A1C jumped after reversal - should I be worried?

[EmDellit]

Thank you everyone for your comforting advice. I got my CGM today and will continue to eat how I have been for the next few weeks and get some data-based insights.

For those asking about how I've been eating, I'll share more detail below. Thankfully I'm a foodie at heart, and part of me has loved the challenge over the last six month of trying new things! Herbs and spices are most definitely our friends to keep things interesting!

Prior to diagnosis:
I was an at-home vegetarian who loved her pasta and loved her ice-cream and chocolate, but ate meat in restaurants.

First 3 months
I was confused by all the research and possible ways to go into remission/reversal (ie - non-diabetic A1C), so threw the book at it
800 cal a day, Keto (10% only of 800 cal was carbs so under 20 carbs a day - all from vegetables). I also did intermittent fasting 16:8-ish. Weighted everything (even the spray oil once I worked out how!)

Some favourite meals:
Meal 1: 1 egg fritatta with mushroom and zucchini, and maybe some smoked salmon OR chicken chipolata with steamed broccoli, some melted cheese, and hemp seeds OR asian omelette - one egg, with undressed slaw, fish sauce, peanuts, lime
Always a cold brew with 60ml of unsweetened almond milk

Meal 2: baked chicken/cauliflower cheese, beef stroganoff w/ cauliflower rice, zucchini ricotta rolls, harissa spiced chicken and veg, stir-fry with konjac noodles.
Always one square of lindt 90% dark chocolate! Sometimes with some strawberries or raspberries

Next 3 months:
As my hair was coming out, and I'd lost a lot of weight, I've kept low carb/keto, but kept at maintenance calories, which I've managed.

Basically, it looks very similar to the above, but in higher volume! I've also experimented with some higher calorie substitutes like store-bought low carb wraps (3.6g a wrap) or keto mug cakes.

9 days out of 10 I've kept to below 40g of carbs a day. All of that increase came through veges, and blueberries/raspberries/strawberries.

I haven't touched bread, pasta, rice or any underground veges for six months now. I have had a cheat item once every week or two (half an orange, an individual quiche, a spoonful of gnocchi at a restaurant).

Anyhow, hope the above helps someone! I most certainly don't have it down pat at this stage, so looking forward to what the data shows me

 

[Ronancastled]

First 3 months
I was confused by all the research and possible ways to go into remission/reversal (ie - non-diabetic A1C), so threw the book at it
800 cal a day, Keto (10% only of 800 cal was carbs so under 20 carbs a day - all from vegetables). I also did intermittent fasting 16:8-ish. Weighted everything (even the spray oil once I worked out how!)

You hit this hard straight out the bat, you'll be strongly rewarded for that.
I wonder what your weight loss was like in that period ?

Next 3 months:
As my hair was coming out, and I'd lost a lot of weight, I've kept low carb/keto, but kept at maintenance calories, which I've managed.

Yeah, nobody warned me about the hair thing either, been there.

Thank you everyone for your comforting advice. I got my CGM today and will continue to eat how I have been for the next few weeks and get some data-based insights.

A couple of titbits, you now have the greatest tool in your arsenal, so how do you use it wisely ?
It may take a couple of days to bed in, don't be afraid to cross check against finger stick readings.
I'd recommend keeping up your keto diet over this period, I think after 4-5 days it will give you your estimated average glucose, so that gives you your baseline for your keto diet.

Now for the fun bit, slowly reintroduce some carbs & note the effect, add food notes to record this for future reference.
A word of caution, as you've been in a low insulin state for months your body will be shocked by even moderate carbs, you will spike, at least initially.
The 2 year follow up to Taylors Direct Study noted that T2s in remission took 12 months to recover their 2nd phase insulin production rates, you might not be there yet.
https://diabetes.diabetesjournals.org/content/68/Supplement_1/66-OR
Of course this level of recovery is dependent on your insulin resistance being purely down to visceral fat with no underlying genetic component.

Test everyday things like tea/coffee & alcohol, you only have this tool for 14 days so you need to gleam as much as possible in that time.
Some people go super strict once they put on the CGM just to have great data to show their doctor/Endo.
In my view that's a waste as they miss it's true value.

 

[SMS1]

Thank you everyone for your comforting advice. I got my CGM today and will continue to eat how I have been for the next few weeks and get some data-based insights.

For those asking about how I've been eating, I'll share more detail below. Thankfully I'm a foodie at heart, and part of me has loved the challenge over the last six month of trying new things! Herbs and spices are most definitely our friends to keep things interesting!

Prior to diagnosis:
I was an at-home vegetarian who loved her pasta and loved her ice-cream and chocolate, but ate meat in restaurants.

First 3 months
I was confused by all the research and possible ways to go into remission/reversal (ie - non-diabetic A1C), so threw the book at it
800 cal a day, Keto (10% only of 800 cal was carbs so under 20 carbs a day - all from vegetables). I also did intermittent fasting 16:8-ish. Weighted everything (even the spray oil once I worked out how!)

Some favourite meals:
Meal 1: 1 egg fritatta with mushroom and zucchini, and maybe some smoked salmon OR chicken chipolata with steamed broccoli, some melted cheese, and hemp seeds OR asian omelette - one egg, with undressed slaw, fish sauce, peanuts, lime
Always a cold brew with 60ml of unsweetened almond milk

Meal 2: baked chicken/cauliflower cheese, beef stroganoff w/ cauliflower rice, zucchini ricotta rolls, harissa spiced chicken and veg, stir-fry with konjac noodles.
Always one square of lindt 90% dark chocolate! Sometimes with some strawberries or raspberries

Next 3 months:
As my hair was coming out, and I'd lost a lot of weight, I've kept low carb/keto, but kept at maintenance calories, which I've managed.

Basically, it looks very similar to the above, but in higher volume! I've also experimented with some higher calorie substitutes like store-bought low carb wraps (3.6g a wrap) or keto mug cakes.

9 days out of 10 I've kept to below 40g of carbs a day. All of that increase came through veges, and blueberries/raspberries/strawberries.

I haven't touched bread, pasta, rice or any underground veges for six months now. I have had a cheat item once every week or two (half an orange, an individual quiche, a spoonful of gnocchi at a restaurant).

Anyhow, hope the above helps someone! I most certainly don't have it down pat at this stage, so looking forward to what the data shows me

Thanks for this.