Newly diagnosed Type 2 metformin semaglutide low calorie diet

[Pashtun]

Hi everyone,

I was diagnosed with type 2 diabetes 3 days ago. I’ve seen a specialist. I’m 35 overweight 123kg BMI of 42. I work 7-7 daily but it’s a sedentary job. Need to increase my physical activity thus decided to take a break from work (I’m self employed) for about a month to increase my physical activity.

I’ve been started on metformin sr 500mg twice a day, semaglutide 0.5mg once weekly for 4 weeks then to increase to 1mg once weekly from there on.

Wanted to know what your experiences of these medications are and any top tips re side effects or timing of taking the injection etc (please excuse my ignorance if these questions seem silly).

I’ve also started low calorie 800/day exante diet.

Is there anything else I should be doing. I need to get my eyes checked. I don’t know how I get an initial diabetes eye check.

I’ve been started on atorvastatin 10mg once daily previous cholesterol readings several years ago were 5.0-5.5. I wonder whether something like pravastatin would have been better given statins can effect blood sugars.

thanks for your opinions and advice in advance

 

[Pipp]

Hello and welcome @Pashtun .
I can comment on Metformin, as I have taken that. Some people have gastric issues with it. I am fortunate not to. It does need to be taken with food, though.

As for the very low calorie diet, I have used that, with some success in the past. I would caution you to make sure you are having support and monitoring from your GP or consultant, particularly as you are also injecting semaglutide. I have no experience of this medication, so won’t comment, other than to say with medication and total food replacement diets you need to carefully check, several times a day, blood glucose levels, as it is possible to go too low.

The Very Low Calorie diets, (I think yours is a total food replacement diet?) can be of use to some in fast weight loss, and removing some of the visceral fat, that can impair pancreatic function. However, where many people go wrong is assuming it is a quick fix, to be undertaken short term, and then return to previous diet. It is not. You need to have a follow on, forever, eating plan. Many of us with T2 diabetes use low carb way of eating, usually without the extreme total food replacement diet first. There have been lots of success stories, and it is not difficult to follow.
That said, I did manage, 10 years ago, to lose a third of my body weight, and get control of my blood glucose levels to non-diabetic. If I had known about low carb diets, I would probably have tried that first.

Statins can raise blood glucose levels, too.

I would also advocate exercise gently and with gradual increasebin activity levels if you have not been used to exercising. Walking is a good start.

 

[Rachox]

I wonder whether something like pravastatin would have been better given statins can effect blood sugars.

Just to say pravastatin is a statin.

 

[Pashtun]

Hi @Pipp

many thanks for taking the time to read my lengthy post. Thanks for sharing your advice and experience.

I will definitely get a glucose monitor.

Re diet thanks for the advice re low carb diet. How many grams of carbs should we be aiming to keep under a day??

thanks

 

[Pashtun]

Just to say pravastatin is a statin.

Hi
You’re right, but I understand it’s less lipophillic therefore less muscle aches and because it’s less intensive statin doesn’t raise blood glucose as much. But I may be wrong

 

[Ronancastled]

Like you I had a BI of 42 at diagnosis.
Low carbing had that down to 31 within 6 months.
Then I slowly reintroduced carbs & ate to my meter, it's gone well so far.

Low carb will greatly accelerate your weight loss, you probably wont need to do the 800cal Newcastle Diet.

 

[Pipp]

Hi @Pipp

many thanks for taking the time to read my lengthy post. Thanks for sharing your advice and experience.

I will definitely get a glucose monitor.

Re diet thanks for the advice re low carb diet. How many grams of carbs should we be aiming to keep under a day??

thanks

This is a thread from a good few years ago, but was most helpful to me when I was confused abot low carb .It is still relevant.

https://www.diabetes.co.uk/forum/threads/a-new-low-carb-guide-for-beginners.68695/

 

[Pashtun]

Like you I had a BI of 42 at diagnosis.
Low carbing had that down to 31 within 6 months.
Then I slowly reintroduced carbs & ate to my meter, it's gone well so far.

Low carb will greatly accelerate your weight loss, you probably wont need to do the 800cal Newcastle Diet.

When you say low carb diet what grams of carbs are you aiming to keep below? Thanks for your advice

 

[Pipp]

Would add, that with the medication you have, @Pashtun , if you do decide to use low carb, reduce the carbs gradually, and monitor your blood glucose carefully.
@Rachox gives good advice on affordable blood glucose monitoring systems.
https://www.diabetes.co.uk/forum/threads/after-some-advice.180513/#post-2378384

edit:
Apologies, my clumsy copy and paste of Rachox’s post had tag to another member.

 

[Pashtun]

@Pipp @Rachox

thank you for the advice and tips. Unfortunately I can’t reply on here won’t allow me, keep getting an error message.

 

[Pipp]

@Pipp @Rachox

thank you for the advice and tips. Unfortunately I can’t reply on here won’t allow me, keep getting an error message.

If you were trying to reply on the thread I posted on low carb, that is an old thread that has been locked to all replies.

can see your posts in this thread, though, @Pashtun .

 

[Ronancastled]

When you say low carb diet what grams of carbs are you aiming to keep below? Thanks for your advice

The lower the better, only your meter will confirm what your acceptable level is.
You should find as your weight decreases & your activity levels increase your insulin sensitivity will improve.
This may allow you increase your carbs but we are all individual in this respect.

Reducing carbs breaks the cycle of hyper insulin you've been living with which has caused your weight gain.
Your body then taps it's fat stores for glucose requirements, otherwise known as weight loss.

 

[Pipp]

The lower the better, only your meter will confirm what your acceptable level is.
You should find as your weight decreases & your activity levels increase your insulin sensitivity will improve.
This may allow you increase your carbs but we are all individual in this respect.

Reducing carbs breaks the cycle of hyper insulin you've been living with which has caused your weight gain.
Your body then taps it's fat stores for glucose requirements, otherwise known as weight loss.

Caution needed due to medication, though. Gradual reduction of carbs to prevent hypos would be better.

 

[Daibell]

Hi and welcome. Although reducing calories should help i would suggest forgetting calories and thinking carbs. A we all suffer from carb intolerance so it's better to focus on reducing them. Following a certain number of calories doesn't define the mix of food groups which makes it a random and approach. Try aiming for 150gm/day or less. We all need different amounts due to variability in metabolisms. Whilist exercise is always important, diet is the highest priority. BTW ref cholesterol and stains, make sure at your next HBa1C you have a full lipids profile as it's the ratios of LDL, HDL, Trigs etc that matter not your total cholesterol. Also bear in mind that reducing it too much can be as harmful as having it too high.

 

[Hopeful34]

Hi and welcome @Pashtun. If you scroll down to Diabetes Medication and Drugs, there is a thread there about Semaglutide under Incretin Mimetics which you might find helpful. You could also put semaglutide in the search box at the top of this page.

 

[VashtiB]

Hello and welcome,

You have received some great advice Already. gradual reduction of carbs to see how your body reacts. You need to prevent hypos.

Good luck and let us know how it goes.

 

[Pashtun]

Hi all

thanks for the advice.

week 1: 0.5mg semaglutide absolutely horrible. Vomiting unable to consume hardly anything.

near the end of week 2 now vomiting has ceased. But still hardly any appetite consuming small amounts.

I’ve lost a stone over this time.

not looking forward to increasing dose of semaglutide to 1mg in 2 weeks time.

quick question re sugar free drinks, is this ok to drink or should I steer clear?

thanks

 

[ianf0ster]

Hi all

thanks for the advice.

week 1: 0.5mg semaglutide absolutely horrible. Vomiting unable to consume hardly anything.

near the end of week 2 now vomiting has ceased. But still hardly any appetite consuming small amounts.

I’ve lost a stone over this time.

not looking forward to increasing dose of semaglutide to 1mg in 2 weeks time.

quick question re sugar free drinks, is this ok to drink or should I steer clear?

thanks

No comments on your medication. I was fortunate to avoid all diabetes meds but myHBa1C was only 53 at diagnosis.

What matters for a Type 2 in all food and drink is the total Carbohydrates, not just the sugars, because you turn carbs into sugars as soon as you start to digest them (with some even in your mouth due to saliva).
Also some people get a Blood Glucose reaction to artificial sweeteners.

 

[Juliarolo]

I follow a low carb high fat diet( though I don’t go really high fat). No calorie counting but weighing food important. Eat full fat Greek yoghurt, use butter, semi skimmed milk. Make wonderful soups with a good dash of cream. I don’t get hungry. I make low carb biscuits and cakes for treats. Eat a small portion of 85% dark chocolate everyday. I try and stick to less than 80g of carb a day. I eat really well and lost nearly 2 stone since October.
When weight loss stops I’ll tweak the amount of fat. Low carb is for life . I’m in remission and off meds. But I know diabetes doesn’t go away it’ll return if I eat like I used to.
Anything under 150g is considered low carb. Average uk diet is over 300g/day.
Less than 80g for me is too restricting and it’s working. I was offered the 800cal Newcastle diet but decided that whilst it would kick start weight loss it was too punishing and unsustainable for myself. Give LCHF a chance. I’m happy to give help

 

[Lesley's]

I follow a low carb high fat diet( though I don’t go really high fat). No calorie counting but weighing food important. Eat full fat Greek yoghurt, use butter, semi skimmed milk. Make wonderful soups with a good dash of cream. I don’t get hungry. I make low carb biscuits and cakes for treats. Eat a small portion of 85% dark chocolate everyday. I try and stick to less than 80g of carb a day. I eat really well and lost nearly 2 stone since October.
When weight loss stops I’ll tweak the amount of fat. Low carb is for life . I’m in remission and off meds. But I know diabetes doesn’t go away it’ll return if I eat like I used to.
Anything under 150g is considered low carb. Average uk diet is over 300g/day.
Less than 80g for me is too restricting and it’s working. I was offered the 800cal Newcastle diet but decided that whilst it would kick start weight loss it was too punishing and unsustainable for myself. Give LCHF a chance. I’m happy to give help

pks could you post ur low carb biscuit and cakes recipe ty