Next stop insulin...... Apparently

Winnie53

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Ketogenic diet is 50 carbs or less, not 20 or less. I think the confusion is caused by the Atkins diet having a 20 carb induction phase which is temporary. When I started the ketogenic diet with an A1c of 9.9% (US), I ate 30 - 42 carbs a day, lost a lot of weight and my A1c dropped into the non-diabetic range in 6 weeks, then continued to improve over the next year.

Wishing you good luck with your ongoing efforts! :)
 
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ElNevera

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Ketogenic diet is 50 carbs or less, not 20 or less. I think the confusion is caused by the Atkins diet having a 20 carb induction phase which is temporary. When I started the ketogenic diet with an A1c of 9.9% (US), I ate 30 - 42 carbs a day, lost a lot of weight and my A1c dropped into the non-diabetic range in 6 weeks, then continued to improve over the next year.

Wishing you good luck with your ongoing efforts! :)
Thanks for your reply.

I've watched a few videos on YouTube that led me to believe it was < 20g, happy to read that that I can do < 50!

So you're A1c was very similar to me then? That is a fantastic turn around in that time frame, well done!

Do you have any tips?
 

ElNevera

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You don't need to fast (skip breakfast) for an HbA1c as it's a 3-month average glucose. You will need to fast (not eat after 12 am from the night before) for a fasting glucose test, which the GP's should do if you asked. The specialists do the c-peptide usually as it's outside the GP's expertise, so not usually, unless you can justify a referral. You'd have to have it done privately.
I'm not sure when I last had a fasting test done then, all that has been mentioned over the last few years is the Hba1c....

I'll make sure to ask for one and if they've been doing them, thank you.
 

HSSS

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I think 20g for keto gets used a lot because that’s the figure that guarantees everyone will be in ketosis. Lots reach it at higher levels. I got there at around 40g.

It sounds daunting at the outset but once you get going and start learning which swaps you like and get used to seeing a plate without carbs on it it definitely gets easier. Seeing better scores on a meter helps a lot with motivation too
 
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ElNevera

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I think 20g for keto gets used a lot because that’s the figure that guarantees everyone will be in ketosis. Lots reach it at higher levels. I got there at around 40g.

It sounds daunting at the outset but once you get going and start learning which swaps you like and get used to seeing a plate without carbs on it it definitely gets easier. Seeing better scores on a meter helps a lot with motivation too
Thanks, how did you know you'd reached ketosis?
 

Winnie53

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I crossed over to type 2 diabetes 14 years ago. Was poorly controlled until 4 years ago. I don't use any medication. Not sure why your doctor is pushing to start insulin. Will try to go back and read what you've posted in a few days. Maxed time wise right now. :)
 
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ianf0ster

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I've not been doing the 2 hour past food testing but I'll start doing it.
For me the main reason for having a Blood Glucose meter and doing the tests is to rule in/out various food.
And the only way to be serious about that is to test what their effect is on my BG.
So I test before a (different) meal and then 2hrs later to get the verdict.
If I knowingly eat a small amount of High GI carbs (e.g. fruit) with a meal, then I also test at the 1hr after first bite mark to make sure I am not getting a nasty quick spike in BG.

I only do a 16hr fast (Intermittent Fasting) about once or twice per week since my weight is controlled and it is just the BG and the carbs I need to focus on.
 
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HSSS

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Thanks, how did you know you'd reached ketosis?
A few weeks into it I bought some urinalysis sticks for ketones from the chemist. Showed a nice dark colour indicating ketosis. In time that faded as the sticks only work for a while. They measure peed out “wasted” ketones and as yo7 become better fat adapted you use them more and waste less. Then you need to measure by breath or blood but those methods cost more.
 

Winnie53

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Elnevera glad you're going to start testing pre- and 2 hours post meal. That will give you a lot of useful information. To rebuild your microbiome after so many rounds of antibiotics, you'll need to start increasing your fiber intake by eating more plant based foods. A variety helps. Also if you can eat some raw vegetables each day, that would be good. Pediatric Endocrinologist Robert Lustig, MD has been a huge influence in my life. Here's one of his more recent lectures...


He's one of my heros. ;)
 
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Tophat1900

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Be a good idea to get those bloods done, c-peptide etc as mentioned and find out what you insulin resistance level is at. I'm sure it's a problem for you and taking insulin will worsen that resistance. The question is how much of a problem is it.

Being diligent and testing as has also been mentioned is important imo. And decreasing the carbs and not eating stuff you know is a mistake. Bread is addictive, but it's not just full of carbs, it's also full of seed oils which also very bad for your health.

Many get great results with changing their diet to suit their condition. I'm sure it's worth trying out the low carb approach.

It's all a learning process, it takes time and we all learn something new all the time.
 
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ElNevera

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For me the main reason for having a Blood Glucose meter and doing the tests is to rule in/out various food.
And the only way to be serious about that is to test what their effect is on my BG.
So I test before a (different) meal and then 2hrs later to get the verdict.
If I knowingly eat a small amount of High GI carbs (e.g. fruit) with a meal, then I also test at the 1hr after first bite mark to make sure I am not getting a nasty quick spike in BG.

I only do a 16hr fast (Intermittent Fasting) about once or twice per week since my weight is controlled and it is just the BG and the carbs I need to focus on.
I am starting the testing around food now not just before. Thank you
 

ElNevera

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A few weeks into it I bought some urinalysis sticks for ketones from the chemist. Showed a nice dark colour indicating ketosis. In time that faded as the sticks only work for a while. They measure peed out “wasted” ketones and as yo7 become better fat adapted you use them more and waste less. Then you need to measure by breath or blood but those methods cost more.
Thanks, I'll have a look for some.
 

ElNevera

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Elnevera glad you're going to start testing pre- and 2 hours post meal. That will give you a lot of useful information. To rebuild your microbiome after so many rounds of antibiotics, you'll need to start increasing your fiber intake by eating more plant based foods. A variety helps. Also if you can eat some raw vegetables each day, that would be good. Pediatric Endocrinologist Robert Lustig, MD has been a huge influence in my life. Here's one of his more recent lectures...


He's one of my heros. ;)
Thanks very much!

I deffo need to eat more veg in general and especially greens.
I need to look up details on carb values.

Thanks for the link, I'll watch it after work.
 

HSSS

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Dietdoctor.com has very useful quick visual guides to carb values to get you started
 
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ElNevera

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Be a good idea to get those bloods done, c-peptide etc as mentioned and find out what you insulin resistance level is at. I'm sure it's a problem for you and taking insulin will worsen that resistance. The question is how much of a problem is it.

Being diligent and testing as has also been mentioned is important imo. And decreasing the carbs and not eating stuff you know is a mistake. Bread is addictive, but it's not just full of carbs, it's also full of seed oils which also very bad for your health.

Many get great results with changing their diet to suit their condition. I'm sure it's worth trying out the low carb approach.

It's all a learning process, it takes time and we all learn something new all the time.
Thanks for your reply.
I'm going to book in to see my GP and ask if I can have the tests done.
In the meantime I'll see if I can get it done privately somewhere.

It usually takes some time to get seen by my GP so I have sometime to really concentrate on taking my own readings and further improving my diet!
 
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ElNevera

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So yesterday I started fasting at 3pm and my BG was 8.
During the fast I only drank peppermint tea and water (with a slice of lemon).
Before breaking my fast (ended up being 18 hours) this morning my BG was 9.2.
I ate,
4 fried eggs
4 slices of ham
4 slices of mature cheddar

I had a tea with whole milk and then took 1g of modified release Metformin.

2 hours later my blood was 10.

Since then I've had another cup of tea and a glass of squash.

My BG is now 8.4

My plan is to eat a meal around 3pm again and then start fasting again.

I don't think I've mentioned but I am 39, 6' 4" tall and am pretty broad in build. I'm currently 20st and at my worst was pushing 25st a few years back.
The 'ideal' weight for me is around 12st apparently but I don't think that would work for my as my new fancy scales say my skeletal muscular mass is just about 8st.... Whatever that means!

I cannot currently exercise due to my feet problems but hoping that changes soon.
I'm thinking of taking up some form or weight training.

Thanks
 

HSSS

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Dawn phenomenon is a factor that can raise our morning fasting readings regardless of food intake.

Fundamentally it’s our liver feeding us a glucose breakfast when it thinks we’re ready to get up and going and needing energy. Very helpful unless as a t2 we don’t respond properly and it keeps on rising beyond what’s helpful. This means that it’s typically the last reading to come into line and can take significantly longer than the rest of the day to do so. Months maybe years not days or weeks like the rest of the day potentially could.

Ultimately low carb done correctly will show results if your pancreas is still kicking out insulin. (Most t2 has a huge amount at least initially). If it’s worn out and isn’t doing so at all or enough then it’ll help some but not solve the problem. The only way to know which yours is if you don’t get the results you want is to get it tested. I know if I ever get to the point insulin is recommended it’s because i don’t have my own rather than the dr is trying to overload me in order to force already high levels to work.
 

Flora123

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Elnevera glad you're going to start testing pre- and 2 hours post meal. That will give you a lot of useful information. To rebuild your microbiome after so many rounds of antibiotics, you'll need to start increasing your fiber intake by eating more plant based foods. A variety helps. Also if you can eat some raw vegetables each day, that would be good. Pediatric Endocrinologist Robert Lustig, MD has been a huge influence in my life. Here's one of his more recent lectures...


He's one of my heros. ;)

Just watching this and I’m confused. He is saying it is only sugar that’s the problem not carbs in general. Have I missed something? It is around 39 mins in. He says took sugar out of diet and made subject eat lots of bagels and potato chips (“**** food” he calls it) and their metabolic health improved.
 

bulkbiker

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I've been doing intermittent fasting for a while now and feel great after fasting for 16 hours. I eat a generally low carb diet but certainly not to the keto level.
I'd recommend trying keto then.. it certainly won't do you any harm and may bring multiple benefits.
If you want to be really hardcore you could try carnivore, assuming you are a meat eater. That along with a One Meal a Day (OMAD) way of eating could be great for you.
 

Gran25

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All of the diet advice notwithstanding, let's look at the exercise piece. I have noticed (just my observations...no science here) that it is really hard for people to switch to another form of exercise once they have found their preferred option. So instead they do nothing. Not sure if it's a cultural thing, guy thing, group identity or whatever.... So I would suggest that you meet with a physiotherapist, exercise coach or similar trained professional to look at options that will work for you with the challenges you currently face.. Maybe running isn't going to be an option, so walking, swimming, cycling, aqua therapy, water walking might be. Light weights, resistance training, electric assist cycle etc.
 
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