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Next stop insulin...... Apparently

Winnie53 said:
Ketogenic diet is 50 carbs or less, not 20 or less.
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Hi Winnie,

I am afraid I disagree.

A ketogenic diet is a diet where whatever you are eating results in ketosis.
That isn’t necessarily at below 50g carbs.
And in fact nil carbs but a high intake of protein could prevent someone from being in ketosis.
Other factors are height, weight, muscle mass, whether the person is fat adapted...

Phinney quotes examples where athletes reach ketosis on up to 100g carbs a day (which is v rare!), whereas some hormonally challenged women need to be under 20g carbs a day (or less) to get into ketosis.

I think the only way to confirm whether an individual is in ketosis is to test for it.

The reason that 20g for a ketogenic diet is quoted so often is because at 20g carbs or below, then it is very, very likely that most people are in ketosis. At 50g a lot of people don’t get to ketosis.
 

A couple of things.
One, that is one hell of a meal.
Right food, but perhaps just a little too much?
How about trying two fried eggs, two slices of ham and two slices of cheese?
You may start out feeling a bit hungry but I think your stomach will shrink to the size of the smaller meals quite quickly.

Secondly, 12 stone is a reasonable weight for someone 6' 4" tall.
I'm 6' tall and I have just managed to get down to 11 and a half stone and although I am slim I am not emaciated. Still above mid range BMI.

A problem I had (and I think many others have had) is that I started out thinking I wasn't that much overweight (at 14 and a half stone) and that losing a stone would be good but losing two stone would be a step too far.
When I got below 13 stone those around me started to worry that I was losing too much weight.
Now I am below 12 stone and trying to get below 11 and a half stone people say "but there's almost nothing of you!" but I am fine, and still in the middle of the healthy weight zone.

So 12 stone isn't ridiculous by any means, but again it is a long way away.
How about doing it in stages?
16 stone is a nice clear target and certainly wouldn't be too slim for someone who is 6'4".
It would certainly be a wonderful improvement over 25 stone, and a spectacular improvement over 20 stone.
Once you are stabilised at 16 stone then you can think about how you would feel at 15 stone.
You need a time at each target to adjust your personal body image so that you are comfortable with your new weight and those around you accept the new you as well.
It is very hard, when you are making good progress with weight loss, to have people around you worrying that you are not eating enough.

Good luck with your weight loss campaign.
It should make a lot of difference to all sorts of aspects of your life, especially leg and foot health.
 
Your story

Hi, may I suggest avoiding the insulin, but go directly to your nearest bike shop and treat yourself to a comfortable bike. Then join Strava and the Fixing Dad team.

https://www.strava.com/clubs/FixingDad

Geoff Whitington (the spiritual leader of the team) was about to lose one of his feet through a needed amputation. Geoff's sons stepped in and forced him to exercise and eat right. He recovered from his 10 year journey into T2DM.
Its quite simple every evening rain or snow , hot or cold cycle 15 miles. & over time most of your issues will melt away! I've cycled 14,000 miles over the last three years. My health now is much better than when I diagnosed 5 years ago.

I hope this simple solution helps you!
 

Brunneria, agreed. You have far more experience than I do following members here as they begin the ketogenic diet.

There's lots of variables that effect if and when we're able to achieve ketosis. When I have a bit more time this week, I'll take some time to further explain my thoughts here regarding starting the ketogenic diet.
 
LittleGreyCat said:
I'm 6' tall and I have just managed to get down to 11 and a half stone and although I am slim I am not emaciated. Still above mid range BMI.
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I think it depends on your build and body type - I got down to that same weight at 5’11 (and a half) and I looked gaunt and emaciated - you could see ribs and vertebrae.
 

Thank you for this link! I look forward to watching the film.

*Edit* Just wanted to add that I am a MTB'er and have been since my youth but I haven't touched my bike since being told I had ulcers and to keep off my feet. I am excited about the thought of getting back on!
 
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Sorry for the lack of update folks, I've been busy with work.
However, I have really concentrated on dropping my carb intake the last couple of weeks and I can now see signs of it working!

For the first time in my recorded BG results I had a result below 10! After an 18 hour fast, my bg was 8.2 this morning. Not great in the grand scheme but a fantastic improvement for me.

I am still struggling with my feet but I feel a positive wave of energy the last few days especially!

I still need to go and see my GP to talk insulin etc but I wanted to go in armed with some good results. I doubt I will get a test for insulin resistance authorised so I am planning to go private for that. Has anyone gone private for this test and can you recommend somewhere?

Thankyou to everyone for their help on this thread.
 
Mel dCP said:
I think it depends on your build and body type - I got down to that same weight at 5’11 (and a half) and I looked gaunt and emaciated - you could see ribs and vertebrae.
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I will aim to go down in weight whilst maintaining muscle. I am a big build and barrel chested so I'll just aim to reduce body fat and see where I get to!
 
Sorry insulin gives you the creeps. Your posts are fascinating as you are really determined not to let this beat you.
I've been on insulin for over 30 years. My HbA1c is 6.8. I'm 62 and have had trouble exercising regularly.
Insulin is a tool, just like diet, fasting and exercise are tools. Your Dr saying that everything has been tried that they are willing to try is important. It sounds like medications have not worked for you.
Hey, they didn't work for me either and I have hated every pill because of the side effects. So totally not worth it.
Insulin gave me freedom and I so appreciate it.
You are very willing to work hard, your posts prove that. Even if insulin scares you, work with it, put in the hard work to make it work for you. With your tremendous drive and dedication I am certain you will find insulin to be a great partner in your battle for better health and better control over your sugars.
Best of luck. Though with your dedication and drive I don't think luck will play a part!
 
Interesting comments about insulin. ‘Am I doomed to go on insulin!’ ‘Insulin terrifies me!’ Sounds like you are working hard trying all avenues to get your health in check. Which I would also do. And indeed do. However, as a type 1 I didn’t feel terrified or doomed by insulin. Just relieved there was something to keep me healthy, and more importantly alive. Eventually you may need it through no fault of your own to remain healthy. Be grateful there is that option. It isn’t a sign of failure it is another tool.
 
I hear those defending insulin. And yes if that is the only tool available (type 1) or other approaches have had insufficient effect or are otherwise undesirable (type 2) then it’s a very valuable tool that enables life to continue as close to normal as possible and in those circumstances not to be feared.

But there’s nothing wrong in being sure that it is the correct tool and that there isn’t a more suitable one for you before starting it (in this case maybe low carb is a better fit and a trial will answer that question). Insulin has its own issues - particularly for an insulin resistant type 2 - and all options need to be weighed for an individual
 
@ElNevera - Sorry to come late to your thread.

You've had a lot of information to take on board here, and of course, you need to find your own way of "skinning this particular cat". Whatever you do, it needs to be sustainable for you, as it'll likely take some time for your feet to reciver from their Charcot and other ailments.

A while ago now, I was a very good presentation by a researcher from the NIHR Biomedical Research Centre, at Leicester, talking about work he had recently (at the time) had published. His area of expertise is exercise, and this piece of work was exercise in people living with diabetes.

This particlar research centre has the most incredible gym facilities and she loads of gizmos, but Joe's work wasn't involving any of that. His research was looking at just plain bearking up sedentary periods.

https://onlinelibrary.wiley.com/doi/full/10.1002/oby.22034

As a result of this work, a high percentage of those working in the Leicester NIHR use rising desks, so that they can both stand and sit whilst they work. Allegedly, the improvement in insulin sensitivty isn't hugely complicated. It's the "effort"of mbilising the large muscle groups, to actually perform the standing task that largely does it.

After Joe's presentation, I set my activity tracker to alarm if I'd been sedentary more than 90 minutes. At 60 minutes it was driving me insane, but at 90 there was a far better chance I'd have done "somthing" in the intervening period.

I'm fortunate to have trouble free feet, but these days, I just do things like park further away from the supermarket entrance, park a little further out of town when shopping, and if I'm downstairs and need to visit the loo, I'll go upstairs, and vice versa. It all helps.

On the downside, I seem to have fallen into the job of near full-time tea monitor!

I think what I'm trying to say is that you don't have to become a gym bunny or marathon runner to move about a bit more.

Of course, healing your feet is of paramount importantce, so consulting with whoever helps you look after those is important if you're considering changing your activity levels.
 
I'm unsure if the "Fixing Dad" video with Geoff Whitington is available to be seen via YouTube in the UK (or via another outlet). Here in the USA its trickier to find. Geoff had Charcot's foot too but when forced by his two sons to become more active, he got on a bicycle. Within three weeks of daily cycling, he recorded much improvement of his Charcot's foot (if I recall correctly). Now every day I put in time to exercise. Yesterday I walked 5 miles up a hill and back down. Today I'm going mountain bike riding for about 9 miles. Its not a long loop but I get a heck of a sweat on while balancing my MTB around a tight loop..
 
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Saw the film! How inspiring on so many levels. The sons are a huge credit ti themselves & their Dad.
 
Yes, it's such an honest film. The love, the struggle, the times when they could have thrown up their hands and given up, but somehow pushed through. This film provides so much hope and encouragement. I wish I could buy it on DVD. Definitely a film I'd watch over and over again.
 
Winnie53 said:
Here's the link to the documentary, Fixing Dad, Living-by-the beach...


Hope @ElNevera sees it. So inspirational!
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@Winnie53

Thanks for the link. I shared it last night with someone desperately in need of encouragement with her T2DM.

I'm currently up for an extended stay at altitude to help with insulin sensitivity

I've found a couple of interesting links on altitude and insulin sensitivity

https://www.nature.com/articles/s41366-019-0422-0.pdf?origin=ppub

https://emj.emg-health.com/wp-conte...to-Improve-Glucose-Metabolism-in-Humans...pdf

My in-laws passed away and my wife invested some of her inheritance into an high altitude apartment where we come and hang out at close on 10,000 feet. We're expecting snow soon so the hiking season will be over. Twice a week I exercise / cycle for about 90 minutes at above 10,000 feet. The other days of the week I go down the hill to about 6000 altitude and do a minimum 16 mile almost totally flat bike ride. The old adage of live high train low comes to mind. One thing that is interesting is that while I'm on my ride at 6000' after about 3 miles my feet feel wonderful. My 'background" neuropathy dissipates totally. .

Having just found the "Nature.com" link above I'm going to hike to the top of the local mountain today as its the weekend and its peak is about 11,300 feet. I'll drive to start of the dirt track and then hike to the top but I'll make it about a 6 mile hike. I have to change up what I'm doing to keep life interesting.

@Winnie53 thanks again for that link. You may have changed someone's life!

Best wishes

LBB
 
LBB, I love your enthusiasm for cycling, and am grateful for your encouraging and empowering presence here. Heading out the door now for a long walk.
 
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