Type 2 issue in retirement

[rovtim]

I am 76 years old and have been low card for 3/4 years (I still eat exactly the same as I did at the start) and a member of this site for all that time. I was diagnosed with type 2 in 2012. I have to say that this has been very successful and I am very grateful to diabetes.co.uk My annual reviews have been 41, 42 and 43.


Here is the but at the start of this year I felt unwell and very weary, I put this down to old age. However I developed pains in my legs and I had to go to the doctors and I was diagnosed with vit D deficiency this has now been sorted out. I have had my annual review and it came at 53 which I am horrified about they are talking about drugs and saying that this is to be expected and the likely cause is the pancreas is failing over time. The only other thing I can spot is that until this year most days I was doing 10,000 steps that dwindled away but I am getting back to that standard again and I have gained 3 - 4lbs in weight - in am underweight anyway and I was not bothered about this.


Subject to the doctor giving the ok I am thinking about tackling this by fasting do people think this is a worthwhile idea .

 

[Oldvatr]

I am 76 years old and have been low card for 3/4 years (I still eat exactly the same as I did at the start) and a member of this site for all that time. I was diagnosed with type 2 in 2012. I have to say that this has been very successful and I am very grateful to diabetes.co.uk My annual reviews have been 41, 42 and 43.


Here is the but at the start of this year I felt unwell and very weary, I put this down to old age. However I developed pains in my legs and I had to go to the doctors and I was diagnosed with vit D deficiency this has now been sorted out. I have had my annual review and it came at 53 which I am horrified about they are talking about drugs and saying that this is to be expected and the likely cause is the pancreas is failing over time. The only other thing I can spot is that until this year most days I was doing 10,000 steps that dwindled away but I am getting back to that standard again and I have gained 3 - 4lbs in weight - in am underweight anyway and I was not bothered about this.


Subject to the doctor giving the ok I am thinking about tackling this by fasting do people think this is a worthwhile idea .

I am not a medical man, so please work closely with your HCP's on this. Certainly fasting is a tool that we can use as part of our control regime, and it can be used aongside a low carb diet. At this stage you do not know if your diabetes is due to low insulin production (pancreas problem) or due to high Insulin resistance, but after several years of LC, then it is probably not IR and in this case fasting may not be as effective in controlling bgl since it is primarily aimed at reducing IR, I believe. Also, using fasting may mask an undelying problem that may be developing. You can fool the doctor once.........You can also fool yourself. I used a similar tactivc by drinking alcohol the night before a review since it dropped my fasting levels by 1 mol/l or so. But that was deliberate cheating.

There are other medical conditions that can affect the HbA1c results. As we grow into second childhood (I am one doing this too) our bodies become less efficient at digesting and using the nutrients from the food we eat. Particularly fat. If your LC diet is in anyway based on ketogenisis, then it may be that upping your fat intake may increase energy without increasing bgl. The other poss is that you may not be absorbing B12 or folate or iron as well as you used to, and a whole blood panel screen is needed to show what your haematocrit levels are and the ferritin levels which control the production of haemoglobin. These should be checked as part of your annual review, but most practices skip it due to cost savings. In my case, I had a stroke so I qualify for one every time my blood is taken, and I get the full works automatically.

There is no easy way to determine if one is insulin deficient or insulin resistant. The C-peptide test is expensive, and not one that a GP would normally prescribe. At an HbA1c of 53 or so, then any meds required will be relatively minor since this is not at any sort of critical level.

You do not mention self testing of bgl. As a forum member since 2012 then it should be no surprise if I suggest that you use a bgl meter to measure how you are currently reacting to your diet. It may be LC, but there may be bad habits developing that are pushing things up a bit. Our bodies change over time, and our guts become more porous and leaky, so our responses will naturally change as we age.

 

[KK123]

I am 76 years old and have been low card for 3/4 years (I still eat exactly the same as I did at the start) and a member of this site for all that time. I was diagnosed with type 2 in 2012. I have to say that this has been very successful and I am very grateful to diabetes.co.uk My annual reviews have been 41, 42 and 43.


Here is the but at the start of this year I felt unwell and very weary, I put this down to old age. However I developed pains in my legs and I had to go to the doctors and I was diagnosed with vit D deficiency this has now been sorted out. I have had my annual review and it came at 53 which I am horrified about they are talking about drugs and saying that this is to be expected and the likely cause is the pancreas is failing over time. The only other thing I can spot is that until this year most days I was doing 10,000 steps that dwindled away but I am getting back to that standard again and I have gained 3 - 4lbs in weight - in am underweight anyway and I was not bothered about this.


Subject to the doctor giving the ok I am thinking about tackling this by fasting do people think this is a worthwhile idea .

Well it could be that although you are eating the same as you did 4 years ago, as we ALL get older our bodies change, for example we may need fewer calories at 70 than we did at 20. Of course this is all speculation but can you give us an example of a day's food? Personally (being underweight) I'm not sure about you fasting, I suppose it depends on your general health and fitness. I think their comments about it all being inevitable is THEM giving up and having low expectations of people. You sound like you are still working hard and showing an interest in your health. I wonder whether you could simply lower the carbs and up the fats to tackle your hb1ac which may work without going for long periods with nothing to eat and unintentionally losing even more weight? I say this with massive caution though because it's not for everyone. x

 

[rovtim]

I am not a medical man, so please work closely with your HCP's on this. Certainly fasting is a tool that we can use as part of our control regime, and it can be used aongside a low carb diet. At this stage you do not know if your diabetes is due to low insulin production (pancreas problem) or due to high Insulin resistance, but after several years of LC, then it is probably not IR and in this case fasting may not be as effective in controlling bgl since it is primarily aimed at reducing IR, I believe. Also, using fasting may mask an undelying problem that may be developing. You can fool the doctor once.........You can also fool yourself. I used a similar tactivc by drinking alcohol the night before a review since it dropped my fasting levels by 1 mol/l or so. But that was deliberate cheating.

There are other medical conditions that can affect the HbA1c results. As we grow into second childhood (I am one doing this too) our bodies become less efficient at digesting and using the nutrients from the food we eat. Particularly fat. If your LC diet is in anyway based on ketogenisis, then it may be that upping your fat intake may increase energy without increasing bgl. The other poss is that you may not be absorbing B12 or folate or iron as well as you used to, and a whole blood panel screen is needed to show what your haematocrit levels are and the ferritin levels which control the production of haemoglobin. These should be checked as part of your annual review, but most practices skip it due to cost savings. In my case, I had a stroke so I qualify for one every time my blood is taken, and I get the full works automatically.

There is no easy way to determine if one is insulin deficient or insulin resistant. The C-peptide test is expensive, and not one that a GP would normally prescribe. At an HbA1c of 53 or so, then any meds required will be relatively minor since this is not at any sort of critical level.

You do not mention self testing of bgl. As a forum member since 2012 then it should be no surprise if I suggest that you use a bgl meter to measure how you are currently reacting to your diet. It may be LC, but there may be bad habits developing that are pushing things up a bit. Our bodies change over time, and our guts become more porous and leaky, so our responses will naturally change as we age.

Thank you for going to this amount of trouble on my behalf

 

[Oldvatr]

Thank you for going to this amount of trouble on my behalf

Thank you. I hope you found it useful.

 

[jpscloud]

I am 76 years old and have been low card for 3/4 years (I still eat exactly the same as I did at the start) and a member of this site for all that time. I was diagnosed with type 2 in 2012. I have to say that this has been very successful and I am very grateful to diabetes.co.uk My annual reviews have been 41, 42 and 43.


Here is the but at the start of this year I felt unwell and very weary, I put this down to old age. However I developed pains in my legs and I had to go to the doctors and I was diagnosed with vit D deficiency this has now been sorted out. I have had my annual review and it came at 53 which I am horrified about they are talking about drugs and saying that this is to be expected and the likely cause is the pancreas is failing over time. The only other thing I can spot is that until this year most days I was doing 10,000 steps that dwindled away but I am getting back to that standard again and I have gained 3 - 4lbs in weight - in am underweight anyway and I was not bothered about this.


Subject to the doctor giving the ok I am thinking about tackling this by fasting do people think this is a worthwhile idea .

From my reading fasting is not recommended for anyone who is underweight - again this is just my understanding and I'm not in a position to say I've achieved it yet, but very low carb with a high healthy (not seed oils) fat diet might help, the high fat part being most important if that has been lacking in your diet.

 

[Brunneria]

Hi @rovtim

I agree that fasting when underweight is not advised, and I understand it is rather difficult too - a slim body has a harder time when fasting than a well padded body.

Interesting in what you said about not walking so much, recently. This could be a factor in your raised test results. Apart from the fuel you burn actually doing the exercise, there is also the possibility that you have reduced muscle mass from less activity. And of course the older we get the easier it is to lose muscle mass. Also, exercise lowers insulin resistance, which has a number of knock on results, including weight gain.

Just a possibility.

You mention you are low carbing, and that it has worked well for you - which is great - but you don't mention how low carb, so I can't tell whether you are likely to be in ketosis or not. If you aren't, then you are still using glucose as fuel, and if so, then less exercise => less glucose used to fuel the activity => higher levels of glucose floating about.

Hope this helps.

 

[EllieM]

Interesting in what you said about not walking so much, recently. This could be a factor in your raised test results.

I second this. In my experience (T1 with mild insulin resistance) exercise can drastically reduce insulin resistance and so reduced exercise is extremely likely to make a T2's blood sugar go up. (As a T1 I just have to increase my insulin). My recommendation would be to get a meter and increase the exercise and/or decrease the carbs - your meter will tell you whether the new regime is working.

Good luck.

 

[Oldvatr]

Hi @rovtim

I agree that fasting when underweight is not advised, and I understand it is rather difficult too - a slim body has a harder time when fasting than a well padded body.

Interesting in what you said about not walking so much, recently. This could be a factor in your raised test results. Apart from the fuel you burn actually doing the exercise, there is also the possibility that you have reduced muscle mass from less activity. And of course the older we get the easier it is to lose muscle mass. Also, exercise lowers insulin resistance, which has a number of knock on results, including weight gain.

Just a possibility.

You mention you are low carbing, and that it has worked well for you - which is great - but you don't mention how low carb, so I can't tell whether you are likely to be in ketosis or not. If you aren't, then you are still using glucose as fuel, and if so, then less exercise => less glucose used to fuel the activity => higher levels of glucose floating about.

Hope this helps.

Our bodies store glucose in two primary fat stores. Firstly glucose is used to top up the muscle cells according to the Krebs (aka Citric) cycle where it is stored as glucogen. This is a fast access store that supplies the initial burst of energy for activity (first wind), and then there is a longer term store in the liver and adipose tissues that is used to provide the second wind, and incidentally gives uus the dawn phenomenon also recognised here as liver dumps. This second store can be overfilled especially in T2D and the spill over goes into the tissue around the pancreas and liver which gives us the signature metabolic syndrome and the spare tyres around the midriff.

It is my understanding that the muscle stores get used up by exercise, and also get depleted when fasting, The liver stores are slower to lose it, and requires a more sustained effort either by low carbing, or by extended fasting / starvation. This is why the spare tyre is the last bit to slim up when following a standard weight loss diet. However, it seems that exercise is not so effective at depleting the liver fat, since one has to walk or run a surprising distance to negate the effects of (say) a chocolate bar or fizzy drink. Thus for someone like me who is also basically sedentary then fasting is a useful tool.

I am normally TOFI so have to keep an eye on my weight. I am using Low Carb, but not actually using ketosis. I also use medication at a low level to assist. I have recently claimed remission, but it was temporary and was messed up by a prolonged stay in hospital for a major operation that was not kind to my pancreas, so I am fighting my way back. I am nearly there - yesterday I had a large helping of beef stew that was full of carrot, butternut squash, onion, turnip and potato, and my daily average bgl on my meter was 5.4 with a maximum upward post prandial swing to 6.1 So I am close to being able to eat normally again, But I am using a small dose of Metformin, so am not yet in remission, My latest HbA1c was 46.

In conclusion, I had been a T2D since DX 25 years ago. I have had meter readings that are off the scale and HbA1c results in the stratosphere. I have probably taken longer to get to remission than others using other methods such as keto or ultra low calorie or extended fasting, but the main thing is that I did get there eventually, and without stressing out over it. I have had a controlled climb up to the pedestal of REMISSION and hope to get back there again in time for Xmas. It seems that careful choice of meals is also plausible to achieve the goal since that is all I did. I was a diabetic, I remain a diabetic for the rest of my life, but I am happy to be in control with a diet plan that is easy to implement and tasty too.