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Newly Diagnosed - Need Advice

veggito

Newbie
Messages
2
Type of diabetes
Type 2
Treatment type
Diet only
Hello, i'm 34/M and newly diagnosed with Type 2 DM. HBA1C of 90, Cholesterol 5.4 and Triglycerides of 1.7. Ever since I've found about this, I've gone into a low carb, low calorie diet + exercise and have lost about 10 kg in about 3 weeks. Ever since I've lost weight my blood sugar levels have started coming down when testing using a home glucose monitor from 12.9 - 2 hours after means to about 7.8.

GP has given me an option to start Metformin but he is happy to support me if I want to go on remission without the introduction of any medication. I wanted some advice from this forum whether to start Metformin or not? I don't want to go on medication, however, I'm happy to go on it if it will really help with remission. Any advice is welcome.
 
Hi @veggito and welcome to the forum.

Are you vegetarian? It's harder for vegetarians to eat low carb, and very hard indeed for vegans.

I'm surprised that your blood glucose levels only started to come down after you lost weight, for most people the blood glucose levels measured by finger prick tests comes down immediately after going Low Carb and then the weight starts to come down (no calorie counting or additional exercise required).

Congrats on the weight loss, my only concern there is that it seems possibly too fast to be sustainable due to the low calorie aspect. In fact many find they have to increase their calorie intake (more proteins and fats) in order to stop their weight loss on Low Carb once they have achieved T2D remission and their weight loss and Blood Pressure goals.
low carb , lower than you did before T2D diagnosis, for the rest of your life! It isn't a one time and then dome thing, at least not for the vast majority at of us. So it must be enjoyable and sustainable!
 
If GP is giving you a choice I'd say it's personal preference. Metformin has other benefits than blood glucose, but sometimes also has side effects.

My choice would be controlling solely with diet and lifestyle. For most type 2's, diet and lifestyle tend to have a much bigger impact than meds anyway. And for me, even when I was taking Metformin and Insulin my bloods could stay in the double digits for hours if I was eating badly.
 
I have been taking metformin for 21 years. Very little downside and huge upside with few side effects if you take extended release. All types of medical studies touting benefits beyond blood sugar control. You may have reversible diabetes through exercise and diet so keep exercising and eating right and hopefully it reverses. My problem is genetic. Good luck?
 
The weight loss is a result of your blood sugars stabilising and you following, currently, a crash diet. Do keep in mind you can't keep up a low cal diet beyond the recommended time period, as after a while you'll basically get scurvy. (Severe malnutrition). So then you just transition to low carb and let go of the calorie restrictions, as that is designed to be for the long term. You're off to an excellent start, all in all, though you're still higher than I'd like to see you at the moment, but you've only just started... Who knows how much ground you've already gained. What are you eating and drinking currently?

Remission, technically, means not having any meds nor symptoms/complications from a condition, so.... You could aim for remission still. Whether or not you want to, temporarily or permanently, get the help of metformin to normalise blood sugars, is up to you. Metformin basically tells the liver not to dump too much glucose in the morning or in stressful situations, so while it would calm down the morning liver dumps, it might also mean it takes longer for the stored glucose to leave the liver. (And since it is stored in fat cells, non-alcoholic fatty liver disease is likely in most T2 diabetics. So if you just let it deplete, and not let it store more glucose, that'd be fine too. Either way, with a low carb diet it'll get better, in the long or short run).

@Gary Winston , Type 2 is usually genetic, we're just blessed that way.
 
Thank you for your advice everyone. My GP has agreed keep me off Metformin for 12 weeks and will reassess after checking the HBA1C. I am still struggling with the morning sugar level.

The diet that I'm following is:

Breakfast
1 Whole Egg, 3 Egg Whites, 5 Almonds
Lunch
5 Cashews, Yogurt Drink (Unsweetened)
Dinner
Double Chicken Tikka Subway Salad without cheese
Before Sleeping
1 Whole Egg

I am a bit concerned about my morning sugar levels as they are above the recommended range.



Here is a summary of how my sugar levels are:
25 May -> 17mmol (After Meal) -> 125.8Kg
2 Jun -> 13.1mmol (Morning Fasting) -> 117.6Kg
5 Jun -> 7.5mmol (Morning Fasting) -> 114.9kg
12 Jun -> 7.2mmol (Morning Fasting) -> 112.4Kg
 

Wow! I have lots of comments on this !

1. I see that you are not vegetarian (despite the user name). Good, this makes a sustainable low cab lifestyle so much easier!
2, You seem to be avoid fats. For most of us Type 2's doing Low Carb, whole eggs, full fat cheese, full fat dairy, fatty fish. fatty cuts of meat (even Bacon) form a large part of our diet. Traditional fats (from whole food your great granny would have recognised ) isn't any worse for you than it was for people back then, and Type 2 Diabetes and Obesity was much, much rarer back then.
3. You are seriously Low Calorie. I tend to advise Low Carb, or low calorie for those who can't handle low carb. This is because with low carb you don't need to cut knowingly calories in order to lose weight - for most of us it just falls off at a pace of 1lb to 2lbs per week without any effort . Low calorie like that actually makes keeping the weight off much harder if done for too long because your body goes into starvation mode meaning your metabolism drops and so you then don't actually need as many calories per day to live. The downsides of that are that you have less energy, you feel cold, your thinking isn't as sharp; because all of these require energy!
4. For Breakfast, may I suggest 2 or 3 whole eggs (possibly as a mushroom omelette, or just fired, boiled , poached or scrambled). Your current breakfast is very low fat and whole eggs are a great mix of protein and fat - remember they build a chick! Also the almonds don't really contribute here while they add carbs.
5. For Lunch, may I suggest Full fat Greek yogurt ( same size as the current yogurt drink). Add in a few berries (strawbs, rasps, blackberries, blackcurrants or worst case blueberries) and some seeds (chia, pumpkin, sesame or sunflower). Or add nuts, but not cashews which are the highest carb in a nut (and aren't a true nut anyway).
6. I don't know what's in a Subway salad - it may be OK so long as it has it doesn't have Subway bread (so sweet it's officially a cake in Ireland). Also beware high carb salad dressings.

Its good that you are using a BG meter, but they are best used for testing your meals or specific foods. Your fasting BG levels are OK. Nothing to be concerned about there! I have been in remission for over 2 yrs and my Fasting BG range between 6.5 and 7.5. They are falling, still but very very slowly. The fasting BG levels are high(ish) because of Dawn Phenomenon which is where out livers try to help us out by dumping glucose into our blood stream in the morning in order for us to go hunt/gather our breakfast like a cave dweller! Over time if we typically have BG levels below 8.0 then it will start to 'realise' that we don't actually need that additional glucose in the mornings!
 
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