It's not a diet, it's a change of diet - taking control

Every so often I get invites to go along to various clinics where people can talk about their diabetes - it feels a bit like the Alcoholics Anonymous meetings are represented in film and television.  One of the things that is quite striking about the meetings are the number of people that talk about being on diets.  There are lengthy complaints by some seriously overweight people about not being able to lose weight; that the various diets don't work. 

When I was diagnosed, I knew that my diet wasn't good - although I've always eaten fresh fruit and vegetables, I knew that my sweet tooth wasn't doing me any good.  Too much chocolate, cake and biscuits were being consumed as well as a healthy dose of cider.  I didn't consider going on a diet using Slimfast or Complan or whatever the latest craze happens to be, I decided to change my diet and take control. 

When it comes to control, being a project manager, I can be somewhat obsessive about detail.  What occurred to me first was that having an hba1C test every few months didn't leave me feeling in control.  That had to be fixed.

1. Blood pressure monitor - they're reasonably inexpensive and remove some of the 'white coat' stress for me.  
2. Blood glucose monitor - this allowed me to check my glucose whenever I wanted to 

That felt like starting to take control.  My rationale was like this:  I would take my blood glucose every morning when I woke up, the closest I could reasonably get to a 'fasting blood glucose' test and use that as a measure.  If it was below 7.0 in the morning then things were looking good. 

Having put some control around the blood glucose, it was time to start looking at the exercise aspect.  Here, having a smart phone helps massively, everyone wants your data so there are a lot of free apps.  My choice was more limited in that I had a Windows Phone but I found something and then started recording my walks and cycle rides.  I use SportsTracker if it helps but I decided, for reasons of privacy, not to link it to Facebook. 

I now had a method of control so it was time to focus on my diet.

1. Check the sugar content of everything in the fridge and cupboard - some real horrors:
• Breakfast cereal - just get rid of it, it's packed with sugar
• Sweetened yogurts  - lots of sugar
• Biscuits - obvious
• Cakes - also obvious
2. Change white bread to granary or wholemeal 
3. Eliminate potatoes and parsnips
4. Eliminate all dried fruit
5. Swap sugar for Splenda
6. Buy a couple of Low GI recipe books

Getting the Low GI books reinforced the decisions I'd made about clearing the fridge and store cupboards. 

The next point is that you have to get slightly obsessive about these things - checking blood glucose and doing some exercise every day is a must.  In my case I feel guilty if I haven't clocked up a 2 mile walk.

The result for me was weight falling off me with no effort and no feeling hungry.  Some recipes had to be adapted (see other pages).  In 9 months I had lost 45lbs and was feeling much better.  I now find too many things overly sweet as I've reset my tastebuds too - natural yogurt is normal and sweetened yogurt far too sweet.

I explain this at clinics (which is largely following the advice that you're given) and people look at me as though I'm weird.  I'm not on metformin or any other medication and my Hba1C is 38.  And that's the way I like it. 

Introduction

Hello.   I was diagnosed as Type 2 diabetic in December 2013 - it wasn't the greatest surprise, I've been overweight for some time and my father was also a diabetic I just hadn't planned on it happening this early on in life.  When I was diagnosed I had an HbA1C of 54 with a fasting blood glucose of 7.5.  At the time of writing this, I'm 49 years old and have a little boy who will be 4 next birthday.  Having a son happened quite late in my life, but as a proud dad of a bundle of energy I intend to be around for him for as long as possible.

I'm managing my diabetes through diet and lifestyle choices although I could have gone the route of a few people I know and started on Metformin and not made any choices at all.  I decided that I didn't want to take pills if I didn't have to and so changing my lifestyle was the way to go.  So far it seems to be working my fasting blood glucose is usually in the 4-7 range and my last HbA1C was 48 or 6.5% and I'm now down to 85 kg from a rather larger 103 kg in December 2013.

I've noticed at clinics a lot of people complain about the difficulty of losing weight and I'll be honest and say it hasn't been too much of a problem - my biggest challenge is in keeping it stable so I'm not constantly buying new clothes.  I've pretty much replaced my entire wardrobe this year which starts to get costly.

I haven't followed a diet as such, certainly not any of the faddy diets that crop up regularly, although clearly I do focus on low GI/GL foods to ensure that I am managing my blood glucose level.  Here's what worked for me - it may not work for you, but I thought I'd share it:

Ditch processed foods

Breakfast cereals are often portrayed as a healthy way to start the day.  If you want to put this in context start comparing what you consider a normal portion with the recommended portion on the packet.  If that doesn't convince you that it's not particularly healthy then start taking a look at the sugar and salt levels even in supposedly organic muesli.  It doesn't take long to reach the conclusion that they're not that good for you.

For years I've been a big fan of yogurts, those 'corners' and rice along with all sorts of different desserts - they're convenient when you've had a busy day and need something to hit that sweet spot.  A quick look at the ingredients and calories should be enough to convince anyone that they can be lived without.

The list of highly processed foods goes on and on.  The more of these that you get rid of the more likely you are to lose weight.

Ditch Fast Food

I've never really been a fan of fast food and living in a small town, the nearest of the big chains is at least 10 miles away, this hasn't been a challenge.  If you've never watched Morgan Spurlock's Supersize Me then you probably should.  

Fresh Fruit & Vegetables

Fresh fruit and vegetables can be more expensive than buying packaged and processed food.  The main thing here is to keep in mind the GI/GL of the fruit or vegetable.  There are a  few things that I keep in mind with this though:

1. Use local markets - you can get some great bargains
2. Be experimental - sometimes you just have to buy stuff and then figure out what to do with it later
3. Be aware of the seasons and buy stuff that's in season.  Don't be afraid to vary the fruit and vegetables that you buy
4. Grow some of your own - can be very rewarding and once things mature you can get some pretty phenomenal crops out of not very much space.  Minarette trees are a great way of growing your own fruit

Portion Control

Sometimes its worth taking the time to measure out portions just to understand what is the right sized portion and what's not.  I always used to use my own measures for rice - about 85g per person (uncooked).  Then I switched to brown rice and discovered that it takes forever to cook and so I took a look at the prepared brown rice microwaveable packets.  Suddenly my old portion size seemed quite large in comparison.

Exercise

I've always done a fair amount of exercise although I can't stand team sports - exercise should be enjoyable and ultra-competitive team sports generally forget that small point.  These days my routine is pretty well established:

1. Walking 2-3 miles each weekday
2. Cycling 15 - 20 miles each day of the weekend

If this seems excessive, then it's important to point out that I used to cycle prior to being diagnosed - I enjoy mountain biking because I can do it straight from the house.  What made the difference was the walking during the week.  I don't just go for a stroll, it's definite power walk - my approach was to create a playlist of tracks which had a speed of 125-130 BPM and use these to keep a fairly steady pace.  

Be in control

At clinics we're always told to take control of our diabetes, don't let it control you.  What always seems to be lacking are the practical tips on how to do this.  As something of a control freak this doesn't really do if for me.  My approach was quite simple.

1. Buy a blood-glucose testing machine.  They're relatively inexpensive and I test myself at 06.30 when I get up everyday which gives me something akin to a fasting blood glucose measure.  I doubt it's perfect, but it lets me see where I am.
2. Blood pressure cuff.  I suffer badly from white coat syndrome.  I'm not hypertensive because I had a 24 hour monitor on, but put me in front of a doctor and it's not good.  Having my own allowed me to become more comfortable with the whole thing and my readings are now much more consistent.  

At a recent clinic, I was struck by how many people who considered testing their blood glucose to be the preserve of those using insulin or glyclazides and I was perceived as a bit 'odd' for being somewhat obsessive and maybe I am, but without information, it's not possible to be in control.