Combatting Type II Diabetes
December 19, 2014 12:18 PM   Subscribe

In July I was diagnosed with Type II Diabetes. Since then I've made significant changes to my lifestyle. I'm wondering what to expect on my next doctor visit.

In July I was diagnosed with Type II Diabetes. My blood sugar was 135 and A1C was 6.5. Since then I've made significant lifestyle changes, losing about 30 pounds and dropping my BMI from 32 (obese) to 29 (overweight).

The lifestyle changes I've made include at least an hour of strenuous exercise 5 to 6 days a week (mostly cardio -- running and biking -- with some weight training), and changing my diet from VB6-friendly to about 80% vegan with minimal simple carbs. (I'm still having a hard time avoiding alcohol, especially beer, but I have cut back quite a bit.)

I have my next blood work schedule for mid-January. With the progress I've made with my health so far, I'm wondering if I can expect my blood sugar and A1C to be below diabetic levels, or whether this takes much longer than a six-month turnaround.
posted by slogger to Health & Fitness (15 answers total) 8 users marked this as a favorite
Response by poster: Additionally, I'd be interested in recommendations for resources on how to manage and reverse Type II Diabetes. Thanks!
posted by slogger at 12:18 PM on December 19, 2014

Dr. Fuhrman says his diet will reverse the diagnosis. It certainly had a very positive impact on my Type II diagnosed spouse's blood sugar levels -- though he has yet to follow the diet 100% --and also made a dramatic positive change in my own cholesterol readings.
posted by bearwife at 12:31 PM on December 19, 2014 [3 favorites]

When I was diagnosed earlier this year my blood sugar was 150 and my HGB H1C was 7.0. About five months and 80 lbs later my numbers were 102 and and 5.2. My BMI went from 42 to just under 31. I was not expecting such a change in the numbers in what I thought was a short period. I did very little exercising, it was pretty much all sticking to a diabetic diet.
posted by greasy_skillet at 12:56 PM on December 19, 2014 [1 favorite]

Well done for making such profound efforts. As a Type II for a number of years (diagnosed in 1998) I think you'll find your next consultation will demonstrate a real drop in your blood glucose levels. Being in the UK we measure our sugars slightly differently, but your 135 blood sugar reading seems to equate to about 7.5mmol/l in British money, which is the upper end of what is termed a normal range here. So with the weight loss and the exercise I would be surprised indeed if you weren't within "normal" ranges.

I had a consultant tell me not long after I was diagnosed that if I could control my weight I would effectively not be diabetic anymore, so while you may always have to watch your weight and what you eat there would seem to be every chance you could control the diabetes as you are now without significant intervention.
posted by Martha My Dear Prudence at 12:59 PM on December 19, 2014 [2 favorites]

It's definitely possible. I was diagnosed several years ago (don't remember what my A1C was at the time, but I had two fasting blood glucose tests above 140). Like you I lost a chunk of weight (and started exercising on the regular) and I don't recall the last time I had an A1C above 5.8

If you don't have one already, you might consider getting a blood glucose meter. They're very helpful for tuning your diet and exercise regimen, although trying to figure out when to test after a meal to catch the peak of your blood sugar spike can be a challenge. One thing I've found, at least in terms of fasting numbers, is that the amount of exercise I've gotten the day before is more important than anything else.
posted by asterix at 1:06 PM on December 19, 2014 [1 favorite]

The A1C is simply a reflection of your blood sugar levels for the past 3 months. If you have been successfully controlling your diabetes with your diet and exercise (as it sounds like you likely have been doing), your A1C should reflect normal blood sugars. If you'd like to get more immediate feedback on how you're doing, you can pretty easily get a glucometer and monitor your own blood sugars (a little bit of an extreme step, but some people really like the positive reinforcement and seeing how their own body reacts to different meals/activities).

Anecdotally, I have PCOS and insulin resistance, and I tried a Whole30 back earlier in the year (which is a diet with no sugar and no grains). I managed to schedule to have my cholesterol panel checked right at the tail end of the W30 and the numbers were spectacular. Everyone's body is different in terms of how they will respond to diet and exercise regimens, but I just wanted to provide some anecdotal evidence that short interventions can make big differences.

Congratulations to you for changing your life!! Your doctor is going to be so impressed/proud (as you should be too, regardless of the numbers!)
posted by treehorn+bunny at 1:09 PM on December 19, 2014 [1 favorite]

How often are you testing your blood sugar? It sounds like you are making great progress towards a healthier lifestyle, but if you are checking your sugar regularly you would have a pretty good idea what your A1C would look like.

This is important because you need to know how your diet and exercise schedule affects your blood sugar. For example, I spend an hour doing intense olympic weightlifting at the gym and see that my blodo sugar has skyrocketed. Poor pre-workout nutrition caused my liver to dump a bunch of sugar into me and now I am at 220. Ick! Or maybe you learn that you are espetially insulin resistant in the morning, as many people are. So you shift some carbs around in your day to a time when you are less resistant.

The A1C tells you about on average what your levels were over three months. But a glucose meter check tells you a point in time and can help illuminate certain behaviors.
posted by munchingzombie at 2:34 PM on December 19, 2014

I tripped across this recently: The underappreciated role of muscle in health and disease
It talks a bit about the role muscle plays in the development of insulin resistance. It also talks a bit about how diet and exercise can combat that.

You can also look for information on "diabetes and inflammation." As one example, here is something I googled up (and did not read): Type 2 Diabetes: Inflammation, Not Obesity, Cause Of Insulin Resistance There are also books out there on anti-inflammatory diets and what not.
posted by Michele in California at 2:37 PM on December 19, 2014

I would definitely visit dr Jason fungs website: Intensive Dietary Management. he is developing a great rep for reversing diabetes with fasting and diet. Highly recommended
posted by chaoscutie at 2:51 PM on December 19, 2014

Response by poster: How often are you testing your blood sugar?

Only by visiting my doctor twice a year. I hadn't really thought of getting a glucose meter.

Or maybe you learn that you are espetially insulin resistant in the morning, as many people are.

Is this something a glucose meter would help me understand? My exercise schedule varies, mostly afternoons or nights. Would that also have an impact on blood sugar?

Thanks for the advice and resources everybody!
posted by slogger at 5:07 PM on December 19, 2014

I'm not a doc, but I work with docs including endocrinologists, and I've had T2 diabetes for 18+ years.
Monitoring your glucose is a good idea. It can help you understand the patterns of your body, and what influences your sugars.
You are absolutely on the right track, but your next readings can't be predicted. Blood glucose levels are determined by genetics and lifestyle, and the ratio is different for everyone. If you continue to do the right thing with diet & exercise, and reach & keep a healthy weight, you'll find out how far lifestyle alone can take you.
But diabetes is a progressive disease, and at some point you may need meds. You may need insulin, and possibly other injectibles. Insulin in particular is a miracle drug -- millions of people live long and productive lives because of it. It's easy, and getting easier. There will be more & better drugs in the future.
You have good prospects in front of you, especially by virtue of your willingness to fight for your health. Good luck.
posted by LonnieK at 5:24 PM on December 19, 2014 [1 favorite]

Is this something a glucose meter would help me understand? My exercise schedule varies, mostly afternoons or nights. Would that also have an impact on blood sugar?

A glucose meter will absolutely help you understand how your body responds to food and exercise and variations in both. Everyone's biochemistry is different, and the rules and tips that work for other people may not work for you. (E.g., some people can tolerate a moderate amount of carbs at dinner; I've found through testing that anything more than a very little bit will reliably spike my blood sugar above 140.) And yes, your schedule will definitely have an impact on your blood sugar.

One thing, if you do decide to get a meter: talk to your doctor and get a prescription for the testing strips. The manufacturers make their money on the razor principle (give away the razor, make all your money on the blades.) They're absurdly expensive if you have to pay out of pocket, but your insurance plan may well cover them.
posted by asterix at 6:26 PM on December 19, 2014 [1 favorite]

I would focus on "controlling" the diabetes not "reversing" it. There is a lot of stuff on the internet that is basically fat-shaming diabetics for causing their own diabetes with their bad diet and lack of exercise and general lack of moral fibre. A lot of this stuff is written by non-doctors, often with a supplement or diet or training plan to sell that they claim will completely cure diabetes if only people stick to it. This is mostly snake-oil - we can't cure diabetes, though we can reduce people's insulin requirements so their blood sugars come down. The super-low calorie diet study everyone talks about followed 11 patients for 8 weeks; that's not a "cure".

Losing weight is great, exercising more is really great, and avoiding simple carbs is great (you do need some carbs in your diet). I bet your results will be better now that you've made those changes. Also if you smoke, stop. But don't be discouraged if you never "reverse" your diabetes - most people just can't and it isn't lack of willpower on their part.
posted by tinkletown at 6:55 PM on December 19, 2014 [3 favorites]

Further anecdata - my dad, who I've written about before, was diagnosed in his late 30s with Type 2 and has now just turned 80. For most of that period of time, he controlled things through diet and tablets. He also tests his blood sugar many times a day (probably too often) with a meter and as such has a very good idea of what's going on in good time to deal with it (more food or more exercise).

And absolutely yes to the genetic aspect - he and his sisters (who were all slim, and he worked in a car factory for 40+ years doing heavy manual work) and his mum were all T2.
posted by Martha My Dear Prudence at 1:09 AM on December 20, 2014

Sounds like you're doing pretty well and as a non-medical person I'd guess that you ought to expect improved numbers on your next doctor's visit! I just thought I'd mention that as someone with much more severe type 2 diabetes than you, what I eventually found is that my consumption of complex carbohydrates play a much more substantial role in determining my blood glucose level than simple carbohydrates do. If earlier on I'd discovered how easy a low-carb diet can make losing weight, I'd probably have arrested the progression of my diabetes much sooner.

Also, check out sugar alcohol products: things that are usually labeled "sugar free" but which are NOT diet food. Sugar alcohols are just sugar substitutes that have all the same calories but a slower, more spread-out effect on blood glucose levels.

Exercising, even just going out for a sedate walk, does reduce my glucose level. My doctor claims that regular vigorous exercise is as valuable as any two oral diabetes medications and my experience has supported that.

As asterix says, if you get a meter to monitor your glucose level, get a prescription for it to reduce costs: the most expensive part of it isn't the meter itself but the disposable test strips or cartridges the meter uses and other attendant supplies, which is why medical equipment companies are so eager to get their brand of meter in your hands. (One more thing - different meters advertise differences in the number of seconds it requires to take a measurement. This sounds unimpressive and doesn't matter much if you only test infrequently, but if you get to a point where you're taking multiple measurements per day a quick test is much more important; if you've just gotten home after working out a complicated testing procedure is annoying and easy to skip.)
posted by XMLicious at 5:32 AM on December 20, 2014

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