Type 2 confusion. Has low carb not worked?

[Flowers3221]

I got diagnosed with diabetes 3 months ago with a hbca1 of 98. I am 1 stone overweight and only 40. Got tested as I had sudden onset fatigue. I have a healthy diet generally, but it did contain lots of carbs.

Told to eat low carb and exercise more. Not to keen to put me on metformin due to IBS. I now eat between 90-120g of carbs and Exercise more. Was told it maybe useful to buy a blood glucose monitor to find out what spikes me. I have logged everything I eat in an app and test 4 times a day.

So my sugars have not reduced. They are 14.5 on wake up, fluctuating to 18 when eaten. Bedtime is around 12-13. I have lost the stone but my blood sugars are not reducing. They are the same pattern. I would of thought it would of reduced considering I have halved my carbs.

I did a week of keto and no change. I didn’t continue as keto is not a life long plan I can follow.

Has any other type 2 not had any change with diet alone. It’s becoming frustrating. Advice needed

Forgot to say it’s type 2 based on my age alone

90g to 120g of carbs is a high carb diet. Below 50g is low carb, 20g and below you’re into Keto territory.

With a type 2 diagnosis I’d be going Keto to tackle that HbA1c

It's likely that you have insulin resistance and that 90-120g of carb is still above your tolerance level.

Try going down to 20 - 30g. Yes it sounds awful but it's the only way I can get my levels down. You will also lose weight faster

Good resources
Dr Bernstein's diabetes solution
The low carb diet forum on Diabetes.co.uk www.diabetes.co.uk/forum/category/low-carb-diet-forum.18/
The low carb boot camp threads on here, whilst not aimed at diabetics, have heaps of support, advice and recipes

Thanks guys. Keto is not sustainable for me. Especially if I have to do this for 40 years.

Diabetes U.K. said 120g was low carb as the normal
Adult eats 250g Plus daily.

You don't necessarily have to sustain it forever - blast it to get the weight off, reduce the liver fat and then maintain through a mix of approaches. My suggestion is to read life after diabetes and see how that resonates.

120g is not low carb. The medical establishment is only slowly waking up to this.

I would say, do keto until your blood sugars are well controlled. Then start to add carbs in a controlled way until your blood sugars tell you not to.

In addition, some carbs will affect you more than others. I find a chocolate bar is not as bad as a banana for example, can tolerate some rice but not sushi and no pasta. You will need to experiment

Running blood sugars as high as you are is dangerous for your eyes, kidneys and toes. Keto is a bit boring, but once into ketosis it does get easier and more sustainable- a week is not long enough

The alternative will be a lifetime of ever increasing medication- it really is worth persevering

I'm so sorry to be a bit harsh, but I do know so many people who are in remission from their T2 diagnosis through low carb, and also some who did not and now take loads of pills and even have to inject insulin 4 times a day

I'm on Metformin OP, the modified release yet I've had awful gastric problems and regularly don't take it for a week to let my stomach lining heal. It's brutal, so I can understand why they're reluctant to prescribe.

I had a massive lifestyle change including lower carb but my hba1c barely shifted. It was medication that made the difference for me. Huge family link, everyone on my Dad's side has it - fat or thin. My Dad is in his 80s and has been T2 for 50 years - is now insulin dependent in spite of a lifetime of healthy eating.

It's a bit sweeping to say that people can reverse T2...... some genuinely can't.

@BrilloPaddy thanks. Think that’s the way I am going.

@Defiantly41 the diabetes nurses said to do life style changes which are sustainable. They said keto would only work short term. Not adverse to it, just don’t think I can sustain it long enough to make a change.

I am checking my sugars snd now know what food spike me. But a salad with chicken and very low carb salad spikes massively. It doesn’t make sense

Agree with the others that 120g carbs is quite high. I generally stick to under 60g a day.

Have you looked at low carb products such as the bread rolls from seriously low carb, sweet potato wraps from Tesco, cauliflower rice, courgetti instead of pasta? There is a whole world of options out there :)

I have the slow release metformin and got my HBA1C from 68 to 36 in 3 months. Yea I'm probably on the loo 8-10 times a day but it's a small price to pay for me.

There are other medications out there though. You don't have to be struck down by the dreaded met 💩

I can only encourage you to stick with Keto if you can't get medication. I had a 3 month blast of low carb 800-1000 cals a day and am now off all my meds.

If they can't offer you metformin perhaps they can offer you something else that will help like dulaglitde ? Unmedicated and running that high, you will have impact long term on your health.

It is not sustainable for me long term either, but neither do I see a
path to insulin dependence as being sustainable, either. Or the otherr consequences. I had to keto down - my kidney function was at 50%. Its not now.

There's actually a new drug now that works like the metaforin but is administered by injection once a week. If you can't control your sugars by diet alone then it might be worth enquiring about this drug as it would by pass your gastric system

Have they ruled out type 1?

@BalloonSlayer they said I was a year too old to be considered for that. But may pay private to rule it out so I know one way of the other

@travailtotravel my liver and kidney function are fine. Why no meds at the moment. I have lost nearly the stone and look much better. Now in weight range. Resisting keto as I really can’t do it. It’s really my last option. I do eat the low carb substitutes. Dr kuo is really good.

@cricketmum84 many loo trips are my life without medication. I don’t want to make it worse. It’s jackpot if food upsets me. I know my triggers but sometimes anything triggers me.

I sound defensive, but this diagnosis has upset me as I love food. Just trying to manage it with an active social life that resolves found food. Alcohol, I don’t drink. It’s tye lack of food freedom that upsets me

I went from hba1c of 100+ to normal level of 40 in 3 months. I too struggled with IBS. Within 3 months I lost 2.5 stone and my IBS disappeared. I went low carb - for me that was below 100g carbs and below 1000 calories on average.

However, I also got tested for type 1.5 LADA as well due to family history. If your hba1c is not shifting it may not be type 1 but could be type 1.5, for which there is a simple blood test. Ask your GP for this to rule it out.

@handmademitlove did you have 1.5? I am now in my weight range and a size 10 - well for some clothes, but it’s in the label!!!

Tye nurse did say I was not her typical type 2 patient. My carbs on average over the last month are 105g daily and a calorie intake of 1100. I walk after dinner for 30 mins and swim 3 times a week. Getting fitter, losing weigh but sugars not changing.

I would of thought cutting my carbs in half would of reduced something. But nope.

Didn't Theresa May get type 1 in her 50s?

@BalloonSlayerYeah she did.

Ask your GP to test you again to establish the type of diabetes you have. Also ask if you can try a GLP-1 instead of metformin to try to help your glucose levels. Also a reminder that a HbA1c measures your body's ability to manage your blood glucose over a long period (around 12 weeks). So ask for it to be retested every 3 months or so to see progress as the standard is once per year. Agree that if you are T2 you may need to do a short sharp shock to the body of keto for 8 weeks or so.

Also did the GP check you for anaemia? That can cause fatigue and high blood glucose.

My DH (40) has completely controlled his Type 2 over the last 4 years with low carb diet and increased exercise - his hbca1 levels are consistently pre-diabetic (I think around 35?) at his 6 monthly checks.
He says he tries to eat under 30g carbs a day, but I don't think he actually manages this.
He eats no bread, no pasta, no rice, no potatoes except this bread which was a recent find (maybe 1-2 slices a week), and sweet potatoes as a treat a couple of times a month. He doesn't eat any sweet treats generally, but buys 70% dark chocolate as a regular treat.

He has never even been offered medication.

He went on a few week course offered by the NHS when first diagnosed which I think he found useful. Maybe ask your diabetes nurse?

We found Diabetes UK and NHS had really weird advice, like pasta recipes on a diabetes website?! Look up Dr Michael Mosley and his book The 8 Week Blood Sugar Diet.

It is a huge change to have to come to terms with, but ultimately it is your health. I'm not sure if it is possible to control T2 on 120g carbs a day.

You say you done want to lower your carbs further because you love food. What are the foods you love? There are lower carb options for lots of things. Failing that could you have a lower portion and side salad? Or maybe combine with intermittent fasting to help lower your daily carbs?

@Flowers3321 my antibody test was negative so type 2. Have your hba1c results dropped at all? I would expect them to be lower due to change in diet and exercise regime. If not I would ask them to check it is not type 1 or 1.5. You are only just into the 'default type 2' age group.
I agreed to cut all refined sugars and carbs for 3 months to see if my hba1c would drop back to normal with minimal sugar / carb intake. Which they did. Maintenence is now about working out what meals don't raise my sugar levels too much. So not strict low carb long term, but fewer carbs at each meal and complex carbs rather than refined. My low carb was about getting the background level back to normal, then rebuilding my 'normal'.

@handmademitlove there is no difference. I check my bs before each meal and 2 hours after as suggested by the nurse. My bs averages around 14.4. I go to bed on bs 12 ish and wake up with it at 15. 8 hours fasting and it rises!

I have gone from quite a high carb intake where I ate lots of pasta and bread to much lower. More than halving it. Would of expected a small improvement, but nothing

I am going to ask at next check up to get tested

I was diagnosed as T1 in my mid- forties. Am actually T1.5 with insulin resistance, that's why keto is so helpful

Press for more tests or go private if you can (I had to)