Had my appointment today with the diabetic nurse

[Freema]

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

on very low carb it is much easier to loose weight , and some have help from the metformin too, I think I have

she is right about not every one being able to reverse their diabetes...
type 1´s can never
and type 2 that have had raised blood glucose so long and where their pancreas has stopped producing insuline where its insuline producing cells have almost gone... they can also not reverse their diabetes..they need forever to have insuline added to their body.

most still have a almost well funtioning pancreas when they are diagnosed, even when they initially get some help from a little added insuline, and they can "reverse" / get low in blood sugar almost like non-diabetics ,when they do go very low in carbs, many times under 50 grams a day and a few under 20 grams of carbs day

 

[Freema]

I have lost most of my belly fat , not all... but really a lot..., I think it is important to also keep moving...the body needs to be used every day in one way or another

 

[bulkbiker]

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.

Your nurse I'm afraid is rather ill informed abut the effects of a low carb diet. Bodies in ketosis do not consume muscle but fat.. how stupid would the body have to be to kill itself by eating a diet on which it thrived for millennia.
There is now a significant body of scientific evidence showing that the LCHF diet is great for weight loss and blood sugar control. Sounds like you are making a good start by cutting carbs as low as you can which should mean your bloods come down faster. Keep up what you have started and the results will come.

 

[Kristin251]

Not to mention ketosis is muscle sparing but many don't like to go that low in carbs. I thrive on it.

 

[daisyduck]

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.

Great to hear you've silenced your nurse You would think she should have been more interested in how you did it though.

Re Atkins and the fluid.. that is totally possible.. My sister has just had a big stomach operation and was on IV fluids alone for over a week.. she's completely peed off that she has gained 10 lbs !

 

[BarbaraG]

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.

Dr Atkins died of a head injury after he fell down stairs.

In studies of LCHF diet, triglycerides reliably reduce and HDL rises. Among the lipid panel, these two and the ratio between them are the best indicators of cardiac risk. Someone changing from a standard American/British diet to the recommended healthy eating low fat etc will also improve these markers - but not as much as someone changing to LCHF.

The body does not consume muscle on a low carb diet. That's a myth and a scare story.

 

[Hiitsme]

Hi @carina62
I asked a similar question of the nurse at my last review- what is the criteria for coming off the diabetic register. Ended up having to see GP who deals with diabetics. He told me it was impossible to come off the register having once been put on. So it seems as if I still have a chronic, lifelong condition that will only get worse so I didn't feel encouraged by that. Though I was told my control was excellent - last 4 HbA1c's all in the normal range.

 

[Bluetit1802]

Hi @carina62
I asked a similar question of the nurse at my last review- what is the criteria for coming off the diabetic register. Ended up having to see GP who deals with diabetics. He told me it was impossible to come off the register having once been put on. So it seems as if I still have a chronic, lifelong condition that will only get worse so I didn't feel encouraged by that. Though I was told my control was excellent - last 4 HbA1c's all in the normal range.

There are people on here that have been taken off the register. I was invited to come off it but declined as it meant losing my mid year blood tests. My nurse said 18 months with HbA1c's in low 40s or less and no meds could move off the register and be put on an at risk register. I would still have annual tests, foot checks and eye checks.

 

[Hiitsme]

There are people on here that have been taken off the register. I was invited to come off it but declined as it meant losing my mid year blood tests. My nurse said 18 months with HbA1c's in low 40s or less and no meds could move off the register and be put on an at risk register. I would still have annual tests, foot checks and eye checks.

Thanks @Bluetit1802
This is a new surgery for me as my last one was closed down. I was just curious as to their views were. I'm not sure I would have chosen to come off the register quite yet as I'm still learning (and making mistakes) but I have now had 4 HbA1c's in the mid 30's so thought I might have been taken seriously. It may be no one else has asked the question. My previous GP had never come across any diabetic with an HbA1c of 33 and told me I was only given a meter and told to test as it was obvious I was going straight onto Insulin. Little did he know how I was going to use the meter to control my diabetes. I hate being told that diabetes has to be a chronic, lifelong and progressive illness though I fully accept that it can be if not tackled. I have fought hard to control diabetes and I want to be able to encourage others such as @carina62 that it is worth really battling to get control. I fully accept that if the pancreas is not able to work properly then medication will be needed but for a lot of people lifestyle changes can work. There are many who post on this forum who have done far better than me.

 

[carina62]

Thanks @Bluetit1802
This is a new surgery for me as my last one was closed down. I was just curious as to their views were. I'm not sure I would have chosen to come off the register quite yet as I'm still learning (and making mistakes) but I have now had 4 HbA1c's in the mid 30's so thought I might have been taken seriously. It may be no one else has asked the question. My previous GP had never come across any diabetic with an HbA1c of 33 and told me I was only given a meter and told to test as it was obvious I was going straight onto Insulin. Little did he know how I was going to use the meter to control my diabetes. I hate being told that diabetes has to be a chronic, lifelong and progressive illness though I fully accept that it can be if not tackled. I have fought hard to control diabetes and I want to be able to encourage others such as @carina62 that it is worth really battling to get control. I fully accept that if the pancreas is not able to work properly then medication will be needed but for a lot of people lifestyle changes can work. There are many who post on this forum who have done far better than me.

How can you find out how well/not so well your pancreas is working? I would like to know. Is it called a c-peptide test?

 

[Kristin251]

How can you find out how well/not so well your pancreas is working? I would like to know. Is it called a c-peptide test?

Yup

 

[librarising]

she said that Dr Atkins died of a heart attack as he went zero carbs

Nonsense. He didn't die of a heart attack. That's what people who are against lowcarbing want you to believe.
"On April 8, 2003, at age 72, Dr. Atkins slipped on the ice while walking to work, hitting his head and causing bleeding around his brain. He lost consciousness on the way to the hospital, where he spent two weeks in intensive care. His body deteriorated rapidly and he suffered massive organ failure.


During this time, his body apparently retained an enormous amount of fluid, and his weight at death was recorded at 258 pounds (again, records say that he was 195 on entering the hospital). His death certificate states that the cause of death was "blunt impact injury of head with epidural hematoma".
https://www.verywell.com/how-did-atkins-die-2241657

 

[Hiitsme]

How can you find out how well/not so well your pancreas is working? I would like to know. Is it called a c-peptide test?

From reading posts on this forum it would seem to be but doctors are reluctant to test presumably cost. When I was first diagnosed 2 years ago there was a lot about the Newcastle diet on this forum and people claiming to have reversed their diabetes. I did a lot of reading about it and what Prof Taylor had written. He was of the opinion that it was too much fat round the pancreas and liver that was stopping them from working. I couldn't get either my GP or nurse to agree to me doing the Newcastle diet. They said I wasn't over weight, well about at the top end of normal. I set about losing weight by eating 500 cals less than I was burning each day. I weighed everything and recorded it. I also used a meter to cut our foods that were raising my blood sugars.On top of that I started walking, at first it took me 30 mins to walk half a mile.I gradually increased my walking and now often walk 8-10 miles a day. Still fairly slow but a lot faster than at the beginning. I managed to lose weight steadily for about 6 months by which time I had an HbA1c in the normal range. I did lose several inches round my waist but that was about the last place I lost weight. This worked for me but it was very hard work recording everything and I was often hungry but I persevered and now pleased I did. I have no evidence that I had too much fat round my liver and pancreas but assume so. I ended up having lost too much weight and had to put some back on but I've still managed to keep my HbA1c in the normal range just a little higher than when my weight was at it lowest. I only restricted the carbs my body couldn't cope with. I didn't do very low carb but plenty of people on this forum claim to have had very good results and a lot quicker than me. I think different things work for different people and I managed to find a way that seems to be working for me for now. I hope you find a way that works for you.

 

[Bluetit1802]

How can you find out how well/not so well your pancreas is working? I would like to know. Is it called a c-peptide test?

These tests are expensive. GPs are reluctant to do them even for newly diagnosed people that don't fit a typical type 2 profile, which results in quite a few being wrongly diagnosed as T2 when they are really LADA. I doubt very much a GP would order you such tests simply to satisfy your curiosity. You could always go private.