Author Topic: I got 99 problems...  (Read 4414 times)

Valiant

  • aka Sam
    • Radiance Audio
I got 99 problems...
« on: 23 July, 2018, 03:29:54 am »
So had a health check up recently, I've been diagnosed with diabetes and have been put on 4x 500mg Metformin a day. It was hellish at first with convulsions etc but hardly notice them now.


The results are a bit of scare but my docs are also a bit confused.

BMI: 44.1. I'm short, fat but with a lot of strong muscles. So no surprise there but it is down from 51.2 a few years ago when I was ballooning due to depression and illness.
Blood Pressure: 120mmHg / 80 mmHg. This is great as it falls into the normal good range, we'd expect to see much worse for something with diabetes.
Cholesterol: 4.8mmol/L. This is apparently good aswell considering how bad my hbA1c is. They say 2-4 is good, 4.1-6 is moderately high and 6.1 to 7 is very high.
Blood Test eGFR: >90ml/min. It was 138ml/min back in 2011. They say that normal function level is 60 and above, and moderate being below 60-40. I take it this is good?
Urine Test ACR/PCR: 7.1mg/mmol.  They say below 3 is healthy  :-\
HbA1c: It's now 99 mmol/mol  :jurek:  vs 44 in 2015. How the fuck did it get so bad, but also how the hell is that so bad when my other stuff isn't as bad? 42-48 (6-6.5) is good, 53-59 (7-7.15) is ok, 64 (8) is high, 69-86 (8.5 to 10) is very high.

So I've changed my diet a bit, I now eat smaller meals more often, I've cut out most of the carbs, eating mostly steamed or raw very along with more fish. I'm now on 1 coffee a day usually with 1 sugar, this is normally around mid day. Rest of the day I'm drinking tea and herbals without sugar if needed. I've increased my water intake to around 3l especially in this heat. I've stopped drinking my can of coke and bottle of OJ once a day. Alcohol isn't an issue. I've also stopped the sweets.

What I'm having the most trouble with is breakfast. What can I have cereal like that is fast and isn't too bad? My usual cereals were weetabix, shreddies, muesli. When I have time and effort I usually go for a handful of spinach, and two dry fried eggs (no oil or butter) and a grapefruit. I've also cut out most fried foods ie fried chicken, burgers etc and go for grilled where I can if I fancy meat.

Also what can I snack on? Like I love carrot sticks and celery but there's only so much you can have. Any nuts still good?
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Auntie Helen

  • 6 Wheels in Germany
Re: I got 99 problems...
« Reply #1 on: 23 July, 2018, 05:31:35 am »
Snack on olives?
My blog on cycling in Germany and eating German cake – http://www.auntiehelen.co.uk


Re: I got 99 problems...
« Reply #2 on: 23 July, 2018, 06:22:18 am »
For breakfast try to love porridge or oat cakes, the latter as snack. Oats are slow release carbs which should limit the blood sugar spikes, spruce it up with a bit of cinnamon 👍

A

ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: I got 99 problems...
« Reply #3 on: 23 July, 2018, 07:20:49 am »
Breakfast, I'm partial to a two egg omelett.

Look up Overnight Muesli on the been, very tasty and about 20-25g carbs per portion. 

Have they definitely diagnosed you as T2?  If so look up DESMOND and the Newcastle diet for a few ideas. If you can afford it, also worth buying yourself enough test strips to allow you to build a pre and post meal profile (2-3 hours post meal) to help you understand how different foods affect you
“Procrastination is the thief of time, collar him.” –Charles Dickens

Re: I got 99 problems...
« Reply #4 on: 23 July, 2018, 09:59:39 am »
Listen to people who are diabetics.
Don't follow fad diets

Avoid artificial sweeteners; they mess with the signals to your pancreas (not good for diabetics and that doesn't help with water retention and weight loss).

I think keeping carb intake down helps a lot with weight loss. Inadvertently I've done this and lost quite a bit over the last 4 months. 9kgs and counting.
<i>Marmite slave</i>

Re: I got 99 problems...
« Reply #5 on: 23 July, 2018, 10:38:40 am »
For breakfast try soaking porridge oats in unsweetened almond milk overnight in the fridge. In the morning chuck in a handful of rasberries and blueberries then top with unsweetened soya yoghurt.

Sounds boring and a bit 'worthy' doesn't it? It's actually really tasty, nutritious and healthy. Daughter chucks in chia seeds, macca powder (whatever that is) and sometimes a splash of vanilla essence.
Hear all, see all, say nowt

ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: I got 99 problems...
« Reply #6 on: 23 July, 2018, 12:40:46 pm »
That's pretty much the overnight muesli, but it adds grated apple, and yoghurt ( I use full fat Greek, but then I'm only 66kg), plus chopped nuts and cinnamon.

I'm T1 BTW and have adopted a low carb diet, typically 50-75g carbs a day.
“Procrastination is the thief of time, collar him.” –Charles Dickens

Valiant

  • aka Sam
    • Radiance Audio
Re: I got 99 problems...
« Reply #7 on: 23 July, 2018, 02:43:27 pm »
Why leave it overnight?
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Re: I got 99 problems...
« Reply #8 on: 23 July, 2018, 02:52:46 pm »
Needs to soak up the milk. - better put by Helly below.
ETA - another porridge user here.
With added black, blue and raspberries - some hazelnuts, pine nuts and goji berries.
I can't say I particularly like it, but its supposedly a very healthy way to start the day.

hellymedic

  • Just do it!
Re: I got 99 problems...
« Reply #9 on: 23 July, 2018, 02:54:12 pm »
To swell and soften the grains.

25 grams of soaked oats are bulky and filling. 25g dry oats doesn't seem like much/enough.

ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: I got 99 problems...
« Reply #10 on: 23 July, 2018, 03:08:39 pm »
On specifics, it might help you to keep a very detailed dietary log for a while, might indicate excess carbs, or just general consumption, remembering that T2 is either body not responding adequately to insulin being produced, or pancreas not producing sufficient.

Also looking at your BMI, and noting the multiple functions of insulin
1) glucose transport to excercising muscles
2) lay down of excess glucose as fat stores for later
3) suppression of use of fat stores in preference to circulating glucose.

Reduction in refined carbs will certaintly help in reducing insulin spikes, with consequent crashes of blood sugar as excess is squirreled away, all the dietary notes above are emphasising unrefined carbs which give much gentler curves on the rate of rise of BG.  Worth going out and looking up tables of carb contents and more importantly for T2 Glycaemic Index.

“Procrastination is the thief of time, collar him.” –Charles Dickens

Valiant

  • aka Sam
    • Radiance Audio
Re: I got 99 problems...
« Reply #11 on: 23 July, 2018, 03:12:57 pm »
Fab thanks
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LEE

  • "Shut Up Jens" - Legs.
Re: I got 99 problems...
« Reply #12 on: 23 July, 2018, 03:29:25 pm »
Assuming you're talking about Type 2 Diabetes:

From what I've read eating small amounts, regularly, is counter-productive.

I'd recommend watching Dr Jason Fung videos but, to summarise his findings (He specialises in T2 DB):

- T2 Db is an illness caused by resistance to insulin
- The resistance is caused by continual over-exposure to insulin
- Over-exposure to insulin is caused by consuming food (mostly carb related but not exclusively carb-related) too frequently and never having an insulin-free period.
- Over-exposure to insulin means your body doesn't process sugars, this triggers more insulin, to deal with the sugars.
- More insulin compounds the resistance
- Medical treatment for Insulin resitance (T2 Db) is to prescribe Insulin
- Addition prescription Insulin compounds the problem
- Eventually you are totally resistant to insulin and then it's incredibly serious

What he recommends:
- Give your body as much time as possible free of insulin
- To do this you leave gaps between insulin spikes (which are normal after eating)
- make those gaps as long as practically possible.
- Try eating just once a day and leave 18-20 hours between insulin-raising meals/drinks.

You probably know all this but if not, it's life-changing stuff.  I used it for weight-loss, not diabetes, beecase the presence of insulin 100% switches off the ability to burn fat (lose weight).

Insulin spikes are normal after a meal.  What is abnormal is the way the western diet has changed to a constant Carb-snacking diet. 
What is "normal' is to eat a meal and then not to eat again for quite a long time.  That's what we did for hundreds of thousands of years.   
Evolution hasn't quite caught up with out Kellogs Crunch Nut for breakfast - Hobnobs for elevenses - Sandwich for lunch - Can of Coke - Doughnuts with afternoon coffee - Spag Bol for dinner - A few more Hobnobs for supper - habits.

The Insulin/Carb cycle explains (to me anyway) the catastrophic rise in obesity and diabetes.


I know it's more complicated that that.

Some people say I'm self-obsessed but that's enough about them.

Re: I got 99 problems...
« Reply #13 on: 23 July, 2018, 03:41:46 pm »
To swell and soften the grains.

25 grams of soaked oats are bulky and filling. 25g dry oats doesn't seem like much/enough.

Even soaked, I wouldn't say 25g is a lot! I use 40g for overnight oats, same as I would for porridge (in the winter)...

Overnight oats are tasty though - Google has loads of ideas for recipes. I like to experiment and keep various flavourings (vanilla essence, cinnamon, lemon essence etc.) in my desk drawer at work, and I brought a grater in to the office kitchen so I could grate apples and carrots. :D

Valiant

  • aka Sam
    • Radiance Audio
Re: I got 99 problems...
« Reply #14 on: 23 July, 2018, 03:48:27 pm »
Assuming you're talking about Type 2 Diabetes:

From what I've read eating small amounts, regularly, is counter-productive.

I'd recommend watching Dr Jason Fung videos but, to summarise his findings (He specialises in T2 DB):

- T2 Db is an illness caused by resistance to insulin
- The resistance is caused by continual over-exposure to insulin
- Over-exposure to insulin is caused by consuming food (mostly carb related but not exclusively carb-related) too frequently and never having an insulin-free period.
- Over-exposure to insulin means your body doesn't process sugars, this triggers more insulin, to deal with the sugars.
- More insulin compounds the resistance
- Medical treatment for Insulin resitance (T2 Db) is to prescribe Insulin
- Addition prescription Insulin compounds the problem
- Eventually you are totally resistant to insulin and then it's incredibly serious

What he recommends:
- Give your body as much time as possible free of insulin
- To do this you leave gaps between insulin spikes (which are normal after eating)
- make those gaps as long as practically possible.
- Try eating just once a day and leave 18-20 hours between insulin-raising meals/drinks.

You probably know all this but if not, it's life-changing stuff.  I used it for weight-loss, not diabetes, beecase the presence of insulin 100% switches off the ability to burn fat (lose weight).

Insulin spikes are normal after a meal.  What is abnormal is the way the western diet has changed to a constant Carb-snacking diet. 
What is "normal' is to eat a meal and then not to eat again for quite a long time.  That's what we did for hundreds of thousands of years.   
Evolution hasn't quite caught up with out Kellogs Crunch Nut for breakfast - Hobnobs for elevenses - Sandwich for lunch - Can of Coke - Doughnuts with afternoon coffee - Spag Bol for dinner - A few more Hobnobs for supper - habits.

The Insulin/Carb cycle explains (to me anyway) the catastrophic rise in obesity and diabetes.


I know it's more complicated that that.



So going into Ketosis then? I can happily do that, I do that during ramadan. But then I've read that giving up the carbs and eating fat, protein and veg does the same?

Anyways, this morning I was 10.4, and then 3 hours after food (Mushroom omelette and salad, coffee with one sugar) it has gone upto 11.8. The metformin does seem to be working, before I was using it my standard was around high 20s, low 30s and the lowest i saw was 24. But now my average seems to be around the 15 marker.
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ElyDave

  • Royal and Ancient Polar Bear Society member 263583
Re: I got 99 problems...
« Reply #15 on: 23 July, 2018, 04:00:36 pm »
Sounds like good progress already.  Ask for an HbA1C again after 4-6 months, it can come down dramatically.  Mine dropped from 129 to 46 in three months, now steady around the mid 40's. 

To pick up on LEE's post - Prescribed insulin is a MAYBE for a T2, if you can manage it with diet, excercise and metformin that is by no means a certainty.  If you are of Asian descent, as it sounds, I'd definitely be cutting out rice, roti, naan, all those wonderful indian sweets etc.  Don't overdo the protein, that is just a waste and can result in gluconeogenesis, look to replace carbs with veg for fibre and nutrients and good healthy fats.
“Procrastination is the thief of time, collar him.” –Charles Dickens

Valiant

  • aka Sam
    • Radiance Audio
Re: I got 99 problems...
« Reply #16 on: 23 July, 2018, 04:07:01 pm »
Yup all done, I never liked the sweets and naan anyway. Chapati's are still ok in moderation though right ie instead of rice? Yep I am south asian.
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LEE

  • "Shut Up Jens" - Legs.
Re: I got 99 problems...
« Reply #17 on: 24 July, 2018, 02:29:43 pm »
So going into Ketosis then? I can happily do that, I do that during ramadan. But then I've read that giving up the carbs and eating fat, protein and veg does the same?

Anyways, this morning I was 10.4, and then 3 hours after food (Mushroom omelette and salad, coffee with one sugar) it has gone upto 11.8. The metformin does seem to be working, before I was using it my standard was around high 20s, low 30s and the lowest i saw was 24. But now my average seems to be around the 15 marker.

Not necessarily as radical as going into Ketosis (Though that's what I'm currently gong for, to lose weight) but definitely not triggering Insulin so many times during the day, giving your body as much insulin-free times as is sustainable for your lifestyle.

Anything too extreme is not sustainable but something as simple as having your last meal of the day at 6pm and your first meal at midday can have a very positive impact, and is an easy habit to stick with.
18 hours a day for your body to start becoming more sensitive/responsive to insulin again (AND 18 hours a day for your body to burn fat reserves).

* Be aware that some stimulants (Caffeine for example), even though zero calorie, can trick your body into an insulin spike.  If in doubt...drink water.

I'm currently drinking water and coffee, not optimal, but I only started yesterday and I need coffee as an initial appetite suppressant, until my stomach realises it's not getting anything for a few days.  The first 24-48 hours are always the worst (but why am I telling this to someone who practices Ramadan?) :-)

Some people say I'm self-obsessed but that's enough about them.

LEE

  • "Shut Up Jens" - Legs.
Re: I got 99 problems...
« Reply #18 on: 25 July, 2018, 12:36:46 pm »
It seems that most of the Youtube Doctors I have been following for a year have made it into a movie about Fasting and its benefits.

Fasting the Movie

Looks like it is set to impact a lot of people.  All the reasoning behind it make perfect sense to me. 

It's fundamentally about reverting to a pattern of eating we evolved to cope with (Feast/Famine cycle).  Why wouldn't that be a sensible idea? 

Conversely why would it be sensible to develop a pattern of eating that put our evolved mechanisms under extreme stress?*

*And is proven beyond any doubt to cause obesity and diabetes, in epidemic proportions.
Some people say I'm self-obsessed but that's enough about them.

Re: I got 99 problems...
« Reply #19 on: 25 July, 2018, 02:25:48 pm »
To swell and soften the grains.

25 grams of soaked oats are bulky and filling. 25g dry oats doesn't seem like much/enough.

Even soaked, I wouldn't say 25g is a lot! I use 40g for overnight oats, same as I would for porridge (in the winter)...

Overnight oats are tasty though - Google has loads of ideas for recipes. I like to experiment and keep various flavourings (vanilla essence, cinnamon, lemon essence etc.) in my desk drawer at work, and I brought a grater in to the office kitchen so I could grate apples and carrots. :D

We make our own muesli - rolled oats, toasted barley flakes, wheat flakes etc., add pistachios, pecans, and  dried fruits, generally apricots, dates, prunes, figs, sultanas, all chopped (well not the sultanas) and soak overnight - I used skimmed milk. In the morning top with fresh fruit, atm it’s strawberries and white peaches, add a dollop of yogurt and a few toasted whole almonds. Really keeps you going through the morning!
We are making a New World (Paul Nash, 1918)

Valiant

  • aka Sam
    • Radiance Audio
Re: I got 99 problems...
« Reply #20 on: 25 July, 2018, 02:45:10 pm »
To swell and soften the grains.

25 grams of soaked oats are bulky and filling. 25g dry oats doesn't seem like much/enough.

Even soaked, I wouldn't say 25g is a lot! I use 40g for overnight oats, same as I would for porridge (in the winter)...

Overnight oats are tasty though - Google has loads of ideas for recipes. I like to experiment and keep various flavourings (vanilla essence, cinnamon, lemon essence etc.) in my desk drawer at work, and I brought a grater in to the office kitchen so I could grate apples and carrots. :D

We make our own muesli - rolled oats, toasted barley flakes, wheat flakes etc., add pistachios, pecans, and  dried fruits, generally apricots, dates, prunes, figs, sultanas, all chopped (well not the sultanas) and soak overnight - I used skimmed milk. In the morning top with fresh fruit, atm it’s strawberries and white peaches, add a dollop of yogurt and a few toasted whole almonds. Really keeps you going through the morning!

That sounds amazing. And like too much effort. Why not just buy it? Or is it because of the added sugar etc?
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hellymedic

  • Just do it!
Re: I got 99 problems...
« Reply #21 on: 25 July, 2018, 02:50:33 pm »
Mixing dry ingredients is not much effort. Buying might be.
You generally get more bang for your buck if you mix your own.

Be VERY wary of portion sizes for any kid of muesli. Given your health issues, I really don't think you should exceed 30 grams dry weight per portion.

LMT

Re: I got 99 problems...
« Reply #22 on: 05 August, 2018, 08:39:27 am »
Assuming you're talking about Type 2 Diabetes:

From what I've read eating small amounts, regularly, is counter-productive.

I'd recommend watching Dr Jason Fung videos but, to summarise his findings (He specialises in T2 DB):

- T2 Db is an illness caused by resistance to insulin
- The resistance is caused by continual over-exposure to insulin
- Over-exposure to insulin is caused by consuming food (mostly carb related but not exclusively carb-related) too frequently and never having an insulin-free period.
- Over-exposure to insulin means your body doesn't process sugars, this triggers more insulin, to deal with the sugars.
- More insulin compounds the resistance
- Medical treatment for Insulin resitance (T2 Db) is to prescribe Insulin
- Addition prescription Insulin compounds the problem
- Eventually you are totally resistant to insulin and then it's incredibly serious

What he recommends:
- Give your body as much time as possible free of insulin
- To do this you leave gaps between insulin spikes (which are normal after eating)
- make those gaps as long as practically possible.
- Try eating just once a day and leave 18-20 hours between insulin-raising meals/drinks.

You probably know all this but if not, it's life-changing stuff.  I used it for weight-loss, not diabetes, beecase the presence of insulin 100% switches off the ability to burn fat (lose weight).

Insulin spikes are normal after a meal.  What is abnormal is the way the western diet has changed to a constant Carb-snacking diet. 
What is "normal' is to eat a meal and then not to eat again for quite a long time.  That's what we did for hundreds of thousands of years.   
Evolution hasn't quite caught up with out Kellogs Crunch Nut for breakfast - Hobnobs for elevenses - Sandwich for lunch - Can of Coke - Doughnuts with afternoon coffee - Spag Bol for dinner - A few more Hobnobs for supper - habits.

The Insulin/Carb cycle explains (to me anyway) the catastrophic rise in obesity and diabetes.


I know it's more complicated that that.

You'd do very well to understand what the primary job of insulin does in the body (none of which I see from the above), from there it would give you a better understanding of how insulin resistance comes about.
https://www.youtube.com/watch?v=5KWAgKR9JBE



Re: I got 99 problems...
« Reply #23 on: 05 August, 2018, 02:30:01 pm »
I am not sure we know what the PRIMARY job of insulin has been in evolutionary terms.

I think you could make a very good case for insulin's primary role in evolution being the storing of excess sugar as fat in the summer and autumn in times of plenty and that the blood glucose control is a mere side effect.

hellymedic

  • Just do it!
Re: I got 99 problems...
« Reply #24 on: 05 August, 2018, 03:37:47 pm »
I am not sure we know what the PRIMARY job of insulin has been in evolutionary terms.

I think you could make a very good case for insulin's primary role in evolution being the storing of excess sugar as fat in the summer and autumn in times of plenty and that the blood glucose control is a mere side effect.

[Tangential musing] I haven't given this much thought or really studied it in any detail but it strikes me that a high blood glucose is metabolically harmful and could quite easily occur during (eg) a fruit glut.