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12 Years in, where now?

C

Caterham

Well-Known Member
Messages
85
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Hi All

Not posted for years! Was diagnosed when 49 with v high blood sugars. Now 61 Put on metformin. I started a food diary, and since then I have aimed to keep my daily carbs at under 150, which I consistently do.

My Hb1AC was soon down to the 42 - 48 range and has stayed there until now. I do sailing for excercise and walk 20-25 miles per week, with no complications to date. I also managed to lose 3 stone at the beginning, and have kept most of it off.

I do still have a weight problem (BMI 35), and have struggled to lose any more weight, mainly as I do go out a bit and enjoy my life.

I have just had my annual tests and my figure is up to 53. All other liver, kidney and cholesterol tests are fine. I take medicines for blood pressure. I have an appointment with my doctor next week to discuss the results and I wanted to get some opinions on where to go from here.

I am slightly concerned that the rise in levels are part of the 'normal' move in Hb1AC higher, but I am not sure it is inevitable and more likely due to covid eating etc. My thoughts at the moment are;

- If the doctor wants to put me on gliclacide I will refuse. (I think). I really don't want to stimuate my pancreas any more!
- I am thinking of asking to be put on Semaglutide, but the nurse at my doctors thinks I am not fat enough or diabetic enough (her words). My reasoning is that they may make it easier for me to lose weight which will help with my Hb1AC and my blood pressure.
- Say that I am going to make a concerted effort to lose weight now, and perhaps reduce my carbs a bit more.

I would be grateful for any considered input.

Thanks

Caterham
 
In your shoes I'd be going for ultra low carb, maybe combined with some fasting.
Cut carbs to 20g per day to get into ketosis and see the weight loss happen.
 
I think that the single increased Hba1c levels I had some time ago - which I only found out about afterwares, was down to the virus as my diet did not alter either before or after.
I have Covid again so might be able to add more information later in the year, but several others have reported similar occurences
 
Hi @Caterham Since moderate carb worked for you in the past, then reducing carbs further should help now.
However there are many factors other than food which can rais blood glucose including:
illness or injury
medication including Statins and Steroids
Stress or lack of sleep
etc. I think there are something like 40 known reasons for raised BG in total.

You say that you have a BMI of 35 because you go out and enjoy life. I presume this mean consuming alcohol, which is always loaded with calories and tend to cause fatty liver , but also most beers , mixers and sweet wines contain quite a lot of carbs (even though they are almost never listed on the label.
So I hope you drink low carb as well as eating moderate carb. Dry white wine, most red wine except the sweet ones, brut champagne and spirits with low carb/calorie mixers are the safest.

While low carb officially has an upper limit of 130gms of carbs per day, many of us eat considerably less carbs (if we need to), so several in this forum are full 'keto' and eat less than 20gms of carbs per day, while others (like me) flirt with keto on between 20 and 40gms of carb per day and still other fit into different ranges below 130gms per day.

The way I found out my best range of carbs and also which specific carbs were OK for me was by testing all my normal foods and drinks using a Blood Glucose meter. So you could say that I 'eat and drink to my meter'.
My main tipples are vodka with a low calorie tonic water or a nice high alcohol red wine. With decent wine the higher the alcohol means more sugars have been fermented out of it, though with cheaper wines (as with fortified wines) alcohol is added to it rather than take the time to ferment out the sugars.
 
Caterham said:
Say that I am going to make a concerted effort to lose weight now, and perhaps reduce my carbs a bit more.
Click to expand...
In your shoes I’d definitely tend towards that option. Semaglutide and similar are pretty heavy duty and personally I wouldn’t want to go near them unless I was running out of options. With an A1C of 53 and carb intake of 150g / day I’d say you’re a long way from there and have a lot of leeway to give dietary interventions more of a shot.
 
Last edited:
bulkbiker said:
In your shoes I'd be going for ultra low carb, maybe combined with some fasting.
Cut carbs to 20g per day to get into ketosis and see the weight loss happen.
Click to expand...

Thanks for that. For me that is a little bit extreme, but I understand your position.
 

I mainly drink very dry white wine with perhaps 3-4 pints of lager per week. Thanks for your input.
 

Thanks for your post. What is your opinion of Gliclacide and the like?
 
Most lagers aren't low carb, but there are some brands which are. However since you want to lose weight that try to cut down on the amount of alcohol too since it's highly calorific and unlike dietary fat it increases your appetite rather than reducing it.
 
Caterham said:
Thanks for your post. What is your opinion of Gliclacide and the like?
Click to expand...
I don’t think they address the underlying issue of metabolic ill health and personally I’d really want to exhaust gentler interventions before considering them and the potential side effects that come along with them.
 
Caterham said:
Thanks for that. For me that is a little bit extreme, but I understand your position.
Click to expand...
I suggest just lowering your carbs in food and drink a bit, maybe keep to 100g or less for a while, and see what happens. Losing some weight may help too. It's a marathon, not a sprint. You have done really well so far. Just a bit of tweaking may be enough, without meds.
 
Dear all

Many thanks for taking the time to respond and give me your opinions. I think I am going to try to get my BMI under 30 over the next year, and see where that takes me, as well as cutting carbs a bit lower. On reviewing my food diary I have slipped into some bad habits, the occasional snack kit kat, the wine too many nights a week etc, etc. I need to get back to a more sensible diet, bearing in mind I am T2, and get more control back with some more testing.

I am semi retiring in the next year, which will give me more time to do more excercise, which will help I think.

I do understand the keto approach, for me it's too much at the moment, although if it was that or insulin I would absolutely go that route.
 
First of all, congrats on staying in remission for 12 years, that's an inspiration to us all.
I see however that once you lost the initial 3st & got back into a pre-diabetic state you never pushed on for a completely non-diabetic A1c.
Not criticizing or being judgmental, it's just interesting how differently motivated some of us are to this condition.

You are obviously prioritizing lifestyle & that's your call.
You are conscious of your remaining beta cells as displayed in your attitude to Glic.

I think you know how to reverse the course of this disease, you just need that push like you did 12 years ago on diagnosis.
 
Thanks for that interesting answer.

I think when I was diagnosed I read all the literature I could on T2, including the NICE pathway and some scientific papers (I have a scientific background), and it scared the c**p out of me. I had visions of being very disabled very quickly if I did not get myself under control. Losing the 3st quickly was a painful process, feeling hungry all the time, but it put me back in the per-diabetic range, and once I was stable in that, it felt enough for me (most people I know would disagree). I also got a lot of praise from my doctor, who had other type 2's who carried on eating what they liked, whilst taking ever increasing amounts of drugs, and blaming the NHS for their health deterioration. Personally, I was amazed by the sheer lack of knowledge of other people I took my initial diabetes courses with.

I think now I need to get refocused following my Hb1AC results, and lose some more weight, this will also help me as I get older. I also need to be a bit more careful with my carbs.

I have been very interested in the recent research about types of T2. I think there is a group of us who are overweight on diagnosis and can achieve control by weight loss and carb control, and I think I am one of these. There are others who are not so lucky.
 
 
Hi Caterham. I feel for you. Thankfully am not T2 but close to it so am also fighting to lose weight. Have lost 23lb several yrs ago on Michael Mosleys original 5:2 over 4 months but sadly put it and more back on. Am presently trying his low carb fast 800 with some success, my wife who follows it daily has lost 12lb in 5 weeks. However for me and I suspect many T2 and overweight sufferers a main issue is our mental health approach to diet no matter what the serious consequences are. I have tried, with some success a "Healthy Diet weight loss" hypnosis programme. It certainly helped while I listened daily to the programme. The slide happened a couple of weeks after I stopped listening so I suspect it should be a continuous listening skill. I can only suggest it as an option. We are all different but while I would not recommend a particular hypnosis programme you could consider researching it to see if it can help. Good luck in your endeavours.
 
Hi Couscous

Interestingly since my first post 6 days ago, I have worked quite hard to eat even more sensibly (not that I was eating particularly badly before), and I am down a kilo. My things that seem to work are;

- Keep a very honest food diary, counting carbs and calories. I have done this for 12 years and you can easily see where you are going wrong.
- Avoid fads at all times (restricted diets etc) What matters is how much you eat, not when.
- The 'carbs and cals' App is really good, you learn quickly how many carbs everything has.
- Recognise for me that weight gain and weight loss lag a few days. So I can eat really well, and stay the same weight, then over a day or two it comes down nicely. The lag can get disheartening.
- Recognise that a diet isn't one decision, it's hundreds of small decisions over years. Will I have that biscuit or not? etc.

Good luck!
 

Hi
I had a BMI of 34, My Diabetic nurse put me on Metformin, Fortiga, and a Trulicity injection once a week, which I take at 5pm on Sundays, and by 5pm on Tuesdays I just don’t want to eat anything heavy, it’s absolutely fantastic, it works as an appetite suppressor, it’s a pre loaded pen. Which you just twist and push the button at the top and it’s all done, I’ve lost 7st in the last 2.5 years,
My Hba1c was up over a 100, but I’m now down to 61 .
If I laid off the tin of Quality Street per day I could probably get it down a lot more.
Ask your Diabetic Nurse about it, it really works!!! Good Luck
P.s I was joking about the Quality Street, they’re Roses really. (I wish, I ain’t seen a choccy bar in ages )
 
I carb around 50 g per day have taken my medications down to just trulicity and metformin, stopped glic about 2 days ago. I only fast by skipping a meal when not hungry. I’ve also lost 30 lbs and stopped all hypertensive medication. This has taken 10 weeks with support of diabetic nurse. Hba1c down from 71 to 49 in 8 weeks. I’m currently reading the diabetes code by dr Jason fung which I’d recommend for understanding of diet and the disease alone. Good luck and let us know how you get on.
 
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