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Can I prove the Dr's wrong?

I think what Brett is warning Ian about is what happened to me. I was taking no insulin, producing insufficient insulin and eating very low carb which was just about keeping my BG down. However, I was losing weight at an alarming rate. I was about 6 stone when I finally saw a consultant and he put me straight onto insulin. Even though my HbA1c wasn't too high, my ketone levels were rising quite badly and I was pretty ill. My body simply didn't have insulin to survive - insulin is needed for far more than keeping BG down.

Smidge
 
Many thanks again Smidge for that clarification. I am currently 12st, 6'-2" BMI = 21.5, so nothing to worry about yet, but I have lost nearly a stone since diagnosis in sept 2013, and still very slowly loosing weight, and it is for this reason why I feel I need some carbs. Indeed why I feel I need to eat carbs when I can, according to my BS readings.


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Firstly Ian, don't get too worried about the prospect of having to go onto insulin. It is a bind yes, but some people on this forum have been doing it for decades and still live active lives. Secondly, understanding the genetics behind what causes the T Cells to attack your Beta cells is only in its infancy:

"Type 1 diabetes, a multifactorial disease with a strong genetic component, is caused by the autoimmune destruction of pancreatic β cells. The major susceptibility locus maps to the HLA class II genes at 6p21, although more than 40 non-HLA susceptibility gene markers have been confirmed."

You might be better off talking to type 1s who have to take insulin and ironing out any misunderstandings that you have about that rather than worry about how to avoid the situation and/or what damage you might be doing to yourself in avoiding that situation. If you are worried about weight loss, try some things like couscous, quinoa, avocado, olives and lots of oily fish as well as fresh vegetables, especially greens and fruits like tomatoes, apples, pears, cherries, plums and berries. Whole grains like pearl barley are very good in soups and stews too. There will in all probability be a rise in BG levels but it will still be a lot less than having marmelade on toast. Ask your GP if he can refer you to a nutritionist at the hospital.
 
Thanks for the advise yorksman, much appreciated. I have seen the nutritionist, she advised 1/3 good carbs on my plate for each meal... If I did that my BS readings would be in double figures and I would be on insulin now.
For now I will go with what Totto said. If it works it works, if not... Insulin. Time will tell..... But I am starting to educate myself about insulin taking.... This forum is a great place to learn.


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Strange that quote says type 1 is genetic... I was told that type 1 isn't genetic but type 2 can be... Nobody in my whole family has ever had diabetes to anyone's knowledge so I guess mine definitely wasn't genetic lol

Also, I would be mindful if seeking advice as though you are a type 1 because type 1 and LADA are very different still...especially when it comes to insulin.

By this I mean that people with full type 1 diabetes can inject to cover their carbs and control their levels but for us LADAs we are still producing some insulin and yet it's impossible to calculate exactly how much and so how do we know how much insulin to inject when we don't know how much we already have??

Sometimes insulin can be problematic for LADAs and can lead to good control being more difficult to achieve.. That being said, everyone with LADA is completely different and their condition progresses at completely different rates and so making any generalisation is problematic... It's so stressful :-(


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.
 
elaine77 said:
Nobody in my whole family has ever had diabetes to anyone's knowledge so I guess mine definitely wasn't genetic lol
Click to expand...

It says it has a genetic component, that's not quite the same. A similar example would be the red haired kid who is born to parents who both had brown hair and whose grandparents also had brown hair. It's actually to do with recessive and dominant genes and Mendelian inheritance but is the sort of thing that leads to jokes about the milkman making more than his usual delivery. Except, in that case only on pair of alleles are involved, the Melanocortin 1 receptor or MC1R genes. With type 1 many more have to exactly right for it to kick in.
 
Aww... That took me by surprise... A BS reading of 3.1, one hour after evening meal (Large stir fry with mackerel, followed by a good cup full of fruit berries and a couple of heaped spoonfuls of natural yoghurt, and a pint of beer), and 20mins light work out on exercise bike. Had a biscuit and a handful of almonds, 20 mins later BS reading was 4.0. I have had a couple of 3.2s when I was on meds a few months back, but nothing this low whilst not on any meds (or insulin).

Stir fry with chicken or fish, fruit desert and a beer or glass of wine always seems to keep my BS levels low, normally around 5.0 one hour after meals, but today's was extra low.

Ian


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Well I woke up on a pre-breakfast, inexplicable 9.9mmol! Doesn't look good for me...


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.
 
Hi Elaine,
Sorry to hear that..... Try a stir fry, no sauce, just a little soy sauce, with fish or meat..... Always gives me a good BS reading.


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My morning readings have always been the worst no matter what I eat or don't eat the night before... I had a twix a couple of nights ago though when I got a 9.6 morning reading so totally my own fault that time lol


Diagnosed with GD in 2010, Completely disappeared postpartum. Re-diagnosed December 2012 with type 1.5 diabetes, age 26, BMI 22 currently controlled by only Metformin, 500mg twice a day.
 
Hi Ian, you've done a lot of testing etc which is excellent. Have you been tested for Vit D deficiency? I'm type 1 and had mine checked after reading that many diabetics have low Vit D without ever knowing. I now take Adcal-D3 Dissolve tablets. I'm taking novorapid, insulatard and Metformin SR tablets over the last 5 months after changing my diabetes team at another hospital. Things have improved a lot. and my last HBA1C is now 7.6% down from 8.9%. I was diagnosed 5 years ago.
 
Hi Nigel
Thanks for the info on vit d deficiency. I will ask my dr to have mine checked.
Good to hear things are improving for you
Ian


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Ian - you ask what you've got to lose. It sounds to me like you're losing some quality of life by restricting your diet! On insulin, if and when reqd, you can eat what you like so long as you learn to count carbs. I'd much rather be T1 than T2 personally - who wants to avoid puddings for the rest of their life?! Insulin gives freedom IF you are willing to work with it...


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Curently I don't feel I am restricting my diet, just eating more natural food. Strange how an apple tastes much nicer now than it used to..... Nicer than a piece of cake.


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Another update. Eight weeks now since I first started taking after meal BS readings instead of the hospital / PCT advised before meal readings. My aim being to keep 1hr after meal readings under 7.8 with an average around 6.0. Around 95% of my 1 hr after meal readings have been under 7.8. I have been over 7.8, 5 times in total (all restaurant meals!!, highest 10.2), but importantly I have learned from each one.

4 weeks ago, with another 1/4 stone loss in weight, I decided to eat more food without increasing my carb totals, thus I have gone on a lower carb and higher fat diet. I have put on 1/2 stone in 4 weeks, now up to 12 1/4 stone. I have been able to keep my 1hr after meal reading largely unchanged, but my pre breakfast reading are up a little now averaging just over 6.0.

My 'lower carb, higher fat' diet, to increase weight, mainly consists of lots of meat and fish (3 good portions a day) typically eggs bacon sausage mushrooms and toms for breakfast. 1/2 chicken with salad for lunch and fried rump steak or fish stir fry in the evening. Full fat milk, lots of cheese, cream, butter and almonds. It's hard to get 2,500 calories a day on low carb, but I am just about achieving it.

My food content intake is probably the highest I have ever eaten in my life! But I feel great, not tired, plenty of energy and enjoying my 'new'....'real' food.... Natural food diet.

I have my 3 month hospital diabetes appointment next week...... I wonder what they will have to say about my LCHF diet?..... I will be taking all my recorded data / graphs plotting my BS readings with me, proving my diet is keeping my BS levels low. My BS control is better now than it was 3 months ago.


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Hiya Ian!

Good to see LCHF working for you. Hopefully you will find a good HBA1C and good lipid profile too - that's what happened to me.

Interesting that your pre-breakfast readings are up. I suspect that means you are getting a protein spike in BG at 3 - 4 hour mark. Obviously I can't be sure of that. Try testing at 4 hours after eating steak - I find I often need an extra unit or two of rapid acting insulin at that time. If you find a small spike then it's because the protein is converting to glucose in the absence of carb and you're not producing quite enough insulin to deal with it efficiently but enough to normalize it by next meal time.

I'd say your diet is a little high in protein and you might be better to reduce the protein a little and make the calories up in fat. See how you go.

Well done though!

Smidge
 
Thanks Smidge, I think you might be right with the protein. I Will try reducing protein and increasing fat over next few weeks


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Done it, I have proved the Dr wrong..... For now.
3.5 months since my previous diabetic hospital appointment, and the consultant said he never thought I would get to this (3 monthly) appointment without insulin (and medication) and that my BS meter readings are great and that whatever I am doing is working, so I should carry on doing it (keeping my 1hr BS reading under 7.8 with LcHf).
I was rather apprehensive prior to my appointment, so I firstly showed the nurse my 3 monthly BS reading and kept quite about LcHf, until asked. Nurse said, these BS readings are great, we have a nurse who is type1, and he is LcHf, and he is a keep fit fanatic, doing cross country / fell running, and he finds the LcHf diet great.
We are off to Antigua next week, and I have been given an insulin pen with instructions on how to use it, if my BS readings go over 12.... Which I am very please about. Hopefully I will not need it, hopefully it will be a long time before I need it.

Also encouraged by reading Dr Bernstein's Paragraph on the 'Honeymoon Period' a couple of days ago (Diabetes Solution, page 96) where he states that:-
"There are several hypotheses as to why conventional treatment won’t let the honeymoon go on forever, but my experience with patients indicates that with proper treatment it can. Essential to this is a low-carbohydrate diet and normal blood sugars. This will help preserve whatever insulin-producing pancreatic beta cells you may have. (The same is true for type 2 diabetics. Beta cell burnout the destruction of beta cells caused by excessive demands on the pancreas and by the toxic effect of high blood sugars upon beta cells — can be avoided, halted, and in some cases reversed if you get on the Diabetes Solution program and get your blood sugars normalized.)".




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Another update, another 6 weeks, and no real change to speak of.
I did not need the insulin in Antigua, Antigua was great, no significant problems with high blood sugars, had a couple of highish ones (8.9 after breakfast, but that was the melon and pineapple!!).
I am now 12 1/2 stone, so still putting on a little weight (I would like to get to 13 st).
My pre breakfast blood sugars are averaging a touch over 6.0, they are heading up, but very slowly.
My carbs are getting less and less, max now is around 20 per meal, certainly less than 100 per day, but my protein is high, often around 100g / meal, which I believe equates to 50g of carbs.
I am trying to cut back on the amount of protein for my evening meal, as this seems to affect my breakfast readings, so now eating more at breakfast and lunch and less in the evening. Big breakfast, 3 sausage, 3 bacon, 3 egg & cheese omelet, fried mushroom and tomatoes.
Certainly the more active I am after a meal, the lower my sugar levels are. Worse case is if I sit down after a meal, they are always higher then..... Thus why evening levels are the worst... Sitting down and watching tv!!!

I know I could not be doing this without the LcHf, and test strips. Testing after eating certainly has established what food I can eat, and surprisingly one pint (max) of bitter does not rise my BS levels, if anything it lowers them. A few glasses of red wine has no effect at all.

As my consultant diabetic Dr said to me.... Whatever you are doing, carry on with it, because it is working..... So I will.





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If you are having 250-300g of protein a day vs <60g carbs and against a basal protein need of 50-75 gpr/day then the additional 175-250 gpr daily could convert (at 60%) to as much as 100-150g glucose. So an estimate of 50% conversion overall sounds reasonable.

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