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Type2 cases for different paths

ianf0ster

Well-Known Member
Relationship to Diabetes
Type 2
All sensible Type 1 diabetics count carbohydrates Yet many would claim this isn't good for Type 2 diabetics - why is this?

1. They claim it upsets Type 2's and causes poor mental health.
2. They say that 'eating less and moving more' is enough.
3. They agree with the NHS, GPs (and( apparently Diabetes,org.uk) that Blood Glucose meters are not required for Type 2's unless they deteriorate such as to have to use strong (potential hypo causing) medication. At which juncture it's apparently then OK for a Type 2 to test their Blood Glucose so they can (at last) tell what makes it go too high as well as when the medication is overpowering the carbs and driving it too low.

Some serious consequences of uncontrolled Type 2 diabetes include retinopathy, neuropathy and wounds not healing - the same as those for hyperglycemia in Type 1 diabetes, so why are Type 2's discriminated against? Possibly because around 90% of us are either obese or overweight, so it is thought to be self-inflicted.
But this means that 10% of Type 2 diabetics are apparently normal, healthy, slim even.

What are the the possible means of Type 2 remission?

1. Bariatric Surgery.
2. Medication.
3. Lifestyle/way of eating/weight loss.
4. Or some combination of the above.

What are the rates of longer term remission from these methods.
(Figures are all approximate but are taken from records of Bariatric surgeons, GPs and diabetes researchers).

1.Bariatric Surgery: 50% at best. Dr Robert Cywes (a bariatric surgeon) says that surgery gives the patient a 12 month to 18month window in which to learn to eat appropriately. Hence the surprisingly low success rate.

2. Medication : approx 0% . Dr David Unwin (a GP) says he was so disappointed at his lack of success in treating diabetes he was about to leave the medical profession. He had treated Type 2 patients for over 20yrs, seen their numbers more than quadruple, seen their medication increase over time and yet had never had a single case achieve remission! Then a patient he didn't recognise came in and called him a terrible doctor. He didn't recognise her because she had 'cured' herself. No longer obese, no longer hypertensive, no longer hyperglycemic. Her Blood Glucose was now normal despite stopping taking all her medications for those conditions.

3. Lifestyle/way of eating/weight loss: Remission rates vary since different approaches suit different people, but up to around 50%.

A). Moderation: - Eat less and move more. These are not starvation diets, yet for long term weight loss they only have a success rate of around 10%. Remission is perhaps a little higher than just for weight loss since their is a greater incentive. But since people continue to fail at weight loss so let's say 20% at best.

B). Weight loss diet: Success for these varies considerably but the 2 main problems with them are that they put your body into starvation mode and that you can only stay on them for a limited time before you start to suffer from deficiencies. So you might expect a success rate of around the same as for WW or SW .Having said that, the Newcastle diet (a shakes based 800 calorie per day diet) supported by diabetes.org.uk has a remission rate of around 40% measured after 2yrs.

C). Way of Eating: Three well known facts about Carbohydrates I). They are not an essential macronutrient unlike Proteins and Fats. II). They turn into glucose very quickly when eaten III). Farmers feed livestock a carbohydrate rich feed in order to fatten them up.
Yet many people including doctors feel it isn't worthwhile for Type 2 diabetics to measure their own individual body's tolerance to carbohydrates in order be able to limit the carbohydrates they eat.
Limiting carbs has been shown in studies both by Virta and in Dr David Unwin's patients to have a remission rate of around 50% or more. So why aren't Type 2's at least advised about using Blood Glucose meters to aid in reducing carbs when it has such a good remission rate - even if the NHS prefers to waste money on medication instead? Instead Low Carb (which doesn't restrict calories or nutrients is treated as a 'fad'diet' not even on a par with WW or SW etc.
 

Inka

Well-Known Member
Relationship to Diabetes
Type 1
Just to be clear @ianf0ster Type 1s count carbs in order to calculate our insulin doses. So when a Type 1 asks a newly diagnosed Type 1 “Do you count carbs?” they mean something very specific and nothing to do with totting up daily carbs or limiting them or anything similar . They mean “Do you know your ratios?” So your first sentence makes no sense with regard to that statement.
 
D

Deleted member 33972

Guest
All sensible Type 1 diabetics count carbohydrates Yet many would claim this isn't good for Type 2 diabetics - why is this?

1. They claim it upsets Type 2's and causes poor mental health.
2. They say that 'eating less and moving more' is enough.
3. They agree with the NHS, GPs (and( apparently Diabetes,org.uk) that Blood Glucose meters are not required for Type 2's unless they deteriorate such as to have to use strong (potential hypo causing) medication. At which juncture it's apparently then OK for a Type 2 to test their Blood Glucose so they can (at last) tell what makes it go too high as well as when the medication is overpowering the carbs and driving it too low.

Some serious consequences of uncontrolled Type 2 diabetes include retinopathy, neuropathy and wounds not healing - the same as those for hyperglycemia in Type 1 diabetes, so why are Type 2's discriminated against? Possibly because around 90% of us are either obese or overweight, so it is thought to be self-inflicted.
But this means that 10% of Type 2 diabetics are apparently normal, healthy, slim even.

What are the the possible means of Type 2 remission?

1. Bariatric Surgery.
2. Medication.
3. Lifestyle/way of eating/weight loss.
4. Or some combination of the above.

What are the rates of longer term remission from these methods.
(Figures are all approximate but are taken from records of Bariatric surgeons, GPs and diabetes researchers).

1.Bariatric Surgery: 50% at best. Dr Robert Cywes (a bariatric surgeon) says that surgery gives the patient a 12 month to 18month window in which to learn to eat appropriately. Hence the surprisingly low success rate.

2. Medication : approx 0% . Dr David Unwin (a GP) says he was so disappointed at his lack of success in treating diabetes he was about to leave the medical profession. He had treated Type 2 patients for over 20yrs, seen their numbers more than quadruple, seen their medication increase over time and yet had never had a single case achieve remission! Then a patient he didn't recognise came in and called him a terrible doctor. He didn't recognise her because she had 'cured' herself. No longer obese, no longer hypertensive, no longer hyperglycemic. Her Blood Glucose was now normal despite stopping taking all her medications for those conditions.

3. Lifestyle/way of eating/weight loss: Remission rates vary since different approaches suit different people, but up to around 50%.

A). Moderation: - Eat less and move more. These are not starvation diets, yet for long term weight loss they only have a success rate of around 10%. Remission is perhaps a little higher than just for weight loss since their is a greater incentive. But since people continue to fail at weight loss so let's say 20% at best.

B). Weight loss diet: Success for these varies considerably but the 2 main problems with them are that they put your body into starvation mode and that you can only stay on them for a limited time before you start to suffer from deficiencies. So you might expect a success rate of around the same as for WW or SW .Having said that, the Newcastle diet (a shakes based 800 calorie per day diet) supported by diabetes.org.uk has a remission rate of around 40% measured after 2yrs.

C). Way of Eating: Three well known facts about Carbohydrates I). They are not an essential macronutrient unlike Proteins and Fats. II). They turn into glucose very quickly when eaten III). Farmers feed livestock a carbohydrate rich feed in order to fatten them up.
Yet many people including doctors feel it isn't worthwhile for Type 2 diabetics to measure their own individual body's tolerance to carbohydrates in order be able to limit the carbohydrates they eat.
Limiting carbs has been shown in studies both by Virta and in Dr David Unwin's patients to have a remission rate of around 50% or more. So why aren't Type 2's at least advised about using Blood Glucose meters to aid in reducing carbs when it has such a good remission rate - even if the NHS prefers to waste money on medication instead? Instead Low Carb (which doesn't restrict calories or nutrients is treated as a 'fad'diet' not even on a par with WW or SW etc.
Hi Ian, I’ve wondered about restricting carbohydrates. What do diabetic vegetarians eat if Carbs are restricted or not to take them at all? Starve?
 

Drummer

Well-Known Member
Relationship to Diabetes
Type 2
A low carb diet for vegetarians is a little problematic, and for vegans it can be rather restrictive.
There have been times in recent days when I have had trouble getting things to eat, and have ended up with the low carb vege mixtures from the freezer and some roast courgette as I grew them in the garden this year.
I tried on one of my winter skirts and could not fasten it tight enough for it to stay at my waist - it is a kilt with straps and buckles. Not a problem for me, as I still have weight to lose, but if I was to continue eating like that in future there might well come a point when I was just skin and bones.
 

trophywench

Well-Known Member
Relationship to Diabetes
Type 1
You cannot 100% avoid carbs whether vegetarian or otherwise, bearing in mind even lettuce contains some carbs. You would have to eat several whole lettuces at a time to get to the same carb value as a carrot though - so the trick is to discover how much of what carbs your body can tolerate and stick to that, plus also not to be afraid of eating fat instead of carby stodge (eg rice or spuds), to fill you up.
 

Leadinglights

Well-Known Member
Relationship to Diabetes
Type 2
Hi Ian, I’ve wondered about restricting carbohydrates. What do diabetic vegetarians eat if Carbs are restricted or not to take them at all? Starve?
There are some super low carb veggie recipes if you look, everybody imagines that veggie meals are all potatoes, rice, pasta and beans but there are lots of alternatives. Some veggie folk do eat fish.
I think if you are vegan that is more of a struggle.
 

Nayshiftin

Well-Known Member
Relationship to Diabetes
Type 2
Hi Ian, I’ve wondered about restricting carbohydrates. What do diabetic vegetarians eat if Carbs are restricted or not to take them at all? Starve?
That tells me you have not researched . Most vegetarians will still eat eggs, lentils nuts seeds, tofu cheese all are protein . Many veg too is not too high and if you test you get what spikes you and I did lower myself considerably this way. I am at the stage though I don’t think my body knows my new sugar insulin level as lots has changed . I think of this ass journey and may use all of the above at some stage . A day is all I can take or an hour at a time. So be it. Do it the way no way is right no way is wrong. That’s my take.
 
D

Deleted member 33972

Guest
You cannot 100% avoid carbs whether vegetarian or otherwise, bearing in mind even lettuce contains some carbs. You would have to eat several whole lettuces at a time to get to the same carb value as a carrot though - so the trick is to discover how much of what carbs your body can tolerate and stick to that, plus also not to be afraid of eating fat instead of carby stodge (eg rice or spuds), to fill you up.
I got slated a few days ago for saying that. Cattle eat grass and antibiotics. You are what you eat. I tried it and couldn’t do the toilet. I am doing well with my carbs. 6.8 I think this morning
 

Nayshiftin

Well-Known Member
Relationship to Diabetes
Type 2
I got slated a few days ago for saying that. Cattle eat grass and antibiotics. You are what you eat. I tried it and couldn’t do the toilet. I am doing well with my carbs. 6.8 I think this morning
If it works for you then that’s great. No one here has your knife and fork and forces you to eat anything . Enjoy take care and yes I think 6.8 I’d be happy too
 

Inka

Well-Known Member
Relationship to Diabetes
Type 1
Hi Ian, I’ve wondered about restricting carbohydrates. What do diabetic vegetarians eat if Carbs are restricted or not to take them at all? Starve?

Eggs, cheese, tofu are all low/no carb protein sources. Meat isn’t the only form of protein. Vegetarians eat a variety of foods but don’t stick to a veggie version of meat, veg, potatoes. We’ll have chillies, curries, bakes, etc etc. It’s a different way of eating. It can have any amount of carbs you choose.
 

rebrascora

Well-Known Member
Relationship to Diabetes
Type 1
I got slated a few days ago for saying that. Cattle eat grass and antibiotics. You are what you eat. I tried it and couldn’t do the toilet. I am doing well with my carbs. 6.8 I think this morning
Beef cattle should be so lucky! After they are weaned they are brought into sheds and fed haylage and grains and perhaps spoilt vegetables..... A large beef cattle farmer I know was feeding his beast straw and jam a few years ago because he got a tanker load of jam that was not fit for human consumption for free. Those carbs will fatten beast too. Most young beef cattle don't see grass again although my local farmer does usually give them a second summer of grass (and freedom), the majority do not. Yes, antibiotics and wormers and other medication is used on them just like we expect to be treated with medication ourselves if we are sick but pesticides are sprayed on fruit and vegetables and a recent report showed there is a high percentage of residue in and on the fruit and veg we buy, so unless you buy totally organic or grow your own and then understand how hard it is to overcome pests and diseases, you have to accept that the food we buy is not always as wholesome as we would like it to be.
I am not advocating one way or another regarding vegetarianism but it isn't necessarily healthier in my opinion and it does take more effort to keep carb intake low for diabetics when most protein sources for vegetarians also contain carbs ie beans, nuts etc.
 

ianf0ster

Well-Known Member
Relationship to Diabetes
Type 2
Just to be clear @ianf0ster Type 1s count carbs in order to calculate our insulin doses. So when a Type 1 asks a newly diagnosed Type 1 “Do you count carbs?” they mean something very specific and nothing to do with totting up daily carbs or limiting them or anything similar . They mean “Do you know your ratios?” So your first sentence makes no sense with regard to that statement.
Yes, but you still count them and you have BG meters to aid you. Dietary controlled type 2's just have a slightly different reason for counting them - so why is it considered so bad for us to do such that we are told not to and not to measure our BG. Or are most Type1's suffering mental distress from carb counting, whilst obviously also happy to be alive.
 

Inka

Well-Known Member
Relationship to Diabetes
Type 1
@ianf0ster I think Type 2s should test their blood sugar. But I don’t get the comparison you’re making with Type 1s. We’re prescribed insulin, we’re given ratios for our bolus insulin and in order to enact these ratios, we have to count the carbs we’re about to eat.

If you’re simply saying that Type 2s on insulin and on an MDI regime should do the same, yes I agree, but I think you’re talking about Type 2s more generally, and it’s that comparison I don’t understand.

Yes, there is a fair bit of mental distress to Type 1 - hence burnout. The cognitive burden of being your own pancreas is hugely under-estimated.
 

trophywench

Well-Known Member
Relationship to Diabetes
Type 1
Well it's a certain fact that nobody (with a functioning brain on here) thinks that T2s should NOT get a meter and strips. You know why the research caused the participants to become depressed? Cos it was designed to do so! Patients issued with meters and strips, told when to test. When anyone noticed - hang on this cow between 2 loaves (not mattresses as unlikely to be high carb) I've just eaten for lunch has just doubled my BG and asked 'how can I stop this happening?', as the Trial instructions said 'You are not allowed to change anything' - they got fed up just pointlessly recording numbers all the while when they could do nob all to change them, even it was supposed to be for research.

It's like offering to teach people to drive and then blindfolding them. 'Of course you can drive! The NHS has taught you!'
 

Lucyr

Well-Known Member
Relationship to Diabetes
Type 2
Not all type 1s count carbs - a lot do but there are those who don’t, for example the newly diagnosed, those without access to education, or those who have been diabetic for a very long time and know what works for them or stick to a meal routine without necessarily counting. Not counting carbs doesn’t mean they aren’t sensible.
 

ianf0ster

Well-Known Member
Relationship to Diabetes
Type 2
You cannot 100% avoid carbs whether vegetarian or otherwise, bearing in mind even lettuce contains some carbs. You would have to eat several whole lettuces at a time to get to the same carb value as a carrot though - so the trick is to discover how much of what carbs your body can tolerate and stick to that, plus also not to be afraid of eating fat instead of carby stodge (eg rice or spuds), to fill you up.
Hence my great annoyance at the policy of discouraging BG meters for Type 2's. How can they e expected to know both which carbs they can tolerate and how many of those carbs if all they get is HnA1C tests several months apart.
Even more frequent HbA1C's would be like steering while only looking in the rear view mirror!

It's all the more frustrating since several prominent politicians have used low carb for both T2 diabetes and weight loss.
Bojo and Hancock for weight loss, Tom Watson and David Davies for diabetes and weight loss. Plus their is even an NHS Low Carb program available on prescription that most GPs don't seem to know about.
 

trophywench

Well-Known Member
Relationship to Diabetes
Type 1
Ian - I have avoided mentioning this at large for the last 49 years because it involves a very dark place which is not a good place to visit even briefly so we avoid it if we have any sense - being diagnosed T1 fairly instantly gives a person the wherewithal to cause serious health concerns (or worse ie death) to anyone they happen to wish to that day - ie Insulin and an injection device. So IMMEDIATELY as well as being 99.9% responsible for our own life - we have an unspoken but inbuilt greater SOCIAL responsibility than we ever imagined the day before.

So we take that on board overnight and immediately have to shove it to the back.

Do 99.9% of T2s have that automatic responsibility?
 

rebrascora

Well-Known Member
Relationship to Diabetes
Type 1
Not all type 1s count carbs - a lot do but there are those who don’t, for example the newly diagnosed, those without access to education, or those who have been diabetic for a very long time and know what works for them or stick to a meal routine without necessarily counting. Not counting carbs doesn’t mean they aren’t sensible.
Must confess I don't religiously weigh things and count carbs but that is mostly because I avoid high carb foods, so I tend just to use my Libre to assess corrections for errors or protein. rather than calculate.... I just use a rough ball park figure and then react to my readings afterwards. This works for me but it might not for others. I think this is one of the benefits of Libre in that it allows you to be less rigid in your approach.

I very much feel that there is a two tier approach to diabetes and I feel that Type 2s are treated like second class citizens in a lot of respects.... even just HbA1c targets. My consultant was absolutely delighted with my HbA1c of 52 and told me I should be too even though it was an increase from the previous year (48) and I was disappointed. Many health care professionals would be berating a Type 2 whose HbA1c had increased. At least that seems to be the general situation from the posts I read here on the forum and that remission levels are the ultimate goal, when many Type 1s have HbA1c levels in the 50s and 60 most of their lives, not just the last 10-30 years, as most Type 2s are diagnosed in later life.

Is it right that someone on insulin should be able to eat whatever they like and just inject insulin to cover it whilst someone with Type 2 is severely restricting their diet to try to gain control of their levels. I know it is different for each type and even within the general types for individuals and I am not sure what the answer is but I do feel like the current approach seems to mostly place "blame" on the Type 2 and sympathy on the Type 1 and they should both be supported equally..... But I also know that the NHS finances are not limitless and are currently under strain, so I appreciate that there may not be enough resources available. The current situation is just the easy option to perpetuate. I think it needs an overhaul but it is undoubtedly not a priority in the current climate.
 

ianf0ster

Well-Known Member
Relationship to Diabetes
Type 2
Not all type 1s count carbs - a lot do but there are those who don’t, for example the newly diagnosed, those without access to education, or those who have been diabetic for a very long time and know what works for them or stick to a meal routine without necessarily counting. Not counting carbs doesn’t mean they aren’t sensible.
I was trying to phrase it in a way that acknowledged that not all Type 1's count carbs, but that those who want to do so have the full resources including meters. And they don't suffer the problems that people say Type 2's would get by doing so.

It's the same for Type 2's. I no longer to weigh food or check up the carbs in most foods any more, nor need to to use my BG to test meals - except in unusual circumstances. But without the opportunity of being able to do that in the first place I wouldn't be in such a good situation now.
 

ianf0ster

Well-Known Member
Relationship to Diabetes
Type 2
Ian - I have avoided mentioning this at large for the last 49 years because it involves a very dark place which is not a good place to visit even briefly so we avoid it if we have any sense - being diagnosed T1 fairly instantly gives a person the wherewithal to cause serious health concerns (or worse ie death) to anyone they happen to wish to that day - ie Insulin and an injection device. So IMMEDIATELY as well as being 99.9% responsible for our own life - we have an unspoken but inbuilt greater SOCIAL responsibility than we ever imagined the day before.

So we take that on board overnight and immediately have to shove it to the back.

Do 99.9% of T2s have that automatic responsibility?
I suggest that they do - e.g. driving a car when hyper. Not always one with such immediate personal consequences - more like smoking 40 cigs a day.
But the huge difference is that for the most part nobody actually tells them that they have this responsibility because T2 is supposedly irreversible and progressive so nobody can do a darned thing about it!
 
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