Off the Rails

[mhtyler]

So, I'm in remission, and I keep my carbs low, around 60 or less per day and try to keep my kcals to 1600 because I still have 8 lbs to go. However, yesterday I went off the rails as sometimes happens. I did a post-mortem, and last night I had nearly 3000 kcals, and over 200 carbs. I checked my sugar this AM with some trepidation. It was 5.55 mmol/L. Huh? Normal after a night like that? What is going on? I don't believe for a minute I could get away with this every day, but I'm astonished I got away with it at all. It's never happened before. Today I'm in the middle of a 38 hour fast that I do each Sunday, so perhaps my sackcloth and ashes will give my liver and pancreas a chance to recharge. All I can think is that my pancreas has woken up and taken charge. Don't wait for me to shout, "Reversal!" I don't believe that, but I just had to share. I never thought that would happen. Color me stunned.

 

[JITR]

Looks like you reversed your fatty liver and your T2D has gone away

 

[mhtyler]

Looks like you reversed your fatty liver and your T2D has gone away

Well, after 4 months I've only lost 25 lbs of the 33 lbs that Professor Taylor says that I need to lose. Since my weight loss has been over a longer period of time, perhaps I'm seeing an effect similar to the full 33 lbs (15 kilos). I just don't trust this yet. As hard as this weight loss has been, it still seems too easy to get such a strong result. Frankly, I'm confused. Time will make things clearer I guess. I'm not quite believing this yet.

 

[JITR]

The amount you need to lose is in range 10-15 kg or more. 15 kg covers about 80% of cases, from memory; RT's partner Mike Lean said some mag need to lose 20 kg. Worth losing another 10 lbs or so. I found the extra to get my BMI and waist back to normal helped a lot.

 

[Eddy Edson]

Well, after 4 months I've only lost 25 lbs of the 33 lbs that Professor Taylor says that I need to lose. Since my weight loss has been over a longer period of time, perhaps I'm seeing an effect similar to the full 33 lbs (15 kilos). I just don't trust this yet. As hard as this weight loss has been, it still seems too easy to get such a strong result. Frankly, I'm confused. Time will make things clearer I guess. I'm not quite believing this yet.

FWIW, I was surprised at how easy it was to get things sorted. It kind of just happened, not quite overnight but close to it. Suddenly everything was pretty much normal, and it has been for 5+ years.

Maybe that's you, maybe not, but it could be & if it is, your glucose regulation has normalised and it really doesn't matter much how many carbs you eat. You can start worrying about really important things instead - BP, lipids, whether or not hell actually exists, odds of an asteroid strike etc etc 🙂

 

[everydayupsanddowns]

Well, after 4 months I've only lost 25 lbs of the 33 lbs that Professor Taylor says that I need to lose. Since my weight loss has been over a longer period of time, perhaps I'm seeing an effect similar to the full 33 lbs (15 kilos). I just don't trust this yet. As hard as this weight loss has been, it still seems too easy to get such a strong result. Frankly, I'm confused. Time will make things clearer I guess. I'm not quite believing this yet.

Congratulations on your amazing progress so far @mhtyler

Great to see all your hard work paying off!

 

[AndBreathe]

Well, after 4 months I've only lost 25 lbs of the 33 lbs that Professor Taylor says that I need to lose. Since my weight loss has been over a longer period of time, perhaps I'm seeing an effect similar to the full 33 lbs (15 kilos). I just don't trust this yet. As hard as this weight loss has been, it still seems too easy to get such a strong result. Frankly, I'm confused. Time will make things clearer I guess. I'm not quite believing this yet.

Personally, I don't find it helpful to hang onto the 15kg, 15% or whatever Professor Taylor finds to be the average amongst his subjects.

Thing is, I find very few people who categorise themselves as average.

I don't know if you have seen this before. It is reported in several places. This link is just the first I found from Google: https://www.diabetes.co.uk/news/201...text=A man who was diagnosed,at the age of 59.

 

[mhtyler]

Personally, I don't find it helpful to hang onto the 15kg, 15% or whatever Professor Taylor finds to be the average amongst his subjects.

Thing is, I find very few people who categorise themselves as average.

I don't know if you have seen this before. It is reported in several places. This link is just the first I found from Google: https://www.diabetes.co.uk/news/2013/aug/case-of-type-2-diabetes-reversed-in-11-days-through-newcastle-diet-91335857.html#:~:text=A man who was diagnosed,at the age of 59.

I think an average is useful in the same vein that medical associations use a standard for what is diabetic, which is that on an individual basis it's only useful as a touchstone.

 

[mhtyler]

FWIW, I was surprised at how easy it was to get things sorted. It kind of just happened, not quite overnight but close to it. Suddenly everything was pretty much normal, and it has been for 5+ years.

Maybe that's you, maybe not, but it could be & if it is, your glucose regulation has normalised and it really doesn't matter much how many carbs you eat. You can start worrying about really important things instead - BP, lipids, whether or not hell actually exists, odds of an asteroid strike etc etc 🙂

LOL, I already worry about those things and more. I'm turning 70 next month, and the average male lifespan in the US is 73, so it appears I have more than one reason not to buy green bananas.

 

[mhtyler]

The amount you need to lose is in range 10-15 kg or more. 15 kg covers about 80% of cases, from memory; RT's partner Mike Lean said some mag need to lose 20 kg. Worth losing another 10 lbs or so. I found the extra to get my BMI and waist back to normal helped a lot.

I agree! I want to do exactly that. 33 pounds is a good initial goal, and I'll be there soon, but that will leave me at the top of normal weight, and I can still feel visceral fat, so I know there's a lot in there that I can't feel. Then there's what the ectopic fat is doing to me. I'm going to try and not let perfect get in the way of good, but I want more.

 

[PerSpinasAdAstra]

Well, after 4 months I've only lost 25 lbs of the 33 lbs that Professor Taylor says that I need to lose. Since my weight loss has been over a longer period of time, perhaps I'm seeing an effect similar to the full 33 lbs (15 kilos). I just don't trust this yet. As hard as this weight loss has been, it still seems too easy to get such a strong result. Frankly, I'm confused. Time will make things clearer I guess. I'm not quite believing this yet.

Congratulations 🙂

Logically I would imagine that the amount of weight loss required depends on body mass and how much excess fat is actually in a person's liver to begin with. In an interview I saw Roy Taylor describe the 15Kg weight loss figure as a guess figured out on the 'back of a napkin' which 'luckily' turned out to be about right for most people.

If you have a smartphone that isn't very old perhaps now might be a good time to slap on a CGM and capture the moment. Have you used up your Libre 2 free trial yet? (I think you can get one free Libre 2 in the US). I found the data hugely valuable. If I could afford them I'd wear one constantly and experiment. As it is I used one when I hit 16Kg weight loss, logged my meals and exercise in the app, took screenshots of the graphs for all my meals, and generated the 2 week report from the LibreView website. I intend to use another Libre 2 soon when I hit my final weight loss target, repeat many of the food and exercise patterns, and compare the graphs and report to see if there's any significant change. Information is power 😉

 

[mhtyler]

Congratulations 🙂

Logically I would imagine that the amount of weight loss required depends on body mass and how much excess fat is actually in a person's liver to begin with. In an interview I saw Roy Taylor describe the 15Kg weight loss figure as a guess figured out on the 'back of a napkin' which 'luckily' turned out to be about right for most people.

If you have a smartphone that isn't very old perhaps now might be a good time to slap on a CGM and capture the moment. Have you used up your Libre 2 free trial yet? (I think you can get one free Libre 2 in the US). I found the data hugely valuable. If I could afford them I'd wear one constantly and experiment. As it is I used one when I hit 16Kg weight loss, logged my meals and exercise in the app, took screenshots of the graphs for all my meals, and generated the 2 week report from the LibreView website. I intend to use another Libre 2 soon when I hit my final weight loss target, repeat many of the food and exercise patterns, and compare the graphs and report to see if there's any significant change. Information is power 😉

Yes, 15Kg is just an average, but since I'm overweight it's reasonable to suppose that the best health outcome for me personally is to not be. That number turns out to be...drumroll....15Kg. However, that only takes me to the top of my normal weight range, so I propose to take it down to the middle of my weight range. Bottom line, I'm not going to end up either too thin or too rich ;-) . I've never tried a CGM, and I wish I'd had one in the past, but I doubt I'd find it useful now. I never seem to spike above 110 mg/dl ....6.1 mmol/L. I'm still using my meter, but more than I seem to need to. I keep using it only to find I needn't have bothered. I still find my morning number useful because it's a kind of report card for the previous day.

 

[AndBreathe]

Yes, 15Kg is just an average, but since I'm overweight it's reasonable to suppose that the best health outcome for me personally is to not be. That number turns out to be...drumroll....15Kg. However, that only takes me to the top of my normal weight range, so I propose to take it down to the middle of my weight range. Bottom line, I'm not going to end up either too thin or too rich ;-) . I've never tried a CGM, and I wish I'd had one in the past, but I doubt I'd find it useful now. I never seem to spike above 110 mg/dl ....6.1 mmol/L. I'm still using my meter, but more than I seem to need to. I keep using it only to find I needn't have bothered. I still find my morning number useful because it's a kind of report card for the previous day.

CGMs weren't around, certainly in the same way when I was diagnosed, but when the Libre became available to purchase, as opposed to purely of prescription, I tried on, thinking I'd not learn much. I was wrong.

Yes, we finger prick test, but there's an awful lot goes on in between those tests.

 

[PerSpinasAdAstra]

I've never tried a CGM, and I wish I'd had one in the past, but I doubt I'd find it useful now. I never seem to spike above 110 mg/dl ....6.1 mmol/L. I'm still using my meter, but more than I seem to need to. I keep using it only to find I needn't have bothered. I still find my morning number useful because it's a kind of report card for the previous day.

There are lots of advantages I've found - a graph gives a better picture than a few data points, seeing Dawn Phenomenon, knowing how quickly your BG falls when you go to sleep for example. Plus the first one is free. I just looked up the US site for the free one though and it seems it's more complicated in the US than it is here - you need a prescription and health insurance or something (something about a 0$ co-pay, whatever that is). It's much more straightforward to get the free one here - no prescription needed. Still - it's not necessary, just nice 🙂

 

[JITR]

Personally, I don't find it helpful to hang onto the 15kg, 15% or whatever Professor Taylor finds to be the average amongst his subjects.Thing is, I find very few people who categorise themselves as average.

In his Counterpoint study Professor found that 80% plus of his subjects who achieved remission had lost from 10 kg to 15 kg to do so. Professor Lean, his partner in the DiRECT study, commenting on two subjects who did not achieve remission said one needed to lose 20 kg, and the other had a damaged pancreas which precluded remission. In these studies, as I recall, remission was defined as HbA1c of 42 mmol/L or less without medication.

The more recent ReTUNE study showed T2Ds of normal BMI had to lose 8 kg to 10 kg or more to achieve remission.

15 kg is a target, not an average. Even so some people will have lose some more.

Professor Taylor's team used advanced MRI techniques to measure liver fat and pancreatic fat. These procedures are too expensive for general use. Currently, as far as I know, waist measurement is the only practical alternative for liver fat, and HbA1c for liver and pancreatic function.

 

[mhtyler]

In his Counterpoint study Professor found that 80% plus of his subjects who achieved remission had lost from 10 kg to 15 kg to do so. Professor Lean, his partner in the DiRECT study, commenting on two subjects who did not achieve remission said one needed to lose 20 kg, and the other had a damaged pancreas which precluded remission. In these studies, as I recall, remission was defined as HbA1c of 42 mmol/L or less without medication.

The more recent ReTUNE study showed T2Ds of normal BMI had to lose 8 kg to 10 kg or more to achieve remission.

15 kg is a target, not an average. Even so some people will have lose some more.

Professor Taylor's team used advanced MRI techniques to measure liver fat and pancreatic fat. These procedures are too expensive for general use. Currently, as far as I know, waist measurement is the only practical alternative for liver fat, and HbA1c for liver and pancreatic function.

Interesting, my loss over 4 months has been just over 11 Kg, but oddly, my sugar was going down, but fell off a cliff after a recent 36 hour fast. I think that actually stimulated and advanced my pancreas recovery. Prof. Taylor recommends an insulin test for pancreas function, but that is rather controversial, at least here in the states because apparently there is a lack of standards. A US expert, Prof Mark Lustig thinks that objection is silly since an initial test forms a baseline, and subsequent tests can show advancement or decline. I think he's likely correct.

 

[its_an_inheritance_tax]

So, I'm in remission, and I keep my carbs low, around 60 or less per day and try to keep my kcals to 1600 because I still have 8 lbs to go. However, yesterday I went off the rails as sometimes happens. I did a post-mortem, and last night I had nearly 3000 kcals, and over 200 carbs. I checked my sugar this AM with some trepidation. It was 5.55 mmol/L. Huh? Normal after a night like that? What is going on? I don't believe for a minute I could get away with this every day, but I'm astonished I got away with it at all. It's never happened before. Today I'm in the middle of a 38 hour fast that I do each Sunday, so perhaps my sackcloth and ashes will give my liver and pancreas a chance to recharge. All I can think is that my pancreas has woken up and taken charge. Don't wait for me to shout, "Reversal!" I don't believe that, but I just had to share. I never thought that would happen. Color me stunned.

Fantastic news!

Feels like it’s more about long term control and not isolated excesses as we can rectify the following days by fasting and increasing activity. That’s what I tend to do if I have strayed.