My partner has had type 2 diabetes for 2 years following a kdney transplant. Had very little help from the hospital on diet, just pills, and his GP is very negative about everything, just telling him he won't manage to lose weight and would be better to go on insuline. I have tried various diets and managed to get his bloods down from over 100 to 75. Then I found the low carb forum on here (don't know what I'd do without this web site, it's been my only support) and tried him on a low carb high fat diet. We cut out potatoes and root veg, bread and all things made from flour (am experimenting with coconut flour), pasta and rice. Doctor at the hospital a few weeks ago was very pleased as my partner had lost 4kg, his blood was down to 65 and his cholesterol was 3.4. The only problem was that his blood pressure was a bit high. And it is continuing to rise despite being on medication to lower it. Having read up a bit on Google, some people are saying that a very low carb diet is not good for you, so do you think we have overdone it? He used to eat bananas every day, but I stopped it. Both they and potatoes have potassium which might have been counteracting the effects of the salt in the bacon and tins of salmon we've been eating. Has anyone experienced anything similar and do you think I should start reintroducing a few carbs here and there, like a few new potatoes or a bit of whole-wheat spaghetti? I am disappointed because I thought we were doing so well.
Hiya...I can completely relate. I had a kidney transplant In February 2015 at 52 years of age after a life on high blood pressure which went along with the gradual deterioration of my kidneys since birth. I was diagnosed with steroid induced "new onset" diabetes a couple of months later - developing into Type 2.
I suspect your husband has had increased blood sugar following long term treatment (ie. more than three months) with a particular steroid...the most common post transplant being
Prednisolone.
You will know that the single most important level to be concerned about is his creatinine level (ie. representing the actual kidney function) and that needs to be protected at all costs. The steroid, along with anti-rejection drugs (in my case
Progaf, or Tacrolimus, and
MMF) are to ensure that the new graft doesn't get attacked by the body's own system...and they do this by lowering the immune system (which can leave us open to infections...so the drugs need to be monitored carefully and tweaked to keep the balance right - a very individual matter). Drawbacks include a slight impact of both creatinine and
blood pressure.
It's a trade off to ensure a good safe kidney. I was warned about the high risk of diabetes from the steroid used..and was prepared to risk it to keep the kidney healthy. I'd rather have Type 2 (which I have now got well under control - thanks to this site and to low carbing) than rejection! My blood sugar has gradually come right down to well manageable levels and I stopped the meds I was given for diabetes along time ago now. All renal docs and my diabetic specialist are delighted and have entirely approved my approach.
So - NO -
DON'T re-introduce more carbs...there is NO need. There is
no such thing as a carb deficiency...and it has very very little to do with the condition of either kidney or blood pressure in your husband's case. Persist with low carbs. Make sure he eats plenty of good veg (broccoli, cauliflower, spinach, leafy stuff) and maybe oily fish, avocado and nuts on top of bef, pork, lamb, chicken, fish (particularly tuna and salmon), mushrooms etc etc. Be strict -
NO spuds/chips, pasta, rice, bread or cereal (at least until you really see the difference in blood sugar levels). CRUCIALLY - he must drink 2-3 litres of fluid a day...preferably water (I prefer very very diluted Robinsons juice) as it will ensure he is hydrated properly (and the kidney needs that).
Not enough fluid also increases the blood pressure. I found my blood pressure was always higher at the clinic, so I got a wee machine and tested it at certain times at home. It's lower with plenty of fluid, reduced anti-rejection meds, lower blood sugar and LESS STRESS (eg. arriving at a clinic stressed and being taken right away to have levels measured!).
I could help more if I knew what your husbands BP actually was. I was up at 160/120...now steadily down around 120/80 (my docs changed my blood pressure meds from lisinopril to amplodopine and added a beta-blocker called atenolol - really helped).
Ask his doctors about cutting the steroid down or out altogether..research indicates this is entirely appropriate and many clinics now avoid steroids completely with transplant patients and rely (successfully) of the anti-rejection drugs alone. I had mine cut from 25mg a day to 2.5 mg per day - made a massive difference to blood sugars, and helped my blood pressure a bit too.
Anyway- hope that helps. If you have any questions at all please don not hesitate to ask. Good luck to your husband...by today's higher standards, a transplanted kidney still functioning after 2 years is well past the big danger areas. He can and will get both blood sugars and blood pressure down with the right approach and should discuss options with his renal team.
Paul
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