Why won't the NHS tell you the secret to treating diabetes?

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Tannith

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@Tannith Metformin didn't give me tummy problems as long as I ate a low carb diet. The few times I went over my own 80-100g carb limit were disastrous. My doctor won't prescribe it for me anymore as my HbA1c is normally 48 or less, so good luck with getting it. It does help with insulin resistance and stopping liver dump so helped my FBGs. It had minimal effect on my HbA1c though. If you do take it then bear in mind that you may need to supplement with vit B12 as Metformin depletes the level of B12.
Thank you Zand. I expect you are right about my doctor not prescribing metformin. When I stopped Newcastle the first time it was because surgery & GP said I was no longer diabetic, when in fact I was still way into the prediabetic range and actually in the diabetic range on some scales. I think it is shameful that the NHS so often ignores prediabetes.
 
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Tophat1900

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Thank you Zand. I expect you are right about my doctor not prescribing metformin. When I stopped Newcastle the first time it was because surgery & GP said I was no longer diabetic, when in fact I was still way into the prediabetic range and actually in the diabetic range on some scales. I think it is shameful that the NHS so often ignores prediabetes.

Seems like you have been badly mislead by your GP and surgery. Once diagnosed T2, that's it... you stay T2, but you can control it well with appropriate diet and maybe some meds if need be (Depends on the individual case). You are right about prediabetes being ignored, that seems to be a common thing everywhere you look.
 

Tannith

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I don't currently need to find out anything about how to do a low carb diet as I have already chosen a very low calorie diet and haven't finished doing it yet. If it doesn't work ( & I have about a 60% chance of its working having had T2 for 4 years), I shall look first at metformin which is apparently very good and consistent at lowering blood sugar, and doesn't give digestive problems to all users.
PS I should however very much appreciate any advice on how to do the diet I am now doing, ie the vlcal diet. From anyone who has either successfully completed it or has made a sustained attempt to do so and can offer experience of any pitfalls they encountered. Also, though I obviously don't need any low carb recipes unless and until I am forced to undertake such a diet, I should be pleased to hear of any low CAL recipes people on low cal diets have found successful.
 

Goonergal

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PS I should however very much appreciate any advice on how to do the diet I am now doing, ie the vlcal diet. From anyone who has either successfully completed it or has made a sustained attempt to do so and can offer experience of any pitfalls they encountered. Also, though I obviously don't need any low carb recipes unless and until I am forced to undertake such a diet, I should be pleased to hear of any low CAL recipes people on low cal diets have found successful.

@Tannith might I suggest you start a new thread for that purpose - your question may not get seen by those with interest/knowledge to respond if it stays here.
 
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Richard'63

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lucylocket61 said:
You misunderstand. Obesity is one of the symptoms, carb intolerance is the disease.

Treating the symptoms and not the disease.
Please can you clarify what you consider the symptom, and what you consider the disease?



Richard, would you mind enlightening Lucylocket and others on your definition of symptoms and disease. I agree with you but no doubt you could explain it better than I can.

Hi @Tannith

My definitions of the symptoms and the disease are;

Diabetes, the disease is when the mechanism for regulating sugar in the body is impaired or broken,

the symptoms at least for a Type 2 are raised baseline (FBG and HbA1c) and/or high, long duration spikes in blood sugar after eating carbs,

and potentially low(ish) blood sugar hours after eating carbs when the insulin production overshoots as the body attempts homeostasis.

Low carb can bring the sugars down into the normal range without necessarily affecting the impairment, to me that is remission. Losing the fat in the pancreas and regaining insulin sensitivity is reversal.

These are my definitions, I’m not asking anyone else to use them.
 

Tannith

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Hi @Tannith

My definitions of the symptoms and the disease are;

Diabetes, the disease is when the mechanism for regulating sugar in the body is impaired or broken,

the symptoms at least for a Type 2 are raised baseline (FBG and HbA1c) and/or high, long duration spikes in blood sugar after eating carbs,

and potentially low(ish) blood sugar hours after eating carbs when the insulin production overshoots as the body attempts homeostasis.

Low carb can bring the sugars down into the normal range without necessarily affecting the impairment, to me that is remission. Losing the fat in the pancreas and regaining insulin sensitivity is reversal.

These are my definitions, I’m not asking anyone else to use them.
Beautifully put. Thank you.
 
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bulkbiker

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Hi @Tannith

My definitions of the symptoms and the disease are;

Diabetes, the disease is when the mechanism for regulating sugar in the body is impaired or broken,

the symptoms at least for a Type 2 are raised baseline (FBG and HbA1c) and/or high, long duration spikes in blood sugar after eating carbs,

and potentially low(ish) blood sugar hours after eating carbs when the insulin production overshoots as the body attempts homeostasis.

Low carb can bring the sugars down into the normal range without necessarily affecting the impairment, to me that is remission. Losing the fat in the pancreas and regaining insulin sensitivity is reversal.

These are my definitions, I’m not asking anyone else to use them.

So in fact its all about insulin sensitivity?
Whether through starvation or low carbing.. once pancreatic fat is lost and insulin sensitivity returns T2 is truly in remission.
Just that one is far more pleasant than the other.
 
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zand

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Hi @Tannith

My definitions of the symptoms and the disease are;

Diabetes, the disease is when the mechanism for regulating sugar in the body is impaired or broken,

the symptoms at least for a Type 2 are raised baseline (FBG and HbA1c) and/or high, long duration spikes in blood sugar after eating carbs,

and potentially low(ish) blood sugar hours after eating carbs when the insulin production overshoots as the body attempts homeostasis.

Low carb can bring the sugars down into the normal range without necessarily affecting the impairment, to me that is remission. Losing the fat in the pancreas and regaining insulin sensitivity is reversal.

These are my definitions, I’m not asking anyone else to use them.
I would suggest that curing NAFLD is important too, something that LCHF does very quickly.
 
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Richard'63

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So in fact its all about insulin sensitivity?
Whether through starvation or low carbing.. once pancreatic fat is lost and insulin sensitivity returns T2 is truly in remission.
Just that one is far more pleasant than the other.

Has someone been advocating starvation?
 

ziggy_w

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Hi @Tannith,

I wish you much success in improving your blood sugars using a low-calorie diet. It has worked for many and there is a good chance it will work for you too. So, keeping my fingers crossed.

However, I tend to disagree with your and @Richard'63 's assertion that using low-calorie is dealing with the disease while low-carbing is only dealing with the symptoms (you argued that the reason for this is that returning to eating high carbs will again result in higher blood sugars). As you will probably agree a similar argument could be made for going low-calorie. Once you return to your previous high-calorie diet (that which led you to develop diabetes in the first place), you will gain weight and high blood sugars will likely return. Wouldn't a "healthy" person not only be able to eat what they want and as much as they want? There are many overweight or even obese people who never develop an "abnormal" glucose metabolism (and also never will as they have the ability to produce an unlimited number of new fat cells, thus never overfilling those that already exist, and therefore never having to store excess fat in the pancreas and in the liver.

Have you listened to the podcast by Peter Attia interviewing Gerald Shulman https://peterattiamd.com/geraldshulman/, an expert on insulin resistance. Shulman has conducted insulin resistance tests on college students (around the age of 20) and has found that about half of them have insulin resistance and an "abnormal" glucose metabolism, even though virtually all of them were slim (which imo this seems to point at weight gain beeing a symptom rather than the cause). I honestly have a hard time accepting that so many us are "abnormal." Isn't it possible (or even likely) that that which we call insulin resistance is just a genetic variation and that people with this genetic variation were never made for the "modern" diet with highly processed carbs and maybe "industrially processed and stabilized" seed oils, but that possibly this genetic variation might have been helpful in times when food wasn't as abundant as today.

Personally, I'm convinced that both low-calorie and low-carb diets may return us to a state where we are metabolically healthy (so it might to some extent come down to preference) ... and this will most likely prevent complications and this is what matters imo. Whether we call this cured, reversed, in remission -- these are just semantics.
 

Tannith

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This week's FBGs: Fri4.8; Sat4.9; Sun4.7; Mon 4.6 Tue 4.6; Wed 4.9 Thur 4.9. Creeping down but ever so S-L-O-W-L-Y Average 4.77. Weight is creeping down slowly too. But moving in the right direction. This is beginning to give me hope that not all my beta cells have been damaged beyond the point of no return in the 4 years since I got T2,. So maybe I shall be able to reverse this dreadful disease..
 

HSSS

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This week's FBGs: Fri4.8; Sat4.9; Sun4.7; Mon 4.6 Tue 4.6; Wed 4.9 Thur 4.9. Creeping down but ever so S-L-O-W-L-Y Average 4.77. Weight is creeping down slowly too. But moving in the right direction. This is beginning to give me hope that not all my beta cells have been damaged beyond the point of no return in the 4 years since I got T2,. So maybe I shall be able to reverse this dreadful disease..
Have you seen or read about this? Just saw it again on another thread and thought it relevant here because of the fasting levels, albeit insulin not glucose..
upload_2021-1-14_10-8-45.png

https://denversdietdoctor.com/diabetes-vascular-disease-joseph-r-kraft-md/
 
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Nicola54

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PS I should however very much appreciate any advice on how to do the diet I am now doing, ie the vlcal diet. From anyone who has either successfully completed it or has made a sustained attempt to do so and can offer experience of any pitfalls they encountered. Also, though I obviously don't need any low carb recipes unless and until I am forced to undertake such a diet, I should be pleased to hear of any low CAL recipes people on low cal diets have found successful.
Hi,
What is a vicacl diet? i have never heard of it before at all?
 
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Tannith

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This week's FBGs average 4.82. A slight rise. Although it's not much, I am disappointed. I think I shall have to try even harder to lose more weight.
 

OB87

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This week's FBGs average 4.82. A slight rise. Although it's not much, I am disappointed. I think I shall have to try even harder to lose more weight.
Just wondering why you are disappointed as that number seems good to me ?
 

Tannith

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Just wondering why you are disappointed as that number seems good to me ?
Mainly because it stopped improving. And because it is accompanied by a rubbish OGT. Also poor Hba1c. I think my FBGs are not a good indicator of my diabetic status. Sometimes, for some people, it works like that. So I was aiming to get them down to consistently below 4.5 before deciding that I had probably reached my Personal Fat Threshold and could stop dieting.
 

oldgreymare

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Mainly because it stopped improving. And because it is accompanied by a rubbish OGT. Also poor Hba1c. I think my FBGs are not a good indicator of my diabetic status. Sometimes, for some people, it works like that. So I was aiming to get them down to consistently below 4.5 before deciding that I had probably reached my Personal Fat Threshold and could stop dieting.
Hi @Tannith, according to your information your fasting levels are reasonable, but your HBA1c and self administered OGTT are diabetic levels. If this was me, I would plan to track BG post prandial levels (plus recording how many gms of carbs in each meal) at 2 hours post meal - this will be so much more insightful and give you much better nuanced information on your personal metabolic response to food.
 
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Tannith

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Hi @Tannith, according to your information your fasting levels are reasonable, but your HBA1c and self administered OGTT are diabetic levels. If this was me, I would plan to track FBG post prandial levels (plus recording how many gms of carbs in each meal) at 2 hours post meal - this will be so much more insightful and give you much better nuanced information on your personal metabolic response to food.
I have read that FBGs reflect liver glucose dumping levels. And that these do not necessarily coincide with other test results, as liver may reduce dumping before other parameters such as beta cell health have had time to improve. It is possible that losing fat from my liver has caused it to do less dumping, possibly by making it less insulin resistant. But FBGs are the easiest test to do so I am using them as a rough guide to whether my T2 is improving, and how fast. I shall double check my diabetes status against OGT fortnightly.
 
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