Type 2 Managing T2 without medication

[Protea]

Have had diabetes for 11 years. Controlled by diet alone. No medication. Never been overweight. Possible cause was septicemia which put me into hospital for a week.
Do not go to a clinic and am no medical lists as a diabetic. Lived in South Africa since 1966. Diagnosis made 11 years ago in the UK by a doctor family member. Have my own Contour Plus meter and buy my own strips. Check before breakfast and aim to be below 7.5. Currently average over last 2 weeks is 7.2. Avoid high carb foods and am partly on a high fat low carb regime as proposed by Prof. Tim Noakes book The Real Meal revolution. Noakes is Professor of Sports Science at University of Cape Town. I miss out on the starchy carbs except for a thin slice of rye bread with sunflower seeds. Currently eating avocados which are in season. Eggs and bacon a regular breakfast with Greek full fat yoghurt to follow. Do miss pasta, rice and potatoes. Occasional HBA1C has been good for a diabetic

I do wonder if I should use medication to make life easier and to eat more carbs.

 

[AndBreathe]

Have had diabetes for 11 years. Controlled by diet alone. No medication. Never been overweight. Possible cause was septicemia which put me into hospital for a week.
Do not go to a clinic and am no medical lists as a diabetic. Lived in South Africa since 1966. Diagnosis made 11 years ago in the UK by a doctor family member. Have my own Contour Plus meter and buy my own strips. Check before breakfast and aim to be below 7.5. Currently average over last 2 weeks is 7.2. Avoid high carb foods and am partly on a high fat low carb regime as proposed by Prof. Tim Noakes book The Real Meal revolution. Noakes is Professor of Sports Science at University of Cape Town. I miss out on the starchy carbs except for a thin slice of rye bread with sunflower seeds. Currently eating avocados which are in season. Eggs and bacon a regular breakfast with Greek full fat yoghurt to follow. Do miss pasta, rice and potatoes. Occasional HBA1C has been good for a diabetic

I do wonder if I should use medication to make life easier and to eat more carbs.

Well done on your years of carb control. You state your "Occasional HBA1C has been good for a diabetic". What actually was it?

Personally, I would prefer my averages a bit lower than yours, but to be fair, mine settled lower without too much hard work, so it's easy for me to say!

Regarding medication; if SA follows similar protocols to the UK, the first medication to be considered would be Metformin. Although Metformin does have an impact of blood scores, it is modest. The singularly most important thing for T2s is diet. Metformin''s other benefits include reducing the glucose released by your liver (impacts usually on morning readings), and apetite suppression, which can help with weight loss, where required. To be honest, I wouldn't be joining a queue for Metformin, on the basis of wanting to eat more carbs.

If you are carrying any weight, losing that could allow you to eat a few more carbs, without recourse to medication. I found my own ability to eat carb was significantly improved as I trimmed up.

 

[MissPooh]

Well done on your years of carb control. You state your "Occasional HBA1C has been good for a diabetic". What actually was it?

Personally, I would prefer my averages a bit lower than yours, but to be fair, mine settled lower without too much hard work, so it's easy for me to say!

Regarding medication; if SA follows similar protocols to the UK, the first medication to be considered would be Metformin. Although Metformin does have an impact of blood scores, it is modest. The singularly most important thing for T2s is diet. Metformin''s other benefits include reducing the glucose released by your liver (impacts usually on morning readings), and apetite suppression, which can help with weight loss, where required. To be honest, I wouldn't be joining a queue for Metformin, on the basis of wanting to eat more carbs.

If you are carrying any weight, losing that could allow you to eat a few more carbs, without recourse to medication. I found my own ability to eat carb was significantly improved as I trimmed up.

That's interesting AB about your body's ability to deal with more cards as your weight dropped. I enjoy a wee slice of Bergen but it pushes my readings up to over the 8 mark.
I hope that might be the case for me - fingers crossed.

 

[Protea]

Found my last HBA1c was in June 2012. Value 57 mmol/mol. Just within the diabetic target. My weight is fine. BMI is 22. Losing too much weight could be dangerous. Don't want to have a HBA1C as it would impact on our medical aid fund saving account. Our South Africa Doctor has got me to take readings before evening meal as well as before breakfast to see if a HBA1C is needed. Over a few weeks. A friend had pills so he could eat bread. He died recently of heart problems. My only current medical problem is the back. My two doctors Uk and RSA say the op would kill me at my age!. Usually OK with Celebrex, stillpayne and omega3 in the morning. Must remember to take them. Omega 3 is very good for diabetes.
The strips are not so expensive here as in the UK. Will not take pills. You convinced me.

 

[AndBreathe]

Found my last HBA1c was in June 2012. Value 57 mmol/mol. Just within the diabetic target. My weight is fine. BMI is 22. Losing too much weight could be dangerous. Don't want to have a HBA1C as it would impact on our medical aid fund saving account. Our South Africa Doctor has got me to take readings before evening meal as well as before breakfast to see if a HBA1C is needed. Over a few weeks. A friend had pills so he could eat bread. He died recently of heart problems. My only current medical problem is the back. My two doctors Uk and RSA say the op would kill me at my age!. Usually OK with Celebrex, stillpayne and omega3 in the morning. Must remember to take them. Omega 3 is very good for diabetes.
The strips are not so expensive here as in the UK. Will not take pills. You convinced me.

How old are you, if the op would kill you, or do you have other medical problems?

Your most recent HbA1c is all very interesting, but far too old to tell you anything, other than what it was on the day.

Personally, I wouldn't be happy with the level of testing you are doing driving any form of decision making. It's just far too sketchy and random. Why would the test impact on your saving fund? If that is truly the case, could you not pay to have it done? Where I am now, it costs cUS$80 for an HbA1c, and it's about £80 in UK. That would at least give you a decent bit of data to work with.

The thing is, home meters and strips just aren't accurate enough, often. My HbA1c scores are in my signature, and I'm obviously pretty happy wit them. At 5.1%, that equates to an average finger pick blood score of around 5.5 - 5.6. Not to shabby I hear you thinking, but, and it's a big but...... I test regularly. I don't est my lunches any more as I have a handful of lunches I eat, which return modest rises. But, my finger prick tests, show current 7, 14, 30 and 90 averages of 4.2, 4.2, 4.3 and 4.2 respectively; and this is using strips found by quite a few people on here to be reading higher than expected. So, I am sure you see my point. I am clearly, clearly missing spikes somewhere. I have done 2 seperate lots of hourly testing over 24 hour periods, in an effort to find them, but failed to do so. With my HbA1c where it has been, I have been unconcerned, and use my meter readings really to develop and monitor trends in my data, do that I could identify drifting scores/control, where necessary.

I would ask you to think hard about how you are managing your diabetes, effectively flying blind, without a very basic instrument. Quite clearly, how you manage your life, finances, well being and your diabetes is in your control. I wish you all good fortune with it.

 

[Brunneria]

Hi,

Congratulations on your long term control, but I have to say that in your place, I would either be cutting carbs futher, or considering metformin.

My (very) personal view is that an HbA1c of 57 is too high.
The A1c reading is not in the same units as your home meter (assuming your home meter uses mmol/l).

See the image below. Your 57 equates to an average of 9.1 mmol/l on your home meter.

Of course, we all decide what our personal acceptable blood glucose limits are, but yours are higher than I would like for my own results. And I would definitely be cutting carbs and considering medication, at those levels.

However, I choose to run at lower bg levels that the NHS thinks are acceptable - mainly because I believe that by doing so, I can delay or even prevent the long term complications that the NHS considers to be inevitable for type 2 diabetics.

But please note: I am not a health care professional, and I am not advising you, just stating my preferences...

 

[Robbity]

That's interesting AB about your body's ability to deal with more cards as your weight dropped.
I hope that might be the case for me - fingers crossed.

@MissPooh

I was overweight (still am!) when I was diagnosed as type 2 and my doctor told me that if I lost weight (down to that recommended) I might well end up no longer diabetic - his reason being that my pancreas wasn't designed to work well at my much higher weight, but could well be able to cope properly again if/when I returned to my normal for my height weight. So it's know that losing weight may help your body cope better with carbs.

Robbity

 

[MissPooh]

I have in the region of 6st to lose!!! I know, I hate thinking about it in such a massive chunk.....but which ever way you look at it its a lot of weight and I need to do something about it.
I'm hoping that even losing 10% of my weight will have a positive effect on both my high BP and diabetes.

Onwards and upwards

 

[Protea]

I will find out the cost of HbA1c in South Africa. As stated earlier my age is 79 and have been advised that the anesthetic for a back op could be fatal.
So, will carry on with my morning anti inflammatory and pain pills. Usually alright after about half hour. Must have them now as it s just after 9am.
Fortunately we don't have a cold Winter like UK or USA. Summer was unusually hot this year with many days around 35 deg C. My wife had an overall series of path tests recently and that included a HBA1C. She had a period of feeling unwell. But all OK. The HBA1C was 37 mmol/mol well within the non diabetes limit of 20-42. The unit used here is mmol/mol not mmol/L. Medical Aid will send me the costs of the procedure. Cost of living in UK is about 4 times of that in RSA but income is also about 4 times!! I can not loose weight. Lost 3Kg recently and went down to 67Kg. Got quite ill. Back up to 70Kg which gives a BMI of 22. My BP is fine for my age. No other probroblem islems. Even our computer isn't giving problems I can't solve!
Originally followed Dr Bernstein, Dr Atkins to some extent and now Prof. Noakes. Problem is that all of them are concerned with losing weight.

 

[Brunneria]

thanks for clearing up that a1c number - pls cheerfully ignore my advice

 

[Protea]

thanks for clearing up that a1c number - pls cheerfully ignore my advice

 

[Protea]

In RSA mmol/mol is the only unit in use, both for HBA1C report and on home meters.
All my quoted values will be in mmol/mol.
I do break the rules a little and sometimes more then a little. My wife is the same age as me and normally very fit
and not diabetic. The recent very hot and humid weather upsets her but a full check up says all is well and the
temperatures are dropping as Winter approaches. Maximum today will only be 27 degC.
Last night I was tempted to have 2 or 3 Lindor chocs. Bad.
In general a small amount of basmati rice with a curry and I make a VERY thin pizza with stone ground flour and
lots of low gi topping and streaky bacon on top. Both have a low gi load.
Bernstein got me going and I now read Noakes book avidly. Problem is that their diets are aimed at losing weight
and I'm now at my correct weight for my height. Noakes does deal with diabetes and his recipes are all good but
I must not lose any more weight. My UK family doctor says that at my age diabetes won't kill me - something else
willl. So will carry on as before. Average over last 2 weeks is 7.2 mmol/mol before breakfast and 6.2 before
evening meal. That will do. You are really doing very well. 50g of carbo per day is really low. You must be
eating a lot of tomatoes !! Great going. Bye P

 

[Baruney]

I have in the region of 6st to lose!!! I know, I hate thinking about it in such a massive chunk.....but which ever way you look at it its a lot of weight and I need to do something about it.
I'm hoping that even losing 10% of my weight will have a positive effect on both my high BP and diabetes.

Onwards and upwards

Onwards and downwards!

 

[Baruney]

In RSA mmol/mol is the only unit in use, both for HBA1C report and on home meters.
All my quoted values will be in mmol/mol.
I do break the rules a little and sometimes more then a little. My wife is the same age as me and normally very fit
and not diabetic. The recent very hot and humid weather upsets her but a full check up says all is well and the
temperatures are dropping as Winter approaches. Maximum today will only be 27 degC.
Last night I was tempted to have 2 or 3 Lindor chocs. Bad.
In general a small amount of basmati rice with a curry and I make a VERY thin pizza with stone ground flour and
lots of low gi topping and streaky bacon on top. Both have a low gi load.
Bernstein got me going and I now read Noakes book avidly. Problem is that their diets are aimed at losing weight
and I'm now at my correct weight for my height. Noakes does deal with diabetes and his recipes are all good but
I must not lose any more weight. My UK family doctor says that at my age diabetes won't kill me - something else
willl. So will carry on as before. Average over last 2 weeks is 7.2 mmol/mol before breakfast and 6.2 before
evening meal. That will do. You are really doing very well. 50g of carbo per day is really low. You must be
eating a lot of tomatoes !! Great going. Bye P

Noakes, like volkes and phinney, maintain that you can go ketosis and maintain your weight - just need find the right fat/carb/protein balance for you personally after initial weight loss. Look these guys up as well.

 

[Protea]

Must not lose weight. Plenty of butter and olive oil, modest amount of protein - chicken, lamb chops, fish, steak tartare. Carbs. vegs especially
tomatoes and how can one have a curry without a smidgen of basmati rice. The garden supplies tomatoes (baby and heritage), herbs, lemons,
limes, butternut, grapes. All depends on the season. The citrus not good due to the very hot January and February. A frosty mid Winter will kill off a lot. The garden also helps to keep me fit. Not much space needed for the above. I know that butternut is not good for diabetes!
Last night was a mod of Nigella's Curry in a Hurry. Enough left over for tonight.

 

[JTL]

http://www.dietdoctor.com/lchf
I was first directed to this site from here and it's served me well so far.
I have started reintroducing some carbs into my diet quite well but only if my meter says it's ok.
If I have a reading in the high fives or above I won't have the rice.
In the low fives probably ... in the fours for sure.
My meter is my decision maker.

 

[Robbity]

Noakes, like volkes and phinney, maintain that you can go ketosis and maintain your weight - just need find the right fat/carb/protein balance for you personally after initial weight loss. Look these guys up as well.

Yes, low carb isn't necessarily a weight loss diet. I'm living proof here on the forum for you that you can do this as I accidentally discovered. I've been the same weight for nearly 12 months now... and actually think I've gained a bit very recently, and I'm still in ketosis.

As far as I'm aware you can maintain or even gain weight on a low carb/ketogenic diet: if you eat enough of anything, you maintain your weight, if you eat too much you'll gain.

Robbity

 

[Protea]

Find it is difficult to totally omit carbs as it is not only the starchy ones to watch. Today made a cold avocado soup.
Had excess of avos. Did not think that avos would have a gi of any significance. Only 18 but I had two small soup
bowls. The same happened with butternut hot soup. Had too much and butternut is a much higher gi. Perhaps
tomato soup would be good idea as the gi of tomato is very low. Today a stuffed chicken on the Weber with fir
potatoes and broccoli. There are two of us and my wife is not diabetic. I shall have to choose carefully and not
give in to temptation. Good luck to all of you relying on diet for success.

 

[JTL]

Find it is difficult to totally omit carbs as it is not only the starchy ones to watch. Today made a cold avocado soup.
Had excess of avos. Did not think that avos would have a gi of any significance. Only 18 but I had two small soup
bowls. The same happened with butternut hot soup. Had too much and butternut is a much higher gi. Perhaps
tomato soup would be good idea as the gi of tomato is very low. Today a stuffed chicken on the Weber with fir
potatoes and broccoli. There are two of us and my wife is not diabetic. I shall have to choose carefully and not
give in to temptation. Good luck to all of you relying on diet for success.

If your type two then diet is all you really have.
The drugs won't deal with it on their own.

 

[DeejayR]

Must not lose weight.

Me neither.
Watch out for tomatoes -- the sweeter the more sugar (surprise, not). I don't go by GI or even GL any more since they don't tell me quite what I need to know.

*Lovely protea avatar. Happy memories of Cape Town ... but in all the parks we did get lectured on the miserably small variety of flora surviving in the UK. I was jealous!
Pleased to meet you, by the way.