Hi Guys!
I'm new here and someone at the introductory board sent me to this one. I'm very excited to find a low carb board directed towards diabetes! I'm usually one of a very few who are diabetic, so often the recipes and discussions don't quite fit my situation.

I'm female, 56 yrs old and a Type 2 diabetic. I'm not on insulin, I take Amaryl 4mg a day and I take a blood Pressure pill (enalapril <vasotec> once a day)

I've been doing low carb for years (mostly Atkins with a little South Beach tossed in ) It works GREAT for my blood sugars (my last hgbA1c was 6.0) , but I haven't been very successful at losing weight

When I cut back to induction (or phase I:SB) I lose 4 or 5 lbs the first week, then that's about it. My body just won't seem to let go! My doctor says that diabetics just don't lose weight as easily. I'm at a loss. I'm not sure what to do next. I get so discouraged that I just give up, but I really want to lose the weight!

Do any of you have any suggestions?

Thanks!!! 'Mina

Hi Armina,
Just dropped by this thread, and wanted to add my welcome and my two cents.

I'm a 65 year old male Type 2 diagnosed over 21 years ago. I didn't do anything about it except gain weight and take progressively more oral meds for about 15 years. I started on Atkins 4 1/2 years ago and lost 60 pounds, from 375 to 315, over one year. I found I could only lose weight staying on or close to "induction", perhaps (many would say) because I don't exercise regularly. I kept it off for almost 3 years, and then started to cheat a little (a little bread in a restaurant, a little ice cream at night, etc.) and gained back 12 pounds.

Last October I started on Atkins, which is basically induction-for-life. Dr. B. says that is necessary to get and maintain good blood glucose control, from which a very strong inference is drawn that for most people that will stop the progression of the Type2 disease, and in many cases reverse it, if the beta cells are not too badly damaged or already dead.

Since last October 9th I have lost 40 more pounds on Berstein. I'm now at 287. It has required strict adherance and constant monitoring and tweaking of meds and food, but the results are there both in weight, meds and BG control, which is the ultimate goal. My last 5 FBG readings were 99, 92, 97, 97 & 94.

In other words, this program works if you drop your resistance (translate "SB modified" to mean negotiating changes to the program because you are not willing yet to conform to it). You have to b e as stubborn as an ox and absolutely resolute. It's not so hard for me because I am always satisifed (never hungry) and I see results. I'm losing about 3 pounds every week.

By the way, when I started on Atkins (4 1/2 years ago), I was taking 10mg Glyburide (GLY) twice a day, 1,000mg metformin (MET) twice a day, and starting on Avandia. As I switched to very LC, I had to start reducing meds almost immediately to prevent hypos. For the 3 years of Atkins maintenance, I was taking only 5mg GLY and 500mg MET, each once daily.

After I started Bernstein, I started reducing the GLY from 5mg at first to 2.5mg and now to 1.25mg once a day, plus the 500 MET. By the way, your Amaryl is a sulfonylurea, like micronaise (Glyburide), and this class of drugs CAUSES weight gain. Metformin (the generic of Glucophage) is weight neutral. In addition, they work in very different ways. Many pharmaceutical trials have shown that the sulfonylureas, which get the pancreas to pump out more insulin, are suspected of wearing out the beta cells, the thing that makes the insulin, causing patients eventually to progress to injecting insulin. Al;ternatively, some now go on Byetta, a pen injection (much smaller needle -- like a finger prick), if they are failing on oral meds. Byetta causes weight loss! Both MET and Byetta have some tolerance issues, so you have to try them and start on lose doses. The majority tolerate them both fine.

I would say that anything that can't keep your fasting BG or your post-pranidial spikes under 140 is "failing." Just my humble opinion.

Hi Dan,
Thanks for the welcome and for the encouragement !

You are absolutely right about sulfonylureas. I tried the metformin but couldn't tolerate it. It's supposed to work by reducing the glucose that your liver kicks out, but I didn't notice much difference while taking it (in my blood sugars) . Not only did it cause the usual problem but also gave me terrible indigestion to the point that it was causing pain in my chest. I've also tried actos and avandia but they both caused swelling and didn't really seem to affect my blood sugars much. Tha amaryl works pretty well though I have to watch out for the occassional low - that only happens if I get stuck somewhere and can't get to my usual meal or snack. I try to make sure I have something with me just in case The amyral has done great with my blood sugars though, and I haven't gained anything since I started taking it. I had trouble losing before I took it, and it's no different now. It keeps my hgbA1c ~ 6.0 which = 120 blood sugar reading.

I've been waiting for Januvia to come out My doctor said he'd try me on it, I have an appointment the end of this month. I'm really hoping it helps. He said it seems to reduce the appetite... that would be great cause I love to eat <sigh> Januvia is a new class of drug called a DDP-4 inhibitor and is supposed to help your body keep your blood sugars and insulin in balance.
Exubera is also out now, a new inhaled insulin (you take it through an inhaler).
I've never tried Byetta, but it's something to discuss with my doc. (who is a proponent of LC, btw )

I didn't realize that Bernstein had a diet. I read his "Diabetes Solution" years ago, when I was pretty overwhelmed with the whole thing, I guess I remember he advised low carb and it seems like he also suggested a pretty rigorous exercise program, which I'd never be able to do. I have a lot of joint and ligament problems, I have a frozen shoulder, hip pain, am quite stiff (especially in the morning) and my knees protest loudly when I go up the steps My orthopod wants to do surgery on my shoulder but my husband just had extensive surgery on his back and can't lift anything, so I can't do it until at least the Fall.

My husband is a big guy and is about where you were when you started. He's not diabetic, but has a lot of back problems (including some congenital stenosis that they just discovered). He needs to lose quite a bit of weight and balks at the regidity of Atkins (thus the Modified, ie: SB) He's very strong, loves to whitewater canoe and camp and hike, his last cholesterol was 154 (his doc was shocked )

We don't eat bread, pasta, rice or potatoes however. But if you don't watch it, you can still most difinitely get too many carbs!

That doesn't mean I don't exercise. I do low impact aerobics and I just got finished raking gumballs out of the front yard today !

Is this Bernstein Diet from his Diabetes Sol. book? Or is there another one? I'll have to find my copy!!

Thanks for your great advice, Dan!
'Mina

Armina,
Bernstein's "The Diabetes Solution" came out first, in the late 1990's I think. Then, in January 2005 he published "The Diabetes Diet." Then, this past Wednesday, he published a revised edition of "The Diabetes Solution," which I've just ordered. I read the Diet book, but not the Solution book. He also has a forum like this.

There's a lot more to this than just "dieting." The biochemistry of nutrition and digestion in particular is interesting and worth looking into, I think.

Januvia is the hot oral med at the moment. It has had a strong launch, but I predict it will falter because 1) DPP-IV Inhibitors lack the efficacy and 2)have health risks which are being increasingly raised. See NEJM op-ed piece last month.

Approval of Galvus, a sister DPP-IV Inhibitor, was recently delayed for 3 months and last week got an "approvable" letter, meaning they will have to run more trials (lasting a year or more) because of questions of skin and renal (kidney) issues. Remember, it is a DPP-IV Inhibitor, which means it INHIBITS a broad range of immunity functions that the body performs. Some people think that may or could increase the risk of allowing cancer cells to grow that the body's DPP-IV's would otherwise INHIBIT.

Exeubra has been a flop. Very few prescriptions are being written. There are a host of reasons, among them that the inhaler looks like a saxophone. Other include concerns about lung function being affected. The list goes on and on.

Byetta is a completely different drug. It is an incretin mimetic and works by a different mechanism. It is unique and alone in its class. Byetta prescriptions have flattened out in recent months too, some people say because of competition from the easier (because it's oral) Januvia. But most people believe it is because of the free samples that doctors are giving out. They don't show as prescriptions, because they aren't paid for, but doctor's, who make the time, are doing it to show patients how to stick the pen in the belly or thigh twice a day just before meals. It controls BG better (especially the primary, 1st response spike) than Januvia, it delays stomach emptying and hunger goes away. Some people report very large weight loss -- 50 pounds and more. Everyone starts on the 5mcg. dose and eases up to 10 after the 1st pen runs out, assuming they don't have nausea like feelings. Anywhere from 15 to 40% of people experience some nausea, and for most it goes away after a few days of tweaking the time you take it. Which means, most people who try it have no problems. I know about this drug because I own some of the stock and follow a message board for investors.
Dan
PS: I live in a town called Amenia. What is the meaning/origin of Armina?

Hi Armina, welcome!
Have you tried timed-release metformin? Regular metformin caused me stomach troubles too, but I have no problem tolerating the timed release.
Generic timed release metformin hasn't been available very long. Before, you had to buy brand name Glucophage.
As far as the slow weight loss, it may just be that SB isn't low enough in carbs for you to lose.
We insulin-resistant Type II's are carbohydrate intolerant, there's no getting around that, as much as we may like to.
Our bodies have lost the ability to turn carbs into fuel for our muscles, so it gets stored as fat.
You need to expirement with how low you need to drop the carbs for weight loss to start. For me, I don't necessarily need to stay at induction levels... I aim for no more than 30 net carbs (carbs minus fiber) spread evenly across my day, and I'm having an acceptable rate of weight loss.
Of course, I'm starting at a much higher weight than you. You're my goal weight! I fully expect things will slow down and get tougher for me too under 200 pounds.
I take 1500 timed release metformin, 40 Actos, and inject 15 units of Lantos daily. In the 6 months I've been LC, I've lost 56 lbs and been able to come off of Glipizide, as well as my cholesterol and blood pressure meds.
This is not my first time LC-ing, but it my first successful time LC-ing. "That's what diabetes did for me" (smile).

If its encouragement you're looking for, consider this. In the 21 weeks since I started Bernstein, I've lost 40 lbs. That's going through the holidays where, in the last 4 weeks of December, I actually gained 4 pounds. In addition, in 4 other weeks I was flat or also gained. So, in over one third of the weeks (8 out of 21) I've been flat or gained weight. Yet, I still lost weight in the other 13 weeks, and lost more than I gained in the others.

My point is that you have to stay on it, stay honest (be strict with yourself, as best you can), and in the end it will produce the desired results. It may seem hard, but it is the easiest way I know of to lose weight quickly enough to reinforce the effort it takes. The bonuses are I have much better glucose control, I eat very well, and I never feel hungry. Last week, it was 4 pounds. This week I think it will be 5. Good luck

Hi Dan,
In the Diabetes Solution book, Dr B tells about his life as a diabetic and how MD's used to think that people couldn't control their blood sugars! It's amazing stuff. When meters first came out, they were only used in Emergency Rooms to tell if someone was diabetic or drunk!

I do know that this isn't about dieting. It's about getting everything back into balance, in my opinion. Certainly, chemistry plays a huge part in that. Changing your whole lifestyle is hard. You get onto the right track, but then those old habits, feelings, desires, etc, come into play and you lose sight of your goal. Next, you're back to square one and realize that you have to take the tiger by the tail again and try to hold on this time... <sigh>

Your thoughts on Januvia are interesting. Did any of these consequences show up in the trials? I haven't seen a drug out there yet that didn't have a list of potential side-effects as long as your arm. To read those pharmaceutical broshures that come with your prescription, is like reading a horror tale!!

As to Exubra, I'd take a saxaphone over a needle any day

Amenia... is that in New York? I got this name thanks to my daughter
Waaay back in .. oh.. about 1992, my niece got a computer. She was on this network called the ImagiNation Network (INN). You played games there - there was an area for playing cards like Spades, Hearts, Black Jack, Canasta, etc. Then there was an arcade area - mostly for kids. And there was an RPG ares: Yserbius. That was the part I loved. I've been into Fantasy since I read Lord of the Rings and The Hobbit at age 11. So my niece let my daughter and I share a slot on INN and we created a character to play there.
We were both into a series of books by Anne McCaffrey called DragonRiders of Pern. Great story One of the characters was Aramina. My daughter wanted to name our character after her, but she misspelled it as Armina and the name stuck ever since Another person on there said I was such a great monster slayer, that he started calling me Meenie for short and a lot of people today actually call me that. . . in fact, it's on my license plate!

I frequently get questions about my name and once I was on a list where a group of Armenians chatted and they thought I was Armenian and all started emailing me... it was a hoot. I've also had a lot of people ask if I'm Armenian (nope, I'm not).

'Mina

You do have an inspiring story, Dan And yes indeed, I'll take encouragement, also knowledge, wisdom, experience, and support
I'm hoping to find a lot here, aren't I?

Hi Miss Kitty,
Thanks for the nice welcome!
No I wasn't aware of the time-releast form of metformin. That's really interesting.

I don't think SB is low enough. I eat more like Atkins actually. My husband eats more like SB That at least puts us close enough that we can eat at the same table, LOL.

I think you're right on target about carbs and us insulin-resistant folk. <sigh> I've been doing low-carb so long that I don't really miss the high-carb stuff anymore (like rice, potatoes, pasta). Only occasionally like when we go out to eat with someone. and they bring that dad-lem bread to the table, hehehe. We usually tell them right away not to, but sometimes they're too fast for us. It can be hard to resist.

Hey, I love to hear I'm someone's goal weight! <sigh> At the rate I'm going, I'll still be here when your elevator goes by, heading to your new goal... ugh.
It's really wonderful, and inspiring, to hear what you've accomplished!
WTG!! I hope I can grow up to be like you someday. Of course, I'm 56 years old now, so I guess I'd better hurry up!!!!

Thanks for the encouragment!!
'Mina

'Mina,
I think you'll find all of those things on this site, and others as well. The web boards are a much deeper, and more resilient and reliable, resource than I imagined, and I am continually impressed by them. It's not just "support." In fact, I generally don't even like to read those posts (like this one).

If you will permit another personal note from me, which I risk only because I sense you may be ready for it (perhaps only if you can bring your husband along with you): you are still a bit on the sidelines. You are watching the parade go by, as you suggested to the above poster (I forgot her tag).

If you are used to the low-carb (LC) way of eating (WOE), as you say you are, and you realize that you and/or your husband are not low enough LC's to lose weight, as I think you now are, you have only to step into the stream (tro mix my metaphors) to be carried along with the current.

I really think you are there, and you should try it for a few weeks, at least. Remember my last post: 40 lbs. in 21 weeks, but I gained weight or was flat for 8 of those weeks. The last 2 weeks I lost 7 lbs. Today I lost 2, after being flat for 2 days. That's the way it goes. Now go ahead -- jump in.
Dan

Thanks, Dan,
For someone who doesn't care to read the support posts, you're mighty fine at writing them!
I'm diving in, headfirst. I have to for myself and for my family. I have an appointment with my doctor on the 26th of this month and I want to wow him with my progress and am looking forward to hearing his take on the new meds and what road I should take with that side of things.
I really want to help my husband and support him in this also. He's had three back surgeries recently. The first was on the cervical spine about 3 1/2 years ago, and that one went great. The other two were on the lumbar spine and haven't gone nearly so well. They discovered he has quite a bit of stenosis (narrowing of the spinal column) they did two laminectomies ... the first because he had developed a ruptured disc and was in so much pain he could barely walk. They were going to treat the stenosis with epidural injections but the disc problem had to be taken care of, so they tried to address the stenosis at the same time. He was still in a lot of pain afterwards, so they took a closer look and discovered the stenosis was much more severe than they'd realized and they had to go in and do a much more extensive laminectomy. But he's still in pain and going back for yet another MRI
He is unable to exercise, just walking for a few minutes causes pain, so he needs a diet where he can see results w/o having to exercise. It's an uphill climb for him right now. He's always been a very active person, despite his weight. He's a white-water canoest (expert - used to teach it at Wm and Mary University for 3 years, and at Wild River Outfitters for 7 years) and loves to camp and canoe. He always has done all our yard work (and we have a beautiful wildbird sanctuary in our back yard) and 2 1/2 years ago, before the lower back kicked in, we built an amazing deck with a herringbone pattern off the back of our house. It's difficult for him to be idle, and being bored, he wants to eat!! He's trying really hard right now though and I'm proud of his efforts.
So I have a lot of reasons to want to make this work and I know I can do it!
Thanks Dan,
I appreciate your thoughts and encouragement
'Mina

'Mina,
Tell your husband that I don't exercise either, and I lose weight, lots of it, by strict adherance to Berstein.

Have him try this for breakfast: 2 fried eggs, 4 strips of regular bacon, and a large cup of coffee with 1 Stevia (or Splenda) and 1/4 cup half and half. I sometimes have a glass of rasberry flavored seltzer to wash down the supplements, if I don't take them with the coffee.

No toast or grits or potatoes or jelly, etc, although butter would be fine if I could just figure out where to put it. Just protein and fat. It is so satisfying I never feel hungry and just eat lunch 'cause it's lunchtime (and I should have more protein and a few carbs after 4 or 5 hours to prevent my body shutting down to a slower metabolism, impairing weight loss, among other reasons).

For lunch today I had half a large avocado with the cavity filled with a horseradish dill mayonnaise (Dr. B recipe), and a can of sardines in soybean oil with hot tabasco peppers. Yum, yum, and look, ma, no dishes!

Other days I have a couple of turkey sausages with Grey Poupon Dijon mustard and coffee for breakfast, and 2 slices of provolone & 6 slices of sopressata for lunch. It's good food. I'm not depriving myself at all. I love it. It just takes making a change. That is the hardest thing to do.

Thanks Dan I'll sure tell him. That's pretty much what we are eating except for lots of salad and veggies too. but we don't eat fruit, bread, pasta, rice, potatoes, etc.
When he goes back to his neurologist, he'll weigh again and see what the results are. He can't weigh on our scale at home, it doesn't go high enough.
Yes we do need a new scale. On the one I have now, I have to stand on my left leg and lean to the side to get the correct number (that matches my doctor's scale) lol. I feel like the Karate Kid <G>

Hello,

I am new to the boards too.

I have LC'd with Atkins a few times but many years ago.

I have been following WW but to no avail of late and now with the onset of diabetes, I have to reevaluate everything.

I know I must LC.

My Doctor has started me off on Amaryl and Metforim. Got to find the right doses to get sugar levels where they belong.

I gather the level should be <100 fasting before meals.

Right now the inhale-able insulin has a minimum dose of 3 units of insulin. According to Dr. Berstein he drops 60 BG, and many mild type 2s drip 80 BG with one unit of insulin. He frequently recommends half a unit of insulin for those who are successful at tight control both of carbs and BG.

I talked with the Exubera folks, they were very helpful, but said that half doses are not (now) possible. Because of the delivery system it is not linear, that is, doubling the dose of powdered insulin does not double the amount you get, nor cutting it in half. Evidently that have to do research on how much insulin you absorb from various size doses.

Too bad. I had calculated that half a unit of inhale-able along with a few grams of carb could make it easy to stay close to 85.