LCHF - with or without medication?

Personally, for me, right now, diet is working. There is a limit, due to other health issues, of how far i can lower my carb intake. If , in the future, I can no longer control my diabetes through diet only, without compromising my other health issues, I will take meds.

Diet is working for me, and has done for 4 years. If/when the time comes that it no longer works I will take meds BUT I will be very careful to research what exactly that med does, how it works, and if it is applicable to me. If Gliclazide, for example, were to be prescribed I would insist on an insulin test beforehand. No point in taking a drug that triggers extra insulin to be produced if I already produce enough. I do not want excess insulin circulating in my blood stream that for some reason isn't doing its job properly.

I do both meds and diet .

Other the Metformin (that I am taking now) and SGLT2 inhibitors there are no "Type2 drugs" I would be willing to take unless my BG was really out of control and could not be controlled with diet. (Say an AC1 of over 60 and no sign of it coming down and/or it has been proved my body is failing to produce a normal level of insulin.) Most drugs used for Type2 make insulin resistance worse, by adding to the level of insulin.

I feel blessed that I don't require meds. If I degraded I would drop the nut amount in half to about 100 g (as I take the mick at present), I would also halve my berrie intake to around 4 of each. I would then exercise a little more and eat one meal a day for the majority of the week. I feel lucky that I have these choices.

I have every intention of living another 50 years (well, we all have to have goals, don't we?)
And I have a sneaking suspicion that controlling my blood glucose by diet will get more and more difficult as time goes by.
So I have every expectation that, in time, I will need meds.

If it happens, it happens, and I will look on it as a positive move to maintain control and prevent further deterioration.

I have always liked Fung, except for the fact that he seems to lump all T2s in one basket, which I think is unwise, and not helpful to those of us (like myself) who are not typical. Likewise, I tremendously admire Bernstein, but flinch when I see he suggests that T2s go on insulin at levels lower than other docs prescribe Metformin.
Adding insulin for me would further drive up insulin resistance.

I just think we should all be treated as individuals, and the moment anyone starts generalising, I trust their advice just a little bit less.

Boo1979 said:

Which I guess takes us back to the difference of opinion expressed in the 2 links I posted form Fung and one of his critics as to whether it is high insulin or high sugars that increase IR.

Click to expand...

Chicken and egg situation, but which comes first? Undoubtedly the higher the blood sugars are the higher the insulin will be, and the higher the IR is the higher both the insulin and glucose will be, but what makes all of this worse is carbohydrate.

Brunneria said:

I have always liked Fung, except for the fact that he seems to lump all T2s in one basket

Click to expand...

Partly I expect that when he sees people himself he does the correct tests and does not call someone with Type3c Type2, unlike nearly all NHS GPs.

Let's remember that both of them agree
That a ‘carb up and shoot up’ approach to diabetes is a losing proposition.

Hence both options are a lot better then what the NHS offers us........

I am reminded here of the hypothesis of Occam's Razor. That being the simplest answer is often the correct one. That doesn't necessarily rule out a more convoluted approach, so imo the 'simple' answer often starts with diet but may go on to a drug treatment and/or insulin. My approach is to maintain by diet alone for as long as I can simply because adding yet another drug (I am on a few for other health issues) will require lots more research and it will obviously change my way of dealing with my T2. I prefer to keep all my options open to avoid becoming complacent which might lead to anguish further up the road.

Edited because of atrocious spelling.