Getting off

[Hareph]

I've googled but nothing has struck me so far. I thought I'd ask.

After a "you're now diabetic" 76mmol/L HbA1c warning at an annual checkup I'm two weeks into 800cal;20g carbs a day with a vitamin and mineral supplement and it's fine so far. Once I get my BMI down from 30 to 23 I'm not sure how to get off the regime when my target BMI is reached.

Do I increase calories to maintain that BMI but keep the carbs at 20g?

Or do I just limit the calories and ignore the ingredients?

I bought a blood glucose monitor this week and all the readings on waking are 5.x so I assume I'm going to bring the HbA1c reading into an acceptable range when I next get tested in March. If that's a result of the 20g carb restriction, must I keep to it indefinitely?

 

[Resurgam]

I use Atkins New Diet Revolution and find that my weightloss and blood glucose levels are not interdependent - I can eat more carbs and keep my BG levels normal after over a year from diagnosis, but I can't eat more carbs and keep my weight constant or reducing. Perhaps if you look at the four stages of the Atkins diet it will give you ideas to try out for maintaining weight.

 

[Hareph]

Thank you Resurgam, I've now read the Wikipedia page for background.

The Atkins website seems to want payment to unlock its support and I'm not sure I want a prescriptive diet at all. I'm an amateur, not a hobbyist. My impression is that once I'm stable I should get away from ketosis, but I definitely intend continuing my food log to monitor myself. What percentage of carbohydrate should I aim for at that stage? Or should it be a fixed carbohydrate weight a day regardless of calories?

 

[Hareph]

I'm 4 weeks into this moderate ketosis plan. My nutrition report says my average over the period is 61g Protein, 29g Net Carbs and 44g Fat. My average weight was 86kg, and the target protein I've aimed for is 0.8g per kg which is 68g so I'm slightly under but not by a significant amount. Balancing protein while under ketosis is a matter of adding white fish daily until the required dose is reached.

As far as I'm aware, only the net carbohydrate figure affects whether one's going to be in ketosis or not. I'm doing it on 30g a day, I don't know whether I could increase that carb allowance but I'm happy to stay at or under it.

As far as getting off the weight-reduction diet goes, switching to a maintenance diet after reaching the target requires an activity-based bodyweight-based calorie intake with adequate vitamin and mineral support. It doesn't require ketosis, though some people do, but it does require the continued use of a food diary such as cronometer.

I did this whimsical spreadsheet showing how many years it's been since I last weighed as little as each milestone. At the moment I'm on track but there's a long way to go.

 

[bamba]

Have a look at www.bloodsugar101.com

There a several good points on dieting there.

http://www.phlaunt.com/diabetes/sp3index.php

 

[Resurgam]

Thank you Resurgam, I've now read the Wikipedia page for background.

The Atkins website seems to want payment to unlock its support and I'm not sure I want a prescriptive diet at all. I'm an amateur, not a hobbyist. My impression is that once I'm stable I should get away from ketosis, but I definitely intend continuing my food log to monitor myself. What percentage of carbohydrate should I aim for at that stage? Or should it be a fixed carbohydrate weight a day regardless of calories?

Sorry I did not see yuor question - the answer is, I'm afraid - it depends. There are so many factors, and so many variables that I just keep the carbs to what I know has my BG level under control, and add other foods depending on what my weight is doing. Routine seems to be the key to stability.

 

[Tannith]

Once you have finished the Newcastle all you have to do is keep the weight off. You should not have to worry about carbs at all, but CALORIES. Once the fat is off the pancreas the beta cells will work normally again like those of a non diabetic. http://www.ncl.ac.uk/press/articles/archive/2017/09/type2diabetesisreversible/
http://care.diabetesjournals.org/content/36/4/1047

https://www.sciencedaily.com/releases/2016/03/160322080542.htm:
"The study also answered the question that people often ask me -- if I lose the weight and keep the weight off, will I stay free of diabetes? The simple answer is yes! - Prof Roy Taylor

 

[Hareph]

@Tannith - that would be very pleasing and it ought to be apparent by next month. I'm down from BMI 30 to 25 so far. Another two or three points and I'll put a Freestyle Libre sensor on my arm for two weeks' continuous blood glucose monitoring, and see whether my insulin response height and duration suggest any remaining insulin resistance or impairment. I'll report back to the thread. By then I'll have my next HbA1c result too.

 

[AlexMagd]

Once you have finished the Newcastle all you have to do is keep the weight off. You should not have to worry about carbs at all, but CALORIES. Once the fat is off the pancreas the beta cells will work normally again like those of a non diabetic. http://www.ncl.ac.uk/press/articles/archive/2017/09/type2diabetesisreversible/
http://care.diabetesjournals.org/content/36/4/1047

That's the dream! My only note of scepticism is that I think the study used HbA1C as its metric - so I'm not sure how they determined that the beta cell function was restored. I've only just started my ND run, but I wear a Libre and will be very interested to see how this affects my BG spikes as the diet goes on.

 

[Hareph]

@AlexMagd We seem to be at roughly the same stage. I asked my GP this week if he had a test for insulin impairment and he thought not, so the Libre graphs will interest me too. The abstract results at https://www.ncbi.nlm.nih.gov/pubmed/16556307 are the starting point for my initial maintenance diet balance.

 

[LittleGreyCat]

@Hareph Medicheck do a test for insulin resistance which measures your fasting BG, your fasting insulin, and then calculates your IR.

I've just read through the thread and you seem to be well organised and fully in control. Your progress is looking good.

I would tread carefully when you hit your target weight and want to start to increase what you eat. From what you list I would be tempted to keep the carbohydrates roughly the same, the protein roughly the same, and increase the fats so you are getting a lot more energy from them.

The big issue with low carbohydrate is that you can achieve normal HbA1c and think that you are cured, but in fact you are only well managed.

To be cured you need tests to show that your insulin production is normal and you have little or no insulin resistance.

Even then, since you developed T2, you know that you can develop it again if you are not careful. So staying in ketosis may end up as a long term life style. Coming cleanly out of ketosis could involve eating 150 g to 200 g of carbohydrate a day and increasing the insulin demand on your pancreas again. It could also start putting some of that weight back on.

Not trying to scare you or put you down. You are making fantastic progress. I'm just wondering what being "cured" would mean to you. The ability to go back to eating what you used to? Or just the ability to relax the strict control, but with an awareness that you became T2 and you don't want it to happen again.

Edit: just to note my BMI is 23 at the moment but I feel the need to lose a bit more. This is a constant struggle. A more important target than BMI is to get your waist measurement to less than half your height. I'm 6 foot and have a waist of 35.5" which is just below the danger level. I would like it lower but find it hard to lose weight over winter.

 

[catapillar]

I asked my GP this week if he had a test for insulin impairment and he thought not

Ask for a cpeptide test to see what your insulin production is looking like. A type 2 diabetic will often have hyperinsulimia, ie the production of more insulin than normal because their body is dealing with insulin resistant cells.