Got given a few options - any advice?

[Anfalas]

Spoke with my diabetic nurse today. My hba1c is 69. She has given me an option of going on an injection called ozenpic or on the Very Low Calorie Diet through the NHS.

I'm scared of the side effects of the injection, I'm worried I won't keep the doet up. I've read about both and would like your opinion.

I would like to loose weight and lower my bg to have a baby.

Thanks for advice x

 

[Roggg]

I would start by pointing out that this is a false dichotomy. They presented you with 2 options, but you can take charge of your health and go in a different direction if you aren't happy with the options you have.

As for me, I think committing to a lifestyle solution is what I would prefer to do unless I find that I'm not able to succeed with it. FWIW, I did a couple tries at the VLC diet, and I has good results with my blood sugar and blood pressure, BUT I found it pretty hard to stick to. I now do keto and some fasting, but that's a different conversation...

 

[bulkbiker]

Spoke with my diabetic nurse today. My hba1c is 69. She has given me an option of going on an injection called ozenpic or on the Very Low Calorie Diet through the NHS.

I'm scared of the side effects of the injection, I'm worried I won't keep the doet up. I've read about both and would like your opinion.

I would like to loose weight and lower my bg to have a baby.

Thanks for advice x

Try low carb.. no starvation and no injection.
Your HbA1c whilst not great is a lot better than many who arrive here. (mine was 87 on diagnosis).
Through low carb and intermittent fasting I manage to put it into reverse and lose weight without "going without".

 

[searley]

If I were in that situation I’d go for trying low carb diet for 3 months

Have another hba1c and if it’s no better decide from there what you would like todo

69 is not massively high in comparison to some and they have managed to turn it round with diet only

 

[Goonergal]

@Anfalas I’d echo what the others say. There are more than 2 options available to you. Neither of the two you’ve been presented with would appeal to me.

Reducing carbs is, at least for me, a far, far easier and more sustainable route to take. You can eat real foods to satiety, lower your blood sugars and likely lose weight too. My A1C was 108 at diagnosis, so it is very doable.

You have your why, now you just need to find your ‘what’! And whatever you pick, it needs to be something you feel confident in and can keep up.

 

[Resurgam]

Best option would be a different nurse.
Watch out for your fertility on low calorie.
On the low carb diet - which I started back in my 20s I found I was very fertile.

 

[Pipp]

Hi @Anfalas , I seem to remember in previous threads, you mentioned being started on insulin?
So, did that happen? Are you on other meds? Helps to know a bit of background when giving advice. How much weight do you need to lose, and is there a time limit for you to do so, if you want to have a baby?
As others have mentioned HbA1c of 69 is not going to be too difficult to reduce, but how long have you had diabetes, and how has that HbA1c changed over time?

Regarding the Very Low Calorie diet, if you can stick to it, you can see quick results. It is recommended only in the early years following diagnosis. Although some regard it as ‘a starvation’ diet, all nutrients are provided in the meal replacement products, especially if you follow the advice to include a small amount of oil (this prevents gallstones forming, or increasing in size if already present) and some green vegetables. However, it does require discipline, and support. I did not feel hungry or deprived. I found the social aspect most difficult, in that most social occasions include an element of eating and drinking, and some people cannot understand why you are refraining from joining in. Also, where many people fail is that they regard it as a one off, short term, fix. It is not. It is important to have a for ever follow on way of eating, for life. If you return to your previous way of eating you will have wasted your time, and will gain the weight back , plus some more.
Having experienced the use of VLCD / Total food replacement, albeit 10 years ago, I found that I did lose weight and very quickly regained non-diabetes blood glucose levels very rapidly. I didn’t have a follow on plan, and did regain some weight. That was mainly due to a different medical condition, two major surgical procedures, over a couple of years, and immobility and dependency on hospital food and others catering for me. More recent years I have, and recommend low carb way of eating. This maintains, usually, good BG levels, though I do still struggle with weight issues.

In addition to lowering carbs, you could try intemittent fasting. The definition of starvation is interesting:
https://www.dietdoctor.com/intermittent-fasting

Whatever you decide, it is important that you make an informed choice, relevant to your individual circumstances, so have a read around the forums, and do your research, rather than being limited to the choice your nurse has offered.

 

[luceeloo]

From personal experience, I was put on a GLP-1 injectable (Lyxumia) similar to Ozempic a while back. When my husband and I decided that we wanted to try to conceive, I had to go off all medications and the GLP-1 was deemed to be the worst for potential pregnancy, and my body had to be completely clear of it for months before. I was given the option of going on oral contraception or signing a disclaimer to say that I accepted full responsibility for any pregnancy defects caused by the drug. I ended up on the pill AND having to sign a disclaimer anyway.
Some nurses are very happy to prescribe the full regime of drugs, but in all honesty, if you are thinking of conceiving, keep it as simple as possible. For women who are of childbearing age, the plan should be different. Ask your Nurse to refer you to a preconception clinic. These are usually run by Endocrinologists and they will help you with all plans geared towards helping you get your hba1c and your body pregnancy ready.

 

[VashtiB]

I'll echo others above.

I followed a very low calorie diet. I was really strict and lost weight (only to find it again with some friends)

I found very low calorie difficult. Not in the sense that I couldn't follow it but the constant weighing, not being able to eat out at all and never actually feeling full.

I also have lost weight on the low carb- very low carb for me. If I increase the carbs I gain weight. I have to say though I am never hungry and am able to eat out although I still struggle with that.

But I agree with @Goonergal - you need to make a choice and commit to it. I think from what I have read that very low calorie can work but like @Pipp said you need to have a plan for the rest of your life. Good luck with whatever decision you make.

This forum has helped me understand it is our body we get to make choices about the medical professionals are there to give advice not to tell you what to do. Often their advice is great but read around and make your own decision.

 

[muzza3]

Hi @Anfalas

As many have pointed out there are more options than you were presented and the dietary ones are the best. A very low calorie diet can be very effective over a short period of time in reducing both Weight and BG but can be very challenging to complete. Low Carb diets are also very effective and are great to use including as a follow up to the Low Calorie Diet. Whichever way you choose to go make that commitment and let us know how you are progressing.

 

[Daibell]

Hi. Go with the 3rd option which is the low-carb diet. I would avoid the Ozempic if you can and a low-calorie diet is based on very shaky science (yes I know the NHS believe in it!) as our problem is glucose intolerance and measuring Calories does not address that and in fact I'm not quite sure what it really does address as it depends on the food groups making up the calorie count.

 

[Maco]

Agree with what others have said, go down your own route & try low carb. You can still have really filling & tasty meals without carbs, a simple option is to swap rice for cauliflower rice for instances. Maybe have a look into Keto diets, not something I've tried but the meals look really nice whilst low carb & supposedly really good for weight loss.

 

[Resurgam]

My sister firmly believes in low calorie dieting.
She was contemplating fertility treatment after eight years of waiting for a second child.
My sister, brother in law and niece came to visit for two weeks just as I found that I was pregnant with my second. I joked that it might be catching.
She complained about the 'fattening' food I served up - but her son was born in the January after my daughter was born in November.

 

[HSSS]

These links can tell you more about option 3 - low carb


Intro to T2 and low carb. https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/
All the things I wish I’d been told earlier https://www.diabetes.co.uk/forum/th...ish-i’d-been-told-at-type-2-diagnosis.173817/

 

[OrsonKartt]

These links can tell you more about option 3 - low carb


Intro to T2 and low carb. https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/
All the things I wish I’d been told earlier https://www.diabetes.co.uk/forum/th...ish-i’d-been-told-at-type-2-diagnosis.173817/

I went down the the low calorie route some years back now. In my case my glucose levels were normalised after a couple of weeks of 500 calories per day and somehow I made it to 8 weeks by which time I found this site and swapped to low carb. If you can deal with a short sharp shock a few weeks of 500 calories a day will get your weight and blood glucose down but as I say after the second or third week it gets brutal. I’ve been low carb / keto / carni for the last four years and now love my food in many unexplored ways. I wish you all the best in your decision.
Ps. I’ve so learnt not to trust doctors.

 

[Tannith]

I went down the the low calorie route some years back now. In my case my glucose levels were normalised after a couple of weeks of 500 calories per day and somehow I made it to 8 weeks by which time I found this site and swapped to low carb. If you can deal with a short sharp shock a few weeks of 500 calories a day will get your weight and blood glucose down but as I say after the second or third week it gets brutal. I’ve been low carb / keto / carni for the last four years and now love my food in many unexplored ways. I wish you all the best in your decision.
Ps. I’ve so learnt not to trust doctors.

I did low cal 3+ years ago. I did very well on it but unfortunately stopped too soon. NHS scale of HBA1C seems too lenient to me. I thought I had reversed my T2 but someone on here told me that I was still at the top of the PreDiabetes scale and actually in the diabetic range on one scale. So I restarted the low cal diet literally immediately, - in the middle of that day! That was 4 months ago and though I am doing a really easy version of the diet (ie 1000 cals per day, real food) I have lost about another stone. More importantly, my latest 2 hour OGT test is down to 8.3 - near the bottom of the pre diabetic range -from 11.3+ (Diabetic range) at the start. OGT is a good measure of how well the beta cells are functioning, and at a specific point in time (rather than simply what your blood sugars have been over a period of 3 months). And my FBGs are down from the top of the prediabetic range to comfortably within the normal. I am not particularly anti drugs normally - I think they can have their uses. But there is no way I would try a newish drug if I were trying to conceive.

 

[zand]

Go low carb to get plenty of good nutrition before pregnancy and you will then be all set to continue it throughout pregnancy. Low cal will just strip the body of nutrients. Nurture your body and it will be ready to nurture a baby.

Thinking of what @Resurgam said... I took over a year to get pregnant, both times and I was always following low cal diets in those days.