Please help me understand

kazd63 said:

Oh update on friend at work. She let me test her today, before breakfast @ 9:51 8.2, 1 hour later @ 10:51 9.3, her breakfast was a large (poss about 400ml) of greek yogurt, blackberries and I think strawberries. Lunch was a salad with boiled eggs and a sugar free, zero carb dressing 6.6 pre lunch, 1hr post 6.7.

She saw her doctor yesterday and she told him about me and he told her not do what I was doing, asked if I had sought any medical help, then offered her a referral to a gastric band program aimed at diabetics.

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A word of caution. Don't critise your friend but support them. Don't nag but show him/her proof that cutting sugar only hasn't worked.
In her/his presence read out some of the success stories and testimonials from this forum, aloud. Tell her not all these people an be wrong.
If she tried Low carb what would be the harm... She/he could still agree to bariatric surgery as it takes over a year for the op to take place (on NHS).
Tell him/her I'm still agreeing to bariatric surgery because of its reversal and remission rates. More than low carb (at the moment). The more low carb obese people, the more reversals.
Eating low carb looks like less harmful than bariatric surgery.
Why can she not have both, if low carb isn't enough for her IR then the bariatric surgery is a last resort.
Ask her to try low carb whilst waiting?

kazd63 said:

I think maybe she was a little surprised when I tested her blood and more so after it got higher after breakfast. I did mention that the HBa1C test was an average over the last two/three months and did not educate as to what was spiking her blood and what didn't. I also mentioned that I had read that nerve damage occurs when the BG is 8+, she is already seeing the effects of another girl at work who told me today that they estimated she had been diabetic for several years before diagnosis due to the amount of nerve damage in her feet. But she also won't listen, insists that Doctors know best, she said she had read up a lot when she was first diagnosed but I doubt it because of the foods they eat. My other friend has not done any research based on what she was saying. She told me that she will give up her takeaway, that consists of a chicken burger in batter in a bun which she has after she has been swimming.

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Re your comment about nerve damage to feet. Type 2 Diabetes starts with insulin resistance and no one can say when an individual became IR so no one can rightly know how long a person has tipped over into Diabetes. Some people are lucky they are diagnosed 'early' but even so they can suffer nerve damage at any stage after a few years of high blood glucose levels. I was diagnosed with a very high A1c but have suffered no nerve damage to my feet. We are individuals we should not compare.
You seem to be doing a lot of talking about what is happening in your T2 freinds health. I would advise that you concentrate on your own management rather than the different approaches those around you are taking.
We can be plagued with fear and doubt after diagnosis but if we can put our energy into improving our prospects of good health by eating well and understanding our condition then things will be a lot easier all round.

Contralto said:

good find. I wont use it because granulated sugar substitute = Splenda, which I will not put in my body, and I have yet to see Xanthan gum on a shelf, but 60% of women don't get depression with Splenda, so maybe they can have it.

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I use a liquid form of sucralose (Splenda) called Sweetzfree. It has no fillers and contains zero carbs whereas 1 cup of granulated Splenda contains 24 grams of carb - not much if you're using it to sweeten your coffee, but it makes a big difference if you're baking with it. I can only buy it by ordering it online - google "Sweetzfree." It seems very expensive, but it's very concentrated and a one ounce bottle lasts me about a year. As for Xanthan gum, I recently discovered that it's available in my regular grocery store, much to my surprise.

Alexandra100 said:

Karen I am relatively new to all this, but I am forever recommending Dr B's book and site to people. I get embarrassed that people will think, "There she goes again!" I also find Jenny Ruhl very helpful, and she too values Dr B highly.

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I like Jenny Ruhl's bookl too, but, although she generally agrees with Dr. B, she advocates having a "cheat" day once a week, and he definitely doesn't think that's a good idea. I can only speak personally, but I know that if I had allowed myself to eat high carb once a week when I started eating low carb, I would never have got rid of my carb cravings, so I'm with Dr. B on that question!

kazd63 said:

Yes, she is very short and like a little barrel.

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Getting weight down is a crucial part of diabetes management. It is often disregarded. It shouldn't be. Pills and less carbs can only do so much over time. Weight is equally as important.

kazd63 said:

Girl at work is diabetic, diagnosed a year or so ago, she still eats loads of carbs and hasn't lost any weight (despite watching her sugars, just her sugars!) has increased walking and swims once a week. She is on Metformin and some other medication and her three/six monthly blood test comes back with her sugars ok allegedly.

So my question is, if she is taking medication that 'artificially' brings her blood sugars down, then how if I have to take them, do I monitor my sugars because surely the blood glucose monitor will show me as having lower blood sugar. Or is it a case that the metformin and other drugs bring your blood sugar down but you can still monitor to see which causes a rise and therefore cut those foods out of the diet.

Hope that makes sense.

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This is my reply;

In the world of Diabetes, each and every individual is as different as our finger prints.

Diabetes is a very individual disease & knowing yourself/your body is the best way to manage it!!

Contralto said:

not risking depression and microbiome distruction

plus

https://www.ncbi.nlm.nih.gov/pubmed/29554272

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I've read all the criticisms about Splenda, but I've been using it for 20 years (before I was diabetic, but my late husband was diagnosed with Type 2 a few years before I was) and it doesn't seem to have done me any harm. As far as depression goes, this is the first I have ever heard of Splenda causing depression, and it certainly doesn't do that in my case.

Terrytiddy said:

As @bulkbiker has said Metformin does not have a big influence on Bs but helps with HbA1c. Be interesting to see what her HbA1c is and also her Bs .

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Since an HbA1C is an average of the previous few months' blood sugar levels, it doesn't make sense to me to say Metformin doesn't have a big influence on blood sugar but helps with A1C, but I realize that's beside the point.

Karen Dwyer said:

Since an HbA1C is an average of the previous few months' blood sugar levels, it doesn't make sense to me to say Metformin doesn't have a big influence on blood sugar but helps with A1C, but I realize that's beside the point.

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As Metformin is said to help with fasting bgs, maybe it improves the A1c by lowering readings throughout the night, but for some people has less effect on the vitally important post prandial bgs. For me, it has helped across the board. Not least in giving me lower bgs which have motivaated me to make even greater efforts in my diet and exercise.

Crocodile said:

Getting weight down is a crucial part of diabetes management. It is often disregarded. It shouldn't be. Pills and less carbs can only do so much over time. Weight is equally as important.

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As most people with T2 gain weight as a symptom of IR/Pre D/T2 then it follows that improved management ameliorates this symptom (to a greater or lesser degree). Therefore it is diet that is crucial and weight loss is secondary to that, a happy side effect of better management. I'm not sure, though, that anyone who is carrying extra weight disregards this weight as unimportant, even non Diabetic obese people carry risks.

I agree with you that whatever one's treatment regime diet must be addressed.

kazd63 said:

I haven't criticised her, I have said why not give lo carb a go for three months whilst she thinks about the gastric band program. She just won't go against anything her doctor or dn say even though they are peddling the nhs guidelines.

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She must be very scared. It's a huge op, and even more so if it goes to open surgery due to obstructions. She may just be too frightened to experiment. Just not the right time for her? Once her body settles down from op (a year after op) she could start experimenting?

kazd63 said:

I haven't criticised her, I have said why not give lo carb a go for three months whilst she thinks about the gastric band program. She just won't go against anything her doctor or dn say even though they are peddling the nhs guidelines.

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Some of us are simply more anxious than others or less open to new experiences. Perhaps there are other examples in her life where she has tried something she was uncertain of and succeeded? I have the same frustration with my type 2 dad; he is intelligent but uses that intelligence to construct rationale for not making change e.g. my genes have predisposed me to eating carbohydrates or my body craves stasis so I cannot fight it...Human beings are inevitably attracted to fat and sugar in this obesogenic environment. All true but as many people on this forum demonstrate, can be overcome.
Some of us, including me, like to give advice but I am mindful that all the time I am distracting myself by giving that well meant advice, I am not 'cleaning up my own room' (one of Jordan Peterson's rules)!

Wow. I don't know how she can get away with that. She needs to understand that all carbs turn into sugar eventually which has a very harmful effect on her health. If not now then in future. High blood glucose levels are no joke. I can't even function when my blood sugar is high. It's like I'm a zombie. exercise definitely helps, but I'm too lazy to workout so I got a bike. Have a nice day!

kazd63 said:

Girl at work is diabetic, diagnosed a year or so ago, she still eats loads of carbs and hasn't lost any weight (despite watching her sugars, just her sugars!) has increased walking and swims once a week. She is on Metformin and some other medication and her three/six monthly blood test comes back with her sugars ok allegedly.

So my question is, if she is taking medication that 'artificially' brings her blood sugars down, then how if I have to take them, do I monitor my sugars because surely the blood glucose monitor will show me as having lower blood sugar. Or is it a case that the metformin and other drugs bring your blood sugar down but you can still monitor to see which causes a rise and therefore cut those foods out of the diet.

Hope that makes sense.

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Crocodile said:

Metformin moderates the release of glucose by the liver. It does sweet ***** adams for what you choose to put in your mouth.

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If you mean, it won't help lower post-prandial bg, I disagree. My bgs after meals are definitely lower now I am taking 2g Glucophage XR daily. And everything I am reading confirms this.

A useful article from DiabetesNet says:
"Metformin lowers fasting blood glucose levels by an average of 25% (17 to 37%), postprandial blood glucose up to 44.5%, and the A1c by an average of 1.5% (0.8 to 3.1%). Metformin reduces raised plasma insulin levels in cases of metabolic syndrome by as much as 30% and reduces the need for injected insulin in Type 2s by 15 to 32%."

You can read the whole article here:
https://www.diabetesnet.com/about-diabetes/diabetes-medications/metformin

Alexandra100 said:

If you mean, it won't help lower post-prandial bg, I disagree. My bgs after meals are definitely lower now I am taking 2g Glucophage XR daily. And everything I am reading confirms this.

A useful article from DiabetesNet says:
"Metformin lowers fasting blood glucose levels by an average of 25% (17 to 37%), postprandial blood glucose up to 44.5%, and the A1c by an average of 1.5% (0.8 to 3.1%). Metformin reduces raised plasma insulin levels in cases of metabolic syndrome by as much as 30% and reduces the need for injected insulin in Type 2s by 15 to 32%."

You can read the whole article here:
https://www.diabetesnet.com/about-diabetes/diabetes-medications/metformin

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The article pretty well confirms what I said. Fasting levels are the result of liver functions. Metformin works on this. The gist is that if you want to keep on eating cream buns and jelly beans, Metformin will do zip for you.

Crocodile said:

The article pretty well confirms what I said. Fasting levels are the result of liver functions. Metformin works on this. The gist is that if you want to keep on eating cream buns and jelly beans, Metformin will do zip for you.

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"Metformin lowers fasting blood glucose levels by an average of 25% (17 to 37%), postprandial blood glucose up to 44.5%, and the A1c by an average of 1.5% (0.8 to 3.1%)"
This quotation shows that Metformin does MORE for post prandial bg than it does for fasting bg. Obviously, if you insist on eating so many carbs that lowering post prandial bg by 44.5% still leaves you with dangerously high bg levels, there is no hope for you. If, as in my case, eating 20-30 g carbs daily still doesn't give satisfactory bg levels, Metformin may just make all the difference.

@Alexandra100
I think you need to go back to page 1 of this thread and read the very first post so that my comment is put into some context. The response was to the original poster with a friend who is taking Metformin but continues to binge on carbs while under the assumption that the drug will do its job and the carbs won't matter. That is most definitely untrue. It is even surprising just how many sufferers think this way.

Classic case was my own mother who, like me, is a T2 but long before I was diagnosed ( Thanks for genes Mum ). I'd see her stuffing down cakes and ice cream and say "I thought you were a diabetic". Her response was that the doctor gives her medication for it and it's OK. It wasn't until I was diagnosed myself and worked things out was I able to impress upon her that she can't go on eating that stuff. Now myself and my non-T2 wife manages her diet for her and at least stopped the developing complications from getting worse.

Your article does not have enough detail to fully explain the physiology behind the drug's actions. There are quite a few studies on Google Scholar if you are really interested. Simply put, postprandial levels will be lower of course since they've started from a lower base. Cellular uptake of blood glucose may be improved slightly by the drug but the primary action is from the liver.