. Carbs are carbs. Bananas and grapes are also very high in sugar and cereals are again high in carbs


I see that now but haven't been following a low carb diet more low calorie to loose the weight. My bloods were coming down with the weight but now the weight has plateaued and blood sugars are climbing again.


adrian1der said:


> Rather than potatoes how about a nice cauliflower cheese?


I will eat that too but husband wont eat cheese cooked.


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## adrian1der (Feb 8, 2021)

You can also use cauliflower to make a substitute for mash and rice. Celeriac also makes a nice mash


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## rebrascora (Feb 8, 2021)

We can only advise you on what would help improve your HbA1c. It is up to you to figure out how to implement it into your lifestyle and circumstances. Maybe let your husband cater for himself for a few weeks whilst you sort your own diet, and have a small carton of whole milk or cream for your morning coffee but have a small bottle of green top for him.  

Your breakfast looks to be the biggest problem and my feeling is that if you were able to address that.... maybe a 2 or 3egg mushroom and/or ham omelette with salad and a big dollop of cheese coleslaw, since you like something substantial, then that would most likely deliver a marked improvement in your levels.


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## rebrascora (Feb 8, 2021)

You also need to restrict bananas and grapes to an occasional treat, maybe once a fortnight and one or the other, never both in the same day. Even apples are not ideal. Berries are the best option for us diabetics because they are the lowest carb fruits and packed full of flavour and nutrients so a small handful is enough and if you find the acidity a problem have them with cream or Creamy Greek yoghurt which will reduce the effect both of the few carbs they contain and also the acidity. 
The low fat advice is something that we have all probably struggled to overcome. We have been indoctrinated with it for years and the NHS are still pushing it at us, so it is difficult to overcome that propaganda. Those of us who have embraced Low Carb Higher Fat eating find it sustainable long term because it is enjoyable and filling but also find we feel fitter and healthier and can adjust that fat intake to lose or gain weight without any great effort along with increasing exercise. I am 56 and I now have the figure I had in my 20s (down to a 26" waist"), my joints no longer give me grief and I feel 30 years younger.... and I eat more fat than I have in my whole life and I enjoy my food. I was a carb monster and sugar addict pre diagnosis, so I understand about having a sweet tooth. I love the fact that I now taste food differently and I enjoy sour and bitter flavours which I didn't like before because all I wanted was sweet and the more sweet I got, the more I wanted. I also like that I have more control over my diet nw because I don't suffer the cravings..... apart from pork scratchings  .... but sounds like you are safe from that guilty pleasure.


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## adrian1der (Feb 8, 2021)

rebrascora said:


> I love the fact that I now taste food differently and I enjoy sour and bitter flavours which I didn't like before because all I wanted was sweet and the more sweet I got, the more I wanted.


I really love the earthy, meaty umami flavours as well


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## Catz63 (Feb 8, 2021)

rebrascora said:


> You also need to restrict bananas and grapes to an occasional treat, maybe once a fortnight and one or the other, never both in the same day. Even apples are not ideal. Berries are the best option for us diabetics because they are the lowest carb fruits and packed full of flavour and nutrients so a small handful is enough and if you find the acidity a problem have them with cream or Creamy Greek yoghurt which will reduce the effect both of the few carbs they contain and also the acidity.
> The low fat advice is something that we have all probably struggled to overcome. We have been indoctrinated with it for years and the NHS are still pushing it at us, so it is difficult to overcome that propaganda. Those of us who have embraced Low Carb Higher Fat eating find it sustainable long term because it is enjoyable and filling but also find we feel fitter and healthier and can adjust that fat intake to lose or gain weight without any great effort along with increasing exercise. I am 56 and I now have the figure I had in my 20s (down to a 26" waist"), my joints no longer give me grief and I feel 30 years younger.... and I eat more fat than I have in my whole life and I enjoy my food. I was a carb monster and sugar addict pre diagnosis, so I understand about having a sweet tooth. I love the fact that I now taste food differently and I enjoy sour and bitter flavours which I didn't like before because all I wanted was sweet and the more sweet I got, the more I wanted. I also like that I have more control over my diet nw because I don't suffer the cravings..... apart from pork scratchings  .... but sounds like you are safe from that guilty pleasure.


I see where your coming from, I have told my husband he must eat the bananas off the side when they ripen. I have also told him he could have anything from the cupboards until they empty then it will all change.  I will try my own meal plan and he can eat his own. 
I will try some berries in Greek yogurt, I've always got my allergy meds to fall back on if it all goes to hives. I cant think what to have for lunch and cant actually face any food at the moment but I foresee a lot of eggs cheese mushrooms and maybe a slice or two of ham in my future. Parts of this diet reminds me of the Atkins diet I tried many moons ago. But then wasn't allowed any veg either.
I struggled to eat a hot breakfast in the past on Atkins so I will try the Greek yogurt with berries and then an omelette at lunch and some cheesy veg for tea. I still await a call from my diabetic nurse.


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## Hammy (Feb 8, 2021)

Hi I'm just recently become type 2 diabetic and have found this thread to be really useful for me as I'm struggling to get my numbers down have got some good things to change and try


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## Lucyr (Feb 8, 2021)

Personally, insulin is the best thing I’ve ever tried. I had side effects from all other medications and haven’t had that with insulin. I’m able to eat a normal diet of 150-200g carbs per day, (though with calorie counting to lose weight), which suits me as fat upsets my stomach so I eat low fat which makes low carb pretty difficult for me. I take long acting insulin in the evening and rapid acting insulin before meals. If it’s just long acting you took you would still need to watch your diet but may help to bring the blood sugars down.

The only downsides to insulin that I’ve found are all the carbohydrate counting and the driving restrictions. You have to test before driving, if under 4 then you have to eat something, wait 15 minutes until over 4, then wait a further 45 minutes. Sitting in the car for an hour in the freezing cold, without being able to start the engine to put the heating on, late on a dark night, and all because of a bg of 3.9 when you just want to be at home is a total pain.


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## goodybags (Feb 9, 2021)

Insulin helped me when I needed it !
although I’m now taking quite a bit less 
I’m getting my blood sugars under a better control (lower carb diet)

BUT plenty of testing needed if taking insulin and eating a low carb diet
(one night I woke up and my B/S was 2.9 ! 
omg nearly ate the contents of the kitchen @ 3:30 am  (now I keep a test kit & glucose tablets by the bed)


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## Drummer (Feb 9, 2021)

I found Atkins very close to the way I was eating, and I still eat the same way. 
I only need to eat twice a day now, and it keeps my blood glucose under control.


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## Catz63 (Feb 9, 2021)

Well my Diabetic nurse got back to me last night. She wanted to know why I wanted to postpone the insulin. I told her I wanted to try reversing the insulin resistance first before taking on the insulin. She was obviously not a convert to the Low Carb Diet, this came across very clearly. She said if I continued to loose weight my numbers would come down and the insulin would help.
 I mentioned to her that both the Liquid Diet and the Low Carb Program were available to people in our area and asked if she would refer me to the Low Carb Program. She said she would refer me to a dietitian and he would have a chat with me about what steps I wanted and would also refer me back to the hospital "to see if they have any more ideas" her words. She ended the conversation agreeing a pause to at least June giving me time to change my BG figures but stressed for me not to cut out all carbs as the drugs I'm on would put me in danger of hypo's. She wants me to have at least a small amount of carbs in every meal.

So there we go NHS holding back and offering little help to reverse my insulin resistance. With the time referrals take at the moment I will be lucky to get on a plan before June.

I am going to try reducing my carbs and start doing as much activity as my body will allow and see how this affects my BG figures.

Thanks for all the feedback


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## rebrascora (Feb 9, 2021)

Sorry to hear your nurse was less than supportive but at least you have a few months to see what you can do. 
Her point about hypos is valid in some respects as 2 other relatively new members here who had very high HbA1c results (in 3 figures I think) and were on Gliclazide have experienced hypos after adopting a lower carb diet and both have decided to cut their medication and stick with the diet after their Health Care Professionals were not overly supportive. @Bazzlejet and @Newbie777 might be able to offer some support or inspiration to you. 
Your nurse's logic falls down a bit in that adding insulin to the mix increases your chances of having a hypo, so whilst your choice of treatment plan (ie diet and exercise) may risk hypos initially, it is working towards reducing the medication which can cause them, her plan is just increasing your medication to 2 lots of medication which can cause hypos. 

It is nigh on impossible not to have "carbs with every meal", short of eating protein and/or fat and nothing else (think winter Inuit diet of seal blubber) and who wants to do that, because vegetables provide all the colour and variation to our food, but cutting out the high carb bulky beige/white stuff should make a big difference to your levels. 

I should mention that if you are going low carb, you need to think about providing your body with an alternative form of fibre as most of us struggled with constipation when we cut out wholemeal bread and pasta etc. I have a fibre drink on a morning which consists of a glass of water with a tspn of chia seeds and a tspn of either psyllium husk or recentluy been using milled linseed. I also add a dash of balsamic vinegar and oddly a splash of diet cola to give it flavour but choose your own low carb flavouring. Give it a good stir and wait for it to absorb some of the water before drinking it. This will produce a bulk of gelatinous fibre which will pass through your digestive tract and keep it healthy and moving comfortably and easily . Chia and linseed are also packed with lots of great nutrients. Chia seeds are one of the highest sources of Omega 3. One of our members has them in his morning coffee instead of my weird concoction. They can also be put in soups or stews and are available in most supermarkets. I also try to include other seeds like hemp, sunflower, pumpkin, sesame etc. I tend to sprinkle those in my breakfast yoghurt with my berries... just a tablespoon or you can sprinkle them on salads etc. If you find the seeds a problem either with getting stuck in your gums or IBS, then psyllium husk in some flavoured water works well. It is the basis of the Fibogel sachets which are prescribed to people with bowl problems, but can be bought from health food shops or online unflavoured and added to whatever low carb drink you like or just plain water. It all does the same job and a teaspoon of the stuff is all you need. Some people even incorporate it into their low carb baking and we have some inspirational members who bake all sorts of cakes and breads and cheese cakes etc using very low carb ingredients instead of grain flour. It is absolutely amazing what you can achieve once you get your head around the whole process and no reason why you shouldn't enjoy your food as much if not more on a low carb diet. Fibre is a very important part of the process though.

Anyway, I think I have waffled on even more than usual so will call a halt for now but just want to wish you good luck and please keep us posted with your progress and reach out if you need any help or support. Some days will be reasonably easy and other days will be challenging. If you fall off the wagon, don't beat yourself up, just get back on and use the forum to help with motivational ideas and inspiration like reading posts by the 2 members I mentioned above as both are doing fantastic and their BG meter readings are evidence to that.


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## Catz63 (Feb 9, 2021)

rebrascora said:


> Sorry to hear your nurse was less than supportive but at least you have a few months to see what you can do.
> Her point about hypos is valid in some respects as 2 other relatively new members here who had very high HbA1c results (in 3 figures I think) and were on Gliclazide have experienced hypos after adopting a lower carb diet and both have decided to cut their medication and stick with the diet after their Health Care Professionals were not overly supportive. @Bazzlejet and @Newbie777 might be able to offer some support or inspiration to you.
> Your nurse's logic falls down a bit in that adding insulin to the mix increases your chances of having a hypo, so whilst your choice of treatment plan (ie diet and exercise) may risk hypos initially, it is working towards reducing the medication which can cause them, her plan is just increasing your medication to 2 lots of medication which can cause hypos.
> 
> ...


Thanks for your help and ideas.I'll let you all know how I get on.


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## stillgoing (Feb 9, 2021)

Lucyr said:


> The only downsides to insulin that I’ve found are all the carbohydrate counting and the driving restrictions. You have to test before driving, if under 4 then you have to eat something, wait 15 minutes until over 4, then wait a further 45 minutes. Sitting in the car for an hour in the freezing cold, without being able to start the engine to put the heating on, late on a dark night, and all because of a bg of 3.9 when you just want to be at home is a total pain.


I was told 5 to drive. My target level is 5 to 8 so that I should always be fit to drive.

Driving when you have diabetes | Diabetes UK

Have a look at this well known site. In my opinion not really clear what you do between 4.0 and 5.0. It seems to say eat some carb and then drive. Below 4.0 wait 45 mins once back to target. Above 5.0 fit to drive


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## Robin (Feb 9, 2021)

stillgoing said:


> Have a look at this well known site. In my opinion not really clear what you do between 4.0 and 5.0. It seems to say eat some carb and then drive. Below 4.0 wait 45 mins once back to target. Above 5.0 fit to drive


The 'Horse's Mouth' so to speak is here, foot of page 2. If below 5 (but over 4) eat a snack.


			https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/834451/inf294-a-guide-to-insulin-treated-diabetes-and-driving.pdf
		

My interpretation of it is that you only need to wait 45 minutes and until you’re over 5 before you drive if you were under 4, or had symptoms of hypoglycaemia (which I supposed some people might get if they are over 4) when you tested.


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## Newbie777 (Feb 9, 2021)

Hello,

Sorry to hear about the dilemma you are now facing.

Am glad that good advice has already been provided and hopefully this will help you.

You are on similar medicines to myself.

I am not an expert, so I can only mention my personal experience and may not be right for you, so please get medical advice as there may be other factors that only your GP can help you. I think, but not sure, Diabetic Nurses cannot prescribe medicine and would nees consult with the GP, so go straight to the GP.

I do not like the idea of going on insulin myself as I think it is a last resort and I don't like the dependancy on it.Medicine wise Glicizide can be increased to a max of 240mg, but not sure if that is suitable, one for your GP. Also, can I ask when do you take your Glicizide?

Yes, it's true that low carb is the way forward. However, I need to point out that I think slow steady change will be better, so keep some treats or hold on to some stuff for bad days, but start straight away with switching to almond milk and Brugen bread, that way you are replacing and not removing food, so it does not feel as bad. You will be amazed how changing to low carb eating will help you with.
1. Losing weight
2. Lowering your sugar  (BG) levels
3. Help you feel fuller for longer.

Finally, it would be rude of me not to mention how well you have done on losing your weight.Well done and keep up the good work!


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## grovesy (Feb 9, 2021)

Newbie777 said:


> Hello,
> 
> Sorry to hear about the dilemma you are now facing.
> 
> ...


If the Diabetic Nurse is a Nurse Prescriber they can can prescribe medicine. I not seen a GP for my Diabetes in nearly 15 years the nurses deal with everything.


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## rebrascora (Feb 9, 2021)

grovesy said:


> If the Diabetic Nurse is a Nurse Prescriber they can can prescribe medicine. I not seen a GP for my Diabetes in nearly 15 years the nurses deal with everything.


And will almost certainly be more knowledgeable than the GP in relation to Type 2 diabetes and probably Type 1 too although the latter might not be saying a lot.


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## grovesy (Feb 9, 2021)

rebrascora said:


> And will almost certainly be more knowledgeable than the GP in relation to Type 2 diabetes and probably Type 1 too although the latter might not be saying a lot.


Yes , and when I was first diagnosed my then GP (now retired) said I will leave it to Debbie ( she has since retired too) . One of my current nurses used to be the Lead Diabetic Nurse for the next town.


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## Newbie777 (Feb 9, 2021)

grovesy said:


> If the Diabetic Nurse is a Nurse Prescriber they can can prescribe medicine. I not seen a GP for my Diabetes in nearly 15 years the nurses deal with everything.


Oh ok thank you for clarify this and that makes sense.


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## Newbie777 (Feb 9, 2021)

grovesy said:


> Yes , and when I was first diagnosed my then GP (now retired) said I will leave it to Debbie ( she has since retired too) . One of my current nurses used to be the Lead Diabetic Nurse for the next town.


Yes, I guess as the name suggest General Practioner, not an expert on everything, unlike a specialist like a Diabetic Nurse.

My experience with Diabetic Nurses has been slightly poor though, with recommendations made to the GP to increase my medicine, year upon year.
Of course all this is totally my fault for poor BG control.


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## Drummer (Feb 9, 2021)

There seems to be a thing about 'needing fibre' to replace that from grains.
As I eat low carb veges, and it would have been my preferred menu all my adult life, I have never had any bother with constipation except when a well meaning HCP has pushed me to accept their print out diet sheet and to eat a low fat high carb diet. 
I have never been able to understand 'feeling full' - I presume that it is the sensation of the stomach being stretched by the amount of food consumed. That would always, in my mind, be associated with having eaten too much 'eyes bigger than the belly' behaviour. 
Having never stuffed myself it is not a sensation I would seek out as being a good thing. I do eat quite slowly, compared to me most people gobble down their food - I often wonder if they actually taste any of it. That might have something to do with it.


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## Newbie777 (Feb 9, 2021)

Drummer said:


> There seems to be a thing about 'needing fibre' to replace that from grains.
> As I eat low carb veges, and it would have been my preferred menu all my adult life, I have never had any bother with constipation except when a well meaning HCP has pushed me to accept their print out diet sheet and to eat a low fat high carb diet.
> I have never been able to understand 'feeling full' - I presume that it is the sensation of the stomach being stretched by the amount of food consumed. That would always, in my mind, be associated with having eaten too much 'eyes bigger than the belly' behaviour.
> Having never stuffed myself it is not a sensation I would seek out as being a good thing. I do eat quite slowly, compared to me most people gobble down their food - I often wonder if they actually taste any of it. That might have something to do with it.


Wow that's control for you.

Sorry to say I am the complete opposite of yourself in everyway and wish I was so much like you.Regular carvery, eating quick, over indulging etc. I would use excessive carb eating to think it would reduce/control my stress, but is not true and no excuse. But was then and not now.

I recently have gone on a low carb diet and constipation is an issue, so more water, an apple and from today Weetabix with almond milk for breakfast.


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## Drummer (Feb 9, 2021)

You might get more  - er - benefit - from a big green salad or a stir fry than having carby foods. 
I get a bag of ready made salad, add in beetroot, radishes, tomato, cucumber, celery, red sweet pepper, coleslaw, olive oil and wine vinegar dressing, - I need a big bowl, then add tinned fish, usually, or boiled eggs and cheese.
If I am frying something I might take the green sweet peppers, mushrooms, outer sticks of celery, courgette, any cooked veges left in the fridge tend to be tossed in as well, to make a stir fry.
I do have a very sensitive sense of taste, even at almost 70 - I used to work for Allied Lyons doing storage testing - picking up when things would start to go off by tasting. I often eat alone as I tend to exclaim at the different flavours as I eat - just can't help myself.
I think that most breakfast cereals are indistinguishable from their packaging.


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## Newbie777 (Feb 9, 2021)

Drummer said:


> You might get more  - er - benefit - from a big green salad or a stir fry than having carby foods.
> I get a bag of ready made salad, add in beetroot, radishes, tomato, cucumber, celery, red sweet pepper, coleslaw, olive oil and wine vinegar dressing, - I need a big bowl, then add tinned fish, usually, or boiled eggs and cheese.
> If I am frying something I might take the green sweet peppers, mushrooms, outer sticks of celery, courgette, any cooked veges left in the fridge tend to be tossed in as well, to make a stir fry.
> I do have a very sensitive sense of taste, even at almost 70 - I used to work for Allied Lyons doing storage testing - picking up when things would start to go off by tasting. I often eat alone as I tend to exclaim at the different flavours as I eat - just can't help myself.
> I think that most breakfast cereals are indistinguishable from their packaging.


Yes that is true 

I am on the right path, salad is once or  twice a day and I experiment with the ingredients, my  carb intake is now between 80g to 100g a day..

I had 1 Weetabix with almond milk and an egg for breakfast.
I do agree with what you are saying about cereals looking at the ingredients and there is a lot of stuff added.


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## Drummer (Feb 9, 2021)

Oh - I forgot to mention herbs and spices. They can really add to the experience of eating salads and veges.


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## JMyrtle (Feb 9, 2021)

Like Drummer I only eat twice a day and restrict carbs as much as possible.
One slice of Wholemeal Nimble is a good bet for breakfast as it's half the carbs of Burgan and Sheldon bottom cooked muffins are half the value of a bread roll. 
It's s also worth testing and comparing the different kind carbs you have with your meals to find what you can tolerate yourself as everyone is different, For instance I am fine with baked or whole potato, chips and pasta but not white bread, mashed potato  or rice.
I am also sorry to say this but you will have to get used to cooking two different meals for you and your husband, for example fish and chips, sausage and mash and Ulster fry are way off my menu but not his so I batch cook and keep my meals in the freezer for the days I need them when we don't eat the same thing.


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## Cjoy (Feb 9, 2021)

Do you test regularly? I’m newly diagnosed, and it has been really eye opening what sends the blood sugar sky high. It has been trial and error, measuring glucose level before and 2 hrs after eating, ditching foods that change the level by more than 3. But once I know I can eat something I don’t tend to test before/after. I’ve certainly found it has really helped in reducing my blood sugar.


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## JMyrtle (Feb 9, 2021)

I test four times  day, on rising, before and after my main meal and before going to bed,  provided my monthly average on the meter is below 7.5 I know I am in the normal range although its usually between 6.8 nd 7. 2
My GP said to keep a my sigle reading under 10.0 but I prefer to be below 8.0 so I know I'm still on track.


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## Bazzlejet (Feb 10, 2021)

Sorry to hear you're having difficulty gaining the support you need @Catz63. I'm in a similar boat, only spoke to my GP and GP Nurse (once). Haven't been able to get a response from the Diabetes Clinic yet, it's tough times for everyone at the moment, but I'll keep trying! 

There's been some great advice above. For me, reducing the carbs has significantly helped and to be honest, I haven't found it that difficult. Lots of advice out there regarding substitution of carb heavy food, and plenty of tasty recipes. It's really a case of change, more than anything!

My normal breakfast consists of 2 plain shredded wheat, 2 tablespoons of Greek yoghurt, 2 strawberries, raspberries and blueberries. Every other day, I change the fruit a bit, to plums, peaches, kiwi, blackberries. Once every week or so, I treat myself to a low carb 'grill up'. A rasher of bacon, 1 sausage, 1 egg, mushrooms and a tomato.

My lunch usually consists of salad and fish. The salad will nearly always contain spinach leaves, rocket, tomato, chia seeds, flax seed, sunflower seeds and 2 tablespoons of apple cider vinegar. To change it up a bit I will add avocado, grated carrot, grated cheese, a boiled egg, a rasher of bacon (cooked as crispy bits), mushrooms, bean sprouts or anything else that I have read up on. My fish is usually tinned mackerel, sardines, tuna or salmon (as a treat). With the tinned stuff you just need to keep an eye on the sauce/oil it's in. Again, to mix it up I will have an omelette with onions, tomato, peas, etc.

My evening meal is pretty much what I'm given. I'm very lucky though as Mrs Bazzlejet is a chef, so she has adjusted the family meal to suit. If I'm gonna have any carbs, this is where they will be. With this said though, portion size is everything, so a set of digital scales have been invaluable, as I can simply check what's going in.

Twice a month I will have a takeaway. One at work on a Saturday night shift and one on payday. I've not cut this out, I've just adjusted what I have. Where I would normally have a keema nan, a starter, rice and curry for an Indian Takeaway, I now just have rice and curry. Where I would normally have a 15inch pizza (please don't judge ) from our Kebab & Pizza place, I'm having a chicken shish kebab and leave the pita bread... so its basically grilled chicken and salad !

One point that's already been raised, and which cant be over emphasised is 'slow and steady'. Don't go cold turkey and get rid of the carbs to quickly. Gradually reduce them. My understanding is that reducing carbs to quickly can impact on the small blood vessels, especially the eyes. As my BG levels have reduced I have found that my eyesight changed quite significantly. Hopefully, having heard from others, my eyesight should get back to normal(ish) in a couple of months as my body gets used to my new, normal levels.

As for the medication, for me it looks like the Gliclazide (together with my diet change) was dropping me to low. I didn't take it yesterday and my readings all day were between 5.4 - 7.2. I will keep regularly checking to ensure my levels remain on track though, that's very important.

I feel like I've rambled on a bit here, so sorry about that . Well done on loosing the weight by the way, hopefully a change in eating will help you maintain it, as it has for me


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## everydayupsanddowns (Feb 11, 2021)

Hope your experiments go well @Catz63 

Do keep an eye on your BGs if you are trying to reduce carbs alongside meds which stimulate your pancreas to produce more insulin.


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## Catz63 (Feb 12, 2021)

Thanks everyone for the feedback. I started cutting back on carbs Wednesday this week. I also started including more exercise into my day. Reducing the carbs showed an immediate effect on my sugars but not as much as the drop I got after 45 mins of low impact exercise. Yesterday my bloods were 7.1 before breakfast. I had some Greek Yogurt with a small portion of granola with my morning coffee (with blue top milk). 2 hours later I checked my bloods and  BG was 8.4. By lunch I was hungry and so had cheese on a small piece of whole meal bread, toasted (my diabetic nurse insists I have some carbs in every meal) but before the meal I tested and the results made no sense, Bg was up to 13.8. I decided to do my 45 mins of exercise at half 2 and tested again before evening meal, Bg was down to 6.2. I had a salad with bacon and 3 small boiled potatoes and an oz of cheese over. I drank lots of water through the day. Checked it before bed I was down to 4.3, this seemed very low for me and I didn't want it to go any lower overnight so I had a cracker before going to bed. This morning before breakfast my Bg was 5.5 so something is working. If I can get hold of my diabetic nurse I will ask about reducing the Glicizide as the drop after tea was a tad extreme.


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## Newbie777 (Feb 12, 2021)

Catz63 said:


> Thanks everyone for the feedback. I started cutting back on carbs Wednesday this week. I also started including more exercise into my day. Reducing the carbs showed an immediate effect on my sugars but not as much as the drop I got after 45 mins of low impact exercise. Yesterday my bloods were 7.1 before breakfast. I had some Greek Yogurt with a small portion of granola with my morning coffee (with blue top milk). 2 hours later I checked my bloods and  BG was 8.4. By lunch I was hungry and so had cheese on a small piece of whole meal bread, toasted (my diabetic nurse insists I have some carbs in every meal) but before the meal I tested and the results made no sense, Bg was up to 13.8. I decided to do my 45 mins of exercise at half 2 and tested again before evening meal, Bg was down to 6.2. I had a salad with bacon and 3 small boiled potatoes and an oz of cheese over. I drank lots of water through the day. Checked it before bed I was down to 4.3, this seemed very low for me and I didn't want it to go any lower overnight so I had a cracker before going to bed. This morning before breakfast my Bg was 5.5 so something is working. If I can get hold of my diabetic nurse I will ask about reducing the Glicizide as the drop after tea was a tad extreme.


Well done for sticking on it, you are doing really well

My GP appointment is 3 weeks away, so am keeping off Glicizide, I still havent got it right as my reads in the evening are a low and guess that is down to very little carbs in the evening.

I do agree that exercise is also key and makes a difference, for me not just my BG levels but reduction of my high blood pressure.

I am not an expert, but is your high BG spike due to slow release of your medicine or perhaps the food?

Good luck, hope you can get hold of the DN.


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## trophywench (Feb 12, 2021)

Lucyr said:


> The only downsides to insulin that I’ve found are all the carbohydrate counting and the driving restrictions. You have to test before driving, if under 4 then you have to eat something, wait 15 minutes until over 4, then wait a further 45 minutes. Sitting in the car for an hour in the freezing cold, without being able to start the engine to put the heating on, late on a dark night, and all because of a bg of 3.9 when you just want to be at home is a total pain.


Lucy - I always tested my blood before leaving wherever I was before I walked to the carpark to come home.  Middle of a shop standing up or sitting at my desk in the office, inside people's houses - just wherever.  No point going out in the cold till I have to, mate!  I've always been nesh.


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## Catz63 (Mar 14, 2021)

Newbie777 said:


> Well done for sticking on it, you are doing really well
> 
> My GP appointment is 3 weeks away, so am keeping off Glicizide, I still havent got it right as my reads in the evening are a low and guess that is down to very little carbs in the evening.
> 
> ...


Hi when I got hold of my DSN she was impressed with my readings and agrees 4.2 before bed was too low and adjusted my Glicizide.I now have 1 and a half tablets before breakfast and take them before a meal not with, This seems to be working better. She actually said she would rather me be in the 6's before bed. Well some nights I'm high 5's so that should keep her happy. Mostly my BG is within the 4- 7 range. I don't test 2 hours after a meal any more as the slow release medication affects these readings. I usually test before break fast, before tea and before bed. My breakfast has changed recently I was on the Greek Yogurt with granola and fruit but the diary has begun to turn on me so I have gone continental and I'm  having ham,cheese and a hard boiled egg with my morning coffee. Its working, I'm not looking for snacks and quite often not really hungry at lunch time.
My joints have been giving me a lot of pain lately so not done as much exercise but still go for a walk each day weather permitting. My weight has dropped a few pounds  even with the high fat so it's all looking positive for now.
Thanks again to everyone;s contributions to this thread they have all been helpful.


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## everydayupsanddowns (Mar 14, 2021)

Catz63 said:


> Hi when I got hold of my DSN she was impressed with my readings and agrees 4.2 before bed was too low and adjusted my Glicizide.I now have 1 and a half tablets before breakfast and take them before a meal not with, This seems to be working better. She actually said she would rather me be in the 6's before bed. Well some nights I'm high 5's so that should keep her happy. Mostly my BG is within the 4- 7 range. I don't test 2 hours after a meal any more as the slow release medication affects these readings. I usually test before break fast, before tea and before bed. My breakfast has changed recently I was on the Greek Yogurt with granola and fruit but the diary has begun to turn on me so I have gone continental and I'm  having ham,cheese and a hard boiled egg with my morning coffee. Its working, I'm not looking for snacks and quite often not really hungry at lunch time.
> My joints have been giving me a lot of pain lately so not done as much exercise but still go for a walk each day weather permitting. My weight has dropped a few pounds  even with the high fat so it's all looking positive for now.
> Thanks again to everyone;s contributions to this thread they have all been helpful.



Ths sounds great @Catz63! Well done on your amazing progress, and congratulations on those levels.

Sorry to year about the joint pain, hopefully this will begin to ease as the weather warms. Is joint pain something you have had before or is it new?


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## Catz63 (Mar 14, 2021)

everydayupsanddowns said:


> Ths sounds great @Catz63! Well done on your amazing progress, and congratulations on those levels.
> 
> Sorry to year about the joint pain, hopefully this will begin to ease as the weather warms. Is joint pain something you have had before or is it new?


I have very loose joints and have suffered all my life with wrists slipping in and out when just getting up out of a chair the knees have been a problem since my teenage years. My shoulders, neck and elbows have become more painful since turning 40 when I had frozen shoulder aggravated by trapped nerves in my neck. So yes I have lived with pain for most of my life. It is always more painful during damp weather but can also play up with changes in barometric pressures both summer and winter. I don't sleep comfortably and sometimes need to take pain medication just to start the day. It comes in waves sometimes just the knees but at the momeny they are all joining force against me.  I have lived a long time with pain and I am still unable to get the Dr to prescribe anything useful that I wont get addicted to.


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## Drummer (Mar 14, 2021)

I use a fair few spice and herbs, and I am told that turmeric is good for joints  - I add a half teaspoon of it to my stews so it either works very well or I don't need it.
You might like to experiment, just in case it is the former.


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## Catz63 (Mar 14, 2021)

I've used tumeric in stews and curries for years I've tried it all over the years but thanks for the suggestion.


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## Drummer (Mar 14, 2021)

I don't come across many people who have the classic spices - no curry powder here.


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## Catz63 (Mar 14, 2021)

I used to do my own curries with all the spices but I mainly use Tumeric these days to add colour to rice and veg and either that or cumin in soups and stews. 

I used to take glucosamine for a long time but it didnt seem to help but I was carrying a lot of extra weight at the time so I might give a few thing another go now the weight is coming down.


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## Newbie777 (Mar 16, 2021)

Catz63 said:


> Hi when I got hold of my DSN she was impressed with my readings and agrees 4.2 before bed was too low and adjusted my Glicizide.I now have 1 and a half tablets before breakfast and take them before a meal not with, This seems to be working better. She actually said she would rather me be in the 6's before bed. Well some nights I'm high 5's so that should keep her happy. Mostly my BG is within the 4- 7 range. I don't test 2 hours after a meal any more as the slow release medication affects these readings. I usually test before break fast, before tea and before bed. My breakfast has changed recently I was on the Greek Yogurt with granola and fruit but the diary has begun to turn on me so I have gone continental and I'm  having ham,cheese and a hard boiled egg with my morning coffee. Its working, I'm not looking for snacks and quite often not really hungry at lunch time.
> My joints have been giving me a lot of pain lately so not done as much exercise but still go for a walk each day weather permitting. My weight has dropped a few pounds  even with the high fat so it's all looking positive for now.
> Thanks again to everyone;s contributions to this thread they have all been helpful.


Well done @Catz63,

Am glad you are getting there, it is very hard and you are determined and that is half the battle.

Well done and keep up the good work.


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## Catz63 (Mar 16, 2021)

_I used to take glucosamine for a long time but it didnt seem to help but I was carrying a lot of extra weight at the time so I might give a few thing another go now the weight is coming down._

_Since writting the above I have come accross information re Glucosamine in relation to diabetes and also glucoma. It can complicate both so we are advised to avoid it.I'm still waiting for a hospital appointment at eye clinic to confirm my Glucoma but my optician is monitoring it._


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## grovesy (Mar 16, 2021)

Catz63 said:


> _I used to take glucosamine for a long time but it didnt seem to help but I was carrying a lot of extra weight at the time so I might give a few thing another go now the weight is coming down._
> 
> _Since writting the above I have come accross information re Glucosamine in relation to diabetes and also glucoma. It can complicate both so we are advised to avoid it.I'm still waiting for a hospital appointment at eye clinic to confirm my Glucoma but my optician is monitoring it._


I took Glucosamine for a number of years never noticed any effect of my glucose levels, but also not  noticed any difference when I stopped taking it on my knee pain.


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## trophywench (Mar 16, 2021)

err, is it not the chondroitin that can help rather than the G - but there again depends what's actually the matter with the joints ......


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## grovesy (Mar 16, 2021)

Alot of supplements have both the one I took did.


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