Diagnosed with type 2 diabetes. Looking for Toronto-based resources.
January 11, 2023 6:22 AM   Subscribe

I was just diagnosed with type 2 diabetes. I'm feeling all the feelings and want to do all the things. Can you provide any Toronto-based recommendations for an endocrinologist, or even a nutritionist or therapist that might be good for someone in this situation? General thoughts would be welcomed as well. Thanks!

I'm a 42 year old male with a history of heavy weight and dieting where weight comes off and on, if it's helpful.
posted by evadery to Health & Fitness (6 answers total) 7 users marked this as a favorite
Hi! I am 48, I was diagnosed with Type 2 Diabetes about 6 years ago (so the same age you are), non-insulin treatment. My weight had increased greatly, but then I changed my diet and took a bunch off but hadn't gotten back to my original weight, it wasn't until my doctor did some unrelated tests (did a pee test for something else, sugars were high) did we connect the weight gain was due to Type II Diabetes.

It sucks, but (if you aren't on insulin) you take some pills once or twice a day, watch your sugar/carbohydrate intake, exercise and monitor your health, and you should be OK. Insulin isn't horrible, it's just a lot more work to maintain.

My two biggest worries are:
  • I don't want it to get worse to where I need to take insulin to control it
  • I'm starting to get some neuropathy in my feet, which concerns me since I don't want to lose any toes
But these just give me goals for things to avoid; I follow through with my labs to monitor A1C and I have a glucose meter to monitor periodically in case I'm feeling weird (which happened quite a bit when we were trying to figure out my meds but has been stable for almost a year I think).

There's pressure to get you into the "normal" range, but I'm still about 20lbs over where I should be, my A1C is over 7, but my weight and A1C are stable and that's probably the hardest hurdle.

Are you good with routines and consistency? Diabetes is largely about maintaining, so if you can go without sugar soda, great, but if you can only do it for a couple months but then lose momentum and return to old bad habits, that will work against you. Endocrinologists and nutritionists can help but if you can't keep up with their instructions their help doesn't matter.

The general good news is weight gain is generally a symptom of insulin resistance, so once you get that under control, it should be easier to control your weight, although due to age it's always hard to really lose weight, but hopefully you at least see some significant improvement once you get your sugars under control.
posted by AzraelBrown at 6:47 AM on January 11, 2023

Hi-type 2 here also.
Here is some more info on that. Perhaps it will be of some help for you?

posted by LOOKING at 8:41 AM on January 11, 2023

I was diagnosed with t2 diabetes a year ago. I have reduced my blood sugar from 280 to 114 and A1C from 11.4 to 5.6 by a pretty strict low carb diet. weight loss, and metformin. I was at my doctor yesterday and he said I was doing "great".

This book is helpful about understanding the condition. The author is the doctor who originated the theory that weight loss is the key to recovery. He basically promises a "cure" which may or may not be realistic, but it is something to hope for. It keeps me motivated to keep losing weight.
posted by H21 at 8:45 AM on January 11, 2023

I’m sorry to hear about your diagnosis. I’m about your age and was diagnosed a couple of years ago. It has been a big adjustment, and a lot of grieving for the stuff I can’t eat anymore, but the good news is that I feel SO much better day to day since my diagnosis and eating appropriately for it, it’s night and day. Problems I’d had for years or basically my entire life with fatigue, low blood sugar episodes, and unbearable hunger just… went away. Which makes it easier to stick to a low-carb diet day to day, because I physically feel the consequences almost instantly.

Jenny Ruhl’s website and books were hands down the most helpful resources I found when I was diagnosed (ignore the terrible graphic design) —they helped me understand the disease much better than my doctor/diabetes educator/nutritionist ever did.

My #1 advice is to get a continuous glucose monitor for at least a month (you don’t need to necessarily stay on it forever) even if you have to pay out of pocket. This gives you a more or less real time, continuous picture of how your blood sugar reacts over time, instead of the single points of data from a fingerstick blood test. You can then observe the way your body reacts to different foods after you eat, and how that makes you feel. Plus you can see the effects of exercise right away. It was eye-opening to see how much just a small bowl of rice would spike my blood sugar, for example.

I also recommend checking out The Glucose Goddess (haven’t read her book but she posts a lot of good info on Instagram) for “hacks” supported by solid science that will help with leveling out your blood sugar, Metabolical by Dr. Robert Lustig for understanding the root causes of metabolic syndrome, and Dr. Jason Fung and Optimising Nutrition for info on intermittent fasting (which i do not personally do because it’s hard for me, but I know people who have had good luck with it.)

I got my A1C down into normal ranges pretty quickly by following a low-carb diet (5.3 when it was at its lowest) and increasing my exercise, so my diabetes has been in remission. It is really important to find a diet and lifestyle that will work for you long-term.

Be aware that the standard treatment guidelines and a lot of the advice you may get from nutritionists and diabetes educators will treat this disease as inevitably progressive, out of your control, and something you just throw meds at until you need to go on insulin and then they’ll prescribe that to you instead. (I’ve had a lot of bad experiences with fatphobic and dismissive healthcare providers through this.) But if you take this seriously from the start of your diagnosis and make some diet and lifestyle changes that you’re able to sustain, you can have a lot more control over your disease and your fate. I have a lot more links to share if you want, feel free to memail me.
posted by music for skeletons at 9:44 AM on January 11, 2023 [2 favorites]

Dr Jason Fung works in Scarborough, so worth checking out. A member of my family has had good results working with him, although she’s now following more of a whole foods program.
posted by warriorqueen at 2:08 PM on January 11, 2023 [1 favorite]

I am really sorry to hear this. I got my first diagnosis about 11 years ago when I was 28. I was overweight/obese at BMI 33. The first three years were really brutal because I just couldn't accept it and I would try to "walk it off". It didn't help either that I was in a stressful PhD program in the US as an international student (and scared of any healthcare bills). After being in Austria for a few years, I got the courage to go and get diagnosed again (A1c around 10) and got put on Metformin. I was told to reduce 5% body weight by any means possible. I used a fingerprick meter for the initial years and tested myself religiously (test strips are way cheaper on ebay, so pay out of pocket if needed). Cut down on carbs as much as possible (kinda difficult for a vegetarian) and tried to exercise. No change in weight, the A1c was at 7.

The thing is one year or so after taking medication, the body righted itself a bit and I lost about 13% weight in about 3 months. No idea how (as in yes I understand posthoc but how the body decided to just do it one day, don't know). However, visceral fat still remains (and still contributes to insulin resistance). Then I lost about 7% more with some extra biking and hiking, some home exercise during Covid (and my mother's death) but have gained about 5% back. I have been at 6-6.5 A1C for 3 years now. Now it is a combo of metformin and Empagliflozin. Sometimes I forget to take them for a day or two. By day 3/4 there is a psychological itch to "fix it". Sometimes there is stressful/mindless eating. However, I don't test blood sugar frequently anymore as I have a feel for changes in blood sugar (dry mouth, body shakes and jitter, general vertigo, night sweats) and just a general awareness for what I have eaten/how much have I walked/how long is it after my last meal etc..

This reads like a diary entry a bit... LOL! But I just want to say it can be really overwhelming and the added existential dread and stress do not help the sugar levels at all. So, feel all the feels. Let yourself grieve for your past and future and give yourself a lot of time and compassion to come to terms with what is a chronic condition for the foreseeable future. Moderation is the key (for both eating and exercising, and so that they can be maintained).

A lot of well-meaning people (not professionals) will try to "help". Try to get a feel for what works for you in your individual case. It will take time but you will get there. I have tried a lot of traditional remedies too, but they haven't really stuck. Regarding diet, what has worked for me is switching to less processed grains/rice, food with low Glycemic Index and Glycemic Load wherever possible (eg: basmati rice instead of jasmine rice, brown instead of white rice, whole wheat/rye instead of white bread etc...), more protein and fat to feel satiated sooner. And portion control. Also being in Austria with not that much sun, vitamin D, selenium, zinc sources (pharmacists routinely tell me this when I go to collect my medicine).

Giving you warm thoughts! Feel free to memail if you need to discuss anything.
posted by ssri at 4:07 PM on January 15, 2023

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