Diabetes -- good numbers, good habits, but no weight loss

[AimeeM]

DH is diabetic.

 

He is on medication. 

He has moved to a (typically) more whole foods / paleo diet. He does eat pasta on Sundays. It was a compromise considering his childhood memories of family pasta dinners after Mass on Sundays :P

 

He is involved in fast-paced, rigorous movement 4-5 nights weekly at the gym, with a good friend from the office (usually they play a full hour of racquetball, lol).

 

No matter what he tries, the weight isn't budging though. According to all tests with the doctor, his "numbers" are great. So, everything he is doing, and the medication he is on, is managing the diabetes itself -- but why isn't the weight budging at all?

 

He's getting particularly disheartened. 

 

Is it time for him to see an endocrinologist, maybe? At this point he sees only his PCP and I believe he sees the nutritionist every few months or so.

[Jean in Newcastle]

What numbers are you talking about?  If he is just being tested by the doctor his hemoglobin A1C can be pretty good but his daily numbers still not all that good esp. after some meals.  Does he have a glucometer?  Is he testing two hours after meals?  His sugars should be 120 or less two hours after every meal. 

[wonderchica]

I think All diabetics should be treated by an endocrinologist.

[AimeeM]

What numbers are you talking about?  If he is just being tested by the doctor his hemoglobin A1C can be pretty good but his daily numbers still not all that good esp. after some meals.  Does he have a glucometer?  Is he testing two hours after meals?  His sugars should be 120 or less two hours after every meal. 

 

His numbers with the doctor are good -- and his numbers after meals. Yes, he has a home meter. 

[itsheresomewhere]

I think All diabetics should be treated by an endocrinologist.

I agree.

 

Just a word of advice but research everything the nutritionist says. I know a few on here have had the same experience of what they recommend for diabetes is not good advice.

[Jean in Newcastle]

You can have good bloodsugar numbers and still be taking in too many calories.  Has he tried tracking his caloric intake? 

[wonderchica]

How long has he been doing “all the right things� Consistency is key. Weight loss can take awhile, especially with contributing factors like insulin resistance.

[Tammi K]

I agree.

 

Just a word of advice but research everything the nutritionist says. I know a few on here have had the same experience of what they recommend for diabetes is not good advice.

 

I soooo agree. If I follow the guidelines published by the American Diabetes Association, my numbers are in the 2-300s after meals.  Yikes.

 

Their  suggestions for 'low carb' meals are no where near what I can consume and keep my numbers under 120.

[AimeeM]

I agree.

 

Just a word of advice but research everything the nutritionist says. I know a few on here have had the same experience of what they recommend for diabetes is not good advice.

 

I don't think he has listened to her :P The paleo move was more of a natural move on his end, and something some of his friends had had success with. 

 

I'm not entirely sure how long he's been at the diet, actually -- I haven't really kept track. I was serving typically paleo meals for family meals before he went that way formally. 

 

He's been at the gym consistently, at this pace, for a couple months? Prior to that, he was having trouble even walking the treadmill at home without being miserable. I really think finding a friend to do something interesting -- and rigorous -- with, was key for him. He's happy to put in the workouts now and comes home feeling great. 

[melmichigan]

Having been on them for years, and currently (temporarily) off them, I will add that some diabetic medications aren't really conducive to loosing weight in the sense that they decrease your insulin sensitivity to exercise.  Diet is all the more important in that circumstance.  Things like glucophage also cause swelling and water weight.  Is he keeping track of his numbers and calories, or did his doctor just give him the medication and send him on his way?  If it's the later then run to the nearest endocrinologist, because there is much more to it. 

Edited February 15, 2018 by melmichigan

[AimeeM]

Having been on them for years, and currently (temporarily) off them, I will add that some diabetic medications aren't really conducive to loosing weight in the sense that they decrease your insulin sensitivity to exercise.  Diet is all the more important in that circumstance.  Things like glucophage also cause swelling and water weight.  Is he keeping track of his numbers and calories, or did his doctor just give him the medication and send him on his way?  If it's the later then run to the nearest endocrinologist, because there is much more to it. 

 

His doctor just gave him the medication, said "good luck," patted his own stomach, and told DH that if he (the doc) had any actual advice regarding weight loss, he (doc) wouldn't have the same problem... essentially.

 

However, DH tracks his numbers, I'm pretty sure. 

[readinmom]

Some medications  cause weight gain...just an FYI.   One of the big things is caloric intake...it is a very difficult adjustment.  

[eternalsummer]

Has he tried eating less?

[Soror]

No advice here but I just wanted to say :hurray:  :hurray:  :hurray: to him, it is fabulous that his numbers are better. Hopefully, the scale starts moving as well. Best wishes on his health journey!

Edited February 15, 2018 by soror

[SparklyUnicorn]

My DH is not diabetic, but he exercises regularly and eats healthfully (for the most part), but not only has he not lost weight, he has gained weight.  The problem IMO is he eats too much.  But, for whatever reason, he's hungry all the time so it would be very hard for him to "just eat less".  I also refuse to micromanage his food intake (that's another discussion). 

 

I figure since all his numbers are good, whatta ya gonna do?  He also comes from a long line of overweight people who lived very long lives. 

[Sarah CB]

This is a pretty good blog post about reversing diabetes and losing weight.

 

There is no reason your dh can't continue to improve his numbers until he is completely off medication.

 

https://idmprogram.com/reverse-type-2-diabetes-the-quick-start-guide/ 

[Caraway]

I would suggest you look at some of Kelly Leveque’s nutrition work. She recently came out with a book called Body Love that is kinda girly, but the science is solid. She talks a lot about how to turn off your hunger hormones and elongate your blood sugar curve to promote weight loss without hunger. Her meal suggestions are protein + fat + fiber + greens. You can listen to her give the basics if you search her name in podcasts and listen to a few interviews.

 

 

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[AimeeM]

Has he tried eating less?

 

Yes. Actually, that's a sticking point for me. I feel like he is frequently fatigued because eats too little to sustain energy... especially now that he's working out regularly. He typically eats only a piece of fruit for lunch, but the only real meal he eats is dinner. Once a week he goes to lunch with a friend from the office, but that's it. 

 

To be fair, he's been slammed at work, which is why he hasn't been leaving the office to grab lunch like he usually would. He's literally been on conference calls for 5+ hours of his work day. There are several local restaurants that offer healthy options, so when he is able to go out to grab food, he has choices.

[AimeeM]

This is a pretty good blog post about reversing diabetes and losing weight.

 

There is no reason your dh can't continue to improve his numbers until he is completely off medication.

 

https://idmprogram.com/reverse-type-2-diabetes-the-quick-start-guide/ 

Thanks! I'll read it when the boys go to bed tonight. 

 

And "off medication" is my other concern. His GP gave no information regarding when it would be time to move him off medication, or at least adjust his dosage. His numbers have been great for a while, and sometimes his sugar levels are low when he checks them at home. 

When do we know it's time to ask for his dosages to be lowered? Wouldn't overmedicating a problem that is no longer as serious as it was, cause problems on some level? 

 

:P Why I think it's time to see an endocrinologist, lol.

[eternalsummer]

Yes. Actually, that's a sticking point for me. I feel like he is frequently fatigued because eats too little to sustain energy... especially now that he's working out regularly. He typically eats only a piece of fruit for lunch, but the only real meal he eats is dinner. Once a week he goes to lunch with a friend from the office, but that's it. 

 

To be fair, he's been slammed at work, which is why he hasn't been leaving the office to grab lunch like he usually would. He's literally been on conference calls for 5+ hours of his work day. There are several local restaurants that offer healthy options, so when he is able to go out to grab food, he has choices.

 

I don't have diabetes, but I have gestational diabetes which I think is somewhat similar in effect, and I can tell you that a piece of fruit by itself for any meal (or even really a snack) is useless for energy.  I'd be great for half an hour and then crash and have nothing for the rest of the day.  Can you convince him to eat an egg or a stick of cheese or even a small hamburger (ideally no bun) instead?  Almost anything.  An avocado.  A swig of olive oil.  5 slices of bacon. 

 

I know how it is being slammed with work - we are in the busy season now and it is a bear.  I have been eating nuts when I have no time.

[melmichigan]

Yes. Actually, that's a sticking point for me. I feel like he is frequently fatigued because eats too little to sustain energy... especially now that he's working out regularly. He typically eats only a piece of fruit for lunch, but the only real meal he eats is dinner. Once a week he goes to lunch with a friend from the office, but that's it. 

 

To be fair, he's been slammed at work, which is why he hasn't been leaving the office to grab lunch like he usually would. He's literally been on conference calls for 5+ hours of his work day. There are several local restaurants that offer healthy options, so when he is able to go out to grab food, he has choices.

I've been off my meds for a week.  I lost almost 10 pounds of water weight (no more swelling).  I have much more energy, and I'm no longer cold all the time.  But, and it's a big but, I am eating on a meal plan and checking my BS 6-8 times a day to see what I will and won't tolerate. There is no way I could eat a piece of fruit for lunch, and my smallest meal is dinner because BS naturally rises in the evening.  This is a test to see where I am with my BS and PCOS.  I may not be able to stay off the meds, time will tell, but for the first time ever that is my goal.  When I started meds the thought was that it was a "cure".  Research has proven that as false.  It just moves the sugar around.

Edited February 15, 2018 by melmichigan

[leeannpal]

This is a pretty good blog post about reversing diabetes and losing weight.

 

There is no reason your dh can't continue to improve his numbers until he is completely off medication.

 

https://idmprogram.com/reverse-type-2-diabetes-the-quick-start-guide/ 

 

I wish this were the case for all people, but it simply isn't. I have Type II Diabetes. Because of PCOS, I've had insulin resistance for most of my life. I lost more than thirty pounds, exercise regularly (walked 12+ miles this last week), and I am controlling my Diabetes (A1C is 6.5). But, I am not off all medications. I take Metformin only. I am so happy that I can manage my Diabetes with very little medication, but to say that everyone can reverse Type II Diabetes leads to so much misinformation out there about Type II Diabetes (like that it is primarily caused by eating too much sugar :)

[SparklyUnicorn]

I wish this were the case for all people, but it simply isn't. I have Type II Diabetes. Because of PCOS, I've had insulin resistance for most of my life. I lost more than thirty pounds, exercise regularly (walked 12+ miles this last week), and I am controlling my Diabetes (A1C is 6.5). But, I am not off all medications. I take Metformin only. I am so happy that I can manage my Diabetes with very little medication, but to say that everyone can reverse Type II Diabetes leads to so much misinformation out there about Type II Diabetes (like that it is primarily caused by eating too much sugar :)

 

Just curious; how many carbs do you aim to eat in a day (if you aim for any particular amount)?

[Sarah CB]

I wish this were the case for all people, but it simply isn't. I have Type II Diabetes. Because of PCOS, I've had insulin resistance for most of my life. I lost more than thirty pounds, exercise regularly (walked 12+ miles this last week), and I am controlling my Diabetes (A1C is 6.5). But, I am not off all medications. I take Metformin only. I am so happy that I can manage my Diabetes with very little medication, but to say that everyone can reverse Type II Diabetes leads to so much misinformation out there about Type II Diabetes (like that it is primarily caused by eating too much sugar :)

 

And I'm curious as to what fasting regimes you have implemented and for what kind of duration? 

 

From the IDM site: Example 3 â€“ Suppose that your main problem is the insulin resistance cycle. This vicious cycle has developed over decades and insulin resistance is now the main stimulus to your high insulin levels. Reducing carbs may not be the most effective treatment. Why? Because your problem is the insulin resistance. Lowering carbs will lower insulin and reduce the vicious cycle, but this cycle has been running for decades.

So what do you need to do? Remember that the question of insulin resistance is mostly a question of ‘when to eat’. Therefore, to break resistance, you need a sustained period of low insulin. This means that fasting will be more effective here than simple carb restriction. You will also need time, because it took time to develop and will require time to resolve.

[SparklyUnicorn]

And I'm curious as to what fasting regimes you have implemented and for what kind of duration? 

 

From the IDM site: Example 3 â€“ Suppose that your main problem is the insulin resistance cycle. This vicious cycle has developed over decades and insulin resistance is now the main stimulus to your high insulin levels. Reducing carbs may not be the most effective treatment. Why? Because your problem is the insulin resistance. Lowering carbs will lower insulin and reduce the vicious cycle, but this cycle has been running for decades.

So what do you need to do? Remember that the question of insulin resistance is mostly a question of ‘when to eat’. Therefore, to break resistance, you need a sustained period of low insulin. This means that fasting will be more effective here than simple carb restriction. You will also need time, because it took time to develop and will require time to resolve.

 

Either way, I have personally never come across anyone who gave (very) low carb an honest try who couldn't get off the meds.  Some people are able to just by losing weight, but I'd venture many can't quite do it with weight loss alone.  And you figure not all diabetics are overweight (my sister has never been overweight and has raging out of control diabetes). 

 

HOWEVER, I absolutely understand not wanting to do that.  Dieticians and doctors often warn against it (for what reason I don't know).  And some just don't want to only eat low carb all the time.  It's not an easy choice.  So some will settle for controlled with meds rather than go that route. 

 

[TravelingChris]

Losing thirty pounds is great, but are you now at a healthy weight?

 

Walking is great, but are you walking fast enough for fitness...i.e. 3.5 mph or higher for 45 minutes at a time? I meet plenty of people who walk, but its not fast enough or long enough to do anything.

Quite a number of studies are showing that you do not need to walk particularly fast, in fact, moderate walking is much healthier.  Many of the exercise tips have been proven wrong.  Like do you know that running fast is bad for you- like really bad?  Running slow is okay but running fast apparently does something to your heart and doing it on a regular basis increases your chances of death.  More and more studies with very long lived people and with generally healthy people are showing that a) low weight is not the panacea that has been touted and b) doing exercises like walking moderately or gardening, for example, are really all that you need to be healthy.  They have also determined that sitting too long is very bad.

 

As to diabetics and sugar and when they should eat, etc,= I am currently living with a type 2 diabetic and I have given up.  He is my s-i-l and I leave the nagging to my dd.  I have tried to provide smaller dinners (basically appropriate food portions)and keep both water and unsweet tea around at all times.  He likes to drink very large cups of juice.  I tell my dd that when he is off or going to work on second shift, I see that he is eating chips and juice for breakfast.  My dd who is INTJ like me and so very analytical, realizes that if he won't change his ways, very bad outcomes will occur.  She has really learned a lot about diabetes but they both have health issues (hers currently is anemia and probably also fibromyalgia) and so often when she comes back from work, she can do a bit and sometimes cook dinner but altogether they eat out too much.  And it is telling that often I, who have absolutely no issues with insulin and never have and never had in my family history, usually eat much less empty carbs and sugars than he does.  

[leeannpal]

Either way, I have personally never come across anyone who gave (very) low carb an honest try who couldn't get off the meds.  Some people are able to just by losing weight, but I'd venture many can't quite do it with weight loss alone.  And you figure not all diabetics are overweight (my sister has never been overweight and has raging out of control diabetes). 

 

HOWEVER, I absolutely understand not wanting to do that.  Dieticians and doctors often warn against it (for what reason I don't know).  And some just don't want to only eat low carb all the time.  It's not an easy choice.  So some will settle for controlled with meds rather than go that route. 

 

I guess i will settle for that :lol: I thought you meant get off meds and still live a normal life. I could eat just lettuce and a little rice and maybe a few beans for the rest of my life, but quality of life means a lot to me!  I do watch my carbs, but I work full time and home school my daughter. I don't have time to micro manage my food intake. I am at a healthy weight, not skinny, but I'm happy. I certainly know that most people will just say I am making excuses. True! I want to live life and not be weighed down with anxiety about what I am eating all the time. I guess I feel confidant that what I am doing is helping, because I am seeing my numbers come down. 

 

Forgot to mention that many people with PCOS take Metformin. So, I really am not on any Diabetes medicines. I've been on Metformin before. My A1C has never been above a 7. 

Edited February 16, 2018 by leeannpal

[SparklyUnicorn]

I guess i will settle for that :lol: I thought you meant get off meds and still live a normal life. I could eat just lettuce and a little rice and maybe a few beans for the rest of my life, but quality of life means a lot to me!  I do watch my carbs, but I work full time and home school my daughter. I don't have time to micro manage my food intake. I am at a healthy weight, not skinny, but I'm happy. I certainly know that most people will just say I am making excuses. True! I want to live life and not be weighed down with anxiety about what I am eating all the time. I guess I feel confidant that what I am doing is helping, because I am seeing my numbers come down. 

 

I completely understand!  Sounds like you are doing great.

[leeannpal]

DH is diabetic.

 

He is on medication. 

He has moved to a (typically) more whole foods / paleo diet. He does eat pasta on Sundays. It was a compromise considering his childhood memories of family pasta dinners after Mass on Sundays :p

 

He is involved in fast-paced, rigorous movement 4-5 nights weekly at the gym, with a good friend from the office (usually they play a full hour of racquetball, lol).

 

No matter what he tries, the weight isn't budging though. According to all tests with the doctor, his "numbers" are great. So, everything he is doing, and the medication he is on, is managing the diabetes itself -- but why isn't the weight budging at all?

 

He's getting particularly disheartened. 

 

Is it time for him to see an endocrinologist, maybe? At this point he sees only his PCP and I believe he sees the nutritionist every few months or so.

I think seeing an endocrinologist is a good idea. Is the whole foods diet new? If it is, give it time. He may begin to lose weight. He is exercising regularly, eating better and his numbers are good. That's great!

[melmichigan]

I guess i will settle for that :lol: I thought you meant get off meds and still live a normal life. I could eat just lettuce and a little rice and maybe a few beans for the rest of my life, but quality of life means a lot to me!  I do watch my carbs, but I work full time and home school my daughter. I don't have time to micro manage my food intake. I am at a healthy weight, not skinny, but I'm happy. I certainly know that most people will just say I am making excuses. True! I want to live life and not be weighed down with anxiety about what I am eating all the time. I guess I feel confidant that what I am doing is helping, because I am seeing my numbers come down. 

 

Forgot to mention that many people with PCOS take Metformin. So, I really am not on any Diabetes medicines. I've been on Metformin before. My A1C has never been above a 7. 

This is where I was to a degree, but my A1C has never been above 5.8 (on insulin some of the time), (I'm OCD about it after seeing the damage it can do firsthand and loosing my mother to diabetes at 35yo).  I have PCOS and take steroids for asthma, which also impacts my glucose levels.  I was stared on Metformin to help with infertility caused by PCOS 15 years ago, and it controls that successfully.  The downside is that I've been on it for 15 years, and now have problems with Vitamin D, B12, and Folate, as well elevated homocysteine levels showing chronic inflammation, all common in long term Metformin use.  My new neurologist is curious to see if it's contributing to my fatigue and pain as well.  Basically I thought I was helping, and in the long run, I created even more problems.  I just wish that a doctor had sat me down in the beginning and made simple suggestions, like lower carbs, and fasting to help decrease my insulin sensitivity.  I might not be where I am now.

 

OP, the highest success rate in reversing Type 2 diabetes is in the first few months, to within a year or two of diagnosis.  I would encourage your husband to research and make decisions with the long term in mind.  I don't have to do super low carb to see a big change. Yesterday I ate 182 carbs.  Wow, that's a high number although most were in the morning, where I tolerate them better. My highest blood sugar was 108, after dinner.  That's probably not low enough to loose weight, but I'm not to that point yet.   ;)

Edited February 16, 2018 by melmichigan

[Kiara.I]

I don't think he has listened to her [emoji14] The paleo move was more of a natural move on his end, and something some of his friends had had success with.

 

I'm not entirely sure how long he's been at the diet, actually -- I haven't really kept track. I was serving typically paleo meals for family meals before he went that way formally.

 

He's been at the gym consistently, at this pace, for a couple months? Prior to that, he was having trouble even walking the treadmill at home without being miserable. I really think finding a friend to do something interesting -- and rigorous -- with, was key for him. He's happy to put in the workouts now and comes home feeling great.

It sounds like his exercise is mostly cardio, though. Could he put in some muscle-building exercise?

 

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[leeannpal]

This is where I was to a degree, but my A1C has never been above 5.8 (on insulin some of the time), (I'm OCD about it after seeing the damage it can do firsthand and loosing my mother to diabetes at 35yo).  I have PCOS and take steroids for asthma, which also impacts my glucose levels.  I was stared on Metformin to help with infertility caused by PCOS 15 years ago, and it controls that successfully.  The downside is that I've been on it for 15 years, and now have problems with Vitamin D, B12, and Folate, as well elevated homocysteine levels showing chronic inflammation, all common in long term Metformin use.  My new neurologist is curious to see if it's contributing to my fatigue and pain as well.  Basically I thought I was helping, and in the long run, I created even more problems.  I just wish that a doctor had sat me down in the beginning and made simple suggestions, like lower carbs, and fasting to help decrease my insulin sensitivity.  I might not be where I am now.

 

OP, the highest success rate in reversing Type 2 diabetes is in the first few months, to within a year or two of diagnosis.  I would encourage your husband to research and make decisions with the long term in mind.  I don't have to do super low carb to see a big change. Yesterday I ate 182 carbs.  Wow, that's a high number although most were in the morning, where I tolerate them better. My highest blood sugar was 108, after dinner.  That's probably not low enough to loose weight, but I'm not to that point yet.   ;)

I am assuming you don't have Type II Diabetes. Is that correct? Not everyone with PCOS will end up diabetic. For a Type II diabetic, and A1C of 6.5 is very good. I have not been on Metformin for years. My vitamin numbers are fine. I am almost 52 years old and have no side effects from PCOS or Type II Diabetes. I've been diabetic for over 6 years. It is so interesting how our bodies can process things like medication so differently. I'm pretty sure I knew about how to eat better all these years, and In the last 4 years, I've mode lots of changes. For me, fasting is a big no no. For some Type II Diabetics, going hours without food causes major blood sugar spikes. I have altered my eating habits so that I eat small meals throughout the day. This has worked well for me. 

[Jean in Newcastle]

Yeah - fasting would cause my body to produce glucagon, which signals the liver to release glucose into the blood, thus raising my bloodsugar level.  It can be a really bad idea for a diabetic.  Being under the care of an endocrinologist who understands all the underlying science and issues would be really important, in my opinion. 

[melmichigan]

I am assuming you don't have Type II Diabetes. Is that correct? Not everyone with PCOS will end up diabetic. For a Type II diabetic, and A1C of 6.5 is very good. I have not been on Metformin for years. My vitamin numbers are fine. I am almost 52 years old and have no side effects from PCOS or Type II Diabetes. I've been diabetic for over 6 years. It is so interesting how our bodies can process things like medication so differently. I'm pretty sure I knew about how to eat better all these years, and In the last 4 years, I've mode lots of changes. For me, fasting is a big no no. For some Type II Diabetics, going hours without food causes major blood sugar spikes. I have altered my eating habits so that I eat small meals throughout the day. This has worked well for me. 

I've been considered diabetic for 10 years, and use an insulin pump when pregnant.  I'm considered an "extremely well-controlled diabetic."  My mother died of complications of peritonitis while a patient in the clinical trial to develop peritoneal dialysis, for treatment of kidney failure (related to diabetes) when I was ten.  

 

What works for one person doesn't necessarily work for another, otherwise doctors would be treating everyone with diet instead of handing them a prescription.  When I quoted you I said "that is where I was to a degree."  I've been in the mindset of just taking the medication because it's easier.  For me it was, and probably still is, but I'm trying something different based on new information.  I'm not sure if I'll be able to maintain it, the french fries my kids had with their fish tonight looked mighty good, and it isn't to say that what you are doing is wrong, I didn't mean to imply that. :)

 

 

Yeah - fasting would cause my body to produce glucagon, which signals the liver to release glucose into the blood, thus raising my bloodsugar level.  It can be a really bad idea for a diabetic.  Being under the care of an endocrinologist who understands all the underlying science and issues would be really important, in my opinion. 

 

Most fasting highs within the first 5 years of diagnosis of NIDDM are related to hormones versus diet.  Some people consider six hours between meals as fasting. :mellow:  I second the recommendation for a good endocrinologist.  

Edited February 17, 2018 by melmichigan