Terribly confused....any ideas ??

[Gezzabelle]

Okay...brief history. I had my initial routine blood tests which showed an HbA1c of 6.5 and had varying diagnosis made from type 2 diabetic to pre diabetic. I changed my diet to low carb/high protein and 3 months later and a retest showed an Hba1c of 5.7 which to me said I had it on the run. Instead, I was told I was no longer diabetic and to go back to eating white bread, pasta, chips and pretty much anything else I wanted ! I saw the doctor again as I wasn't happy at all about that and was told I am pre diabetic and should continue eating as I am but then further advice from dietician says to eat wholemeal bread, pasta and rice plus beans and pulses, fruit etc. All of those things send my BG through the roof and it takes a long time for them to return to normal. I am losing too much weight...gone from 11st 2 to 9st 3 and its still dropping off despite eating more fat. So the question is...how do I stop the weight loss and what on earth should I eat???...totally confused as to maintain the weight and from the advice given I should be eating lots more carbs BUT if I do my BG will rise badly and no doubt lead to a diabetic range in a years time when they take it again! I feel so out of control as I don't know what to eat or do anymore. I have to stop the weight loss AND keep my sugars under control to prevent diabetic problems in the future. It runs in my family so I obviously need to be careful. I eat less than 50g of carb a day but if I add any more to my meals my bg goes sky high and takes forever to come down I eat a lot more fat in the form of butter and cream etc but it isn't helping to keep my weight up. Any advice on what I should be eating or how to stop the weight loss without sending my BG through the roof?

 

[AndBreathe]

Okay...brief history. I had my initial routine blood tests which showed an HbA1c of 6.5 and had varying diagnosis made from type 2 diabetic to pre diabetic. I changed my diet to low carb/high protein and 3 months later and a retest showed an Hba1c of 5.7 which to me said I had it on the run. Instead, I was told I was no longer diabetic and to go back to eating white bread, pasta, chips and pretty much anything else I wanted ! I saw the doctor again as I wasn't happy at all about that and was told I am pre diabetic and should continue eating as I am but then further advice from dietician says to eat wholemeal bread, pasta and rice plus beans and pulses, fruit etc. All of those things send my BG through the roof and it takes a long time for them to return to normal. I am losing too much weight...gone from 11st 2 to 9st 3 and its still dropping off despite eating more fat. So the question is...how do I stop the weight loss and what on earth should I eat???...totally confused as to maintain the weight and from the advice given I should be eating lots more carbs BUT if I do my BG will rise badly and no doubt lead to a diabetic range in a years time when they take it again! I feel so out of control as I don't know what to eat or do anymore. I have to stop the weight loss AND keep my sugars under control to prevent diabetic problems in the future. It runs in my family so I obviously need to be careful. I eat less than 50g of carb a day but if I add any more to my meals my bg goes sky high and takes forever to come down I eat a lot more fat in the form of butter and cream etc but it isn't helping to keep my weight up. Any advice on what I should be eating or how to stop the weight loss without sending my BG through the roof?

It sounds as if more carbs isn't going to work for you, but if you could help me out by clarifying what you mean by "through the roof" and "a long time to come down" when referring to your bloods.

When I reached a point where I wanted to stop losing weight it took me a while to achieve it, during which time I continued to lose, albeit more slowly, but frankly you are going to have to eat more. When I started trying to level out, I firstly upped my protein a bit, and ensured that if I was eating pork chops, or another fattier cut, that I was eating that fat, rather than discarding it. When that wasn't enough, it was up with the deliberate fats - mainly cheese, but also a bit more butter on veg etc.. I started eating more cheese, but when that wasn't enough I started adding some peanuts at lunchtime, and so on. But, it's important to do things in a controlled way. I don't mean weighing every morsel, but I do mean, making a conscious effort to ensure you are actually eating more. If you go on auto-pilot, it is likely you will fall back to what has been your recent habits.

At a BMI of 21, you're not underweight, so there is no medical concern, I'm assuming,

Looking at your HbA1c, at 5.7 /39, you are under the diabetes dignosis line by some margin, and pre-diabetes by a few mmol/mol, so you may be able to get a way for a few additional carbs - but not going all the way back to "old life" eating. If I up my carbs and consume more than I am used to, my bloods will go up a bit, but come down pretty pronto, which I accept differs from your description, but please do a little reading on the "last meal effect", which explains how it can take eating something a couple of times before your body is completely comfy with it. First time around, the reaction is sometimes a bit more extreme and it's almost as if you shock your body into trying to cope with the extra carb.

You're just going to have to feel your way through this.

 

[Gezzabelle]

It is a minefield for sure. My initial Hb1c was 6.5 and that's the grey area it seems for diagnosis. Some gps see it as diabetic but others say it is pre diabetic. My 5.7 was achieved by changing my diet and they saw 5.7 as me not being diabetic or even pre diabetic and didn't take into account at all that it was only diet changes that made it come down to that...(the same as a diabetic would hope to achieve ) If I eat a small slice of wholemeal bread or a small amount of wholegrain pasta or rice my bg goes up to high 20's and takes up to 10 hours to come down. Even vegetable like broccoli and cauliflower make my numbers go up by 4 or 5 which surprises me. Too much protein also makes it rise to 9's and 10's and takes 8 hours to come down. I am not underweight but really don't need to lose any more either. It is as you say a case of ''feeling my way through it and finding the right balance.

 

[andcol]

Hi @Gezzabelle not good. if you had said that a piece of bread takes you to 10 I would have said that that is just you being unused to the carb load but that clearly isnt the case as you are going so high and also the broccoli and cauliflower raising your levels so high is surprising too.
Have you told your Dr this? I would request an insulin test as it sounds to me that you aren't producing much at all. I think all you can do is try more fat to stem the weight loss. I find peanuts are quite a good load of fat,protein and carb for weight maintenance/gain, but you may find that takes you too high

 

[Gezzabelle]

Hi @Gezzabelle not good. if you had said that a piece of bread takes you to 10 I would have said that that is just you being unused to the carb load but that clearly isnt the case as you are going so high and also the broccoli and cauliflower raising your levels so high is surprising too.
Have you told your Dr this? I would request an insulin test as it sounds to me that you aren't producing much at all. I think all you can do is try more fat to stem the weight loss. I find peanuts are quite a good load of fat,protein and carb for weight maintenance/gain, but you may find that takes you too high

My doctor refuses to even acknowledge that I am diabetic as I strongly suspect. Every place I have looked and also on this forum an HbA1c of 6.5 is diabetic but my gp at best says pre diabetic. Pre diabetes is the closest he will go to any kind of diagnosis and the dietician is as bad only telling me to eat lots of ''healthy carbs'' and to stop testing. I despair at getting any kind of help from them now and will just have to go on trying to find the right balance with everything I eat....more fat and nuts and see what effect that has. I was quite surprised to see more weight loss as it had stabilised and also because I have added a lot more butter and cream to my diet to try and keep it there but seems my body has other ideas on that.

 

[andcol]

well there is the option of eating as she says for 3 months get retested and prove them wrong. Not great I know but ... Thinking about what you said again I would also push for tests for MODY as you do seem to fit the pattern some what. If your doctor will not take you serious is there another one at the practice you can see or you could ask to be referred to a specialist for a second opinion as you do not fit into his/her knowledge base.

 

[hankjam]

When you were losing your weight, did you keep a record so you could see the rate of loss?
BMI comes with baggage and I use it when I was losing. I'm 21.6 at the moment, 1.8m in height, which means I'm getting close(ish) to the edge of recommended. I did flatten and worried at one stage I was not going to... though last week was a shock!

I've not really changed what I eat, though I am trying to eat less meat.... proving a challenge.
Good luck

 

[Gezzabelle]

well there is the option of eating as she says for 3 months get retested and prove them wrong. Not great I know but ... Thinking about what you said again I would also push for tests for MODY as you do seem to fit the pattern some what. If your doctor will not take you serious is there another one at the practice you can see or you could ask to be referred to a specialist for a second opinion as you do not fit into his/her knowledge base.

Things are getting very strained between me and the practice as I made a complaint about the way I have been treated after being left with no information and then being told to go back to eating anything I wanted after all my hard work to get my Hba1c down. I didn't consider being told to eat chips, chocolate or anything like it to be correct or helpful. I have to get more tests for liver function and other stuff in a month so perhaps then I can approach them about further investigation and if not find another practice.

 

[Hiitsme]

Hi Gezzabelle
Can you eat the Lidl rolls or is there a problem with them now? I know you were having a scan. I have lost all the weight I needed to and told not to lose any more. My BMI went from 25 to 20.2. I've now put on a little (though I darn't put on much) by adding Lidl rolls and Lovlife bread in small quantities which seems to work for me. It took a couple to months to stop losing weight and even so my blood sugars have gone up a bit but nothing like what seems to be happening to you. I wonder if Andrew's idea for getting tested for MODY would be a good idea though I have no knowledge of MODY.

 

[Lamont D]

I take it you keep a food diary with all your readings and what you have eaten.
I agree with Andrew, that your GP is and has been out of his depth with your problems.
It does sound like your insulin is very low!
The only way to convince him is to pester him and prove to him that there is more going on than he realises, that could mean eating carbs, to prove a point!
He will eventually see sense, if you show him your records.
Here's hoping!

 

[Gezzabelle]

Hi Gezzabelle
Can you eat the Lidl rolls or is there a problem with them now? I know you were having a scan. I have lost all the weight I needed to and told not to lose any more. My BMI went from 25 to 20.2. I've now put on a little (though I darn't put on much) by adding Lidl rolls and Lovlife bread in small quantities which seems to work for me. It took a couple to months to stop losing weight and even so my blood sugars have gone up a bit but nothing like what seems to be happening to you. I wonder if Andrew's idea for getting tested for MODY would be a good idea though I have no knowledge of MODY.

I don't eat the Lidl rolls now as the soya content has caused me problems. I maybe have one a week now and not daily as I did before. It was because of the weight loss I ate them so much as they seemed to help and didn't affect my blood. I thought my losing had stopped but it has suddenly kicked in again so will have to eat more...maybe 4 or 5 smaller meals instead of the normal breakky, lunch and dinner. As for MODY....the diabetes in my family is type 2 as far as I know so would have thought mine would be the same

 

[Bluetit1802]

I had 4 stones to lose when I was diagnosed. I lost it very easily on a low carb increased fats diet. When I reached target weight I increased my dairy fats but carried on losing, albeit slower. I increased my fats more. Then more again. I didn't want to increase carbs because I still had a little way to go to get my levels down to where I wanted them. It took at least 2 months to get the balance right and a lot of calorie counting before my weight stabilised with a BMI of 20. I have been at this lovely new weight now for 10 months, but it really was hard work getting the balance right.

I would simply ignore your nurse's dietary advice if you want to say in non-diabetic territory. Eating white bread? What planet is she on? Mind you, my nurse told me to eat baked potatoes with baked beans, and plenty of mushy peas. You know what you ate to get your levels down to 5.7 (well done by the way) so continue with that, but keep adding extra calories back from fats and protein until your weight stabilises where you want it. It may take a couple of months, as it did with me.

 

[Gezzabelle]

I take it you keep a food diary with all your readings and what you have eaten.
I agree with Andrew, that your GP is and has been out of his depth with your problems.
It does sound like your insulin is very low!
The only way to convince him is to pester him and prove to him that there is more going on than he realises, that could mean eating carbs, to prove a point!
He will eventually see sense, if you show him your records.
Here's hoping!

I take it you keep a food diary with all your readings and what you have eaten.
I agree with Andrew, that your GP is and has been out of his depth with your problems.
It does sound like your insulin is very low!
The only way to convince him is to pester him and prove to him that there is more going on than he realises, that could mean eating carbs, to prove a point!
He will eventually see sense, if you show him your records.
Here's hoping!

Yes I do keep records and when I tried to show them I got ignored....so I vocalised some of what I ate and got told that all of it was wrong and to stop testing and eat ''healthy carbs''. My practice is very much of the 'old school' and refuses to move in to the new way of thinking.

 

[Bluetit1802]

Yes I do keep records and when I tried to show them I got ignored....so I vocalised some of what I ate and got told that all of it was wrong and to stop testing and eat ''healthy carbs''. My practice is very much of the 'old school' and refuses to move in to the new way of thinking.

The only way to deal with a practice like yours is to nod happily when they tell you to eat carbs, and then go away and ignore them. Entering into discussions probably won't get you anywhere at all and will only antagonise them.

 

[Gezzabelle]

The only way to deal with a practice like yours is to nod happily when they tell you to eat carbs, and then go away and ignore them. Entering into discussions probably won't get you anywhere at all and will only antagonise them.

That is basically what I have done now....I don't need the stress of trying to get through to them. The only glimmer of hope was a new long term locum I saw last week. He said I had done very well to get my HbA1c down so quickly and to go on doing whatever it was I was doing as it is obviously working. He also passed on my previously ignored complaints and the practice manager rang me to sort a few things out which may or may not benefit others. As for me...I will go on as I am and hopefully stop the weight loss with a little more effort and with thanks to all the help and advice here

 

[Brunneria]

Brilliant advice above.

These are a few suggestions you could try, but i am unsure whether they will be any use, because a rise to 20mmol/l is pretty severe!

Hummus - its an interesting blend of carbs, protein and fat. So it may help you bring in extra carbs in a slow release, non spiking way plus lots of extra calories in the fat. But while it works fine for me, it will depend entirely what your personal chick pea tolerance is.

What happens to your cauli and broccoli spike if you have them with cheese and/or cream?

If those two work for you, or don't, we can put our heads together for some more suggestions.

Your bg control, in such circumstances is awesome. I am very impressed, and not a little jealous. But not of the negatives, you understand!

 

[Gezzabelle]

Brilliant advice above.

These are a few suggestions you could try, but i am unsure whether they will be any use, because a rise to 20mmol/l is pretty severe!

Hummus - its an interesting blend of carbs, protein and fat. So it may help you bring in extra carbs in a slow release, non spiking way plus lots of extra calories in the fat. But while it works fine for me, it will depend entirely what your personal chick pea tolerance is.

What happens to your cauli and broccoli spike if you have them with cheese and/or cream?

If those two work for you, or don't, we can put our heads together for some more suggestions.

Your bg control, in such circumstances is awesome. I am very impressed, and not a little jealous. But not of the negatives, you understand!

If I eat cauli with cream or cheesy sauce it spikes less. Chick peas are something I haven't tried yet....need to give them a whirl and also black beans....used to love them and haven't had any since. I am strict with my number control and hate to see a big rise. No way is this messing up my health...I will beat it whatever it takes. I even eat sprouts for heavens sake and that is devotion way above normal for me as I absolutely hate them lol. I just need a few pounds back on my bones without spiking my bg too much and with all these suggestions and good advice, hopefully that will happen

 

[Brunneria]

Been mulling this over, and if there is anything in life that i know how to do well, it is halt weight loss and put ON weight!

I only put on weight from carbs, although too much protein will halt weight loss. Obviously you are more sensitive to both carbs and protein than me, but the same principle may work...

The trick will be to use fat and fibre to slow digestion, while eating just enough carbs to produce just enough insulin, that you start laying down teensy fat reserves, while not spiking.

So basically that is fat and fibre with small amounts of carbs or protein, and lots of experimentation. Off the top of my head, i am thinking:
Pate
Cheese
The hummus i mentioned
- all on things like low carb crackers, oatcakes, ryvita.
You may need to eat just half an oatcake, and see what happens, to start with.
And with the Last Meal Effect you will need to start VERY slowly, and keep it up for a week or two.

Remember when you spiked with lidl rolls, the first day, but it improved over the next few days. That may have been the last meal effect in action.

Nuts are good. Cashew has the highest carb, but you will have to rest to see if that is good or bad for your bg.

Introducing dessert. LC mug cakes. Berries and cream. - watching for the last meal thingy, may mean you start with just one or two strawbs, and build slowly.

Basically, i am suggesting infinitesimally slow and small carb re-entry over time, building gently to give time to adjust, accompanied by lashings of lovely fat. As a first step, you might want to just increase protein a wee bit, to let the carb release from the protein start the process. Only you will know what portions to start with.

 

[ButtterflyLady]

Is there any way you can change to another medical practice and start afresh? I understand that if you contact the NHS office and say you have had problems with a practice they may allow to register outside your area. It's not nice when you don't feel you have a good relationship with your HCPs.

 

[Gezzabelle]

Been mulling this over, and if there is anything in life that i know how to do well, it is halt weight loss and put ON weight!

I only put on weight from carbs, although too much protein will halt weight loss. Obviously you are more sensitive to both carbs and protein than me, but the same principle may work...

The trick will be to use fat and fibre to slow digestion, while eating just enough carbs to produce just enough insulin, that you start laying down teensy fat reserves, while not spiking.

So basically that is fat and fibre with small amounts of carbs or protein, and lots of experimentation. Off the top of my head, i am thinking:
Pate
Cheese
The hummus i mentioned
- all on things like low carb crackers, oatcakes, ryvita.
You may need to eat just half an oatcake, and see what happens, to start with.
And with the Last Meal Effect you will need to start VERY slowly, and keep it up for a week or two.

Remember when you spiked with lidl rolls, the first day, but it improved over the next few days. That may have been the last meal effect in action.

Nuts are good. Cashew has the highest carb, but you will have to rest to see if that is good or bad for your bg.

Introducing dessert. LC mug cakes. Berries and cream. - watching for the last meal thingy, may mean you start with just one or two strawbs, and build slowly.

Basically, i am suggesting infinitesimally slow and small carb re-entry over time, building gently to give time to adjust, accompanied by lashings of lovely fat. As a first step, you might want to just increase protein a wee bit, to let the carb release from the protein start the process. Only you will know what portions to start with.

All that info is very helpful....thank you so much. I will try and introduce a few carbs and fibre and also fat (which is always kind of easy to do ) Never thought I would be struggling to put some weight on...it was all but impossible to get rid of before all this lol.