Which route to take?

[Mr Hairyman]

Hi all.
My first post, so be gentle!
Received my Type 2 diagnosis last week. HbA1C of 80. Weight is 152kg. 49 years old
Obviously I need to lose weight, as well as bring down my mmol score.
Have started exercising, have removed 'white carbs' and am going down what resembles a "low GI" diet.
I've been prescribed Metformin - building up to 2000mg and a statin.

I would very much like to put the diabetes into remission. From reading around the forums, a lot of people seem to favour, and have found success with going very low carb, and Ketogenic.

The initial information I received was to cut out the 'white carbs' and switch to wholemeal flour, brown rice, sweet potato etc - along with taking in less carbs. I'm measuring that using MyFitnessPal. Even though I've reduced my Carb target - it's still at 165g
I'm confident that I can definitely lose weight through exercise and the GI approach, but I'm concerned that this won't really put a dent into my HbA1C of 80. Keto seems very challenging. I cook for my whole family, which makes it even more of a challenge.

Would appreciate peoples thoughts.

 

[EllieM]

Hi @Mr Hairyman and welcome to the forums.

An hba1c of 80 corresponds to an average blood sugar of 12.5 mmol/L over the last 3 months.

Some new diabetics do go into remission just by losing weight but it can be hard to do without severe calorie restriction and the low carbers often (but not always) lose weight as a result of not exceeding their body's carb tolerance threshold.

My suggestion to anyone in your position would be to buy a meter and see how your body copes with different foods and carb loads. Though many of the folk here go keto to control their levels, many just do low carb, though I admit that is probably a little less than 165g. Brown carbs may be absorbed more slowly than white ones, but they still get absorbed.

Anyway here's my favourite link to low carb and T2

The Nutritional Thingy

There’s a few things you should know. 1. Practically all carbs turn to glucose once ingested , so not just straight sugars, but starches...

josekalsbeek.blogspot.com

I expect some T2s will be along soon to give you more informed advice.

Good luck.

 

[LeafyArts]

Hi there, I am still very new to this too and finding my way around, so I am absolutely no expert. I second EllieM's recommendation of a blood glucose meter.
I am trying to keep my carbs below 100g per day. Not easy, but doable and I have lost some weight which is great.
There is a weight loss thread here to report in every Friday, I find the accountability very encouraging. Please join in, I would like to see more people in there.

 

[MissMuffett]

I’m doing the extreme of going less than 20g net carbs a day but that’s because I’m very carb intolerant. Unfortunately the colour of the carb doesnt make much difference (ie brown rice, brown bread etc) it’s still carbohydrates and converts to sugar when consumed. There are a huge amount of low carb recipes on YouTube so have a look at those to give you some ideas and swaps.

 

[MissMuffett]

Oh and check out Dr David Unwin he gives great advice, he has a GP surgery in Southport and also diet doctor both on YouTube

 

[niblue]

I've had good results with targeting between 50 and 100g of carbs per day, as well as running a calorie deficit. That has meant I've lost about 13kg since my initial diagnosis with an hb1ac of 106 a couple of months ago, My BMI is now exactly 25 and am hoping to move into the "healthy" range in the next few days.

I've got my first follow-up blood test in about a week and am hoping I'll see a decent improvement in my hb1ac as well - certainly my blood sugar readings are down a lot now.

I initially followed the advice from the diabetes nurse to switch to brown carbs from white and to eat more fruit - which actually had the effect of increasing my blood sugar readings. I did my own research (including on here) and decided to switch to low-carb and that's been effective.

 

[Outlier]

As others have targeted carb reduction, I'll simply say I agree, but assure you that cooking for the family does not have to derail your progress. My husband is a lean fit non-diabetic who can eat/drink anything any time without any health issues. Our home is full of the kind of food that I mustn't eat, much of which I used to enjoy, but life isn't fair so I just see all that as past tense. We cook alternately, so the house is full of various carbs as well. It simply means I have the protein, healthy fats and diabetic- friendly vegetables, and he adds carbs to his own plate. It's no trouble, and I never feel in the slightest hard done by. It should be the same for you.

 

[Antje77]

I cook for my whole family, which makes it even more of a challenge.

It can be as simple as them having spaghetti bolognese and you having a larger portion of the sauce, with courgetti if you like. Or you having a bigger portion of meat and veggies or an extra hard boiled egg on your salad, and them having potatoes. Them having crisps, you having pork scratchings.

If you like, there is a thread in the low carb section of the forum where we share what we eat, it's a good place to get ideas.

What have you eaten today? (Low carb forum)

Cooked last of my rhubarb crop this morning with lemon and ginger in slow cooker as usual . @DJC3 no I hadn't tried eating the cooked ginger root just drunk the infused cooking water but will try it this time, thank you for suggestion - dipping it in chocolate sounds creative and tempting...

www.diabetes.co.uk

 

[Mr Hairyman]

Hi folks
Huge amount of v useful information.
One of the things that no-one here seems hugely bothered with is salty foods - people enjoying bacon and pork scratching etc.
Is it just that the health issues with salt are less of a concern when you're worried about blood sugar and carb reduction?

 

[carty]

I have a few alternatives to carby things for example when my husband' has spaghetti I have sweetheart cabbage sliced across a little thicker than the spaghetti ,a quick blanch in boiling water or quickly fried
cab bol instead of spag bol ! I also have caulli instead of rice and I top lasagne with aubergine or celeriac sliced .These are easy substitutes so you are not making two separate meals.and they taste better too !!
Carol

 

[Antje77]

One of the things that no-one here seems hugely bothered with is salty foods - people enjoying bacon and pork scratching etc.
Is it just that the health issues with salt are less of a concern when you're worried about blood sugar and carb reduction?

Personally, I've never bothered about salt anyway. But I think on the whole, many people consume less salt on low carb. Bread, potatoes, rice, pasta, chips are usually all made with salt, and while pork scratchings are salty, so are the crisps I used to eat before diabetes. I've always liked bacon so no difference there.

 

[Guilty]

Hi folks
Huge amount of v useful information.
One of the things that no-one here seems hugely bothered with is salty foods - people enjoying bacon and pork scratching etc.
Is it just that the health issues with salt are less of a concern when you're worried about blood sugar and carb reduction?

You'll find a mix of opinions on what is healthy in terms of sat fat, cholesterol etc. especially with low carb / keto advocates. Too much added salt is almost certainly bad for you though at any age and health condition.

Speak to your diabetes team. But I'd suggest focus on losing weight and bringing the A1c down. Then look at other concerns further down the line.

Low carb worked great for me a few years ago. Veggie, with reasonable portions of brown rice / wholemeal bread, works great for me now. I'm sure you'll find what works for you!

 

[Mr Hairyman]

Personally, I've never bothered about salt anyway. But I think on the whole, many people consume less salt on low carb. Bread, potatoes, rice, pasta, chips are usually all made with salt, and while pork scratchings are salty, so are the crisps I used to eat before diabetes. I've always liked bacon so no difference there.

That's a good point. I guess I've been hyper focused on being Low sugar, low fat, low carb, low salt - to be super healthy.
I've read around the forums now and really I need to focus on calorie deficit and going as low carb as I can manage - plus checking how my blood sugar responds

 

[Antje77]

That's a good point. I guess I've been hyper focused on being Low sugar, low fat, low carb, low salt - to be super healthy.
I've read around the forums now and really I need to focus on calorie deficit and going as low carb as I can manage - plus checking how my blood sugar responds

Keep in mind that this is a marathon, not a sprint.
Many people find that going low calorie increases the risk of falling off the wagon, it's a hard diet to maintain because it will make you hungry.

It can be helpful, but it may not be necessary if you find it hard. We have many T2's who have lost weight on low carb alone, no hunger. But we also have members who need to watch their calories as well to lose weight, no predicting how this will be for you.

 

[Hezzal]

That's a good point. I guess I've been hyper focused on being Low sugar, low fat, low carb, low salt - to be super healthy.
I've read around the forums now and really I need to focus on calorie deficit and going as low carb as I can manage - plus checking how my blood sugar responds

Part of the problem is that we’ve all been brain washed into the low cal , fats are the enemy way of thinking, and when we first start to go low carb it feels very wrong! But proteins, dairy and lower starch vegetables, with some fruit will provide you everything you need and will not adversely affect your blood sugar.

If you’ve been an over consumer of sugar/carbs (which most of us have been- it’s the nature of the beast!), the first few weeks of dietary change will be a bit of a chore, but once you’re past that point you’ll feel so much better and you won’t have the peaks and troughs of energy anymore. You don’t really need to worry about calories when your’re low-carbing, it kind of takes care of itself..BUT if you try to restrict your calories at the same time you may well be setting yourself up to fail!

 

[HSSS]

That's a good point. I guess I've been hyper focused on being Low sugar, low fat, low carb, low salt - to be super healthy.
I've read around the forums now and really I need to focus on calorie deficit and going as low carb as I can manage - plus checking how my blood sugar responds

I’d ignore the calories for right now (assuming they aren’t absolutely ridiculous). Focus on getting the carbs right down and getting used to that first. You’ll likely want to replace them with more proteins and naturally occurring fats (not vegetable or seed oils) to avoid hunger and failure. Once you have that under control look at what your weight is doing. It’s highly likely you’ll be losing weight too. If not then that is the time to thing about the calories.

 

[Lobsang Tsultim]

I found keeping below 30g carbs per day but eating as much protein and fat as I wanted so that I wasn’t ever hungry put me in a calorie deficit. In fact, after a little while I began missing the odd meal because I simply wasn’t hungry. I didn’t worry about salt tbh - as I lost weight my blood pressure and lipids dropped to normal levels anyway.

 

[Lupf]

Hi @Mr Hairyman welcome to the forum.
First an HbA1c of 80 mmol/mol is well into the diabetic range, but many here, including myself, were diagnosed with an HbA1c over 100 and have reduced to non- or prediabetic levels. Thus there is a realistic chance that you can get on top of your T2 too.

As other have said already reducing your carbs will reduce your HbA1c, and many here do very low carb, i.e. 30 grams per day. If you can do that great, but it is not all or nothing. Any reduction in carbs will be beneficial, but you want to monitor your progress, so you need to get a blood sugar meter, which your GP will not want to give, so either you are persuasive or need to fund it yourself. By measuring you will find out what works for you and which food does spike you.

Going low carb will most likely make you lose weight, as you will eat more fatty food, which are more satiating and make you less hungry. You need to forget the "fat is bad" mantra, it has never been proven. At the opposite, consider banning all low-fat food (like I did), because it has added sugar for taste and is in my view unhealthy. Check for any other low hanging fruit, e.g. fizzy drinks and juice. A glass of orange juice has seven oranges in it. and you wouldn't eat this in one setting, so consider eating an orange or an apple instead.

Depending on how much and how fast you want to lose weight, in addition to what you achieve by low carbing, there are different diets, but restricting simply calories is not sustainable in the long term. If you eat less than your body needs you will lose weight, but your metabolic rate will go down, so at some point you will stop losing or start gaining weight again. Thus you will become miserable and give up at some point.
Have you considered intermittent fasting? this is what our ancestors had to cope with - no success in hunting, and they started burning fat reserves. This seems to work for us as well

I've successfully reduced my HbA1c by intermittent fasting, using the 5+2 blood sugar diet from Michael Mosley. On fast days I've restricted to 600 calories (now it says 800 calories) where I did not have any carby food, such as bread, potatoes or rice, and ate green vegetables, e.g,.curries, soup salad, and egg and a bit of chicken or fish. On the other days I ate normal/ Being able to cook helps, if you like vegetable curries and soup you can eat a lot for 600 calories, so I never really felt hungry and the pounds started simply melting away. I've lost 10+ kg of weight and reduced my HbA1c to the 40s.

Metformin is fine, if you can tolerate it, i.e. it does not cause hypos.
Statin is another story, we can discuss this later.

 

[Resurgam]

That's a good point. I guess I've been hyper focused on being Low sugar, low fat, low carb, low salt - to be super healthy.
I've read around the forums now and really I need to focus on calorie deficit and going as low carb as I can manage - plus checking how my blood sugar responds

I have to add in salt to my diet as soon as the weather gets warm, and I add a tiny sprinkle of salt to my coffee all through winter - I tend to abandon hot drinks around April. If I don't I get awful cramps - but there is no salt in the foods I eat as they are all unprocessed.
I don't need to even think about calories, and being in a calorie deficit never worked as a way to lose weight anyway.
I found it very easy to feed the family a low carb diet as it was just a matter of leaving off the high carb foods from my plate and adding in the lower carb foods - I eat cauliflower not rice, swede not potato - I find a pressure cooker very useful and it saves on energy use too. I got back almost a whole month's payment recently as our usage is unusually low.
There is nothing to be gained from going hungry.
These days I am eating less, but because I am not hungry, not due to some effort of willpower.

 

[Sax]

Yes this is the church of low carb and many follow the cult of keto, but its a broad church and what works for you as a long term sustainable diet is more important. Low carb is anything below 150g, 130g or 100g depending who you ask, so you could step down in stages along that and see where it gets you. Also too fast a drop may have impacts on the eye health so a staged reduction over a few weeks will reduce that risk.