Sometime listener, first time caller...

Hello, I've been lurking here for a while reading all the advice I can possibly cram into my brain, but thought it was time to finally join.

I officially got my diagnosis of Type 2 Diabetes today after about a month of faffing about with the various nurses at my medical practise. I saw the DN there this morning and after "the talk" she prescribed Canagliflozin (Invokana) which I guess I start taking tomorrow. Anyone else in this position? I kind of expected metformin from what I've been reading... My HbA1c came out at 92 (it was at 100 for the first test a week earlier), which I realise is awful.

Since the initial call from the nurse (following some general blood tests because of anxiety attacks and related chest pain - lockdown has been a world of fun...) to tell me that my blood sugar was "sky high" I decided to take action and read and impliment as much as I could before even the follow up blood test. This site, plus a bunch of others, were very helpful. I ordered a blood glucose monitor that arrived the following day (12.4 that first day, currently surfing around 8 - 9, testing at all kinds of times to see what's going on), and over that weekend learned all about Keto and low carb lifestyles, which is the approach I've been taking since. It's been difficult adapting (oh potatoes...), but I've been pushing hard and finding all kinds of useful advice and recipes. Almond flour - who knew?!

I'm a fat girl. I've been a binge eater (a fun accompaniment to depression and anxiety, yay!) since about age 12 (many years in secret) but I'm gaining control of that thanks largely to an amazing therapist and have been a Very Good Girl since that inital phone call. I'm struggling with the shame side of things, like I've done this to myself (because, lets face it, I have), like this is punishment for my gluttony and for not being a more controlled person. I'm trying to find a way through that, but I'll be honest, it's not easy. I'm lucky because I have a lot of support from an amazing husband, parents and friends, but I thought it was time to sign up here just to help with the billion questions I'm bound to have.

Sorry, this has turned into an essay...

Thank you! I'm trying to learn to be kind to my mind and my body now.

ziggy_w said:

Hi @CaptainTwitchy,

Welcome to the forum. It's seems you are already making good progress on lowering your blood sugar levels through diet.

I was also diagnosed with a level of 100 mmol and have been able to return to truly normal blood sugar levels through diet within three months. So, there is quite possible this might work for you too. So, well done on grapping the bull by the horns.

As you have decided to embark on a ketogenic diet -- did you know that SLGT2 inhibitors (i.e. Canagliflozin) and keto don't mix well. The problem is that it can lead to euglycemic ketoacidosis. So, it might be worthwhile to talk to your GP/nurse again and ask whether you can switch to metformin or to try diet alone for three months.

As to blaming yourself, there is no reason to feel ashamed -- you really didn't do this to yourself. First, not everyone who is overweight becomes diabetic. Second, many would even argue that weight gain is a symptom of a deranged metabolism rather than the other way around. The reason for this is that above normal insulin levels (a hallmark of insulin resistance, prediabetes and T2) prevent the body from burning fat. So all the carbs, which aren't burned immediately, are stored as fat. However, as high insulin prevents us from accessing this stored fat for energy, we only always add to the fat stores rather than using them for energy as normal people do. This seems to end in a kind of a vicious circle, excess insulin leading to excess fat storage and excess fat leading to higher insulin levels.

By the way, eating no or very few carbs work directly on lowering insulin levels and might break this vicious circle.

Again, welcome to the forum. Looking forward to updates on your journey.

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Okay, this is a bit of a concern. I think I'd better consult with my GP before I start taking this as I've been taking Keto very seriously indeed and don't want to end up damaging myself further!

JoKalsbeek said:

There you go again with the self-flagellation. You didn't do this to yourself, okay? The binge eating, depression, anxiety.... Those can be caused by high blood sugars or rapidly fluctuating blood sugars. Get your blood sugars under control and you might find your emotional stability'll change for the better. So that's a perk of low carbing right there. (Take it from a clinically depressed introverted borderliner with PTSD. I'm a mess, but not a hot mess anymore.).

As for keto in combination with blood glucose lowering medication... I was on gliclazide myself and even the endo didn't know it could cause hypo's. They're not fun. So keep your meter handy, test extra if you feel off, (sweats, trembling, rubbery knees, confusion, hair standing on end, palpitations etc) have some dextro energy or something similar if your numbers are dropping too low. Just until you get the medication situation sorted with the doc. I don't know why they didn't try metformin first, that's the usual go-to. And while it has severe side effects, it won't cause hypo's... Odd.

I know with a slight eating disorder kind of thing, overhauling a diet is harder than it usually might be. But you'll figure out what works for you. In the meantime, should all this stress bring up the urge to binge, make sure you only have no or low carb snacks available. Eggs, cheeses, cold cuts, pork scratchings, sausages, whatever. Kick the rest out of the pantry. Those won't raise your blood sugars and you'll still feel some satisfaction.

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Thanks, kicking my own bum is something of a special skill, but I'm working through it I've not started the meds yet, I've decided to hold off until I've spoken to my GP (hopefully Monday) to get a better idea of the thinking behind it.

VashtiB said:

Hello and welcome,

Another fat girl with high anxiety. First I agree with everyone ditch the self blame. I have always eaten both more 'healthily' and many many less calories than my super skinny husband. I put on weight and am diabetic -he is not. So yes for us type 2s eating too many carbs for your body will mean that you put on weight- the trick is that for us type 2s the level of carbs that our body can tolerate is much less than people without this condition. In my personal opinion this is before you could possibly know as your levels will be within the normal range. secondly the usual 'healthy' diet doesn't suit most type 2s so following that advice doesn't mean you wouldn't have developed this condition anyway.

Sorry- a bit of a rant but I really understand the shame. Intellectually I get this but emotionally I still struggle- very few people know about my diagnosis. The world has many people who consider it a completely self induced condition.

You have come to the best place in the world for us- I have followed the advice here lost over 30 kgs so far- more to lose- not counted calories- just carbs. My blood sugars are in the normal range. Also I have 'met' some great people on this site. Truely inspiring people and I'm sure you will 'met' them also if you stick around.

Keep posting and asking questions and venting when necessary- this is an amazing place that will give you the additional support you need from other people in your position. My husband is super supportive too but this site has been a life saver.

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Thank you! Learning not to beat myself up over this is one of the hardest parts so far. Aside from giving up potatoes. I do have plenty of fat friends who have perfectly normal blood sugar levels which is comforting and frustrating in equal measures. But still, I feel like finding this place and all the kind people here is a huge help. Where better to get advice than from people actually living and thriving with the condition? I'm very determined to not let this beat me.