Here's hoping the third forum will be the charm!

[Neohdiver]

My standard MO when life throws me a new medical adventure is to find an online support forum so I have some buddies along the way. I've found that support forums are one of the best ways to learn more - and explore the edges of what medical science knows, and where it is headed in order to better manage my care (or that of a family member).

Unfortunately, I haven't had much luck with finding a home for online diabetes conversations. The first forum I tried seems to operate at about 1 new post a day. The second looked more promising - but it turned out to be an echo chamber for one narrow view of how to treat diabetes. Even though I mostly agreed with that view, I also wanted to see research and have substantive conversations that were apparently not permitted.

This forum appears to be active and open to multi-faceted conversations - so I hope this will be a good fit.

I was diagnosed with Type 2 diabetes in October. I immediately switched to a low-carb, moderate protein diet. My BG levels have been normal (4.7 - 7.8) virtually all of the time since 3 days post-diagnosis (the first time I got brave enough to test it).

I'm currently eating no more than 20 grams of carbs in a 3 hour period. Depending on how my body reacts, I cut back more. My current goals are to continue eating this way at least until I'm in the normal weight range. I started needing to lose 4.8 st and I'm about halfway there. Once I'm there I'll start testing to see if my insulin resistance has decreased. I would love to add some whole grains back into my diet.

My big questions are whether a ketogenic diet (or close to it) is healthy long-term.

Short term - I feel better than I have in years! I got rid of brain fog I wasn't even aware I had.

 

[azure]

Welcome @Neohdiver

Let me tag @daisy1 for you as she has some basic info for the newly diagnosed.

I hope you enjoy the forum and stay long term. We appreciate that one size doesn't fit all, as far as diabetes is concerned

 

[Mike d]

Those figs are good ...7.8 just a tad high but no issue ... but that is based upon when you test.

Great (and I mean great) start but return to wholegrains? No .. would not touch them, well at least not yet ... first things first though. What was your HB1ac as those numbers after such a short time indicate a lot of positives. FAR better than from many I've seen. You'll get heaps of advice here, a good lot of experienced people, but 4.7 is a terrific result.

Let's see that HBa1C test but you're awfully close to non diabetic ranges already, notwithstanding that 7.8 and what you ate and when you took your bloods. In effect, more info on your diet, your weight loss targets and how you use your meter

 

[Liam1955]

Hello Neohdiver. Welcome to the Forum.

 

[Neohdiver]

Those figs are good ...7.8 just a tad high but no issue ... but that is based upon when you test.

Great (and I mean great) start but return to wholegrains? No .. would not touch them, well at least not yet ... first things first though. What was your HB1ac as those numbers after such a short time indicate a lot of positives. FAR better than from many I've seen. You'll get heaps of advice here, a good lot of experienced people, but 4.7 is a terrific result.

Let's see that HBa1C test but you're awfully close to non diabetic ranges already, notwithstanding that 7.8 and what you ate and when you took your bloods. In effect, more info on your diet, your weight loss targets and how you use your meter

7.8 is at 1 hour after eating. I test before eating, at 1 hour, 2 hours, and (if it is higher at 2 hours) at 3 hours. So 7.8 is the top of the spike. I'd love for it to stay below 6.7 - but as long as it only goes above right after eating I'll live with it. I haven't had an a1c test since diagnosis (it was 7.2%/55.2 at diagnosis). My average (based on around 400 tests, deliberately searching for the peak blood g;icpse is 6.1, so I am expecting my a1c to be below 5.45%/36.1- since there is a lot of time I'm much lower but just not testing when it is tested again in March. (Which units are used for a1c? - I'm converting from what is used in the US).

As noted above - I eat no more than 20 (net) carbs in any 3 hour period. I test any new food (before, at 1 hour, at 2 hours and- if needed - at 3 hours). If a food pushes the limit on BG (elevates it above 6.9), I either don't eat it again, eat a smaller quantity, or buffer it by eating cheese or nuts first (both of which drop my BG within an hour of eating them). If I'm buffering, I expect to have to run a 3rd tests because that doesn't necessarily lower the spike - but it often flattens out and extends the curve. Sometimes it appears the first spike was random - so I'll test it a 3rd time before abandoning the new food or adding it to my diet. I'm eating a lot of cheese and nuts, as many low carb veggies as my body will tolerate, eggs, etc. My goal is fewer than 50 net carbs a day (although I'm more tied to the per meal limitation), about 60 grams of protein (based on lean muscle mass), and the rest fat.

The only grains I've had since diagnosis are homemade spritz cookies (leftover from Christmas). I tolerate a small quantity (i.e. they don't elevate my blood sugar above 6.9) - they are very small and have almost as much butter as they have flour (two have a total of 13 carbs). Once they're gone it will be back to no grains at all until I reach my target weight.

Assuming my a1c (or historical average depending on timing) stays low once I hit my target weight, I'll probably cautiously test vegetable that have a higher carb content to see if the weight loss has changed my insulin resistance. (My response to larger low carb salads suggests it is starting to change a bit.) If the vegetable tests work out well, I'll try small quantities of whole grains - since I really miss occasionally eating bread. But that's about 6 months down the road.

 

[daisy1]

@Neohdiver

Hello and welcome to the forum Here is the information, mentioned above, which we give to new members and I hope you will find it helpful. Ask as many questions as you need to and someone will be able to help.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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 over 150,000 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

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

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

LOW CARB PROGRAM:
http://www.diabetes.co.uk/low carb program


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 bloodglucose 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.

 

[Neohdiver]

Welcome @Neohdiver

Let me tag @daisy1 for you as she has some basic info for the newly diagnosed.

I hope you enjoy the forum and stay long term. We appreciate that one size doesn't fit all, as far as diabetes is concerned

Thanks - for both the welcome and the confirmation that one size doesn't necessarily fit all.

It was quite a rude awakening to run into that philosophy in a disease support forum, since it does not match my experience in around 10 other medical support forums I've been involved with (unfortunately, my family has lots of experience in managing disease that is not well managed by the medical community). I don't understand why it is even desirable to live in a medical echo chamber. Playing with the ideas on the edge of what science/medicine know is what has been so beneficial to my family with other diseases, and playing with those ideas works best if there are voices on both sides of the question.

This forum appears closer to the mold I'm used to.

 

[Neohdiver]

Hello Neohdiver. Welcome to the Forum.

Thanks!

 

[Neohdiver]

@Neohdiver

Hello and welcome to the forum Here is the information, mentioned above, which we give to new members and I hope you will find it helpful. Ask as many questions as you need to and someone will be able to help.

BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

. . .

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

.

Thanks for the info! I'm mostly beyond this information (I'm a research fiend - so I covered most of this in the first couple of hours after diagnosis.)

It is interesting to see how differently the NICE handles it than the US recommendations. My doctor's advice was test a few times about 2 hours after eating and make sure your blood glucose is below 10.

Not good enough for me, since I very quickly found out that sustained elevated blood glucose - even in the pre-diabetes range - does organ damage (including to the cells that produce insulin, so his recommendation would push me toward insulin resistance). When I went back to see him 2 months later, I had lost 1.43 st, and my average of around 200 tests was 5.9.

I am glad to see the more realistic target of 8.5 within 2 hours after eating - but even that is not an acceptable range for me.

 

[Juicyjan53]

My standard MO when life throws me a new medical adventure is to find an online support forum so I have some buddies along the way. I've found that support forums are one of the best ways to learn more - and explore the edges of what medical science knows, and where it is headed in order to better manage my care (or that of a family member).

Unfortunately, I haven't had much luck with finding a home for online diabetes conversations. The first forum I tried seems to operate at about 1 new post a day. The second looked more promising - but it turned out to be an echo chamber for one narrow view of how to treat diabetes. Even though I mostly agreed with that view, I also wanted to see research and have substantive conversations that were apparently not permitted.

This forum appears to be active and open to multi-faceted conversations - so I hope this will be a good fit.

I was diagnosed with Type 2 diabetes in October. I immediately switched to a low-carb, moderate protein diet. My BG levels have been normal (4.7 - 7.8) virtually all of the time since 3 days post-diagnosis (the first time I got brave enough to test it).

I'm currently eating no more than 20 grams of carbs in a 3 hour period. Depending on how my body reacts, I cut back more. My current goals are to continue eating this way at least until I'm in the normal weight range. I started needing to lose 4.8 st and I'm about halfway there. Once I'm there I'll start testing to see if my insulin resistance has decreased. I would love to add some whole grains back into my diet.

My big questions are whether a ketogenic diet (or close to it) is healthy long-term.

Short term - I feel better than I have in years! I got rid of brain fog I wasn't even aware I had.

Hi there and welcome. It's great to see you've got a handle on everything and congrats on your weight loss already. Anyway, at least you know we're all here to support you when you need it take care and let us know how you get on. Jan x

 

[Brunneria]

Hi and welcome.

Have you come across the www.bloodsugar101.com website?
Worth a read, if you haven't.

 

[Neohdiver]

Hi there and welcome. It's great to see you've got a handle on everything and congrats on your weight loss already. Anyway, at least you know we're all here to support you when you need it take care and let us know how you get on. Jan x

Thanks!

I'm actually down even more now (2.4 stone).

Still battling balancing the dawn phenomenon against the need to take thyroid meds on an empty stomach - since (for me) the dawn phenomenon keeps BG creeping up until I eat something. If I test on awakening, it is almost always below 5.6. If I test later (before eating) it is modestly higher until I eat something. Today it was much higher than I am comfortable with 7.7 (the highest morning reading I've had since diagnosis.) No apparent reason - other than my testing was about an hour and a half after I woke up, rather than immediately. (Of course, that tells me that I probably need to intentionally start testing later, since today may not be an isolated phenomenon - and I was just not aware of its severity because I only test fasting and then before lunch.)

I may have to experiment with eating a serving of nuts immediately when I wake up to chase away the liver dump, then taking the meds a half an hour later. (The Hashimoto's thyroiditis is also a new diagnosis - same visit as the diabetes diagnosis. When it rains, it pours...)

 

[Neohdiver]

Hi and welcome.

Have you come across the www.bloodsugar101.com website?
Worth a read, if you haven't.

Thanks! I read that early on - and go back periodically when I need to check something or find a link to the underlying resource. Definitely a great resource!

 

[poohtiggy]

Hi and welcome to the forum, you will soon find your way around and hopefully become a regular. Some of us are a little crazy but we have a lot of fun, stick around and you will find all the help you need

 

[Neohdiver]

Hi and welcome to the forum, you will soon find your way around and hopefully become a regular. Some of us are a little crazy but we have a lot of fun, stick around and you will find all the help you need

Hey - I tried to pick your avatar as mine, but it told me it was too big... I'll have to try again. This generic kewpie doll look isn't cutting it for me.

 

[Kristin251]

Neohdiver, I believe I know which forum you were referring to and I can only say THIS ONE is SO MUCH better. Every body is helpful and knowledgeable and appreciates that every bodies diabetes is different. Though the other forums premise I believe in, LCHF, I certainly don't think every body needs to drown themselves in grease.
Welcome and above all enjoy!

 

[Mike d]

Hi @Clivethedrive

Have you got that conversion chart handy for @Neohdiver ?

Glad to see those figs CTD

 

[Neohdiver]

Neohdiver, I believe I know which forum you were referring to and I can only say THIS ONE is SO MUCH better. Every body is helpful and knowledgeable and appreciates that every bodies diabetes is different. Though the other forums premise I believe in, LCHF, I certainly don't think every body needs to drown themselves in grease.
Welcome and above all enjoy!

Almost certainly the same one I did a search for "bully" and the chief offending mod's name and discovered that I was not alone in my perception.

My position, for now, is a carb max (primarily a meal max), a daily protein target (going too low is bad for muscle retention/going too high is bad for kidneys), a daily calorie deficit (for now) and goal (once I hit my desired weight) and top off my calories with fats (since there are only 3 kinds of macronutrients).

Short term I did enough research to be confident that I will at least do no harm - and to the extent it allows me to control my blood glucose and weight, I will be doing good.

I am concerned (over the long term) about my ability to obtain an appropriate balance of micronutrients, balancing my thyroid needs against my diabetes needs (some research indicated they may conflict in a low car diet), and about the impact of a diet that is largely fat on (at least) cardiovascular health. I have been unable to find any good, well controlled, long term studies of the combination of low carb and high fat (in part because the studies have not consistently classified diets - or been able to reliably track over an extended period of time because people don't live in boxes into which a restricted diet is fed).

In short, I'm interested in research (actively discouraged on the other forum), as well as a variety of personal experiences.

 

[Kristin251]

Almost certainly the same one I did a search for "bully" and the chief offending mod's name and discovered that I was not alone in my perception.

My position, for now, is a carb max (primarily a meal max), a daily protein target (going too low is bad for muscle retention/going too high is bad for kidneys), a daily calorie deficit (for now) and goal (once I hit my desired weight) and top off my calories with fats (since there are only 3 kinds of macronutrients).

Short term I did enough research to be confident that I will at least do no harm - and to the extent it allows me to control my blood glucose and weight, I will be doing good.

I am concerned (over the long term) about my ability to obtain an appropriate balance of micronutrients, balancing my thyroid needs against my diabetes needs (some research indicated they may conflict in a low car diet), and about the impact of a diet that is largely fat on (at least) cardiovascular health. I have been unable to find any good, well controlled, long term studies of the combination of low carb and high fat (in part because the studies have not consistently classified diets - or been able to reliably track over an extended period of time because people don't live in boxes into which a restricted diet is fed).

In short, I'm interested in research (actively discouraged on the other forum), as well as a variety of personal experiences.

I am well aware of the bully!
In my long term experience (20+ years and before any known diabetes) I have been VLC moderate P and HF and I have found saturated fat doesn't work so well with me. I eat mostly fish, turkey and eggs. I use plant fats as the majority of my fats. I don't eat dairy, chicken skin, bacon grease, rib eye steaks etc. BF is guacamole ( VERY BS stabilizing ) for BF with celery and radishes. Lunch is usually turkey and dinner fish of some sort. My main fats are avocado, EVOO, mayo. olives and WAS nuts (macs mostly) but I would like to drop a few pounds and coincidentally found out they were making me hungry so they are on the back burner. I recently had kidney stones so it is good to let them go anyway. Yes protein is hard to figure out. I should be getting about 43 G in P but i eat about 30-35 in animal / fish and I think I get the rest in veg protein. I am maintaining my muscle with the help of insulin. Too much P at one meal raises my BS so until I see my muscles shrinking I will stay here. Otherwise I might have to split boluses.
If you haven't read The Rosedale Diet you might want to look into it. He taught me to moderate P as well as space it 4 hour apart. This helped immensely when I was T2. Other good reads are Bloodsugar101, The Bernstein Solution and of course this forum. Your guns will be loaded.

 

[Neohdiver]

I am well aware of the bully!
In my long term experience (20+ years and before any known diabetes) I have been VLC moderate P and HF and I have found saturated fat doesn't work so well with me. I eat mostly fish, turkey and eggs. I use plant fats as the majority of my fats. I don't eat dairy, chicken skin, bacon grease, rib eye steaks etc. BF is guacamole ( VERY BS stabilizing ) for BF with celery and radishes. Lunch is usually turkey and dinner fish of some sort. My main fats are avocado, EVOO, mayo. olives and WAS nuts (macs mostly) but I would like to drop a few pounds and coincidentally found out they were making me hungry so they are on the back burner. I recently had kidney stones so it is good to let them go anyway. Yes protein is hard to figure out. I should be getting about 43 G in P but i eat about 30-35 in animal / fish and I think I get the rest in veg protein. I am maintaining my muscle with the help of insulin. Too much P at one meal raises my BS so until I see my muscles shrinking I will stay here. Otherwise I might have to split boluses.
If you haven't read The Rosedale Diet you might want to look into it. He taught me to moderate P as well as space it 4 hour apart. This helped immensely when I was T2. Other good reads are Bloodsugar101, The Bernstein Solution and of course this forum. Your guns will be loaded.

Thanks for the literature points. I have similar issues with fats - although at this stage not too bad.

What I have found, over decades, is that sugar causes cravings (no conflict with how I'm currently eating), but that certain fats also cause cravings (on a high fat diet that is partly supposed to prevent cravings - not a good thing), and the absence of grain carbs also causes cravings (bigger problem when grains are not compatible with my body's insulin resistance), and more dense (less volume) foods cause cravings (so I can't fill that hole in my belly with voluminous popcorn or rice cakes or even 10 oz bags of veggies). And I hate avocado, coconut oil, and pretty much any fat that is not combined with sugar, or conveyed to my belly on a nice whole grain slab of bread.

All in all LC/HF (or even moderate protein) is not a good fit for me. I'm managing (about 100 days, so far), sorting out which fats cause cravings (bacon is one). Staying away from grains (with the exception of my small serving of leftover spritz cookies - when my blood glucose allows it). I even managed to keep my blood glucose and calories in check during both Thanksgiving and Christmas, but it is will power - rather than a thrilling diet where I can eat slabs of bacon and don't have to worry about how much I'm eating. I guess about the only good thing is that I never really get hungry - my food drivers are emotional. And pretty much nothing I'm eating now is anything I'm likely to eat in excess (assuming I'm sticking with safe levels of carbs and protein).

I've never had a short term motivation problem for weight loss - it is the long term, once the big motivation of just having been diagnosed is in my rear view mirror, that concerns me because it is not a way of eating that I can adopt without conscious daily effort - which makes it a very poor long term plan (for me). But I'll cross that bridge when I come to it, I guess.