2nd Post

[Hm112819]

Hi

I posted here a few weeks ago and found the info really useful, sadly way more than the doctors appointment.

A quick update and then a few more questions (apologies).

Random Blood test for blood pressure meds, flagged up as 52 on H1AC test, I took a second test 2 weeks later. But for 10 of those days (when I found out the results), I increased my exercise significantly, lost a stone (from 17.5, 6 foot 3) and changed to a Low carb diet.

The results from the second test where 49 H1AC.

My doctor wanted to start me on medication, which I refused as I want to give diet and exercise a crack. My questions are:

1> I test regularly and after 3 weeks all BG readings are fine. Except for the fasting bloods in the morning. My BG before bed is typically 5.2-5.4 and this is the same at 3am-4am (I've got a new baby and do the night feeds). But the fasting blood at 7am-8am is typically 6.4-7.4. I mentioned this to my doctor who just said 'don't worry about it'. Is this good advice, is there anything I can do about it? I don't typically eat breakfast.

2> I'm going hammer and tong at exercise and eating a low carb diet, how low is low and what do people aim to consume, I reckon i'm at 20g-40g a day.

3> Do I really have to add high fat, can I not just fill up on veg and lean meat?

4> Will it have a massive adverse effect, if I go for a posh meal once every few months and indulge. Or is this a no go now?

5> I am feeling rather lethargic at work, is there anything I can take/do to compensate this.

6> Bit of strange one, I bought a load of fruit teas. One of my colleagues, pointed out they contain fructose, any ideas?

I appreciate any thoughts.

Regards


Adrian

 

[Prem51]

Hi @Hm112819 Well done on reducing your HbA1c from 52 to 49 in just two weeks. And on your weight reduction. They are both impressive reductions in such a short time.
in answer to your questions:
Your finger test results are good. Fasting blood test results are often higher, usually due to 'Dawn Phenomenon' where your liver dumps stored glucose into your blood stream as you wake to give you an energy boost as you get going. It's quite normal and non-diabetics can get it too. Your readings of 6.4-7.4 aren't very high, so your doctor is right, they aren't anything to worry about. some people on here find that a small protein snack like a few nuts or a piece of cheese before you go to bed can block the DP. Others say that some fat or protein when you get up can stop it. Many have a coffee with double cream if they don't have breakfast.

Your 20-40 gms of carbs is low. Some on here go for even less than that, some more.

You don't have to go high fat, I know that puts people off after being told for years that we should eat less fat. But there are different fats, and most HCPs will agree that some fatty foods like oily fish, nuts, olive oil and avocados are beneficial.

Your lethargy at work might be due to not eating enough protein or fat to compensate for the energy you would have got from starchy carbohydrates, so you might need to increase them. Your exercise might also be tiring your body, but that should improve as you get fitter.

I just checked the nutrition information on the fruit teas I have and they contain zero sugar and carbs, except for the Lemon & Honey tea which has a very small amount of carbs 0.3 gms per 100 ml, but no sugar.

 

[Hm112819]

Thanks for the reply. I'd done a bit of reading about the dawn phenomenon.

I'll give the nuts/cheese a go and then a coffee.

Whilst I appreciate not a very good solution, a bottle of wine the night before seems to work (i'm not planning this as a long term solution).

 

[Geordie_P]

OK, let me have first crack at this. I'm sure others will come, and you can find what the consensus is
1) Those figures look quite reasonable: I believe fasting should be under 6.1, so it might be worth looking into why it goes up overnight. Is it the 'dawn phenomenon'? Do you eat late? Worth working on, but probably not something to worry about per se.
2) I cut out starch rather than counted carbs, but I think the answer to 'how low?' might be 'as low as possible'. I try to stick to: no bread, no pasta, in fact nothing made of grains, no legumes, pulses, beans etc, nothing that grows underground. It did work for me, and I never missed those things. I get some carbs from vegetables and tree-nuts I suppose, but it doesn't do much to my blood readings.
3) I had hyperlipidemia and truly awful triglyceride readings when I was diagnosed with type 2, so I didn't go 'high fat' per se. I tried to get just enough fat from sunflower seeds, olive oil, sardines and salmon. I lost a lot of weight and the doctor recommended I eat more, so I started having quite a lot of boiled eggs and experimenting with high fat. I can say that KFC barely raises my blood, whereas rice is pretty bad, so those who advocate HIGH fat may have a point. For me, I try to be moderate: a good piece of steamed fish fills me up as well or better than, say, fried chicken, and I think it's better for health in general.
4) I've had some big 'one-off' meals that haven't hurt me much. I've also had one or two meals that put me up way higher than I thought. I suppose one thought is that you can eat like a king as long as you stay off the carbs: over Chinese New Year I ate a lot of lobster, shrimp, roast goose, pigeon- the works, and my blood readings were fine- I wasn't touching the rice.
...Um, another trick that works for me, but I'm still not sure is to be recommended, is to drink spirits or dry red when you have a 'cheat' meal. I've had stunningly low readings after big meals using that trick. The trouble is that you end up cheating and drinking gallons of gin to compensate. Still, it's another thing where judicious application may be worth looking into.
5) Yes: I dieted really hard when I was first diagnosed- I had neuropathy, hyperlipidemia and the doctor said I had the worst cholesterol readings he had ever seen, even including research literature- my fasting blood readings tended to be in the mid threes back then, and I was really sluggish going to work. Almonds, pistachio nuts, sunflower seeds during the day got me back on my feet. That, and black/ green tea. Something else is that you might like to experiment with having breakfast. I have two boiled eggs and black coffee, and that keeps me pretty boisterous until lunch time.
6) Try to check the label on the teas. If they do have a lot of fructose, you might be better doing without. Having said that, I've seen a lot of fruit teas that don't have much to worry about. What's the brand?

 

[Geordie_P]

Oops. I got interrupted writing this and by the time I sent it, the info had already been covered admirably by Prem51. Seems like the OP has spotted the alcohol trick too........ Well, I'll leave my post above in case there's anything useful anyway!

 

[Hm112819]

Really appreciate the posts, I'm going to buy a load of nuts tonight.

The tea I bought where Sainsburys fruit infusion.

 

[Salvia]

Hi @Hm112819, Very impressive results you've shown, in such a short time; all kudos to you for what must have been very hard work (particularly with night feeds on the agenda). I don't want to dampen your enthusiasm, but take care with the selection of nuts - some can be quite carby; I got caught out on this a couple of times till I learnt which were the better varieties.

There's a quick overview on the dietdoctor site that might be helpful to get started, if you want it: https://www.dietdoctor.com/low-carb/nuts. That site is also an excellent source of information and low carb dietary advice - and recipes.

 

[Hm112819]

Great thankyou

 

[Resurgam]

Eating enough fat can safeguard your lean body mass - which is a really good idea.
The research into low fat eating being a good thing does seen to be rather lacking, or even an illusion, so I will go on collecting and using the fat from the meat I roast and using it for cooking low fat stuff such as mushrooms in order to keep my muscle from harm.

 

[Daibell]

Hi. Those results are pretty good so far. I never use the acronym LCHF as it's confusing; I just say 'low carb' and add you can eat fats and protein freely. You don't need to do High Fat. Fruit teas have no carbs. Yes, the dawn phenomenon is a problem. Just ignore fasting tests as relatively valueless. I'm sure we all pig-out every now and again; I certainly do. Just don't do it too often; it's lot easier when you're on insulin!

 

[TallLeeds]

Just follow the Low Carb High Fat diet. ....it works. I lost 11 kilos using this regime....not diet.....it's' a way of life now and forever. And it works. Try using an American site for recipes. ...they are much more imaginative than the English sites...just avoid rhe fancy flours and coconut ingredients. ...substitute with ordinary flours....as long as you're not eating it every day it will work. You're hungry at work because your blood sugar levels are falling. ...eat cheese and nuts with some grapes.....picks u up and fills u up. Give it a go.I'm speaking from experience...in a months time I am coming off the Metformin because I have radically reduced my blood sugar levels after just 3 months following this dietary advice. ...Good luck .

 

[kokhongw]

Hi

My questions are:

1> I test regularly and after 3 weeks all BG readings are fine. Except for the fasting bloods in the morning. My BG before bed is typically 5.2-5.4 and this is the same at 3am-4am (I've got a new baby and do the night feeds). But the fasting blood at 7am-8am is typically 6.4-7.4. I mentioned this to my doctor who just said 'don't worry about it'. Is this good advice, is there anything I can do about it? I don't typically eat breakfast.
2> I'm going hammer and tong at exercise and eating a low carb diet, how low is low and what do people aim to consume, I reckon i'm at 20g-40g a day.
3> Do I really have to add high fat, can I not just fill up on veg and lean meat?
4> Will it have a massive adverse effect, if I go for a posh meal once every few months and indulge. Or is this a no go now?
5> I am feeling rather lethargic at work, is there anything I can take/do to compensate this.
6> Bit of strange one, I bought a load of fruit teas. One of my colleagues, pointed out they contain fructose, any ideas?

I appreciate any thoughts.

Regards
Adrian

1. Your fasting BG is still elevated. This will improve overtime with lower carbs. Normal is < 5.0, good control is < 6.0. Dr Jason Fung's blog gives a good explanation of how to lower it... https://intensivedietarymanagement.com/dawn-phenomenon-t2d-8/

2. Low carb is usually anywhere from 20-120g. Though most require < 50g to maintain ketosis and weight loss.

3. Lean meat is protein. Excessive protein will still spike insulin and glucose...though much less than carbs.

4. This is where everyone of us may have a different metabolic response. You will have to measure your results and share with us if the indulgence is worth it.

5. I find taking virgin coconut oil to be helpful. This is because our T2D brain have likely developed insulin resistance and have impaired glucose uptake. It requires either elevated glucose levels or alternative fuel to keep it happy...

6. Fruit juices will be likely more contentious. Fruit tea should be less so...