Dietary Advice for an impaired metabolism

ticker7

Member
Messages
15
Hi,
I am a type two diabetic, with a spinal problem, that stops me from walking more than 50m or standing very long - 30 secs to 1 minute. The spinal problem is operable but need to lose weight before the orthopaedic surgeon will feel the surgical risks are minimised.

After a series of appointments with my 8th dietician, in 2 NHS trusts, I have been following a Low Carb diet (after 10 years of asking) since early May 2014.

I have become quite cynical about NHS dietary advice after discovering that the advice for eating starchy carbohydrates promoted weight gain, and then found the dietician had given me the wrong insulin advice for five years after she acknowledged the wrong carb count insulin advice was in her handwriting. I found I was taking 90 units of NovoRapid per day for 5 years!

The first question I asked the latest dietician was "Do you give dietary advice for diabetics who have impaired metabolism, and is this different to dietary advice you give people whose metabolism is not impaired by diabetes". She was unable to answer this question even though I asked it verbally twice, and then in writing.

After asking in writing the third time, her written reply rather took me by surprise, it said:

"Diet advice for diabetes and for healthy individuals (as it is the same principles) is not based on someone with impaired metabolism. I am not sure I can fully answer your question ‘why haven’t you lost weight on 1500kcal’

For the past 15 years I have followed advice from the dietician, and have averaged 1500 calories per day. When presenting detailed food records and asking what should I change the answers have always been "Not much".

On this new low carb diet I am averaging 900 calories or less (with carbs target of 50g of carbohydrate per day). My recent extremely close adherence and detailed recording of my low carb diet, medication etc has confirm that my low carb diet works on a couple of important levels.

I feel fantastic again.

Blood sugars are very good insulin requirements now in the 0-3 range.

But I have gained 5 kg
. the dietician and her colleagues are as mystified as I am


Question 1 as a type 2 diabetic with impaired metabolism is the dietician so last written response correct or is it questionable advice?

Question 2 do low carb diets actually work on type 2 diabetics?

Question 3 are there any other tests of the endocrine system worth having, e.g. thyroid?
 

jack412

Expert
Messages
5,618
Type of diabetes
Type 2
Treatment type
Tablets (oral)
stay on the low carb, it's working. weight is secondary and may adjust as you settle into low carb, 3-4 months down the road re-evaluate the amount of protein/fat you are having. eat till you are satiated not full as a goog
this is worth a read and the video
http://www.dietdoctor.com/lchf
 

Totto

Well-Known Member
Messages
2,831
Type of diabetes
Type 2
Treatment type
Diet only
The LCHF advice given on the site Jack linked to is fab. Read through the success stories. Low carb is a really good idea, but you have to fill up with fat to get full and not snack. Eat until satisfied and I am sure you will lose the weight. The challenge after years of low calorie dieting usually is to eat enough fat but you will get there.

If your thyroid is up to scratch, that is. Have you had any thyroid tests recently? Get the actual results. In thyroid matters "normal" covers a lot of sins. And a slow thyroid makes you put on weight no matter how little you eat.
 

Dee_226

Well-Known Member
Messages
53
Type of diabetes
Type 2
Treatment type
Diet only
Definately ask for a thyroid function test. I have hypothyroidism and newly diagnosed Type 2 diabetic but through eating low carb high fat I have lost weight (losing 1/2 stone per month).

On the other hand, my daughter has uncontrolled hypothyroidism, currently taking 1,000 mcg levothryoxin (that is not a typo) and 60 mcg of T3 per day, been on nhs diet for 6 months (seeing dietician and other specialists fortnightly at "fat club") and puts on weight every week. Unless you get your metabolism sorted you will probably not be able to lose weight no matter what you do.

My suggestion would be to get your doctor to refer you to an Endocrinologist who should be in a position to get you all the right tests to find out exactly what your problem is.

Good Luck,

Hugs,
 

ticker7

Member
Messages
15
stay on the low carb, it's working. weight is secondary and may adjust as you settle into low carb, 3-4 months down the road re-evaluate the amount of protein/fat you are having. eat till you are satiated not full as a goog
this is worth a read and the video
http://www.dietdoctor.com/lchf

Thanks that's a good site and I am following all the advice given there already. Your point about sticking with it for 3-4 months is spot on.
 

ticker7

Member
Messages
15
The LCHF advice given on the site Jack linked to is fab. Read through the success stories. Low carb is a really good idea, but you have to fill up with fat to get full and not snack. Eat until satisfied and I am sure you will lose the weight. The challenge after years of low calorie dieting usually is to eat enough fat but you will get there.

If your thyroid is up to scratch, that is. Have you had any thyroid tests recently? Get the actual results. In thyroid matters "normal" covers a lot of sins. And a slow thyroid makes you put on weight no matter how little you eat.

It is a good site and I am following it very closely. Am seeing an endocrinologist, and when I suggested other tests he ignored my request, so I have asked my GP for a thyroid test- it was normal when I had it done in January 2013. Your point about actual results is a good one thanks a lot.
 

dawnmc

Well-Known Member
Messages
2,431
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
My quack, said there was no money for an endo - sucks. I've been eating lchf for 2 years with no weight loss. My thyroid is 'normal'. I just wish it worked for everyone, but it doesn't.
 

Totto

Well-Known Member
Messages
2,831
Type of diabetes
Type 2
Treatment type
Diet only
I was told, by several GPs and other Drs including two endocrinologists that my thyroid was perfectly healthy. Problem was I wasn't, So I started to self medicate with NDT and got my life back. I am also back to my normal weight, a 25 kg weight loss.
 
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Pipp

Moderator
Staff Member
Messages
10,635
Type of diabetes
Type 2
Treatment type
Tablets (oral)
My quack, said there was no money for an endo - sucks. I've been eating lchf for 2 years with no weight loss. My thyroid is 'normal'. I just wish it worked for everyone, but it doesn't.
I am struggling with LCHF too. Its the weight gain causing my problems. Not sure what to do, though admittedly I have only been trying LCHF for just over a week. I don't feel well, with headache so severe, that I don't want to move, and sort of water retention I only usually get if I have too much carb. Weight gain of 3kg in a week.
 

dawnmc

Well-Known Member
Messages
2,431
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
Have you tried drinking more water? Its well known that you can get the 'flu' from reducing carbs. Flush your system with water. I haven't gained any weight but I haven't lost any either. A week is early days, hang in there you may be luckier than me.
 
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Pipp

Moderator
Staff Member
Messages
10,635
Type of diabetes
Type 2
Treatment type
Tablets (oral)
Have you tried drinking more water? Its well known that you can get the 'flu' from reducing carbs. Flush your system with water. I haven't gained any weight but I haven't lost any either. A week is early days, hang in there you may be luckier than me.
Thanks, yes, I am drinking plenty of water. I am hoping the weight gain is due to water retention.
 
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jack412

Expert
Messages
5,618
Type of diabetes
Type 2
Treatment type
Tablets (oral)
everyone is different, I dropped a heap of weight the first couple of weeks then was stable for months before losing again
 

ticker7

Member
Messages
15
I was told, by several GPs and other Drs including two endocrinologists that my thyroid was perfectly healthy. Problem was I wasn't, So I started to self medicate with NDT and got my life back. I am also back to my normal weight, a 25 kg weight loss.
My sense of disbelief in what Doctors tell you has made me more and more cynical and far less trusting of what doctors tell you and more importantly do not tell you. In 1997 I went to my GP with a back problem, 27 consultants later it was diagnosed as spinal stenosis. Diabetes took 9 years to diagnose! Just 2 years ago 3 GPs and a surgeon all told my daughter that she had a hernia and definitively was not pregnant. At a pre-op ultrasound invited by the surgeon, she found she was 38 weeks pregnant with a 9lb 12 oz little boy. The surgeon told her at 7.5months that the movement she could feel was just wind.

So I applaud you in taking control and getting your life back and getting back to normal weight. For the last 10 years I have followed the dieticians advice and typically 700 calories less than the RDA. But requests to endocrinologists for other test of the metabolism are ignored. As Winston Churchill would say " keep buggering on!"
 

dawnmc

Well-Known Member
Messages
2,431
Type of diabetes
Type 2
Treatment type
Non-insulin injectable medication (incretin mimetics)
I was told, by several GPs and other Drs including two endocrinologists that my thyroid was perfectly healthy. Problem was I wasn't, So I started to self medicate with NDT and got my life back. I am also back to my normal weight, a 25 kg weight loss.
Whats NDT?