Diabetic diet (carbs vs cals)

[Cogcog]

Male Aged 64.

I am currently on the new NHS T2 Diabetes Remission Programme, 8 weeks in to a 12 week programme of under 1000 calories a day delivered via 7 mini shakes and soups. I have lost 9kg in 8 weeks, now 77g and heading to 73kg by mid August. My blood tests are looking very good, as if I have dodged the bullet and may be heading for a diabetes remission. I cannot go back. Overall I have lost 15kg since January but I can see that some of that is muscle from my chest, arms and shoulders. The programme includes an extended period of 1-2-1 monthly telephone coaching through to May 2026. I have a new gym membership starting next month with plenty of time on my hands to make that a habit. Waist has gone from a 35/6 to a 30. All good.

I had done pretty well on a low carb diet for 5 years ( I started at 100kg) but had let it slip in the last year and my diabetes returned with a vengeance. I quickly got back on top of my eating/weight but the 'future' diet is looking like a low calorie armageddon of salad and tiny portions of meat. My coach is very much 'low calorie' orientated and not concerned about my muscle loss (suggested I may have just lost my moobs!) but the prospect of a life watching every mouthful doesn't fill me with enthusiasm. I also want my arms, shoulders and chest muscle back!

Here is my question; what are the thoughts about periods (weeks/months) switching berween a Low Carb (but maybe high protein) and a Low Calorie high protein diet? Will my body go into confused download? Is there a hybrid option?

Edited by Cogcog on Thursday 10th July 08:31

[InitialDave]

I can't advise you on a diet in support of a medical need, but in terms of a low calorie, low carbon diet, there's no reason why it can't be high protein.

What shakes specifically are you having? Casein, rather than whey, tends to keep you feeling full a bit longer.

[Cogcog]

InitialDave said:

I can't advise you on a diet in support of a medical need, but in terms of a low calorie, low carbon diet, there's no reason why it can't be high protein.

What shakes specifically are you having? Casein, rather than whey, tends to keep you feeling full a bit longer.

NUPO ( Total Diet Replacement), which were the ones they used in the clinical trials and they don't recommend any other shakes or more shakes after the initial 12 week period as they may not fit into the 'balanced diet' going forward. Put simply, I have to avoid the glucose spikes created by consuming processed carbs like sugars, as my body can't process that quickly enough, so slow release carbs are the way to go.

[3george]

Might be worth you getting a Libre sensor ( free one from website ) to at least try to see in a fortnight what you are consuming is causing your sugar to spike. It has really helped me adjust my diet ( especially breakfast ) which I've found if I delay for an hour helps my body and smooths out the peaks caused by carb consumption.

Worth a try

[Cogcog]

3george said:

Might be worth you getting a Libre sensor ( free one from website ) to at least try to see in a fortnight what you are consuming is causing your sugar to spike. It has really helped me adjust my diet ( especially breakfast ) which I've found if I delay for an hour helps my body and smooths out the peaks caused by carb consumption.

Worth a try

I had 2 of the Libre sensors but my phone didn't like them. I have a new phone now and would be Ok to buy them for a period of learning, but thanks, as it didn't occur to me to use it to tailor my diet rarher than as a warning device. I do the finger prick tests but I would look like a pin cushion to work out all the what and whens!

[InitialDave]

Cogcog said:

NUPO ( Total Diet Replacement), which were the ones they used in the clinical trials and they don't recommend any other shakes or more shakes after the initial 12 week period as they may not fit into the 'balanced diet' going forward. Put simply, I have to avoid the glucose spikes created by consuming processed carbs like sugars, as my body can't process that quickly enough, so slow release carbs are the way to go.

This is the issue. If it's relating to a medical situation, I'm simply not in a position to tell you anything that goes against medical advice.

But looks like those shakes are about 13g of protein for 120 calories, whereas my lunchtime casein shake will be 34g of protein for 160 calories.

[WyrleyD]

I adopted a low-carb/high fat, time restricted eating diet 2 years ago, the time restricted to eating is a 6 hour window from mid-day to 6pm and the low-carb is < 30g of carbs a day where possible. My weight has been stable at around 72-74 kg in that time and my diabetes went from diabetic to pre-diabetic to non-diabetic but has now slipped back to diabetic at my last blood test in May due to some other medication I was given that made glucose control all but impossible, I will probably get a private blood test in August/September as I stopped the other medication in May when I found out what it was doing to my glucose levels (hoping it would have dropped back in the 3 months to August). GP surgery will only allow one HbA1c test a year which seems to me to be very restrictive when trying to control diabetes, in France it was closely monitored with tests every 3 months. I did try a Dexcom CGM for three months at my own cost but found it to be a bit unreliable as I couldn't find a spot on my body that I didn't lay on during the night (restless sleeper) which set off the CGM alarm as it couldn't get a reading.

[Phil.]

Achieving remission from type-2 diabetes is a great achievement. It means you are controlling your glucose levels within a healthy range reducing the risk of future complications. However, it doesn’t mean you have reversed your diabetes. If you eat too many carbs your system can’t regulate glucose sufficiently and your glucose numbers will rise.

If you want your glucose levels to stay low (in remission) then you need to adopt a low carb diet which can easily be high protein. The best low carb nutritionally dense food is fresh meat, veg, eggs, cheese etc. which means you don’t feel hungry. It’s also tasty in my experience. Low carb will also mean you maintain your weight.

Check out Dr David Unwin and his wife’s publications. They provide very practical advice and have had great success with their diabetes patients.

https://www.nhsconfed.org/people/dr-david-unwin

[ashenfie]

I have type 2 also. I was also around 100kg an am now stable at around 75kg. They talk of remission but that has not happened for me and a stable diet that is carb controlled keeping my glucose levels in check. The muscles loss is an issue with dieting and the only real solution seams to be exercise. This should help the insulin to work properly and therefore reduce glucose levels.

[Cogcog]

ashenfie said:

I have type 2 also. I was also around 100kg an am now stable at around 75kg. They talk of remission but that has not happened for me and a stable diet that is carb controlled keeping my glucose levels in check. The muscles loss is an issue with dieting and the only real solution seams to be exercise. This should help the insulin to work properly and therefore reduce glucose levels.

I think they will be retesting over the year before they declare a 'remission'. Last time I got my HBA1C down below the NHS diabetic and back into pediabetic tey stopped my Metformin! I know it is a life long and chronic condition which is why I need to find a permanant diet that keeps the glucose and the weight under control without making my life miserable or creating additional health risks.

[Cogcog]

InitialDave said:

This is the issue. If it's relating to a medical situation, I'm simply not in a position to tell you anything that goes against medical advice.

But looks like those shakes are about 13g of protein for 120 calories, whereas my lunchtime casein shake will be 34g of protein for 160 calories.

It will be my gig to decide after late August when the 12 weeks and the exra 6 weeks of reintroducing 'real' food one meal at a time end. They were concerned abiout using shakes, as it needed to be in a wider balanced diet, which should not be impossible.

[M5-911]

Not sure if doctor Reginald Allouche produce a book in English but worth having a look. If not get the book "Glucose revolution" by Jesse inchauspe. Understanding what to eat in which order will change your life without having to go through some drastic diets.

Edited by M5-911 on Thursday 10th July 18:32

[Dave Hedgehog]

My blood was peaking at 20+mmol at the end of last year before i switched to primal/paleo/whole food diet with only natural low GI carbs no processed or refined carbs. I prefer it to low carb diets as i find them unstainable.

I am also taking Mounjaro which can be used to treat T2

6 months in and my blood now peaks at high 6s and my A1C is 4.7 and i have lost some weight

i took my bloods 2 hours after eating lunch yesterday and it was 5.3 mmol

I also had a very similar result 10 years ago on the same diet without the MJ

so for me controlling my insulin response etc. comes down to processed carb control more specifically than calorie control