Does anyone else feel like me?

[A l a n]

Hi,

I have been a type 2 diabetic since 2002. When I was 37. I have seen family members die through their neglect of the condition, most notably my mother. My biggest hang up about the condition is putting on too much weight, so much so I have refused to take insulin, although my condition has worsened so much so that I do need it, according to the Doctors.

I was taking Metformin, Gliclazide and Byeta ( to help control the weight put on by Gliclazide)

Anyway, to cut a long story short I indicated that I 'd rather live a shorter life than put on too much weight through the use of insulin. I now just take metformin, I am losing weight but still need help getting my sugar levels down.

I do not intend to cut my life short through neglect. I am just going to go for a run in a minute

Can anyone suggest ways I can help my self, Diet wise without using insulin.

Also does anyone else feel like I do? It is over a month now that I got my less than tactful letter stating that I had chosen to die early than take insulin. It sent a chill down my wife's spine when she read it.

I'd like to hear from people with similar views.


Thanks

Alan

 

[Martin Canty]

Hi Alan, welcome to the group....

A lot of us have had a lot of success with weight loss & maintenance, both insulin users & non users, it all comes down to a strategy which you find sustainable. There are many ideas about diet on this forum so I'll just share mine which appears to work for me....
My diet consists of pretty much all made from scratch food, omitting bread, pasta, rice & starchy vegetables.... I see no problems in replacing them with leafy vegetables. I don't worry about the fat except that it has to be quality fat (no vegetable, corn or other artificial oils) extra virgin if from plant based sources.
My A1c is running at about 36 & FBG is usually about 5.0. Weight 170 or thereabouts (6' tall)

 

[grovesy]

Welcome.

 

[A l a n]

Hi Alan, welcome to the group....

A lot of us have had a lot of success with weight loss & maintenance, both insulin users & non users, it all comes down to a strategy which you find sustainable. There are many ideas about diet on this forum so I'll just share mine which appears to work for me....
My diet consists of pretty much all made from scratch food, omitting bread, pasta, rice & starchy vegetables.... I see no problems in replacing them with leafy vegetables. I don't worry about the fat except that it has to be quality fat (no vegetable, corn or other artificial oils) extra virgin if from plant based sources.
My A1c is running at about 36 & FBG is usually about 5.0. Weight 170 or thereabouts (6' tall)

Thank you for your reply. I'm just back from my run now. This is the main reason for not wanting to put on the weight. I prefer to be active than immobile as I head towards 60. Unfortunately, I am not familiar with some of your terminology so I will have to get someone to translate for me. Thank you for sharing this with me. Alan

 

[trophywench]

Well - it's carbohydrates which all diabetics have problems with - not fats. And whether you are diabetic or not - absolutely everyone can lose weight by cutting down on all carbs. You may not have to give em up completely, but you have to discover how much of each one you wish to eat, by assessing your Blood Glucose with a meter before and approx. 90 mins/2 hours after you eat it. If your BG shoots up too high - firstly cut down on the amount and if you can't reduce it enough and still have a sensible amount, then it's probably best to decide 'I best not eat that, then.

 

[Martin Canty]

My A1c is running at about 36 & FBG is usually about 5.0.

A1c is a 3 month average of blood glucose, 36 indicates good control & is in the "non diabetic" range
FBG is the fasting Blood Glucose level (usually taken just after you wake up, again 5.0 is where non diabetics fall

Don't be fooled by these fairly good numbers, if I am not careful they will quickly rise & undo all my good work.

 

[A l a n]

A1c is a 3 month average of blood glucose, 36 indicates good control & is in the "non diabetic" range
FBG is the fasting Blood Glucose level (usually taken just after you wake up, again 5.0 is where non diabetics fall

Don't be fooled by these fairly good numbers, if I am not careful they will quickly rise & undo all my good work.

Thank you for explaining. Alan

 

[Owen]

Hi,

I have been a type 2 diabetic since 2002. When I was 37. I have seen family members die through their neglect of the condition, most notably my mother. My biggest hang up about the condition is putting on too much weight, so much so I have refused to take insulin, although my condition has worsened so much so that I do need it, according to the Doctors.

I was taking Metformin, Gliclazide and Byeta ( to help control the weight put on by Gliclazide)

Anyway, to cut a long story short I indicated that I 'd rather live a shorter life than put on too much weight through the use of insulin. I now just take metformin, I am losing weight but still need help getting my sugar levels down.

I do not intend to cut my life short through neglect. I am just going to go for a run in a minute

Can anyone suggest ways I can help my self, Diet wise without using insulin.

Also does anyone else feel like I do? It is over a month now that I got my less than tactful letter stating that I had chosen to die early than take insulin. It sent a chill down my wife's spine when she read it.

I'd like to hear from people with similar views.


Thanks

Alan

Insulin in small amounts with a GL diet will help you lose weight. There is also Trulicity that can run alongside insulin to help control weight. You link insulin with weight gain, which is not correct.

Its your life and your choices, but you need to become more informed so that you can make the best choices.

 

[James 048]

Hi,

I have been a type 2 diabetic since 2002. When I was 37. I have seen family members die through their neglect of the condition, most notably my mother. My biggest hang up about the condition is putting on too much weight, so much so I have refused to take insulin, although my condition has worsened so much so that I do need it, according to the Doctors.

I was taking Metformin, Gliclazide and Byeta ( to help control the weight put on by Gliclazide)

Anyway, to cut a long story short I indicated that I 'd rather live a shorter life than put on too much weight through the use of insulin. I now just take metformin, I am losing weight but still need help getting my sugar levels down.

I do not intend to cut my life short through neglect. I am just going to go for a run in a minute

Can anyone suggest ways I can help my self, Diet wise without using insulin.

Also does anyone else feel like I do? It is over a month now that I got my less than tactful letter stating that I had chosen to die early than take insulin. It sent a chill down my wife's spine when she read it.

I'd like to hear from people with similar views.


Thanks

Alan

Hi Alan
Welcome to the forum

 

[Deleted member 16779]

Hi Alan, I'd echo the key to managing your diabetes is to keep the carbohydrates very low - if you search the internet for the Low Carb High Fat diet, you'll find a lot of resources - don't let the 'high fat' put you off, it sounds so wrong, but many people (myself included) have lost weight and are keeping it off by eating the diet. Precisely why is still up for debate, but it seems to be combination of the way this diet affects your appetite - many people find they don't get the urge to snack or can go longer between meals - some slight improvement in your metabolism and the fact that you don't find as many snacking opportunities if you're avoiding carbs.

I find it a great diet because I haven't felt at any point that I've been hungry - and I can eat really tasty interesting food. Carbs are mostly the boring part of the meal - the rice, the pasta, the bread - after all.

The figure of 36 in his HbA1c Martin Canty mentioned is a FANTASTIC result for a diabetic - he's being very modest - it puts you well below the target that your diabetic healthcare professional is aiming for (48) - it's essentially like not having diabetes (as long as you don't eat carbs).

As has been said, you don't have to give up carbs completely - you need to start testing your blood sugar after meals to find out what you can eat without it going to high. I have a rule of thumb of around 25g per meal that seems to work for me, that's a few roast potatoes, a couple of slices of certain low-carb breads, or a small portion of rice. Quite a few people report that they can have a normal portion of porridge, but I can't unfortunately. I believe it's all down to your gut bacteria and the way it digests food differently. You really need to test in the mornings and after meals.

Exercise is great too - losing weight and exercising will both likely improve your numbers and of course both make each other easier. Personally, I've lost about 20kg and exercising has become easier and more fun and in turn that's help me lose weight. (Actually I must admit that I kind of cheat on the LCHF diet - I do love my wife's homemade jam and marmalade, so we have a good brunch at weekends with several rounds of toast and jam, but then I make sure I'm at the gym within an hour and having done that a few times and tested my blood sugar as I went along, it's keeps it at sufficient low levels - I promise myself to burn off at least all the calories from the carbs - so if I have 3 slices of low carb bread (40g carbs) with jam/marmalade (60g carbs) that's 400kCal (4kCal per gram of carb).

So what you need to do in short is:
1) Get a blood glucose test meter - you might be lucky and get your doctor or diabetic nurse to get you one and strips on the NHS, but many people have found they won't do it - you can buy one for about £25 and 50 strips for about £12, and some lancets for about 100 for £5.
2) Without changing your diet, test for a few days to a week: first thing in the morning - that's your fasting level and the 'background level' - you should hope to see that drop gradually; also after 1 hour and 2 hours after a meal - the level will go very high after an hour, but you'll be aiming for it to come back to your fasting level after an hour, if you're eating too many carbs, it probably won't at first.
3) Start cutting out carb while continuing to test - you should start to see immediate results with your levels dropping back to normal. You'll need to be a bit creative with meals, but there are a lot of low carb recipes and some surprising things that you can eat.
4) Don't eat anything labelled 'low fat' - it's probably sweetened instead of the fat, and generally don't avoid fat - you don't have to go out of your way to eat it, but you'll find e.g. full fat greek yoghurt doesn't need anything sweet in it to be tasty. Make sure that you eat some of the good fats too - Olive oil, avocados, nuts, oily fish, flax seeds (crushed or they'll just pass through). A good breakfast is about 100-150g Greek yoghurt with some crushed flax/linseed, and a small handful of broken walnuts and a bit of dried fruit or grated apple. (Lidl and Aldi both sell the crushed flax and large tubs of Greek yoghurt very cheaply - while you're at Lidl look out for their 'Protein rolls', they're 9g carb per roll).

 

[A l a n]

Hi Alan, I'd echo the key to managing your diabetes is to keep the carbohydrates very low - if you search the internet for the Low Carb High Fat diet, you'll find a lot of resources - don't let the 'high fat' put you off, it sounds so wrong, but many people (myself included) have lost weight and are keeping it off by eating the diet. Precisely why is still up for debate, but it seems to be combination of the way this diet affects your appetite - many people find they don't get the urge to snack or can go longer between meals - some slight improvement in your metabolism and the fact that you don't find as many snacking opportunities if you're avoiding carbs.

I find it a great diet because I haven't felt at any point that I've been hungry - and I can eat really tasty interesting food. Carbs are mostly the boring part of the meal - the rice, the pasta, the bread - after all.

The figure of 36 in his HbA1c Martin Canty mentioned is a FANTASTIC result for a diabetic - he's being very modest - it puts you well below the target that your diabetic healthcare professional is aiming for (48) - it's essentially like not having diabetes (as long as you don't eat carbs).

As has been said, you don't have to give up carbs completely - you need to start testing your blood sugar after meals to find out what you can eat without it going to high. I have a rule of thumb of around 25g per meal that seems to work for me, that's a few roast potatoes, a couple of slices of certain low-carb breads, or a small portion of rice. Quite a few people report that they can have a normal portion of porridge, but I can't unfortunately. I believe it's all down to your gut bacteria and the way it digests food differently. You really need to test in the mornings and after meals.

Exercise is great too - losing weight and exercising will both likely improve your numbers and of course both make each other easier. Personally, I've lost about 20kg and exercising has become easier and more fun and in turn that's help me lose weight. (Actually I must admit that I kind of cheat on the LCHF diet - I do love my wife's homemade jam and marmalade, so we have a good brunch at weekends with several rounds of toast and jam, but then I make sure I'm at the gym within an hour and having done that a few times and tested my blood sugar as I went along, it's keeps it at sufficient low levels - I promise myself to burn off at least all the calories from the carbs - so if I have 3 slices of low carb bread (40g carbs) with jam/marmalade (60g carbs) that's 400kCal (4kCal per gram of carb).

So what you need to do in short is:
1) Get a blood glucose test meter - you might be lucky and get your doctor or diabetic nurse to get you one and strips on the NHS, but many people have found they won't do it - you can buy one for about £25 and 50 strips for about £12, and some lancets for about 100 for £5.
2) Without changing your diet, test for a few days to a week: first thing in the morning - that's your fasting level and the 'background level' - you should hope to see that drop gradually; also after 1 hour and 2 hours after a meal - the level will go very high after an hour, but you'll be aiming for it to come back to your fasting level after an hour, if you're eating too many carbs, it probably won't at first.
3) Start cutting out carb while continuing to test - you should start to see immediate results with your levels dropping back to normal. You'll need to be a bit creative with meals, but there are a lot of low carb recipes and some surprising things that you can eat.
4) Don't eat anything labelled 'low fat' - it's probably sweetened instead of the fat, and generally don't avoid fat - you don't have to go out of your way to eat it, but you'll find e.g. full fat greek yoghurt doesn't need anything sweet in it to be tasty. Make sure that you eat some of the good fats too - Olive oil, avocados, nuts, oily fish, flax seeds (crushed or they'll just pass through). A good breakfast is about 100-150g Greek yoghurt with some crushed flax/linseed, and a small handful of broken walnuts and a bit of dried fruit or grated apple. (Lidl and Aldi both sell the crushed flax and large tubs of Greek yoghurt very cheaply - while you're at Lidl look out for their 'Protein rolls', they're 9g carb per roll).

Thanks for this, even after 12 years I'm still learning new things. Alan

 

[Martin Canty]

Precisely why is still up for debate, but it seems to be combination of the way this diet affects your appetite

As far as I understand it's a balancing act between energy requirements & macronutrient ratios....

For a ketogenic diet (AKA very low carb diet) the macronutrient ratio (based on energy not grams) is 5% carbs / 25% Protein / 70% fat, to adjust +/- body weight increase/decrease the amount of fat..... To lose weight reduce the fat & the body will make up the difference by burning body fat.
As for appetite suppression, fat tends to sate the appetite very fast so we don't tend to eat as much.
For energy, once keto-adapted (body is able to efficiently use fat for energy) the body has reserves of about 70,000 KCal of fat vs 2500 from glucose..... I noticed recently (while staffing an aid station for an ultra marathon) that the top runners only took nuts & water, avoided the carb offerings that we had.

One thing to note is that though we term this LCHF (Low Carb High Fat) it is probably about as much fat in the diet as a regular person will eat, perhaps slightly more but not by much. I was at a cooking demonstration in Crete (last year) I was shocked by how much Extra Virgin Olive Oil they used (this was before I discovered LCHF) form there I was exploring the Mediterranean diet (which is incidentally low carb) & eventually descended into the heresy of LCHF.
One final note, using this approach I have lost between 50-60lb, the first 30 was just by modifying my diet to reduce carbs, second (and hardest) 30lb was going LCHF, I am maintaining between 160 & 170lb right now

PS I avoid processed food like the plague, I look at the ingredient list & if I can't pronounce any of the ingredients then back on the shelf it goes

 

[Deleted member 16779]

PS I avoid processed food like the plague, I look at the ingredient list & if I can't pronounce any of the ingredients then back on the shelf it goes

Don't eat this then!
https://i.kinja-img.com/gawker-media/image/upload/19cthrwhxoxpmpng.png

 

[Redkite]

Hi Alan and welcome, you've had lots of great advice already on diet/carbs. I hope you don't mind if I add a different perspective - I think you should think again about insulin. It's NOT the case that insulin makes you gain weight. You have a lack of insulin at the moment - basically despite all your efforts with diet/exercise, and the medications to increase insulin sensitivity and to stimulate your pancreas to produce more insulin, the fact is your pancreas can't produce enough for your needs.

Insulin is used in the body's cells for the process of "burning" glucose for energy. Glucose comes from digestion of all types of carbohydrate. If you eat more carbs than you need for your energy output, any excess glucose will be converted to fat and stored. Neither of these processes can happen without the presence of insulin, but you can ONLY put on weight if you eat more carbs than you need for your activity levels. A lack of insulin leaves excess glucose in the bloodstream, where it causes all sorts of problems, and leaves you with a lack of energy.

You're likely to feel much better and full of energy again if you start on insulin....🙂

 

[A l a n]

As far as I understand it's a balancing act between energy requirements & macronutrient ratios....

For a ketogenic diet (AKA very low carb diet) the macronutrient ratio (based on energy not grams) is 5% carbs / 25% Protein / 70% fat, to adjust +/- body weight increase/decrease the amount of fat..... To lose weight reduce the fat & the body will make up the difference by burning body fat.
As for appetite suppression, fat tends to sate the appetite very fast so we don't tend to eat as much.
For energy, once keto-adapted (body is able to efficiently use fat for energy) the body has reserves of about 70,000 KCal of fat vs 2500 from glucose..... I noticed recently (while staffing an aid station for an ultra marathon) that the top runners only took nuts & water, avoided the carb offerings that we had.

One thing to note is that though we term this LCHF (Low Carb High Fat) it is probably about as much fat in the diet as a regular person will eat, perhaps slightly more but not by much. I was at a cooking demonstration in Crete (last year) I was shocked by how much Extra Virgin Olive Oil they used (this was before I discovered LCHF) form there I was exploring the Mediterranean diet (which is incidentally low carb) & eventually descended into the heresy of LCHF.
One final note, using this approach I have lost between 50-60lb, the first 30 was just by modifying my diet to reduce carbs, second (and hardest) 30lb was going LCHF, I am maintaining between 160 & 170lb right now

PS I avoid processed food like the plague, I look at the ingredient list & if I can't pronounce any of the ingredients then back on the shelf it goes

I have found that since I have stopped taking the gliclazide, my appetite has dropped markedly. Over the past month I have found little need to snack before mealtimes at work. This has improved my weight loss. My argument with taking all these tablets was that most of them made me put on weight and made the affects of Diabetes worse. In the first week of not taking the tablets I lost weight and felt on top of the world. But I know I have to reduce my sugar if I don't want to lose my sight and other complications. I'm only 12st 9lb. and am 5"6 roughly. I know that is over weight but not by much. I can still run and do sport which is the main thing for me.

 

[Redkite]

The thing is Alan, if you have high blood glucose your body tries to get rid of it through the urine, and compensates for the lack of glucose in the cells (where it can only go with sufficient insulin) by breaking down body fat to use as fuel. This is a terribly unhealthy way to lose weight

 

[Northerner]

Hi Alan, welcome to the forum 🙂 I echo what @Redkite has said about insulin - it does not automatically lead to weight gain, and it is essential for continued good health if your body is no longer capable of producing sufficient insulin of its own. If your levels are constantly elevated or fluctuating then this can lead to some of the dreadful complications of diabetes I am sure you are fully aware of Living without insulin when you need it won't necessarily shorten your life, it can lead to a vastly reduced quality of life for many, many years and something you clearly want to avoid because you want to be as fit and active as you can be! I use insulin, I'm also a runner - I have good blood sugar control and a BMI of 20.1 (9st 10lbs and 5'9"), so there's been no weight gain for me - I inject the insulin I need to allow my body to process my food efficiently and enable me to exercise and use the energy from the food, leaving no excess to lay down as extra weight 🙂 I'm also 58, so a similar age to you 🙂 I'm also called Alan!

Obviously, your doctor is best placed to know your situation. It's possible that you need the support of injected insulin for now, but there may be a possibility that adaptations to your diet and increased physical activity may bring you to a point where your body is able to cope without it - it's impossible to say or predict, as we are very complex beings and can vary considerably in our needs. Much depends on the state of your pancreas 🙂

What are your levels like at the moment? What level do you wake at in the morning?

 

[grovesy]

I have been on this journey along not quite as long as you.
I have found you have to find what works for you and what you can maintain long term.
I personally can't go very low carb as some do, but what I do works for me. When I was first diagnosed I had good results but I could not maintain that regime long term.
You have to find what works for you.

 

[Stitch147]

Hi and welcome to the forum. There is definately good advice from the people above.

 

[A l a n]

Hi Alan, welcome to the forum 🙂 I echo what @Redkite has said about insulin - it does not automatically lead to weight gain, and it is essential for continued good health if your body is no longer capable of producing sufficient insulin of its own. If your levels are constantly elevated or fluctuating then this can lead to some of the dreadful complications of diabetes I am sure you are fully aware of Living without insulin when you need it won't necessarily shorten your life, it can lead to a vastly reduced quality of life for many, many years and something you clearly want to avoid because you want to be as fit and active as you can be! I use insulin, I'm also a runner - I have good blood sugar control and a BMI of 20.1 (9st 10lbs and 5'9"), so there's been no weight gain for me - I inject the insulin I need to allow my body to process my food efficiently and enable me to exercise and use the energy from the food, leaving no excess to lay down as extra weight 🙂 I'm also 58, so a similar age to you 🙂 I'm also called Alan!

Obviously, your doctor is best placed to know your situation. It's possible that you need the support of injected insulin for now, but there may be a possibility that adaptations to your diet and increased physical activity may bring you to a point where your body is able to cope without it - it's impossible to say or predict, as we are very complex beings and can vary considerably in our needs. Much depends on the state of your pancreas 🙂

What are your levels like at the moment? What level do you wake at in the morning?

Hi Alan, thank you for this. Maybe it will give me inspiration.
Unfortunately, I got up late this morning and did not have time to do a blood test. My body is telling me I bet I was still over 10.

I said I took Byeta for the last 3 years, I don't know whether you are familiar with this. In combination with this they gave me humilin I a synthetic insulin. Within the first 4 weeks I put on a stone. And then stopped taking it. It was another month before I told the Diabetic Nurse I had stopped taking it. I think I forgot to mention I have started to take the Humilin I again. I have not found the right level to make a difference to my sugar. The only time my sugar has been below 10 was the day I had breakfast at 8am and nothing else until tea time. Not really good though.