Scared & In Denial of Type 2

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I am scared, ashamed and in denial of my type 2 diagnosis 3 ½ yrs ago at age 60, HBA1c 6.5. Managed since then by diet and exercise, but with very little GP monitoring, mostly my fault. The 6 month follow-up reviews have slipped to 12 months, nobody reminds me if I miss one, which suits my denial, I know it’s stupid but I’m almost trying to pretend it isn’t there.

I was put on the short Intro to Diabetes course and a 4 part dietetic course, simply focused on losing weight. Llittle about management of diabetes diet, which is different to just losing weight! I lost 8kg but then lost motivation. Sadly with conveyor belt 8-10mins GP / nurse appointments, I just feel a nuisance, feels like they are clock watching!

My latest glucose reading is 7.2 but I know it could be better if I both managed it and fully accepted what I have, BMI now shows 26.7. The GP wants to review in 3mths for Metformin which terrifies me, it seems to have so many side effects! But I don’t really know how to manage my diabetes, what and how to eat, there is so much confusing/conflicting advice out there.

I swim energetically 4 times a week and my diet and meals are mostly sensible, until late evening, extreme fatigue and hunger so the ‘easy’ fix is to eat to relieve it, not go to bed. So the good dieting is easily undone. I know nothing about hypo’s or hyper’s, all confusing.  Doesn’t help that they say there isn’t a specific diabetic’s diet! But I beg to differ, of course there has to be, not special foods but a specific dietary approach. Low, slow-release carbs, protein, the right fruit & veg, avoid high sugars, small well-spaced meals etc. And that’s just the little I have grasped, is it correct?

I always thought that if anything big like this happened I would be open with myself and others. But I feel like those people on Embarrassing Bodies who can’t tell the GP or their nearest but can open up to 8m people! The overly PC hands-off approach doesn’t help either when the clinicians won’t spell out exactly what you are getting in to. How can they let overweight patients pass through their surgery for decades without spelling out the risks, then say …….  “Oh, by the way, you’re diabetic”?

I’m not a Blog person and there is so much opinion and is the info reliable? I followed the thread here from poor barbara26695, worried sick with a sugar level of 9.5 reading and fearing a T2 diagnosis. After 70 replies and much opinion and advice; she was pronounced clear with a 4.5 normal sugar level.

Please don’t scare me with too much info and also who am I talking to? Someone with a lot more knowledge than me, coz mine is very little? 

Can anyone help me please? Thank you.

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  • Posted

    Hello there Clive.

    If it's any help to you I am 71 years of age, male and also have T2 diabetes.

    The first point I would like to make is that there is absolutely no point in being 'in denial', whatever it is you mean by that.

    Diagnosed diabetes is a 'fact', so there is nothing to be in denial about.

    If you mean that you cannot understand why this has happened to you because your health up to this point has been good, then please be assured that it is not uncommon for older people like ourselves to receive a diagnosis of being 'pre diabetic', or as in our cases 'fully diabetic', apparently having arrived out of the blue.

    The reality is that as we get older, our Pancreas produces less insulin to cope with the simple sugars occurring in our diet.

    When it comes to coping with this autoimmune condition, you will probably find the most helpful and knowedgeable person in your doctor's surgery to be the diabetes nurse, who solely specialises in this subject.

    Most doctors initially try to encourage us to control our diabetes by exercise and diet, but when it is demonstrated that this isn't working, then you will be invited to take a medication.

    Depending upon how severe your diabetes actually is will determine which medication is most suitable for you, which could range from oral tablets to injections - but initially oral Metformin is prescribed as the 'starter'.

    In some cases because of other prevailing health conditions such as Pernicious Anaemia, Metformin cannot be prescribed because it is known for this medication to attack the iron within the body, so worstening the anaemia.

    So in this instance, as an alternative medication Linagliptin can be given, and where that doesn't work or disagrees with your system, then Gliclazide can be used, but there are many alternatives to chose from.

    So what I am trying to say to you Clive is as your doctor appears to have everything under control, then you really have nothing to worry about.

    Just do your best to cut down (not completely cut-out) such things as sugar, biscuits, pastries, carbohydrates and continue with as much excercise as you feel comfortable to take,

    If you need any further information please feel free to PM me by clicking the small envelope icon near to my display name. 

     

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    • Posted

      Hello Archemedes and a big thank you for your thorough and sensitive reply. I have just returned from doing 50 lengths of the pool so I am keeping up the exercise bit, diet is also quite good - until just before bedtime and then I am ravenous. If I start eating there is no stopping! I can't explain it because I don't understand what is going on in my body.

      Thank you for explaining the different medications, I want to avoid any of them for as long as possible because all I seem to read of are side effects not benefits. I would want them to make my life better not worse! Please convince me it is mostly positive?

      I understand that the diabetic nurse is probably my best ally at the GP practice but it is always such a long wait even for an 8-10 min appointment, many weeks for a double plus needing to justify it.

      To clarify my initial statements:-

      Shame - there isn't a of of sympathy out there for type 2 and one doesn't exactly shout about it. In fact it is difficult to manage it in secret, but I don't want others to know. Rightly or wrongly it is judged by others as a lifestyle error and a consequence of that. I also come from a long line of healthy relatives all living well into their 80's - 90's, Dad made it to 94. A tall order to live up to, or survive to! Then there is me with a life-limiting probably self-induced condition identified at 60! 

      Denial - I am not suffering unduly in these early years and I am not on medication (yet) so it is all too easy to carry on regardless. A bit like smokers denial I suppose. I do watch what I eat, exercise regularly but I don't want to be checking my blood sugar every meal, if that time comes then so be it. But I don't want to make a hobby of it, I will understand what I need to do, and do it, and get on with life! Even if people ask why I don't eat / drink certain things I will make an excuse about watching my weight or similar. My GP did say a year ago when I broached this denial that there is a course/ counselling for this? Any ideas?

      I could go on, and usually do! I am just pleased to have found sympathetic and helpful dialogue and thank you again. I am slowly getting there but I do probably need to enlist a close friend's support, I have told almost nobody for these 3+ years and only referred to my 'high sugar levels' to my family. What's in a name? I'm not proud of being type 2, but I don't want it to limit the length of my life unduly either. Do I need a head doctor or am I being my own counsellor? With the waiting lists you almost need to be your own.

      Many thanks

       

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    • Posted

      Hello again Clive.

      Please let me assure you that you have nothing to hide when it comes to diabetes. You like the rest of us didn't open the door to it and say 'hail fellow, well met', - it just arrived as any unwelcome guest would do, but unlike the guest, will never leave.

      Having said this, it would probably be a good thing if you could let your guard down and discuss it freely with friends and family, because from personal experience I have found that they do make allowances. and try to understand the extent of the changes we have had to make in our lives to accomodate this condition.

      Please remember, the word 'diabetes' is not a dirty word - unfortunately in our society it is becoming all to common, but those who do not suffer with it cannot understand the effect that it can have on us - unless of course we tell them - which in my opinion is a reasonable thing to do.

      Again, in my opinion I would certainly not bother taking a counselling course for this, because once you have accepted that you have it, what can be gained by sitting for endless hours in front of someone (probably not a sufferer) just be told that you have it.

      You hit the nail squarely on the head when you mentioned the need to just get on with your life, which is the most important thing.

      Don't get me wrong, diabetes an important issue, but you should not allow it to take-over your life - just take reasonable care.

      In my case I am one of the unlucky ones (very rare) who also became a victim of diabetic peripheral neuropathy. Yes it can be an awkward and debilitating experience, but I have managed to overcome that with a change in medications.

      So as to medication, it is all very well and good of you saying that you really don't want to take anything, but what you have to remember here is that the name of the game is 'getting on with your life'. If you are advised to take a medication then I would say that if taking it allows you to carry on with life unhindered, then do it.

      Believe me Clive this is no big deal, unless of course we blow it out of all proportion in our minds, then it can become a problem.

      Finally as to whether you need a special doctor, well no you don't - but you will need to have regular (3 - 6 monthly, or maybe annual) HBA1c haemoglobin tests which will effectively keep a record of how your condition is progressing, and you will need to see the diabetes nurse who will keep your records and make adjustments in any prescibed medications that you may have to take.

      Do keep these appointments Clive as they are important for your welfare.

      There are very good reasons why I probably make the worst patient in the world, but even I have had to behave myself, and so should you.

      Just try to remember that it is no big deal.

      All the best

      Rod

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    • Posted

      Hi again Rod.

      I had a real 'ureka' day today! And after so long out there carrying this alone!

      I had to go for my company annual medical today, a private 1 hour full 'MOT'. The doctor there gave me a massive boost of confidence and from airing my fears and issues on this blog, I was able to express much of the same to him, plus the small steps forward that I have made in the past few days. We must have discussed specifically my T2 for more than half an hour and I learned so much as well as boosting my confidence to face up to this. He reiterated much of what you have said as well as from John in this same thread.

      The Dr gave me the confidence to tackle this head on. There was no sugar in my urine which he said was a good sign, also that it is perfectly reasonable and practical to try to avoid medication while I can, and that the solution is largely about weight, diet, weight and diet!. Obviously other aspects including a good exercise regime, but the message was very clear, that a lot of this can be within my control, This was what I needed and now at 10:30pm I have not eaten or craved anything since dinner earlier this evening, this was always my weak period when I could start snacking and almost binge, undoing any good work from earlier in the day.

      I was 93kg at 1.77cm when diagnosed 3 yrs ago, BMI 30 I think. Today I am 84kg and plan to get down to 75kg slowly, hat is 5kg above my ideal weight.

      I have also been to Harvester - eating out is one of the hardest times! There I had plenty of salad, grilled chicken breast, jacket spud and peas. This is a routine I have followed before and can again maintain. No pudding, no beer but still going out and eating reasonably healthily. Harvester put the calorie count on absolutely everything, which is very helpful.

      Thank you again for so many good guiding words. I don't want to make this a bigger thing in my life than it has to be, but to just simply manage it and get on with life. To that end the Dr agreed that I should perhaps NOT attend for my 3 monthly blood check this time in 4 weeks,  as they will simply want to put me on Metformin if my sugars are the same or rising. Whereas with a new found drive I'm sure i can start the 12 weeks again and then if my sugars aren't any better in 3 months I can either resign myself to having done my best and face the medication, or blame myself if I haven't stuck to the routine.

      I think I am getting there, in my own way, thanks again.

      Clive

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    • Posted

      I am delighted that you feel more settled Clive.

      As I've said, this is really no big deal and it is well within your capacity to manage it and to manage it well.

      If you do just that then you may well avoid medication, but even if that day comes when you do need help, then you know it is there for you, and it will still remain no big deal - so I hope that just get on with life and enjoy it.

      My very best wishes for your future.

      Rod

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  • Posted

    Hi Clive, 

    I want to say that it take a lot of courage to come out and tell everyone how you feel. Diabetes is scary. My son is 2 and was diagnosed with type 1 in december. although its not me thats diabetic, my worries and fears for him are much like yours. I guess we are fortunate that we are given more advice on how to manage his diet and health because of his age, monitored every 3 months and obvioulsy my son has no choice at this age. I would urge you to take any opportunity to be monitored by a healthcare professional. Rest assured you are not alone- there are people out there that will listen and help. Do you have any family of friends that have experienced diabetes that can offer you the support you need? It sounds like you are doing your best to stay healthy and the before bed snacking is quite normal- i would suggest to maybe think about what you eat at this time- we give my son some oatmeal biscuits (belvita) as it is slow releasing and that way his sugars dont fall too low in the night. Have you been on diabetes websites? I think if all else fails- blogging is a great way to reach out. I hope you find the answers you want and the support  you need. 

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    • Posted

      Hi msb.

      So many kind people have replied that I can't leave them unanswered, yours especially. Your son has type 1 at an incredibly young age, which is very sad. He can't decide for himself, so his caring Dad does that and you will instill good well informed routines for him to hopefully take on as a natural routine of his life. An old geezer like me however has probably invited this type 2, I don't know. You will see my reply to Archimedes on shame and denial. - people thing I am fit, healthy and much younger than by 62 years but that doesn't help when I have a potential raft of related health risks stacking up in front of me for the future. You are so right that Blogs can help greatly, I just wish there was better advice from the GP than 'eat in moderation' with 'a well balanced diet'. It isn't quite that simple for a diabetic and there is so much contradiction on what and what not to eat. Thank you again and my best wishes for your son, and you managing this for him.

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  • Posted

    I found the info given by diabetes nurses etc pretty much useless in real life.  The best ever book to read to help you understand is Patrick Holford's one which explains how to choose food wisely.  Also the emotional aspect of having type 2 is never discussed and it can have a huge impact on how you cope.
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    • Posted

      Hi Whizzieliz - many thanks, I agree regarding standard dietary/ lifestyle NHS info given out. It feels a token obligatory gesture. So do the incredibly rushed 'consultations'. I hardly get started explaining things and they are looking at the watch and ushering me to the door with a .."next!"

      'Eat in moderation, a well balanced diet' seems a bit obvious and not very specific for a diabetic who has to take a very different and specific cut of that statement.

      I am too much of an open book, but not with mi]y loved ones who I am oddly 'protecting' from my dilemma. But you are so right, there is little spoken of the concern and fear for health and the future where type 2 is concerned. Once again it is largely regarded as an avoidable condition, therefore little said and little sympathy! Almost a secret society !!

      Thanks again, I will look up the book.

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  • Posted

    clive,

             In 2002 I became marginally diabetic. I followed Atkin's advice to eat less carbohydrate and more protein (like eat 500gm. meat a day and not processed foods) and do more exercise, which for me was on a kind of rowing machine, 200 operations every day. I had a finger-prick meter, and doing this dropped my blood-glucose down below the diabetic threshold. Without the meat, the effect of exercise would last just that day, but meat prolonged it until the next day, so if I missed exercising one day I did not go over the diabetic threshold.

              I tested non-diabetic 12 months later. But, after 7 years, I developed background diabetic retinopathy. Then I took things very seriously. I followed web-site recommendations to buy an electric steamer and eat 500gm. a day of lightly steamed greens (broccoli, brussel sprouts, kale, collards, cabbage, asparagus). All that is very filling, and I lost weight quickly. After 9 months the retinopathy had regressed, and annual retinal photographs show it has gone completely after 4 years.

               My BMI is now 25, and H1BAc is 4.4.  I walk a 3 mile circuit, jogging up the hills, and when weather prevents, I do isometric hand-grip exercises and arm curls with an 8Kg. weight in each hand.

               I have completely eliminated bread, biscuits, rice, breakfast cereal and potatoes. Just recently I eat 200gm. carrots, but only after jogging, and only up to 3 times a week. The high greens diet is tremendously filling. If I avoid cheese and restrict my red wine, I can lose about 0.5 lbs. per week, provided I walk every day. I snack on nuts (almonds and walnuts), and have a cup of cocoa (NOT drinking chocolate) after jogging. The more muscle you can put on, the lower will be your blood-glucose.

     

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    • Posted

      Hi John.

      Wow, you certainly take this very seriously and if I could go back 10 years, even perhaps 5 yrs, who knows; I would have done a few things differently and maybe with little effect, but I would have made informed choices and at least known I had tried to 'beat this' or at least keep it at bay as long as I could. It almost sounds like a military strategy, a finely tuned and oiled machine! If you don't live alone it must be very difficult with a partner in having very separate meals. My wife even resists brown vs. white rice and pasta, but seems like you have cut them out altogether. I just wonder if you've been losing weight since 2002 at 0.5lbs a week ..... !!? However, I can understand why you have taken this all very seriously and hope I can do likewise without the threat of a serious health issue forcing me to do it too late.

      I wonder how old you are? I am 62 and discovered swimming 10 years ago as something I have learned to a good level and gain great pleasure from. I just hope it is the right type of exercise. I am not much for jogging, value my joints at this time of life. Good tip on the muscle vs glucose. Pity you have had to do and research this largely on your own so it seems.

      Many thanks

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  • Posted

    Clive,

             I am 65, nearly. I initially went down from 19.5 stone to 16 stone on my doctor's diet in 2002, at the time he diagnosed me as diabetic. I got the retinopathy in 2011, then dropped to 14.5 stone. Over last summer I dropped to 13 stone. Retinopathy is no joke. Diabetes affects your arterioles all over the body, but those in the retina are visible using an opthalmoscope. I look at it like this:

             I am picking up pensions, and every extra year of healthy life is more money in the bank. Worth reminding your wife of that.

             Swimming is good, but load-bearing exercise is often recommended. A different set of muscles is involved, and you need as much muscle as possible to keep the blood glucose down. I have been walking 3 or 4 times a week for 4 years now, except last summer I did it 7 times a week and lost 1.5 stone.

             Vigorous exercise with raised pulse (say to 135) is also recommended. Only done it since November, but hair is now growing on the top of my head, and I feel like an athlete. My knees and ankles have tightened up. However, I did overdo someing and got bursitis in my hip which took a month to recover from. So you need to be careful, probably more than me. 

             The hand-grips and weights take only 20 minutes, while I am watching TV.

             Why not say Yes to 10 years more healthy life? Diabetes is not a disease like chicken pox with bacterial proliferation. It is a metabolic imbalance that occurs when we don't maintain muscle and don't work off too much carbohydrate with enough exercise. It is fixable.

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  • Posted

    Of course, T1 is a disease. But even there, following a few web-sites that specialise in that, people get retinopathy, modify their diet, and then it disappears. T1 diabetics have got the same digestion and glucose-burning systems in their bodies as everybody else. Its just insulin they lack. When you exercise, your muscle cells produce GLUT4, about the same amount as from insulin. This carries glucose from the cell wall into the the cell, and lowers blood-glucose, a high level of which causes all the damage in diabetes. To help your son, I would look at the US sites on T1 diabetes.

     

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  • Posted

    In a nutshell and actually I now eat loads of nuts as snacks and as nut butter on toast instead of jam or marmalade!  It seems that you can carry on eating white bread, pasta etc but only about a third of the quantity you could have if you ate wholemeal - your choice.  Also you have to up your protein intake a bit  as eggs, meat and fish fill you up so you need to eat less.
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    • Posted

      Thank you. Is it walnuts and ?? almonds or? And any other tips for snacks please?

      O

      n the protein or protein only (Atkins type route) my Dr said to beware of no carbs, but to instead cut them back and clearly identify slow release carbs and eat quite a bit of them. Any other tips gratefully received.

      Many thanks

      Clive

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    • Posted

      I think it depends on how sedentary your lifestyle is. I can comfortably work on the computer all day, and go out walking/jogging 4 times a week for 35 minutes, with no carbs. I tend to substitute good fats: nuts, olives, cocoa with whole milk, and probably rather more cheese than is good for me. Very low carbs is claimed by many researchers to change a number of cells, particularl in the liver, so that fat rather than glucose becomes the main fuel source. There is carbohydrate in my diet, around 20 gms. from my 600gm (I eat 100gm raw cavolo nero cabbage for lunch) a day of green veg.

      If I do a big shop, say around 4 supermarkets over 4 or 5 hours, I get washed out and I eat 4 or 5 plums to add more carbs. These are also slow-release, but not as slow and low as green veg. Whether or not the cells do change to fat burning, this diet breaks our addiction to sweet-tasting things, which is re-inforced by the glucose "high" that they cause. So when I crave food, it is usually for strongly-tasting green veg or cheese. Nowadays manufacturers put high-fructose corn syrup, which is sweeter than table-sugar, into everything (including Ryvita and bread). They try to addict us to their products.

      I eat blueberries and real live unsweetened jogurt for breakfast and dinner, and that gives me about another 20 gms. carbohydrate.

      When I lost 1.5 stone last summer, I dropped the cheese for 5 months, and lost nearly a pound a week.

      Green veg and berries are full of anti-oxidants, which we need to repair damage to our arteries, and possibly to fight off cancer, although the research is mixed.

      The latest research shows that cancer cells can only metabolise sugars (clucose, fructose, sucrose) and not fats. All our normal cells are happy on fats. So as I get to 65+, I want to reduce my cancer risk.

      So I am firmly committed to very-low-carbs, but eat fruit when my blood-glucose drops and I feel washed-out.

       

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