My doctor doesn't know what to do!

Once a diabetic, always a diabetic in my opinion. If you reverted back to your old dietary habits then you would more than likley end up in the position you were in 20 months ago. And you sound like you're fully aware of this. I would say "have a go and see what happens" but we both know that would be daft and could cause you some damage with high BG levels, etc...

As for the weight, you could always try increasing your fat and protein intake to maintain/increase your weight. There are lots of healthy fats which include and are not limited to avocado, nuts, olive oil, butter, cheese, fish, etc. Protein is self explanatory really, but I'd stay away from processed meats where you can.

Hi There
it would seem to me that you just need some reassurance that you are continuing on the right path.

I shall tag some of the illustrious T2's I know that can hopefully offer some support.
( I think it sounds like you are doing a fabulous job )

@Brunneria , @bulkbiker , @AndBreathe , @Indy51

Doctors do sometimes seem to be a bit stupid..
You have probably confounded her expectations of what you could achieve.
Yes you should carry on eating low carbs as it has obviously helped bring your sugars down. Is the 40 a recent HbA1c? is so what is it down from and especially very well done indeed.
You could I guess experiment with more carbs to see what happens but personally I would be wary of that approach although you have been doing this for a lot longer than me. An HbA1c of 40 is only just outside "pre-diabetic" so I'd carry on with what you have been doing. Maybe try upping the fat content a bit if you are feeling a bit underweight or even a bit more protein but carry on measuring your bloods to make sure this doesn't spike you. I've still got more weight that I want to lose so I'm not really ready for maintenance yet. How low carb have you been to get where you are now?

MargJ said:

20 months after diagnosis having cut carbs and increased exercise my blood test results show a normal reading of 40. I've lost 3 stone, am now borderline underweight but don't mind if I can keep my levels down. Doctor said "I don't know what we do now." She then asked how I had done it. Not sure she liked the answer. Testing and eating to the meter seemed strange to her but she couldn't deny the results. She seemed to think I could now eat 'normally' . This must be wrong. Surely I still need to be careful with carbs or I will be back to high levels?

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To be honest, only you can decide where to go on this. I would however add the caveat to say, provided you have stabilised your weight. If your weight is still falling, I would suggest (on the basis you state you are borderline underweight), that you address that before doing too much else. I say that on the basis it took me a while to arrest my own weight loss, and I ended up a bit skinnier than my ideal, before I got that balance right!

As you are experienced in eating to your meter, you could elect to carry on as now, or you could see how your body copes with a few extra carbs, if that's what you would prefer. Many, including myself, find that I can handle more carbs now, with no detrimental effect on our blood score, but not everyone has that "luxury".

To be honest, once I had had several non-diabetic range HbA1Cs, and other excellent blood test results, my GP became much more relaxed about the whole matter as she could see how well I am, and had the lab results backing up my protestations of well being.

Good luck with whatever you decide your next steps to be.

Fine job you have done, keep on doing it and keep on excercising... so wonderful that some do succeed that much... it is also funny about the GP´s attitude if it wasn´t such a serious disease, soon i hope more and more doctors will open their eyes for how well people are doing on low carb high fat diets...

Otherwise we maybe should go together and pay for at great adverticment on the front of the guardian and make the whole world notice the results when the doctors seems to keep ignoring the amazing results people like people in this forum and other places actually have accieved

Doctor said "I don't know what we do now."


I think you should report them for being clueless!!

try these for some weight putting back on stuff http://www.cakedarla.com/2011/04/23/xylitol-part-1/

MargJ said:

20 months after diagnosis having cut carbs and increased exercise my blood test results show a normal reading of 40. I've lost 3 stone, am now borderline underweight but don't mind if I can keep my levels down. Doctor said "I don't know what we do now." She then asked how I had done it. Not sure she liked the answer. Testing and eating to the meter seemed strange to her but she couldn't deny the results. She seemed to think I could now eat 'normally' . This must be wrong. Surely I still need to be careful with carbs or I will be back to high levels?

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What is your weight now? As long as you keep your current weight you could probably eat anything you wont and not see your sugars rise.

This is important however. You say you have been very careful with carbs in 20 months. The body needs time to be able to process carbs after having been on lowcarb for such a long time. So eat lots of carby food for 3 days, but dont increase your weight, and then check your meter. You would probably be surprised.

Great job @MargJ on your results. It seems you have a calm ordered mind and a measured approach, especially in the face of a dopey doctor!
The low-carb message is out there and gaining strength - it just hasn't reached everybody yet.

If you have been keeping to a specific carb limit then you could try raising that limit by 5 grams per week and keeping track of BG and weight. You will soon find out what your tolerance is. When BG starts to go up then dial it back 5 grams. Nuts and cheese are both a good way to stall weight loss without adding a lot of carbs. Boursin slightly warmed up in the microwave with celery sticks to scoop it is a personal favorite.

You've done good.
By now you'll understand the cause and effect of dose of carbs. It's your choice now how you proceed... clearly your doc is out the picture.... I would suggest you go as you are and maybe push the edges a bit.
I'm in a similar position. I only test in the morning and did, for about a week, try upping the carbs a tad but found no pleasure in them, probably some Presbyterian guilt and so have gone back to low carbs...
Good luck to you

Give it a couple of months doing what you are doing and see if your weight naturally plateaus. I think it might. If not I endorse the small addition of extra carbs that you enjoy, checking as you go. There's a lot of excellent advice on this thread already. Very well done you!

MargJ said:

Surely I still need to be careful with carbs or I will be back to high levels?

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Yes...unfortunately by the time we have been diagnosed for Type 2, we may have lost up to 50% functionality for our pancreatic beta cells. So we've got to do what is necessary to preserve the remaining 50% and keep ourselves medication and complication free...perhaps till an affordable solution comes along for regenerating those dysfunctional beta cells.