Low carb not working for Type 2?

[Ronancastled]

T2 is a progressive illness. It gets worse over time. So I would expect if low carbing you would have to lower your carbs over time as well to keep up with the progression.

It gets worse over time if you don't remove the original stressers & the mask the symptoms (high glucose) with pharmceuticals.
Low carb, weight loss & exercise had halted the progressive nature for some & even reversed it for others.

 

[EllieM]

I do wonder how many of the T2 folk who find that low carb stops working go and get their cpeptide and/or GAD checked. We know that a significant number of T2s are misdiagnosed T1/LADAs. Doctors seldom bother to do the differential tests when people first present with high blood sugars unless you are young. Low carb can put LADA folk in remission for years, but there is a big difference between lack of insulin production and insulin resistance.

But of course, T2s can end up with reduced insulin production, so there are no easy answers.

And COVID seems to put everyone's systems under more stress and pressure.

 

[lucylocket61]

I think there are many sub-sets of diabetic types. Within those subsets are individual bodies doing their own thing. I am no sure generalisations are possible really, except in a very, very wide sense.

 

[Pipp]

I was wondering about people who still find that their blood glucose remains in the diabetic range despite having a low carbohydrate diet ( defined as < 130g carbohydrate per day) and maybe also taking Metformin.

Until very recently I found that despite best efforts at low carb, and with metformin, I tend to maintain, or sometimes slowly gain weight. For a couple of years I have had HbA1c in pre-diabetic range. This was after several years in non-diabetes range. A shock last year was HbA1c of 51. My solution was to reduce calorie intake as well as keeping to less than 60 g of carbs a day, plus some fasting. Carbs come mainly from vegetables. Last month HbA1c was 41.
I believe my difficulty maintaining low BG levels is due to excess weight, which I cannot seem to shed like some folks do with a LCHF diet. Of course, there would be other variables to consider when making comparison with others, such as age, gender, level of activity, for example. Also, length of time since diagnosis, (I was diagnosed T2 16 years ago) and other health conditions and medications could impact.

 

[lucylocket61]

My weight has hardly altered from morbidly obese over this 9+ years of low carbing. But my blood sugar levels (except when ill) have been stable. Mostly around HbA1c of 45.

 

[Pipp]

Having given this a bit more thought, I would add that I do believe that a low carb diet has helped me remain free of diabetic complications, despite the medical opinion that I was given when diagnosed, which was “This is a progressive illness, that will require increasing levels of medication, but don’t worry, we will look after you”. This advice was accompanied by a diet sheet recommending ‘healthy carbs with every meal, and low fat, with plenty of fruit and vegetables’.I was also given a free BG meter, and prescription for test strips. How times have changed. Only diabetes meds I have ever had has been Metformin, which I took in early days following diagnosis, and returned to last year. Iam very gratefulthat I found my own solutions, and grateful too for the shared experiences and generousity of members here.

 

[Mbaker]

@Mbaker is such an exercise regime sustainable for life?

At one stage I was training up to 3 hours a day with my sport, so I find this easy. I could bring this down to nothing in the morning, eat then 10 - 15 minute walk (perhaps 5 of this brisk), 12 mins resistance and repeat.

With the resistance training I train squats 50% of my 1 rep max, leg extensions at around 40%, bench press at 80%. This I am deeming as my blood sugar protocol, because I find it easy everyday....apart from yesterday. My second workout was at the gym for the first time since lock down re-open, I upped my squats 70%, bench press to 92%, deadlift to 80%.

I used to walk 5 miles at a time with a heart rate around 140, this is chronic and I feel dangerous continually.

My goal is that as I age, I will eat less food, as I typically have 4 plates, maybe 2.5 is more appropriate (I have alot of room for optimisation), this will lead to:

As much walking as I enjoy. 2 x 7 mins resistance.

 

[HSSS]

At one stage I was training up to 3 hours a day with my sport, so I find this easy. I could bring this down to nothing in the morning, eat then 10 - 15 minute walk (perhaps 5 of this brisk), 12 mins resistance and repeat.

With the resistance training I train squats 50% of my 1 rep max, leg extensions at around 40%, bench press at 80%. This I am deeming as my blood sugar protocol, because I find it easy everyday....apart from yesterday. My second workout was at the gym for the first time since lock down re-open, I upped my squats 70%, bench press to 92%, deadlift to 80%.

I used to walk 5 miles at a time with a heart rate around 140, this is chronic and I feel dangerous continually.

My goal is that as I age, I will eat less food, as I typically have 4 plates, maybe 2.5 is more appropriate (I have alot of room for optimisation), this will lead to:

As much walking as I enjoy. 2 x 7 mins resistance.

I’m exhausted just reading this. Does that count toward my exercise regime?

 

[Mbaker]

I’m exhausted just reading this. Does that count toward my exercise regime?

It might seem alot but it really is quite small. Serious gym goers workout for about 45 minutes minimum, as I have a good baseline I am compressing a moderate resistance workout into a shorter time to get some cardio and difficulty benefits. Tonight I am going to do the finisher again, to see if I can turn the 4.3 fbg this morning into a 3.8, like I did a couple of days ago. The finisher is 2 exercises to almost failure - less than a minutes work (bicep curls and deadlifts using X3 Bar).

 

[LittleGreyCat]

I am interested to know if any Type 2's have stuck to a low carbohydrate diet but have not managed to get into remission? We are delighted to celebrate those who have but do not seen to hear from people for whom this approach has not worked

I am controlling (more or less) my HbA1c but the Libre shows peaks and troughs instead of a regular trace with not more than 2 mmol/L rise for food.

It took me a while to get fully into LCHF and to get my weight down to 12 stone or below but I think that I am amongst the 20% of normal weight T2s (or TOFI).

Absolutely no sign of remission.

 

[EllieM]

I am controlling (more or less) my HbA1c but the Libre shows peaks and troughs instead of a regular trace with not more than 2 mmol/L rise for food.

Three thoughts here : do we actually know what is normal for non diabetics here. Don't they have peaks and troughs?

It seems likely that you are T2 just because it's 13 years since diagnosis but I know that some posters have been rediagnosed as LADA after a decade. A cpeptide test might be useful?

And though you aren't quite achieving non diabetic levels it sounds like you've done very well. As a T1 I'd be happy with any of the hba1cs that are quoted in your signature.... Low carb doesn't have to put your into full remission, maybe it's good enough if it allows you to be healthy....

 

[LittleGreyCat]

A cpeptide test might be useful?

That measures how much insulin you are producing.
I had a private HOMA-IR test a couple of years back which showed that my insulin production was on the low side of normal but my BG was slightly elevated.
Conclusion; some Insulin Resistance.

I am endlessly confused by LADA.
Back in the day T1 was an auto-immune problem where your own immune system ate your Beta cells.
This could be confirmed by testing for antibodies.
Of course, lack of antibodies didn't rule out T1.

So for me, I wonder if old and tired Beta cells is the same as T1/LADA?
I assume it is convenient to group these together because insulin underproduction from whatever cause will normally be treated in a similar way.

I do wonder from time to time if an old and slow pancreas might benefit from some insulin being added (assuming that lack of insulin resistance has been confirmed).
Roughly, assume that your pancreas is producing basal insulin then bolus for dawn phenomenon or carbohydrate heavy meals.
I'm not sure if this is considered to be a standard treatment.

 

[HSSS]

I had a private HOMA-IR test a couple of years back which showed that my insulin production was on the low side of normal but my BG was slightly elevated.
Conclusion; some Insulin Resistance.

Was that the official conclusion or yours? I assumed IR would have both higher bg and higher insulin (attempting to overcome the resistance) whereas a lower insulin level suggests more towards LADA or type 1 perhaps.

 

[LittleGreyCat]

Was that the official conclusion or yours? I assumed IR would have both higher bg and higher insulin (attempting to overcome the resistance) whereas a lower insulin level suggests more towards LADA or type 1 perhaps.

That was the official report.

As I understand it I had insulin in my blood which should have brought my fasting BG down to normal levels.
However my BG was raised so my body was resisting the insulin.
I assume that if all was working as expected I would have produced more insulin until my BG dropped (the traditional T2 over producing insulin to overcome IR).
I was eating LCHF and possibly in ketosis so that normally comes with lower insulin production, so I don't know if my Beta cells were running flat out, or if they were just bored with not much to do.
This was a fasting test.

Either way, low normal range doesn't sound like T1.

 

[LittleGreyCat]

As a T1 I'd be happy with any of the hba1cs that are quoted in your signature..

Which reminds me that I must update my signature!!

 

[HSSS]

Either way, low normal range doesn't sound like T1.

No, but it might be the early stages of LADA. It could be interesting now, several years later to re do it if that’s possible for a comparison.

 

[EllieM]

I had a private HOMA-IR test a couple of years back which showed that my insulin production was on the low side of normal but my BG was slightly elevated.
Conclusion; some Insulin Resistance.

I am endlessly confused by LADA.
Back in the day T1 was an auto-immune problem where your own immune system ate your Beta cells.
This could be confirmed by testing for antibodies.
Of course, lack of antibodies didn't rule out T1.

If it was a few years back then it might be worth doing another one to compare.

My understanding is that while beta cells from T2s can be damaged by too high blood sugars, they can possibly recover (Dr Google is a little inconsistent about this ), whereas LADAs are slow onset T1s who gradually (possibly over years) get their beta cells all destroyed. But I agree, not quite sure how you tell whether reduced insulin production is a result from long term T2 or a result of LADA. Do antibodies still get produced after ten years???

 

[LindaManville]

I am a type 2 on metformin and victoza. I have been trying to
Lower my bgl by limiting my carbs under 100 gm after
My sugars soared to 20.2 despite my medication. It took a few days
And the diet worked, I got it down to 10.3 which is where I am stuck
At the moment. I fear that in order to get below that I need to
Cut carbs more. So unfortunately no remission so far. Maybe in time

 

[Brunneria]

Hi Everyone,

Several posts have been moved to prevent derailing this thread.
The moved posts can now be found in a new thread here
https://www.diabetes.co.uk/forum/threads/tanniths-views-on-reversing-t2.181313/