• Guest - w'd love to know what you think about the forum! Take the 2025 Survey »

Type 2 Remission question

And some of us no matter how much weight we lose or how low we keep our carbs never achieve remission :( whilst it’s a goal it’s not the be all and end all - I’m 13 years in started out on insulin for a short while along with Gliclizide and metformin, morbidity obese. To date dropped a LOT of weight reduced and then stopped all meds apart from metformin,
I am in remission? No
Am I successful? Yes
Totally agree with what you are saying and I apologise if I was a little careless in how I phrased my original question, I was just looking for options that would provide me with a like for like experience. I fully appreciate not everyone can achieve remission no matter how hard they try and for those of us that can, we should never really take "remission" for granted we do not know if or when things might change. I feel I am very fortunate to have achieved remission, it now says so on my blood results so it must be true ;) But even trying my best and being very strict with what I eat my HbA1cs are never what I would like or even what my glucose readings would estimate which is around low 30s whilst in reality they are usually around 40. I guess I must miss some peaks somewhere. You have done marvelously coming off all but metformin I would say that is definitely a success.
 
Last edited:
regards real exercise, I have always avoided too strenuous activity partly because I think I am too old to exhibit myself in a gym. I
Simplest, easiest and free is to start building up a regime of exercises like squats, sit ups, press-ups. Nice and private at home. Lots of you tube videos to follow if you want
 
I guess I must miss some peaks somewhere.

Not necessarily. There are a number of medical conditions (eg anaemia) that can make hba1cs not reflect your actual blood sugar results.
 
there are 3 known ways to get into remission namely bariatric surgery, low cal 800 for 12 weeks or low carb /keto (it is a spectrum ranging from 'prescription strength' keto to 130g carb daily).
It is reckoned that those who did the 800 kcal Newcastle diet then had to keep their calories lower than 2000 in order to maintain their remission/weight loss if they continue to eat a Eatwell Plate/Med diet volume of carbs.
As others have indicated the carb tolerance of each individual is going to vary based on your amount of muscle (correlates with sex and age generally) and activity level.
Some people also continue with metformin though this isn't then remission technically. on the basis that is a safe drug that does help with IR in the context of a low carb diet.
I am not even going to mention the stomach surgery option as that is an extreme option with serious downsides which may still fail!
Yes I've used two of these diet plans in the past, low cal and my normal keto/low carb - not planning of looking at bariatric surgery any time soon though, as at 56 kilos I don't think I would be eligible somehow. ;) I didn't have a problem keeping to the low cal diet as over the years I had to eat lower and lower calories to make any headway in losing weight. 800 calories is a cinch, just ate plenty of soups, smoothies and salads. I never made it so the maintenance part though as I migrated to low carb after 8 weeks. I still do a couple of days low cal/keto now and again just as a reset. Maybe I can try this again over a sustained period. I could do with losing some weight as at 56 kgs I am actually at the top end of the scale for my height (an optimistic 5ft.) It may also be interesting to see what my lipids do with a low cal diet. I am not sure 2000 calories maintenance would suit long term though as in the "old days" I had to limit my intake to about 1800 calories if I went higher I started putting on weight. Will keto have changed my metabolism I wonder?

When I posted my original question, I actually expected to hear from those who may have had success with other eating plans. Eating a vegetarian or vegan diet for example, or what about Paleo? Then there is the Mediterranean diet which my GP surgery advocates. How successful is that I wonder?

You mention metformin. I actually asked if I could be prescribed this a couple of years ago as I read it was helpful in preventing atherosclerosis and that it can bring down cholesterol - I was told in no uncertain terms by the registrar at the lipid clinic that I did not need it as it is only prescribed to people whose bloods were out of control. Hmm..
 
Went all out on LCHF diet (20 grams of carbs or less most day) and ended up at 11.10 stone (lost over 5 stone) and looked like i was still going to keep loosing weight. Had to up my carbs to 50 grams daily and got my weight back to 12.10 stone and bloods seem ok so i am happy with that :). I just go for a walk with the dogs now and again
Biggest problem right now is the cost of living, having to cut out things and finding cheaper cuts of meat mean my diet is limited to chops, burgers, roast chicken and a bit of steak when i see it cheap. Lucky i only eat twice a day and some cheap ass snacks spread through the day to make my carbs up :angelic:
You are exemplar @ultradad, you have seen my FBGs when I post them on the FBG some chat thread, they aren't bad but they cannot compare with yours. if I eat a lot of protein and my numbers go up.:oops:
 
Simplest, easiest and free is to start building up a regime of exercises like squats, sit ups, press-ups. Nice and private at home. Lots of you tube videos to follow if you want
I am sure I can find lots of excuses not to do this but I take your point - squats for goodness sake and sit ups, gosh! Maybe I will have to pay a visit to Joe Wicks online. Seriously its something to aim for. My hubby had me clambering over rocks the other day when we were out walking. We decided to try to walk from one local beach to another and we had to go around a head point - its not much he said, just a few rocks to get over to get over and once around the point it will be beach. So about a quarter of a mile later having had to scale rocks which I had to lever myself down from they were so high we finally managed to get to the other side. It was a really good work out though - still counting bruises. LOL.

Never really thought about exercise as an option until folks pointed it out but Its quite an attractive one.
 
Not necessarily. There are a number of medical conditions (eg anaemia) that can make hba1cs not reflect your actual blood sugar results.
Thought about that but surely anemia would show up in blood results?
 
Sensible decision in my opinion.

I wonder just what it would take for people who state that we should measure this or weigh that, to realise that there are several different shapes to normal healthy humans, and it is quite usual for otherwise lean people to carry weight around the waist, just as others can have lean waists but carry weight across shoulders, upper back or thighs and bums.
Yes I know what you mean, I felt insulted that it should be suggested that I would be diabetic just because of my shape. My brother is also diabetic he is TOFI I at his heaviest he has only ever been 10 and a half stone. Bet they didn't suggest monitoring to him,
 
There's a whole list of conditions. You could ask for a fructosamine but I suspect your GP wouldn't agree to it (given that 40 is technically not even prediabetic).
Reasons for Elevated A1C Without Diabetes | Lymphatic & Endocrine system articles | Body & Health Conditions center | SteadyHealth.com
It'll also be out if your red blood cells live an unusually long or short time..
Just read the article, interesting I see that taking vitamin C tablets can affect HbA1c. I have been taking these throughout the pandemic. Hmm....

Thank you for posting,
 
Just read the article, interesting I see that taking vitamin C tablets can affect HbA1c. I have been taking these throughout the pandemic. Hmm....

Maybe take advantage of Abbott's libre free trial for diabetics to use a libre for a fortnight to see what your time in range is? I personally (disclaimer am T1 and not a doctor) would believe cgm readings over a hba1c, though in my case the hba1c results have always been pretty similar to those predicted by my reader.
 
Maybe take advantage of Abbott's libre free trial for diabetics to use a libre for a fortnight to see what your time in range is? I personally (disclaimer am T1 and not a doctor) would believe cgm readings over a hba1c, though in my case the hba1c results have always been pretty similar to those predicted by my reader.
Thanks for the suggestion, I actually did this last July when the estimated HbA1c was 34 but I didn't take note of time in range but it was quite a high percentage. I actually remember lowing the thresholds to between 3 and 7 as not being on any medication I do not have hypos. Because I know my readings seem to record lower than actuals, I simply add around 5 points to the estimated reading as a rough guide. Sure enough my HbA1c for that year was 39.
 
@Ryhia you seem to have the food aspects nailed, and are looking at increasing exercise, but what about the third leg of the stool? The time between food, better known as fasting or time restricted eating.
Many people swear this helps the bgs, and therefore their hba1c
When you you usually have your meals? Are there snacks in between perhaps?
 
Ryhia, forgive me if I have missed it, but do you know what your lipids scores actually are? Do you have any medical history of cardiovascular disease? Is there cardiovasculr disease in your close blood family?

My total cholesterol is always high, but my breakdowns are excellent. At one stage, my GP wanted to refer me to the Lipid Clinic, but the total dropped again.

When I took part in cardiac research, I was dreading the conversation about my lipids, but they were supremely unconcerned - due to my breakdowns.

I'm not saying your doctors are wrong in anything, but just wondered where their specific concerns lie.

Apologies for the long post.
When I started eating low carb my cholesterol levels rose to 6.7, I thought this was the result of losing weight but the next blood results showed my total cholesterol to be at 10.00. Of course everyone panicked including myself. My ratios were good though except my HCP was only interested in my LDL levels. I was referred to the lipid clinic, where they undertook more blood tests including looking at my Apob and my Lipoprotein (a). Whilst I don't like my high levels my ratios are fine and putting the info through the report tool at Cholesterolcode.com I was in the lowest risk. When I pointed out how good my ratios were I was told it didn't matter as LDL was too high. I refused the statins that were offered. Since then every time I have a blood draw people panic and so this has caused me a great deal of stress and even depression. Of course stress also puts up cholesterol. I did manage to get my levels down somewhat probably through chance and also a bit of fiddling. Eating certain foods just before a blood draw. However this last time I just couldn't be bothered to try to change things so my cholesterol had gone back to the high levels. Because the lipid clinic had referred me back to my GP with the recommendation to change my diet and introduce statins, I was called into the surgery. Having discussed things, my GP finally offered to put a note on my record to say I have not be hassled about my bloods however he does believe that having high LDL is a cardio vascular risk but said it was up to me what I did about it. It still felt quite a hollow victory though as I still have questions I have no answers for and the elevated Apob is a little disturbing. You asked about my cholesterol breakdown, I last had my lipid bloods taken in June, one set by the hospital and one set through the doctors surgery - the hospital ones were delayed so the surgery took them again I have not received the full set of blood results from the hospital, just the basic breakdown which showed 8.8 total cholesterol trigs 0.7, HDL 2.2 giving a non HDL of 6.6 and a calculated LDL of 6.3. The breakdown of the bloods taken at surgery were serum cholesterol 9.6, trigs 0.8, HDL 2.1 LDL 7.5. Non HDL Cholesterol level 7.5. Bloods were taken a couple of weeks apart I was also not very well with an ear infection when my bloods were taken at the surgery so don't know if this would have affected the result. My blood results using my own tester after the experiment I undertook showed Chol 6.01, HDL 150 TG ,76 LDL 4.17 Chol/HDL 4.0 HDL/LDL 2.8 bloods, My own cholesterol tester does measure a little lower than bloods taken venously.

You asked about family health, my father died of heart issues he was 78, two of my siblings have had heart attacks so there are risk factors there. Maybe statins might be a good idea although I know others on this forum would adamantly disagree.
 
@Ryhia you seem to have the food aspects nailed, and are looking at increasing exercise, but what about the third leg of the stool? The time between food, better known as fasting or time restricted eating.
Many people swear this helps the bgs, and therefore their hba1c
When you you usually have your meals? Are there snacks in between perhaps?
I usually eat my last meal around 5:15 with another cup of tea around 9:00. I may have a glass of wine or other alcohol on occasion which I need to cut out as it interferes with my glucose levels. I try not to snack but if I need to I will have a couple or three nuts or a square or two of 100% chocolate. In the hot weather I have been drinking slimline tonic fairly late at night. I usually don't deliberately fast during the day. sometimes if we are out and miss lunch I can mess things by having something to eat when I get in. This generally has a knock on effect on my glucose levels making them higher than I would like at my next meal. If I decide to delay eating until my next regular mealtime, I find I am really hungry for my evening meal and then about an hour later I am ravenous again. And yes I have tried drinking water. Not sure if I just do not eat enough having missed a meal or my brain is not comfortable with 2 meals a day who knows.
 
Apologies for the long post.
When I started eating low carb my cholesterol levels rose to 6.7, I thought this was the result of losing weight but the next blood results showed my total cholesterol to be at 10.00. Of course everyone panicked including myself. My ratios were good though except my HCP was only interested in my LDL levels. I was referred to the lipid clinic, where they undertook more blood tests including looking at my Apob and my Lipoprotein (a). Whilst I don't like my high levels my ratios are fine and putting the info through the report tool at Cholesterolcode.com I was in the lowest risk. When I pointed out how good my ratios were I was told it didn't matter as LDL was too high. I refused the statins that were offered. Since then every time I have a blood draw people panic and so this has caused me a great deal of stress and even depression. Of course stress also puts up cholesterol. I did manage to get my levels down somewhat probably through chance and also a bit of fiddling. Eating certain foods just before a blood draw. However this last time I just couldn't be bothered to try to change things so my cholesterol had gone back to the high levels. Because the lipid clinic had referred me back to my GP with the recommendation to change my diet and introduce statins, I was called into the surgery. Having discussed things, my GP finally offered to put a note on my record to say I have not be hassled about my bloods however he does believe that having high LDL is a cardio vascular risk but said it was up to me what I did about it. It still felt quite a hollow victory though as I still have questions I have no answers for and the elevated Apob is a little disturbing. You asked about my cholesterol breakdown, I last had my lipid bloods taken in June, one set by the hospital and one set through the doctors surgery - the hospital ones were delayed so the surgery took them again I have not received the full set of blood results from the hospital, just the basic breakdown which showed 8.8 total cholesterol trigs 0.7, HDL 2.2 giving a non HDL of 6.6 and a calculated LDL of 6.3. The breakdown of the bloods taken at surgery were serum cholesterol 9.6, trigs 0.8, HDL 2.1 LDL 7.5. Non HDL Cholesterol level 7.5. Bloods were taken a couple of weeks apart I was also not very well with an ear infection when my bloods were taken at the surgery so don't know if this would have affected the result. My blood results using my own tester after the experiment I undertook showed Chol 6.01, HDL 150 TG ,76 LDL 4.17 Chol/HDL 4.0 HDL/LDL 2.8 bloods, My own cholesterol tester does measure a little lower than bloods taken venously.

You asked about family health, my father died of heart issues he was 78, two of my siblings have had heart attacks so there are risk factors there. Maybe statins might be a good idea although I know others on this forum would adamantly disagree.

Bottom line @Rhyia is that people on this forum, even well respected ones can believe what they like (and for full disclosure, I'm not a statin fan), but only you can decide how to manage your own health and where you set your risk dials. Every decision carries a risk, even whether to scale the stairs one more time, or boiling a kettle, so there is nothing emotive in that statement.

Did the do an ApoA test alongside the ApoB? Ratios of those can be taken into account too.

Have you considered asking for a cardiology referral?

Going back to my statement relating to the cardiologist I spoke with on the research project, their response to me was couched with something along the lines of "we might feel differently if you had already experienced a CV event". (There is no CVD history in my family.)

I'm not making any suggestion you just crack on and take stating (like I say, only YOU can decide), but sometimes, looking at the bigger picture we have to accept a compromise in our approaches.

You have to manage your overall condition, including your stress and potential for longer standing depression. Life is an adventure, but sometimes the adventures are less pleasant than we anticipated at the outset.

Genuinely, good luck with it all.

(Edited to add question on ApoA.)
 
@AndBreathe There was no mention of ApoA, being tested just ApoB and Lp(a). My Apob levels were shown as 1.68g/l when they should be under 1.0g/l and they like even lower for someone with diabetes. My Lp(a) levels were 22.5 I understand anything under 30 is ok.
 
Can I ask, what are your oppositions to statins? I have been prescribed them but my cholesterol levels are nowhere near as high as you mention Rhyia. I was reluctant but started anyway on the further advice of the diabetes nurse. Now I’m unsure again reading this thread?
 
Can I ask, what are your oppositions to statins? I have been prescribed them but my cholesterol levels are nowhere near as high as you mention Rhyia. I was reluctant but started anyway on the further advice of the diabetes nurse. Now I’m unsure again reading this thread?

I was prescribed statins, I had one borderline high measurement out of many normal ones, I refused until I can get a couple subsequent readings. Personally I’m not against them for people that are really at risk, but I’m still kinda upset my doctor tried to dump them on me for no reason.

The reason I’m against them for “me” is.

it’s a life long medication, I’m in my 50s, I don’t want to eat them every day for 20-30 years

They can change your hormones, testosterone, estrogen, dhea, pregnenolone, vitamin D etc. are all made from cholesterol.

they can damage your memory, even though the risk is low, why would I even risk this?

they can cause muscle pain, I’m into fitness, why would I take something that inhibits this?

If you’re way outside the reference range, statins are probably okay just to get inside the reference range. Crushing your level to some low end of the reference range is probably not good for your health.

sorry end rant
 
I am so jealous of you,:) if I could tolerate 150-200gms carbs a day pretty sure that would resolve my cholesterol problem but I am not even close I generally only eat between 30 and 50 gms a day and eating 50gms caused my HbA1c to rise a couple of points. I am not even sure what 150 gms of carbs even looks like as for years prior to diagnosis I was eating the recommended diet, i..e. the Eatwell plate or struggling to lose weight. I know now that the problems with weight was insulin resistance building up. I thought after 3 years in remission my insulin resistance would not have been so impactful but this does not appear to be the case. I am still struggling to get levels down after my short experiment. To be honest I also felt yuck eating so many carbs and only managed to keep to 95gms for a couple of days. As soon as I dropped the to around 60gms carbs my cholesterol started to rise. So higher carbs seem to resolve my issue but I think my body won't be able to cope.
Sadly Doctors still do not get the message that ketosis is fat burning, and that means more lipids in the blood. Cholesterol's purpose is simply as bulk transport of lipids to where it is needed. A low carb diet, or a fasting diet will give periods when fat burning takes place naturally. So if you fast for your lipid panel blood test then you are probably pushing up the cholesterol levels.

What nutritionists ignore is that fat, when eaten, gets transported in different supertankers called chylomicrons and a form of LDL called VLDL and these go direct from the gut to the liver.. these two do not get measured in the lipid panel test, so it is not what you eat that causes high cholesterol, but rather what you use. When fat burning occurs, there is an increase of lipids coming out of storage in the adipose tissue in their way to the liver for packing into LDL, but also in LDL going to the muscles. That is why low carbers can have high TC results. it is a natural progression.
 
Back
Top