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newly diagnosed - IBS and type 2

A

AnnaWB

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5
Hi everyone, I am a 48yr old woman with an underactive thyroid so my risk of type 2 has been monitored for a few years, although no advice was given about pre-diabetes. This July my HbA1C went up to 53, with subsequent tests in August and November both at 50 (and another test due in March to check stability). My lovely diabetes nurse gave me a full sweep of tests and everything has come back perfectly fine - liver, kidney, heart, feet etc.

The problem is that I already follow a very restricted diet due to my IBS-D so a lot of what is recommended for a diabetic diet I simply cannot do. I am firmly of the opinion that my weight gain over the last decade is down to the underactive thyroid and shattered metabolism, and not what or how much I eat - 6 years ago I managed to lose 2 and a half stone through jogging but the IBS made that difficult and so it has crept back on. Since the summer I have started swimming every Monday to Friday lunchtime to get that metabolic rate back up and burn some calories and now do 1km + every time. So far I have lost a stone in weight simply from doing that, with another 2 realistically to go so I know I need to keep that up.

I am really struggling to find any dietary advice for those already on a low Fodmap eating plan - high fibre/wholegrain, yoghurt, soup, salad, cereal and most fruits are simply a no-go for me, along with caffeine, onions, cruciferous veg etc. My daily diet is basically toast and no sugar peanut butter for brunch (always too nauseous for breakfast), a packet of salted popcorn and an orange for post-swimming snack and a meat or fish based evening meal that I cook from scratch (protein is slower to digest ). I have already cut back on portion size as well, but I have to eat something nutritious! I drink decaf redbush tea and about half a litre of water a day, with a little wine at the weekend (again too much alcohol upsets the IBS). I am not a complete saint and do like a chocolate treat, but I do mean treat and I don't eat junk food or takeaways. There really is little wiggle room on the diet, so perhaps that is why information is scant?

Added to this my GP would like me to try Metformin, and I have requested the slow-release version but obviously I am anxious about the potential side effects - it really doesn't take much to upset my already very delicate gastric system. Are there any alternatives that are kinder to one's digestion? (lactose and caffeine generally need to be avoided as ingredients). If I can lose the weight and get the HbA1C down to 48 or below do I even need medication?

If anyone is managing IBS alongside type 2 I would be really grateful for some help and advice about diet and medication; even if it's just confirmation to keep doing what I am doing!
 
AnnaWB said:
and a meat or fish based evening meal that I cook from scratch (protein is slower to digest ).
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Hi @AnnaWB , welcome to the forum.

I don't know much about your diet or IBS, but if you do well on protein, could you eat more of that during the day instead of some of the high carb foods you eat now?
 
Hi @AnnaWB and welcome to the forum.
I have type 2 but not IBS, however my son has IBS and was on a low Fodmap diet for a while.
Your HbA1c is only just into the diabetic range so would think it’s perfectly reasonable to try diet alone, no meds at least until your next review. It’s always said here that it’s a marathon not a sprint so if I was in your position I would make one change at a time. May I suggest you look out for LivLife bread avaiable at Sainsburys or Waitrose or get bread from:
https://lowcarbfood.co/
No sugar peanut butter is fine, a small amount of unsweetened popcorn should be ok, try swapping the orange for some berries, they are low carb and low fodmap, be careful with what veggies you have with your dinner, those grown above ground are generally lower carb than root veg. Here’s a link to a very useful website with easy to follow graphics for low carb:
https://www.dietdoctor.com/low-carb/visual-guides
come back here and ask questions if you get stuck.
 

Thank you - I know the unsweetened peanut butter is slow release, which gets me through the day and unsweetened popcorn is low GI, which is all good. I will certainly look into the bread, thank you - as an alternative to my 'safe' white would be fantastic. Fruit and veg are a fun game with IBS, apples are devil food for IBS and also diabetes it seems! I think I need to switch out my usual brunch for egg based alternatives though - scrambled, hard boiled or omelettes... luckily I work from home so it isn't a problem. Thank you for the links, I will go and investigate
 
Freeze your bread before toasting. Changes the carb balance and affects blood sugars less!
 
Hello @AnnaWB
I was an IBS sufferer. I was diagnosed as T2 in May, changed my diet to salads & things that are supposedly healthier. Soon after, thankfully, I found this forum & after an awful lot of reading, decided to go low carb. It's the best thing I could have done. Bloods dropped from 91 to 43 in three months & IBS is a thing of the past. I was also gluten intolerant & that isn't an issue now. Dr prescribed slow release Metformin at the start, thank goodness, as I had none of the explosive side effects from that either. Considering how my gastric system behaved, I am ****-a-hoop. I know we're all different, but from how my body has reacted, I would give low carb a try.
 
Thank you, and apologies for the slow response due to Christmas. I am looking at how I can reduce bread and pasta, given they are a mainstay of my diet along with starchy veg (another issue) meat, fish and other protein. I simply do not digest salad leaves (and have to avoid rocket), I have a long list of trigger foods I have to avoid (including cruciferous veg, onions and pretty much all fruit) and things like soup and yoghurt are just a non starter. Gluten is one of the things I can tolerate, but I have have to avoid high fibre, so cannot simply switch to brown bread/rice/pasta! It's a complete minefield to be honest. GP has prescribed the slow release Metformin, but I'm holding off starting it til after a trade show in the middle of Jan, as my IBS will already be enough to manage. Except for meat and fish, every 'low carb' list /diet I look at is simply a list of all the things I cannot eat!
 
No probs! It sounds like you should try a carnivore diet to start off, it would cut out all your triggers. If that isn't for you, then there are several non starchy veg that you could try, courgettes, cabbage, celery, sprouts, toms, asparagus, olives etc. Even rocket, so maybe once you've sorted out your own low carb diet from what you can eat, then you could gradually try one of your triggers at some point, like rocket, just to see how you fair. There were only a couple of salad leaves that I could manage (oddly, one was rocket) & that's not the case now. I can enjoy a nice mixed leaf salad if I fancy one.

Pleased that you've been prescribed SR Metformin. Once you're able to start that, hope you're okay & that you also find an LC menu to suit you & your tum. Good luck on your diabetic journey.
 
I suffered from IBS for years and years. Once I went keto, and had settled down from the metformin, the IBS went away and has stayed away. I can now eat all the things that used to trigger my IBS and that fit in with keto. But I'll be the first to say that in the beginning, metformin (not slow release) affected me just like the IBS. Maybe the slow release will suit you.
 
i have Diverticular disease not a lot unlike IBS, eating low carb all the foods that i should avoid cause no problems at all now.
My problem is trying to resist things like Pork pies, sausage rolls and cheese and onion pasties, although i have found a great flaky pastry recipe
Flaky Keto Puff Pastry - Mouthwatering Motivation
and as for bread
Deidre's Low Carb Bread Recipe (made Keto!) - Low Carb Inspirations
Now bacon sandwiches etc are back on the menu.
Even bread and cheese so simple but so enjoyable knowing it's no problem.
 
Poor you, your IBS sounds horrific, I've never been formally diagnosed, but have(had) what I describe as an awkward stomach, and I've found that going down the low(er) carb route has not only helped the T2, but I have fewer flare ups as long as I stick to it (usually only time off the month upsets when even water can set it off). Balancing the needs of multiple conditions can be an absolute nightmare
 

Not sure if it is appropriate to post my story here as I can’t help with your IBS. What I can say is that my wife also suffers from the same debilitating condition that you describe, with all its ramifications, so I can fully sympathise with your plight.

I am type 2 diabetic and have been controlling my hba1c - and weight - by sensible eating (NB I choose not to use the word diet) and regular exercise. When first diagnosed some 15 years ago, my weight and cholesterol were way too high and from a graph that I was shown my chances of survival were not good! Following the advice, 12 months later my hba1c, weight and cholesterol (aided by statins) were brought under control. However, as I have said elsewhere, diabetes takes no prisoners and in recent times my weight has started to creep up and likewise my hba1c. Not obese nor even technically overweight, but still not where I would like to be. (As a consequence of the hba1c, the diabetic nurse actually recommended that I start on Metformin, which appears to be giving me serious undesirable joint pain). I also asked the doc to check my thyroid and whilst initially no action was deemed to be necessary, 12 months later the surgery requested that I take another test. Finding the results to be similar to the original test I put a strong case to the doc that my thyroid was, according to the British thyroid foundation, underactive (hypothyroid) and explains the weight gain. Net result, I now take a daily dose of Levothyroxine. The dosage has been titrated up to 50 mg, which is quite low but the local surgery says that results are within normal limits. That said, I am of the opinion that the thyroid is still not performing as well as it did and the dosage could be titrated still further. Unfortunately, the GP simply looks at the figures and because they are comfortably within the normal range he will not agree to an increase!!

Research on this subject has shown that there is a link between hypothyroidism and elevated hba1c levels so my theory is that if the thyroid were performing as well as I believe it originally did, in my case with a stronger dose of Levothyroxine, the hba1c would be lower and therefore no need to swallow the Metformin tabs.

I would be interested to see if anyone has any views on this.
 
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