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Type 2 is back


Again @Walter Wolf, I feel privileged to read your clear thoughts and feelings on this issue (a big issue for all who get so diagnosed - how to treat this type two? How to live with it? How to live as happily as possible?).

I think to some degree, one goes through stages like the stages of grief when you get some huge health diagnosis like diabetes. And we all have our ways of dealing with that.

I hope you continue to feedback to us how the medications route goes for you, as it is an important route, and important for interested parties like those of us on these forums to hear about it from a clear communicator like you.

Just some more titbits before I leap off into my day: Dr Jason Fung does some great analysis of pharmaceutical treatments, giving overviews of the studies and results - and you could just ignore the 'lifestyle changes' (ie diet) he talks about a lot and many of us here tune in on at his 'intensive dietary management' website. Just pay attention to what he says on the pharmaceuticals! He's such a thorough researcher and straight talker you could trust him.

Also, have a panel of endocrinologists behind you. When it comes to diabetes heath professionals my experience of endos is that they are hugely into a pharmaceutical response to type two. I've been taught how to handle syringes, for instance, from a fabulous endo I was in contact with early on after I was diagnosed. As far as I understand - the end point of the pharmaceutical route is injecting insulin.

If you were my son I would be concerned that were accepting a future where subsequent nerve and organ damage was in your sights, but I might think this because those possible outcomes are horrifying to me. (You should be thankful I am not your mother because I fear I would be on your doorstep offering to move in and be your personal cook! A low carb one of course, lol.) (My own actual adult son would be chuckling - as he moved to the opposite end of the country to avoid exactly this! )

With personalised medical care, (I guess I am thinking of you paying for the extra care), with various medical teams behind you, you can offset the worst possible medical outcomes, I imagine.



 
The only other thing I feel confident to talk about is the metformin. When the doctor prescribed it to me. The normal variety not the slow release he started me low. One 500mg a day for a week, then two a day for three weeks, now up to three and maybe because of that I've been lucky as I've had no side effects I know of, certainly no toilet problems. I have noticed, I think it's worked as an appetite suppresent for me as I'm not feeling as hungry as I used to, maybe that's the less sugar I'm stuffing down, I still get a little confused with all this low Carb counting but I must admit since I've cut all the rubbish down, and it's only been a month I've lost 5-6kg and feel so much better. Obviously I've been alot more active also which helps.
 

If you are able to overcome your fear of fasting and fats...then you may find liberation...

And I suspect Germany is a great place for roast meat...which pretty much flatline my glucose levels...even the vegans agrees...no miserable diet for me here...


 
Walter Wolf said:
Too much. About 110kg.
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I think you are feeling overwhelmed by it all.
So
What foods do you enjoy and feel you cannot drop from your diet?
I assure you, you can have everything.
I eat reheated fresh mashed potato, leek sheets as lasagna sheets and protein bread for fried egg on toast x2 by cutting of crusts.
Do you like any vegtables?
I part boil my frozen veg then wok the life out of them to give them the flavour I fancy.
Do you like cheeses? What's your favourite?
 

Haha, I really loved that part though! That's what I first read while going through this blog. Also, I'm still confused about the red meat thing. I read this https://harvardmagazine.com/2012/01/a-diabetes-link-to-meat and this another blog by WHO
http://www.searo.who.int/india/topics/diabetes_mellitus/en/
even they talk about red meat increasing the risk of diabetes. I'm not sure about this though, but I hope that you got some help just like I did and maybe it'll help others too. My initial HbA1C was 62 and now it is down to 49 in nearly two months. I hope you are doing fine too!
 
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Hello @Walter Wolf - some great posts in this thread which I hope will give you some reassurance and ideas when the time is right for you. Just an idea - a couple of other Forum members have posted about great low-carb cafes/restaurants in Germany (apologies, I can't remember who or where the places were, Berlin perhaps?): could you track one down and suggest to your friends that you all have a meal there? My group of friends take it in turns to suggest eating places, including new and different ones, like a vegan restaurant (not the greatest of successes for my carnivore friends!) and it's a good way of trying them out. That way you are still eating out and enjoying that social aspect and it might be a way of easing the way into LCHF, without you having to cook.

I am glad you have come here to put down your thoughts and feelings. I can understand your views on diet too: many of us here, me included, have been on diets for years with not much success (sticking to the HCLF stuff) and it can seem like "not again, I just can't do 'dieting' again". I know that feeling: I was fine after diagnosis (just got on with it) but had a huge wobble recently when my third hbA1c came back the same as the one three months before. Stuff the whole thing was my knee-jerk reaction - what's the point if nothing's moving (my bp and cholesterol are fine though and always have been) and everyone else's bg is on a vertical line down. It was coming here and reading @Brunneria's similar problem of sticking in the 40s that got me back on track. All my waffle is saying is that your reaction is not unusual, and hopefully us Forum members will be able to help you. When you are ready - you have to work through these feelings. Best wishes.
 

Just be careful about fruit. The fructose in fruit goes straight to the liver and is stored there as fat. As most T2s have a problem with Fatty Liver it would be wise to seriously cut back or even cut out fruit from the diet until the liver empties its stores of fat then reintroduce a small quantity whilst testing your tolerance by using your meter.
 
Yes, I understand your point of view. I was diagnosed last August and can honestly say that I felt far, far better in myself at that time then I ever have since. Many folk recommend the low carb or keto diet and report feeling brighter, sharper and full of energy. Not me. Tired, constant colds an sinusitis and brain fog here. I still do the low carb though, to keep my blood sugars down.

Here are the reasons in no particular order:
On metformin I was just ready to give up living altogether.
On gliclazide I knew I would eventually have to move on to insulin (I'm 46 and the nurse informed me the Gliclazide would eventually burn my pancreas out).
On insulin I would have to carb count, so I may as well carb count now. On insulin there is a very real risk of stuffing up the dose and ending up in hospital.
Without the meds, I am left with one option: diet control.
I want to stick around to see my five year old hit at least 18 years.

I just wanted to let you know that it isn't all happy days on the lchf, and I know how lousy it can make you feel. I do a lot of intermittent fasting because I look at the meal for that day, or the possibilities of eating out and think to myself, "nah, I'm not that hungry". I wish I could be as active and energetic as I was last year. That part of my life has gone, and there is naff all I can do about it.

Sending sympathy, empathy, and a solidarity low five yor way. I truly hope you find the right meds, or diet/med combination to get your life on track.
 
I kind of look at Food that I eat now as the food that I wanted but was always to afraid to eat it. Fatty meat full-fat cheese full-fat butter and so on. I think that most people who are on a low-fat diet would love to eat those things but like I was, and that is too afraid because of what the stance was on high-fat foods. Red meat and bacon were classed as giving people cancer..anything full-fat was going to cause problems etc..I do miss my grains, pasta potatoes etc, but it is what it is..but at least I am learning not to feel guilty eating the things that I was afraid to eat
 

I think you are absolutely right to not be sure about some of the media headlines, and science/medical journal hypotheses about meat eating adding to diabetes risk, and cancer risk. Even from WHO.

But dealing with that first - my partner and I spent a whole day following the 'meat-eating is dangerous for humans' trail once, including the WHO material, and we ended up with the fact that WHO says, if memory serves right, that they can't rule out that meat eating is bad for us, not that the evidence says it is. That's quite a different statement than it is bad for us! And the risk for illness was attached to processed meat, that there is little evidence that red meat was able to be singled out in any meaningful way from a host of other nutritional aspects of the studied people's diet, and, when they came up with a risk it was relative risk, not absolute risk, and the relative risk of processed meat and red meat eating was 1% increase for cancer. And the evidence is associative. Hence the statement about not being able to say it's safe, and not ruling out it is unsafe.

This is a good link about the difference between absolute and relative risk -

http://scienceblog.cancerresearchuk...-relative-risk-making-sense-of-media-stories/

And, I went through the 'egg thing' from beginning to end. So I am VERY suspicious of a 'red meat thing' now. Our species has been eating meat as long as we have been a species, is my understanding. As with eggs. We got through the last ice age by eating meat and fish, when horticulture was under snow and ice or at best difficult conditions, is my understanding. For healthy folk, I just don't see how meat and seafood could be dangerous for us to eat - we have the teeth and guts to do so. It's wonderfully nutritious. Filling. And tasty to boot. (And, oh, I wish I had thought that through regarding eggs back in 1978! What a waste of possible perfectly good breakfasts! That would not have genuinely raised my risk for the eventual rooting my pancreas and liver!)

And do we know anyone who got type two from an excess of red meat and seafood? I would put my life on the line to say it was excess sugar and sugary drinks and processed food that did it to me, and not steak and salmon. How about you?

But, once we have diabetes, I have come across some (complex) fatty acid info in combo with high blood glucose that causes us problems. I as yet don't really understand it, but have been trying to. It's a work in progress. (There is also info about eggs doing the same to us.)

Until I really understand, I use the good old 'eat and meter' method - and I have yet to find meat and seafood giving me blood glucose spikes. (I wish I could say the same thing about my favourite Atkins 'no sugar' bar, which spikes me to bits but I so wish it didn't!)

Some people do well with protein and fats from dead fish and animals, as diabetics, many people too do well with no animal products and lots of legumes and vegetables. I strongly suspect individual/ethnic genetics and body type stuff has a lot to do with it. I bring up the new evidence that many people have an extra 'vegetarian alelle' that allows them to get nutrients better from plant matter. Some people just do great on a roast, and treat salad as s condiment. The key for us diabetics is to find out what works for us individually, or ethically.
 
Thank you everyone for your responses.

I have got over the initial anger now and am definitely going to look much more deeply into the pharmaceutical treatments.

One decision I have made is that I am going to fire my GP, as soon as I have the full detailed laboratory results on Monday. He is very much the type who gives stock answers to everything and just wants you out through the door as quickly as possible.

To give you an example, today I asked him about the appetite suppressing effect of metformin and mentioned that I had felt no wish to eat a single thing for the last 5 days. His reply to this was, "Good".

I also asked him about the slow release form of metformin and he didn't even seem to know it existed. His reply was that the metformin he prescribed was the only form of metformin there is and that it is the best drug for diabetes. Essentially his attitude is, "Take these and get out of my office".

As regards the side effects, he said it was not a concern as it would pass eventually. I tried to explain that I work at a busy customer facing counter and simply couldn't be dealing with raging diarrhoea. His response was, "You can work with diabetes". I had to stop myself from saying, "What, with a waste paper basket duct taped to my bum?"

Quite frankly, I am beginning to wonder if this idiot is even a doctor.

In the end, I just called my boss and switched my shifts up to and including today. I'm back to work on a 6-hour morning shift tomorrow.

I have, on my own initiative, halved my dose of metformin and the side effects (or rather, bottom effects) seems to be abating.

I am currently searching for a private specialist to pursue the pharmaceutical angle. I am fortunate enough to be able to afford this, so I may as well make use of that.

As regards the dieting, it is not what I can or can't eat, it is the constant monitoring. I am well aware that there are many nice things I can eat on a low-carb diet.

I just can't handle constantly having it on my mind - I can't handle the "Can I eat this? How many grams is that? Is there anything else? Where can I find a low-carb _______?" If I start thinking like that, then this illness will take over what's left of my life. I don't want that. I want my life back.

The pharmaceutical treatments are what I am focusing on now. I don't care how many pills I have to pop (as long as the bottom effects can be controlled) or even how much I have to pay the specialists. I just need to get back on my feet.
 
Thank you all again for your kind contributions. Your time and effort is much appreciated.
 
Walter Wolf said:
The pharmaceutical treatments are what I am focusing on now. I don't care how many pills I have to pop (as long as the bottom effects can be controlled) or even how much I have to pay the specialists. I just need to get back on my feet.
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Not meaning this in a nasty way, but be aware that if you go along the pharmaceutical route without some reduction in carbohydrate you will probably end up having to take insulin via injection. And I honestly don't recommend that as an option. But there's nothing wrong with getting some decent pharmaceutical help, it just may not be enough on its own. Good luck.
 
Walter Wolf said:
Thank you all again for your kind contributions. Your time and effort is much appreciated.
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Faced with potentially life changing news/diagnosis, there is a pattern that that describes the phases people can go through - Shock -Anger-Denial-Acceptance, I believe there is also a degree of grieving for the previous care free life of being able to eat / drink whatever you want without thoughts of its effects - I went through this post diagnosis myself, why me , life is ruined, etc - but the reality of this condition is at least you have a choice - its your life and only you can decide the trade off between potential complications and perceived quality of life based on your perception of the restrictions and effort that dietary adjustments mean. You could argue that the quality of life of being free of worrying about your condition, to you, is more valuable than possibly extending your life without complications, its up to you at the end of the day-however, things may have moved on from the last time you controlled your diet, certainly the low fat approach is not necessary, and you may find you could make adjustments without feeling like the condition is totally controlling you ?. My brother is also T2 - my choice post diagnosis was LCHF and tight control of my blood glucose levels - I am happy with my life, my brother on the other hand, takes the metformin, smokes, eats pretty much what he likes - he has terrible levels, however, he his happy with his life - and I respect that - its a personal choice - all I would say is before you choose your path, at least have a look at what people on here are doing regarding dietary control and especially Intermittent Fasting - there could be ways that you could adapt without feeling like you are denying yourself the things that make you happy - at this point in time, whilst grieving for your pre-diagnosis, carefree life, you are probably not in the best frame of mind to make best choices - give yourself some time to come to terms with it - and choose what makes you happy - your life, your choice, its all a trade off in the end - good luck with whatever you do.
 

This. Absolutely, 100% this.
 
Like Ellie says, the purely pharmaceutical route will probably end up with you on insulin, and then you’ll really have to count every morsel you eat to get the dose right.

As I see it, you’re basically intolerant/allergic to carbs. You can’t process them. A few meds might ease that a bit, but that’s treating the symptoms, not the underlying cause. I’m allergic to meat, and get breathing problems if I eat any. I can alleviate that with an inhaler, but I feel pretty ropey for hours after. So it’s better for me to not eat the things I can’t handle, and not have to take meds for them, which have their own side effects. Took a bit of adjusting (I definitely went through the stages of grief @Element137 mentioned), but I’ve accepted it now. I was a pretty hardcore carnivore, but I’d rather feel well than eat things that are basically poisoning me.

But having said all that... we all have the choice to live how we see fit. We’re fortunate that we do have the medicines available for us to pretty much live as we choose. So if you feel that your life will be most enjoyable by doing the things you love, and popping the pills to make that possible, then fill your boots
 
Walter Wolf said:
Too much. About 110kg.
Click to expand...

well, we are many that weigh too much in here, but also many that even then have gotten the blood glucose down into a normal range.

I would suggest you to start only by changing the breakfast meal into a meal totally without any carbs, this is the easiest way to get rid of some of the carbs one do normally eat.

and then remember a glass of red wine or a whisky on the rocks or with zero-coke in it is not really that bad to diabetes... it is not like you could never have a drink no more ever in life.. but the days you go out with your friends for meals you could choose the drinks that do not contain carbs, and beer is no go... but a few glasses of red wine or whisky or gin and alike is okay mixed with zero-coke and other diet drinks.

if you do eat meals without carbs earlier in the day where you want to enjoy life with your friends, then you could see it as if you save carbs for the cozy time with your friends, it is not the optimal choice but it is a much better strategy than doing nothing and dissolve your health to rubbish by self-pity

here is a link to low carb breakfast suggestions :
https://blog.paleohacks.com/keto-breakfast-recipes/
https://www.dietdoctor.com/low-carb/recipes/top-keto-breakfasts
https://ketodietapp.com/Blog/category/Recipes?page=1
 
unfortunately metformin only helps like a stick to lean at, it maybe lower ones blood glucose with 1 mmol daily , and if ones is at a level of averaging 12 mmol then ones blood glucose is still far too high... when only lowered to like 11 mmol.

the normal level is under 6 mmol , pre diabetes around 6.5 mmol and fulblown diabetes is around 7.5 mmol in average and this is where most of the damage over time occure, sometimes it takes years , sometimes people do get the adding diseases only after a short while and also sometimes while only being in the prediabetic level...


https://www.dietdoctor.com/low-carb/keto/recipes/breakfasts/5-min
 
When I started eating low carb medium fat I didn't keep a food diary or weigh food - the only monitoring I did was to test my BS to see what effect the food I was eating had on me and if my BS went too high I wouldn't eat it again or have it in smaller portions and if I stayed within range I would eat it again. I don't go very low carb and still enjoy most foods inc bread and potatoes in moderation and my hba1c has been between 35 and 38 (currently 35) for the last 4 years. Although you may think it's a pain for the first few months you will soon learn what you can and cannot eat - you may be surprised. I also don't worry too much if, once in a while, I have to eat more carbs than I usually do because nothing else is available - this is one advantage of being diet only but I'm not sure if you would have that flexibility on insulin as I think you will still need to count carbs so you may not gain the freedom that you think you will. Ultimately it's your decision but I rarely test now and still have control of my diabetes. In addition I rarely test now but it is a useful guide to see how the BS levels are doing. Good luck in your choice but consider tryng diet first - I'm sure even you can make scrambed eggs in the microwave and fry some bacon!
 
Just a quick update.

For the last few days, I have halved the dose of metformin to 500mg, twice a day. The side effects have abated, so I am going back to work tomorrow and continue with the 500mg until the weekend. Once I am not working for a couple of days, I will try to go back to the full 1,000mg dose.

I got the results back from the lab today and my HbA1c is 11.3. I have been put on a 10mg daily dose of Jardiance (empagliflozin) for the next 14 days. This will likely increase after then.

Once the Jardiance starts to reduce my levels, I should get my energy back and be able to start going out for my long walks again (which I enjoy and intend to increase).

Generally, I am feeling much more positively about things and am ready to resume my life.

Hopefully, a combination of the medication and exercise will bring my symptoms under control and allow me to gef back to being the person I used to be.
 
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