Hello, I’m a recently diagnosed type 2.

Shawn14564 said:

Full story;

I am a 39 year old male, overweight but otherwise in good health.

I had routine bloodwork in mid August, fasting blood glucose came in at 178mg/dL. Not good.

Next test was the a1c, that was 8.4% (in American terms). Not good!

Doctor put me on metformin, 1000mg/day.

I never took it.

Instead, I started a 1400 calorie a day diet combined with daily cardio exercise.

Less than a month later my fasting glucose is 118-121 in the mornings. Not perfect but better. I’ve also lost 10 pounds (4.5kg) so far.

My goal, possibly unreasonable but worth trying, is to lose 45 pounds (20kg), with daily exercise and diet, to see the if I can put this into full remission without medication.

Any comments, thoughts are welcome!

Thanks for having me!

Shawn

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Hello Shawn, and welcome,

Good job on the weight loss! Going forward from this though, a low calorie diet may be helping you to lose weight, but it isn't sustainable in the long run. So you'll need to shift to a different diet sooner or later, for both weight control and bloodsugar control. https://www.diabetes.co.uk/forum/blog-entry/the-nutritional-thingy.2330/ could help, just so you know... Because you can't stay in a calorie deficit forever, not without beginning to suffer ill effects eventually. Plus, you're not happy with your FBG yet, and that would be tackled on LCHF. Takes a little while, but it's worth it.

Good luck, and again, welcome!
Jo

Shawn14564 said:

I could be wrong, (I see the dietitian today), but I am of the opinion that my excess fat (specifically around the pancreas) is the reason for my insulin resistance, and that drastically reducing that fat (and adding skeletal muscle) may help kick my pancreas into action.


Do you think after I lose the weight on my low calorie diet, it’s possible that my FBG will be “normal”, and I can switch to a level of calories to maintain my new weight and thus my normal blood sugar levels?
It would be solely a calorie restriction (at a weight maintenance level, not a deficit), with no foods off limits, just excess calories off limits.

I know, it may be a bit of wishful thinking, but one can hope.

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Your last line says it all... You know it is wishful thinking. It's not the calories you can't handle, it's the carbs. Your body has a metabolic condition, and because of that you can't process them. The excess glucose (from the CARBS, not FATS) gets stored in fat cells on your liver and pancreas. Basically, you can eat a stick of butter and you'd lose weight. Just fats in there, so a blood sugar flatline, and it doesn't get stored anywhere. It's the glucose spikes that are adding on the visceral fats... (And especially from fruits, as the liver considers fructose to be toxic.). It's all a lot to take in, I know... You might want to read The Diabetes Code by Dr. Jason Fung... But once I started counting carbs instead of calories, and ditched the bread, spuds etc, I lost weight. While having bacon once or twice a day. Considering I was about as broad as I was tall... That's saying something. And I'm not the only one either.

Correct me if I'm wrong, but are you currentl only checking your fasting blood glucose? You want to know what happens with a meal. Test before a meal and 2 hours after the first bite. That'll tell you exactly where you're at. (You don't want to see a rise of more than 2.0 mmol/l or 37 mg/dl. If it's higher, there were more carbs in there than your body could handle).

I had a dietician who was still on the high carb low fat bandwagon. They got me to 105 kilo's and diabetes, with the bread and other carbs they were pushing. Once i tossed that advice into the wind I got my weight down, my diabetes in the non-diabetic zone, no more complications and no more medication... And I am but one of the MANY on here who have done that.

There are foods off limits, if you want to stay medication-free... But there's enough left over to make eating a bona-fide pleasure. I am on a ketogenic diet, which is a form of low carb/high fat, and if I eat this way for the rest of my life... Could well be I stay in the non-diabetic range permanently, and enjoying my meals to boot. And I get to keep my feet, eyesight and kidneys. (Relax, I'm kidding. A T2 isn't doomed per definition. And you're more than willing to act on this, obviously. You're going to be fine.)

Hi @Shawn14564 , welcome to the forum!
I'm not T2, so I don't have much to comment except a well done already!

We have a very useful info sheet about diabetes we like to offer to new members: http://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/
And I also like to tag some members who have gotten their bg levels and weight back to healthy: @Rachox , @Goonergal , do you have any comments and thoughts for Shawn?

Shawn14564 said:

It would be solely a calorie restriction (at a weight maintenance level, not a deficit), with no foods off limits, just excess calories off limits.

I know, it may be a bit of wishful thinking, but one can hope.

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May I ask why you would prefer calorie restriction to carb restriction? In the little experience I have with calorie restriction, it makes hungry, which I don't like and which I would find very difficult to maintain long term, while carb restriction has helped a lot of members with weight loss and blood sugars without going hungry (and while eating things like bacon and eggs too).

Your pancreas has probably been throwing out insulin and (metaphorically) sobbing hysterically at being ignored.
I was on a low fat high carb diet - to lower cholesterol - which it did not - and at diagnosis I went low carb at once. It pushed me back into normal readings quite quickly and I lost weight without any effort.
Testing after meals will show you what not to eat, and then fasting levels should gradually drop as metabolism normalizes.

Shawn14564 said:

with no foods off limits, just excess calories off limits.

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Your thinking seems a little backwards there Shawn this would assume that your body treats all food the same.
Simply not true, it can not handle sugar for a start you know this to be true.

So the rules:
1. No sugar. You already know this.
2. No carbohydrates. Carbs = sugar it sounds like you are not aware of this.
3. The medical profession follows the guidelines set down by the government on how to tackle diabetes which is eat lots of carbohydrates with every meal. Doh!

Shawn14564 said:

My goal, possibly unreasonable but worth trying, is to lose 45 pounds (20kg), with daily exercise and diet, to see the if I can put this into full remission without medication.

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There is nothing unreasonable about this Shawn it can take as little as 3 months to drain your liver of fat and reduce blood sugars to a non diabetic (remission/ reversed) level.

If it takes a little bit longer so what you have the rest of your life in front of you.
Take a look at LCHF diets you should find it helps you get there quicker.

Thanks @Antje77 for the tag.

Hi @Shawn14564 and welcome

Firstly congratulations on the steps you’ve taken so far. Great progress on both the blood glucose reduction and weight loss.

I’m a type 2 who has lost a lot of weight and dropped my blood glucose into the normal range (details in signature) so am speaking from personal experience as well as from what I’ve learned on the forum.

You said:

Shawn14564 said:

I could be wrong, (I see the dietitian today), but I am of the opinion that my excess fat (specifically around the pancreas) is the reason for my insulin resistance, and that drastically reducing that fat (and adding skeletal muscle) may help kick my pancreas into action.

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That is quite right. As you’ll have seen from the differing opinions in the replies above, there are many viewpoints about the best way to go about achieving this, with a low carbohydrate diet and a very low calorie diet being the two most popular.

Personally I lean towards the low carb approach mainly because as @JoKalsbeek says above, it’s more sustainable in the long run. Eating that way generally results in less hunger, less restriction and allows you to adjust naturally as you go along. With the very low calorie approach, once weight loss goals have been reached, there needs to be a re-evaluation so that you are able to eat enough without regaining weight.

The extent to which you need to reduce carbs to lower blood glucose, which is the main aim for type 2s, is personal. @There is no Spoon is quite correct, all carbs turn to sugar, but not everyone needs or desires to cut them out completely. I personally do eat as close to zero carb as possible, but that is by no means the only route.

You obviously have a meter and are testing. Aside from fasting blood glucose levels (which are often the slowest to come down) are you also testing before and after meals to understand the impact of particular foods on your blood sugars? That will be the main guide as to the amount of carbs you can eat whilst achieving your blood glucose and weight loss goals. Ideally you need to test immediately before eating and again 2 hours after the first bite. Ideally you’re looking for a rise of no more than 36 mg/dl (2 mmols) at the 2 hour point.

You mention exercise and that’s definitely a good plan for your overall health, but diet is the single biggest influence on your blood sugars. There are many on here with excellent HbA1c numbers who do very little exercise.

Finally, a couple of links for you:

http://www.diabetes.co.uk/forum/threads/basic-information-for-newly-diagnosed-diabetics.26870/

www.dietdoctor.com

Edited to correct typo.

Hi @Shawn14564

Congratulation on the weight loss and getting stuck in to this.

Ditto all the above advise for me.
As said its the glucose we can't handle
That IS the issue... And it's going to be an ongoing issue.

So going low calorie might help now, but you'll be going low cal forever, I think.

I went LCHF about 8 weeks after Disgnosis and the EATWELL plate left me exhausted, constantly hungry and in a very dark place emotionally.
And when I went back to check how much all my efforts had reduced my HBA1c... It had actually gotten worse.

3 months on here and eating LCHF got me from 57 mmol... To just outside normal 42 mmol.

Bottom line is we all must do as we feel it's right for is.. But never hurts as your visit her proves, to look at all the options.

For me.. That was LCHF..1 year in, I'm fitter, slimmer then I've been for a good 10/15 years.
HBA1c. Now normal at 40 mmol.. and lost close on 4 stone.... Others are much more impressive....

And more importantly ALL my blood tests from doctors are now much improved over those at DX...

Welcome to the board, and best of luck managing this demon of an illness, whatever journey you take.

Welcome to the forum.

Congratulations on what you have achieved so far.

My advice is that you invest in a meter. That will allow you to measure your blood sugar levels. I understand why you want to lose weight but I suggest that your first focus be on your blood sugar levels. Too high blood sugars can lead to health consequences.

Once you have a meter you are able to try different food and see the effect on your blood sugar. Full disclosure- I'm another on the low carb lifestyle as I find that means my blood sugar levels are in n normal range. I wanted to bring them down as quickly as possible.

Good luck. whatever you decide to do there are people here who will help, sympathise and listen and answer any questions you have.

Shawn14564 said:

Full story;

I am a 39 year old male, overweight but otherwise in good health.

I had routine bloodwork in mid August, fasting blood glucose came in at 178mg/dL. Not good.

Next test was the a1c, that was 8.4% (in American terms). Not good!

Doctor put me on metformin, 1000mg/day.

I never took it.

Instead, I started a 1400 calorie a day diet combined with daily cardio exercise.

Less than a month later my fasting glucose is 118-121 in the mornings. Not perfect but better. I’ve also lost 10 pounds (4.5kg) so far.

My goal, possibly unreasonable but worth trying, is to lose 45 pounds (20kg), with daily exercise and diet, to see the if I can put this into full remission without medication.

Any comments, thoughts are welcome!

Thanks for having me!

Shawn

Click to expand...

Your case sounds very similar to mine. I also was diagnosed at 8.4%. I went low carb. Three months later I was 30 pounds lighter (from 225 to 195) and my A1C was at 5.9%. Low carb worked amazingly well for me, although I am currently stuck at 195 pounds (for over a month). Trying to get to 185. You might consider the low carb high fat approach. To me, it is more sustainable than low calorie. I still can eat plenty of things I like.

Welcome @Shawn14564

I eat a much more moderate carb diet than most on this site, so you may not have to change as much as others. I regularly eat many of the foods many hear find off limits. I eat fruit and starchy veggies regularly. I eat around 200g carbs per day.

One thing I agree on is a change in diet IS necessary. I lost all the necessary weight, I exercise regularly, but some foods are not good for my blood glucose - mainly bread, pasta, rice. My A1c was higher than yours - 11.8%. I’m now always 4.x% or 5.x%

You’ll need to test and see what works for you.

@Shawn14564 well done on your progress so far. I average between 100 - 130g of carbs a day which is the higher range of low carb and a lot more than many forum members. I’ve maintained my hba1c in non diabetic levels for approx 6 years and FBS ranges between 5.0 and 5.6. I use my BS monitor to decide what foods I can and should not eat and, through testing, have found that I can eat bread, potatoes albeit in smaller portions than before, some fruit and reheated pasta without too much affect on my BS. The thing to remember with T2 diabetics is that the ‘healthy’ diet recommended by most dieticians is unhealthy for us because of the number of carbs it contains so meat, eggs, cheese, butter, full fat yoghurt, not much fruit etc are actually better for us - it seems strange at first as it seems contrary to what we’ve always been led to believe is unhealthy however, as many on here can testify, it works!

Walking Girl said:

Welcome @Shawn14564

I eat a much more moderate carb diet than most on this site, so you may not have to change as much as others. I regularly eat many of the foods many hear find off limits. I eat fruit and starchy veggies regularly. I eat around 200g carbs per day.

One thing I agree on is a change in diet IS necessary. I lost all the necessary weight, I exercise regularly, but some foods are not good for my blood glucose - mainly bread, pasta, rice. My A1c was higher than yours - 11.8%. I’m now always 4.x% or 5.x%

You’ll need to test and see what works for you.

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It’s great to know that you can get results and not be super low carb. The LCHF diet makes me feel sick and constipated. There is no joy on that way of eating for me. Thanks for sharing.

Shawn14564 said:

Thanks for all the responses!

Sorry for the delay in posting.

My dietician recommends 1500-1700 cals a day until I reach my goal weight, with the added stipulation of no more than 180g carbs per day. Fasting blood sugar is still at “pre-diabetic” levels, around 110-120 in the mornings. I’ve seen it as high as 145 after meals.

Vigorous exercise seems to *really* help the blood sugar levels, dropping it into the 90’s or even 80’s.

I think I’ll continue on this course of action until I’m at a normal body weight, then reevaluate and see if a very low carb diet would be the right choice for me, or if continued daily exercise and calorie control would be fine.

Cheers!

Shawn

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Well done on your progress so far. I have just one thing to mention. Do you have a backup plan for if you are unable to exercise, due to illness or injury? As well as considering low carb for when you have achieved your desired weight it could be your back up plan if exercise isn’t possible for any reason.

I would caution against relying on exercise to deal with so many carbohydrates.
More calories from protein and fat should stop weightloss, so maybe practice a little adjusting up and down to see how your weight responds, but so many gm of carbs having to be burned off by exercise is still keeping the glucose side of the metabolism running rather than closing down and fats being used as fuel. Ketosis will continue if not switched off by carb intake, using the pathways which are still working well, not those made erratic by diabetes.

Shawn14564 said:

Interesting advice!

I will bring this all up to my dietician today in 2 hours and see what she thinks. I will post what she says here.

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What did the Dietician say?