All the things I wish I’d been told at type 2 diagnosis

[HSSS]

You’ll probably have been or will be told something along the lines of all things in moderation, reduce sugar and fat, eat lots of fruit and veg. This advice has led to diabetes t2 being seen as progress and leading to more and more medication for the last few generations. Plenty of official sources still say this. However more and more are waking up to the reality and science that carbs or more specifically lowering carbs is the answer. It is NHS, ADA and NICE endorsed so safe.

Can I suggest you take a good look at LCHF ie low carb, higher fat (than recommended for the last few decades) methods of eating.

It’s how an awful lot of us get our blood sugar levels under control and for some even eliminate medications and achieve remission and also reduce or improve complications.

It is often the easiest and most sustainable form of weight loss for a type 2 if you need that. Other conditions often improve including but not limited to blood pressure, joint pain, inflammation, PCOS, and despite the dire warnings of the last few decades it improves cholesterol for most, yes improves cholesterol.

Some jump right on it, others edge their toes in a bit at a time.

Try clicking these links for more detailed explanations that are well worth readings. These is a lot here so go at your own pace.

http://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html for info including low carb made simple

And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation

also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Also specifically the pages https://www.dietdoctor.com/diabetes and https://www.dietdoctor.com/low-carb. Excellent site and first port of call for many getting their head round low carb. They also have information regarding medications https://www.dietdoctor.com/low-carb/with-diabetes-medications and cholesterol https://www.dietdoctor.com/low-carb/cholesterol-basics

Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy. Be aware the the USA count carbs differently so be aware if you look at their counting, recipes or products. They include fibre in their count we don’t. So if it’s USA stuff deduct the fibre to get our figures. (Fibre isn’t generally digested thus doesn’t get counted)

Also it’s very important to be able to check for yourself what’s happening so you can make the necessary adjustments day to day and meal by meal rather than wait 3, 6 or even 12 months and then have no idea what had what effect. It also helps keep an eye out that any meds are working appropriately not too much or too little. Getting a blood glucose meter is the only way to do this (no matter what contradictory advice you may have heard - it’s usually budget based rather than anything more scientific). Test before a meal and 2hrs later hoping for a rise of 2mmol or less. More and the carbs eaten were too many! Please ask if you want any guidance on this.

IMPORTANT FOR ANYONE ON DIABETIC MEDS (Not applicable to just metformin): if you lower your carbs then any glucose lowering meds or insulin increasing meds may need to be adjusted accordingly to make sure you aren’t taking more than your new diet requires. It can cause a hypo if you have more gliclazide or insulin etc than your new carb intake requires. Keep a very close eye on your bgl numbers and do this with your dr’s knowledge so they can reduce medication accordingly. Please don’t be put off by an ill informed out dated rubbishing of low carb diets or being told you should eat carbs to match meds, it should be the other way around. Low carb is endorsed by the NHS and the ADA as an effective method of control, even if the practice staff don’t realise that yet.


edited April 2023 to update some links.

 

[xfieldok]

@HSSS reported post to ask if it can be made a sticky.

 

[jpatricia]

You’ll probably have been or will be told something along the lines of all things in moderation, reduce sugar and fat, eat lots of fruit and veg. This advice has led to diabetes t2 being seen as progress and leading to more and more medication for the last few generations. Plenty of official sources still say this. However more and more are waking up to the reality and science that carbs or more specifically lowering carbs is the answer. It is NHS, ADA and NICE endorsed so safe.

Can I suggest you take a good look at LCHF ie low carb, higher fat (than recommended for the last few decades) methods of eating.

It’s how an awful lot of us get our blood sugar levels under control and for some even eliminate medications and achieve remission and also reduce or improve complications.

It is often the easiest and most sustainable form of weight loss for a type 2 if you need that. Other conditions often improve including but not limited to blood pressure, joint pain, inflammation, PCOS, and despite the dire warnings of the last few decades it improves cholesterol for most, yes improves cholesterol.

Some jump right on it, others edge their toes in a bit at a time.

Try clicking these links for more detailed explanations that are well worth readings. These is a lot here so go at your own pace.

http://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html for info including low carb made simple

And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation

also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Excellent site and first port of call for many getting their head round low carb.

Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy. Be aware the the USA count carbs differently so be aware if you look at their counting, recipes or products. They include fibre in their count we don’t. So if it’s USA stuff deduct the fibre to get our figures. (Fibre isn’t generally digested thus doesn’t get counted)

Also it’s very important to be able to check for yourself what’s happening so you can make the necessary adjustments day to day and meal by meal rather than wait 3, 6 or even 12 months and then have no idea what had what effect. It also helps keep an eye out that any meds are working appropriately not too much or too little. Getting a blood glucose meter is the only way to do this (no matter what contradictory advice you may have heard - it’s usually budget based rather than anything more scientific). Test before a meal and 2hrs later hoping for a rise of 2mmol or less. More and the carbs eaten were too many! Please ask if you want any guidance on this.

IMPORTANT FOR ANYONE ON DIABETIC MEDS (Not applicable to just metformin): if you lower your carbs then any glucose lowering meds or insulin increasing meds may need to be adjusted accordingly to make sure you aren’t taking more than your new diet requires. It can cause a hypo if you have more gliclazide or insulin etc than your new carb intake requires. Keep a very close eye on your bgl numbers and do this with your dr’s knowledge so they can reduce medication accordingly. Please don’t be put off by an ill informed out dated rubbishing of low carb diets or being told you should eat carbs to match meds, it should be the other way around. Low carb is endorsed by the NHS and the ADA as an effective method of control, even if the practice staff don’t realise that yet.

Oh my, brilliant thank you so much. After 2 weeks of floundering, it's beginning to make sense. The websites are most helpful regards Patricia

 

[saky]

You’ll probably have been or will be told something along the lines of all things in moderation, reduce sugar and fat, eat lots of fruit and veg. This advice has led to diabetes t2 being seen as progress and leading to more and more medication for the last few generations. Plenty of official sources still say this. However more and more are waking up to the reality and science that carbs or more specifically lowering carbs is the answer. It is NHS, ADA and NICE endorsed so safe.

Can I suggest you take a good look at LCHF ie low carb, higher fat (than recommended for the last few decades) methods of eating.

It’s how an awful lot of us get our blood sugar levels under control and for some even eliminate medications and achieve remission and also reduce or improve complications.

It is often the easiest and most sustainable form of weight loss for a type 2 if you need that. Other conditions often improve including but not limited to blood pressure, joint pain, inflammation, PCOS, and despite the dire warnings of the last few decades it improves cholesterol for most, yes improves cholesterol.

Some jump right on it, others edge their toes in a bit at a time.

Try clicking these links for more detailed explanations that are well worth readings. These is a lot here so go at your own pace.

http://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html for info including low carb made simple

And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation

also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Excellent site and first port of call for many getting their head round low carb.

Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy. Be aware the the USA count carbs differently so be aware if you look at their counting, recipes or products. They include fibre in their count we don’t. So if it’s USA stuff deduct the fibre to get our figures. (Fibre isn’t generally digested thus doesn’t get counted)

Also it’s very important to be able to check for yourself what’s happening so you can make the necessary adjustments day to day and meal by meal rather than wait 3, 6 or even 12 months and then have no idea what had what effect. It also helps keep an eye out that any meds are working appropriately not too much or too little. Getting a blood glucose meter is the only way to do this (no matter what contradictory advice you may have heard - it’s usually budget based rather than anything more scientific). Test before a meal and 2hrs later hoping for a rise of 2mmol or less. More and the carbs eaten were too many! Please ask if you want any guidance on this.

IMPORTANT FOR ANYONE ON DIABETIC MEDS (Not applicable to just metformin): if you lower your carbs then any glucose lowering meds or insulin increasing meds may need to be adjusted accordingly to make sure you aren’t taking more than your new diet requires. It can cause a hypo if you have more gliclazide or insulin etc than your new carb intake requires. Keep a very close eye on your bgl numbers and do this with your dr’s knowledge so they can reduce medication accordingly. Please don’t be put off by an ill informed out dated rubbishing of low carb diets or being told you should eat carbs to match meds, it should be the other way around. Low carb is endorsed by the NHS and the ADA as an effective method of control, even if the practice staff don’t realise that yet.

Why should the post meal sugar spike be less than 2mmol/l or less. What if it is more and the sugars return to base line after 2.5 hours/3hours after eating the meal?

 

[HSSS]

Why should the post meal sugar spike be less than 2mmol/l or less. What if it is more and the sugars return to base line after 2.5 hours/3hours after eating the meal?

Because a non diabetic is typically back to baseline at 2hrs after most meals. The aim is to mimic this normal response as closely as possible. If you manage less of a rise and even closer to “normal” even better. This shows you roughly how many carbs you can cope with at your current level of insulin resistance/production. It’s not an exact figure but a realistic goal to aim for. Same as keeping levels below 7.8mmol as much as possible (excepting these 2 post prandial hours possibly) as that’s the level the chances of retinopathy increase noticly at and the reason they set the diagnostic level at the hba1c average equivalent. I certainly seems to work to reduce hba1c in those that stick to it.

The longer it takes the more you are struggling to clear that meal, the more insulin it’s taking and the longer your bgl is raised for. This increases insulin resistance making the underlying issues worse and complications more likely. Reducing the time spent raised will help reduce your insulin resistance.

 

[saky]

Thank you.. I understand now.

 

[saky]

Thank you.. I understand now.

Prediabetes Pre diabetes​

My today's(28th Jan) hba1c is 5.8% and RBS is 77mg/dl. I use freestyle libre cgm device and monitor my sugars and also use finger strips. Last hba1c was 5.4% on Dec 10th. My sugar readings(CGM and finger sticks) don't reflect the A1C value. Could the HbA1C be wrong? or what is going on?

 

[HSSS]

Prediabetes Pre diabetes​

My today's(28th Jan) hba1c is 5.8% and RBS is 77mg/dl. I use freestyle libre cgm device and monitor my sugars and also use finger strips. Last hba1c was 5.4% on Dec 10th. My sugar readings(CGM and finger sticks) don't reflect the A1C value. Could the HbA1C be wrong? or what is going on?

The hba1c is how much the red bloods cells have been effected by glucose in their (approximately 12 week) lifespan.

The blood glucose readings are how much glucose is in your body right now. If those readings were constantly the same then you could calculate the hba1c - In theory. In reality it’s a guesstimate.

Bgl varies throughout the day. Fingerpricks can miss high and low values and give a false estimate of the average as a result. The more reading you take across all parts of the day before and after eating etc the more accurate it will be. cgm are not always calibrated brilliantly. Some read high or low and sometimes only in one part of the range.

Lastly your blood cells might live a less than typical amount of time or be different in same way and effect the hba1c accuracy as a result. This tends to be things like some forms of anemia or something like sickle cell.

Both types of test have their uses and value but they are different and measure different things. Trying to use equilvients therefore is tricky for all the above reasons.

 

[saky]

Will try time restricted eating intermittent fasting

 

[louisew2605]

Will try time restricted eating intermittent fasting

I was put on basal only in september. I started 5:2 intermittent fasting on 6th January 2023. I am on Low carb 60g every day. Hbac1 on 29th December was 7.1. My Diabetes:M app is now estimating it at 6.4. ( but that included 2 months of very high readings at the start) I have reduced my basal insulin gradually to 12 units from 23. I have actually not been able to reduce it quickly enough and have had a couple of hypos at night. But I did get a Freestyle libre in case of this and I wake up anyway and take glucose. I can actually see my blood sugar dropping quite quickly in the evening and often have to have carbs to bring it up to 6 to avoid it. Dropping it another 2 to 10 tonight probably if needed. Absolutely no support from the diabetic nurse. Told to go low carb, no literature, no advice to look at website communities, no invitation to diabetes education. She didn’t even tell me to adjust my basal until i went in and told her I felt terrible 24 hours a day. Then she told me I could adjust it every 3 days So I decided to go for remission myself. Not overweight, so can’t lose too much weight, but lost 6lbs so far, which is advised even for thin diabetics to reduce visceral fat. Feeling fabulous and positive now

 

[HSSS]

I was put on basal only in september. I started 5:2 intermittent fasting on 6th January 2023. I am on Low carb 60g every day. Hbac1 on 29th December was 7.1. My Diabetes:M app is now estimating it at 6.4. ( but that included 2 months of very high readings at the start) I have reduced my basal insulin gradually to 12 units from 23. I have actually not been able to reduce it quickly enough and have had a couple of hypos at night. But I did get a Freestyle libre in case of this and I wake up anyway and take glucose. I can actually see my blood sugar dropping quite quickly in the evening and often have to have carbs to bring it up to 6 to avoid it. Dropping it another 2 to 10 tonight probably if needed. Absolutely no support from the diabetic nurse. Told to go low carb, no literature, no advice to look at website communities, no invitation to diabetes education. She didn’t even tell me to adjust my basal until i went in and told her I felt terrible 24 hours a day. Then she told me I could adjust it every 3 days So I decided to go for remission myself. Not overweight, so can’t lose too much weight, but lost 6lbs so far, which is advised even for thin diabetics to reduce visceral fat. Feeling fabulous and positive now

This is a guide for health care professionals you might wish to share with yours https://www.frontiersin.org/articles/10.3389/fnut.2021.688540/full

and this is general advice on medications and keto https://www.dietdoctor.com/low-carb/with-diabetes-medications which may be of interest.

On low carb and keto the way to maintain or gain weight is adding healthy unprocessed fats and proteins.

 

[saky]

You’ll probably have been or will be told something along the lines of all things in moderation, reduce sugar and fat, eat lots of fruit and veg. This advice has led to diabetes t2 being seen as progress and leading to more and more medication for the last few generations. Plenty of official sources still say this. However more and more are waking up to the reality and science that carbs or more specifically lowering carbs is the answer. It is NHS, ADA and NICE endorsed so safe.

Can I suggest you take a good look at LCHF ie low carb, higher fat (than recommended for the last few decades) methods of eating.

It’s how an awful lot of us get our blood sugar levels under control and for some even eliminate medications and achieve remission and also reduce or improve complications.

It is often the easiest and most sustainable form of weight loss for a type 2 if you need that. Other conditions often improve including but not limited to blood pressure, joint pain, inflammation, PCOS, and despite the dire warnings of the last few decades it improves cholesterol for most, yes improves cholesterol.

Some jump right on it, others edge their toes in a bit at a time.

Try clicking these links for more detailed explanations that are well worth readings. These is a lot here so go at your own pace.

http://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/

https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html for info including low carb made simple

And https://www.diabetes.co.uk/forum/category/success-stories-and-testimonials.43/ to show it really works and for motivation

also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Excellent site and first port of call for many getting their head round low carb.

Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy. Be aware the the USA count carbs differently so be aware if you look at their counting, recipes or products. They include fibre in their count we don’t. So if it’s USA stuff deduct the fibre to get our figures. (Fibre isn’t generally digested thus doesn’t get counted)

Also it’s very important to be able to check for yourself what’s happening so you can make the necessary adjustments day to day and meal by meal rather than wait 3, 6 or even 12 months and then have no idea what had what effect. It also helps keep an eye out that any meds are working appropriately not too much or too little. Getting a blood glucose meter is the only way to do this (no matter what contradictory advice you may have heard - it’s usually budget based rather than anything more scientific). Test before a meal and 2hrs later hoping for a rise of 2mmol or less. More and the carbs eaten were too many! Please ask if you want any guidance on this.

IMPORTANT FOR ANYONE ON DIABETIC MEDS (Not applicable to just metformin): if you lower your carbs then any glucose lowering meds or insulin increasing meds may need to be adjusted accordingly to make sure you aren’t taking more than your new diet requires. It can cause a hypo if you have more gliclazide or insulin etc than your new carb intake requires. Keep a very close eye on your bgl numbers and do this with your dr’s knowledge so they can reduce medication accordingly. Please don’t be put off by an ill informed out dated rubbishing of low carb diets or being told you should eat carbs to match meds, it should be the other way around. Low carb is endorsed by the NHS and the ADA as an effective method of control, even if the practice staff don’t realise that yet.

What about beta cell destruction as time goes by. The insulin production also drops as the disease progresses?

 

[catinahat]

What about beta cell destruction as time goes by. The insulin production also drops as the disease progresses?

What makes you think this is inevitable?
For people with T2 or pre, there is nothing attacking our beta cells, our beta cells are working fine. The inability to use the insulin efficiently that our beta cells produce, is our problem.

After years of forcing the pancreas to produce more and more insulin, by continually eating more carbs than our insulin can process. It is possible that the pancreas can get tired/burnt out, and will fail to produce enough insulin.

Add to that the fact that as we get older, nothing works as well as It did in our youth, heart, kidneys, eyes, everything deteriorates, why should the pancreas be any different

Type 2 is not the same as T1 who's own immune system is attacking and killing off their beta cells.