New diagnosed with type 2 but running London marathon next week - advice pls!

Rossi5 said:

Without taking the gliclazide? Within a week?

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I don't know. It wholly depends on how much sugar is stored in your liver, and how much it'll start dumping, but... It would be fast. Don't be in too big a rush though. Blood sugar changes can wreak havoc when going too fast. Your eyesight'll change, so vision'll be blurry for a while as it is, but from what i've heard from others, retinopathy could become a factor with too a quick change. Your body'd probably become dehydrated (adding alcohol at that stage would make it exponentially worse), so there'd be fatigue and headaches as well, and I don't know whether you have electrolyte supplements on hand to fix that. Don't be in such a rush. Your body is used to high numbers now, crashing them down will make you feel quite unwell most likely, making you deal with false hypo's on top of dehydration. Can it be done? Possibly. Would you feel like hell? More than likely. Slow and steady would be better, though I understand you feel the need to get answers quickly. I did zero carb for a while, and it messed me up for about a month until stabilizing. There's a reason I went back to keto rather than zero after half a year of that, though. Like @HSSS said, it HAS to be sustainable for basically forever. This isn't a wuick fix and back to what used to be.

On top of that, you don't know what kind of diabetes you're dealing with... You mentioned already doing zero carb and still being in the teens, which makes me wonder, was it truly zero carb, yea or nay? Or were mistakes made and were these some carbs, or was it truly zero and is another type of diabetes likely. You haven't mentioned yet what you've been eating and drinking on the "zero" days. So if you remember, please do sum up some, if you can?

Rossi5 said:

I’d gone zero carb for a week before the marathon and then had some carbs to make sure i was ready to run. Zero carbs for me means eggs, nuts, meat salad and veg. Although I did still have a few beers so that’s clearly not helped! It did drop a bit though to 9 at one point

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There’s still a few carbs in those. Not many and often not enough to cause an issue but they are there. Some nuts are higher than others and same with veg. This is what keto typically consists of.
Yeah maybe the beer had a somewhat neutralising effect. Seeing a drop does show that it was having an effect. And if you are type 2 that’s what you need.

The only downside to going low carb (or even taking the gliclizide) now is that it can make a LADA person look like a type 2 for a while, until it becomes ineffective as insulin production inevitably falls over time. These people often don’t get any further testing done as a result. Then people get labelled a fast deteriorating type 2 rather than correctly identified as a type 1. The difference is in whether insulin is essential or avoidable and currently to the tech and equipment available on the nhs. Please note when being tested further that a positive antibody test with diabetes is positive for type 1. But a negative doesn’t rule out type 1. And that there are more antibodies than just GAD. I guess that is an argument for continuing testing to avoid scary high numbers and moderating carbs to a nhs 130g recommendation without drastically cutting them if the appointment is soon. It’s waited this long a week or two might be worth the wait before starting treatment to avoid confusion or potentially causing further testing not to be done.

Rossi5 said:

Ok - I guess the balancing is that I’ll need some carbs for the longer runs, even some gels, once a week. Is that why the doc wants me to take glic so that I can still train and consume some carbs/sugars? And is it possible to take glic just on the days you will be adding carbs or sugars to balance?Apologies for all the questions!!

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I very much doubt that is the reasoning. And it’s possible to do endurance exercise on keto. In fact it could be said to be advantageous as you us eketones and don’t bonk. See https://www.amazon.co.uk/Art-Science-Low-Carbohydrate-Performance/

I’m really not sure about the glic taken like that. And it actually makes no sense to me either. Glic deals with excess carbs/glucose. If you are training then you will use the carbs. Therefore no excess so quite possibly a hypo. If not training then you don’t need them and there doesn’t need to be an excess so no need for the glic.

Honestly if your type is in question as it is with the appointment pending I’d get that sorted first before doing anything drastic. Then the approach to carbs/medication is much clearer.

Rossi5 said:

Thanks HSSS

I’ve ordered the book too.

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@HSSS makes a lot of excellent points. One more to add to the chorus of "be careful"'s: I mixed gliclazide and low carb. I didn't know any better, neither did my specialist, and I hit hypo's repeatedly as a result. Not something you want to go though, especially not during anything strenuous, because you will faceplant. Don't change anything all too drastic until your appointment, you don't want to skew results right now. And there are indeed athletes who run on a keto or carnivore diet, without any carb loading. Going purely on fats and protein. But it takes a while for a body to adjust to that, so don't rush it. (That's a thing too.... Your body needs to adjust, and every time you carb load, it reverts back and you have to give it time to adjust again. So plot a course when you know what you have exactly, and stick with it. Otherwise you end up with perpetual fatigue.)

Give yourself time to catch up to the new status quo, whether that be T2 life or Lada and the like. Dunno what nuts you had, but some are carby than others (cashews for instance... I have them, but just a few at a time in my yoghurt). If you want to try zero carb, you'd have to go full carnivore, and not all bodies can handle that. Mine couldn't, I ended up with kidneystones. My blood sugars were always 4 or 5 at most, absolutely stuningly perfect... But kidneystones are hell to deal with, so back to keto I went. You'll figure out what works for you, but find out what's going on first!!!
Hugs,
Jo