Cocosilk’s questions (moved to their own thread to avoid derailing)

britishpub said:

Well I have a “partial” answer.

I have T2D and undertook an OGTT whilst following a low carb diet and without changing my diet in preparation.

I had a none-diabetic response.

But everyone is different, so the response will always differ.

On the other hand, if I had never been diagnosed as T2D I wouldn’t be testing my BG or undertaking an OGTT.

I would certainly prefer never to have been diagnosed T2D, and I am confused as to why so many people appear to want to be affiliated by it.

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What numbers for you constituted non-diabetic? Were you under the bottom limits for all 3 (fasting, 1h and 2h?)
And how long did you eat low carb to get such a good result?
And last question, after getting a non-diabetic response on a GTT, did you add a few extra carbs back to your diet or would that just slide you back into the diabetic range all over again?
Wait, one more question (if I may . Did you happen to get your fasting insulin measured at the same time?
And last one this time, I promise: has you cholesterol done naughty things since low carbing?

britishpub said:

1) Yes to all three. The fasting was never in doubt (the 1 hour was “tight”)

2) about 3 years

3) no I have no interest in eating unnecessary carbs

4) unfortunately not

5) my total number went up at first, then reduced. As most LC’ers find it is the LDL that often elevates the total number

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Does "tight" mean not quite 11mol? So anything over, like the 12 - 13.8mmol that I had, is probably not great.

Had you done a GTT while you were still getting diabetic readings? How much higher were you then ( or was it a Hb1ac diagnosis - I've not had one of those).

I just had an insulin test which apparently came back normal.

My total cholesterol on the other hand was 8.7mmol with LDL 5.5, but HDL 2.89 and Trigs 0.7. My doctor wants me to start me on statins immediately ( and for that I would have to quit breastfeeding my 8 week old baby...).

kitedoc said:

Just from my reading, not as medical advice or opinion:
If you subscribe to zoeharcombe.com, you will see that on low carb diets the LDL Cholesterol reading is overestimated ( that is artificially raised) whereas on hi carb diet the HDL-C is underestimated. Your doctor may not be aware of this and thus may be giving advice based of incorrect figures.
Also you have recently given birth so is he confident that residual hormonal influences on your body are not influencing your cholesterol and that it may perhaps take longer before your cholesterol levels settle.?
You are breast feeding also which may affect things also.
Finally statins are not allowed to be given to infants. Can he guarantee that someone taking statins would not have an adverse effect on their breast-fed baby?
And with all the above why should you give up breast feeding to take something that Zoe Harcombe with all her research cannot find any benefit in taking.
The important thing that she and others like Dr Paul Mason ( see Fat Emporer podcasts - Dr Paul Mason 1 --> 5) say is that it is maintaining in normal range bsls is the best way to prevent problems.
The more relevant numbers that people like Dr Mason use are the triglycerides ( low in low carb, high and damaging to liver otherwise) and the triglceride to HDL-C ratio.
What does your doctor make of this more modern way?
Best Wishes

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She is young and clueless actually. When I first asked about statins and breastfeeding she said "oh no problem", but then looked it up on her computer and said, oh, actually, you'd have to stop breastfeeding. But better that than have a heart attack in the next 5 years" something along those lines. Didn't consider pregnancy hormones, no. I asked her to look up some of the people doing new research on cholesterol (Dave Feldman) but I'm not sure if she will do it. She was hesitant about ordering an insulin HOMA test for me but I convinced her joking that I hope she wouldn’t get in trouble. I'm glad I know my insulin is apparently in the normal range.
Also she didn't mention the note on my results saying I may be glucose intolerant because my 1h GTT reading was 12.something. No mention that I should continue low carb. Now it's all about the cholesterol - eat low fat, cut skin off chicken and fish, eat margarine, reduce salt... I laughed telling her I will never eat margarine. BLAH!
Anyway, something else she missed on my results was that my urea ia slightly high, 7.3 (top of normal is 7.0). Would you happen to know if that means I'm eating too much meat and not enough vegetables (which has happened sometimes), or maybe it's because I get dehydrated easily if I eat more keto than just low - mod carb. I know my urine ph 5 or 6 on the acidic side lately too. I try to drink but breastfeeding takes it out of me too.

wiflib said:

This is my opinion, feel free to ignore it but your doctor is an (it will get modded, choose a derogatory term of your liking).

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She's probably just graduated. She's very young and seems to just go by the book. I was hoping she might be more open minded. I was looking for someone to medically "supervise" me on keto just to see what it does to my bodily functions but I guess she isn't going to be much help afterall now that our whole interaction revolves around my cholesterol...
Imagine giving up breastfeeding an 8 week old to take a statin... I'd want to be sure I would die if I didn't take it before I would ruin my baby's start in life. And she tried to reassure me that I might!

Jim Lahey said:

Sadly, I’m of the opinion that a sizeable majority of GPs are little more than prescription-writing machines. Recognise symptom - must be a natural deficiency of xyz medication. Prescribe xyz. Job done.

It’s not their fault, they’re just a product of the system. Clearly there will be exceptions, but in my opinion they’re few and far between. Certainly when it comes to the business of diabetes, it seems that most would be best served taking the advice of their GP and turning it upside down and inside out.

That’s my opinion. Everyone else is encouraged to decide for themselves.

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Yes, it is starting to look like that...

britishpub said:

Sorry, I am in Italy on holiday so not on the forum much.

My GP didn’t do a 60 minute check, but my own meter said 11.7, so based on the fact that the result is unreliable I call it tight.

My official 2 hour reading was 7.6, whilst my own meter recorded 7.9

I had not undertaken an OGTT previously post diagnosis, and this was only undertaken as a new GP was confused how someone diagnosed as a T2D in 2015 could have had consecutive HbA1c results in the 20s for over 2 years.

It filled a spare couple of hours anyway, but didn’t prove anything as far as I am concerned.

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Mi dispiace! Don't waste Italy on me!

There are so many nice parts of Italy, aren't there?

One day I want to take my husband there. Maybe when the kids are bigger.

I loved the villages, like Assissi.
Cinque Terre was charming. Sienna was pretty. Venice, Rome and Florence obligatory for the common tourist.

Buon Voyage!

A (dumb) question for later:
Does a hb1ac result in the 20s mean 20% or 20mmol?
I'm assuming you had non-diabetic hb1ac results anyway.
Really, your GTT is pretty darn good if you'd been properly diabetic before that! I assumes the sensitivity to glucose would remain and once diagnosed, one would always fail a GTT, but you can obviously heal your body a bit from that too. That's pretty amazing.