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Discussion Starter · #1 ·
I am interested in losing weight. Someone suggested a low carb, high fat diet, which is not so useful to me.

I am a type two diabetic. High insulin levels, which I always have, cause the body to take whatever sugar is in the blood stream and store it as fat.

I had a four-way bypass in November 2001; a high fat diet is not for me. My diet is more limited by the poverty of my Social Security payments than my personal choice.

I need to find the point where my insulin level can be maintained at both a low enough a level to lose weight and to keep both insulin and sugar levels in that range for an extended period of time. Yes, I realize that fat in the diet would probably be a good means to get into that range, and keep it there. As I said, that will not work for me, and I am not anxious to try to spend ten years losing a hundred pounds. I think I need more than 12 pounds a month.

Most medical doctors measure the treatment of Diabetes by controlled blood sugar levels. High insulin levels, since there is not an inexpensive way to measure, are generally not talked about. I strongly believe that high insulin levels are more damaging to ones health than some moderately high sugar levels.

I think I will forego all the searching on this forum about weight loss because, it seems I am already seeing recommendations of treatment(s) that I have discovered are not useful to me.

A little more back ground on my specific issues.

I am concerned with quality of life issues, and being 130 pounds overweight is not quality of life. If I take care of quality of life, with reasonable precautions, then length of life need not be the goal.

I, like many of us, have multiple health issues, which drives other health problems, exacerbates them and multiplies the effect of others. I have Arthritis (both Osteo and RA), stomach problems, allergies, hypertension, high cholesterol, heart disease, sleep apnea, and had Shingles before I was 60. My doc loves my blood pressure and I hardly have the energy to get out of a chair, on the three blood pressure meds I now take.

I take 2 mg Glimperide, (Amaryl) once a day, because years ago Metformin made me really ill . My insurance is Medicare, which is limiting in what it will not pay for.

So my doc sent me to talk to someone about the Weight Watchers program, I guess thinking I would benefit from emotional support. Unless there is a special section in Weight Watchers for Diabetics, I am not sure their diet fits. I am a guy, I am not into using more energy than I have to do grocery shopping, cooking meals, and then washing up.

Several years ago I went through a multi day diabetes education program by the American Diabetic association. Interesting, but none of that resolves the issue of my losing weight in a reasonable period of time.

Someone will suggest exercise (to be followed by a higher levels), to which my body says, how much you want to hurt all the time, plus I have heart disease, three hypertension meds that reduce energy. Consider, If I exercise I have lowered blood sugar because burn sugar, and reduce insulin resistance. Both good, then it leaves me with higher insulin levels, which is bad for losing weight.

I suggest that we agree some things do not work equally well for all and try to talk with a mutual search for the truth.
 

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Most of us here are insulin resistant, it is a symptom of Type 2. It is unfortunate that you can't take metformin. It is the best med to treat insulin resistance. Amryl is probably one of the worst drugs for IR because it creates more insulin in your pancreas which compounds the problem. I understand what you mean about exercise. I also spike while exercising. But I still exercise because in the long run it will help use up extra glycogen in your liver. It is this glycogen that is available to dump glucose throughout the day. The way you reduce glycogen is reduce the carbs in your diet. I understand why you don't want to eat fat but you could add small amounts in the form of peanut butter, olive oil or almonds. Eggs are one of the best foods on a LC diet and they are cheap. A LC diet does not have to be expensive. When you cut out processed foods and grains you cut out most of the things that cause your insulin levels to rise. Have you considered Byetta. Many find it does work. Are you using insulin? For some that is the only way to get bgs down. As long as you count carbs and match your insulin to what you eat, you can usually stablalize weight . Many people even lose weight using insulin by reducing portions and carbs. There are tons of diets out there that will help you lose weight but you need one that also lowers bgs. People do all levels of low carb. You could start out on a higher level and slowly reduce it. Besides a gastric bypass I doubt you will find a diet that allows you to lose 12 pounds a month without going low carb.
 
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Discussion Starter · #4 ·
Maybe I was unclear. My dosage of Glimperide was doubled less than a year ago. As I worshipped at the feet of the God of keeping blood glucose low in the last year, I have gained thirty pounds.

What helped to me to gain weight is high insulin levels, which are doing damage to my body. More high insulin levels, from Byetta, or exercise or a closely controlled diet are not going to aid in either reducing insulin levels, or losing weight.

We as diabetics frequently have these kinds of weight gains, and they are related to high insulin levels, and we follow the advice to do exactly the opposite of reducing insulin levels, by keeping blood glucose down with diet and exercise.
 

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I think you are suggesting that exercise will raise your insulin levels or perhaps keep them higher than then should be? That does not fit with my understanding of IR or Type 2 but you probably know your own body better than I do.

As already mentioned, there are "healthy fats" which can be eaten if you still buy into the unproven myths surrounding the "artery clogging" qualities of saturated animal fats... but please understand that replacing some of the energy which you would get from carbohydrates, with energy from fat, does not require sitting around eating from a tub of lard with a spoon -- indeed as fat is over twice as calorie dense as carbohydrate; a substitution of just 43g of fat instead of 100g of carbs can be enough to change a diet from being described as high-carb to high-fat. This can be as easy as simply not avoiding fat by choosing "low fat" versions of food and eating real whole food instead.

You may also consider cutting out (at least for a while) all wheat. Dr Davis has an interesting book on this topic which has been discussed elsewhere on the forum.
 
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Discussion Starter · #6 ·
My initial insulin levels are set more by the Glimperide. Surely some insulin is used in exercise. Exercise reduces insulin resistance. Which leaves more insulin. It is partially a matter of where I am in my disease level as to whether the insulin levels hang around in my body as constantly high.

While I may benefit from exercise, in both weight loss and how I feel, and so on, the truth is I am looking for a specific magic level of things.

Where this topic is heading is a sorta, you can figure it out for yourself by a lot of suffering and keeping records on what happens. Which would be easier if I could measure insulin levels with the ease I my blood glucose.

On a different tangent, I am on Medicare, the only diabetes medication I can switch too would be like Avandia, or that class of drug. These drugs cause heart problems, last thing a person who has already had a heart problem needs.

Your comment on wheat is interesting, I will think on it. Wheat is in so many things. Statistically it is like saying that I fear I could get cancer from breathing air anywhere. But still, Wheat as we use it today can not be all good. There is a good argument that to lose weight, then a good thing to do is to cut out the bread.

I feel very confident that the good oil versus bad oil controversy is proven. There are good oils, and it is better to eat them. So what are you referring to?
 

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If I were you and this concerned about my high insulin levels, I would absolutely stop taking Glimepiride, a potent sulfonylurea which punishes your already overworked pancreas to produce ever MORE insulin. You're going to burn out every beta cell you have and then you're going to be insulin-DEPENDENT. Beta cells do not regenerate.

Maybe I was unclear. My dosage of Glimperide was doubled less than a year ago. As I worshipped at the feet of the God of keeping blood glucose low in the last year, I have gained thirty pounds.

What helped to me to gain weight is high insulin levels, which are doing damage to my body. More high insulin levels, from Byetta, or exercise or a closely controlled diet are not going to aid in either reducing insulin levels, or losing weight.

We as diabetics frequently have these kinds of weight gains, and they are related to high insulin levels, and we follow the advice to do exactly the opposite of reducing insulin levels, by keeping blood glucose down with diet and exercise.
 

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Discussion Starter · #8 ·
Dropping Glimperide. Yes I am concerned with the same issue, I am burning out my pancreas. Curiously the medical community does not have anything to say about my pancreas going out because of the Glimperide, or other drugs. I guess they feel it is inevitable. Just a matter of time.

As I said, I have Medicare, who has rules about the type of treatment I can receive based upon the level of my diabetes. Medicare also says I can only qualify for on blood glucose test every day. I have to spend a bunch of money for more strips.

Is there any value in my having a weight scale in my home? Sounds like it would be more like a constant source of frustration and I would be better to spend that money on better quality of food. Plus, I have purchased a number of items and found them to be defective, it is hard to know what to buy from where.
 

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Discussion Starter · #9 ·
Stopping Glimperide. Nope. Then my blood sugars would be completely out of control. I must do something.
 

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Discussion Starter · #11 · (Edited)
Metformin led to days of barfing. Then the doc wrote a prescription for some drug which should reduce the barfing. Then another ten+ days of barfing even water, or anything else. Yes one can lose weight with Metformin, not good for the dehydration, or general health. then there is the walking around my apartment with a bucket. Gross.

However, it is true, Medicare will pay for Metformin for me.

low carb, high fat, sorta been there. Not much help. Please focus on the idea (IMO) that taking the higher dosage of Glimperide caused me to gain over thirty pounds not because I ate more, but because of high insulin levels.
 

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What has worked for me both in reducing excess fat mass and reducing my overall need for insulin was to significantly cut carbohydrates from my diet. I stopped eating anything which listed more than 1g of carbs per serving and focused on real whole foods (as eaten by my Grandparents) that are naturally low in sugars and refined starches. Because of my damaged metabolism (metabolic syndrome.. Type 2) I also have to avoid natural foods which are high in starch like root vegetables and most fruit... although I do occasionally have berries and I do eat green leafy vegetables.

I know I have dramatically reduced my needs for insulin (and all my medication) because I started this process on an insulin pump while using around 130u per day... now I just inject 6u Levemir each night to help combat Dawn Phenomenon. I take no other medication. Evidently my body is able to provide the rest of my insulin needs. Real whole food bought fresh locally and prepared by myself is often cheaper than processed and packaged "convenience" food.

By avoiding those foods which tend to raise BG and thereby drive the need for insulin higher; I can both manage my BG to near normal levels and do so with less insulin. Plus I get to eat good wholesome food.

Cut the increased need for insulin, reduce the meds which drive the insulin up and start to shed excess fat mass naturally.
 

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Maybe I was unclear. My dosage of Glimperide was doubled less than a year ago. As I worshipped at the feet of the God of keeping blood glucose low in the last year, I have gained thirty pounds.

What helped to me to gain weight is high insulin levels, which are doing damage to my body. More high insulin levels, from Byetta, or exercise or a closely controlled diet are not going to aid in either reducing insulin levels, or losing weight.

We as diabetics frequently have these kinds of weight gains, and they are related to high insulin levels, and we follow the advice to do exactly the opposite of reducing insulin levels, by keeping blood glucose down with diet and exercise.
As I said above Glimperide is the main culprit here. It will increase your insulin levels which you do not need. Byetta does not increase insulin levels it is an incretin drug which blocks certain hormones. It is mainly a weight loss drug and people have a lot of succsess with it. I would suggest that you go to Blood Sugar 101 and get some information of all the oral meds and insulins that are available for diabetics. I'm not sure if exercise increases insulin levels. It may increase glucose because of stress hormones and stored glycogen in the liver. What you want to do is reduce these glycogen stores.
 

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To be blunt, I think your BEST OPTION is to:

  1. Cut the insulin-producing drugs
  2. Go VERY Low-carb, high-fat in your diet.
As far as I can see, the only reason you aren't going low-carb is because of insulin-producing medications.

If that's the case, cut the carbs and drop the meds. You can titrate the dosage down if you require.

Then add in gentle exercise that doesn't hurt your RA/OA too much.

If this solution won't work, please let me know why so I can see what else I can offer.
 

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Discussion Starter · #16 ·
We see people who come to the forum who say that they started taking insulin and their weight went up dramatically.

Once I was speaking with a Diabetes education nurse (who had to have insulin in first grade) who told me she had 'discussions" with patients who the medical docs believed had had diabetes for years.

For a long time they ate whatever they wanted, they were skinny because all the extra sugar was dumped out through their kidneys. They start taking insulin, they start gaining weight. They come back to the doctors and say, I would rather be like I was before, I was skinny and I do not like being fat and getting fatter.

They are not eating more. They get fat from taking more insulin than their cells need.

As a type two I will always have high insulin levels. I need a means to determine that spot where my body loses weight, not too high an insulin level, and a blood glucose that does not drive more insulin to be produced, or drive me into quick low blood sugar. that is, I need to be able to maintain that point for awhile.

In reply to other suggestions. Medicare guidelines, which are more about saving the Medicare money than my health, controls which meds I can get. If I can not physically take Metformin, Avandia, and its class cause dramatically high rates of heart failure, (and I already had open heart surgery) In truth, Avandia is on the verge of being banned by the FDA, lawsuits are already going on. So I do not have an option as to which drug I take. If I do not take any Diabetes meds, my Blood sugar will rise and stay over two hundred, I am pretty sure. Some of my dawning blood sugars are now 140.

My diet, as I stated, will be more selected by my poverty Social Security payments. Did anyone ever notice that the states with the lowest per capita income have the largest rates of obesity? It is from the diet.

Insofar as those here who advocate a high fat diet. Ever look at the stats of diabetics who die of heart disease and stroke versus the normal population. I may do more of that low carb high fat diet, but I am not keen on it. It is not my choice of a solution.
 

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Surely some insulin is used in exercise. Exercise reduces insulin resistance. Which leaves more insulin
I think you may be confused about what insulin resistance really is. Think of it as your cells becoming "deaf" to insulin so your body "shouts" by making more until it is heard. So insulin resistance = excess insulin. When you reduce insulin resistance, your cells get better "hearing" and your body can speak "softer" by producing less insulin.

Reducing your insulin resistance (either by drugs, exercise or diet) will cause your body to make and use less insulin total, helping with weight loss.

When you exercise and your blood sugar goes down, it is mostly due to your muscles using up more glucose than normal and not because your body produced extra insulin. Many types of exercise, especially weight lifting, enable your muscles to use glucose without the presence of insulin in fact.
 

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Discussion Starter · #19 ·
Most medical doctors measure the treatment of Diabetes by controlled blood sugar levels.

If just controlling Blood Glucose levels were the solution to treating Diabetes, then why do we have so many obese Diabetics?
 

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If you are worried about the fats I would suggest you just start eating salads , loaded up with veggies and some nuts. Then add some lean protein like chicken or turkey. I would use 0 carb dressing like oil and vinegar or get some Walden Farms 0 carb dressing to put on it. When you say a weight scale are you referring to a food scale or a bathroom scale. Some use the food scales, I don't. I just eye ball my food. I like to use smaller salad plates to eat my meals off of. I fill 3/4 of the plate up with salad or veggies and 1/4 up with protein. Your protein serving should be no bigger than the size of your fist.

I know we have lots of people here on Medicaid and use different drugs or insulin. As far as the strips you can get your doctor to write a letter to appeal for more stips. My insurance doesn't cover any strips for me. I have to buy mine at Amazon. Many buy their strips at Walmart, they are the cheapest. You said you tried Metformin, did you try the Extended Release version. It is supposed to be much gentler on your stomach. Also metformin is much better tolerated on a lower carb/high fiber diet. Another treatment to consider would be a long acting insulin which would give you small bursts of insulin throughout the day which would bring down your bg. When you say you have high insulin, it doesn't mean all insulin is bad. You need insulin to live. What you are referring to is when you eat your body doesn't recognise the insulin you make so your pancreas keeps cranking out more. The glimperide just makes this worse. The drugs which will help your IR are Metformin and Actos. I don't think that they prescribe Avandia anymore. Byetta and Victoza will help you lose weight and lower bgs which can also lower IR. Januvia and Onglyza also help lower bg by blocking certain hormones which raise bg.
 
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