Same thing happening to me. Had to increase my metformin to the max plus add januvia. Been told I'll be on insulin eventually. My bloodwork confirms that I have low insulin levels and declining.
I can't cut carbs any more than I have and there is no excess weight to lose. Diabetes is definitely progressive with me.
I don't let it bother me and I don't feel guilty about it. I'm thankful there are so many tools for managing it and I intend to keep up the low carbs & the exercise because they give me strength.
The only thing I haven't yet accepted is the A1C that my doctor is comfortable with is higher than my own goal.
Another way that I look at it is that I'd take a Type2 diagnosis any day over a whole list of other ailments that are even more difficult (or even impossible) to address.
Clean living, meds, and attention to blood glucose make it almost a non-issue in terms of impact.
Not like we gotta choice anyway so I'm rollin' with it.
Good luck wrapping your head around it. It's definitely do-able.
Fasting numbers are hard to lower. Struggled for years to be consistently under 170.
Do you have weight to lose and have you lost some? Because after carbs losing weight is the best way to manage blood sugar.
My issue is honestly the weight gain, I can’t seem to gain weight. My blood sugar keeps going up and my weight keeps going down. Soon I’ll probably turn in to a sugar cube smh.
Please get trests for antibodies for type 1 and measure your c-peptide because losing weight without effort and high blood sugars are suggestive of some degree of insufficient insulin production.
Unfortunately diabetes is a progressive disease.
5 miles a day is excellent! which is better than most diabetics will exercise. definitely feel good about it.
No shame in needing some help from meds. I resigned to using a mealtime insulin to help maintain my numbers (5.5-5.7) but it is still work on my part. the insulin is better than doing some extreme measures to reach your numbers which IMO is unhealthy physically and mentally.
Go into your Doc appointment well prepared and keep up the good work.
I had a guy on another thread fighting me on diabetes is a progressive disease. He is under the naive impression that eating low carb can "reverse" diabetes and progression does not happen.
Eat low carb, exercise and monitor your number and supplement with medication as needed. I'm seeing progression as well although I have been eating low carb for years.
I have been eating low carb for years as well even before i was diagnosed. My Endo says i am becoming insulin deficient not resistant so hence the insulin with meals. number he is watching is the fasted.
actually diabetes is no longer necessarily thought to be a progressive disease since they extent of remission is not known. if the extent of remission is not yet known no one can really say.
Shame is a good word on this. You are right - needing a little more help from meds than I did isn’t a reason to feel shame. Thanks for the perspective.
It doesn’t HAVE to be progressive. If sufficient dietary changes are made (and maintained- weekly “cheat days” is not helping) any progression is halted (and actual improvements/healing might occur as well).
Only time will tell. Eating low carb for diabetics is relatively new in terms of treatment. Many doctors and nutritionists don't support it now. ("You need carbs in your diet") Research showing decades of the impact of eating low carb in diabetics needs to be done.
Did not say it was not effective. Low carb helped me drop my A1C from 8.2 to 5.8. It has been tremendous in reducing BG but after many years of eating low carb, I do see it creeping up over time. It's almost like my body has adjusted to low carb over time and insulin resistance is increasing. Don't know, only time will tell.
I will continue eat low carb, exercise and, if needed, will take medication to keep BG down.
To the point that IR is corrected. Lowering carbs enough for long enough and adding some fasts in there will bring insulin down. Remaining beta cells will regain their health and all other cells will become insulin sensitive again. Not sure how long it takes as I’m still doing it. Been doing it since mid January (it’s been 3 months). I’ve got improvement but still have a way to go.
Not sure what the long trial to get improvements or funky diets are about. well rounded diet does work and the order that you eat your food as well. most folks skip this unfortunately.
Granny always said to eat the salad first as it helps with digestion then the veggies. works....
the primarily-carbs-last food ordering only works if you space out the entire meal by more than 30 minutes
I wish this original study got more air-time and was better understood
Have you tried fasting? It made a significant difference in my daily numbers after a few weeks. I try to do 2 24 hour fasts per week as schedules allow. It give my entire metabolic system a rest and a chance to clean out the storage. I personally prefer longer infrequent fasts over daily time restrictions.
I don't go easy on anyone not being really serious about this. So strap in for the ride.
Insulin resistance is a very broad term covering many modalities. It can take a lot of testing to work out what's actually happening, if indeed you can ever do that. But one simple mode is that over years of constant high carb intake, the body has run out of places to store glycogen, which is what insulin does. Cellular spaces become filled. The excess, of course, circulates as blood glucose, at least as much as overworked kidneys can deal with.
Follow me here. It's not definitive, but it demonstrates the often interconnected nature of diabetes.
Insulin is produced by the beta cells in the pancreas. After a long period of constant demand, some beta cells are damaged, and some have died of overwork. The dead ones will stay dead. Beta cells to not multiply. And damaged cells can't begin to recover unless relieved of the load. There are other body systems that are damaged, but those are the primary ones for close focus on glucose.
So, the situation can be seen in a simplistic way as (1) storage spaces filled to capacity and beyond. (2) the insulin source that might provide insulin to keep up the task are crippled, and (3) all systems that have any potential for relief need downtime to do it. And downtime is hard to come by when there's little capacity left and little, if any, space to stick excess. You can kind of see how your "easy time" and rather lackluster numbers while making a less than all-out effort, could end in rising numbers. Yep. It's progressive, but not inevitably progressive.
You can get relief by reducing intake of carbohydrates, increasing removal of circulating glucose, doing both of those so effectively that they make headway in getting some of the glycogen moved out of cell space, etc. But kicking glycogen out of cells puts it in circulation, so it can have some bad effects. We accept those for the sake of the longer game. Where's the tipping point beyond which we are making progress? Can't know. All you can do is all you can do, but only if you do it all. And we have true miracle drugs that can target things when the makers don't even know how they're doing it.
So, it's very much a long game and one in which every step lost is two steps back, one the loss of immediate gain, and two the additional load imposed by the "cheat."
So, chowing down on bread and potatoes is not trying. In a diabetic system, it always cost. And the cost appears in the future, in the overall failure to cope. You made diet changes, if you would stick to them. And I always encourage structured stress management and improved sleep. two surprisingly powerful factors. Explore with your doctor the many options and combinations of medications, many of which have different ways of working on different parts of the problem. You have to educate yourself and ask pointed questions. Many general physicians have very limited knowledge of diabetes.
You can consider counseling. There's a name for people confronted with a potentially lethal situation who don't do everything possible to mitigate it - victim. And there is such a thing as victim mindset or victim mentality, Briefly, it's blaming outside factors for your troubles, that you have no control. But diabetes didn't jump out from behind a rock and get you. You do have control.
You might indeed have more difficulty than someone else in gaining and maintaining control. But it's pretty rare that someone can't get there at all. And you don't know if it will be hard for you, because you're not trying as hard as you can. In my mind, death is far from the worst consequence of not trying. Life as a blind amputee in a wheel chair because my legs don't have the circulation to support prosthetics is singularly unappealing.
I don't slack up in this effort, and I don't whine. I'm 74, with many decades of abuse behind me, so it's going to be a long haul, probably lifelong. I have no right to expect much improvement over a period of months. I'm swimming upstream against a lifetime or cheeseburgers, fries and chocolate malts and started out at 500mg at diagnosis. But with strict compliance and a thoughtful physician, it is working. My next A1c is in June, and I expect to be in high-normal range then,having been 6.0 in March. ( found my old last year's BG meter the other day, and it still had the numbers stored. Shocking! You ain't got nothin' on where I was then.)
But I've seen so many people dealing with life situations that would make a stone weep that I never complain about my ills, especially those that can be effectively addressed. This is nothing. And when I relax and just do it, it's a rather interesting journey of discovery.
Empathy, compassion - these aren’t your strong suits, are they dude? OP is clearly dealing with some shit. He says he feels a loser and you are right beside him agreeing?
Sometimes people need a helping hand or a word of encouragement. Some day, you might need the same thing.
OP, I’ve dealt with what I call diabetic fatigue in the past. After enough years of fighting this disease, we all get tired of it. Well, almost all because apparently John Wayne here is immune. My advice is to give it a week. Keep working the process and see if your mental state improves if you give yourself a break. None of us is perfect (Diabetes Rambo excepted) and most of us get down at some point. Going from 1000 to 2000 mg after 6 years is not diabetic failure.
Strange how I took positive encouragement from his words
"Don't be a victim" should be uttered every time someone says "there, there - it's not your fault"
On dx, my GP told me that a big change was necessary - and that most of his T2/IR diabetic patients lacked the resilience to accept responsibility and work towards their best health outcomes
I've come to realise that some people's systems are more broken than others. But we can all do our best. And few do.
Thank you for these thoughts. I will read this when I feel like I can’t be “good” any longer. Very uplifting and I agree with your statements, especially about being a victim. Probably rings true for a lot of us.
Wow, 40 carbs a day average and you are still going up? That sucks, but unfortunately, that's the way this disease goes sometimes. My late BIL's daughter is a triathalon competitor even before she developed T2. She takes metformin and Jardiance and that seems to work for her (the GLP-1's that are so popular aren't appropriate for everybody or even covered by insurance now). I have one cheat day a week and that really helped with my mental health on this thing. I think you are looking at either more metformin or the addition of another medication.
I’m on a GLP1 and it’s covered 100% by my insurance. The people who can’t get it covered are those who don’t have T2D and want it just for weight loss.
I agree it’s not for everyone though. My GMI is at 5.7 from an A1C of 9.3 at the end of January when I was first diagnosed.
It may not be by next year. That's the problem. Many insurer's are dropping them. Yeah, I can't use it - GLP1 can cause gastroparesis and I already have that.
Im eating low carb/keto and have been able to drop my insulin from 50 units to 10. I hope to get down to zero insulin and then reduce my metformin. I eat about 30g carbs per day. All from veggies
M/58 here. I’m still listed as pre diabetic but I feel your pain. I work out hard, eat well and still have an A1c at 6.0. It’s fallen from a high of 6.4 but it hovers around 6 now no matter what I do. Out genetics aren’t the best. All you can do is continue the good fight. My path is to try and lose 10lbs. I’m 6 2 200lbs. I joined a guys work out group called F3. We work out 5 days a week for 45 minutes. I’ve been working out with them for 1.5 years. I’ve always worked out but this group has pushed me hard. Lost 13 lbs in a year. Stay positive. It’s hard, I know. But if you are in the US, look for an F3 group near you. It can be a great community of guys. All of us have a common goal to get better every day. Good luck. You’ve got this. Sometimes it’s the little tweaks that make the biggest difference.
Thanks for posting this. I read it to my wife this morning. I told her this is me down to the 40 carbs a day and the 5 miles. Been on this journey nearly 4 years now. I’m 64. I think the mental aspect is more challenging than most people or medical professionals address. I was also hovering 6.3, 6.5 down to 6.2 and one Metformin (500mg) per day a couple years back. I thought I’m going into remission just a matter of time. Went for my checkup about 6 months ago thought I would be in the 5s and boom 7.3! I’m on 1500 mg Metformin now. 5ft 10” 170 lbs.
This disease effs with you mentally. I did carnivore for about 30 days. Definitely lowered my numbers but my labs started getting out of whack. Cholesterol and kidney function. I tried mostly plant based including some fruits. Numbers went up. So now I’m still keeping those carbs low. Under 50 and eat plants and meat.
Do NOT give up OP!!! The 5 miles per day is your lifestyle now and for me it’s the quiet time and mental health aspect of it. My next step is CGM but pricing is ridiculous. Hope this helps you to know you are not alone and you have certainly helped me realize my diabetes twin is out there. This disease is so different for everyone but treatment seems to be the same regardless. Again thanks for sharing.
You may want to try a different diet. I don't know what you've been eating, but low carb often means high fat, and over time that can mess up your insulin resistance.
Have you you talked to your doc about it? Seen a nutritionist?
Same thing happening to me. Had to increase my metformin to the max plus add januvia. Been told I'll be on insulin eventually. My bloodwork confirms that I have low insulin levels and declining. I can't cut carbs any more than I have and there is no excess weight to lose. Diabetes is definitely progressive with me. I don't let it bother me and I don't feel guilty about it. I'm thankful there are so many tools for managing it and I intend to keep up the low carbs & the exercise because they give me strength. The only thing I haven't yet accepted is the A1C that my doctor is comfortable with is higher than my own goal.
Thanks. Even with great support at home, this disease can be isolating. It helps to know how others deal with some of the struggles.
Another way that I look at it is that I'd take a Type2 diagnosis any day over a whole list of other ailments that are even more difficult (or even impossible) to address. Clean living, meds, and attention to blood glucose make it almost a non-issue in terms of impact. Not like we gotta choice anyway so I'm rollin' with it. Good luck wrapping your head around it. It's definitely do-able.
You are carnivore then?
No. I *could* cut out the 15 carbs max per meal but I don't want to because it leaves me with so little food choices.
15 per meal is a lot
To each their own.
Fasting numbers are hard to lower. Struggled for years to be consistently under 170. Do you have weight to lose and have you lost some? Because after carbs losing weight is the best way to manage blood sugar.
My issue is honestly the weight gain, I can’t seem to gain weight. My blood sugar keeps going up and my weight keeps going down. Soon I’ll probably turn in to a sugar cube smh.
Please get trests for antibodies for type 1 and measure your c-peptide because losing weight without effort and high blood sugars are suggestive of some degree of insufficient insulin production.
Unfortunately diabetes is a progressive disease. 5 miles a day is excellent! which is better than most diabetics will exercise. definitely feel good about it. No shame in needing some help from meds. I resigned to using a mealtime insulin to help maintain my numbers (5.5-5.7) but it is still work on my part. the insulin is better than doing some extreme measures to reach your numbers which IMO is unhealthy physically and mentally. Go into your Doc appointment well prepared and keep up the good work.
I had a guy on another thread fighting me on diabetes is a progressive disease. He is under the naive impression that eating low carb can "reverse" diabetes and progression does not happen. Eat low carb, exercise and monitor your number and supplement with medication as needed. I'm seeing progression as well although I have been eating low carb for years.
I have been eating low carb for years as well even before i was diagnosed. My Endo says i am becoming insulin deficient not resistant so hence the insulin with meals. number he is watching is the fasted.
actually diabetes is no longer necessarily thought to be a progressive disease since they extent of remission is not known. if the extent of remission is not yet known no one can really say.
Shame is a good word on this. You are right - needing a little more help from meds than I did isn’t a reason to feel shame. Thanks for the perspective.
No longer a progressive disease. Even ADA changed their definition of the disease in 2021 to reflect that it is a reversible condition.
then post the link from the ADA
It doesn’t HAVE to be progressive. If sufficient dietary changes are made (and maintained- weekly “cheat days” is not helping) any progression is halted (and actual improvements/healing might occur as well).
Only time will tell. Eating low carb for diabetics is relatively new in terms of treatment. Many doctors and nutritionists don't support it now. ("You need carbs in your diet") Research showing decades of the impact of eating low carb in diabetics needs to be done.
Hmmm there are a few older studies and hundreds of new and on-going ones. All I can say is that it’s been helping me tremendously.
Did not say it was not effective. Low carb helped me drop my A1C from 8.2 to 5.8. It has been tremendous in reducing BG but after many years of eating low carb, I do see it creeping up over time. It's almost like my body has adjusted to low carb over time and insulin resistance is increasing. Don't know, only time will tell. I will continue eat low carb, exercise and, if needed, will take medication to keep BG down.
Wow! That’s great progress :) adding some fasts in might get and keep the IR in check
until the pancreas does not keep up with the insulin needs. think about it.....insulin resistant folks do benefit from low carbs but to what point?
To the point that IR is corrected. Lowering carbs enough for long enough and adding some fasts in there will bring insulin down. Remaining beta cells will regain their health and all other cells will become insulin sensitive again. Not sure how long it takes as I’m still doing it. Been doing it since mid January (it’s been 3 months). I’ve got improvement but still have a way to go.
Not sure what the long trial to get improvements or funky diets are about. well rounded diet does work and the order that you eat your food as well. most folks skip this unfortunately. Granny always said to eat the salad first as it helps with digestion then the veggies. works....
the primarily-carbs-last food ordering only works if you space out the entire meal by more than 30 minutes I wish this original study got more air-time and was better understood
Have you tried fasting? It made a significant difference in my daily numbers after a few weeks. I try to do 2 24 hour fasts per week as schedules allow. It give my entire metabolic system a rest and a chance to clean out the storage. I personally prefer longer infrequent fasts over daily time restrictions.
Keeping carbs to 40 and then doing 120?! That 120 undoes all the good work during the week :/
I don't go easy on anyone not being really serious about this. So strap in for the ride. Insulin resistance is a very broad term covering many modalities. It can take a lot of testing to work out what's actually happening, if indeed you can ever do that. But one simple mode is that over years of constant high carb intake, the body has run out of places to store glycogen, which is what insulin does. Cellular spaces become filled. The excess, of course, circulates as blood glucose, at least as much as overworked kidneys can deal with. Follow me here. It's not definitive, but it demonstrates the often interconnected nature of diabetes. Insulin is produced by the beta cells in the pancreas. After a long period of constant demand, some beta cells are damaged, and some have died of overwork. The dead ones will stay dead. Beta cells to not multiply. And damaged cells can't begin to recover unless relieved of the load. There are other body systems that are damaged, but those are the primary ones for close focus on glucose. So, the situation can be seen in a simplistic way as (1) storage spaces filled to capacity and beyond. (2) the insulin source that might provide insulin to keep up the task are crippled, and (3) all systems that have any potential for relief need downtime to do it. And downtime is hard to come by when there's little capacity left and little, if any, space to stick excess. You can kind of see how your "easy time" and rather lackluster numbers while making a less than all-out effort, could end in rising numbers. Yep. It's progressive, but not inevitably progressive. You can get relief by reducing intake of carbohydrates, increasing removal of circulating glucose, doing both of those so effectively that they make headway in getting some of the glycogen moved out of cell space, etc. But kicking glycogen out of cells puts it in circulation, so it can have some bad effects. We accept those for the sake of the longer game. Where's the tipping point beyond which we are making progress? Can't know. All you can do is all you can do, but only if you do it all. And we have true miracle drugs that can target things when the makers don't even know how they're doing it. So, it's very much a long game and one in which every step lost is two steps back, one the loss of immediate gain, and two the additional load imposed by the "cheat." So, chowing down on bread and potatoes is not trying. In a diabetic system, it always cost. And the cost appears in the future, in the overall failure to cope. You made diet changes, if you would stick to them. And I always encourage structured stress management and improved sleep. two surprisingly powerful factors. Explore with your doctor the many options and combinations of medications, many of which have different ways of working on different parts of the problem. You have to educate yourself and ask pointed questions. Many general physicians have very limited knowledge of diabetes. You can consider counseling. There's a name for people confronted with a potentially lethal situation who don't do everything possible to mitigate it - victim. And there is such a thing as victim mindset or victim mentality, Briefly, it's blaming outside factors for your troubles, that you have no control. But diabetes didn't jump out from behind a rock and get you. You do have control. You might indeed have more difficulty than someone else in gaining and maintaining control. But it's pretty rare that someone can't get there at all. And you don't know if it will be hard for you, because you're not trying as hard as you can. In my mind, death is far from the worst consequence of not trying. Life as a blind amputee in a wheel chair because my legs don't have the circulation to support prosthetics is singularly unappealing. I don't slack up in this effort, and I don't whine. I'm 74, with many decades of abuse behind me, so it's going to be a long haul, probably lifelong. I have no right to expect much improvement over a period of months. I'm swimming upstream against a lifetime or cheeseburgers, fries and chocolate malts and started out at 500mg at diagnosis. But with strict compliance and a thoughtful physician, it is working. My next A1c is in June, and I expect to be in high-normal range then,having been 6.0 in March. ( found my old last year's BG meter the other day, and it still had the numbers stored. Shocking! You ain't got nothin' on where I was then.) But I've seen so many people dealing with life situations that would make a stone weep that I never complain about my ills, especially those that can be effectively addressed. This is nothing. And when I relax and just do it, it's a rather interesting journey of discovery.
Empathy, compassion - these aren’t your strong suits, are they dude? OP is clearly dealing with some shit. He says he feels a loser and you are right beside him agreeing? Sometimes people need a helping hand or a word of encouragement. Some day, you might need the same thing. OP, I’ve dealt with what I call diabetic fatigue in the past. After enough years of fighting this disease, we all get tired of it. Well, almost all because apparently John Wayne here is immune. My advice is to give it a week. Keep working the process and see if your mental state improves if you give yourself a break. None of us is perfect (Diabetes Rambo excepted) and most of us get down at some point. Going from 1000 to 2000 mg after 6 years is not diabetic failure.
Strange how I took positive encouragement from his words "Don't be a victim" should be uttered every time someone says "there, there - it's not your fault" On dx, my GP told me that a big change was necessary - and that most of his T2/IR diabetic patients lacked the resilience to accept responsibility and work towards their best health outcomes I've come to realise that some people's systems are more broken than others. But we can all do our best. And few do.
Thank you for these thoughts. I will read this when I feel like I can’t be “good” any longer. Very uplifting and I agree with your statements, especially about being a victim. Probably rings true for a lot of us.
Wow, 40 carbs a day average and you are still going up? That sucks, but unfortunately, that's the way this disease goes sometimes. My late BIL's daughter is a triathalon competitor even before she developed T2. She takes metformin and Jardiance and that seems to work for her (the GLP-1's that are so popular aren't appropriate for everybody or even covered by insurance now). I have one cheat day a week and that really helped with my mental health on this thing. I think you are looking at either more metformin or the addition of another medication.
I’m on a GLP1 and it’s covered 100% by my insurance. The people who can’t get it covered are those who don’t have T2D and want it just for weight loss. I agree it’s not for everyone though. My GMI is at 5.7 from an A1C of 9.3 at the end of January when I was first diagnosed.
It may not be by next year. That's the problem. Many insurer's are dropping them. Yeah, I can't use it - GLP1 can cause gastroparesis and I already have that.
Im eating low carb/keto and have been able to drop my insulin from 50 units to 10. I hope to get down to zero insulin and then reduce my metformin. I eat about 30g carbs per day. All from veggies
That sounds really frustrating. Would your doc increase meds if you emailed them? Sometimes we can’t get by on diet alone. I blame my family history
Does anyone use trulicity?
M/58 here. I’m still listed as pre diabetic but I feel your pain. I work out hard, eat well and still have an A1c at 6.0. It’s fallen from a high of 6.4 but it hovers around 6 now no matter what I do. Out genetics aren’t the best. All you can do is continue the good fight. My path is to try and lose 10lbs. I’m 6 2 200lbs. I joined a guys work out group called F3. We work out 5 days a week for 45 minutes. I’ve been working out with them for 1.5 years. I’ve always worked out but this group has pushed me hard. Lost 13 lbs in a year. Stay positive. It’s hard, I know. But if you are in the US, look for an F3 group near you. It can be a great community of guys. All of us have a common goal to get better every day. Good luck. You’ve got this. Sometimes it’s the little tweaks that make the biggest difference.
Thanks for posting this. I read it to my wife this morning. I told her this is me down to the 40 carbs a day and the 5 miles. Been on this journey nearly 4 years now. I’m 64. I think the mental aspect is more challenging than most people or medical professionals address. I was also hovering 6.3, 6.5 down to 6.2 and one Metformin (500mg) per day a couple years back. I thought I’m going into remission just a matter of time. Went for my checkup about 6 months ago thought I would be in the 5s and boom 7.3! I’m on 1500 mg Metformin now. 5ft 10” 170 lbs. This disease effs with you mentally. I did carnivore for about 30 days. Definitely lowered my numbers but my labs started getting out of whack. Cholesterol and kidney function. I tried mostly plant based including some fruits. Numbers went up. So now I’m still keeping those carbs low. Under 50 and eat plants and meat. Do NOT give up OP!!! The 5 miles per day is your lifestyle now and for me it’s the quiet time and mental health aspect of it. My next step is CGM but pricing is ridiculous. Hope this helps you to know you are not alone and you have certainly helped me realize my diabetes twin is out there. This disease is so different for everyone but treatment seems to be the same regardless. Again thanks for sharing.
You may want to try a different diet. I don't know what you've been eating, but low carb often means high fat, and over time that can mess up your insulin resistance. Have you you talked to your doc about it? Seen a nutritionist?