What should I do about my diabetes?
Sometimes people- and it may sometimes be a doctor or a nurse rather than a patient- tells me that they do not know what to believe about the best way to manage diabetes. Should they follow a low carbohydrate (low sugar and low starch) way of eating, or should they follow the Eatwell guide where a third of the plate is devoted to complex carbohydrate foods? Actually, not a lot of people know this yet, but NICE Diabetes guidance December 2015 changed and now recommends low GI foods (so porridge, pasta, rice and bread are OUT) and individual carbohydrate management, so you will be following best practice if you cut out those starchy and sugary foods, and also work out what works best for your body.
Your nurse or doctor may not be aware of this yet, so if they are still encouraging you to have wheat cereals, porridge, potatoes, rice and pasta with every meal here is something you can show them.
Let’s suppose you are a diet controlled diabetic or just take metformin for your diabetes. Go ahead and have your usual carbohydrate-based breakfast- like porridge and fruit or toast- and measure your blood glucose before and 2 hours after your meal. Write down the readings. Do the same before and after your mid day and evening meals. Make sure you eat as it tells you on the Eatwell Guide. The next day follow the meals on a lower carbohydrate guide such as www.fatismyfriend.co.uk or www.dietdoctor.com and measure your glucose levels before and 2 hours after each of the meals. Write them down and compare them. Then you know which way of eating works best for your body. It is unlikely that the starchy or sugary based meals will work best- after all that is why the guidance has changed- but either way show your readings to your health care worker and tell them what works best for you and your body.
You may want a lot more readings than one day; so try it for a week, or a month, or 3 months. Then ask your doctor or nurse to check a blood test called HBA1c, which is an index of your blood glucose control over the last 3 months and see how it has changed. Tell your GP or nurse which way of eating you have been following and share your success with your friends and family as they may well wish to follow it too.
My daughter went out with a friend, and was delighted to hear her friend’s father was very much better with regard to his Type 1 diabetes. He had been following a low carbohydrate way of eating, which he found out about via the Internet and needed less insulin, he had less hypos and more energy. Many websites like www.diabetes.co.uk can help you with this, but I recommend help from a dietitian if you are on insulin or tablets other than metformin.
Ask your doctor or nurse to see a dietitian to discuss doing a low carbohydrate plan.
In my area they will definitely be able to advise you on it, and I am certain- with the new NICE guidance in place- that all areas will eventually be covered.