Confused

Roy Batty said:

That's interesting as my understanding is that greater muscle mass increases skeletal muscle glucose uptake and improves insulin sensitivity. Why then is there so much emphasis on cardio exercise to reduce weight when resistance based exercises to boost muscle mass may be equally, or more effective?

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How can I put this politely? Perhaps I could just pose other questions about UK, US and global health services:
1. Why do they all advise same high carb, whole grain, high fruit low calorie, high(er) cardio exercise for everybody no matter whether healthy or diabetic or any other condition?
2. Why do they mostly say that T2D is incurable and progressive even with the most powerful medication?
3. Why do they (in UK at least) tell T2D's not to test BG and say it will depress them if they do test? Even those who tell their Doctor they want to control by diet? Saying an HbA1C every 3 or 6 or even 12 months is sufficient for those trying to control BG by diet?

Well I think the answer is pretty clear - don't you ?

Roy Batty said:

Noi, not to me.

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Then you will have to get somebody else to tell you. I'm not risking getting banned just for that !

Roy Batty said:

It must be contentious and controversial then.

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It is in some circles - maybe not so much on this forum. A lot of this started within living memory: there was an assumption 50-60 years ago that we were about to face a heart disease crisis. You might want to read up on Ancel Keyes and his role in all of this.

Dietary advice (the same official advice we have today) and a lot of research was aimed primarily at preventing heart disease. In fact the heart disease crisis never happened, mainly because people stopped smoking. The UK had trained a lot (I mean a lot) of cardiologists who had no work, because the expected heart disease patients failed to materialise.

The realisation that governments could be fairly easily panicked into doing something which could potentially become a big earner was not lost on the pharma industry. This has gone hand in hand with the corruption of scientific research and scientific publications. Politicians rarely come from a scientific background and it's remarkably easy to raise enough concerns for them to want to "be seen to do something".

So the official advice was to eat carbs to prevent heart disease; the carb/processed food diet over the last 40-50 years has led to increased obesity and a rise in T2 diabetes; as the advice is "official", changing it is difficult because you might have to admit it was wrong in the first place, and nobody likes to admit they were wrong, particularly when people might justifiably complain that they followed the official advice and it made them very sick.

One of the issues (for governments, pharma, and the medics) with low carb is that it's just the old pre-1980 advice of "cut out starches and sugars". There's also nothing to sell, and no drugs needed. The other issue is that it works.

CatsFive said:

Not for the drugs industry, but maybe the food industry will latch on and start labelling carbs as clearly as calories, and making more low-carb foods. Of course they would probably still be ultra-processed...

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What a wonderful thought....but it will be a cold day in hell when that happens.

Roy Batty said:

No previous tests.

Lots of fruit, 3 pieces of day most days.

Water, tea with a little full fat milk, cortado. Maybe one fizzy drink a week.

One glass of red wine per day.

I have no reason to think that I have insulin resistance, but then I'm new to this. What might the symptoms be?

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You might be taking in more sugar than you realise, if you're eating a lot of fruit. Tropical fruit in particular is high in sugars, including fructose. Potatoes are another suspect item.

Have a look here: https://www.dietdoctor.com/low-carb/fruits

Alcohol tends to suppress blood glucose levels as it stops your liver adding glucose while it deals with the alcohol.

Some people report no symptoms at all prior to diagnosis, others have lots of symptoms but no diagnosis is made because, as was said to me, "your blood sugar isn't high enough". If you've got an A1c result as you did, and assuming the test was valid, it's evidence that your system is holding high levels of glucose in the blood stream much longer than it should. High levels over time do physical damage to nerves and capillaries.

Do you have and use a blood glucose meter? That would show you the ability of your system to deal with the impact of what you've just eaten.

IncogKeto said:

I can't recall what the accuracy of the HbA1c tests are (maybe someone could comment) but the 41 and 47 numbers may in reality not have been as far apart as they seem. They both may have been around 44 so not necessarily showing a worsening over the four weeks. If you're doubting the validity of either of them then don't forget you could always throw some money at it and pay for a private test through the post.

You may be someone whose red blood cells turn over more slowly than most meaning that they'll get more glycated over their lifespan for the same average blood glucose level. This would result in a higher HbA1c. Previous test results in the 30s would probably have discounted that.


If you're not eating until 1pm then when are you eating the three pieces of fruit? You're not blending them into smoothies are you?


What does that consist of?


Well, insulin resistance can cause you're HbA1c to go up so there's one reason to think that you might have it.

Since you've just had a cholesterol test but haven't been put on any medication I'm assuming that your LDL was low. How much fat do you eat and what types?

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Total allowable error of 5% - eg 2.5 mmol/mol either way at an indicated A1c result of 50 mmol/mol.

Roy Batty said:

Hi Incogketo,

I frequently have a portion of fruit with my first meal of the day e.g. blueberries or raspberries with full fat Greek yoghurt and some keto granola. I might have an apple, pear or banana mid-afternoon and maybe some grapes or melon after my dinner.

I never make or buy smoothies.

A Cortado is usually 2 shots of espresso coffee with an equal amount of steamed milk, it's a mini stronger version of a latte.

I've no idea how much fat I eat, I never buy anything that claims to be low fat, diet etc. I don't eat junk food or UPFs. I tend to have full fat Greek yoghurt most days, it's also high in protein. I only add a little milk to tea and that would be full fat.

I bought a prick tester and used it for the first time this morning when the reading was 6,5. that seems to me to confirm my blood sugar is too high.

It seems to me that given how much exercise I do then the only realistic way for me to lower my blood sugar level is to lose weight,

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A 6.5 reading needs to be put in context. Was it your fasted reading, or after food, for example? It wouldn't be unusual to have a first thing 6.5 reading - that's because your liver has probably been manufacturing glucose to get you going in the morning. It does come down eventually but the liver is a slow learner.

I found that blood sugar reduction (via low-carb) preceded my weight loss.

The fruit you're eating (with the exception of raspberries and for some people blueberries) are all at the higher sugar end. It might be worth doing a before and two hours after set of tests to see how well you handle the sugar load. If it's fine for you,