Second Opinion?

[everydayupsanddowns]

Welcome to the forum @Pat N

The terms ‘remission‘ and ‘reversal’ seem to get thrown around quite a bit at the moment, but they can be quite hard to understand.

The Newcastle Study that has been mentioned I believe uses the definition of an HbA1c of 48 or lower without any medication.

However there is not much clarity about how long that might be expected to last, and it seems to be ‘diabetes in remission’ rather than ‘no longer living with diabetes’. Many members here have reached the same threshold, but still consider themselves to live with diabetes, because they believe that if they returned to eating higher levels of carbohydrate, then their elevated BG would return.

We have had a very few members over the years whose Drs have mentioned ‘taking them off the diabetes register’ but I think this is a list at the surgery rather than a nationwide thing?

 

[Eddy Edson]

Yes, statins, betablockers etc. Never had high cholesterol or high blood pressure but having to take the NHS package "just in case". I did confim with the diabetes nurse that she was aware of my medication. Do you think the meds will have an effect?

Statins may increase yr HbA1c a little bit, but it seems like a very individually variable thing and certainly not a good reason not to take them.

 

[DaveB]

Hi again. A surgery that has an HBa1C machine is very unusual and impressive. My last private hospital operation involved a similar machine. Statins and BP pills can increase BS a bit. I would ensure you know your lipids profiles/ratios e.g. HDL, LDL etc without the Statins and the same for the BP pills. Use you own BP meter at home and give the nurse the results. A cholesterol level that is too low thru a high pill dose can be just as harmful as high cholesterol but many GPs/DNs don't know that. BP pills can also have small side effects so use the lowest dose that brings you in range e.g. below 130'ish

 

[Pat N]

It's a small machine in the corner of the surgery that seems to agitate the small amount of blood taken and a few minutes later produces a print out.

Sorry, finger trouble it is 4.7mmol/L! I usually take the readings a couple of hours after a meal, no specific time. I obviously need to take a more scientific approach!

The nurse did mention the possibility of T1 (no mention of LADA) but only in passing and said it could be investigated further at a later date if I didn't improve. I may speak to my GP for guidance.

I do eat some of the berries you suggest and have done so for many years.

Thank you for your time.

Hi again. A surgery that has an HBa1C machine is very unusual and impressive. My last private hospital operation involved a similar machine. Statins and BP pills can increase BS a bit. I would ensure you know your lipids profiles/ratios e.g. HDL, LDL etc without the Statins and the same for the BP pills. Use you own BP meter at home and give the nurse the results. A cholesterol level that is too low thru a high pill dose can be just as harmful as high cholesterol but many GPs/DNs don't know that. BP pills can also have small side effects so use the lowest dose that brings you in range e.g. below 130'ish

Hi DaveB, I've been into my online records to check what was completed in June and the sister used a 'DCA' machine as well as sending a larger blood sample to the lab. She's added that "the lab result would be more reliable." The 'DCA' reading in Jun was 'pre-D'. I did question why she wasn't sending a sample to the lab because of what she had said about reliable results but she pretty much ignored my comment.

 

[trophywench]

How interesting

DCA Vantage® Analyzer

Clinically trusted HbA1c and ACR resultsMonitors progress and allows therapy adjustment during the visit

www.siemens-healthineers.com

My husband used to work for Siemens but as he was a meter reader for them rather than anything to do with S Medical, no he can't get your GP or ours, a discount!

 

[Piglet]

HI,

if you are following a low blood glucose ? diet it might be that you are actually not eating enough. I know this sounds strange but our bodies need carbs in order to function and not en=ating enough means your blood glucose levels might rise as your body produces it own glucose from the liver. try to aim for approx 140-150 grammes of carbs per day and see how you go.

It is a common train of thought that if you reduce carbs then you can reduce my blood sugar level. this is true to a point but there are lots of other bodily functions at play, and as a diabetic you have to think about balancing them all at the same time . Good luck.

 

[trophywench]

Oh dear @Piglet - if we all need to eat that much carb a day - how on earth do you suppose I am I not dead then?

Had a very piggy tea tonight cos since there would have only been a very small amount of spag left in the packet I chucked the rest in anyway, so my portion of that was 55g, I had a thin slice of Genoa this afternoon, 15g and ham lettuce & mayo sandwich for lunch, 35g, I don't eat brekkie 999 x out of 1,000. Total seems to only be 105g. I only eat what I want to eat and have no necessity to force more down my gullet.

 

[Loobyloo]

I regularly eat under 70g carbs a day and feel fine and my sugars are good after being terrible 3-4 months ago when diagnosed. My nurse said keep below 130g a day which they recommend for diabetics but if i can manage less all for the better and i know quite a few on this forum eat far less than me and get good results so little confused about advice to eat at least 140-150g a day. Totally confused whether i am doing the right thing now.

 

[Ralph-YK]

I regularly eat under 70g carbs a day and feel fine and my sugars are good after being terrible 3-4 months ago when diagnosed. My nurse said keep below 130g a day which they recommend for diabetics but if i can manage less all for the better and i know quite a few on this forum eat far less than me and get good results so little confused about advice to eat at least 140-150g a day. Totally confused whether i am doing the right thing now.

I've been at talks given for diabetics (some at diabetic support groups). HCP said at one the minimum was 130g carbs a day. At most there was no support for the idea of managing carbs at all. The diabetic dieticians in my area don't support it.

 

[silentsquirrel]

I regularly eat under 70g carbs a day and feel fine and my sugars are good after being terrible 3-4 months ago when diagnosed. My nurse said keep below 130g a day which they recommend for diabetics but if i can manage less all for the better and i know quite a few on this forum eat far less than me and get good results so little confused about advice to eat at least 140-150g a day. Totally confused whether i am doing the right thing now.

If <70g a day is working well for you, stick with it. The 140-150g and "needing carbs to function" is considered out of date advice by many, especially for T2s. Very many here are well under that, and it is working for them. Glad your nurse seems more up-to-date!

 

[trophywench]

LOL at the term diabetic dietician. If the dietician really were diabetic - I'd put money on it that they'd have to change their tune!

Also laughed at a granddaughter today. Her mother is c. 5'9" and her dad is a good 6ft, so she's c. 5'10". She's 11 st something and size 12. I said I'd been 11st 3lbs once and the size 16s were getting tight so I gave myself a good talking to and lost it again. How on earth would that make you size 16 Grandma - I've never seen you fat!

Well you weren't even a twinkle in someone's eye 30 years ago, I'm only 5ft 3 and my bone structure is skinny in comparison to yours. Suffice it to say myself and a colleague at my new place of work after I'd lost the weight again had been talking to a chap I'd trained when he and I both worked for another company. Chap said he couldn't believe new colleague didn't know me, I'd worked for old company for so long. Well, what's she like then? Little fat person - really jolly, good fun!

Thanks Andy - I used to like you too! I didn't hold a grudge for the first half of the sentence though. It was 100% truthful !

 

[Midnightcatpatrol]

My background is of a very fit, 68 year old, non-smoking, sports playing, running male. I had a heart attack in 2016 brought on by an unknown birth defect. Since then, due to medication, I've not been able to train as hard as I'd been used to however, I've maintained a very fit and healthy lifestyle but developed into a Pre, Type2 Diabetes condition. 4 months ago my 'score' went up to 48 on the Diabetes scale and I refused medication. Since then I have trained (run/walk/ex) or played golf every day, followed a low blood sugar diet and lost 11 kgs and weigh 72 Kgs (Height 1.74m). My score last week dropped by just point and I remain a 'Type 2 Diabetic'. The Surgery Nurse says we'll check it again in 3 months but I don't have any more weight to lose even though I'm happy to maintain the diet. I don't have any confidence in the surgery; what should I do?

I'm not sure what you are taking issue with. The diagnosis of type 2 diabetes given the inverted commas, or that they aren't in a rush to medicate.

 

[pm133]

Oh dear @Piglet - if we all need to eat that much carb a day - how on earth do you suppose I am I not dead then?

Had a very piggy tea tonight cos since there would have only been a very small amount of spag left in the packet I chucked the rest in anyway, so my portion of that was 55g, I had a thin slice of Genoa this afternoon, 15g and ham lettuce & mayo sandwich for lunch, 35g, I don't eat brekkie 999 x out of 1,000. Total seems to only be 105g. I only eat what I want to eat and have no necessity to force more down my gullet.

That is really puzzling and needs some proper research to establish exactly how many carbs the human body needs and what, if any, long term effects there are from limiting your carb intake.
Clearly there's a ton of anecdotal evidence out there but it would be nice if someone could do some credible peer-reviewed research on the matter.

 

[adrian1der]

I'm confused.....can I ask what might be a silly question?

If we restrict carbs aren't we, in effect, following the keto diet? This will result in ketones in our pee - my wife did the diet a few years and I remember her dipping her pee everyday. How do we differentiate between ketones from the keto diet and ketones from DKA? Sorry if I'm being dense

 

[trophywench]

Cos they are lower in dietary ketosis as opposed to ketoacidosis which a) only happens in diabetes and b) (I think) c 1.5 is the cutoff between the two. That's using a blood testing meter though, dunno about pee and levels in that cos dunno what units the urine testing ones measure in.

 

[rebrascora]

DKA only occurs when there is a toxic combination of ketones and persistently high BG levels (mid teens+ BG) Normal BG levels and ketones just indicates that you are burning fat instead of carbs.... it can sometimes be referred to as starvation ketones because you are causing your body to burn it's own fat stores.

 

[adrian1der]

Thanks @trophywench Makes sense.

The reason I asked is that I do have ketones in my pee which I had assumed were from cutting the carbs right back. You have reassured me that I was right! Just had a momentary wobble...

Thanks again

 

[trophywench]

DKA for this Type 1 also has symptoms - nausea; dizziness; thirst; dog tired and - of course - BG well in the teens or higher.

However if you also happen to have CV19, DKA can occur at lower BG - 10-ish from what I've gathered, so we do need to be extra vigilant both right now and in the foreseeable future.

 

[grovesy]

DKA only occurs when there is a toxic combination of ketones and persistently high BG levels (mid teens+ BG) Normal BG levels and ketones just indicates that you are burning fat instead of carbs.... it can sometimes be referred to as starvation ketones because you are causing your body to burn it's own fat stores.

I think there is also some medication that cause DKA at lower BG levels.

 

[everydayupsanddowns]

I believe the absence of insulin is also crucial?

Though I’m unsure of the role of insulin in processing ketones