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New to the site - 13 years late!

E

ElNevera

Active Member
Messages
40
Type of diabetes
Type 2
Treatment type
Other
Hi All

My name is Simon and I am a new member.

I was diagnosed as type 2 13 years ago. I am a big bloke and always have been. I was quite a bit bigger when diagnosed but still classed as Obese.

Over the years I've been on various meds but have always been on Metformin.

I was on Gliclazide for a while and ended up on the max dose, my bloods were at their best at that point but also my weight was my worst recorded and looking back I was very depressed. I came off it as it was making me feel ill.

I am currently on Metformin 2g per day (Modified release) and Victoza 1.2mg per day.

My most recent Hba1c was 89. My doctor now wants me to go on insulin.

I have trouble getting my doc to understand my blood readings as I do intermittent fasting and try to eat a low(ish) carb diet.

My readings start the day in the mid to high teens and I have breakfast and lunch (take my meds at breakfast) and then stop eating until the next day. When I test my bloods in the evening or before bed they can be quite good and often in the 'normal' range but despite no further food it will then rise all night. I am at a loss, my docs can't figure it out and they are saying insulin at bedtime will help.

I'm worried being on insulin will cause weight gain.

I was doing really well this year, my weight isn't falling quickly but I've been buying smaller clothes and building muscle mass but it doesn't seem to be helping my bloods enough.
I tried starting a couch to 5k program and was doing well but then hurt my foot and got a lot of blisters and that led to being diagnosed with two foot ulcers recently.

I haven't gone strictly keto yet as I struggle to see the long term sustainability of doing it.

This feels like a confession but I am feeling so overwhelmed....

I know I need to get reading and all that but my doc wants to start the insulin on Monday.

Can anyone help or at least give me a good direction to go in?

Cheers

Simon
 
Hello and welcome.

ElNevera said:
I haven't gone strictly keto yet as I struggle to see the long term sustainability of doing it.
Click to expand...

I've been following a ketogenic way of eating for the past 3 years and am now veering towards carnivore what do you see as a struggle?
When you say your blood sugars are in the "normal" range in the evening when fasting what kind of level are you seeing?
Any idea how "lowish" carb your diet is? do you keep a food diary for example?

I'll tag in @daisy1 for the intro to the site.
 
Thank you.

I've tried keto a few times in the last but I am a horrendous carboholic and I kept failing. There is also the fact I have a wife and two young children that can all eat what they want and although I don't eat an evening meal Monday to Friday I do enjoy cooking for them and eating with them on a weekend.

In regards to low carb, I just try and avoid 'carby' foods. Mon to Fri I usually have eggs, mushrooms and cheese for breakfast and a salad for lunch. I feel great on an evening if I stick to that and don't feel hungry.

I've been hearing a lot about the carnivore diet recently and I am interested in how it would be nutritional enough.

Thanks again

Simon
 
@ElNevera
Hello Simon and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it useful. Ask as many questions as you want and someone will be able to help.

BASIC INFORMATION FOR NEW MEMBERS

Diabetes is the general term to describe people who have blood that is sweeter than normal. A number of different types of diabetes exist.

A diagnosis of diabetes tends to be a big shock for most of us. It’s far from the end of the world though and on this forum you'll find well over 235,000 people who are demonstrating this.

On the forum we have found that with the number of new people being diagnosed with diabetes each day, sometimes the NHS is not being able to give all the advice it would perhaps like to deliver - particularly with regards to people with type 2 diabetes.

The role of carbohydrate

Carbohydrates are a factor in diabetes because they ultimately break down into sugar (glucose) within our blood. We then need enough insulin to either convert the blood sugar into energy for our body, or to store the blood sugar as body fat.

If the amount of carbohydrate we take in is more than our body’s own (or injected) insulin can cope with, then our blood sugar will rise.

The bad news

Research indicates that raised blood sugar levels over a period of years can lead to organ damage, commonly referred to as diabetic complications.

The good news

People on the forum here have shown that there is plenty of opportunity to keep blood sugar levels from going too high. It’s a daily task but it’s within our reach and it’s well worth the effort.

Controlling your carbs

The info below is primarily aimed at people with type 2 diabetes, however, it may also be of benefit for other types of diabetes as well.

There are two approaches to controlling your carbs:
  • Reduce your carbohydrate intake
  • Choose ‘better’ carbohydrates
Reduce your carbohydrates

A large number of people on this forum have chosen to reduce the amount of carbohydrates they eat as they have found this to be an effective way of improving (lowering) their blood sugar levels.

The carbohydrates which tend to have the most pronounced effect on blood sugar levels tend to be starchy carbohydrates such as rice, pasta, bread, potatoes and similar root vegetables, flour based products (pastry, cakes, biscuits, battered food etc) and certain fruits.

Choosing better carbohydrates

The low glycaemic index diet is often favoured by healthcare professionals but some people with diabetes find that low GI does not help their blood sugar enough and may wish to cut out these foods altogether.

Read more on carbohydrates and diabetes.

Over 145,000 people have taken part in the Low Carb Program - a 10 week structured education course that is helping people lose weight and reduce medication dependency by explaining the science behind carbs, insulin and GI.

Eating what works for you

Different people respond differently to different types of food. What works for one person may not work so well for another. The best way to see which foods are working for you is to test your blood sugar with a glucose meter.

To be able to see what effect a particular type of food or meal has on your blood sugar is to do a test before the meal and then test after the meal. A test 2 hours after the meal gives a good idea of how your body has reacted to the meal.

The blood sugar ranges recommended by NICE are as follows:

Blood glucose ranges for type 2 diabetes
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 8.5 mmol/l
Blood glucose ranges for type 1 diabetes (adults)
  • Before meals: 4 to 7 mmol/l
  • 2 hours after meals: under 9 mmol/l
Blood glucose ranges for type 1 diabetes (children)
  • Before meals: 4 to 8 mmol/l
  • 2 hours after meals: under 10 mmol/l
However, those that are able to, may wish to keep blood sugar levels below the NICE after meal targets.

Access to blood glucose test strips

The NICE guidelines suggest that people newly diagnosed with type 2 diabetes should be offered:
  • structured education to every person and/or their carer at and around the time of diagnosis, with annual reinforcement and review
  • self-monitoring of plasma glucose to a person newly diagnosed with type 2 diabetes only as an integral part of his or her self-management education

Therefore both structured education and self-monitoring of blood glucose should be offered to people with type 2 diabetes. Read more on getting access to blood glucose testing supplies.

You may also be interested to read questions to ask at a diabetic clinic.

Note: This post has been edited from Sue/Ken's post to include up to date information.
Take part in Diabetes.co.uk digital education programs and improve your understanding. Most of these are free.

  • Low Carb Program - it's made front-page news of the New Scientist and The Times. Developed with 20,000 people with type 2 diabetes; 96% of people who take part recommend it... find out why

  • Hypo Program - improve your understanding of hypos. There's a version for people with diabetes, parents/guardians of children with type 1, children with type 1 diabetes, teachers and HCPs.
 
Hey Simon, and welcome,

So you tried keto, but it didn't work out for you because you're a carboholic? Really, it's a choice... Do you hate the thought of insulin more than you love the carbs? (Either answer is fine, not judging.) My husband doesn't eat a ketogenic diet along with me, but that just means he gets spuds with dinner, and I pile on more veggies instead... Plus, I have some tea at breakfast while he's got bread or crackers. Were you hungry on keto? Unsatisfied? Are you sure you got the ratio's right? (Upped the fat and protein?). It could make the difference between going on insulin and not, but if you're bored with foodchoices or something, you could try a thousand meal-ideas over on dietdoctor.com. Including things like mug cake, chocolate mousse, fatbombs and what have you. Fathead pizza, never tried it myself because I'm hopeless in the kitchen, but it could be something your entire family would enjoy for the weekend. Just some ideas.

Hope you'll be back to good soon. And hey, YOU decide when you go on insulin... Not the doc. If you want one more chance with diet, discuss it. Not saying you shouldn't, but that relationship is a democracy, not a dictatorship.

Take care,
Jo
 

Hi Jo

Thanks for replying. I'll admit I was a little emotional when I posted this thread.
I know I have not managed my diabetes for such a long time and I tried to follow the original advice I was given (and still am given) by the medical staff to stick to low fat and low calorie foods. It has only ever worked on and off and as I said I am a big person carrying a lot of weight.
I am 6'4" and 20st 10lb as of now and I have been in the 25st range.
I do not trust the BMI as I have a big frame and honestly think my ideal weight is going to be in the 16 17st range.

As for Keto, I really want it to work. I love high fat foods and for a good period this year I thought I was doing the right thing only to be told my cholesterol ratio is way up (7%? I can't quite remember how it works).

I am soon to be 39 and by the time I am 40 I want to be close to my 'ideal' weight.

I am scared to death that going on insulin will just enable me to carry on eating the wrong food and just have insulin adjusted to cope with it. That would be a disaster for me. I have 0 will power right now.

I am however willing to reduce my carbs right down and even aim for keto for a long term change rather than a 'diet'.

Someone has suggested I try one of those vlcd's for now to get a good start and hopefully bring my bloog sugar down significantly.

Sorry for the rambling and thanks for your help!
 
Of course you were emotional: who wouldn't be? (Certainly wouldn't be the first one to post here feeling rather out of sorts). You know, I was relatively big. I thought it was due to my then new medication, but as it turns out I had PCOS, which causes insulin-resistance. The first stop on the way to T2. So I went to the doc, who referred me to the hospital's dietician. Following her advice to the letter (up the carbs, cut the fats and calories, you know the drill), I went from obese to morbidly obese. An over 102 kilo woman, because I was so afraid of the scales I didn't step on them again, so no idea how big I'd actually gotten. But it was BIG, for a 5ft8 lass. You and I, we're insulin resistant... That means that we can't process the glucose back out of our bloodstream. It ends up in our wee, in our eyeballs, our kidneys.... And in our fatcells! It gets stored! It's not dietary fat that piles the weight on, it's the carbs! And you know what? If we start losing weight, our cholesterol *temporarily* goes up. What was stored in and around the liver enters the bloodstream on its way out... Which would be a good thing, no? Once you get to a healthier weight, things stabilise and that means cholesterol too. (Which, by the way, has gotten a bad rep unnessesarily.) As for fats and T2: it doesn't spike us, and it actually mitigates the effect of what carbs we do have. So while just berries would spike me, berries with cream, nuts or with a nice cinnamon omelet....? Not so much.

As a T2, as i've mentioned before, you're insulin resistant. Sorry if I'm telling you things you already know, but that means you're just not sensitive anymore to the insulin you produce. You have LOADS of insulin hovering around, your body just doesn't do much of anything with it, other than store glucose in fat cells, rather than burning it. Tossing more insulin into the equation... I dunno... (Unless, of course, your pancreas has given out due to the demanding output, and it's just stopped working, but you haven't mentioned that.).

I'm just a fellow T2, I'll probably get things wrong here and there, but in effect... I've been so big I had trouble breathing when i put my shoes on, as my belly would crush my lungs. My HbA1c was quite high, and now it's 34. Know why? because when i was diagnosed everyone wa on holiday, so I had to figure this stuff out on my own. I read books, and by the time I finally saw someone and they gave me bad advice, I'd already gotten my numbers down and knew what I was doing, worked!

I'm turning 40 in little over 3 months. I've not been this healthy in over 18 years. Check keto (which is indeed vlcd), check the Dr. Jason Fung books, check dietdoctor.com, and our own success stories section. It can be done. If you want to, of course.
 
Hi and welcome!

I’m going to be straight out brutal and to the point. No malice intended at all, but perhaps a bit of motivation. You say that you don’t think keto is sustainable, but do you think foot ulcers are more sustainable? I’m sure I don’t need to point out where that might end. If you’re successful with keto long term then you’ll no longer feel the need for carbs. I’m not judging, just trying to understand where your priorities lay.

Your only other option it seems is insulin, and that will very likely make you put on quite a bit of weight, whilst probably not improving overall health outcomes in the long term. As always of course, the choice is yours - keto or insulin. I know which I would choose.

Beef, chicken, bacon, pork belly, cheese, eggs, fish, butter, cream, nuts, vegetables...and feet vs. bread and insulin.

 
When eating low carb with a family I simply had an extra lot of veges and made more carbs for them - but not that many more, but it worked out very well.
My son is 6ft 3 or 4 and still slender in his late 30s.
Why your doctor can't tell you that your liver is releasing its stores of glucose I cannot understand - having normal levels of blood glucose after not eating for some hours is also normal.
 

Thank you, it's only been a day since I joined but I am already so much more positive about this and this is thanks to the replies here.

I am going to see the DN on Monday and I will negotiate a month or two of my low carbing/keto'ing to see what I can achieve. I honestly feel Insulin is the wrong thing for me, unless there is nothing left I can do myself.

Thanks again!
 

Thank you very much Jim (Feels very surreal saying that seeing as I am a massive TPB fan!)

Honestly, blunt is what I need. I am going to start low carbing and Keto and prove to the Doc's and more importantly myself that I can do this.
 

Thanks, I don't have a slim frame by any means and all my weight is on my gut, chest and back.
As for the doc's, well they've only just stopped trying to tell me to following the old low fat and low calorie ****. The nurse was shocked when I said I was doing intermittent fasting.
 
It helps when you've got support. This place can make all the difference. I wish I'd found it when I started this journey, as the dutch site, well.. When I asked questions there, I mostly got crickets: those people were as lost as I was. If they didn't know how to deal with this, then how was I supposed to? Here though, there's always people around with answers, or a shoulder, or a listening ear. That makes it a lot easier to keep things up.

You can do this.
 
ElNevera said:
Thank you very much Jim (Feels very surreal saying that seeing as I am a massive TPB fan!)

Honestly, blunt is what I need. I am going to start low carbing and Keto and prove to the Doc's and more importantly myself that I can do this.
Click to expand...

Ha! Trailer Park Boys is awesome, isn’t it?

Glad you didn’t take offence. I wondered if my post was a bit harsh. Anyway you’re in the right place now. Opinions vary in all sorts of things but I think you’ll find we are all rowing in the same direction at least. You certainly won’t be short of help and advice regarding low carb eating
 
Thanks Jo, I can't explain how much better I already feel.
Talking to people with experience makes such a difference, kinda like someone has put their arm around shoulder and said "you can do this and it'll be okay!"

 
One of my favourite shows. Found it on Netflix only 2 years ago, hooked ever since. Mr Lahey will be missed!

There is already such a difference in my mental state, I'm not resigned to being put on insulin now, I am positive about how well I can do myself.
 
ElNevera said:
There is already such a difference in my mental state, I'm not resigned to being put on insulin now, I am positive about how well I can do myself.
Click to expand...
The problem with insulin (apart from the injections!) is that being a T2 we are already insulin resistant so you usually end up with ever increasing doses and the problem gets worse. I struggle with my glucose even on a low card diet but I know I would be a lot worse if I wasn't very careful with my diet.
 
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