Remitting or reversing type 2 diabetes with Newcastle diet

[Cheltonian31]

Hello, this is my first post after 3 months looking at and learning from the contributors on this site.

I was diagnosed with type 2 diabetes at the end of September 2023 (HbA1c = 88, 18st, age 57). The diagnosis was and wasn't a shock at the same time. Dr prescribed metformin (500g rising to 2000g over 4 weeks, plus statins). He mumbled about lifestyle changes and referred me to the diabetes nurse. That's when I hit google and learned about the Newcastle research, rapid weight loss and reversal/remittance. It seemed well worth a try. I contcted my GP again before commencing, he tried to get me on the NHS programme but the threshold for acceptance was an HbA1c of 87 so I just missed out). I started on 4 October on a strict very low calorie diet of 3 Exante Shakes per day (618 cals total) plus one daily plate of grilled or steamed veg, salad or vegetables blended into a soup. This was supplemented by tea (with a little milk) and at least 2 ltrs of water. I did stick to the diet rigidly for 11 weeks. In discussions with GP I stopped ramping up the metformin during the diet and am currently on 1 metformin (500g) and 1 statin per day.

By Christmas I had lost 4st (56lbs) or 22% of my start weight. HbA1c has dropped to 37, cholestorol and blood pressure well within normal range. Whilst I am still overweight (but no longer classed as obese) I am now slowing down the pace of weight loss and aim to get to 13st 7lbs by the end of January.

The promise of the Newcastle Diet seemed to me to be that (with the strong proviso that the weight loss is maintained over the longer term) type 2 diabetes would be reversed and that the need to overly control carbs and worry about unhealthy blood sugar spikes would go away because insulin resistance would reduce and the liver and pancreas would repair and function more normally.

Now that i am moving towards eating to maintain my weight loss, and stepping up the exercise a little, my hope is that I can eat bread, rice, pasta potatoes etc in moderation and my body will be able to cope. My fear is that the recent HbA1c of 37 was entirely due to metformin and a very low calorie diet that I could not sustain over the long term.

Does anyone have any experience of life after a Newcastle type diet/weight loss? Will I be able to just focus on maintaining the weight loss or will I still need to limit carbs in addition? Have you been able to come off medication totally or not? And what's the best way to monitor my progress/condition. A yearly or quartely HbA1c test does seem like a very blunt tool, but I have read that CGMs are not prescribed/recommended for type 2. I have a finger prick monitor but I'm not even sure when is the best time to take a measure each day (and I am very reluctant to measure more than once a day if possible).

Any advice, words of wisdom, reassurance or pointers about what I should or should not be doing next or saying to, or asking my GP would be very welcome.

Thanks for reading this far and all the very best.

 

[harbottle]

Metformin won't have caused a reduction from 88 to 37. It doesn't have that much effect. I was only ever on 1000mg and it was halved after 3 months when hba1c dropped to 36 (From 83). It was 36 again at my last test 6 months ago. I was told I could come off the medication if I wanted to 'see what happened'. I opted to stay on it, as I have no side effects.

Well done, anyway, that's great progress.

As for testing: I sometimes test before meals and two hours later.
I sometimes test in the morning when I get up.
I test if I'm eating something new (With a lot of carbs) before I eat and two hours later - I've noticed BG tends to peak around 8 these days if I eat a lot of carbs.

 

[Martin.A]

Well done with your weight loss and HbA1c reduction. As @harbottle has said your Metformin alone wouldn't have been responsible for the drop as it works by reducing the amount of glucose the liver releases into the body and by helping the body's insulin work better.

I stopped taking Metformin when my DN suggested it after she saw that I was getting good numbers from my finger prick tests, and have managed to stay off it by maintaining my low carb diet, though I still tweak it. The usual testing regime is on waking (fasting test), just before a meal (pre-prandial) and 2 hours later (post-prandial). The target ranges are to be between 4 and 7 fasting and pre-prandial and no more than 8.5 post-prandial, with the rise from pre-prandial being no more than 2 or 3. More than 3 suggests too many carbs.

Testing after meals has also enabled me to build up a food diary which now contains a list of 125 meal choices that don't take me out of range.

 

[childofthesea43]

My own experience may be encouraging, although T2D is not a uniform creature. I put all my faith in the Newcastle findings and adopted my own weight reduction regimen. This got my A1c down from 74 to 42 nearly three years ago and it has stayed at or below that ever since. I eat what I like within a fixed calorie limit, thereby keeping weight and waistline constant, and have no fear of bread, rice, pasta, potatoes, porridge, ice creams, etc. But - I enjoy these in careful moderation, as I ought to have done during the years when I was giving myself T2D. I choose to limit carbs to about 145g, but have found that 180g is perfectly Ok; and probably 250g would be too, but I just don’t fancy more than my 145. You have done very well indeed, and can look forward to a life being non-diabetic, not a “diabetic with good control”. Just never, never, never, ever regain the weight.

 

[Cheltonian31]

Thanks for the encouraging replies and advice.

To be honest I hadn't thought that the drop in HbA1c was down to the Metformin alone, but I was/am worried that its down to the drugs (in some part) and (chiefly) the very low calorie diet and that once I move on to weight maintenance my blood sugars may rise again. What you say about Metformin suggests that the bounceback (if any) won't be great if my GP thinks about ending the medication at some point.

childoftheseas's experience is hugely encouraging and I hope that (in moderation) I too can still enjoy bread, rice, pasta etc whilst maintaining the weight loss and keep HbA1c in the 30s. I've still got a huge amout to learn about this condition and lots of questions that are only likley to be answered by experience and learning how my body copes over the next 12 months.

 

[Drummer]

Thanks for the encouraging replies and advice.

To be honest I hadn't thought that the drop in HbA1c was down to the Metformin alone, but I was/am worried that its down to the drugs (in some part) and (chiefly) the very low calorie diet and that once I move on to weight maintenance my blood sugars may rise again. What you say about Metformin suggests that the bounceback (if any) won't be great if my GP suggests ending the medication at some point.

childoftheseas's experience is hugely encouraging and I hope that (in moderation) I too can still enjoy bread, rice, pasta etc whilst maintaining the weight loss and keep HbA1c in the 30's. I've still got a huge amout to learn about this condition and lots of questions what are only likley to be answered by experience and learning how my body copes over the next 12 months.

As long as your maintenance diet is one you can cope with, all should be well.
I have eaten a low carb diet since diagnosis and that did the trick for me, as it is what I can cope with and my blood glucose meter showed me that.
My diet remains low carb as I never felt right when eating all the 'healthy' carbs, and on top of that, I am maintaining the weight loss - or more exactly the fat loss which happened without effort. Steak or chops with mushrooms or stirfry seems far more attractive than with chips, I make icecream with cream and eggs. It has been no trouble to eat this way for the last 7 years.
I was left unaware of a test result indicating high glucose levels for ten years before diagnosis, which I think accounts for my being unable to push my HbA1c down into the 30s, but the low 40s seems to be good enough at my age.

 

[Cheltonian31]

This is just an update on my January 2024 post. I'm managing to maintain my weight loss and I'm hovering at 13st for the past month. Loosing another pound or two would get me to a total loss of 5st since diagnosis last September. I'm not trying for that, but I'd be delighted if it happened.
I'm only eating between 12 noon and 8pm daily (black tea, water and sleep in the 16 hrs fasting). That means just 2 meals a day which also helps control calories. I usually have a light lunch between 12 and 1 and then dinner at 6ish. I dont count carbs or calories but the fasting and smaller portions both working to limit/control both. My waking finger prick testing is averaging 5.4 over the past 3 months, which is only slightly up from 5.2 when I was rigidly following the Newcastle Plan.
I tend only to test first thing on a morning but yesterday I did a full day's testing and was delighted with the result. Waking was 5.5, pre lunch 4.8, 2hr after lunch 7, pre dinner 4.9, 2hrs after dinner 5.7 and 5.0 at bedtime. Meals were a tin of cream of celery soup and a seeded wholemeal roll, and a dinner of seafood pasta with lemon sauce (edemame pasta), a small side salad, yogurt with raspberries and a glass of white wine.
The next challenge comes with a 2 week holiday in Korea and Japan. My next HbA1c test is due just after I get back, so that will be interesting. Have not decided yet whether to take the finger prick monitor with me or leave it at home.
I'm a lot lighter, have much more energy, BP and cholesterol also back to healthy and am enjoying building a new relationship with regular food. For me the weeks of just shakes and veg not only helped with rapid weight loss, it also broke my established patterns of unhealthy eating. The plan for the future is not to cut anything out of my diet, but eat in moderation and in balance. So far so good.
Cheers.

 

[childofthesea43]

This is just an update on my January 2024 post. I'm managing to maintain my weight loss and I'm hovering at 13st for the past month. Loosing another pound or two would get me to a total loss of 5st since diagnosis last September. I'm not trying for that, but I'd be delighted if it happened.
I'm only eating between 12 noon and 8pm daily (black tea, water and sleep in the 16 hrs fasting). That means just 2 meals a day which also helps control calories. I usually have a light lunch between 12 and 1 and then dinner at 6ish. I dont count carbs or calories but the fasting and smaller portions both working to limit/control both. My waking finger prick testing is averaging 5.4 over the past 3 months, which is only slightly up from 5.2 when I was rigidly following the Newcastle Plan.
I tend only to test first thing on a morning but yesterday I did a full day's testing and was delighted with the result. Waking was 5.5, pre lunch 4.8, 2hr after lunch 7, pre dinner 4.9, 2hrs after dinner 5.7 and 5.0 at bedtime. Meals were a tin of cream of celery soup and a seeded wholemeal roll, and a dinner of seafood pasta with lemon sauce (edemame pasta), a small side salad, yogurt with raspberries and a glass of white wine.
The next challenge comes with a 2 week holiday in Korea and Japan. My next HbA1c test is due just after I get back, so that will be interesting. Have not decided yet whether to take the finger prick monitor with me or leave it at home.
I'm a lot lighter, have much more energy, BP and cholesterol also back to healthy and am enjoying building a new relationship with regular food. For me the weeks of just shakes and veg not only helped with rapid weight loss, it also broke my established patterns of unhealthy eating. The plan for the future is not to cut anything out of my diet, but eat in moderation and in balance. So far so good.
Cheers.

⭐️⭐️

 

[everydayupsanddowns]

I'm a lot lighter, have much more energy, BP and cholesterol also back to healthy and am enjoying building a new relationship with regular food. For me the weeks of just shakes and veg not only helped with rapid weight loss, it also broke my established patterns of unhealthy eating. The plan for the future is not to cut anything out of my diet, but eat in moderation and in balance. So far so good.
Cheers.

Congratulations on your terrific success @Cheltonian31 🙂 🙂 🙂

Another forum member also mentioned exactly that ‘broke my established patterns’ effect of the soup & shake phase, which allowed a sort of ‘reset’ to his eating habits.

Hope your levels continue to respond well as you evolve your new way of eating.

 

[JITR]

Great responses, little to add. I followed a real food version of the ND without medication to get my weight down by 15 kg (A1c 39) and a further 7 kg (A1c 32) to get into my 32 inch trousers again. I then found the biggest challenge was what to add to my diet. Ian Marber's guideline was helpful, every meal should consist of protein, vegetables (complex carbs), and some carbs - and you can always replace the carbs with more veg! I have since gravitated more towards nutrient rich protein foods to make sure my waist still l lets me get into those trousers. No finger pricking, I just keep a record of what I eat on Cronometer to keep an eye on my nutrients.

 

[Cheltonian31]

Another update since March. Still following a daily 16/8hr eating window. Eating only two meals each day between 12 noon and 8pm. Being careful with portions rather than food types. Only water and black tea in the 16 hrs gap. Weight has dropped a little more, now 12st 10 which is a total loss of 5st 3lbs (29% of my starting weight) and just 4 lbs over a "normal" BMI for my height. April's HbA1c result was 33, which I'm delighted with, but total cholestorol has risen to 6.2 though the ratio is 4.8 and trigs are 0.9 I'm seeing my GP in a couple of weeks, he may want me back on statins. That's now two Hba1cs in the normal range since my first diagnosis in Sept 2023 (HbA1c then was 88) but I had been taking metformin prior to the first drop. Thanks everyone for your supportive comments.