Diagnosed today...

[Luthien]

I've got another update... after more trips to the hospital I've gotten more questions... and more concerns... not only regarding the diagnosis, but also regarding the treatment the doctor has prescribed.

so... went back to the doctor yesterday to ask about side effects of the medications, if what I'm feeling are in fact side effects of the medications(I specifically do not look up side effects of meds until I feel something). They include:
A dull constant headache since I started taking the meds
A pain on left side, just below the rib cage, sensitive to touch, feels like a painful pressure, since I started taking the meds.
This is rather embarrassing, but I have no where else to turn... My libido has become almost non existent since I started taking the meds. whether this is due to the meds or just the stress of this last week, I dont know. However, I've had people close to me pass away that have affected me way way worse than this and it had no effect on my libido, its been very consistent since I became a teenager.

For the headache, the doctor sent me for a sinus x-ray(no results yet)
For the pain on my left side, the doctor referred me to cardiology who did an ecg and echo(both normal, YAY SOME GOOD NEWS! got a ct scheduled this week.......)
For the libido(I spoke to cardiologist as I couldn't gather the nerves to ask the female internal medicine doctor). The doctor, and I WISH I was paraphrasing here, said "you not married and dont have a girlfriend, dont worry about it"

As for the treatment plan concerns I have... As well as the diagnosis... are that I've been prescribed the max dose of Gliclazide(120mg a day) which from what I've seen is a medication only given to diabetics when they cannot control their diabetes AFTER trying weight loss, diet, and exercise. This is doubly concerning given that I asked the doctor yesterday if I can try manage the diabetes through diet. and once again, I WISH I was paraphrasing here. said "no, keep your normal diet and continue to take the medications" having checked the side effects of metformin today and now knowing the doctor either doesn't know the side effects of the drugs she is issuing and referred me to another doctor for no reason or just wants me to stay on meds DESPITE the side effects I'm experiencing is just astonishing to me! Now, personally I hope I am very very wrong about the conclusions I've come to, but this is not something I want to take lightly considering it will define the rest of my life.

some concerns I have regarding diagnosis are the following:
The doc has said its type 2, no tests have been done other than a1c. My concern with the a1c is that we all just coming out of the holiday season. I dont know about everyone else... but holiday season is when I'm not active, I'm normally on leave, my diet changes drastically for those 2-3 months, Its generally the only time of year I would consider eating cake, having chocolate, festive foods....(still no alcohol though) I still don't know enough about all of this to know for sure if that could have effected the a1c which lead to this diagnosis..... all of this coupled with the doc insisting on me NOT changing my lifestyle or diet, what I feel like was very quick to put me on meds, and also meds that from what I've seen.... I shouldn't be taking(Gliclazide). I'm losing weight already. I'm not having trouble losing weight! that was my primary reason for going to the hospital to begin with and the doc has put me on meds for diabetics who either cant lose weight or the weight loss isn't affecting their diabetes.

I put most of this together today while I was with my father who decided to see a general surgeon regarding I lipoma on his back and I KID YOU NOT!!!! the doctor put in a request to the insurance for surgery within 45 sec of walking into his office. There was another major red flag I spotted while tagging along with my father to his appointments and him to mine. I can't give specifics because I'd rather avoid any legal issues.... So I'll say this... My father is in the emergency medical field, the hospital I'm using currently has just been approved to receive EMS cases. However, because they "the new kid on the block" the EMS workers don't generally know about this hospital being open to EMS cases. The head of the hospital landed up coming down to my cardiology appointment to have an informal meeting with my father regarding this. In my entire life, I have never ever ever had a stronger feeling of these people just want money walking through the door and it, excuse my language, scared the **** out of me. I cannot stop thinking after that meeting that management has told the doctors to try push pills and keep people coming back.

@MrsA2 @JoKalsbeek @ianf0ster (Hope those tags work)
I would deeply appreciate any input you, or any one else, have on this situation.

 

[HairySmurf]

This is rather embarrassing, but I have no where else to turn... My libido has become almost non existent since I started taking the meds. whether this is due to the meds or just the stress of this last week, I dont know.

I don't have the knowledge to respond to much in your post other than this, and we are not allowed to offer medical advice on this forum. We are allowed to speak from personal experience however, so I can say that shortly after I started Metformin I experienced greatly lowered libido for a period of around 3 or 4 weeks. Things went back to normal pretty soon after than, and all has been fine for me on this front since then. I of course can't say if your experience and mine will be alike. I hope others on the forum can help you with your other questions. Best of luck.

 

[MrsA2]

What are your bg finger prick readings? Or from cgm if you have one.
Pre meal reading
What you ate
2 hour post reading

Did you get a way of testing ketones?

Not only can we not diagnose on here, so many of the things you mention could be attributed to other things, including anxiety and stress.
So first just breathe
And then give us actual numbers

 

[ianf0ster]

Hi @Luthien I'm sorry to hear what you are going through.
I have no personal experience of diabetes medications and we are not allowed to give medical advice.

You are being prescribed Gliclazide and Sitagliptin to lower your blood glucose - not to reduce your weight. Both of them act (in different ways) to help your pancreas produce more insulin (which lowers your Blood Glucose).
There could be a problem if you blindly (i.e. without measuring your Blood Glucose) reduce the amount of carbohydrates you eat by too much without also reducing the amounts of Gliclazide and Sitagliptin you take - they need to be in balance. Otherwise you may suffer from too low a blood glucose - known as a Hypo - which is very unpleasant and also dangerous.

However I feel you also need to be aware that in some cases Gliclazide can make you feel more hungry - so some people actually gain weight while lowering BG on gliclazide. So watch out for that.

The unexpected nature of the weight loss does mean that there may be another cause - such as Thyroid or your diabetes being Type 1 instead of Type 2. However although Type 1 is associated with unexpected weight loss, Type 2 is associated with obesity. There are 2 simple blood tests which can diagnose Type 1, but nothing except high Blood Glucose and the absence of Type 1 or another type of Diabetes can diagnose Type 2 - it is the default case.

 

[Luthien]

What are your bg finger prick readings? Or from cgm if you have one.
Pre meal reading
What you ate
2 hour post reading

Did you get a way of testing ketones?

Not only can we not diagnose on here, so many of the things you mention could be attributed to other things, including anxiety and stress.
So first just breathe
And then give us actual numbers

I haven't been testing too long... what i've got so far is
71 before food, 92 2h later. Chinese chicken hakka noodles(egg noodles) with a side of sweet and sour prawns. It was a fairly large portion that day as it was all I had so far for that day.
last nights dinner was 89 before food and 114 2h later, it was 2 slices of bbq chicken pizza
todays test from lunch 77 before food, 124 2h later from first bite. I was interrupted several times throughout the meal and it took almost 50minutes to actually finish eating. it was a Fatoush salad. salad(lettuce, onion, radish, tomato, lemon, vinaigrette) with crisped arabic flatbread, pomegranate, and pomegranate molasses. I tested myself at the 3h mark also thinking because the meal took so long, get it just in case and it was an even 90.

I did manage to find results for my ketones from when I was first tested on the 10th, got the results on the 12th when I was diagnosed. unfortunately the test does not seem to be a very accurate test as it just says 1+ for ketones. from what i've read anything above 0.6 should be something to look in to... and the doc once again, just didn't mention it....

edit: the fatoush salad was also eaten without meds as i forgot to keep some on me with my glucometer and I wasn't going to return home for roughly 6h

 

[Luthien]

Hi @Luthien I'm sorry to hear what you are going through.
I have no personal experience of diabetes medications and we are not allowed to give medical advice.

You are being prescribed Gliclazide and Sitagliptin to lower your blood glucose - not to reduce your weight. Both of them act (in different ways) to help your pancreas produce more insulin (which lowers your Blood Glucose).
There could be a problem if you blindly (i.e. without measuring your Blood Glucose) reduce the amount of carbohydrates you eat by too much without also reducing the amounts of Gliclazide and Sitagliptin you take - they need to be in balance. Otherwise you may suffer from too low a blood glucose - known as a Hypo - which is very unpleasant and also dangerous.

However I feel you also need to be aware that in some cases Gliclazide can make you feel more hungry - so some people actually gain weight while lowering BG on gliclazide. So watch out for that.

The unexpected nature of the weight loss does mean that there may be another cause - such as Thyroid or your diabetes being Type 1 instead of Type 2. However although Type 1 is associated with unexpected weight loss, Type 2 is associated with obesity. There are 2 simple blood tests which can diagnose Type 1, but nothing except high Blood Glucose and the absence of Type 1 or another type of Diabetes can diagnose Type 2 - it is the default case.

Yes, I do agree both gliclazide and sitagliptin are there to lower the blood sugar and not the weight. however, after some reading up on Gliclazide, it is used for diabetics that weight loss has not been affective in managing diabetes. My worry is I've been given a med that doesn't appear to be slowing down my weight loss(which is expected, although I'm still losing weight fast) but is also something that is used when weight loss in ineffective. Now I know doctors are good, but I doubt she can see the future and know how from a single test that my current weight loss is/will be ineffective. what happens if my current weight loss does begin to lower my blood sugar and I'm still taking Gliclazide on top of that. I'm losing weight really really quickly. 2months and its been 12kg(1.88 stone, 26 pounds). becoming hypoglycemic seems like it could be a genuine risk if the doctor is wrong on the off chance that my weight loss doesn't affect the diabetes. I also dont have the full medical history from my biological fathers side, I've met the guy once in my entire life, its not impossible that type 1 is present on that side of the family. I've also got gut issues that have been prevalent my entire adult life, another thing that could cause blood sugar problems... but it remains undiagnosed. this internal medicine doctor was supposed to schedule a check up for it but nothing has materialized after enquiring 3 times. I did a fecal test which said there was a colon issue but the investigation just stopped there.... at this point I just want answers and the doctor just keeps going back to stay on your normal diet.

I've booked an appointment at a different hospital for tomorrow/today(currently 4am) and hopefully I can get a 2nd opinion. here's to hoping the medical insurance doesn't give me hell for it....

edit: thyroid was tested, all clear on that front

 

[ianf0ster]

the conversion between UK units and units that you use means that you want to keep the BG rise from a meal below 36 mg/dl and the 2hr post meal numbers below 144 to 153 mg/dl.

Here is a link to an online converter: https://www.diabetes.co.uk/blood-sugar-converter.html

All your per-meal numbers are either low or low to good - probably due to your medication.

Your first tested meal was OK. In UK units your pre-meal was 3.9 mmol (which is low) and it rose to 5.1 mmol which is a good value. The rise was less than 2 mmol = so that meal was OK for you (despite the side of sweet& sour prawns).

Next meal, pre-meal was 4.9 mmol (which is good) and 2hrs later was 6.3 which is also good and the rise was higher, but still showing that that meal was also OK for you.

'Today's lunch' pre-meal was 4.3 mmol which is low/good and 2hrs later it was 6.9 which is good, however the rise was a little high (at 2.6) so the meal was perhaps a little too high in carbs. Though BG meters aren't 100% accurate, so you may want to try that meal again before deciding if you need to reduce the portion size of (say) the pomegranate molasses, or the flatbread.

I'm not sure if the units used in your country for Ketones are the same as in the UK, but in the UK a ketone reading of 1 isn't unusual (and is OK so long as the BG level is good) for somebody eating fewer carbs than they used to.

I hope this helps, it seems quite encouraging.

 

[Luthien]

I'm not sure if the units used in your country for Ketones are the same as in the UK, but in the UK a ketone reading of 1 isn't unusual (and is OK so long as the BG level is good) for somebody eating fewer carbs than they used to.

it was before I started the meds, a1c was at 9.6, random glucose blood test(fasting) was 10.6 . I'm not 100% sure exactly how long the fast was, it was definitely around 8h. as for the carbs, it was my normal diet, I wasn't watching carbs. had rice and lamb the night before.

 

[ianf0ster]

..................................... My worry is I've been given a med that doesn't appear to be slowing down my weight loss(which is expected, although I'm still losing weight fast) but is also something that is used when weight loss in ineffective. Now I know doctors are good, but I doubt she can see the future and know how from a single test that my current weight loss is/will be ineffective. what happens if my current weight loss does begin to lower my blood sugar and I'm still taking Gliclazide on top of that. I'm losing weight really really quickly. 2months and its been 12kg(1.88 stone, 26 pounds). becoming hypoglycemic seems like it could be a genuine risk if the doctor is wrong on the off chance that my weight loss doesn't affect the diabetes. I also dont have the full medical history from my biological fathers side, I've met the guy once in my entire life, its not impossible that type 1 is present on that side of the family. ..............................................

I understand your concerns, and that is why you need to keep testing your BG levels. Normally in a Type 2, when your BG level starts to get too low, your liver will dump glucose into your blood stream. But if your medication dose is too high, or you are not an ordinary Type 2 then it is possible that this won't work properly.

I'm not going to give medical advice, just some information: The action of both Sitagliptin and gliclazide is to raise insulin levels. The action of Metformin is to 'discourage your liver from dumping glucose'.
If your BG goes too low due to too much insulin, it would be nice if your liver did its job and dumped some glucose into your blood stream, otherwise you would need to eat (or drink) a little of something sweet in order to avoid/minimise a hypo.

 

[JoKalsbeek]

I've got another update... after more trips to the hospital I've gotten more questions... and more concerns... not only regarding the diagnosis, but also regarding the treatment the doctor has prescribed.

so... went back to the doctor yesterday to ask about side effects of the medications, if what I'm feeling are in fact side effects of the medications(I specifically do not look up side effects of meds until I feel something). They include:
A dull constant headache since I started taking the meds
A pain on left side, just below the rib cage, sensitive to touch, feels like a painful pressure, since I started taking the meds.
This is rather embarrassing, but I have no where else to turn... My libido has become almost non existent since I started taking the meds. whether this is due to the meds or just the stress of this last week, I dont know. However, I've had people close to me pass away that have affected me way way worse than this and it had no effect on my libido, its been very consistent since I became a teenager.

For the headache, the doctor sent me for a sinus x-ray(no results yet)
For the pain on my left side, the doctor referred me to cardiology who did an ecg and echo(both normal, YAY SOME GOOD NEWS! got a ct scheduled this week.......)
For the libido(I spoke to cardiologist as I couldn't gather the nerves to ask the female internal medicine doctor). The doctor, and I WISH I was paraphrasing here, said "you not married and dont have a girlfriend, dont worry about it"

As for the treatment plan concerns I have... As well as the diagnosis... are that I've been prescribed the max dose of Gliclazide(120mg a day) which from what I've seen is a medication only given to diabetics when they cannot control their diabetes AFTER trying weight loss, diet, and exercise. This is doubly concerning given that I asked the doctor yesterday if I can try manage the diabetes through diet. and once again, I WISH I was paraphrasing here. said "no, keep your normal diet and continue to take the medications" having checked the side effects of metformin today and now knowing the doctor either doesn't know the side effects of the drugs she is issuing and referred me to another doctor for no reason or just wants me to stay on meds DESPITE the side effects I'm experiencing is just astonishing to me! Now, personally I hope I am very very wrong about the conclusions I've come to, but this is not something I want to take lightly considering it will define the rest of my life.

some concerns I have regarding diagnosis are the following:
The doc has said its type 2, no tests have been done other than a1c. My concern with the a1c is that we all just coming out of the holiday season. I dont know about everyone else... but holiday season is when I'm not active, I'm normally on leave, my diet changes drastically for those 2-3 months, Its generally the only time of year I would consider eating cake, having chocolate, festive foods....(still no alcohol though) I still don't know enough about all of this to know for sure if that could have effected the a1c which lead to this diagnosis..... all of this coupled with the doc insisting on me NOT changing my lifestyle or diet, what I feel like was very quick to put me on meds, and also meds that from what I've seen.... I shouldn't be taking(Gliclazide). I'm losing weight already. I'm not having trouble losing weight! that was my primary reason for going to the hospital to begin with and the doc has put me on meds for diabetics who either cant lose weight or the weight loss isn't affecting their diabetes.

I put most of this together today while I was with my father who decided to see a general surgeon regarding I lipoma on his back and I KID YOU NOT!!!! the doctor put in a request to the insurance for surgery within 45 sec of walking into his office. There was another major red flag I spotted while tagging along with my father to his appointments and him to mine. I can't give specifics because I'd rather avoid any legal issues.... So I'll say this... My father is in the emergency medical field, the hospital I'm using currently has just been approved to receive EMS cases. However, because they "the new kid on the block" the EMS workers don't generally know about this hospital being open to EMS cases. The head of the hospital landed up coming down to my cardiology appointment to have an informal meeting with my father regarding this. In my entire life, I have never ever ever had a stronger feeling of these people just want money walking through the door and it, excuse my language, scared the **** out of me. I cannot stop thinking after that meeting that management has told the doctors to try push pills and keep people coming back.

@MrsA2 @JoKalsbeek @ianf0ster (Hope those tags work)
I would deeply appreciate any input you, or any one else, have on this situation.

If you read the leaflet to metformin for instance, that too suggests a change in diet/lifestyle/weight first, and if it doesn't work after 3 months, to then try medication. Most doctors don't actually know that, (medication's more the area of the pharmacist, docs just know what to prescribe, they don't know the leaflets by heart) and if they do, they thoroughly believe their patients haven't the spine to stick with a diet or to change things around in any meaningful, permanent way. I have been told repeatedly I wouldn't be able to keep it up, 7 years ago. That shows them! So it's really pretty normal. Not good, per se, but par for the course, all over the world, just about. (As for a lipoma, if it inhibits movement and/or is painful, well... They don't go away on their own, so surgery's the only option. Or live with it, naturally.)

In someone with a normal metabolism, two months of holiday eating wouldn't push their HbA1c up so much it showed prediabetic or diabetic numbers. Keep testing, and if you feel something's off, go back to a doc with your suspicions. You lost weight fast without trying, which is always something to keep an eye on and take seriously, so always say that up front, before anything else. It could point to T1, after all. Keep measuring, and if you feel like you should maybe cut back on medication, you're always free to try and see what that gets you. I'm a rather stubborn person, so I tend to use myself as a guinea pig. You could just experiment a little, too. But only if you have a massive amount of test strips, or a CGM to back you up and keep you from going overboard.

My doc knows low carbing works. She's seen my numbers go down and stay down these past 7,5 years. To date though, I am the only one in the practice to have achieved normal numbers through diet. Considering the dieticians I was sent to at diagnosis, I'm not surprised. (Up the carbs, no fats. That advice got me into this mess in the first place!) They're basically all working with what they've got, and what they've got is usually massively outdated, for most practices. Exceptions exist, but they're few and far, you know? Go from the assumption that they want to help, they just don't always quite know how.

Good luck,
Jo

 

[HairySmurf]

However although Type 1 is associated with unexpected weight loss, Type 2 is associated with obesity.

To clarify this point, unexpected weight loss is a symptom of both Type 1 and Type 2 diabetes. The weight loss is caused by uncontrolled, very high blood glucose levels, which causes the body to dump excess glucose via the urine. You pee calories. While diagnosis of Type 2 is typically associated with obesity, diagnosis is often, but not always, preceded by a period of unexplained weight loss, which is why unexplained weight loss appears on every list of typical, uncontrolled Type 2 symptoms.

In my case I lost about a stone during the year leading up to my diagnosis. Not only was I not trying to lose weight, I was overeating in a massive way. A typical evening meal for me at the time might be a large pepperoni pizza with extra cheese followed by two bottles of wine - around 2400 calories. I would guess, but of course cannot be sure, that had I been eating a fairly normal diet I might have lost weight more rapidly during that period.

 

[EllieM]

it was before I started the meds, a1c was at 9.6, random glucose blood test(fasting) was 10.6 . I'm not 100% sure exactly how long the fast was, it was definitely around 8h. as for the carbs, it was my normal diet, I wasn't watching carbs. had rice and lamb the night before.

an a1c of 9.6% corresponds to an average bg of 12.7mmol/L or 230mg/dL and an hba1 of 81mmol/mol
Blood glucose in mg/dL is 18 times the mmol/L value
https://www.diabetes.co.uk/blood-sugar-converter.html

The diabetic hba1c cut off point is 48mmol/mol or 6.5%

I am a little concerned that you may have hypos on your current dose of gliclazide, as in your units 70mg/dL is at the cut off point for hypoglycemia. I urge you to keep something sweet on hand and always test before driving a car, as if your blood sugar goes lower than that you could become confused and (worst case scenario) pass out. Speaking as a long term T1 on the ultimate hypoglycemia inducing medication, insulin, I have been managing hypos for years and get symptoms of hunger/shakiness when my blood sugar is low, which is why I always have fastt acting sugar with me. Did your doctor mention the possibility of hypoglycemia to you?

 

[Jomider]

Hello all,

Today I received the news that I am in fact, diabetic. The doctor says its most likely type 2, but I have not been told for sure what type it is. I've read through some of the other posts and I think its safe to say I'm just as scared everyone else when they first get their diagnosis. This is how my journey is going.

I've been morbidly obese(136kg) for a good portion of my life, now 29yo. About 6 months ago I made the decision to stop drinking fruit juice and soda's, purely to try save some cash. I had hoped that I would lose some weight as a result of the change. Nothing changed, my weight didn't budge. That is, until 2 months ago when I started losing weight without doing anything different. A client I work with, who is a doctor, noticed my weight loss and congratulated me on taking steps to improve my health. I explained to him that I'm not doing anything different except the change to water 6 months ago. To which he replied, "get it checked, just in case."

I was concerned that it had something to do with thyroid, mother has thyroid issues also. So 3 days ago I had my labs done. it was at that point the doctor said it could be diabetes. Today, it was confirmed by an internal medicine doctor. My hemoglobin A1c is 9.6. This is just the start of my confusion.
The lab results give:
Normal: <5.7
Prediabetic: 5.7-6.4
Diabetic: >6.4
How does this relate to the results mentioned elsewhere on the forum?

Like many others, quite frankly, I'm terrified and I dont know where to go or what to do. I've seen other people mention low carb diets. That's all well and good, except I also have familial hypocholesteremia, hereditary high cholesterol. Throughout my life and dozens of doctors, I've only ever come across 1 doctor who had seen cholesterol higher than mine. mine is normally in the range of 700-750 for LDL. With having to remove or cut down on carbs, what's left? I feel defeated... and the sugar on top(guess I cant really make that joke anymore) I just literally just received the report from radiology that I have grade 2 fatty liver. Since I was a child I knew I wouldn't pass 40, I accepted that, sacrificed things because of it. I didn't get married, I'll never have children, I can't bare the thought of me passing and leaving someone behind. I've lived my life trying my best to love every minute, but to get this news at 29 and know that my body is yet again failing me is just... I don't have the words... I'm not ready for this, I cant afford more medications, I can't afford the tests, I can BARELY afford the food I eat now! I'll leave the current emotional state out of it...

I guess that's my journey so far, got more tests on Monday to see how effective the medication is. I guess I'll post an update then...

If there is a god, I just pray that I will look back on this moment and have it be the lowest point in my life.

Hi Luthien, sorry for the late reply, I have had a few issues logging on to the forum..

I completely understand why you would feel like this getting your diagnosis. The story we are told is this is downhill and you have spoken about wasting away with diabetes. The truth is very different. For most people (even those mildly overweight) Type II can go into remission or even be reversed. For those who are carrying more weight, the news is even better.

Why is this? Type II can be the result of EITHER a failure to produce enough insulin, which is why someone suggested you get your C peptide tested OR most likely a build up of insulin resistance. When the diet contains a lot of sugar in any form, Sodas, Fruit Juice, Carbs, pasta, pizzas, rice, even potatoes. The body stores the excess as fat. It is this fat that reduces insulin sensitivity, so the body is making plenty of insulin but the cells are not responding to store any more and so the sugar (glucose) remains in the bloodstream.

You say you haven't changed anything and the weight is coming off - CONGATULATIONS.. be happy about that. The change you made was to drop the sodas. Depending on how much you were drinking, that could have been A LOT of sugar. IN a hot climate we drink more, so you could have been having a litre of more of Coca Cola or whatever. One can alone has 40 grams in - so a litre would be 120 grams!!!

I wont go into my story, but I have had TII for nearly 20 years, am not even particularly heavy (83Kg and about your height). They had me on insulin fpr a year after I became very ill and I'd tried all of those meds you're having. I read this fantastic book and went to see the author and he told me about the low carb approach. I put it in place there and then and had dropped the insulin after 4 days. I lost about 6Kg over the next couple of months and my bolld sugar normalised. have now come up again to around my normal weight. I had a hospital appointment with another dcotor who said she wasnt sure why I was there as I don't have diabetes.

The big differences we have are that I had had it for way longer than you and am a lot older. You are 29 and with a single step can (I believe) go into remission at the very least.

Have a read of Dr. David Cavan's wonderful book. He is at the London Diabetes Centre. HIs book is on Amazon - I can't post a link yet

I recommend you speak to your doctor before adopting a radical low carb diet. Especially the gliclazide will drop your blood sugar too far and you risk going hypoglycaemic. So do be careful about that, please.

The truth is that with enough willpower most of us can defeat diabetes TII. I'm not saying it is easy, or that I have much willpower at all. In my case I fast for most of the day, (funnily enough it is eating carbs that make us hungry, so IM not even hungry) So I eat at say 8pm and then do not eat again until perhaps 2pm the next day and combine this with very low carbs. Intially, I went super low, but that is very hard to sustain, so once I got control on zero meds, I allow myself the odd bit of bread with my meat, cheese etc. as you have high cholesterol, you need to keep an eye for sure, but I think you will see your metabolism stabilise if you cut the carbs. Work out which ones are worst for you with your meter - in my case it's rice - I have not eaten a grain for 16 months now.. Steak is my friend.

In your case, you have weight to lose, so I wouldn't be afraid to let it come off and you probably wont need to be super radical or keto. Look what dropping the soda did. This is not about calories, it is about carbs, so you can pretty much eat as much as you want of anything not a carb, provided you keep an eye on the cholesterol and triglycerides if your'e having a lot of fat.

Above all don't despair. Many of us have been on this journey and come out the other side. Dr Cavan himself says you can choose the path that's right for you, but just reducing carbs as low as you can will have a great result. Keep your doctor informed, don't be too radical, but keep doing what you're doing and most of all celebrate the success you're already having.

All the best Jonathan

(mod edit to delete naming of HCP for consultation purposes.)

 

[Ro9998]

Low carb program is worth it and Roy Taylor Newcastle university. My thoughts diet chnage lifestyle change lose weightbut do slowly one at a time little by little read wokr gradual good luck. I was like you terrified still am but you c

 

[Luthien]

Been a while since i've put an update. I've been keeping up on the low carb diet and is going great and i find myself craving salads now. i also think i found the best diabetic finger food ever.... chicken necks! zero sugar, take a long to eat and are tasty

my weight loss seems to have stopped completely. and is hovering around 116kg-117.5kg, 20kg lost in total and does not appear to be coming back with the low carb diet.

Only more questions seem to be popping up almost daily... The main question/confusion I have is something I and my family plain and simply do not understand and have worn out google trying to find an answer to it.... so.... a couple weeks ago, Dune part 2 came and I was excited and wanted to have a small cheat day while watching the movie.... so i bought an extra large popcorn with 2 small bowls of cheese(nacho cheese, just the cheese, no nachos). When I got home I immediately took my blood sugar expecting to see it around 135-140 like I had seen back in January when I was diagnosed. Instead of seeing 135-140, I was greeted with 84 (2 above my fasting avg), very confusing... the next day the family ordered some chinese as they do and being the curious cat I am, I ate a meal with them to see what was up.... I tried this same meal in January while I was on meds and it came to 92(2h after food), after I stopped the meds and gave it a week, that meal spiked me to 230(2h after food) which led me to cut that out my diet.... spring rolls, noodles, and sweet and sour chicken(who could've known that that would spike sugar xD ) anyway.... when the family ordered more after the popcorn incident, I decided to try it again and see what the results would be. 121(2h after food), diabetes doesn't just go away over night. that meal should've put me over 200+ and it was only SLIGHTLY above normal. I've also tested it with some other foods that should've spiked my sugar and it just isn't spiking my sugar anymore... its reached the point where I've had a camera on 24/7 in my room to see if someone is doing something while I'm sleeping or hiding something in my food, i know I sound paranoid but I'm at a complete loss. I know type 2 diabetes can go into remission and you can gain back SOME glucose tolerance, but that is supposed to happen over YEARS. not 2 months... my only current theory is that with the extreme diet change I've done, its given my body SOMETHING that it needed that I wasn't getting before and that's allowed me process glucose and made my metabolism normal. Its only my non-doctor theory though. I'm only going back to the doctor at the end of April for my 2nd a1c test and will insist on a glucose tolerance test at the same time. I'm not too keen on going back to the doctors for this just yet. I went to the hospital 2 weeks ago for lower abdominal pain... this led to an emergency contrast ct scan, an ecg, an x-ray, bloodwork, urine samples, and 3 ultra sounds, and a colonoscopy(I noped out of that) and was also referred to 5 specialists... diagnoses: constipation... so yeah, I'm not too keen on going back anytime soon.

If anyone has any ideas, or has come across anything similar. Please both myself and my family would love any ideas as to what might be causing this.

 

[HairySmurf]

my weight loss seems to have stopped completely. and is hovering around 116kg-117.5kg, 20kg lost in total and does not appear to be coming back with the low carb diet.
...
I know type 2 diabetes can go into remission and you can gain back SOME glucose tolerance, but that is supposed to happen over YEARS. not 2 months...

Welcome back, and congratulations!

In the world of Roy Taylor a 20Kg weight loss is enough to get fat out of your liver, increase insulin sensitivity in that organ and lower your blood triglyceride levels. That process seems to begin quite quickly when losing weight. Lower triglyceride levels leads to lower levels of fat in the pancreas, which can for many people partially restore insulin secretion, if insulin output was degraded in the first place. That takes a long time, but according to the slides from Taylor's DIRECT trial (link below) first-phase insulin response can recover substantially within four months or so. Taylor asserts that how well and how fully a Type 2's pancreas recovers after getting the fat out is down to genetics - some people, he says, have more resilient pancreatic beta cells than others.

You mention in an earlier post that you began to lose weight quite some time before diagnosis so, at a guess, and this is just amateur speculation, you may indeed have gotten some function back in your pancreas following your weight loss, given that it began some time before you were diagnosed and given that 20Kg is so much.

If all that is the case then you are still diabetic of course - as you rightly state diabetes doesn't go away. I would suggest that you continue to be cautious around high-carb foods. If Taylor is correct in all his assertions (and I'm not sure he is) - if you keep your weight steady or trending downwards then that should keep fat from re-accumulating in your liver and that in turn should keep it out of your pancreas. Nobody knows if that's enough to prevent diabetes from progressing - Taylor claims it is but there's no hard evidence either way. In Taylor World it's entirely possible though that your current response to food is your 'new normal'. It's even possible that it it will improve a little further over the next year or so, so long as you keep your weight down.

Do you have access to a free trial of the Freestyle Libre 2 or a similar CGM device where you live? If so, a couple of weeks with a CGM on your arm should give you a wealth of information about response to food at this point in time. You might be pleasantly surprised, but whether good news or bad, a CGM or lots and lots of finger prick tests will tell you what's going on. Best of luck!

https://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/Insulin%20secretion%20recovery%20during%20remission.pdf

 

[Luthien]

Welcome back, and congratulations!

In the world of Roy Taylor a 20Kg weight loss is enough to get fat out of your liver, increase insulin sensitivity in that organ and lower your blood triglyceride levels. That process seems to begin quite quickly when losing weight. Lower triglyceride levels leads to lower levels of fat in the pancreas, which can for many people partially restore insulin secretion, if insulin output was degraded in the first place. That takes a long time, but according to the slides from Taylor's DIRECT trial (link below) first-phase insulin response can recover substantially within four months or so. Taylor asserts that how well and how fully a Type 2's pancreas recovers after getting the fat out is down to genetics - some people, he says, have more resilient pancreatic beta cells than others.

You mention in an earlier post that you began to lose weight quite some time before diagnosis so, at a guess, and this is just amateur speculation, you may indeed have gotten some function back in your pancreas following your weight loss, given that it began some time before you were diagnosed and given that 20Kg is so much.

If all that is the case then you are still diabetic of course - as you rightly state diabetes doesn't go away. I would suggest that you continue to be cautious around high-carb foods. If Taylor is correct in all his assertions (and I'm not sure he is) - if you keep your weight steady or trending downwards then that should keep fat from re-accumulating in your liver and that in turn should keep it out of your pancreas. Nobody knows if that's enough to prevent diabetes from progressing - Taylor claims it is but there's no hard evidence either way. In Taylor World it's entirely possible though that your current response to food is your 'new normal'. It's even possible that it it will improve a little further over the next year or so, so long as you keep your weight down.

Do you have access to a free trial of the Freestyle Libre 2 or a similar CGM device where you live? If so, a couple of weeks with a CGM on your arm should give you a wealth of information about response to food at this point in time. You might be pleasantly surprised, but whether good news or bad, a CGM or lots and lots of finger prick tests will tell you what's going on. Best of luck!

https://www.ncl.ac.uk/media/wwwnclacuk/newcastlemagneticresonancecentre/files/Insulin%20secretion%20recovery%20during%20remission.pdf

during one of the three ultrasounds I did a few weeks back, the report did say I had grade 1 fatty liver, this is of coarse good news considering it was grade 2 fatty liver in January. maybe Taylor is on to something... I'll have to check out his stuff. during my (post popcorn) testing phase I even pulled into tart. something that I normally wouldn't dare even look at, came out to 118 after 2h. bare in mind that this tart should've killed me.... sweetened condensed milk, sugar, cream, icing sugar and a biscuit base. tart was maybe 25-30cm diameter and I ate half of it! I know 20kg is a lot to lose and I hope to lose 30kg more, but could losing just 20kg really have an effect THAT drastic in 2 months?

I still do a few pricks every now and then or if I eat something new or may not be sure about. When I was diagnosed I was doing 6-8 pricks a day and that along with a food journal gave me a very good idea of meals I can eat and which ones I can't.

 

[HairySmurf]

during one of the three ultrasounds I did a few weeks back, the report did say I had grade 1 fatty liver, this is of coarse good news considering it was grade 2 fatty liver in January. maybe Taylor is on to something... I'll have to check out his stuff. during my (post popcorn) testing phase I even pulled into tart. something that I normally wouldn't dare even look at, came out to 118 after 2h. bare in mind that this tart should've killed me.... sweetened condensed milk, sugar, cream, icing sugar and a biscuit base. tart was maybe 25-30cm diameter and I ate half of it! I know 20kg is a lot to lose and I hope to lose 30kg more, but could losing just 20kg really have an effect THAT drastic in 2 months?

I still do a few pricks every now and then or if I eat something new or may not be sure about. When I was diagnosed I was doing 6-8 pricks a day and that along with a food journal gave me a very good idea of meals I can eat and which ones I can't.

Based on what I've learned so far 20Kg could well be enough to make such a big difference, though the 2 months part I'm unsure about. I'm in a somewhat similar situation at the moment - I've lost 21Kg since diagnosis (at the end of October) and I've seen big changes in my BG levels, though it's very hard to tell just how big as I wasn't testing around meals in the beginning and so I have nothing to compare my current post-meal numbers with. My HbA1c was 89 mmol/mol (10.3%) at time of diagnosis and it was 39 mmol/mol (5.7%) in January. I had lost 12Kg by the day I had my blood taken in January. I had not gone low-carb in any meaningful way at that time - I had reduced carbs to lose weight but I was still eating starchy foods with every meal. I was and still am on medication though (Metformin and Dapagliflozin) so I can't tell how much of the HbA1c improvement was due to weight loss and how much was due to the meds.

If you still have that food journal, perhaps you could eat some of the same things again, do some fresh testing, and compare the numbers? It's not exactly scientific but it might help give you an idea if there is real improvement, and how big or small that improvement might be.

Here's a long interview with Prof. Roy Taylor by the way - all his theories on Type 2, some well-proven and some not so well-proven in my opinion, are described in detail: