Just bought the app for my iPhone. Hope that's as good
I think it's about 50% pancreas function by the time T2 is diagnosedSome people who are newbies are not new to diabetes.Some people who are newly diagnosed may have had undiagnosed diabetes for a long time .
As Indy says beta cells can be lost . And of course there are people who may have been labelled as T2 but who actually produce less insulin. Beta cells may have been destroyed by the immune system (LADA), they may have a defect in the signalling system( some types of MODY) or something else entirely.
If insulin levels are low then glucagon levels will rise and gluconeogensis will increase .The liver will use protein or break down body muscle to make glucose (that's what happens in T1 before diagnosis but it can also in longstanding T2. It may also be that people are actually producing far more glucagon than they should do (so more glucose is being made/released.
In some of these cases then people may not be able to lower their levels with diet , of any kind ,without some form of medication ( for example metformin acts,in part, to reduce the glucagon response)
Can you imagine how someone in this situation would feel if they were told that they somehow weren't doing it right?
(in any case I can give examples where people use other diets successfully but that isn't the thrust of this thread.)
My second point is that in a minority of cases getting levels down as quickly as possible isn't necessarily a good thing.
In someone who has developed some degree of retinopathy, a rapid reduction of HbA1c may lead to a more rapid progression of the existing retinopathy. In the long term a lower level is certainly better but taking many months to get there may , according to this hospital website, be sensible .
http://www.diabeticretinopathy.org.uk/retinopathyprogression.htm
also from the same website :
Late diagnosis " is very common, even in wealthy areas such as North Birmingham. 15% of patients have retinopathy at presentation, and diabetes may have been present 5-9 years previously"
Hi Phoenix, thank you for this, it is indeed very informative and gives a very good understanding of why we cannot all expect a sudden fall in numbers, where lots of us do.Some people who are newbies are not new to diabetes.Some people who are newly diagnosed may have had undiagnosed diabetes for a long time .
As Indy says beta cells can be lost . And of course there are people who may have been labelled as T2 but who actually produce less insulin. Beta cells may have been destroyed by the immune system (LADA), they may have a defect in the signalling system( some types of MODY) or something else entirely.
If insulin levels are low then glucagon levels will rise and gluconeogensis will increase .The liver will use protein or break down body muscle to make glucose (that's what happens in T1 before diagnosis but it can also in longstanding T2. It may also be that people are actually producing far more glucagon than they should do (so more glucose is being made/released.
In some of these cases then people may not be able to lower their levels with diet , of any kind ,without some form of medication ( for example metformin acts,in part, to reduce the glucagon response)
Can you imagine how someone in this situation would feel if they were told that they somehow weren't doing it right?
(in any case I can give examples where people use other diets successfully but that isn't the thrust of this thread.)
My second point is that in a minority of cases getting levels down as quickly as possible isn't necessarily a good thing.
In someone who has developed some degree of retinopathy, a rapid reduction of HbA1c may lead to a more rapid progression of the existing retinopathy. In the long term a lower level is certainly better but taking many months to get there may , according to this hospital website, be sensible .
http://www.diabeticretinopathy.org.uk/retinopathyprogression.htm
also from the same website :
Late diagnosis " is very common, even in wealthy areas such as North Birmingham. 15% of patients have retinopathy at presentation, and diabetes may have been present 5-9 years previously"
When I started low carbing, I did it gradually - going from 100 to 50 to 30. However, it was only when I took the final step of going below 20 that I saw dramatic reductions in my readings and got them to the levels they are now.
I'd agree with what others have said that when people start they are eating more carbs than they realise - they hide everywhere
I think...I seem to recall Prof Taylor suggesting that in type 2, certainly in the early years, the beta cells are not so much destroyed as hibernating. By losing the excess weight that many of us carry at diagnosis, we give our bodies a chance to heal itself. I can't say I did any fancy calculations with calories, percentages of fat, protein etc other than jogging stuff down on paper in the early days and making the decision that high fat was better viewed in my case as enough fat as I could so easily have just over eaten fat as I had previously over eaten carbs. Something clicked and ice lost over 5st since last May. My BS levels came down as I lost the weight , even though I dropped Metformin tablets so I think for some people it may not be until significant weight loss has occurred that they see a substantial drop in BS levels. Also even now, I notice elevated levels for me following an excess of protein so I do think that is something we all need to be mindful of. Also if the person has eating issues , they do need to be mindful that low carb while alleviating carb cravings and helping BS, in itself may not address weight problems if a mountain of food of one type is just replaced by a mountain of food of another type- some folk won't lose weight on bulletproof coffees or a cow's worth of dairy - this isn't them doing it wrongly, but rather that a one size fits all approach is doomed to fail someone. Only by testing and recording can we decide what works for us as individuals within an overall lower carb framework. Sadly Prof Taylor also pointed out that our personal fat thresholds ( the going over of which he cites as major cause of type 2 ) may be a lot lower than we'd like - as a generation our weight distribution curves have shifted right wards so just because I'm not the fattest person I see, doesn't mean I'm not too fat in my liver and pancreas for me.
I seem to recall Prof Taylor suggesting that in type 2, certainly in the early years, the beta cells are not so much destroyed as hibernating. By losing the excess weight that many of us carry at diagnosis, we give our bodies a chance to heal itself. I can't say I did any fancy calculations with calories, percentages of fat, protein etc other than jogging stuff down on paper in the early days and making the decision that high fat was better viewed in my case as enough fat as I could so easily have just over eaten fat as I had previously over eaten carbs. Something clicked and ice lost over 5st since last May. My BS levels came down as I lost the weight , even though I dropped Metformin tablets so I think for some people it may not be until significant weight loss has occurred that they see a substantial drop in BS levels. Also even now, I notice elevated levels for me following an excess of protein so I do think that is something we all need to be mindful of. Also if the person has eating issues , they do need to be mindful that low carb while alleviating carb cravings and helping BS, in itself may not address weight problems if a mountain of food of one type is just replaced by a mountain of food of another type- some folk won't lose weight on bulletproof coffees or a cow's worth of dairy - this isn't them doing it wrongly, but rather that a one size fits all approach is doomed to fail someone. Only by testing and recording can we decide what works for us as individuals within an overall lower carb framework. Sadly Prof Taylor also pointed out that our personal fat thresholds ( the going over of which he cites as major cause of type 2 ) may be a lot lower than we'd like - as a generation our weight distribution curves have shifted right wards so just because I'm not the fattest person I see, doesn't mean I'm not too fat in my liver and pancreas for me.
Thanks rowan I will look for that one tooThe book Eat Fat also explains it very well, the link for that is in my signature. It's a very different book to Carbs and Cals, but both equally helpful
I didn't say you did, what I'm pointing out is that although reducing A1c can trigger increased retinopathy, it is still recommended as the long term outcome is worth the initial worsening.Jack: Where did I say years? If anyone is in that situation they can read the link.
My points were that some may not be able to reduce levels with diet alone. Not everyone is in that position.
Here also is one members account which speaks for itself http://www.diabetes.co.uk/forum/threads/diabetic-retinopathy.21830/
I think the point you are making is extremely important. Because a generalized one size fits all approach can be very counterproducent in the wrong individual. I had the opposite experience, I was convinced that my problem was not lack of insulin but lack of sensitivity. I was given Gliclazide and thought that it was not the right protocol for me, however, I took it, due to the pressure that my other half put on me to take them and me being scared after hospital experience, the result: my acne came back in full rage... which only means (in a PCOS lady who is IR since as long as she can remember) one thing: excess testosterone induced by the effect of insulin over the ovaries. FBG didn't drop properly until I got rid of the Gliclazide. But I do agree the right medicine for the right case should be considered a way through and not a stigma, and I am happy with the results I get from metformin. But I do certainly acknowledge that a person that isn't insulin resistant or that is not having results while LC might have a problem of insulin production. So thank you for de-stigmatizing meds.This is me exactly - as you see in my sig I had a high A1c at diagnosis and feel I probably been undiagnosed for about 4 years. I was on max meds at the start and I have now reduced as far as I can. I did try for a few weeks without gliclizide at all and very low carb and made my diverticulitis worse to the point of avoiding an op by the skin of my teeth and my bs gradually begun to rise and weight gain
I am happy to use a small dose of gliclizide that keeps my A1c below 6 along with about 90g carb a day rather than very low carb and a A1c in the high 6s. Sometimes on here I do feel that the impression is given that if you extreme low carb you won't need the meds sadly it's not always the case and we have to decide personally what we are happy with. There is no shame in taking meds if you need them
I didn't say you did, what I'm pointing out is that although reducing A1c can trigger increased retinopathy, it is still recommended as the long term outcome is worth the initial worsening.
"A sudden improvement of control, perhaps with a 3% HbA1c drops, causes an increase in retinopathy progression for 1-3 years. After 3-4 years of very good control retinopathy usually stops progressing completely and most patients will never need laser again (our patients are discharged back to the retinopathy screening service)."
I think there is the normal blurry that happens when you drop BG, it's said to be the 'sugar' leaving the lens and does settle down ..as you found out.I'm not sure I have retinopathy (I hope not... need the test) but certainly my eyes went from been utterly blurry from distance (at high BG) to been unable to focus from nearby for a week or two after lowering the BGs. I can see fine now after a month
@millysue - why are you being a defeatist. Instead of looking at what you cant eat - look at what you can . For example - why not check our the LCHF recipe section. I use the cauli-mash instead of normal mash - and its fantastic on a shepherds pie. You can eat all types of meet - you can eat fruit but in moderation - most people seem to stick to anything with berry in, ie, raspberries, strawberries, blackberries. I am not a lover of salad (as in lettuce) but I eat lots of other things in my salad and only ever have it for lunch. I have learnt how to make crustless quiches - which there are no end of varieties. There are lots of people on hear who follow their own version of LCHF - a lot of people still have takeaways, chinese, indian and even fish and chips - but they have it in moderation. You dont have to live on salad you just need to experiment more. You can still have your cake and eat it... look at all the fabulous LCHF recipes there are for sweet things.I'm looking at what I have stopped eating, which is: spuds, all root vey, all bread, cakes, crisps, ALL fruit, fish and chips, Chinese takeaways.
I used to eat lots of roasted root veg.
Now if I have cut all that out, which I have. That's got to be good. However, if that doesn't lower my bs when I go back to nurse in April I will throw in the towel. I can't live on salad for ever. I have IBS and green lettice kills me.
Blurry is relatively normal, it's the difference in pressure at high levels and low levels This isn't retinopathy .I'm not sure I have retinopathy (I hope not... need the test) but certainly my eyes went from been utterly blurry from distance (at high BG) to been unable to focus from nearby for a week or two after lowering the BGs. I can see fine now after a month
Yeah I agree, but I'm still happy I can see wiiiiiiiiii!!!!I think there is the normal blurry that happens when you drop BG, it's said to be the 'sugar' leaving the lens and does settle down ..as you found out.
but I think you still get your eye examination..to see what's going on, just incase you have some retinopathy that may need treatment.
@millysue - why are you being a defeatist. Instead of looking at what you cant eat - look at what you can . For example - why not check our the LCHF recipe section. I use the cauli-mash instead of normal mash - and its fantastic on a shepherds pie. You can eat all types of meet - you can eat fruit but in moderation - most people seem to stick to anything with berry in, ie, raspberries, strawberries, blackberries. I am not a lover of salad (as in lettuce) but I eat lots of other things in my salad and only ever have it for lunch. I have learnt how to make crustless quiches - which there are no end of varieties. There are lots of people on hear who follow their own version of LCHF - a lot of people still have takeaways, chinese, indian and even fish and chips - but they have it in moderation. You dont have to live on salad you just need to experiment more. You can still have your cake and eat it... look at all the fabulous LCHF recipes there are for sweet things.
@millysue - why are you being a defeatist. Instead of looking at what you cant eat - look at what you can . For example - why not check our the LCHF recipe section. I use the cauli-mash instead of normal mash - and its fantastic on a shepherds pie. You can eat all types of meet - you can eat fruit but in moderation - most people seem to stick to anything with berry in, ie, raspberries, strawberries, blackberries. I am not a lover of salad (as in lettuce) but I eat lots of other things in my salad and only ever have it for lunch. I have learnt how to make crustless quiches - which there are no end of varieties. There are lots of people on hear who follow their own version of LCHF - a lot of people still have takeaways, chinese, indian and even fish and chips - but they have it in moderation. You dont have to live on salad you just need to experiment more. You can still have your cake and eat it... look at all the fabulous LCHF recipes there are for sweet things.
@millysue - why are you being a defeatist. Instead of looking at what you cant eat - look at what you can . For example - why not check our the LCHF recipe section. I use the cauli-mash instead of normal mash - and its fantastic on a shepherds pie. You can eat all types of meet - you can eat fruit but in moderation - most people seem to stick to anything with berry in, ie, raspberries, strawberries, blackberries. I am not a lover of salad (as in lettuce) but I eat lots of other things in my salad and only ever have it for lunch. I have learnt how to make crustless quiches - which there are no end of varieties. There are lots of people on hear who follow their own version of LCHF - a lot of people still have takeaways, chinese, indian and even fish and chips - but they have it in moderation. You dont have to live on salad you just need to experiment more. You can still have your cake and eat it... look at all the fabulous LCHF recipes there are for sweet things.
I don't eat meat, not bothered about sweet things. Quiches, no thanks any pastry gives me indigestion......
.....I have been type 2 for 6 years plus. I am now thinking the damage may already have been done.
I am a veggie. Not bothered about sweet things
I don't eat meat, not bothered about sweet things. Quiches, no thanks any pastry gives me indigestion.
What I was trying to say, look at what I have cut out, and that must be good.
My salad is. Peppers, celery, cucumber, Chinese leaves, sundried tomatoes, radishes and full fat Mayo.
My styfry veg is almost the same as above but with courgette.
I love cheese and peanuts, I was told that was ok, but on reflection I think I have been eating too much of that.
I have been type 2 for 6 years plus. I am now thinking the damage may already have been done.
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