Better to use concept of ‘in remission’ than ‘cured’ but otherwise mostly agree with your posting
Type 2 maybe. But type 1 is definitely not and you should not be saying so as that is deeply irresponsible. My daughter has type 1, my wife is a GP, so I believe I have some understanding
I don’t think MikeON intended it to come across like that, there may even be a typo in his final sentence, I assumed he was talking about Type 2/impaired glucose tolerance as a precursor, but you are quite right to clarify that ‘curable’ is not really a prospect for Type I. Let’s hope there are some real breakthroughs in coming years.
Not sure if you’re in the UK or elsewhere MikeON, but in the UK I doubt NHS dietitians are in it for the money, but I do believe a lot of advice was more generic many years ago following a more ‘healthy dietary’ plan which in practice I know simply doesn’t work for me.
It matters not if I indulge in refined or unrefined carbs they are all digested incredibly quickly and from testing spike my glucose levels in a fairly similar manner - admittedly unrefined carbs (wholegrains etc) may have other benefits such as higher fibre/mineral content but for many with Type 2 DM those are the least of their concerns compared to large hyperglycaemic spikes.
I can eat mixed nuts, cheese, fatty foods until the cows come home and glucose levels barely change. Add a tiny piece of bread/pizza/pasta and they go haywire.
Absolutely agree, but have to say that Prof Roy Taylor’s work was so incredibly encouraging for those tagged and often shamed as Type 2 as it provided the possibility of reversal/remission with strict calorie restriction/weight loss - even if this only delays eventual declines that has to be a good thing.
I say inevitable as for most people extreme caloric restriction is far from easy to maintain, but in addition as we age it’s far harder to exercise as much as we would like especially when our joints/bodies can’t do what they could only a few years, let alone decades ago.
I am British but living in in South Africa (27 yrs) where most dieticians are in “Private Practice” ,There is no NHS equivalent , the state health system is in disarray and if you can afford it most health care is managed by Insurance a la BUPA .
I may be a bit biased as I ignored 2 of them when their recommendation’s results failed and “did it myself” Most dieticians here are aimed at weight loss (obesity is a national disease) not ailment correction. We have just had a series of consultations for my wife that were frankly so hit and miss as to be useless (and expensive in the supplements she recommended)
Google Prof (DR.) Tim Noakes , he makes good reading on diabetes , he is the professor of Sports Science in Cape Town and a long term diabetes sufferer.
Full blown diabetes is not a nice condition, I didn’t mean to sound flippant.
Keeping off carbs is a science in itself as the amount of hidden sugar in processed foods is horrendous.
Touch wood I’m the only one in my immediate family that hasn’t been inflicted. My brother is on a dialysis machine twice a week.
Seems it’s on the increase and we probably have to come to terms with the fact it’s a direct result of our western culture and standard of living.
Thanks MikeON, I thought you might be referring to private healthcare.
I’ve heard of Tim Noakes before but haven’t really explored his output in detail, thanks.
Sorry to offend I meant pre-diabetes and type 2 , I appreciate Type 1 is a much more serious state.
I must come across as a Carb Crusader. South Africa has a serious obesity problem especially in women but as more affluence spreads its spreading to men too. Men in general worked physical jobs and kept fit/slim as a result but now more sedentary jobs has lead to “spread”
The norm here for tea and coffee is 3 sugars or more !! and all meals seem to comprise a massive carb input
I had to find a way of losing weight, I have been a brewer all my working life and beer was an absolute norm as was overweight and all that brought with it. For arthritic reasons I had a Full Ankle Replacement which was not going to last supporting my 120 kg frame . So diet.
The revelation of the Banting Diet/Lifestyle was amazing 5 kg in the first month. In 18 months I shed 43 kg (sounds like a article from a dieting magazine). Keeping it off is not that difficult but it is a lifestyle change . For me giving up beer was hard but 6 years on I still drink no beer just a small amount of wine.
The good thing about the Banting Lifestyle is that if you slip and put weight on , 2 weeks of “hard adherence” will get you back on track as your body starts to convert to Fat > Glucose not Carbs > Glucose (Ketosis)
I am sorry if I offended it was not intentional. I was described as Pre - Diabetic and now no longer am as a result of carb control, hence the crusade
I was diagnosed with T2 about 8years ago and started on the standard Metformin, eventually to 2g/day. My Hba1c never went below 53 but my GP was okay with this given my age (61).
I moved from Argyll to Northumberland and apparently my Hba1c was 74 and increasing, reaching 103 a year ago so the mediation was increased to include Sitapgliptin. (DPP4 inhibitor)
But here’s the thing: I’ve never had a thirst, do have to pee during the night 2-3times but enlarged prostate also causes nocturnal peeing, my feet have good circulation, my retinas are perfect and finally I don’t suffer from tiredness.
So if it wasn’t for the Hba1c tests, I’d probably not be diagnosed as a T2 diabetic so one can conclude that the medication is working, yet the results don’t show this.
I have started doubting the accuracy of the tests and reliability of the lab used by my local health centre.
But I am also very cynical of the NICE guidelines setting targets which cannot be appropriate for all patients, but which the medics are encouraged to follow. (the NHS doesn’t care about the individual, only about keeping citizens from using major NHS resources.
My next bloods are due on the 31st and despite my diet and excercise regimes, coud mean a 3rd medication being prescribed. (probably a SGLT2 inhibitor)
However, I have refused to be over-medicated (I also take a child’s dose (5mg) of Lisinopril for high bp and 10mg of Omeprazole for GORD - these are half the doses the GP wanted to prescribe but work for me. I was offered a SGLT2 inhibitor but refused due to risk of the horrible side effect of genital Necrotising Fasciitis. (can be fatal)
My Scottish GP said that patients were in charge of their medication whereas in England, you are expected to take what they prescribe and disagreeing raises eyebrows…
Where to start…
The Naim forum isn’t the place for medical advice but I’d gently suggest that you arrange to review things with your GP - and perhaps if you don’t have confidence in their diabetes expertise ask for a referral to your local hospital diabetes service.
I assume that’s in response to Atyn’s post Svetty?
Good general advice for anyone though.
I think there’s a lot of validity in relation to increasing sedentary jobs and lifestyle. When I was a lad whole regions relied on coal mining for a high percentage of employment as well as other physical jobs including workers at large steelworks. You had tough rugged men who were fit and strong due to their physical jobs and many club or international rugby players probably didn’t need to train in the same way as professional players do now due to the sheer physicality of their non-sporting jobs.
My current work is considerably more sedentary than 20-30 years ago - it may not have been heavy physical work but involved a heck of a lot more walking around.
It’s only part of the problem though, we have genetic factors at play, higher risk for certain ethnicities and of course too much cheap high calorie but often poor quality food full of carbohydrates, and the oh so convenient processed/ready meals. As for convenience foods it’s probably not surprising that so many people buy them as times have changed and with two parents generally needing to work these days there are many time pressures on families especially if parents don’t work ‘standard’ hours 9-5.
One of the problems with Type 2 is that you can have fairly high glucose levels for many many years and have no symptoms whatsoever until they get quite high, so by the time it is diagnosed you may have had quite poor glucose levels for a very long time and no symptoms (years or even over a decade). Some people will be picked up due to checkups, others as they develop classic symptoms - you do not need to have any symptoms to have type 2. Apologies if that’s a bit repetitive but ultimately it also means that absence of symptoms despite lifestyle changes/medication does not necessarily mean things are as well controlled as recommended.
As the problem develops more slowly than type I which is normally fairly sudden, I suspect many of us with type 2 would not even have noticed development of milder symptoms which gradually became ‘the norm’.
Hospital/other labs testing Hb A1c for the NHS would I assume have to be properly accredited/monitored and would surely regularly test their processes to ensure results were valid and accurate so it would seem extremely unlikely you’ve had spurious results. If this genuinely concerns you raise it with your GP to see if they have any suggestions.
I wonder if you maybe had a good rapport with your old GP and haven’t yet established the same with someone at your new practice? I had a very good rapport with my GP for many years, but when they retired it took quite some time to adjust to other staff I had not consulted previously.
Thanks. All good points. I’ve always had a ‘sweet tooth’ so probably prediabetic for years but always quite physically active.
I was diagnosed when I saw my Scottish GP due to developing Ballanitis which I thought was due to a UTI but the GP said straightaway it would be high urine glucose. I also had all the usual symptoms and was an obese couch potato with barely the energy to walk the dog more than 100m.
I moved to NE England 4years ago and havent had a face to face appointment with a GP and nor even a phone call about my diabetes. (they’re very short staffed)
They seem to have passed all responsibility for diabetic patients to Nurse Practitioners but not the same one and she was taken aback when I refused the SGLT2 inhibitor as the second treatment. (I live alone and in the country so cannot risk a hypo or DKA, never mind the UTI side effects).
My concern is that I have lost about 20kg over 8years but this inclludes a lot of muscle so there is much loose skin where once there was muscle - upper arms, calves, thighs, chest, and there is little flab left, so I cannot afford to lose more muscle or I will become a couch potato again. (I have started using dumbells and a cycling machine to stem the losses)
The loose skin is an issue , I lost 43 kg out of 120 kg and I looked fine clothed but my bikini line was not a pretty sight
You can get cosmetic plastic surgery but at my age I hardly qualify as “Body Beautiful” so as long as it has no detrimental health effects why worry
I am serious about the carb crusade it does work to maintain body weight , keep you carb intake <150 g/day and maintenance of weight is almost assured. Go less say < 25 g/day and weight simply falls off
I do gentle gym exercises 3 days a week to maintain some muscle tone , also well worth it physically and mentally
BY keeping carbs low you must be helping any pre-diabetic conditions. That said its not an easy lifestyle , sadly most foods, restaurants etc have never even thought of low carb . Go out for a meal and carb control leaves half of it “BANNED”
I think losing that 43kg is a fantastic achievement.
Generally my carb intake is fairly low, though I suspect there are hidden carbs in wine which I do enjoy, or at least empty calories from the alcohol. I think I mentioned earlier I can eat generous portions of home made stir fries with loads of meat/veggies/mushrooms (no conventional rice or noodles) and blood sugar is fairly static. The other day we got a take away Chinese meal for the first time in ages, and although I avoided the rice there must have been loads of added sugar in the sauces which surprised me as they weren’t the typical ‘sweet’ dishes with sugary sauces.
I may have once reached 110kg but struggled to get below 95kg even after intense periods of exercise and dietary restriction years ago - losing fat and gaining muscle probably accounted for much of this which was a good thing but it’s increasingly hard to maintain muscle bulk as we age especially when aches/pains/sprains affect our ability to do what we used to.
I’ve really ramped up exercise in recent weeks, I feel thinner/more toned but was astonished to see I’d put 4kg on yesterday unless it was a spurious reading on the electronic scales. Maybe retaining fluid after trying many soy sauces out in dishes recently!
I am 69 so muscle wasting is to be expected and realistically, there’s no way to reverse it fully.
I am doing leg and upper body excercises to stop further wasting and to end that ‘weak’ feeling when I have to do something strenuous.
Recently, it’s been said that a few minutes excercise, or even just wallking about is good for keeping blood glucose and bp down.
My weight loss is now slow which is probably not surprising as I have little subcutaneous fat, although no idea how much visceral fat remains. (I was diagnosed a coupe of years ago with a fatty liver - NFA - non alcoholic fatty liver, but so far no fibrosis)
Obsessing over the bathroom scales is not good and the BMS is rubbish unless you are one of NICE’s average humans. It’s only quite recently that the BMS has had to take into account build - i.e. muscularity and bone thickness.
I took part in the DIabetes Remission study run by Glasgow and Newcastle Unis but was in the control group. It meant regular full bloods and various measurements but of course, no special treatments or diets. I do wonder whther the test subjects have managed to maintain their low Hba1c readings - probably some have and some haven’t.
Yes, BMI (I assume) is not an ideal measurement.
Many years ago I went to see my Consultant endocrinologist and he told the ‘observing’ medical student there that although my BMI was quite high it was probably not that high for someone with a mesomorphic body habitus who’d played as a front row forward in rugby!
Too many generalisations don’t help us.