Thank you very much.

It's not for me, which makes it a little difficult. I'll check out those sites you left. I appreciate that.

There seems to be an awful lot of conflicting advice around. I've advised her to talk to a dietician privately but in the meantime just trying to gather some more information.

I'd totally forgotten about the Clinics that have been set up at our hospitals. I'll get her on to that as well. Free is good.

thanks.

Be careful with dieticians! Some are still recommending low fat diets!

Insulin resistance eating is low carb at each meal. The metabolic X diets are slightly higher in good fats and provide good protein at each meal. Smaller meal sizes and addition of protein rich snacks throughout the day.

There are some tricks... Dreamfield's pasta has some undigestable carbs added to lower its glycemic index.
Eating certain fruits is better than others... bananas vs cherries.
The cherries are much lower in sugars.

Finding a copy of the glycemic index online is very helpful for choosing things. Good fats like avocados, will slow gastric emptying and reduce insulin spikes and lower postprandial glucose readings, which then improves the HbA1C overall.

I like this resource too:
http://nutritiondata.self.com/

I find adding beans to a meal instead of starchy veggies, or bread, is very satisfying, lasting longer for suppression hunger. Substitute sweet potatoes or yams for regular potatoes.

I use flat breads when making sandwiches...you can save 1/2 or more carb calories this way.

Excellent site. I'll pass that on. Some ideas for recipes in there as well.

I thought the dietician might be able to help her with meal planning/actual recipes. She's not a cook and has limited funds for going all out and is finding it really difficult to put meals together that are fast and tasty. She loves stir fries, but then doesn't know what to use as a sauce .. just an example. A splash of lime at the end isn't doing it for her. I guess as she gets more understanding of it all then her taste buds will change. Also been prescribed metformin (and currently taking oestrogen for PCOS) and she says the metformin is affecting her senses negatively. Is that possible? She's very tiny and yet the doctors keep telling her to lose weight. She's really not eating enough imo.

Flat breads are great idea! I'll remind her about the sweet potato. She's cut out all potato at present.

thanks so much.

p.s. Just also looking at a few sites that Jo has posted in the "sticky". Very helpful too. Thanks Jo.

Yes, metformin changes reactions to food. In general it can reduce appetite, and sometimes cause a low grade nausea that results in avoidance of food in general. It has been used in various weight loss plans for this effect.

A good meal replacement can be a whey protein shake, with yogurt/ low glycemic fruits, and some flax oil. This will provide calories, and nutrients, and taste good. People will drink when they don't feel like eating. Avoiding sugar and using whole things in the smoothie controls insulin too.

Ahh. OK. Yes, has the constant nausea from the tablets and has been avoiding food. The shakes sound good.

She needs to turn this around fast. Has so little energy and is studying so hard and half the time she says her brain just can't think anymore. She's been avoiding any sugary foods for a long time now but has shocking cravings which is part of the insulin resistance I suppose. Once her diet is on track I imagine those new cravings will subside.

There is a metformin here called Glumetza...it is what I am using now. It has much fewer GI side effects. They still come up for me now and then, but not like regular metformin can be!

Also a delayed release version may help if Glumetza is not available there. Sometimes just a small dose reduction helps.
Always take with food...alcohol and carbs make it worse.

It may help to have a glucometer, to see if the cravings are in fact low blood sugar. Also my doctor requires kidney tests every 4 months or so, to check for acidosis.

She's due to see the Endocrinologist again soon. She should ask about that one you mentioned. Copied it down. Actually strangely the Endo told her when he prescribed the Metformin that a lot of people didn't find it helpful. Maybe he meant they couldn't tolerate it. She has definitely noticed improvement since starting it, esp in her energy levels. I figured it was the oestrogen addition, but maybe the combination. She was pretty bad before. She doesn't drink alcohol so she won't be swigging it down with that lol.

Kidneys. Well, she only has one of those and it's not perfect. Has her own testing gear for urine/kidneys. So she can measure ketones. Doesn't have glucometre.

Just was reading some old threads. Heck, lots of good info.

thanks.