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DavidHannay

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Hi, I’m a 61 year old man with T2 diagnosed 10 years ago. Lost 10kg then and have largely kept it off. On Metformin, gliclazide and alogliptin plus statins, blood pressure and triglyceride meds (). My hba1c has been steadily climbing over the last few years from 55 to 61 to now 81! I try (relatively unsuccessfully) to low carb but I’m worried about the progression. My question for more experienced folk is this; what are my options? Do I try (again) with a severe low carb high fat diet (which has worked in the past for a month at a time with low readings but hard to stick to) or am I looking at insulin? Many thanks. David
 
DavidHannay said:
Hi, I’m a 61 year old man with T2 diagnosed 10 years ago. Lost 10kg then and have largely kept it off. On Metformin, gliclazide and alogliptin plus statins, blood pressure and triglyceride meds (). My hba1c has been steadily climbing over the last few years from 55 to 61 to now 81! I try (relatively unsuccessfully) to low carb but I’m worried about the progression. My question for more experienced folk is this; what are my options? Do I try (again) with a severe low carb high fat diet (which has worked in the past for a month at a time with low readings but hard to stick to) or am I looking at insulin? Many thanks. David
Click to expand...
Low carb works. What do you find hard about it? Perhaps we can offer suggestions to make it easier for you
 
I'll be a second for low carb and some intermittent fasting working extremely well for a "classic" T2.
Have you ever had your insulin levels checked though?
 
I see you’re new here. I’ll tag @daisy1 for her welcome and add my own links that might give you some answers about how to make low carb work for you.

Can I suggest you take a good look at low carb high fat methods of eating (keto is just a version of this). It helps many of us lose significant amounts of weight, if desired, keep our numbers down and for some even eliminate medications and achieve remission and reduce or improve complications. Try clicking these links for more detailed explanations that are well worth readings

https://www.diabetes.co.uk/forum/blog/jokalsbeek.401801/ 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

and https://www.diabetes.co.uk/forum/threads/what-have-you-eaten-today.75781/ for food ideas

also https://www.dietdoctor.com/ for more food ideas and general info of carb content of foods. Lots of other websites for recipes out there too. Just use the term low carb or keto with whatever you fancy.

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. 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). Please ask if you want any guidance on this.


IMPORTANT FOR ANYONE ON MEDS CONSIDERING LOWERING CARBS: if you lower your carbs then any glucose lowering 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 (this is not relevant for metformin on its own) than your new carb intake requires. Keep a close eye on your numbers and ideally do this with your dr. 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.
 
DavidHannay said:
am I looking at insulin?
Click to expand...

Well you are already on a lot of medication for T2D, which doesn't appear to be helping much.

A change of diet and/or lifestyle is always an option worth pursuing, but possibly some further tests with your GP to try and assess why the current regime isn't working.
 
As a T2 who was on insulin for 4 years I would just like to say that I didn't find insulin the easy option. I was on Novarapid after every meal and lantus at night. Having to work out the correct insulin dose for everything I ate was really hard work. The same meal on different days would not give the same blood sugars. So sometimes I didn't inject enough and other times I injected too much. It was so frustrating.

Insulin is brilliant if you are T1 because it keeps you alive. But, as a T2, injecting insulin seemed to make me more insulin resistant - which in turn meant it didn't work so well so it was harder to control the diabetes. Then I would have days where it would work too well and I had hypos. There was no 'rhyme or reason' as to why it was ok sometimes but not ok other times.

Oh the joy of low carb. I eat a wonderful, varied and tasty diet. OK - if you don't like meat, fish, cheese (my favourites are organic cheddar and stilton), eggs, bacon, nuts, ground flaxseeds, a few berries, and all above ground veggies (stir fried in butter is my favourite - especially mushrooms which I often fill with stilton cheese) you are going to find low carb a challenge - but not impossible. The trick is to eat the low carb stuff you really love./

I still marvel at the freedom of not having to inject insulin.

Edited to correct typos.
 
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Thanks all. I’m pretty clued up on LCHF diets, just find them hard to stick to despite the good results. It’s a willpower issue I suspect - instant gratification (pizza, bacon roll etc.) over knowing LCHF is best for me, plus issues eating out with family. Thanks especially Krystyna for the input from a T2 who was injecting insulin - encourages me to avoid that path. I’ll get back on the diet and try to keep to it.
 
DavidHannay said:
Ps bulkbiker - what would insulin testing involve and can I request it from my GP? What might it reveal? Thanks.
Click to expand...
It would show if you are a "classic" T2 with a lot of endogenous insulin sloshing around in your body or if you have been misdiagnosed and are under producing your own insulin.
Your GP may well have never heard of the test but there is a chance that they may have.. I think we have one forum member who managed to have it done on the NHS. Otherwise I had mine done privately by medichecks (in fact I had the insulin resistance test done).
 
DavidHannay said:
Ps bulkbiker - what would insulin testing involve and can I request it from my GP? What might it reveal? Thanks.
Click to expand...

Insulin testing is not normally done on the NHS, but can be done privately for not a lot of money. You could try asking for a c-peptide test from your GP. This is a test given to those suspected of being type 1 and gives an indication of the amount of insulin you produce naturally. Knowing how much insulin we produce naturally is, in my opinion, crucial, but to date the NHS hasn't caught up with this.

If you are eating a high carb diet at the moment (bread, potatoes, cereals, pastries, rice, fruit, some root vegetables, pulses and sweet foods) then this is most likely the cause of your increased HbA1c. Perhaps you could tell us a typical day's food and we can help.

Do you have your own blood glucose meter? If not I strongly urge you to buy one with plenty of testing strips. This is the best way to see what your food choices do to your levels. You can see instantly the results. You do not have to wait till your next HbA1c. Let us know if you have a meter and if you need advice using it to your best advantage.
 
If you go to site like rxlist.com and type in side-effects to statins you will find that statins can raise BSLs
and there is a current case against a statin manufacturer alleging statin caused onset of diabetes.
 
DavidHannay said:
just find them hard to stick to
Click to expand...
Because of what though? Boredom? Not knowing what to cook? Eating out? Missing the carbs? Hunger?

The first two can be solved by doing a bit of web surfing for recipes, either new ones of working out how to adapt old ones.

Eating out appears daunting but once you get the hang of it definitely gets easier. Pick a meal that has the carbs separately ie not a cooked all mixed up in one pot type thing. Ask for the rice/potatoes/pasta to be swapped for extra salad or veg or a different item from the sides section perhaps. They rarely bat an eyelid and I’ve been known to agree with them if they ask if it an intolerance issue. It is! Some even bend over backwards to find alternative stuff or make suggestions depending on what you feel comfortable disclosing. Ask for sauces to be served on the side so you can check if they are sweet first. Creamy ones are generally the safest. Any not coated meat/fish works well. If need be scrape and batter/breading off. Burgers can often be served bun less with extra salad instead of chips. I’ve had a pasta dish with the cheese sauce served over a veg side dish instead of the pasta before now. You get the idea. I now carry a teaspoon. If I’m out and about stuck for on the run lunch I’ll grab a pot of ready made egg mayo or similar and it right out of it. Or a packet of sliced cheese and another of sliced meat and roll them up together as a kind of sandwich replacement.

How long did you last before? Carb cravings do disappear somewhat after a while. The first few weeks are the hardest physically in that sense. Continuously telling yourself you are missing out and framing it negatively prolongs it mentally. Try seeing it as an adventure in food. Sure sometimes it a bit of a pain convienience wise when faced with the carb devouring society we’re in but it’s doable if sometime a bit of a creative challenge.

Hunger will be because you haven’t replaced the carbs with anything else most likely. Add some fats!
 
kitedoc said:
If you go to site like rxlist.com and type in side-effects to statins you will find that statins can raise BSLs
and there is a current case against a statin manufacturer alleging statin caused onset of diabetes.
Click to expand...

Do you have a link to that current case, @kitedoc ?
 
@DavidHannay
Hello David and welcome to the Forum :) Here is the Basic Information we give to new members and I hope you will find it interesting and helpful.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 147,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:

  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
 
Short update. Been sticking to LCHF (mostly) since lockdown started - lost 15kgs and my latest self-test hba1c came back as 6.4 and/or 46.4 which I’m pretty happy with. Many thanks to all.
 
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