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I'm prediabetic with two T2 parents and a T2 grandparent and my primary care doctor is entirely unconcerned about it. My lowish tech solution to delay (and hop

I'm prediabetic with two T2 parents and a T2 grandparent and my primary care doctor is entirely unconcerned about it. My lowish tech solution to delay (and hopefully prevent!) the onset of T2 is to use a glucose monitor every 2 hours, every day, and create a database of foods with my postprandial blood sugar reaponse at 1.5 and 2 hours. I also keep track of how exercise affects my blood sugar. Over the last couple years, I have gotten great data on the foods which spike me and the foods which are neutral to my blood glucose. A lot of foods doctors/the internet tout as "diabetic friendly" (like beans, lentils, corn in any form, brown rice, buckwheat groats, non-granny-smith apples) spike me like crazy. Other foods are totally fine (bananas, snap peas, nuts, steel cut oatmeal, fermented dairy, fish). Having an autoimmune disorder on top of the prediabetes, I've learned that the only one who cares about my health and longevity is me. My doctors care about my inflammatory markers and nothing else.

mpreda 2y ago
What is your weight situation? Eat less, exercise more, and you may delay T2D. Reduce or avoid fast carbohydrates. Reduce carbohydrates.
coldtea 2y ago
>My doctors care about my inflammatory markers and nothing else They care about your payments, more likely...
- jvossy 2y ago
  They're doctors, not CEOs. They are advising based on the behaviors they see from most of their patients, who probably come in asking for quick solutions and are unable to make lifestyle changes stick. Patients who are educated about their own conditions, willing to listen to advice, and able to keep to that advice over the long haul are a very small proportion. Not that doctors shouldn't offer this sort of advice anyway, I am just asking you to please try to understand why they behave in such a way.
  - LeifCarrotson 2y ago
    I was talking to my physical therapist this morning about my experience with the recent exercises he'd given me, and I pulled up my Garmin workout calendar to show him my inconsistency. He'd told me to do a particular stretch every 3 hours or 6x/day, and I'd been having several days a week where I'd only completed the routine 4 or 5 times. He said that level of consistency was fantastic, that at least a third of his patients flat-out told him they hadn't done any of the exercises at all, another third showed no improvements above baseline and he suspected they had lied about it, and the remainder had moderate compliance. When he'd told me 6x/day, he was anticipating 2x on the high end. We adjusted to 4x/day, where morning, lunch break, after work, and before bed were easier habits to stick to than trying to drop and do press-ups in the middle of my 9:00 meetings. And that's at a sports and fitness-focused PT organization, not an average general practitioner working with median diets and advising a society that by default trends towards diabetes.
beauzero 2y ago
Just anecdotal. Was T2 and getting kidney stones every two or three months (cause not related but treatment was). Cut out oxalates which restricted diet. Monitored sugar 3-5 times daily. Switched to carnivore diet + onions and mushrooms and went on Metformin. All at the same time. Did this for 2.5 months with no additional exercise. This dropped me down below T2 level. Went off Metformin and am maintaining with same daily testing. Off carnivore for paleo minus anything with oxalates after the 2.5 months strict carnivore. Strict carnivore for me was steak, hamburger, stew meat fried in butter, mushrooms and onions in butter, bacon, and very sharp cheddar (only on burgers or raw). Eat every bit of gristle and fat. It is very hard to get enough fat. Brain fog lasted for 10-11 days. Felt fantastic after that. To keep your carnivore costs down I would recommend stew meat from Costco fried with onions and mushrooms when you can't stand steak or plain burgers. This has worked for me for the last 6 months. I have no idea what it will be long term. Maybe someone will find something useful in it.
- tracker1 2y ago
  I've found I do best with a very similar diet... mostly meat and eggs, some cheese and sometimes onions, mushrooms etc. I notice that some starchy foods hit me worse than others. Legumes are pretty bad on how I feel, and spike me to no end. Similar with wheat products. Corn, rice and potatoes spike my glucose, but I don't feel physically ill the next day like with many other foods. It sucks, and I wind up cheating 2-3x a week (I live with people that eat different than I do).
- nextos 2y ago
  Check the work of David Unwin from NHS, who has reversed T2D in many patients using dietary interventions: https://www.diabetes.co.uk/blog/2015/08/dr-david-unwin-publishes-more-evidence-of-low-carb-diet-benefits-in-the-bmj https://www.diabetes.co.uk/blog/2015/08/dr-david-unwin-publi... This publication is a good starting point to his approach. Early time-restricted eating of low sugar and low starch meals is the key: https://nutrition.bmj.com/content/bmjnph/early/2023/01/02/bmjnph-2022-000544.full.pdf https://nutrition.bmj.com/content/bmjnph/early/2023/01/02/bm...
  - 2y ago
gregschlom 2y ago
Get a continuous glucose monitor. You should be able to convince your doctor to write you a prescription for it. If not, there brands that will do the prescription for you after a quick video call with a doctor (but they're more expensive). Also the FDA cleared at least one brand of CGM to be sold without a prescription, starting "summer 2024": https://www.dexcom.com/stelo https://www.dexcom.com/stelo You should expect to pay $80 - $200 per device, and they last one 14 days, but the insight they give is really worth it.
rdedev 2y ago
Is it conclusively proven that glucose spikes influence the risk of T2D by a big margin? Like imo calorie balance is more influential than glucose spike. This is all assuming that you are currently healthy. I don't think spiking blood glucose is a good idea of you are diabetic
- nradov 2y ago
  There is no conclusive proof that occasional blood glucose spikes by themselves significantly increase the risk of T2D. In particular we know that the stress hormones produced during high intensity exercise cause temporary spikes by stimulating glucose release from the liver. But we have fairly good evidence that such exercise actually decreases the risk of T2D. Insulin resistance seems to be triggered more by chronic elevation of blood glucose and not clearing the spikes quickly enough.
galago 2y ago
I was diagnosed with T2 last year, and started a CGM (Freestyle Libre 3) like you did. I started off with lists of foods I could eat, but the monitor let me see actual data on what was happening. Its not very accurate, but the absolute numbers don't matter as much as seeing the actual trend effect on my own body. I never let it go over 150, ever. I can eat some legumes in moderation, but your specific body may be different. I initially took Metformin, but discontinued. My last A1C was 5.1 and and endocrinologist I was consulting with put in his notes that my diabetes is "remission." So, if you're prediabetic, keep at what you're doing. I eat very little meat, btw, so while that might work for some people, its not strictly necessary.
photon_lines 2y ago
I already mentioned some of this in another response, but I'll include it here as well: you can take measures to not have to take medication / insulin if you have type 2 diabetes. The number one thing to avoid it is to stay lean and not be over-weight, but some other things which can greatly help out: - Exercise: 'Exercise plays a major role in the prevention and control of insulin resistance, prediabetes, GDM, type 2 diabetes, and diabetes-related health complications. Both aerobic and resistance training improve insulin action, at least acutely, and can assist with the management of BG levels, lipids, BP, CV risk, mortality, and QOL, but exercise must be undertaken regularly to have continued benefits and likely include regular training of varying types. ' - Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992225/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992225/ - Intermittent fasting: there's great evidence that IF (intermittent fasting) can put it in remission: https://www.endocrine.org/news-and-advocacy/news-room/2022/intermittent-fasting-may-reverse-type-2-diabetes https://www.endocrine.org/news-and-advocacy/news-room/2022/i... - Minimally processed and ketogenic diet: avoid foods which have sugar or high-fructose corn-syrup and mostly stick to low-glycemic index minimally processed foods. 'Diets with a high glycaemic index and a high glycaemic load were associated with a higher risk of incident type 2 diabetes in a multinational cohort spanning five continents. Our findings suggest that consuming low glycaemic index and low glycaemic load diets might prevent the development of type 2 diabetes.' - Source: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00069-X/abstract https://www.thelancet.com/journals/landia/article/PIIS2213-8... - Take a teaspoon with turmeric + black-pepper daily: 'Clinical trials and preclinical research have recently produced compelling data to demonstrate the crucial functions of curcumin against T2DM via several routes. Accordingly, this review systematically summarizes the antidiabetic activity of curcumin, along with various mechanisms. Results showed that effectiveness of curcumin on T2DM is due to it being anti-inflammatory, anti-oxidant, anti-hyperglycemic, anti-apoptotic, anti-hyperlipidemia and other activities. In light of these results, curcumin may be a promising prevention/treatment choice for T2DM.' - Source: https://www.preprints.org/manuscript/202404.1926/v1 https://www.preprints.org/manuscript/202404.1926/v1

mpreda 2y ago

What is your weight situation? Eat less, exercise more, and you may delay T2D. Reduce or avoid fast carbohydrates. Reduce carbohydrates.

coldtea 2y ago

>My doctors care about my inflammatory markers and nothing else They care about your payments, more likely...

jvossy 2y ago
They're doctors, not CEOs. They are advising based on the behaviors they see from most of their patients, who probably come in asking for quick solutions and are unable to make lifestyle changes stick. Patients who are educated about their own conditions, willing to listen to advice, and able to keep to that advice over the long haul are a very small proportion. Not that doctors shouldn't offer this sort of advice anyway, I am just asking you to please try to understand why they behave in such a way.
- LeifCarrotson 2y ago
  I was talking to my physical therapist this morning about my experience with the recent exercises he'd given me, and I pulled up my Garmin workout calendar to show him my inconsistency. He'd told me to do a particular stretch every 3 hours or 6x/day, and I'd been having several days a week where I'd only completed the routine 4 or 5 times. He said that level of consistency was fantastic, that at least a third of his patients flat-out told him they hadn't done any of the exercises at all, another third showed no improvements above baseline and he suspected they had lied about it, and the remainder had moderate compliance. When he'd told me 6x/day, he was anticipating 2x on the high end. We adjusted to 4x/day, where morning, lunch break, after work, and before bed were easier habits to stick to than trying to drop and do press-ups in the middle of my 9:00 meetings. And that's at a sports and fitness-focused PT organization, not an average general practitioner working with median diets and advising a society that by default trends towards diabetes.

beauzero 2y ago

Just anecdotal. Was T2 and getting kidney stones every two or three months (cause not related but treatment was). Cut out oxalates which restricted diet. Monitored sugar 3-5 times daily. Switched to carnivore diet + onions and mushrooms and went on Metformin. All at the same time. Did this for 2.5 months with no additional exercise. This dropped me down below T2 level. Went off Metformin and am maintaining with same daily testing. Off carnivore for paleo minus anything with oxalates after the 2.5 months strict carnivore. Strict carnivore for me was steak, hamburger, stew meat fried in butter, mushrooms and onions in butter, bacon, and very sharp cheddar (only on burgers or raw). Eat every bit of gristle and fat. It is very hard to get enough fat. Brain fog lasted for 10-11 days. Felt fantastic after that. To keep your carnivore costs down I would recommend stew meat from Costco fried with onions and mushrooms when you can't stand steak or plain burgers. This has worked for me for the last 6 months. I have no idea what it will be long term. Maybe someone will find something useful in it.

tracker1 2y ago
I've found I do best with a very similar diet... mostly meat and eggs, some cheese and sometimes onions, mushrooms etc. I notice that some starchy foods hit me worse than others. Legumes are pretty bad on how I feel, and spike me to no end. Similar with wheat products. Corn, rice and potatoes spike my glucose, but I don't feel physically ill the next day like with many other foods. It sucks, and I wind up cheating 2-3x a week (I live with people that eat different than I do).
nextos 2y ago
Check the work of David Unwin from NHS, who has reversed T2D in many patients using dietary interventions: https://www.diabetes.co.uk/blog/2015/08/dr-david-unwin-publishes-more-evidence-of-low-carb-diet-benefits-in-the-bmj https://www.diabetes.co.uk/blog/2015/08/dr-david-unwin-publi... This publication is a good starting point to his approach. Early time-restricted eating of low sugar and low starch meals is the key: https://nutrition.bmj.com/content/bmjnph/early/2023/01/02/bmjnph-2022-000544.full.pdf https://nutrition.bmj.com/content/bmjnph/early/2023/01/02/bm...
- 2y ago

gregschlom 2y ago

Get a continuous glucose monitor. You should be able to convince your doctor to write you a prescription for it. If not, there brands that will do the prescription for you after a quick video call with a doctor (but they're more expensive). Also the FDA cleared at least one brand of CGM to be sold without a prescription, starting "summer 2024": https://www.dexcom.com/stelo https://www.dexcom.com/stelo You should expect to pay $80 - $200 per device, and they last one 14 days, but the insight they give is really worth it.

rdedev 2y ago

Is it conclusively proven that glucose spikes influence the risk of T2D by a big margin? Like imo calorie balance is more influential than glucose spike. This is all assuming that you are currently healthy. I don't think spiking blood glucose is a good idea of you are diabetic

nradov 2y ago
There is no conclusive proof that occasional blood glucose spikes by themselves significantly increase the risk of T2D. In particular we know that the stress hormones produced during high intensity exercise cause temporary spikes by stimulating glucose release from the liver. But we have fairly good evidence that such exercise actually decreases the risk of T2D. Insulin resistance seems to be triggered more by chronic elevation of blood glucose and not clearing the spikes quickly enough.

galago 2y ago

I was diagnosed with T2 last year, and started a CGM (Freestyle Libre 3) like you did. I started off with lists of foods I could eat, but the monitor let me see actual data on what was happening. Its not very accurate, but the absolute numbers don't matter as much as seeing the actual trend effect on my own body. I never let it go over 150, ever. I can eat some legumes in moderation, but your specific body may be different. I initially took Metformin, but discontinued. My last A1C was 5.1 and and endocrinologist I was consulting with put in his notes that my diabetes is "remission." So, if you're prediabetic, keep at what you're doing. I eat very little meat, btw, so while that might work for some people, its not strictly necessary.

photon_lines 2y ago

I already mentioned some of this in another response, but I'll include it here as well: you can take measures to not have to take medication / insulin if you have type 2 diabetes. The number one thing to avoid it is to stay lean and not be over-weight, but some other things which can greatly help out: - Exercise: 'Exercise plays a major role in the prevention and control of insulin resistance, prediabetes, GDM, type 2 diabetes, and diabetes-related health complications. Both aerobic and resistance training improve insulin action, at least acutely, and can assist with the management of BG levels, lipids, BP, CV risk, mortality, and QOL, but exercise must be undertaken regularly to have continued benefits and likely include regular training of varying types. ' - Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992225/ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2992225/ - Intermittent fasting: there's great evidence that IF (intermittent fasting) can put it in remission: https://www.endocrine.org/news-and-advocacy/news-room/2022/intermittent-fasting-may-reverse-type-2-diabetes https://www.endocrine.org/news-and-advocacy/news-room/2022/i... - Minimally processed and ketogenic diet: avoid foods which have sugar or high-fructose corn-syrup and mostly stick to low-glycemic index minimally processed foods. 'Diets with a high glycaemic index and a high glycaemic load were associated with a higher risk of incident type 2 diabetes in a multinational cohort spanning five continents. Our findings suggest that consuming low glycaemic index and low glycaemic load diets might prevent the development of type 2 diabetes.' - Source: https://www.thelancet.com/journals/landia/article/PIIS2213-8587(24)00069-X/abstract https://www.thelancet.com/journals/landia/article/PIIS2213-8... - Take a teaspoon with turmeric + black-pepper daily: 'Clinical trials and preclinical research have recently produced compelling data to demonstrate the crucial functions of curcumin against T2DM via several routes. Accordingly, this review systematically summarizes the antidiabetic activity of curcumin, along with various mechanisms. Results showed that effectiveness of curcumin on T2DM is due to it being anti-inflammatory, anti-oxidant, anti-hyperglycemic, anti-apoptotic, anti-hyperlipidemia and other activities. In light of these results, curcumin may be a promising prevention/treatment choice for T2DM.' - Source: https://www.preprints.org/manuscript/202404.1926/v1 https://www.preprints.org/manuscript/202404.1926/v1