New diagnosis. confused

[MihaiM]

Hello,
Merry Christmas everyone!

I'll try to be short and concise. 10 days ago (Friday 13th, talk about bad luck) I have been diagnosed with Type 2 Diabetes, with two blood tests resulting in
HbA1c level 48mmol/mol. It's very strange because I was prediabetic for 2 years, I haven't tried to lose weight or change my diet, that's true, but in October 2023 my HbA1c was 42, and constantly for 2 years around that area. In January 2024, in just 3 months it jumped to 46. In May it was 47, and now 48, and I haven't changed anything between October and January.

The diabetic nurse told me to go on a low carb diet to lose weight as I had 110 kg and 180 cm height, how many kilograms should I lose to go in remission?
She said that she will not give me metformin at the moment as it can go in remission if I lose weight and won't need tablets.
Since the diagnosis, 12 days ago, I stopped all the alcohol (was a heavy drinker, around 5 beers every day or wine sometimes, probably one of the reasons I got diabetes) and all sugar/sweets. Was eating only very low carb vegetables, like cabbage, sprouts, eggs, tomatoes and some chicken/beef.

Are there any supplements that Improve insulin sensitivity? Read somewhere that Omega 3, Cinammon, and Magnesium helps with that?

In these 12 days I have managed to lose 3 kilograms from 110 to 107.

The trouble I have is that I started measuring the blood sugar levels and in the mornings after waking up, it is always around 7.2 mmol/L on an empty stomach! Why so high considering I was on an empty stomach? I heard this is called the Dawn phenomenon? If so, how can I have a lower blood sugar level when waking up and fix the Dawn phenomenon?

I had dizziness/headache and felt weakness in my legs and also heart rate a bit low, 54-55-56, but after an hour or so it improved to 60. I tried skipping breakfast for 3 mornings, and the blood sugar was going down very low, from 7.2 to 6.1 at 12:15 pm with eating just a slice of cheese and a plum. Shouldn't it go down faster? When I arrived home at 5 pm it was very low, 3.3, so that is dangerous? It means I shouldn't skip breakfast?
Also after those 3 days of skipping breakfast, I had a constant headache/dizziness and legs felt weak when walking.

Went to see the gp and explained all this, he told me for now to eat a normal diet with carbs, but smaller portions, until I get on the Desmond Course to help me with my nutrition. After I started eating carbs again the headache and week legs started to go away. I think I been in keto for those 3 days when I didn't have carbs and I took energy from fats and that's why I felt dizzy and with weak legs?

I heard a low fat hypocaloric diet would be good to try? Can you recommend a diet like that please or how to lose weight faster?

Also, I remember 2 years ago the gp told me I have low cortisol levels and had a injection to increase cortisol levels. I did not know for what that injection is, asked me if I agree to have it and just said yes. Could that also triggered prediabetes?

Also, in the last few days after skipping those 3 breakfasts my face is reddish in color sometimes and all face is dry, including lips and nose, skin is flaky, was that the cause? Or maybe because of the sudden alcohol cut off?

Would greatly appreciate your help on what to change/improve for my journey on losing weight and also hope I get the answers at the questions mentioned above if you can spare some time!

 

[Alan44]

Hi @MihaiM and welcome to the forum.
Diabetes can at best be complex, as what works for one may not work for another.
We have many members who have tackled their diabetes in different ways and most will tell you it's a marathon not a sprint and at 48 hba1c you are only just in the diabetic range so no need to panic, maybe just a slight lifestyle change will help ie weight, diet and exercise.

One point to note is that we are not medics and can only give suggestions based on what has worked for us or not as the case mat be.
A good starting point is the "learning zone" (top of the page)

Alan 😉

 

[Felinia]

Hello and welcome to the Forum
It's very confusing when you are first diagnosed, with a lot to take in. You are very lucky on 2 counts - your nurse is one of the enlightened ones who is giving you a chance to make lifestyle changes without medication, and you are just into the diabetic zone, so time to take charge of your body now, before your HbA1c rises. Well done on cutting back on the beer, as not only will that reduce your glucose, but help with weight loss.
I can tell you what worked for me. As Alan44 suggested, the Learning Zone is a good place to start. I worked through each module slowly, so I could retain the information, starting with food, then exercise, then the remainder.
I also kept a totally honest food diary of all my intake - food, drink and snacks. I kept mine via an app - NutraCheck - which I set to monitor daily calories and carbs. It works out at around £29 a year (how much beer intake?). As you have learned it's not just sugars, but carbs you have to watch - so bread, pasta, rice, potatoes, cereals, processed foods and some fruits. As you have also found the hard way, cutting out too much too quickly can make you feel unwell! I think it's called Keto flu. The suggested maximum is 130gm carbs a day. In my case it meant smaller portions of carbs, and increased portions of veggies and protein. I believe in moderation, not abstinence, for myself. You might like to look at the Freshwell website for food ideas.
You asked about the Dawn Phenomenon. It's how our bodies work first thing, so we are ready to get up and go. As far as I know, you can't "fix" the Dawn Phenomenon. You asked about your weight. Your BMI is 34 which puts you in the obese category. To get a BMI of 25, you would need to weigh 81kg. However, Type 2 diabetics are advised that a 10% weight loss - in your case 11kg - is an excellent start. I don't know your build or ethnicity so suggest you aim to lose 11kg first, then take it from there to a weight you are comfortable with that suits you. I never could get my weight down!
Best wishes

 

[medidia]

Hello,
Merry Christmas everyone!

I'll try to be short and concise. 10 days ago (Friday 13th, talk about bad luck) I have been diagnosed with Type 2 Diabetes, with two blood tests resulting in
HbA1c level 48mmol/mol. It's very strange because I was prediabetic for 2 years, I haven't tried to lose weight or change my diet, that's true, but in October 2023 my HbA1c was 42, and constantly for 2 years around that area. In January 2024, in just 3 months it jumped to 46. In May it was 47, and now 48, and I haven't changed anything between October and January.

The diabetic nurse told me to go on a low carb diet to lose weight as I had 110 kg and 180 cm height, how many kilograms should I lose to go in remission?
She said that she will not give me metformin at the moment as it can go in remission if I lose weight and won't need tablets.
Since the diagnosis, 12 days ago, I stopped all the alcohol (was a heavy drinker, around 5 beers every day or wine sometimes, probably one of the reasons I got diabetes) and all sugar/sweets. Was eating only very low carb vegetables, like cabbage, sprouts, eggs, tomatoes and some chicken/beef.

Are there any supplements that Improve insulin sensitivity? Read somewhere that Omega 3, Cinammon, and Magnesium helps with that?

In these 12 days I have managed to lose 3 kilograms from 110 to 107.

The trouble I have is that I started measuring the blood sugar levels and in the mornings after waking up, it is always around 7.2 mmol/L on an empty stomach! Why so high considering I was on an empty stomach? I heard this is called the Dawn phenomenon? If so, how can I have a lower blood sugar level when waking up and fix the Dawn phenomenon?

I had dizziness/headache and felt weakness in my legs and also heart rate a bit low, 54-55-56, but after an hour or so it improved to 60. I tried skipping breakfast for 3 mornings, and the blood sugar was going down very low, from 7.2 to 6.1 at 12:15 pm with eating just a slice of cheese and a plum. Shouldn't it go down faster? When I arrived home at 5 pm it was very low, 3.3, so that is dangerous? It means I shouldn't skip breakfast?
Also after those 3 days of skipping breakfast, I had a constant headache/dizziness and legs felt weak when walking.

Went to see the gp and explained all this, he told me for now to eat a normal diet with carbs, but smaller portions, until I get on the Desmond Course to help me with my nutrition. After I started eating carbs again the headache and week legs started to go away. I think I been in keto for those 3 days when I didn't have carbs and I took energy from fats and that's why I felt dizzy and with weak legs?

I heard a low fat hypocaloric diet would be good to try? Can you recommend a diet like that please or how to lose weight faster?

Also, I remember 2 years ago the gp told me I have low cortisol levels and had a injection to increase cortisol levels. I did not know for what that injection is, asked me if I agree to have it and just said yes. Could that also triggered prediabetes?

Also, in the last few days after skipping those 3 breakfasts my face is reddish in color sometimes and all face is dry, including lips and nose, skin is flaky, was that the cause? Or maybe because of the sudden alcohol cut off?

Would greatly appreciate your help on what to change/improve for my journey on losing weight and also hope I get the answers at the questions mentioned above if you can spare some time!

First of all I would say that the decision of seeking remission instead of taking meds should be yours. My GP said we manage diabetes in partnership, she prescribed metformin to help me het started, I'm not taking it and went low carb instead, but I was given the choice.
Regarding weight loss the figured I've seen in research studies was at least 5%. BUT the success rate of reaching and maintaining weight loss is very low, after 5 years most people got it back, and those who didn't had to continue to work on it. These were volunteers, they were not coerced...
Low (ish) carbs is working well for me, I think like you when I started I went too low and I wasn't feeling great, I was scared of carbs, so I forced myself to eat a bit more and now it's going well.
I hope you find what works for you And taking med to control diabetes is a perfectly valid choice, not everyone can lose weight, or restrict their diet

 

[Leadinglights]

A lot of good advice in the posts above to take in but you are only just over the threshold into the diabetic zone and is likely explained by what I call diet creep over time and likely your body being less tolerant of high carb foods so cutting those out or reducing portions is probably all that is needed. Certainly cutting out the beer and keeping to low carb drinks like wine or spirits with diet mixers will help.
Whatever you choose has to be a sustainable new way of eating not a quick fix and then a return to previous ways.
I found following the principals in the Freshwell program successful and reduced my HbA1C from 50mmol/mol to 42 in 3 months and it is now just my new way. No extras which generally all they achieve is to part you with your money.
This is the link https://lowcarbfreshwell.com/
There is no need to panic but take time to make a plan, it is better to reduce blood glucose gradually to prevent issues with eyes and nerves.
Use your morning /fasting readings to check progress and look for trend downwards rather than individual readings. Having a low carb breakfast is often better than fasting as that means to liver releases glucose to give you energy for your organs to function and for any activity in the absence of food.
You could do some strategic testing of your meals by testing before you eat and after 2 hours and if the increase is no more than 2-3mmol/l or no more than 8-8.5 after 2 hours then the meal is OK. you are aiming at 4-7mmol/l before meals and morning /fasting.

 

[Inka]

The diabetic nurse told me to go on a low carb diet to lose weight as I had 110 kg and 180 cm height, how many kilograms should I lose to go in remission?

Welcome @MihaiM Your BMI is 34, so it might well be that weight loss will help. According to the NHS calculator, the best weight for your height is between 60 kilograms and 81 kilograms.

Remember that “low carb” doesn’t mean no carbs. Remember too that people use a variety of diets, depending on what suits them and works for them as an individual. Anything sensible that helps you lose weight should be helpful. You’re only just in the diabetes zone, so small, sustained changes should hopefully improve things.

 

[JITR]

@Medida
I like to make a few comments, triggered by your excellent post.

First of all I would say that the decision of seeking remission instead of taking meds should be yours. My GP said we manage diabetes in partnership, she prescribed metformin to help me get started, I'm not taking it and went low carb instead, but I was given the choice.

Whenever medically advisable, GPs should give everyone should be that choice. Following the World Health Organisation protocol they should usually recommend diet and exercise before medication and agree targets with their patients. I was not and I suspect many others are not either. I chose diet because it would faster acting and more effective than Metformin. When I explained why My GP said she knew nothing about the world leading research on weight loss remission carried out at Newcastle University Magnetic Resonance Centre 15 years previously.

Regarding weight loss the figured I've seen in research studies was at least 5%.

To achieve remission T2Ds who are overweight or obese may have to lose 15 - 20 kg or more. The success rate is over 50% who achieve the target but that is an average. It is much higher for the recently diagnosed and much less for those who have had the condition for over 6 years.

Targets for T2Ds of normal weight are lower (5 - 8 kg?). It seems, optimal patterns of weight loss have yet to be fully researched. Maybe a combination Early Time Restricted Eating (eTRE), intermittent fasting and exercise may prove effective - who knows?

BUT the success rate of reaching and maintaining weight loss is very low, after 5 years most people got it back,

Many people are reaching their weight loss targets, both on managed and self-managed programmes. For example, Dr David Unwin quotes a 50% success rate for T2Ds at his surgery - and a 93% success rate with prediabetics. He and his colleagues monitor their patients HbA1c during maintenance and help to keep them on track.

A major problem with the reports I have seen is they deal only in averages. They do not analyse the whys and wherefores of individual successes and failures.

and those who didn't had to continue to work on it.

Of course we do. Our bodies are all to happy to put on weight. We know that from experience. Each of us has to find a dietary regime which works for us. I have found it helpful to build in weight loss principles into mine (allow time between meals for fat burning, some intermttent fasting to correct imbalance). It would be good to a concerted action to come up with some basic guidance which everyone can follow (both HCPs and patients)

Not everyone can lose weight, or restrict their diet

True, but experts say the great majority of the newly diagnosed and prediabetics could. I think restricting diet is the wrong approach. Be positive, eat what is good for you and forget the rest.

 

[JITR]

@MihaiM

I am 180cm too and was 92kg at diagnosis. My HbA1c was 117. After reading Prof Roy Taylor's book, Life without Diabetes, Type 2, I lost 22kg on protein and vegetable diet with no medication. My HbA1c went down into the 30s, normal.

If you are like me, your weight and waistlin increased over the years while you went from normal to prediabetic and now T2D. At the same time your glucose and fat control has probably become disregulated, insulin resistance has developed and, to make matters worse, so has a fatty liver. In 2008 or thereabouts Prof Taylor and his team at Newcastle University etablished many people can reverse that process by losing weight.

I suggest you watch Roy Taylor, Achieving T2D remission (May 2023) He ends by urging everyone to lose excess weight by any available means.

You could choose from these dietary approaches (all variations on a low carb theme):
- https://www.lowcarbfreshwell.com/documents/8/Freshwell_Red_Amber_Green.pdf
- https://phcuk.org/wp-content/uploads/A_5_page_low_carb_diet_leaflet_Unwin_2021-converted.pdf
- What should we eat? https://www.zoeharcombe.com/2021/08/what-should-we-eat/
- https://drive.google.com/file/d/1zfenN1cLfGNHa7qBp9KDh1u1iqxvTGJF/view
(or go to: realmealrevolution.com)

If your GP/DNs do not know about remission you could draw their attetion to:
- Information for Doctors:

 

[goodybags]

Hi @MihaiM welcome to the forum, many users will confirm this is a great source of knowledge from other Diabetics sharing their thoughts and experiences
your Hba1c @48 puts you just at the threshold of now being Diabetic, as obviously previously you were shown to be Pre-Diabetic
It might just take a few changes in your diet to bring your Hba1c and your weight down
I think someone else has already recommended looking at freshwell page for diet advice on a lower carb healthy diet
and you’ve already been recommended keeping a HONEST food diary

I would like to add that breakfast can be the most important meal of the day, I noticed you commented you were skipping breakfast, that might’ve not always be a good idea, but make it low carb & healthy
also you said you were trying to loose some weight, take a look at the NHS BMI calculator if you haven’t seen it you will find it at

Calculate your body mass index (BMI) for adults - NHS

Check your BMI to find out if you're a healthy weight for your height, and get advice on what to do next. This BMI calculator is for people over 18 years old.

www.nhs.uk

set your goal regarding some weight loss
mine hasn’t been by diet alone, but got mine down (in the last 6 months) from 33 down to 28

 

[BobbleHat]

Hello,
Merry Christmas everyone!

I'll try to be short and concise. 10 days ago (Friday 13th, talk about bad luck) I have been diagnosed with Type 2 Diabetes, with two blood tests resulting in
HbA1c level 48mmol/mol. It's very strange because I was prediabetic for 2 years, I haven't tried to lose weight or change my diet, that's true, but in October 2023 my HbA1c was 42, and constantly for 2 years around that area. In January 2024, in just 3 months it jumped to 46. In May it was 47, and now 48, and I haven't changed anything between October and January.

The diabetic nurse told me to go on a low carb diet to lose weight as I had 110 kg and 180 cm height, how many kilograms should I lose to go in remission?
She said that she will not give me metformin at the moment as it can go in remission if I lose weight and won't need tablets.
Since the diagnosis, 12 days ago, I stopped all the alcohol (was a heavy drinker, around 5 beers every day or wine sometimes, probably one of the reasons I got diabetes) and all sugar/sweets. Was eating only very low carb vegetables, like cabbage, sprouts, eggs, tomatoes and some chicken/beef.

Are there any supplements that Improve insulin sensitivity? Read somewhere that Omega 3, Cinammon, and Magnesium helps with that?

In these 12 days I have managed to lose 3 kilograms from 110 to 107.

The trouble I have is that I started measuring the blood sugar levels and in the mornings after waking up, it is always around 7.2 mmol/L on an empty stomach! Why so high considering I was on an empty stomach? I heard this is called the Dawn phenomenon? If so, how can I have a lower blood sugar level when waking up and fix the Dawn phenomenon?

I had dizziness/headache and felt weakness in my legs and also heart rate a bit low, 54-55-56, but after an hour or so it improved to 60. I tried skipping breakfast for 3 mornings, and the blood sugar was going down very low, from 7.2 to 6.1 at 12:15 pm with eating just a slice of cheese and a plum. Shouldn't it go down faster? When I arrived home at 5 pm it was very low, 3.3, so that is dangerous? It means I shouldn't skip breakfast?
Also after those 3 days of skipping breakfast, I had a constant headache/dizziness and legs felt weak when walking.

Went to see the gp and explained all this, he told me for now to eat a normal diet with carbs, but smaller portions, until I get on the Desmond Course to help me with my nutrition. After I started eating carbs again the headache and week legs started to go away. I think I been in keto for those 3 days when I didn't have carbs and I took energy from fats and that's why I felt dizzy and with weak legs?

I heard a low fat hypocaloric diet would be good to try? Can you recommend a diet like that please or how to lose weight faster?

Also, I remember 2 years ago the gp told me I have low cortisol levels and had a injection to increase cortisol levels. I did not know for what that injection is, asked me if I agree to have it and just said yes. Could that also triggered prediabetes?

Also, in the last few days after skipping those 3 breakfasts my face is reddish in color sometimes and all face is dry, including lips and nose, skin is flaky, was that the cause? Or maybe because of the sudden alcohol cut off?

Would greatly appreciate your help on what to change/improve for my journey on losing weight and also hope I get the answers at the questions mentioned above if you can spare some time!

Hello and welcome to the forum.
I was diagnosed in July with a hba1c of 52. I had been prediabetic (hba1c of 42) for 2 years previously. In hindsight, the prediabetes was a warning I ignored and my genetics kicked I'm as I got older ... et voila, type 2 diabetes.

I was pleased that my nurse was happy for me to try diet control first. I used the Freshwell App and went low carb. It suits me very well. I still enjoy eating and it feels long term sustainable to me. I have found that I've settled quite naturally into around 60g carbs per day. I don't eat breakfast - I've never liked it and find I am hungrier all day on the days when I do eat it. So, I fast in a rough 16:8 pattern - I'm not rigid about it - and I do take a splash of milk in my tea sobsome people would say I do break my fast first thing when I have my morning cuppa. I was diagnosed with non-alcoholic fatty liver before I was diagnosed which I think was a factor in my morning numbers being higher than my pre-prandial (although never over 7 so I didn't stop my fasting because of it). As my liver has healed, my numbers have settled to high 5-low 6 so happy to stick with this approach.

4 months of doing it this way, my last blood results showed normal liver function and a hba1c of 39 so I feel positively about my approach. (I've also lost some weight - I don't weigh regularly but over 13kg so far).

As others have said, diabetes is complex and individual so what has worked for me may not be the right approach for you. I shared because I saw a lot of similarities in our starting numbers, weights etc. Good luck as you work out how to manage your diabetes.

 

[JITR]

@BobbleHat

You mention fatty liver. I was diagnosed with that too at the same time as T2D. The radiologist said treat it by diet, meaning lose weight to get rid of its excess fat. That is exactly what Prof Roy Taylor prescribed to treat T2D after his team's ground breaking research in c.2008 (funded by Diabetes UK). See my post above yesterday.

Roy Taylor says show me a T2D and I will show you a fatty liver. He means about 98% of the c.170,000 newly diagnosed as T2D each year (*). From that point of view we are all in the same boat and the way back to dry land is the same.

Nothing could be simpler. 'Too much fat' - see Roy Taylor Information for Doctors:

* i.e. not the c.3,000+ categorised as T2D for all sorts of other reasons.