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I need a kick up the ….

Jersey_Girl13

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Hello everyone, I’m hoping joining here is the first step towards seeking the help I need. I would really appreciate some advice and motivation.

Diagnosed Type 2 diabetic 8 years ago. Metformin, exercise and a low carb diet helped me keep my A1C under 6 and all was going well. Tested all the time and knew exactly what every food did to my BG levels, even noted the variations at different times of day. I liked to keep it tight, allowing myself very occasional treats but generally keeping carbs under 50g a day and it worked for me for years. I have also lost well over 100lbs since my diagnosis, though I could lose another 40lbs and not be underweight. For now not gaining is good enough for me.

However, since the pandemic started, my self-care has gone to pot. I won’t go into the reasons why, I think lots of people have had a very bad couple of years and I don’t want to moan too much, but haven’t tested for months and my carb creep has finally got to the point where not only am I not counting the carbs but I seem to be seeking them out and devouring them.

My last comprehensive blood test was in November and everything came back alright but the fasting blood glucose was higher than ever and I’m sure it’s only got worse since then. Doc and I agreed I would try and get it down before we made any drastic changes but honestly, I haven’t done anything to help myself since then and I know I need to go back and get it sorted but I haven’t yet, it can only have got worse.

Thankfully I am still exercising a lot but I have done nothing to address the carb issue. It’s always “oh, I’ll start on Monday” or “After Christmas” etc and then after Christmas came and went and I’ve done nothing. I’m going on holiday in May and I’m telling myself I will sort it all after that but it really needs addressing before then and I’m not entirely sure I’ll do anything about it then at this rate.

I’m so ashamed and scared of going to the doctor. I’m in the US now (originally from the UK) and can refer myself to an endocrinologist but I’m worried he or she will admonish me or put me straight on insulin, something which I always aimed to avoid (no disrespect to anyone on insulin)

I’m exhausted with worry. I have health anxiety anyway, which isn’t helping.

Does anyone have a similar experience they can share and let me know how it all ended up?
 
Welcome @Jersey_Girl13
You have no reason to feel ashamed, your body has trouble processing carbs, it's not your fault. Carbohydrates are extremely addictive and carb creep is something we all try to avoid, quite often unsuccessfully. I think most of us have fallen of the wagon at some point.
You don't need any advice on how to get back in control because you have done it before, you know how, all you need is to get your head in the right place to do it again.
Use your meter, test just before you eat and again 2hr's later, let your meter show you what all those carbs are doing to your levels, that should be all the motivation you need to start cutting them down. Oh and the best time to start tackling your diet is now, not after your holiday or next week. The longer you wait to get started the more potential damage is being done by all that glucose.
 
Thanks for replying @catinahat

You’re right I know exactly what I need to do. Although I did not test today, I’m not quite ready for that yet, I did eat low carb all day for the first time in a very, very long time. No snacks, no small bowl of mini eggs (and a refill), just exactly what I would have eaten two years ago.

At the moment it really is one day at a time and I did the first day.
 
Yeah - me and millions of others!!!

So far, I've kept myself alive - and that's about my biggest achievement in life - although I have a sneaky feeling I'll fail at that, too, some day ... :)

Motivation does go in cycles, and we start from wherever we are right now - certainly not something to get beat over (until the last paragraph!) And the worst carbs are very addictive - it's important to admit that.

A psychologist once told me there are three parts to making change:
  1. Identifying the change,
  2. Being motivated to do it, and
  3. Knowing how to do it.
You and I and most people here get (1) - good - done.

On point 3 ....

For me, when things are bad like that, it can sometimes be easier to go ultra-low carb, cold turkey, go into ketosis and stay there - at least until you retrain your body and your palate. I haven't done that for years, but when I have, I have been very happy once I got there - my biggest issue was forcing myself to eat some vegetables in the evening to keep my calorie intake up, and to get nutritional diversity. I find even a small amount of carbs (certainly anything starchy) can mess with my will power - it's easier to make sure I have only healthy stuff around, and not give my body the chance to get hooked again. I did eat nuts, when I was doing that regime. No root veg (maybe I had small amounts of carrot and beetroot - can't recall).

I kinda think of myself as a carboholic, in a very real sense; were I alcoholic, I'd find it easier to drink nothing than to drink a little.

When I'm addicted to bad fats, to grain, to sugar, or salt (and I've been all of those), it's easier to cut them out pretty much totally (not sodium/potassium completely, or you'll die after some weeks - especially in hot climates) than to cut them down. And none of them (except salt) is essential (there are many essential fats, but mostly you get those in healthful foods without realising it).

The other thing that really helped me - but not everybody finds this easy, and (anecdotally) there may be a gender difference in difficulty and success rates - is intermittent fasting; I have eaten One Meal A Day for years now (not every single day, but as the general rule); it doesn't particularly help with weight management, but it certainly helps a lot with HbA1c, and allows many of the body's systems to heal, allegedly significantly reducing the odds against you for various metabolic and autoimmune type problems. And it means I only have one decision point per day where I can screw up and eat the wrong thing; and I know that I have to eat a healthy and nutritious meal then, because it's the only meal I'm getting - there is no question of burger, fries, donuts and ice-cream for lunch and it'll be OK 'cos I'll have steamed vegetables later to make up for it! If I eat badly at night (when I have my meal), that's it for 24 hours. If I eat carbs and spike overnight, I'll have an increased chance of feeling hungry and miserable by lunchtime (at least overnight the worst of it levels out while you sleep - it's not as bad as spiking in the morning when I used to eat breakfast, and then spend most of the day hungry!). My decisions have immediate effects, in the next 24 hours - not just in 24 years. that's an important point - sometimes it's easy to make bad decisions when the consequences are vague or distant. Find ways of making clear and imminent consequences.

You and I both already know what we are doing, but even so, keeping a food diary cam help us realise how much we are doing it, to call ourselves out, making clear just exactly what the cumulative weight of our choices is.

And pure regime can help; if I have too many choices, I'm more likely to make bad ones. So if I'm in that kind of place, I'll shop when I'm disciplined, only buy the right stuff, and know in advance what every meal looks like. It takes some creativity out of mealtimes, but it de-risks them hugely, too. Other times, I can have chocolate in the house for years until it gets thrown out or someone else eats it in desperation (it helps to buy high-cocoa chocolate, of course :)), and I can sometimes go without bread, pasta, potatoes for months - or more often at least for weeks.

On point 2 ...

There's carrot and stick.

The carrot can very often be finding small things to love, and doing them often. Focusing on doing good things for ourselves, in small doses, can help us become addicted to good behaviours, and also can generally improve our outlook and motivation to the point where we want to live and be healthy, and the fries and popcorn just don't seem important anymore.
My number one rule, even though I am a very self-sufficient and self-motivated person - is to have a person to love, who I need to be around, and who I know loves me. If you don't have this, work on making better friends as a top priority. I'm not talking about (necessarily) a life-partner - but somebody you feel accountable to, and who makes you know you are worth saving. Because you are. We all are - and most of us acknowledge that in the aggregate - but often we individually are the least convinced of it for ourselves. And I make no mistake - I am talking about saving myself here - we know where this disease can go to if we choose that other path.

The stick: if you know you don't respond to dark brutal self honesty, and that you'll warp it against yourself, do not read on.

<trigger warning>
There is a brutal response as well - although I know even this doesn't seem to help when you are in the depths of a slump; I think about the worst outcomes of going down that slope - and I get graphic about it ... <self-redacted> ... and then force myself to answer what do I choose? Do I choose to put off self-care 'til Monday, when I know that Monday never comes? Or do I choose to get and stay healthier while I still am able to - when all it means is not doing that one stupid thing - but instead doing something that actually is just as pleasant, when I think about it! (I don't really feel better 10 minutes after eating the chocolate than after eating some cheese)? I consider if this choice is left unmade, it is a positive choice to exit stage left in one of the frightening ways I know (with a few horrific exceptions) - having lost any control over my own body and life (because I failed to exert control over it while I was still able).
</trigger warning>

The great thing about T2 is that for most of us, it's not too late. And having binged out and self-defeated for years doesn't usually mean that you can't get a lot better - or maybe still totally better. It's not over until it is. So consider today as day 1, not day 745 ...

And if this fails, I think I would force myself to come clean to a friend, a counsellor, or somebody else who'd help me be honest with myself about what I really want out of life and death, and about whether my actions support those wishes. That is very difficult. Or a 12-step might actually be easier - I don't know. I've never really done this; I've talked loosely about my challenges, but not honestly and intimately in a "help me keep my ^£%£ straight" way. But if I need to, I have the relationships to support that. Ultimately, for me at least, sometimes the cost of not living and dying miserably is being honest with myself - about what I want, what I am scared of, what I am actually doing right now, and how those things support each other.
 
Well Done. You made your mark. You have started your recovery plan. Owning up to yourself can be hard, since we can be more critical of our failings than anyone else except a mother-in-law.

Except that as has been said, it is not something to blame yourself for. We all suffer the problems of carb creep from time to time. And Covid certainly has not helped.

Testing is expensive both here and in the US, but it is essential to getting control back. Worth the investment. I found that when I went TWOMAD I found my pre meal reading in the evening was close to my fasting reading, so I dropped the morning test to save a strip. A test 2 hours after eating a meal is what most people do, but it tends to miss any delayed spike due to protein and fat content. A test at 3 hours instead may give a better picture

The other trick I use is my choice of breakfast. Its the same everyday. An english fry up. When I started this trick I tested it many times and tuned it to get a repeatable result that was only slightly elevated so my bgl dropped back to fasting at suppertime. This repeat of a known meal removes any testing until the evening. The English breakfast is high-ish fat content, so I do not feel the need to snack at all much to the chagrin of my cat.
 
Thank you both for those utterly brilliant replies. I am reading and reading them again to get every drop of advice and wisdom out of them.

I know what to do about eating, it’s just a case of sticking to it. That’s the hard part. It’s ridiculous as I don’t even prefer carb-heavy meals to low carb ones but it’s often easier to have the carbs, especially if that’s what everyone else is having.

What could happen is a very powerful tool for me and I need to use it more often. I don’t want sight problems or to have an amputation. If it comes to that, so be it and I will deal with it then. But I want to be able to say I did everything I could to avoid that.

There was one point that I was actually glad of my diagnosis. I was 100lbs lighter, exercising regularly and felt better than I had ever done as an adult. I want to get that back and surely that is worth more than a bag of crisps or toast.
 
Just a quick update: I’ve been strictly low carbing now for not even a week and changes that were noticeable almost immediately are:

Sleeping better

Very dry mouth at night pretty much gone

Not needing to get up in the night to wee

Not nearly as hungry

A pimple that has been very slowly healing for weeks has pretty much disappeared

I hadn’t realised how thirsty I had been before until I’m not, iyswim


Still a long way to go but the improvements are already palpable. Most of all, I feel happy I am taking control again. This is where I enjoy being. Here’s to another week of low-carbing. Then another.
 
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