Hello from Canada

[Sarada]

Hello everyone! I was diagnosed with type 2 diabetes 15 years ago, and it has slowly been getting worse.

I have been doing some research on the internet over the last 5 months, and found that the newest approach focuses as much on hyperinsulinemia as hyperglycemia.

It seems that the large quantities of insulin in the blood can contribute to many metabolic problems.

There is a growing effort outside of mainstream medicine to reduce insulin resistance while maintaining good blood sugar levels. Does this approach have any followers in the UK?

 

[Robinredbreast]

Hello and welcome to the forum. I have tagged @daisy1 who will be along with diabetes info.

With best wishes RRB

 

[daisy1]

@Sarada

Hello and welcome to the forum

Here is the information we give to new members as mentioned above. I hope you get some replies to your post soon. Ask as many questions as you want and someone will help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you’ll find over 150,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.
There are two approaches to controlling your carbs:

• Reduce your carbohydrate intake
• Choose ‘better’ carbohydrates

Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

Another option is to replace ‘white carbohydrates’ (such as white bread, white rice, white flour etc) with whole grain varieties. The idea behind having whole grain varieties is that the carbohydrates get broken down slower than the white varieties –and these are said to have a lower glycaemic index.
http://www.diabetes.co.uk/food/diabetes-and-whole-grains.html

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 8.5 mmol/l

Blood glucose ranges for type 1 diabetes (adults)

• Before meals: 4 to 7 mmol/l
• 2 hours after meals: under 9 mmol/l

Blood glucose ranges for type 1 diabetes (children)

• Before meals: 4 to 8 mmol/l
• 2 hours after meals: under 10 mmol/l

However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:

• structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
• self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to bloodglucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic

Note: This post has been edited from Sue/Ken's post to include up to date information.

 

[Daibell]

Hi. As I understand what you are saying, this is what much of current T2 treatment tries to manage. Metformin is almost always given to T2s. This is of most relevance when the person is overweight and suspected of having insulin resistance. You can, of course, have some insulin resistance even if not visibly overweight. One of Metformin's mechanisms is to reduce this resistance. Many of us on this forum recommend a low-carb diet to reduce glucose production in the body from carbs taken in which in turn helps on all fronts. Are you aware of other approaches to reducing excess insulin production?

 

[Sarada]

There are 2 controversial methods which I have found to be helpful, although most of the medical establishment in North America freaks out at these.

The first is a form of the Atkins diet induction phase which has <20g of carbs, moderate protein, >75% of calories from fat, and some calorie restriction. This will reduce insulin resistance and put the metabolism in a ketogenic state where it turns fat into ketone bodies which are then used as fuel. Ketone levels as measured by a ketone meter will be in the range of 0.5 to 5.0. This is called nutritional ketosis, which is quite different from ketoacidosis, which can be experienced by T1's. Ketoacidosis occurs when ketone levels are higher than 150 and is very dangerous.

The second method is intermittent fasting, as described by Dr. Jason Fung, a nephrologist in Canada. He guides people around the world through his international program in conjunction with your family doctor, and has many patients in the UK. Fasting requires less insulin and therefore decreases insulin resistance over time. He recommends a variety of fasting regimes starting with fasting for 16 hours every day with an 8 hour eating window, to fasting 42 hours straight with a 6 hour eating window.
He stresses that if you are on medications, you need to be monitored closely by your doctor because your requirement for diabetes and other medications will change quickly.

I started 20 weeks ago on metformin and gliglazide with a fasting blood sugar of 12, and I was to be put on insulin. Instead, I tried these methods. First on the low carb high fat diet, and then on a combination of low carb high fat plus intermittent fasting.
I started with fasting at 16/8 and have gone up to 42/6 for twice a week. I am now off the gliclazide, and my fasting blood sugar ranges from 5.5 to 6 mmol/dl.

This is not easy at first, but it gets easier as you go, as your body adjusts to this new way of eating. I have been banned from a North American Diabetes forum for attempting to discuss this way of eating, I wonder how the administrators in this forum will react.

All the best,

Sara

 

[Daibell]

Hi. The Atkins diet is in many ways the same as the Low-carb (or LCHF) diet mentioned on this forum and as you say it works (ask my wife who isn't diabetic but has managed to reduce her weight). Most of the establishment thru the world baulks at this diet as they are so entrenched on the low-fat mantra that that can't admit it's been wrong for so long. Many health experts don't know the difference between ketosis and ketoacidosis and think ketosis is bad.