Newly diagnosed T2D, doing the 800cal diet.

[mondFi]

Hi,

I'm Peter, I was diagnosed with T2D 5 weeks ago and I've been following Dr. Michael Mosely's 8-week Blood Sugar Diet and reading stuff on the forum.

I'm male, 49, just over 5'6 & weighed 15.5 stone at diagnosis. I've had M.E (Chronic Fatique Syndrome) for the past 20 years which is, I believe the main reason I've got diabetes and an ongoing complication to managing this new development.

So far, I've lost just over 2 stone since diagnosis, and my blood sugar for the past 2 days is has been firmly in the "normal" range. My highest reading in the last 2 days was 6.1 mmol/l. 1 hour after eating and it went down to 4.7 an hour later. I've even had a 3.8 after a 15-minute walk and 18 hours fasting.

4-5 days ago, when I last did a stint of testing, my blood sugar levels after meals and before meals was within (high) normal levels and low pre-diabetic levels overnight and first thing in the morning so something looks to have changed.

Doctor put me on Metaformin, and I've been taking it for 3 weeks now. I also got put on Statins 3 weeks ago when I got the diagnosis and my Cholesterol was also high. I've been on BP meds for a year or two but blood pressure looks to be reducing on the diet.

I've a lot of time on my hands so I've really been digging into the research on "reversing" D2 and reading all of the real-world experience on this forum, but I've got a lot of questions which I'll post if I don't find the answers with a bit more digging.

My approach so fat is basically Mosely's 8 week Blood Sugar Diet, I fast for 18-20 hours and tend to have 2 meals late afternoon and evening, it's very low carb and I was in low Ketosis (~1.0) when I checked myself a few days ago, I've probably been under 700 calories a day on average.

The diet is great, I don't feel deprived or hungry, but my concerns are the long term. Doing something that requires aggressive action is a very different thing to permanently changing lifestyle and pushing through despite life's many challenges…

I've learned over the years of being ill to enjoy running experiments on myself, so I imagine I'll be entertaining myself with diabetes experiments for the next period of my life!

If the "twin cycle" theory proposed by Dr. Taylor is correct, then I think that I've gone under the pancreatic fat threshold and my post-meal insulin is working OK (hopefully for as long as I remain under the threshold).

I've been reading up on crash diets and haven't found any "proper" evidence that they "ruin" metabolism. The stuff I've read shows that the metabolism slows but I haven't been able to determine whether it slows to a greater rate proportional to the weight loss.

On the other hand, I've read a number of warnings (especial thanks to @Brunneria and @zand) about the dangers of crash dieting and I value advice based on real experience and don't want to make things harder for myself down the track, so I'm currently thinking of coming off the 800 calories and slowing my weight loss.

I think I'd be very happy with long-term version of this low carb diet if that is necessary to saving my eyesight, I'm less sanguine about a permanent keto diet, but I am also very interested in keeping my long-term options open until I know different.

The Newcastle studies didn't restrict carbs and transitioned people back to "normal" eating. There's a lot of scope for error with the term "normal eating". I know I have to keep my calories down appropriate to my weight and I have to keep my liver and pancreas clean of fat but I want to know how well I can tolerate carbs, so my first experiment will be "the cream cracker diet" where I start with one cracker, test, repeat and then build up if blood sugar allows.

Well that's me. Sorry about the length of the post, I'm not one to use 5 words when I can use a thousand (well 709 words to be precise)!

 

[Terrytiddy]

Hi Peter @mondFi welcome to the forum. I will tag @daisy1 for the welcome info for you. From what you have said you seem to be doing some of the right things. I found the Low Carb High Fat (LCHF) eating worked for me and also it can be a long term eating regime in my opinion. 800 calories a day is very low and wonder how long you could keep this up. I also do18/6 fasting no food after 20.00 till 14.00 next day, only black tea, coffee, water, and vitamin water as needed during fast I keep to less than 15 - 20% carbs as well. I have food twice a day so I can have my meds. I have seen great results so far so seems like I'm on the right track for me. You have come to the right place for help, advice and support. Any questions just ask.

 

[Brunneria]

Hi @mondFi

Thanks for the tag

Re your situation and the questions about the slowdown of metabolism, I think that a lot of it depends on your individual health history and diet history. My metabolic slowdown happened (I think - remember this is all speculation, because I know of no way to measure it) because I had a couple of hormonal/metabolic things going on AND I subjected myself to very low calorie diets. It didn't happen instantly, and it was (I think) a combination of factors.

Not sure if I have explained that very well. So I will have another go:

I suspect (again, speculation) that a fit young man with more muscle mass, no previous history of low calorie dieting, and no other health issues would experience a great deal less 'starvation mode' metabolic slowdown than a (post) menopausal woman with a history of other hormonal conditions and a life long battle with weight which has involved a series of low calorie diets and/or yoyo dieting. I see those two examples as being at opposite ends of a spectrum covering everyone who chooses to reduce their calories in the long term.

I guess it is up to you to work out where you fit on that spectrum, and then up to you how much you want to factor it in to your weight loss plans.

One thing you have said is that you are still losing, and may want to reduce the rate at which you lose weight in future. That suggests to me that you are not yet experiencing metabolic slowdown - which is a good thing. The question is whether you want to make any changes before that may happen, or to wait for it to happen. If you choose the latter, then your metabolism will have learned to 'cut its sail to fit its cloth' as it were.

You may also find Jason Fung's book 'The Obesity Code' an interesting read. He looks at a number of different factors in obesity, from insulin and insulin resistance to the importance of calories. And he quotes one fascinating study from decades ago where prisoners in America were subjected to reduced calorie and raised calorie diets, and what it did to their metabolic rates. Very interesting stuff.

 

[Mbaker]

You are doing really well, and have responded to the methodology employed. In your position I would ensure my metabolic rate remained high, so would employ HiiT, for both cardio and weights. Something like a static bike with 2 minutes warm up, then 30 seconds flat out, slow cycle for 1.5 minutes and 30 seconds flat out again, repeat x 3 (start at lower sprints say 10 seconds initially). Directly after 10 minutes of resistance exercise, every other day push this to exhaustion but with good form.

To support the above ensure protein is the right level for you and good fat is level.

 

[zand]

Not much left for me to say really. I agree with all of the above posts. The main thing is to stick with a maintenance diet once you have reached your ideal weight (or maybe a bit before you have reached your ideal weight) because if you need to lose weight in the future it may be harder next time.

Oh and welcome to the forum @mondFi

 

[mondFi]

Hi Peter @mondFi welcome to the forum. I will tag @daisy1 for the welcome info for you. From what you have said you seem to be doing some of the right things. I found the Low Carb High Fat (LCHF) eating worked for me and also it can be a long term eating regime in my opinion. 800 calories a day is very low and wonder how long you could keep this up. I also do18/6 fasting no food after 20.00 till 14.00 next day, only black tea, coffee, water, and vitamin water as needed during fast I keep to less than 15 - 20% carbs as well. I have food twice a day so I can have my meds. I have seen great results so far so seems like I'm on the right track for me. You have come to the right place for help, advice and support. Any questions just ask.

Hi, thanks for the reply, it's always good to know what works for other people.

The 800 calories is/was just to stay as close to the Newcastle protocols as possible but now I think I've hit the reverse tipping point, there is no reason to push the weight loss, steady loss (if I can do it would be better).

 

[zand]

Hi, thanks for the reply, it's always good to know what works for other people.

The 800 calories is/was just to stay as close to the Newcastle protocols as possible but now I think I've hit the reverse tipping point, there is no reason to push the weight loss, steady loss (if I can do it would be better).

Totally agree with you, increase calories gradually, keeping fairly low carb and you should be fine. You may be able to manage moderate carbs in due course.

 

[mondFi]

Hi @mondFi

Thanks for the tag

<Re your situation and the questions about the slowdown of metabolism, ... Not sure if I have explained that very well. So I will have another go: ...>

One thing you have said is that you are still losing, and may want to reduce the rate at which you lose weight in future. That suggests to me that you are not yet experiencing metabolic slowdown - which is a good thing. The question is whether you want to make any changes before that may happen, or to wait for it to happen. If you choose the latter, then your metabolism will have learned to 'cut its sail to fit its cloth' as it were.

NOTE: this quote was shortened by mondFi

Thanks for the reply and your explanation made perfect sense.

You are right, I'm not having problems losing weight at the moment that is the reason why I'm planning to stop the crash diet before the 8 weeks are up. Restoring pancreatic function was the main goal and that trumped possible negative side-effects, now that looks like it's been achieved there isn't the overriding necessity to lose weight quickly (I need/want to lose weight but I can take my time)

 

[mondFi]

You are doing really well, and have responded to the methodology employed. In your position I would ensure my metabolic rate remained high, so would employ HiiT, for both cardio and weights. Something like a static bike with 2 minutes warm up, then 30 seconds flat out, slow cycle for 1.5 minutes and 30 seconds flat out again, repeat x 3 (start at lower sprints say 10 seconds initially). Directly after 10 minutes of resistance exercise, every other day push this to exhaustion but with good form.

To support the above ensure protein is the right level for you and good fat is level.

That sounds like good advice, unfortunately not possible with my CFS. I have had times when my CFS has been in remission and I was even able to work part-time for a year or so but most of the time I've been house bound and unable to exercise at all.

I'll make a note of your advice so next time I get into remission I can try it.

 

[daisy1]

@mondFi

Hello Peter and welcome to the Forum Here is the Basic Information we give to new members and I hope you will find it helpful and interesting. Ask as many questions as you need to and someone will be able to help.


BASIC INFORMATION FOR NEWLY DIAGNOSED DIABETICS

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.
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