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Most people with type 2 diabetes will also eventually need to use insulin.

Discussion in 'Type 2 Diabetes' started by sheepie123, Apr 24, 2017.

  1. Indy51

    Indy51 Type 2 · Expert

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    @Bluetit1802 - as a comparison.

    I had the abdominal ultrasound on 9 January 2012, prior to my diagnosis of Type 2 in March of the same year. The ultrasound showed fatty liver and pancreas. The ultrasound was to investigate liver/gallstone pain.

    My prior liver function test March 2011 showed ALT of 9 and GGT of 37 - perfectly healthy apparently.
    By the liver function test in March 2012, ALT was 27 (normal) and GGT elevated at 69 (I believe GGT is related especially to bile duct dysfunction).

    In a similar rise - my FBG in March 2011 was 5.2 but by March 2012 was 5.8. Whatever happened, it seemed to have worsened significantly over that year. At the same time I was diagnosed with low D3, hypothyroid and hypertension :(
     
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  2. serenity648

    serenity648 · Guest

    I looked at the NHS website for diagnosing fatty liver. The blood test I had may not pick it up.

    The bit which resonates is where it says:
    • a dull or aching pain in the top right of the tummy (over the lower right side of the ribs)

    • Which is something I used to get daily and, since i have been low carbing, has disappeared unless I slip off the wagon. So I may well have a fatty liver and not know it.
     
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  3. serenity648

    serenity648 · Guest

    I have just read the treatment of fatty liver on the NHS website:

    try to have a balanced diet high in fruits, vegetables, protein and carbohydrates, but low in fat, sugar and salt. Eating smaller portions of food can help too.

    Following this some of this info isnt going to help, is it?
     
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  4. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    This is the NHS remember! Sounds very like the Eatwell Plate.

    I use NHS Choices frequently website for many things but always ignore the dietary advice. For every ailment, complaint, ache, pain, vitamin or mineral deficiency, the dietary advice is the same. Other than that, it is a very useful site.

    For fatty liver, the worst thing we can eat is fruit. Fructose is dealt with by the liver rather than the normal digestive path and is a known contributor to fatty livers.
     
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  5. justism91

    justism91 Type 2 · Member

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    Hi, I've also been diagnosed with type 2 diabetes earlier this year in june. Im only 26 years old. Genetics! Haha, my dad has it and so it got passed on to me. I've had fatty liver and my cholesterol was 300 at the point of diagnosis. Not to mention my hba1c was 14. But today, i just met up with my doctor to do a hba1c and blood test. Hba1c was 6.4 and my cholesterols have came down to just 75.

    Well, regarding if type 2 is progressive, my doctor have told me that eventually i may require insulin but also may not require it in my life. So my guess is, just do whatever we can to keep our BGs down and lead an active lifestyle. And if that day ever comes, we just have to deal with it. Thats life!

    For me, i don't exactly call my diet plan low carb. My carb intake per day may be slightly over 50g as per my estimation as i take im carbs for all my 3 meals. Breakfast is usually multi grain toasts, lunch and dinner usually its wholemeal pasta or brown rice. To me, diet is different for different people. So just test ur BG regularly to know what food spikes u the most and avoid it at all cost. Just dont take in refined sugars, I've never had them ever since my diagnosis.

    With that said, i wish you all the best in your life. Stay strong bud!!
     
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  6. Grateful

    Grateful Type 2 · Well-Known Member

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    Well done in getting your HbA1c down from 14% (130) to a "pre-diabetes" 6.4% (46) level since June! Fantastic!!!! It is clear that you are not taking insulin; are you taking any drugs?

    Your low-carb approach is somewhat different to many of the others here (including me). Frankly it sounds like it may perhaps be a fair amount more than 50g of carbs per day if you are having toast with breakfast and pasta or rice with dinner. However it sounds like you are testing regularly and that is what matters if you are "experimenting" in this way. At 26 years old you can probably benefit much from a period of experimentation.

    I totally agree that diet is different for different people. I have been thinking aloud about this kind of "flexibility" and I see some others speculating about the same issue (for example @woodywhippet61).

    Your example also encourages me to speculate that I might have "overdone" it with my ultra-low-carb diet. Mind you, I ended up with a very low HbA1c which gives a good "reserve" if (for instance) I become ill with something or other and end up neglecting my blood-glucose control for a while.

    Despite the medical consensus, I personally doubt that well-controlled Type 2 diabetes is inevitably progressive (leading eventually to injected insulin and possible diabetes complications), except in one sense. As we get older our bodies just get worse at handling all sorts of stuff. I was diagnosed with T2D at 59 years old and even though my BG is now well-controlled, I am ready for the possibility that 10, 20 or 30 years from now I may need some extra help, perhaps in the form of a diabetes drug of one kind or another. Meanwhile I am just doing my best to control it with the means provided by nature, i.e. diet and exercise.

    Thank you for your perspective. Much food for thought (sorry, dreadful pun).:D
     
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    #46 Grateful, Nov 16, 2017 at 3:30 AM
    Last edited: Nov 16, 2017
  7. ickihun

    ickihun Type 2 · Master

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    There is no guarantees in life.
    One way or the other.

    Fighting to stay healthy, is often a lot easier to others.
    I find it always hard work. Insulin doesn't make it easier to stay healthy, just a neccessity when all other options don't work.
    I'd have loved to have been put on a low carb diet with metformin from the start. Far less obesity and bullying for it. I exercised everyday, anyway. I scootered everywhere then cycled and swam. A very active childhood. A great childhood. Camping, abseiling, canoeing and rockclimbing.
    Exercise only helps a tiny bit. Well, for me. Exercise is like breathing in and out for me. Just part of normality. I'm still just under morbidly obese. Blurt!
    Diet is a big clincher for type2. Everyone knows that. Just the majority ignore its a specialist diet, not the normal well balanced which is pushed, when highly insulin resistant.
    Insulin therapy is needed for some if no other meds cannot help.

    Once they figure out why metformin helps IR then more targeted meds will prevent insulin therapy.
    I once again read canagliflozin tablet isn't the perfect type2 med. Better than nothing, for some.
    Once IR is given the full help and support it needs then more will suffer unneccessarily. :(
    Please nhs seek out more and more help for sufferers which isn't just meds.
    I whole team of dietitians just for IR are needed. Now.
    Get IR researchers recruited and beat it into oblivion. At childhood. After weaning or some argue at weaning stage.
    My overweight son is seeing dietician next week but no loss. He's 10yr old. Very very active. I think he needs low carb but no support from anywhere. Dietician no. School meals no. His father no. I'm on my own and it needs everyone or most to keep him slim.
    I will be talking in depth with dietician and will ask her to make a note of it on her pc. I want it made very clear I'm not getting the right support for him.
     
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  8. Slalom

    Slalom Type 2 · Member

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    I exercise a lot and my weight is fairly stable, and my HBA1C was 51 in june Usually 47 to 50 with a 55 outlier. I dread an injury, as this would stop the exercise, which benefits my Diabetes and Asthma. Also means I am fit enough to ski.

    I probably eat a volume of Carbohydrates which would shock you all, but I cycled from Cornwall to the west Midlands in 3 days in September, and my weight is fairly constant BMI < 21.5.

    However I eat very little processed food.
     
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  9. Grateful

    Grateful Type 2 · Well-Known Member

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    I am beginning to suspect that the very-low-carb diet is necessary to get a very low HbA1c (for a diabetic) such as the ones I list in my signature below. But your level, and the level reported above by @justism91, are both low enough to satisfy my doctor: he has told me that his goal is to keep my A1c at 7% (53) or below. He is very happy that I have achieved a lower number, but he still would not add drugs to my diet-only therapy unless the A1c bumped above 7%.

    Of course, once again, we are all different. I don't know whether a more "lenient" higher-carb diet would work as well for me as it has for you and @justism91. Also, I rather like having a "cushion" by being well into the "non-diabetic" range. I worry about getting ill (with something other than diabetes) and having to neglect my BG control for a while. In that case it would be useful to have good starting point, with a large "reserve" of low BG to use up.
     
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  10. ringi

    ringi Type 2 · Well-Known Member

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    I have seen it claimed that the risk of coronary (heart) disease increases with increased HbA1c at levels well below diabetic levels. This also seems to be the case with some cancer. There is limited data, as HbA1c is often not tested for (and therefore not recorded) when a random BG is normal. (This is the case with the NHS.)

    But the ACCORD study showed that lowing HbA1c with any drug other then metformin did not reduce the risk of coronary (heart) disease. Metformin reduced the risk by more than was expected given the reduction in AC1. SGLT2 inhibitors were not in use at the time of the ACCORD study, but they too seem to reduce the risk of off coronary (heart) disease.

    The A1c at 7% (53) or below is based on the risk of people going blind and having their feet cut off…… Below 7% (53) greatly reduces the risk, to a level that makes treatment not cost-effective.
     
  11. justism91

    justism91 Type 2 · Member

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    Hi there. No worries about that haha. Erm im currently on januvia 100mg, 1 pill in the morning and metformin 1000mg, 1 pill at night.

    Actually im pretty concerned about getting type 2 at my age. Apparently this means that i would have to live with diabetes for a longer period of time.

    I would still like to lower my hba1c to less than 6 though. Since im young i would want to get better control u see.

    But then again, i feel that by going on a extremely low carb diet like yourself is worth a try for me since i do get occasional spikes from time to time and it really does make my heart pound alot .

    But nevertheless congratulations for lowering your hba1c. Lets continue to fight valiantly against diabetes
     
  12. Grateful

    Grateful Type 2 · Well-Known Member

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    You are doing great: you got a fantastic result in a short time. You are young, and as you said, will have to live with T2D for a lot longer than some of us. Getting things under control now, and keeping them under control, should stand you in good stead.

    In your place, I would be wondering whether I might get even better results with a really low-carb lifestyle -- which is admittedly a PITA with meal planning and just socializing in general. Plus, it should only be done under medical supervision because you are taking Januvia. Nothing to lose, and possibly something to gain -- good information at the very least.

    Good luck.
     
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  13. ringi

    ringi Type 2 · Well-Known Member

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    If I understand correctly there is very low risk of hypos with Januvia, but best to ask a GP about the risk of hypos directly. (Asking most GPs about low carb in the UK is pointless, as they have got most of their training from drugs companies....)

    Its possible to be "very low carb" for most of your meals, while still being more relaxed while eating out. Once we have removed most of the fat from our livers, we can cope with more carbs at some meals. But if we have the additional carbs often, we risk putting the fat back on our livers. (One option is to combine eating out with a 23hr fast.)

    However some people find it hard to switch between "burning carbs" and "burning fat", they people get a lot better if all their meal are very low carb.
     
  14. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    Slightly over 50gm might be a bit of an understatement - but if it works for you that is fine - but if you actually check and weigh your foods I suspect that you might get a surprise.
     
  15. justism91

    justism91 Type 2 · Member

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    I agree with this too. I mean it is ok to take in carbs as long as we are able to use them effectively during exercises. However, it is easier said than done as sometimes we can't really tell how much calories we burn off during a workout
     
  16. Boo1979

    Boo1979 Other · Well-Known Member

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    I was diagnosed at 39 and told at that point that Id been diabetic for at least 15-20 years
    Ill be 61 next birthday and Im not on insulin although I have taken Gliclizide almost continuously since diagnosis ( they started me off on insulin but then I got it changed)
    Ive used the feedback from testing to make modifications to diet along the way requiring changes in medication / dietary regime are a fairly inevitable part of the disease progression although we can influence the rate of progression
     
  17. justism91

    justism91 Type 2 · Member

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    Wow! 15-20 years! you are one tough man there. You mean to say over those years you have never felt unwell or have any symtoms?

    But anyway, good job in controlling your diabetes. At age 61, there is still a long way to go and plenty to experience . Stay safe and fight hard bud!!
     
  18. Boo1979

    Boo1979 Other · Well-Known Member

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    Cheers
    I had symptoms from an early age (8 ish) and had multiple dip stick tests done via the GP which always came back negative so having been told multiple times that I didnt have D it wasnt my first thought as an adult. When I did ask to be tested as an adult (different GP) the GP said no because I had an infected blister on my foot and there was no point testing until it healed - that nearly cost me my leg and led to a 4 month stay in hospital - as you might guess, I have very little faith in GPs!
     
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  19. Oldvatr

    Oldvatr Type 2 · Expert

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    Unfortunately DCUK now charges for the online Low Carb program. It is still worth making the investment IMHO. I am glad I did it, and I am still using the principles and the recipe book from 2 years ago, and I have significantly reduced my medication and my HbA1c to a sensible level.

    I am not cured of my T2D, but I avoided the insulin dependent route (so far) by the skin of my teeth after being referred for training for the treatment. So I use the term reversed not to indicate that I have stopped my disease, but that I have stepped back to a time pre diagnosis where I was probably pre-diabetic, but still making my own insulin,

    Low Carb has shown me that T2D is not a progressive disease in the way the medics say, but is as said above, a result of wrong diet and over-medication
     
  20. Oldvatr

    Oldvatr Type 2 · Expert

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    There are two different types of IR that can affect T2D. The first stage seems to be muscle resistance where the blood glucose gets prevented from entering the muscle cells, and so they lose efficiency. This stage makes us produce more and more insulin in an effort to force insulin into the cells. Unfortunately this extra insulin also increases the storage of excess glucose as fat in the adipose tissues (e.g. the liver and pancreas) and this leads to fat buildup in those orgns leading to NAFLD. This is called the Metabolic Syndrome which give the telltale beergut profile around our waistline.

    A Low Carb diet will help to reduce the muscle IR, and it seems that a ketogenic diet and/or fasting (or an ultra low calorie diet like ND) will help to tackle the fat stores in the adipose tissues. This used to be done by serious and intensive exercise, but since many T2D tend to be elderly then this becomes less of an option for us pensioners. LC seems an easier way of getting the same result, but without the pecs.,
     
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