Type 2 When does diabetes get worse?

[chiefsub68]

Hello, I was 53 when my T2 was diagnosed nine years ago. Since then my HbA1C has gone up and down – 45, 43, 41, 46,45, 51, 52, 57 (ouch), 50, 68 (ouch) and most recently back to 58. I initially controlled my diabetes by diet and exercise but I am now on 2 x Metformin, diet and exercise.

My question is this: when do people's harsher symptoms kick in, and do they do so comparatively quickly? So far, touch wood, all my sight, feet, and kidney tests have been fine. Thanks in advance. Will

 

[AshrafUM920]

Hello, I was 53 when my T2 was diagnosed nine years ago. Since then my HbA1C has gone up and down – 45, 43, 41, 46,45, 51, 52, 57 (ouch), 50, 68 (ouch) and most recently back to 58. I initially controlled my diabetes by diet and exercise but I am now on 2 x Metformin, diet and exercise.

My question is this: when do people's harsher symptoms kick in, and do they do so comparatively quickly? So far, touch wood, all my sight, feet, and kidney tests have been fine. Thanks in advance. Will

It depends on how well diabetes is controlled. - i know people who are T1/T2 with complications - amputee or blind and on dialysis because of bad control... looking at your hba1c.. it isn't bad you can improve my last few have been in the 80s and mid- 70s. and my most recent hba1c was 76. i have a few problems which i am just living with feet and eyes but my main focus is to keep my levels down.. the higher and longer the blood sugar is up the more damage it will do.

focus on getting better and probably not wonder when things get bad.... DIABETES is a "silent killer" so if you're not keeping your levels in control you will sooner or later have complications - but time will tell. unfortunately for me i am starting to have circulation issues now as well have eye retinopathy and feet issues. but i have to keep focused it can get worse.

 

[Lamont D]

Hello, I was 53 when my T2 was diagnosed nine years ago. Since then my HbA1C has gone up and down – 45, 43, 41, 46,45, 51, 52, 57 (ouch), 50, 68 (ouch) and most recently back to 58. I initially controlled my diabetes by diet and exercise but I am now on 2 x Metformin, diet and exercise.

My question is this: when do people's harsher symptoms kick in, and do they do so comparatively quickly? So far, touch wood, all my sight, feet, and kidney tests have been fine. Thanks in advance. Will

The good news, is it can be slowed down.
The bad news, is you need to control your blood glucose levels.
This is done by dietary restrictions.
This means controlling your portion size.
The reduction of carbs and sugars to stop the spikes.
The increase in exercise, if you can, a little more everyday
The increase of good fats and protein.
Finding a balanced dietary intake designed for your tastes, affordability, availability, culture, work life and your social life. For you!
If your looking for really good information, Google dietdoctor.com also have a read of our low carb diet forum.
There are plenty of success stories on here.
The low carb diet does lower your hba1c levels.

Best wishes.

 

[catinahat]

Sorry Will, no one will be able to give you a detailed breakdown of when Complications will appear and at what level of HbA1c.
People have had HbA1c levels much higher than yours without any symptoms or complications. Others however have experienced symptoms and complications at levels less than yours.
We are all individuals, if your diabetes progresses or not and what complications you get(or not) is unique to you.
What is fairly clear though from your steadily rising HbA1c levels is that maybe your diet has too many carbs.
The closer we can get our hba1c to non diabetic levels, the more chance we have of avoiding unpleasant complications

 

[chrisjohnh]

Hello Will, has the gradual rise in A1c been accompanied by a gradual gain in weight or waist size also, or have they remained essentially the same?

 

[Jam&Scones]

As a mody, I’d say some of it might come down to genetics in the end, which is out of our control.

Keep doing the right things that keep your blood sugar levels under control and don’t sweat the longer term. There will always be treatments.

 

[KennyA]

Hello, I was 53 when my T2 was diagnosed nine years ago. Since then my HbA1C has gone up and down – 45, 43, 41, 46,45, 51, 52, 57 (ouch), 50, 68 (ouch) and most recently back to 58. I initially controlled my diabetes by diet and exercise but I am now on 2 x Metformin, diet and exercise.

My question is this: when do people's harsher symptoms kick in, and do they do so comparatively quickly? So far, touch wood, all my sight, feet, and kidney tests have been fine. Thanks in advance. Will

Hi, not sure there's a simple answer. For example, one of the reasons the medics chose an HbA1c level of 48 as the point where they would diagnose diabetes is that retinopathy is "rare" - ie not unknown - at levels lower than that. My experienece was to have a range of symptoms while my A1c was in the low 40s and rising: I was told on several occsions that I wasn't diabetic, despite the symptoms, because I hadn't reached the magic 48. I also know people who have much higher HbA1cs than I ever had and have had exactly no symptoms.

The good news is that once I took action, stopped eating carbs, and dropped my blood glucose, the symptoms have either gone or been massively reduced. The only thing I still have a touch of is neuropathy in my feet but this is 2% of how it was in 2015.

You've been lucky to dodge any complications. I'd suggest you look at the benefits of low-carbing as a means to bring down your blood glucose and reduce weight.

 

[MrsA2]

A professional view came from my ophthalmologist (eye surgeon). I have non-diabetic eye problems and am concerned that I may get diabetes related problems in my good eye. He said the best way to avoid this is to keep my sugars low. In his experience its high levels over some time that is the culprit. And he's seen a lot of diabetes related eye problems.
That's all the motivation I need to keep low as possible (just need to remember it!!)

 

[Robbity]

I'm over 80. and I've had T2 for just over nine years now and have eaten a low carb/ketogenic style diet since diagnosis, and not needed diabetic meds (metformin) since 2017. My HabA1c was 60-61 on diagnosis, but came down within three months to lower pre diabetic levels (see my signature) and had remained there. I have not had any complications from T2, but I do have other non diabetic health issues. I don't believe that we'll necessarily end up with complications if we're prepared to keep our diabetes under control, but genetics, etc could have an impact if we're less fortunate, but there's no way we can predict this. (And in my opinion it's the misinformation about carbohydrate requirements that is behind the belief that T2 is actually progressive. )

 

[chiefsub68]

Hello Will, has the gradual rise in A1c been accompanied by a gradual gain in weight or waist size also, or have they remained essentially the same?

Hi Chris. My weight has stayed essentially the same. When I was first diagnosed I went on a powder diet and lost a lot of weight but (as always happens with sudden weight loss) it crept back on within seven months. I'm going to cast around to see if I can get rid of the more carby parts of my diet.

 

[chrisjohnh]

Hi Chris. My weight has stayed essentially the same. When I was first diagnosed I went on a powder diet and lost a lot of weight but (as always happens with sudden weight loss) it crept back on within seven months. I'm going to cast around to see if I can get rid of the more carby parts of my diet.

My understanding is that if one’s initial weight loss has been sufficient to clear excess fat from the pancreas and so get one’s A1c down into the remission zone then allowing weight to rise by as little as 6 lbs can be sufficient to put one back into non-remission. It’s that thought that keeps me glued to the bathroom scales week after week after week, probably for ever.

 

[LairQueen]

My understanding is that if one’s initial weight loss has been sufficient to clear excess fat from the pancreas and so get one’s A1c down into the remission zone then allowing weight to rise by as little as 6 lbs can be sufficient to put one back into non-remission. It’s that thought that keeps me glued to the bathroom scales week after week after week, probably for ever.

That's really interesting. I was only diagnosed in July with an a1c of 116 (eek!) but was really strict on the low carb, lost about 14lb (not over weight for the 1st time ever!) and 3 months later having stopped the metformin about 1 month in, my a1c was 42 and my fasting finger prick tests were coming in under 6mmol/l.
Unfortunately I slacked off a bit and the weight crept back on and my fasting finger prick levels went up over 7. As I've lost the weight again, the finger prick numbers are slowly coming down again. I'm hoping that if I get to the lower weight again (and a bit more to be honest) and actually stay there this time, I can officially go in to remission.

 

[chrisjohnh]

That's really interesting. I was only diagnosed in July with an a1c of 116 (eek!) but was really strict on the low carb, lost about 14lb (not over weight for the 1st time ever!) and 3 months later having stopped the metformin about 1 month in, my a1c was 42 and my fasting finger prick tests were coming in under 6mmol/l.
Unfortunately I slacked off a bit and the weight crept back on and my fasting finger prick levels went up over 7. As I've lost the weight again, the finger prick numbers are slowly coming down again. I'm hoping that if I get to the lower weight again (and a bit more to be honest) and actually stay there this time, I can officially go in to remission.

I believe it takes only half a gram of fat in the pancreas to compromise the insulin signalling or secretion, so if one’s (dratted!) genes are disposed to direct excess fat to the pancreas rather than subcutaneously then that’s how easy it is for a little weight gain to undo our remission. My concern is that there may be people who have not expelled that fat but whose bg is kept low by low carbs alone. And although the latter situation is a good thing while it lasts, I have seen reports that long term that fat may damage beta cells permanently and take away the diet-only option of good T2 management. So I believe that carb reduction has a powerful role to play but that the fat stripping is a greater priority and is not getting enough emphasis.

 

[Daibell]

I believe it takes only half a gram of fat in the pancreas to compromise the insulin signalling or secretion, so if one’s (dratted!) genes are disposed to direct excess fat to the pancreas rather than subcutaneously then that’s how easy it is for a little weight gain to undo our remission. My concern is that there may be people who have not expelled that fat but whose bg is kept low by low carbs alone. And although the latter situation is a good thing while it lasts, I have seen reports that long term that fat may damage beta cells permanently and take away the diet-only option of good T2 management. So I believe that carb reduction has a powerful role to play but that the fat stripping is a greater priority and is not getting enough emphasis.

And the best way to fat strip remains lower carbs and exercise

 

[mariavontrapp]

I believe it takes only half a gram of fat in the pancreas to compromise the insulin signalling or secretion, so if one’s (dratted!) genes are disposed to direct excess fat to the pancreas rather than subcutaneously then that’s how easy it is for a little weight gain to undo our remission. My concern is that there may be people who have not expelled that fat but whose bg is kept low by low carbs alone. And although the latter situation is a good thing while it lasts, I have seen reports that long term that fat may damage beta cells permanently and take away the diet-only option of good T2 management. So I believe that carb reduction has a powerful role to play but that the fat stripping is a greater priority and is not getting enough emphasis.

This is interesting. I managed by low carbing for many years but now that is no longer working and I do think my beta cells have declined. I take glimepiride now. In the past I have had a cut off point with my weight, below which my Hba1c was very good. Unfortunately I went above the threshold and couldn't lose the weight no matter what I tried.

 

[MrsA2]

My understanding is that if one’s initial weight loss has been sufficient to clear excess fat from the pancreas and so get one’s A1c down into the remission zone then allowing weight to rise by as little as 6 lbs can be sufficient to put one back into non-remission.

Can you provide a reference or link to these figures please?

 

[chrisjohnh]

Can you provide a reference or link to these figures please?

The figure of about 3kg regain as a sufficient trigger for loss of remission is one I picked up from several papers a couple of years back and kept in my memory, but I do not have all the refs readily to hand now. But it’s a threshold figure that Taylor has often mooted from his own experience as stated near the end of the article below where he says that sometimes “a few kilograms” can be enough.

https://wchh.onlinelibrary.wiley.com/doi/full/10.1002/pdi.2297