I saw the doctor....

[Sam72]

I saw the doc this morning after a horrendous appt with the nurse last week who told me LCHF was silly and unhealthy and booked me straight in with the doc as a problem patient I think!!

The doc was less patronising and was pleased with my levels. My HbcA1 was 13.9 4 weeks ago and my readings are now 7s and 8s although he said it was pointless to test after meals because they will be higher.

I told him what I was doing and he said that only weightloss will bring my levels down and that my current readings are because the metformin was working. Buthe then said if my levels stay down I would still have to carry on with same levels of medication. His main argument against LCHF was that my cholesterol is 8 and I need to bring it down to 5 and that high fat will increase my cholesterol.

He said I should be eating the same diet as a healthy slim person without diabetes and that it's the weight that needs to come off not obsessing withBG levels. Basically lose the weight and my BG will be fine. Is that true? I'm overweight but not obese according to BMI.

Half of me thinks that it does seem " sensible " and it's tempting to go back to bread potatoes and pasta!!! But then I don't feel I would've brought my levels down so quickly if I hadn't done low carb. And I am losing weight as a side effect! And feel better. But is that just medication working?

I'm booked in for my next hbac1 in December and cholesterol. My main worry is the cholesterol argument.

Any opinions on that?

 

[RosieLKH]

Why not do low carb and not high fat? That's what several people do. I do, because I do need to lose lots of weight and it doesn't happen for me if I eat lots of fat.

As to the reading being low only due to metformin, I'm sorry, but from my experience that's a load of tosh! I know I'm no doctor, and so in theory your doc should be right, but it just doesn't fit with my experience. I've been on metformin for years. I've been obese for years, but for many years I have generally stuck to a healthy, normal diet. It wasn't one that made me lose weight, but I stopped putting it on too. My BS reading remained high, because of my weight, despite being on metformin and gliclzide.

It wasn't until going low carb that I got consistent readings between 5 and 8. On a healthy, normal diet, my reading were generally above 10 and if I ate anything sugary they were a lot higher.

It's worth trying low carb and not going to high fat and then see how your cholesterol is next time.

 

[zand]

Oh please stick with us! My cholesterol has got better with LCHF, it isn't the fat that causes it to go up, it's the carbs. The thing is, my husband is a healthy slim person without diabetes. He once had a 6 pack of Snickers on one evening. Does your doctor think this would work for you too?! Some people are healthy and slim no matter what! It's not fair, but it happens. In fact LCHF is a healthy diet for non diabetics too.

LCHF will bring weight loss and great BG's. Exercise and drinking lots of water help too.

Your cholesterol is high, but in my opinion the authorities want cholesterol levels to be too low. My own was at it's highest at 7.9, It was 5.4 in April with no statins. I am happy with 5.4

 

[AndBreathe]

I saw the doc this morning after a horrendous appt with the nurse last week who told me LCHF was silly and unhealthy and booked me straight in with the doc as a problem patient I think!!

The doc was less patronising and was pleased with my levels. My HbcA1 was 13.9 4 weeks ago and my readings are now 7s and 8s although he said it was pointless to test after meals because they will be higher.

I told him what I was doing and he said that only weightloss will bring my levels down and that my current readings are because the metformin was working. Buthe then said if my levels stay down I would still have to carry on with same levels of medication. His main argument against LCHF was that my cholesterol is 8 and I need to bring it down to 5 and that high fat will increase my cholesterol.

He said I should be eating the same diet as a healthy slim person without diabetes and that it's the weight that needs to come off not obsessing withBG levels. Basically lose the weight and my BG will be fine. Is that true? I'm overweight but not obese according to BMI.

Half of me thinks that it does seem " sensible " and it's tempting to go back to bread potatoes and pasta!!! But then I don't feel I would've brought my levels down so quickly if I hadn't done low carb. And I am losing weight as a side effect! And feel better. But is that just medication working?

I'm booked in for my next hbac1 in December and cholesterol. My main worry is the cholesterol argument.

Any opinions on that?

Have you tested, having eaten bread, potatoes and pasta? If you want to try his way, you could do a couple of days eating "normally", testing along the way. Your after meals tests are important in identifying the tricky foods, so I challenge that assertion from your Doc. For many of us, that answers a few questions without looking any further.

Many, many people have found that restricting carbs brings the lipids down, not fats. I know that just sounds so bonkers, but it's true. My lipids came down quite sharply, but have gone up a bit again, but I'm not convinced statins are for me. But, that's a whole different conversation!

Your Metformin will be having a bit of an impact now, after 4 weeks, but the impact of Metformin is found to be 1-1.5% (sorry, I don't have a reference for that, but somebody will).

He is right that weight loss will have a positive impact on your levels. That aspect has been found time and again on here, but it makes sense to also work on the blood scores as the weight does come off. In my view anyway.

I would urge you to stick with what you can evidence every day is returning positive results, but you have to have belief and confidence in whatever course of action you choose to follow. It's that belief that gets us over the bumps in the diabetes road. Are either your GP or the nurse carrying any weight? Did you ask if they, or any immediate family members have diabetes or take statins. My GP (not the Doc I spoke to most recently) told me that as we get older we sometimes need a bit of help, by way of medication. He stated he was doing that himself, with statins, as he clasped his hands across his somewhat rotund tummy.........

Hmmmmm.

 

[RosieLKH]

The thing is, my husband is a healthy slim person without diabetes. He once had a 6 pack of Snickers on one evening. Does your doctor think this would work for you too?! Some people are healthy and slim no matter what! It's not fair, but it happens. In fact LCHF is a healthy diet for non diabetics too.

Glad it's not just me who lives with someone like that! My husband's a cyclist, so uses up a huge amount of carbs that way, but he (and all his blooming family) have always been thin - no matter what they're eating - and I have never known anyone eat as many flapjacks on a weekly basis as my husband.

By contrast, everyone I am genetically related to has weight issues, and as they get older, diabetes. It's taken me years to accept that my problems with weight are not just because I'm stupid, weak-willed or lazy (I might be all of them, mind, but my problems are not just down to that!).

I'm treating carbs like a peanut allergy (although you have to have some, so not really like the allergy analogy). I'm not adding extra fat to my diet though, but I'm also not stressing about low fat varieties of foods like yoghurt. Mostly I'm just not eating bread, potatoes, rice or pasta - and by doing that am cutting so many carbs. It takes me back to the 70s when the diet advice was not to eat bread and potatoes if you wanted to lose weight. Turns out they were right, and an added bonus is your BS goes down too.

 

[Micky25]

Stick with it Sam. You are already making gains on a reduced carb diet. If you go back to bread, potatoes etc, your BG levels will definitely rise. As for cholesterol, did you get a breakdown of lipids ? Also, even if your levels are slightly elevated, what were they before ? They still may be slowly reducing.

 

[Loobles]

I saw the doc this morning after a horrendous appt with the nurse last week who told me LCHF was silly and unhealthy and booked me straight in with the doc as a problem patient I think!!

The doc was less patronising and was pleased with my levels. My HbcA1 was 13.9 4 weeks ago and my readings are now 7s and 8s although he said it was pointless to test after meals because they will be higher.

I told him what I was doing and he said that only weightloss will bring my levels down and that my current readings are because the metformin was working. Buthe then said if my levels stay down I would still have to carry on with same levels of medication. His main argument against LCHF was that my cholesterol is 8 and I need to bring it down to 5 and that high fat will increase my cholesterol.

He said I should be eating the same diet as a healthy slim person without diabetes and that it's the weight that needs to come off not obsessing withBG levels. Basically lose the weight and my BG will be fine. Is that true? I'm overweight but not obese according to BMI.

Half of me thinks that it does seem " sensible " and it's tempting to go back to bread potatoes and pasta!!! But then I don't feel I would've brought my levels down so quickly if I hadn't done low carb. And I am losing weight as a side effect! And feel better. But is that just medication working?

I'm booked in for my next hbac1 in December and cholesterol. My main worry is the cholesterol argument.

Any opinions on that?

According to my dietician, cardiovascular markers such as cholesterol and BP tend to be better with low carb diets (he also tells me to replace carbs with some fats). I trust my dietician by the way

 

[jack412]

eat to your meter

LC and LF with normal protein can leave you cold and light headed, but you may lose weight faster, without the fat calories, the Newcastle works on 800 cal but I don't like how they do the macro nutrient with the diet drinks...you can have the same calories and be a more healthy diet

50g/200 cal protein
30g/120cal carbs leafy veg
50g/ 450 cal fat

that's normal RDA protein.. minimum RDA fat ...low carb...that's as healthy as I can get it...for a very calorie restricted diet

take a low dose statin, they are good for you, see the latest statin thread for my post
they have a real side effect rate of 1%
http://www.diabetes.co.uk/forum/threads/big-question-sratins-or-not.65603/

 

[Totto]

If you want to loose weight you stay low carb. If you want to control bg, the same.

And I have never had so good cholesterol as I had last time it was tested with HDL at 1.9 and LDL 3.3 with triglucerides at 0.7, after three months of strict LCHF, 20 grams of carbs per day so high fat indeed to make up for lost calories. My last HbA1c was 35 and I am on no meds at all, only controlled by LCHF diet.

 

[cold ethyl]

Hi, some great advice from above. I follow the low carb bit of the equation but don't go mad on the fat bit as I've weight to lose and highish cholesterol which I'm trying to avoid statins for. I know that low carbing tends to lower it in most folk, but it can push it up too for some so I steer clear of the cream and butter with everything option that some use and stick to lower fat dairy options( though I check that thy don't have hidden carbs in like tapioca starch!) I never had an appetite pre-diagnosis for full fat dairy apart from cheese so have just stuck with that way of eating whilst cutting carbs and upping exercise. As fat is so much more calorie dense than carbs and proteins, you don't actually need much to make up the carb deficit - I sometimes think that the HF bit is a misnomer and scares people, especially our health care providers who have been brought up on the low fat mantra - far better so say enough healthy fat from good quality unprocessed foods like avocado, olive oil, few nuts etc.
Weight loss is important but it won't necessarily reverse the diabetes and won't necessarily be a weight loss that would have you classed as slim- it would seem that we all have a personal fat threshold above which diabetes may occur and once we get below this, I'm not sure what benefits other than general health are achievable by pushing weight lower and lower. The Metformin will be helping with weight loss as it is an appetite suppressant - it's effect on BS levels isn't that profound - around 1 to 1.5 % reduction, with this effect being most pronounced on the fasting level reading. So really the changes in your levels are largely down to your new eating regime - I'd keep at it and show them.

 

[douglas99]

I saw the doc this morning after a horrendous appt with the nurse last week who told me LCHF was silly and unhealthy and booked me straight in with the doc as a problem patient I think!!

The doc was less patronising and was pleased with my levels. My HbcA1 was 13.9 4 weeks ago and my readings are now 7s and 8s although he said it was pointless to test after meals because they will be higher.

I told him what I was doing and he said that only weightloss will bring my levels down and that my current readings are because the metformin was working. Buthe then said if my levels stay down I would still have to carry on with same levels of medication. His main argument against LCHF was that my cholesterol is 8 and I need to bring it down to 5 and that high fat will increase my cholesterol.

He said I should be eating the same diet as a healthy slim person without diabetes and that it's the weight that needs to come off not obsessing withBG levels. Basically lose the weight and my BG will be fine. Is that true? I'm overweight but not obese according to BMI.

Half of me thinks that it does seem " sensible " and it's tempting to go back to bread potatoes and pasta!!! But then I don't feel I would've brought my levels down so quickly if I hadn't done low carb. And I am losing weight as a side effect! And feel better. But is that just medication working?

I'm booked in for my next hbac1 in December and cholesterol. My main worry is the cholesterol argument.

Any opinions on that?

Well, you asked for opinions.
And a different one off every poster by the look of it.

It's tempting to try to fix everything in one go, but you won't.

Focus on one thing at a time.
The one thing most people would agree with is losing weight
Whether it's the focus, or the effect of the diet, it'll help.

Eat to your meter, keep the BS at the level you want, lose the weight, exercise to improve muscle, when you've done that, focus on a maintenance diet, one you like, one you can stick with for life, and tweak that one thing at a time to reduce your cholesterol.
If you do one change at a time, rather than everything at once, you'll know what works for you.

 

[Bluetit1802]

Hi Sam and welcome,

Some good advice from the others, so my advice is to hear what fellow type 2's are saying rather than your doctor and nurse - who are not diabetic and don't tend to see many well controlled type 2's (mainly because the majority of type 2's are not well controlled due to following the advice given by the NHS).

My own personal regime has been to cut carbs down to between 60 and 65g a day and ditching low fat products in favour of the real thing. I don't deliberately add fat, I just don't actively avoid it and no longer feel afraid of a good old fry up. I have kept my protein much the same as previously apart from doubling the amount of eggs I eat and I have 3 or 4 portions of oily fish a week. My cholesterol levels have improved significantly without statins, which is one in the eye for my GP. I have lost almost 4 stones since January and am now at target weight. My blood sugars are now in the pre-diabetic range, and my averages are dropping. But that is just me. Not everyone is the same.

 

[izzzi]

It is obvious both you and your Doctor are intelligent.
When I tell my Doctors etc; I am on a vegan type diet, They just say keep up the good work. Never has any one rung alarm bells.
( I was not brain washed to go on a vegan type diet nor am I a vegan ). Also never would I tell you to go on this kind of diet as we are all different.
Your Doctor seems to be making a very strong point regarding your good health, my point being your Doctor knows you and not us.
I am on the half side of you, that wants to enjoy the good food of your choice, good control and a good Doctor.

 

[Daibell]

Hi. Just keep at it. Your HBa1C reduction will be due to your LC and little will be due to the Metformin which helps but only a bit. The Doc is incorrect when he says eating fats will increase your blood cholesterol. This is not evidence-based medicine but popular mantra based on a lack of understanding of how the liver etc works. Going LC is more likely to help with reducing overall cholesterol.

 

[sanguine]

I saw the doc this morning after a horrendous appt with the nurse last week who told me LCHF was silly and unhealthy and booked me straight in with the doc as a problem patient I think!!

Well she sounds sensible - not. If she labels you as a 'problem patient' get ready to see the practice manager to complain.

The doc was less patronising and was pleased with my levels. My HbcA1 was 13.9 4 weeks ago and my readings are now 7s and 8s although he said it was pointless to test after meals because they will be higher.

Where do they get these people? Of course it will be higher, that's what you're testing to see what food suits!

I told him what I was doing and he said that only weightloss will bring my levels down and that my current readings are because the metformin was working. Buthe then said if my levels stay down I would still have to carry on with same levels of medication. His main argument against LCHF was that my cholesterol is 8 and I need to bring it down to 5 and that high fat will increase my cholesterol.

Nonsense. Most people on LCHF find that cholesterol goes down - it's the components of the total that are important anyway.

He said I should be eating the same diet as a healthy slim person without diabetes and that it's the weight that needs to come off not obsessing withBG levels. Basically lose the weight and my BG will be fine. Is that true? I'm overweight but not obese according to BMI.

Words fail me. A diabetic should eat the same as a healthy thin person? There are links between weight, diet and BG but not necessarily causal ones.

Half of me thinks that it does seem " sensible " and it's tempting to go back to bread potatoes and pasta!!! But then I don't feel I would've brought my levels down so quickly if I hadn't done low carb. And I am losing weight as a side effect! And feel better. But is that just medication working?

It's the low carb that is bringing your BG down and making you feel better, not the metformin to that extent. Eat to your meter and check what happens if you do eat potatoes and bread.

I'm booked in for my next hbac1 in December and cholesterol. My main worry is the cholesterol argument.

Any opinions on that?

Keep doing what you are doing and keep testing (and experimenting if you want). Have a read of Malcolm Kendrick's 'The Great Cholesterol Con'.

You will be able to take some great results to your next appointment. Concentrate on the blood sugar levels, the rest will follow.

 

[satindoll]

Hi Sam,
You have been doing so well up to now, I said in your other post continue do what you feel is working for you, you know your body they don't.

 

[Sam72]

I think I will! Thanks for all your advice. Had German style rye bread from M&S bakery for lunch- just 2 small slices and blood sugar spiked from 8 to 9.6 :-( think I'll forget the idea of bread for now! 9.6 is the highest I've been since I started testing last Wednesday. 8 is quite a high starting point for today too. Started the day at 8.5. Could what I ate last night for dinner be affecting me today even though it didn't spike myBS at the time or 2hours after?

 

[douglas99]

I wouldn't write it off yet, a rise of only 1.6 is good.
As to the high reading of 8, it can take a long while for your BS to fall, if you have been higher for a while before. Your body will be used to a normally high number, your liver will be trying to keep the level high, until it adjusts to the falling numbers.
Give it time, it'll keep dropping.

 

[Bluetit1802]

I agree with Douglas. Your spike was only 1.6, which is quite acceptable and normal. It was your starting point that made it look bad. By all means cut out the bread, but you could always try again with one slice for the time being, and then try 2 slices again when your pre-meal level is down. It is all trial and error, and takes a long time with lots of tests and experiments before you find your personal ideal diet. Also, with bread, much depends what you have with it! Fats will help, such as a couple of eggs, or butter etc.

 

[satindoll]

Hi Sam,
The morning one is always the last to behave itself, even now I can get an early morning liver dump and be up in the 6's in which case I have breckie as normal of bacon and eggs and mushrooms and that always drops my numbers back to 4.5 - 5.0, so don't worry about it too much, you are doing so well to give up now would be sad, and as Bluetit says next time try one piece of bread with some chicken and salad or sausage and work up to trying 2 slices.
You will get there, the thing is to keep testing and find something you can eat that will drop your numbers, and if you get a high like that have the number dropper, job done.
Go Girl well done a mini rise well within limits, yea.