I’ve been following Atkins, doing low-carb, to control my numbers. It was working well, I only took 1 Prandin at breakfast (dawn phenomenon issue), and was able to control my bs and lose weight. I’ve lost 41 pounds since diagnosis in 8/08.

Now the problem. I have gallstones and will be having my gallbladder removed in 2 weeks. Surgeon told me to stop the low carb/high fat as it is only aggravating my problem and I won’t be able to follow Atkins after surgery. I’ve changed my diet to a more South Beach diet approach but my numbers have jumped :frowning: and I’m back to taking the Prandin before all meals. I’m sure the weight loss will stop also. (It was slow enough before!)

What do I do now? It seems everytime I figure out something that will work for me, I have to change it. I plan to go to a dietician/nutritionist after surgery for some help but would appreciate any thoughts on what I could do now. Thanks:)

Am happy for you, losing the 41 pounds. And YES seeing a dietitian will help a lot, I saw one yesterday and she gave me too much information and many options and ideas to do for losing weight
Let me share couple of links for ideas and programs that I found interesting, she gave it to me:

The Joy of Mindful Eating Camp

another one is called DASH

Hope these helps, take care and good luck

Congratulations on losing 40 lbs!

You should be able to do low carb after your surgery with moderate fat & adequate protein. That’s what I follow. Of course, eating the right fats is important:) How many carbs are you eating now?

Hope you have better luck than I have with dieticians/nutritionists than I have. The ones I’ve worked with push way too high carb ADA guidelines, for diabetics.

Seems like the way to wealth in our country is to push a diet plan. All promise the sun & moon & cost a fortune to join.

That is a great achievement you have there, congratulate yourself. I agree with Gerri, forget about a diet plan as such. I tend to eat mostly salad, fruit, veg and a bit of bread. It is far lighter on the digestive system and therefore leaves you with more energy. That is just what works for me, but as you know everyone is different. I’m not informed about your meds at all so I can’t comment on those. Good luck with the diet and look at how far you have come.

Thank you for the links and good thoughts. I’ll check them out!

Hi Gerri,
I was eating around 20-30 carbs per day. Now I am eating around 60 per day. I saw a nutritionist before and wasn’t impressed, as you said, carb were too high using ADA. I’ve done entirely too many diet plans for too many years and all I have lost is a lot of money. Thanks for your help!

I agree, I am getting tired of trying to follow a “set” plan for eating. The way you eat sounds so sensible and healthy, maybe I’ll try that. Thank you for your kind words!

Hi Teresa,

I eat about 30 carbs, not particularly high fat, though not low fat. A far cry from the 45-60 carbs per meal our ADA friends recommend:) I walked out on one diabetic nutrition class sponsored by the local hospital & never went back to another nutritionist. It was the same ole, same ole info with their food pyramids.

Gotta say that those diet gurus with their latest & greatest really annoy me! Snake oil salespeople & they make a lot of money until the next fad comes along. Amazing how little info they put on their sites & expect people to give them money for the latest weight loss secret.

After your surgery I would talk to your doctor and dietician about what foods you definitely shouldn’t be eating. I do low carb ( about 50-75 a day) But I don’t eat a lot of meat. I do eat eggs and cheese. Do you have a Trader Joes near you. They have a new frozen dinner called Polenta Provencal - 10 carbs a serving and it only takes 5 min to cook. They also have low carb sprouted bread (7 c-3 fiber) a slice. It makes great toast and lets you have sandwiches. I eat lots of grilled vegetables ( mushrooms, squash, peppers, tomatoes). I’ve started to use Dreamfields Pasta ( 4 net carbs a serving) Somehow they lock the carbs in. I have to limit serving size. But it is great mixed with veggies, pesto and a little chicken or fish. I eat a lot of nuts, not sure if they are ok with gall bladder problems. The other thing I eat is soymilk smoothies. I take 1/2 - 1 c frozen berries, add lite soymilk, whey powder and cinnamon and blend in a small blender. They are low fat, low carb and high protein. There are lots of things that are low carb without eating meat. Tonight I’m going to try to make a pizza using shredded zucchini, cheese and eggs for the crust and then adding pizza fixing on top. It’s not easy to cook low carb but for me this is a lifesyle. You’ve done great with you weight loss and I know you’ll get over this road bump and figure a way to continue losing. Good Luck

Dear Teresa.

This is like stuck between the devil and the deep blue sea. Might be an idea to go on insulin. One thing that I have found out is that insulin resistance really increases when your blood sugars are too high. The more insulin resistant you are the more difficult it is to control weight. You have done a great job so far.

If the orals are not adequate to control the BG on a low carb diet they will be a lot worst with more carbs. Might be way netter to start insulin sooner than later the less insulin the easier it is to control weight.

Thanks for the suggestions. I do have a Trader Joe’s near me so I will have to check it out.


I’ve been thinking along the lines of insulin also. After surgery I plan to find an endo. My primary doctor is not comfortable prescribing insulin. This insulin resistance crap really stinks.

Have you had any luck trying Metforim again? Thanks for your ideas.

Have you thought about Byetta? I was using insulin before byetta, but carefully watching my carb intake. Have been on byetta for 2 1/2 years now, have lost 20 pounds (am now at my ideal weight, just could not lose those 20 pounds while on large doses of insulin) and can now eat carbs which I could not eat before. I could not eat any fruit without having a massive bg spike. So I limited myself, to 1/2 an apple a couple of times a week. Now I can eat fruit at least 3 times a day, without bg spikes. My current A1C is 5.7, and over the past two years has ranged from 5.3 to 6.0. I have been able to stop taking humalog (short acting insulin) and have reduced the amount of lantus I take to 15 units from 50 units. I would suggest that you try and find an endocrinologist, my experience with dieticians was that they advocated too many carbs in the diet.

I had not really thought about Byetta, but will look into it. After surgery, I am definitely going to find an endocrinologist. I would love to eat some fruit again. So far, I just can’t handle it. Great job on your a1c. Thanks for your help.

I had my gallbladder out and now follow atkins without difficulty. But I do suggest not being at atkins until after you have your gallbladder out and have recovered.

Thanks Misty. It would be great if I could go back to following atkins, it really gave me good control.

Dear Teresa

Yes the PCP or GP are chicken ■■■■ when it comes to insulin. I don’t see why it is less dangerous than a lot of the other stuff the hand out by the tonne like anti-depressants which cause you to gain weight like crazy.

You can definitely combine insulin and metformin. If you can tolerate the metformin then it will lower the amount of insulin you need. I pop a 1000 mg of metformin on occaision with a meal and it does help. Not sure if I can take 2000 mg per day on a continuous basis. I go dead tired and some people get uncontrollable GI upset which I don’t if I take with food.

It is important that you keep your BG in the normal range as much as possible because high blood sugars increase the insulin resistance another perverse effect.

Hey Teri,I’ve been thinking about Byetta. I’m on 20 units of Lantus and having great fasting numbers,but not crazy about them on the Januvia during the day.I’ve read a little about it,did you or do you have a hard time figuring out just when to take it? Thanks

Hi Melody - the recommendation is to take Byetta at least 6 hours apart with your meal. Lots of people do breakfast and dinner, but I prefer to do lunch and dinner. I have to make sure to be sure to allow for the 6 hours between injections though, as I have had extreme nausea if it was less than 6 hours. I usually take my injection and eat immediately, others wait to get more appetite suppresion. It is suggested to eat within one hour of taking byetta, I eat immediately, as it helps with decreasing the nausea. When I went on byetta I had great bg numbers, my A1c was 5.3, but I was on large dosages of humalog and lantus. I exercised vigorously 7 days a week with an hour of aerobic training and 45 minutes of weight training, but I could not lose weight due to the amount of insulin I was taking. Since going on Byetta, I have been able to reduce the amount of lantus and eliminated taking short acting insulin (humalog - used to take about 90 units a day). I was skeptical at first about taking Byetta, as I had good bg control on insulin, but once I went on it and started to lose weight, I became a believer. My fasting numbers are 85-90, pre meals 95-105, two hours post prandial 80-90, four hours post prandial 120-130. My spikes come around 4-5 hours post meal, due to the slower stomach emptying. It was a learning experience when I was still taking humalog, as I would give myself an injection with a meal, and experienced some drastic lows, until I started taking my humalog abut 3 hours post meal. Eventually I was able to decrease the amount of humalog to nothing. That was what was the hardest to figure out.

Chalk one up to another Byetta fan. What helped me to manage my diabetes in my 30s was the Zone diet. I learned so much from eating a low-fat protein choice with a low glycemic index carb at all times, and then maybe a smattering of fat in an olive, nut, or avocado along with that. My body seemed to really be able to metabolize all I ate better when I followed that diet. I still to this day, follow its principles, but I am not as religious about it.

I also worked out quite a bit, which seriously reduced my insulin sensitivity.

Then I hit 40 and it all went to hell in a handbasket.

Insulin only made it worse, and Byetta has saved me.

Incidentally, I am sans gallbladder also, but had mine removed right after my 1st pregnancy, which went undetected as gestational. It wasn’t until my latter two pregnancies that I was finally “discovered” as a diabetic.

Good luck - you know for everyone, it is different, but I can echo a lot of others’ thoughts here - an endo is like a good road map. Together, you can navigate the territory to figure out where to go.