Need help as still confused

[MihaiM]

Hello,
Merry Christmas everyone!

I'll try to be short and concise. 10 days ago (Friday 13th, talk about bad luck) I have been diagnosed with Type 2 Diabetes, with two blood tests resulting in
HbA1c level 48mmol/mol. It's very strange because I was prediabetic for 2 years, I haven't tried to lose weight or change my diet, that's true, but in October 2023 my HbA1c was 42, and constantly for 2 years around that area. In January 2024, in just 3 months it jumped to 46. In May it was 47, and now 48, and I haven't changed anything between October and January.

The diabetic nurse told me to go on a low carb diet to lose weight as I had 110 kg and 180 cm height, how many kilograms should I lose to go in remission?
She said that she will not give me metformin at the moment as it can go in remission if I lose weight and won't need tablets.
Since the diagnosis, 12 days ago, I stopped all the alcohol (was a heavy drinker, around 5 beers every day or wine sometimes, probably one of the reasons I got diabetes) and all sugar/sweets. Was eating only very low carb vegetables, like cabbage, sprouts, eggs, tomatoes and some chicken/beef.

Are there any supplements that Improve insulin sensitivity? Read somewhere that Omega 3, Cinammon, and Magnesium helps with that?

In these 12 days I have managed to lose 3 kilograms from 110 to 107.

The trouble I have is that I started measuring the blood sugar levels and in the mornings after waking up, it is always around 7.2 mmol/L on an empty stomach! Why so high considering I was on an empty stomach? I heard this is called the Dawn phenomenon? If so, how can I have a lower blood sugar level when waking up and fix the Dawn phenomenon?

I had dizziness/headache and felt weakness in my legs and also heart rate a bit low, 54-55-56, but after an hour or so it improved to 60. I tried skipping breakfast for 3 mornings, and the blood sugar was going down very low, from 7.2 to 6.1 at 12:15 pm with eating just a slice of cheese and a plum. Shouldn't it go down faster? When I arrived home at 5 pm it was very low, 3.3, so that is dangerous? It means I shouldn't skip breakfast?
Also after those 3 days of skipping breakfast, I had a constant headache/dizziness and legs felt weak when walking.

Went to see the gp and explained all this, he told me for now to eat a normal diet with carbs, but smaller portions, until I get on the Desmond Course to help me with my nutrition. After I started eating carbs again the headache and week legs started to go away. I think I been in keto for those 3 days when I didn't have carbs and I took energy from fats and that's why I felt dizzy and with weak legs?

I heard a low fat hypocaloric diet would be good to try? Can you recommend a diet like that please or how to lose weight faster?

Also, I remember 2 years ago the gp told me I have low cortisol levels and had a injection to increase cortisol levels. I did not know for what that injection is, asked me if I agree to have it and just said yes. Could that also triggered prediabetes?

Also, in the last few days after skipping those 3 breakfasts my face is reddish in color sometimes and all face is dry, including lips and nose, skin is flaky, was that the cause? Or maybe because of the sudden alcohol cut off?

Would greatly appreciate your help on what to change/improve for my journey on losing weight and also hope I get the answers at the questions mentioned above if you can spare some time!

 

[JoKalsbeek]

Good morning, @MihaiM , and I hope your Christmas season'll become merrier as you learn more about diabetes. There's a lot to unpack here, but just so you know, there's a lot you yourself can do, and had already started on.... I've got my tea, my husband is still sleeping, so let's get into it while we can!

Your prediabetic numbers went into the diabetic range because you didn't change your diet. Diabetes is a progressive condition unless you actively try to stop it in its tracks, be it through diet, medication or a combination of those two. The reason the numbers went up wasn't because anything changed at that point, but because there were no changes. Natural progression of the condition, which is a bummer, because a lot of us never knew we were prediabetic, (often not bothered to be told until the ship has sailed), and you had a chance there... And no-one acted on it or informed you to do something. But you know you're diabeti now and you're asking the right questions, so who knows, this may get licked yet!

Your nurse was right about the low carb diet, sort of. But you gain weight because you have insulin resistance/developing diabetes, you don't get diabetes due to the gained weight. More often than not the goal is to lose at least 10 percent of the body weight (which in your case would be 11 kilo's), but there's no guarantee that would bring on remission. Low carbing would likely achieve it though. And more weight loss to boot. Stopping beer was a good move, as there are a lot of carbs in there. (It's called Liquid Bread for a reason) Some wines might be a bit carby, but quite a few of them shouldn't be a problem.

There are supplements that increase insulin sensitivity some, like berberin which works a little like the drug Metformin would, but the main thing would just be low carbing. You're insensitive to your own insulin because you make so much of it. If you ask your pancreas to produce less, your sensitivity should improve as you're not overloaded on insulin all the time.

You lost 3 kilo's rapidly, you had severe headaches and your skin turned flaky. That is likely all due to the low carbing. And it's a shame you stopped, because you were well underway to getting through the worst of what is called carb- or keto-flu. Carbs retain water, so when you drop the carbs, you rapidly lose water-weight. You might have noticed you were weeing for England, so to speak. When you lose a lot of liquid in a short period of time, your electrolytes flush out along with them, causing headaches, fatigue, muscle weakness, dehydration (explaining the flaking skin), dizziness, joint pain, that sort of thing. Would have been easily solved with bone broth, coconut milk/water or, quite simply, electrolyte supplements. This transitional period lasts something like two to three weeks, and then your body finds a new equilibrium, and the problem solves itself. You were about halfway there from the sound of it, and if you want to low carb, you'd have to start over. But do it with supplements at hand (magnesium, potassium, salts etc, all that good stuff.), and paracetamol too.

7,2 on an empty stomach does sound like Dawn Phenomenon, and the only thing you can do about that, besides start taking something like metformin, is, you guessed it, going low carb. Carbs turn to glucose when ingested, you already know that. But what you can't use to burn off -and that is a lot, because with insulin resistance, burning it off doesn't quite happen as it should- it gets stored in the liver, usually as fat cells. In the morning your liver wants to help you get your dayu started, and because you're always high, it thinks that that is your "normal". So it releases more glucose than you actually need. It takes just about forevere to get those numbers down, but should you tackle diabetes through low carbing, there'll be less to no glucose to store as there won't be too much in your system, and the stores in your liver eventually get depleted, which is a good thing. Be ready for it to take a half year or so for that to happen, though. Better thing'd be to test around meals and see what happens there. If you test before a meal and 2 hours after, there should be a rise of 2.0 mmol/l or less. If that's the case, your body could deal with what you've put in it and there's no excess glucose going around. No excess, no storage, nothing to dump in the morning, lower dawn phenomenon.

Skipping breakfast is fine, and going to 3.3 is perfectly normal for someone who is NOT on blood glucose lowering medication like gliclazide or insulin. It's when you see numbers like that when you're on medication (or have a different condition) that you have a problem, but if not, no worries. Plums, by the way, are decidedly not low carb.

There are three macro-nutrients: Fats, protein and carbohydrates. You cut one, you up the other two. If you cut both carbs and fats, you'd be on a crash diet, get malnourished and basically collapse at some point or other. (And for a diabetic, fats aren't a problem, they're a helper actually: they don't raise blood sugars and can help avoid a spike if you do eat carbs, by slowing down the food uptake.) It's not something that is doable long term, as fun things like scurvy aren't something squarely from the Golden Age, you can get that sort of thing now, still. So pick a macronutrient to cut if you want, but never, ever cut two. Carbs up blood sugars, fats don't. So while conventional advice is to cut the fats, you're dealing with a metabolic condition where it's the carbs you can't process. Fat isn't really the problem here. But if you want to find out and experiment, see what diet your blood glucose responds to better, go ahead, who knows it might work for you, as we're all different. What is true for one, might not be true for another. But please, don't mix a low carb and a low fat diet. I can't stress enough how dangerous that is for your health.

Cortisol is a hormone you really need. And yes, it can trigger higher blood sugars. Sometimes we have to do or take things that have an adverse affect on our glucose levels, but it can't be helped. (Some people absolutely need steroids and such, there's no way around it). If you can't affect one component of what raises your blood sugars, influence that which you can control. Usually, diet.

I think that covers the bulk of it... I know it's a lot of low carb, low carb, low carb, but it just happened to be the answer the bulk of the time, haha. Sorry. In the end, you decide what you do with all this. Go for portion control like your doc suggested, until the course, (And a Desmond course is very much hit and miss, some are outdated, some are on the cutting edge... You never know until you go! If they come up with the EatWell Plate, they're off the outdated variety, alas). Try low fat rather than low carb. Try low carb but with the aid of supplements so you don't get dehydrated like you did before. Whjatever you do, test. So you know what is working for you. Honestly, when I started out with my own experiments, I thought low carb was absolutely bonkers, until my meter told me it was working. And my blood glucose was up in the twenties, daily, prior to that. Sometimes you just have to take a little time to find out what works for you.

Good luck!
Jo

 

[MihaiM]

Good morning @JoKalsbeek

Thank you very much for all the help, really appreciate it!
I think that’s what I’ve done wrong, was having very low carbs and low fat at the same time! Will try again with a low carb/high fat diet and if it still doesnt suit me a low calorie/low fat diet.
Will having a lower blood sugar around 5.0 mmol/L before going to sleep help with having a lower blood sugar dawn phenomenon also?
I read somewhere else about somebody going on a zero carb diet, eating only meats, mayo, fish, eggs, cheese and butter and saying he lost a lot of weight that way and got diabetes in remission, but how long can you keep that diet without causing damage to your body?

Also the low carb diet, is it healthy to stay on this diet for a long time or after how long should it be stopped before damaging my health?

 

[Outlier]

Rather than low carb high fat, think of it as low carb normal fat. It doesn't make doctors and nurses quite so horrified! Just have healthy fats that come with the protein plus olive oil and/or butter. Proper butter not processed stuff with fancy names that pretends to be better than real butter. You are at the start of a voyage of discovery, and we who are a bit further along - or a lot further along - can help and support because we are real diabetics in the real world. None of us come out of the pages of a book or the notes of a lecture.

So next I can say from personal experience of a mere three and a half years (others have more than twice that amount of lived experience) that it is perfectly do-able to eat low carb, very low carb or keto for - for ever if you want. This is what I am doing, and the only changes have been positive (and remarkable). It's impossible to stay completely free of carbs, but if you aim for that, it's as good as it gets. However I would say don't do as I did which was go cold turkey (which suits my personality) but rather ease yourself into as low carb as you can possibly manage.

And test, test, test you blood glucose because that is how you tell which foods affect you and which don't. Before you do any of that, have a thorough read round the forum and ease yourself into all this information. Take your time. Ask anything you want to. No such thing as a stupid or unnecessary question. If you want to know, we are hear to show.

Welcome.

 

[JoKalsbeek]

Good morning @JoKalsbeek

Thank you very much for all the help, really appreciate it!
I think that’s what I’ve done wrong, was having very low carbs and low fat at the same time! Will try again with a low carb/high fat diet and if it still doesnt suit me a low calorie/low fat diet.
Will having a lower blood sugar around 5.0 mmol/L before going to sleep help with having a lower blood sugar dawn phenomenon also?
I read somewhere else about somebody going on a zero carb diet, eating only meats, mayo, fish, eggs, cheese and butter and saying he lost a lot of weight that way and got diabetes in remission, but how long can you keep that diet without causing damage to your body?

Also the low carb diet, is it healthy to stay on this diet for a long time or after how long should it be stopped before damaging my health?

Good morning again,

Zero carb, you mean a Carnivore diet? You can keep that up indefinitely, just like keto. Only thing is you'd have to do it properly. It's very easy to become vitamin deficient on a carnivore diet if you don't also add in things like liver and such. The vitamins hide in the organs, and quite a few people give that a hard pass. For me it wasn't sustainable because I am one of the lucky few who is prone to ureum kidney stones, which I get on this diet. If I wasn't, I'd still be very happily on it: I never felt better, was my target weight, had energy aplenty, clear headed, blood sugars between 4,5 and 5,5 all day every day... Until the kidney stones hit. If you do try keto again, or a carnivore diet, do keep the electrolytes handy, you'll need them for that first transitional period of dehydration/carb flu. Personally, I'd try the keto diet again if I were you, as the odds of getting deficient in anything are smaller then. Just have enough varity in what you eat and get those vitamins and minderals in there. (Carniovore is trickier and needs more research to get the hang of it properly.)

As for being a 5 before bed, it might help, but it's really more about what your liver gets up to. If you wake in the night for a wee, it might think you're up and need energy, so it dumps glucose. If you have nightmares, it might think you need to run for your life, and dump. If, like me, you're waking up with the sniffles, it might dump. Being low in the evening isn't a guarantee, as there's other factors that might be of influence, but it wouldn't be bad either. Better to start from am low than to have to get there from a high.

Good luck,
Jo

 

[Daibell]

Hi as others have said, keep the carbs down and have enough fats and proteins to keep you feeling full.

 

[OrsonKartt]

Hi as others have said, keep the carbs down and have enough fats and proteins to keep you feeling full.

And no matter what anyone else tells you self testing your glucose levels is not a bad thing. If you can afford it a continuous glucose monitor is great if not finger pricking works.

 

[Resurgam]

@MihaiM You might find that not drinking is all you need to do - easier written than done, but the amount of carbs in beer is considerable so that will make a huge difference and it will free your liver from having to deal with the alcohol so it can concentrate on the blood sugar situation.
Although many people lose weight and then see HbA1c numbers showing they are in remission, I do suspect that it is down to getting the blood glucose figures in the normal range first, then the metabolism starts to recover and that is the reason for weightloss. I didn't even think about weightloss after diagnosis as type 2, until my clothes were so loose they were sliding south at surprising moments. Luckily always in private, but it was a near thing a few times.
Eight years on I an considered unusual at my GP surgery for having dealt with type 2 so effectively without medication.