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Fasting with Medical Conditions

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Just Received The News...
13 Dec 2015, 23:54
...That I am diagnosed with Type 2 Diabetes.

Found out within the last hour. I am not surprised as I've been overweight since birth, more mad at myself for not taking care of the situation sooner, but what's done is done, we live for the present and the future, so the work begins now.

I have more tests that needs to be done (urine test, for example). I know I have a high fasting glucose and high LDL levels. I can't tell you the specific figures as I don't even know. My doctor didn't tell me my figures. He told me that I will be put on a diabetes management program and with some medications.

I've began my weight loss journey for over a year now. I've lost 60lb so far, and I intend to keep going. I am starting my 3rd week of 5:2, I'd like to know if there's anything I should be aware of, or cannot do with this diet. Currently, I am eating a whole foods diet, with mostly complex carbs, and some protein. I eat mostly vegetarian at home and eat protein when I eat out. I've cut out almost all refined carbs. I don't have a sweet tooth, but the occasional starchy foods get to me. Anyway, I haven't told anyone yet, but I do intend to tell my sister. I am not sure if I will let the rest of my immediate family know right away, especially my 65 year old parents and 90 year old granny. I don't want them to have anxiety issues (which they already have). One thing that I cannot handle is going on a very low-carb diet. I was on a Ketogenic diet 5 years ago, where I failed miserably. All the high fat, medium protein, and less than 30g of net-carb was something that I couldn't do. So if I can, at least eat complex carbs, I'll be content with that. If anyone else shares the same position as me, please chime in. Thank you!

I feel somewhat relieved right now. Just gotta continue to do what I need to do. Thanks for reading everyone. Hope everyone had a wonderful weekend. :)
Re: Just Received The News...
14 Dec 2015, 01:24
Well the good news is that it's Type 2, which can be managed! I'm sorry to hear about this, but have no doubt that the 60 pounds you have already lost is a big step in the right direction.

I had gestational diabetes and so I'm therefore at a higher risk of developing type 2 at some point. My endocrinologist (who treats me for thyroid issues, not diabetes) says the single best thing you can do to avoid or control diabetes is exercise. He says get a pedometer and do a minimum of 10,000 steps per day. He says if you can do more, even better. We have a fitbit group here. My husband and I have had our fitbits for about two years now. His Flex just died and had to be replaced, but my One is still going strong.

You're going to hate the next thing he says (I know, because I hate it too and I've been working toward this goal for about two years) -- cut down your carbohydrates, even complex ones, dramatically. You do not have to go extreme down to ketosis/Atkins. But you do need to reduce your carbohydrate intake dramatically so that it's not the bulk of your calories. My endocrinologist says someone with diabetes really shouldn't be eating more than 75 grams of carbohydrates a day. 1 cup of cooked brown rice is about 45 grams of carbs. He says even healthy people shouldn't eat more than 150 grams of carbs per day unless they want to develop weight gain and diabetes. I know this isn't fun -- I can't stand the extremely low carb diets either. But 75g per day is a lot more doable than 30.

So what to do? Try to eat as many vegetables as possible. I don't count carbs or calories for green veggies. Eat as many colors of veggies as you can in a day. Fill half of your plate with vegetables for at least lunch and dinner. Of the rest of your plate, 25% can be carbs and 25% protein.

If you can control your blood sugars with diet and exercise, you might be ok to keep fasting. But if you are uncontrolled, fasting could make things worse. You can't let your blood sugar drop too low, that's dangerous. I wouldn't fast again until you have your sugar monitor and can test yourself to make sure you're not in a bad zone for sugars. And definitely talk to your doctor about it.

I hope you are able to get in with a doctor soon, so you can get more direction.
Re: Just Received The News...
14 Dec 2015, 02:08
Bummer. The same news hit both my brother in law and wife last week. The BIL ("...type II" with a guessed-at mid-30's BMI) had gained considerable belly-weight when I saw him in May. The wife - ("...pre-diabetes" with a mid 40's BMI) was an issue I saw coming for a far longer time. Long before my own success with 5:2. (But a spouse, no matter how well intended and how much science there may be behind it, realistically can only suggest. Apparently I do so poorly.)

Success with fasting and its 5:2 variations depends on a willingness to experiment and a fervent desire to retain direct (and what must be permanent) personal control of the situation. By implication this means a willingness to make substantial dietary changes which become critically important once in maintenance. This is where most seem to fail. There are several excellent books out there that scientifically explain the situation with weight-gain and weight-loss that also layout workable science-based solutions. Your unfortunate additional complication is the introduction of diabetes medicines, the dosage of which depend on having a consistent diet. So unless you can come to workable agreement with the doctors to adjust medicines as needed as you fast you've a tough road ahead.

Before I dropped from ~31 BMI to 25, my cholesterol and blood sugar numbers were bad - some shockingly bad in retrospect - but not bordering on diabetes. From my initial 5 months of ADF-ing and for the last several years of maintenance they've all remained in the ideal range.

Realize that much of the interpretation of cholesterol numbers and ratios has changed in the last few years with certain ratios gaining overriding importance. Be sure to compare your numbers before your weight loss with the current set. Have your doctor explain what he sees with that weight loss in mind. I'm very hopeful that there's already an encouraging trend in there.

Change is hard, especially after a life time of eating a certain way and getting away with it. No one like giving up favorite foods. For example, for me the ketogenic approach is ideal even though I can't maintain it for long. But it is possible to adequately reset the phrase "normal eating" by finding ways of eating that finally respect the actual needs of one's body. Ultimately a most important point to discover is the amount in grams of carbohydrates that your body will tolerate without initiating weight gain. From that limit you can re-expand dietary choices to add back some old favorites. I apologize in advance here if I've overstepped.
Re: Just Received The News...
14 Dec 2015, 02:38
Thanks for all information and the encouragement.

The biggest obstacle for me will not be eating low carb (<less than 75g/day), rather it will be difficult to get those around me to support this new lifestyle, as it goes against everything they know about healthy eating. In addition, it's not widely accepted by today's medical professionals (doctor's) that it's an effective way to combat and reverse diabetes, so not only I need to go through the hardship of low carbing, but I will also need to take the constant abuse from those around me that what I will do is not right. I know what I am about to partake is the right path for me, but it will be difficult to convince others that I am (my family).

Anyway, time to re-design my diet plan for the week. I will make sure that I discuss with my doctor about the need to fast. How does taking diabetic medication effect fasting?
Re: Just Received The News...
14 Dec 2015, 03:13
MisterChew wrote:
The biggest obstacle for me ... it will be difficult to get those around me to support this new lifestyle, as it goes against everything they know about healthy eating. In addition, it's not widely accepted by today's medical professionals (doctor's) ...


Then check these two links out (for a start):


http://authoritynutrition.com/how-to-wi ... ritionist/

5-2-diet-chat-f6/handling-objections-to-5-2-t14052.html?hilit=ancestors

:smile:
Re: Just Received The News...
14 Dec 2015, 04:59
Well my endocrinologist is a regular American doctor and he is the one who made me take a second look at reducing my carbs. So I wouldn't automatically assume the doctor won't be supportive. I admit I don't know a whole lot about differences between American and Canadian systems, but I've always assumed that they're of similar quality of care.

In any case, it's probably best to listen to your doctor and follow their recommendations and see if those recommendations work for you. If they don't work, it's on to different options. What I told you is just what my doctor tells me. I know when I had gestational diabetes 15 years ago, they didn't specify 75 grams of carbs, but the diet plan definitely was limited carbs to one serving per meal. And that was back when nobody was second guessing the lowfat recommendations. The old weight watchers exchanges from the 1970s was based on "diabetic exchanges" which limited the servings of carbs to maybe 4 per day -- with one slice of bread or one half cup of pasta/rice considered a full serving of carbs. So it's fairly standard to limit carbs, unfortunately.

Perhaps you can try telling your family that you're "prediabetic" and the doctor is putting you on the diet to avoid getting diabetes. Hopefully that would be a good cross between worrying them and getting them to help you with your new dietary restrictions.
Re: Just Received The News...
14 Dec 2015, 05:05
Oh - medication and fasting -- it really depends on what medication they give you. They're likely giving you a medication to help control your blood sugars. Or they might start off with no medication. But since fasting affects blood sugar, you really need to discuss your particular situation with your doctor. Don't be surprised if s/he wants to see a journal with a week or two blood sugar measurements before they allow you to fast. Depending on the medication, it could cause a fasting blood sugar to go too low if you're fasting for too long and that can be dangerous.

And if you start to feel weak, dizzy, confused or nauseated, that could absolutely be low blood sugar.
Re: Just Received The News...
14 Dec 2015, 08:23
Have you come across the work of Dr Jason Fung? He treats T2D diabetics with ADF and low carb. He has lectures on YouTube about what he calls "diabesity" and this web site has his blogs https://intensivedietarymanagement.com/carbohydrates-faulty-gi-index-idm-2-2/.
Re: Just Received The News...
14 Dec 2015, 11:54
barbarita wrote: Have you come across the work of Dr Jason Fung? He treats T2D diabetics with ADF and low carb. He has lectures on YouTube about what he calls "diabesity" and this web site has his blogs https://intensivedietarymanagement.com/carbohydrates-faulty-gi-index-idm-2-2/.


Excellent link, barbarita!

Among the many "diabetes"-specific links on the above site these seem especially relevant to the current conversation:

https://intensivedietarymanagement.com/ ... -reversal/

https://intensivedietarymanagement.com/ ... e-hansraj/

https://intensivedietarymanagement.com/ ... tes-t2d-4/

https://intensivedietarymanagement.com/ ... lie-t2d-2/

https://intensivedietarymanagement.com/ ... -weight-x/

Be sure to read the clarifying reader comments at the bottom of this last one.
Re: Just Received The News...
14 Dec 2015, 14:17
I would just urge you to get your blood sugar checker first. When I had gestational diabetes, I was able to completely control it with just diet and exercise. But before it was diagnosed, I would feel very sick if my blood sugar was off. My stepfather also has diabetes, and I've watched him have a lot of trouble (although to be honest his diet is terrible and he's disabled and has trouble exercising). I would wait to fast at least until you have a way to check your blood sugar numbers.
Re: Just Received The News...
14 Dec 2015, 14:41
You have had some great advice here and it is good news that you can control it. Ignore people around you and put yourself first. We will support you here. I agree get a glucose monitor asap. I am not diabetic but bought a monitor to keep a track of what foods influence my glucose levels. The results quite surprised me. Having the data feedback really does help to adjust your diet accordingly.

Lots of steppers on this forum - so maybe get a fitbit too and join the gang. Good luck to you.
Re: Just Received The News...
16 Dec 2015, 19:41
I've had Type 2 for over 20 years, started managing it by diet first then with medication (metformin) and have been on 5:2 since the beginning of April with the approval of my medical team. The one stipulation from the nurse was that I MUST eat a SMALL amount at the time of my medication, for me that is normally 10g of instant porridge at breakfast time. After the results came back from my annual check-up with everything improved by several points the doctor also expressed his approval of this method of weight management. After the initial drop of several Kgs it has slowed considerably to around 1Kg per month but being realistic that means the weight is more likely to stay off and I haven't had a positive self-monitor test for several months.
Your dietician will give you guidance about what and what not you should have. Listen to your body, you will find that that food you found so delicious was not a good idea so avoid in the future. You will also find that after several months some things you used to enjoy no longer appeal or in very small quantities. For instance any more than a couple of squares of chocolate now make me feel sick and at one time I could eat a whole bar quite happily.
GOOD LUCK. Read as much as you can, Diabetes UK have some excellent books and the whole of my family enjoy many of their recipes.
Re: Just Received The News...
17 Dec 2015, 09:40
Sorry to hear about the diabetes.
I think you have a good attitude, you can only proceed from where you are, not from where you'd like to be. But it sounds like you have done really well so far.
I can understand that you do not want to worry your family, but their support would be so helpful. It's not untrue to say that the doctor is unhappy with your glucose and cholesterol levels and has suggested some dietary changes?
If this is not appropriate, well, you will just have to get your support from forums, and tough it out in real life. Hard though that is, (and frustrating too) you know you are doing what is right for you, and well done for your huge progress so far.
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