Type 2 Diabetes

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Type 2 Diabetic? 5 things to do right now.

You’ve worked hard for your life. Children have left home. Now it’s your time. Time to be footloose and fancy-free. You’ve gained a bit of weight over the years. Things ache more than they used to. Energy, what’s that? Whenever you go to the doctor you’re given warnings about what could go wrong, but you’ve got time, it isn’t urgent. Or is it?

Finally the shoe drops. You visit the doctor and it’s no longer a warning, you are actually sick. You are sent off with a diet sheet and a prescription. Shell -shocked would be the best way to describe how you are feeling at the moment.

This wasn’t how it was supposed to be. You knew you were getting older but you still thought you were invincible. This kind of thing happens to other people, not to you. You don’t even want to talk to your friends about it. They might think you brought it on yourself. This isn’t what you had planned for your future.

This is something that 100,000’s of people around the world experience every day. This disease claims a life every 7 seconds. It doesn’t have to be this way.

 1: Don’t be fooled

As shocking as it is to be told you’re diabetic - it can often feel like nothing has changed. Most people still feel well and have no outward signs that they are diabetic. The fact that Type 2 diabetes is common can also mean it’s not taken as seriously as it should be.

The doctors and nurses can sometimes be blase about the diagnosis. They give out a prescription and a diet sheet and tell people to come back in 12 months.

All of this can mean it’s seen as a mild condition and that the medication means people can carry on as normal.

Don’t be fooled - diabetes is a serious disease and means that people lose 10 birthdays on average - that’s losing a decade of life!

The medication does not treat the underlying cause of diabetes - insulin resistance. The medication is only lowering blood sugars. That means that type 2 diabetes is a progressive disease unless the insulin resistance is treated.

The only way to treat insulin resistance it to change lifestyles, there is no magic pill out there that will make people sensitive to insulin again.

The Answer:

The medication does not treat the underlying cause of diabetes - insulin resistance. The medication is only lowering blood sugars. That means that type 2 diabetes is a progressive disease unless the insulin resistance is treated.

The only way to treat insulin resistance it to change lifestyles, there is no magic pill out there that will make people sensitive to insulin again.

2: Test your blood sugars yourself

This is the only way to know what is really happening. So many people I speak to are told by their doctor “there’s no point - don’t test yourself”. They are wrong.

The doctor is basing their information on studies that were done on self-monitoring blood glucose at home. The studies showed that it made no difference at all.

BUT (remember, ‘but’ negates everything that’s gone before it…) the people in the studies weren’t shown how to interpret the data or make changes to their diet as a result of the readings. That makes testing totally pointless in the studies.

Without knowing how to interpret the data - it’s just numbers and means nothing.

The Answer:

The International Diabetes Federation is very clear in its guidelines and recommends self-testing for all diabetics - provided they are given support and training on how to use the data to get better control.

Some people I speak with say they don’t like testing as they feel fine and it reminds them that they’ve got something wrong with them. The downside with that approach is that they will be blindsided by diabetes in the future - when they could take action now to stop that happening.

Time isn’t on your side when you're diabetic.

3: Get your HbA1c tested every 3 months

The regular blood test your doctor uses to measure your diabetic control is called the Hba1c (or A1c) test. Your Red blood cells are being created all the time and live for about 12 weeks.

Sugar (glucose) attaches to the red blood cell as it circulates. The more sugar in the blood, the greater the amount of sugar sticking to the red blood cell. The sugar sticks to your red blood cells - candy coating them. The sugar doesn’t coat it like a smooth M&M, it encrusts it with rough sugar molecules, think more like sand. This is how high blood sugar does all the damage to your small blood vessels.

The Hba1c test simple measures how candy-coated your red blood cells are. It gives us an indication of how much sugar you had in your bloodstream while the blood cell was circulating in its 12-week lifespan.

The Answer:

Don’t wait for the letter from your doctor - call and book the appointment yourself. The Hba1c will give you an average of blood sugar levels over a 3 month period.

The changes that you make will show up quite quickly and it makes it easier to see what is working and what’s not and take action. Waiting 6-12 months between tests makes it much harder to see patterns. 

4: Be an annoying patient

Ask questions - lots of them - all the time. Be that annoying person who visits the doctor with printouts from the internet. Search Google for the latest information on type 2 diabetes and look for answers. 

Your doctor won’t have all the answers. They are not a specialist in type 2 diabetes and your life. You are the expert in that area. I often have situations where my clients become the teachers and they train the medics! Their doctor is initially skeptical but as they see the changes in their patient they become enthusiastic and want to know all the details.

The Answer:

If your doctor wants to increase or change your medication ask why. Ask them for the research that supports that. Statins are a great example of this. It’s really common when people are diagnosed that they are put on metformin and a statin. There’s good evidence for the metformin - but not for the statin. There’s no evidence that a statin will benefit a healthy type 2 diabetic.

5: Don’t follow the standard dietary advice

I often hear from people that they were told ‘just to cut back’ with no specifics at all. Let me tell you about Bill. Bill was diagnosed with type 2. He was given the obligatory diet sheet. Bill asked his doctor if coffee was ok - the doctor said yes, but asked Bill no further questions about his diet at all.

It turns out that Bill loves coffee - drinking about 10 cups a day. What the doctor didn’t ask was “does Bill have anything in his coffee”. If only Bill had been asked. 

Bill doesn’t have anything in his coffee now - he’s lost 20 lbs and his sugars are fine without medication.

But Bill was having 2 tsp of sugar in each coffee - that means 20 tsp of sugar a day! Once he stopped the coffee (he couldn’t stand it without sugar) his sugars and his weight dropped like a stone. Sometimes it can be obvious things hiding in plain sight that can make all the difference to blood sugar control.

The Answer:

The standard diet sheet handed out to diabetics will not help either. The advice is based on a diet of starchy carbohydrates. When you are diabetic it doesn’t matter if it’s brown rice, whole grain pasta or wholemeal bread.

The body breaks down all carbs into sugar. Exactly the substance that diabetics are advised to avoid. Following the standard advice on diet is going to make diabetes worse.

Eating more whole foods and limiting carbohydrates is one approach that is shown to have big benefits for diabetics.

You don't have to miss out treats. Here's how chocolate helps your heart and diabetes.

What advice and support did you get given when you were diagnosed?