No mention of diet because the ADA and other guideline producing organizations do not believe that dietary control works in the long term. I believe I read in the 2017 ADA Guidelines something along the lines of "when lifestyle measures fail” not “if, lifestyle measures fail”….. in their discussion of treatment escalation from lifestyle measures to medication.
My personal hypothesis is that I have controlled my T2DM with a low carb, healthy fat diet and I am now in remission. However, as I have had both gestational DM and T2DM I know that I am hardwired to revert to hyperglycemia when ectopic fat reaccumulates in my pancreas and liver.
So, I hope/need to stay as low carb as I can long term, with my BMI at 20.2; I have no desire to poke this particular tiger so I have no plans to revert to a ‘normal’ diet. This is my new normal now!
The " hardwired" idea is very interesting. My mum, 5 of her 6 sisters and several of my female cousins are t2d. Her one brother is lada. He has a t1 son and his daughter has gestational diabetes. Some of my cousins have t1 children. However, there are a great many of us, so it obviously didnt affect fertility.
My point is that none of this can be a new thing in my family. It didnt just start 30 odd years ago when my eldest aunt was told she had maturity onset diabetes. It (whatever genetic quirk "it" is) did not just suddenly hit that generation. But looking through family history it doesnt seem as tho we died sooner than most, or went blind or lost our feet. We have never been wealthy and usually worked on farms, so the diet was seasonal , adequate and rich in calories. But it is very far removed from a normal diet of today.
No snacks just 3 meals. Cooked breakfast. Lots of dripping, butter and well cooked cheap meat like mutton and trotters!! Lots of fish if my uncles had been fishing. There was bread but not much cake. No pasta, no rice unless it had milk and had been in the oven for hours, and then reheated 2 days in a row.
Sweets and chocolate were birthday treats. Icecream only if we had money when the ice cream man came around. Roast dinner once a week and jelly on sundays. No other puddings except if we were poorly. No squash or lemonade. No fruit juice but lots of seasonal fruit. No mango, grapes or lychee but apples, pears and strawberries as a summer treat.
I dont think we were that unusual. Could be wrong about that. But I remember eating like this for most of my childhood. My children did not have a diet like this. Sweets could be had every day. There was always icecream in the freezer. Cake, squash, pizza, pasta, rice readymeals ..... they are always at hand. Snack as many times a day as you want, food is always there. Its this diet that is not normal.
I have been thinking about this a lot recently. What I am doing is returning to a normal diet. I am going to eat a normal diet of the type my family had eaten in the years before we all became diabetic. And my older great aunts ( we are a very female family!)were not skinny. I had some enormous great aunts but they didnt seem to go blind or lose their toes. Whatever made them fat did not seem to trigger t2d. Or if it did they still made into thier 80s and mostly died of heart problems after smoking for 50 years.
I am not " controlling my diet" in an abnormal way. The diet I had before was abnormal and it provoked an illness response. If I go back to an abnormal diet I will become ill again. My diet is now normal.
