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Can a diabetic ever become non diabetic? Print
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Bill Harborne
August 14, 2011, 1:20pm Report to Moderator
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Posts: 241
Given that diabetes type 2 can be triggered by obesity, does it go away if a persons weight is brought within the normal range?


T2, 121Kg,HbAic 11.3%, BP 144/79
Metformin 500mg x4, Lipitor 40mg,Lisinopril 10mg, Asprim75mgx2,Ranatadine 5mg, Insulin Novomix30  60units day 40units a day,Adizem xl 300mg. Toblerone 50 gr monthly.


My Poetry:http://www.diabetes-support.org.uk/diabetes_blogs/?cat=20

Latest poems.  Recommended accomodation and The Masters Dying..
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nytquill17
August 14, 2011, 3:08pm Report to Moderator

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Bit of a controversial question actually.  We have a member Wallycorker who pops in from time to time who in his own words is no longer diabetic for reasons similar to what you're asking about.

But in the main I think most people feel that once diabetic, always diabetic.  Though if you lose enough weight your blood sugars might come down on their own, your need for medication might drop or disappear but...the function of the pancreas would still be limited, and if the weight came back (or the person started eating the "standard" high carb refined flour/sugar diet again) the high blood sugars would also be back.  So in that sense the person isn't "cured" because they still have to maintain certain lifestyle changes in order to maintain the results, and can never go back to living the way they were before diagnosis.

Not to mention there are plenty of people that lose weight, change their habits and actually don't see that kind of result in the first place.

A couple folks on here have had quite a fight trying to stop their doctors reclassing them as "nondiabetic" just because they worked hard and got an A1C in the 5's.


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libra201055
August 14, 2011, 5:33pm Report to Moderator

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Quoted from nytquill17

But in the main I think most people feel that once diabetic, always diabetic.  Though if you lose enough weight your blood sugars might come down on their own, your need for medication might drop or disappear but...the function of the pancreas would still be limited, and if the weight came back (or the person started eating the "standard" high carb refined flour/sugar diet again) the high blood sugars would also be back.  So in that sense the person isn't "cured" because they still have to maintain certain lifestyle changes in order to maintain the results, and can never go back to living the way they were before diagnosis.


I agree Nyt - I was not clinically obese when diagnosed T2 and have lost weight, I now hover around 10st & @ 5'8" that is kind of ok. I have managed to reduce my meds (was originally on Glimepiride and then metformin was introduced) but not completely and I know from testing that I am still diabetic and always will be.

I cannot eat bread, pasta, pastry etc anymore and expect to retain my HbA1c at the levels I have managed to get it to with testing and managed carbs - and I suspect that my next one at the end of the month will not be anywhere near as good as it has been the last few times due to an overindulgance of chocolate and Mikado sticks for the last 8 months.  


Jenny

Dx Type 2 in October 2004

Meds currently - 2 x 500mg Metformin SR, Ramipril (10mg), Fluoxetine (20mg)

HbA1c - At Dx 12.3; '05 - 7.1; '06 - 8.1; '07 - 7.1 & 7.3; Feb'08 - 10.3; July '08 - 7.7; Feb '09 - 5.8: Aug '09 - 5.6: Sept '10 - 5.7: Sept '11 - 5.9  

Join us in the new DSF forum here - http://79.170.42.2/diabetes-support.org.uk/diabetesforum/index.php
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Idreamofchocolate
August 14, 2011, 5:39pm Report to Moderator

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Hello, Bill. I will never believe that you can become 'non diabetic' just because you have good levels and an HbA1c in the 'normal' range. I am one of the people that Nytquill mentions whose GP is trying to reclassify as non diabetic, with a glucose tolerance test in two weeks' time. Purely because through modifying my diet, exercising and losing weight I dropped my HbA1c from 7.4 to 5.7.

However, that was about twelve months ago, and I have proved, sadly, that weight gain and a shift to the dark side diet wise has meant weight gain, rising levels on my meter (which my GP is dismissing) and very probably a rise in HbA1c, a blood test for which I had last Wednesday. I get the results next week, and that should be interesting. You will be able to knock me down with a feather if my HbA1c is the same as twelve months ago.

I am back on the wagon big time now, and I fully expect to get things back under control. But that is all it is - under control. It hasn't gone away, and it will rear its ugly head the minute I take my foot off the brake for more than a moment or two.

There is this thing going round now about that very low calorie diet making diabetes go away, but I'm very sceptical. http://www.guardian.co.uk/society/2011/jun/24/low-calorie-diet-hope-cure-diabetes I truly don't think you would be able to eat as you did before, after having been on this low calorie diet, and not show signs of diabetes again. Having said that I can't possibly know and can only give my very humble opinion. It remains a nice dream


Maureen

Type 2 diagnosed June 08. HbA1c 5.9 (Sept '11)  Doxazosin 2mg/Amlodipine 10mg.

“Piglet: "Pooh, how do you spell 'love'?" Pooh: "You don't spell it, you feel it."” ~ Winnie The Pooh

When the world says, “Give up,” Hope whispers, “Try it one more time." ~ Author Unknown
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Pattidevans
August 14, 2011, 8:15pm Report to Moderator

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I think Wallycorker was working on the theory that if he removed all fat from round his pancreas and liver then the diabetes was "reversed".  He certainly said he could eat carbs with impunity, I think it may work for a few, but most people will always be diabetic and just succeed in being a well controlled diabetic.


Patti

Type 1 on Levemir/Humalog, Lisinopril, Thyroxine, Liothyronine and now 1000mg Glucophage SR. Last Hba1c 5.6  Highest Hba1c since March 2004.
Please visit our new forum http://diabetes-support.org.uk/diabetesforum/index.php as this one has closed
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TessaH
August 14, 2011, 8:43pm Report to Moderator

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That's what I'm working on being. The nurse practitioner at the GP's asked if I wanted to be reclassified and I told her absolutely not , as I know from testing that if I start eating as I did before, I will be back up to diabetic levels . I hover too close to 12 stone and at 5'4 this is no time to be putting weight back on. I'd like to be hovering around 11 stone , tops .

I like the nurse prac but was surprised she even asked the question as the answer is so obvious to me. Turned out she had recently had a patient who did want to be declassified .. I might ask her one day if that patient has managed to stay non-diabetic ! I may be deluding myself but for me it seems important to feel the label stuck to my forehead. As it were.


Type 2 ; Dx Nov 5th 2009; diet and exercise;
HbA1c  5.8 May 11,5.4 Oct 10, 6.1 Feb 10 ,5.9 Nov 09;
Total chol 7.1 Dec 10,7.3 Oct 10 ,4.4 Feb 10 (statins),7.5 Nov 09 

Weight loss 42 lb, working on next 14 lb
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Alan
August 14, 2011, 11:25pm Report to Moderator

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Quoted from Bill Harborne
Given that diabetes type 2 can be triggered by obesity, does it go away if a persons weight is brought within the normal range?

Weight loss alone is not going to do it, although there is present research suggesting that surgically-induced weight reduction methods may have that effect. I reckon it is still too early to know for procedures such as bariatric surgery.

If by "non diabetic" you mean cure, the answer is emphatically no. If by "non diabetic" you mean become controllable to minimise or defer complications, the answer is maybe.

Weight loss is, for most type 2s, only part of the control regimen. My own example is here; I reduced my A1c from 8.2% to 7.5% when I lost about four stone, but I had to do more to get under 6%. Weight loss improves insulin resistance but it does not change signalling flaws, beta cell loss or other underlying problems.Weight loss, or more correctly, achieving and maintaining an appropriate weight, is a valuable part of the treatment but not the complete  treatment.


Cheers, Alan, T2 dx April 2002, Australia.
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Everything in Moderation - Except Laughter.
http://loraldiabetes.blogspot.com (Free Radicals and James Bond)
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Bill Harborne
August 15, 2011, 12:11am Report to Moderator
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I found all your answers most interesting and about what I expected, the only hope then lies in new ideas such as stem cell implants. What then does being obese actualy do to bring on diabetes? presumably it does permanent damage to pancreas cells? can panceases (pancri) be transplanted? I have a sister who is looking a bit green round the gills, maybe I could take out an option on hers.
Another question, I am now on Victoza and insulin, ive already had to reduce the insulin by 20% to avoid hypos, is it likely I will be able to come off insulin altogether? thus avoiding its propensity to put my weight up?
I am currently going down the low carb route and I wonder if this is sutainable long term? are there health concerns regarding low carb diets? can low carb diets include fruit because I do like my fruit and fruit is of course considered healthy yet low carb diets seem to focus on vegetables.

One more question regarding long term hssbcacwhatsits, is that measure basicaly an average of all the sugar levels over a 3 month period or do the odd spikes knock it up out of proportion to the norm? do hypos pull it back down in an equal manner? Im just trying to get a handle on this most complitated and frustrating condition.

Oh and one more question lol, does any nerve damage or other unfortunate effects of diabetes ever repair itself if good control is achieved? I have no real signs of any damage after 14 years of poor control but has there probably been some damage that i am not aware of?

There is no fourth question (yet)

Kindest regards and thanks, Bill


T2, 121Kg,HbAic 11.3%, BP 144/79
Metformin 500mg x4, Lipitor 40mg,Lisinopril 10mg, Asprim75mgx2,Ranatadine 5mg, Insulin Novomix30  60units day 40units a day,Adizem xl 300mg. Toblerone 50 gr monthly.


My Poetry:http://www.diabetes-support.org.uk/diabetes_blogs/?cat=20

Latest poems.  Recommended accomodation and The Masters Dying..
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TessaH
August 15, 2011, 10:54am Report to Moderator

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Fruit : your meter will tell you what you can eat and when. Many of us find that breakfast is a bad time for fruit as all carbs seem to have more of an effect on our BGs earlier in the day. As for which fruit , berries are the least carby. Oranges and bananas spike my BG worst of all , so I don't have them. Stone fruits are OK for me in moderation , eg two plums or a nectarine , and I'll have them after lunch or in the evening - maybe both. Dried fruits are lethal , as is good old orange juice - I don't drink any fruit juice because I've seen what my meter says about it . Berries are a wonderful discovery , and you can test to see what size portion is OK for you.
"Healthy" takes on a different meaning when your most important criterion is "low in carbs" . Yes , if I ate more fruit I would have less trouble with constipation , but I prefer to solve that with medication (Movicol) rather than raise my BGs. I eat a lot of veg but even so they don't provide enough fibre.


Type 2 ; Dx Nov 5th 2009; diet and exercise;
HbA1c  5.8 May 11,5.4 Oct 10, 6.1 Feb 10 ,5.9 Nov 09;
Total chol 7.1 Dec 10,7.3 Oct 10 ,4.4 Feb 10 (statins),7.5 Nov 09 

Weight loss 42 lb, working on next 14 lb
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Pattidevans
August 15, 2011, 11:46am Report to Moderator

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Quoted Text
I found all your answers most interesting and about what I expected, the only hope then lies in new ideas such as stem cell implants. What then does being obese actualy do to bring on diabetes? presumably it does permanent damage to pancreas cells? can panceases (pancri) be transplanted? I have a sister who is looking a bit green round the gills, maybe I could take out an option on hers.
It's something to do with fat around your liver and pancreas Bill.  The more fat you carry the more you have insulin resistance.  Pancreases can be transplanted, but it's highly likely yours is still producing insulin and you just have insulin resistance.  Of course, sometimes the trigger has gone missing so you don't produce enough first phase insulin, though second phase may kick in as usual.  I think it's highly unlikely a T2 would get a pancreas transplant and in any case I'd not want one even if on offer, the anti rejection drugs you have to take can be very unpleasant apparently.
Quoted Text
I am currently going down the low carb route and I wonder if this is sutainable long term? are there health concerns regarding low carb diets? can low carb diets include fruit because I do like my fruit and fruit is of course considered healthy yet low carb diets seem to focus on vegetables.
I have sustained a moderate carb diet for 8 years with no bad effects.  As Tessa says, your meter will be the judge of what you can and can't tolerate (and when) in the way of fruit.
Quoted Text
Another question, I am now on Victoza and insulin, ive already had to reduce the insulin by 20% to avoid hypos, is it likely I will be able to come off insulin altogether? thus avoiding its propensity to put my weight up?
People can and do come off insulin when other meds/diet are controlling the BGs.
Quoted Text
One more question regarding long term hssbcacwhatsits, is that measure basicaly an average of all the sugar levels over a 3 month period or do the odd spikes knock it up out of proportion to the norm? do hypos pull it back down in an equal manner? Im just trying to get a handle on this most complitated and frustrating condition.
It's a little bit more complicated than "an average" but to answer your question, yes, wildly fluctuating blood sugars can result in a Hba1c that looks OK on the surface of it, but is actually reflecting many highs and lows.
Quoted Text
Oh and one more question lol, does any nerve damage or other unfortunate effects of diabetes ever repair itself if good control is achieved? I have no real signs of any damage after 14 years of poor control but has there probably been some damage that I am not aware of?
The problem generally with neuropathy is that it's insidious, comes on very slowly so you don't notice you're getting it.  When I got my BGs under control I got some nasty pains in my feet, which was the damage repairing itself, but I hadn't previously noticed that my feet were getting numb.  My feet are just fine now.


Patti

Type 1 on Levemir/Humalog, Lisinopril, Thyroxine, Liothyronine and now 1000mg Glucophage SR. Last Hba1c 5.6  Highest Hba1c since March 2004.
Please visit our new forum http://diabetes-support.org.uk/diabetesforum/index.php as this one has closed
© 2011 Patti Evans
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nytquill17
August 15, 2011, 12:31pm Report to Moderator

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Okay, deep breath, this is a bit of a long reply!

Quoted from Bill Harborne
I found all your answers most interesting and about what I expected, the only hope then lies in new ideas such as stem cell implants. What then does being obese actualy do to bring on diabetes? presumably it does permanent damage to pancreas cells?


Well, there's a lot that isn't fully understood.  But the thinking is that the beta cells (the type of cells within the pancreas that produce insulin) sort of exhaust themselves and burn out.  Being overweight means the insulin has more area it has to get to (so to speak) and also a lot of times that the body is not able to use this insulin efficiently so it actually takes more insulin that it should to do the job.  Which adds up to an increased workload for the beta cells until they just can't cope anymore.  But there are other factors at work also that aren't fully explored.  Plenty of normal-weight people get T2 diabetes also.  Some overweight people actually developped the weight problem because of an insulin problem first, etc.  Diabetes is a lot less straightforward than we used to think.

Quoted Text
can panceases (pancri) be transplanted?


They can.  But it's not done until the need is dire, because it means a life-threatening surgery and immunosuppresant drugs for the rest of your life.  Those drugs are more heavy-duty than the oral meds for diabetes or even insulin so they don't like to condemn you to take them forever unless not getting a transplant would be somehow worse for you.  And in most T2s the pancreas is actually still working, though not quite enough, so it just needs a little boost to get the whole job done.

Quoted Text
Another question, I am now on Victoza and insulin, ive already had to reduce the insulin by 20% to avoid hypos, is it likely I will be able to come off insulin altogether? thus avoiding its propensity to put my weight up?


It depends why you were put on insulin.  Sometimes the beta cells in a T2 diabetic will pack it in, if their high workload goes on for long enough.  If enough of them do this, then you're not producing much insulin at all by yourself anymore and you need injected insulin to do the job for you.  If that's your case then you probably won't be able to come off insulin because the injected insulin is only or near the only insulin you're getting.  But losing weight can reduce the amount of insulin you need overall which doeos help towards weight loss.

On the other hand if it's just that the oral meds weren't doing enough of a job, or were having lots of nasty side effects, and insulin was the better option, you may have enough insulin production of your own still going underneath that you might be able to get by without it.  The thing is, we often don't really know which is which, because the only evidence we have to go on is "the oral meds aren't working" but we don't know WHY - whether it's due to no more insulin being produced in the body for the pills to go to work on, or whether it's some other quirk of body chemistry and the insulin is still there underneath.  So I don't think it's possible to know really until you get there, what medications you could come off of and what you will still need.

Quoted Text
I am currently going down the low carb route and I wonder if this is sutainable long term? are there health concerns regarding low carb diets? can low carb diets include fruit because I do like my fruit and fruit is of course considered healthy yet low carb diets seem to focus on vegetables.


Tessa has given you great advice re: fruit.  Absolutely low-carb is sustainable long term; many of our members have been doing it now for years and years.  And there was a time in our history when carbs weren't such a big part of our diet.  Now between post-war economics and a giant fear of dietary fat, they are practically being pushed at us and we've been conditioned to think anything less than 300g a day is somehow scary.  But when you think about it, the human race has survived on nuts, berries and whatever it could hunt, for ages before we invented farming and started growing grains and making bread, didn't we?  Or if that's too theoretical, then just look back 50-100 years ago or a bit more, people were eating more fat and fewer carbs than what we get today and yet they didn't have our epidemics of obesity and heart disease and they survived quite well.

Some people worry that low-carbing might deprive a person of the B vitamins normally contained in/added to grain foods and flours.  B vitamins are also found in meat though, and some vegetables, etc.  Personally I don't think it's a big problem, but if you're concerned you can easily take a B-complex supplement.   I take one anyway, just for general health purposes not related to low-carbing.  Do be warned if you've never taken one before it can give you bright yellow urine for a few hours afterwards! (that's the excess vitamin B1 getting filtered out - harmless, but a bit startling!)

Quoted Text
One more question regarding long term hssbcacwhatsits, is that measure basicaly an average of all the sugar levels over a 3 month period or do the odd spikes knock it up out of proportion to the norm? do hypos pull it back down in an equal manner?


An HbA1C (or haemoglobin A1C) essentially measures your red blood cells' total lifetime exposure to glucose.  Haemoglobin is one of the substances contained in a red blood cell and among other things it "collects" bits of glucose as it travels along, like a piece of sticky tape.  So during periods of high blood sugar, there's more glucose floating around so more than usual gets stuck to the "tape."  During periods of low or normal blood sugar, less glucose gets stuck to the tape.  So each kind of blood sugar affects the A1C proportionately to the length of time it persisted.  If you have high blood sugars for 6 hours, well that's 6 hours each red cell is exposed to that amount of glucose.  If you have a low blood sugar for 30 minutes, that's 30 minutes they are exposed to low amounts of glucose.  Does that help?

One thing to keep in mind about the A1C measurement is although it's talked about as a "3-month average" it's really not.  The life of a red blood cell is 3 months, yes, but when they draw the sample it's not all 3-month-old cells at the end of their life cycle.  There are also lots of new young cells, lots of middle aged cells, etc.  So when they read the average of the sample, there are far more cells that have been around for only 2-4 weeks in that sample, then there are cells that have been around the whole 3 months.  The further back you go, the fewer cells there will be representing that time period (ALL cells in the sample have been present the last week or so, most cells have been present the last month, some have been present for 2 months, and a few have been around 3 months).  So the last few weeks of your BGs are overrepresented, which makes it a weighted average, weighted to the last few weeks.  This is important if, say, you've been having great BGs but the last 2 weeks have had a nasty bout of flu or something causing your BGs to go up, then you get your A1C done, it's going to reflect a higher number than you might expect because recent events like the flu are overrepresented.

Quoted Text
Oh and one more question lol, does any nerve damage or other unfortunate effects of diabetes ever repair itself if good control is achieved? I have no real signs of any damage after 14 years of poor control but has there probably been some damage that i am not aware of?


It certainly can.  A lot of diabetic problems can be reversed if a person gets better control before the damage gets beyond a point the body can heal and repair.  In fact a lot of people report uncomfortable sensations as their blood sugars come back down, which worries them, but in point of fact it's just the nerves healing.  Like your leg going to sleep.  You don't notice as you're sat on it that anything has happened, because the nerves just gradually go dead so you don't feel a thing.  But when the blood flow comes back and they start to wake up, then you feel it!  There is also a "neuropathy cocktail" of vitamins that many people find helps the repairs along, we have an article about it here: http://www.diabetes-support.org.uk/info/?page_id=597

Quoted Text
Im just trying to get a handle on this most complitated and frustrating condition.


That's a very apt description.  I think we all get frustrated and confused at times, I know I certainly do (at least a few times a week, LOL).  But you're doing a great job educating yourself and you're asking lots of really good questions   Keep on asking, as many as you have!  You are 99% of your diabetes care, not your doctors.  So you're the one that has to know this stuff as much as, if not more than, they do!

Edit: was typing while Patti posted


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TessaH
August 15, 2011, 2:44pm Report to Moderator

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Bill, you might like to know one of the few useful things my GP said : "if you lose 10% of your bodyweight, your pancreas will be 20% more efficient". I don't know how accurate this is, and as Alan says, there's a lot more to it, but I have read this elsewhere as well , and find it encouraging.


Type 2 ; Dx Nov 5th 2009; diet and exercise;
HbA1c  5.8 May 11,5.4 Oct 10, 6.1 Feb 10 ,5.9 Nov 09;
Total chol 7.1 Dec 10,7.3 Oct 10 ,4.4 Feb 10 (statins),7.5 Nov 09 

Weight loss 42 lb, working on next 14 lb
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Idreamofchocolate
August 15, 2011, 3:29pm Report to Moderator

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I know one thing - I've been back carb controlling as I did when diagnosed for a little while now and I am not losing an ounce. I feel it's going to be harder this time somehow. Back to the drawing board  


Maureen

Type 2 diagnosed June 08. HbA1c 5.9 (Sept '11)  Doxazosin 2mg/Amlodipine 10mg.

“Piglet: "Pooh, how do you spell 'love'?" Pooh: "You don't spell it, you feel it."” ~ Winnie The Pooh

When the world says, “Give up,” Hope whispers, “Try it one more time." ~ Author Unknown
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Bill Harborne
August 15, 2011, 6:24pm Report to Moderator
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What a brilliant load of answers from you all, perhaps my doctor could do with a few hours on this board.

Just one more question, Ive been on Victoza now for two weeks, the mild nausea has helped me eat far better than i used to, together with my new found entheusiasm. but I am not losing weight. Im my 63 year old semi confused state I have developed a theory born out of dieting since i was a teenager and continualy off and on ever since. This is it, perhaps you could all let me know if there is some sense to this.

I believe the body has a momentum for either putting weight on, or losing weight. If one is on an upward curve it takes a few weeks to halt that and begin a downward curve, no amount of starving will speed this up, conversley if one is on a downward curve, you can cheat quite a lot (not regularly) and the downward curve is maintained. Maybe this is just how it works for me. I have lost a lot of weight over the years from 20 stone to 13 st a few years ago, and more recently from 22 to 18, (Now back up to 19st) but every time  for one reason or another (Chistmas, holidays etc) it all piles back on in a terrifyingly fast time. Over the years there has been a change in my body shape, when i was farming I had strong powerful legs and arms, now I have amazingly thin legs and arms, quite normal in fact, but all the weight has gone to my stomach area. Am I talking utter twaddle or is there some sense in this.

My dieting over the years has been for health reasons without the diabetic insentive, but of course now it is literaly life or death. I had two replacement hips a few years ago and unfortunately I still get pain if i walk any distance, this makes exersise problematic, I think losing weight (if it happens) will ease the strain on my hips and make walking easier.

Kind regards Bill


T2, 121Kg,HbAic 11.3%, BP 144/79
Metformin 500mg x4, Lipitor 40mg,Lisinopril 10mg, Asprim75mgx2,Ranatadine 5mg, Insulin Novomix30  60units day 40units a day,Adizem xl 300mg. Toblerone 50 gr monthly.


My Poetry:http://www.diabetes-support.org.uk/diabetes_blogs/?cat=20

Latest poems.  Recommended accomodation and The Masters Dying..
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libra201055
August 15, 2011, 6:35pm Report to Moderator

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Can't comment about Victoza as have never taken it

I do know that some years ago (before diabetes) I lost 2 st on a "group" diet programme in 6 months - stopped going when I reached my target and over the next year quickly put on 3 stone with no trouble as I had not changed my relationship with food and gradually moved away from the diet to my old ways of eating.

The difference with carb management is that I feel so much better when I am "good" and rubbish when I overdo the carbs. I lost weight when I started testing and eating to my meter but have put a bit back on this year, however, my weight has been stable now for 3 months or so so I reckon that what I eat now and the little exercise I do is right for the weight I am and that is kind of ok while I try and get back on track with the testing regime.

I am hoping the HbA1c at the end of the month will be bad enough to give me the kick I need....


Jenny

Dx Type 2 in October 2004

Meds currently - 2 x 500mg Metformin SR, Ramipril (10mg), Fluoxetine (20mg)

HbA1c - At Dx 12.3; '05 - 7.1; '06 - 8.1; '07 - 7.1 & 7.3; Feb'08 - 10.3; July '08 - 7.7; Feb '09 - 5.8: Aug '09 - 5.6: Sept '10 - 5.7: Sept '11 - 5.9  

Join us in the new DSF forum here - http://79.170.42.2/diabetes-support.org.uk/diabetesforum/index.php
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