My poor management of Type 2 Diabetes

Hi Jen,



I appreciate your honesty regarding YOUR management of YOUR diabetes. Having a diagnosis of diabetes is different for every individual. Every person with diabetes has their individual challenges with management of their diabetes. The people around you - family, friends, health professionals - are resources to help you understand yourself and manage your health. In the end, you are in charge of how you manage your health.



You included two important personal pieces of information which can be helpful with your food dilemma:

- your daughter is currently 8 years old and you want to see her have kids

- you don't really want diabetes-related illnesses



Separately these personal comments are great motivators for you to make some changes to your diet. Seeing your daughter grow up and have children of her own would be lovely… Being a grandparent has rich rewards! (so my mother and father tell me - my mother has lived with type II diabetes for 25+ years, has insulin with meals and mobility concerns). My mother regularly has the same eating dilemma that you mention - yet she follows a healthy eating plan and regularly gets a good report from her GP and endocrinologist. At last review, my mother had a reduction in her insulin due to good efforts in maintaining a healthy eating plan and walking regularly. 



Given that at the moment you are limited by your knee as to how much exercise you can undertake, watching what you eat is very important. If your doctor is talking about having insulin with meals - this is not necessarily a good thing. It tells me that your blood glucose management is not ideal! Accepting a few small changes to your eating plan can make a significant difference to YOUR management of diabetes…



All the best with your eating plan!



Regards, Neil

I understand how you feel. I have also been diagnosed as Type 2 and struggle with it.   Your thread made me think of my parents, both of whom were diagnosed Type 2 many years ago.  My father changed his habits to include some exercise and he modified his diet a bit  whilst my mother lived in denial for many years eating as you do.  The difference in their outcomes is incredible.  It is not so much that my mother will live a shorter life but the complications and obstacles she now faces is far greater and her quality of life is reduced.  It is hard but I think it is worth it.

Hi jan,
You sound like alot of the clients i see and i think it is totally normal to feel this way. We often call it diabetes fatigue when people are sick of thier diabetes so don't be too hard on yourself!!!

There are alot of reasons why your sugars can be high. Yes food is an important part of the equation but its not the only thing. Stress, medications and physical activity are other important players as well.

I just want to emphaise that “THERE IS NO SUCH THING AS A DIABETIC DIET”. My colleagues and also Diabetes Australia promote the idea of healthy eating. Just because you have diabetes DOESNT means that you cant eat potatoes or  pasta. They can be incorporated as part of a healthy eating plan in MODERATION. and sweets. I generally teach people to think of foods as “everyday” and “sometimes” food as opposed to “good” and “bad”. Also we tend to find that people tend to crave or want the foods that they “ can't have”. If you allow yourself to have these foods every now and then you wont feel deprived or resent your condition.

Also you dont need to change your DIET COMPLETELY. I am sure that there are aspects of your eating pattern that are healthy. As dietitians we work with peoples current diet and negotiate ways which we can improve this without having to change your diet completely. So if you havent seen a dietitian i would highly recommend you see one-preferably one with an interest in this area.

Diabetes is a condition that can be managed and it does sound like you are trying. it does seem like you are overwhelmed with it though. You can take control of your condition as opposed to letting your condition control you.

I can relate to this. I am struggling with food side of things as well as exercise. I have joint problems which make it hard for me to exercise and I'm also hopless around food. I have just been put on insulin as the tablets are not working anymore. I started off with one jab a day now I have to inject twice a day and still take my tablets. I don't know how to get out of this rutt. I'm suffering with depression and some denial as well.

I have very few friends and no support from family as none of them live in Melb any more. Most times I go down to our local shooping centre I find it hard not to buy a cake or a pie fom the local bakery. I love my food and of course it's all the wrong food I love.

I'd also like some help in changing but don't know when or how to start.

Hey lovemyfood

I also have few friends and family living interstate. Im in Melbourne too :)

I am also new to this forum and dont know how to contact you privately, but maybe we could support each other !

My diabetes went totally out of control approx 7 months ago and ive just started on Byetta

Ive also had a recent, ummmm…. Well crisis involving stress, Not too sure ide call it depression, but certainly Anxiety ( almost panic state )…. Not a nice thing anyway

I also Love my food, who doesnt !!! but i taught myself….. baby steps, :) change things slowely , have the things i love but only have small amounts and not as often

Maybe some one will be able to help us get together to help each other :)

Its nice to know that I am not alone in having trouble with food, motivation seems to be a big factor but what do you do when motivation fails….. Fatiques.

I am Type 2 Diabetic and also have PCOS and am on my 4th Cycle of IVF to have a child.
(no Family history in any of these illnesses but my Dad is a vietnam Vet and I believe these are common problems for first borns)

we have been trying for 5 yrs.

It seem that I can keep up a good diet and excersise for a year then we have a fail and it falls apart then we get up and get fit and heathly then it fails and it falls apart again.
I can not seem to stay consistant. I have 6 months till the next round and am really struggling to get motivated again. Everyone talks about healthy life styles, making a change not having a diet. ect but in the end you have to be diciplined. What happens when the disipline fails.

Some days I just want to give up then other days I am renued with vigure to keep going. But it is never consitant. I have been to my healthy living dietition, and nurse but they say the same things. I really want to go with someone like Lite and easy and they dont deliver to the NT.  …….

MY biggest issue is that my Sugars and between 5.8 and 7 and this would be considered Good but when falling pregnant they want you at 5 or its insulin for you………… its almost like they want to give you an unobtainable goal.

any way any suggestions?? Bek

There can be plenty of dogma regarding the superiority of lifestyle and dietary intervention for T2D. That many people with T2D end up feeling like they have failed for not being able to be managed with lifestyle.

It turns out that the evidence for lifestyle intervention is not absolute. T2D is a progressive disease and depending on where one is in the diabetes journey, lifestyle modification can have small effect on overall glycemic control.

It has been observed that poor glycemic control during pregnancy for a pre-existing diabetic leads to worse outcome, therefore the more strict target. However the targets cannot be achieved all the time, therefore close specialist care is warranted.

If the IVF specialist is unable to improve your glycemic control, it is prudent to consider seeing your GP again with a view of referring to a specialist who can help you to optimise glycemic control.

Regards,
Dr Kevin Lee

Endocrinologist

http://www.banyoclinic.com.au/dr-kevin-lee-endocrinologist/

http://www.facebook.com/kevinleeFRACP

Hi Jen ( original comment)
I am interested in your comments and one of the biggest problems with the dietary information given for people with T2 diabetes and weight management it is always about a DIET and information is not often given how to use real food in many different ways to get good BGL levels. It is often rigid. We have the low fat, low carb, high fat, high carb, Ketogenic, no sugar and the list goes on. Unfortunately we also hear very simplistic approaches to T2 diabetes which works for educating the public in this area but when Dieticians help people a more individualised plan is established addressing the specific areas for you. And can be very successful. As Dung ( Dietitian) said there is no Diabetic Diet.

The main goal for you is to achieve better blood glucose levels and this can be achieved in many ways, certainly weight loss can help but start with BGL first. I always start with what your BGL readings throughout the day are and then manipulate the food to manage this part of the day where the BGL are too high. This is often with understanding of how your different medications are working ( not just insulin but many others) and how best to use these for good BGL control for you. Getting a better HBA1C is the goal.

The goal from your doctor to get your fasting BGL below 6mmol/l before breakfast and again at night would also come with a real risk in increasing hypoglycaemia and this itself can increase your average BGL (the HBA1C). This requires some understanding on how to eat, portion control, timing of meals and how to make up meals to prevent hypoglycaemia and reduce the rise of BGL after meals.I also do not think your Doctor will be in a rush to start more insulin as this will make it harder to lose weight and hopefully they will help you look at many ways to help get your BGL down. However if you are unable to get your BGL down having more insulin may be the best for you. Seing a Diabetes specialist team or endocrinlogist may be helpful to see all the options available to you.

Because of the good/bad food approach with T2 diabetes you often get to feel bad when you eat any perceived bad food. And with all the stuff around this area in the media and the social space just about any food can be seen as bad. What is required is an understanding on how to include any food into your diet when you choose to, but know how to do this in a way that you still get good BGL. This is a journey where you will move to a better lifestyle but understand why, but not feel deprived but also get the rewards you are looking for.

As Dr Kevin Lee ( Endocrinologist) said diabetes is a progressive disease so you are not able to control everything only some things. You often personally blame yourself when you control is not as good as you would like, maybe you haven't been given the information to manage this better yourself, maybe you need a different combination of medication. And with this maintain a good quality of life as you age.

I can understand you as I too have trouble following a so called healthy diet. I am on 120 units of insulin in the mornings and 150 units at night, I also am on diabex, yet I still have high BSL's. I am T2 and have been for over ten yrs now. I an so sick of it all.

I would like to be able to go to a support group but there is nothing at all around my area, eve though I have a grat diabetes nurse it's not enough as I only can see her twice a year. I live alone and don't really have any support.

I am miserable, I already have diabetic neuropathy of both feet which is quite painful, even with meds. Wish there some words of wisdom I could share with you but know that you are not alone with these problems. I love my food, I'm overweight and have servere arthritis as well so life is pretty shitty.  However I wish you well.

from Lovemyfood  :)

Jen, at 66 I am at that stage in my life where I'm so fed up with Type 2!  Living in a remote rural area, and not having access to a regular doctor or other diabetes educators working with me as a team, I recently became aware of Health Navigator, which is available on the Silver Chain wedsite.  I have just contacted them via email and looking forward to a telephone conversation which will be arranged at a time that suits me. As this website is for those with chronic conditions, as is Diabetes, I am keeping fingers crossed that with their assisstance I will eventually come to grips with my condition.  Why not give it a try??!! I am!!  Farmgirl.

This situation being 5 foot 4 inches, weighing 107kg, poor dietary regulation, Type 2 Diabetes. Whilst your diet might not be ideal, I guarantee that your diet alone is not the only reason why you suffer from obesity.

This situation is the EXACT reason why bariatric surgery exists. High chance of diabetes remission, AND not to say the additional quality of life benefits that come with increased self esteem, self image, mental health, physical activity and ability to do more things with family and friends. Things that taking medication to control blood sugars do not bring about also.

Do not fall into the common misconception that far too many people believe in, that obesity and diabetes are from eating the wrong foods, eating too much and lack of exercise. They are small components of an obesogenic exposure that allow for underlying genetic predisposition to develop obesity and subsequent metabolic syndrome.  

Poor eating habits can also be driven through inadequate gut stimulation by gastrointestinal hormones. Something bariatric surgery can also help to correct. There is a psychological element to this also, and in my clinic I work with a clinical psychologist who specialises in obesity and disordered eating habits.

Please feel free to contact me through my profile or website www.drjasonwong.com.au if you would like to learn more about how obesity and diabetes can be controlled through metabolic surgery.

All the best!

Dr Jason Wong