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22 Months In .........

C

CoastGirl

Well-Known Member
Messages
105
Location
Hampshire
Type of diabetes
Type 2
Treatment type
Diet only
Well, here I am 22 months down the line from diagnosis and still confused!!

HbA1c at diagnosis of 63. This came down to 40 in first three months on LCHF and hasn't budged since. I just can't seem to get this any lower. I don't t carb count but keep them as low as I can. A normal days food would be something along the lines of

Breakfast - coffee with cream or a small bowl of nut granola with 1/2 skyr yogurt and 4-5 berries

Lunch - salad of leaves, pepper, advocado, olives, tomato or similar with a protein of tuna/salmon/chicken/eggs/cheese

Supper - Meat/fish and vegetables

I haven't eaten any wheat based breads or pasta, rice or refined carbs since diagnosis. Occasionally I have a roast or new potato. I only eat 85% chocolate or very occasionally some low carb bake I've made.

My fasting glucose is normally in the low 6s and I've never really managed, except a couple of occasions, to get into the 5s. It remains there until mid morning when I might or might not drop into the top 5s. By mid afternoon I am normally in the low 5s. After supper will rise to mid 6s and may or may not drop before bed depending on what I've eaten.

I do a couple of exercise classes a week, am on the go all day with work or at home with house work and young teenager, do lots of gardening and general running around. Only time I really sit down is to read the forum or try to do some frustratingly confusing research around diabetes:confused:

I am 52 and yes, I am menopausal:(. I am 5'7 and at diagnosis was 75kg so just in the obese range. In first 3 months I dropped to 60kgs and BMI 21. I have not really budged from this weight and don't really want to go much lower. All my bloods appear to be in a fairly healthy range . Cholesterol is 5.7, HDL 1.5, LDL 3.2, Trigs 1.

I am guessing I am still very insulin resistant but do not understand why! According to my GP I do not have fatty liver however I think she is only basing this on my liver tests. My ALT, which I understand can predict fatty liver, has dropped from 40 to 15 and all other liver results are well within range. According to Jason Fung, if I read correctly, once your liver is emptied of fat and you are eating low carb, your insulin resistance should go.

I am 2 weeks into intermittent fasting 18/6 or 16/8 depending on the day and no significant improvement in fbg or any other reading:banghead:. I have also given up the very small amount of full fat milk I drank in my tea.:(

In my search for answers I saw a functionally medicine practitioner in Lewis last week and she is testing the following:
Fasting insulin
Insulin Antibodies
GAD
Estrogen
Progesterone
Testosterone
DHEA-S
SHBG
Cortisol
Adrenaline
Free T4
Free T3
TSH
TPO antibodies

I have a follow up appointment with her at the beginning of November.

Is anyone else hitting a similar brick wall:banghead:? Any ideas any of you extremely knowledgeable crowd may have I would love to hear.

Thanks so much for reading this rather long ramble I REALLY appreciate it.

Best wishes to you all!
 
Your diet sounds very similar to mine including 85% chocolate and occasional low carb bakes! I got my HbA1c down from 70 to 36 in four months, with fasting bloods in the 5s now. I also lost over three and a half stone in the process but I still have more to loose. The only differences I see are that I do count my carbs accurately every day, I currently eat 50-70g per day and I take Metformin 500mg x 3/day. I appreciate that you may not want to go down the drugs route but that might just bring your bloods down a little bit further.
 
an HbA1c is actually excellently well done and something to be proud of..

if you want it even lower then you could up fitness , long walks and also counting the number of grams of carbs in a day, to many it is low enoungh to go under 150 grams in a day others have to go under 100 grams or 50 grams in a day , it all depends on how huge one insuline resistance is , and that differs from one person to the other...

I think my HbA1c will be around 40 next time , even though it was 34 last time.. I live more relaxed now and also eat almost the double of what I did when doing 1000 calories initially... my level of carbs is around 200 grams a day and I also do take metformin 2 x 850 mg...
just keep you nose in your track and remember to give yourself credit for what great work you are actually doing...
as people say in here it is a marathon not a short sprint to have the diagnosis of diabetes and live controlled with it

by the way I am 53 years old..
 
Rachox said:
Your diet sounds very similar to mine including 85% chocolate and occasional low carb bakes! I got my HbA1c down from 70 to 36 in four months, with fasting bloods in the 5s now. I also lost over three and a half stone in the process but I still have more to loose. The only differences I see are that I do count my carbs accurately every day, I currently eat 50-70g per day and I take Metformin 500mg x 3/day. I appreciate that you may not want to go down the drugs route but that might just bring your bloods down a little bit further.
Click to expand...
Thanks @Rachox. I don't count my carbs either but guess I'm about 30g ish. I would love to go on metformin but GP won't prescribe as she says I'm well controlled!! I think I would have to let my HbA1c go up for her to even consider it and not sure that is the best thing to do!
 
Freema said:
an HbA1c is actually excellently well done and something to be proud of..

if you want it even lower then you could up fitness , long walks and also counting the number of grams of carbs in a day, to many it is low enoungh to go under 150 grams in a day others have to go under 100 grams or 50 grams in a day , it all depends on how huge one insuline resistance is , and that differs from one person to the other...

I think my HbA1c will be around 40 next time , even though it was 34 last time.. I live more relaxed now and also eat almost the double of what I did when doing 1000 calories initially... my level of carbs is around 200 grams a day and I also do take metformin 2 x 850 mg...
just keep you nose in your track and remember to give yourself credit for what great work you are actually doing...
as people say in here it is a marathon not a short sprint to have the diagnosis of diabetes and live controlled with it

by the way I am 53 years old..
Click to expand...
Thanks @Freema. I do walk most days for about half an hour to work and back with heavy shopping. You are right, I just have to keep my nose to the ground and continue the good work. Hopefully some of the test results my shed some light into why I am stalling. Think it may well be a complex mess up of hormones!:bored:
 
CoastGirl said:
Thanks @Rachox. I don't count my carbs either but guess I'm about 30g ish. I would love to go on metformin but GP won't prescribe as she says I'm well controlled!! I think I would have to let my HbA1c go up for her to even consider it and not sure that is the best thing to do!
Click to expand...
Oh no that wouldn’t be right! But I guess you’re kind of stuck between the devil and the deep blue sea :grumpy:
 
Freema said:
an HbA1c is actually excellently well done and something to be proud of..

if you want it even lower then you could up fitness , long walks and also counting the number of grams of carbs in a day, to many it is low enoungh to go under 150 grams in a day others have to go under 100 grams or 50 grams in a day , it all depends on how huge one insuline resistance is , and that differs from one person to the other...

I think my HbA1c will be around 40 next time , even though it was 34 last time.. I live more relaxed now and also eat almost the double of what I did when doing 1000 calories initially... my level of carbs is around 200 grams a day and I also do take metformin 2 x 850 mg...
just keep you nose in your track and remember to give yourself credit for what great work you are actually doing...
as people say in here it is a marathon not a short sprint to have the diagnosis of diabetes and live controlled with it

by the way I am 53 years old..
Click to expand...

Wow @Freema, just re-read your post! Well done to you if you get HbA1c of 40 and eating 200g of carbs per day ...... I'm jealous!
 
CoastGirl said:
Well, here I am 22 months down the line from diagnosis and still confused!!

HbA1c at diagnosis of 63. This came down to 40 in first three months on LCHF and hasn't budged since. I just can't seem to get this any lower. I don't t carb count but keep them as low as I can. A normal days food would be something along the lines of

Breakfast - coffee with cream or a small bowl of nut granola with 1/2 skyr yogurt and 4-5 berries

Lunch - salad of leaves, pepper, advocado, olives, tomato or similar with a protein of tuna/salmon/chicken/eggs/cheese

Supper - Meat/fish and vegetables

I haven't eaten any wheat based breads or pasta, rice or refined carbs since diagnosis. Occasionally I have a roast or new potato. I only eat 85% chocolate or very occasionally some low carb bake I've made.

My fasting glucose is normally in the low 6s and I've never really managed, except a couple of occasions, to get into the 5s. It remains there until mid morning when I might or might not drop into the top 5s. By mid afternoon I am normally in the low 5s. After supper will rise to mid 6s and may or may not drop before bed depending on what I've eaten.

I do a couple of exercise classes a week, am on the go all day with work or at home with house work and young teenager, do lots of gardening and general running around. Only time I really sit down is to read the forum or try to do some frustratingly confusing research around diabetes:confused:

I am 52 and yes, I am menopausal:(. I am 5'7 and at diagnosis was 75kg so just in the obese range. In first 3 months I dropped to 60kgs and BMI 21. I have not really budged from this weight and don't really want to go much lower. All my bloods appear to be in a fairly healthy range . Cholesterol is 5.7, HDL 1.5, LDL 3.2, Trigs 1.

I am guessing I am still very insulin resistant but do not understand why! According to my GP I do not have fatty liver however I think she is only basing this on my liver tests. My ALT, which I understand can predict fatty liver, has dropped from 40 to 15 and all other liver results are well within range. According to Jason Fung, if I read correctly, once your liver is emptied of fat and you are eating low carb, your insulin resistance should go.

I am 2 weeks into intermittent fasting 18/6 or 16/8 depending on the day and no significant improvement in fbg or any other reading:banghead:. I have also given up the very small amount of full fat milk I drank in my tea.:(

In my search for answers I saw a functionally medicine practitioner in Lewis last week and she is testing the following:
Fasting insulin
Insulin Antibodies
GAD
Estrogen
Progesterone
Testosterone
DHEA-S
SHBG
Cortisol
Adrenaline
Free T4
Free T3
TSH
TPO antibodies

I have a follow up appointment with her at the beginning of November.

Is anyone else hitting a similar brick wall:banghead:? Any ideas any of you extremely knowledgeable crowd may have I would love to hear.

Thanks so much for reading this rather long ramble I REALLY appreciate it.

Best wishes to you all!
Click to expand...
Surely an hba1c of 40 is really good? I genuinely don't understand why you want it lower?
 
My last A1c was 43 and I was blummin chuffed with that. I would like it in the non diabetic range but wouldn't be brokenhearted if I never got there. My reading at dx was 98, my reduction means that I have vastly lowered my risk of complications so I am well pleased.
I am post menopausal and that might have something to do with it, I liken the menopause to being pregnant plus being a teenager at the same time, the body is having to deal with so many changes that there are few systems that it does not affect.
 
Hi @CoastGirl,

Looking at your diet, I don't really know what you could change to get your carbs even lower. Also, you seem to be very active -- so there probably isn't room for improvement either.

I have two thoughts about what might be going on -- but mind you I'm only guessing.

First, given your busy lifestyle, your cortisol might be a bit higher, leading to higher insulin resistance and somewhat higher blood sugars. I guess since you will get this tested, this should be an easy one to figure out.

Second, it might be due to adaptive glucose sparing (or physiological insulin resistance), i.e. your muscles use fat as their preferred source of energy in order to conserve glucose for those processes that absolutely depend on it, such as creating red blood cells and the brain. Thus, adaptive glucose sparing might increase your overall blood glucose levels somewhat. One of the sources, I read (unfortunately I don't remember where) states that fasting blood sugars up to 110 mg/dl (6.1 mmol) are absolutely normal on a ketogenic diet and nothing to worry about.

You might be able to deal with this by increasing your carbs slightly (maybe try to go up to 50 carbs for a while) and see what happens.
 
CoastGirl said:
Thanks @Rachox. I don't count my carbs either but guess I'm about 30g ish. I would love to go on metformin but GP won't prescribe as she says I'm well controlled!! I think I would have to let my HbA1c go up for her to even consider it and not sure that is the best thing to do!
Click to expand...

well that might be a good idea after all type 2 is usually for good.... so if one can get numbers lower by taking that , but well metformin do have side effects one can be not being able to uptake vitamin B 12 .. and that is a disaster for our health and body and can in itself lead to neuropathy
 
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the most important is to be under HbA1c of 45 as that is the level over which the most frequent damage in the body seems to really start occurring... but of cause better to be under 40 ...
I think your GP will give you metformin only to let you relax a bit on your carbs... they are usually against such low levels of carbs on a daily basis... you could use that as an argument, I think your GP will understand how hard a regimen you are on only eating like 30 grams of carbs in a day
 
Lally123 said:
Surely an hba1c of 40 is really good? I genuinely don't understand why you want it lower?[/QUOTE
woodywhippet61 said:
That's what I was going to say. Why do you want it lower? You've done really well to keep it there for so long.
Click to expand...
Thanks @Lally123 and @woodywhippet61 I am not too bothered about the HbA1c as it is only the average although I would like to get it a little lower to maybe give me some leeway. I am more concerned with the fbg and why, no matter what I do, I just can't nudge it down to non diabetic range and that it stays in the 6s most of the day. I think this probably means my insulin is running high and this is more of a concern. Yes, overall I am very happy with what I've achieved.
Click to expand...
 
ziggy_w said:
Hi @CoastGirl,

Looking at your diet, I don't really know what you could change to get your carbs even lower. Also, you seem to be very active -- so there probably isn't room for improvement either.

I have two thoughts about what might be going on -- but mind you I'm only guessing.

First, given your busy lifestyle, your cortisol might be a bit higher, leading to higher insulin resistance and somewhat higher blood sugars. I guess since you will get this tested, this should be an easy one to figure out.

Second, it might be due to adaptive glucose sparing (or physiological insulin resistance), i.e. your muscles use fat as their preferred source of energy in order to conserve glucose for those processes that absolutely depend on it, such as creating red blood cells and the brain. Thus, adaptive glucose sparing might increase your overall blood glucose levels somewhat. One of the sources, I read (unfortunately I don't remember where) states that fasting blood sugars up to 110 mg/dl (6.1 mmol) are absolutely normal on a ketogenic diet and nothing to worry about.

You might be able to deal with this by increasing your carbs slightly (maybe try to go up to 50 carbs for a while) and see what happens.
Click to expand...
Hi @ziggy_w, yes, upping my carbs slightly may well work. Might give this a try when I have some time off so I can monitor properly. I do suspect my hormone balance has a lot to answer for though!
 
Guzzler said:
My last A1c was 43 and I was blummin chuffed with that. I would like it in the non diabetic range but wouldn't be brokenhearted if I never got there. My reading at dx was 98, my reduction means that I have vastly lowered my risk of complications so I am well pleased.
I am post menopausal and that might have something to do with it, I liken the menopause to being pregnant plus being a teenager at the same time, the body is having to deal with so many changes that there are few systems that it does not affect.
Click to expand...
Thanks @Guzzler. I do think my hormone balance at the moment holds many of the secrets.
 
CoastGirl said:
Thanks @Freema. I do walk most days for about half an hour to work and back with heavy shopping. You are right, I just have to keep my nose to the ground and continue the good work. Hopefully some of the test results my shed some light into why I am stalling. Think it may well be a complex mess up of hormones!:bored:
Click to expand...

well I have done more things than lowering my level of carbs, I have also deliberately been building muscle to better my insulin sensitivity and think I now have gained around 5 kg of muscles and do high very high cardio twice a week for around 1 hour each time
 
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Freema said:
well that might be a good idea after all type 2 is usually for good.... so if one cant get numbers lower by taking that , but well metformin do have side effects one can be not being able to uptake vitamin B 12 .. and that is a disaster for our health and body and can in itself lead to neuropathy
Click to expand...

I hadn't thought of that @Freema, that is obviously something to consider.
 
Freema said:
well I have done more things than lowering my level of carbs, I have also deliberately been building muscle to better my insulin sensitivity and think I now have gained around 5 kg of muscles and do high cardio twice a week for around 1 hour
Click to expand...
Maybe some resistance work would be good for me to build the muscle and maybe lower IR.
 
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