# Diabetes and cake stops etc



## gbs (16 Jan 2016)

Recently I was diagonosed as diabetic, albeit marginally so. Not a classic type 2 in that my BMI has always been around 23/24, I exercise a lot and generally eschew sugary foods. I am making good progress according to blood sugar tests by cutting done on wine, honey, chocolate and fruit juice. Now, after 6 weeks of idleness post op I am anticipating riding again.

My typical ride is up to 4 maybe 5 hrs. What are the recommended fuel and recovery foods? A lot of peering at labels etc has lead me to conclude that walnuts, almond and brazils are the best option. All suggestions incl carrot cake will be interesting BUT I must minimise sugars, particularly cane sugars, wherever possible. I think that I should be looking for foods/energy or recovery bars that are 1) sugar light 2) carb and protein heavy - I am not worried by risk of weight gain 3) jersey pocket transportable


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## mjr (16 Jan 2016)

That, cashews or yoghurt.

I mix oats and sunflower or pumpkin seeds with a little dried fruit and enough nut or seed butter to bind it. I also add some carob or agave syrup but that might not be good for diabetics.


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## Spoked Wheels (17 Jan 2016)

4 or 5 hours on the bike is too long to rely on walnuts, almonds, etc. They are lovely but also rich in calories.

A good portion of porridge is the starting point for me. I take with me some fruit, banana, apple, etc. Sunflower seeds and almonds. A sandwich of ham, chicken, turkey or beef is fine too. Boiled eggs it's also an option. 
Depending on the weather and the length of the ride I decide what I take with me..... on Thursday I took some vegetable soup as it was over 3 hours ride and very cold.


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## gbs (17 Jan 2016)

Ham (off the rbone) on rye bread will tick my boxes!

I have expanded my second para - please see OP


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## Firestorm (17 Jan 2016)

I too have been recently diagnosed as type 2.
The advice I got, and all the reasearch I have seen since, indicates that whilst refined sugars are a problem, because the give a rapid increase in blood sugar which cant be dealt with by the body of a type 2 as well as it used to. Carbs in general are the issue as all carbs turn to sugar in the blood eventually. 
The advice I got was cut white carbs, sugar, obviously, white rice, white pasta, white bread. Replace , except the sugar, with wholegrain with a high GI as the increased fibre decreases absorbtion rates.
That said, exercise, obviously, uses blood sugar so the effect may not be as bad.
my suggestion would be to take a Blood sugar level before you go out, eat what you normal eat on the ride and then after you have been home a short while, before you eat anymore do another test. If the second reading is higher than the first then you are retaining more sugar than you are using and need to adjust.


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## fossyant (17 Jan 2016)

As a type 2 you need to watch carbohydrates, not just sugar, so rice, potatoes etc.

On a ride I don't see it being an issue -* it's general diet you need to modify.*

My son is type 1, so he can eat anything, but has to take insulin. One thing we learnt was carb counting. It's essential for a Type 1 to ensure the right amounts of insulin are taken. It's also a great way for Type 2's to reduce carbs by weighing them. Carbs and Cals is a great book that gives the carbs per meal size/weight. There is also a paid phone app.

Believe it or not, one blueberry muffin has as many carbs if not more than a homemade curry. It's the rice that is the carbs in the curry.


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## Yorksman (17 Jan 2016)

Firestorm said:


> wholegrain with a high GI as the increased fibre decreases absorbtion rates.
> That said, exercise, obviously, uses blood sugar so the effect may not be as bad.



That should be Low GI. Foods with a lower glycaemic index take longer to digest. Pure glucose has a GI of 100, other foods have GI values relative to it. Low GI is anything below 55. 

http://www.the-gi-diet.org/lowgifoods/


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## Yorksman (17 Jan 2016)

gbs said:


> I think that I should be looking for foods/energy or recovery bars that are 1) sugar light 2) carb and protein heavy - I am not worried by risk of weight gain 3) jersey pocket transportable



Avoiding sugar is a must but you need to avoid more than just sugary drinks, chocolate bars, biscuits and cakes. Sliced white bread is every bit as bad as sugar. You should avoid starchy carbs as much as possible. Stick to complex carbs like wholegrain pasta, pumpernickel, wholewheat wraps. You can use them all in transportable meals. Stick to northern european fruits, apples, pears, plums, cherries, berries and try to avoid fruits like bananas, mangos, pineapple. You are find with meats and fish is your friend.

The standard NHS 'eat plenty of carbs' line is increasingly rejected and probably leads to the 'inevitable progression' of the disease. What prompted it was a fear of people getting high cholesterol by going on very low carb/high fat diets. It is easy to pig out on double burgers with cheese toppings and a fried egg and whilst your blood glucose won't change, your blood lipids certainly will. The easiest way to remember a lot of complex dietary advice is by and testing and them your choice of foods becomes second nature.

Tuna salad wholegrain wrap. The biggest problem is establishing that the wrap is genuinely wholegrain.








A cheese, ham & egg pumpernickel sandwich. You can see the rye grains in the bread. It is often called brick bread because it feels like a solid block. This bread is as far away as you can get from the 'no time process' bread we see in supermarkets.






Bacofoil is a good way of keeping it all together if stuffing it in a jacket pocket. If there is anything runny or juicy, like tomato, wrap it first in cling film and then in bacofoil. It works for a favourite of mine, salmon, cream cheese and chives in a wholewheat wrap.

Also, things like chicken legs are transportable, tasty and zero carb. Many supermarkets sell cooked roast cicken pieces still warm so, if you see one on your root, call in. If you want to take a flask, take some soup with you. The sky is your limit with carb free or low carb soups. Homemade mushroom soup is a favourite of mine. It might be worth your while getting a cheap soup maker where you bung in your ingredients and it'll blend and cook your soup for you.

Have a look at http://www.diabetes.co.uk/food-and-recipes.html and in particular what it has to say about diets for type 2 and also, check out some of the recipes. They have a forum where members discuss these things in more detail too.


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## ayceejay (17 Jan 2016)

Check out the Team Novo Nordisk web site and Twitter feed. This is a pro racing team all of whom are diabetic. Being diabetic and being a diabetic athlete are two different things and some of their specific knowledge may be of help to you.


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## ayceejay (17 Jan 2016)

I am reluctant to offer advice because diabetes is not a one size fits all disease and whatever anyone says (including me) you should suck it and see. 
I am not a fan of eating as you go, although 4 - 5 hours is a long ride and it is wise to take emergency food. More important is to make sure that you are going out with enough real food stored in your body (not belly) and to replenish it as soon as you get back. If you don't take on what your body needs after your ride the recovery period is much longer and could lead you into hypo country with no warning.


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## Yorksman (17 Jan 2016)

ayceejay said:


> If you don't take on what your body needs after your ride the recovery period is much longer and could lead you into hypo country with no warning.



The OP is type 2 and by the sound of it, not on any meds. He won't go into hypo.

Its the very strong meds and, in particular, insulin, which causes type 1 diabetics who have to take insulin to run the risk of going hypo. As they have to calculate how much they need and inject it, it can be tricky for performance athletes to get the dose right. Most carry small 'emergency packs' of jelly babies in case they inject too much or exercise more than they thought. Unless on very strong meds, type 2s will always produce extra glucose via a process called gluconeogenesis, literally, glucose new creation, from stored lipids. This happens automatically once the blood plasma level gets to around 4.0 mmol/mL. Strong meds interfere with this process and when the person has miscalculated, it can continue to fall until all the reserves are used up. Type 2s have the opposite problem as their metabolism is often insulin resistant and most are hyper, not hypo. They suffer from the problems of having too much glucose in their blood.

There are several other types of diabetes too, slow onset type 1, gestational diabetes, though I assume the OP is not pregnant, pancreatic diabetes, which is due to pancreatitis and monogenic diabetes which would be evident from a family history of the disease. But, the OP has been diagnosed with type 2 so his main problem is getting the blood glucose down. It should normally be withing a range 4.0 to 6.0 and although it does go up after a meal, or exercise, it should have fallen to below 7.8 after 2 hours. Most cases are struggling with levels in the 10.0 - 20.0 range. Diet and exercise does work but most people don't keep up with the exercise or don't change the types of food they eat. Many take the meds and expect it to do all the work for them.

Lamb and pearl barley stew, a tasty, filling and healthy meal for a type 2 diabetic:






http://www.theguardian.com/lifeandstyle/2011/mar/14/lamb-stew-pearl-barley-recipe


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## ayceejay (17 Jan 2016)

and with that I shall bow out


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## Yorksman (18 Jan 2016)

ayceejay said:


> and with that I shall bow out



It all depends of course if the doctor has got the diagnosis right. As you correctly point out, there are several causes of diabetes and of course, everyone has a slightly different metabolism and reacts differently to different foods. Doctors in the UK are often too quick to diagnose and prescribe.

Performance athletes who are nearly always type 1 have to be very precise in their medication. Steve Redgrave who has 5 consecutive olympic gold medals for rowing is diabetic. However he was diagnosed with 'adult onset' type 2 at the age of 35, 3 years before his last gold medal in Sydney 2000. The standard National Health advice of diet and exercise wasn't going to help him.


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## Firestorm (18 Jan 2016)

Yorksman said:


> That should be Low GI. Foods with a lower glycaemic index take longer to digest. Pure glucose has a GI of 100, other foods have GI values relative to it. Low GI is anything below 55.
> 
> http://www.the-gi-diet.org/lowgifoods/


Thanks, I got a bit muddled there....


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## Yorksman (18 Jan 2016)

Firestorm said:


> Thanks, I got a bit muddled there....



It's shocking that table sugar has a slightly lower GI than white bread. So much for the sliced white loaf!


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## Firestorm (18 Jan 2016)

The all carbs thing is not that well known amongst a lot of Type 2s
A bloke at work has had it for years and it was the thing which sent his dad to an early grave, yet he insists that its only sweet stuff he needs to cut out. I still haven't convinced him that all carbohydrates are technically known as sugars.


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## mjr (18 Jan 2016)

Yorksman said:


> It's shocking that table sugar has a slightly lower GI than white bread. So much for the sliced white loaf!


Calling that white factory sponge "bread" shouldn't be allowed...


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## ayceejay (18 Jan 2016)

Fossy can you explain this as it doesn't seem right to me

_My son is type 1, so he can eat anything, but has to take insulin_


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## gbs (18 Jan 2016)

Firestorm said:


> I too have been recently diagnosed as type 2.
> 
> That said, exercise, obviously, uses blood sugar so the effect may not be as bad.
> my suggestion would be to take a Blood sugar level before you go out, eat what you normal eat on the ride and then after you have been home a short while, before you eat anymore do another test. If the second reading is higher than the first then you are retaining more sugar than you are using and need to adjust.



You seem to be suggesting self testing. Seems v logical but how?


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## fossyant (18 Jan 2016)

Lower GI stuff can have extra problems for Type 1's - especially if you inject, so it's all trial and error. With low GI food it takes longer to absorb, so allowing for the same insulin will cause a hypo, but if you lower the insulin, your bloods will go up. Add in the complication of fat (e.g. burgers) then that also slows the absorption down.

Type two can be better managed by adjusting carb intake, but you'll need to learn how your blood sugars are affected.

Your best bet is to take the meter with you and test your blood through the ride. It's what a type 1 would do.


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## gbs (18 Jan 2016)

fossyant said:


> As a type 2 you need to watch carbohydrates, not just sugar, so rice, potatoes etc.
> 
> On a ride I don't see it being an issue -* it's general diet you need to modify.*
> 
> ...




I agree re the general diet point and indeed SWMBO and I monitoir that carefully. My OP was meant to gather tips re ride foods that would not spike/upset the blood sugar level. It is well known that standard energy gels and bars have v high sugar content and I am hoping to find a way to fuel up/recover without pushing up blood sugar levels. Maybe I should not if worry if high sugar level inputs produce temporary high blood sugar levels - the reverse, hypoglaecemia, is v unpleasant/dangerous.


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## gbs (18 Jan 2016)

Yorksman said:


> It all depends of course if the doctor has got the diagnosis right. As you correctly point out, there are several causes of diabetes and of course, everyone has a slightly different metabolism and reacts differently to different foods. Doctors in the UK are often too quick to diagnose and prescribe.
> 
> Performance athletes who are nearly always type 1 have to be very precise in their medication. Steve Redgrave who has 5 consecutive olympic gold medals for rowing is diabetic. However he was diagnosed with 'adult onset' type 2 at the age of 35, 3 years before his last gold medal in Sydney 2000. The standard National Health advice of diet and exercise wasn't going to help him.




Yorks, thank you for this helpful response and for the other posts - mouth watering photography! You seem to be v well versed in the issues. Are you professionally involved in some way?

And I confirm that I am not pregnant - as a 73 old male that would be news!


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## Firestorm (18 Jan 2016)

gbs said:


> You seem to be suggesting self testing. Seems v logical but how?


There are simple blood testing kits available in most chemists. I dont know if they can be prescribed , I might have a word at my next check up


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## fossyant (18 Jan 2016)

gbs said:


> I agree re the general diet point and indeed SWMBO and I monitoir that carefully. My OP was meant to gather tips re ride foods that would not spike/upset the blood sugar level. It is well known that standard energy gels and bars have v high sugar content and I am hoping to find a way to fuel up/recover without pushing up blood sugar levels. Maybe I should not if worry if high sugar level inputs produce temporary high blood sugar levels - the reverse, hypoglaecemia, is v unpleasant/dangerous.



Gels and the like, I'd not recommend anyway, diabetic or not. They are best used for an emergency. You are better off with some food wrapped up in chunks and or a food stop. Diluted fruit juice or a powdered energy drink would do.

Personally, I go for a couple of bananas, malt loaf and fig rolls on a log run.


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## gbs (18 Jan 2016)

Firestorm said:


> There are simple blood testing kits available in most chemists. I dont know if they can be prescribed , I might have a word at my next check up



WOW! I wonder why my GP did not suggest that? He knows that I am on the case and definitely not one of those that expects medicine to cure the problem.


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## fossyant (18 Jan 2016)

Firestorm said:


> There are simple blood testing kits available in most chemists. I dont know if they can be prescribed , I might have a word at my next check up



The meter comes free usually or at minimum cost. The cost is in the test strips (£30 for 50), and you should get these on prescription as a Type 2, but I certainly know my mum and dad are in 70's, and my mum in law of 79, none of them have meters/test strips.


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## Yorksman (18 Jan 2016)

SD Codefree is a cheap meter with cheap teststrips. It is on the market precisely because many GPs will not prescribe test kits for type 2s.
http://www.amazon.co.uk/s/ref=nb_sb...d+glucose+monitor&sprefix=SD+codefree,aps,238

They tend to read a little high but, for comparing before meal and 2 hours after meal, they are a very good way of assessing an individual's reaction to a particular meal. Over time, you learn a lot. The one I got on presciption, after 12 months of nagging is the Gluco RX

http://www.amazon.co.uk/s/?ie=UTF8&...vptwo=&hvqmt=b&hvdev=c&ref=pd_sl_132krg458n_b


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## fossyant (18 Jan 2016)

ayceejay said:


> Fossy can you explain this as it doesn't seem right to me
> 
> _My son is type 1, so he can eat anything, but has to take insulin_



You can. So long as you carb count. Type 2 and type 1 are very different.

Type 1 has no natural insulin (or very little), a type 2 is generally insulin resistant, and lots of other health problems can cause it.

A Type 1 has to inject insulin, no matter what.


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## Yorksman (18 Jan 2016)

fossyant said:


> Type 1 has no natural insulin (or very little), a type 2 is generally insulin resistant, and lots of other health problems can cause it.
> 
> A Type 1 has to inject insulin, no matter what.



That's right. Type 1 is an auto immune disorder where the body's own immune system attacks and destroys the insulin producing beta cells which it sees as 'foreign invaders'.


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## ayceejay (18 Jan 2016)

It was the notion that you son could eat anything that bothered me rather than the need to inject insulin.
Now that gbs has dropped his age into this question do you think this is a factor that will influence the answer to his question?


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## Yorksman (18 Jan 2016)

gbs said:


> You seem to be v well versed in the issues. Are you professionally involved in some way?



No, but my wife is a biomedical scientist specialising in blood sciences and I also took the time to read up on the subject. I also joined the Diabetes Forum when I was diagnosed 4 years ago. I had an HBA1c of 86 but got it down to normal levels, ie below 40 within 12 months. Having said that, I am semi retired and work from home so I have lots of time to learn, learn about food, buy the right foods and learn how to cook it. Type 2 diabetes for most people, but probably not in your case, is a disease of modern life. Too many people have to drop their kids off at pre school nursery and then have long commutes in heavy traffic to work where they sit at a desk. Lunch is a pie and a sandwich followed by a bun and at the end of the day they have a long drive back in traffic to pick the kids up from after school nursery. When they get home they are either physically too tired or mentally too tired to start peeling and washing fresh veg and preparing a healthy meal. Moreover, the kids won't let them, so, it's reaching into the freezer, grabbing a ready meal and sticking it in the oven ir microwave. Ready meals ought to come with a health warning. One of Waitrose's Mixed Wholegrain loaves only contains 6% wholemeal flour and 51% refined white flour. It also contains 43% of other unspecified stuff. See A Wholegrain of Truth. You can't beat preparing your own food. You can control what's in it.

I went to one of the Desmond courses and met a couple of men, not overweight by any means, one in his 70s the other in his 80s who were dignosed with type 2. It appears that the ageing process can bring it on too. As with most other things, you wake up in the morning and as you get older you discover that this or that doesn't work as well as it used to. It's the same with your pancreas. However, as long as you just watch what you eat, there is no reason why it should ever bother you. Many people live with it for 30 years before they have to start taking meds and even then, they start on a simple med called Metformin. All that does is make your digestive system slower. Too many people think it is a cure however, so they continue to eat all the starchy stuff they used to. You can do the same by eating foods which take longer to digest. Your GP should put you in touch with the local Desmond course organisers. Some of it is a bit silly. They showed us a plastic fried egg, sausage and bacon. At 62, I already know what these things look like. Not that these things are bad for diabetics, but they are paranoid about people getting high cholesterol levels. There are lots of good recipes online and books available.

There used to be a type of flatbread called Haverbread. It's made from oatmeal. Oats are mostly OK for most diabetics, and the Havebread below with ham and cheese and some pickle was wonderful:





http://adambalic.typepad.com/the_art_and_mystery_of_fo/2008/01/oatcakes.html

Just don't pour melted butter with maple syrup on it, though it does taste wonderful if you do!


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## gbs (18 Jan 2016)

A terrific amount of knowledge is accumulating here. I will try to prduce a summary at some time when we appear to be talked out.


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## Yorksman (18 Jan 2016)

gbs said:


> A terrific amount of knowledge is accumulating here. I will try to prduce a summary at some time when we appear to be talked out.



If you are interested in the specifics, Prof Roy Taylor at Newscastle Uni leads the research in the UK. If you ever watched the Hairy Bikers series - The Hairy Dieters, you will recognise him. His team maintain a website and below is an extract:

_"A crucial point is that individuals have different levels of tolerance of fat within liver and pancreas. Only when a person has more fat than they can cope with does type 2 diabetes develop. In other words, once a person crosses their personal fat threshold, type 2 diabetes develops. Once they successfully lose weight and go below their personal fat threshold, diabetes will disappear. 

Some people can tolerate a BMI of 40 or more without getting diabetes. Others cannot tolerate a BMI of 22 without diabetes appearing, as their bodies are set to function normally at a BMI of, say 19. This is especially so in people of South Asian ethnicity."
_
http://www.ncl.ac.uk/magres/research/diabetes/reversal.htm


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## Yorksman (18 Jan 2016)

Just for a bit of fun - and definitely not recommended:

The Wigan Slappy






The Wigan Kebab:


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## ayceejay (19 Jan 2016)

At 73 and pre diabetic I wouldn't worry unduly beyond paying attention to your diet. A bad combination with diabetes is high cholesterol so have this checked at your next GP visit but this is another dietary issue. Another bad combo is diabetes and high blood pressure so keep an eye on that, salt can be one factor so if you use a lot of salt in your cooking or eat a lot of processed food (check the labels) watch out for this.


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## gbs (20 Jan 2016)

On the big three I score well on blood pressure and sub-optimally on blood sugar (although it has responded well to diet modification in the six weeks since diagnosis) and cholesterol (the total is marginally high but the ratio is reasonably good). I am fairly relaxed about the situation but SWMBO seeks perfection.


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## Yorksman (20 Jan 2016)

gbs said:


> I am fairly relaxed about the situation but SWMBO seeks perfection.



Mrs Yorks keeps telling me that any high levels that I might have are nothing compared to what she sees in the lab every day. In situations where I am a few points above the normal range, she often points to people being 100 points above range, "_and we've been seeing him for years!_"

By the way, Someone gave me this link about age related diabetes. If you can definitely rule pregnancy out, you might find this interesting:

http://www.salk.edu/news-release/blocking-immune-cell-treats-new-type-age-related-diabetes/


_"New research has discovered that diabetes—or insulin resistance—in aged, lean mice has a different cellular cause than the diabetes that results from weight gain (type 2)."_
If you've been eating a lot of cheese, you might have Type 4 diabetes


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