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[Arcteryx]

I'm Type 1, and I lost a lot of weight in the months before my diagnosis. I'm typically around 165lbs, but went down to around 130lbs before going to the doctor. I knew I had been losing weight, but had no idea it was that much. Gained it all back pretty quickly after getting on insulin.

Who here is on a pump? I'm considering switching to a pump once I get on new insurance when I start my new job in a month or so. I've been on injections with Humalog/Levemir (and Novolog/Lantus for awhile), but would like to see how much a pump could help me with my control. My A1C is pretty low, but I think it's been thrown off the last couple of times from having too many lows.

Been on a pump for ~16 years(Medtronic). It makes ALL the difference in the world IMO, especially if you start pumping right away(so you don't get bad habits).

If you've got an active lifestyle/want the best control, then it's a no-brainer.

My advice: if you do do it, buy this book, http://www.amazon.com/dp/B009NNKZKA/?tag=neogaf0e-20. Edition doesn't matter so much, as the differences will mostly be with available pump manufacturers, but the book itself is INCREDIBLY helpful at the start.
Also, try and get a week or so trial with a CGM(continuous glucose monitor) at the start/fairly soon. That way, you will have a good baseline for how your body acts and will help you get in target quicker.

As far as losing weight goes: yea, when I was newly diagnosed, I had lost something like ~30 lbs...and I was a pretty skinny 12 year old at the time...so you can imagine what -30 lbs would look like. My parents were freaking out and I just felt like shit in general. Pretty remarkable though, how the human body can bounce back like that. Within a month or two I was back near my normal weight and feeling fine again after being on insulin/the pump.

And hey, if you get a pump, you can always make bionic man jokes with the ladies.

 

[Deleted member 17706]

I'm 5'8" and 160 pounds. Weight doesn't fluctuate outside of being lighter in morning and heavier at night as are with most I assume. My cholesterol levels are still normal. Good cholesterol high, bad low. Blood pressure normal. Liver panel normal. Waist is 34 inches. BMI is 24. Body fat percentage is 18%. But I guess bad carbs are bad carbs and I wasn't even eating them that often anyway.

Nurse told me to watch what I eat. Ok... guess I'll switch to eating grass.

Like I said my levels were normal until I gave up exercising. I probably eat better now than when I was exercising.

Just out of curiosity, what is "eating well" to you? You mention bad carbs, but from a blood sugar perspective, there's not a ton of difference between the different sources outside of how much fiber they might have to slow absorption.

You seem healthy for the most part if not ever-so-slightly overweight (unless you're quite muscular). Honestly, your blood sugar levels might not be a huge concern for you personally, but definitely get the opinions of a few medical professionals.

One thing that might be effective is completely eliminating carbs for one meal of the day. Maybe, dinner for example. That would give your body plenty of rest time (half or more of the day) when it comes to having to deal with elevated blood sugar.

 

[jmdajr]

Just out of curiosity, what is "eating well" to you? You mention bad carbs, but from a blood sugar perspective, there's not a ton of difference between the different sources outside of how much fiber they might have to slow absorption.

You seem healthy for the most part if not ever-so-slightly overweight (unless you're quite muscular). Honestly, your blood sugar levels might not be a huge concern for you personally, but definitely get the opinions of a few medical professionals.

One thing that might be effective is completely eliminating carbs for one meal of the day. Maybe, dinner for example. That would give your body plenty of rest time (half or more of the day) when it comes to having to deal with elevated blood sugar.

Normal eating day

Breakfast - Plain Rolled Oats (no sugar), milk, Blackberries, natural peanut butter.
Snack-Almonds
Lunch-Frozen meal. Lean Cuisine kind. Is it healthier than home made food? No. Better than fast food? Yes. Most are low in calories and Carbs are not that high. At least I can see the nutrition info. I make sure they have veggies and I usually add an avocado if the calorie count is low.
Snack-Fruit (apple/orange)
Snack-Yogurt usually one in low in sugar.
Dinner. Some type of meat (chicken/turkey) and vegetable. No potatoes/pasta/bread rice. No refined carbs.
Dessert. Maybe a few berries.

Do I usually count the carbs? No. Oustide the frozen meal most everything is fresh.
Most of the week I eat like this. On the weekends I might eat worse content but less frequently.
Sometimes people at work try to feed me cookies/cake and crap. Sadly I do eat it sometimes.

The day before my physical. Did I eat healthy? No. How much did that effect stuff..beats me.

EDIT: Currently working on getting closer to 150 since my frame is small (My wrist measures like 6 inches). I have some muscle but I've lost a lot compared to when I was working out. If I flex you can still see a bicep!

 

[JetBlackPanda]

So its been almost two months since I was diagnosed and started this thread. Its funny the ride I've been on already.

From being super gung ho at diagnosis to being depressed right after.. to just kind of accepting it and learning to deal with it.

Like I have said before I am currently Lada (type 1.5) and in my honeymoon period. My glucose levels usually hang around 90-120 as long as I keep most meals to <40 carbs and take my metformin.

reading this thread and the diabetes subreddit has been amazing. I don't know anyone else with diabetes so talking to you guys and reading about your life helps to cope.

I can't wait to go in next month and test my a1c again and see where I am, at diagnosis I was a 10.

 

[Deleted member 17706]

Normal eating day

Breakfast - Plain Rolled Oats (no sugar), milk, Blackberries, natural peanut butter.
Snack-Almonds
Lunch-Frozen meal. Lean Cuisine kind. Is it healthier than home made food? No. Better than fast food? Yes. Most are low in calories and Carbs are not that high. At least I can see the nutrition info. I make sure they have veggies and I usually add an avocado if the calorie count is low.
Snack-Fruit (apple/orange)
Snack-Yogurt usually one in low in sugar.
Dinner. Some type of meat (chicken/turkey) and vegetable. No potatoes/pasta/bread rice. No refined carbs.
Dessert. Maybe a few berries.

Do I usually count the carbs? No. Oustide the frozen meal most everything is fresh.
Most of the week I eat like this. On the weekends I might eat worse content but less frequently.
Sometimes people at work try to feed me cookies/cake and crap. Sadly I do eat it sometimes.

The day before my physical. Did I eat healthy? No. How much did that effect stuff..beats me.

EDIT: Currently working on getting closer to 150 since my frame is small (My wrist measures like 6 inches). I have some muscle but I've lost a lot compared to when I was working out. If I flex you can still see a bicep!

Well, as you may have seen from the various nutrition threads, I'm firmly in the low/no-carb camp for people who don't get a lot of vigorous exercise on a near-daily basis. It would be especially true for someone worried about blood sugar, since the only thing that causes high blood sugar is carbs. You know the causative mechanism at play, so it seems strange to me to continue to feed it.

Switching over to a high protein and fat diet with next to zero carbs except after resistance training has had countless benefits to my health. The people I've convinced to try it in real life, too, have all had great results, albeit it's only been about a dzoen people. One ex-coworker, who was immensely obese a couple of years ago, was able to get off his diabetes medication (forgot the name) and drop over 200 lbs. in under two and a half years.

In the end, you have to find what works for you personally, but just some food for thought.

Unrelated, but I can totally relate with having small wrists! I'm around 5'10" and don't necessarily have a tiny frame, but I, too, have around 6 inch wrists. When I was entering my measurements on Indochino to get a suit custom made, that was the only measurement they asked me to double check because it was so out of whack with the rest of my measurements.

 

[jmdajr]

Well, as you may have seen from the various nutrition threads, I'm firmly in the low/no-carb camp for people who don't get a lot of vigorous exercise on a near-daily basis. It would be especially true for someone worried about blood sugar, since the only thing that causes high blood sugar is carbs. You know the causative mechanism at play, so it seems strange to me to continue to feed it.

Switching over to a high protein and fat diet with next to zero carbs except after resistance training has had countless benefits to my health. The people I've convinced to try it in real life, too, have all had great results, albeit it's only been about a dzoen people. One ex-coworker, who was immensely obese a couple of years ago, was able to get off his diabetes medication (forgot the name) and drop over 200 lbs. in under two and a half years.

In the end, you have to find what works for you personally, but just some food for thought.

Unrelated, but I can totally relate with having small wrists! I'm around 5'10" and don't necessarily have a tiny frame, but I, too, have around 6 inch wrists. When I was entering my measurements on Indochino to get a suit custom made, that was the only measurement they asked me to double check because it was so out of whack with the rest of my measurements.

I started fitness like in 2000, and never really had a physical until 2004. My doctor was always impressed with my numbers. So it's possible that whole time I was keeping my numbers in check so I have no clue what they were pre-2000. In the end I need to start exercising again and refine my diet even more. I don't want to go insane yet on that but I will keep making changes until I see results.

I'm a young 37!

 

[Deleted member 17706]

I started fitness like in 2000, and never really had a physical until 2004. My doctor was always impressed with my numbers. So it's possible that whole time I was keeping my numbers in check so I have no clue what they were pre-2000. In the end I need to start exercising again and refine my diet even more. I don't want to go insane yet on that but I will keep making changes until I see results.

I'm a young 37!

Well, you've been in the fitness game much longer than I have! I'm sure you know the value of experimenting and finding what works for you (and more importantly: stopping what isn't working or is having negative effects).

 

[jmdajr]

Well, you've been in the fitness game much longer than I have! I'm sure you know the value of experimenting and finding what works for you (and more importantly: stopping what isn't working or is having negative effects).

I definitely feel like I have been wasting away. I used run/do yoga,/and weight/resistence train every week. Now the only thing I do is walk and take the stairs. I can't imagine the shape I'd be in without that.

It is tough with a 2 year old but I have do something if I want to be around years from now.
No more excuses. Have to make time.

 

[Deleted member 17706]

I definitely feel like I have been wasting away. I used run/do yoga,/and weight/resistence train every week. Now the only thing I do is walk and take the stairs. I can't imagine the shape I'd be in without that.

It is tough with a 2 year old but I have do something if I want to be around years from now.
No more excuses. Have to make time.

As someone in a similar boat (16 month old son at home), I've found that calisthenics has been great for letting me keep up some kind of resistance training. Easy to do at home in very short bursts. I'd recommend checking out the book Convict Conditioning if you're interested. Cheesy title and possible bullshit character as the author, but there is a lot of good information on how to get started on body weight training.

Working with weights is great, but I can totally relate with how challenging it can be to find time to go to the gym on many days.

 

[jmdajr]

As someone in a similar boat (16 month old son at home), I've found that calisthenics has been great for letting me keep up some kind of resistance training. Easy to do at home in very short bursts. I'd recommend checking out the book Convict Conditioning if you're interested. Cheesy title and possible bullshit character as the author, but there is a lot of good information on how to get started on body weight training.

Working with weights is great, but I can totally relate with how challenging it can be to find time to go to the gym on many days.

Finally did some push ups the other day. Man my lats hurt.
(edit: My muscles are twitching! This is exciting!)

Gotta build those glucose eating muscles!

I set up my phone with an alarm to takes the stairs every so many hours. People here will take the elevator for 1 fucking floor. Madness to me. And that's why we're all fat.

 

[jmdajr]

link


well this isn't helping :\

 

[Deleted member 17706]

well this isn't helping :\

No idea what you do for work, but see if you can't get a standing desk solution. If you can't do it for work, maybe set one up at home?

 

[jmdajr]

No idea what you do for work, but see if you can't get a standing desk solution. If you can't do it for work, maybe set one up at home?

The stairs are real close to my office (around the corner) so I have been doing that every so often.

Some people here have already gotten the standing desks. Thing is I'd have to pay for it :\

Being more active has actually helped me stay asleep longer. I feel recently I'd wake up way too often. Maybe way of body telling me that I need to do something.

 

[The Lamp]

Finally got the blood strip meter to work. Took it at 1pm today after sleeping in. I hadn't eaten since 7pm last night (but my diet was horrible yesterday because I was a groomsmen at a far away wedding that served nothing but cake...I hadn't eaten all day so I had like 5 slices...and I had to grab fast food on the long drive home :/)

First the machine said error, glucose levels too low, or redo the test. I redid the test and it said it was 110 mg/dL and I guess this was my fasting glucose. Could this reading include all the sugar from yesterday?

Should I make an appointment with my doctor? That's not good, is it...

EDIT: just checked it after having a meal. I ate two plates of Indian food (vegetables, chicken, rice, curry, sauces, etc.) and waited two hours. My glucose was at 111 mg/dL so it didn't even change. WTF i'm confused.

 

[vikki]

Two hours after eating at 111? That's good.

 

[JetBlackPanda]

Is anyone around here on Afrezza? or know anyone that takes it? the stuff seems amazing.

 

[Relix]

Random question. I've been verifying my sugar levels since I could be developing diabetes. I have been eating better for a week now but tonight decided to gulp down a large popcorn bag and a 48oz Coke. Verified about 2 hours later and sugar levels were at 170..or so says the machine. How's that? Good? Bad? Very bad?

 

[JetBlackPanda]

Random question. I've been verifying my sugar levels since I could be developing diabetes. I have been eating better for a week now but tonight decided to gulp down a large popcorn bag and a 48oz Coke. Verified about 2 hours later and sugar levels were at 170..or so says the machine. How's that? Good? Bad? Very bad?

170? I would see a doctor. I am new to this but everything I have heard is that a reading over 120 isn't normal. I would start checking every morning and 2 hours after every meal. Write it all down.

 

[Dr. Feel Good]

Non diabetics really shouldn't have fasting blood sugars over 100. The 110 to 120 range would tell me pre diabetes. 170? Diabetic.

 

[Relix]

170? I would see a doctor. I am new to this but everything I have heard is that a reading over 120 isn't normal. I would start checking every morning and 2 hours after every meal. Write it all down.

Non diabetics really shouldn't have fasting blood sugars over 100. The 110 to 120 range would tell me pre diabetes. 170? Diabetic.

Oh so even if I gulped down that shitton of Coke it should be within that range at least 2 hours after drinking it?

 

[Deleted member 17706]

Oh so even if I gulped down that shitton of Coke it should be within that range at least 2 hours after drinking it?

Hard to say. You downed probably 150g of sugar (think 70 or so little sugar cubes) in a very short amount of time. That's going to spike the shit out of your blood glucose levels and quickly, since what you consumed doesn't take long to convert into glucose.

From there, it depends on how sensitive you are to insulin and how much your body is producing. Sitting at 170 two hours later (you didn't consume anything else during this time, did you?) sounds really bad, but obviously you should get a professional medical diagnosis.

Before any of that, though, you should really stop drinking sugar and eating popcorn if you're concerned at all. You're killing yourself, and for what?

 

[vikki]

If I drank 48oz of coke, my sugar would be like 400. Really, if you're afraid that you're on the precipice of getting diabetes then stop doing shit like that. Stop drinking soda, for a long while, I'd suggest. Look into changing your diet, even just a little. Better to try and prevent getting diabetes than to not take care of yourself and get it, like I did.

 

[Wag]

Anyone eat sugar free food? I know I shouldn't, but I have a sweet tooth and now that I've lost so much weight and my blood sugar is normal I have a treat once in a while. I definitely stay away from soda though.

Some of the problem with the sugar free chocolates is that they're sweetened with maltitol and sorbitol which are laxatives so they make you fart, a lot.

Let's start a list of some of the better sugar free foods:

I really like these:

They don't taste like they're sugar free at all.

 

[vikki]

Let's start a list of some of the better sugar free foods:

I'd like to have a master list of recipes and food items that you people eat to maintain your BG levels. I don't want to get burnt out on eating the same three things.

As of right now, I usually eat egg whites on toast with a cup of coffee for breakfast, chicken sammie for lunch, chicken veggies for dinner. I mix it up with the spices, but it's all pretty similar no matter what. I'm going to supplement Tofu to maintain a decent B12 levels.

As for sugar free? I got nothing.

 

[JetBlackPanda]

Hows everyone doing?

I have had a few cheat days here and there where I let my self have a bowl of breakfast cereal for dinner ( I love that shit ) my blood jumps to 160-180 and I feel bad afterwards but still.

As far as sugar free food goes.

I really like Popsicle brand no sugar added fudge pops.

 

[lastplayed]

I went to the doc a while ago convinced I had diabetes. I was thirsty all the time, have a lot of headaches, sometimes feel hazy after eating a big meal. He checked my blood and was fine.

It took me a while but I've quit all sugary drinks and fast food (except eating out with people which isn't all that often). I've been at it about 3 weeks and I'm a lot less thirsty now!

Ha, we'll see how it goes.

 

[Wag]

I eat these. I think they're sweetened with maltitol and sorbitol so be careful, they'll give you the shits if you eat too many.

If your A1C levels are consistently below 6.5 you don't have diabetes. Mine was as high as 7.7 at one point and now after losing 70lbs and changing my diet I was able to get it down to 5.6, normal levels.

 

[Laurentius]

Hows everyone doing?

I have had a few cheat days here and there where I let my self have a bowl of breakfast cereal for dinner ( I love that shit ) my blood jumps to 160-180 and I feel bad afterwards but still.

I have cereal (and other "carb-y" foods) fairly often, but I bolus for it so I don't feel too bad about it...

 

[Dany]

Random question. I've been verifying my sugar levels since I could be developing diabetes. I have been eating better for a week now but tonight decided to gulp down a large popcorn bag and a 48oz Coke. Verified about 2 hours later and sugar levels were at 170..or so says the machine. How's that? Good? Bad? Very bad?

A random blood sure test that is over 200 is diabetes.

It's high but not diabetes. A fasting blood sure test that is over 126 is diabetes.

 

[Contra11]

https://www.youtube.com/watch?v=zjUdtK6ukqY

Not a diabetic patient but LCHF diet is fantastic for people with genetic susceptibility like me as well as T2 diabetec patients

 

[A Fish Aficionado]

https://www.youtube.com/watch?v=zjUdtK6ukqY

lol. His basis is idiotic. It's been more than 10,000 years since agriculture. And any anthropologist could see through his supposed studies

I want more proof than rat studies, short-term, and n=1 studies and Atkins/similar CoI sponsored studies.

More quality research and meta studies are needed before policy changes.
The DASH diet is somewhat close.

The ketogenic diet can certainly be medically prescriptive in diabetic patients. I just want the full data before I even start mentioning it. Drug intervention is the best for most.

Consult a doctor and dietitian more than a forum. Be sure that the blood sugar is measured over time. These people are actually trained and certified. Many ascribe to a LCHF lifestyle nowadays.

 

[A Fish Aficionado]

Interesting research about depression and diabetes.
http://www.thelancet.com/series/depression-diabetes

 

[momo no oji]

Diabetes runs in my family on both my mom and my dads side. Diabetes can be a scary thing if you don't manage it well. Both my parents have it and they didn't really take good care of themselves before when they found out and now are on a ton of meds. One of my cousins didn't even have symptoms of having it until one day he felt dizzy and couldn't see right. He checked his sugar at his friends place and it was 400. Sure enough after a doctors visit he found out he was type 2. I've heard if you catch it early a good balanced diet and exercise can fix it. It won't cure it for good but you can at least tone down the symptoms and may not even need medication or so one of my teachers told me.

 

[grumble]

Diabetes runs in my family on both my mom and my dads side. Diabetes can be a scary thing if you don't manage it well. Both my parents have it and they didn't really take good care of themselves before when they found out and now are on a ton of meds. One of my cousins didn't even have symptoms of having it until one day he felt dizzy and couldn't see right. He checked his sugar at his friends place and it was 400. Sure enough after a doctors visit he found out he was type 2. I've heard if you catch it early a good balanced diet and exercise can fix it. It won't cure it for good but you can at least tone down the symptoms and may not even need medication or so one of my teachers told me.

Sometimes you're just screwed but sometimes diabetes comes because of inactivity and poor eating habits combined with a genetic propensity to get it. Take extremely good care of yourself and you may be able to delay it, reduce the severity or prevent getting it completely.

 

[mightynine]

Type 1 diabetic, diagnosed when I was in 8th grade.

All I can say is take your blood sugar. Everything else is basically window dressing if you don't do that.

For years, I hated taking it because, at the time, the test strips required a perfect drop of blood, and it took a minute to find out you screwed up and had to do it again. Incredibly frustrating.

So when I went away to college, I went away from taking them. And my A1C level drifted higher and higher, eventually hitting double digits. It was the only black mark when I would do blood work.

A few years ago, the doctor I was seeing at the time just asked me point blank, "How long do you want to live?" No frustration, just matter-of-fact. That shook me a bit.

But at the same time, I got a new blood sugar machine, one that takes the least amount of blood I've ever had to give, and the lancets are so thin they don't leave my fingers sore, and I gotten back into the habit of taking my blood sugar regularly. Dragged my A1C back to almost normal (still a tad bit too high).

So seriously, take your blood sugar.

 

[Deleted member 17706]

Drug intervention is the best for most..

How can you really argue for this?

Using drugs to keep people alive but in a sick state that increasingly worsens over time is the best when there are clear cut options that actually attack the cause of the issue instead of just treating symptoms?

 

[A Fish Aficionado]

That's a complete misrepresentation of medicine.

 

[Deleted member 17706]

That's a complete misrepresentation of medicine.

I wasn't talking about medicine in general, of course, but I would argue that it is not a misrepresentation when it comes to type II diabetes treatment.

 

[Meia]

Had type 2 5 years or so ago. Was weighing in a 310lbs at 5'5", so no shit I had eaten way too much sugar.


Went on a doctor approved no carb diet, went down to 197 in 6 months, and my blood sugar normalized after about a year. Still get blood work every 6 months or so, but on no medication and have no issues at all with blood sugar, so losing the weight knocked it right out.

 

[Deleted member 17706]

Had type 2 5 years or so ago. Was weighing in a 310lbs at 5'5", so no shit I had eaten way too much sugar.


Went on a doctor approved no carb diet, went down to 197 in 6 months, and my blood sugar normalized after about a year. Still get blood work every 6 months or so, but on no medication and have no issues at all with blood sugar, so losing the weight knocked it right out.

Congratulations on that weight loss. That's amazing stuff.

While losing the weight was surely a huge factor (for other health factors, too), it's pretty clear that the absence of carbohydrates in your diet is what allowed your blood sugar condition to improve.

There are plenty of people, especially in countries like Japan, who come down with type II diabetes despite not being particularly overweight.

 

[Metra]

How can you really argue for this?

Using drugs to keep people alive but in a sick state that increasingly worsens over time is the best when there are clear cut options that actually attack the cause of the issue instead of just treating symptoms?

Non-pharmacological (eg. diet, physical exercise) and pharmacological (eg. Metformin, Insulin) interventions for type 2 Diabetes (DM2) are complementary (ie. not mutually exclusive nor independent), Zefah. Many patients with DM2 (probably the majority, if I recall correctly) will develop insulin resistance and hyperglycemia, despite optimal nonpharmacological control. Thus, for such patients, drugs are necessary.

Also, DM2 is an insidious disease and, for that reason, many patients only seek medical attention when they're already symptomatic, with high HbA1C levels and micro/macrovascular impairment. Generally, in those cases, a nonpharmacological approach - alone - won't be enough to reduce morbimortality.

 

[momo no oji]

Had type 2 5 years or so ago. Was weighing in a 310lbs at 5'5", so no shit I had eaten way too much sugar.


Went on a doctor approved no carb diet, went down to 197 in 6 months, and my blood sugar normalized after about a year. Still get blood work every 6 months or so, but on no medication and have no issues at all with blood sugar, so losing the weight knocked it right out.

This is really great! I wish more people would take the initiative to care about their health. Diet and exercise is the best way to prevent this from happening and I'm glad you were able to overcome it and not have to be on any meds. My parents are healthier than before and they lost a good amount of weight but I think the damage was done so it isn't reversable anymore.

 

[Meia]

This is really great! I wish more people would take the initiative to care about their health. Diet and exercise is the best way to prevent this from happening and I'm glad you were able to overcome it and not have to be on any meds. My parents are healthier than before and they lost a good amount of weight but I think the damage was done so it isn't reversable anymore.

People usually don't care about their health until they're just about to lose it, as was the case for me(add in a healthy dose of depression I still work through here and there). Still remember one day driving my friend to college, and suddenly realizing my foot had gone numb. Couldn't attribute that to sitting on it or something while driving, so went to the doctor and found my level to be a good 300.


A diet consisting of trays of brownies and hundreds of dollars of fast food a month are bad for a diet, again who knew? Still think I was kind of just eating myself to death when I think back on it, and still something I catch myself doing once in awhile if I let myself slack off too much.



Sometimes wonder if there's a "diet" GAF or something on the community. One thing I found out helps a lot with something like this is being accountable for yourself.

 

[Deleted member 17706]

Non-pharmacological (eg. diet, physical exercise) and pharmacological (eg. Metformin, Insulin) interventions for type 2 Diabetes (DM2) are complementary (ie. not mutually exclusive nor independent)

They kind of are mutually exclusive when it comes to insulin shots. You need to time carb consumption appropriately in order to keep your blood sugar from dropping too much from the injected insulin.

That's why the dietary guidance is forced to move in the direction of high-carb, but lower calorie with exercise thrown into the mix in the desperate hope that the patient will lose any extra weight.

Many patients with DM2 (probably the majority, if I recall correctly) will develop insulin resistance and hyperglycemia

I'm confused by this statement. You don't just come down with type II diabetes out of nowhere. It is a disease of insulin resistance. That comes first.

 

[Metra]

They kind of are mutually exclusive when it comes to insulin shots. You need to time carb consumption appropriately in order to keep your blood sugar from dropping too much from the injected insulin.

That's why the dietary guidance is forced to move in the direction of high-carb, but lower calorie with exercise thrown into the mix in the desperate hope that the patient will lose any extra weight.

Based on my experience, this is partially correct. Indeed, exercise-induced hypoglycemia can be a problem to patients with insulin-deficient diabetes. In addition to increased glucose utilization by muscles, exercise can shift the glycemic threshold for the sympathoadrenal response to hypoglycemia, which affects glucose counterregulation mechanisms related to epinephrine, causing "delayed" post-exercise hypoglycemia. However, exercise-induced hypoglycemia can be prevented with an educational program for patients with DM2, and thus it's completely feasible (and encouraged by medical professionals) to practice physical exercise while under insulin regimen.

I'm confused by this statement. You don't just come down with type II diabetes out of nowhere. It is a disease of insulin resistance. That comes first.

Forgive me here. The sentence that you quoted is correct in my primary language but, in english, "develop" isn't the right/best word. What I meant is: despite optimal nonpharmacologic control, most patients with DM2 will get progressively worse (ie. insulin resistance will gradually worsen and, consequently, near-normal glycemia will become harder to achieve), therefore, those patients will need pharmacological treatment, in order to reduce morbimortality. And again: drugs (metformin, insulin, etc) will be added to the therapy; it won't replace lifestyle changes (diet, physical exercise, weight reduction), as I explained above.

 

[Contra11]

Based on my experience, this is partially correct. Indeed, exercise-induced hypoglycemia can be a problem to patients with insulin-deficient diabetes. In addition to increased glucose utilization by muscles, exercise can shift the glycemic threshold for the sympathoadrenal response to hypoglycemia, which affects glucose counterregulation mechanisms related to epinephrine, causing "delayed" post-exercise hypoglycemia. However, exercise-induced hypoglycemia can be prevented with an educational program for patients with DM2, and thus it's completely feasible (and encouraged by medical professionals) to practice physical exercise while under insulin regimen.



Forgive me here. The sentence that you quoted is correct in my primary language but, in english, "develop" isn't the right/best word. What I meant is: despite optimal nonpharmacologic control, most patients with DM2 will get progressively worse (ie. insulin resistance will gradually worsen and, consequently, near-normal glycemia will become harder to achieve), therefore, those patients will need pharmacological treatment, in order to reduce morbimortality. And again: drugs (metformin, insulin, etc) will be added to the therapy; it won't replace lifestyle changes (diet, physical exercise, weight reduction), as I explained above.

http://www.dietdoctor.com/yes-a-low-carb-diet-greatly-lowers-your-insulin

 

[Metra]

http://www.dietdoctor.com/yes-a-low-carb-diet-greatly-lowers-your-insulin

Thanks for the link, Contra. I'd like to note, however, that I'm not arguing about DM2 patients' diet details. I do not disagree with that article nor, as I explained above, with Zefah -- regarding exercise-induced hypoglycemia and dietary management.

I'm simply pointing out - based on my experience as a doctor (and on what I see in clinical practice, for most patients with DM2) - that, while nonpharmacologic intervention is a fundamental, essential and vital part of Diabetes management, insulin resistance is generally progressive and most patients will require - at some point - pharmacological therapy (as an addition, not a replacement, to nonpharmacologic measures) in order to control glycemia and reduce (or, at least, delay) morbimortality.

 

[Deleted member 17706]

Metra, I think I may have caused a misunderstanding by not posting more clearly.

What I was saying is that patients treating their condition with insulin shots effectively prevents them from ever being able to rid themselves of the disease. It allows them to stay alive, but puts them into a cycle of an ever-worsening condition that requires increasingly large doses of insulin to cope with.

You cannot do insulin shots and treat the disease with a ketogenic diet unless you want to quickly induce hypoglycemia. A diet that does not spike blood sugar and thus does not require massive amounts of insulin to be secreted in order to prevent a case of hyperglycemia is an effective treatment to typical cases of type II diabetes that so many suffer from.

Insulin and medication treats the symptoms (reduced insulin sensitivity/not enough insulin being secreted), not the root cause, which is constantly elevated levels of blood sugar.

 

[Metra]

Ah, thanks for the clarification. I think I understand your initial point now. And I'm mostly in agreement with you.
I mean, I definitely agree with this part:

What I was saying is that patients treating their condition with insulin shots effectively prevents them from ever being able to rid themselves of the disease. It allows them to stay alive, but puts them into a cycle of an ever-worsening condition that requires increasingly large doses of insulin to cope with.

Insulin and medication treats the symptoms (reduced insulin sensitivity/not enough insulin being secreted), not the root cause, which is constantly elevated levels of blood sugar.

And I honestly don't have enough experience to agree or disagree with this part (considering that the patients in question have a clear protocol-based indication to use insulin):

You cannot do insulin shots and treat the disease with a ketogenic diet unless you want to quickly induce hypoglycemia. A diet that does not spike blood sugar and thus does not require massive amounts of insulin to be secreted in order to prevent a case of hyperglycemia is an effective treatment to typical cases of type II diabetes that so many suffer from.

 

[kingwingin]

I know I will get type 2 diabetes one day. I'm quite over weight and it runs in my family, my dad had his license revoked due to being legally blind and his brother died from heart problems related to it.

I just don't really care about life