Low carb diet , not no carb diet?

[Shs]

I was diagnosed type 2 diabetic in July with fasting blood sugar level at 18.5 , Hba1c was 75 mmol.
I was put on Metformin. I read Dr Cavan's book and was inspired to go as low carb as possible to beat this "beast". I have been on very strict diet with no intake of potatoes, bread, fruit,pasta , sugar or rice . I have mainly taken only green veg or above ground growing veg or salads with eggs , meat, queen or fish. My snack has been nuts. I have not been so great with exercise. I have lost 3 stones and my HbA1c was last week 35 mmol. I feel great . One thing that has kept me going has been monitoring daily my sugars and seeing them coming down. If I take more than 2dl milk in a day, my sugars go up. If I have a meal in restaurant with my usual restrictions excepting what ever sauce came with it, my sugars go up .

I have 2 questions:
1) When can I stop taking Metformin and carry on diet control? Too soon now?
2) curiously in last 2 weeks I have let myself have a few exceptions to my diet .I had twice wild rice mixed with basmati and on both occasions the next morning my sugars where actually better than on days before. In fact this morning I was hypoglycaemic! Does this mean I SHOULD eat wild/brown rice in moderation?

 

[GrantGam]

1) A joint decision between you and your GP. It's all dependent on how much you're relying on that medication to keep your BG at a good level.

2) You're drastic dietary change has possibly reduced your insulin resistance. Meaning, your body is responding to the carbohydrates a lot better than it used to. You shouldn't HAVE to eat carbs to avoid hypos, your liver should be able to release some stored glycogen to put your sugars back up, and your pancreas some glucagon to inhibit the operation of surplus insulin. The latter is especially true as you're not on any DPP-4 inhibitors or incretin mimetics.

What was your hypoglycemic BG value? If you're experiencing low BG then it may be time to discuss your Metformin dose with your GP.

Oh and by the way, congratulations on your results and your attitude towards your situation. They're both fantastic

 

[ickihun]

I was diagnosed type 2 diabetic with fasting blood sugar level at 18.5 , Hba1c was 75 mmol.
I was put on Metformin. I read Dr Cavan's book and was inspired to go as low carb as possible to beat this "beast". I have been on very strict diet with no intake of potatoes, bread, fruit,pasta , sugar or rice . I have mainly taken only green veg or above ground growing veg or salads with eggs , meat, queen or fish. My snack has been nuts. I have not been so great with exercise. I have lost 3 stones and my HbA1c was last week 35 mmol. I feel great . One thing that has kept me going has been monitoring daily my sugars and seeing them coming down. If I take more than 2dl milk in a day, my sugars go up. If I have a meal in restaurant with my usual restrictions excepting what ever sauce came with it, my sugars go up .

I have 2 questions:
1) When can I stop taking Metformin and carry on diet control? Too soon now?
2) curiously in last 2 weeks I have let myself have a few exceptions to my diet .I had twice wild rice mixed with basmati and on both occasions the next morning my sugars where actually better than on days before. In fact this morning I was hypoglycaemic! Does this mean I SHOULD eat wild/brown rice in moderation?

1) when you and your nurse/dr think your bgs are looking good for some time. Ultimately it's your decision.
2) look up 'the somogyi effect'.(Maybe a rebound from high sugar)

 

[Brunneria]

Hi and welcome!

1) is really something you need to discuss with your doc or nurse or health team. Are you in the UK? If so, the NHS has a protocol of prescribing drugs (starting with metformin) at different stages of type 2 diabetes. If your HbA1c is now 35, then you could put forward a good argument to come off the drug, ask for monitoring, and see how it goes. However, a lot of people (and their health care team) like to stay on Metformin because it is considered to be 'protective'. I would say it was down to you to decide which way you wanted to go, and then discuss it with them.

2) this is an interesting one. Personally, I have similar experiences (fasting reading is lower after carbs the day before). A lot of people see that as a positive thing, because a low fasting reading is considered good. But I take a different view - I want my pancreas to have a nice long rest, and not be kicked into activity for a bit of carbs - especially if it results in too low bgs the next morning! Maybe consider factoring this in, when speaking to your team about coming off the Metformin, because maybe it was the Metformin than took your blood glucose low on those mornings...?

 

[LinziC78]

Crikey well done. I am finding it a bit difficult to get my blood sugars to drop, I was average of 11 when diagnosed about a month ago, and monitoring it can be anything from 13 to 16.7. Can I ask how much metformin you are taking and have you had any side effects?

 

[GrantGam]

2) look up 'the somogyi effect'.(Maybe a rebound from high sugar)

Is this not actually the opposite to the somogyi effect @ickihun? i.e. lower sugars after carbohydrates (high to low), rather than low BG resulting in a rebound high BG?

 

[ickihun]

Is this not actually the opposite to the somogyi effect @ickihun? i.e. lower sugars after carbohydrates (high to low), rather than low BG resulting in a rebound high BG?

After second thoughts......your definitely right. Also I think somogyi effect is suppose to just effect insulin or lowering agent med takers?
Could be just an effect from the liver refilling with glucogen after a previous low carb diet! Liver too busy to dump. Some who drink certain alcohols have the same effect. Blocks liver dump, in some. It all needs tweeking to get the best out of techniques to con the liver, muscles and other organs output.

 

[Shs]

1) A joint decision between you and your GP. It's all dependent on how much you're relying on that medication to keep your BG at a good level.

2) You're drastic dietary change has possibly reduced your insulin resistance. Meaning, your body is responding to the carbohydrates a lot better than it used to. You shouldn't HAVE to eat carbs to avoid hypos, your liver should be able to release some stored glycogen to put your sugars back up, and your pancreas some glucagon to inhibit the operation of surplus insulin. The latter is especially true as you're not on any DPP-4 inhibitors or incretin mimetics.

What was your hypoglycemic BG value? If you're experiencing low BG then it may be time to discuss your Metformin dose with your GP.

Oh and by the way, congratulations on your results and your attitude towards your situation. They're both fantastic

1) A joint decision between you and your GP. It's all dependent on how much you're relying on that medication to keep your BG at a good level.

2) You're drastic dietary change has possibly reduced your insulin resistance. Meaning, your body is responding to the carbohydrates a lot better than it used to. You shouldn't HAVE to eat carbs to avoid hypos, your liver should be able to release some stored glycogen to put your sugars back up, and your pancreas some glucagon to inhibit the operation of surplus insulin. The latter is especially true as you're not on any DPP-4 inhibitors or incretin mimetics.

What was your hypoglycemic BG value? If you're experiencing low BG then it may be time to discuss your Metformin dose with your GP.

Oh and by the way, congratulations on your results and your attitude towards your situation. They're both fantastic

Hi
BG was 3.5 this morning but I felt ok
Thanks for encouraging reply! And so fast!

 

[GrantGam]

After second thoughts......your definitely right. Also I think somogyi effect is suppose to just effect insulin or lowering agent med takers?
Could be just an effect from the liver refilling with glucogen after a previous low carb diet! Liver too busy to bump. Some who drink certain alcohols have the same effect. Blocks liver dump, in some. It all needs tweeking to get the best out of techniques to con the liver, muscles and other organs output.

I think you're also right wrt who is affected by the Somogyi phenomenon. Someone who is un-medicated or a non insulin user - would be unlikely to have hypoglycemia (to warrant the Somogyi effect) due to their glucagon response being sufficient to over-ride the natural insulin production of the pancreas. Further to that, it's unlikley for a non-medicated diabetic to have prolonged hypoglycemia to trigger the Somogyi effect.

http://www.diabetes.co.uk/blood-glucose/somogyi-phenomenon.html

 

[GrantGam]

Hi
BG was 3.5 this morning but I felt ok
Thanks for encouraging reply! And so fast!

No problem!

 

[Shs]

After second thoughts......your definitely right. Also I think somogyi effect is suppose to just effect insulin or lowering agent med takers?
Could be just an effect from the liver refilling with glucogen after a previous low carb diet! Liver too busy to bump. Some who drink certain alcohols have the same effect. Blocks liver dump, in some. It all needs tweeking to get the best out of techniques to con the liver, muscles and other organs output.

I definitely have to look up somogyi - there is so much to learn and understand at the early stages! Thank you!

 

[GrantGam]

I definitely have to look up somogyi - there is so much to learn and understand at the early stages! Thank you!

It's highly unlikely that it applies to you, but if you're anything like me - then you'll find it all really interesting anyway

"Somogyi theorised that prolonged levels of untreated hypoglycemia could lead to stress (due to low blood sugar) and a high blood sugar levels rebound."

Good luck @Shs

 

[Freema]

Hi
BG was 3.5 this morning but I felt ok
Thanks for encouraging reply! And so fast!

3.5 mmols how very fine , must say I do envy you a lot.... wow

besides that ; I do love your headline... as when going lower than 20 grams of carbs a day, shouldn´t we rather call that a "no carb diet" then , just to be able to differ from the two very different diets ... like one diet is under 130 grams of carbs a day , and the other is under 20 grams of carbs a day which is very close to "no carbs."

 

[ickihun]

I think you're also right wrt who is affected by the Somogyi phenomenon. Someone who is un-medicated or a non insulin user - would be unlikely to have hypoglycemia (to warrant the Somogyi effect) due to their glucagon response being sufficient to over-ride the natural insulin production of the pancreas. Further to that, it's unlikley for a non-medicated diabetic to have prolonged hypoglycemia to trigger the Somogyi effect.

http://www.diabetes.co.uk/blood-glucose/somogyi-phenomenon.html

Very helpful. I believe you are total right on this!

 

[ickihun]

Hi
BG was 3.5 this morning but I felt ok
Thanks for encouraging reply! And so fast!

With plenty of 3s and 4s, I'd consider lowering my meds. Maybe after your next hba1c so you know where the med reduction is taking you?

 

[kokhongw]

1) When can I stop taking Metformin and carry on diet control? Too soon now?
2) curiously in last 2 weeks I have let myself have a few exceptions to my diet .I had twice wild rice mixed with basmati and on both occasions the next morning my sugars where actually better than on days before. In fact this morning I was hypoglycaemic! Does this mean I SHOULD eat wild/brown rice in moderation?

1) Metformin may be stopped any time. It doesn't have that much/immediate effect on your glucose level. It requires two or more weeks of continuous intake to have noticeable improvements in glucose levels.

2) It could simply mean that after a high carb meal, you have delayed excessive insulin secretion. Would it make sense to do that on a regular basis? Keeping in mind that upon T2D diagnosis, it is generally agreed that we have 50% beta cell function impairment. Whether this is due to cells death or dysfunction that may be restored is still a matter of research. But I think it would be prudent for us to find ways to preserve and extend the remaining functional cells...

 

[CherryAA]

I was diagnosed type 2 diabetic in July with fasting blood sugar level at 18.5 , Hba1c was 75 mmol.
I was put on Metformin. I read Dr Cavan's book and was inspired to go as low carb as possible to beat this "beast". I have been on very strict diet with no intake of potatoes, bread, fruit,pasta , sugar or rice . I have mainly taken only green veg or above ground growing veg or salads with eggs , meat, queen or fish. My snack has been nuts. I have not been so great with exercise. I have lost 3 stones and my HbA1c was last week 35 mmol. I feel great . One thing that has kept me going has been monitoring daily my sugars and seeing them coming down. If I take more than 2dl milk in a day, my sugars go up. If I have a meal in restaurant with my usual restrictions excepting what ever sauce came with it, my sugars go up .

I have 2 questions:
1) When can I stop taking Metformin and carry on diet control? Too soon now?
2) curiously in last 2 weeks I have let myself have a few exceptions to my diet .I had twice wild rice mixed with basmati and on both occasions the next morning my sugars where actually better than on days before. In fact this morning I was hypoglycaemic! Does this mean I SHOULD eat wild/brown rice in moderation?

I've seen the same thing myself re eating more carbs than planned and finding its actually quite good news. As a matter of interest what was the actual blood sugar level that caused you to say you were hypo -?

 

[Shs]

Crikey well done. I am finding it a bit difficult to get my blood sugars to drop, I was average of 11 when diagnosed about a month ago, and monitoring it can be anything from 13 to 16.7. Can I ask how much metformin you are taking and have you had any side effects?

500mg and I've been very lucky not to have any side effects

 

[Indy51]

Dr Bernstein says there's no such thing as the Somogyi effect - only dawn phenomenon:

 

[Claudio1]

Is there any time of day when the somogyi effect is more common or depends on each person?