Discouraged

[Glink]

It's been over a year now, and I've dramatically changed my diet, continued exercising daily, and started medication, and I still cannot bring my numbers into the "normal" range, especially the fasting ones. It's just discouraging. I am thin and fit, and eat low carb now, but my blood sugars swing too much, and it really feels like it's just out of my control. Does anyone else grapple with this? How do you manage to feel better about not making progress on the metre. My check-in blood tests are next week and I'm worried the #s will be worse than last time. And then I just feel like giving up and eating regular food again, even though I know that will make me feel worse. Who's in this boat with me? Want to give me a pep talk?

 

[bulkbiker]

Well might be useful if you gave us some numbers.. also how "low carb" are you eating?

 

[britishpub]

It's been over a year now, I am thin and fit, and eat low carb now, but my blood sugars swing too much, and it really feels like it's just out of my control.

You may want to go back to your GP and possibly seek an alternative diagnosis.

 

[Glink]

My GP sent me to an endo last year who ran a bunch of tests for non-diabetes possible underlying causes, got bored of me when nothing turned up, and sent me back (with no guidance/plan, just cancelled a follow-up appt and had the receptionist tell my GP he didn't want to see me again now) to my GP to manage until/unless things got markedly worse.

FBG usually around 6.1. Not awful, I know, but stubbornly prediabetic. When I first went low carb I could get high 4 or 5's. Nowadays it's never like that, and that's really discouraging.

My last HbA1c (in spring) was the first one I've ever had that was normal! (ETA - After starting, then upping metformin--I definitely did not get there with diet alone.) Which was exciting, after a year's strict diet, but I'm not very optimistic that this one will be again. Summer heat was rough on my sugars, and maybe they're just gradually getting worse for no reason at all. Blah.

I was holding at <50g carbs/day for about a year (all from veggies/nuts; absolutely no grains and very few bites of any starchy veg), but have really been slacking since getting discouraged this summer with my stubborn/rising #s, and going up to at least 75g/day...maybe even close to 100g some days. I've had a small (11g carb) slice of wholemeal toast a few nights lately, I admit--I sleep so well afterward! And since my fasting #s are not great anyway, it seems like why deprive myself? But I recognize that that is a self-defeating attitude and a potential slippery slope, and am just looking for some sort of encouragement, ideas, or reboot here.

I was "normal" weight when all this started (but at my personal heaviest), have lost 20% of that body weight and am still "normal" weight, and I exercise regularly (bike commute, garden/maintenance, and lifted weights until frozen shoulder stopped this--but hope to resume that again soon now that I'm unfreezing) so weight/exercise are not my personal challenge.

 

[bulkbiker]

Reading around here everyone seems to have different levels of carbs that work for them. I would suggest trying ultra low carb for a couple of weeks (less than 20g per day) to see if there is any benefit. If your bloods don't go down on that then I think another trip to the doc for a reassessment of the type of diabetes you have may be in order which I think is what @britishpub was implying.
I get my best numbers when fasting but I realise that's not for everyone. Have you tried eating in a more limited window to give your body some recovery time from the food processing maybe 16-8 fasting where you eat in an 8 hour window.

 

[Glink]

How on earth do you eat <20 g of carb? Just meat & eggs? Even lettuce is 1g/cup and it takes many cups of lettuce to make a lunch salad (for me at least)! Broccoli = 6g/cup. Almonds 6g per 1/3 cup (my usual snack). Celery at 1-2g/stalk (another usual snack of mine). It really adds up! Or are you subtracting fibre from total g carb (I have not been, just been looking up total carb g in my food)?

 

[Glink]

I usually have 2 sausages for breakfast (1g carb), plus coffee w almond milk (6g) before biking to work.
Mid-morning snack of nuts (6g)
Lunch salad w lettuce, cuke, bit of red cabbage avocado & smoked fish (25ish?)
Afternoon snack before biking home, maybe celery & almond butter (~10).
Dinner, usually sauteed veggies (courgette, broccoli, bit of onion & garlic) maybe some pesto or sundried tomato for flavour, and some sort of meat (~20g more)

When I "cheat" I end the day with a slice of toast or a bit of dark chocolate (either one is ~11g).

That's about...68g total without my bedtime cheat snack. 20g would be only a salad and maybe eggs?

 

[Glink]

Another "cheat" is this super low carb granola I made with coconut instead of oats, and various seeds & nuts and lots of spice. It's also about 11g/serving (about 1/2 a cup). So yummy (if incredibly high fibre).

Ugh. It all just seems so impossible and, well, eating-disordery. I just want to give up and eat a freaking sandwich since all this work and deprivation doesn't seem to fix things anyway. It's taking all my willpower not to have bread or crisps or something today. Maybe I'll splurge and have a few ripe raspberries out of my garden (usually no fruit at all for me).

I don't think going back to my GP would do anything. He seems just to throw up his hands and shrug and say I'm really unusual. He might prescribe me another drug like glicazide that would then have me needing to lookout for lows too (my one blessing is that I never have lows no matter how long I fast or how much I exercise!). I get the feeling he's just waiting for it to get worse enough that it's officially diabetes and he can send me back to the endo, and that's also discouraging.

 

[dawnmc]

If you google 'fat fast' that should give you some idea how to eat ultra low, its only meant to be undertaken for a few days. Failing that maybe 'they' should consider LADA.

 

[bulkbiker]

How on earth do you eat <20 g of carb? Just meat & eggs? Even lettuce is 1g/cup and it takes many cups of lettuce to make a lunch salad (for me at least)! Broccoli = 6g/cup. Almonds 6g per 1/3 cup (my usual snack). Celery at 1-2g/stalk (another usual snack of mine). It really adds up! Or are you subtracting fibre from total g carb (I have not been, just been looking up total carb g in my food)?

Well I would cut out the almond milk if it has so many carbs and have cream instead. And yes why not try just meat and eggs with a bit of green veg for a couple of weeks. Also cut out the snacks and give your body a rest from what you are consuming.
Try getting into ketosis and see if that helps. That's what has worked for me. No breakfast and try to have at most 2 eating periods per day. As I say it has helped me bring my bloods under control.

 

[Neohdiver]

I was holding at <50g carbs/day for about a year (all from veggies/nuts; absolutely no grains and very few bites of any starchy veg), but have really been slacking since getting discouraged this summer with my stubborn/rising #s, and going up to at least 75g/day...maybe even close to 100g some days. I've had a small (11g carb) slice of wholemeal toast a few nights lately, I admit--I sleep so well afterward! And since my fasting #s are not great anyway, it seems like why deprive myself? But I recognize that that is a self-defeating attitude and a potential slippery slope, and am just looking for some sort of encouragement, ideas, or reboot here.

My blood glucose doesn't care what my total daily carb consumption is - all that matters is what I've consumed in the last 2 hours. (And, more specifically, all it cares about is the net carb consumption - at least as to fiber. My salads are typically ~40 gross carbs, 20 net.)

Have you tried tracking your BG response to specific foods - not to the daily overall consumption? I find that I can consume about 20 net carbs in a 2 hour period. That means, depending on how frequently I eat, my daily carb consumption varies between 20 net carbs and slightly over 100 net carbs (with gross carbs up to 150).

I started out on Oct 2 measuring after nearly everything I ate to see what I could eat, and how much. I tested before, at 1 hour after the first bite, 2 hours after the first bite, and (if 2 hours was higher than 1) at 3 hours. If I ever went over 7.8, I eliminated the food - or cut the portion way back. That pretty quickly let me find out a general absolute tolerance - and tolerances related to specific foods (since some low carb foods triggered disproportionately high spikes).

With very few exceptions (a dozen or so) my BG has been within normal ranges (i.e. below 7.8) at all times since October 2. The fasting BG is more challenging - if my calorie count is high over a period of time and I'm not getting adequate sleep, fasting runs close to 5.5. If my calorie count is low, and I'm getting between 6 & 8 hours of sleep a night it is generally between 3.9 and 5.0. It took going on a variation of the Newcastle diet to discover the difference between 1200 calories & 800 (Newcastle diet - in an attempt to achieve diabetic remission). I'm hoping to be able to gradually return to around 1800 calories (maintenance, I hope) and keep the low fasting numbers. Three more weeks to go, then I start easing back up!

 

[Neohdiver]

No breakfast and try to have at most 2 eating periods per day. As I say it has helped me bring my bloods under control.

One of the things I did simultaneously with the Newcastle variation was to fast close to 16 hours a day, in an attempt to get rid of the glycogen stores in my liver. So it may be either the fasting rather than the very low calorie diet that kicked the fasting BG levels to the curb.

 

[bulkbiker]

One of the things I did simultaneously with the Newcastle variation was to fast close to 16 hours a day, in an attempt to get rid of the glycogen stores in my liver. So it may be either the fasting rather than the very low calorie diet that kicked the fasting BG levels to the curb.

Could be although I have never done a low calorie diet per se ... in fact I eat quite big meals when I do eat..just don't do it so often.

 

[AndBreathe]

It's been over a year now, and I've dramatically changed my diet, continued exercising daily, and started medication, and I still cannot bring my numbers into the "normal" range, especially the fasting ones. It's just discouraging. I am thin and fit, and eat low carb now, but my blood sugars swing too much, and it really feels like it's just out of my control. Does anyone else grapple with this? How do you manage to feel better about not making progress on the metre. My check-in blood tests are next week and I'm worried the #s will be worse than last time. And then I just feel like giving up and eating regular food again, even though I know that will make me feel worse. Who's in this boat with me? Want to give me a pep talk?

Can you help folks perhaps by sharing where your numbers aren't in the "normal range" you quote?

Whilst many folks are fortunate enough to be able, by whatever method, to reduce their bloods to pretty impressive levels, not everyone can. I also feel it could be very easy, in this environment where there is a good deal of success to lose sight of the actual normal ranges, in the pursuit of really low levels, which are well down the acceptable range, in terms of general population.

I know sometimes it's hard not to strive for really very good all of the time, instead of really good enough of the time (as defined by each individual).

 

[Glink]

6.1 FBG. Even if I'm hardly eating anything. Even if I have toast the night before.
My HbA1c has been good: 5.6 down to to most recently only 5.3 post-metformin.

I've checked and eliminated a lot of foods by using my metre. I am clearly making insulin still because when I eat something my post-meal response isn't too bad (the first time--if I repeatedly eat something more carby than usual within a span of a few days the subsequent times don't go as well as the first). My fasting just won't get in line anymore. We'll see what my A1c is in a week or two.

I just feel like giving up. How can the answer be cutting back until I am eating nothing? How is that okay? Am I supposed to just keep losing weight until I'm sickly? I get dizzy when I exercise if I haven't eaten all day. I don't know. Maybe I don't even have prediabetes; but that's what I'm diagnosed with and I'm not getting anything else out of my clinicians at this point. And I get diabetic symptoms when I'm highish, which stinks, and is likely contributing to why I feel so down about this whole thing.

You're right, AndBreathe, it's discouraging reading all these success stories that I can't replicate. I've been really hardcore about counting/reducing/eliminating carbs and making sure to keep exercising and getting rest for over a year and it's not "reversed." I haven't had a potato in over a year and it's not "better." It's maybe slightly worse than it used to be. Perhaps I need to take a break from the forum and from trying to control things so much.

 

[Neohdiver]

Could be although I have never done a low calorie diet per se ... in fact I eat quite big meals when I do eat..just don't do it so often.

Because I did both at the same time, and stopped both at the same time on doctor's orders as part of treating cancer, I don't know which caused the elevation of non-food related readings. The post-prandial readings (those after eating) have not gone back up - but during the 3 month period when I was eating at maintenance and not fasting, the morning fasting reading was higher (generally still below 5.0, but a few over), and the background level (after returning to normal/baseline and before eating the next meal) were higher

(The levels were consistent with my morning and between meals readings before I simultaneously started the blood sugar diet & intermittent fasting.)

 

[Neohdiver]

6.1 FBG. Even if I'm hardly eating anything. Even if I have toast the night before.
My HbA1c has been good: 5.6 down to to most recently only 5.3 post-metformin.

Repeated readings of 6.1 fasting BG would be prediabetes in the US.

I've checked and eliminated a lot of foods by using my metre. I am clearly making insulin still because when I eat something my post-meal response isn't too bad (the first time--if I repeatedly eat something more carby than usual within a span of a few days the subsequent times don't go as well as the first). My fasting just won't get in line anymore. We'll see what my A1c is in a week or two.

What is the process you're using for eliminating foods? The recommendation I was given was to make sure I was below 10 by 2 hours. The measure I use is never go above 7.8 - a very different standard. If I used the doctor's recommendation for elimination, I'd be in the same boat you're in. So the standards you use for eliminating/cutting down food make a difference in whether it is possible to succeed.

I just feel like giving up. How can the answer be cutting back until I am eating nothing? How is that okay? . . . I haven't had a potato in over a year and it's not "better." It's maybe slightly worse than it used to be. Perhaps I need to take a break from the forum and from trying to control things so much.

I wouldn't recommend just cutting back until you're eating nothing long term. You're right - that's not a solution. But a brief (8 week) period on 800 calories a day has been demonstrated in a small but very thorough, well-documented, study to have put diabetes in remission for 100% of a group of individuals diagnosed less than one year prior to starting the study. That was enough to convince me it was worth giving it a try. (I got to 6 weeks before I was diagnosed with cancer & had to go to maintenance calories until treatment was complete - but during that period I moved from diabetes to prediabetes based on an OGTT, and my carb tolerance increased 25% - and held during the 3+ months of higher calories. I've just now started back up again on a Newcastle-inspired diet, likely for 4-5 weeks, to see if I can move it the rest of the way.)

But - if reading success stories is a sources of stress, I would take a step back. Stress really impacts my BG. That impact was the biggest driver for firing my initial cancer team - dealing with the administrative side of their operation made me furious at least 2-3 times a week, and my BG spiked every time.

 

[Pinkorchid]

I usually have 2 sausages for breakfast (1g carb), plus coffee w almond milk (6g) before biking to work.
Mid-morning snack of nuts (6g)
Lunch salad w lettuce, cuke, bit of red cabbage avocado & smoked fish (25ish?)
Afternoon snack before biking home, maybe celery & almond butter (~10).
Dinner, usually sauteed veggies (courgette, broccoli, bit of onion & garlic) maybe some pesto or sundried tomato for flavour, and some sort of meat (~20g more)

When I "cheat" I end the day with a slice of toast or a bit of dark chocolate (either one is ~11g).

That's about...68g total without my bedtime cheat snack. 20g would be only a salad and maybe eggs?

Your diet is really good so I don't why you want to go lower why eat less carbs than you need to

 

[AndBreathe]

Because I did both at the same time, and stopped both at the same time on doctor's orders as part of treating cancer, I don't know which caused the elevation of non-food related readings. The post-prandial readings (those after eating) have not gone back up - but during the 3 month period when I was eating at maintenance and not fasting, the morning fasting reading was higher (generally still below 5.0, but a few over), and the background level (after returning to normal/baseline and before eating the next meal) were higher

(The levels were consistent with my morning and between meals readings before I simultaneously started the blood sugar diet & intermittent fasting.)

If your fasting level is your greatest concern, have you read much about dawn phenomenon/liver dump? Another thing worth considering is if you personally are putting quite a bit of emphasis on the fasting score, you could be experiencing a cortisol surge as you prepare to test? Cortisol, in a sort of fight or flight basis, will raise levels. I can sort of feel when I have a cortisol rush, but not everyone can.

If you are unable to mentally settle to the levels you have, if you can afford to fund it, it could be worthwhile investing in a couple of Libre sensors to track you for 24/7 for a couple of 2-week periods. These days, it is possible to use certain android phones (with NFC) to read the sensor data, rather than pay for a Libre Reader/Meter.

Whilst I've had great results, from almost immediately after diagnosis (I reckon I got lucky somewhere), I learned a massive amount from the Libre; most folks do, because no matter how many finger prick tests you do a day, you don't pick everything up. I don't use it full-time. I simply couldn't justify the costs, however sticking one on from time to time, helps reassure me I'm not meandering off-track and that my physiological functions are pretty stable.

 

[Brunneria]

a brief (8 week) period on 800 calories a day has been demonstrated in a small but very thorough, well-documented, study to have put diabetes in remission for 100% of a group of individuals diagnosed less than one year prior to starting the study.

Could you reference that study?

I would be very interested to read it.
I'm assuming that it isn't the Newcastle Diet study, since Professor Taylor's first study selected patients with T2 for 4 years or less, and his second study is using people with longer diagnoses. Both are showing 'reversal' rates based on HbA1c, not glucose tolerance tests, and a lot less than 100% 'remission'.