How long for Metformin to show the effects

Guzzler

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I am glad that you enjoy excercise and hope that you will be able to take part for many years to come. Being wheelchair bound and unable to excercise (even resistive bands caused a flare up of my chronic pain) I cannot take part in any form of excercise, however, since LCHF I have seen a small but definite improvement in my ability to transfer from the wheelchair to sofa/bed/bathroom. The biggest improvement has been in my blood glucose levels which are quite satisfactory now. My HbA1c has come down well and I hope to acheive non Diabetic numbers at my next review due very soon.

We each do our very best to stay as healthy as we can to better enjoy life and to avoid the nasty complications that can happen to some. Someone wise said 'You can't outrun a bad diet' so I do as much as I can to make sure that my diet is full of the foods that keep me healthy and so far it has worked for me and for many thousands of others. I am not a fish in a shoal, I have read and researched and LCHF makes logical sense to me and my glucometer agrees.

Best wishes.
 

bulkbiker

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Hi @ittiandro
Glad you haven't gone.
Just because we disagree doesn't mean we can't all get along.

This site has a low carb program which so far I believe has over 250,000 members of which a significant number have achieved great things through low carb. So far as I know the data from the program will be published in the not to distant future @Administrator please correct me if I am wrong here. This may supply you with some of the evidence you seek. Also there has been a recently published Virta Health study on their success with Low Carb diets.

You start off mentioning low carb then switch to low calorie? Was this deliberate on your part as it has confused me rather.
Low calorie diets of the "Newcastle Study" type are also used by some on the site for blood glucose control and they also dangle the "reversal" moniker. In the actual studies this means a HbA1c of less than 48mmol/m which is still (in the UK) deemed to be pre diabetes. So how they can claim "reversal" is beyond me but hey some people get taken in.

You quote Diabetes UK (which is a different entity to Diabetes.co.uk of which this forum is part). I'm not sure if you know that Diabetes UK is like the ADA and is a known Low Carb sceptic organisation although they have recently started admitting that is can be successful. They instead advocate the Eatwell guide .. a high carb cr*p fest of food which causes raised blood sugars in most who try it.

As to your blood sugar levels, on my unhealthy ketogenic diet which you seem to think won't work I try and remain within the 3-6.5 mmol/l range at all times. I am usually quite successful in this. I would be severely disappointed if my blood sugar levels went above this. This has for the most part been maintained for the past 18 months without really any more exercise than walking the dog and some swimming. I'm sure lots of people get better results by doing more exercise but I am by nature a lazy beast so don't like it very much and therefore avoid it where possible. My main concern is that your blood sugars appear to be quite high. They are in the region that could be causing your body damage and I think your healthcare professionals have been remiss in not alerting you to this sooner. You however seem quite happy with them so...

As for metformin.. I took it for 3 weeks of sheer hell when I could not be more than 10 feet from the toilet. I tried regular and slow release with disastrous consequences on a number of occasions. I vowed never to let them pass my lips again no matter how "safe" the docs tell me they are.

I can assure you I have a healthy disbelief in both guru's and religion. I like to "follow the science" and try to keep as informed as possible in regards to this condition that I have been blessed with. With that in mind I am pretty convinced that ultra low carb is both healthy and well worth doing. But as with everything else that is my own (not very) humble opinion. I would still recommend you try it for a couple of months and watch your blood sugar numbers tumble.

Wishing you well in your future.
 
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NoCrbs4Me

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@ittiandro

These 200+ Canadian medical doctors disagree with the Canada Food Guide:

www.foodmed.net/2016/canada.pdf

Take special note of their point #5:

"The Canadian Dietary Guidelines should promote low-carb diets as at least one safe and effective intervention for people
struggling with obesity, diabetes, and heart disease ."

They provide plenty of references to lots of published papers that support their point of view that you can review. Maybe ask your doctor what she thinks of this.
 
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ickihun

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I was about to bow out of this Forum, faced with the sanctimonious resentment of some members, who see my arguments as biased, wrong and bent on proving that I am right at all costs (and , of course, the others wrong , without listening to them.) ..I do listen more than some may think, but I also listen to those who have different opinions than Dr Unwin’s. This is the difference.

I will step in again, though, because I read somebody in this Forum referring to Dr David Unwin as “ Our guru” and a red light immediately flashed in my mind..

This person has probably used the term guru more as an analogy than in the full literal, ( and uncritical) sense of a devotee blindly obeying his Guru’s precepts, but, still, the reaction of some members to my rebuttal, in which I questioned the LCHF diet, sounded somewhat more akin to the reaction to heresy than a simple disagreement..

I will point out the following:

1.The same site hosting your Forum (https://www.diabetes.co.uk/blog/201...vidence-of-low-carb-diet-benefits-in-the-bmj/, while saying that

Quote

The low-carb diet has been shown to improve blood glucose control and HbA1c levels, while it can also help with weight loss and type 2 management.

Unquote,

Also explicitly recognizes

Quote

However, most medical guidelines in the UK do not recommend the diet. The NHS advocates eating relatively high-carb and low-fat foods, while Diabetes UK highlights a lack of evidence regarding the “long-term safety”

Unquote

Precisely! This lack of evidence is exactly the point I have been making all along! You cannot accuse me of harboring prejudices or not listening to the others, when Diabetes U.K. itself expresses my same reserves..

Regarding the effectiveness and long term safety of the diet, I asked my doctor yesterday..

In all fairness, contrary to my initial belief, I must admit that both her and the head-nurse of the clinic, who deal with diabetic patients all the time, didn’t deny that a low calories diet has some benefits, but there is a perverse flip side: if you go off the diet, there is a dangerous rebound effects: the hyperglycemia then soars up with a vengeance and in the end the damage outweighs the advantages of the diet… They have seen this time and again…

In the end, they believe that with Diabetes 2, the traditional approach, i.e. exercise and medication, is still the best and the safest approach, because not everyone and probably only a few , have the discipline and the resolve to stick to the diet..

Metformin, widely used for Diabetes 2, has been around since 1922 ! It wouldn’t be so widely prescribed if it was not effective, or worse, if it had serious long-term side effects.

Exercising is certainly easier and more rewarding, even in the short term.

In fact, even those days that I feel sluggish or ..lazy, I make an effort to go to the gym , because of the “ kick “ it gives me, in terms of mood and physical well-being.

It may be ..the placebo effect, too, but it is also scientifically well-documented that exercise, especially jogging, somehow enhances the production of endorphins, our… natural and healthy drugs..

In a way, like many, I ..am addicted to exercise, but this is why I can still eat carbs and keep my sugar within an acceptable range: according to numerous sources and my doctor’s diagnosis , 7.3 fasting and 8.4 p.p. , while not normal, are within the pre-diabetic range ( which goes up to 11 mmol/L contrary to the opinion of others in this Forum) .

In the end, exercise is demonstrably 100% safe and efficient for everybody, including diabetics, while low calories diet is widely controversial and may be only 50% safe (for every Dr Unwin there is bound to be at least another doctor, if not more, with a different opinion.)

In the doubt, I choose the 100% option : exercise. I think it stands to reason.

I am sure that among those who swear on a low carb diet and perhaps struggle hard to stick to it day in , day out , there are many able-bodied diabetics who would enjoy ( and greatly benefit from) one hour of jogging, treadmill, swimming , jumping around , ANYTHING (!) at least 2, 3 times a week., without gambling with their diet.

2.Concerning the list of eminent doctors and scientists who can dispel my “misconception” about the metabolism of fats and who, assumedly support a low carbs diet, I am sure they exist, but if you read the Australian clinical study I mentioned earlier (http://care.diabetesjournals.org/content/diacare/38/6/1008.full.pdf),

you will also see a list of other equally eminent doctors, scientists, universities and Health Organizations that have the same” misconception” about fat metabolism..( actually that “misconception”, if it is one, was not really mine. I simply quoted it from the study. So you have to argue it out with them, not me..)


4.As to the argument” It worked for me”, I do not intend to question that many, probably most of those who followed Dr Unwin’s guidelines have seen some improvement in their diabetic condition , but , once more, I am not too sure that there is a scientifically proven causal link between the LCHF and a better glucose management.

There are too many variables at play and the causes of these improvements in the diabetic condition may lie elsewhere…

Also, the placebo effect ( i.e. the psycho-somatic element) is well known : there have been thousands of well documented gravely ill religious believers recovering from deadly diseases or crippling conditions after dipping in the “holy “ waters of the Holy Virgin’s Shrines at Lourdes( France) or Fatima( Portugal) , waters that were appallingly dirty and bacteria infected like those of a cess-pool . But they believed and, for some reasons, many healed completely..


This is my take


Ittiandro
Yes I totally agree rebound happens.......but that's because low carb isn't supported by the NHS.
I have the same trouble with bariatric weight loss programme. Low carb is now heard off as being effective in patients for weight loss but not encouraged or supported.
Hence rebound and mental health injury.

Your old fashioned views don't help either. Read some modern journals and stop barking on the old ones.
Old ones are for reference only......no other use.
We have so much info these days and more eloquent patients who aren't scared of a doctor or authoritarian to rely their finding too. Instead of doctors with pokers up their ar&e making huge assumptions.
I rate the more modern info in the medical journals now as we live in the now, not the past!
Wake up and have some foresight!
 

NoCrbs4Me

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2.Concerning the list of eminent doctors and scientists who can dispel my “misconception” about the metabolism of fats and who, assumedly support a low carbs diet, I am sure they exist, but if you read the Australian clinical study I mentioned earlier (http://care.diabetesjournals.org/content/diacare/38/6/1008.full.pdf),

you will also see a list of other equally eminent doctors, scientists, universities and Health Organizations that have the same” misconception” about fat metabolism..( actually that “misconception”, if it is one, was not really mine. I simply quoted it from the study. So you have to argue it out with them, not me..)
I'm very curious about what it is that you think this study ("Impact of Fat, Protein, and Glycemic Index on Postprandial Glucose Control in Type 1 Diabetes: Implications for Intensive Diabetes Management in the Continuous Glucose Monitoring Era") says about low carb diets with respect to type 2 diabetes? Why have you stopped at one single study? Why not explore more studies?
 

oscarucho

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1
Type of diabetes
Type 2
Treatment type
Tablets (oral)
I am 76, very active ( gym, swimming, treadmill, windsurfing). My doctor put me on Metformin ( 500 mg/day, 2 half-doses) because my blood sugar is hovering on borderline with occasional spikes to 14 mmo/l.

I started Metformin last week. I still can’t get my fasting glucose below 7.5 avg measured at wakeup. Not much difference 2hrs after a meal( between 7.6-9.0 mmo/l. I use mostly aspartame , refined sugar very moderately. I weigh 85 kgm ,athletic build, except for some fat around the belly. I could do with losing a few kg, if anything because the more I weigh, the harder it is to ….sail on my windsurfer. Also, fewer kg would be less of a strain when jogging..

How long before I see the effects of Metformin, both in terms of blood sugar and, possibly, weight loss ?


Thanks


Ittiandro
My friend!!!I'm 77, only walk a bit, my 1Ac is 9,3 my fasting is 10 or 11 every day!!!Ittiandro enjoy your gym,swimming,etc!!!!
Eat every thing you like(in moderation,of course) 7,5 is NOTHING,enjoy life.With yours numbers you can live 20 years more, and by 97 it is OK it is not?
 

ittiandro

Member
Messages
19
Type of diabetes
Other
Treatment type
I do not have diabetes
Hi @ittiandro
Glad you haven't gone.
Just because we disagree doesn't mean we can't all get along.

This site has a low carb program which so far I believe has over 250,000 members of which a significant number have achieved great things through low carb. So far as I know the data from the program will be published in the not to distant future @Administrator please correct me if I am wrong here. This may supply you with some of the evidence you seek. Also there has been a recently published Virta Health study on their success with Low Carb diets.

You start off mentioning low carb then switch to low calorie? Was this deliberate on your part as it has confused me rather.
Low calorie diets of the "Newcastle Study" type are also used by some on the site for blood glucose control and they also dangle the "reversal" moniker. In the actual studies this means a HbA1c of less than 48mmol/m which is still (in the UK) deemed to be pre diabetes. So how they can claim "reversal" is beyond me but hey some people get taken in.

You quote Diabetes UK (which is a different entity to Diabetes.co.uk of which this forum is part). I'm not sure if you know that Diabetes UK is like the ADA and is a known Low Carb sceptic organisation although they have recently started admitting that is can be successful. They instead advocate the Eatwell guide .. a high carb cr*p fest of food which causes raised blood sugars in most who try it.

As to your blood sugar levels, on my unhealthy ketogenic diet which you seem to think won't work I try and remain within the 3-6.5 mmol/l range at all times. I am usually quite successful in this. I would be severely disappointed if my blood sugar levels went above this. This has for the most part been maintained for the past 18 months without really any more exercise than walking the dog and some swimming. I'm sure lots of people get better results by doing more exercise but I am by nature a lazy beast so don't like it very much and therefore avoid it where possible. My main concern is that your blood sugars appear to be quite high. They are in the region that could be causing your body damage and I think your healthcare professionals have been remiss in not alerting you to this sooner. You however seem quite happy with them so...

As for metformin.. I took it for 3 weeks of sheer hell when I could not be more than 10 feet from the toilet. I tried regular and slow release with disastrous consequences on a number of occasions. I vowed never to let them pass my lips again no matter how "safe" the docs tell me they are.

I can assure you I have a healthy disbelief in both guru's and religion. I like to "follow the science" and try to keep as informed as possible in regards to this condition that I have been blessed with. With that in mind I am pretty convinced that ultra low carb is both healthy and well worth doing. But as with everything else that is my own (not very) humble opinion. I would still recommend you try it for a couple of months and watch your blood sugar numbers tumble.

Wishing you well in your future.

Thanks for your comments. The low calorie term I have used somewhere is a slip of the tongue. I meant low carbs all along.


Your Metformin experience confirms once more that each individual may respond in different ways, be it to medications or perhaps dietary styles.

I have been taking Metformin for about two weeks now. No side effects so far.


I’ll also mention something from my own experience about the subjective component in health and the accuracy ( or..lack thereof) of diagnoses based on the established medical standards, especially when relying extensively on sophisticated electronic devices..

May be this vindicates all those who swear by their own self-perception in the diet they choose to follow..

In the end we may all be right or all wrong.

But maybe it doesn’t matter, after all if, like the Lourdes devotees healing after dipping in those “ holy” waters, we all feel better and ARE better after choosing our ways to be healthy.

Two years ago ( at 74) , while crossing the road, I fell on the ice , almost full strength and almost flat on my back. It was an excruciating pain, but after a few days it subsided considerably..

The X-rays and CT-scan didn’t reveal anything serious , structurally, in the spine. Probably a badly pulled muscle, while resisting the fall.

The muscle pain however lingered on for weeks, especially when getting in and out of bed. I could hardly exercise. Since the windsurfing season was approaching, I saw my doctor again. She sent me to an orthopedist, who gave me a full DXA scan.

The diagnosis fell like a brick on my head: late stage osteoporosis, severe risk of spine fractures, avoid any twisting of the spine., be careful when you lace your shoes or pick up objects from the floor, don’t jog etc, etc. Briefly , I might as well have gone on a wheelchair..

By summer, however, the pain was completely gone and I did windsurfing as usual for the following two seasons, in addition to my usual activities, like biking, the gym, etc. I even had my fair share of twists and falls when windsurfing and I also fell from the bike once to avoid another biker. NO PROBLEM!

Today I am as good as new, business as usual.

I was puzzled, though. I couldn’t believe I am osteoporotic, at that level!

I did a lot of readings.

Some clinical studies, one conducted by a couple of British universities ( or hospitals) as well as by McGill University here in Montreal , ( the orthopedist/endocrinologist who is treating me teaches at the same university!) raise some doubts about :

1. The reliability of the conventional indicator of osteoporosis, (low bone density ) and the reliance on scanning equipment like the DXA machines .

There seems to be a difference between bone density (as measured by the DXA scanners) and bone strength. Unfortunately the latter, which may be the key element, cannot be picked up by the DXA scanners ..

A low bone density may not be a reliable indicator of fracture risks, if bone strength is high. I suspect this is my case, because, by now, at 76, with a O.P. score of -4.3, almost as low as one can get., I should have already broken vertebrae or bones..

2. The DXA machines testing bone density require an ongoing maintenance and calibration, which is not always performed as it should because financially costly. Without it, the readings can ( and often have been shown to be) off , leading to false positives or lower T-scores.

3. In addition, the DXA machines compare the actual bone density of the patient to that of a healthy individual and the variation yields a T-score index, which indicates the severity of O.P.: it begins at -2,5. I am at -4,3, well beyond..). The hic is that there is an ethnic-demographic variable in the bone density of healthy individuals..

In fact, a study conducted, again, by a British hospital among samples of healthy individuals in 13 different European countries, indicated deviations in their mean bone density of as much as 2 points, the widest being in the Hungarian samples.

I am Mediterranean, (Italian ) and if the Canadian DXA machine used the mean bone density of the North-American population as a reference , my reading could well mean the difference between being osteoporotic or under the threshold..

Unfortunately , the radiologists signing the reports just go by the face-value of the machine readings, without verifying neither the maintenance, nor the calibration of the machines, nor the accuracy of the data fed in its computer program , even less worrying about the demographic variable, because all this falls within the responsibility of the computer technician or programmer…

To conclude, today's medical knowledge and technology are wonderful. They have saved millions of lives, but sometimes there are black holes in it and some caution is not out of place, especially given the real danger , evoked by some in this Forum, that the medical establishment be steered by the commercial interests of the pharmaceutical industry.
If this argument justifies some caution in following the guidelines of the medical establishment when it comes to high carbs diet, it should also call for caution, though, in going the opposite way and accepting other more unconventional theories.


Ittiandro
 
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NoCrbs4Me

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I reversed my Type 2
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Thanks for your comments. The low calorie term I have used somewhere is a slip of the tongue. I meant low carbs all along.


Your Metformin experience confirms once more that each individual may respond in different ways, be it to medications or perhaps dietary styles.

I have been taking Metformin for about two weeks now. No side effects so far.


I’ll also mention something from my own experience about the subjective component in health and the accuracy ( or..lack thereof) of diagnoses based on the established medical standards, especially when relying extensively on sophisticated electronic devices..

May be this vindicates all those who swear by their own self-perception in the diet they choose to follow..

In the end we may all be right or all wrong.

But maybe it doesn’t matter, after all if, like the Lourdes devotees healing after dipping in those “ holy” waters, we all feel better and ARE better after choosing our ways to be healthy.

Two years ago ( at 74) , while crossing the road, I fell on the ice , almost full strength and almost flat on my back. It was an excruciating pain, but after a few days it subsided considerably..

The X-rays and CT-scan didn’t reveal anything serious , structurally, in the spine. Probably a badly pulled muscle, while resisting the fall.

The muscle pain however lingered on for weeks, especially when getting in and out of bed. I could hardly exercise. Since the windsurfing season was approaching, I saw my doctor again. She sent me to an orthopedist, who gave me a full DXA scan.

The diagnosis fell like a brick on my head: late stage osteoporosis, severe risk of spine fractures, avoid any twisting of the spine., be careful when you lace your shoes or pick up objects from the floor, don’t jog etc, etc. Briefly , I might as well have gone on a wheelchair..

By summer, however, the pain was completely gone and I did windsurfing as usual for the following two seasons, in addition to my usual activities, like biking, the gym, etc. I even had my fair share of twists and falls when windsurfing and I also fell from the bike once to avoid another biker. NO PROBLEM!

Today I am as good as new, business as usual.

I was puzzled, though. I couldn’t believe I am osteoporotic, at that level!

I did a lot of readings.

Some clinical studies, one conducted by a couple of British universities ( or hospitals) as well as by McGill University here in Montreal , ( the orthopedist/endocrinologist who is treating me teaches at the same university!) raise some doubts about :

1. The reliability of the conventional indicator of osteoporosis, (low bone density ) and the reliance on scanning equipment like the DXA machines .

There seems to be a difference between bone density (as measured by the DXA scanners) and bone strength. Unfortunately the latter, which may be the key element, cannot be picked up by the DXA scanners ..

A low bone density may not be a reliable indicator of fracture risks, if bone strength is high. I suspect this is my case, because, by now, at 76, with a O.P. score of -4.3, almost as low as one can get., I should have already broken vertebrae or bones..

2. The DXA machines testing bone density require an ongoing maintenance and calibration, which is not always performed as it should because financially costly. Without it, the readings can ( and often have been shown to be) off , leading to false positives or lower T-scores.

3. In addition, the DXA machines compare the actual bone density of the patient to that of a healthy individual and the variation yields a T-score index, which indicates the severity of O.P.: it begins at -2,5. I am at -4,3, well beyond..). The hic is that there is an ethnic-demographic variable in the bone density of healthy individuals..

In fact, a study conducted, again, by a British hospital among samples of healthy individuals in 13 different European countries, indicated deviations in their mean bone density of as much as 2 points, the widest being in the Hungarian samples.

I am Mediterranean, (Italian ) and if the Canadian DXA machine used the mean bone density of the North-American population as a reference , my reading could well mean the difference between being osteoporotic or under the threshold..

Unfortunately , the radiologists signing the reports just go by the face-value of the machine readings, without verifying neither the maintenance, nor the calibration of the machines, nor the accuracy of the data fed in its computer program , even less worrying about the demographic variable, because all this falls within the responsibility of the computer technician or programmer…

To conclude, today's medical knowledge and technology are wonderful. They have saved millions of lives, but sometimes there are black holes in it and some caution is not out of place, especially given the real danger , evoked by some in this Forum, that the medical establishment be steered by the commercial interests of the pharmaceutical industry.
If this argument justifies some caution in following the guidelines of the medical establishment when it comes to high carbs diet, it should also call for caution, though, in going the opposite way and accepting other more unconventional theories.


Ittiandro
Perhaps not breaking any bones when you fell while having advanced osteoporosis was a placebo effect?
 

Sam50

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228
Type of diabetes
Don't have diabetes
Treatment type
Diet only
Thanks for your imput Paulus 1

There seems to be a wide-spread bias in this Forum in favour a low carbs diet to control glycemia . You go as low as recommending 50-70 g /day!

I don’t know on which medical grounds people can make this recommendation, unless they are prompted by an unbounded faith in hear-say and popular wisdom and a corresponding wide-sweeping mistrust in the medical establishment , which indeed warns against an indiscriminate low CHO diet..

I am sure some will say “ Well , it works for me..”.

I’ll only say that even if glycemia were to improve with a low CHO diet in one or more individuals, it is difficult to establish a an uncontrovertible causality link, because there are too many complex variables of which the layman, as compared to health professional, may not be aware..

First, according to Diabetes Canada, formerly the Canadian Diabetes Association,(http://guidelines.diabetes.ca/fullguidelines/chapter11#sec1 , the current recommended minimum intake for CHO is not less than 130 g/day, to provide glucose to the brain, a far cry from 50-70 g/day !

This can be outright dangerous ,as according to D.C. , the long-term sustainability and safety of CHO-restricted diets (mean CHO from 4% to 45% of total energy per day) may not ensure sufficient vitamin, mineral and fibre intake. While these low CHO diets may improve A1C and triglycerides (TG), they do not improve total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) or body weight compared with higher-CHO diets over the short term.

D.C. recommend that the percentage of total daily energy from CHO should be no less than 45% to prevent high intakes of fat, which are associated with higher risk of chronic disease for adults and I see no reason to question their opinion.

Secondly, speaking of “low” CHO ( and 50-70 g /day at that!) without further qualification is problematic , without considering the glycemic index ( G.I.) of the carbs.

According to D.C, the key point is not an indiscriminate reduction of CHO, with the risk of going below the safe limit, or replacing them with other energy sources ( fats and proteins) which can be just as dangerous if taken in higher quantities, but to exchange high-GI CHO foods with low-GI CHO foods.

You can go to the D.C. website to read more extensively. I will only quote an excerpt from their recommendations:

QUOTE Meta-analyses of controlled feeding trials of interventions replacing high-GI CHOs with low-GI CHOs in mixed meals have shown clinically significant improvements in glycemic control over 2 weeks to 6 months in people with type 1 or type 2 diabetes .

This dietary strategy also leads to improvements in cardiovascular risk factors, such as TC, over 2 to 24 weeks improvements in postprandial glycemia and high-sensitivity C-reactive protein (hsCRP) over 1 year (40) in people with type 2 diabetes, and reduces the number of hypoglycemic events over 24 to 52 weeks in adults and children with type 1 diabetes.

Dietary advice to consume a low-GI diet was shown to sustain improvements in glycemic control and HDL-C compared with a high cereal fibre diet over 6 months , and to improve beta-cell function compared with a low-CHO, high monounsaturated fat diet over 1 year (42) in people with type 2 diabetes.UNQUOTE

So the key point is not to drastically decrease the daily quantity of CHO intake in absolute terms, but to exchange high-GI CHO foods with low–GI ones.


Ittiandro
Hello, I'm a member here because my Hubby was diagnosed with T2 diabetes last summer. As he doesn't use social media and forums and such, I joined up to ask for advice and help on his behalf. I have to say that the folk here have been an invaluable source of support :)

I'm currently studying Nutrition - a pathway brought about by what I learnt after his diagnosis last year and the inaccurate and misleading dietary advice given by our surgery. Have you heard of the Paleo Diet ?
When people question why he follows a low carb diet I simply remind them that in evolutionary terms we still have caveman bodies. Caveman ate very few carbs
Thanks for your imput Paulus 1

There seems to be a wide-spread bias in this Forum in favour a low carbs diet to control glycemia . You go as low as recommending 50-70 g /day!

I don’t know on which medical grounds people can make this recommendation, unless they are prompted by an unbounded faith in hear-say and popular wisdom and a corresponding wide-sweeping mistrust in the medical establishment , which indeed warns against an indiscriminate low CHO diet..

I am sure some will say “ Well , it works for me..”.

I’ll only say that even if glycemia were to improve with a low CHO diet in one or more individuals, it is difficult to establish a an uncontrovertible causality link, because there are too many complex variables of which the layman, as compared to health professional, may not be aware..

First, according to Diabetes Canada, formerly the Canadian Diabetes Association,(http://guidelines.diabetes.ca/fullguidelines/chapter11#sec1 , the current recommended minimum intake for CHO is not less than 130 g/day, to provide glucose to the brain, a far cry from 50-70 g/day !

This can be outright dangerous ,as according to D.C. , the long-term sustainability and safety of CHO-restricted diets (mean CHO from 4% to 45% of total energy per day) may not ensure sufficient vitamin, mineral and fibre intake. While these low CHO diets may improve A1C and triglycerides (TG), they do not improve total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) or body weight compared with higher-CHO diets over the short term.

D.C. recommend that the percentage of total daily energy from CHO should be no less than 45% to prevent high intakes of fat, which are associated with higher risk of chronic disease for adults and I see no reason to question their opinion.

Secondly, speaking of “low” CHO ( and 50-70 g /day at that!) without further qualification is problematic , without considering the glycemic index ( G.I.) of the carbs.

According to D.C, the key point is not an indiscriminate reduction of CHO, with the risk of going below the safe limit, or replacing them with other energy sources ( fats and proteins) which can be just as dangerous if taken in higher quantities, but to exchange high-GI CHO foods with low-GI CHO foods.

You can go to the D.C. website to read more extensively. I will only quote an excerpt from their recommendations:

QUOTE Meta-analyses of controlled feeding trials of interventions replacing high-GI CHOs with low-GI CHOs in mixed meals have shown clinically significant improvements in glycemic control over 2 weeks to 6 months in people with type 1 or type 2 diabetes .

This dietary strategy also leads to improvements in cardiovascular risk factors, such as TC, over 2 to 24 weeks improvements in postprandial glycemia and high-sensitivity C-reactive protein (hsCRP) over 1 year (40) in people with type 2 diabetes, and reduces the number of hypoglycemic events over 24 to 52 weeks in adults and children with type 1 diabetes.

Dietary advice to consume a low-GI diet was shown to sustain improvements in glycemic control and HDL-C compared with a high cereal fibre diet over 6 months , and to improve beta-cell function compared with a low-CHO, high monounsaturated fat diet over 1 year (42) in people with type 2 diabetes.UNQUOTE

So the key point is not to drastically decrease the daily quantity of CHO intake in absolute terms, but to exchange high-GI CHO foods with low–GI ones.


Ittiandro

Hello and welcome to the forum :)

I've not been on the forum for quite a few weeks so I'm just having a catch up. I'm here because my Hubby was diagnosed with T2 last summer (he doesn't use forums or social media) I have found the advice and support of the folk here invaluable.

In reply to your points about the evidence (or lack of) for why so many diabetics follow a low carb diet-I would simply say this-Paleo Diet. We are still walking around with caveman bodies. Early man didn't farm so didn't consume grains or carby veg and probably didn't have diabetes either. With high GI foods versus low GI foods it makes no difference-the impact on a person's BG is simply in the time it takes to show an effect. Many people assume that if you cut carbs you will have 'no energy'. Not true in fact most people find that they feel less sluggish and more energized.

I adopted the LCHF diet to show support and make meal planning easier (I'm not diabetic) lost 2.5 stone and feel better than I have done in years !!

The best way to ascertain whether something works is not to worry whether there is scientific or anecdotal evidence but to try it for yourself and see :D
 
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ittiandro

Member
Messages
19
Type of diabetes
Other
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I do not have diabetes
Perhaps not breaking any bones when you fell while having advanced osteoporosis was a placebo effect?
Perhaps your comment is an ironic or facetious response to my statement that, for some ,the benefits of a low carbs diet may be due to the placebo effect…

I hinted to this as a possibility, though, without implying that it is the only explanation or that the diet has absolutely no scientific ground..

On the other hand, if you seriously think that my resilience to breaking bones, in spite of my “ official” osteoporotic diagnosis is due to the placebo effect, I must disagree, because the placebo effect, if it can play a role in the bio-chemistry of the body and other subtle processes related to the nervous system, like in the case of some psycho-somatic conditions, will never go as far, unfortunately, as shielding us from the raw mechanical forces impacting the bones like in the case of a fall or a rock hitting your head..

Besides, the placebo effect always implies an ongoing expectation of a given effect, conscious or unconscious and it has no time to kick in when the traumatic event is sudden and unexpected, like when you fall or when a bullet hits you....

I will only say that experiments conducted in laboratories under close medical and scientific supervision, have shown that bio-feedback techniques can alter and control basic functions such as blood-pressure, heart rate and the production of alpha-waves by the brain.

From here, it is not far-fetched to envisage that other bio-chemical processes, such as the ones involved in glucose management can also be affected by that mysterious internal compass of our expectations, known as placebo effect. It doesn’t always work, perhaps rarely, but for some it may work.

Ittiandro
 

Resurgam

Expert
Messages
9,868
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I was ill taking Metformin and a statin - I felt very ill and close to suicidal. My memory is recovering a little now, over one year after stopping them
No mention of that was put into my notes, and I have been contacted and urged several times to resume taking the tablets - because they are 'beneficial' - well they would be seen as beneficial if no record is ever made of the bad effects they can have.
My husband was so shaken by the change in me that he has stopped taking statins.
 

Shahnaz2357

Well-Known Member
Messages
286
Type of diabetes
Treatment type
Tablets (oral)
I am 76, very active ( gym, swimming, treadmill, windsurfing). My doctor put me on Metformin ( 500 mg/day, 2 half-doses) because my blood sugar is hovering on borderline with occasional spikes to 14 mmo/l.

I started Metformin last week. I still can’t get my fasting glucose below 7.5 avg measured at wakeup. Not much difference 2hrs after a meal( between 7.6-9.0 mmo/l. I use mostly aspartame , refined sugar very moderately. I weigh 85 kgm ,athletic build, except for some fat around the belly. I could do with losing a few kg, if anything because the more I weigh, the harder it is to ….sail on my windsurfer. Also, fewer kg would be less of a strain when jogging..

How long before I see the effects of Metformin, both in terms of blood sugar and, possibly, weight loss ?


Thanks


Ittiandro

Hi! @ittiandro... your blood sugar spikes to 14 mmol/l are high and your dosage of metformin of 500mg x 2 day may not be enough to bring it down to acceptable levels along with weight loss very soon although you are very active. Maybe you should consult your Dr. for a diet plan or upping the dosage.....
 

Guzzler

Master
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Hi! @ittiandro... your blood sugar spikes to 14 mmol/l are high and your dosage of metformin of 500mg x 2 day may not be enough to bring it down to acceptable levels along with weight loss very soon although you are very active. Maybe you should consult your Dr. for a diet plan or upping the dosage.....

Metformin does very little to lower blood glucose levels and is prescribed for a different reason so raising the dosage in this case would do little to help. What would help is a change to diet and/or drugs that actively lower blood glucose levels.
 

Resurgam

Expert
Messages
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The OP is eating a high carb diet and burning it off with exercise, but spikes are only to be expected with that sort of regime - check on the first page of the thread to see the things eaten.
 

Rachox

Oracle
Retired Moderator
Messages
15,904
Type of diabetes
I reversed my Type 2
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Tablets (oral)
I wasn’t going to comment any further on this thread but ittiandro, twice I think you have suggested that low carb dieting is just having a ‘Placebo effect’ on those of us that recommend it. I just wanted to say that my blood sugar monitor, my BP machine and my bathroom scales only measure real statistics. I really don’t think that the placebo effect can be transferred from any psychosomatics in my mind to these inanimate machines?
 

Guzzler

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I wasn’t going to comment any further on this thread but ittiandro, twice I think you have suggested that low carb dieting is just having a ‘Placebo effect’ on those of us that recommend it. I just wanted to say that my blood sugar monitor, my BP machine and my bathroom scales only measure real statistics. I really don’t think that the placebo effect can be transferred from any psychosomatics in my mind to these inanimate machines?

Well said.
 

mark-boy

Newbie
Messages
4
Type of diabetes
Type 1
Treatment type
Insulin
You’re right that there is not a lot of official info on the success of low carb diets to control type 2 diabetes, however there is masses of anecdotal evidence, take a look at the ‘Success Stories and Testimonials’ subforum on here.
You don’t need carbs for energy, fats and protein can do that in the absence of carbs. I eat 50-70g per day and actually feel more energetic now. I can’t explain the science, so I’ll tag in a couple of people who I’m sure can. @NoCrbs4Me and @bulkbiker can you help out here please?

hi, just looking at your weight loss and now your diabetes is in remission, that's great news - I was diagnosed with supposedly type 1 diabetes, I had lost around 2 stone when my sugars were running crazy high without my knowing, I have spent the last 12 months on novorapid and lantus to control my sugars and I have piled the weight back on (a common side effect of insulin) last week I was told I may be type 2 after all and have now started metformin once and now twice a day but still taking lantus through the night, my number are now way better on the pills, couple of questions:

1. with a reduction in insulin and the taking of metformin am I likely to see any weight loss
2. if I lose around 15kg will my diabetes go into remission?

cheers
 

Bluetit1802

Legend
Messages
25,216
Type of diabetes
Treatment type
Diet only
1. with a reduction in insulin and the taking of metformin am I likely to see any weight loss
2. if I lose around 15kg will my diabetes go into remission?

Metformin is an appetite suppressant, so in some people this helps with weight loss by helping them to eat less. Certainly less insulin should help with weight loss. Insulin is a fat carrying hormone. Too much of it circulating round your body causes weight gain.

There is no magic weight loss figure for diabetes remission. Some can achieve remission without any weight loss. Others need to lose a lot more than 15kg. Much depends on how much you are overweight to begin with, how much fat there is round the liver and pancreas, and how insulin resistant you are. It is the same as asking how long a piece of string is.
 
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Rachox

Oracle
Retired Moderator
Messages
15,904
Type of diabetes
I reversed my Type 2
Treatment type
Tablets (oral)
Metformin is an appetite suppressant, so in some people this helps with weight loss by helping them to eat less. Certainly less insulin should help with weight loss. Insulin is a fat carrying hormone. Too much of it circulating round your body causes weight gain.

There is no magic weight loss figure for diabetes remission. Some can achieve remission without any weight loss. Others need to lose a lot more than 15kg. Much depends on how much you are overweight to begin with, how much fat there is round the liver and pancreas, and how insulin resistant you are. It is the same as asking how long a piece of string is.
Thanks for replying for me Bluetit, I have found Metformin to suppress my appetite
hi, just looking at your weight loss and now your diabetes is in remission, that's great news - I was diagnosed with supposedly type 1 diabetes, I had lost around 2 stone when my sugars were running crazy high without my knowing, I have spent the last 12 months on novorapid and lantus to control my sugars and I have piled the weight back on (a common side effect of insulin) last week I was told I may be type 2 after all and have now started metformin once and now twice a day but still taking lantus through the night, my number are now way better on the pills, couple of questions:

1. with a reduction in insulin and the taking of metformin am I likely to see any weight loss
2. if I lose around 15kg will my diabetes go into remission?

cheers

Good luck with your weight loss Mark
 
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