new sufferer - advice needed

[Dejacq]

My husband has just been diagnosed with Type 2 Diabetes. Could anyone
recommend a good web site so I can find out more about it please?

Also, I'd be grateful if anyone could answer me a couple of queries;

He's been prescribed gliclazide at a dose of 80mg morning and night to get
his blood sugar down but it's still never dropping below 14 and varies
between 14 and 25. How high is this in relation to other diabetes sufferers?

Also, I've read that high blood sugar long term can affect the heart and
circulation etc but HOW?

What effect does the odd can of lager or glass of wine have on his blood
sugar? Is he allowed it occasionally or is it a definite no no? And what
kinds of meals should I be doing? Obviously he's no longer having apple pie
and cream or trifle etc but what about main meals? And are there any
desserts he could have, other than fruit salad?

His main symptom was his thirst and also the blurring of his eyes. His
eyesight is still blurred - will that recover?

He's a little bit overweight but nowhere near the obese level and does a
reasonable amount of exercise but his mother has had type 2 for years.
Thanks for any help

[RodS]

Post by Dejacq
My husband has just been diagnosed with Type 2 Diabetes. Could anyone
recommend a good web site so I can find out more about it please?
Also, I'd be grateful if anyone could answer me a couple of queries;
He's been prescribed gliclazide at a dose of 80mg morning and night to
get his blood sugar down but it's still never dropping below 14 and
varies between 14 and 25. How high is this in relation to other diabetes
sufferers?
Also, I've read that high blood sugar long term can affect the heart and
circulation etc but HOW?
What effect does the odd can of lager or glass of wine have on his blood
sugar? Is he allowed it occasionally or is it a definite no no? And what
kinds of meals should I be doing? Obviously he's no longer having apple
pie and cream or trifle etc but what about main meals? And are there any
desserts he could have, other than fruit salad?
His main symptom was his thirst and also the blurring of his eyes. His
eyesight is still blurred - will that recover?
He's a little bit overweight but nowhere near the obese level and does a
reasonable amount of exercise but his mother has had type 2 for years.
Thanks for any help

Better informed people than me will be along soon here is some sites to
help you.

NEWSGROUPS:
alt.support.diabetes
misc.health.diabetes
alt.food.diabetic
alt.support.diet.low-carb

Blogs:
http://loraldiabetes.blogspot.com/2006/10/d-day.html
http://loraldiabetes.blogspot.com/

Support sites:

http://www.diabetes-support.org.uk/


(- -)
=m=(_)=m=
RodS T2
Australia

[GysdeJongh]

Post by Dejacq
My husband has just been diagnosed with Type 2 Diabetes.
He's been prescribed gliclazide at a dose of 80mg morning and night to get
his blood sugar down but it's still never dropping below 14 and varies
between 14 and 25. How high is this in relation to other diabetes sufferers?

Hi Dejacq,
sorry to hear that and welcome :)

I'm just an other diabetes type II patient
I'm no dokter

Here are my two cents :
Go back to your dokter TODAY
Tell him about your blood sugar : between 14 and 25 mmol/l
It should be below 7.5 _Always_ If your dokter does not act
_Iimmediately_ than ask for a second opinion.

Here is the American College of Endocrinology Consensus Statement on
Guidelines for Glycemic Control from 2002.It contains all the normal
bloodsugar values in American Units, devide by 18 to get the continental
values in mmol/l.There is a newer version but it is not free and about the
same.

In the mean time stay tuned and follow Rod's links

Free :
http://www.aace.com/meetings/consensus/dcc/pdf/dccwhitepaper.pdf#search=%22%22ENDOCRINE%20PRACTICE%20%22%20%2Bconsensus%20%2BGlycemic%22

Newer version, not free :
http://www.ncbi.nlm.nih.gov/pubmed/17613449?dopt=Citation
Endocr Pract. 2007 May-Jun;13 Suppl 1:1-68.
American Association of Clinical Endocrinologists medical guidelines for
clinical practice for the management of diabetes mellitus.AACE Diabetes
Mellitus Clinical Practice Guidelines Task Force.
PMID: 17613449

hth
Gys

[John Williamson]

Post by Dejacq
My husband has just been diagnosed with Type 2 Diabetes. Could anyone
recommend a good web site so I can find out more about it please?
Also, I'd be grateful if anyone could answer me a couple of queries;
He's been prescribed gliclazide at a dose of 80mg morning and night to
get his blood sugar down but it's still never dropping below 14 and
varies between 14 and 25. How high is this in relation to other diabetes
sufferers?

High, but controllable with experience. Cut down the carbohydrates. If
you can find it, there's a book I use called "The Fat, Calory, and
Carbohydrate Counter" which lists most foods, and there are other
sources, including websites, that people will point you towards.
Has he also been prescribed Metformin? If not, it might be worth
politely asking why not.

Post by Dejacq
Also, I've read that high blood sugar long term can affect the heart and
circulation etc but HOW?

There's more details on the medical websites, but basically, high blood
sugar makes the blood more viscous and sticky, which affects blood
circulation, especially in the smaller blood vessels such as those in
the eyes, liver, kidneys and round the edges (Fingers, toes...)

It also makes the system more sensitive to cholesterol, but one problem
at a time.....

Post by Dejacq
What effect does the odd can of lager or glass of wine have on his blood
sugar? Is he allowed it occasionally or is it a definite no no? And what
kinds of meals should I be doing? Obviously he's no longer having apple
pie and cream or trifle etc but what about main meals? And are there any
desserts he could have, other than fruit salad?

Alcohol has the same effect as any other calories, in that it will raise
the Blood Glucose levels. I don't think *any* diabetic I know of is
abstinent because of their diabetes. A beer or wine (or two) now and
again isn't a problem, just count it as one of your treats. If it's
beer, then a premium lager has a lot less sugar in it than Bitter or
Mild. If it's wine, a dry red is better than a sweet white. The carbs
are generally on the label nowadays if you buy it in a shop.

As to the kinds of meals, good, balanced meals, with not too many
carbohydrates, checking his Blood Glucose before, and, to start with, 90
minutes after to find out what's happening. Others will say an hour and
2 hours after eating, which gives a better idea, but costs a fortune
unless you're getting strips on prescription. It's possible, but the
general experience is that they're *very* hard to get prescribed.

Fruit salad is acceptable as a dessert, as long as it's drained and has
never been in syrup. Easier just to eat some fruit as it comes.

Post by Dejacq
His main symptom was his thirst and also the blurring of his eyes. His
eyesight is still blurred - will that recover?

As his Blood Glucose levels get better over time, his eyes will improve.
See an Optician, though there's no immediate panic to, telling him
that he's a newly diagnosed diabetic. There may already be retinal
damage, though it's highly unlikely, and it's easily treated if it's
caught early. If he wears glasses, his prescription will probably change
slightly.

Post by Dejacq
He's a little bit overweight but nowhere near the obese level and does a
reasonable amount of exercise but his mother has had type 2 for years.
Thanks for any help

Keep up the exercise, keep control of the diet, and that'll stop most
complications before they start.

Read this page:-

http://www.diabetes-support.org.uk/joomla/jennifers-advice

Then the rest of the site.

Oh, and one final piece of good news, if you're in the UK, once he
registers, *all* prescriptions are now free.

[Alan S]

On Tue, 19 May 2009 09:53:13 +0100, John Williamson

Post by John Williamson
Alcohol has the same effect as any other calories, in that it will raise
the Blood Glucose levels.

Sorry John, that's not correct.

Not all calories are created equal when it comes to raising
blood glucose levels. Alcohol definitely will not raise
them.

Straight alcohols will have no direct affect, but can
actually have a secondary effect of causing low blood
glucose levels. One of the biochemists can explain why.

Read here for more support for that comment (just the first
of several that appeared in a search):
http://tinyurl.com/oqdv37

However, the carbohydrates that alcohol may be packaged in
or mixed with can raise blood glucose levels. For example,
beer has carbs, so does sweet wine or a sugared liqueur or a
rum and regular coke. But a dry red wine or a straight
scotch will have no BG increasing effect.

As a side issue, the calories in fat will also have almost
no effect and the calories in protein will have a much
slower and lower effect over a longer period when compared
to carbohydrates. As I said, all calories are not equal for
BG effects.


Cheers, Alan, T2, Australia.
--
d&e, metformin 2000 mg
Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (Aspartame)
http://loraltravel.blogspot.com (Jerash, an Ancient City in Jordan)

[Bernard Peek]

Post by Dejacq
He's a little bit overweight but nowhere near the obese level and does
a reasonable amount of exercise but his mother has had type 2 for
years. Thanks for any help

Talking to other diabetics will often get you little tips that can help.
You might suggest to your husband that he drops in here himself.

I'll just reiterate one piece of advice. It's often called sugar
diabetes but that's a bit misleading. Sugar in the diet is only a small
part of the problem. It's sugar in the bloodstream that causes the
symptoms.

Reducing dietary sugar is a good thing but in most people's diets their
blood-glucose is mainly derived from carbohydrates like starch. That's
why you should put most effort into eliminating easily digested starch
as well as sugar from his diet. It's not just a question of changing the
amount of starch he eats but also of changing the form he eats it in.
Avoid mashed potato and serve roast potatoes instead. Eat more green
vegetables because they provide bulk with almost no calories.

Nothing is completely forbidden although it's a good idea to start off
with a strict diet in the early stages. That's for physiological and
psychological reasons.

In the long run your husband should also seriously consider increasing
the amount of exercise he gets. That can have as much effect as a change
in diet. Sell the car, buy a rowing-machine.

[Jonathan Ellis]

Post by Dejacq
My husband has just been diagnosed with Type 2 Diabetes. Could anyone
recommend a good web site so I can find out more about it please?
Also, I'd be grateful if anyone could answer me a couple of queries;
He's been prescribed gliclazide at a dose of 80mg morning and night to get
his blood sugar down but it's still never dropping below 14 and varies
between 14 and 25. How high is this in relation to other diabetes sufferers?
Also, I've read that high blood sugar long term can affect the heart and
circulation etc but HOW?
What effect does the odd can of lager or glass of wine have on his blood
sugar? Is he allowed it occasionally or is it a definite no no? And what
kinds of meals should I be doing? Obviously he's no longer having apple
pie and cream or trifle etc but what about main meals? And are there any
desserts he could have, other than fruit salad?
His main symptom was his thirst and also the blurring of his eyes. His
eyesight is still blurred - will that recover?
He's a little bit overweight but nowhere near the obese level and does a
reasonable amount of exercise but his mother has had type 2 for years.
Thanks for any help

I believe he's been put on totally the wrong medication right from the
start. Especially for someone with a family history of "type 2" which
involves insulin resistance.

Important questions are:

(1) Does his blood sugar tend to come down slowly, overnight, over a long
period? If so, it implies he is still producing SOME insulin - but not
enough for his needs. This could imply (a) that he is not producing enough
(hence the gliclazide treatment - which will eventually end up being
replaced, in the long term, by injections of a slow-acting "background"
insulin such as Lantus or Levemir) - but this is not proving adequate.
Therefore I also conclude (b) that he suffers from insulin resistance and
should be put on Metformin immediately. It's the standard first treatment
for type 2's anyway, and is unlikely to have much in the way of side
effects. Typical doses are: 2x 500mg tablets twice a day, or 1x 850mg tablet
3x per day. If this isn't sufficient, he may be tried on another drug such
as Rosiglitazone or Pioglitazone (tradenames: Avandia, Actos), but the
chances are that he'd be insulin-deficient too, and thus need the gliclazide
treatment (or, later on, Lantus or Levemir injections) IN CONJUNCTION with
metformin - NOT as a replacement for it.

(2) How do meals affect it? Does his blood sugar come down to pre-meal
levels within 2 hours of the meal? If so, then his body's capable of
producing insulin "spikes" to cover the mealtimes, for all that he's got
messed-up levels of blood sugar. This would imply that insulin resistance is
his primary problem (i.e. standard type 2). If the answer is "well, no, it
doesn't come down at all except slowly over several hours", then it means
he's not coping with meals. This MAY improve on metformin (reduced insulin
resistance means reduced insulin needs, meaning that the body may actually
be able to cope with the lower demand, having failed to cope with the higher
demand): if it doesn't, then he will need insulin injections of a
fast-acting insulin type (such as Humalog or Novorapid), tailored specially
to meal times and to the contents of each meal. Because what you don't want
is to be *slowly* reacting to a post-meal blood sugar spike - what that
leaves you with, is both too much sugar AND too much insulin in the blood
simultaneously, and the latter may increase any problems you might have with
insulin resistance... or result in having an unexpectedly hidden overnight
hypo when you finally, after eight hours, get back down to "normal" and
still have too much insulin in the system. Ideally, whatever you get from a
meal, should be dealt with, within a couple of hours, returning to a
"stable" background level at whatever you were before the meal.

(I found this out, for myself, the hard way: having recently gone on
Novorapid insulin, I discovered that an increased dose of the slow-acting
Levemir is DIRECTLY in correlation with making the Novorapid work far less
efficiently and far more slowly - for instance, what should start acting
after an hour and finish in three, took nearly twice as long to knock off
half as much blood sugar, compared with after I reduced the Levemir dose.)

In both cases, proper understanding of diet helps, as does having a decent
amount of exercise.

But. This is VERY IMPORTANT. Talk to your doctor and ask him to try you out
on metformin - straight on to a full-sized dose.

Jonathan.

[Phil Launchbury]

Post by Jonathan Ellis

Post by Dejacq
My husband has just been diagnosed with Type 2 Diabetes. Could anyone
recommend a good web site so I can find out more about it please?
Also, I'd be grateful if anyone could answer me a couple of queries;
He's been prescribed gliclazide at a dose of 80mg morning and night to get
his blood sugar down but it's still never dropping below 14 and varies
between 14 and 25. How high is this in relation to other diabetes sufferers?

I believe he's been put on totally the wrong medication right from the
start. Especially for someone with a family history of "type 2" which
involves insulin resistance.

It now seems to be the standard for new non-obese T2s (it's what I was
put on when newly diagnosed).

Post by Jonathan Ellis
Therefore I also conclude (b) that he suffers from insulin resistance and
should be put on Metformin immediately. It's the standard first treatment

Metformin alone did pretty much diddly-squat for me. I was taking
2500mg/day and my BG was still rising. Adding pioglitazone (30mg) into
the mix worked wonders..

Which all goes to underline that a 'one treatment fits all' approach
doesn't work. Prescribe, test, change if needed, retest seems to be a
much better approach. Unfortunately it relies on two things - clued up
GPs and clued-up diabetics. Neither of which appear terribly common..

Post by Jonathan Ellis
for type 2's anyway, and is unlikely to have much in the way of side
effects. Typical doses are: 2x 500mg tablets twice a day, or 1x 850mg tablet

It had pretty nasty side effects on me.. permanent diahorrea for a
couple of weeks for one!

Post by Jonathan Ellis
In both cases, proper understanding of diet helps, as does having a decent
amount of exercise.

Indeed.

Phil

[Colin Reeves]

Post by Phil Launchbury
Metformin alone did pretty much diddly-squat for me. I was taking
2500mg/day and my BG was still rising. Adding pioglitazone (30mg) into
the mix worked wonders..

Agree that one size does NOT fit all! I was put on pioglitazone when BS
got over high. Did not work with me though - ended up on the jabs!

[Mike]

Post by Dejacq
My husband has just been diagnosed with Type 2 Diabetes. Could anyone
recommend a good web site so I can find out more about it please?
Also, I'd be grateful if anyone could answer me a couple of queries;
He's been prescribed gliclazide at a dose of 80mg morning and night to get
his blood sugar down but it's still never dropping below 14 and varies
between 14 and 25. How high is this in relation to other diabetes sufferers?

It's very high but not unusual for a newly diagnosed diabetic. , look
for 4 - 5 before meals, and more importantly an absolute max of 8 two
hours after meals. Below 5 first thing in a morning is good

Post by Dejacq
Also, I've read that high blood sugar long term can affect the heart and
circulation etc but HOW?
What effect does the odd can of lager or glass of wine have on his blood
sugar? Is he allowed it occasionally or is it a definite no no? And what
kinds of meals should I be doing? Obviously he's no longer having apple pie
and cream or trifle etc but what about main meals? And are there any
desserts he could have, other than fruit salad?

Yogurt, as long as it's low in carbs and low in sugars. Nuts (not
salted peanuts!) and cheese - but no grapes!

Post by Dejacq
His main symptom was his thirst and also the blurring of his eyes. His
eyesight is still blurred - will that recover?

Almost certainly, when the blood sugar is under control.

Post by Dejacq
He's a little bit overweight but nowhere near the obese level and does a
reasonable amount of exercise but his mother has had type 2 for years.
Thanks for any help

Look at what fuels the blood sugar, a proportion of it is from the
liver but the rest, and a very significant proportion comes from diet.

*Seriously* assess the level of carbohydrates being consumed.
Weigh everything (with carbohydrate) he eats or drinks for one day.

If he is currently eating 150-200g of carbs a day then eat 50-100g of
carbs for one day and see the way the blood glucose changes.

If you see a significant change, without the blood glucose dropping
through the floor (initially view anything sub 4.0 as 'bad') reduce
the carbohydrate portion size on a semi-permanent basis and eat more
protein, 'fats' and green vegetables.

You'll find heaps of conflicting advice on 'diabetic diets' and some
will recommend starchy food and low fats. The key is 'good fats' in
quantity and reduced carbs. Trust me, It's a complete waste of time
trying *anything* else - it's chemistry and a bit of biology and not
rocket science.

--

[Dejacq]

Thanks for all the advice.
Why no grapes?
Are some carbs better than others? ie wholewheat pasta, wholegrain rice,
jacket potatoes or does it all have the same effect?
Yes his blood sugar comes down overnight and gradually after meals. It's
averaging now between 8 - 14
Thanks again

[John Williamson]

Post by Dejacq
Thanks for all the advice.
Why no grapes?

Because they're choc-full of ready dissolved sugar, which will cause a
quick and very large short lasting increase in blood glucose. Bananas do
the same for some people.

Post by Dejacq
Are some carbs better than others? ie wholewheat pasta, wholegrain rice,
jacket potatoes or does it all have the same effect?

Generally, and it's not always 100% predictable, the less refined a
carbohydrate is, the slower it acts. So, white bread acts faster on your
blood glucose than wholemeal, other things being equal, rice of any sort
is not recommended, in my opinion, as it's all short chain, fast acting
carbs inside the grain, with the only slowdown in absorption being
caused by the "wrapper" left on the wholegrain rice, jacket potatoes are
a "fast carb" food where I always eat the skin and add fat such as
butter, cheese or margarine as well, to slow down absorption of the
carbohydrates.

Post by Dejacq
Yes his blood sugar comes down overnight and gradually after meals. It's
averaging now between 8 - 14

To put it possibly over-simply, it seems he's making not quite enough
insulin in total, not fast enough to get the spike in level down quickly
after a meal. There's a proper name for it that eludes me at the moment.

Complex carbs, such as wholemeal bread will help, but there are probably
still too many carbs in his diet. One small potato with his evening
meal, leave the top slice off the sandwich, that sort of thing. It's
possibly needed only for a while, until the levels are better, then he
can add stuff and see what happens.

If it's a couple of hours after, then it's heading the right way, and he
should be aiming for the lower end of that range.

Hope this helps.

[Bernard Peek]

Post by Dejacq
Thanks for all the advice.
Why no grapes?
Are some carbs better than others? ie wholewheat pasta, wholegrain
rice, jacket potatoes or does it all have the same effect?

It's not just the amount of carbohydrate it's the speed with which it's
digested. So wholemeal bread is definitely better than white bread,
whole wheat pasta is better than white. If you look around you will find
references to "GI" or glycaemic index. That's a measure of how fast the
food gets converted into blood sugar. Look for low GI foods.

Grapes are stuffed full of sugar syrup, which will go through the
stomach wall and into the bloodstream in no time at all. Many diabetics
can't tolerate even a few grapes.

Post by Dejacq
Yes his blood sugar comes down overnight and gradually after meals.
It's averaging now between 8 - 14

That's a lot better.

[Robert Miles]

Post by Dejacq
My husband has just been diagnosed with Type 2 Diabetes. Could anyone
recommend a good web site so I can find out more about it please?
Also, I'd be grateful if anyone could answer me a couple of queries;
He's been prescribed gliclazide at a dose of 80mg morning and night to get
his blood sugar down but it's still never dropping below 14 and varies
between 14 and 25. How high is this in relation to other diabetes sufferers?

[snip]
A good web site to start with is:

http://alt-support-diabetes.org/new.php

Dry wine, especially dry red wine, is often acceptable, but usually not
the other types which contain more natural sugar. I'm not familiar enough
with lager to know how good or bad it is, but you need to check the
carbohydrates content and choose something low in carbohydrates.

I'm in the US, but if I've converted my readings correctly, they are
usually between 5 and 6 the way you measure them at least half of the
time.

Robert Miles

[Nick Cramer]

Post by Robert Miles

Post by Dejacq
My husband has just been diagnosed with Type 2 Diabetes. Could anyone
recommend a good web site so I can find out more about it please?
Also, I'd be grateful if anyone could answer me a couple of queries;
He's been prescribed gliclazide at a dose of 80mg morning and night to
get his blood sugar down but it's still never dropping below 14 and
varies between 14 and 25. How high is this in relation to other
diabetes sufferers?

[snip]
http://alt-support-diabetes.org/new.php
Dry wine, especially dry red wine, is often acceptable, but usually not
the other types which contain more natural sugar. I'm not familiar
enough with lager to know how good or bad it is, but you need to check
the carbohydrates content and choose something low in carbohydrates.
I'm in the US, but if I've converted my readings correctly, they are
usually between 5 and 6 the way you measure them at least half of the
time.

I'm in the US, too. I was raised on dry red wine and drink about one bottle
spread out over a week. I love beer, too, especially a Guinness
Stout or a good dark Belgian. I like lagers, too. I'll have a bottle or can
of beer with a high protein and fat meal, maybe once every two months, as
alone, it spikes me really bad. I don't at all care for light beer.