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Hi Group -
It's been a while since I've come to the board to read and post. I was diagnosed with Type 2 Diabetes back in September of 2011. My progress has been mixed: on one hand, I've done great - I've stopped taking Humalog and I'm just taking Metformin and Lantis insulin at night. My glucose levels are much more stable, and my endocrinologist says I don't need to come back for another visit for 3 months.

But it's been hard... I've been to two visits with a nutritionist, and yet I'm not losing weight. I had an appendectomy in early March and the experience just wore me out. The healing seemed to take forever, and it brought on so much depression. I lost some pounds during my recovery, but my appetite has come back and I've found myself going off my diet, and my will to go to the gym has been non-existent for almost three months now. I've been waking up in the middle of the night with my sheets soaked in sweat and my heart racing... I think I have high blood pressure (my primary care doctor said he thought that might be the case last year.) I'm 5'8" tall, and I've been up and down in weight over the past year from a high of 314 pounds to a low of 258 pounds. Now I'm at 296, so I've gained back much of the weight that I lost before I was diagnosed with diabetes.

I am at times unbelievably frustrated.
I feel shame attached with my inability to lose weight. Ever since I quit smoking three years ago, losing weight has been so very hard. I'm 43 and still single, and the pressures of trying to date when your self-esteem is low has a profound affect.

I'm also in a quandary about my primary care doctor. I live and work at a distance from him now (he's in downtown Boston) and I feel as though I want to switch to someone closer to me so it's easier to see him or her. But I also think there's some shame there, too. I am not proud of the weight I've gained, and I feel as though he'll judge me for that... I'm a bit angry that he didn't take my high glucose levels more seriously when we first detected them. Does it seem foolish to change primary care doctors, or is it OK to do that, and center my care under one hospital where my endocrinologist is?

I apologize in advance for ranting and raving - I know in many ways I should feel lucky - I have a job, I am busy with my time, I have good friends, I'm mobile and active; but ever since my diagnosis, it's been hard.

Thanks for listening to me.
John
 

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I'd like to add something here... What is difficult is that when I was losing weight (unfortunately due to diabetes) I have to admit that my mood was ecstatic... I'd not felt better in years; my libido was up, my energy level was through the roof. Of course, my glucose was probably through the roof, too. But the irony is that now that I'm treating my diabetes, I am heavier, more lethargic and more depressed. For some reason, I make a direct association between my weight and my state of mind. I am much, much happier when I am thinner. My meds are making me gain weight. How do I make sense of this?
 

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What are your other methods, John, besides just meds? What are you eating? Diet has an incredible effect on diabetes health and weight loss. If you're eating the way most dietitians recommend, I'm sorry to have to say that's prob'ly your problem.
 

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What are your other methods, John, besides just meds? What are you eating? Diet has an incredible effect on diabetes health and weight loss. If you're eating the way most dietitians recommend, I'm sorry to have to say that's prob'ly your problem.
Hi Shanny - I'm working my way to a more protein-based diet: A lot more eggs, low fat cottage cheese, low fat yogurt, chicken. Also more fresh vegetables. I've pretty much cut out pasta and rice (with rare exceptions.) I found that whole wheat crackers were doing me good for just that bit of grain, but they are the first things I reach for when I'm hungry, so I'm wondering if I have to keep them out of the kitchen now.

Like many other people, I turn to carbs when I'm listlessly hungry and maybe feeling a bit down... the classic comfort foods. I also feel guilty that I've neglected the gym. Perhaps I need to take that leap back into the gym and maybe I'll get some of my energy back.
 

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John, I am sorry you are having such a difficult time. I think some of your depression could be related to your surgery. You may feel healed now but your body takes a full year to truly recover from surgery. Between that and the Diabetes dx, it isn't surprising you have some issues with depression. I understand your frustration with weight, and I think Shanny may be on to something regarding following the dietitian/ADA diet and your weight issue.

As far as changing your doctor, it makes perfect sense to have all your doctors in a single location. If your doctor is judging you or you fear it, just remember he works for you and if you aren't happy, you can fire him/her and get a new doctor. You are lucky to be living in a big metropolitan area, you have a multitude of doctors to choose from. In the boonies where I live, not so much!!
 

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John, hi! I see some things I'd advise you to watch...

I eat eggs every day, and never eat low fat anything. Fresh vegetables if they grow on top of the ground, but not any root vegetables. Whole wheat crackers or any others but for our Optimist crackers are out for me. Comfort foods for me are cauliflower cooked, mashed, with sour cream, real butter, chives, cheese, etc are wonderful and are safe.

I eat no pasta, or rice or any white foods with the exception of cauli. I don't drink milk. Cheese is very important for me.

Gym would no doubt help. Others will come along with more hints I'm sure, but for starts this should help.

Welcome to our little piece of heaven! Good luck,
 

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Lantus is a basal insulin, so it won't help you where diet is concerned, and metformin can't do the job alone - it requires a low-carb way-of-eating to be effective. Why did you stop taking humalog? When you say your glucose is stable - what are the numbers? What was you last A1c, and what are your postprandial levels looking like?

The low-fat foods are not helping you, and increasing protein prob'ly won't help either. Cut out all the processed low-fat foods, and start eating the real thing - butter, bacon, cream, sour cream, mayonnaise . . . all the full fat versions. When food processing companies remove the fats, they replace it with carby thickeners and fillers - which all sabotage our blood sugars.

You're on the right track dropping pasta & rice. You'll do even better to drop anything made with wheat or any other grains - even whole grains. Eating carbs leaves us hungering for more carbs, so yeah - remove the whole wheat crackers completely. If the munchies attack, go eat some full fat cheese! Thing is, hunger is not part of the lower-carb/higher-fat regimen. Once we stop eating carbs, we don't get those attacks of hunger. Using more fats in your diet will curb the hunger, and lowering carbs is what allows you to use more fats. The carbs are the problem, all the way around.

And while you should return to the gym, I think you'll discover that changing your diet to lower carbs and higher fats will provide a lot more energy, and keep your blood sugar in check also.
 

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I can only vouch for my own experience, that the fewer carbs I ate, the fewer I craved - but, that's pretty common/usual. The easiest way to cut the comfort carbs is to replace them with non-carb comfort foods.

My current go-to comfort food is steamed cauliflower, buried in chives, crisp bacon, cheeses - baked until the cheese is melted and gooey-great. I then eat with a huge blob of full-fat sour cream. Now, nobody can tell me that's not an ultimate comfort food :) - and it's so easy.

I think having all your docs under one roof is a great idea. Last year I started with a large medical clinic in my area and admit to loving it for now. Everything is online, and it seems so much more comprehensive and organized. But - if I didn't like one of my docs there, I wouldn't hesitate to go outside the foundation/clinic to find someone I did.

I do think once you can bring your carb cravings down via eating fewer, having lower numbers, more energy from some weight loss, your depression will lift and make all this so very much easier.

Sorry you're having a rough go of it at the moment - hang in there!
 

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Hi John. You have received some great advice. Unfortunately dieticians and doctors are not the best ones to advise on diets for diabetics. Most will tell you that you need a certain amount of carbs to survive. They will convince you that your brain cannot function on a LC diet. If that were the case most of us here would be walking around like Zombies. Instead we have lowered our bgs to normal, lowered our HbA1c, got off or reduced our meds and have increased our energy levels. I think you are on the right track with a protein based diet, but don't avoid the fat. You want to avoid the wrong fats. Things like vegetable, canola , soy or corn oil are high in omega 6's. They also oxidize in you body when you heat them. You are better off with real butter, real coconut oil and yes bacon fat. Many of us have gone back to the bacon fat jar on the stove. My meals revolve around fat, an average amount of protein and a very small amount of carbs mainly from veggies and seeds. I don't shy away from fat at all. I am at my lowest weight in years. Have you read the book by
Dr Bernstein. Dr. Bernstein's Diabetes Solution. A Complete Guide to Achieving Normal Blood Sugars. Official Web Site I have read it so many times and just bought his new edition. If you follow his plan you may be able to reduce your meds and get your weight turned around.
 

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Hi everyone -
Thank you for the advice and suggestions. I've been pondering it and making some plans. Clearly, changes are needed.
I am a bit concerned about a high-fat diet. Won't this contribute to elevated bad cholesterol levels and high blood pressure? Have there been any studies on the possible negative side affects of eating so many fats, including animal-related fats (butter, bacon fat, etc.)? It's just that it goes against a lot of science out there, so I'd like to feel a bit safer before making a change.
 

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Are you talking about Ancel Keys study that started all the fat/cholesterol scare? Go watch Big Fat Fiasco on YouTube. There are 5 parts to it and about an hour to see. Google for cardiologists views of saturated fats.

Sent from my iPhone using Diabetes
 

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Fat that you eat, provided it is the natural kind (bacon fat, coconut oil, etc. won't raise your lipids. In fact, eating that way has made mine drop. We've all been brainwashed about fats and it's hard to get your mind around, but actually they are good for us. Carbs are what raises your lipid levels...believe it or not!
 

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John? The fat in our own bodies is natural saturated fat - something manufactured by our own bodies is not going to be toxic. When we lose weight and reduce the fat from our bodies, we're burning natural saturated fat as fuel for our activities. And when we incorporate natural saturated fat into our way-of-eating, it enables our bodies to convert to burning fat for fuel all the time, and it eliminates a lot of the glucose problems related to diabetes.

I have recently made this conversion, and my blood sugar is dropping steadily as time goes on. I'm getting fastings under 100 (5.5) for the first time in two years, and that is possible because there is less chance for glycogen to accumulate in my liver, so there's less of it to convert to glucose if my liver thinks I'm getting low.

The ratio is the imperative - very high fat, and very low carbs.
 
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Hi everyone -
Thank you for the advice and suggestions. I've been pondering it and making some plans. Clearly, changes are needed.
I am a bit concerned about a high-fat diet. Won't this contribute to elevated bad cholesterol levels and high blood pressure? Have there been any studies on the possible negative side affects of eating so many fats, including animal-related fats (butter, bacon fat, etc.)? It's just that it goes against a lot of science out there, so I'd like to feel a bit safer before making a change.
The current science, properly conducted, is heavily in favour of eating saturated animal fats. Read this blog entry which contains links to clinical trials that support the use of saturated animal fats. There is also plenty of evidence out there that over history, diabetes incidence has been lower when the populations ate a healthy diet that included lots of animal fats, and that it increased when low fat diets became fashionable. The current epidemic of diabetes can be directly connected to the HCLF promotion by governments, particularly the US, which has been adopted by most other western countries as a result.
 
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