The challenge - My story + How does one choose the best approach to Type 2 Diabetes Remission?

[saffron15]

I am impressed at your focused approach. I haven't sorted out sufficiently exercise apart from walking more. I'm hoping to go swimming tomorrow and join an exercise class. I've bought a resistance band as strength training is important but have watched some videos but not yet organised. It will be three months at the end of the month since my first blood test. Still I have lost 10 kg and hope to continue. I am eating more nuts as snacks or on yoghurt in the morning. I also bought chia seeds that I sometimes add to breakfast as extra fibre. I have not bought salted nuts as 1. I like them too much 2. I have high blood sugar so we're occasional treat but now no more.
Decades ago Mum used to buy as monkey nuts which we enjoyed shelling ( no nutcracker required) I think in late 60s they were popular and cheap. Some unshelled would go on the bird table. Now people snack more and nuts are fancier. You can buy them in garden centres and pet stores. I buy nuts at a local garden nursery which has a good shop. I go on Friday when a fishman attends. They in turn get their nuts packaged by a local health food shop. If I go to Norwich where they are based I buy there.
My preference is 1, walnuts because I like rather than love them. 2, Macadamia nuts 3. Hazelnuts 4. Almonds. With walnuts I enjoy a few but am not tempted to finish the pack. Apart from almonds they are slightly lower carb than peanuts.
I see many shops including Tesco Waitrose and the Grape tree sell roasted monkeynuts in their shells. I hadn't heard of grapetree but see they have a branch in my local city. It seems a good way to eat nuts mindfully although I can shell pistachios quickly.
If I am in Norwich in a hurry I tend to buy nuts at M and S as it is close to bus station. I tend not to drive there due to cost of parking.

I look forward to next instalment.

 

[OK1]

You can roast the raw nuts yourself and then the seed coat just rubs of if you roll them in your hands - once they've cooled down.

Great idea. Thanks.

 

[OK1]

I am impressed at your focused approach. I haven't sorted out sufficiently exercise apart from walking more. I'm hoping to go swimming tomorrow and join an exercise class. I've bought a resistance band as strength training is important but have watched some videos but not yet organised. It will be three months at the end of the month since my first blood test. Still I have lost 10 kg and hope to continue. I am eating more nuts as snacks or on yoghurt in the morning. I also bought chia seeds that I sometimes add to breakfast as extra fibre. I have not bought salted nuts as 1. I like them too much 2. I have high blood sugar so we're occasional treat but now no more.
Decades ago Mum used to buy as monkey nuts which we enjoyed shelling ( no nutcracker required) I think in late 60s they were popular and cheap. Some unshelled would go on the bird table. Now people snack more and nuts are fancier. You can buy them in garden centres and pet stores. I buy nuts at a local garden nursery which has a good shop. I go on Friday when a fishman attends. They in turn get their nuts packaged by a local health food shop. If I go to Norwich where they are based I buy there.
My preference is 1, walnuts because I like rather than love them. 2, Macadamia nuts 3. Hazelnuts 4. Almonds. With walnuts I enjoy a few but am not tempted to finish the pack. Apart from almonds they are slightly lower carb than peanuts.
I see many shops including Tesco Waitrose and the Grape tree sell roasted monkeynuts in their shells. I hadn't heard of grapetree but see they have a branch in my local city. It seems a good way to eat nuts mindfully although I can shell pistachios quickly.
If I am in Norwich in a hurry I tend to buy nuts at M and S as it is close to bus station. I tend not to drive there due to cost of parking.

I look forward to next instalment.

Thanks for your response. Appreciated. Being in touch with others via this forum, is a lot of encouragement. Nothing as good as being able to chat with others who have something in common with one's own experience.

My three concerns are pretty weighty - High blood pressure, Diabetes, and Kidney disease - all correlated. And being Obese, which is a 4th challenge. Such a relief to have others to "unburden". with.

And I am trying to get to the bottom of - why did it get so bad - How did I miss or not pay attention to the warning signs. Or not pay attention to them enough.

I have not used sugar for about 8 to 10 years, stopped regular purchase of fruit juices at least a year ago, and have been regular with some vegetables and/fruit most days of the week, for at least 8 years. OK exercise and sleep have been challenges, that I should have done much better. I recall moving from white bread to wholegrain 12 years ago. Point being - ok I have not been the most adherent on exercise and sleep, but did make some effort to live in good health. So the diabetes diagnosis was a bit of a shock, and I'm keen to know what do I do?

Really hope that if I can identify what went wrong, I can eradicate this and make a full recovery. Hope is all I have.

Thanks.

 

[everydayupsanddowns]

I'm watching this, which provides some justification that : Lower carb diets, lead to a higher metabolic rate, which improves weight loss, without having to cut back too much on calorie intake, cos we burn off more of what is consumed.

Good to see you are reading around and finding different options to choose from.

There is a body of evidence that shows that in some people lower carb / higher fat diets can unfortunately increase insulin resistance. So as always it’s about trying methods for yourself, being cautious about sources making extravagant claims for approaches at the extremes (eg ultra-low carb, carnivore). Not that these don’t work for some, but there are valid concerns about their safety and sustainability.

Regarding the carbohydrate-insulin model, one member here @Eddy Edson follows some researchers who have collected research that fails to find evidence for the carbohydrate-insulin model in practice.

Thread 'Time to stick a fork in the carbohydrate-insulin model (CIM) of weight-gain'

May 8, 2021

Thread with a new piece reviewing all the evidence against the CIM, with rejoinders from David Ludwig, the most credible proponent of it.

https://twitter.com/x/status/1390647967439224833

Despite Ludwig's efforts, the CIM is surely well & truly toast now, removing the main "scientific" support for all the low-carb articles of faith:

- "Carbs make you fat; calories don't matter"
- "Carbs make you hungry"
- "Carbs decrease energy"
- "Carbs cause diabetes"

Etc etc.

• Eddy Edson
• Replies: 1
• Forum: In the news...

• 

Having said that, lower carb menu plans are a very effective strategy for many T2 members here. And are now widely supported by a body of epidemiological and clinical evidence as one option that can help some people.

So low carb, and weight loss are both highly effective strategies, and both have enthusiastic supporters and advocates on the forum - but it can pay to be a little cautious about websites / channels / blogs that suggest more extreme versions of these approaches (and often seem to have a book, supplement, or course to sell!)

 

[OK1]

I am impressed at your focused approach. I haven't sorted out sufficiently exercise apart from walking more. I'm hoping to go swimming tomorrow and join an exercise class. I've bought a resistance band as strength training is important but have watched some videos but not yet organised. It will be three months at the end of the month since my first blood test. Still I have lost 10 kg and hope to continue. I am eating more nuts as snacks or on yoghurt in the morning. I also bought chia seeds that I sometimes add to breakfast as extra fibre. I have not bought salted nuts as 1. I like them too much 2. I have high blood sugar so we're occasional treat but now no more.
Decades ago Mum used to buy as monkey nuts which we enjoyed shelling ( no nutcracker required) I think in late 60s they were popular and cheap. Some unshelled would go on the bird table. Now people snack more and nuts are fancier. You can buy them in garden centres and pet stores. I buy nuts at a local garden nursery which has a good shop. I go on Friday when a fishman attends. They in turn get their nuts packaged by a local health food shop. If I go to Norwich where they are based I buy there.
My preference is 1, walnuts because I like rather than love them. 2, Macadamia nuts 3. Hazelnuts 4. Almonds. With walnuts I enjoy a few but am not tempted to finish the pack. Apart from almonds they are slightly lower carb than peanuts.
I see many shops including Tesco Waitrose and the Grape tree sell roasted monkeynuts in their shells. I hadn't heard of grapetree but see they have a branch in my local city. It seems a good way to eat nuts mindfully although I can shell pistachios quickly.
If I am in Norwich in a hurry I tend to buy nuts at M and S as it is close to bus station. I tend not to drive there due to cost of parking.

I look forward to next instalment.

What I'd like to do going forward, in addition to all the efforts to improve, is focus on the positives. i.e. Where have I done well? And appreciate every improvement. Take stock regularly and make sure I am doing all I can. And appreciate where else I can make an improvement.

1. With exception of two days, I have walked at least 30 minutes every single day, in the recent month.
2. I have cut out all bread - completely, not a single bite.
3. I have had barely any rice or pasta, most of my carbs now come from vegetables and a bit of sweetcorn.
4. Reduced salt. Planning to eliminate salt completely.
5. Got a little bit more regular sleep, definitely not staying up regularly till the early hours. Definitely I can do a lot more here.
6. Bumped up vegetables to at least 50% of any meal.
7. Started my Lisinopril (an ACE Inhibitor) medication.
8. Cut out processed foods, to almost nothing - unless I count shop bought Humus, which I had a few times with tomatoes and lettuce, and a few cookies I had once. No biscuits, no cakes, no ice cream, nothing. Even baked beans is off the menu, and when used occasionally - I rinse off the tomato+sugar juice.
9. Invested a lot of time to educate myself on my various health challenges. Obesity, Kidney health, High Blood Pressure, and Diabetes.
10. Joined this forum - huge comfort for me.
11. Definitely cut my total intake of calories.
12. 1st three weeks was almost exclusively doing OMAD (one meal a day), or very short feeding window intermittent fasting of about 5 hours, or less. Now eat twice a day. in an 8 hour window. I.e. 16:8.
13. Bought Professor Roy Taylor's book - Life Without Diabetes - this arrived yesterday. I rarely buy books, cos I usually read a lot - off the internet.
14. Definitely have my calories under control - no more overeating, and eating in between meals is rare. My appetite is definitely under control.
15. No juice of any kind any more.
16. Supplements - Vitamin D and Magnesium Glycinate.
17. I have not had alcohol, for about 10 years, and prior to that maybe one glass of wine per year on average, over 20 prior years. So I have no further alcohol to cut out. One less thing to worry about.!!
18. Just replenished on iodised salt. This is important in the UK, cos the salt normally is not iodized, and the only source of supplemental iodine is in milk. I do not take that much milk, in my one or two cups of peppermint tea - per day.

Benefits - Kind of difficult to know the impact of all these changes, without a blood test, and measuring blood pressure and weight.

1. One major change is my hunger pangs are under better control.
2. I have had two recent days, when I did not get "tired" and sleepy after meals. It has been usual for me to fall asleep after a meal, something that has bothered me for at least a year or two.
3. I look just a little bit trimmer.

Areas for improvement.

1. Getting a better understanding of how much carbs maximum, I should include. So many different opinions.
2. Getting a better understanding of how much and what type of protein is best for me.

The food wars between the plant and animal centric opinions, is not doing anyone any favours. It is pure madness out there, who does one believe? When there is so much divergence.

3. Get a better understanding of how fast I should lose weight, two schools of thought.

Slow gradual weight loss, improves metabolic rate, causing greater fat loss, and less muscle loss.
Faster weight loss, reduces metabolic rate, causing less fat loss, and more muscle loss.

4. Reduce the intake of nuts. Further to my diabetes diagnosis, reducing the carbs was such a priority, that I had nothing else I could eat. But I'll make nuts a smaller contribution, and only add this to salads, from now on. So easy to snack on peanuts. From today that ends. I guess progress is in phases, time to end the indulgence on nuts. Normally nuts were occasional treats, prior to my T2D diagnosis.
5. Reduce the salt to very very low added salt. Just a few grains per day of the iodized salt - to get a little bit of iodine.
6. Improve exercise. I feel that the last month was a great warm up. My fitness has improved, and my walk is more brisk, I tire less. Now I can push things a bit further. Hitherto I have not done any High Intensity exercise, but I think I'll aim to do at least one minute of this each day, and ramp it up slowly. Move the 30 minutes daily to an hour per day.
7. Get more sleep.
8. Try and have more fun and enjoyment of life.
9. Remember to follow up with the GP and all tests, that I think need to be done at the right time.
10. Thinking of quitting every other liquid intake, such as peppermint tea, except a small bit of whole milk each day, otherwise just water. Must remember to keep hydrated. Just got some advice to get at least 2 litres of water per day, ideally as much as 3. So I'll aim for 2.5 litres per day. Hitherto, I think I've been doing about 1 to 1.5 litres of water a day, over the recent month.

Yeah taking stock after the 1st month. So far so good. Can't think of too much I could have done better. So far so good. Already done quite a bit to improve. Taking stock, the list of things to do, while still a fair number, this list is reducing. It would be great to the end of month 2, and have at least half of my to-do-list done, and so much better if I can tick off at least 8 of the 10 items on the list. So good to have been able to look back and take stock. Makes me feel so much better, I am definitely doing quite a bit, to get better. Just need to keep on track, and plug whatever oustanding loopholes that remain, as I learn more.

 

[beating_my_betes]

Really hope that if I can identify what went wrong, I can eradicate this and make a full recovery. Hope is all I have.

It needn't be anything other than the extra weight/obesity, the reversal of which can reverse a lot of these kinds of issues. Choose whichever diet feels the least restrictive to you, so that you can imagine sticking to it in the long term.

 

[OK1]

Good to see you are reading around and finding different options to choose from.

There is a body of evidence that shows that in some people lower carb / higher fat diets can unfortunately increase insulin resistance. So as always it’s about trying methods for yourself, being cautious about sources making extravagant claims for approaches at the extremes (eg ultra-low carb, carnivore). Not that these don’t work for some, but there are valid concerns about their safety and sustainability.

Regarding the carbohydrate-insulin model, one member here @Eddy Edson follows some researchers who have collected research that fails to find evidence for the carbohydrate-insulin model in practice.

Thread 'Time to stick a fork in the carbohydrate-insulin model (CIM) of weight-gain'

May 8, 2021

Thread with a new piece reviewing all the evidence against the CIM, with rejoinders from David Ludwig, the most credible proponent of it.

https://twitter.com/x/status/1390647967439224833

Despite Ludwig's efforts, the CIM is surely well & truly toast now, removing the main "scientific" support for all the low-carb articles of faith:

- "Carbs make you fat; calories don't matter"
- "Carbs make you hungry"
- "Carbs decrease energy"
- "Carbs cause diabetes"

Etc etc.

• Eddy Edson
• Replies: 1
• Forum: In the news...

• 

Having said that, lower carb menu plans are a very effective strategy for many T2 members here. And are now widely supported by a body of epidemiological and clinical evidence as one option that can help some people.

So low carb, and weight loss are both highly effective strategies, and both have enthusiastic supporters and advocates on the forum - but it can pay to be a little cautious about websites / channels / blogs that suggest more extreme versions of these approaches (and often seem to have a book, supplement, or course to sell!)

Thank you ever so much. Highly appreciated. I think the truth lies somewhere in between. I come to this conclusion from a variety of sources, 1st of them being the eating pattern of carnivores and herbivores, which dawned on me early this morning.

Typically carnivores have one big meal and may not eat anything for many many hours, maybe days. Their food is very calorie dense.

Herbivores typically eat quite frequently, grazing quite a bit, cos their food source is not very calorie or nutrient dense. So they have to eat a lot.

The human dentition is NOT either of these, we are obviously omnivores, somewhere in between. This is where I take my cue from. Furthermore human beings have thrived on a variety of diets. And as we have in recent times travelled - as we migrate, our diets change, and we adapt.

Definitely extremes like vegan, or carnivore have risks. There are no known vegan ancestors, in human history, so clearly that is a step too far - having to supplement B12 or other things like iodine, just tells me - not for me. I have once attempted the vegan approach many years ago, and the constipation from too much fibre was memorable. I had to stop it. I also do not think the extreme of a high fat diet can be correct. I in particular do not like huge amounts of meat/fish/eggs, on a regular basis - just does not seem right - I'm not a lion. In the past, especially after a nice dish with eggs, I'd always become drowsy, and usually fall asleep for a few minutes. So am wary of too much animal protein.

My aim is - when I look at the plate, typical target would be :

1. 40% vegetables.
2. 10% carbs (max)
3. 25% protein
4. 25% fats. (max)

So its low on the explicit carbs, moderate in proteins, and definitely NOT high in fats, and lots of fibre. And whole foods almost exclusively. Protein and fats coming from either plants or animals depending on what the dish is. Red meat once a week, and fish once a week. Eggs - maybe twice a week. Chicken and Sardines make up the other days. Some days, I may skip Animal sources entirely.

 

[OK1]

Thank you ever so much. Highly appreciated. I think the truth lies somewhere in between. I come to this conclusion from a variety of sources, 1st of them being the eating pattern of carnivores and herbivores, which dawned on me early this morning.

Typically carnivores have one big meal and may not eat anything for many many hours, maybe days. Their food is very calorie dense.

Herbivores typically eat quite frequently, grazing quite a bit, cos their food source is not very calorie or nutrient dense. So they have to eat a lot.

The human dentition is NOT either of these, we are obviously omnivores, somewhere in between. This is where I take my cue from. Furthermore human beings have thrived on a variety of diets. And as we have in recent times travelled - as we migrate, our diets change, and we adapt.

Definitely extremes like vegan, or carnivore have risks. There are no known vegan ancestors, in human history, so clearly that is a step too far - having to supplement B12 or other things like iodine, just tells me - not for me. I have once attempted the vegan approach many years ago, and the constipation from too much fibre was memorable. I had to stop it. I also do not think the extreme of a high fat diet can be correct. I in particular do not like huge amounts of meat/fish/eggs, on a regular basis - just does not seem right - I'm not a lion. In the past, especially after a nice dish with eggs, I'd always become drowsy, and usually fall asleep for a few minutes. So am wary of too much animal protein.

My aim is - when I look at the plate, typical target would be :

1. 40% vegetables.
2. 10% carbs (max)
3. 25% protein
4. 25% fats. (max)

So its low on the explicit carbs, moderate in proteins, and definitely NOT high in fats, and lots of fibre. And whole foods almost exclusively. Protein and fats coming from either plants or animals depending on what the dish is. Red meat once a week, and fish once a week. Eggs - maybe twice a week. Chicken and Sardines make up the other days. Some days, I may skip Animal sources entirely.

Forgot to conclude - By and large we do not eat like lions, i.e have a huge meal, and go lie down somewhere in the shade to digest. A lion can go without food for days, perfectly normal.

Neither do we graze all day - come to think of it there is a business with that name in the UK - Graze, which encourages snacking. Something I do not think is what I want to do. I do not think human beings are grazers like cows, or sheep who can eat for many hours of the day.

So we are somewhere in between, as omnivores. Definitely NOT grazers, and definitely NOT Lion Kings. Which tells me our diet is also somewhere in between.

Where I think there has been a confusion from modern living is, a mismatch in energy needs and the abundance of sugar and carbs. Many of us are no longer physically active, and live in a world where carbs and fats are the cheapest things we can buy. An example would be rice or fatty sources like les expensive vegetable oils. Our improved farming methods have produced these foods which none of the herbivores and carnivores eat. In a way I'd call them Farmed Hybrid - foods, introduced only after agriculture was invented.

Centuries ago, carbs and oils were not consumed in the kind of quantities we eat today, but modern agriculture has made them relatively inexpensive and we can gorge ourselves on inexpensive carbs and fat. No other animals, in nature eat tons of carbs or vegetable oils, or cheese. or processed derivatives like bread.

So my diet would trend towards Paleo, with minimal consumption of food sources which became prominent with farming, such as non vegetable carbs(rice, wheat, tubers like potato, pasta) and oils of any kind.

Oh definitely include as much spice as will help to make it all taste great, since salt will be as low as possible.

 

[s'nic]

Reduce the salt to very very low added salt. Just a few grains per day of the iodized salt - to get a little bit of iodine.

Remember your body needs a certain amount of salt a day, if I remember rightly it's about 1.5-2 grams a day.

I naturally tend to lean to a late breakfast and an evening meal, so lately I have been looking at something around the 16:8 eating/fasting model.
I'm a firm believer in just aim for a sensible diet, avoiding extremes, fads, or excessive messing about. For a lifestyle to work long term it has to be something you can happily stick to.

 

[OK1]

It needn't be anything other than the extra weight/obesity, the reversal of which can reverse a lot of these kinds of issues. Choose whichever diet feels the least restrictive to you, so that you can imagine sticking to it in the long term.

Thank you.

Over a month, I think I've finally found a balance, that avoids extremes of any kind, which especially over two recent days has evolved to a point where I am now very satisfied with the reduced portion, without hunger afterwards. Also feel I have gotten the balance of food macros right. It's not exactly same - like a machine each meal, but the previous post has the approximations for the macros in %'s.

I'd call it Vege-Paleo Centric - Low Fat, Moderate Protein, Low Carb., Nutrient oriented. Very low salt, and very low in vegetable oils(using only Extra Virgin Olive Oil- Lidl's which seems to be the least expensive).

 

[OK1]

Remember your body needs a certain amount of salt a day, if I remember rightly it's about 1.5-2 grams a day.

I naturally tend to lean to a late breakfast and an evening meal, so lately I have been looking at something around the 16:8 eating/fasting model.
I'm a firm believer in just aim for a sensible diet, avoiding extremes, fads, or excessive messing about. For a lifestyle to work long term it has to be something you can happily stick to.

I was initially - NOT too concerned about salt, obviously not wanting to be on a high salt diet, but because of a concern about kidney function, the consensus seems to be - for both high blood pressure and improving kidney function, with the Lisinopril meds I'm taking, the lower salt intake, will result in improvement of both these targets.

I'll give very low salt a go, for at least a month or two until my next test, and see.

 

[beating_my_betes]

Thank you.

Over a month, I think I've finally found a balance, that avoids extremes of any kind, which especially over two recent days has evolved to a point where I am now very satisfied with the reduced portion, without hunger afterwards. Also feel I have gotten the balance of food macros right. It's not exactly same - like a machine each meal, but the previous post has the approximations for the macros in %'s.

I'd call it Vege-Paleo Centric - Low Fat, Moderate Protein, Low Carb., Nutrient oriented. Very low salt, and very low in vegetable oils(using only Extra Virgin Olive Oil- Lidl's which seems to be the least expensive).

Good luck!

 

[s'nic]

I also have CKD (stage 3a), at my last test my eFGR had improved.
My blood pressure has fallen while losing weight. Additionally I am eating less proteins in order relieve some of the strain on the kidneys. I've never used a lot of salt, so am naturally low salt (it could be argued that I should eat a bit more salt).

 

[BobbleHat]

I was initially - NOT too concerned about salt, obviously not wanting to be on a high salt diet, but because of a concern about kidney function, the consensus seems to be - for both high blood pressure and improving kidney function, with the Lisinopril meds I'm taking, the lower salt intake, will result in improvement of both these targets.

I'll give very low salt a go, for at least a month or two until my next test, and see.

I think, for those of us who are readers/researchers/medically minded, the hardest part of a diagnosis is finding out how much contradictory information is out there and then finding out that the reason for that is that there is no one singular Diabetes and individual physiology plays such a huge part in what 'works'.
I'm a midwife so I've had exposure to supporting women with a diagnosis of gestational diabetes and a basic level of knowledge around diabetes because of that (although the majority of pregnancy care in my Trust is provided by the specialist diabetes team. I'm doing the 'pregnancy' bit not the 'diabetes' bit.
I know how to read scientific papers, how to apply an appraisal tool like CASP to see whether they're good quality pieces of research.
Despite that, my head and heart have been battered this past 6 weeks trying to absorb information because now it's not theoretical - it's my health and my life involved now.
Ultimately, whilst anecdote isn't data as they say, I'm the best expert I know on ME so gathering information about ME is the best path forwards. And testing is a really big part of that. E.g I know I need to work on my fasting bloods which are the high end of normal so I try to focus my reading on that. I know I can eat a small amount of noodles now and not 'spike' after a meal but even a tiny amount of potato does bad things to my control so no potato for me.
I had to choose one approach from the multitude out there. Despite the valid research shared above, I've decided to go low carb with intermittent fasting (16:8) because the evidence felt secure to me, so far my blood glucose has stayed within normal parameters, it feels long term sustainable to me, I find it tasty and I don't feel hungry. The proof of the pudding, as they say, will be my hba1c in November (and my cholesterol which needs not to spiral with what I'm eating).
You seem to have a very solid plan. I would just say beware of diabetes burnout which is very real thing. You might be the sort of person for whom a lot of changes all at once - a line in the sand marking old life from new- is the right approach. Me, I need an incremental approach. Manage the diet, then think about cholesterol once I feel more comfortable with managing diabetes. Now that I feel Iike I have a bit of a handle on diet, I turning my attention to exercise (and hoping that will affect my pesky fasting glucose!)
I wish you much success in whatever approach you adopt. And, yes, the forum is a wonderful place to be with people who 'get it'.

 

[Leadinglights]

I was initially - NOT too concerned about salt, obviously not wanting to be on a high salt diet, but because of a concern about kidney function, the consensus seems to be - for both high blood pressure and improving kidney function, with the Lisinopril meds I'm taking, the lower salt intake, will result in improvement of both these targets.

I'll give very low salt a go, for at least a month or two until my next test, and see.

I would be careful about going without salt as the body need salt to maintain electrolyte balance. People often find when they reduce processed food in their diet they lack salt and can get symptoms like headaches, cramp, nausea. The amount of salt from all sources is suggested as no more than 6g per day, about 1 teaspoonful.

 

[OK1]

Good to see you are reading around and finding different options to choose from.

There is a body of evidence that shows that in some people lower carb / higher fat diets can unfortunately increase insulin resistance. So as always it’s about trying methods for yourself, being cautious about sources making extravagant claims for approaches at the extremes (eg ultra-low carb, carnivore). Not that these don’t work for some, but there are valid concerns about their safety and sustainability.

Regarding the carbohydrate-insulin model, one member here @Eddy Edson follows some researchers who have collected research that fails to find evidence for the carbohydrate-insulin model in practice.

Thread 'Time to stick a fork in the carbohydrate-insulin model (CIM) of weight-gain'

May 8, 2021

Thread with a new piece reviewing all the evidence against the CIM, with rejoinders from David Ludwig, the most credible proponent of it.

https://twitter.com/x/status/1390647967439224833

Despite Ludwig's efforts, the CIM is surely well & truly toast now, removing the main "scientific" support for all the low-carb articles of faith:

- "Carbs make you fat; calories don't matter"
- "Carbs make you hungry"
- "Carbs decrease energy"
- "Carbs cause diabetes"

Etc etc.

• Eddy Edson
• Replies: 1
• Forum: In the news...

• 

Having said that, lower carb menu plans are a very effective strategy for many T2 members here. And are now widely supported by a body of epidemiological and clinical evidence as one option that can help some people.

So low carb, and weight loss are both highly effective strategies, and both have enthusiastic supporters and advocates on the forum - but it can pay to be a little cautious about websites / channels / blogs that suggest more extreme versions of these approaches (and often seem to have a book, supplement, or course to sell!)

Highly appreciate your comments.

A defence of the Insulin/Insulin resistance as a possible cause of T2D diabetes. This does not imply that insulin is the only cause, as there could be other causes. Professor Roy Taylor - his hypothesis is more oriented towards a combination of genetics and fat stored in the liver and pancreas (I would add also fat stored in or in the region of, the adrenals, kidneys, and heart, by extrapolation)

The human body is obviously complex. Quite complex. And our world is also complex. One one hand, I think that the various hypotheses and theories about how we function, will remain subject to improvement, as we learn more, and I doubt if this evolution of understanding will ever end. We will always know in part.

Nevertheless, like the imperfection in Newton's thinking, which was superseded by Einstein's, which finally explained planetary motion more precisely, I think theorems and hypothesis have some value, even where the evidence does not completely line up to observation. Newton's thinking failed to explain the motion of the planets 100%, but was a good enough approximation, until Einstein produced a more complete explanation.

I am not a scientist by day, but studied some science earlier in life, and highly value much of the ethos of science, albeit, sometimes science can be a bit slow, to get the picture cos of the rigour. Especially in the area of medicine, some experiments to isolate the truth, would be deemed ethically inappropriate, so some extrapolation sometimes has to be made.

I do not know if there is any relationship between the hormones Insulin, and Insulin Like Growth Factor 1 (aka IGF1). I watched a documentary many years ago, by the absolutely wonderful medical journalist - Michael Mosley, who is no longer with us - he passed away 2024, but I have since posted a link to the BBC documentary, which I watched over a decade ago, and it left a strong impression on me. I obviously did not have diabetes at the time (I definitely hope not), so the import did not fully dawn on me. In that documentary it describes a small group of people of whom there were less than 400 in the world, who have a gene mutation, which gives them low levels of the IGF1 hormone. They are typically very small, no taller than about 4 feet. They may be obese, smoke like chimneys, but they do not get diabetes or cancer.

If we correlate this with Roy Taylor's thinking, the common thread is definitely genetics playing a part. As Roy Taylor also postulates, in some of the videos I have watched, that there are "normal" people, not these "special" ones, who will get fat, but their genes protect them from developing diabetes. Can't remember the %. he mentioned, in a Youtube video. i.e some people will never get diabetes, even if they became overweight. For me that is very comforting, cos it's not all my fault !! insert a good chuckle here..🙂🙂🙂🙂. Definitely makes me feel better about myself.

Then for those who do become diabetic, according to Roy Taylor, also have a poor response to fat deposited in the liver and pancreas, with removal of fat from the liver and pancreas being the foundation of diabetes remission - for T2D. i.e just lose weight and keep the weight off. The one issue I would want to know is - does this apply to everyone with T2D?, or are there other factors, which may apply to some of those with T2D, cos the TD2 remission is not proven to be 100%, even after weight loss.

Therefore if we put all this together, there is an inferred justification that :

1. Insulin Resistance (if this is a true phenomena) could be a factor, and cause in the progression of diabetes, starting in the prediabetic stage.

2. Obesity, has a very high likelihood of being a key factor, if we accept the hypothesis of Roy Taylor.

3. Genetics also plays an important role.

Clearly there is still room for more research, to refine all the causes of T2D.

All this gets even more granular when we understand that there is also T1.5D, which is midway between T1D and T2D, where insulin production has declined, but is not - non existent as in T1D.

If I were to speak honestly about this, I am not sure the current model of care in the UK where the GP is directly responsible for T2D patients, is adequate.

My view is that anyone diagnosed with T2D, should immediately be referred to a proper specialist, a diabetician doctor, in the same way that would happen with things like cancer or a cardiovascular condition. I feel the subject of diabetes is far more nuanced than the ability of GP's to address, especially their ability to keep up with the most current knowledge on the subject. The worst thing to happen is a post code lottery, where our diabetes care on the NHS is based on who your doctor is. In the same conversation where my GP was educating me on what do do about my diabetes, I was the one educating her about my awareness of diabetes remission, cos this was something I had heard about in the news over many years on several occasions, and I had also informed members of my own family who became diagnosed with T2D, before me. Patients should NOT be more informed than their GP. !!

We are fortunate, we have the Internet. Without which I'd be at the mercy of my GP's knowledge and best practice., with the impression that there was no hope, and I will need to remain on medications - for a lifetime - without any other options., or the possibility of a better outcome.

 

[OK1]

Highly appreciate your comments.

A defence of the Insulin/Insulin resistance as a possible cause of T2D diabetes. This does not imply that insulin is the only cause, as there could be other causes. Professor Roy Taylor - his hypothesis is more oriented towards a combination of genetics and fat stored in the liver and pancreas (I would add also fat stored in or in the region of, the adrenals, kidneys, and heart, by extrapolation)

The human body is obviously complex. Quite complex. And our world is also complex. One one hand, I think that the various hypotheses and theories about how we function, will remain subject to improvement, as we learn more, and I doubt if this evolution of understanding will ever end. We will always know in part.

Nevertheless, like the imperfection in Newton's thinking, which was superseded by Einstein's, which finally explained planetary motion more precisely, I think theorems and hypothesis have some value, even where the evidence does not completely line up to observation. Newton's thinking failed to explain the motion of the planets 100%, but was a good enough approximation, until Einstein produced a more complete explanation.

I am not a scientist by day, but studied some science earlier in life, and highly value much of the ethos of science, albeit, sometimes science can be a bit slow, to get the picture cos of the rigour. Especially in the area of medicine, some experiments to isolate the truth, would be deemed ethically inappropriate, so some extrapolation sometimes has to be made.

I do not know if there is any relationship between the hormones Insulin, and Insulin Like Growth Factor 1 (aka IGF1). I watched a documentary many years ago, by the absolutely wonderful medical journalist - Michael Mosley, who is no longer with us - he passed away 2024, but I have since posted a link to the BBC documentary, which I watched over a decade ago, and it left a strong impression on me. I obviously did not have diabetes at the time (I definitely hope not), so the import did not fully dawn on me. In that documentary it describes a small group of people of whom there were less than 400 in the world, who have a gene mutation, which gives them low levels of the IGF1 hormone. They are typically very small, no taller than about 4 feet. They may be obese, smoke like chimneys, but they do not get diabetes or cancer.

If we correlate this with Roy Taylor's thinking, the common thread is definitely genetics playing a part. As Roy Taylor also postulates, in some of the videos I have watched, that there are "normal" people, not these "special" ones, who will get fat, but their genes protect them from developing diabetes. Can't remember the %. he mentioned, in a Youtube video. i.e some people will never get diabetes, even if they became overweight. For me that is very comforting, cos it's not all my fault !! insert a good chuckle here..🙂🙂🙂🙂. Definitely makes me feel better about myself.

Then for those who do become diabetic, according to Roy Taylor, also have a poor response to fat deposited in the liver and pancreas, with removal of fat from the liver and pancreas being the foundation of diabetes remission - for T2D. i.e just lose weight and keep the weight off. The one issue I would want to know is - does this apply to everyone with T2D?, or are there other factors, which may apply to some of those with T2D, cos the TD2 remission is not proven to be 100%, even after weight loss.

Therefore if we put all this together, there is an inferred justification that :

1. Insulin Resistance (if this is a true phenomena) could be a factor, and cause in the progression of diabetes, starting in the prediabetic stage.

2. Obesity, has a very high likelihood of being a key factor, if we accept the hypothesis of Roy Taylor.

3. Genetics also plays an important role.

Clearly there is still room for more research, to refine all the causes of T2D.

All this gets even more granular when we understand that there is also T1.5D, which is midway between T1D and T2D, where insulin production has declined, but is not - non existent as in T1D.

If I were to speak honestly about this, I am not sure the current model of care in the UK where the GP is directly responsible for T2D patients, is adequate.

My view is that anyone diagnosed with T2D, should immediately be referred to a proper specialist, a diabetician doctor, in the same way that would happen with things like cancer or a cardiovascular condition. I feel the subject of diabetes is far more nuanced than the ability of GP's to address, especially their ability to keep up with the most current knowledge on the subject. The worst thing to happen is a post code lottery, where our diabetes care on the NHS is based on who your doctor is. In the same conversation where my GP was educating me on what do do about my diabetes, I was the one educating her about my awareness of diabetes remission, cos this was something I had heard about in the news over many years on several occasions, and I had also informed members of my own family who became diagnosed with T2D, before me. Patients should NOT be more informed than their GP. !!

We are fortunate, we have the Internet. Without which I'd be at the mercy of my GP's knowledge and best practice., with the impression that there was no hope, and I will need to remain on medications - for a lifetime - without any other options., or the possibility of a better outcome.

If we merge the various hypotheses, clearly in terms of actions, one MUST explore :

1. Approaches to lower blood sugar levels, and keep them in the normal range, which is good for all human beings, diabetics included.

2. Approaches to lose excess body fat.

3. Approaches to reduce Insulin Resistance (if such a phenomenon actually exists, in the human body).

4. Approaches to lower Inflammation - if it is true that such a phenomenon exists, which hypothetically is correlated with the onset of Insulin Resistance.

Why do I add Inflammation? My father passed away from diabetes, which was what took him into hospital and he died in hospital. When he was admitted, I had no knowledge of diabetes, him being the 1st person close to me, with this condition. I asked the doctor - why?, and at that time, he explained that the cause was possibly some event which triggered the diabetes. A bit of a strange explanation. In the same way that an auto-immune event triggers T1D, is it possible that there are lifestyle incidents that exacerbate T2D? I do not know. But there is no harm in keeping inflammation low, just in case it has any relevance to T2D. Even if that is an indirect association, such as via reduction in High Blood pressure.

I see T2D as an end result possibly triggered by multiple factors, so the response should be comprehensive, and all encompassing, as well as aggressive, pulling out all the stops.

 

[OK1]

I would be careful about going without salt as the body need salt to maintain electrolyte balance. People often find when they reduce processed food in their diet they lack salt and can get symptoms like headaches, cramp, nausea. The amount of salt from all sources is suggested as no more than 6g per day, about 1 teaspoonful.

Noted and thanks.

One way to look at the salt issue, is similar to the side effect issue with medicines. We take medicines, with the full knowledge that all of them have possible side effects, or rather they all have side effects, and some side effects are more noticeable than others, and in some cases the side effects are worse than the benefits.

The lowering of salt, in my case is intended to be only for a season, so I can know I have done all I can to address two other issue, high blood pressure and improve kidney function. It is so hard, when one is making many changes at the same time, such as medications, and other lifestyle changes, to determine which is the cause, but I will watch out for the symptoms you have described.

What's interesting is that for example, cramps, I had been experiencing leg cramps in my calf muscles, in the months leading up to my T2D diagnosis, but since I made changes after my T2D diagnosis, I cannot recall any more cramps i.e. now that I have done a bit more to limit salt, my cramps have gone. Kind of strange, still trying to figure that out. Was it the introduction of magnesium supplementation, after T2D diagnosis?

Based on something I learnt recently, apparently the medicines prescribed for high blood pressure, in one way or another, have the net effect of causing the kidneys to release sodium along with fluid from the blood, into our urine, so the heart pumps a lower volume of blood, and blood pressure is therefore reduced.

There was also the Rice Diet - not something which I would suggest to anyone in today's world, which had a low salt regime, actually a NO salt regime, cos extra effort was taken to deplete any natural salt in the rice, by extra pre-wash, and this had proven efficacy for some, in the improvement of diabetes (about the 1st experiment recorded on diabetes remission) as well as reduction of blood pressure. I have not studied the side effects of this regime.

Especially as high blood pressure is implicated as a co-factor in diabetes, and especially as a factor in kidney health, the benefit of lowering salt to improve kidney health, as well as high blood pressure, at least for a season, outweighs any possible side effects.

There is also the possibility that as one loses fat, and some muscle, due to caloric restriction, this releases minerals that were stored in the fat. Which reminds me, that is one more important reason to be well hydrated, during weight loss, so the kidneys can get rid of any excess minerals, dumped from shrinking fat cells. A lot of the initial weight lost is also water loss, and I can imagine that during that phase, there is already more than enough salt stored along with that water, in the body, which is being released into the blood, from both the blood, and other cells. So in theory, there may not be the need for a while, to worry about salt, cos there is already a fair amount of salt, stored in the excess body fluids and fat.

 

[OK1]

I think, for those of us who are readers/researchers/medically minded, the hardest part of a diagnosis is finding out how much contradictory information is out there and then finding out that the reason for that is that there is no one singular Diabetes and individual physiology plays such a huge part in what 'works'.
I'm a midwife so I've had exposure to supporting women with a diagnosis of gestational diabetes and a basic level of knowledge around diabetes because of that (although the majority of pregnancy care in my Trust is provided by the specialist diabetes team. I'm doing the 'pregnancy' bit not the 'diabetes' bit.
I know how to read scientific papers, how to apply an appraisal tool like CASP to see whether they're good quality pieces of research.
Despite that, my head and heart have been battered this past 6 weeks trying to absorb information because now it's not theoretical - it's my health and my life involved now.
Ultimately, whilst anecdote isn't data as they say, I'm the best expert I know on ME so gathering information about ME is the best path forwards. And testing is a really big part of that. E.g I know I need to work on my fasting bloods which are the high end of normal so I try to focus my reading on that. I know I can eat a small amount of noodles now and not 'spike' after a meal but even a tiny amount of potato does bad things to my control so no potato for me.
I had to choose one approach from the multitude out there. Despite the valid research shared above, I've decided to go low carb with intermittent fasting (16:8) because the evidence felt secure to me, so far my blood glucose has stayed within normal parameters, it feels long term sustainable to me, I find it tasty and I don't feel hungry. The proof of the pudding, as they say, will be my hba1c in November (and my cholesterol which needs not to spiral with what I'm eating).
You seem to have a very solid plan. I would just say beware of diabetes burnout which is very real thing. You might be the sort of person for whom a lot of changes all at once - a line in the sand marking old life from new- is the right approach. Me, I need an incremental approach. Manage the diet, then think about cholesterol once I feel more comfortable with managing diabetes. Now that I feel Iike I have a bit of a handle on diet, I turning my attention to exercise (and hoping that will affect my pesky fasting glucose!)
I wish you much success in whatever approach you adopt. And, yes, the forum is a wonderful place to be with people who 'get it'.

You are so kind. I appreciate your comments. Yeah T2D was a real wake up call for me. I was the last person who thought it could happen to me, cos I had already made certain changes as far back as 15 years before my diagnosis, but clearly all my efforts had not been enough. So that's why my approach may seem dogged.

Before T2D, I had cut out margarine and white bread 12 years earlier, prohibited the use of any "cubes" with MSG - 15 years earlier, was conservative with salt, stopped using any sugar - I never bought any - 10 years earlier, fruit juice was a rare treat and restricted to the best quality juice - , and the only juice I took was the zero calorie kind (but I have read in recent times that these should also be prohibited), and had introduced vegetables and fruits as a regular component of most meals. I'm the veggie cook in my home, over about 8 recent years, I'd prepare boiled vegetables an average of three times a week, for the family, and I was also the salad cook, fresh salads - from all natural sources, no salad source - average of once a week. So to be diagnosed with T2D, was a real blow. I had been the one "preaching" to others to cut their sugar intake, and cut the booze. I had been teetotal for at least years, and prior to that rarely had any alcohol, average of one or two glasses of wine a year, prior. Quit smoking 33 years ago. So clearly it was NOT for a total lack of effort. Which is why my approach has been - what did I miss? And what can I fix.

Over the year prior to my T2D diagnosis, I had increased the fruits and vegetables in my diet, and from this change alone, but sadly with no effort at exercise, I had already lost 3 KG, without trying - eating as much as I wanted to. So it was a case of - I had done a few things right, but clearly as I have discovered, my genes are not the lucky ones, and my efforts were also not enough.

The good fortune to have learnt about T2D remission, prior to my diagnosis is what gives me a foundation of encouragement, and the companionship and advice here has been a massive boost.

I had an experience with piles (haemorrhoids) about 9 years ago, and this was the start of my paying attention to vegetables and fibre, as recommended on the NHS website, and by the doctor who attended to me in A&E. With this one change, piles has been no longer a worry, and bleeding from it almost non existent - maybe once or twice, when I was constipated, or dehydrated, in all these years. So with that confidence that there is a way out, that also encourages me, to find the way with T2D. Especially encouraged that others, with so many testimonials, from trusted sources, over many decades, have also found their solutions.

In a way, I'm doing all this, not just for me, but for my entire family. I have a sister who I had been encouraging that her T2D - diagnosed before mine, could be put into remission. I also have a brother who has T2D, and it runs in the family. My wife has parents and a sibling who died from T2D, and I have children who obviously have the T2D gene from both my wife and I. I have three cousins who died from T2D complications. So there is a lot of hope, and huge implications. It would be so amazing if I could get on top of this, put T2D 100% in remission, and continue to advocate for lifestyle changes for all members of my family. And a sister whose husband and son have T2D. It's pretty much everywhere. So I really look forward to getting to the bottom of this, and being a forerunner for educating and advocating, the wider family, on the required lifestyle changes, for the various generations, and the yet unborn. So that not just for me, but for many others, their lives can be so much better. My benefit is obviously a motivation, and motivating my family to do better is a further motivation.

Best wishes. We'll beat T2D, by the grace of God, and put the worry about it behind us. And only have to show up for regular checks, to reaffirm that we are still in remission.

 

[OK1]

I think, for those of us who are readers/researchers/medically minded, the hardest part of a diagnosis is finding out how much contradictory information is out there and then finding out that the reason for that is that there is no one singular Diabetes and individual physiology plays such a huge part in what 'works'.
I'm a midwife so I've had exposure to supporting women with a diagnosis of gestational diabetes and a basic level of knowledge around diabetes because of that (although the majority of pregnancy care in my Trust is provided by the specialist diabetes team. I'm doing the 'pregnancy' bit not the 'diabetes' bit.
I know how to read scientific papers, how to apply an appraisal tool like CASP to see whether they're good quality pieces of research.
Despite that, my head and heart have been battered this past 6 weeks trying to absorb information because now it's not theoretical - it's my health and my life involved now.
Ultimately, whilst anecdote isn't data as they say, I'm the best expert I know on ME so gathering information about ME is the best path forwards. And testing is a really big part of that. E.g I know I need to work on my fasting bloods which are the high end of normal so I try to focus my reading on that. I know I can eat a small amount of noodles now and not 'spike' after a meal but even a tiny amount of potato does bad things to my control so no potato for me.
I had to choose one approach from the multitude out there. Despite the valid research shared above, I've decided to go low carb with intermittent fasting (16:8) because the evidence felt secure to me, so far my blood glucose has stayed within normal parameters, it feels long term sustainable to me, I find it tasty and I don't feel hungry. The proof of the pudding, as they say, will be my hba1c in November (and my cholesterol which needs not to spiral with what I'm eating).
You seem to have a very solid plan. I would just say beware of diabetes burnout which is very real thing. You might be the sort of person for whom a lot of changes all at once - a line in the sand marking old life from new- is the right approach. Me, I need an incremental approach. Manage the diet, then think about cholesterol once I feel more comfortable with managing diabetes. Now that I feel Iike I have a bit of a handle on diet, I turning my attention to exercise (and hoping that will affect my pesky fasting glucose!)
I wish you much success in whatever approach you adopt. And, yes, the forum is a wonderful place to be with people who 'get it'.

Huge appreciation for all that the medical people do. I had Covid, and was in hospital for a few days. The care I received was second to none. I can never forget. Really great people. Extended my life.

I am reminded that one of the most important things that helped me get out of hospital so quickly was a nurse who advised me - drink plenty of water. As long as I did, my oxygen measurements improved, and one day I was slack with water, and was put back on oxygen tubes in the nostrils. Definitely learnt my lesson sharpish. No one told me afterwards about drinking water or liquids.

I would postulate, that diabetes has a similar challenge. Whatever the causes, while of course excess water intake cannot be a good thing, is there any possibility that lack of hydration could have an impact on diabetes progression, or reversal. The thought pattern is this :

1. Is the issue of "sugar" in the blood a function of the amount of glucose, or the concentration of glucose? If one thinks of simple things like washing up liquid, the efficacy is more about the concentration.

2. Is it possible that remaining properly hydrated can have a positive impact, to lower the concentration of glucose in the blood?, as one more tool in the arsenal. This should not be an excuse to load up on glucose sources such as carbs. I mention this because, I have not really heard much about hydration as a potential weapon in defeating T2D.

Definitely a topic I'd like to learn much more about. Impact of hydration in T2D.