Oatcakes

While on holiday in Scotland I tried some plain oatcakes made by Goodfellows. They were a revelation. Though they had absolutely no sugar they were lovely and oaty, delicious plain with a cup of tea. They may not be suitable for all diabetics as they will be high in carbohydrates but for my type of low sugar and slow release carbohydrate diet they are a welcome alternative to conventional biscuits.

On returning to London I have been trying to track down plain oatcakes (yet to find a supplier of Goodfellows), surprisingly difficult as the alternatives all seem to have been made unpleasantly salty. I thought I'd create a table here of the results and add to it as I try others (note that percentages are based on the weight content declared on the product label per 100g):

Oatcake	Sugar %	Price Guide per 100g	Flavour
Nairns rough oatmeal oatcakes	1.2	30p (2008)	Taste too salty (salt content: 1.2%). 300g packs.
Paterson's olive oil oatcakes	1.8	50p (2008)	Salty but slightly less salty than Nairns and taste okay with peanut butter
Sainsburys Organic Sunflower and Pumpkin Oatcakes	3.8	40p (2008)	Excellent. Though there is added salt (1.25%) they do not taste salty, the flavour is suitably sweet (not as sweet as Goodfellows) and oaty. Great with cheese or even as very low sugar biscuits to go with a cup of tea (compare with a Rich Tea biscuit which has 20% sugar).
Orkney Oatcakes	3.9	50p (2009)	Excellent, the thick version (200g packets) is highly recommended. Sweet tasting triangular biscuits, great on their own or with cheese. These can be bought on-line (made by Stockan & Gardens) but are hardly available in any shops in England. I purchased these in Asda in Berwick upon Tweed and the 100g thin version (no thick versions in stock) at Tesco in Redruth, Cornwall for a comparatively cheap 33p/100g.

Chocolate custard (sugar free)

I made up a batch of sugar-free custard last night to have with a sliced pear. Custard powder is sugar free so I just added sweetener instead of sugar. It was a real homely treat. Oddly this is the first time I've made custard since being diagnosed two years ago.

The recipe couldn't be simpler: 1 tablespoon of Birds custard powder, 1 tablespoon of sweetener (or equivalent), 1 teaspoon of unsweetened cocoa powder (I used Green & Black's Fair Trade) and 1/2 pint of milk. Mix dry ingredients with a little milk to make into a paste, heat up the milk (microwave) and slowly add the hot milk to the paste while heating in a saucepan.

The only sugar present is from the milk (5% sugar) and naturally in the pear (~10% sugar) so it's around 8% sugar in total which is pretty nicely acceptable for a diabetic.

Sugar in urine panic

It was around 11am and I happened to use a diastix test strip in my urine (I've been so well controlled for the past 18 months that I only bother about once a week). Sudden panic, the strip went green rather than the perfect blue I always get!

Was in a funk for the next hour or so. Should I take another Metformin? Was I reacting to my newly prescribed statin? Should I call up my GP for such a small change? Crap, the trouble with diabetes is that you know it's going to creep up on you eventually.

Drunk plenty of herbal tea and stayed on very low sugar food for the rest of the day. Tested again around 3pm, perfect blue result again. Panic over I hope. Looked in the mirror and saw how much younger and sexy I look after losing weight for the last two years; not so bad after all.

Simvastatin

Just over a week ago I started on Simvastatin. My weight and cholesterol levels are pretty much perfect but after initially resisting the idea (I really don't want to take unnecessary medication) my GP convinced me that with a history of heart disease in my family, being on a statin would help reduce any likelihood of a future heart attack significantly.

I have noticed some side-effects. Within a fairly short time of taking the pill I feel general muscle aches making me weak and useless and so I only take it just before going to bed. I'm also getting mild constipation, as with my experience of mild stomach problems with Metformin, I'm hoping this will change over time. It could be a co-incidence with Christmas, but I am a bit more tired and grumpy than usual. Keeping a sense of humour is just a tad harder for diabetics at the best of times...

I'll go in for more tests in January so that will be a chance to review side-effects with my nurse.

On the food side, had a lovely bowl of trifle made by my aunt-in-law who's husband has recently been diagnosed with high blood sugar. She used sugar-free jelly and home made sponge and custard using a sweetener rather than sugar. It worked really well.

Home made diabetic cookies

As it's been months since I last found sugar free cookies for sale anywhere in London, I thought I'd try my own sugar free variation. The result was just under 30 of these diabetic friendly cookies, they go down a treat with a cup of coffee in the evening.

Recipe for low-sugar
porridge oat cinnamon cookies

• 1 cup of flour
• 1½ cups of porridge oats
• ½ tsp baking soda
• ½ cup sweetener*
  
• 1 tsp vanilla
• ½ cup sultanas (or raisins)
• 2 tsp cinnamon (or less to taste)
  
• ¼ tsp nutmeg
• 2 egg whites (lightly beaten)
• ½ cup skimmed milk
• 1/3 cup olive oil
• ½ cup walnuts (high in Omega3)
  

Sift the dry ingredients, add the oats and mix in the rest of the ingredients. Drop a generous teaspoon at a time onto greased paper and bake at 190C (375F) for 12 to 15 minutes.

* The sweetener should be suitable for baking and the amount used is equivalent to a half cup of granulated sugar.

The sultanas (or golden raisins) are just under 60% "natural" sugar. There are around 4½ cups of solid ingredients including the ½ cup of sultanas this makes the cookies a total of 13% sugar. You could make these with fewer sultanas (1/3 of a cup would make the total 9% sugar) and more nuts but they begin to taste a bit dry (I tried once with only nuts but they are not as nice). You could swap the walnuts for any other nuts (I added some Brazil nuts I had to use up) but walnuts are particularly good for Omega 3 fats (I'm still low on this sort of "good" cholesterol).

The original recipe called for a ½ tsp of cinnamon but as it is highly recommended for diabetics I quadrupled the levels making them smell nicely of cinnamon. If you are not such a fan of cinnamon you might try just 1 tsp.

I think the sugar levels are pretty acceptable (being on the same proportion as the sugar you would find in a fresh apple) so long as you don't immediately scoff the lot. If you are worried about the carbohydrate hit from the oats and flour, I suggest no more than 2 or 3 in a day, the oats make them pretty filling anyway.

High price of sugar free chocolate

After finding out that Chocology (I frequently walk past their stall at London Bridge Station) has put the price of 85g Cavalier bars of dark chocolate (only 1% sugar) up from £1.99 to £2.49, I decided to do some research on the internet. I quickly found that ordering from goodnessdirect.co.uk (it's okay to click the link, I don't get any commission) saved quite a bit as by buying enough for free delivery the bars came out as £1.42 each, a saving of £1.07!

It seems a little sad that shops like Chocology feel the need to add such a large mark-up on food that is so useful to diabetics.

Unhelpful GP

I managed to get my latest HbA1c results from my diabetic nurse, still good at 5.4.

My GP managed to be unencouraging. The surgery phoned me up and asked me to come in for a meeting with my GP, when I turned up he immediately apologised for calling me in as it was unnecessary and some sort of confusion on behalf of reception. Looking at my results he gave me the feedback that he thought I probably had the best results and control of all the surgery's diabetic patients and suggested that we reduce the number of times I come in for testing (currently 4 times a year). As I find the HbA1c results helpful and they refuse to fund self-testing I suggested we continue with every three months. The GP then launched into a bit of a diatribe saying that patients with much worse problems than mine can't get appointments (remember they called me in for an appointment unnecessarily) and if I wanted more regular tests he would give me the forms and I could go to hospital for blood tests.

I didn't argue with him but listened patiently. I suspect that despite his rant it will not make any difference to the arrangements with the diabetic nurse. I had 3 visits last year and as it's up to me to phone and make appointments I guess there's nothing to stop me keeping up the same level of monitoring.

He offered to take me off Metformin, to which I suggested that I would try coming off Metformin if he could supply a self testing kit so I could see the effects of attempting to control my diabetes with diet alone. He wouldn't do this (a false economy in my view) and so I'm staying on 500mg/day of Metformin.

He then went on to discover that my blood cholesterol tests had not been processed, later on I received another phonecall from the surgery asking me to come in to give more blood as my cholesterol blood test had been lost; so my 1 visit for regular monitoring had now turned into 3 appointments!

My experience added to what I read on the diabetes newsgroups convinces me that the NICE guidelines encouraging the PCT to form a "team" with the patient are pointless as anytime I actually ask the surgery for support (self-testing or frequency of monitoring) they use funding as an excuse not to bother.

I eventually got my cholesterol results, my HDL is still low (0.6, should be greater than 1.5) with total cholesterol normal. So I might try moving to margarine with Omega3 added. If the GP had been a bit less of an arse I might have tried talking to him about it but I'll wait for my next appointment with the diabetic nurse in June.