newbie. Diet advice asked.

[Roy Gardiner]

I have just joined as a recently diagnosed type 2 diabetic. I feel a bit of a fraud as I'm symptom free as far as I can tell, but here goes anyway (As I don't know (entirely) what's relevant I've brain dumped a profile of myself below, it's quite long, sorry).

I've been advised to eat low sugar, low fat, high fibre diet and to restrict alcohol to 2 drinks maximum per day.

Questions: Low sugar, OK. Why low fat? Does that directly affect diabetes control? I do not have a weight problem (fat index around 18%, although I could bring it to 10% if I wanted; should I?). What's high fibre to do with diabetes? Alcohol lowers blood sugar; isn't that good:) ? My tests have shown high BG.



My profile

I am 54 (born 1952) male 183.5cm (6’ ½”) 79kg (174lb) recently diagnosed Type 2 diabetes after tests of 14 and 10 mmol/l (252 and 180 BG if multiplying by 18 is the correct conversion). My body mass index is 23.5 body fat index varies around 17%.

Microalbumin test positive, exact figure not known.

Cholesterol is high; total is 7.0mmol/l (273mg/dl) LDL 4.9 (191) trigyceride 1.3 (50.7) HDL 1.5(58.5) HDL/total 21%. Blood pressure 120/82. Resting pulse variable with fitness, typically around 58. Lowest I’ve seen is 48.

May 2006 I had an electron beam tomography scan of my heart at the European Scanning Centre. This gave a 0 score for calcification and ‘No identifiable atherosclerotic plaque. Very low cardio-vascular disease risk’ and ‘A “negative” examination. Greater than 97% chance for absence of coronary artery disease’. A consultant endocrinologist has advised that as of now statins are not indicated.

By the standards of the general population I am very fit. My sport is bike racing. My target is to ride to work (17 miles) home (12 miles… different route) Monday-Friday, train 2 hours on Saturday and race on Sunday. I rarely hit 100% of it making typical weekly mileage vary between 100 and 200.

My sins were smoking and is drinking. I smoked 60 a day, but quit 26 years ago. I drank very heavily in my twenties and thirties and steadily less over the next 20 years. Today it’s ½ bottle of wine (my wife drinks the other half…) with dinner and either a bottle of beer or (rarely) a large scotch afterwards. About once a month more is consumed with friends over a meal.

Diet: Working day, sandwich around 9am for breakfast, canteen lunch 12.00 (typical meals include lasagna, spaghetti Bolognese, fish and chips, curry and rice. Pudding is 2 oranges.). Weekend breakfast toast and Marmite and jam, sandwich for lunch. Dinner is at 21.00 is the biggest meal of the day. Home prepared with fresh ingredients. Fish, poultry, meat, pork. With rice or pasta or potatoes, various vegetables. No pudding. Sometimes eat out or get take-away (maybe 3 times a month). Almost never eat cakes, sweets, chocolate, sweet courses at mealtimes; drink tea and coffee without sugar; drink a soda (typically coca-cola) maybe once a month.

I have no diabetic symptoms (that I know of); my eyes are fine (my ophthalmic practitioner confirms), no excessive thirst, no frequent urination (I have to get up typically once per night, have done for years), no finger or toe tingling. Without the tests I wouldn’t know.

[liz32]

Ok well here goes, the sugar answer is the obvious one. Low fat becuase the side issues of diabetes are heart attack and stroke. Fat clogs the arteries and can lead to heart complications which are already at a greater risk due to the diabetes. Also, the less fat you consume the less you'll weigh. The more you weigh the harder it is for you to utilize the insulin you do produce. At a recent diabetes seminar I was told that at diagnosis, you pancrease is already down to 60% out put. As for your list of diet. I would steer clear of white rice, the fish and chips (ok on occasion). If you are going to eat pasta stick with whole wheat (it really tastes better anyway). Alcohol is a subject I'll leave to others as I don't drink so I can't offer any advise there. My biggest advise would be getting into a dietitian and have them lay out some ideas on a meal schedual that works with you lifestyle and work times. I hope this is a bit of help. It's a huge topic and I'm sure that others will be along to add to this. It's a start anyways.
Liz

[Roy Gardiner]

Ok well here goes, the sugar answer is the obvious one. Low fat becuase the side issues of diabetes are heart attack and stroke. Fat clogs the arteries and can lead to heart complications which are already at a greater risk due to the diabetes. Thanks, Liz. This is why I'm asking; my heart scan shows zero plaque and calcification, and I don't have a weight problem. Why bother, then, about the fat part?

You indicated there are direct heart complications from diabetes. What are they? Also, the less fat you consume the less you'll weigh. The more you weigh the harder it is for you to utilize the insulin you do produce. Liz so should I reduce my body fat to 10%? Below that can compromise the immune system, I understand.

[Funnygrl]

I sorta know what you mean about feeling like a fraud. While I had symptoms galore before I started insulin, now I feel too good and like controlling my bs is too easy to actually have diabetes and feel like I am faking sometimes. But I can't let that stand in the way of doing what I need to do to stay healthy.

[psilocybin]

I sorta know what you mean about feeling like a fraud. While I had symptoms galore before I started insulin, now I feel too good and like controlling my bs is too easy to actually have diabetes and feel like I am faking sometimes. But I can't let that stand in the way of doing what I need to do to stay healthy.

welcome to the world of honeymooning...

[liz32]

The way I understand it is that since when sugars are higher then they should be (why we are diabetic), the sugar binds to cells, which then slowly damage our vascular system. Avoiding fats may not seem to be an important thing right now but it's more for down the road say 20 years. It seems to be that if we keep our control good now, there are a lot less complications later on. It's like wearing a seatbelt. Nine times out of ten you really don't need it driving down the road. BUT< in the case of an accident, a seatbelt will save your life. Watching what we eat, keeping the odds down will help you avoid the long term potential damage. I have neither high blood pressure or high cholesterol but I take two pills to prevent these potential complications later in life. There are days when I feel like chucking it all in and wonder what the point is. But, it comes down to what am willing to do to keep me around for a long time. Plus, it's cheaper to avoid these complications, then it will be to pay for medications later on. I guess you have to way the odds and decide what you are and aren't willing to do. It's your life and you are the only one responsible for it. But educating yourself will help you make the best decision.
Liz

[TvBabe]

Questions: Low sugar, OK. Why low fat? Does that directly affect diabetes control? I do not have a weight problem (fat index around 18%, although I could bring it to 10% if I wanted; should I?). What's high fibre to do with diabetes? Alcohol lowers blood sugar; isn't that good:) ? My tests have shown high BG.



The reason for the low fat and high fibre is to help regulate your blood sugars, fats tend to help increase your blood sugars, fibre helps to regulate it.

Oh and yes, alchohol does lower blood sugar for a temporary time period unfortunately once that time period expires then your liver plays catch up and dumps glucose into your blood stream therefore increasing your blood sugars. The idea is to reduce your blood sugars not increase them :) Oh and just because your not showing symptoms doesn't mean that you are not doing damage, anything over 10 in your scale is doing perm. cumulative damage and is nothing to play around with. You need to keep those sugars down, exercise and be a good boy, that way you will reduce your risk of developing diabetic complications :)

[Harold]

I'm symptom free as far as I can tell
Do you get sleepy around a hour after a large meal?

Questions: Low sugar, OK. Why low fat? Does that directly affect diabetes control? I do not have a weight problem (fat index around 18%, although I could bring it to 10% if I wanted; should I?). What's high fibre to do with diabetes? Alcohol lowers blood sugar; isn't that good
Low Sugar you say Okay, but then you say you have rice, pasta, or potatoes with dinner. Whenever I look at rice, pasta, potatoes, and white bread I see piles of sugar. Google Carbohydrates and Glucose Index/Glucose Load.

Why low fat? Lots of conflicting information here and much of it old. The solid fats are the ones to avoid, especially Trans fats. Some fats are essential for good health.

BMI Distubution is the key. For some reason the fat found around the middle contributes to high bg's. Lose the the spare tire if you have one and you will improve bg's.

What's high fibre to do with diabetes? Slows digestion! We have intestinal flora or bacteria that aid us in digesting food as well as protecting the walls of the intestines. Some of these need fiber as a growth medium to to do their job.

Alcohol lowers blood sugar Not directly, but does slow or inhibit the release of stored glucose from the liver.

[Roy Gardiner]

Do you get sleepy around a hour after a large meal? Yes; after lunch at around 2pm, after dinner at around 22.30-23.00. What do I learn from this (genuine question, not being smart)?

[Funnygrl]

Yes; after lunch at around 2pm, after dinner at around 22.30-23.00. What do I learn from this (genuine question, not being smart)?
That your post-prandial glucose is likely high.

[Roy Gardiner]

Do you get sleepy around a hour after a large meal?Yes; after lunch at around 2pm, after dinner at around 22.30-23.00. What do I learn from this?That your post-prandial glucose is likely high. Hmm. Anyone who's ever given a course or presentation knows that your audience will be sleepy just after lunch; it's well known as a low point of the day.

At 23.00 wouldn't I expect to be tired anyway?

Is what I learn 'don't eat a heavy meal at lunchtime'? That's simple enough I guess. Or, Harold, is there a further point to your question? Again, I'm not trying to be smart, I'm very new to all this.

I find also that if I drink wine or beer at lunchtime, even small amounts, I get very sleepy very quickly; is this related to diabetes?

[Harold]

Harold, is there a further point to your question? Again, I'm not trying to be smart, I'm very new to all this.
Yes, the point is getting sleepy 45 to 75 minutes after the start of a large meal is probably the first noticeable symptom of elevated bg's. Now I am not talking a little sleepy like most people get after lunch when inactive like in a presentation. This is more like great big eye watering yawns can't keep my eyelids open I could sleep standing up. You know like when you were young and had been up and going for 30+ hours sleepy. Most likely you will not feel really sleepy every time you bg's are elevated. It depends on how active mentally and physically you are. I do not believe any of us reconized the connection with the sleepies before dx. Try putting at least 3 hours between dinner and bedtime. You will need to check your bg's at 2 hours post meal anyway.

[Roy Gardiner]

Try putting at least 3 hours between dinner and bedtime.Why?

A central part of my family's life is dinner together, at or around 9pm. It's one of the last things I'd want to try to change. You will need to check your bg's at 2 hours post meal anyway. I will? My doctor isn't talking about doing those kind of checks, as yet. Should he be?

All my background says 'Change one thing at a time; change more and you don't know which one works.' Is there a well-known or standard hierachy of importance of things to change?

[DeusXM]

Why low fat? Does that directly affect diabetes control? I do not have a weight problem (fat index around 18%, although I could bring it to 10% if I wanted; should I?).

Because now you have diabetes, you're far more at risk from CVD. Doesn't matter how much exercise you do, how fit you are, how healthily you eat. If your HbA1c is over the maximum of a non-diabetic (ie. over 6%) then you need to do more work than a normal person to help stave off heart disease.

18% is also a little high for body fat percentage - ideally it should be between 10 and 17%. Also your cholesterol is a bit high (should be around 5mmol or less) and so a low-fat diet will naturally help reduce your cholesterol intake.

Alcohol lowers blood sugar; isn't that good

Not always. Alcohol is probably THE trickiest thing you'll ever have to deal with when it comes to diabetes, and the reason your doctor has told you to limit your intake is so that you've got one less variable to deal with in the early days.

Managing diabetes is a hugely complicated balancing act. You need to ensure that your diet, exercise and physical activity are all in balance. Alcohol is literally like some drunken fool coming up to your desk with those neatly stacked three piles and then chucking them all round the room before taking a leak in the corner of the office.

Dependent on its form, alcohol may initially increase your BG level, because usually it's in a form that has high carbs. Beer will increase your BG. Cider will increase your BG. Wine will increase your BG. As a general rule, the higher the alcohol content, the lower the carb content.

Then it gets a bit complicated. To control your blood sugar level, you need two working organs - your pancreas and your liver. Your pancreas is already screwed, so you're having to take medication to offset that. Guess what happens when you drink?

Yes, that's right, your liver's screwed. Your pancreas makes insulin, that reduces your blood sugar. Your liver releases glucose, which stops your blood sugar from dropping too low. When you drink, your liver gets preoccupied and 'forgets' to release glucose. If your blood glucose drops too low, you get hypoglcaemia, which can kill you if you don't do something about it pretty quickly. As in it needs treating in 15 minutes. It's that serious.

Now, under normal circumstances, if your blood sugar drops too low and you don't deal with it, your liver will get a bit excited and throw sugar around everywhere, thus saving your life. Unfortunately when your liver's drunk, it won't do this. Now, most people usually drink alcohol and go to bed. So in other words, you're unconscious and your blood sugar control mechanisms are all a bit messed up. Which can cause some serious problems. Which is why in the early days you need to limit your booze intake.

If it's any consolation I graduated last year and I had diabetes throughout my whole time at university. I also spent most of those three years inebriated. You can still drink with diabetes, but only when you know what you're doing.

I will? My doctor isn't talking about doing those kind of checks, as yet. Should he be?

Your doctor should have given you a blood glucose testing meter, and you should be checking your BG when you wake up, before you eat, two hours after you eat, and any other time when you want to see how things are going along.

As a T2 you are also going to have rather less flexibility about mealtimes. Do you go from between 2pm to 9pm without eating anything between those times? This is bad for your body and bad for your BG control. Ideally you should be eating small meals every five hours or so, or at least having a small snack between longer periods.

[Funnygrl]

All my background says 'Change one thing at a time; change more and you don't know which one works.' Is there a well-known or standard hierachy of importance of things to change?

Change one thing at a time is a good idea most of the time, and it will be with diabetes once you get more used to living with it, but part of being diagnosed with diabetes is changing many things at once at first, to learn all you can, and to normalize glucose as quickly as possible.

[Roy Gardiner]

Thank you Mr DeusXM, strong stuff. Some questions (as ever...)Because now you have diabetes, you're far more at risk from CVD. Doesn't matter how much exercise you do, how fit you are, how healthily you eat. If your HbA1c is over the maximum of a non-diabetic (ie. over 6%) then you need to do more work than a normal person to help stave off heart disease. Yet my recent heart and artery scan showed a calcification score of zero and 'arteries like motorways'. Is there a different kind of heart disease caused by diabetes?18% is also a little high for body fat percentage - ideally it should be between 10 and 17%. Hmm, my medical insurance company quote 17-20% as 'desirable' and 10-16% as 'below average'; and I would regard 10% as the lowest safe level because of impact on the immune system (I know professional athletes go lower, but I'm not one!).

Where do your numbers come from? Genuine question, not being smart.Also your cholesterol is a bit high (should be around 5mmol or less) and so a low-fat diet will naturally help reduce your cholesterol intake.It's been high for years, yet the endocrinologist I consulted didn't seem worried (yeah I know it's not his heart...)....When you drink, your liver gets preoccupied and 'forgets' to release glucose. If your blood glucose drops too low, you get hypoglcaemia, which can kill you if you don't do something about it pretty quickly. As in it needs treating in 15 minutes. It's that serious.

Now, under normal circumstances, if your blood sugar drops too low and you don't deal with it, your liver will get a bit excited and throw sugar around everywhere, thus saving your life. Unfortunately when your liver's drunk, it won't do this. Now, most people usually drink alcohol and go to bed. So in other words, you're unconscious and your blood sugar control mechanisms are all a bit messed up. Which can cause some serious problems. Which is why in the early days you need to limit your booze intake.

If it's any consolation I graduated last year and I had diabetes throughout my whole time at university. I also spent most of those three years inebriated. You can still drink with diabetes, but only when you know what you're doing.Scary stuff, yet the doctors didn't say anything to give a sense of urgency. And all the measurements I've had (wow, like, all 3!) have shown glucose high, not low.Your doctor should have given you a blood glucose testing meter, and you should be checking your BG when you wake up, before you eat, two hours after you eat, and any other time when you want to see how things are going along. No hint of any of that stuff.

I'm beginning to wonder what my medics are about; isn't this serious, or what?As a T2 you are also going to have rather less flexibility about mealtimes. Do you go from between 2pm to 9pm without eating anything between those times? This is bad for your body and bad for your BG control. Ideally you should be eating small meals every five hours or so, or at least having a small snack between longer periods. I sometimes, not always, have a snack at around 17.30, if I come home by car. If I'm on the bike then I don't get home until roughly 18.30 and then I'm busy until dinner time helping to get everything done.

During the summer I'll often race at 18.00 for an hour or at 19.30 for half an hour.

I've never had a problem with this (other than not winning...) and I seem in good shape; is the 'bad for your body' just to do with diabetes?

[Georgia]

Welcome to the forum :)

Alcohol is probably THE trickiest thing you'll ever have to deal with when it comes to diabetes Yep, that's true. I had 2 vodka & diet cokes last night (last drink at 10:30pm) & I was up until after 1am keeping an eye on my blood sugar as it started to drop quickly. Woke up this morning at 5.2mmol/L so all ok :thumbsup:

[HelenM]

Cholesterol
Many doctors use charts to define your risk of heart disease if you look at
http://www.diabetes.org.uk/infocentre/inform/downloads/riskchrt.pdf
it shows that for a man of 54 with a total cholesterol/HDl of 4.6, low systolic BP and diabetes your risk of heat disease within the next 10 years is less than 15%, that coupled with your heart scan suggests why your doctors don't feel it necessary to treat the higher than desired LDL cholesterol. Having said this my diabetologist is concerned that I keep my LDL cholesterol low (at around 1 g/l) Certainly some doctors consider that just having diabetes is the equivalent cardiac risk as someone who has had a heart attack.
Diet
The diet you were recommended is a healthy diet for everyone! but I do think you need some advice from your doctor as to the amount of carbs you eat and when to eat them as you will need more than the average sedentary person.
I would suggest that you look up info on the glycaemic index use of which could help to balance out your sugar levels through the day. You should also cut down on the 'bad fat' and concentrate on the 'good' ones as if your HDL goes down your TC/HDL ratio will go up.
You are fit and your exercise should act to lower your BS but the fasting ones are high. I wonder whether your heavy lateish meals are contributing to that. (how long did you fast before testing?) It would be interesting to know what your BS are after other meals in the day.

Finally you had no symptoms so I presume the high fasting sugars were found during a routine check up. You may be very lucky in that you have caught it early and in time to adjust your eating habits enough to prevent damage caused by sustained high glucose. But do keep a close watch on things (make sure that you have a HbA1c done every 3 months) and if you don't sustain BS within the normal range do ask for further investigations.

[Roy Gardiner]

I've been advised to eat low sugar, low fat, high fibre diet and to restrict alcohol to 2 drinks maximum per day.
Helen, thanks for your comments
The diet you were recommended is a healthy diet for everyone! Quite so! What I guess I'm after is startup advice on the most important things both to go for and to avoid. For instance, on a Saturday I'll typically eat two or three very thick slices of toast thickly spread with butter and jam (preserve, for the Americans) before going out training. Highly contra-indicated I gather (the only good bit is wholemeal bread).

I guess I'm feeling a bit :hmmmm: as the only diet I can find with no negatives looks to be Vegan -- that can't be right.... and even some fruit is a no-no! ...You are fit and your exercise should act to lower your BS but the fasting ones are high. I wonder whether your heavy lateish meals are contributing to that. (how long did you fast before testing?) It would be interesting to know what your BS are after other meals in the day. Morning tests 08.30 and 10.30 giving 180 and 252, respectively. Finished eating maybe 21.30 to 22.00 the evening before, can't remember the meals, will have had 1/2 bottle of wine with them, maybe a beer too, again can't remember.Finally you had no symptoms so I presume the high fasting sugars were found during a routine check up. You may be very lucky in that you have caught it early and in time to adjust your eating habits enough to prevent damage caused by sustained high glucose. 5 years ago the same medical gave 126, on the borderline I believe, so development over that time.

BTW I am always hungry in the mornings, I thought that was caused by low BS?

[Penny]

Thanks, Liz. This is why I'm asking; my heart scan shows zero plaque and calcification, and I don't have a weight problem. Why bother, then, about the fat part?

Roy, I was about your age, and 3 weeks before I rushed to the hospital and and my heart stopped, I got a report from the doctor that said I had "zero plaque and calcification". My blood pressure was 120/74, pulse 64. I was overweight, and had diabetes, but did not take it seriously. Didn't test, didn't follow any real diet, just avoided sweets. I don't want to scare anyone, but you need to keep on top of it now, the damage sneaks up on you, right when you are feeling smug with all your medical tests. Even after the first heart thing, I was more careful, but thought I was doing OK, It took a second attack for me to understand that this is serious stuff.

[Roy Gardiner]

Thanks, Liz. This is why I'm asking; my heart scan shows zero plaque and calcification, and I don't have a weight problem. Why bother, then, about the fat part?Roy, I was about your age, and 3 weeks before I rushed to the hospital and and my heart stopped, I got a report from the doctor that said I had "zero plaque and calcification". My blood pressure was 120/74, pulse 64. I was overweight, and had diabetes, but did not take it seriously. Thanks for your help, Penny.

I really, really don't get it. Your BP was better than mine, rest HR higher but still good.

So what was wrong with your heart to give you an attack? What use is the proof of lack of arterial and coronary plaque if it's not predictive? How do you know if anything you do is working?Didn't test, didn't follow any real diet, just avoided sweets. I don't want to scare anyone, but you need to keep on top of it now, the damage sneaks up on you, right when you are feeling smug with all your medical tests. Pardon me but 'smug' does not describe my feelings, I don't think. 'Ignorant' and 'scared' get closer.

All the stuff about diabetes, cholesterol etc. give a statistical estimate of the risk of heart disease. But mine is clear, as yours was. Doesn't this count for anything?

I am going, as you say, to get on top of it. Understanding comes first; and this is only three weeks old for me.

[Penny]

I was the smug one, Roy. I thought because all my test results were good, nothing could happen to me. I walked alot, so thought I got plenty of exercise. I am not sure, I don't even think my docotors are, what caused my heart attacks. They did say I was probably having some really big BS levels and was not aware as I did not test, I did not see my doctor more than once a year, because I had no symptoms (that I was aware of)...I don't even remember if he did a A1C. I had every test they could do for the heart, everything came back good. Sometimes my pulse goes down to 55, generally it is around 60. The only thing that wasn't right was my BS levels. The heart doctor told me something when I was in the hospital and asked "What happened?" :embarasse , but I only vaguely remember it. He said even though I have a very good everyday blood pressure, when I have some kind of stress (physical or mental), it soars quickly, normally comes back down just as quickly, but can cause some damage while it is high. I have had several stress tests, both chemical and physical, and the blood pressure never got real high.....but I take medicine to keep it low. So the conclusion I came to is it has to have something to do with the diabetes, that was the main area I did not have under control. The only firm fact I can offer is that I have had no more heart problems since I got my BS under some control, I did not get that under control even with injections, until I changed my diet.
The one thing I have learned on this forum is that we are all so different. What effects me, might not bother you. Fatty food does not work for me, I cannot eat much at all and keep my numbers down. I really need to count carbs to keep things where I want them. You need to figure out what works for you, that means testing everything.
Sorry if this isn't making sense, I have grandchildren sending me IM's.:o

[Ronin]

Hi Roy!

Reading your profile you sound a lot like me. As a fellow cyclist (albeit non-competitive) I see what you are doing with your diet, and it is a pretty typical cyclist diet with emphasis on high carb content. My guess is that the diagnosis came from subsequent Fasting Blood Glucose (FBG) tests. The first thing I would do is get an HbA1C test done to determine your 90-day average. That is the best measurement.

Now, to your eating habits. Being a bit familiar with British English (as opposed to American English) you do have more than a little bit of sugar in your daily diet. Your "Weekend breakfast toast and Marmite and jam" is an absolute sugar fest! Also your last meal of the day should be the smallest, not the largest and have an emphasis on protiens.

What I did when I was diagnosed was to cut 50% of the sugars out of my daily eating. Then I split up the three meals into six "snack sized portions." I fully understand that this isn't easy whey you are working. But planning ahead and putting snacks into conatiners and having a schedule makes it possible under all but the most difficult circumstances. This technique is called "grazing." The "mantra" for a grazer is "never hungry, never full." If you are ever hungry or full you aren't doing it right. You either have to slightly increase portion size (if you're still hungry) or cut back if you feel full.

For me the result was a dramatic loss of fat. I dropped 20 pounds of fat in about three months. Yes, that fast. And that was during the winter when my exercise was at the lowest point. Now, I actually had to slightly increase the portion sizes to maintain my low weight.

As a cyclist, how much do you ride? More to the point, road or mountain? Do you manage long sustained efforts of up to or more than 90 minutes at least 5 times per week? (Not counting races.) BTW: have you ever bonked while riding or racing?

Do you have home testing equipment? If not, get some. I learned a lot by self testing. Pre and post exercise testing is also very important as you will learn a lot about how your body reacts to exercise.

Finally, the low-fat part of the recommendation is very important as many have noted here. We areobic athletes often think we can get away with anything -- we can't. We also think we can eat the way we did when we were teenagers -- can't do that either. You are fortunate to have no calcification in you cardio-pulmonary system. However, all that cholesterol (and not a good ratio at that) is going to do damage sometime and somewhere. That added to the excess glucose is a nasty combination.

The good news is that you are here with us and we're here to help.

[Roy Gardiner]

...My guess is that the diagnosis came from subsequent Fasting Blood Glucose (FBG) tests. Correct! The first thing I would do is get an HbA1C test done to determine your 90-day average. That is the best measurement. Waiting to see the Doc about the results.Now, to your eating habits. Being a bit familiar with British English (as opposed to American English) you do have more than a little bit of sugar in your daily diet. Your "Weekend breakfast toast and Marmite and jam" is an absolute sugar fest! Yes, I know, and I'm wondering what alternatives I should consider. It's typically followed by 2 hours of hard training. Also your last meal of the day should be the smallest, not the largest and have an emphasis on protiens. I've talked with many people about this, and some very well qualifed have dismissed this idea as nonsense (no disrespect intended to you). They say that it's the total intake that counts, not when you take it. What difference is it supposed to make?

It is in any case the last thing I'll change as it will affect four other members of my family, not just me, and their lifestyles.What I did when I was diagnosed was to cut 50% of the sugars out of my daily eating. If you're including carbs in that, then I've plenty of scope too. If you mean refined sugars then that Saturday and Sunday morning jam on toast is it, very little further scope available; more suggestions very welcome.As a cyclist, how much do you ride? More to the point, road or mountain? Do you manage long sustained efforts of up to or more than 90 minutes at least 5 times per week? (Not counting races.) BTW: have you ever bonked while riding or racing? All road work. Journey to work (17 miles) home (12) train Saturday (40) race Wednesday (10 mile TT) Sunday (30 miles odd). Only ever bonked once on about 100 miles, many years ago. Ridden up to 120 miles since on coffee & cakes.Do you have home testing equipment? If not, get some. Doc didn't seem to think I need it; I'm beginning to wonder...!Finally, the low-fat part of the recommendation is very important as many have noted here. ... You are fortunate to have no calcification in you cardio-pulmonary system. However, all that cholesterol (and not a good ratio at that) is going to do damage sometime and somewhere. Is it? Why then hasn't it so far? (not trying to be smart, genuine question).

Don't forget that the relationship between cholesterol and heart disease is statistical; that is, it's not known why some get it and some don't -- or is there more to it again?The good news is that you are here with us and we're here to help. Glad to be here. I hope in times to come to be able to answer as well as ask; long way to go.

[DeusXM]

Yet my recent heart and artery scan showed a calcification score of zero and 'arteries like motorways'. Is there a different kind of heart disease caused by diabetes?

That's great news. However, that's 'now'. What about in 10 years time? The problem with diabetes isn't a different kind of CVD, it's that elevated blood sugar inhibits your body's ability to stave off heart disease itself. If you haven't got a non-diabetic HbA1c, then you have impaired ability to keep your heart and arteries clean. Granted, you're still able to do it, but it might be considerably more difficult.

From the sounds of things so far you don't sound like you've actually got full-blown T2 just yet but you're well on your way to developing it. So you're in a sort of honeymoon period right now.

Hmm, my medical insurance company quote 17-20% as 'desirable' and 10-16% as 'below average'; and I would regard 10% as the lowest safe level because of impact on the immune system (I know professional athletes go lower, but I'm not one!).

Where do your numbers come from? Genuine question, not being smart.

Various different sources. Google 'body fat percentage' and you'll find a whole host of resources, most of which suggest 10-20%. On reflection though I've found that the recommended percentage varies according to age - the figures I suggested were for someone of my age and so don't apply to you.

Scary stuff, yet the doctors didn't say anything to give a sense of urgency. And all the measurements I've had (wow, like, all 3!) have shown glucose high, not low.

It is. But it's only serious if you let your condition go out of control. Given the fact you haven't been given a monitor or the necesary education, I'd suggest that you're either developing T2 or your doctors are really not doing their job. If it's any consolation though, I get the impression that T2 is the trickier form of diabetes to treat but has less immediate danger than T1. T2s generally have far fewer low blood sugar incidents than T1s - but as I said, alcohol is the drunken fool who comes and tips up everything.

The 'bad for your body' element isn't a 'diabetic' thing - it's simply not healthy for anyone to unduly stress their metabolism. When you stress things, they break.