I was diagnosed with type-2 diabetes back in April by accident, with an HbA1C figure of 11.5% (I think - this was a confusing time with a lot of numbers thrown around, typically without the units they were being expressed in, and getting data out of my GP's receptionist is challenging).
I was given a ten-minute appointment with a diabetes nurse, who gave me some very basic advice on diet (portion control), leaflets on looking after my feet, and so on. Many assumptions were made, such as that I was on a "typical Scottish diet of mince and tatties" (I have never eaten mince and tatties in my life, nor would I!), and that I should perhaps eat fewer tatties. I was told (in words of one syllable) that red meat is the only source of dietary iron (which I knew to be wrong), NOT to test my own blood sugar (which I now consider to have been bad advice) and left to my own devices.
I crash educated myself on type-2 diabetes, going back to the primary literature when I needed to.
Mistakes were made. In particular, "eat lots of wholegrains" very quickly becomes a quantity of wholegrains that will cause a vicious glucose spike. The protein shakes I was drinking in order to buffer the carbohydrates in a meal contained enough carbs in themselves to do likewise. Eating even low-GI fruit can become "too much" very, very quickly. If I had ignored the diabetes nurse this would have been clear much, much earlier.
Otherwise, I threw the kitchen sink at the problem. Walks. The rowing machine I bought at the height of the pandemic was repurposed from the clothes horse it had inevitably become when it was relatively safe to get out again. Strength training. Berberine. Cinnamon. I cut out most of the ultra-processed food, all the refined sugar, alcohol, fruit juice, potatoes (oh, potatoes!).
My BMI has dropped from 25.7 to 21.9. My waist to height ratio has gone from 0.55 to 0.51. I have a body roundness index figure of 0.35. My friends say I "look skinny".
By early August, my HbA1C was down to 8.4%. Not good enough. I took the better advice of people living with diabetes and started glucose testing, initially with a finger-prick device and very shortly thereafter with a CGM.
That tells me my current A1C estimate, based on 27 days of data, is 6.2%. For the past 14 days, I have spent 99% of the time with my glucose levels between 3.9mmol/L and 10mmol/L (for the past 10 days it's been 100%). My average daily glucose for the past fortnight has been 6.7mmol/L, with a variability coefficient of 16.6%. I ran the numbers through a linear regression calculator, which tells me my daily glucose average is dropping by just short of 0.5mmol/L a week.
Some of that is clearly about learning what foods cause a problem. To what degree it's an actual improvement in insulin response remains unknown, in part because I'm nervous about eating a large sandwich and finding out.
That having been said, I'm winning. The glucose figures are such that, if I can sustain them without the drugs (I'm on Empagliflozin as well), that puts me into the remission category.
Achievement.
BUT:
I can safely lose about another 3 or 4 kilos before I run the risk of a high fever dropping me into a position where I would be dangerously underweight. At present rates of weight loss (I have been fairly steadily losing about half a kilo a week since April), that would be in late October or early November, which is now looming in a way it wasn't back when I started. Everything I know of that will maintain safe glucose levels is going to incidentally cause me to lose weight.
On the other hand, at present rates my average daily glucose should be into the nondiabetic (not prediabetic, *non*diabetic) range perhaps a little bit before that.
So, I have some related questions I was hoping someone could answer, please:
Does anyone have any experience of maintaining remission without losing weight? What worked for you?
and
What actually happens to your insulin response when you are in remission? Do you reach a point where you can eat a banana without your glucose levels heading for 11 or 12 mmol/L (which is what happened last time I tried it), or is it simply the fact that remission or not, I am still going to be diabetic and too much carbohydrate is going to cause a nasty sugar spike? Is remission really just good ongoing glucose control? Is the way that I know I'm in remission the (currently hypothetical) fact that those spikes don't happen? Would I be able to go to my local café and eat a slice of chocolate cake and see my glucose go up to 7.8mmol/L and come straight back down?
Thank you.
I was given a ten-minute appointment with a diabetes nurse, who gave me some very basic advice on diet (portion control), leaflets on looking after my feet, and so on. Many assumptions were made, such as that I was on a "typical Scottish diet of mince and tatties" (I have never eaten mince and tatties in my life, nor would I!), and that I should perhaps eat fewer tatties. I was told (in words of one syllable) that red meat is the only source of dietary iron (which I knew to be wrong), NOT to test my own blood sugar (which I now consider to have been bad advice) and left to my own devices.
I crash educated myself on type-2 diabetes, going back to the primary literature when I needed to.
Mistakes were made. In particular, "eat lots of wholegrains" very quickly becomes a quantity of wholegrains that will cause a vicious glucose spike. The protein shakes I was drinking in order to buffer the carbohydrates in a meal contained enough carbs in themselves to do likewise. Eating even low-GI fruit can become "too much" very, very quickly. If I had ignored the diabetes nurse this would have been clear much, much earlier.
Otherwise, I threw the kitchen sink at the problem. Walks. The rowing machine I bought at the height of the pandemic was repurposed from the clothes horse it had inevitably become when it was relatively safe to get out again. Strength training. Berberine. Cinnamon. I cut out most of the ultra-processed food, all the refined sugar, alcohol, fruit juice, potatoes (oh, potatoes!).
My BMI has dropped from 25.7 to 21.9. My waist to height ratio has gone from 0.55 to 0.51. I have a body roundness index figure of 0.35. My friends say I "look skinny".
By early August, my HbA1C was down to 8.4%. Not good enough. I took the better advice of people living with diabetes and started glucose testing, initially with a finger-prick device and very shortly thereafter with a CGM.
That tells me my current A1C estimate, based on 27 days of data, is 6.2%. For the past 14 days, I have spent 99% of the time with my glucose levels between 3.9mmol/L and 10mmol/L (for the past 10 days it's been 100%). My average daily glucose for the past fortnight has been 6.7mmol/L, with a variability coefficient of 16.6%. I ran the numbers through a linear regression calculator, which tells me my daily glucose average is dropping by just short of 0.5mmol/L a week.
Some of that is clearly about learning what foods cause a problem. To what degree it's an actual improvement in insulin response remains unknown, in part because I'm nervous about eating a large sandwich and finding out.
That having been said, I'm winning. The glucose figures are such that, if I can sustain them without the drugs (I'm on Empagliflozin as well), that puts me into the remission category.
Achievement.
BUT:
I can safely lose about another 3 or 4 kilos before I run the risk of a high fever dropping me into a position where I would be dangerously underweight. At present rates of weight loss (I have been fairly steadily losing about half a kilo a week since April), that would be in late October or early November, which is now looming in a way it wasn't back when I started. Everything I know of that will maintain safe glucose levels is going to incidentally cause me to lose weight.
On the other hand, at present rates my average daily glucose should be into the nondiabetic (not prediabetic, *non*diabetic) range perhaps a little bit before that.
So, I have some related questions I was hoping someone could answer, please:
Does anyone have any experience of maintaining remission without losing weight? What worked for you?
and
What actually happens to your insulin response when you are in remission? Do you reach a point where you can eat a banana without your glucose levels heading for 11 or 12 mmol/L (which is what happened last time I tried it), or is it simply the fact that remission or not, I am still going to be diabetic and too much carbohydrate is going to cause a nasty sugar spike? Is remission really just good ongoing glucose control? Is the way that I know I'm in remission the (currently hypothetical) fact that those spikes don't happen? Would I be able to go to my local café and eat a slice of chocolate cake and see my glucose go up to 7.8mmol/L and come straight back down?
Thank you.
