Recently diagnosed with Type 2 and new to this forum so I am really sorry if I ask something already covered, but we are just getting our head around all this.
After reading “fast 800” and “The 8 week Blood Sugar diet” we have decided to follow Michael Mosley’s approach. However, after a few weeks of confusion I read from a few members that followed the diet with Shakes, , so DH who likes “simple/clear”things decided to go for the approach of the shakes, “no confusions with food, no calorie counting, you know your nutritional needs are covered”. He will be following this approach, while I ( not diagnosed but in need of losing weight) will be following Michael Mosley’s “food approach” with the idea of transitioning to this type of eating once he finishes with the shakes.

We have one question though (before starting). I am guessing that a very big amount of people is taking Metformin. DH (HbA1C 79, when he was diagnosed a couple of months ago) has been put straight away from the beginning at 2x500mg (morning) and 2x500mg (night); according to the insert it is not advised to take Metformin following diets under 1000Cal, and this diet is 800Cal per day. Also, according to the insert, it is advised to have carbohydrates regularly throughout the day, this, the nurse said it was very important specially when having the tablets otherwise he might end up with an stomach ulcer. We are a bit confused as I told the nurse very clearly of our intention of following this diet, so I am now having two conflicting advises; the nurse AND the medication insert. What does normally people do? Is it ok to follow this diet with Metformin? Do you keep some carbs for when you take the tablets? Can anyone enlighten me on how they did it and how they got on please?

Hello Megan84 and welcome to the site. First we are not medical people and cannot give medical advice. What we can offer is the benefit of our experience. Sorry to hear your DH has been diagnosed with T2 but as it is recent he is in an excellent position to reverse that diagnosis. Shame the doctor/nurse put him straight onto drugs rather than offering dietary advice as an alternative. To be fair doctors and nurses are not great at giving that sort of advice, they prefer and easy fix. Not their fault but a gap in their training (and I speak as an ex nurse).

Your hubby should stick with the advice of the 8 Week Blood Sugar diet as it gives so much more detail about T2. Next, if he wants to go the route of shakes he will have to make sure they are the right ones. Many have artificial sugars and alternative carbs (like rice powder). You will learn more about sweeteners as you go along. Can I also say he will be bored to death in a couple of weeks as in my opinion they dont give you satisfaction you get from real food. There really doesnt have to be anything complicated going the real food route – in fact I dont know anyone on this site that uses shakes although there have been. Make your normal meals and add some extra vegetable portions.

Not sure about the Metformin along with eating carbs causing ulcers but I do know they gave me the runs (excuse me). If they insist he has carbs with the meds there are lots of good carbs like an apple or celery stick, if he really must. Again, people forget there are carbs in almost everything except meat and dairy. The carbs we avoid are the white starchy type – potatoes, bread, rice, pasta, breakfast cereal (except oats), the obvious processed foods and cakes, sweets and biscuits. To get an idea of what are good or bad carbs or what level of carbs he is eating use a food calculator such as my fitness pal where you log your food and it tells you. He should be looking at less than 50g per day.

There is one important piece of advice. Your DH will have to be careful with his Metformin doses. Is he testing his bloods? If he sees his blood sugars going down he should be able to reduce the amount of Metformin but he should have medical advice. If he feels at all unwell – shakey, sweating, faint etc then he should have something to eat fairly quickly. From experience it is not necessary to eat sugar, sweets or bread and jam as I used to. He can bring his levels back up with some yoghurt, cheese, slice of ham, chicken etc.

There is a lot for you to take in but I can assure you if he follows this plan he will get back to full health but it is hard going and he will need support. Feel free to keep coming back no matter how many times we have answered the same questions it is okay to ask.

You could read the thread by RubyG, she and her husband were in the same position as you just over a year ago and they are both doing really well. I think her husband is now off all meds.

Hi Megan and welcome, and thanks for the reference S-G.
In Oct 2020, hubby was diagnosed as pre-diabetic (HbA1c low 40’s) and his GP agreed to not medicate him and to allow him to try this way of eating first.
He hit the 8 weeks hard and disciplined, kept his cals to <800cals per day and under 50g carbs per day, no alcohol at all, a bottle of water by his side at all times – he has since maintained the low carb way of eating but has upped his calorie intake and has the occasional drink on a weekend. He has lost 7 stone and his HbA1c was in the 30s at his last blood test. He was on 2 separate meds for high blood pressure, and has reduced that to a single dose of 5mg Ramipril now, with BP around 120/70 now. We are both mid-fifties in age.
I will stress, he was not on metformin, so following sunshine-girl’s comments above, your hubby should do this with some form of medical supervision regarding his meds. In fact, my hubby had to call his GP a few times re. his BP dropping so quickly when he started to lose the weight.
I would also say it is do-able with real food, but it does take planning ahead to maintain motivation and interest and vary your food intake while keeping to the numbers. Eggs are your friend, especially for breakfast.
The dietdoctor also has some good visuals for what types of veg are more suitable than others.
Good luck, and feel free to ask away.

Hi Megan
As Sunshine-girl says we can’t give you medical advice just the benefit of our own experiences.
I was diagnosed with T2 in 2011, I think! I discovered this way of eating in 2016, that was the original Book Sugar Diet book. I was taking the highest dose of metformin at that time and my diabetes nurse was telling me I needed to go on to even more medication.
Can I just say that taking diabetes medication is like getting onto a ‘hampster wheel’ which just keeps running and running and needs more and more medication to keep it spinning until you end up on insulin.
Ok, so I started eating low carb in 2016, not necessarily 800 calorie, but I cut out bread, potatoes, rice, pasta and all the other high carb stuff and especially processed, foods. I followed my doctor’s advice so at my 3 month review my metformin was cut in half and after a further 3 months I came off metformin completely. So that would have been in mid 2017 and my BS had been within the ‘normal’ range ever since …. drug free!
I can only say that this way of eating really does work. CARBS in REFINED, PROCESSED foods really are the ‘enemy’ for anybody who has T2. As sunshine-girl says carbs are in most foods apart from meat, fish and dairy.
I can only tel, you from my experience, given that I have been on the highest dose of metformin, my advice would be to ask your medical adviser if your OH can try ‘diet’ before medication.
Best of luck …. don’t go down the ‘drug’ route unless you really have to.

Journey so far has been more than frustrating. I did the research, I read the book, the only thing I was hoping for was medical support, but we didn’t get any.
When DH was diagnosed with Type 2, (HbA1C 79), in our appointment with the nurse we told her we would love to work with a dietitian that would support us and advice us following the diet and trying to reverse the diabetes. She referred us to a local diabetic info group and to the community dietitian. A month later, going for the 2nd appointment (with a different nurse) we informed her that no one has contacted us. She was alarmed by the “high level of the blood results” and we were advised to go on Metformin while we were waiting to be contacted so we could get down the sugar blood level. We were given appointment for 8 weeks later with the idea we would be contacted and we would follow the diet so we could see by then the results. It’s over a month from that second appointment and we are not in any better position, we haven’t been contacted by the local group or any dietitian. We are full of questions we don’t have nobody to ask about and with no support at all, motivation is now running thin. I have been told by someone that has gone to one of these local groups (I think DESMOND, but I cannot be sure) that the importance of diet was hardly touched upon and some other people I heard from have been told that carbs are just fine, when clearly the information on the book I have read is completely the opposite. So I have started to wonder if actually the wait will be worth it or we will find a complete opposite advice. He has also high blood pressure and cholesterol which, we think, it would go down once we manage to get the blood sugar down.
I have been trying to find a local group (physical meetings or online) or a dietitian that would support us following the diet, someone we could actually ask for advise or sit down for a consultation but I couldn’t find any. We are in Lewisham (South East London)
We asked if we could have a follow up with the GP once a month or every few weeks (that is what the book said “Talk to your GP so he can support you and follow with regular checks”). Well, she just said that “no, the normal checks is one after 3 months of the original diagnoses and then every 6 months”, (so ” that you know, we are not gonna waste time with you” sort of…sounded to me).
We were told his sugar blood level is “very high” so we needed to get the metformin to get it down (I have no clue what is the meaning of “79” whether it is too high or not that high, we just went with “professional” advice), he is not having “yet” any medication for high blood pressure, although she was ready to “prescribe” some as well. I just said that for what I read it seems to be linked so if we could get the Blood sugar down then the Blood pressure and cholesterol would go down. She was reticent so she just went with “ok, take the metformin for now and next appointment we will discuss the medication for blood pressure”.
We got a call last week from the surgery, they want to fix the next appointment for the first week of may, it just made me feel completely frustrated. We haven’t managed to get in contact with any of the referrals to get a diet into place and therefore lower the blood sugar level so now I am wondering, “surely they MUST know that, so what is the point of the appointment?”
Anyway, I just wanted to say that we were very reticent to get the medication, with any minimal support from any GP we would have been more than happy to just go ahead with the diet, knowing that he is being checked regularly but (not knowing better at the moment), we just decided to take it. Funny enough, she said it is completely fine to take the metformin and follow the diet because “the metformin is natural plant base and doesn’t produce hypos”.
After seeing the appointment date approaching and just the lack of follow up and support they have given us we just decided to go for it ourselves.

Megan so sorry to ‘hear’ the frustration in your post.
Firstly, I’m glad you’ve decided to go ahead yourselves. Can I suggest your husband follow the Blood Sugar Diet anyway as I doubt it can do him any harm. Neither bread, rice, potatoes or pasta are really adding much nutrition to his diet.
Secondly, metformin is said to only decrease blood sugar by 10% so even on the top dose there will still be room for improvement.
HbA1c is ‘normal’ when it’s less than 44, 44-48 is classed as pre-diabetes and over 48 is classed as diabetes.
Speaking to a dietitian may not be the panacea you are hoping for. It’s only in recent years that low carb diets have been seen by the NHS as a tool to help regulate blood sugar. It’s possible that you will be seen, eventually, by a dietitian that still gives out the old mantra of carbs with every meal.
I know how much information there is on the internet and that in itself can be confusing.I’ve posted a link for you from an NHS trial program that has now become more mainstream. It will take you through low carb eating step by step, week by week.
https://www.lowcarbprogram.com
Also as Ruby suggested take a look at http://www.dietdoctor.com as there are great visuals of foods in the low to high carb groups…. and also lots of other useful material.
Best of luck with the journey. It might seem daunting at first but you soon get into it and we’re always here if you have questions.

Megan I really feel for you. I am sorry to hear that doctors, nurses, and as Verano says, dieticians are still as s%%t today as they were 16 years ago when I was diagnosed. There are a few exceptions like Dr Unwin, Prof Taylor and, of course, Dr Mosley. Just a point about Metformin and us giving you advice. If it only gives a 10% benefit and it wont give hubby hypos then I would suggest you just go along with this diet with or without the Metformin. As your DH has only been on it (the drug) for a few weeks it might be a good idea to talk to the nurse again and TELL HER you are doing the diet and ask that she allows your husband the 3 months between testing to do this without the drug. Although I am sure he can speak for himself I am saying you because it is you posting. One reason is that this diet does actually work and secondly, if he continues with the Metformin and has a good result they will say it is the drugs doing the job. Is he still going for the shakes and has he sourced a good one with no carbs or artificial sugars.

Verano has already told of her success with her diabetes in remission. RubyG has also told you about her husband getting rid of the pre-diabetes diagnosis and off meds and losing 7 stone. And for me, I was like your hubby, first results so high I was put on several meds including Metformin. I couldnt tolerate the stomach upset so the doctor put me on insulin after 6 months. The worst day of my life. I am not blowing my own trumpet here but it might help you to read my blog which is a diary of my dieting life on BSD. It is called – 5 Years of BDS – A Blog of Memories. It goes right back to day one when I was so nervous and fearful of having my hopes dashed and the diet not working. It tells of peoples responses and being called a nutcase etc. Type it into the Search bar at the top of the page.

Here I am 6 years on and although I havent had the results Verano and others and your husband will find possible because of the insulin, it has still saved my life. I went from readings of over 80 down to around 50 in 3 weeks, I have reduced my blood pressure and cholesterol and have ditched most of my meds. I am in the process of getting rid of the insulin injections when I pluck up the nerve. And can I say all this happened without massive weiight loss. Just ditch the bad carbs and it will work.

As for you not having anyone to speak to – no we are only virtual but so are your medical professionals – we are here 24/7. Any questions will be answered. Chin up, what did Bob the Builder say – we can fix it. Take care.

Megan I missed the bit about the shakes. I use them very occasionally and if you are looking for ones without any ‘artificial’ ingredients or ‘e’ numbers etc. I use purition. I know I shouldn’t advertise here but I found it really difficult to find ‘whole food’ shakes. They do a lot of different varieties and you can buy them in individual sachets so can find your favourites before committing to large packets. Take a look at their website.