Had my appointment today with the diabetic nurse

[carina62]

Had my appointment today with the diabetic nurse and I asked a number of questions about diabetes with her, one was about possible 'reversal' (she emphasised not cure). She made it sound that not everyone can reverse it despite all good intentions ie weight loss, low carbing etc - is that true? she said that it depends how the disease has progressed although not quite sure what she meant by that. I know of people on Forums who have been T2 for years (some 20 years) who have managed to reverse their diabetes by lifestyle change and the nurse told me of a patient recently whose HBa1c came out at 11 and he was offered medication but declined and tried to get it down with lifestyle change and he succeeded in getting his number down to 5. She said getting an hba1c of 6 or below would take someone down to pre-diabetic stage so I asked her that if it was 5 would that make you a non-diabetic and she didn't really say yes or no. Can all be very confusing can't it?

Also, I told her that I'm trying hard to lose weight and I especially want to lose my belly fat and she said it is very difficult for diabetics to lose their belly fat and fat around the thighs. How can it be difficult to lose the belly fat and why would this be?

Although she is very nice and did a good job in checking me over including my feet, I didn't feel very positive when I walked out with her answers. I would like to know what others think please? thanks

 

[Kristin251]

There is no cure for diabetes but it certainly can be managed no matter what stage with diet and / or exercise for most people. Lchf works best but as soon as you eat more carbs than you tolerate your bs will go up.

Lchf will help you lose weight as well. You have to find your carb tolerance level through your meter. Mine is 20 or less per day or I gain weight.
I also need to not eat dairy ( cheese, cream, etc) or any grains. I have to keep nut consumption low too.
My carbs all come from avocado, a few nuts and above ground vlc veggies. That's it.

How are your blood sugars? What foods do you eat?

Don't let her discourage you by saying you can't lose weight!!

 

[coleyd]

I felt bad after my appointment too and my nurse was vegan and pretty much didnt appreciate the fact that i used to be vegan and asked if i would go back vegan. I was confused after the appointment and i am still confused so i am sorry no help but i noticed your saying you were diagnosed with bs of 7.8 ? mine was 9.8 and hba1c of 58 and she said it meant my diabetes wasn't that bad ??

 

[Bluetit1802]

Had my appointment today with the diabetic nurse and I asked a number of questions about diabetes with her, one was about possible 'reversal' (she emphasised not cure). She made it sound that not everyone can reverse it despite all good intentions ie weight loss, low carbing etc - is that true? she said that it depends how the disease has progressed although not quite sure what she meant by that. I know of people on Forums who have been T2 for years (some 20 years) who have managed to reverse their diabetes by lifestyle change and the nurse told me of a patient recently whose HBa1c came out at 11 and he was offered medication but declined and tried to get it down with lifestyle change and he succeeded in getting his number down to 5. She said getting an hba1c of 6 or below would take someone down to pre-diabetic stage so I asked her that if it was 5 would that make you a non-diabetic and she didn't really say yes or no. Can all be very confusing can't it?

Also, I told her that I'm trying hard to lose weight and I especially want to lose my belly fat and she said it is very difficult for diabetics to lose their belly fat and fat around the thighs. How can it be difficult to lose the belly fat and why would this be?

Although she is very nice and did a good job in checking me over including my feet, I didn't feel very positive when I walked out with her answers. I would like to know what others think please? thanks

Quite honestly, your nurse is correct. She is right (in my opinion) to refer to it as reversal and not cure. She is right that not everyone can reverse it no matter what they do as it does depend on how badly affected the pancreas is. Even losing weight and severely reducing insulin resistance can't mend a damaged pancreas that can't produce sufficient insulin.

Whether getting an HbA1c down to 5 makes you non-diabetic is a matter of debate. It makes you an extremely well controlled diabetic presenting with non-diabetic levels. Whether it makes you non-diabetic is a different story. What would happen if that person returned to eating the way they used to? That is the question.

As for belly fat and thigh fat I've no idea. My thighs and belly shrank like the rest of me did, in equal measures I think.

 

[DevonVee]

Hi
As someone who has had PCOS for 30yrs and tried all sorts of diets none of which worked,I have read an awful lot since being diagnosed t2 before xmas.
The insulin resistance means that my blood is swimming with glucose from all the carbs I was told to eat. As my body does not use it, it gets stored as fat around the middle. This makes you more insulin resistant and so the cycle continues. If someone had suggested I ditch the carbs 12 yrs ago when I had gestational diabetes and while I could have done more I would not be here. I have lost about 10lbs since going lchf. This is something I have not been able to do before. I hope to continue and get the insulin resistance down. This will lower my glucose which will lower insulin.
Lots of others seem to have achieved a lot by this approach. Having had useless advice for so long I am a bit cynical about the medical profession. It makes more sense to treat it a carb intolerance and avoid as much of the carbs that cause a problem.
I have read that 50 percent of women with PCOS end up with T2.
I have my first blood test since starting lchf next week . Wait and hope.

 

[carina62]

There is no cure for diabetes but it certainly can be managed no matter what stage with diet and / or exercise for most people. Lchf works best but as soon as you eat more carbs than you tolerate your bs will go up.

Lchf will help you lose weight as well. You have to find your carb tolerance level through your meter. Mine is 20 or less per day or I gain weight.
I also need to not eat dairy ( cheese, cream, etc) or any grains. I have to keep nut consumption low too.
My carbs all come from avocado, a few nuts and above ground vlc veggies. That's it.

How are your blood sugars? What foods do you eat?

Don't let her discourage you by saying you can't lose weight!!

I am still experimenting with my meter with foods but find even the smallest amount of carbs will raise my BS but haven't actually worked out how many grams of carbs (if any) I can tolerate per meal. The nurse also said that going zero carbs in not good and that I must have some carbs a day (I tend to have a low amount of carbs, it can be up to 50g or less) is that too little? she said that Dr Atkins died of a heart attack as he went zero carbs and although he lost weight, its not good for the body as it then starts to consume muscle and the heart is a muscle so that's where he got his problems.

My recent hba1c is 7.1% (gone up from 6.9% I think the raise was due to xmas) but I'm now going to work in getting it lowered. My recent blood test results which are part of my diabetic review all came back fine.

 

[BrianTheElder]

Quite honestly, your nurse is correct. She is right (in my opinion) to refer to it as reversal and not cure. She is right that not everyone can reverse it no matter what they do as it does depend on how badly affected the pancreas is. Even losing weight and severely reducing insulin resistance can't mend a damaged pancreas that can't produce sufficient insulin.

Whether getting an HbA1c down to 5 makes you non-diabetic is a matter of debate. It makes you an extremely well controlled diabetic presenting with non-diabetic levels. Whether it makes you non-diabetic is a different story. What would happen if that person returned to eating the way they used to? That is the question.

As for belly fat and thigh fat I've no idea. My thighs and belly shrank like the rest of me did, in equal measures I think.

I agree that we should talk of reversal rather than cure. At my age, if I stay on my current diet, I hope that my reversal will last a lifetime.
However, I am hopeful that for younger people, eating a good diet may over the years let their bodies recover so that insulin resistance can recover and pancreas damage repaired. They would still need to eat sensibly so that they don't go into insulin resistant mode again. So technically they might not be diabetic (ie cured), but practically it would be very much the same diet, with a bit of leeway.

 

[carina62]

Quite honestly, your nurse is correct. She is right (in my opinion) to refer to it as reversal and not cure. She is right that not everyone can reverse it no matter what they do as it does depend on how badly affected the pancreas is. Even losing weight and severely reducing insulin resistance can't mend a damaged pancreas that can't produce sufficient insulin.

Whether getting an HbA1c down to 5 makes you non-diabetic is a matter of debate. It makes you an extremely well controlled diabetic presenting with non-diabetic levels. Whether it makes you non-diabetic is a different story. What would happen if that person returned to eating the way they used to? That is the question.

As for belly fat and thigh fat I've no idea. My thighs and belly shrank like the rest of me did, in equal measures I think.

I do sincerely hope with weight loss I will reduce my belly fat as that is what's bothering me, the rest of my body ie legs, arms are ok.

 

[coleyd]

i have pcos too dr and nurse did say it could be because of all the carbs combined with weight and health issues and lack of exercise in me that caused the diabetes

 

[Nicksu]

Unfortunately the belly fat will probably cling on until the last. I've lost 3 stone - (low carbing) and still have another 2 plus to go. I've done this since the middle of August last year and my exercise is walking. My weight has come off all over but the walking has helped to move weight from my upper legs, and quite a lot from my tummy - but unfortunately its still there. Its a case of see how it pans out I'm afraid.

 

[daisyduck]

My nurse confuses me too. I think she is an all purpose nurse at the practice and not exclusively for diabetics so her knowledge seems limited, and she faffs around questions and sounds a bit like yours.
I think we all have to do the best with what we've got. As long as I feel good. I love the food and my BG levels remain good then I'm happy.

 

[JRTwalker]

Carina62, if it encourages you in any way, my weight has fallen from my mid-drift and thighs, in fact 6 inches+ reduction on waist line in past 4 months and that is with low carb. Difficult to say exactly how many carbs but not zero for sure and probably closer to 30g/day? I don't add more fat consciously but I worry less than I would have on my years of useless low calorie, low fat regime. I've reduced fruit of any kind to only the odd portion each week since this was undoubtedly my achilles heel in the past.
I've also lost muscle but have increased my exercise to around an hour a day where my heart rate is increased - hopefully my heart doesn't wither.
My bloods are within target but my weight & BMI aren't so I want to reach both goals and then I will re-evaluate what I need to eat to stay on-side. My mindset here is to emulate what bariatric surgery would provide but without the surgery.
What I would say is that your experience with your diabetes nurse seems comparable with mine and I wouldn't expect her to tell you to embark on a journey that is too far away from their NHS policy of reduced intake against a balanced diet. In my case I felt that privately my Nurse would like to say more that she is allowed to though.

 

[Kristin251]

I am still experimenting with my meter with foods but find even the smallest amount of carbs will raise my BS but haven't actually worked out how many grams of carbs (if any) I can tolerate per meal. The nurse also said that going zero carbs in not good and that I must have some carbs a day (I tend to have a low amount of carbs, it can be up to 50g or less) is that too little? she said that Dr Atkins died of a heart attack as he went zero carbs and although he lost weight, its not good for the body as it then starts to consume muscle and the heart is a muscle so that's where he got his problems.

My recent hba1c is 7.1% (gone up from 6.9% I think the raise was due to xmas) but I'm now going to work in getting it lowered. My recent blood test results which are part of my diabetic review all came back fine.

I have eaten less than 20 c per day for k er 25 years. It's when I eat more than that that I gain weight, achy, brain fog, high bs etc.

As I said, certain foods stall all weight loss for me , carbs or no carbs.

As far as Atkins, who's to say his heart attack was caused from no carbs? He wasn't NO carbs either, he was low carb. Anything could have caused his heart attack.
Even small amounts of carbs raise my bs. Protein too. Almost everything. When we eat carbs and protein we spike our insulin and then we can become insulin resistant. Once you become more sensitive ( by limiting carbs Andy not over eating protein) your insulin that you do produce will work better. The foods I listed above make me insulin resistant. I know this because I need to take more insulin and it doesn't work as well as a meal without those foods.

I know it seems like we give up loads of beloved foods, and we do, but if it helps us reach our bs goals and weight loss goals, more power to it !!! There's loads of lovely weight friendly blood sugar friendLy foods. I CHOOSE to stick with those. Love love avoacado, salads, some random other veggies, and some nice pure fresh protein. I've eaten this way for so long I can taste any processed foods and preservatives. Mayo and hot sauces are my only foods with more than one ingredient. I love fresh food!!

 

[daisyduck]

There seems to be some controversy over Dr Atkins heart attack
This is from Wiki
Atkins suffered cardiac arrest in April 2002, leading many of his critics to point to this episode as proof of the inherent dangers in the consumption of high levels of saturated fat associated with the Atkins diet. In numerous interviews, however, Atkins stated that his cardiac arrest was not the result of poor diet, but was rather caused by a chronic infection.[11] Atkins' personal physician and cardiologist, Dr. Patrick Fratellone, confirmed this assertion, saying, "We have been treating this condition, cardiomyopathy, for almost two years. Clearly, [Atkins'] own nutritional protocols have left him, at the age of 71, with an extraordinarily healthy cardiovascular system".

Dr. Fratellone treated Dr. Atkins from 1999 until 2002, and also worked with the doctor at the Atkins Center. He says Atkins suffered from cardiomyopathy, a chronic heart weakness. But this condition, he says, was caused by a virus—not his diet: “I was his attending cardiologist at that time. And I made the statement… When we did his angiogram, I mean, the doctor who performed it, said it's pristine for someone that eats his kind of diet… Pristine, meaning these are very clean arteries. I didn't want people to think that his diet caused his heart muscle – it was definitely a documented viral infection

 

[Kristin251]

There seems to be some controversy over Dr Atkins heart attack
This is from Wiki
Atkins suffered cardiac arrest in April 2002, leading many of his critics to point to this episode as proof of the inherent dangers in the consumption of high levels of saturated fat associated with the Atkins diet. In numerous interviews, however, Atkins stated that his cardiac arrest was not the result of poor diet, but was rather caused by a chronic infection.[11] Atkins' personal physician and cardiologist, Dr. Patrick Fratellone, confirmed this assertion, saying, "We have been treating this condition, cardiomyopathy, for almost two years. Clearly, [Atkins'] own nutritional protocols have left him, at the age of 71, with an extraordinarily healthy cardiovascular system".

Dr. Fratellone treated Dr. Atkins from 1999 until 2002, and also worked with the doctor at the Atkins Center. He says Atkins suffered from cardiomyopathy, a chronic heart weakness. But this condition, he says, was caused by a virus—not his diet: “I was his attending cardiologist at that time. And I made the statement… When we did his angiogram, I mean, the doctor who performed it, said it's pristine for someone that eats his kind of diet… Pristine, meaning these are very clean arteries. I didn't want people to think that his diet caused his heart muscle – it was definitely a documented viral infection

Excellent!! And his diet does not have to be high saturated fat if one chooses not to. It just needs to be low carb. The amount and type of fat we eat is up to the indiviuaL. I prefer more plant fat to saturated but that's just me.

 

[ME_Valentijn]

She made it sound that not everyone can reverse it despite all good intentions ie weight loss, low carbing etc - is that true?

Diabetes is a disease, and it's going to effect everyone a bit differently, and everyone will be at different stages when diagnosed. It's also often multifactorial - there can be insulin resistance, there can be fatty livers dumping glucose, and there can be impairment in insulin production, even for Type 2. Some of those factors can be easier to deal with than others ... insulin resistance might be largely resolved (or even reversed) with a low-carb diet. Losing weight might or might not help with a fatty liver. But damage resulting in impaired insulin production might not be something that can be resolved.

But even if there's an aspect which can't be resolved, other aspects probably can be improved quite a bit. So it's worthwhile for someone to take steps to reduce insulin resistance, even if their insulin production is never going to be great. And weight loss is pretty much always going to be beneficial, if overweight.

She said getting an hba1c of 6 or below would take someone down to pre-diabetic stage so I asked her that if it was 5 would that make you a non-diabetic and she didn't really say yes or no.

If that person could live like a non-diabetic, eat carbs like a non-diabetic, not take meds, etc, then that might be a cure or reversal. If they have to keep eating low-carb or taking diabetic meds, then someone with the same HbA1c is still very much diabetic, just with their diabetes being stable and well-managed.

How can it be difficult to lose the belly fat and why would this be?

Fat goes where it wants to, which is pretty much the opposite of where we want it. Accordingly, boobs shrink first We can't control where the weight will be loss. Doing crunches might increase abdominal muscles, but it won't remove the layer of fat over them any faster. But as weight is lost, eventually it'll even come off of the annoying locations.

 

[dipsydo]

I have lost about 28lbs - another 28lbs to go . I am on about 60/70 carbs . Weight has been lost around my thighs and my stomach .. I now have a waist so the nurse is not necessarily right about belly and thighs being the last place to go but remember we are all different.
It is all a bit trial and error, the mistake I made originally was to replace carbs with a bit too much protein, protein is fine as long as in moderation as will break down to sugar in the blood so needs to be kept an eye upon.

 

[TheBigNewt]

There seems to be some controversy over Dr Atkins heart attack
This is from Wiki
Atkins suffered cardiac arrest in April 2002, leading many of his critics to point to this episode as proof of the inherent dangers in the consumption of high levels of saturated fat associated with the Atkins diet. In numerous interviews, however, Atkins stated that his cardiac arrest was not the result of poor diet, but was rather caused by a chronic infection.[11] Atkins' personal physician and cardiologist, Dr. Patrick Fratellone, confirmed this assertion, saying, "We have been treating this condition, cardiomyopathy, for almost two years. Clearly, [Atkins'] own nutritional protocols have left him, at the age of 71, with an extraordinarily healthy cardiovascular system".

Dr. Fratellone treated Dr. Atkins from 1999 until 2002, and also worked with the doctor at the Atkins Center. He says Atkins suffered from cardiomyopathy, a chronic heart weakness. But this condition, he says, was caused by a virus—not his diet: “I was his attending cardiologist at that time. And I made the statement… When we did his angiogram, I mean, the doctor who performed it, said it's pristine for someone that eats his kind of diet… Pristine, meaning these are very clean arteries. I didn't want people to think that his diet caused his heart muscle – it was definitely a documented viral infection

A viral cardiomyopathy is the result of the body's reacting to a common viral infection by attacking myocytes, heart muscle cells. It's akin to a type 1 diabetic's disease onset being preceded by a common viral infection sometimes. The most common cause of a cardiomyopathy is ischemic (lack of blood flow through the coronary arteries), and diabetics (esp. Type 2's) are more likely to have CAD than non diabetics. They tend to get "macrovascular" disease involving the coronary arteries, arteries to the legs, and to the head, whereas Type 1s tend to get "microvascular" disease involving the very small blood vessels in the eyes and kidneys. That's why Type 2's often are prescribed statins like Lipitor, which lower the risk of coronary artery disease, especially in people who are know to already have it. And yes, patients with cardiomyopathy of any type are more prone to SCD (sudden cardiac death), which is why they sometimes receive AICDs (automatic implantable cardioverter/defibrillators). I implanted quite a few of those some years back. But I don't think they were available in Dr. Atkins' day. He didn't have CAD evidently.

 

[Resurgam]

The diabetes adviser I saw trotted out that Dr Atkins died from a heart attack as he was obese at the time of his death - they love to be able to smirk about it. I asked her if she knew his weight at the time of his admission to hospital after his fall - he suffered organ failure but was given fluids continuously which remained in his body causing a massive increase in size and obviously weight as well.
I saw her again today, when she got my results from my second blood test - that shut her up.

 

[coleyd]

My nurse confuses me too. I think she is an all purpose nurse at the practice and not exclusively for diabetics so her knowledge seems limited, and she faffs around questions and sounds a bit like yours.
I think we all have to do the best with what we've got. As long as I feel good. I love the food and my BG levels remain good then I'm happy.

lol same as with me she is a sister nurse or something and a bit scatty very nice and all but still