So how come...?

Newlysweet said:

If I then introduce a little more (complex, low GI) carbs, won’t the numbers just go straight back up again?

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They might they might not but lower blood sugars will be beneficial anyway so nothing to be sneezed at.

After 4 years keto and now carnivore I can "pass" every diagnostic test for T2 so does that mean I'm "cured"?

I don't really care if cured or controlled as I have no intention of going back to eating what made me ill in the first place.
That includes complex, low GI carbs.

I have lost virtually no weight in over 8 years of low carbing, but my diabetes is controlled.

Remission can mean different things to different people.

I find that control is not about the weight, it's about the carb intake for me.

Newlysweet said:

Thanks, both, it’s useful to hear the perspective of people further along the road than me.

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Are you trying a Newcastle Diet shakes method of weight loss for your 3 month 15kg reduction?

Newlysweet said:

Newly diagnosed type 2 here, trying the ‘no meds, 15kg weight loss’ approach for 3 months to see if I can induce remission.

But here’s the thing - doing low carb (I’m around 30 - 50g/day), I would expect my HBA1C to plummet anyway, just because I’m not eating any carb. If I then introduce a little more (complex, low GI) carbs, won’t the numbers just go straight back up again? I wouldn’t call that ‘remission’, more ‘control’.

Do people who are overweight and doing ‘keto’ for weight loss, maybe not actually losing much, have a lower chance of developing type 2 because of their low carb intake - so it’s not just about the weight?

Anyone know?

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Remission's a debatable term... I'm listed on here as in remission, but if I eat a cake, up my blood sugars go, so yeah... To me, remission comes down to being well-controlled, complication and medication free for a prolonged period of time. The weight I lost solved a bit of my insulin resistance, but it's not gone, and after 4 years, I don't think it'll ever magically vanish. Weight is secondary, the important bit is having your blood sugars under control. The weight won't ruin your eyes or kidneys, the glucose would. So that's a matter of priorities. I'll never go back to eating carbs, because my body just can't cope with them. It never will be able to either. So yeah.... Control rather than remission, really. And yes, people who do keto but don't lose weight, (or as was the case for me, regained some when hitting perimenopause) do have decent blood sugars, so should be able to avoid T2 and/or complications.

Started low carb in February, down 20kg as of today.. A1c from 9.4% to 5.2%. Still more to go before I’m lean and mean, but I’ll be there in less than 90 days.
Feeling great, driven to meet the new goals I’ve set, got some muscles growing.

Am I cured? Not yet, I’ll do some experiments once I reach my target body composition. I read somewhere < 5% can actually be cured. I’m going to be in that group!

Newlysweet said:

Newly diagnosed type 2 here, trying the ‘no meds, 15kg weight loss’ approach for 3 months to see if I can induce remission.

But here’s the thing - doing low carb (I’m around 30 - 50g/day), I would expect my HBA1C to plummet anyway, just because I’m not eating any carb. If I then introduce a little more (complex, low GI) carbs, won’t the numbers just go straight back up again? I wouldn’t call that ‘remission’, more ‘control’.

Do people who are overweight and doing ‘keto’ for weight loss, maybe not actually losing much, have a lower chance of developing type 2 because of their low carb intake - so it’s not just about the weight?

Anyone know?

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Hi @Newlysweet (what a great username),

I think this would be a difficult question to answer. Yes, just losing weight, without going very low carb, can bring about normal blood sugar levels in some as can going low carb or ketogenic. However, if the weight is regained for those on the low calorie-diet or if high carb foods are reintroduced for those on a low-carb/ketogenic woe, there is a reasonable chance of returning to higher blood sugar levels. So, I don't really see much of a difference, why we would use the term remission in the first instance and control in the second instance. For me, they are pretty much the same thing.

Personally, I believe some of us are genetically predisposed towards T2 (about half of my family has been diagnosed), but if we take into account this predisposition and adapt our lifestyle, we might never be diagnosed with excessive blood glucose. Even if we are diagnosed and T2 is caught early, many of us can return to normal blood sugar levels and probably avoid complications.

So, can we return to a high-carb woe after having successfully brought down blood sugar levels by low-carb/ketogenic woe? The answer may be yes (as some such as @bulkbiker have seen) or may be no (for others). However, I believe regardless of what happens in the shorter term, that in the longer term, many of us would be likely to experience similar problems again due to our genetic predisposition.

So, is a genetic predisposition the same thing as diabetes? Or alternatively is a peanut allergy the same thing as an anaphylactic shock? And is then eating no peanuts just an anaphylatic shock under control?

In the end, I believe these are just words (reversal, control, remission). In my mind, what matters that we stand a reasonably good chance of avoiding most if not all complications -- and this is what matters in my mind.

The way I see remission is that just because my hb1ac may be in the 'normal' range (only the once in the last 3 years but still) that is ONLY because I use insulin. I reckon it's the same with carbs in reverse almost, the non partaking of carbs IS the medicine, stop doing that and chances are your body will react as it did before. Is a person with a nut allergy cured because they avoid nuts? x

Newlysweet said:

No, I wasn’t offered that and anyway I quite like food - so I discovered and embraced the low carb world, hybridised with calorie restriction and balanced with my fitness pal!

The nut allergy analogy is a good one, but my impression is that radical weight loss in T2D can actually modify the disease process a bit, reducing insulin resistance and increasing sensitivity of the insulin/glucose balance. That’s what I’m not sure about - again, thanks for your thoughts.

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Watch out for calorie restriction as it can lead to slowing metabolism and weight loss stalls.
Most of us low carbers tend not to restrict calories as they are a very poor measure of food energy.

Newlysweet said:

No, I wasn’t offered that and anyway I quite like food - so I discovered and embraced the low carb world, hybridised with calorie restriction and balanced with my fitness pal!

The nut allergy analogy is a good one, but my impression is that radical weight loss in T2D can actually modify the disease process a bit, reducing insulin resistance and increasing sensitivity of the insulin/glucose balance. That’s what I’m not sure about - again, thanks for your thoughts.

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Hi there, yes, weight loss may indeed modify it to some extent but I've always thought a person MUST have a 'flaw' in the body in the first place, many people who are not overweight still have diabetes and there are plenty of overweight people without diabetes too. It's a very complicated condition that's for sure but I do agree that by doing everything we can to be healthy must surely help. x

Great thread.

I am overweight and I have been doing low carb for some time. My bloods have been so good that I have ceased taking one of my tablets (Gliclazide).

Newlysweet said:

Is that just in combination with the LCHF approach? Because the Newcastle/Michael Mosley regimes are extremely low calorie (800/day) but lead to dramatic weight loss.

I’ve always struggled with the idea that if your weight loss stalls, increase your calorie intake. I’m doing 1200 Kcal not 800, in ketosis but feeling ‘normal’ and losing weight. Early days though...

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The Newcastle/Mosley diets are crash diets, they're not intended for long term use, due to malnutrition in the long run.

Newlysweet said:

Is that just in combination with the LCHF approach? Because the Newcastle/Michael Mosley regimes are extremely low calorie (800/day) but lead to dramatic weight loss.

I’ve always struggled with the idea that if your weight loss stalls, increase your calorie intake. I’m doing 1200 Kcal not 800, in ketosis but feeling ‘normal’ and losing weight. Early days though...

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I have never deliberately "restricted calories" but lost 120 pounds eating wholesome food that was satiating.
I ate in a restricted time window skipping breakfast and only having lunch and dinner (these days that has shrunk even more).
Ultra low carb at the start and nowadays virtually carnivore.

I've not restricted calories in any way since diagnosis, I simply cut out high sugar food from the start, and made that all high carb food shortly after. My HbA1c came right down from low 60s to pre-diabetic within a couple of months.

Many year ago, however, when I originally started seeing middle age spread, I did go on a strict calorie limited diet for a few weeks after husband "challenged " me to lose some weight, and this certainly caused me to lose a fair bit, but as soon as I started eating normally again, that weight came right back up with a vengeance. In retrospect it was one of the daftest thing I've ever done.

I've kept to fairly low carb/ketogenic (target <50g a day but sometimes down to 20ish) for over six and a half years and my glucose levels have been low end of pre-diabetic for most of this time, and I haven't taken metformin for three years now. I've eaten normal full fat food all my life and simply upped my consumption slightly to balance out the reduction in carbs. My GP & I both believe I'm well controlled, and I know that if I scoffed carbs regularly my glucose levels would go back up - but I've no intention of changing my current style of eating.

I spent the first half of my life skinny and underweight, and only started putting on weight in middle age, but it took me over 70 years to become diabetic. I very quickly lost about half the weight my GP advised me to lose, by cutting right down to 20-25g carbs a day for a few weeks, but I hadn't actually realised at first this loss was happening until someone commented!! But this happened after I'd seen the big reduction in my glucose levels. The fact that I'm still quite overweight and no longer very active has had little impact on my glucose levels, it's been cutting out the carbs that I can no longer handle properly that's keeping me where I am.

So as far as I'm concerned it's my low carb diet, rather than weight or exercise, that has enabled me to control my diabetes.

As I see quite low levels of blood glucose after eating, my Hba1c 'should' be lower than 42, but it seems stuck there. I think something broke.
I see it as a warning that despite changes in weight shape and strength, the observation I made in my 20s, that I do not react to carbs like I'm supposed to, still holds true, despite it being declared impossible by Drs and nurses. If I had been able to eat as I did in my 20s, low carb with the natural fat from the foods, then I probably would never have become almost spherical and type two - but carbs are generally considered to be a healthy choice for all, no excuses no exemptions.

Newlysweet said:

Is that just in combination with the LCHF approach? Because the Newcastle/Michael Mosley regimes are extremely low calorie (800/day) but lead to dramatic weight loss.

I’ve always struggled with the idea that if your weight loss stalls, increase your calorie intake. I’m doing 1200 Kcal not 800, in ketosis but feeling ‘normal’ and losing weight. Early days though...

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drastic reduction of calories dont make me lose weight. I have to reduce the carbs in those calories to make any difference. Then I go into starvation mode in weeks, so when I try to increase my intake, I gain weight.

I am going to see if increasing my intake of only fats has the same effect. Insulin resistance is an important part of this.