Absolutely horrified and terrified

[Lizajane10]

Is 2 slices of granary bread a lot of carb? Are sandwiches not allowed any more?

If having bread I’ve just had one slice and called it an ‘open sandwich’ but then have been quite generous with the filling/topping eg cheese is low carb, some pates are (check the label for under 10%), tuna, egg, cold meat, prawns etc. So still feels like a sandwich but the topping is the main component and should be filling if high protein.
There are also some smaller loaves so you could have two slices but they are tiny!

 

[Drummer]

It’s also important to remember that medication is not a Bad Thing.

Not everyone is in a position to be able to manage on diet alone, and there should be no shame in using a combination of appropriate meds balanced with an adjusted menu to aim for improved glucose outcomes.

Not everyone will find a low carb approach appropriate, appealing, sustainable, or even effective (we have members who simply do not get the expected BG changes on low carb).

We are all on a journey trying to find our own way through the various options and choices available to improve our diabetes management. And medication, as advised by a person’s medically qualified Doctor or nurse, can be a valid and important part of that.

Type 2 really is not a simple thing - not even one thing, I suspect, but several different problems improperly categorised as one. There is the additional prospect of it not being type 2 at all.
If eating a low carb diet doesn't prove effective then it isn't plain ordinary simple type 2 but something more complex and it ought to be investigated, not allowed to drag on with possible consequences for the future.

 

[Halfhybrid]

Type 2 really is not a simple thing - not even one thing, I suspect, but several different problems improperly categorised as one. There is the additional prospect of it not being type 2 at all.
If eating a low carb diet doesn't prove effective then it isn't plain ordinary simple type 2 but something more complex and it ought to be investigated, not allowed to drag on with possible consequences for the future.

I thought there was only Type 1 and Type 2. What else is there?

 

[Halfhybrid]

If having bread I’ve just had one slice and called it an ‘open sandwich’ but then have been quite generous with the filling/topping eg cheese is low carb.

That sounds doable. More topping would certainly be appealing, thanks.

 

[everydayupsanddowns]

If eating a low carb diet doesn't prove effective then it isn't plain ordinary simple type 2 but something more complex and it ought to be investigated

But some people’s “plain ordinary simple type 2” just doesn’t respond to a low carb diet as yours did. So it’s important for readers, lurkers, newcomers and old hands alike to know that low carb is one option, among many, with or without the support of medication. It is not the only option. There are lots of valid alternatives to consider and try 🙂

 

[everydayupsanddowns]

I thought there was only Type 1 and Type 2. What else is there?

Ooooh there are all sorts of rare and glamorous flavours! Gestational, various flavours of MODY, LADA, multiple subtypes of Type 3c. A veritable smorgasbord

 

[Leadinglights]

That sounds doable. More topping would certainly be appealing, thanks.

Open sandwiches were fashionable about 60 years ago, I remember going to a coffee shop in a back street in Bowness and they served Danish open sandwiches usually on a slice of rye bread. Very nice they were.

 

[Halfhybrid]

Ooooh there are all sorts of rare and glamorous flavours! Gestational, various flavours of MODY, LADA, multiple subtypes of Type 3c. A veritable smorgasbord

!! Now you mention it, I have heard of gestational, as somebody I worked with had it. Never heard of any of the others. Type 3c???

 

[everydayupsanddowns]

Never heard of any of the others. Type 3c???

Don’t worry! Quite a few docs haven!t heard of type 3c either 🙂

What is type 3c diabetes?

You may have heard of the more common types of diabetes like type 1, type 2 and gestational. But there are actually many other types of diabetes that aren't as well known. Type 3c diabetes develops because of the damage to the pancreas, which can happen for a few different reasons. And although...

www.diabetes.org.uk

 

[JITR]

It’s also important to remember that medication is not a Bad Thing.

Not everyone is in a position to be able to manage on diet alone, and there should be no shame in using a combination of appropriate meds balanced with an adjusted menu to aim for improved glucose outcomes.

Not everyone will find a low carb approach appropriate, appealing, sustainable, or even effective (we have members who simply do not get the expected BG changes on low carb).

We are all on a journey trying to find our own way through the various options and choices available to improve our diabetes management. And medication, as advised by a person’s medically qualified Doctor or nurse, can be a valid and important part of that.

There will be much less confusion about diet when all Type 2 diabetics and prediabetics know they have a fatty liver. All HCPs need to know that too.

In 2008, Diabetes UK scientists, Professor Roy Taylor and his team at Newcastle University discovered Type 2 diabetes goes away when people reverse their fatty liver. This was achieved by a diet to eliminate excess fat in the liver and pancreas. The criterion for remission in this study was HbA1c of less than 42 without medication.

After the results of this study were published hundreds of people from round the world contacted Newcastle University for guidance on putting their T2D into remission. Subsequently 77 of those who achieved remission provided sufficient data for inclusion in a published report.

Thanks to further research by Professor Taylor, Professor Mike Lean and their teams, also supported by Diabetes UK, we know T2D is highly unlikely to return while people maintain their new low weight, and thereby normal function of their liver and pancreas.

Thousands have now reverted their fatty liver to normal. This includes participants in the NHS Soups and Shakes programme and members of this forum who have reported sustained HbA1c results in the 30s.

At the Public Health Collaboration conference in May 2023 Roy Taylor emphasised people needed to lose weight by any means. In other words by any healthy, nutritious diet. These include low carb diets such as Freshwell, Norwood (Dr David Unwin), Harcombe, Diabetes UK and DIY.

My question is what other types of diet, or ways of eating, are suitable for T2 diabetics and prediabetics to lose and maintain weight?

 

[Martin.A]

Open sandwiches were fashionable about 60 years ago, I remember going to a coffee shop in a back street in Bowness and they served Danish open sandwiches usually on a slice of rye bread. Very nice they were.

We have German friends and their sandwiches are always of the open variety - "Belegte Brot" as it's known in Germany (and in Switzerland and Austria).

 

[snowball12]

There will be much less confusion about diet when all Type 2 diabetics and prediabetics know they have a fatty liver. All HCPs need to know that too.

In 2008, Diabetes UK scientists, Professor Roy Taylor and his team at Newcastle University discovered Type 2 diabetes goes away when people reverse their fatty liver. This was achieved by a diet to eliminate excess fat in the liver and pancreas. The criterion for remission in this study was HbA1c of less than 42 without medication.

After the results of this study were published hundreds of people from round the world contacted Newcastle University for guidance on putting their T2D into remission. Subsequently 77 of those who achieved remission provided sufficient data for inclusion in a published report.

Thanks to further research by Professor Taylor, Professor Mike Lean and their teams, also supported by Diabetes UK, we know T2D is highly unlikely to return while people maintain their new low weight, and thereby normal function of their liver and pancreas.

Thousands have now reverted their fatty liver to normal. This includes participants in the NHS Soups and Shakes programme and members of this forum who have reported sustained HbA1c results in the 30s.

At the Public Health Collaboration conference in May 2023 Roy Taylor emphasised people needed to lose weight by any means. In other words by any healthy, nutritious diet. These include low carb diets such as Freshwell, Norwood (Dr David Unwin), Harcombe, Diabetes UK and DIY.

My question is what other types of diet, or ways of eating, are suitable for T2 diabetics and prediabetics to lose and maintain weight?

How do you find out how much fat is in your liver? Is there a scan available? I struggle with a low carb diet as I am not keen on veggies in any form and if I see one more egg I will scream!! Just interested that's all

 

[DianeD]

How do you find out how much fat is in your liver? Is there a scan available? I struggle with a low carb diet as I am not keen on veggies in any form and if I see one more egg I will scream!! Just interested that's all

There are a number of home weight scales that measure visceral fat, that will give you an indication of overall fat in your organs if not specifically your liver. You need to research carefully to make an informed choice as I'm sure some are more accurate than others. Otherwise you would need tests that I suspect a gp would not agree to as they are expensive.

 

[wantonnoodle]

I would suggest for food ideas to look at the diabetes books by Giancarlo and Katie Caldesi. They give some excellent ideas to reduce carbs. Tom Kerridge's book The Dopamine Diet, is also very good.

Other than that, I would test before meal and again 2hrs after. Aim for a difference of less than 2 for now, as that will show you can tolerate that meal. Testing was amazing for me, as it showed me which carbs I can tolerate and which I can't (I can tolerate more than I expected) so carefully incorporating those in my diet and binning those I can't means I don't feel deprived. Before testing, I'd tried, struggled with, and failed, to bring down my numbers using purely a strict low carb diet alone, ending up with me taking metformin and empagliflozin.

There's no shame in struggling to get your numbers down using diet alone, but testing is not something to be scared of.

 

[JITR]

How do you find out how much fat is in your liver? Is there a scan available? I struggle with a low carb diet as I am not keen on veggies in any form and if I see one more egg I will scream!! Just interested that's all

Professor Taylor's team at Newcastle University measured it with an MRI scanner using their own techniques. It's not economically viable for general use.

As I recall the subjects in his original study, called Counterpoint, had from 10% to 35% liver fat. 2% to 5% is regarded as normal.

By chance I had ultrasound scans immediately before and after losing weight. The GP had referred me to hepatology suspecting hemochromatosis had damaged my liver. The first scan showed a fatty liver, the second six months later under 5%. You may persuade your GP to arrange a scan but I doubt it.

HbA1c between 42 and 48 is said to correlate well with visceral fat levels.

The simplest method is waist measurement. More than half your height is indicative of a fatty liver.

Hope this helps

 

[Halfhybrid]

Thanks all, for your advice.
I had a phone call out of the blue from the GP at my new practice who specialises in diabetes. We had a frank discussion and she is prescribing me Mounjaro for diabetes. Apparently, Mounjaro for obesity cannot be prescribed on the NHS. Whatever, I feel like I have been thrown a lifeline and don't want to screw it up. The GP said I still need to take Metformin while on Mounjaro, which I still don't understand.
I do understand that one's appetite decreases on this drug, which is a good thing, but I would like to know how much I can eat and whether I should still try to do low carb.
I don't have the drug yet. Hopefully will get it in a couple of days.

 

[Maz2]

Metform on its own won't do it. You also need to reduce your carb intake, be more active and lose weight if you need to and yes, there are other meds.

Remission (no signs, no symptoms, no meds) is possible but not everyone is successful, even if they do all the right things. Remission doesn't mean cured, though.

Thank you for that information as I wondered why the poster's reading was so high when on meds. I know people who are Type 2 and are on Metformin and make no effort with their diet at all and think the meds will do everything.

 

[Maz2]

Sorry to hear this halfhybrid. I think everything has already been said by previous posters.

I hope you will be able to get it down. Getting a blood glucose machine is a good idea as you can check what foods upset you.

I got myself one at pre-diabetes and got down to normal, albeit the higher side. I found it invaluable together with advice here and Michael Moseley's books and website. Unfortunately the latest one is 42 again so am having to start again. I cannot, at present, seem to find anything that upsets me but something must so will continue on. Have given up loads of lattes and cappuchinos in case it is them.

 

[Halfhybrid]

Sorry to hear this halfhybrid. I think everything has already been said by previous posters.

I hope you will be able to get it down. Getting a blood glucose machine is a good idea as you can check what foods upset you.

I got myself one at pre-diabetes and got down to normal, albeit the higher side. I found it invaluable together with advice here and Michael Moseley's books and website. Unfortunately the latest one is 42 again so am having to start again. I cannot, at present, seem to find anything that upsets me but something must so will continue on. Have given up loads of lattes and cappuchinos in case it is them.

What's wrong with lattes and cappuchinos as long as you don't put sugar in them?

 

[Halfhybrid]

Have now had 2 doses of Mounjaro, lowest dose there is, to see how I tolerate it. GP said to continue taking metformin as well. The injections are fine and don't even hurt. No noticeable bad side-effects. Slight weight loss but I've had a virus and didn't feel like eating much anyway. Every cloud.
What is weird is that prior to starting Mounjaro, weighed myself and found that since the last time I weighed myself, maybe 4 months ago, I had somehow lost 11Ibs without consciously trying to lose weight.