5 ms·

As a newly diagnosed Type 2, but not overweight, I take metformin and have a carefully altered my diet to slow down my digestion and have few easily digestible

As a newly diagnosed Type 2, but not overweight, I take metformin and have a carefully altered my diet to slow down my digestion and have few easily digestible carbs (i.e. such as the whites, flour, sugar, potatoes and rice). But it takes 3 months to see if my A1C goes down (a measure of the past 3 months of blood sugar), so I won't know for a couple more months. Going keto to me seems like using a shotgun to kill a fly on your foot, it is too hard to keep up with, and causes other issues, while simply understanding how carbs affect your blood sugar is much easier to do. Part of the problem is that all the tables of carbs assume you are only eating the one thing (which is how they make the tables), but the actual affect on blood sugar spikes is the sum of what you ate. For example, eating a boiled potato by itself will spike a Type 2 steeply, but eating it with lots of butter will not. I prefer to understand my health issues by reading a wide variety of information from people who specialize in them, not just read one guy's opinion.

chimeracoder 3y ago
> ). But it takes 3 months to see if my A1C goes down (a measure of the past 3 months of blood sugar), so I won't know for a couple more months. Yes, though depending on what your diagnosis is, you may be able to get a monitor which allows you to track your blood sugar in near-realtime. The technology has advanced a lot in the last 20 years.
- didgeoridoo 3y ago
  A1C represents the long-term glycation of hemoglobin due to blood sugar exposure. Even if you could measure it at home, it wouldn’t change fast enough for rapid tracking to be meaningful. You need to wait for red blood cells to be replaced (hence the 3 month cadence) before expecting any change in A1C.
  - chimeracoder 3y ago
    > A1C represents the long-term glycation of hemoglobin due to blood sugar exposure. You're not measuring HbA1C in real-time; you're measuring the blood sugar in real-time. HbA1C is a lagging indicator, used because it's a convenient and non-invasive diagnostic and a summary statistic. It's not the way you measure the short-term or medium-term effectiveness of interventions.
    - didgeoridoo 3y ago
      Ah I misread your comment — thought you were suggesting measuring A1C at home, which wouldn’t get you anything. Re-reading, you definitely meant measure blood glucose itself. I do wonder if A1C remains a useful metric though, as perhaps it better captures the actual damage done by consistently high blood glucose. Would be interesting to see if there is research showing that CGM area under the curve is a better (or worse) predictor of clinical outcomes than A1C.
      - chimeracoder 3y ago
        > I do wonder if A1C remains a useful metric though, as perhaps it better captures the actual damage done by consistently high blood glucose. Both metrics have their own use. Continuous glucose monitoring is better for measuring the short-term impact of interventions, but it's also more invasive (albeit less so than it used to be) and more expensive. HbA1C is still measured for diabetic patients who have continuous glucose monitoring. One downside of A1C is that the baseline values actually vary, and it's known to be either downward biased or a particularly lagging indicator for certain groups that are predisposed to Type 2 diabetes (e.g. South Asians and people of African descent).
  - deleted 3y ago
    [deleted]
- SubiculumCode 3y ago
  Ancedotally, a friend spent 3 months on a keto diet, and yes they eventually quit. However, their carb shock thirst tiredness that they used to have after a modest meal stopped occurring, and persisted after stopping keto. I've heard that there is some evidence of regeneration of receptors with ketogenic diet.. perhaps occasional bouts of keto can be therapeutic?
- dpeck 3y ago
  For anyone new to it, the words you’re looking for are “continuous glucose monitor” (GCM), and “flash glucose monitor”. Popular brands of it in the US are Freestyle Libre and Dexcom. Their final cost to you will vary hugely by your insurance provider. Some with little to no cost, and others several dollars per day. If you like data and are analytical by nature, and since you’re on HN that’s fairly likely, I’d highly recommend using them for a little while if you can afford it. They’re great for newly diagnosed people to understand in near real time without repeated finger pricking. But those are no terrible either and much better than not managing and monitoring! Slightly annoying at first but it is something that most people can get used to fairly easily.
foepys 3y ago
It is incredibly hard to beat a sugar addiction (a lot harder than nicotine or weed) but it is worth it, I promise. Going full on no-carb and taking long walks daily got a friend out of pre-diabetes type 2. No sugar, no fresh potatoes (cooking and putting them into the fridge for 24 hours is fine), no rice, no fruits, and much more got them off metformin and normalized their blood sugar enough for them to be able to eat cake and sweets again without fearing to get diabetes.
- caminante 3y ago
  > no fresh potatoes (cooking and putting them into the fridge for 24 hours is fine) What does waiting a day accomplish?
  - DoughnutHole 3y ago
    Leaving starchy foods to rest for a decent amount of time after cooking results in some amount of the starch converting into “resistant starch” which the body can’t convert into glucose. So a given portion will be less blood glucose spiking than a portion that hasn’t had that rest. The overall effect is modest though, the whole thing doesn’t turn into resistant starch. It makes it better, but I don’t think it would make a big portion of potatoes suddenly safe for a diabetic.
  - cmrx64 3y ago
    the thermal cycling causes resistant starches to form. actually you are best off heating/cooling it twice, and minimizing the extra water content. instead of being broken down into sugars they get fermented into fatty acids deeper in the gut. pasta is eligible for this effect too idk how the final starch compositions vary between them tho.
- bityard 3y ago
  > It is incredibly hard to beat a sugar addiction (a lot harder than nicotine or weed) but it is worth it, I promise. It's not trivial, I will certainly admit, but it is eminently doable with the right mindset and a reasonable plan. The hard part is that sugar and carb-laden foods are positively ubiquitous in the western diet, due to the fact that carbs are cheap to grow, process, ship, and store. Fat and protein are expensive and harder to find depending on where you live. But I look at it like this: by going out of my way to find and cook metabolically-optimal food for myself, I am investing in my future health in a way that will be _much_ cheaper than the cost of getting my foot removed in a few decades. If I could give any advice at all to someone considering a keto diet, it would be this: do some research, start with some kind of plan, and be forgiving of yourself. It will take some time to figure out which keto-friendly foods you have available to you, and which ones you will actually enjoy eating. If you fall off the wagon and murder a bag of chips in a moment of weakness, know that the whole effort isn't down the drain. You just try to do better tomorrow.
voisin 3y ago
> have few easily digestible carbs (i.e. such as the whites, flour, sugar, potatoes and rice) Should potatoes be in this list? I understood the potato diet to be very effective at causing weight loss (thought to be due to high potassium content of potatoes)? Can something consistently cause weight loss and cause a major insulin response (which I think causes calories to be stored as fat…)?
- DoughnutHole 3y ago
  Potatoes have a GI of about 70, comparable to white rice or white bread (pure glucose is 100). So pretty bad. The “potato diet” will only lead to weight loss if you’re eating fewer calories than you’re expending, same as anything else. You could eat nothing but bacon grease and you’d lose weight if you were eating below maintenance. The effect of food on blood glucose if a matter of how easily it is converted to glucose. Starches like those in potatoes, flour, rice etc are basically converted nearly as easily as straight sugar.
  - ajmurmann 3y ago
    I think there might be other things going on with the potato diet. In Slime Mold Time Mold's study participants seemed to lose more weight when cooking potatoes with the skin on. My wife and I recently tried three diet for about a week with good weightloss. However, my wife who prefers potatoes cooked with skin quickly got abdominal pain and dropped the diet. When I started to eat all the potatoes I had cooked for her, I got similar issues. I think there is a good chance that the solanine which is mostly in the skins messes with people's digestive system and contributing to weightloss. Poisoning yourself doesn't strike me as a valid approach to weightloss. Supposedly someone tried supplementing solanine and didn't see the weightloss. I don't trust that though, since there was a more comprehensive trial or a believable alternative explanation
UncleSlacky 3y ago
Same here (diagnosed about 10 days ago, on metformin, removed simple carbs as much as possible). I've been looking at Michael Mosley's 800-calorie and 5:2 fasting diets, involving an intake of 800 calories a day for about 8 weeks to "reset" your system, then fasting 2 days out of every 7 (i.e. 800 calories for two days a week) thereafter. I haven't "officially" started it, but in practice without simple carbs and sugars, my calorie intake must be pretty close to 800 (the appetite suppressant characteristics of metformin really help here). I've also started exercising after big meals (I've never really exercised before!). There's a website marketing a guided programme if you're into that kind of thing): https://thefast800.com/programme/ https://thefast800.com/programme/ as well as a book: https://oceanofpdf.com/authors/michael-mosley/pdf-epub-the-8-week-blood-sugar-diet-how-to-beat-diabetes-fast-and-stay-off-medication-download-97896161555/ https://oceanofpdf.com/authors/michael-mosley/pdf-epub-the-8...
- ramraj07 3y ago
  Exercise is probably the most important thing you could do! Hope you’re able to stick to it and improve! The other thing that helps me is cutting off sugar - not carbs or starch just actual sweet sugar. In coffees and desserts. Makes me eat less!
salad-tycoon 3y ago
That’s interesting about fat and potatoes. Didn’t know that. Another similar thing is vinegar. It slows gastric emptying and keeps the spikes lower (eg french fries with malt vinegar). You can test fructosamine which I believe is a 2 week avg. or you could do finger pokes or even a CGM if you got the ability. [1] I personally enjoyed The diabetes code by Jason Fung. He’s a nephrologist in Canada. Good luck in your diabetes journey! Luckily you seem interested which is such a distinction. 1 https://www.diabetic.org/fructosamine-to-a1c/ https://www.diabetic.org/fructosamine-to-a1c/
kcplate 3y ago
I’ve been a T2 diabetic for 14 years. For the first 8 years I was insulin dependent and bought into the dietary reqs provided to me at the time which was “grains and fruit are good, just push insulin to manage glucose”. I realized that every month it was taking more and more insulin to manage my blood sugar. I shifted my diet to higher fat and low carbs and was off insulin completely within 3 months and within 6 months my A1c was running low 5s YMMV of course, but at no point eating the approved ADA diet and pushing insulin was my A1c ever below 6.5. Since eating low carb and no insulin, my A1c has never been above 5.4
Projectiboga 3y ago
Increase unsaturated fat in your diet and take melatonin. Melatonin upregulates the insulin receptors, so the insulin you have can do more. Trace minerals and following a standard meal plan worked up by a nutritionist.
pstuart 3y ago
One interesting thing about those digestible carbs is that cooling them after cooking helps convert them into diet resistant starch that helps feed the gut biome, e.g., https://www.foundmyfitness.com/news/s/q2g00a https://www.foundmyfitness.com/news/s/q2g00a
dave8088 3y ago
Have been tested for the type 1 antibody? I was diagnosed as type 2 cause doctors assume type 1 doesn’t happen in your late 30s. It happened to me. Wasted a bunch of time trying to treat it as type 2. Not overweight and type 2 is rare.
marcus_holmes 3y ago
T2 Diabetic for ~12 years (actually probably a lot longer but I only got diagnosed 12 years ago). I've "beaten diabetes" (i.e. I tested as not being diabetic) twice now by losing weight (via calorie counting) and getting fit, but found it too hard to maintain that lifestyle. I've made dietary changes but they had less/no effect. Keto was fine, but my wife didn't get on with it and making two meals every time we ate was too onerous. I stopped measuring my blood sugar a few months after getting diagnosed because it was kinda pointless. I haven't had a single symptom. If I didn't visit the doctor every 3 months or so I'd never know I was diabetic (and I was probably diabetic for 10+ years before getting diagnosed). I take Metformin regularly mostly for the anti-aging side effect. The endless diarrhoea from Metformin is something I got used to, though I had to suspend taking it while travelling because the combination of Metformin shits and travel shits was too much. It all feels like a non-thing to be honest. I know people lose limbs to D2, and go blind, and stuff, but it's hard to take that personally and know that as a definite risk that mean I need to make drastic and difficult lifestyle changes. I keep getting checked and told there's no sign of any damage, but my blood sugar is too high. For 12 years now. I know this sounds a bit anti-vax, but it feels like the science is wrong here. I do not want to go down an anti-science rabbit hole and end up in a conspiracy theory world of my own. So I just keep doing the thing they tell me as best I can. But when/if someone finds out that we've been thinking about D2 all wrong, I will not be the faintest bit surprised. edit: and another thing: I've never had consistent advice from doctors around this. Some GPs say I need to come in every month to get checked up. Others says I only need once a year. Some examine my feet and eyes. Others don't. Some think I'm on too high a dose of Metformin. Others say it's fine. Some are really strong on the diet thing, others not so much. Almost every aspect of this disease seems to be subject to personal opinions about treatment.
- bruce511 3y ago
  Opinions vary a lot, because people vary a lot, and because of this science "that applies to everyone" is very hard to do. There's no question that there us good medical science, but equally there is a lot of junk-science and so in this age of "hearing everyone's opinion", it can be hard to separate fact from opinion. I think we can agree on some stuff. Smoking is bad for you, exercise is good, and so on. Keeping your weight down, more accurately keeping % body fat down, and so on. Making small, incremental, sustainable changes to lifestyle that trend you in good directions, are definitely the best. GPs are (with respect) not a terribly good source. They tend to see sick people all day, and gather lots of superficial anecdotes. Which is not to ignore them, but to understand their POV. But it's worth taking their opinions on board as an hypothesis.
darkclouds 3y ago
[dead]
thepasswordis 3y ago
There's a standard formula for calculating your A1C based on your average glucose level. If you get a dexcom G6, (about $200), you can monitor your glucose levels constantly, and know what your A1C will be. The app gives you rolling averages for 2 days, 7 days, 14 days, and 30 days. Extremely useful. I'm not a T2 diabetic, but did have a slightly elevated A1C at my last physical. I asked my doctor for a prescription for a CGM, she gave me one, and it has been a huge help in learning both how food effects my blood sugar, as well as how blood sugar effects my mood. I think everybody regardless of their current health should have one of these things. Blood sugar is a fantastic look into sorts of aspects of your health.
sn9 3y ago
Strength and endurance training both increase insulin sensitivity. You might not be overweight, but you might still have a high body fat percentage. Increasing the amount of muscle you have while getting leaner should help all aspects of your health. I'd recommend checking out the Barbell Medicine podcast episodes on diabetes, cholesterol, strength training, and their recent 3-part series on endurance training.
al_borland 3y ago
I ended up prediabetic and switched over to eating what basically amounts to a strict paleo diet, or something like whole30, and 0 sugar (other than the occasional piece of fruit). Something switched in my head, as I had other issues going on and thought I was going to die. In 3 days some of the really worrying issues went away. 3 months later my blood sugar levels had come down considerably, and a few months after that they were well within the health range. I didn’t count calories or carbs or anything like that. I just ate stuff with 1 ingredient… and hot sauce or whatever, that had real ingredients and no sugar (or fake sugar). It’s kind of crazy, after a while, carrots start to taste sweet. My dad ended up with Type2, I mentioned the no sugar thing. He said it sounded too hard and he had done Atkins before. He read all the recommended books and tried all the recommended diets, even went vegan for a while. After about 6 years he found some doctor that put him on an extreme elimination diet as part of a medical study, basically nothing but protein shakes (with some added nutrients). He didn’t eat solid food for months. Then had to slowly add real food back over several months after that. It ended up working for him, but it seemed far more difficult and unmaintainable than what I suggested to him 6 years earlier. My mom also ran into it. She called me, did what I mentioned and was good to go a few months later. Of course that doesn’t mean she could go back to eating how she did before, but still has some treats and things she enjoys. She found some balance once out of the danger zone. My dad’s experience made me pretty cynical of the industry around type 2 diabetes. They have no incentive to cure a person, when they can keep them sick and have a lifelong customer buying all that medication. The diet may have been extreme, but for me, I’d rather be extreme for a few months than have it drag on for years like my dad. And actually, I didn’t feel like I was being that extreme. I ate until I was full (giant plates full of vegetables), I felt great, and didn’t feel deprived. Every Saturday I’d cook myself a big ribeye with a sweet potato; it was great. It was only other people saying it was extreme or too hard that got to me. I started questioning myself. My doctor told me I was doing awesome and not to listen to them. Best of luck on your next A1C check. Hopefully the road you’re on work for you. If things aren’t working, I’d question the motivations of those providing the information, or the systems which educated them. A doctor telling someone with type 2 diabetes to eat white flour and sugar doesn’t sound like a doctor who understands what type 2 diabetes is.
isaacfrond 3y ago
If you want to deal with T2 through diet, you should really try to get a sensor on your arm, if only for a year or so. You need to learn what food cause a sugar spike in you, and which don't.

chimeracoder 3y ago

> ). But it takes 3 months to see if my A1C goes down (a measure of the past 3 months of blood sugar), so I won't know for a couple more months. Yes, though depending on what your diagnosis is, you may be able to get a monitor which allows you to track your blood sugar in near-realtime. The technology has advanced a lot in the last 20 years.

didgeoridoo 3y ago
A1C represents the long-term glycation of hemoglobin due to blood sugar exposure. Even if you could measure it at home, it wouldn’t change fast enough for rapid tracking to be meaningful. You need to wait for red blood cells to be replaced (hence the 3 month cadence) before expecting any change in A1C.
- chimeracoder 3y ago
  > A1C represents the long-term glycation of hemoglobin due to blood sugar exposure. You're not measuring HbA1C in real-time; you're measuring the blood sugar in real-time. HbA1C is a lagging indicator, used because it's a convenient and non-invasive diagnostic and a summary statistic. It's not the way you measure the short-term or medium-term effectiveness of interventions.
  - didgeoridoo 3y ago
    Ah I misread your comment — thought you were suggesting measuring A1C at home, which wouldn’t get you anything. Re-reading, you definitely meant measure blood glucose itself. I do wonder if A1C remains a useful metric though, as perhaps it better captures the actual damage done by consistently high blood glucose. Would be interesting to see if there is research showing that CGM area under the curve is a better (or worse) predictor of clinical outcomes than A1C.
    - chimeracoder 3y ago
      > I do wonder if A1C remains a useful metric though, as perhaps it better captures the actual damage done by consistently high blood glucose. Both metrics have their own use. Continuous glucose monitoring is better for measuring the short-term impact of interventions, but it's also more invasive (albeit less so than it used to be) and more expensive. HbA1C is still measured for diabetic patients who have continuous glucose monitoring. One downside of A1C is that the baseline values actually vary, and it's known to be either downward biased or a particularly lagging indicator for certain groups that are predisposed to Type 2 diabetes (e.g. South Asians and people of African descent).
- deleted 3y ago
  [deleted]
SubiculumCode 3y ago
Ancedotally, a friend spent 3 months on a keto diet, and yes they eventually quit. However, their carb shock thirst tiredness that they used to have after a modest meal stopped occurring, and persisted after stopping keto. I've heard that there is some evidence of regeneration of receptors with ketogenic diet.. perhaps occasional bouts of keto can be therapeutic?
dpeck 3y ago
For anyone new to it, the words you’re looking for are “continuous glucose monitor” (GCM), and “flash glucose monitor”. Popular brands of it in the US are Freestyle Libre and Dexcom. Their final cost to you will vary hugely by your insurance provider. Some with little to no cost, and others several dollars per day. If you like data and are analytical by nature, and since you’re on HN that’s fairly likely, I’d highly recommend using them for a little while if you can afford it. They’re great for newly diagnosed people to understand in near real time without repeated finger pricking. But those are no terrible either and much better than not managing and monitoring! Slightly annoying at first but it is something that most people can get used to fairly easily.

foepys 3y ago

It is incredibly hard to beat a sugar addiction (a lot harder than nicotine or weed) but it is worth it, I promise. Going full on no-carb and taking long walks daily got a friend out of pre-diabetes type 2. No sugar, no fresh potatoes (cooking and putting them into the fridge for 24 hours is fine), no rice, no fruits, and much more got them off metformin and normalized their blood sugar enough for them to be able to eat cake and sweets again without fearing to get diabetes.

caminante 3y ago
> no fresh potatoes (cooking and putting them into the fridge for 24 hours is fine) What does waiting a day accomplish?
- DoughnutHole 3y ago
  Leaving starchy foods to rest for a decent amount of time after cooking results in some amount of the starch converting into “resistant starch” which the body can’t convert into glucose. So a given portion will be less blood glucose spiking than a portion that hasn’t had that rest. The overall effect is modest though, the whole thing doesn’t turn into resistant starch. It makes it better, but I don’t think it would make a big portion of potatoes suddenly safe for a diabetic.
- cmrx64 3y ago
  the thermal cycling causes resistant starches to form. actually you are best off heating/cooling it twice, and minimizing the extra water content. instead of being broken down into sugars they get fermented into fatty acids deeper in the gut. pasta is eligible for this effect too idk how the final starch compositions vary between them tho.
bityard 3y ago
> It is incredibly hard to beat a sugar addiction (a lot harder than nicotine or weed) but it is worth it, I promise. It's not trivial, I will certainly admit, but it is eminently doable with the right mindset and a reasonable plan. The hard part is that sugar and carb-laden foods are positively ubiquitous in the western diet, due to the fact that carbs are cheap to grow, process, ship, and store. Fat and protein are expensive and harder to find depending on where you live. But I look at it like this: by going out of my way to find and cook metabolically-optimal food for myself, I am investing in my future health in a way that will be _much_ cheaper than the cost of getting my foot removed in a few decades. If I could give any advice at all to someone considering a keto diet, it would be this: do some research, start with some kind of plan, and be forgiving of yourself. It will take some time to figure out which keto-friendly foods you have available to you, and which ones you will actually enjoy eating. If you fall off the wagon and murder a bag of chips in a moment of weakness, know that the whole effort isn't down the drain. You just try to do better tomorrow.

voisin 3y ago

> have few easily digestible carbs (i.e. such as the whites, flour, sugar, potatoes and rice) Should potatoes be in this list? I understood the potato diet to be very effective at causing weight loss (thought to be due to high potassium content of potatoes)? Can something consistently cause weight loss and cause a major insulin response (which I think causes calories to be stored as fat…)?

DoughnutHole 3y ago
Potatoes have a GI of about 70, comparable to white rice or white bread (pure glucose is 100). So pretty bad. The “potato diet” will only lead to weight loss if you’re eating fewer calories than you’re expending, same as anything else. You could eat nothing but bacon grease and you’d lose weight if you were eating below maintenance. The effect of food on blood glucose if a matter of how easily it is converted to glucose. Starches like those in potatoes, flour, rice etc are basically converted nearly as easily as straight sugar.
- ajmurmann 3y ago
  I think there might be other things going on with the potato diet. In Slime Mold Time Mold's study participants seemed to lose more weight when cooking potatoes with the skin on. My wife and I recently tried three diet for about a week with good weightloss. However, my wife who prefers potatoes cooked with skin quickly got abdominal pain and dropped the diet. When I started to eat all the potatoes I had cooked for her, I got similar issues. I think there is a good chance that the solanine which is mostly in the skins messes with people's digestive system and contributing to weightloss. Poisoning yourself doesn't strike me as a valid approach to weightloss. Supposedly someone tried supplementing solanine and didn't see the weightloss. I don't trust that though, since there was a more comprehensive trial or a believable alternative explanation

UncleSlacky 3y ago

Same here (diagnosed about 10 days ago, on metformin, removed simple carbs as much as possible). I've been looking at Michael Mosley's 800-calorie and 5:2 fasting diets, involving an intake of 800 calories a day for about 8 weeks to "reset" your system, then fasting 2 days out of every 7 (i.e. 800 calories for two days a week) thereafter. I haven't "officially" started it, but in practice without simple carbs and sugars, my calorie intake must be pretty close to 800 (the appetite suppressant characteristics of metformin really help here). I've also started exercising after big meals (I've never really exercised before!). There's a website marketing a guided programme if you're into that kind of thing): https://thefast800.com/programme/ https://thefast800.com/programme/ as well as a book: https://oceanofpdf.com/authors/michael-mosley/pdf-epub-the-8-week-blood-sugar-diet-how-to-beat-diabetes-fast-and-stay-off-medication-download-97896161555/ https://oceanofpdf.com/authors/michael-mosley/pdf-epub-the-8...

ramraj07 3y ago
Exercise is probably the most important thing you could do! Hope you’re able to stick to it and improve! The other thing that helps me is cutting off sugar - not carbs or starch just actual sweet sugar. In coffees and desserts. Makes me eat less!

salad-tycoon 3y ago

That’s interesting about fat and potatoes. Didn’t know that. Another similar thing is vinegar. It slows gastric emptying and keeps the spikes lower (eg french fries with malt vinegar). You can test fructosamine which I believe is a 2 week avg. or you could do finger pokes or even a CGM if you got the ability. [1] I personally enjoyed The diabetes code by Jason Fung. He’s a nephrologist in Canada. Good luck in your diabetes journey! Luckily you seem interested which is such a distinction. 1 https://www.diabetic.org/fructosamine-to-a1c/ https://www.diabetic.org/fructosamine-to-a1c/

kcplate 3y ago

I’ve been a T2 diabetic for 14 years. For the first 8 years I was insulin dependent and bought into the dietary reqs provided to me at the time which was “grains and fruit are good, just push insulin to manage glucose”. I realized that every month it was taking more and more insulin to manage my blood sugar. I shifted my diet to higher fat and low carbs and was off insulin completely within 3 months and within 6 months my A1c was running low 5s YMMV of course, but at no point eating the approved ADA diet and pushing insulin was my A1c ever below 6.5. Since eating low carb and no insulin, my A1c has never been above 5.4

Projectiboga 3y ago

Increase unsaturated fat in your diet and take melatonin. Melatonin upregulates the insulin receptors, so the insulin you have can do more. Trace minerals and following a standard meal plan worked up by a nutritionist.

pstuart 3y ago

One interesting thing about those digestible carbs is that cooling them after cooking helps convert them into diet resistant starch that helps feed the gut biome, e.g., https://www.foundmyfitness.com/news/s/q2g00a https://www.foundmyfitness.com/news/s/q2g00a

dave8088 3y ago

Have been tested for the type 1 antibody? I was diagnosed as type 2 cause doctors assume type 1 doesn’t happen in your late 30s. It happened to me. Wasted a bunch of time trying to treat it as type 2. Not overweight and type 2 is rare.

marcus_holmes 3y ago

T2 Diabetic for ~12 years (actually probably a lot longer but I only got diagnosed 12 years ago). I've "beaten diabetes" (i.e. I tested as not being diabetic) twice now by losing weight (via calorie counting) and getting fit, but found it too hard to maintain that lifestyle. I've made dietary changes but they had less/no effect. Keto was fine, but my wife didn't get on with it and making two meals every time we ate was too onerous. I stopped measuring my blood sugar a few months after getting diagnosed because it was kinda pointless. I haven't had a single symptom. If I didn't visit the doctor every 3 months or so I'd never know I was diabetic (and I was probably diabetic for 10+ years before getting diagnosed). I take Metformin regularly mostly for the anti-aging side effect. The endless diarrhoea from Metformin is something I got used to, though I had to suspend taking it while travelling because the combination of Metformin shits and travel shits was too much. It all feels like a non-thing to be honest. I know people lose limbs to D2, and go blind, and stuff, but it's hard to take that personally and know that as a definite risk that mean I need to make drastic and difficult lifestyle changes. I keep getting checked and told there's no sign of any damage, but my blood sugar is too high. For 12 years now. I know this sounds a bit anti-vax, but it feels like the science is wrong here. I do not want to go down an anti-science rabbit hole and end up in a conspiracy theory world of my own. So I just keep doing the thing they tell me as best I can. But when/if someone finds out that we've been thinking about D2 all wrong, I will not be the faintest bit surprised. edit: and another thing: I've never had consistent advice from doctors around this. Some GPs say I need to come in every month to get checked up. Others says I only need once a year. Some examine my feet and eyes. Others don't. Some think I'm on too high a dose of Metformin. Others say it's fine. Some are really strong on the diet thing, others not so much. Almost every aspect of this disease seems to be subject to personal opinions about treatment.

bruce511 3y ago
Opinions vary a lot, because people vary a lot, and because of this science "that applies to everyone" is very hard to do. There's no question that there us good medical science, but equally there is a lot of junk-science and so in this age of "hearing everyone's opinion", it can be hard to separate fact from opinion. I think we can agree on some stuff. Smoking is bad for you, exercise is good, and so on. Keeping your weight down, more accurately keeping % body fat down, and so on. Making small, incremental, sustainable changes to lifestyle that trend you in good directions, are definitely the best. GPs are (with respect) not a terribly good source. They tend to see sick people all day, and gather lots of superficial anecdotes. Which is not to ignore them, but to understand their POV. But it's worth taking their opinions on board as an hypothesis.

darkclouds 3y ago

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thepasswordis 3y ago

There's a standard formula for calculating your A1C based on your average glucose level. If you get a dexcom G6, (about $200), you can monitor your glucose levels constantly, and know what your A1C will be. The app gives you rolling averages for 2 days, 7 days, 14 days, and 30 days. Extremely useful. I'm not a T2 diabetic, but did have a slightly elevated A1C at my last physical. I asked my doctor for a prescription for a CGM, she gave me one, and it has been a huge help in learning both how food effects my blood sugar, as well as how blood sugar effects my mood. I think everybody regardless of their current health should have one of these things. Blood sugar is a fantastic look into sorts of aspects of your health.

sn9 3y ago

Strength and endurance training both increase insulin sensitivity. You might not be overweight, but you might still have a high body fat percentage. Increasing the amount of muscle you have while getting leaner should help all aspects of your health. I'd recommend checking out the Barbell Medicine podcast episodes on diabetes, cholesterol, strength training, and their recent 3-part series on endurance training.

al_borland 3y ago

I ended up prediabetic and switched over to eating what basically amounts to a strict paleo diet, or something like whole30, and 0 sugar (other than the occasional piece of fruit). Something switched in my head, as I had other issues going on and thought I was going to die. In 3 days some of the really worrying issues went away. 3 months later my blood sugar levels had come down considerably, and a few months after that they were well within the health range. I didn’t count calories or carbs or anything like that. I just ate stuff with 1 ingredient… and hot sauce or whatever, that had real ingredients and no sugar (or fake sugar). It’s kind of crazy, after a while, carrots start to taste sweet. My dad ended up with Type2, I mentioned the no sugar thing. He said it sounded too hard and he had done Atkins before. He read all the recommended books and tried all the recommended diets, even went vegan for a while. After about 6 years he found some doctor that put him on an extreme elimination diet as part of a medical study, basically nothing but protein shakes (with some added nutrients). He didn’t eat solid food for months. Then had to slowly add real food back over several months after that. It ended up working for him, but it seemed far more difficult and unmaintainable than what I suggested to him 6 years earlier. My mom also ran into it. She called me, did what I mentioned and was good to go a few months later. Of course that doesn’t mean she could go back to eating how she did before, but still has some treats and things she enjoys. She found some balance once out of the danger zone. My dad’s experience made me pretty cynical of the industry around type 2 diabetes. They have no incentive to cure a person, when they can keep them sick and have a lifelong customer buying all that medication. The diet may have been extreme, but for me, I’d rather be extreme for a few months than have it drag on for years like my dad. And actually, I didn’t feel like I was being that extreme. I ate until I was full (giant plates full of vegetables), I felt great, and didn’t feel deprived. Every Saturday I’d cook myself a big ribeye with a sweet potato; it was great. It was only other people saying it was extreme or too hard that got to me. I started questioning myself. My doctor told me I was doing awesome and not to listen to them. Best of luck on your next A1C check. Hopefully the road you’re on work for you. If things aren’t working, I’d question the motivations of those providing the information, or the systems which educated them. A doctor telling someone with type 2 diabetes to eat white flour and sugar doesn’t sound like a doctor who understands what type 2 diabetes is.

isaacfrond 3y ago

If you want to deal with T2 through diet, you should really try to get a sensor on your arm, if only for a year or so. You need to learn what food cause a sugar spike in you, and which don't.