Treatment advice needed please

Hi everyone, I am a Type 2 (NIDDM).

I have been experiencing rapid weight loss over the past couple of months, since I was diagnosed. This is caused by my not being able to eat in order to keep my spikes below 140. I went from about 192 down to 148 this morning, with most of my weight loss occurring in the month of december. I am below the 150 mark, and my weight is considered in the normal range for my height. I can suspend my weight loss by eating more food, but my averages creep up for the past week.
I am just buying time until I see my endo. They will be my first appt with them. The other 4 doctors ignored my diabetes and wanted to check me for everything else first like cholesterol.
Cholesterol will kill me in 20-30 years, but diabetes can kill me now. Go figure?

Mornings, I can eat 1/2 grapefruit and 1 egg and stay below 140.

Later in the day, I can usually eat about 15g to 20g of carbs and keep under 140.

Most days, I hover around 50g of carbs for the whole day.
My dietitian wants me to eat 75g of carbs 3 times a day plus 2 snacks. I won’t do it! If 15g of carbs spikes me to nearly 140, 75g will spike me to 300. Incidentally, 75g did spike me to 294. If I eat greasy pizza, I can eat 100g of carbs and be nearly 200, but fasting numbers are quite high for days afterward.

Every once in a great while, I can get lucky and eat 30g of carbs and be under 140, but rarely.

My fasting numbers are almost always below 100 in the mornings.

I have seen them as low as 69, but usually either in the mid 80’s and mid 90’s, depending on what I ate the night before.

I have an appointment with an Endo on Feb 23rd and was wanting to know what medications I should ask for.

Here are my dietary requirements:

I need to eat 70% or more of my daily caloric needs in the form of carbs, but absolutely no veggies whatsoever (non negotiable, ever). This must include Wheat products (low carb whole wheat bread is part of that) and grains like oatmeal (cholesterol reasons).

Right now, I can eat maybe 3-4 meals a day, but when the weather warms up, I can only eat 2 meals a day, unless the doctor wants me to eat junk food (McDouble with cheese and fries) at McDonald’s drive thru for my middle meal. I do not eat non American foods like Taco anything or etc. No wraps either.

Both meals need to be high carb meals, between 100-250g each to get my needed calories in. Quality meat is far too expensive for me to afford, nor can I drop everything, run home and prepare something. I cannot take anything with me either.

I wanted to know what I should ask my endo for to accommodate my dietary requirements and lifestyle needs.

Also, I know that my endo will probably not want to do it this way, but if they don’t, then how do I convince them to treat my needs?

I will be stuck with the following choices:
1) Continue not eating and die from starvation (current method).
2) Eat anyway and accelerate my diabetes complications, thusly dieing early with a horrible death.
3) Get meds to keep me from spiking above 140 for my 2 hour postprandial.

I am having an awful time treating this, but I do have my blood sugars under some reasonable control.

Look at my blood sugar logs please:
http://manage.sugarstats.com/zolar1

Based on those fairly good numbers, how then can I get meds?
I wanted Metformin and Byetta or Metformin and Victoza, or even Metformin and Insulin.

Right now, I am eating between 800 and 1000 calories per day on average. This is far less than what I will need when winter is over, FAR LESS.

Due to other health problems like bad back and bad knees, It is difficult to do much exercise except walking most of the time.
I can’t do hardly anything when the weather is cold, but generally am fairly active in the summer months. (7-year old son keeps me pretty busy when we can go outside :slight_smile: )

I am not looking to abuse the meds like so many of the diabetic people I know in real life (both type 1’s and type 2’s). They are crazy. They eat Junk Food all day long, drink 2 liter bottles of sugary soft drinks, and tons of other bad things.

I just want to eat normally with my 2 meals a day. Normally for me would be a lousy bowl of Wheat Chex (2 cups) with a sliced up banana in it, or a bowl of oatmeal and a clementine, or something as simple as a peanut butter & low sugar strawberry preserves sandwich (my favorite) and a bowl of Tomato soup.

I don’t want to eat after 6pm if I can help it. Not only does it raise my fasting numbers, it will also make me gain back all that weight I lost.

I don’t use sugar, I use Sun Crystals.

Also, my last blood pressure test came back at 100/70. And that’s by just not eating salt and no meds for it either.

My next one will be higher though. Stress…

Yowza. You sound a bit like me. I had a terrible struggle with my doctors over the whole cholesterol thing. The doctors wanted to treat my diabetes by lowering my cholesterol. What kind of whacked treatment is that. In the end after extensive reading and study on my own I concluded that I needed forcefully decline cholesterol treatment and instead focus my diabetic treatment on lowering my blood sugar. In the end, the statistics are clear, the added risk heart attacks from elevated blood sugars (even after correcting for cholesterol levels) is four times the risk from cholesterol If you want to reduce your risk of heart problems, your first order of business should obviously be your blood sugar.

That being said, if you want to reduce your blood sugar, reduce the carbs in your diet. Target 30% of your calories from carbs and then work to get lower values. Some of us get less than 10% of calories from carbs. Next, get your brain around eating healthy fats. Yes, avoid transfats, but other fats are good for you. Also eat protein, eat lots of meat, seafood and dairy, try to get get at least 1-1.5 grams per pound of bodyweight.

Whoever told you as a diabetic to go on an all carb diet should be taken out back and whipped.

Hi, Zolar
I am an endocrinologist. From everything you said, likely you have autoimmune diabetes (LADA), not type 2. In this case your pancrease does not make enough insulin to cover your meal, unless it contains very few carbs. But restrictiong so much usually results in weight loss (if you only consume 800-1000 kcal/day you are goona loose 2 lb a week). Metformin is not a drug for you, it helps to control fasting BS but not post-meal BS. I doubt Byetta or Victoza will work eigher. You need eigher meal type insulin (rapid acting) with all of your meal, or you can start with pills that can stimulate your pancrease to make more insulin (it will work for a while). These pills are - glipizide and glimepiride. Your PCP can start you on this until you see an endocrinologist. Dietitian is not goona help you, because you already see that to control your blood sugar you need to restrict your carb intake and by doing so you are losing weight. For now until you see a doctor to stop weight loss we should increase your caloric intake by increasing calories from protein and fat (tuna salad, steak, eggs etc). Hope, it helps.

I am really quite surprised to see you come out and suggest Zolar is a LADA. On what basis? Poor Zolar has been given what I consider “wacko” dietary advice, he is an adult male eating by his estimate 800 to 1000 calories a day, do you think that might be why is losing weight? Is his blood sugar control really bad? He ate a pizza of 100g and he went to “nearly 200.” He said his fasting blood sugar is usually under 100. I see nothing which would indicate leaping to LADA. My fastings are 130-140 mg/dl with tight diet, exercise and three inneffective medications and if I eat more then 20-30 g of carbs I go to 200 mg/dl. That is poor blood sugar control. Poor Zolar has been given poor and conflicting dietary advice and is trying to work through it.

Zolar has been given an initial diagnosis of diabetes and is using diet and exercise as a treatment. He was only diagnosed on 11/24 of last year. His writing gives some indication that with a low carb diet, he could readily control his blood sugar. If that is not the case, a first step would be to prescribe metformin and see if he makes improvements. I don’t see any indication that metformin (or byetta) would be bad for Zolar. In my view, leaping to LADA is not appropriate. He does need help in navigating the conflicting advice he has been given.

ps. And I am not a fan of sulfonylureas.
pps. And if you did not guess it already, I am a difficult patient.

Dieticians push higher carb ADA guidelines & constant snacks. Do what works for you. Your fasting is great. Congratulations.

Please check out Jenny’s site & book http://www.bloodsugar101.com

I don’t understand your statement “I need to eat 70% or more of my daily caloric needs in the form of carbs.” Why? Also don’t understand that this must include wheat products.

Grains will raise BG instantly. There are other ways to get fiber other than from oats & other grains. Don’t believe the Quaker Oats commercials:) The best way to improve lipids is by controlling your blood sugar. Do this by whatever means you can, whether it’s oral meds or insulin.

Find a doctor who’s supportive of your goals to have more normal BG & who will prescribe what you need. Sometimes we have to be pretty assertive with doctors. What’s your A1c?

Sufficient protein will prevent too much weight loss. Sufficient good fats will keep you from being hungry. You can get the calories you need from protein & fat, not carbs. You don’t have to buy expensive cuts of meats. Do you like eggs, cheese, turkey, chicken, fish, nuts?

Swimming is a great low-impact exercise, if there’s a community center indoor pool or YMCA near you. Some colleges allow the use of their pool by non-students. You can also use weights. Building muscle mass increases insulin sensitivity.

Some low carb recipe sites:
Linda’s Low Carb Menus & Recipes http://genaw.com/lowcarb/index.html
The Low Carb Cafe www.lowcarbcafe.com
Low Carb Luxury http://www.lowcarbluxury.com/index.html
Simply Recipes http://simplyrecipes.com/recipes/low_carb/
Low Carb Eating http://lowcarbeating.com/
Low Carb Friends www.lowcarbfriends.com

Just my two cents, but we need the vitamins, minerals & other nutrients & fiber in vegetables. Fruit is fine, if it doesn’t send you high & try to eat a variety of fruits to get a broad range of nutrients. Berries are packed & lower carb than bananas. Avocadoes have good fats, vitamins/minerals & are low carb, if you like them.

I agree that it is premature to jump to diagnosis of LADA, since I do not have enough information. But I met a number of people misdiagnosed with type 2 diabetes, started on metformin, diet, etc. But they soon find out that the only way to control their sugar is to restrict carbs to almost zero. If Zolar is correct he is only eating 50 gm of carbs (and not by the advise of his dietitian). If he starts eating more cabs - his blood sugar will be >200s and metformin does nothing to help with postprandial spike. You can read up on metfromin mechanism of action of you want. Byetta right now will be a bad idea because Zolar wants to stop losing weight. Byetta helps to decrease appetite, slow down food absorption among other things.
Again, I certainly not making diagnosis here. I just suspect, based on my experience. Knowing family history, antibolies status, c-peptide level whould be important for his doctor to make this decision.

I am sorry I jumped on you. I can get a little testy sometimes, and I was out of line. I do agree with you, many doctors diagnose patients as t2 and miss obvious signs of LADA. I am such a case as you suggest, not responding to metformin, low c-peptide and so forth. I have had a terrible time trying to get the autoantibodies test. If Zolar does continue to have difficultly with blood sugar control and metformin does not work, you might be right, he should be further evaluated for LADA.

About the LADA. It might be possible, but no C-Peptide test was taken, despite my FIRST request to know what my insulin levels are. FOUR doctors didn’t want to do the test to see.

My ANACHOICE came back negative. I think that for some immune thingy??

My diabetes was caused by 2 different medications I took last year. Risperdal and Geodon (works great for depression, but jacks up blood sugars a LOT). I stopped taking Risperdal early last year, and the Geodon once I was diagnosed. It took a bit, but my fasting numbers dropped from 127 back to normal. It’s the rotten spikes nailing me.

At time of diagnosis, my GTT came back at 294 and my a1c was 6.8 .
My most recent a1c, about 2 1/2 months later, came back at 5.7.

I am trying NOT go out and self treat this disease. I do have the contacts and can buy any non class 1 or class 2 medications I want. I want to do this the right way.

About foods: yes, I like nearly all fruits. I significantly slowed down my weight loss by eating 1/2 cup pecans and 1/2 cups walnuts (for example) which amounts to about 1/2 my daily carb needs.

Yes, I like most kinds of beef, chicken is OK, deep fried red lobster shrimp is a wonderful food :slight_smile:

Did you know that the first doctor that diagnosed me only wanted me to check blood sugars 3 times a week? The 3rd doctor said only once a day?

Here’s how I check:
In the morning, right before first bite of any meal (except if I eat 1 or 2g of carbs like a dill pickle spear - I don’t even bother to count that), and 2 hours after every meal, then at bedtime.

If I know I am eating something really bad like spaghetti or pizza, then I will add a 1 hour postprandial. If I am too high, and the weather is OK, I will try to walk for at least 30 minutes to control the spike. I even will drink 30 ounces of water which will drop me blood sugars in a hurry.

The doctors said I needed to be at my ‘ideal’ weight. Well, they never gave me a number. So, I got down into my normal weight range for my height. I can literally choose what weight I want to be at. If I want to be 100 pounds, I can easily do that as well. I just won’t eat until it drops. I have no hunger whatsoever. I eat because I know I have to or because I feel a little weak. Sometimes, I can even go through the effort and choose my fasting blood sugars, although this is a bit difficult to do, to a point. I got them as low as 69 without meds or exercise.
How’s that for control?

The doctor wanted my blood pressure down below 100. I gave them 100/70. That’s the blood pressure of an Olympic athlete. Of course, my body does NOT like it that low. Extremities are way too cold.

If I eat a double pepperoni & sausage pizza (4 slices, about 100g of carbs), I can think clearly, have lots more energy, and am not cold! But I have to pay for it with high blood sugars for DAYS…

Did anyone look at my blood sugar logs and averages yet?

I suspect that I may have pancreatitis due to some of the symptoms. Pain and discomfort just under the right ribs. I get the same sometimes just under the left ribs that feels like a long needle poking right through me.
They might be caused by gallstones.
If this is true, then I may be able to recover significantly from this disease.

The diet they wanted me to be on was a ‘Low fat’ diet consisting of 75g of carbs, 3 times a day, plus 2 snacks.
I told my PCP that there was no way in H3ll that I would do that. I am NOT going to walk around with blood sugars in the 300 range all day. He didn’t seem to like that much at all. This diet is actually a high carb diet for normal people who have high cholesterol, not diabetics.

I have my own reasons for needing to eat 70% of my daily calories from Wheat products and grains. And limiting myself to only 2 meals a day to accomplish that need.

I know 100% for sure that this can be accomplished with some combination of meds, without any doubt whatsoever.
If I can eat some significant carbs, my foggy mind will clear, and I can concentrate once more. I proved it to myself several times during my testing.

Did you know that the brain needs 6g of carbs per hour just to function? The liver needs 4g of carbs just to exist?

Those 2 alone add up to 240g of carbs per day. The brain cannot use protein or fat for energy either.

I would GLADLY take insulin if I could eat normally again, less the sugary bad foods.
BUT, I will tell you all this:

The instant they prescribe insulin, I will celebrate by eating ONE cinnamon roll (56g of carbs, mostly from sugar)! LOL
Then back to the diet and exercise.

BTW: I can drop a whopping 100 points off any of my blood sugar spikes if I drink 30 ounces of water and get on my brother’s treadmill for 45 minutes to an hour. 30 minutes generally does it though. Anything more can bring me to Hypo, so I don’t overdo it.

I gave the doctors all they asked for except for one thing: Cholesterol. I can’t raise my good cholesterol above 35 and can’t lower my bad cholesterol below 160. It’s in my genes. My dad had total cholesterol numbers around 250 for his whole life, and no heart disease either.

Gerri, here’s how I determine what I can eat -

My boss dictates that to me.

Your boss you think?

Yep, my boss is my glucose meter. If it says under 108, I can eat about 10g of carbs. If in the 90’s, about 15g to 20g of carbs, if 85 or less, then about 20-25g of carbs, as long as none of them are in the morning. 11g max during mornings. How I came up with this? It’s the amount of carbs in 1/2 grapefruit with 1 egg. This calculation works 95% of the time. This is if I am sedentary. If I plan on being active, I can sometimes eat up to 50g without too much of a problem. But it takes almost a week of exercise for me to eat one meal, then 2-4 days afterward to keep numbers low.

My daily normal caloric needs calculate to about 2170 cal/day, if I’m not doing a lot of exercise. About 1600 if I just sit on the computer.
But in real life, anything more than 1100 +/- 300 will cause my weight loss to stop and reverse. Unless I can exercise.

BSC, I have a suggestion for you. I can’t find any where I live, but you just might.

Get some ‘jerusalem artichoke’ Eat some on Tuesday, raw. Then on Thursday, cooked with the skin. If necessary wait 2 more days and eat some more.
Watch that help with your blood sugars. It’s not perfect, but it can help most people (type 2’s).

I have also read about salt. A study was done with medical students, all of whom were non diabetic.
All were given a GTT to establish a baseline. Then 1/2 of them were given 2g of salt, the other 1/2 a placebo. A GTT was done again. The 1/2 that took the salt has 20-30% lower blood sugars.

Another study was done concerning FAT.
Same deal as above.

1/2 were told to eat a lot of junk food with fat. Pizza especially. Then a GTT was performed again. Those that ate a lot of fat had significantly higher spikes than those that didn’t.

I have been to bloodsugar 101 a few times. Nothing very interesting there for me as it does not address my dietary and lifestyle needs.

I know that I will need more testing. I also know that Metformin alone will not do the job. I must have metformin and either a byetta type drug or rapid insulin. Unless I am in fact LADA.

I want to hit this disease hard. I want to eat normally as outlined above from the day that I see the endo, not weeks or years down the road.

Now, here’s one good analogy of my disease:

A car alternator usually has a diode pack consisting of 6 diodes. We’ll call this my pancreas. The diodes are called beta cells.
My gas tank is my liver.

Now, some of my ‘diodes’ either aren’t working or are weak. So, it makes less ‘insulin’ for my body to use.

My body needs the ‘juice’ from the alternator & gas tank for the car to run properly, or my spark (my energy levels) will get weak and my battery (energy reserves) runs out quick.

Now if I step on the gas (consume more food - carbs), my ‘alternator’ puts out extra juice and I can go (energy). But with a bad diode pack, my alternator won’t last too long.

Byetta or similar would be like adding an external diode pack with filter capacitors to the system. It won’t fix he bad diodes, but it can make things run better.

This is how I see my disease.

Not a perfect analogy, but not a bad one either.

Lowering my blood sugar is fine most of the time, but when I eat, I need that blood sugar to get into the cells quickly so I can do things.

I would write more, but my back is really hurting right now. Have to go lay down for a bit. I will write more later.
Oh, and no pain meds for that problem either.

So, I am stuck in pain and can’t eat much. What a combo…

I think you are doing great. Everyone has to find their own way with diabetes, and it sounds like you have already started your journey. You have to realize, you have already brought you HbA1c down to 5.7 on your diet and exercise alone. I know that we all would like to just go to the doctor, take a test find out what is wrong and just fix it. Diabetes is not so simple. I know you are feeling frustrated with the diet thing. You have gotten contradictory information,but you clealy know that eat carbs raises your blood sugar. Early on I discovered the writing of Richard Bernstein a doctor who himself has T1. His book “Diabetes Solutions” argues for a very strict control of carbs, advocating 30g /day. I’ve never felt comfortable with that level, but I do follow a very low carb diet. Over time, I’ve discovered lots of variety to fill my diet, but initially as I am sure you can attest to, it can be a challenge. I do hope you feel better.

ps. I’ll give the Jerusalem artichokes a try. They contain a fiber called inulin which is considered by some to be very good for you.

Wonderful work lowering your A1c!

Yes, I read your BG readings.

Most doctors don’t encourage frequent testing of their Ts patients. My feeling is that this is a disservice. Some insurance won’t cover sufficient test strips for T2s to test frequently. Terrible. My meter is my boss also.

About 58% of protein turns to glucose, though at much slower rate than carbs. Being alive contributes glucose as part of the process of cells breaking down, new cells being formed & other metabolic processes. A small percentage of fat also converts to glucose. So, your statement is not quite correct.

I’d question whether your tiredness is due to 70% of your calories are coming from carbs & perhaps not enough protein.

Thanks for the complement. And the comments from everybody.

Out of all the site I have been to, this one seems to be the best out of them all. I am getting great feedback on my problems, and excellent suggestions. Many thanks!

Perhaps I should talk more about why I need that 70% of carbs in my diet.

If I eat too much protein, I begin to have problems with my joints, especially my ankles (pain) and swelling (knees). This happens if I eat too much at one sitting, too much in one day, or too much in a week. I have had this aggravating problem long before I was a diabetic, about 2 decades. My kidneys are fine up to now, and my creatinine levels seem ok too. The lab sheet came back with all that in the normal range.

70% of carbs cannot equal 3500 calories, unless I eat a corresponding amount of fat/protein in the ratio.

Assume that I need exactly 2000 calories per day. 70% of those I need to come from carbs, specifically Wheat products. So, I need about 1400 calories from carbs, and the rest from fat & protein.
So, 1400 carbs from wheat products at 4 calories per gram = 350g of carbs per day. My dietitian wanted me to eat about 250-300 per day, but too much protein.

The 1400 carbs do not need to be exclusively from Wheat products. Some can be from fruit and other starches, but the bulk needs to be from Wheat products.

I figures this out a very long time ago. I used to eat cheesecake. More than one piece in a week, gave me really bad ankle pain. It took a while for me to figure out that if I ate wheat products and stayed away from high amounts of protein, that I wouldn’t have the pain.

I know that there is a way to do this, and I will find it. This is why I needed the Metformin and either Byetta or the new drug that works like it. I believe, through my careful research, that these two can do two things: allow me to eat the way I have to, and keep blood sugars under control at the same time.

One other item I recently discovered is that Alleve (naproxin sodium) causes my blood sugars to be about 30-40% higher than expected. And of course, I have to take it for the swelling in my knees.

More on my diet:

Last year, about may, 2009, I was drinking my coffee and started using Splenda instead of sugar. A wise choice I thought - less calories.
I developed severe headaches. Within 3 months they were so bad that I saw a neurologist to see if I had an aneurysm or something. The headaches were extreme. On a scale from 1-10 they easily were at 10.

They couldn’t find any problems, no narrowing of the arteries, even though I had high cholesterol.
There was a very big ‘bullseye’ with about 5 concentric rings in it. They called it an anomaly.
Still I couldn’t get relief. I had several blood tests, which returned nothing, until they checked my fasting blood sugars.
127.
I requested a GTT to be certain. I didn’t believe the pre diabetes and felt it was just a guess on the doctor’s part.
Good thing. I had it and came back at 294. Immediately, I knew I was diabetic and started watching everything. It took about a month before I could get in to see the doctor. And a few more weeks later to see them again. But the day after I saw the doctor the first time (waste of time and money by the way to tell me something I already knew), a Type 1 friend of mine gave me a meter. I started testing that night and ever since.
I study every single day about this disease. I used to know know that diabetics had to use insulin and shouldn’t eat sweets. Well, I came a long long way since then.
With one exception, all the diabetics, except one, are always eating all sorts of bad things, including whole 2 liters of sugary soft drinks and everything sweet they can get their hands on. Every one, except one, is overweight.

This perplexed me. This started my quest to find a way as to why they could eat like that being diabetic, and I couldn’t eat a single slice of bread.

I found out that they were just ignoring the disease and treating when they had to, just to keep living to eat.

I also discovered that sooner or later, they will go blind and lost toes and have to have kidney dialysis.
I surely don’t want to go through any of that at all. Especially the blindness part.
This is where I get my resolve to watch what I eat.
Those cinnamon rolls call my name constantly, and the Pillsbury commercials about them tear me up.

But which do I want more? The cinnamon rolls or my eyes?
The eyes win every time.

In a normal non diabetic, they can eat that and not spike. It seems that normal pancreas must do something else to accommodate the blood sugar spike. What is it?
If injecting insulin won’t keep the spike down, then what is the other part of the equation?
Either insulin keeps the spike down to normal or it doesn’t.
You can inject an unlimited amount of insulin, far more than a human pancreas can make in a week, all in just a few minutes. If you ae injecting large amounts of insulin and it’s not keeping your spikes down, then you must be converting into a Type 3 diabetic (my coinage). A type 3 is a type 1 that is also insulin resistant. Like both a type 1 and a type 2 combined.

My theory is that the alpha cells are dumping glucagon thinking that it’s insulin to combat blood sugar spikes. I have not seen anything about this on the internet. Yet.

The metformin can reduce my insulin resistance, but I know another way to almost ‘cure’ that problem - almost guaranteed. Or at least get rid of the vast majority of it. Isn’t the internet wonderful?
I have about a 30 day supply of some of what I need to counter insulin resistance. I am trying to resist self treating this problem. But I most certainly will self treat if the doctors keep milking me for money, wanting me to stay a diabetic.

But without knowing my insulin levels, I can only guess as to what needs to be done. But eventually, I will find out. Either they test and tell me or I won’t pay the bill. And I fire them and find another doctor who will do their job. A job that I am PAYING for.

I will test exactly like every single diabetic should, at least until I figure out what I have to do to correct this problem or run out of money. And spot check thereafter.

Absorbing carbs: If Byetta or similar slows down digestion, the rate of carb absorption should also be lower. Perhaps 3 drugs are needed. Metformin, Byetta (or similar) and insulin.

There is one other drug that is not traditionally used for diabetes. It can be of great value, and is pretty cheap. Have to wait and see what the doctor wants to do.

My tiredness is coming from this area:

  1. wrecked metabolism - I have the metabolism of someone bedridden or worse.
  2. A high degree of insulin resistance.
  3. Not enough insulin (my supposition).

Eating several meals comprised of high carbs is far easier than eating several meals that have high protein/fat in them. You can buy a pack of peanut butter crackers anywhere, but you can’t carry around a sirloin cheeseburger, plate, knife, and fork on your pocket all day long.

I will never trust another doctor again. Anything they want to do, prescription they want me to take, I will THOROUGHLY investigate it before doing anything.
If I do not want to assume the risk, either they will have to devise an alternative method or I won’t do it.
I blindly did what one doctor wanted me to do and I went from a healthy non diabetic full of energy and vitality in all of 2008 and early 2009 to a whimpering half starved type 2 diabetic in 2009 with no vitality, no energy, and non existent quality of life.

Oh, and I still do not have any symptoms of diabetes at all, except the foggy mind and general weakness. I never ever was thirsty nor had to run to the bathroom all the time. The only reason I have to use the bathroom all the time now is because I drink umpteen mugs of black tea all day long. When I’m not drinking all that tea, I don’t run to the bathroom but 3 times a day.

About losing weight:

Did you know that for every 16% in body weight reduction, there is a direct corresponding doubling of your metabolism. and a resulting decrease in insulin sensitivity?

I reached my 16% right now. Still waiting for my old blood to die to make room for new blood with lower a1c levels.

Oh, here’s a question for the experts:

Glucose sticks to red blood cells until the cell dies.

Ok, once the cell dies, what happens to all that stuck glucose from the dead cells??

Here’s another question: When blood sugars are above 180, beta cells die by the thousands.
However, I keep hearing the word 'sustained. with that.

Please define, in hours or minutes, how long the word sustained refers to.

Can you be above 180 for a week and not kill beta cells? or one minute? One hour? 4 hours?

I need a more specific value than ‘sustained’ please.
If I knew how long it took to kill beta cells with blood sugars above 180, then I can recalculate how I eat to make sure I don’t go above 180 for that length of time.

How long does it take for glucose to stick to red blood cells? Instantly? within 1 hour? 10 minutes? what time frame please.

This would equate to eating more carbs and less everything else. Or even a piece of my son’s birthday cake this September with icing!

Did you know that I can eat 1/12th of a Hershey chocolate bar and have blood sugars at my 2 hour postprandial that are less than when I started?

More on food and spiking:

Chicken, and especially fish do absolutely nothing to curb any spikes I get. And both seem to cause spikes in me. I have no idea why either.

And I am beginning to see a pattern developing with cheddar cheese. When I eat 2 sirloin cheeseburgers with zero carbs, I seem to spike as if I ate 1 slice of bread.

I will have to experiment with that one day.

You see, if you know what the limits are, you can enjoy life a lot better. Guessing is far too bad of a thing to do. I can meet this disease only partway, but I will NEVER let it rule my life totally, if I have anything to do with it.

Note: at one point, my calculated a1c level would have been under 5.0, but I couldn’t sustain that rate for more than a few days. It’s hovering about 5.2 or so now.

Sheesh, have to take some more Alleve to get rid of the swelling in my knees. If I bend my knees more than 90 degrees for more than a scant few minutes, they swell up like water on the knee. They are very painful to straighten out after that, and can stay swelled for days.

About meter test strips: I will buy my own if necessary. At least until I get this disease under MY control.

I usually test about 4-10 times a day. Depends on if I eat or not.

About FAT.

Ok, if fat contains calories, then how is fat utilized on the body as fuel? And why did the doctor want me on a low fat diet??

What method is required for vitamin uptake into the cells?

One more medical history bit for you to contemplate:
Many years ago, while working at a factory, I contracted lead poisoning. (long story).
After walking around with lead in my body for 6 weeks (got really sick within minutes of going back to work), I got tested. It came back at 93mcg/100ml If memory serves me. I know the 93 part is correct, but unsure of the units. Anyway, into the hospital I went for 8 days. Calcium EDTA was administered.
The 93 was more than 2 1/2 times the federal limit of lead allowed, and that’s after walking around excreting it for over 6 weeks.

Is it possible that the Lead poisoning is giving me a slow metabolism now? That poisoning happened about 25 years ago.

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Zolar,

Diabetes is complicated, and even the experts will tell you that we only know a tiny fraction of what is going on. Please understand, that you are only starting your journey and figuring things out. From what you have written there are a number of things that you appear to have misunderstood and I would encourage you to keep reading and learning about this stuff, in the end it will serve you greatly.

We have repeatedly encouraged you to follow a lower carb diet and I am at a loss on why you decline this advice. If you cannot eat high protein, then don’t eat high protein. A low fat diet is not useful to a diabetic, particularly one that is trying to reduce their blood sugar levels using their diet. I really am at a loss on where you got this advice to follow a very high carb low fat diet. Even with your high carb diet, your blood sugar is reasonable well controlled, but that may be because you are literally “starving.” You need to eat more, plain and simple.

Now let me help explain how fat is used. On a low carb diet, your body can actually burn fat by converting the fat to what are called “ketone bodies.” Your body can then burn the ketones instead of glucose for energy. You can read about this by looking up ketosis, ketones and the “Krebs cycle” Your body can technically operate on as little as 50 g of glucose a day, all generated by your liver, so technically you could eat ZERO dietary carbs and be fine, although I would not recommend this.

I really don’t think tha the lead problems years ago are likely to be causing your problems now. You got that treated, and actually it sounds like it was actually not dangerously elevated. Although it was not good, people have survived much more serious poisoning.

I am concerned about you Zolar. You are clearly distraught over these matter. You appear to be setting goals for things that are inconsistent with what most of us would try to achieve and in certain cases (like undereating) you are doing things that may just not be good for your health. I am not sure how we can help you at this point. Will you consider dietary suggestions? Would you consider suggestions about how to talk about this with your doctor? Exactly how can we help you?

Yes, I will consider all options.

What screwed me up was the following facts:

  1. No C-Peptide test was taken
  2. No GAD test was taken
  3. No test for gallstones was taken (possible pancreatitis)
  4. A dietitian wanted me to eat that high carb, low fat diet because of Doctor’s Orders (cholesterol was a little high, but not bad).

So, to treat the cholesterol issues, the dietitian planned out a high carb/low fat diet, ignoring the fact that I cannot eat carbs without spiking.
This really caused me some serious grief. There was literally nothing I could eat.
Then the depression hit and stress over all this. I am still going through all this.

About setting my goals: They are just goals. They can be achieved if enough effort (and meds) could be put in to it. However, I do realize that I may not be able to reach those goals, and may have to settle for something less than my optimal desires, based on financial constraints. Money buys health.

But in life, if you don’t set your goals high enough for any endeavor, you fail to grow and learn.

I can stop my weight loss AND keep blood sugars near normal should I choose to. But for every action, there are consequences. I am trying to do this the ‘right’ way if I can.

Self treatment is quite risky, but I can not only meet those goals, I can actually exceed them.
It can take a lot of effort on my part, and a lot of money that I don’t want to spend, but they are achievable.

I was wanting to know what treatment program (meds) I can take to satisfy my requirements. I know that there is some combination of drugs that can help me do what I need to do, but I have no true idea as to what to ask for. Or shouldn’t I ask for anything and just leave that decision up to the doctor (very reluctant about this). The last few times I trusted a doctor for my health, they wanted to kill me with high blood sugars. Burned once, twice shy.

Without knowing my insulin levels, and treatment, either by doctor’s orders or self treatment is just a guess. Right now, I am struggling to control both the blood sugars and the weight loss.
Eventually, I will discover a happy medium that I can live with.

I am open to any and all suggestions. Even if they might be wacky or logical.

My will is still strong although my body is weak.

However, I cannot make an informed decision as to how I want to be treated without enough information.

This is why I started this thread. To see about medication options.

Sure, I could do the Atkins, south beach, or Dr Bernstein diets, less the vegetables.
But I know my body and it does not like it when I don’t eat enough wheat and grain products (intestinal problems). I discovered this many years ago when I had gout in my ankles a few times and couldn’t walk. That was from eating too much protein in my diet and not enough wheat. Why wheat products, I don’t know. But for some reason Wheat fixes a lot of my problems. So, once I slowed down eating protein and supplemented by eating more grains, especially Wheat products into my diet, the intestinal problems subsided and no more gout. This is how I arrived at my 70/30 dietary needs. Treating diabetes by not eating wheat and grains will exacerbate my other problems. When I ate a lot of FAT, that gave me intestinal problems too, like a lot of loose bowels.

I am looking for a method that will satisfy both my need for wheat products and diabetes disease.

I was thinking that metformin and perhaps Byetta or similar could do what I need to.

Maybe others here can share their experiences about different medications, their effects, and side effects, as well as if they worked well or not.

I am looking for a plausible solution to treat my disease and other problems. The simplest way is for me to eat normally, less the sugar.

Again, I am open to all suggestions, no matter what they may be.

A real dilemma here. Fix one problem and make another worse, and vice versa.

I have to tell you, I am not aware of any wheat diet treatment for gout. Typically dietary treatments for gout focus on reducing high purine foods, usually avoiding high protein diets as those are thought to create uric acid and create gout. Is it possible that your high wheat diet is just a diet that also reduces protein and reduces high purine foods? Would you consider trying a diet that is lower carb diet that also reduces protein and high purine foods? As you note, life can sometimes be a gentle balance.

As long as the diet does not contain veggies, I am open for suggestions.

It’s hard to find anything to eat that has the necessary calories I need, the fiber I need, and the vitamins I need without causing some kind of problem.

My former diet was ideal, but now I have to worry about blood sugars…for now.

I do like nuts, but they have a LOT of calories in them, and not enough of the other needed vitamins and minerals.

If my endo can’t medicate me so I can eat somewhat normally, I have no idea what to do, except starve to death or put up with high blood sugars.

But at least I will be skinny :slight_smile:

Note: My current blood sugar is 81. I started this morning at 87, ate 1 egg and 1/2 grapefruit then my 2 hour was 100. 11g of carbs from this morning. 4g for the pecans, total calories was about 350 so far for the day.

Do you have any idea as to what meds can help me?? I am only diabetic when I eat lol

Take a look here please:

http://www.goutpal.com/foods-that-cause-gout.html

Since you’re opposed to eating vegetables, you should look into powdered green drinks for vitamins & minerals. I don’t see how a person could be healthy avoiding vegetables.

Protein powders are another option to maintain weight & get calories. If you get unflavored ones, they’re low carb. Whey isolate powder (not hydrolyzed) has the most protein per gram. NOW brand makes a great whey protein powder. Mixed in unsweetened almond milk with flavorings, it’s delicious.

Hemp protein powder is also good. Not as high protein as whey, but it has good fats & fiber.

I use almond meal & golden flaxseed meal for baking. Protein & fiber without the BG raising effects of wheat.

Talking to a doctor is the way to find out what meds will hopefully help. You’ve clearly done a lot of research on your own & know what’s available, so I’m not sure what you’re asking.

Due to severe abuse issues regarding veggies in my youth (beaten and severely punished if I didn’t eat them), I cannot eat them at all, except for corn, sweet peas, potatoes, yams, and on occasion, a raw carrot.

I have had my blood tested many times. I was only deficient in Folic acid, and that was not by much.

Buying the protein items you mentioned can help me with my fiber needs, but this still doesn’t address the wasted food that my wife has to toss out every day because I can’t eat any of it.

So, not only does my food costs double (or more), I would have to purchase other items to meet dietary needs that I could have gotten easily if they would medicate me so I can eat wheat & grains.

Cost is one of the biggest factors I have to contend with. I have to pay for testing supplies and doctor bills, plus any medications. Something I have to figure into my budget.

The job my wife got was supposed to pay her credit card bills, but now it will have to supplement my health problems.

Once they sue her, then I won’t be able to pay to treat my diabetes. I have to find my own way. And that means I must be able to eat the food that she throws away, with meds or without.

I figure that in 2 months, the lawsuits will fly. They may garnish her wages, and since she just started the job, she might lose it. Then I would have no choice but to stop treating diabetes and eat normally anyway.

This is one of the reasons I needed meds to eat. At least I can slow down or stop the weight loss (safely), buying me time to come up with other viable alternatives.

I was thinking of hanging a sign around my neck and standing on a street corner. The sign would say:

“Need money to treat my diabetes, please help”.

Then maybe a few people would be willing to help out.

If the drunks and druggies can do it and make $500 a day, I should be able to do it to make $50 a day to treat my disease.

Maybe even get my son to wear a sign that says:

"I want my daddy to live, please help with his diabetes"
And have him stand next to me.

Thanks to all the greedy CEO’s out there for making people suffer needlessly.

Necessity is the mother of invention. I need to invent a suitable treatment so I can survive.

I will see about those supplements though. Not sure if I can afford them every month.

I test between 6 & 10 times a day. That’s a lot of strips and a lot of money.
At least my endo would have a decent data list to devise a plan for me.

I still don’t know what all foods I can eat and what the blood sugar spikes would be.

About research: yes, I study this awful disease every breathing moment of every day.

I am willing to meet this disease partway, but not to the exclusion of my life and my family’s survival.

I will not allow this disease to dictate my whole life. If it did, my life wouldn’t be a life, it would simply be an existence. Who can live like that?

Who can live like a prisoner with this disease, a prisoner without parole?

Just really depressed here. And all the meds that I need to treat depression (except one so far, but haven’t got to see that doctor yet) either cause diabetes, make it worse, or elevate blood sugars.

I have so far given the doctors no excuse not to treat me, except for the cholesterol issue, but it’s only 221.

From what I understand dairy products are actually low in purine and are good for gout. What about butter, cheese and eggs? Do you like them? If you cannot handle whey protein (dairy based), perhaps you can handle casein protein. If you have trouble with veggies, perhaps they can be prepared so that they are unrecognizable. Can you get a juicer? Can your wife just make you up a shake?

You know a lot of your problems right now is your depression over the situation. You need to just get your head around this. Sometimes this stuff just clearly s*cks, but you can surmount these challenges. You need to stop looking at all this as a situation where you are set up to fail, and instead choose yourself as a winner. I have faith you are going to figure this out. It all looks hopeless now, but you need to have some faith in yourself. We all here got diagnosed with diabetes. We all have felt variously at times that life has just come to an end. But you need to pick yourself up and get on with things. You may need to eat some distasteful stuff. You may need to deal with some hardships. You are going to have to navigate confused and conflicting advice. But in the end you are going to overcome this.