Need some advice please!

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  • posted by Flak999
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    I started the BSD two weeks ago I am a man 5′ 11″ and weighed 13st 3lbs my HBAC1 test score was 44 placing me in the pre-diabetic range. In the two weeks I have been on the diet i have lost 11 lbs which i am very pleased with and my fasting blood sugars in the morning have been 5.5 mmol/L or below for the past five days. My question is how long should I continue on the BSD. My goal weight is 12 st and as I am now 12st 5lbs at the rate i am going it wont be long before I have achieved this (hopefully!)

    Do i go over to the 5:2 diet as maintenance, or should I continue on the BSD until my next HBAC1 test to confirm my readings? I don’t really want to go below 12St as i will be under weight on the NHS BMI calculator.

    Your thoughts please.

  • posted by sunshine-girl
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    Hi Flak999 – welcome to the site and well done so far. You have only been doing this for 2 weeks and the initial length of the programme is 8 weeks so lets see where you are then. Judging from your Hba1C numbers you have dodged a bullet leading you into full diabetic status. That is great and that should always be your main focus. You say you only have 5lbs to go to your ideal weight but there is a possibility that your weight loss will slow down anyway – drat that men lose weight so quickly – but the important part of this diet is the low carbs, no starchy carbs. That is what will keep your blood glucose healthy. If you find you are dropping too much weight then I would just suggest you add some extra healthy but fat dense calories like nuts, avocados, meats and poultry. Do not be tempted to go back to starchy carbs or you will soon see your BG levels start to rise again. I’m sure someone will come along who is following a maintenance plan who will be able to help you more. I personally have been on this way of life for nearly 3 years and do it because I know as a full blown diabetic, as soon as I start eating carbs my BG go through the roof and it is more important to me to keep that stable than to lose weight. Good luck.

  • posted by Flak999
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    Hi, sunshine-girl and thank you for your reply which makes great sense. i will continue with what i am doing as i have a Doctors appointment on the 15th April to discuss all of this, one thing that did occur, is it possible on this diet to make your blood glucose readings fall to low? Some mornings mine have been as low as 4.4 mmol/L?

  • posted by sunshine-girl
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    I would say if you were a full blown diabetic and / or if you were on medication then yes it can go too low. However, if you answer no to these questions then, no, none diabetics can perfectly regulate their BG. With low carb you can go low but you wont get the diabetic hypo – warning – if there is any chance you are diabetic, and future tests will tell you, then you can go too low. 4.4 to me is a perfect figure although pre BSD I would freak out if I went as low a 5.0. Anything between 4.5 and 6.0 is acceptable. If you get any symptoms of hypo – and these are well recognised – blurred vision, hot flushes, sweating, numb lips or fingers, shakiness, confusion – then eat something urgently. It doesn’t have to be something over sweet but maybe some cold chicken or ham, spoonful of yoghurt with a couple of prunes or dried apricots. Test and test again until it comes up to a safe level. I find my danger level is under 4.0 so maybe I worry at 3.5. My danger times are late afternoon, especially if I have been exercising. So, until you are familiar with your own body and symptoms etc err on the side of caution. Hope that helps, just take care.

  • posted by Flak999
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    Thanks very much for the good advice!

  • posted by Flak999
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    Another question please, I understand that carbs are the key with this diet. But how many? I have been keeping strictly to 50g carbs a day, but I see that some say 30g and some 20g, is there an optimum carb intake for the day or as i am losing weight and my blood glucose is coming down do I just stick at 50g as it seems to be working for me?

  • posted by alliecat
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    Flak999, if you are happy with your rate of loss at 50g of carbs per day, continue on at this pace. Some of us
    have to acknowledge insulin resistance, and need to drop down further to achieve our goals. It differs from
    person to person, and there are no rules set in stone. Listen to your body, and it will tell you how to proceed.
    Shout out if you have any questions or concerns, and there is a whole community of experienced BSDers who
    are out and about, and more than happy to share knowledge and advice. Best to you,

    Allie

  • posted by sixturkeys
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    This is the marvel I think of this WoE – it is “prescriptive” – low carb – but at the same time, as Allie says, within that it encompasses different aims, blood sugars and/or weight loss, and a range of “quick or slow” and the daily numbers can vary, recognising the individual. I am more tortoise, others are hares, but at the end of the day, it works for all. Without the “deprivation” other “diets” which allow a little bit of that and the other just perpetuate.

  • posted by JGwen
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    Hi flak,
    I would agree with sunshine-girl, once you reach your target weight you can maintain by increasing calories from healthy fat. The normal “formula” that many people have found successful is low carb, 0.6 to 0.8 grams of protein per kilo of TARGET weight, and make up the rest of your calories from fat. – Remember if you have too much protein it will have the same effect as having too high a carb intake.
    With regard to your question about carb levels. My response on that is written both because I feel its important to provide the reason for the recommendation and with one eye on the fact that this is an open forum and there will be people who reading the advice but don’t yet feel comfortable asking questions, because I have a different take on how to assess if your carb levels are correct than Allie. –
    In your case you are monitoring your blood sugar levels and are seeing them reduce on 50g of carbs, which indicates that your body is healing and you can choose between staying at 50g or reducing carbs further.
    If you were someone who had a lot of weight to loose and were looking at doing multiple cycles of BSD and were not testing your blood sugar I would advise you that just loosing weight is not a strong enough indicator that you have got your carb levels set at the right level.
    The reason that the diet industry depends on selling the calories in / calories out model so successfully is because you will loose weight in the short term if you eat less calories than your body needs . – However, after a period of time your body will reduce your metabolism to adjust to a lower calorie diet as standard IF your carb levels within those calories are high enough to maintain high levels of insulin. Which means that when you try to go into maintenance you put the weight back on and its even harder to loose weight the next time you try. There will be some people for who the BSD would work like that CI/CO diet on 50g of carbs so for anyone who is not testing blood sugar levels, or ketosis I would recommend erring on the side of caution and aiming for under 20g of carbs not using just weight loss as an indication that carb levels are low enough.

  • posted by Flak999
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    Thank you all for your very informative answers.

  • posted by Flak999
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    Sorry to keep asking these questions but, when I have achieved my goal weight and my blood sugars are in control (presumably i will confirm this with another Hba1C test?) some people have suggested going over to the 5:2 diet as maintenance? Is this a good way to keep things on the right track? Also the big question, does this mean I can never eat or drink high carb foods ever again? ie: no more beer, bread, potatoes, rice or pasta? Thanks for your patience!

  • posted by sunshine-girl
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    First of all the 5:2 is a good move for maintenance or just eating a sensible Mediterranean diet. As for the carbs, yes you will be able to have bread or other carb but they will be more of a treat than a regular accompaniment to your meals. Getting to a weight goal and then returning to eating the way you were before will make you regain the weight. No problem there if you dont mind having to diet again. Getting your HbA1c down to normal and then returning to carbs and an abnormal BG count is not a sensible thing to do. So, returning to carbs will increase your BG and possibly put you back into the pre-diabetic range. I still drink wine (more than I should) and occasionally have a bread roll in a restaurant but I can honestly say that rice, potatoes, pasta etc hold no attraction for me. This has become a way of life and, giving this a good go, you might find that your tastes change. I would rather have an extra helping of veg than a tasteless carb like rice.

  • posted by alliecat
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    Hello, Flak! If I’m remembering your profile, you are one week into this lifestyle? I hope it’s going well for you 🙂
    It’s a bit early to be thinking about maintenance, or returning to the bad “whites” or beer. They will only take
    you back to where you started from. The longer that you omit the carbs, you will lose your taste for them. Even
    though I’m 2 years into maintenance, I’ve never gone back to them, and I believe that to be the principle reason
    for my long term success. There is a process called the reverse diet for when you arrive at the maintenance
    stage of your journey. More about that later! If you’re able to think of this eating protocol as a permanent
    lifestyle change, and not some quick fix with a return to previous habits, you will be “home free”, and yo yo
    dieting will become a distant memory. It’s so very liberating!!! Wishing you much success as you approach
    week #2

    Allie

  • posted by Flak999
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    Hi all, another strange question! i have been doing really well following the diet and yesterday i was 12st 2lbs, however when I get on the scales this morning I am 12st 5lbs! How does that work? I had a good day yesterday I actually ate less than 800 cals and only had 25g of carbs. I monitor everything i eat on the ‘My fitness pal’ app , and I have not cheated once. Could this unexpected weight gain be fluid? I have been drinking about 2 litres of water a day and am speed walking two miles everyday. Should I expect these strange weight fluctuations ?

  • posted by sunshine-girl
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    Hi Flak, this is possibly why it is not a good thing to weigh everyday. Look upon it as a glitch and keep an eye on the overall picture. Yes, it could be fluid retention, are you female, is it time of the month, have you had a good result in the back end toilet. So many reasons but use it as an indication that you need to keep on and this will pass.

    By the way, I do weigh every day so I was not criticising – if the scales go down I am pleased, if they go up I am more determined.

  • posted by JGwen
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    A litre of water weighs a kg, and on top of that there is the weight of what is in your digestive system. If you eat a lot of veg you can have a lot of bulk / weight with 800 calories, just imagine the size of the pile if you were to eat 800 calories of celery. ———- This is why its normal for your body to fluctuate by upto 3kg during the course of a day.

    The scales are not the best way of monitoring progress. – As you keep insulin levels low your other hormone systems can also work properly. That includes growth hormone responsible for bone density and repairing muscles after exercise. – Its far better to monitor your progress with a tape measure, but remember, our body has this amazing ability to find all sorts of places to remodel before it starts on the spare tyre. Quite a few of us have even dropped shoe sizes, and many report the re-emergence of collar bones.

  • posted by Flak999
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    Apologies, i should have made it clear, I am a 61 year old man. I guess these fluctuations are to be expected then? I must admit that I am a wee bit constipated, so perhaps that may explain things. I shall take a spoonful of Lactulose solution tonight and see if that has the desired result tomorrow morning! 🙂

  • posted by Flak999
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    Hi all, just a quick update. I seem to have cracked the constipation issue 🙂 I upped my water intake and took a couple of spoons of Lactulose solution at bedtime and the problem seems to be solved for now! Maybe i was eating to many eggs? Anyway, my numbers are looking good , 12st 1lb this morning. I started three weeks ago at 13st 3lb and my morning fasting BG levels are consistently in the normal range. My BMI is now in the healthy range at 23.6 Does any body know when I could realistically have another Hba1C test to confirm I am out of the pre-diabetic range?

  • posted by sunshine-girl
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    Flak999 you can have a new test minimum 3 months after the last one. The measurement is of blood glucose averages over a 12 week period.

  • posted by Flak999
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    Hi, thanks for that, I had my last Hba1C test on the sixth of March so I guess I will just have to wait until after the sixth of June!

  • posted by sunshine-girl
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    Also whether your doctors surgery is willing to pay for it. Some make you wait 6 months or a year.

  • posted by Flak999
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    Really! I wasn’t aware of that. Presumably I could pay for a private test if I were so minded?

  • posted by Flak999
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    Hi all, me again! I have just started my fourth week on the BSD, I think I have been doing really well, in that time I have lost 1 Stone 2 pounds in weight and my fasting morning blood sugars have been less that 5.5 mmo/l for two of those weeks! So I had been thinking that this was a done deal! It was my birthday two days ago and my son took me to London for the day and we had a lovely meal and some drinks and i thought well one day off won’t do any harm! Apparently not it would seem, I have been straight back on the diet for two days but my morning fasting readings are back up to 6 mmo/l again!

    Does this mean that one day of being off the diet has ruined my three weeks of progress or is this just a blip?

  • posted by Jennie10
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    Hi Flak,
    A belated happy birthday – a trip to London sounds lovely, I must drop a heavy (basically tell them) hint to my children.

    No, it’s definitely not ruined all your great work, it is just a blip, or maybe a planned step-off BSD for the day if you like. Keep going with the BSD and keep your carbs low and they’ll come down into the 5s again. You’re doing really well.

    Jennie
    Btw, I know what you mean, 6 isn’t the same as 5.5, but 6mmo/l is still good and is still within the normal range. Let us know how it goes. xx

  • posted by Flak999
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    Thanks for the positive thoughts! Another question has occurred to me, as i have been diagnosed as pre-diabetic Hba1C score of 44. When I have finished the eight weeks of the BSD with hopefully my blood glucose in the normal range and I have another Hba1C test which confirms I am no longer pre-diabetic (Hopefully!) Does this then mean my body has returned to normal or am I just in remission? I guess what I am asking is will I still constantly have to watch every morsel that I eat for the rest of my life?

  • posted by Scottishgal
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    Hi Flak, personally I believe that diabetes only goes into remission and if you start eating all the carbs again then yes your BG levels will go up. So, basically yes you will have to watch what you eat for the rest of your life. I think the odd rare treat won’t do much harm but if you go back to your old way of eating then the diabetes comes back.

  • posted by Verano
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    Hi Flak999 I have type 2 diabetes but have been in remission for two and a half years. My HbA1c was 44 in April 2016 and I was taking 2000mg of Metformin a day. At my next test in October 16 my HbA1c had dropped to 37 and six months later I was drug free with a figure of 34 and I have remained in the low 30’s since. My latest test a few weeks ago was 32.
    So far you have been given great advice. I have often struggled with the definition and measurement of carbs and have very recently read that …….
    The Net Carbs number reflects the grams of carbs that significantly impact your blood sugar. Net carbs are the ones that are digested so are the only ones to be concerned with. Net carbs, as you probably know, are total carbs minus fibre which works fine with fresh produce but not packaged/labelled foods as the system in the U.K. shows net carbs, but in the US they are shown gross. I struggle! A rule of thumb is if the total carb number is lower than the number for fibre then the fibre has already been deducted.
    So to answer your question I think it will be a bit of trial and error but I do think you can eat some ‘good quality’ carbs and still be fine. I never eat rice, pasta or potatoes but very, very occasionally I have a small portion of good quality seeded bread. I think my carbs probably average out at between 40 and 70g a day but that’s the level that keeps my blood sugar stable and yours could be way different.
    I think that something to remember when reading the responses to your questions is that weight loss and blood sugar regulation may require different levels of carbs. I’m not sure that I’ve read of anybody having to drop down as low as 20g of carbs a day to keep their blood sugar in the ‘normal’ range. So don’t panic there is ‘life’ once you are in remission but you just have to be discerning about the type and amount of carbs you eat.

  • posted by sunshine-girl
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    Hi Flakk – sorry for assuming you were a woman although, judging by his moods I am sure my hubby has a time of the month. Can I just say that the readings or around 5.5 or whatever that you get on your home test will bear no resemblance to the HbA1c results. I usually read around 4.5 to 5.0 daily but my HbA1c was 6.2. When I pointed this out to my doctor he said they are not measuring the same thing. The daily finger prick measures what you have had to eat, what time of day, have you done any exercise, have you had a poo, are you suffering from a cold – so many things. The times I test are probably when my BG is at its lowest, i.e. first thing in the morning and around 7pm just before I have dinner. So I tried testing at other times and some times I was as high as 8.0 (2 hours after a meal) so that would be taking into account on the 12 week ‘average’. By the way, sorry to say this, but you cant just do this diet for a few weeks, lower your BG then go back to the bad old ways. Sorry, it doesn’t work like that. Consider yourself with a particular digestive problem which will always be there and you have to keep it under control. Maybe not so strictly in the future but the future is another day. You are not there yet.

  • posted by alliecat
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    I agree with sunshinegirl, Flak. Perhaps you didn’t see my post on April 1, or perhaps it was simply not what you wanted
    to hear? 🙂 All here have conditions that we will have to monitor for life, and the BSD is how we accomplish it. Thinking
    of this as a lifestyle change, rather than a quick fixx followed by a return to old patterns is the greatest gift that you
    can give yourself. Best wishes!

    Allie

  • posted by Flak999
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    Thank you all for your very informative replies!

  • posted by Jennie10
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    Hi Flak,
    I’ve not been on the forum much the last few days so missed your last question, but came on to your thread to wish you well at your doctor’s appointment tomorrow. Hopefully, they will be supportive of your following the BSD and any health results will be positive ones.
    About if your body returns to normal or not, I agree with what everyone else has said. I see my Type II as being in remission or really well controlled by my diet (and 3 cheers for that). What I would add is it’s not too bad at all. When I was first diagnosed my first thought was exactly your question – Will I constantly have to watch every morsel that I eat for the rest of my life? The thought that I’d never be able to eat my favourite foods was heart-sinking. But it doesn’t work that way. You learn/get to know what you can and can’t eat so you’re not monitoring everything all the time. You still have delicious favourite foods/drinks, they’re just different delicious favourite foods/drinks. I can’t cook, I’ve got no will power and I loved chocolate and crisps and I managed fine. It just takes a little bit of time to adjust. Also, you’re pre-diabetic, not diabetic, so, as Verano says, it may be that you just need to be more discerning about the amount and type of carbs you have.

    The only other thing I’d add is about your blood sugar numbers. Sunshine-girl is completely right the hba1c and the home blood glucose meter kits test two different things. The hba1c is ultimately the one that counts but, personally, I think the home testing numbers are valuable, not necessarily for looking at one-off numbers (they can bounce around a bit) but for looking at trends, particularly initially as you are doing – hope yours are doing OK.

    Let us know how you go on.
    Jennie xx

  • posted by Flak999
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    Hi Jennie, and thank you for your upbeat positive reply! I have literally just got back from my Dr’s appointment and am heartened by her fulsome praise for what I have achieved so far. She confirms basically everything that you all have been telling me here, ie: that this is a marathon not a sprint, She will retest my Hba1c levels in eight weeks time along with my cholesterol. she considers that as I have now lost over 10% of my body-weight ( I was 13st 3lbs i am now 11st 12lbs!) BMI 23.2) that I should not lose any more.
    Her advice is basically keep eating the way I am (low carb) but to just increase my calories to stop any further weight loss!

    Sound reasonable?

  • posted by sunshine-girl
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    Well done Flak, yes we have all had similar results and although my doctor seems to have forgotten I am on this diet he still cant get over my results. Unfortunately I still have some weight to lose but I put my BG and other health factors first. As I always say, keep on keeping on…

  • posted by Jennie10
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    Sounds bloody marvellous!

    Seriously, it’s great that your Dr recognises what you’ve achieved and is so supportive of you doing this, and that you’ll get your hba1c test. Win, win, win. Yes, her advice sounds reasonable to me. It’s what you thought anyway, isn’t it.

    Sunshine-girl’s initial advice is good about getting extra calories from things like nuts, avocados, meats and poultry.
    A site worth visiting is dietdoctor.com which has some great information about what is good to eat, visual guides etc e.g. https://www.dietdoctor.com/low-carb/fruits. Ignore the paid for bit – there’s lots of good, free info. (Although there is a month free trail to gain access to the paid-for stuff, which at some point I will do).

    It’s always nice to read positive news.

    Jennie

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