Pre-diabetes reversal despite the dietician

[srg100]

Please excuse me while I rant a bit!! Need to get this off my chest...

I was diagnosed with pre-diabetes in Feb this year with a HbA1c of 43.2.
My GP advised cutting out sugar and white flour and losing weight.
I've not had much success in the past with losing weight and asked to be referred to a dietician.

This took a while as the service in my area has been affected by cutbacks and I had to be referred twice before I got anywhere. In the meantime, I tried various things and then I found your website and thought it was worth trying going low carb.
I had ups and downs with it but finally really got going with it in September with the consent of my GP who advised me to keep the dietician appointment as they could give me more detailed advice.

Ha!! Well, the NHS maybe saving £4m as a result of your low carb program as per The Diabetes Time's report on Arjun Panesar at EHI Live in Birmingham recently
http://diabetestimes.co.uk/low-carb-diet-saves-nhs-4m-in-diabetes-costs/ but the dietician I saw wasn't impressed.
I actually saw a trainee dietician with a supervisor watching.
The trainee told me I should be following the Eatwell Guide.
http://www.nhs.uk/Livewell/Goodfood/Pages/the-eatwell-guide.aspx

I told her that's what got me where I was now and that my GP supported my use of the LCHF diet and had sent me to them for more advice.
The supervisor told me they couldn't offer weight loss advice as they no longer ran that service - that was done in a different hospital in a nearby city (!) but they could offer dietary advice.
She said they couldn't support an Atkins style diet as it was against the Dieticians official guidelines. And that long term effects were not good on the Atkins diet. (And they are good on the Eatwell Guide?!!)
Between them they suggested a plate 1/4 carbs, 1/4 protein and the rest fruit and veg.
I told them if I ate wholemeal bread,potatoes or pasta I found it hard to stop at a few slices or a portion but they were still not happy with me doing the LCHF diet. Especially the healthy fat part.
They then weighed me and measured my height. But not my waist.

I asked what happens next. They said if I wanted I could try their way and come back to see if I'd lost weight - but I thought they said they couldn't give weight loss advice I hear you say ....
But if not then there wasn't much point in my coming again.
I said thanks but no thanks.

I made sure that the consultation was not acrimonious and made sure they hadn't felt I was getting at them.

I was very disappointed, especially as my GP thought it would be helpful.

Anyway, I carried on trying to eat as low carb as I could and had my bloods redone on 3 Nov.
My HbA1c was 40!! Not as good as it was in Feb 15 at 36.6 but I was really pleased.

BTW I wasn't told that my HbA1c was slowly going up until it was in the pre-diabetic range - although I was told repeatedly that I was overweight and should try to do something about it.I told my GP that I had problems losing weight and she didn't push me. I am an emotional over-eater.

Anyway that's my story. Hope it wasn't too long!!

Thanks for listening )

 

[Squire Fulwood]

No it was a fine story and there are about three million people in this country who followed the eatwell plate and got sick. There is always a feeling that obese people got that way by not following the official party line but the Public Health Collaboration pointed out that in this country the population, as a whole, have followed the guidlines. Look where it got them.

 

[Freema]

Please excuse me while I rant a bit!! Need to get this off my chest...

I was diagnosed with pre-diabetes in Feb this year with a HbA1c of 43.2.
My GP advised cutting out sugar and white flour and losing weight.
I've not had much success in the past with losing weight and asked to be referred to a dietician.

This took a while as the service in my area has been affected by cutbacks and I had to be referred twice before I got anywhere. In the meantime, I tried various things and then I found your website and thought it was worth trying going low carb.
I had ups and downs with it but finally really got going with it in September with the consent of my GP who advised me to keep the dietician appointment as they could give me more detailed advice.

Ha!! Well, the NHS maybe saving £4m as a result of your low carb program as per The Diabetes Time's report on Arjun Panesar at EHI Live in Birmingham recently
http://diabetestimes.co.uk/low-carb-diet-saves-nhs-4m-in-diabetes-costs/ but the dietician I saw wasn't impressed.
I actually saw a trainee dietician with a supervisor watching.
The trainee told me I should be following the Eatwell Guide.
http://www.nhs.uk/Livewell/Goodfood/Pages/the-eatwell-guide.aspx

I told her that's what got me where I was now and that my GP supported my use of the LCHF diet and had sent me to them for more advice.
The supervisor told me they couldn't offer weight loss advice as they no longer ran that service - that was done in a different hospital in a nearby city (!) but they could offer dietary advice.
She said they couldn't support an Atkins style diet as it was against the Dieticians official guidelines. And that long term effects were not good on the Atkins diet. (And they are good on the Eatwell Guide?!!)
Between them they suggested a plate 1/4 carbs, 1/4 protein and the rest fruit and veg.
I told them if I ate wholemeal bread,potatoes or pasta I found it hard to stop at a few slices or a portion but they were still not happy with me doing the LCHF diet. Especially the healthy fat part.
They then weighed me and measured my height. But not my waist.

I asked what happens next. They said if I wanted I could try their way and come back to see if I'd lost weight - but I thought they said they couldn't give weight loss advice I hear you say ....
But if not then there wasn't much point in my coming again.
I said thanks but no thanks.

I made sure that the consultation was not acrimonious and made sure they hadn't felt I was getting at them.

I was very disappointed, especially as my GP thought it would be helpful.

Anyway, I carried on trying to eat as low carb as I could and had my bloods redone on 3 Nov.
My HbA1c was 40!! Not as good as it was in Feb 15 at 36.6 but I was really pleased.

BTW I wasn't told that my HbA1c was slowly going up until it was in the pre-diabetic range - although I was told repeatedly that I was overweight and should try to do something about it.I told my GP that I had problems losing weight and she didn't push me. I am an emotional over-eater.

Anyway that's my story. Hope it wasn't too long!!

Thanks for listening )

I think you do a very fine job believing in yourself and the way you have found... stick to that, I couldn´t myself loose weight untill i learned to cut carbs out of necesity when i got diabetes, and then suddenly I was actually able to loose weight, especially when i added intermittent fasting, like not eating from 19 o´clock untill next day 12 o´clock...(it helps insuline go down too)

 

[Brunneria]

Well done! It isn't always easy to resist the Party Line (and that applies here on the forum as much as in 'Real Life') but you stuck to your guns and have made a big difference.

Brilliant.

 

[Jay-Marc]

Prior to around 1980 it was thought that blood glucose control could not be achieved without carbohydrate restriction. 'Research' indicated more liberal consumption was possible, along with a theory it was total energy intake, rather than carbohydrate intake, that had an impact on glucose levels leading to today's official recommendations of decreasing the proportion of energy from fat, and protein, eating high in fibre increasing the amount of fruit and vegetables.

Personally I think the old theory that if you have a carbohydrate metabolism disorder then the best course of action is to reduce carb consumption seems a lot easier to comprehend - especially if this 'new' theory is true it still doesn't require you to eat more carbs only that it may be 'possible'.

 

[srg100]

Thanks!

I've found that the LCHF diet makes me feel full for longer and the kind of fullness that is hard to override.
Unlike the stuffed feeling I had overeating on carbs .

Mind you - I can still overeat, especially on cheese, low carb or not!

I think you do a very fine job believing in yourself and the way you have found... stick to that, I couldn´t myself loose weight untill i learned to cut carbs out of necesity when i got diabetes, and then suddenly I was actually able to loose weight, especially when i added intermittent fasting, like not eating from 19 o´clock untill next day 12 o´clock...(it helps insuline go down too)

 

[srg100]

Thanks to all of you who replied.

Any advice on what level of carbs to stick to?
There are so many LCHF versions out there it gets confusing!
And then there are the ones that say eat cheese if it's low carb and the ones that say don't eat it it's fattening.

The interesting thing to me is that in the last few months my weight hasn't really changed.
It is down about 7kg from this time last year but most of that loss was before I really went properly low carb, when I cut out sugar and white flour but not the other high carb foods. At the moment it's fluctuating up and down a kg here and there.
Maybe I'm eating too much protein?

Thanks again - it's great to get positive feedback!

 

[Freema]

Thanks to all of you who replied.

Any advice on what level of carbs to stick to?
There are so many LCHF versions out there it gets confusing!
And then there are the ones that say eat cheese if it's low carb and the ones that say don't eat it it's fattening.

The interesting thing to me is that in the last few months my weight hasn't really changed.
It is down about 7kg from this time last year but most of that loss was before I really went properly low carb, when I cut out sugar and white flour but not the other high carb foods. At the moment it's fluctuating up and down a kg here and there.
Maybe I'm eating too much protein?

Thanks again - it's great to get positive feedback!

stick to carbs in vegs over the ground.... not many carbs but really filled with nutrients

 

[bulkbiker]

Thanks to all of you who replied.

Any advice on what level of carbs to stick to?
There are so many LCHF versions out there it gets confusing!
And then there are the ones that say eat cheese if it's low carb and the ones that say don't eat it it's fattening.

The interesting thing to me is that in the last few months my weight hasn't really changed.
It is down about 7kg from this time last year but most of that loss was before I really went properly low carb, when I cut out sugar and white flour but not the other high carb foods. At the moment it's fluctuating up and down a kg here and there.
Maybe I'm eating too much protein?

Thanks again - it's great to get positive feedback!

Depends on what you are currently eating? Have you tried a bit of fasting.. maybe not having breakfast for example?

 

[AndBreathe]

Thanks to all of you who replied.

Any advice on what level of carbs to stick to?
There are so many LCHF versions out there it gets confusing!
And then there are the ones that say eat cheese if it's low carb and the ones that say don't eat it it's fattening.

The interesting thing to me is that in the last few months my weight hasn't really changed.
It is down about 7kg from this time last year but most of that loss was before I really went properly low carb, when I cut out sugar and white flour but not the other high carb foods. At the moment it's fluctuating up and down a kg here and there.
Maybe I'm eating too much protein?

Thanks again - it's great to get positive feedback!

Dr David Unwin, from Southport, has developed a LC programme he runs as part of his General Practise. One of his observations in that work is that one of the most common hiccough so his patients encounter is LC, but at the same time, eating larger, than best suited to them, portions. It is such a common issue that he asks patients to photograph their food to show him.

 

[srg100]

Depends on what you are currently eating? Have you tried a bit of fasting.. maybe not having breakfast for example?

No I haven't but I really need to eat something in the mornings. By fasting do you include not drinking as well?
I could try stopping eating earlier in the evening - but I find my lunchtime meal keeps me full longer and so I don't want to eat my evening meal until later.
How long a fast are you talking about?

 

[srg100]

Dr David Unwin, from Southport, has developed a LC programme he runs as part of his General Practise. One of his observations in that work is that one of the most common hiccough so his patients encounter is LC, but at the same time, eating larger, than best suited to them, portions. It is such a common issue that he asks patients to photograph their food to show him.

I've heard about Dr Unwin - in fact he was the one that made me decide to try LCHF as he's a GP and has published papers on the subject and therefore seemed someone I could rely on.
Glad to hear it's not just me!
What's the answer then?

 

[AndBreathe]

I've heard about Dr Unwin - in fact he was the one that made me decide to try LCHF as he's a GP and has published papers on the subject and therefore seemed someone I could rely on.
Glad to hear it's not just me!
What's the answer then?

If only it was so simple.

In your shoes, what I might try would be looking at something like Carbs and Cals (I only know definitely about the App and physical book, although I own neither). Carbs and Cals can be useful in calculating carb counts of foods and meals, but what makes it a bit different, in my understanding, is it illustrates portion sizes for the various foods or meal combinations.

I think if adopting the LCHF way of eating, it can be easy to eat big on cheese, cream and some proteins.

As I say, I didn't increase fat (aside from switching low-fat to full fat) or protein to begin with, as I didn't feel the need, as I wasn't hungry on what I was doing. I trimmed up very quickly - even though I didn't have masses to lose (I wasn't fussed on weight loss to be honest), but that doesn't work for everyone, but I would look at portion size.

Good luck with it all.

p.s. Dr Unwin is a member here (@Southport GP ) , although in total fairness, he posts as a member, and is happy to talk about his work and publications from time to time, he doesn't contribute as a Health Care Professional.

He past created a few threads, which you would be able to find by using the Search facility on the site.

 

[MikeTurin]

Prior to around 1980 it was thought that blood glucose control could not be achieved without carbohydrate restriction. 'Research' indicated more liberal consumption was possible, along with a theory it was total energy intake, rather than carbohydrate intake, that had an impact on glucose levels leading to today's official recommendations of decreasing the proportion of energy from fat, and protein, eating high in fibre increasing the amount of fruit and vegetables.

After the '80 at least in the US the trend of obese people is always positive http://stateofobesity.org/adult-obesity/ even if in 1980 the first gudelines https://health.gov/dietaryguidelines/1980thin.pdf?_ga=1.38617187.1522053892.1479036016
One could thint there's causationn even if there's only correlation.
One thing in the first guidelines is interesting is that is said that starches are better than fats because are less enegy-dense.

At this point in my opinion if one need a filler for the stomach eating spinach frittata or fennels with cheese obtains the same effect with a fattier food compared to potatoes or pasta.

I suppose that the real problem is that the bad food offer after the '80s skyrocketed.

 

[bulkbiker]

No I haven't but I really need to eat something in the mornings. By fasting do you include not drinking as well?
I could try stopping eating earlier in the evening - but I find my lunchtime meal keeps me full longer and so I don't want to eat my evening meal until later.
How long a fast are you talking about?

No I always have a couple of mugs of tea.. with lactofree milk. I found that skipping breakfast was relatively easy and extends your overnight fast with all the benefits that brings.I guess I fast for at least 16 hours every day..and sometimes do extended fasts up to 7 days.

 

[srg100]

No I always have a couple of mugs of tea.. with lactofree milk. I found that skipping breakfast was relatively easy and extends your overnight fast with all the benefits that brings.I guess I fast for at least 16 hours every day..and sometimes do extended fasts up to 7 days.

OK. Thanks/
Maybe I'll try that if my weight stays stuck.

I have lost a few inches round my waist - and my rings are looser!

 

[srg100]

If only it was so simple.

In your shoes, what I might try would be looking at something like Carbs and Cals (I only know definitely about the App and physical book, although I own neither). Carbs and Cals can be useful in calculating carb counts of foods and meals, but what makes it a bit different, in my understanding, is it illustrates portion sizes for the various foods or meal combinations.

p.s. Dr Unwin is a member here (@Southport GP ) , although in total fairness, he posts as a member, and is happy to talk about his work and publications from time to time, he doesn't contribute as a Health Care Professional.

He past created a few threads, which you would be able to find by using the Search facility on the site.

Thanks for that.
I've had a look at Carbs and Calcs but I don't think it has the foods I usually eat. Maybe I'll have another look.

I know Dr Unwin is on Twitter but I don't do social media so seeing him here is great!

 

[AndBreathe]

Thanks for that.
I've had a look at Carbs and Calcs but I don't think it has the foods I usually eat. Maybe I'll have another look.

I know Dr Unwin is on Twitter but I don't do social media so seeing him here is great!

What sort of things do you eat? I'm sure there will be a way to do it.

Some others have also reduced their plate size, to ensure they don't overdo things. As dinner plates have got bigger in my time (that makes me sound even older than I am!), I can see how portion size can creep up; particularly if you are enjoying your way of eating.

 

[srg100]

What sort of things do you eat? I'm sure there will be a way to do it.

Some others have also reduced their plate size, to ensure they don't overdo things. As dinner plates have got bigger in my time (that makes me sound even older than I am!), I can see how portion size can creep up; particularly if you are enjoying your way of eating.

I think I need to check portion sizes in recipes more and serve myself one portion only.
Sometimes I only cook one portion which helps but isn't always practical.
I do sometimes use a smaller plate - although most of ours are quite old and therefore not so big!

I like eating fish, chicken, beef, lamb and also cheese, but not with the fish or the meats.
I also like most vegetables.
I think part of the problem maybe not getting the right balance of fats and proteins. I tend to eat more protein rather than more fats if I'm still hungry.

Thanks for your help.

 

[Laura7800]

I think you do a very fine job believing in yourself and the way you have found... stick to that, I couldn´t myself loose weight untill i learned to cut carbs out of necesity when i got diabetes, and then suddenly I was actually able to loose weight, especially when i added intermittent fasting, like not eating from 19 o´clock untill next day 12 o´clock...(it helps insuline go down too)[/

Yep I've gone lo carbohydrate and do intermittent fasting from 8.00 to midday and find this helps hoping my hba1c will be good when I next get tested