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Curiosity and all that

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Defren

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I have been reading blogs, websites, articles anything I can find about diabetes, as I know have many other folk. I'm not getting into this is better than that, and all that ****, we all have our own ways of managing our conditions. However, one question keeps coming to mind, and so far I have been unable to find an answer. I have read time and time again, as soon as a LCHF diet is started BG comes down as well as cholesterol. Brilliant - I ultra low carb, so that's all very reassuring. What I am curious about, if a person is diagnosed, I don't know, lets say for arguments sake 10 years ago, and through following their DSN, GP, Diabetes UK whomever's advice it was to eat say 50-80% of your daily calories as carbs, you then went from Metformin to higher and harder medication. (I say higher and harder in terms of making your pancreas work harder). Perhaps even those drugs don't work and eventually you end up on Insulin. (Sorry I know I'm waffling). Once you start a LCHF diet and it works for you, your BG's begin to tumble, sense tells me that you would begin to reduce all the additional medication. The problem is, I can't find out if that is true, except in odd cases where Glic has been given so the patient begins having hypo's all over.

My question: Can a person who is on all kinds of diabetes medication, up to and including Insulin, get their figures so under control they come off all meds?

I have to add, this is not my plan, I am ok on Metformin, but don't want anything else. I am being nosy pure and simple :lol:
 
That is what I am in the process of doing although not on a major scale. I was on Glimepiride due to rampant sugar figures. I stopped mucking about and rewrote my personal food menu and did lots of experiments using the meter.

At my last review I had an Hba1c of 42 and have been told I can try it without medication now. No problems so far.
 
Hi I think it a case of how much damage has been done to our pancreas. By reducing our carbohydrate intake , we reduce the demand on our available insulin production. Therefore when we get our diet , medication and our insulin production in balance we achieve normalised blood sugar levels. We can tweak meds and diet to some extent i.e more carbs more meds. I do however believe that there is a limit to this, and it is the balance we must strive to achieve.
I don't believe that the pancreas is capable of repairing itself (this is why we will remain Diabetic) and as a result I think it unlikely that someone with very low insulin production wouild ever be able to become medication free.

Hope that makes sense
 


:clap: :clap: :clap: Brilliant news. It's people who are more advanced along the medication route I am curious about, but reading great stories like yours is always amazing. Can I be more nosy than usual and ask, did you follow the standard dietary advice and that pushed your figures up, or was it low carb that just didn't work for you? Please don't feel obliged to answer, it is curiosity, nothing more on my part.


It makes perfect sense. I think what I am trying to find out is, can we damage our pancreas to such a degree there is no way to turn back and use diet alone? Or, is it possible to reduce carbs low enough, that even someone on loads of diabetic medications and Insulin could still use diet alone as control? I think the answer is no, once the pancreas is damaged to a certain degree, there is no going back, but I can't find out for sure.
 
"Brilliant news. It's people who are more advanced along the medication route I am curious about, but reading great stories like yours is always amazing. Can I be more nosy than usual and ask, did you follow the standard dietary advice and that pushed your figures up, or was it low carb that just didn't work for you? Please don't feel obliged to answer, it is curiosity, nothing more on my part."

Initially the only advice I was given was a diet sheet written by the British Hypertension Society and another one entitled "A diet to reduce your cholesterol". There was no other advice except that a dietitian told me to eat carbohydrates with every meal. My sugar levels started to climb. Looking back I think the statins which temporarily crippled me took exercise out of the equation.

I was prescribed Glimipiride a year ago and given a meter and let out of the surgery door. I did experiments, lots of experiments some of them designed to deliberately make things worse to find out what would happen. Somewhere along the way I joined this forum to discover that I was covering a lot of ground already covered by the contributors.

Last March I stopped experimenting and put what I learned into practice. Meals with flour in were thrown out. Some new meals introduced including the stir fries. Potatoes and rice were now a lesser proportion of meals but there proved no need to cut them out entirely. I introduced a system of measured debauchery. If I had chocolate and wine I made sure it was at least 2 hours after a meal when to graph was going low. And lots more besides.

So in September I presented with the Hba1c of 42 and was told I could try and see what would happen without medication.
 


That is a fabulous story Squire, well done. I love seeing people take hold of their condition and all but kick it into touch. Well done, and keep up the brilliant work. :clap: :clap: :clap:
 
Hi defren. I think we are all looking for the answer to your last point. my medication peaked two years ago with 2000mg metformin sr and 200mg gliclazide per day . I had tried most diet ideas including the Wonderful NHS advice . It wasn't until I read Richard Bernsteins book Diabetes Solution that the penny dropped and i started low carbing. I've been on approx 20 gr carb per day for nearly two years and in that time I've managed to reduce the gliclazide down to 40g per day, but prefer to take 80mg as it makes it far easier to control my bm's. I'm constantly trying to find ways to reduce my meds further , unfortunately with limited results. My current line of thought is that Cortisol plays a big part in our morning fasting levels . To this end I think we all hope that one day we will find a magical solution to share with everyone.
I would mention my partner, who is on the cusp of pre diabetes to diabetes. She was diagnosed in february this year and went immediately onto the same diet as me, she has managed to have normalised levels for fasting , radom and HBA1C's , but no initial improvement in glocose tolerence. However within the last 4 weeeks we noticed a sudden drop in Bm's and a recent ogtt test we did ourselves at home has shown an improvement form earlier tests. I intend to tell the full story on the forum once we have alot more data and confirmation of the improvments. again I think it's a question of how much damage had or had not occured to the pancreas before active control measures are started
 
I also suspect that Diabetic progression is not linear, but happens in fits and starts. So it is not possible to predict when pancreatic function will take a nose dive.

I have no evidence as such, just from my reading and observations with 26 years of familial type 2.
 


I have to say I am really impressed. I suppose I was lucky, I knew I was being tested for and likely to be diagnosed with diabetes, so looked and found this forum before I was actually diagnosed. In the time between having my blood taken and getting the result, I spent hours reading here. By the time the inevitable happened, I knew about low carbs so hit the road running. I was diagnosed with an HbA1c of 7.0% four months later it was 4.9%. I know without a shadow of doubt I would never have achieved that without this forum, and would have done exactly what you did, follow the NHS line. So in that respect I know I am very, very lucky. That doesn't detract from your hard work and what you have achieved.

I think you may be right, the question I posed is what we all want to know. I have read so much and anecdotal evidence of people cutting down the meds they are on, but never from someone on the harder meds and Insulin. I think what you said about our pancreas burning out is very true. I just want to know if anyone has managed to come back from that to diet alone. I think I may have to keep reading, there again, I may never find out the answer. Doesn't stop the curiosity though. :lol:


Yes, that could well be the case Lucy. It just seems firm medical opinion on the subject is thin on the ground. It could be because it is an area being researched now. It could also be, I have been reading in the wrong places.
 
You have either not read or forgotten my diabetes history.
I used to take 3 different medications for diabetes, 4 for alone pressure, 4 for side effects, iron supplement and all at maximum dose.
Then came the turning point for me I was introduced to the lchf lifestyle, I was able to reduce medication after just one week, but it still took around 2 years until I was able to stopall medication.
Now I don't even look at an aspirin never mind take one - present circumstances excepted - all I am taking is cinnamon and alpha lipoic acid.
 

Thank you Judith, no I have never read your story, but well done getting all those meds down to nothing. :clap: :clap: :clap:
 
I think it is quite possible for clear-cut Type 2s to come off meds or reduce them a lot.

The only warning I'd like to issue is that if at some point 10-20 years down the diabetes route, things do not keep working without meds, don't get too disappointed.

Things can happen over time, and it's good to have goals and also good to be realistic if the situation changes. Not saying that you people aren't, because I know you all as very responsible people. Just don't consider it a failure if it doesn't work forever, or if someone else is reading along: Don't take it personal if your diabetes does not behave that well, or you were diagnosed at a stage where more damage had been done, etc.

In the end, we'll have to assume it is the numbers (blood sugars, hba1c to some degree) that are the ultimate goal. And there may have to be medication added to make that equation work out.

Well done to all those who have managed to reduce or come off medication. :thumbup:

I know that I never will as my diabetes is auto-immune and progressive - however, I am quite content I have reduced my insulin dose to about 33 percent of what it started out as. For the time being. Who knows what's around the next bend. Certainly not me with type 1.5 LADA.

Hope this isn't viewed as spanners in the works too much - just hope that these stories will be inspirational, and not discouraging to those who may for various reasons not manage to achieve similar results.
 

Mileana – I agree with everything you say, but surely this is should prompt us to renew the call that has been made before for there to be a separate section of the forum for those who are not T1 or T2? Our low-carbing T2 friends are inspirational, and are achieving wonderful things and give excellent advice to the newly diagnosed, but every now and then they can (understandably) slip into failing to specify which type of diabetes they are talking about, and into implying that T2 controlled by diet alone is the only game in town. This can then lead to a relentless stress on the importance of abandoning medication and denying that diabetes is progressive, and as you point out that can be deflating and dispiriting for those whose diabetes IS progressive. There have been numerous cases reported on the forum of people with LADA being wrongly diagnosed. Hasn’t the time come for a separate dedicated section for those in the non-T1/2 category (which doesn’t just mean LADA), whose condition and treatment doesn’t necessarily follow the dicta of T1 or T2? (and maybe just a gentle tap on the shoulder of our T2 low-BG heroes to remember that, while their dietary advice is of great value to all diabetics, nevertheless their remarks on medication and halting progression may not work for all).
 
A T2 diabetic can come off high levels of medication even insulin as I did, by losing weight.

In T2 diabetes it is visceral fat which causes insulin resistance, lose the weight = lose the visceral fat = use less mediction.

I was injecting 48 units of insulin spilt into one 12 unit of long acting insulin at night which stopped my levels rising overnight and three pre meal injections of 12 units of short acting insulin. I was also taking 2000mg of metformin.

After losing over 4 stones in weight I was able to reduce my insulin needs bit by bit, little by little as my insulin resistance reduced in tandem with my weight loss until I stopped using insulin all together which I actually found a little scary at first but did manage to keep my HbA1c in the 5's at all times.

This was without any fad diet, I just cut back on the carbs by testing every possible combination of foods and portions until I knew what I could and couldnt eat. So just carb reduction and portion control. Oh, and for 6 months or more I did not drink any alcohol, I did not eat any snack or treat, I was very strict, but once I lost the weight I was able to eat more carbs and keep within safe levels and I now drink alcohol in moderation and am able to eat the odd snack between meals occasionally.

Now you ask in your OQ about long term use of high level meds which I did not use, as I started to reduce my insulin use almost from day one. If someone has damaged their pancreas to any great extent then i doubt that they could easily come off medication, as in the case of T1's who can not produce any insulin and who will require insulin even if they cut their carb intake to the bone, they will still need insulin keep they levels down.

Without some sort of test however it is impossible to know to what extent your pancreas is working, I would think that most T2's have reasonably good pancreatic function unless they have been badly controlled for many years, I dont think that pancreatic damage happens overnight, how quickly it does occure and to what extent is probably unknown although it is known to happen. I think most T2's need to try to remove as much of the visceral fat surrounding their organs as they are able to get the best control on the smallest amount of medication, even thin people can have visceral fat so it is not just obese diabetics who will have visceral fat although those who are overweight will be more likely to have visceral fat causing insulin resistance.

We all know that the Newcastle Study diet worked well for those who stuck with it, simply by reducing visceral fat.

There will always be T2's who for whatever reason are unable to come off drugs, I would not want to come off the metformin I take as without it my levels would no doubt rise by somewhere between 1 and 2 mmol/L which would take me out of the 5%'s. I am lucky that I am able to keep my levels down to the level they are, others may not be so lucky.

I would only recommend that you dont try to compare your own condition with others, we really are all different, just try to manage your own condition to a level that you are happy with, and if that means taking medication to do so then take it, it is not a sign of weakness or failure, those who have transplants have to take anti rejection drugs for life, that doesnt make them failures does it? T1 diabetics have to use insulin regardless of their diet, that doesnt make them failures does it? There are many more instances where people have to take medication, for some it means the difference between life and death and for many T2's it means the difference between running safe bg levels or running the risk of complications.

Many people take drugs and use the pharmaceutical knowledge built up over many years of research to help them live long healthy happy lives. I would rather take drugs that help me than refuse them out of hand and then reach the point where I have no choice but to use them, I am convinced that my early use of insulin helped me protect my pancreatic function so that I was able after losing weight to keep safe bg levels with only a minimum of medication, had I not taken insulin early on or had I not lost weight then I am positive that I would not have the control I have enjoyed so far.
 
This is a really interesting topic, I wanted to know this too. I'm impressed by how people have managed to reduce their BS to amost normal through lchf. I haven't yet, but I feel I can't reduce anymore because my diet is restrictive anyway for now.
 

I have never understood why LADA T1.5 and any other variants have not had a forum designed for you guys. My limited understanding of your condition is that it is very unique to each patient, and very difficult to control. It might be worth speaking to admin and seeing what they say.

dawnmc said:
This is a really interesting topic, I wanted to know this too. I'm impressed by how people have managed to reduce their BS to amost normal through lchf. I haven't yet, but I feel I can't reduce anymore because my diet is restrictive anyway for now.
Click to expand...

I'm so pleased I'm not the only nosy one :lol: I have read so much stuff on various sites and articles etc, yet it seems the answer is not easily available. It may well be that it is out there, I just haven't found it.
 

Great post Sid. :thumbup: :thumbup:

Perhaps this thread should be moved to Type2 board?
 

I think I reacted as it was in the normal 'question section' which is shared for us all, and because I do not believe it is doable for everyone. But I am happy for the ones who can.

Regarding the LADA, I think it would be a good idea with a LADA forum. Work is being done at the moment on creating a sticky for a start about the little quirks as there isn't a lot of knowledge available in one spot. I think one thing I have heard before is that LADA, Mody and the other 'odd numbers' were a rather small percentage. I am not sure I personally agree that 10-15 percent is small, compared to for instance pregnancy-diabetes. But I digress a little, I will let you have your thread back - just wanted to point out the to newbie readers that it may not be possible for all. But great when it is.

-M
 

I have no problem with this thread being hijacked. It's not a serious thread, just me being nosy, so hijack away. I sometimes think if a thread does go off on different tangents it's more like a real conversation. When we chat to someone on the phone or face to face, it's rare we just stick to one topic. I realize it doesn't help people who have serious questions, but on this one, different views add to my knowledge.
 
[/quote]
I think one thing I have heard before is that LADA, Mody and the other 'odd numbers' were a rather small percentage. I am not sure I personally agree that 10-15 percent is small, compared to for instance pregnancy-diabetes. -M[/quote]

I'm with you on that. When it comes to numbers of people rather than percentages of all diabetics that is rather large, and perhaps a higher percentage among them need forum help than straightforward T1s or T2s. Besides, with you and smidge we have at least 2 LADA forum moderators (and remember borofergie's joke about there being more LADAs around here than in a 1980s Russian car showroom). I would pm benedict about having a new section but he seems to ignore my messages... Sorry Defren -- the hijack continues!
 
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