Insulin resistance

That can work for some people - and has. I'm thinking of @andcol here.

It doesn't work for others - I guess it depends on how long you'd had IR before you were diagnosed and how extensive damage was beforehand.

All you can do is test and see - and keep vigilant about weight regain.

If you are looking for permission to eat carbs again (within or without reason) then you are probably barking up the wrong web site. Since you reached 20st. you were obviously eating more carbs than you needed to by quite a long way. The boat is now broke. Sadly for most people there seems no going back to a position where they can eat what they like even if they change diet, lose weight and exercise. The diabetic condition seems to have an element of permanence about it. Your purpose should now be to stop it getting worse.

I think a lot of it depends on why a person is insulin resistant in the first place.

It may be from weight gain and a sedentary lifestyle, but it may also be from other medical conditions, medication, age related factors or a genetic predisposition. Those won't disappear with weight loss and extra exercise.

Fortunately, eating fewer carbs, exercise (and/or fasting) will address the insulin resistance, even if it doesn't address the root cause of it.

jonnoras said:

Thanks for the reply. I never thought of looking at it from a "broken boat" perspective. I'm not looking for permission to eat carbs - that was simply my expression of eating "normally" again. I don't miss carbs. I find testing my blood is really stressful and depressing. I think I get obsessed with the numbers if they are not what I was expecting. That makes me preoccupied and I become distant from my family. I suppose I was hoping that I could relax a little around the testing and be "normal" again. Does that make sense?

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Yes it makes perfect sense and it is one of the reasons the health service give for people not to test. They also have financial reasons. I sense that the diagnosis came as a nasty shock and you were hoping you could put matters right. So far the evidence seems to be that you can't go back to how you were before but if before meant that you put on weight and got diabetes then maybe some compromise should be sought.

Try not testing so often or at all but make sure you avoid carbs as much as possible. Your weight will be an indicator of progress or lack of it.

My DN said I should make a choice between quality and quantity of life and maybe you should go for a bit more quality.

Well done with the weightloss.
I've been T1 since 1972 and a couple of years ago had Roux-En-Y bariatric surgery because of my concerns over insulin resistance.
The fatter you are the more insulin you need compared to a thinner person eating the same carbs.
I never saw myself as a fatty even at 22st (5'10")
I lost around 10 stones in 6 months and my insulin requirements dropped to about 1/3 of what they were when I was big.
Priot to the weightloss my sugars were well controlled but since losing the weight control is harder due to me now being more sensitive to insulin.
Good luck getting sorted

jonnoras said:

why should I not become permanently less insulin resistant now I am a better weight and exercising.

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You are assuming that insulin resistance is the only reason for the impaired glucose control. And that diet/exercise may be able to fully restore this...to a certain extent, we have some limited success...but few if any have reported full and sustainable restoration of first phase insulin response to be fully metabolize carbs.

It appears that it is a combination of factors that leads to the "clinical" loss of glucose control. And it is not clear which plays a greater part. And how much each can be restored...namely but not exhaustive...

• Liver, Skeletal Muscles, Brain insulin resistance.
• Beta Cells death/dysfunction
• Insulin signalling

On beta cells dysfunction
β-Cell loss in response to nutrient excess and stress was traditionally felt to occur exclusively via β-cell death. Although β-cell death might be a final common pathway in the natural history of T2D, more recent evidence indicates a more complex situation in which β-cells can initiate several alternative responses to avert irreversible loss, suggesting the potential for earlier intervention.
http://care.diabetesjournals.org/content/37/6/1751

Insulin signalling seems to be restored via FGF1 protein injections...They were even successful with healing NAFLD in newer studies.
Effective treatment of steatosis and steatohepatitis by fibroblast growth factor 1 in mouse models of nonalcoholic fatty liver disease
http://www.pnas.org/content/113/8/2288

I am sure we will hear more about FGF1 as a treatment option for Alzheimer's and other T2D/insulin resistance related complications. We are living in a promising era...