Newbie 5 weeks in with some questions

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Amyfaith

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Hi everyone.

Very recently diagnosed type 2 here (early Jan) - did the full gamut of blood tests due to thunderclap headaches before Christmas and an a1c was in there. Headaches were caused by a new pillow and a mucked up neck, turns out, but the a1c came back at 85 (!). Was a bit of a shock as at the time I didn’t think it ran in my family (turns out it does, but my family is frankly awful at communication). My GP was thankfully not fat-shaming but equally kind of useless (‘just eat less’). Zero obvious symptoms. I’ve always had a high BMI, but I’ve never weight cycled, deliberately never dieted, I do a good amount of exercise (I don’t drive so it’s busses and walking for me) and always had a fairly balanced diet, so I guess genetics will always out. 2023 was an extremely high stress year for me, with proposed compulsory redundancies at my workplace and the process took an absurd 9 months to complete, so I suspect that likely had an impact.

As I’m an academic, I immediately did a slew of (real, like scientific papers) research because that’s just how I approach things. The very next day I went moderate-to-low carb, and in the past 5 weeks I’ve been keeping my carb count to about 130ish (usually below). I’ve managed to lose about 7% of my body weight in that time, still going down. I’m approaching this as weight neutrally as possible, but it is still nice to see the numbers go down.

Because my GP/surgery is being slow at getting me into the education programme (I received a link to a website, but that’s it so far…), and I hate working blind, I went and got myself a glucose meter. I have an existing skin condition (urticarial vasculitis) which means a CGM may not be a good option, though I’m tempted to try to get the data. Though my fasting glucose is a tad higher than ‘normal’ (6.1 on average), my pre and post meal numbers are disconcertingly normal (5.4-6.7ish max post meal). These don’t really match up with my last a1c, and I can’t imagine such a massive drop so quickly. Like if this was 3-4 months in, fine - but something here reads oddly. I’m sure the lowish carb is part of it, and I intend to do some experimenting to see what happens if I add some higher carb foods in, but - anyone else experienced something like this? Was my Jan a1c way off?
 
Welcome to the forum.
The HbA1C test is usually pretty reliable unless people have an haemoglobinopathy in which case not so as the test is a measure of how much glucose is attached to red blood cells over the 3 months or so prior to the test so a sort of average.
Things like stress or illness can increase blood glucose levels so that could be a reason.
Anyway looking forward you have made some positive changes in your diet. A good starting point for reducing carbs is no more than 130g per day so I would not think of increasing above that certainly until you have your next HbA1C which should be 3 months after the first.
Have you been prescribed any medication which would be usual with a high HbA1C and that in combination with your dietary changes should give you better results.
Getting as much knowledge as you can will stand you in good stead.
I found following the principals in this link successful and it is a easily sustainable regime, I have gone as low as 70g carbs per day but that is what I determined by testing at home. https://lowcarbfreshwell.com/
 
Thanks for that. No meds - just diet and lifestyle to start, so not sure what my GP was thinking but as that seems to be working I'm happy to go on like that. Next a1c also not till the six month mark, apparently, Lord only knows why. Strikes me after reading around on here and elsewhere that the 'general' in GP does seem to very much apply with diabetes care, which is a little frustrating when I want specific information.
 
Forget about A1c for now it's a 3 month average. Keep an eye on your sugar levels which seem OK, and keep your weight and waistline coming down.
If you haven't seen them have a look at these videos:
- Information for Doctors:
- Roy Taylor, Achieving T2D remission (May 2023):
- The nuts & bolts of drug free T2 diabetes remission by Dr David Unwin: 


I did Roy Taylor's Newcastle Diet, (real food version for weight loss). In retrospect I think the Harcombe Diet would have been easier, I am following its principle (rules) for weight maintenance:
- Harcombe Diet article (scroll down to seven added links to handy summaries and guides:
https://diabetes-type2-remission.blogspot.com/2023/12/the-harcombe-diet-how-to-eat-your.html

For some more information Google 'Marty Kendall Satiety' and take your pick including his website.
 
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Thanks for that. No meds - just diet and lifestyle to start, so not sure what my GP was thinking but as that seems to be working I'm happy to go on like that. Next a1c also not till the six month mark, apparently, Lord only knows why. Strikes me after reading around on here and elsewhere that the 'general' in GP does seem to very much apply with diabetes care, which is a little frustrating when I want specific information.
Your GP experience is not that unusual. I got nothing from mine other than my diagnosis but she did arrange for me to see the surgery's Diabetic Nurse and she was brilliant. Diet and Lifestyle changes worked for me and I had to come down from a much higher level than you, others have done the same, and it sounds like you're making good progress.
 
Welcome to the forum @Amyfaith

We do see different approaches from different GPs here. Some won’t confirm a T2 diagnosis until there have been 2 HbA1c checks both above the threshold… some leap straight into meds… some check / follow-up HbA1c way more rapidly than others.

3-6 months between HbA1c checks is pretty common as the Hb in HbA1c is the red blood cells, and they last for about 120 days, so more frequently than 3months tends to have some overlap between the samples/results.

Hope you find the weight loss continues and your results stay as on-target as you have seen so far. It may be that reducing your carb intake and losing those kilos has helped your metabolism take a breather and cope better.

Keep going!
 
Thanks all - this is very helpful to know. I’ve been to my practice’s diabetes nurse, too, which was similarly unhelpful - though this could be because it was chaotic as apparently I was having a full on panic attack during it and that had a just *wonderful* effect on my blood pressure (it is absolutely normal, after extensive testing; I just freak out over health things to the tune of extremely high levels of BP). The practice seems to be good at dotting Is and crossing Ts but that’s about it. It all very much feels like being left to ‘get on’, but in many ways the implication was ‘we have to do this, but we don’t really think you can do much on your own or you wouldn’t be like this’, which I take umbridge with on a number of levels.

My favourite bit was them sending the link to the mydiabetes website to my university email (when they have my private email as my default) - which very occasionally I need to have have on a projector while teaching. Loved that.

It does seem my system is getting a rest - which is definitely good! My sense is that a lot of diet/lifestyle treatment is giving your endocrine system a rest and seeing if it will reset correctly before going in with chemical interventions (do correct me if I’m wrong!). Very glad I decided to get a meter - already really eye opening (again, another thing that my GP said just wasn’t done because it ‘isn’t helpful’).
 
Thanks all - this is very helpful to know. I’ve been to my practice’s diabetes nurse, too, which was similarly unhelpful - though this could be because it was chaotic as apparently I was having a full on panic attack during it and that had a just *wonderful* effect on my blood pressure (it is absolutely normal, after extensive testing; I just freak out over health things to the tune of extremely high levels of BP). The practice seems to be good at dotting Is and crossing Ts but that’s about it. It all very much feels like being left to ‘get on’, but in many ways the implication was ‘we have to do this, but we don’t really think you can do much on your own or you wouldn’t be like this’, which I take umbridge with on a number of levels.

My favourite bit was them sending the link to the mydiabetes website to my university email (when they have my private email as my default) - which very occasionally I need to have have on a projector while teaching. Loved that.

It does seem my system is getting a rest - which is definitely good! My sense is that a lot of diet/lifestyle treatment is giving your endocrine system a rest and seeing if it will reset correctly before going in with chemical interventions (do correct me if I’m wrong!). Very glad I decided to get a meter - already really eye opening (again, another thing that my GP said just wasn’t done because it ‘isn’t helpful’).
Unless you have an extremely good GP surgery you will find more help and information here, these days people have to be proactive in managing their condition and take control and you have done that by getting a monitor and coming on here.
 
Unless you have an extremely good GP surgery you will find more help and information here, these days people have to be proactive in managing their condition and take control and you have done that by getting a monitor and coming on here.
Ha, story of my life. I had to diagnose my own auto-immune condition. They were happy to have me on 500% the normal dose of antihistamines before I sent them a dozen paper that described exactly what I had (one quick skin biopsy later and I was right). What’s one more condition to self-advocate for between friends?
 
Hello from a fellow thunderclap sufferer!! I don’t meet many (none in the flesh) so virtual sympathies from me because they are horrid. My pain is always just above my right ear.

Anyway, back to diabetes. My GP and diabetes nurse were fantastic but this forum has been an amazing source of information so keep logging in and searching for information. No question is a silly one and everyone is really friendly.

I followed a low carb approach to managing my diabetes with great success. Good luck with your journey xx
 
Hello from a fellow thunderclap sufferer!! I don’t meet many (none in the flesh) so virtual sympathies from me because they are horrid. My pain is always just above my right ear.

Anyway, back to diabetes. My GP and diabetes nurse were fantastic but this forum has been an amazing source of information so keep logging in and searching for information. No question is a silly one and everyone is really friendly.

I followed a low carb approach to managing my diabetes with great success. Good luck with your journey xx
Awww thanks! Luckily for me the thunderclaps were limited to two weeks off and on (GP thinks they were migraines triggered by neck problems given the pattern), and seem to have gone away. But commiserations - utterly debilitating!

Had my first slightly high glucose number today - 8.2 - after having a tiny bit of whole wheat pasta this evening with dinner (30g dry - genuinely not sure why I brothered even if I only did it for the experiment!). Had same dinner but different sauce carrier last night and totally normal number (6.6). Forgot to set a timer but I wasn’t too far out of 2 hours. Trying not to stress about it as I knew it could happen (and it’s still within broad target ranges but I was getting a little full of myself, I think!). More work stress, too, which I’m sure didn’t help. I am finding that while testing is making me calmer about things, it’s also weirdly stressful too.
 
Though my fasting glucose is a tad higher than ‘normal’ (6.1 on average), my pre and post meal numbers are disconcertingly normal (5.4-6.7ish max post meal). These don’t really match up with my last a1c, and I can’t imagine such a massive drop so quickly. Like if this was 3-4 months in, fine - but something here reads oddly. I’m sure the lowish carb is part of it, and I intend to do some experimenting to see what happens if I add some higher carb foods in, but - anyone else experienced something like this? Was my Jan a1c way off?
It seem feasible that what's changed is the new diet in combination with the weight loss. Figure 2 in this paper, illustrating data from the Counterpoint study, shows how quickly fasting blood glucose can fall on a very low calorie diet. Weight loss getting fat out of the liver, improving insulin sensitivity in that organ, reducing fasting BG very quickly. If your fasting BG was very high at time of diagnosis then that, in combination with whatever you were eating in the months leading up to test, may explain why your HbA1c was so high relative to the numbers you're seeing now. Great success! 🙂
 
Losing 7% of body weight would be expected to have a significant impact on BG regulation and maybe even enough to get to "remission" (as an outlier).
 
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