Having a wobble...

[TheSecretCarbAddict]

As great as my progress has been over the last 12 weeks I'm having a bit of a wobble right now. It looks like relaxing my routine just a little bit (some extra carbs in a couple of meals, eating my last meal of the day closer to bed time a few times, missing out my alternate fasting day) has upset a very fine balance. My blood glucose levels feel like a runaway train - shooting up during daily dawn phenomena / foot on the floor occurrences, not returning to my normal baseline during the day and then the cycle repeats the next day but from a new slightly higher baseline. I am trying to keep calm, stay the course and recognise that my body might need time to adjust to the new normal of almost no diabetes medicine after years of maxing out on it, but it is mentally very hard.

Full disclosure, I am a control freak and hold myself to very high standards. My green range for CGM is currently set to 3.9 to 7.0 mmol/l with low alarm at 3.5mmol/l and high 7.8 mmol/l. I know I need to relax a little bit, and standard time in range is probably good enough for my health outcomes. And maybe I don't need to chase time in tight range or non-diabetic readings. While my lifestyle changes are not something I'm doing for the sake of doing them and are to control my long-term condition, apparently highly restrictive behaviours can be another manifestation of my food addiction. Why can't life be simpler?

I've been trying to figure out what's going on:

- Went off my normal pattern of interventions, but not massively. Now settled back into normal routine, but this doesn't not seem to be restoring the balance, or at least not working as quickly as I'd like.
- My weight loss has plateaued and I'm showing an out of ordinary day to day yo-yo pattern of weight going up and down. Wondering if this is my liver or pancreas behaving like a spluttering car engine which is reflected in my BG.
- One factor is CGM as for my last sensor I went from Libre 2 Plus to Libre 2. I find that Libre 2 tends to run 1-1.5 mmol/l higher than glucometer test, but even taking that into account some of my high readings have been over 10 mmol/l on glucometer.
- When it comes to BG patterns it seems like my morning spike is more pronounced, but the levels during the day stay quite stable, albeit at a higher level than I'd like them to. Does this mean that my BG levelling mechanisms still work, but my homeostasis level is out of whack (BG stability maintained relatively well, just at the wrong level)?
- I have increased my physical activity, and while it helps the impact is somewhat limited. Event went for a run on Sun, but all that did was push my morning spike 1.5mmol/l higher.
- In terms of diet I'm quite low carb (<20g a day net), but when all this started I did have a few larger portions of protein - have tried to reduce this a bit, but again there wasn't an immediate impact one way or another.
- I've now doubled down on fasting as a more radical intervention to stabilise. On my day 3 of fasting and levels are becoming a bit more normal. Want to see what happens over next day or so. Not necessarily looking to do any extra long fasting, but considering up to 7 days as a therapeutic intervention before going back to my IF alternate day fasting pattern of 42h every 2 days.
- I do have my blood tests in a week and then GP appointment week after. I expect improvements on my results against my blood test a few weeks back, but worried about more longer term management of my journey towards remission - still want to explore drug free remission (only on one dose of Metformin right now), rather than accepting that I might need some more medication to support me.

I guess I'd like to get another perspective on this from those who are on their remission journey. Are periods like this normal? Do I just keep my calm and see this through? Or do I need to worry about finding an appropriate intervention sooner rather than later to bring my BG levels closer to non-diabetic range?

 

[Outlier]

Well done for all you have achieved so far, and better is to come!

Bodies are dynamic. They adjust to the tiniest of circumstances, You know this but I'm simply saying it to remind you. Your body is making adjustments in its own time and those will not be linear. Two steps forward, one back, three to the side then forward again....plateaux, progress, regress, that's what they do. Hold on to your goals and keep your eyes on the horizon. Don't give up, don't be distracted. Above all "know thyself", recognise what might be pitfalls for you which won't be the same as for some others, and sidestep 'em. If you stumble, don't take it as failure, just a bump in the road. If your next blood results aren't where you want them to be, it happens to all of us and we just keep Churchilling on. Then we get good results in our body's time, no-one else's. You have time. You have the game plan. We've all been there. You are not alone.

 

[TheSecretCarbAddict]

Thanks, @Outlier, for reminding me that this is a journey and it won't always take us direct to the destination we want. I think I might have been a bit blinded by how fast things have been moving over the last few months. I think I just need to take this one step at a time, focus on the journey rather than trying to race to the destination, track my daily choices, and stick to what I see working.

 

[Paul_]

As @Outlier says, you've done really well so far. In my 10 months with diabetes so far, I've found effort in overcoming the various challenges of the diagnosis to be 99% mental approach, 1% doing.

The key things I try to remind myself of when times get tough:

1) Everything I do has to be sustainable, particularly when it comes to diet and exercise. For example, it would be easy to join a gym, with very good intentions and the exercise would be better quality, but I hate gyms and I'd end up getting no exercise because I wouldn't go. Instead I walk a lot, which I really enjoy and I look forward to doing. If something isn't working for you, or fills you with dread, don't be scared to adapt/change it.

2) Numbers aren't good or bad, they're just data points which allow you to make informed decisions (I stole this from an article I read). T2 is lifelong, you can't live that life chasing numbers, from one reading to the next. Use the trends you've built up to make good decisions, don't let your brain use them to demotivate you and make you feel bad.

3) Diabetics are allowed a break now and again. It's a very full-on condition to have, especially if you're diet managed. It feels like you have to be on your game all the time, watching every carb, measuring BG levels etc. It's ok to get fed up with it, it's natural for there to be times in life where things slide. Most important is to identify that things are sliding, then get it back on track, which your post above shows you've already made a start on.

4) Give yourself credit. When you need motivation to get back on track, or to keep going, remember how good you felt about doing all the things right. Think of the positives of the behaviours which brought improvements. This can help sustain or restart your motivation. It's easy to get bogged down in "things aren't going right", but it's important to remember your achievements and how they made you feel.

From your post, you've identified the potential issues, you know where improvements are needed, and you've previously proved you can be successful in putting these into practice. We're all allowed down days/weeks, but never give up. You can do this!

 

[JoKalsbeek]

You already know you're setting the bar high and being very, almost impossibly strict with yourself. Non-diabetics don't even stay in range all the time. The idea is that this becomes a no-brainer for you, not something that controls every second of your life, but is just... Part of it. You don't think about breathing, and hopefully soon, you won't think overmuch about blood sugars either. One of the NHS excuses for not giving people a meter is "Those numbers would just make you stressed". See whether that's true for you. (They can't always be wrong, after all. Just kidding, I know the NHS often does good work too, and under pressure. Just don't always agree with some policies around T2 here and there. But that's a global thing, not just the NHS. Aaaanyway, back to being on topic!)

If your meter helping or hindering you right now? Because your body is going to do what it does, and it is not going to adhere to whatever schedule you want it to follow... Sometimes after quick changes things just slow down because they need to. Because a new equilibrium is being figured out, and you can't do more than your part in helping your body find it. (By low carbing, in your case). Be a bit more forgiving, your body's been through a lot and it's trying to keep up, really. So cut it, and yourself, a break. Take a breather, stick with the low carbing, don't kick yourself around if you go a tad higher for a tiny little bit... I mean, we're having weird weather lately, even that can affect what your bloods are doing. Not everything is within your control. So just tackle the things that are: what you eat/drink, and how much stress/forgiveness you allow yourself for all this.

You're making massive progress and I am so deeply sorry you're not able to see the big wins here. Because you so deserve to enjoy them.
Jo

 

[Lainie71]

As @Outlier says, you've done really well so far. In my 10 months with diabetes so far, I've found effort in overcoming the various challenges of the diagnosis to be 99% mental approach, 1% doing.

The key things I try to remind myself of when times get tough:

1) Everything I do has to be sustainable, particularly when it comes to diet and exercise. For example, it would be easy to join a gym, with very good intentions and the exercise would be better quality, but I hate gyms and I'd end up getting no exercise because I wouldn't go. Instead I walk a lot, which I really enjoy and I look forward to doing. If something isn't working for you, or fills you with dread, don't be scared to adapt/change it.

2) Numbers aren't good or bad, they're just data points which allow you to make informed decisions (I stole this from an article I read). T2 is lifelong, you can't live that life chasing numbers, from one reading to the next. Use the trends you've built up to make good decisions, don't let your brain use them to demotivate you and make you feel bad.

3) Diabetics are allowed a break now and again. It's a very full-on condition to have, especially if you're diet managed. It feels like you have to be on your game all the time, watching every carb, measuring BG levels etc. It's ok to get fed up with it, it's natural for there to be times in life where things slide. Most important is to identify that things are sliding, then get it back on track, which your post above shows you've already made a start on.

4) Give yourself credit. When you need motivation to get back on track, or to keep going, remember how good you felt about doing all the things right. Think of the positives of the behaviours which brought improvements. This can help sustain or restart your motivation. It's easy to get bogged down in "things aren't going right", but it's important to remember your achievements and how they made you feel.

From your post, you've identified the potential issues, you know where improvements are needed, and you've previously proved you can be successful in putting these into practice. We're all allowed down days/weeks, but never give up. You can do this!

Just wanted to say thanks for the above, as have been not feeling it for a while. If I don't post my readings on here I seem to get unmotivated and then things slide. I have hit the restart switch quite a few times over the last couple of months. Seems I get to a good place then I am on the slide again. I am definitely at my best with routine, its not my diet that's the problem but the exercise slump. Its the exercise that gives me the hit, I crave it, the motivation yet its the thing that goes when I am down, then I don't post my numbers and the cycle carries on. I will never give up, as the alternative is not a nice option its just really, really hard sometimes accepting my type 2 especially when I see others that don't have to watch their diet, exercise and they seem to breeze through life with no medical or other health/mental problems.

 

[MrPeaky]

As great as my progress has been over the last 12 weeks I'm having a bit of a wobble right now. It looks like relaxing my routine just a little bit (some extra carbs in a couple of meals, eating my last meal of the day closer to bed time a few times, missing out my alternate fasting day) has upset a very fine balance. My blood glucose levels feel like a runaway train - shooting up during daily dawn phenomena / foot on the floor occurrences, not returning to my normal baseline during the day and then the cycle repeats the next day but from a new slightly higher baseline. I am trying to keep calm, stay the course and recognise that my body might need time to adjust to the new normal of almost no diabetes medicine after years of maxing out on it, but it is mentally very hard.

Full disclosure, I am a control freak and hold myself to very high standards. My green range for CGM is currently set to 3.9 to 7.0 mmol/l with low alarm at 3.5mmol/l and high 7.8 mmol/l. I know I need to relax a little bit, and standard time in range is probably good enough for my health outcomes. And maybe I don't need to chase time in tight range or non-diabetic readings. While my lifestyle changes are not something I'm doing for the sake of doing them and are to control my long-term condition, apparently highly restrictive behaviours can be another manifestation of my food addiction. Why can't life be simpler?

I've been trying to figure out what's going on:

- Went off my normal pattern of interventions, but not massively. Now settled back into normal routine, but this doesn't not seem to be restoring the balance, or at least not working as quickly as I'd like.
- My weight loss has plateaued and I'm showing an out of ordinary day to day yo-yo pattern of weight going up and down. Wondering if this is my liver or pancreas behaving like a spluttering car engine which is reflected in my BG.
- One factor is CGM as for my last sensor I went from Libre 2 Plus to Libre 2. I find that Libre 2 tends to run 1-1.5 mmol/l higher than glucometer test, but even taking that into account some of my high readings have been over 10 mmol/l on glucometer.
- When it comes to BG patterns it seems like my morning spike is more pronounced, but the levels during the day stay quite stable, albeit at a higher level than I'd like them to. Does this mean that my BG levelling mechanisms still work, but my homeostasis level is out of whack (BG stability maintained relatively well, just at the wrong level)?
- I have increased my physical activity, and while it helps the impact is somewhat limited. Event went for a run on Sun, but all that did was push my morning spike 1.5mmol/l higher.
- In terms of diet I'm quite low carb (<20g a day net), but when all this started I did have a few larger portions of protein - have tried to reduce this a bit, but again there wasn't an immediate impact one way or another.
- I've now doubled down on fasting as a more radical intervention to stabilise. On my day 3 of fasting and levels are becoming a bit more normal. Want to see what happens over next day or so. Not necessarily looking to do any extra long fasting, but considering up to 7 days as a therapeutic intervention before going back to my IF alternate day fasting pattern of 42h every 2 days.
- I do have my blood tests in a week and then GP appointment week after. I expect improvements on my results against my blood test a few weeks back, but worried about more longer term management of my journey towards remission - still want to explore drug free remission (only on one dose of Metformin right now), rather than accepting that I might need some more medication to support me.

I guess I'd like to get another perspective on this from those who are on their remission journey. Are periods like this normal? Do I just keep my calm and see this through? Or do I need to worry about finding an appropriate intervention sooner rather than later to bring my BG levels closer to non-diabetic range?

Years of meds - then almost no meds is a huge achievement and take a minute to sit back look at that and say HEY I DID THAT MYSELF!


Your body isn't going to up it's insulin resistance overnight, and it has had a load of chemically induced help for many years, and you have taken that a way so it's going to be a little but like an angry teenager at times and demand what it wants now!
You have to find a balance between what is sustainable long term, what keeps you mentally robust and a quality of life that is not 100% about your Blood Sugar.

I eat the same diet more or less religiously as I have for close to 5 years now, I could drop a few things I eat out if those become troublesome, but I think after that point I would look at medication, to find a balance of staying healthy and living rather than just existing.

With regards to the spikes and morning, everyone is different, at the start of my journey I had hugely NAFL and was super skinny fat.
Now I have completely reversed that and I am sure that has played a huge part in my control, something else you could ask your GP for a US to check internal fat content?

You have achieved so much already dude keep at it and I really hope you find a balance that works for you but top top job so far!

 

[TheSecretCarbAddict]

@Outlier, @Paul_ , @JoKalsbeek and @MrPeaky, thanks for taking time to give your perspective and a bit of pep talk. It made a lot of difference when I really needed it and really underscores the importance and value of this community. Thank you!

So, what did I re-discover today? It's more about the journey, than the actual destination. It is about accepting that setbacks are part of managing our conditions and that it is important to stop and enjoy our wins. There is no point about obsessing about getting it perfect, it is a lot more productive to figure out an imperfect but sustainable approach you can enjoy. It is also worth remembering that what we can't always bend nature to our will.

I'm very logical and data driven person, and I recognise that sometimes I can get too obsessed with what I can measure and optimise. Most of the time it is helpful and really motivates me, but there are times like this last week where it worked against me. Especially when it is combined with my need to 'fix' things, even though in this instance there might not be any quick fixes. I need to work on this, but just getting this perspective has meant that I didn't just throw in the towel, didn't try to fix my problems by eating excessive amounts of highly refined carbs and am staying the course.

Can I thank you all again?

 

[Paul_]

@Outlier, @Paul_ , @JoKalsbeek and @MrPeaky, thanks for taking time to give your perspective and a bit of pep talk. It made a lot of difference when I really needed it and really underscores the importance and value of this community. Thank you!

So, what did I re-discover today? It's more about the journey, than the actual destination. It is about accepting that setbacks are part of managing our conditions and that it is important to stop and enjoy our wins. There is no point about obsessing about getting it perfect, it is a lot more productive to figure out an imperfect but sustainable approach you can enjoy. It is also worth remembering that what we can't always bend nature to our will.

I'm very logical and data driven person, and I recognise that sometimes I can get too obsessed with what I can measure and optimise. Most of the time it is helpful and really motivates me, but there are times like this last week where it worked against me. Especially when it is combined with my need to 'fix' things, even though in this instance there might not be any quick fixes. I need to work on this, but just getting this perspective has meant that I didn't just throw in the towel, didn't try to fix my problems by eating excessive amounts of highly refined carbs and am staying the course.

Can I thank you all again?

No need to thank me, everything I've said is based on a perspective the amazing people on this forum have encouraged and enabled me to gain through their great advice. It's also easier to have this perspective when you're through those initial few months that you're still in of trying to control T2 via diet, they really are the toughest point.

In terms of your reply above, don't think of it as "fixing" things or "setbacks", you've just got some bumps in the road. You're always moving forward on that road, you're moving towards where you need to be, it's just sometimes you need to smooth out the bumps. You really are doing well, but sometimes in those aforementioned difficult months, it's difficult to have confidence in that. Your approach is very similar to mine and if you stick with it, you'll almost certainly see ongoing improvement. Don't lose hope, you'll get there.

Anyway, just in case you think my approach has always been perfect, or it seems remarkably tranquil, here's an overview of the insanity that followed my diagnosis!

Post in thread 'Hello and Thank You' https://www.diabetes.co.uk/forum/threads/hello-and-thank-you.198715/post-2655998

 

[TheSecretCarbAddict]

I'm still struggling with my BG levels and weight loss and have decided to do a blood glucose boot camp. What's that you might ask? Well, all I'm doing is going back to my own metabolic health principles and just making sure I don't ignore these whenever I feel like it. I've set myself some targets I want to achieve over the next four weeks and today marks day one of this journey. I'm posting here to keep myself accountable. I plan to track my more detailed progress on my blog if anyone is interested: https://thesecretcarbaddict.uk/2024/06/blood-glucose-boot-camp-day-1/

 

[Paul_]

I'm still struggling with my BG levels and weight loss and have decided to do a blood glucose boot camp. What's that you might ask? Well, all I'm doing is going back to my own metabolic health principles and just making sure I don't ignore these whenever I feel like it. I've set myself some targets I want to achieve over the next four weeks and today marks day one of this journey. I'm posting here to keep myself accountable. I plan to track my more detailed progress on my blog if anyone is interested: https://thesecretcarbaddict.uk/2024/06/blood-glucose-boot-camp-day-1/

Sounds like a good approach. Like me, you appear to be someone who is motivated by data driven goals and targets. For me, being able to track my progress, successful or not, has been critical to the longer term success of my approach. It's why the NHS recommended approach of "don't test your BG, just eat normally and come for an hba1c blood test every few months" was something I quickly looked for alternatives to.

I've had bad days and weeks, everyone does, but through tracking them it's allowed me to use those days/weeks to make improvements and they motivate me to ensure the longer term, bigger picture.

Good luck @TheSecretCarbAddict, keep us updated!

 

[TheSecretCarbAddict]

A picture is worth a thousand words... sort of.. according to MS Word my Day 2 update is about 550 words long.

Full update: https://thesecretcarbaddict.uk/2024/06/blood-glucose-boot-camp-day-2/

 

[Melgar]

I’m also into stats so my life is definitely quantifiable, which may be viewed me as controlling. Your regime, Is it a combination of physical activity plus the fasting that usually keeps your blood sugars relatively stable until now ? You may have mentioned the reasons in your earlier posts but my eye sight is lousy so please forgive me if I’m saying something you have already mentioned. I use exercise to bring my blood sugars down and I’ve been quite successful so far. I do sufficient exercise to put myself in to exercise induced ketosis. I see you walk 9km a day, this is what I do plus I do weights. My exercising temporarily impacts the following day‘s blood sugars . I do notice that when I don’t exercise like now, as I’ve just had surgery, so I have been forced to take it easy, my blood sugars have gone up noticeably so. My baseline has annoyingly risen to 7mmol/ls from 4 (it went down to 4 due to the effects of blood sugar lowering meds I started a few weeks ago ) but now they are up. Of course if your baseline has risen then it raises all the averages. One thing comes to mind and I am sure you have considered this but how is your hydration while fasting because that will raise your baseline. A change of cgm sensor may also be a culprit, if that correlates with your raised blood sugars.

Like others here i would be interested to see your results over several weeks.

 

[Paul_]

I see very similar BG trends to what @Melgar describes with exercise. Admittedly, some forms of exercise raise my BG levels, if they're particularly strenuous or stressful to do. However, in all cases, my BG is always either the same (if I had a low pre-exercise result) or lower than my pre-exercise result, when taken 2 hours after exercise finishes. Like both of you, I generally do quite a bit of walking though as my primary form of exercise.

I've also been careful to schedule exercise around food where I can, to either burn carbs post-meal if needed, or to time exercise before meals to avoid the post-exercise munchies!

 

[TheSecretCarbAddict]

I’m also into stats so my life is definitely quantifiable, which may be viewed me as controlling. Your regime, Is it a combination of physical activity plus the fasting that usually keeps your blood sugars relatively stable until now ? You may have mentioned the reasons in your earlier posts but my eye sight is lousy so please forgive me if I’m saying something you have already mentioned. I use exercise to bring my blood sugars down and I’ve been quite successful so far. I do sufficient exercise to put myself in to exercise induced ketosis. I see you walk 9km a day, this is what I do plus I do weights. My exercising temporarily impacts the following day‘s blood sugars . I do notice that when I don’t exercise like now, as I’ve just had surgery, so I have been forced to take it easy, my blood sugars have gone up noticeably so. My baseline has annoyingly risen to 7mmol/ls from 4 (it went down to 4 due to the effects of blood sugar lowering meds I started a few weeks ago ) but now they are up. Of course if your baseline has risen then it raises all the averages. One thing comes to mind and I am sure you have considered this but how is your hydration while fasting because that will raise your baseline. A change of cgm sensor may also be a culprit, if that correlates with your raised blood sugars.

Like others here i would be interested to see your results over several weeks.

Thanks for taking time to share your experience, @Melgar. In terms of exercise, brisk walking works really well for me. I have to do 45min+ for BG to start going down after a small initial rise. I have been thinking about including some resistance exercise, but don't want to be changing too many things at once. I do hydrate plenty when fasting and have ruled out CGM sensor impact via glucometer. I think for me this is still very new and I'm figuring what works and doesn't work for my body with no meds to support me.

 

[TheSecretCarbAddict]

Day 3 update - my first day back in 'green' after a few weeks of elevated BG. CGM showing 4.4 mmol/l as I post this (it is still a few hours to go until 3am when I seem to be at my lowest point of the day).

Full update here: https://thesecretcarbaddict.uk/2024/06/blood-glucose-boot-camp-day-3/

 

[Paul_]

Day 3 update - my first day back in 'green' after a few weeks of elevated BG. CGM showing 4.4 mmol/l as I post this (it is still a few hours to go until 3am when I seem to be at my lowest point of the day).

View attachment 68100
Full update here: https://thesecretcarbaddict.uk/2024/06/blood-glucose-boot-camp-day-3/

Encouraging progress, very interesting to read. Keep up the good work!

Two points I would raise, based on your blog:

1) Peanuts

Actually lets just say nuts generally, as if you're anything like me, they're all extremely moreish! If you're looking to lose weight, they definitely need to be portion controlled in my experience. Additionally, if diet managing T2, they also need to be controlled due to carbs (just to state the obvious). However, purely based on my personal experience and weight loss efforts so far, I'll just raise a point of caution when it comes to "banning" foods, whether that's for nuts or any other food.

For me, every diet I've done previously before my T2D diagnosis essentially involved banning foods. Every single one of those diets failed, plus I gained more weight again after the diet failed. Since T2D diagnosis, I've been on a keto diet, maybe extending to low carb territory very occasionally, and have lost over 9 stone - but nothing is particularly banned. Instead, I've learnt how to portion control and this has been far more successful.

Sustainability is the most important factor with any diet in my opinion, so denial of foods doesn't always help from a psychological or diet sustainability perspective - or at least it doesn't for me. Banned foods can lead to cravings, which can get out of hand. Sometimes "a little of what ails you" isn't necessarily a bad thing. Almonds are a good, lower carb alternatives to peanuts. Alternatively, Aldi sell small 25g snacks packs of peanuts (various flavours, around 3g carbs per pack) and these can really help with portion control. Might not be for you, but just wanted to put the alternative approach out there.

2) Protein

Unless you have kidney issues, protein can be a valuable macronutrient when trying to lose weight, even on a LCHF diet. Protein keeps you fuller for longer, which can help stave off cravings and hunger. It's also important to hit your protein target (generally 1-2g per kg of ideal weight) to reduce muscle mass loss while losing weight. Additionally, although the science is somewhat disputed from what I've read, if trying to lose weight using LCHF then replacing some of the fat intake with protein can potentially help with burning fat mass, especially when your overall calorie intake isn't in excess of what your body requires.

Good luck with your doctor's appointment, let us know how it goes.

 

[Melgar]

Thanks for taking time to share your experience, @Melgar. In terms of exercise, brisk walking works really well for me. I have to do 45min+ for BG to start going down after a small initial rise. I have been thinking about including some resistance exercise, but don't want to be changing too many things at once. I do hydrate plenty when fasting and have ruled out CGM sensor impact via glucometer. I think for me this is still very new and I'm figuring what works and doesn't work for my body with no meds to support me.

You are so welcome. Your new stats look very encouraging , you must be pleased with that result. Exercise is my thing and my go to. To be honest I have a couple of 5lb weights that I use, nothing like bar bells or multi gyms just basic repetitive movements. It keeps me toned lol. I exercise my leg muscles with mountain hikes. We have some pretty steep climbs here in British Columbia which serves me well. Once again well done.

 

[TheSecretCarbAddict]

Encouraging progress, very interesting to read. Keep up the good work!

Two points I would raise, based on your blog:

1) Peanuts

Actually lets just say nuts generally, as if you're anything like me, they're all extremely moreish! If you're looking to lose weight, they definitely need to be portion controlled in my experience. Additionally, if diet managing T2, they also need to be controlled due to carbs (just to state the obvious). However, purely based on my personal experience and weight loss efforts so far, I'll just raise a point of caution when it comes to "banning" foods, whether that's for nuts or any other food.

For me, every diet I've done previously before my T2D diagnosis essentially involved banning foods. Every single one of those diets failed, plus I gained more weight again after the diet failed. Since T2D diagnosis, I've been on a keto diet, maybe extending to low carb territory very occasionally, and have lost over 9 stone - but nothing is particularly banned. Instead, I've learnt how to portion control and this has been far more successful.

Sustainability is the most important factor with any diet in my opinion, so denial of foods doesn't always help from a psychological or diet sustainability perspective - or at least it doesn't for me. Banned foods can lead to cravings, which can get out of hand. Sometimes "a little of what ails you" isn't necessarily a bad thing. Almonds are a good, lower carb alternatives to peanuts. Alternatively, Aldi sell small 25g snacks packs of peanuts (various flavours, around 3g carbs per pack) and these can really help with portion control. Might not be for you, but just wanted to put the alternative approach out there.

2) Protein

Unless you have kidney issues, protein can be a valuable macronutrient when trying to lose weight, even on a LCHF diet. Protein keeps you fuller for longer, which can help stave off cravings and hunger. It's also important to hit your protein target (generally 1-2g per kg of ideal weight) to reduce muscle mass loss while losing weight. Additionally, although the science is somewhat disputed from what I've read, if trying to lose weight using LCHF then replacing some of the fat intake with protein can potentially help with burning fat mass, especially when your overall calorie intake isn't in excess of what your body requires.

Good luck with your doctor's appointment, let us know how it goes.

Thanks, @Paul_, some solid advice here and as you can imagine I have pondered both items at length and it is complicated.

Peanuts - salted or chilli were my go-to snack before I went low carb. While not terrible in terms of carb content it's all in portion control. As you mentioned there are alternatives and I swapped to a mix of plain brazil nuts and wallnut halves + almonds now and then. Just see allowing myself to finish off that open packet of peanuts as kicking off a chain of unexpected events.

Peanuts, take two - a more interesting and wide-reaching topic you touch on is food restriction and whether it is generally a good idea. This is what's been on my mind for a few weeks and in my case, there are several different competing considerations at play. I'm still trying to figure out what's healthy, maintainable and a good balance for me.

Here are some thoughts on this:

- Different versions of low carb diet are inherently about restriction to specific ratios of macros or even specific macros (low carb vs very low carb vs no carb)
- I have found a carb level that I'm comfortable with at the moment (<20g net carbs a day) and have a rule of thumb for making my food choices to help support this: foods with up to 5g carbs per 100g are on my safe list, up to 10g per 100g on my use sparingly list, and above 10g per 100g on my avoid list. That is not to say I can't eat foods higher in carbs - but it is about making a conscious decision about it and then controlling portion size.
- Fasting in different forms - from avoiding snacks between meals and intermittent fasting to alternate day fasting and longer therapeutical fasts are also about restriction
- When tackling my food addiction abstinence is often more effective than moderation. From this perspective it is critical for me to identify my trigger foods and the avoid these. In this case I'd go as far as say ban. I find that not having foods that cause me cravings reduce those cravings over time. As with diabetes remission this is not a cure, but recovery that need to be constantly maintained.
- My individual metabolism will also dictate what works or doesn't work for me - I need to keep listening to my body and avoid foods that don't agree with me based on biofeedback. While psychologically I might not want to avoid peanuts, my body might have a different idea physiologically.
- If I am to be successful in maintaining any lifestyle changes, I also need to work with how I am as an individual. I tend to be a bit of all or nothing - I'm either in and doing it, or not bothering at all. For me it might be easier to fully abstain from certain things, rather than try and moderate.
- Now, if I start to bring this all together, for me a clear set of principles with not too many gray areas is what I need for me to be successful and maintain my approach and then manage sticking to those principles. Where I'm struggling is deciding if it is healthy to have such a strict approach from long term mental wellbeing perspective. On one hand, I'm doing all this to better manage my long-term health conditions and it is really my body that dictates what interventions are needed. On the other hand, I'm wondering if my food addiction is now trying to find other outlets and is disguising some of its obsessiveness as me trying to live a more helthy lifestyle, and really going for it rather than taking it easy. But then again, I'm usually either all or nothing person.

Protein - My original target was at least between 1-1.5g protein per kg of my current weight, but despite me cutting down carbs to <20g net a day and really sticking to this my BG levels still were elevated, and dawn phenomena was going crazy. If there were not that many carbs in my body and I'm eating quite a lot of protein my next line of enquiry is if excess protein is being converted into BG instead. And if that's the case, what is the right level of protein for me. Initial tests seem to show that it is either fasting or reduced protein that is helping me, now need to separate the two interventions to see individual impact. I'm partial to Dr Jason Fung's approach on fasting and when it comes to protein intake his recommendation is 0.6g of protein per kg of your body weight, or less if you are trying to lose weight. That feels a little bit too low, so I'm setting my current target at 0.8g to see how it goes and will nudge it up until I find my tipping point.

The most important learning point which gets reinforced every day is that it is a journey, nothing stay still, you just need to keep listening to your body and adjust as needed.

 

[Outlier]

FWIW, nearly 3 years now of keto and my body is still changing in good ways. Luckily I find myself fascinating.