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Type 2 New to T2D - Help Needed Please

Discussion in 'Ask A Question' started by MoonUnit, May 25, 2020.

  1. MoonUnit

    MoonUnit · Newbie

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    Hi everyone,

    I'm not sure if I have done this right but I was hoping that you would be able to help me please.

    Background - I'm 34 and I was diagnosed with PCOS around twenty years ago and receive no treatment/medication. My adult weight has fluctuated between 14st and 23st at my heaviest. I am a prolific yo-yo dieter and can lose weight successfully to a certain point. In March 2019 I was diagnosed with Type 2 Diabetes and had a HbA1c of 75 (my weight at that time was around 23st) . The nurse was not overly concerned as blood tests in July 2018 (for something else) had recorded my HbA1c as 45, so she believed the T2D was only a recent development and probably a result of 'overindulgence at christmas' (her words not mine). I was given a prescription for Metformin and sent packing by the Diabetic Nurse at my GP Surgery. I suffer from episodes of depression and anxiety, denial kicked in and I buried my head in the sand. Diet did not change and I did not take the medication. In retrospect, I should have sought support and advice but I didn't. If I could go back in time then I would.

    Fast forward to March/April 2020. I wasn't feeling well (short of breath, fatigue, headaches, pains in my muscles, digestive issues etc) so I confessed to my GP that I was not controlling my T2D. Blood tests done and my most recent HbA1c is 131.

    Since the last HbA1c results, I've been trying to cut out junk food etc. I am a stubborn s*d and thought I could get my numbers under control myself. I've now reached my 'it's now or never' moment and know that I have to make serious changes and take action before I (1) die (2) end up in hospital (3) create serious long term health problems. So, 3 days ago I have given in to taking the Glicazide (80mg a day (2x40)) my GP prescribed in March and I'm monitoring my fasting blood glucose. But I have lots of questions and desperately need some support please.

    I've set myself a goal of reversing my T2D diagnosis or getting it within remission limits within 12 months. Can any of you offer some general advice please? And/or answer my specific questions below?:

    1. I've found some really interesting material by Dr Jason Fung online - have any of you had any good results with fasting? Either fasting for 24/36hrs at a time? Or fasting for 16 hours? I've been trying the 16/8 method of fasting for the last 3 days as my GP said I shouldn't do 24 hours or longer due to the Glicazide?

    2. If any of you do fast, do you notice that it impacts your fasting blood glucose? I'm not sure whether this will improve or hinder my fasting blood sugar control.

    3. I'm going to try to follow the Low Carb High Fat diet - does anyone experience gallbladder problems with this type of diet? I have gallstones and my GP always said fat is a trigger for gallbladder pain but after doing some reading I'm not sure if this is right.

    4. Has anyone else with PCOS found that the LCHF helps with their symptoms? Or will PCOS prevent me from getting my T2D in remission?

    5. How quickly can I expect my fasting blood glucose to get to normal/acceptable levels? It was 27 on day one, 21.5 on day two, 19.5 yesterday and 15.7 today. Also, is it normal to feel a little woozy and woolly headed even when my blood sugars are still over the limit? Is it just my body getting used to less sugar (albeit still high by normal limits).

    6. How quickly can I expect my HbA1c to drop? I know it won't happen overnight. I have my next HbA1c in 4 weeks time and I'm not expecting much change as I realise that I've only just started to implement the changes. However, can I expect good results at the HbA1c check after that? (so in 16 weeks time?)

    7. I'm reluctant to take medication in the long term (I'm conscious of the impact medication has on the liver). Will my GP take me off the medication if I can get my numbers down?

    8. I'm extremely unfit at the moment, having done little to no exercise for nearly 2 years (I work 40 hours a week at a desk job and have been spending 30 hours a week on top of that studying for my Masters). It is recommended that I do 150 minutes a week of cardio - how is best to divide this? For example, I've been doing an hour long walk every other day for the last week. Is this the best way forward? Or will I see better blood sugar control if I do say 30 minutes every day (as opposed to 1 hour every OTHER day)?

    9. Do I need to test my blood sugars before going out for a walk? I read stuff on line about exercise causing problems with blood sugars but I couldn't ascertain if this was for T1D or T2D and did't know if it only applied to intensive or strenuous exercise.

    10. On my last HbA1C blood tests, there were some abnormal results for my liver. The GP said she isn't overly concerned but is sending me for a x-ray/scan. I've read online that it could be fatty liver - once I get my diet and numbers under control will this also improve a fatty liver?

    I'm sure I'll have a million other questions as I begin getting to grips with this awful situation but any help you can offer will be greatly received and appreciated.

    Thanks in advance!
     
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  2. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Welcome to the forum. You have found the best place on the internet for advice and support. I was diagnosed with 122 and decided to go keto. less than 20g carbs per day. Back in normal range in 4 months. Tagging @JoKalsbeek for her brilliant intro.

    If you have read Jason Fung's The Diabetes Code, he talks about PCOS. Members on here have reversed the fatty liver. Some have parrted with their gall bladders. By the way, Jason is pretty much revered around these parts.

    Tell us what you eat in a typical day.
     
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  3. MoonUnit

    MoonUnit · Newbie

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    Thank you for the advice and the warm welcome!

    Previously my diet in recent years was very heavy in carbs - most meals centred around refined carbs - pasta, rice, white potato etc. I have a very fussy partner who has a huge appetite (he has a manual job) so it was easy to knock up meals loaded with carbs to fill him up. Also a dessert fan - ice cream, cake, etc. Obviously not a wise idea in retrospect as eating the same meals as him has probably led me to the T2D diagnosis.

    Luckily, I've always been a massive lover of fruit and veg etc. too so altering my diet won't be too hard for me. I don't really have a set plan at the moment. I've been doing the 16/8 fasting so I've been having my first meal around 12noon, a snack around 4pm if I'm hungry and my last meal around 7.30. I go to bed at around 10.30. In terms of what I eat, I've been having eggs (either poached with avocado or baked beans on seeded bread toast) or yoghurt with strawberries for the first meal. The snacks are usually something like cheese, fruit, seafood or lentil crisp things. For the evening meal, I've struggled a little bit as I've not been as prepared with food shopping and haven't been able to get a delivery. So I've been having things like breaded chicken with salad and a jacket potato. Basically, using up what I've got in the freezer etc. However, I'm due a food delivery this week and will then have all the ingredients in to make meals from scratch. I've got things like chilli, spag bol, roasted chicken etc. on the menu for this week so this should improve the quality of my evening meals. The other half knows now that he either eats the LCHF diet with me or he makes his own meals :)
     
  4. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Your diet needs a lot of changes.
    Fruit apart from berries is not good for T2. It delivers fructose directly to your liver, and yours is working overtime as it is.
    Baked beans on toast is another carb fest.
    Breaded anything is out.
    Potatoes. Out. I eat them once a year on Christmas Day.
    Chilli and spag bol. No pasta please.
    Real all labels on packet or tinned stuff and learn all the names for sugar, glucose, fructose, sucrose etc and avoid.

    Now I have devastated your menu (sorry), what can you eat instead?
    Rice - cauliflower rice (I make a agnificent cauliflower cheese)
    Pasta, look up zoodles, ccourgettes spiralized

    Anything you fancy google keto (whatever)

    We usually say to stick to above ground veggies. No sweetcorn. I tolerate a tiny amount of carrot,likewise onion.

    People tolerate food differently, you need to check your meals using a glucose meter.

    It's a lot to get your head around, but you do, surprisingly quickly.
     
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  5. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    Hi @MoonUnit
    I'm going to go over all your questions one by one, but let's start off with this link here: https://josekalsbeek.blogspot.com/2019/11/the-nutritional-thingy.html . That's a decent starting point, if i say so myself. Okay, so, your questions:

    1. I've found some really interesting material by Dr Jason Fung online - have any of you had any good results with fasting? Either fasting for 24/36hrs at a time? Or fasting for 16 hours? I've been trying the 16/8 method of fasting for the last 3 days as my GP said I shouldn't do 24 hours or longer due to the Glicazide?

    Gliclazide, combined with low carb or fasting, can cause hypo's. It forces your pancreas to produce insulin, whether you need it at that moment or not... Kind of like a T1 shooting too much insulin and getting a hypo. So while you're on gliclazide, test often when you experiment with food, okay? because the hypo's are NOT fun. Maybe ask your doc whether you can try diet for a while, then go back to glic if it doesn't work. (It will work though. ;) ) Dr. Jason Fung's a minor god here for a reason. The guy knows what he's talking about.

    2. If any of you do fast, do you notice that it impacts your fasting blood glucose? I'm not sure whether this will improve or hinder my fasting blood sugar control.
    It'll help your FBG. The sooner your body gets used to lower blood sugars, the less your liver will dump in the morning.


    3. I'm going to try to follow the Low Carb High Fat diet - does anyone experience gallbladder problems with this type of diet? I have gallstones and my GP always said fat is a trigger for gallbladder pain but after doing some reading I'm not sure if this is right.

    More often than not, from what I understand, gallstones develop because the bladder isn't emptied often enough. Fats cause it to empty. https://www.dietdoctor.com/gallstones-and-low-carb might be of assistance.

    4. Has anyone else with PCOS found that the LCHF helps with their symptoms? Or will PCOS prevent me from getting my T2D in remission?

    PCOS was the reason i became insulin resistant and later, a diabetic. I've been in diabetic remission for a few years now, but keep in mind PCOS does make it a little harder to lose weight. If I didn't have that issue, i probably would've lost more. But hey, i used to be over 102 kilo's (I stopped weighing, was too depressing), and now I hover between 82 and 85. I'll take it. So PCOS may throw up some hurdles, but your diabetes should be able to get under control, and for quite a few people, the PCOS symptoms alleviated on low carb. I don't know how my ovaries are doing because I haven't had an ultrasound in years and I have no desire to have children, so... Haven't been checking.

    5. How quickly can I expect my fasting blood glucose to get to normal/acceptable levels? It was 27 on day one, 21.5 on day two, 19.5 yesterday and 15.7 today. Also, is it normal to feel a little woozy and woolly headed even when my blood sugars are still over the limit? Is it just my body getting used to less sugar (albeit still high by normal limits).

    Those numbers by themselves mean absolutely nothing. Mainly because they depend entirely on two things: What you're eating, and the gliclazide. If you don't know what your sugars were doing before a meal, and 2 hours after the first bite, you'll not learn much. If you see a rise of no more, and preferably less than 2.0 mmol/l, then your blood sugars will continue to get lower. Your fasting blood sugars too. Give it a couple of weeks.

    6. How quickly can I expect my HbA1c to drop? I know it won't happen overnight. I have my next HbA1c in 4 weeks time and I'm not expecting much change as I realise that I've only just started to implement the changes. However, can I expect good results at the HbA1c check after that? (so in 16 weeks time?)

    A HbA1c is an average of 3 months, weighing more heavily on the most recent 2 weeks. So you'll get your numbers down some in those 4 weeks, but you want to know what they're doing 3 months after you've implemented changes.

    7. I'm reluctant to take medication in the long term (I'm conscious of the impact medication has on the liver). Will my GP take me off the medication if I can get my numbers down?

    If you go low carb and stay on glic, you'd be hypo-ing left and right. So yeah... While some docs don't think it can be done, you could get to a point where you won't need medication.

    8. I'm extremely unfit at the moment, having done little to no exercise for nearly 2 years (I work 40 hours a week at a desk job and have been spending 30 hours a week on top of that studying for my Masters). It is recommended that I do 150 minutes a week of cardio - how is best to divide this? For example, I've been doing an hour long walk every other day for the last week. Is this the best way forward? Or will I see better blood sugar control if I do say 30 minutes every day (as opposed to 1 hour every OTHER day)?

    Strenuous exercise can cause your liver to start dumping glucose to help you out, give you energy. A long, steady walk however, will just lower your blood sugars as you go along. So walks are an excellent idea!!! Do it in whichever way suits your lifestyle best, so your odds of keeping it up are better.

    9. Do I need to test my blood sugars before going out for a walk? I read stuff on line about exercise causing problems with blood sugars but I couldn't ascertain if this was for T1D or T2D and did't know if it only applied to intensive or strenuous exercise.

    See answer to no.8. ;)

    10. On my last HbA1C blood tests, there were some abnormal results for my liver. The GP said she isn't overly concerned but is sending me for a x-ray/scan. I've read online that it could be fatty liver - once I get my diet and numbers under control will this also improve a fatty liver?

    Practically all T2's have something called Metabolic Syndrome. That'd be any or all of the following: Non-alcoholic fatty liver disease, high blood pressure, high cholesterol, diabetes. Odds are you do have a fatty liver and maybe a couple of the other issues too. And yes, going low carb, high fat can indeed fix those. (They thought my liver was one big tumor, turned out to be, and I quote, "an abnormal stacking of fat". Perfectly fine now!).

    Hope some of this helps!
    Jo
     
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  6. Hotpepper20000

    Hotpepper20000 · Well-Known Member

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    I have PCOS and it is very hard to loose weight with a traditional “healthy” diet.
    The combination of metformin and low carb higher fat, no fruit, except berries, and no grains, helped me loose 60 pounds.
    The acne, fatigue and body pain has for the most part disappeared.
    I still have some weight to loose but my BG had is non diabetic now.
    Stick to the forum, there is a lot of help here.
     
  7. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Yup. Listen to Auntie Jo :)

    Over time your tastebuds will change. In the meantime, look up keto fat bombs.

    Google keto muffins.

    Fat head dough for pizzas, very filling and a great base for gaic bread.

    Dietdoctor.com for info and recipe ideas.

    Indian headbangerskitchen.com

    Pork scratchings blitzed make an alternative to breadcrumbs.

    Ask and you will receive more info than you can handle :)
     
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  8. dipsydo

    dipsydo · Well-Known Member

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    As you have a meter you can see what disagrees with you by pushing up your blood sugars , take a reading , just before you eat and about 90 mins after the first bite. If your blood sugar increases substantially then you know not to eat that food in future. Also if you go low carb , or are intermittently fasting, as you are on a med ( Glicazide )which makes your pancreas produce more insulin you need to monitor your blood sugar to make sure the limiting of carbs or timing of intake does not result in a hypo. ( low blood sugar ) . If all goes well with a change of diet you may be able with your doctors agreement be able to reduce meds.

    You mention fruits sadly they are not good for diabetes as full of sugar apart from berries which are lower and can be eaten in moderation . You mention breaded chicken which is surprisingly high in carbs , as you have already bought them I would cook and remove the crumbs before eating and not buy any in the future . Low carb would mean that potatoes are out as are most below ground vegetable , above ground vegetables are generally OK but peas and other legumes can impact some people but not others so this is when a meter comes in . Baked beans are generally high in carbs as is bread , anything with flour and rice and pasta , so no spag boll , well you can have the boll but not the spag . There are good low carb alternates such as cauliflower rice and if you really need to eat bread then low carb bread such as Livlife is available but expensive. There is low carb ice cream as well available look at the labels . With low carb you need to ensure you drink a sufficient fluids I drink at between 2 or 3 litres. The fat in the the low diet helps with preventing hunger but you can go moderate with the fat . Snacks , if needed, could be olives, pork scratchings, small pieces of cheese , nuts ( not peanuts) or two small pieces of dark chocolate (85%) or more.
    If you like meat it is low carb and most cheese is low carb although some some is not so look at the the label.
    So meat and and salad / green vegs is fine but ditch the baked potato (but you could cook a potato for your other half as long as you can resist it ) . To avoid larger portions , maybe you could use a smaller plate than you other half so yours looks fuller as it sounds that he needs more food than you do.
    Good luck if you go low carb and remember that you are not looking at a short term diet but the food you want to eat for the future and there is lot of help on this site for advice and encouragement.
     
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  9. MoonUnit

    MoonUnit · Newbie

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    Thank you all so much, your advice and guidance has been really useful and I feel a lot more informed already.

    I've started the LCHF/Keto diet yesterday and I'm monitoring my bgl's throughout the day now (as opposed to just fasting bgls). I'm still fasting 16:8 also. Hopefully this will help me get my HbA1c and bgl's under control.

    Does anyone know how quickly blood sugar levels improve? For example, I ate less than 50g of carbs yesterday and my last meal was at 7.45pm. I woke up at 8am today expecting much lower levels and did my fasting bgl around 9am - it was 15.4. I've just eaten my first meal of the day and I took my bgl's immediately before eating - it was 14.4.

    Will the fasting have an impact on bgl's? I've been reading about liver dump etc. so I'm not sure if this is the cause. I've lived on such a high carb diet for so long that I wonder if the distinct lack of carbs is now causing my liver to empty and/or dump carbs to try and match previous levels.

    I'll keep monitoring as I know it's only early days and will probably correct itself as my body gets used to low carb but was wondering if anyone else had gone through similar things?

    Thanks
     
  10. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Fasting is usually the last number to come down, this is due to the dawn phenomenon.

    For now concentrate on your numbers before and after eating. The rest will follow in time. It's hard to be patient, I know, been there, done that.
     
  11. LaoDan

    LaoDan Type 2 · Well-Known Member

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    I started seeing small results in about ~6 weeks with a really low carb + exercise. Nice results after about three months. :)
     
  12. Hotpepper20000

    Hotpepper20000 · Well-Known Member

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    My numbers took about a month to slowly come down in the morning.
    But the post meal BG came down immediately after going low carb.
    I started feeling better after a week.
     
  13. mouseee

    mouseee · Well-Known Member

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    Honestly the best place to be, this forum!

    You have a really good mindset at the moment and that's important. It's really hard getting out of the habit of matching your protein in a meal to the carbs you are planning but I generally don't miss them. (Although finding low carb 'pasta' in Aldi was a blessing!)

    Good luck and keep coming back for support!
     
  14. MoonUnit

    MoonUnit · Newbie

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    Thanks everyone!

    Out of curiosity, when will my blood sugars start getting within normal ranges? I'm on my third day of Keto/LCHF (eating less than 50g of carbs a day) and I've yet to record a bgl reading lower than 11. Is this normal? Could it be because my levels have been so high for so long that they are just taking a little while to come down?

    Also, how is the HbA1c calculated? I know its based on 3 months average readings but I don't understand how readings of say 7, 10, 13 etc. translate in to HbA1C's of say 75 or 99.
     
  15. Mr_Pot

    Mr_Pot Type 2 · Well-Known Member

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    HbA1c is not calculated it is measured. Some of the haemoglobin molecules in your blood get glucose attached, the higher the average level of glucose the higher the percentage of molecules with attached glucose, which is measured in a laboratory as HbA1c. Because the haemoglobin molecules are renewed on average every 3 months HbA1c gives an indication of the glucose level for the previous 3 months. It is possible to relate HbA1c to average measured glucose levels but you would have to take lots of readings at lots of times of the day to get a representative average.
    Here is a chart which shows conversion from HbA1c to average glucose level.

    hba1c-chart.jpg
     
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  16. LaoDan

    LaoDan Type 2 · Well-Known Member

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    I went super low carb, like shooting for zero, I didn’t count green leafy veggies though. Started adding some carbs back once I learned how to measure my progress. One symptom of progress in the beginning for me, was losing water. I lost like 4lbs of water weight in the first two weeks.
     
  17. Resurgam

    Resurgam Type 2 (in remission!) · Expert

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    as you eat fewer carbs your body will convert to ketosis and start to burn fats, but you have stores of energy in easily accessible form - I think it is glycogen (but there are a lot of glycosomethings about) mainly in the liver and muscle tissue - that is emptied out during the first stages of low carb eating.
    When you see a reduction in your waist size I suspect that indicates that your liver has begun to shrink down. I lost about 12 inches off my waist in the first few months - I really cannot deal with carbohydrate but have always had GPs who pushed for a high carb diet, lots of those healthy fruits and vegetables which were killing me bit by bit.
     
  18. JoKalsbeek

    JoKalsbeek Type 2 (in remission!) · Well-Known Member

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    You're not likely to get into ketosis at 50 grams of carbs a day. I think it might be possible for some though, but to absolutely ensure ketosis, 20 grams or less is pretty much a guarantee. I didn't start with a keto diet. Just gradually lowered carbs until I found a plateau I was comfortable with. That turned out to be keto. ;) So if you're feeling fine at 50, you're fine at 50. If not, keep lowering until your meter and your body tell you they're happy. And yes, your liver is dumping stores to get your blood glucose back up to the level it thinks you should be on. It'll calm down eventually, and get used to the new normal. Time is your friend. And while a HbA1c is a measure taken through a blood test, you could get an estimate if you record a lot of consecutive days/meals in the MySugr app. It won't be spot-on, but it might give you a ballpark.
     
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