Diabetes and brain function

[NoMoreBeerAnymore]

Why do NHS let these people loose on us?

Do they think we completely ignore a condition that makes you feel dizzy, sweaty, thirsty, itchy, cranky (as well as just generally rough) ?

So today was a diabetes check up (last one was in August). The diabetes nurse was on top form

"what you need to do is lose lots of weight". In my head my reply was "if you learn to fly unaided first"

Your HBA1C is 56 which is "perfect", great progress. In my head my reply was "well its above the top end of recommended, like it was last time, so perfect is not the right word"

Your blood pressure is fine. Again, "160/110" so is not. "I can prescribe something" as I winced thinking about the other meds I am fed. I said, I had better see my GP as she did say my BP could be affected by the Duloxetine I am on for pain relief. "nonsense, I don't see anything about hypertension and Duloxetine" I was told (contradicting my doctor).

I was told "I making myself upset testing my blood glucose", as I measured before and after each meal, especially if I was feeling wobbly or suspect a food choice is sending my sug's sky high.

I got told to shut up (twice), and "let her finish" as she started on "how Metformin and Gabapentin together" doesn't stop you losing weight. I went on a low-cal / carb diet for months and lost weight, then my BG really started going loopy (really high hours after a protein shake).

Next review in August, can't wait. Meanwhile, I decided to get a review of my meds (by my GP), go back on my 800 cal a day shake diet lose two stone and not worry about the odd 11.5 and 12 reading.

Wish I was a cat.

 

[Chris24Main]

It's a really tough situation managing conflict in a consultation. I've come out shaking all over, and had to go just sit down and write notes about what was said. I got the "let me finish" treatment as well... that was fun.. :-(

... funny thing is, I'd love to go back and talk to that consultant; she was wrong about a couple of things, but I reckon she saved my life...

Just one quick thing to think about - you may want to think about lowering carbs or calories but not both, at least not for long. The body does need energy, and if you're only putting in protein in the form of shakes; eventually it will start to turn that into sugar for energy, but in a way that's going to cause even more inflammation. - that could be why you are seeing these odd results.

Cutting carbs may also help with blood pressure - at least it did for me, but I have no idea how that interacts with your pain meds.

 

[Melgar]

Diabetes and brain function - @NoMoreBeerAnymore , sorry you are having to deal with conflicting information from your HCPs. That is never helpful and it erodes trust and then where do you turn to get health advice when you cannot even trust your health professionals, and the internet is full of disinformation and down right nonsense.

I think one of the more significant aspects of metabolic syndrome is insulin resistance (IR) . IR is the name given to the inability of your cells to absorb glucose from your blood stream, this is due to your cells becoming resistant to the effects of insulin, which to put it simply, insulin opens the door to your cells to allow glucose in, so it can be converted into a useable form of energy. If you become insulin resistant then this action of insulin is compromised. Insulin resistance (as well as a pancreas that cannot keep up) is highly associated with the development of T2DM. Importantly insulin resistance is correlated with chronic Inflammation in the body.

Insulin resistances means your body has to produce more insulin to compensate for the resistive state of your cells. So you not only have raised/high blood glucose - Diabetes Mellitus - circulating in your blood, but high levels of insulin too. High insulin levels increase insulin resistance. Insulin resistance is correlated with chronic inflammation.

You are only mildly diabetic, if that is any consolation. I know it can knock you sideways to receive such a diagnosis and saying you are only mildly diabetic doesnt mean you don't need to do anything about it , because you do. At 56 it is well within ones ability to reduce that figure. Many members here have achieved this through reducing carbohydrates , sugars and starch intake by diet.

The reason I mention inflammation is this, chronic inflammation ( I'm not referring to short inflammation duration associated with injury or infection) is associated with damage to blood vessels, heart disease, cancer, autoimmune disorders, gastrointestinal disorders and mental health. There have been recent studies which suggest that inflammation in the brain, may significantly contribute to dementia, in particular alzheimer's disease - diabetes and brain function.

Reducing your carb intake, plus introducing exercise into your daily routine , particularly resistance training such as weights, as well as some aerobic exercuse such as simply walking with purpose, may reduce insulin resistance, blood pressure and importantly inflammation.

And just a quick mention on not testing your blood sugars. This seems to be a UK thing. My take on this is to ignore this advice and test your blood sugars. My test strip prescription instructs me to test twice a day.

I have attached a couple of links which you may find useful.

https://www.niehs.nih.gov/health/topics/conditions/inflammation#:~:text=Inflammation%20in%20your%20body's%20cells,further%20tissue%20injury%20and%20disease.

https://www.nature.com/articles/s41577-024-01104-7

 

[Deleted member 596235]

Your blood pressure is fine. Again, "160/110" so is not. "I can prescribe something" as I winced thinking about the other meds I am fed. I said, I had better see my GP as she did say my BP could be affected by the Duloxetine I am on for pain relief. "nonsense, I don't see anything about hypertension and Duloxetine" I was told (contradicting my doctor)...

I'm not sure how things work in the UK, but here in Australia a
diabetes nurse cannot prescribe any/all medications requiring
a prescription. I can understand why, as I could foresee a confusing
conflict of clinical advice between the nurse and the doctor.

Whatever the case, it's important for a diabetes educator and your
doctor to report to each other after your consultation with either.

I can't of course comment on your individual BP readings, but if
mine were that high—particularly the diastolic value—I'd definitely
be running that past my GP.

My doctor also makes an allowance during my BP checks for the
so-called "white coat fever". A good GP will take your BP at the
beginning of the consultation, and then again as you're about to
leave.

I'm also concerned that your treating clinicians are apparently causing
you this unnecessary grief; all I can say mate is to hang in there.

 

[EllieM]

The body does need energy, and if you're only putting in protein in the form of shakes; eventually it will start to turn that into sugar for energy, but in a way that's going to cause even more inflammation. - that could be why you are seeing these odd results.

Not disagreeing but do you have a link for this?

 

[Chris24Main]

Its gluconeogenesis.
Not directly, of course the liver breaks down protein into amino acids then turns those into glucose
Here's the most obvious link, but I don't think this is controversial at all.

Protein is one of the three main energy providing macronutrients, along with carbohydrate and fat. Protein helps the body to grow new tissue, therefore helping to build muscle and repair damage to the body.

Protein is one of the three main energy providing macronutrients, along with carbohydrate and fat. Protein helps the body to grow new tissue, therefore helping to build muscle and repair damage to the body.

www.diabetes.co.uk

 

[EllieM]

Its gluconeogenesis.
Not directly, of course the liver breaks down protein into amino acids then turns those into glucose
Here's the most obvious link, but I don't think this is controversial at all.

Protein is one of the three main energy providing macronutrients, along with carbohydrate and fat. Protein helps the body to grow new tissue, therefore helping to build muscle and repair damage to the body.

Protein is one of the three main energy providing macronutrients, along with carbohydrate and fat. Protein helps the body to grow new tissue, therefore helping to build muscle and repair damage to the body.

www.diabetes.co.uk

Thanks very much, not disputing gluconeogenesis at all , but why does this cause "even more inflammation" ? Unless you're referring to the "can protein be bad for you in the article" ?

 

[Chris24Main]

Because the pathways for converting protein into energy are inherently inflammatory, because they have to deal with the nitrogen that isn't present in fats or glucose.

Sorry - I'm sounding both defensive and at the same time condescending - I'm taking this for granted, but it's not at all obvious.

1. Fatty acid conversion to energy - direct and non-inflammatory - what we evolved to do.

2. Glucose conversion to energy - direct and somewhat inflammatory in nature because the process isn't as "clean" as burning fat. Plus the whole problem with glucose in the blood and cells, damaging everything by glycation.

3. Protein conversion to energy - indirect, and pro-inflammatory conversion first into glucose. Creates additional nitrogen-based products such as Uric acid, which is pro-inflammatory. Then, all the same issues as 2.

So - if you force your body to have to use protein for fuel, because there is not sufficient fat or glucose, it's even more inflammatory.

One of the surprising things about really evidence-based nutrition, is that we actually require a surprisingly small amount of protein - even to build and maintain muscle mass (different story for body builder type) - We cannot store it, so anything above that threshold will get converted in the liver to other things in order to be stored, or excreted. Protein in the form of powder will hit the liver in a rush in a way we are not evolved to cope with (more about particle size than what it's made of) so more of it will get converted.

Protein eaten with fat will be digested more slowly (ie real food) because it needs to get down into the intestines to be broken away from that fat, and will be subject to digestive juices triggered by that fat, which allow us to absorb more of the protein in a healthy way.

 

[NoMoreBeerAnymore]

I'm not sure how things work in the UK, but here in Australia a
diabetes nurse cannot prescribe any/all medications requiring
a prescription. I can understand why, as I could foresee a confusing
conflict of clinical advice between the nurse and the doctor.

Whatever the case, it's important for a diabetes educator and your
doctor to report to each other after your consultation with either.

I can't of course comment on your individual BP readings, but if
mine were that high—particularly the diastolic value—I'd definitely
be running that past my GP.

My doctor also makes an allowance during my BP checks for the
so-called "white coat fever". A good GP will take your BP at the
beginning of the consultation, and then again as you're about to
leave.

I'm also concerned that your treating clinicians are apparently causing
you this unnecessary grief; all I can say mate is to hang in there.

I just did a blood pressure. I am down to 140/90 after just a few days on ACE Inhibs. I would say I am excited by that but it would raise my pressure.

 

[Deleted member 596235]

One of the surprising things about really evidence-based nutrition, is that we actually require a surprisingly small amount of protein...

Yes. According to Harvard Health, the recommended dietary allowance (RDA)
for protein is a modest 0.8g of protein per kilogram of body weight, or 0.36g
per pound. The RDA is the amount of a nutrient you need to meet your basic
nutritional requirements. In a sense, it's the minimum amount you need to keep
from getting sick—not the specific amount you are supposed to eat every day.

According to this protein calculator, my daily intake is ideally 78 grams.

 

[NoMoreBeerAnymore]

Its gluconeogenesis.
Not directly, of course the liver breaks down protein into amino acids then turns those into glucose
Here's the most obvious link, but I don't think this is controversial at all.

Protein is one of the three main energy providing macronutrients, along with carbohydrate and fat. Protein helps the body to grow new tissue, therefore helping to build muscle and repair damage to the body.

Protein is one of the three main energy providing macronutrients, along with carbohydrate and fat. Protein helps the body to grow new tissue, therefore helping to build muscle and repair damage to the body.

www.diabetes.co.uk

Diabetes and brain function - @NoMoreBeerAnymore , sorry you are having to deal with conflicting information from your HCPs. That is never helpful and it erodes trust and then where do you turn to get health advice when you cannot even trust your health professionals, and the internet is full of disinformation and down right nonsense.

I think one of the more significant aspects of metabolic syndrome is insulin resistance (IR) . IR is the name given to the inability of your cells to absorb glucose from your blood stream, this is due to your cells becoming resistant to the effects of insulin, which to put it simply, insulin opens the door to your cells to allow glucose in, so it can be converted into a useable form of energy. If you become insulin resistant then this action of insulin is compromised. Insulin resistance (as well as a pancreas that cannot keep up) is highly associated with the development of T2DM. Importantly insulin resistance is correlated with chronic Inflammation in the body.

Insulin resistances means your body has to produce more insulin to compensate for the resistive state of your cells. So you not only have raised/high blood glucose - Diabetes Mellitus - circulating in your blood, but high levels of insulin too. High insulin levels increase insulin resistance. Insulin resistance is correlated with chronic inflammation.

You are only mildly diabetic, if that is any consolation. I know it can knock you sideways to receive such a diagnosis and saying you are only mildly diabetic doesnt mean you don't need to do anything about it , because you do. At 56 it is well within ones ability to reduce that figure. Many members here have achieved this through reducing carbohydrates , sugars and starch intake by diet.

The reason I mention inflammation is this, chronic inflammation ( I'm not referring to short inflammation duration associated with injury or infection) is associated with damage to blood vessels, heart disease, cancer, autoimmune disorders, gastrointestinal disorders and mental health. There have been recent studies which suggest that inflammation in the brain, may significantly contribute to dementia, in particular alzheimer's disease - diabetes and brain function.

Reducing your carb intake, plus introducing exercise into your daily routine , particularly resistance training such as weights, as well as some aerobic exercuse such as simply walking with purpose, may reduce insulin resistance, blood pressure and importantly inflammation.

And just a quick mention on not testing your blood sugars. This seems to be a UK thing. My take on this is to ignore this advice and test your blood sugars. My test strip prescription instructs me to test twice a day.

I have attached a couple of links which you may find useful.

https://www.niehs.nih.gov/health/topics/conditions/inflammation#:~:text=Inflammation%20in%20your%20body's%20cells,further%20tissue%20injury%20and%20disease.

https://www.nature.com/articles/s41577-024-01104-7

I'm eating a Cadbury's Whispa chunk as I

Diabetes and brain function - @NoMoreBeerAnymore , sorry you are having to deal with conflicting information from your HCPs. That is never helpful and it erodes trust and then where do you turn to get health advice when you cannot even trust your health professionals, and the internet is full of disinformation and down right nonsense.

I think one of the more significant aspects of metabolic syndrome is insulin resistance (IR) . IR is the name given to the inability of your cells to absorb glucose from your blood stream, this is due to your cells becoming resistant to the effects of insulin, which to put it simply, insulin opens the door to your cells to allow glucose in, so it can be converted into a useable form of energy. If you become insulin resistant then this action of insulin is compromised. Insulin resistance (as well as a pancreas that cannot keep up) is highly associated with the development of T2DM. Importantly insulin resistance is correlated with chronic Inflammation in the body.

Insulin resistances means your body has to produce more insulin to compensate for the resistive state of your cells. So you not only have raised/high blood glucose - Diabetes Mellitus - circulating in your blood, but high levels of insulin too. High insulin levels increase insulin resistance. Insulin resistance is correlated with chronic inflammation.

You are only mildly diabetic, if that is any consolation. I know it can knock you sideways to receive such a diagnosis and saying you are only mildly diabetic doesnt mean you don't need to do anything about it , because you do. At 56 it is well within ones ability to reduce that figure. Many members here have achieved this through reducing carbohydrates , sugars and starch intake by diet.

The reason I mention inflammation is this, chronic inflammation ( I'm not referring to short inflammation duration associated with injury or infection) is associated with damage to blood vessels, heart disease, cancer, autoimmune disorders, gastrointestinal disorders and mental health. There have been recent studies which suggest that inflammation in the brain, may significantly contribute to dementia, in particular alzheimer's disease - diabetes and brain function.

Reducing your carb intake, plus introducing exercise into your daily routine , particularly resistance training such as weights, as well as some aerobic exercuse such as simply walking with purpose, may reduce insulin resistance, blood pressure and importantly inflammation.

And just a quick mention on not testing your blood sugars. This seems to be a UK thing. My take on this is to ignore this advice and test your blood sugars. My test strip prescription instructs me to test twice a day.

I have attached a couple of links which you may find useful.

https://www.niehs.nih.gov/health/topics/conditions/inflammation#:~:text=Inflammation%20in%20your%20body's%20cells,further%20tissue%20injury%20and%20disease.

https://www.nature.com/articles/s41577-024-01104-7

Definitely testing my BG. I get 2 checks a year and that is it. The 56 is with me working hard, I had a A1C of 120 when I was diagnosed.

I am not going back to my NHS clinic apart from the A1c test, and to remind myself don't get any worse or else.

Thanks for all other comments, yes looks good.

What is key for me is being off Duloxetine and Gabapentin (as these were random picks by my GP to avoid me being on Tramadol and Codeine after the NHS keyhole surgery went wrong and I came out of hospital minus 3 ribs, and a part of my lung).

Edited by mod to remove forum rule breach