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Surprise diebetes diagnosis

Hello @KennyA

This is my 8th day into this problem, and yes I have reduced the things the contain high Carbs. With my doctor, over the phone, I have also adjusted my insulin 3 times, to initally bring BG down to an acceptable level. I have read a lot about Type 2 diabetes, and become aware of what I need to do to try to control the illness. This site has pointed me to helpful information, and I will continue to ask questions hoping to understand a little about diabetes.
Royjk
 
That would apply if a pancreas is damaged to the point of no longer producing any insulin, whatever the cause of the damage. Normally such people are not diagnosed as T2. One of the issues is that the media generally do not understand diabetes at all and are both confused and confusing in what they report.

As has been said earlier, T2 is typically not in this "pancreas not working" area - the pancreas is working and is producing plenty of insulin, but the naturally produced high levels of insulin are not having effect. The issue here is in the receptor cells becoming insulin resistant. You can approach this in a couple of ways - add additional insulin, or reduce the glucose load to the level that the natural insulin can manage, and by doing so reduce the level of insulin resistance at the same time.

As far as I know no-one is making claims that a low carb diet somehow "regenerates" a pancreas. The low carb diet - what was called "cutting starches and sugars" up to the 1980s, is one effective means of reducing the glucose load the system has to deal with.
 
Hello @JoKalsbeek

At the moment I just need to bring things into some form of control, to bring my BG within a range of 4 - 8 mmol/l. Although I have changed my diet, with minimal carbs, and adjusted my insulin a few times I am still not hitting my BG target. So as you say short term 'do insulin', but when I have things under control, I can look to reduce my need for insulin, by understanding aspects of the illness. I need a greater understanding of the glycemic index, to be able to choose good food and adjust amounts of food on the plate.
You are correct that steroids are not optional for some people, believe me there are worse things than diabetes in the world, thats why it has never been high on my to do list. But I think it may be possible to get diabetes under control, and it is time to spend some energy looking for answers.
I plan to do the pancreatic blood tests sometime in the first or second week of January, that will eliminate the spectre of serious pancreas problems. All I know at the moment is what my doctor told me.
Funny thing I was watching a podcast by your Dr Fung, he seemed quite clued up on diabetes, I also started to read his book, and looked at some of his recipes in his cook book.
Thanks for the support.
Royjk
 
You're doing a deep dive into this, so I have a feeling before too long, you'll be teaching your specialist a thing or two.

And yes, there's worse things than diabetes. I always found the T2 to be easier to manage than my other issues, it's the only one I got licked. I wish I could get the rest of it under my thumb as relatively easily. Not something I thought I'd say, when diagnosed 8 years ago or so... But it's the truth. It does need dealing with though, as best as one can. You hang in there, keep reading, keep learning, keep podcasting, and keep throwing questions out there. There's no one-size-fits-all, so the more you can tailor things to your own specific needs, the better. And if you ever feel like having the forum go over your current diet, just list everything you would normally eat and drink in a day. Could well be there's no hidden carbs to be found, but then you also know it's due to the steroids and/or other conditions like chronic inflammation driving things up. It's good to know sometimes, that you're doing everything that is humanly possible, and that some things are simply out of your hands.
Good going, in any case, taking the bull by the horns like this.
Jo
 
Big fan of Dr Jason Fung - "The diabetes code" was, I think, the first book about any of this that I read.
Extremely good for common sense understanding of what IR is.

There are others who will lay out the case that, IR is actually the root of all ills (literally) - in other words only one route from IR leads to T2DM, and there are others - but even if you don't buy that completely, it follows that doing anything to control insulin will help in other areas to.

The arguments around "is it damage to the pancreas" kind of stem from an experiment into the fundamental nature of diabetes in 1889 - when the pancreas was removed from a group of lab dogs - who all went on immediately to develop severe (what was only becoming understood to be T2) diabetes - for a while then, you can understand that this, somewhat random, discovery drove the idea that pancreatic damage was a fundamental feature of some types of diabetes.

We know that to be true, of course, but for much smaller numbers - the issue is that the idea that "it must be damage to the pancreas" still lingers, when there is much better scientific evidence that was beyond medicine in 1889 that relates to insulin signalling (the way that insulin actually works to tell cells that they should or should not take in glucose molecules). There isn't any evidence I've seen to indicate that a pancreas cannot recover (indeed, as stated, in most cases of IR, the pancreas is doing more work than a "healthy" pancreas) - there is evidence that some of the effects of IR can kind of go beyond a tipping point which makes reversal much more difficult.. but I definitely do not understand enough (yet) to begin to explain that...
 
Hello @ChasingRemission

Sounds like you have got the carb reduction well under way, and with not doing meat you may have a good initial start to you diabetes control. I checked my pending blood tests they are for C-peptide, and antibodies. Is an antibody test a GAD test?
So like you I have not done bread potatoes and sugar for the week, but I think I may be eating too much, I may go to the shop and buy some smaller plates. I am trying to include lemon and lime juice with my meals because the internet said that could be good.
I think it will be chips that I will miss most even though I can up the insulin to take care of higher carbs, But I put the chip pan into a box, with all my old junk food. Bish bosh all done.
Royjk
 
I would press for the other 3 forms of the autoantibodies. GADA antibodies are the most common, but not everyone produces GADA autoantibodies , there are three other types IAA, ZnT8Ab and ICA. GAD autoantibodies are by far the most common.

As for one’s pancreas, my personal view is that everyone’s pancreas‘ cell mass is different. By that I mean we are not all born with the same beta cell mass. As we age and develop fatty tissues this can cause challenges for the pancreas, the development of IR, along with reduced muscle mass, carby diets and so forth.
 
Unless you happen to digest carbs exactly as the panel who tested the foods given a GI value, you will find that the GI value is just a rough guide and that you need to keep a food diary in order to work out which foods in which quantities are OK for you and which raise your BG by too much.

Unfortunately, both GI and Glycaemic Load (GL) can be deceptive because they depend upon the digestion (i.e. enzymes, acidity, microbes of the person doing the consuming as well as the particular natural sugar/carb content of the food (depends upon variety, freshness, if fats were eaten at the same time, if it is eaten on empty or full stomach etc etc.
 
Hello @ianf0ster

Yes I belive that you are correct, I have looked at some GI charts and have see that some are AI based and others are a life's work collating as many items as possible. I see their use in choosing better alternatives, a simple example would be carrots and parsnips. I will chose carrots based on the chart, and avoid parsnips or have very small portions because of higher carbs.
So far my food diary is only 5 days, and what I have tried to do is swap out the high carbs.
Rolls, doughnuts, chips, pepsi, sugar in my tea etc. I am just on the first week of this.
Royjk
 
Just over 6 months into my diagnosis. I've dropped from an HbA1c of 105 at diagnosis to 50 this week. Still not at my target level, but an improvement.

I've found Metformin to be fine for me (750mg slow-release at morning and evening). I found that using as many free trials of the Lifestyle Libre and Dexcom to see what elevates my blood sugars. Not really any big surprises. I don't eat anything between 8pm and 8am most of the time. I rarely have bread, cut-down on soft fruit, cut-out chewy sweets, fruit juice, minimise wheat. I've cut-loose on a few occasions. Really endeavour to improve again .
 
Hello @ChasingRemission, that sounds good dropping HbA1c in the six months, it seems to take time to get to target levels. I also have now done six months of treatment, I have not yet done the CGM thing yet but my doctor has suggested that I give it a try in a couple of weeks time. Did you find anything interesting with the Libre that I can look for, or was it all about the bread and sweets. Anyway keep up the good work, and keep taking the tablets.
Royjk
 
Are you finding the Freestyle Libre fascinating as I do? I feel really grateful to have been given the 2 weeks on it.
I'd like to continue so I can see my patterns better.
 
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