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Which way to go?

Q

Qwerty101

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Hi Everyone,

I understand a lot of people post on here and many with the same questions so I will try not to repeat and I will appreciate any replies.
So I was diagnosed Type 2 after being picked up on a works medical. No symptoms to note. my diet wasn't great and little exercise but quite an active job. Im technically overweight BMI wise but I'm not if you know what I mean. BMI26 age 37
my HBA1C came back at 7.4... now the only advice given at the time was that I was told to eat healthy and wait to speak to the nurse.... That was 8 weeks ago and despite asking no nurse appointment as of yet.

So I came here and researched as I am sure most do. And all over the internet I find contradiction info/opinions. I invested in a meter for the first 5 weeks and logged via mySugr. My results always seemed normal range. and my estimated A1C on there is 5.2. I do seem to spike after carbs, more so in the morning but they generally come down back to normal range within 2 hours.

The last nearly 3 weeks I have been wearing a libre CGM and have my time in rage set at 3.9-7.8 which I understand is what a non diabetic would have. My Time in range in 96% over the last 18 days and average glucose 5.6.
This is pretty good right?
I mean, I know I have been making an effort to eat healthy (LCHF) and done a bit more exercise than normal but it just seems a little too normal.Would these results be completely different if I wasn't making an effort? My diet before wasn't great but could definitely be worse.
I even had a Donor kebab and chips in a pitta last night (I caved in! its been so long!) and my readings only hit 7.8 and came down in 2-3 hours.

I guess I just need a little direction, do I carry on LCHF, do I do Mediterranean diet, low calorie?? It seems there is all these ways to go and all seems dependant on the person as what is good for some could be doing bad for others.
Should I ask for another HBA1C? Could it of been a mistake?
Do I need my cholesterol checked before continuing with LCHF? I have lost 5kg in 8 weeks off this diet and kind of levelled off 77kg now. I think only doing full on keto would help lose much more.

Any advice would be great just a little confused at the minute.

Thankyou
 
Eating low carb works - it simply puts us into normal numbers for blood glucose.
You should get another test at 3 months from diagnosis, but things in the NS seem rather chaotic at the moment. If you are happy that you are winning, it is up to you if you push for appointments or not.
You seem to be like me in that carbs in the morning cause higher spikes. I do eat some carbs with my first meal as that seems to give the best results, then I eat more in the evenings. I only need two meals a day these days - I am 4 years from diagnosis and went low carb from that moment.
Although weightloss is pushed as something advisable, it isn't always necessary to beat diabetes. I found that I'd lost weight without trying in the weeks after diagnosis, as soon as I stopped the carb heavy cholesterol reducing diet - which didn't work.
 

Thanks for your reply. I guess part of me is thinking that because my numbers appear normal, maybe it was a mistake. but I guess that's purely down to the changes I have made since diagnosis. It would be nice to think that carbs weren't always going to have to be cut out though! haha
 
Probably not a mistake, I’d get another test 90 days after the first. You may not have to stick to some hardcore diet, maybe just cutting out the junk is enough. You’ll probably want to be tested every so often for the rest of your life, just to make sure you’re on track
 
I have a normal hba1c from my last results and if I keep to lower levels of carbs them my levels remain close to non diabetic

However, up the carbs too much and I easily spike into diabetic levels. Even with weight loss, improved health etc. I remain diabetic. So yes... Maybe some people could fully reverse but my suspicion is that once T2 always T2. I don't know of anyone who has fully reversed such that they could eat Substantial regular carbs and maintain levels. Anything is possible of course but complacency leads to problems

To be fair to all that this is from a no drug perspective, but I have found drugs may help but over time progress to being harder to maintain.

Everyone is different though, some can eat low carbs of 130g or less, others at that level cannot control their bloods

One size deosnt fit all
 
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I do wish you could read my medical history or my blog.
I was feeling a bit strange and looked horrible, this was in work and and like you sent to my doctors. I was on a production line most of my working life.

I was really ill in 2012/13, because I was misdiagnosed with T2 in 2009.
Because of being totally having no medical knowledge, I didn't have a clue what was happening to me.

I'm not diagnosing you, because I can't, forum rules.
But was found to have carb intolerance, and only when I didn't eat carbs constantly, would be the only part of the day when I didn't have brain fog.

This contradicts the diagnosis of T2, because my last Hba1c was 37 and my fasting levels are usually normal. Around 4.5mmols.
So why the misdiagnosis?
If I had my usual porridge in the morning, water and no sugar, no milk because I have had lactose intolerance since forever. My blood glucose levels would quickly get up to mid teens, so if the bloods were taken in the first couple of hours after the porridge, then my blood glucose levels were in diabetic range.
My doctors didn't have a clue.
Ignorance is not bliss.
Ignorance from these doctors was killing me.
My specialist endocrinologist who I was referred to in 2013 had a hunch it was not T2.
He directed me to this site and recommended a low carb diet.
This along with intermittent fasting has improved my health. I had a cat scan last month, all clear, all normal, nothing to worry about.
Not bad for an old lodger.

There is no way I could say that I know what is happening to you, but if it's anything like me, you could have some type of blood dysregulation. I have Hypoglycaemia and suggest you read the reactive hypoglycaemia forum, because somethiyour sng that is on there to remind you of your symptoms.

Keep safe
 
Hi Thanks for the reply

to be honest I am almost happy in a way that it has given me a kick up the a*** to sort my diet out and I would like to keep it healthy. if not for me then for my kids.

Like I say it wasn't all that bad though probably just too much sugar and a few too many takeaways which seems to be the norm nowadays! not that its right that is!

Probably the worst part I think is I didn't have a regular eating pattern.

I don't really miss the sugar all that much but I did love nice food, I'm not a fan of macdonalds or kfc etc but I like to indulge in restaurants etc with the odd Chinese or kebab. It seems I now am only ever thinking of ways to cut out carbs rather than being able to enjoy food.

I would love to get to a place where my levels were normal even if that means a relatively low carb diet the majority of the time but I can still enjoy the odd restaurant without having to think I can't have them potatoes or that desert. or eat roast potatoes and Yorkshire puddings on a sunday, or dare I even say a Chinese once in a while. the word cheat night seems to be a swear word so I won't call it that haha.

Is that even possible? or is that dreamland now?
 

This sounds like best case scenario! fingers crossed! haha
 
I have also been offered a repeat HBA1C by my GP but I am holding off for a while the general opinion seems to be to wait 3 months. is it pointless going earlier?
 
Qwerty101 said:
It seems I now am only ever thinking of ways to cut out carbs rather than being able to enjoy food.
Click to expand...
Most of us have found that carbs aren't that nice after cutting them out for a decent time period.
I think I enjoy food far more now than I ever used to.
 
Qwerty101 said:
So I was diagnosed Type 2 after being picked up on a works medical
Click to expand...

Hi there, who diagnosed you? I get that it was picked up at a works well person check but did that get referred to your GP who did the hb1ac check? I'm just checking whether you've been diagnosed properly I guess. Leaving you hanging is terrible but unfortunately not that unusual. You sound like you are doing great so far but yes, if I were you I'd make sure to get another hb1ac in another 4 weeks. Also, phone your surgery and ask them what's going on, they may be busy but it's possible you have slipped through the net somewhat. As for being told 'eat healthily and wait for a Nurse', that would enrage me! They presumably know nothing else about you other than your hb1ac.
 


I get it!
Since realising that fasting helps me so much, I only have food in the afternoon and early evening, I have discovered that eating every three or four hours or times a day, is too much, we just don't have to eat that much. The dictates that we must have breakfast is total nonsense or have four square meals a day, this leads to eat nearly every moment of the day.

I'm not hungry at all and I'm going to have grilled chicken and tomatoes.
 

It was a routine medical it got picked up on who told me to go to my GP and they arranged a HBA1C test at the hospital.
So I guess it was done properly... The diabetes nurse actually rang me up assuming I had already been told about the diagnosis (which I hadn't) to arrange an appointment 3 weeks later, that's when I was told to just eat healthy for now. The appointment was cancelled by them last minute. with no clue when they can re book me in. that was a little frustrating to say the least!! enrage kind or comes close! haha from my understanding it is something out of their control though so I cannot blame them.

I have done the testing and CGM off my own back to go into the appointment with some sort of data for them to perhaps work out wether I need medication or not. so yes up to now they know nothing other than my HBA1C result and a 2 min chat on the phone. It was only through contacting my GP he offered me a repeat HBA1C but I think its probably too soon. The food forms are sat waiting for me to pick up.

I kind of just in limbo waiting to find out which route is best having taken the choice so far to go LCHF.
 

See this is what I mean about contradicting info haha. So, I never ate breakfast. In fact I could go all day without eating then binge at tea time and though the night. Obviously this isn't good.
Most I read is that a structured meal routine is essential with Type 2. Is this not the case?

One thing I have noticed especially with CGM is that my levels are higher in the morning. Fasting usually around 5.5 then after breakfast up to just over 7ish sometimes dependant on what I eat it may spike to 10-12 but back down to under 7 within 2 hours. it just seems to drop slower through the morning, then it is low after lunch and tea where is don't seem to get the same rise after eating that I gat at breakfast. It seems to be breakfast that affects me the most. Should I fast the morning??

I even only went to 7mmol after a kebab and pitta bread with half a portion of chips!

So much info to take in haha
 
Qwerty101 said:
The last nearly 3 weeks I have been wearing a libre CGM and have my time in rage set at 3.9-7.8 which I understand is what a non diabetic would have. My Time in range in 96% over the last 18 days and average glucose 5.6.
This is pretty good right?
Click to expand...

Here's data on a non-diabetic cohort who wore a CGM recently.
https://www.diabetes.co.uk/forum/th...ine-normal-glucose-the-results-are-in.182221/

Looks like your figures match theirs, well done on getting back to normal.
 
Ronancastled said:
Here's data on a non-diabetic cohort who wore a CGM recently.
https://www.diabetes.co.uk/forum/th...ine-normal-glucose-the-results-are-in.182221/

Looks like your figures match theirs, well done on getting back to normal.
Click to expand...

This is good to see thank you. I had read something similar elsewhere which is what lead me to set the limits to 3.9-7.8 for my time in target range on the CGM app.

I am more than aware though that my carb intake is very low to achieve this. I would like to experiment and eat a regular diet to see how my results were but obviously that isn't going to be recommend!
 

Any reason why you can't trial slightly carbier meals and see whether they spike you? (ie test just before meal and 2 hours after). Some people need to go virtually keto to achieve normal blood sugars, others can go much higher. (I am T1 so not necessarily the best person to advise on this though.)
 
@Qwerty101 well done on your progress so far. There is nothing wrong with experimenting particularly if you take things slowly - I used to test my reaction to the same food 3 times and if I was happy with the numbers it was a keeper if not I’d try it again in a years time. I have maintained a normal hba1c on approx 130g carbs per day for about 8 years. My morning readings normally range between 5.00 and 5.8 although I don’t test every day. Through the years I have tested and found out which foods I can and should not eat and test occasionally to check my reaction to the foods are still the same and, through testing, I have discovered that Scampi is still my nemesis but I can eat up to 5 dates - although I find them so sweet so don’t bother!
 

Hi so I did a little experimenting this week. My wife wanted an Indian takeaway for her birthday so i went for tandoori meat and very little sauce then a little onion rice (basmati has lower GI right?) and a whole meal chapati.
My bloods on GCM spiked at around 8.2 but was back to 5,1 within 90 min. then an hour or so later another spike of 7-8 but back down to around 6 within 10 min. strange. it hovered between 5-6 all night and was 5.8 fasting when i woke up the next day.
Is this pretty good?

Another thing I have noticed in regards to not eating in the morning which was mentioned previously. Yesterday I has a small breakfast of some high fibre porridge ( a very quick spike of 8 then down as quick as it went up) But I was that busy at work I forgot to eat lunch!! so from around 3pm my levels seemed to fluctuate ALOT dropping to 3.2 at one point . then I ate and had a minimal spike from dinner but kept dropping lower through the evening and spiking back up once (unless it was the excitement for the football haha.)
Is this a worry? It seemed to be fine overnight, although I spiked to 10ish from the porridge today. (down to 5 now I am writing this 2 hours after eating)
I feel like I am more bothered its dropped my time in range from 98 to 97% hahaha.

thanks for all replies. Its good to hear from people who know whats going on!
 

While eating through the night isn't a good idea, many T2's in this forum use Time restricted Eating (sometimes known as Intermittent Fasting).
This means: A). We use an LCHF way of eating to get 'fat adapted (= able to use our own body fat for energy).
then B). We reduce the number of meals we eat to only 1 or 2 per day and only eat in a time window of 8hrs or less( which is no problem since being fat adapted, we don't get seriously hungry.

The reason for having a small time window for eating in is because insulin is the 'fat storing' hormone. Basically it's produced in response to higher Blood Glucose (due to carbs) and then causes the body to store that excess glucose (energy) safely away in the body's cells. This means both muscle cells and fat cells. In fat cells Glucose is converted into and stored in the form of fat. This is how carbs such as starches and sugars make you fat.

Naturally whilst Insulin is high, the body is in 'fat storing' mode and thus any 'fat 'burning' is effectively switched off. We want to stay in 'fat burning mode' at least most of the time, hence we want low insulin, hence we don't keep having lots of meals/snacks since most of them will boost our insulin levels.
 
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