Like a bad penny...

[luceeloo]

Hey, I've been gone for a while, but like a bad penny I always turn up

I'm not doing brilliantly. I got moved on to a full insulin regime, but with very little advice or guidance from the hospital. So I've been bumbling along for a while. I've been on one diet or another for 7 months with zero weight loss, in fact, after the last three months on LCHF I've managed to gain about 5kg. I'm at my wits end. My care team don't seem to be bothered about weight loss (I am because at this point I'm 120kg) they want me to get better glucose control using just insulin. For me personally, weight loss is one of the most important things on my to-do list, and at my weight I'm insulin resistant and the more insulin I use, the more weight I gain. For the first time in my life I've been suffering from anxiety and it's all connected to the feeling of failing at Diabetes. I'm doing loads of exercise, I'm fitter than I've ever been in my life... but I can get the insulin-food thing balances. I wasn't sure where to turn, and then remembered this forum.
So, I'm back... I'm starting from the beginning... wherever the beginning is.

 

[Winnie53]

luceeloo, I have questions...

Are you using any diabetes medications? Are you using any other medications? Are you using insulin? (Your post says you're using insulin, your signature line says "no insulin needed since 8th February 2019.")

When you were diagnosed with Type 2 in 2013, what was your A1c? What was your A1c when you were "moved on to a full insulin regime?"

More recently, when you were moved to a "full insulin regime", was testing done showing you have an autoimmune condition such as LADA, or was testing done showing that your insulin production has dropped significantly?

Trying to understand why you were put on insulin after only have T2DM for 6 years.

Have you read Jason Fung's book The Diabetes Code? He uses fasting in addition to the LCHF/Keto diet, and argues that most type 2 diabetics should not use insulin, that insulin resistance is fatty liver, and beta cell dysfunction is fatty pancreas.

Latent Autoimmune Diabetes in Adults (LADA) however is a different conversation.

I'm heading to bed now. Hope others come along to offer support and suggestions.

 

[Flora123]

I’d also recommend The Obesity Code by Jason Fung too. Some overlapping info but very. interesting.

 

[JoKalsbeek]

Hey, I've been gone for a while, but like a bad penny I always turn up

I'm not doing brilliantly. I got moved on to a full insulin regime, but with very little advice or guidance from the hospital. So I've been bumbling along for a while. I've been on one diet or another for 7 months with zero weight loss, in fact, after the last three months on LCHF I've managed to gain about 5kg. I'm at my wits end. My care team don't seem to be bothered about weight loss (I am because at this point I'm 120kg) they want me to get better glucose control using just insulin. For me personally, weight loss is one of the most important things on my to-do list, and at my weight I'm insulin resistant and the more insulin I use, the more weight I gain. For the first time in my life I've been suffering from anxiety and it's all connected to the feeling of failing at Diabetes. I'm doing loads of exercise, I'm fitter than I've ever been in my life... but I can get the insulin-food thing balances. I wasn't sure where to turn, and then remembered this forum.
So, I'm back... I'm starting from the beginning... wherever the beginning is.

Hey Luceeloo,

That's quite the story... I'm sorry things have gotten this bad. I have to wonder though... Are you absolutely positive you're a T2? Were C-peptide and GAD tests done? Because if you've been on keto, it should've had some impact, somewhere... I know my weight's stopped shifting on it, alas, but at least my BS is under control. What are you eating in a day? Maybe there's something hidden in there? If not, and none of the aformented tests have been done, maybe they'd merit looking into?

In any case... Hugs. Big ones. Sounds like you could do with them.
Jo

 

[ert]

Luceeloo, I hope you manage to get a working strategy for your weight loss and blood sugar control soon. Have you tried walking 15-20 minutes after every meal (I'm assuming you're avoiding insulin for a little while longer based on your post)?

 

[Juicyj]

Sorry to hear this @luceeloo

As you know anxiety is bad for diabetes it can push your levels up and cause insulin resistance, so getting your mind in a better place would be a good starting point and lessening your feelings of anxiety. Have you thought about meditation, so getting the app 'calm' on your phone is useful, just taking time out each day to listen in and tune out will help you cope better. Walking is also a good way to help with anxiety, i've suffered with this myself since my diagnosis, it's really common with diabetes to feel like this. Also is it just your weight that makes you feel this way or has the diagnosis impacted you ?

Running higher levels can also increase feelings of anxiety, so being able to adjust your insulin and correct where necessary will help you get in range more frequently and also improve your mood.

Weight loss can and will happen but it's more important to feel better mentally first.

 

[luceeloo]

Sorry my signature is out of date... I will fix when I get a chance. Are you sitting comfortably for the long story?

I was diagnosed as type 2 at 33. Put on metformin, lost some weight, but still couldn't adequately control glucose. I've been on canagliflozin, dapagliflozin, glicazide, lixisenatide injections, and probably a lot more in the middle.
My hba1c hovers around 67 to 72.
I was under the care of a diabetic nurse at my gp surgery. She left, then each replacement changed my meds. 12 months ago the latest diabetic nurse left and I was referred to a community clinic at a local hospital. At that point I was on lantus. They changed it to toujeo and added canagliflozin. Things were great.

Without warning, last September, I was referred to a consultant led clinic at another hospital, and there the consultant changed everything. She kept the toujeo, added novorapid, and took me off canagliflozin.
In January I read the diabetes code by Dr Jason fung. It made sense, I followed it and had some success at first, especially with IF. I managed to reduce insulin to the point where I could come off it. I was then told off by the diabetic nurse attached to the consultant clinic... I actually offered her my copy of the book but she refused to accept the differences between ketosis and ketoacidosis. So each month, to avoid an argument I made sure that I wasnt in ketosis before I had to provide a urine sample!

Things have been very difficult since about April/may. My weight is creeping up, my blood sugar is more erratic and I've had no advice how to deal with this ("inject 2 more units of novorapid" is the standard response from the nursing team).

I've had conversations over the years about being tested for LADA etc, but my GP won't and the consultant wont entertain it either. They see weight and can't see past it.

I've never suffered from anxiety before and its crept upon me out of the blue. I think that I've become so obsessed with all of these numbers that control my life... hba1c, bg readings, weight, carbs everything has a value and it overwhelms me trying to balance it all. Specifically losing the numbers battle is making it feel worse. I get stuck in the circle of no motivation, feeling rubbish, etc. Above all else in life I want to lose some weight. I'm under no illusions - I'll never be thin, but I am fairly fit, do quite a bit of exercise and I enjoy hiking and hill walking... so I'm not sedentary
But this stress-head isn't me. I'm normally focused and in control.
I think I just need a fresh start. Back to day one with clean low carb, watching the proteins and eating good fats, and doing more towards accountability!

Phew, that was long!

 

[Winnie53]

@luceeloo I'm so sorry this is happening to you. I understand your treatment team trying to be helpful, but what they are doing is abusive and hurtful. It's the current standard of care, and it's wrong, wrong, wrong. I can't begin to get around how difficult it would be dealing with a succession of treatment providers, each with a different treatment plan.

The only way I know forward without the appropriate lab tests is exactly the fresh start you stated at the end of your post. A real, whole foods diet that provides adequate protein, fiber and nutrients from non-starchy vegetables, nuts and seeds, and some healthy fats to keep the cravings controlled, while trying to find the appropriate amount of insulin.

I just got my copy of The Diabetes Weight-Loss Cookbook by Katie and Giancarlo Caldesi yesterday with "forward by Dr. David Unwin". It looks really good, and the few reviews I've read here on the forum on the recipes have been 100% positive so far.

Your level of physical exercise and fitness is excellent. You're also smart, and savvy. That's clear in your writing. That makes so much more possible.

Do you have an adequate number of test strips to see how your meals are affecting your glucose levels, also your exercise? Or can you purchase the cheapest test strips available and the meter to go with them? All you need to do is test pre-meal, then 2 hours post meal. For exercise, pre-exercise, then immediately post exercise. You might also want to keep a food and exercise journal with your glucose readings, and insulin injections.

With that information, perhaps you can begin to see some patterns.

Thanks for posting your medication, toujeo. Not familiar with that one so need to research it to see how it works on the body. Will let the type 2's and 1's who inject insulin speak to the insulin. That's outside of my knowledge and experience. [Edited to add]: I now see that toujeo and novorapid are both insulin. That might be good. Not using any other diabetes medications might make the process of sorting out food, exercise, and insulin easier. Hoping others here who inject can provide guidance.

I love your determination. I'm a fighter. Sounds like you are too. That's good, really good.

Got to go to work now. Please keep posting. The more information you provide, the better we'll be able to help.

 

[JoKalsbeek]

Sorry my signature is out of date... I will fix when I get a chance. Are you sitting comfortably for the long story?

I was diagnosed as type 2 at 33. Put on metformin, lost some weight, but still couldn't adequately control glucose. I've been on canagliflozin, dapagliflozin, glicazide, lixisenatide injections, and probably a lot more in the middle.
My hba1c hovers around 67 to 72.
I was under the care of a diabetic nurse at my gp surgery. She left, then each replacement changed my meds. 12 months ago the latest diabetic nurse left and I was referred to a community clinic at a local hospital. At that point I was on lantus. They changed it to toujeo and added canagliflozin. Things were great.

Without warning, last September, I was referred to a consultant led clinic at another hospital, and there the consultant changed everything. She kept the toujeo, added novorapid, and took me off canagliflozin.
In January I read the diabetes code by Dr Jason fung. It made sense, I followed it and had some success at first, especially with IF. I managed to reduce insulin to the point where I could come off it. I was then told off by the diabetic nurse attached to the consultant clinic... I actually offered her my copy of the book but she refused to accept the differences between ketosis and ketoacidosis. So each month, to avoid an argument I made sure that I wasnt in ketosis before I had to provide a urine sample!

Things have been very difficult since about April/may. My weight is creeping up, my blood sugar is more erratic and I've had no advice how to deal with this ("inject 2 more units of novorapid" is the standard response from the nursing team).

I've had conversations over the years about being tested for LADA etc, but my GP won't and the consultant wont entertain it either. They see weight and can't see past it.

I've never suffered from anxiety before and its crept upon me out of the blue. I think that I've become so obsessed with all of these numbers that control my life... hba1c, bg readings, weight, carbs everything has a value and it overwhelms me trying to balance it all. Specifically losing the numbers battle is making it feel worse. I get stuck in the circle of no motivation, feeling rubbish, etc. Above all else in life I want to lose some weight. I'm under no illusions - I'll never be thin, but I am fairly fit, do quite a bit of exercise and I enjoy hiking and hill walking... so I'm not sedentary
But this stress-head isn't me. I'm normally focused and in control.
I think I just need a fresh start. Back to day one with clean low carb, watching the proteins and eating good fats, and doing more towards accountability!

Phew, that was long!

Holy ****.... I have no answers for you. In the Netherlands, I'd say go for a second opinion, but I don't know how do-able that is on the NHS...

Just do whatever you need to do to take care of yourself. This diabetes team is detrimental to your health, physically and mentally, by the sound of it. And your GP is an **** (Pick whatever word best suits the *'s). Choose you. Always.

*hugs*
Jo

 

[luceeloo]

Holy ****.... I have no answers for you. In the Netherlands, I'd say go for a second opinion, but I don't know how do-able that is on the NHS...

Just do whatever you need to do to take care of yourself. This diabetes team is detrimental to your health, physically and mentally, by the sound of it. And your GP is an **** (Pick whatever word best suits the *'s). Choose you. Always.

*hugs*
Jo

I think that writing it all down has made me realise that I have to get another GP. I think that's my first step... first someone who cares a little more!

 

[Winnie53]

Makes me happy when someone with diabetes seeks healthcare elsewhere when not properly diagnosed and/or not receiving appropriate treatment.

That said...and this is coming from someone who has received both excellent health care at times, and awful at other times...yes, do find another healthcare provider, but please understand while they do genuinely care and want to help you, the current standard of care does not allow them the time needed and sometimes the use of the right lab tests to properly diagnose and treat you. That's not to say we're completely on our own, they hopefully get it right more than wrong most of the time, but in a sense, we are on our own if we desire restored health through making significant lifestyle changes.

When I help someone, I spend hours and hours understanding what's happening and what they need. Put yourself in their shoes for a minute. How many times in your life have you been able to assist someone in a 10 minute visits every three months or so? That's the position they're in. And why it's so important that they refer you, or you seek out for yourself, current, science based diabetes and nutrition guidance: ketogenic diet, fasting, and exercise. To that I'd add quality sleep and stress management.

Additionally, and sadly, most healthcare providers only provide medication management for diabetes, which allows the disease to progress if diet and exercise are not included in the treatment regimen.

If you have LADA, or your ability to produce insulin has significantly dropped and you're not able to restore good insulin production with diet, fasting, and exercise, you may be insulin dependent for the rest of your life. But it's too early to know that. You've only had diabetes for 6 years. Much is still possible.