Does it get harder to control BG levels as time goes on?

There are some very large studies which examined the slow rise of A1c relative to age




Then you toss into the equation you've already passed the diagnostic cutoff for diabetes so there's been some depletion of your functioning beta cells. The old adage was that most diabetics had lost 50% of their beta cells at diagnosis.



Prof Roy Taylor was able to show that in the subset of diabetics, whose insulin resistance was purely down to visceral fat, that if they acted fast enough to remove enough of this fat then normal beta cell function could return to normal within 12 months.
Bare in mind though that he hand picked those with an obese BMI & a short duration of diabetes for this study.
There was also a high relapse rate as the weight was regained by many.

So what stops diabetes in it's tracks, what prevents progression ?
(1) Remission protects your remaining beta cells.
(2) Low carb reduces the requirement for insulin production.
(3) Intermittent fasting reduces the instances of insulin production.
(4) Weight loss increases insulin sensitivity.
(5) Exercise aids weight loss, reduces postprandial BG & increases insulin sensitivity.
(6) Self testing/CGMs to make informed decision re diet.
(7) GP/SN/Endo . . . your diabetes team.
(8) Pharmaceuticals.
(9) Insulin.

These are the main tools in your box along your journey, you may use all, you may only need some . . . you've made a great start, congrats.

Ooops . . . . I forgot the most important tool of all

(10) Join a l knowledgeable diabetic forum.

You've ticked that box already

Sammy2011 said:

i just wonder if diabetes is progressive like I’ve been told

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it is if you treat it the wrong way, unfortunately my experience is practice seems to lag at least 15 years behind research. Unfortunately you need to fight for your health ... at least the information to help you do so is more freely available these days
Good luck on your journey

I would add that I get congratulated on my results at each yearly checkup, followed by concern or being told I need to eat more carbs if I foolishly mention low carbohydrate diets. And that has been from 4 different DNs!
However, a young dietician did suggest no more than 30-40g carb per meal. Some common sense at last.

My strict dietary requirements means that my body has adjusted and improved my health dramatically.
And I can talk to my GP, my endocrinologist and my dsns, who have listened to me and endorsed, witnessed, questioned me about this rare (ish) condition.

Do I believe that I will again suffer from hypos, who knows?
But I'm gonna try and cope without carbs.

Sammy2011 said:

Diagnosed in April with A1C of 108, latest results 32! Nurse believes they aren’t right as she said A1C can’t come down so much, so fast? I’ve been really strict with my diet so I contribute it to that. I’m curious if anyone had a similar reduction in A1C and does it typically get harder to control bg levels as time goes on? Thanks

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I’ve gone down from 48 to 37 in just over a month. I have found it easy to control my carbs but expect it to be much harder to maintain my exercise regime!! . My belief is that my initial value was above my normal, lots of Packlava that month!! However, I do accept that I must have been in the pre-diabetes level.

Sammy2011 said:

does it typically get harder to control bg levels as time goes on?

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Not necessarily. Consider Dr Richard K Bernstein, rising 90, almost lifelong T1 and author of the classic book "Diabetes Solution". Still working as a doctor, treating T1s & T2s, presenting an hour-long Q&A session each month on Youtube, sharp as a tack with an impish sense of humour. Still works out in the gym and recently remarried (some time after being widowed). Yet he got off to a terrible start in life healthwise, being prescribed in childhood a high carb diet that nearly finished him off. His story is well worth reading, as is his book, many extracts from which are available free on his site:
http://www.diabetes-book.com/bernstein-life-with-diabetes/
I take Dr B as proof that the more normal the bg we can maintain, as far as possible by lifestyle, the less we will deteriorate. I believe Dr B when he says that many established diabetic complications can even be reversed by patient adherence to his protocol. For example, he even fought his way back from quite advanced kidney disease.
So take heart! If Dr B could flourish all these years with diabetes, so can you and I!

Sammy2011 said:

Diagnosed in April with A1C of 108, latest results 32! Nurse believes they aren’t right as she said A1C can’t come down so much, so fast? I’ve been really strict with my diet so I contribute it to that. I’m curious if anyone had a similar reduction in A1C and does it typically get harder to control bg levels as time goes on? Thanks

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Well… yes and no
If you use drugs to manage blood sugars and don’t change the underlying diet then in my experience, yes it does get harder and it does progress and eventually for T2, insulin isn’t that uncommon. Sone (Many) nurses will say it is progressive

however, if you manage your diet and that may well mean low carb, or for some people lowering of fat levels works. Many on the forums have found the former the best way. That seems to be a long term sustainable way to manage their levels

personally I am not perfect, I am much better than I was though and for me as long as I can keep to a lower carb (sub 150g a day) plus exercise I am maintaining now with a significant reversal even a decade plus after

whether it is maintainable and eventually will need even lower carb I don’t know. But I have no doubt that my old diet would have led to harder to control levels

Alexandra100 said:

Not necessarily. Consider Dr Richard K Bernstein, rising 90, almost lifelong T1 and author of the classic book "Diabetes Solution". Still working as a doctor, treating T1s & T2s, presenting an hour-long Q&A session each month on Youtube, sharp as a tack with an impish sense of humour. Still works out in the gym and recently remarried (some time after being widowed). Yet he got off to a terrible start in life healthwise, being prescribed in childhood a high carb diet that nearly finished him off. His story is well worth reading, as is his book, many extracts from which are available free on his site:
http://www.diabetes-book.com/bernstein-life-with-diabetes/
I take Dr B as proof that the more normal the bg we can maintain, as far as possible by lifestyle, the less we will deteriorate. I believe Dr B when he says that many established diabetic complications can even be reversed by patient adherence to his protocol. For example, he even fought his way back from quite advanced kidney disease.
So take heart! If Dr B could flourish all these years with diabetes, so can you and I!

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Hi,

What was your A1c on diagnosis?
& how much improvment have you experienced since adopting Dr B's way of BG managment?

For me, T2 from A1c from 9.4% to 5.1%.. over the last 18 months I’ve learned a lot about how my body responds to diet and exercise. So from a maintenance perspective it’s easier, since I know what works for me,

Yesterday was my daughters birthday, an opportunity to do a stress test. I ate everything bad, sandwiches, french fries, pizza, chocolate cake, back into normal range in less than two hours. Last year, my BG would have been nuked for days.

Everyone’s coming from a different position, but for me I think I’ve found a plan that’s put me back to near normal. So, I feel that if I stick to the plan, I should be ok, for life , I hope lol,

LaoDan said:

Yesterday was my daughters birthday, an opportunity to do a stress test. I ate everything bad, sandwiches, french fries, pizza, chocolate cake, back into normal range in less than two hours. Last year, my BG would have been nuked for days.

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Fabulous result @LaoDan, great to see all that graft paying off.
Getting away with a cheat can be so empowering but also tempting.
You're clued on anyway so carb creep won't be an issue for you.

Ronancastled said:

Fabulous result @LaoDan, great to see all that graft paying off.
Getting away with a cheat can be so empowering but also tempting.
You're clued on anyway so carb creep won't be an issue for you.

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Yeah, I’ll be low carb for life, one cool thing is I don’t have to eat my mother in law’s cooking lol