T2 - am I correct these are my two options?

[Member496333]

No not in the slightest..
When I was first diagnosed by FBG's were in the 7's and 8's for the first 3-4 months. You have been following low carb for less than 2 months and have had FBG"s in the 4's and 5's which is absolutely amazing.
Starving yourself however will not help with blood sugar or weight loss.
Not sure how much weight you have to lose but you need to build a sustainable regime that you can follow for months.
Your slightly higher FBG's could well be down to the body releasing the stored sugar and burning it off so should be applauded not dreaded.
Intermittent fasting and ultra low carb was my chosen path but it took months to get anywhere near the levels of FBG you have already achieved.

Bingo.

I believe that @Adm_Mad is doing a sterling job and it can only get better from here.

 

[Cocosilk]

I was diagnosed T2 in April, and my GP gave me three months to try and manage with diet and exercise alone. So, so far I am not on medication or insulin.

My starting HBA1C was 9.3 and the confirmation fasting finger prick test my GP did was 12 point something. I immediately cut carbs and started to lose weight as fast as I could, and by the start of May had got my predicted HBA1C (via the MySugr app which it stresses is just an estimate based on your daily readings) down to 5.1, taking between 4-8 finger prick tests a day averaging 4's and 5s, with a few 3's.

HOWEVER... that was just the first few weeks. In the last few weeks, i.e. most of May, my fasting readings have been creeping up into the 6's and 7's, with some others spiking into 8's and some post-prandials also spiking into 8's. I have NOT changed anything, haven't gotten slack and started eating more carbs, eating more calories, or exercising less. My predicted HBA1C has now risen to 5.2% and I'm guessing 5.3% isn't far off.

(Side note: is it possible to not have eaten enough but your blood sugar not be low enough to hypo? Because my weekly calorie deficit is in the thousands, and I'm hungry and tired all the time, but my blood glucose levels have never dipped low enough to hypo.)

The only times I've been able to get my fasting blood glucose back down into a 5 is when I eat nothing for at least 36 hours. The best I achieved was yesterday morning when I got a 4.5 in the morning, after having not eaten for 54 hours. I managed to stay not eating for some of the day but kept getting dizzy spells and seeing spots in front of my eyes, and I caved and ate an avocado, a 10 g cube of Parmesan and a hard boiled egg at 4 p.m. and my pre and post-prandial readings shot from 4.4 to 7.0, I ate nothing else for the rest of the day, and my reading this morning was 7.2.

Edit to clarify: this spike from 4.4 to 7.0 has been the only time this month that the spike itself has been so big. The rest of the time my post-prandial levels have been in the high 7's and 8's only because my pre-prandial has been higher, because my fasting level seems to have inexorably risen.

Am I correct that with these kind of readings it's likely that I am simply not able to manage to control my diabetes with diet alone, and that I will have to start medication? Because I have to be totally honest and say that feels like the beginning of the end, as decline into disability and early death (however many years it takes) seems to start with requiring medication.

I have been steadily losing weight due to my calorie deficit, and am close to my first goal weight of 64 kg, starting from 73.

So am I correct that these are my two options:

1. Go on medication and eat closer to the number of calories I should be getting.

2. Try to manage with diet alone but be eating way less than I should be.

I am still very stressed and depressed about my diagnosis, which I know probably isn't helping my levels. I know there isn't really a solution to depression apart from trying to not be depressed.

This may help you understand what your body is up to https://www.dietdoctor.com/low-carb/fasting-blood-glucose-higher

 

[ert]

You have reversed your diabetes with an HBa1c of 5.3%. Huge congratulations. It's an enormous achievement and so soon after diagnosis. Intermittent fasting, which I'm doing too, spikes your waking blood sugars. Dr Jason Fung supports fasting for T2DM's and suggests ignoring the morning spikes as your sugars are only elevated a couple of hours with the dawn phenomenon. I recommend his books.

 

[HSSS]

Am I correct in thinking you’ve lost 9kg in a month? And that you are now 64kg. How tall and what sort of age are you? It doesn’t sound to me like further weight loss is desperate. It can be taken at a much more reasonable rate. And correct that your current regime is making you feel terrible? Ever considered that you may be doing more damage than your diabetes is in the short term at least? Your muscles will likely be being ‘eaten’ for fuel and your metabolism slowed meaning it’ll get harder and harder to lose any weight you may still need to lose. Are you eating fats as well as low carb? You’ve got great predicted hb1ac. Your fingerpricks are slightly confusing but as several,other have listed there are a number of possible explainations, none of which will be solved by starvation.

Please make sure you tell your dr exactly what you’re doing eating wise and weight wise. It has a bearing on your mental health the appointment is about.

The 3 months is to see improvement not full remission. A 9kg loss is a big change as are your estimated hb1ac. Perhaps ask for more blood tests now for peace of mind and to convince you that it’s going in the right direction, as well as GAD and c peptide to rule out (or confirm) LADA.

At the end of the 3 months no one can force you onto meds for diabetes and likely won’t even try if you’ve improved. More likely congratulate you and give you more time if needed or further testing then maybe.

 

[Adm_Mad]

I’m currently at 66 kg so still have two to go to my first goal weight, then I’ll see if I’m able to keep managing my blood sugar levels without having to lose any more. I’m 35 and 165 cm so not exactly wasting away. My first goal weight will still be at the high end of the normal range.

At this point I feel there’s not much I can do but carry on like I have been and see if my fasting level keeps creeping up or whether it drops back down again or does anything different.

 

[HSSS]

I’m currently at 66 kg so still have two to go to my first goal weight, then I’ll see if I’m able to keep managing my blood sugar levels without having to lose any more. I’m 35 and 165 cm so not exactly wasting away. My first goal weight will still be at the high end of the normal range.

At this point I feel there’s not much I can do but carry on like I have been and see if my fasting level keeps creeping up or whether it drops back down again or does anything different.

I’m not meaning to be rude here but have you read all comments above? And really thought about them? There’s plenty of other options to consider beyond carryon on with the extreme approach you’ve had so far. Talk to your dr, she sounded one of the good ones, and good luck.

 

[Tophat1900]

I’m currently at 66 kg so still have two to go to my first goal weight, then I’ll see if I’m able to keep managing my blood sugar levels without having to lose any more. I’m 35 and 165 cm so not exactly wasting away. My first goal weight will still be at the high end of the normal range.

At this point I feel there’s not much I can do but carry on like I have been and see if my fasting level keeps creeping up or whether it drops back down again or does anything different.

To me it seems you are obsessed with FBG levels and basing all health related decisions on it. Diet, how much, how often you eat etc.

If carrying on like you have been means starving yourself to the point of being so deficient in food and fasting for very long periods to the point of feeling dizzy and seeing spots. Feeling tired and hungry all the time, then I think you need to rethink that decision.

Your body is clearly not happy with this. You are tired because you don't eat enough to generate the energy needed to keep organs healthy and get through the day. You are hungry for obvious reasons, your body is trying to tell you to feed it, but you are refusing to do so because you seem so obsessed with numbers.

If you lose more weight it will most likely be due to muscle wastage from a lack of protein intake. Your organs will start to struggle if they don't get the needed nutrients.

It just seems to me you are unable to see this. I hope your appt goes well and you do get back to eating in a sensible manner, life doesn't revolve around your FBG level. You are really risking damaging your health. People are trying to tell you that and I'm not trying to be rude about it.

Good luck.

 

[1spuds]

Like I say, I know that thinking calories aren't totally irrelevant to absolutely everybody is not a popular opinion on this forum, so I'm happy to agree to disagree.

I would steady up the diet.First thing I would do.You are all over the place and your bodily reactions are scary to me,I worry that isnt helping you by not having consistency in nutrition.

Homeostasis-'A property of cells, tissues, and organisms that allows the maintenance and regulation of the stability and constancy needed to function properly.'
https://www.medicinenet.com/script/main/art.asp?articlekey=88522

I break issues into units....diet,weight loss,Im a do one at a time kinda guy so I dont ask too much at once,and I dont overextend myself to the point of being overwhelmed.Think marathon,not a sprint

Hope the Dr appt. gives you more information to make this work.I believe in you,I do,now you need to believe in you too.

YOU CAN DO THIS,I really believe that.Dont give up.

 

[1spuds]

If carrying on like you have been means starving yourself to the point of being so deficient in food and fasting for very long periods to the point of feeling dizzy and seeing spots. Feeling tired and hungry all the time, then I think you need to rethink that decision.

THE most important point being made on this thread IMO is right there in the passage above.

 

[DCUKMod]

@Adm_Mad - I have read your thread and agree you seem very focused on weight loss and fasting blood sugars. In my world, fasting is only a timy part of my day, and may not reflect the rest of how my body is performing.

On another front, when I was diagnosed and reduced my carbs, I lost weight, even though that was never a goal for me. Now, that's not to rub salt in the woounds of anyone finding it hard to lose, but what did then happen was I found it quite tricky to find a balance where my bloods behaved and I stopped losing weight. As a result, I am very slight indeed, and skirt around the bottom of the healthy BMI range.

So, I think what I'm trying to say is that having, at your current weight got yourself into the Healthy weight range, why not try to maintain your weight? That will take some dietary adjustment and likely it will take a few weeks to get that balance right.

That way, if your weight is more stabilised, you could be in a better position for making longer terms strategies for managing your prediabetes.

That's my 2p worth.

 

[Resurgam]

You do realise - I hope - that your weight has got nothing to do with getting 'good' blood glucose levels?

 

[MEValentijn]

It's not uncommon for fasting blood sugar to be higher than it should in diabetics who otherwise have excellent control, and it's often not really a problem. It's just how some bodies react to waking up. Pre-meal readings before lunch and dinner, when I haven't eaten for several hours, have always been far more indicative of the quality of control for me.

In my case, I was just testing fasting for months and assumed everything was the same as usual because fasting levels didn't really change and I was taking the same meds and eating the same foods. Then I got much higher HbA1c results at a checkup, so I tested the rest of the day, and my other values during the day had gotten much worse.

I'm pretty sure guidelines here in the Netherlands even tell doctors to disregard elevated fasting levels in diabetics if HbA1c is telling a different story.

Basically - fasting blood sugar is being strongly influenced by variables other than your diet, exercise, weight, meds, etc, and can't be relied upon to show you the full picture. Test at other times of day, and wait to see what your real HbA1c says before assuming that your blood sugar isn't suitably controlled.

And take care of yourself. No making yourself sick with starvation.

 

[Arfie]

Hi,

I'm newly diagnosed T2 and constantly confused over what I can and can't eat etc. My other half had a mini stroke a few months back and has hypertension so this confuses us even more about who can eat what.

I've always feared diabetes as I have a sweet tooth and a fear of needles, but sadly I ate with impunity so here we are.

Firstly you seem obsessed with avoiding the meds, I understand this fully, BUT I am on them, why? because they are helping me control sugar while I lose weight and adjust to my new normal lifestyle. Going on meds isn't a life sentence, there's enough people on here managed to come off withing a year or less to back that up. If you can manage without the meds, then great but fearing them to the point that you are making yourself physically (dizziness, vision problems) and mentally ill is not good AND stress can increase your BS and BP and other nasty side effects.

I had around 30KG to lose just to get DOWN to overweight, in 3 weeks I've lost 6.4KG with a small amount of exercise and a mainly low carb diet, I also set myself a target by the end of this month and have 1.7KG to go, but it wont hurt if I miss it.

Eating full fat greek yoghurt (add a few blueberries or strawberries for flavour) rather than low fat normal fills me up for longer with less, hard boiled eggs are the snack of the gods, in fact I'm getting by with this for breakfast and lunch without feeling hungry. Overall a much lower calorie count than ever before in my life, but still leaving me full and able to jump on the bike for 20/30 minutes.

What you are doing now has stopped working, why not try something different? Give eating a go, you dont HAVE to add butter to your coffee or eat lard, but dont stress over it. The stress will kill you faster than the blood sugar (or meds) can!

Arfie

 

[Daphne917]

@Goonergal Like I say, I know that thinking calories aren't totally irrelevant to absolutely everybody is not a popular opinion on this forum, so I'm happy to agree to disagree.

@Adm_Mad calories are important to a certain extent however you can have too few as well as too many. When I was younger I went on a vlc diet and lost very little weight in 3 months (about 7 lbs) despite being overweight. However I felt so ill that I went to the Dr who told me to go home and have a good meal as my metabolism had gone into starvation mode and was trying to preserve my vital organs by shutting down the rest of it. He also sent me to an endocrinologist who confirmed his diagnosis and I was told to ensure that I always ate enough calories but eat healthily which I did (or thought I did until T2 made me rethink the theory that low fat etc was the way to go!). Although he softened the blow by telling me I was one of his few patients who could honestly blame their metabolism for their weight it still meant that I had little chance of losing weight. My thyroid was also yo-yoing between too high and too low which didn’t help and that finally sorted itself out 8 years ago when it was definitely confirmed as being under active. I am still over weight although the thyroid medication and lower carb diet has helped me lose approx 3 stone albeit very slowly but over the years I have accepted that my metabolism will never let me be a size 12 but I will be healthy and my weight is still dropping by about 1lb per week

 

[Viv19]

@adm-Mad
Be kind to yourself. I was told In February that I had tipped over from pre-diabetes to T2. Tears, fears and yelling at OH for things he hadn’t done wrong.
I’m aiming to lose quite a few kilos to try to get my T2 into remission but I’ve discovered that slowly is the best word. I’m nearly 9 kg down, with another 6 to go to my initial goal.
Others on this thread have lost serious amounts of weight by controlling carbs and eating more (good) fat. Listen to them - although they’re (mostly) not medics, they’ve all had a lot of experience and done loads of research to work out what works for them personally. It sounds as though you’re trying to reach your goals in an unrealistic time scale. Check your bg levels by all means so that you know if there’s something you are eating that has an unexpected effect on your levels.
You can do it, but do it more slowly. Eat healthy food, have a glass once in a while, take some exercise and relax. You will get there. It isn’t necessary to beat yourself up about it. Good luck.