How long before you saw an improvement (type 2, on metformin)?

[FurryLlama]

This time last year, all my bloods were fine. I've had substantial stress and v poor sleep for the past few years (but slow and steady weight gain) , then put my back out at the beginning of the year, so was very sedentary for many months, along with bad food choices. At a recent check with a new doc, she saw my BGL were now prediabetic and got me to do the glucose tolerance test, which showed I was insulin resistant at a type 2 diabetic level. Previous doc had just told me to watch my sugar intake, which I had already cut back. So in the months of being laid up, it tipped over the edge into diabetes. Am rather peeved that this was not flagged up by the old doc, but she was pretty useless.

The diagnosis was a bit scary, and at this point I can walk around for a limited time in the morning without pain, so I've been walking and using a static bike. Can't do anything high impact or too vigorous. Diet is very good right now - low carb, nothing 'bad'. Slightly better sleep, though I don't think I can improve this in any substantial way. Apart from a small loss at the start, weight isn't budging though, which is very discouraging esp as everything I read says about having to lose 10% of body weight to make a difference. I'm nearly 50, premenopausal, now just into the obese category, and know that's commonly a difficult combination for weight loss anyway.

Anybody started from a similar situation and had good results? I'm feeling pretty low about it right now tbh.

Maybe this video serie can give you some inspiration for some other change to apply. nutritionfacts.org/topics/diabetes/

I don't have diabetes, but a very high risk of cancer and one of the side effect of changing my diet following the recommendation of nutritionfact was weightloss, and I was past 50.

Good luck

You are doing everything right. Have you looked into Intermittent Fasting? That's the big weapon in your arsenal. Because of insulin resistance and your hormones, weightloss will be slow, but I see posts by people who have completely reversed T2 and prediabetes/metabolic disorder on FB groups for IF (16:8). There are IF threads on MN and they can tell you more. Videos by Dr Jason Fung and the Gin Stevens book Feast Fast Repeat is the best on how to do it and the medical research.

Just to say that while exercise is good for us, the concensus is that 90% of weightloss is about what we eat. With insulin resistance it's not just what you eat, but when, because you don't want to eat for 12 hours a day causing an insulin response. You want a small window of eating to achieve 16+ hours of not dripping insulin into your body. Your GP/dietician should have told you this. I think they stop short, because for a person who previously ate sugar and carbs, just getting used to a low carb diet can be a huge challenge. While I think of it, there are some videos about base insulin levels - the constant one not spiked by food (different for T2 people and most overweight people) and you need to understand that to beat it.

Agree re. Intermittent fasting. Type 2 diabetes can be put into remission by being strictly low carb and fasting. There is so much information online. People worth looking up are Michael Moseley, Jason Fung, Tim Noakes, Gary Fetke, Ivor Cummins, Stephen Phinney. Lots and lots of YouTube videos out there explaining the science.

My Dh was diagnosed a couple of years ago. The gp sent him on an xpert course to learn how to look after his diabetes. He followed their advice & lost weight. This with taking Metformin has kept him well. They’ve just started an online course too - maybe your gp could refer you? I’ll find the link

www.xperthealth.org.uk/

Thanks for your replies! Yes, I've come across IF quite a bit in the reading I've done, but haven't been able to discuss it with anyone as my first dietician appt is still some weeks away. I'm still trying to understand the details of insulin resistance, and someone on a forum I read mentioned it wasn't good for them for some reason I can't remember! In theory you're supposed to check with your healthcare team before starting, so it's one of the things I'll be asking about. I think I also read that you shouldn't exercise before eating on a fast so BGL don't go too low. I think I'll struggle though as I need to exercise in the morning due to my back pain (and it getting too hot here to be walking by 11-3), so ideally around 9-10am, which means eating before getting kids off to school. So that's finishing eating at about 4pm on a 16:8, which isn't going to work with sorting the rest of the family. A 14:10 might be more easily manageable though. Id love to hear how others organise it with school aged kids to sort and husband coming in at about 6?

I'll have a look for some base insulin level stuff, I don't know anything about that, and the other recommendations. Thanks.

@defnotadomesticgoddess thanks for the link. I'm not in the UK, but I'm hoping the diabetic clinic my doc is referring me to will have some similar info, when I finally get to see them.

OP I really enjoy listening to podcasts while I get the housework done and I’ve really enjoyed the LowCarbMD podcast series. They should really help you understand the science behind this WOE and it will feel less intimidating.

Just to reassure you my dh is diabetic T2 and he started off with blood glucose in the 30s, he has not made many changes to his lifestyle (main exercise is walking the dog) or diet (he switched to coke zero and rich tea biscuits instead of custard creams 😂) but his metformin is now keeping his habc1 at a healthy level and he feels well. I forget the number but his nurse was pleased and told him to carry on as he is. I'm not saying you shouldn't try to improve your diet and even maybe reverse your diabetes but hopefully this reassures you that the medication will work even if you can't lose weight quickly or increase your exercise.

I am on keto at the moment and you may wonder why dh doesn't give it a try, the thing is he is very stuck in his ways about eating and it would be hard for him to change. Maybe if my health and weight improve a lot he will consider it but so far it's been slow progress.

@KetoPenguin my DP has lost 1 stone in three weeks following low carb and we’ve managed to find some really good alternatives to foods he enjoyed. For example we’ve found Keto bread on amazon that tastes as good as normal bread. I’ve found a pasta alternative in Aldi made from
Black beans and Lidl sell high protein noodles that I use in stir fried. Waitrose sell veggie chips which I’m using instead of potato chips. Basically anything your husband can’t live without, they’ll be a Keto alternative.

Do you go low/hypo? If not then you can probably just skip breakfast and start eating at lunchtime, I have type 2 and do that most days because our evening meal is fairly late. IF doesn't really suit people who get hypos, for instance my Dad who had type 2 used to get hypos and would get cranky and disorientated. He had to have regular meals and carry snacks with him because he wouldn't have been safe to do things like driving if he was low.

I'm type 2. I take Metformin and sitaglyptin.

Last year when I was first diagnosed I went low carb, did it properly for a few months, alongside taking the Metformin. I lost about a stone and a half in 3 months. My hbac1 went from 89 (ridiculously high!!!!!) To 68 (still far too high, but better than it was). Then the carbs crept back in, til over lockdown I was back to eating the crap diet I had before. My latest hbac1 was still 68, when it should have continued going down. I've gone back to the proper low carb diet, and am trying IF, basically just by skipping breakfast. I'm not worried about exercising before eating because I don't take any medication that would ever make my blood sugars too low. I don't have time for much exercise during term time anyway, but have been doing a lot of walking over lockdown.

Thanks for the recommendation @justanotherneighinparadise, I shall have a look for that.
That is kind of reassuring @KetoPenguin. Your th probably already does more walking than me, with your dog, but interesting that his biscuits are well controlled :).
@BlackAmericanoNoSugar I don't think so, though my levels are normal sometimes if I've eaten something particularly 'good', and I'm not sure how it would work then. If BGL is at normal levels and you exercise enough for the liver to need to release glucose because the muscles need to take up more, but the metformin reduces this release (as I understand it), doesn't that mean that there will be a much lower level of glucose available in the blood than there should be? Or is that only if you exercise very vigorously? My walks are up and down hills, generally 45-60 mins, at a decent pace (maybe not the uphill bits!). I guess the only way to know is to test it? Have you always felt fine fasting then exercising @MsAwesomeDragon? Do you know what your levels are afterwards?

Ive always felt shaky coming up to the 4-5 hour mark inbetween food, even before the diabetes. Seems to be a family thing. I must be accustomed to high levels right now though, as I feel like I'm hypo sometimes when my level is actually fine (or high).

I don't have a monitor, so never know levels. I only know my hbac1 levels which are taken every 6 months currently.

Apparently the daily monitors don't help many people gain control, so they don't recommend them for type 2 unless they are on medication which can cause hypos. Metformin doesn't cause hypos, so I don't have a monitor.

Now that I think back I did used to feel a bit hypo when I was at normal levels when I first started Metformin. That went away after a few months though. I skip breakfast and do the school run, shopping, walk the dog etc and am fine. When I go to the gym I eat a late breakfast (after the school run) that I know is neutral for blood glucose, usually two scrambled eggs and a small piece of granary toast. Then I have a veg/protein type snacks to keep me going until dinner, eg celery and tuna mayonnaise.

It's useful to do meal tests for things that you eat a lot. You take blood glucose before the meal, then 2 hrs after and 4 hrs after (I generally also do 1 hr after as well). I'm always on the look out for easy meals that have a very low rise in blood glucose. It's not always what you expect, for instance I remember the diabetes nurse talking about porridge being good because it's slow-release but when I tested it I was spiking like mad. Or pasta is surprisingly not too bad if I cook it, chill it and then reheat it (apparently some of the carb molecules lengthen and become non-soluble fibre). Pizza gives me a spike but one of our local pizza places does a spelt base and that's completely fine for me.

@MsAwesomeDragon

I don't have a monitor, so never know levels. I only know my hbac1 levels which are taken every 6 months currently.

Apparently the daily monitors don't help many people gain control, so they don't recommend them for type 2 unless they are on medication which can cause hypos. Metformin doesn't cause hypos, so I don't have a monitor.

I was told that about monitors too, they said they're not recommended because they cause anxiety. They are actually incredibly useful for meal testing (as I describe above). I don't use mine regularly but I do use it if I'm trying a new way of eating or a new recipe that I think I might end up making a lot.

That's interesting, one of the first things my doc told me to do (after diet and exercise) was to keep a BGL diary. Maybe it's recommended more in countries other than the UK. I've only been testing a week, but have found it pretty illuminating, and reassuring when I felt a bit hypo. Also will be extremely useful for testing out different meals (def going to try the pasta cooling, that's well worth knowing!)....

I very strongly suspect that the official attitude about monitors not being necessary is only partly about anxiety and at least partly about cost. The NHS can't afford to prescribe monitors and strips (the monitors are often free, it's the strips that are the main cost) to the growing numbers of type 2 cases when they are useful to some but not strictly necessary.

I have thought that I might invest in a monitor of my own, but I'm not entirely sure if it'll be worth it. I would like to know my daily blood levels, but I've already changed my eating habits so it'd just be for my own piece of mind really.

@DianaT1969 and justanotherneighinparadise

This is a digital book that talks about intermittent fasting a very popular and much talked about topic and sought after by those who want to lose weight.
Which is related to diabetes.

Intermittent fasting is based on not eating for a period of time to help burn fat, that is, to make you lose weight.

With this simple digital book you will have your chance to learn more stuff because it is cheap and you can apply what you have learnt easily.

To help you below is the link to get your eBook

www.digistore24.com/redir/335501/Qwesi1442/

Contact me if you have any questions, I will be happy to help you with anything.

Monitors are not given freely to T2 now a days and it is to do with money.

It doesn’t cause anxiety if your eating to your meter it helps to know why your itching or feeling crap or Why you are sweating etc.

I wasn't given one by the doc, but they are freely available at pharmacies, even Amazon, and are not that expensive. I have found it very reassuring.