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It's all about weight and/or excess belly fat.

Priam

Active Member
Messages
39
Type of diabetes
Type 2
A couple of months ago I posted that I believed type 2 diabetes was probably down to weight. I also queried the need for monitoring blood sugar levels: if you felt o.k. after eating a particular food why bother to monitor. I was taken to task by a couple of posters who claimed that slim and normal weight people did suffer from type 2; also that HbA1c measurements didn't tell the full story, and it was the spikes in blood sugar that caused the problems - but what problems?
I didn't particularly dispute this but I decided to carry out my own experiment.
Before I was diagnosed in January this year I had already started a fairly intensive exercise programme. I'm an ex racing cyclist and wanted to get fit so I could once again enjoy my bike when the weather improved in the spring. My racing weight had been about 11st. 10lb. but owing to inactivity it had risen to 12st. 13lb. - not particularly overweight for my height, but there was definitely some excess there.
At around this time my HbA1c was 65, wheresas it should have been between 42 to 48. In addition to the extensive exercise on my trainer, I did pursue the low-carb diet. I even went to the extent of weighing my food in order to keep within a prescribed limit.
The weight dropped off and by April I was down to 11 st. and in May my HbAc1 was down to 46.
It was at this stage I began to conduct my experiment. I continued with my intensive exercise on the trainer and a couple of rides each week - between 30 to 45 miles. But I no longer religiously kept to the low carb diet. I did keep to a sensible diet: no sugar and only between two to four very thin slces of bread per week, but other than this I ate normally. I monitored my weight daily and it remained constant between about 10st.12lb. and 11st. 3lb. When I went for my HbA1c test August it had fallen even further to 39.
I'm not suggesting my type 2 diabetes is reversed, as some claim when it drops to these low levels, because the raised levels will come back if I stuff myself silly and don't exercise. But the point I am making, and what my experiment has proved (for me anyway) is that if you maintain a sensible diet (not necessarily austere) and exercise regularly to maintain a constant weight, your HbA1c levels should remain within the prescribed limits.
 
Hi Priam - I think for you this is absolutely true - and for me as well as I am very overweight and in the 'obese' range so need to lose weight . I started my diet prior to my operation and they found out 2 days before that I had Type 2 and cancelled my op. My HbA1c said 50. I continued dieting and switched to low carb - and then waited several weeks to have my next HbA1c and it had gone down to 44. The second reading was to check first results and to attend the clinic with the diabetic nurse. Due to these results, the doctor said I was pre-diabetes which suits me. I'm hoping to lose more weight and to drop down the scale further and it certainly seems that it's going to work.

I do however believe I'm type 2 and will return to raised levels if I eat what I want. I'm making a conscious life changing decision to eat better to avoid it. If I go low enough i hope that I can reverse it. But all of this is about 'us' ...a person slightly overweight and a person majorly overweight. It doesn't unfortunately account for skinny or normal weight people who also have this issue where something else has caused Type 2. I guess it's a little like a car. Working parts aren't being lubricated because you have an oil leak ...or because you have run out of oil as you forgot to top it up, or there is a blockage somewhere. Same problem....but lots of different reasons! I also think T2 may have started after a personal shock (either of stepping on the scales or having a brain haemorrhage!).

As to monitoring - I suppose it's personal preference. I am analytical so I like to look at what foods spike me. I see many people able to eat porridge on this forum and many people saying it spikes them too much. It's so interesting that different people have different results. When I spike I can't honestly seem to tell the difference from when i'm 7.5 or 8.9 or 12.2 ...but if I want to avoid damage then I really need to know what 'does' and 'doesn't' work for me personally (in my humble opinion!) to keep figures as low as possible.

So glad you've managed to turn things around hon :-D xxx
 
There is also my anecdoctal case of simply eating about 150g of roast pork belly on a regular basis (lunch or dinner) with occasional intermittent fasting...with less than 1000 steps of walking per day over a year and HbA1c has dropped from 11% to 5.5% within 3 months and maintained for the past 9 months.

Weight has remained relatively stable throughout the year. ~74kg but waist line has drop a couple of inches.

My point being there has been excessive focus on weightloss rather than glucose/insulin level normalization. In fact many have noted that bariatric surgery results in normalization of insulin/glucose level before any significant weightloss has been observed.

So there is hope even for those who are unable to exercise for whatever reasons...
 
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That's good news, from a scientific point of view though, what is a sensible diet? Would it contain 100 gms of carbohydrate? 200 gms of carb? Also how does that compare to your days as a racing cyclist? I would imagine that you would have consumed extra calories and plenty of carbs to maintain the sort of exercise regime athletes follow.
A sensible diet for me is supposed to contain 2300 calories if Harris Benedict is to be believed and in fact if the machinery for measuring Substate utilisation and energy expenditure at the University of Westminster in London is to be believed. From experience, if I was to eat anywhere near that I would gain weight, so I'm still looking for the sensible diet.
 
Hi @Priam. My experience is much the same as yours. I reduced my HbA1c and weight by a spartan diet, lchf and exercise after being diagnosed T2. My HbA1c at my 12 month test was 39 too. I now eat more 'normally' including some starchy carbs but not as much as I would have eaten before. I test every morning and my fbgs are around 6-6.5 usually. I think that is ok, if they started going up I would adjust my carb intake. I could probably get a lower HbA1c if I ate less carbs but I think 39 is ok.
I don't exercise so much now. In my efforts to lower my bs I had been walking 25-40,000 steps most days. Now I walk 15-20,000 steps most days. My weight has stabilised at around 140 lbs, after having lost about 33 lbs. I would like to be below 140 lbs (10 stone) if I can more for psychological reasons than anything.
But I am aware that I need to be careful and continue to exercise and be aware of what I eat, and monitor my bs levels. I know it it would be easy to slip back into diabetic levels again.
 
Congrats on achieving and maintaining good control. Your observations are often true for people who are newly diabetic and not yet very overweight. Unfortunately for a lot of people, it goes undiagnosed for a long time and by the time a person is diagnosed the disease has progressed. Diabetes also often goes hand in hand with other serious, often autoimmune, diseases. These other health issues can be disabling. Different people also have different degrees of hyperinsulinemia and insulin resistance which drives weight gain and which can make losing weight and controlling blood sugar almost impossible without cutting out almost all the carbs and taking meds. Even then it can be a struggle. I am truly happy for your success but no two people are alike.
 
@Priam - That's great news that you have made such excellent progress, and appear to have a formula that works for you. Diabetes is a very personalised condition or there would be a simple solution/management style and Fora like this wouldn't exist. All we would need would be a couple of YouTube videos and an A5 flyer.

My only words of caution would be to somewhat vigilent over the colder and winter months when weather conditions can sometimes render outdoor exercise regimes a bit trickier, plus of course the usually increased prevalence of heavier food around the place.

I'm sure you are more than capable of tweaking your regime accordingly, but it can be a time when folks trip up and find themselves becoming a bit more sedentary or adjusting their eating styles, without realising what's happening.

Thanks again for the update.
 
Exercise is a wonderful thing. But the problem is that people get to rely on it - then along comes a virus, an injury or bad weather, and their bg control goes to pot. If the problem continues long enough, their weight increases too.

This can be very challenging for people who thought they had it licked, and who then need to learn (or relearn) a whole new set of control measures to compensate.
 
Prior to the end of the summer (boo hoo!) when I was getting home from work (after 7pm), I would go for a half hour brisk walk. Because of the change in light levels now and going forward, I can't really do that safely. So I've changed my hours so I start work half an hour later and finish half an hour later (which makes not much difference to how I work), but means that I can get off the bus at a few stops earlier than I would have done and walk to work. This gives me the chance to get my exercise in before the work day starts (and puts me in a better frame of mind for the day). I am thankful that my employers allowed me to change my hours, and will continue to do this. Just a bit of food for thought.

Also been doing LCHF since diagnosed just over 8 weeks ago. Shifted 1½ stone approximately. Still a lot to lose - at least 3 stone, but this has been a kick up the backside for me and a nudge for the rest of my family who are overweight. My sister has given up chocolate and mum's given up buying cakes - both with positive effects on their waistlines! Small changes can have big effects.
 
Since diagnosis, I have been eating LCHF and walking at least 10,000 steps a day. As a result I have lost about 1 1/2 stone, the bulk of which came off rapidly in the first few weeks. Now it's slowed to around 2-3lb a week, which is quite respectable. I have a target weight in mind and should reach around February/March, all being well.

The darkening days may put the kybosh on my walking too, particularly in the evenings. I may walk for longer at lunchtime, or join a contract-free gym for the winter if the weather gets really bad.
 
That was me too - I lost a lot of the weight in the first 2-3 weeks (giving up a lot of carbs and sugar does that in any event), and I seem to be losing about 3-4 pounds a week at the moment. Its a case of keeping motivated (getting into clothes I haven't been able to for a while is a great motivator - not to mention people saying "have you lost weight?!). Fingers crossed we get a relatively dry autumn and winter - so much easier to walk when its dry.
 
 
Thanks for your response. I appreciate certain foods act differently for different people, and certain foods can cause a spike. You say you don't feel any difference - and that was the point I made in a previous post. Do you assume because it spikes, it's causing damage. I think one can become a bit paranoid about these spikes. My doc and diabetes nurse don't recommend monitoring but I can understand those who feel spikes can cause damage and want to keep control of it. Good luck, anyway and thanks again for your reply.
 
 
That must be pretty boring eating roast belly pork on a regular basis; although I assume you do have variations.
The thought of bariatric surgery would scare me to death; although I appreciate for some people there is no alternative.
 
 
That has given me something to think about .... not exercising as much in the winter ... Will need to consider how to cope & not turn into a couch potato
 

Good question: "What is a sensible diet." My version would be not to eat a plate of sausages every day - but maybe two or three once a week; never eat MacDonalds or similar takeaway foods - especially pizzas. As a competing cyclist I would have loaded on pasta but nowadays I would limit pasta to about once every couple of weeks. In fact when I was first diagnosed with T2 I didn't eat pasta or bread (we bake our own) until my HbA1c came down from 65 to 46. I now have a few very thin slices a week. I try and eat food with a high fibre content and a low net carbo content, such as avocado. I usually now eat about two a week, in massive salads. I now also eat a lot more fish and protein with no carbs. Between January and May this year I was restricting my net carbs to between 50-70 grams per day, but I no longer measure them and try and rely on common sense - which as my wife says: "ain't that common."
 
Hi @Ruth26 - there are tons of exercise videos on Youtube ranging from the easy start-ups to the more strenuous high intensity training. I have bookmarked loads of them, and occasionally work through one of these, as well as my almost-daily one hour walks. There are even some that are geared towards those with diabetes. Try a google search; I'm sure you'll get plenty of options - so definitely no need to be a couch potato through the winter
 

I think you are absolutely right about it being undiagnosed for a long time. I'm sure this was my case and believe I'd had it (or at least pre-diabetes) for probably twelve years.. About 2004 on the same day and exactly the same time in both legs, I experienced a strange sensation in my toes: it felt like a rolled-up sock between my toes and the ball of my foot. The doctor could give no diagnosis, just advising that circulation was normal. He arranged for me to see a podiatrist who also could give no diagnosis but gave me some orthotics. They made no difference. It wasn't really painful - just annoying. I thought it may be a nerve problem so I was sent to a hospital that did nerve tests. The results said there was nothing wrong with the nerves. Next there was an MRI scan - again showing nothing. My next course was to try Oswestry orthopaedic hospital. They are one of the top orthopaedic hospitals in the country. They had done a terrific job on a knee replacement for me so I thought I'd give them a try. I explained to the consultant that I'd had a nerve test which had showed nothing. He replied that sometimes these tests didn't show up any faults but he would arrange for a special ultra-sound scan with an injection which would definitely show up any nerve damage. It didn't. He said he could do an operation, which may or may not cure the problem. On the basis that it didn't hurt I decided the operation may well be a waste of time so I declined. It was only after I was diagnosed with T2 and saw the diabetes podiatrist and explained my problem that it was suggested it was probably a pre-diabetes case. What staggered me was that as I'd had blood tests every year since experiencing a mild heart attack in 2002, not a single one - from my own doctor to all the experts, not one of them had suggested it may have been the onset of diabetes. So I would suggest whoever you are and whatever your age - get tested.
 
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