The Story So Far

My mother claimed I was "full of energy" when I was little. Some of the photos I found after she died seem to agree.

Just after starting school over fifty(mumble) years ago, I caught mumps, followed before I came out of "quarantine" with chickenpox. Shortly after finally returning to school I was off again with the measles.

Whether this damaged my pancreas or was coincidental I don't know.
I DO know that there are two lines to one side of my family - long lived healthy folks who die of CVD at an advanced age, and diabetics and (probably) undiagnosed diabetics/prediabetics who die young of CVD, often after amputations and despite being on insulin, and an above average number of children who die before or soon after (premature) birth like my siblings. Curiously these are mostly male and all skinny. So chronic IR is an obvious factor.

Anyway, I restarted wetting the bed, mainly in the wee small hours. I also developed soaking night sweats and attacks of trembling and shaking mostly soon after going to bed.

Hmmm, what disease is associated with nocturia and nocturnal hypoglycemia? Of course, anxiety and neurosis, and hypochondria. Obvious!

Well to be fair diabetes was much less common then, I was obviously not Type 1 and had few characteristics of classic Type 2 - never been overweight - and MODY and other genetic forms were not known, so my symptoms were blown off. I also became extremely skinny.

Later I started fainting, or feeling faint, mainly in assembly or soon after. Also sometimes I would be unable to keep my eyes open a couple of hours after lunch, and would run out of energy both physical and mental. seemingly at random.

In retrospect I'd like to go back and check but I STRONGLY suspect the days when I fainted/felt faint were when I had cornflakes for breakfast and/or walked to school and they days I didn't were when I had bacon and/or got a lift. Likewise I'd like to know what I had on the days when I did, and did not, crash out.

I spent most of my life suffering from mild but chronic and annoying symptoms like skin, eye, sinus, gum and fungal infections, and thrush.
Decades ago I discovered that if I went on a long walk or did other prolonged exertion I would crash both physically and mentally after two - three hours, and learned to take sandwiches, chocolate, Kendal Mint Cake, coffee with sugar etc. to revive myself.

Again in retrospect I realise I was getting reactive hypos, and then overtreating them, leading to another a few hours later. Likewise the childhood problems improved greatly when I had my "bedtime drink" stopped - this was Horlicks, Ovaltine, Milo or cocoa made with milk and sugar.

My mother was an excellent cook, albeit with a fairly limited range, mainly meat and three or four veg (and fish on fridays!) and puddings and cakes. We always had bread and butter. My father baked amazing bread, a skill I learned (oh the irony!)

When I went to college in the early seventies I was suckered into an Ornish-style high carb low fat grain based vegan diet. I stopped because it failed to improve my health, and most of my friends, including my ex-wife, were excellent cooks with a very wide range of diets, but all still based on low fat and Healthy Whole Grains, including my home-baked bread for which I was notorious, home made muesli (ditto) and brown rice, man!

In my twenties I started suffering from symptoms which friends, colleagues and other sufferers assured me were gallstones, but my GP was adamant I had no such thing, I was not "in fact" rolling on the floor in agony passing them and even my jaundice was "psychosomatic". Likewise friends, colleagues and other diabetics suggested my symptoms were diabetes. This just got me a diagnosis of "pretending to be ill for sympathy". Obviously I was too stupid to notice I never got any - and yet so intelligent that even in early childhood I was not pretending to have symptoms of anything else.

After five years I finally had the gallstones removed (does anyone remember Surprise peas? that's what they resembled.) I was told they were cholesterol and blamed for not eating a "low fat" diet, which I already WAS eating. A couple of the hospital consultants were actually quite clueful, one of them was at least part way to understanding "metabolic syndrome" years before Gerald Reaven, though obviously he also blamed this on "too much fat". He also noted that I had low HDL, high LDL and very high trigs, but told me as long as I kept my LDL down with a low fat diet the trigs would be no problem. This was not true then and still isn't true, but it continues to be believed.

It was ten years later that a GP checked my lipids again and found they were exactly the same, which he described as "weird" without considering why. I was sent to a dietician who was obsessed with eliminating every trace of fat from my diet and replacing it with more carbs. When this obviously failed I was accused of "failing to comply" with the diet and put on these new-fangled statins. They dropped the LDL but left the HDL and trigs where they were, but GP was content with this. Fortunately they didn't give me any side effects.

Around this time my BP started going up so BP meds were added. For the first time in my life I started gaining weight, all around my middle (seen Ian Beale in East Enders recently?) I became semipermanently exhausted and constantly hungry. My infections became constant and my gums got so bad that teeth started falling out.

The "anxiety" and "neurosis" were rediagnosed as "depression" (and of course "side effects of antidepressants". Tricyclics helped, albeit with side effects. SSRIs had only a temporary effect. Effexor worked very well and was free of side effects and withdrawal effects, NOT the case for some folks. Again in retrospect the cause was not addressed - the body reacts not just to a hypo but to an impending hypo by releasing cortisol, epinephrine and norepinephrine, but not serotonin. In fact it worked so well I was then told I was never depressed but "only" had a Personality Disorder, which was untreatable and incurable. Oh and I had "strange blinking behaviour", no thought that my eyes were brimful of sorbitol from the constant BG spikes.

Fortunately I moved and finally met a half clueful GP. Previously they had either dipped my preprandial urine or checked my fasting BG. She gave me a GTT in which I scored 10.7 after an hour but was back to 7.8 after two hours. AT LAST she agreed this was not normal, although definitely not diabetes: she told me to treat myself AS IF I was already diabetic - and then gave me the standard high carb low fat diet leaflet which curiously was exactly the same diet I'd been given verbally over a decade earlier. She also told me "we" didn't approve of patients testing their BG - well of course not as it would demonstrate the harm done by the diet.

I went online and was fortunate to meet the likes of Jenny and Alan and the above advice. I also discovered hundreds if not thousands of well-controlled diabetics, many of them maintaining control for decades without progressing. Also a significant proportion of non-overweight diabetics and a small but significant number with exactly the same set of symptoms as me. I learned that reactive hypoglycemia results from a lack of Phase 1 insulin so the BG shoots up after eating carbs, but the Phase 2 is unaffected and stops the BG from reaching diagnostic levels. Then once the insulin starts it fails to shut down properly, hence BG rebounds low. This does NOT show up on an HbA1c, the prolonged periods of low BG counterract the high spikes - which are still high enough to do "diabetic" damage. While A1c correlates to microvascular complications, BG spikes correlate with MACROvascular complications, such as CVD.

The postprandial BG testing showed clearly what was obviously occurring all my life, and also showed what to do to make it stop. Initially I was limited to about 15g carbs at breakfast and around 30g by evening.

After doing this for a while my BP actually came down, I lost all the weight I'd gained, my HDL DOUBLED and my trigs fell to about 1/10 of what they were. Trigs/HDL went from nearly 7 to under 1. In UK numbers around 1.3 and less indicates no pathological insulin resistance. The result was that my carb limits changed, strangely at breakfast I am now limited to about 10g carbs but my evening I can do 50 - 80g and on occasion more. Not that I do this often as I suspect the IR would return if I made it a habit.

Generally I aim at around 50g/day which gives me a VERY wide range of food. Following "paleo" and similar research I eliminated wheat, sugar/HFCS and trans fats, grossly reduced all other grains and Omega 6 seed oils and stopped being afraid of saturated fats. My HDL went up and my LDL came down by around the same amount. All of my symptoms, including some I didn't realise I had until they stopped, improved. I used to get tooth decay and needed regular fillings and scrapings which were always blamed on "too much sugar". Well OK I ate too much sugar FOR ME, but never as much as the Government's recommended 70 - 90 g/day. The culprit was the savoury carbs I loved. Without them I seldom even need plaque scraping. Interestingly after my recent wheat binge my teeth felt quite hairy and became hard to clean for a couple of days.

My mood swings stopped and as for physical energy, i routinely go 6 - 8 hours without even thinking of eating, and have gone 9 hours or more while walking carrying several kilos of photographic gear. I threw out the chocolate from my camera bag as it went mouldy.

I eat breakfast of a buttered oatcake with smoked salmon or similar, and a couple of cups of coffee. My main meal may be any time from late afternoon to late evening and consists of meat, poultry, game, fish and a wide range of vegetables. I eat a lot of seasonal stuff - I demolish a pheasant or partridge roasted wrapped in bacon a week with brussels sprouts and chestnuts, or purple sprouting, in winter, and silver darlings (what we call herrings) in season. All year I eat grass-fed beef, lamb. other fish, pheasant breasts and venison from the farm shop freezer, multicoloured peppers, garlic, mushrooms, herbs, spices, red wine, 85% chocolate, crab, prawns, nuts etc. etc and other seasonal stuff like asparagus, samphire, runner beans. "Processed" food consists of oatcakes (Nairns which unlike some other brands have no added wheat), coffee, Splenda, tinned fish in brine, butter, olive oil and occasionally locally produced cold pressed rapeseed oil. Oh and tomato puree and toasted sesame oil. I can't handle many fruits except berries which I have with double or clotted cream, ground flaxseed and brandy. Oh I forgot the cheese, Wells Alpine from over the border in Narflk and somerset Brie among others. Strangely I prefer skimmed milk purely for the flavour and texture, otherwise absolutely nothing "low fat".

However I'm under no illusions that I'm not going to be dead soon, I'm over 60 now and spent fifty of those years at high cardiovascular risk. Naturally when I DO die this will be blamed on the last decade of low carb high fat and not on the previous years when I dutifully followed a low fat diet while disintegrating.

Recently I started getting a new bunch of symptoms which have turned out to be hypERthyroid, not the much more common hypOthyroid. My BP went through the roof and the circulation to my feet was affected leading to my nearly losing a toe, before this was diagnosed and is now being treated. Strangely this has NOT been blamed on "not eating enough starch", although one GP did assure me I am not and never have been either diabetic OR prediabetic. Allegedly he is very highly regarded, well he may be a good diagnostician and may be excellent with acute diseases but is terminally clueless about metabolism and chronic disease. He assured me that "the only thing that matters" is A1c, and that BG spikes after eating are "perfectly normal". NO!!! Just because they have become common doesn't make them normal! Obesity is common but no GP, even the fat ones, would call THAT normal.

I know enough diabetics who have tested friends and family and found exactly the same as Richard Bernstein - who used to test meter salesmen - genuinely normal people have VERY tightly controlled BG. Once that control starts to slip you are On The Diabetic Progression. The earlier you can catch this and do something about it the easier it is to control. Which is obviously why the current Rule is that diabetes must only be diagnosed by a A1c over 6.5%. As you no doubt know, since ACCORD doctors have been instructed not to use "intensive control" to reduce A1c below 6.5%, or whatever the hell that is in new currency. Many doctors and PCTs take this to mean they must INCREASE the A1c of their diabetics. They don't realise the world of difference between using heroic amounts of medication, including ones that have been BANNED, on the results of a high carb low fat diet, and using no or minimal meds on an appropriate low carb diet. They don't appear to have been told about EPIC-Norfolk or the huge New Zealand study which shows a linear relationship between A1c and CVD, starting from truly normal numbers (below 5%). But then what is laughably called "Evidence-Based" medicine is actually dumbed down one-size-fits-all dogma based medicine.

Everything I have done is endorsed by doctors in other countries and backed by research "hidden in plain sight" on PubMed. It doesn't always work for everyone, but it does for the vast majority, not just diabetics/prediabetics but obese people, people with CVD and other diseases, members of the "fitness community", endurance athletes. Which is a LOT more than can be said for high carb low fat, which predominantly works for the bank balance of the Foodlike Substance Manufacturing Industry (Michael Pollan) and the drug companies who market the antidotes.

Thanks very much for that Chris. Although I'm a bog-standard very obese T2 I can identify with some of the things you say. The bit about being blamed for not sticking to whatever diet you're given when you have stuck to it to the letter and the diet simply doesn't work is a classic.

I have been wondering who you are since you joined us. Now I know. Thank you.

Chris c, what an fascinating story.  Despite a sunny afternoon, with opportunities to be in the garden, I have just sat indoors reading it right through!  We are of a similar age, so some childhood experiences were similar - I chuckled at "bed time drinks" and then the student/1970's move towards brown rice etc.  
I particularly appreciated your emphasis on the shortcomings of the HbA1c and its inability to demonstrate what is going on in finer detail, resulting in people whose response to sugars is far from normal being told that they are not diabetic.  You write, "genuinely normal people have VERY tightly controlled BG".  There are perfectly clear graphs out there, showing how a true non-diabetic deals with a sugar input almost immediately - barely a trace to be seen.  
Despite this, how often have we read (on another forum) about diabetics claiming that they CAN eat sugary confections because their double figures BS readings are echoed by their partner's, who are not diabetic, after the same meal.  On one occasion, I made the suggestion that the partner was "a bit diabetic" or on the way to full diabetes (as currently defined).  The response was abusive and I was told that you either are or you are not diabetic.  You are probably aware of the "50 shades of diabetes" chart (google and you'll find it), which I think illustrates matters rather well.

I am almost certainly not diabetic according to current definitions (partner is), but being of a certain age and having a diabetic father (quite possibly statin induced), keeping my carb intake low can only be beneficial.  I certainly accept that I could be "a bit diabetic".

Sally

What a great, honest, concise post Chris .Fascinating story and I'm pretty sure certain parts will ring true for many of us . When I read the part about if anything were to happen to you now, they would probably blame the LCHF diet rather than the many years following a carb laden one it really made me stop and think. Sad, but probably true. Well, I truly wish you many more healthy years :-)

Quite, no matter how many hundreds of times they see it, for most doctors and nurses and all dieticians it's the patient's fault, not the diet. I remember one story of a diabetic whose numbers and weight were getting worse and worse and who was all but abused by Nursey. Then she discovered low carb and the improvement was immediate and astonishing.

"I see the low fat diet's working at last!" quoth the nurse.

My A1c initially went UP from, I think, 5.2% to 5.6% despite my BG spikes dropping from 8 - 10 after meals to 6 or so, which shows how much time I must have spent with BG below normal. Last printout it was 34 which I think is 5.3%. The GP who saw that is obviously one of the many who pronounce patients "cured" if they get below 6%. They have no concept of "controlled" diabetes.

My regular GP is almost impossible to see. She is the "diabetes specialist" and I have been pleasantly surprised how much she seems to have learned in the last decade. She admitted that if I'd followed her advice, by now I'd be diagnosed diabetic, on metformin and at least one other drug.

The other downside of the A1c is that a number of blood conditions, and also probably genetic reasons, for the blood cells living longer or shorter than average, affects the A1c but not spot readings, or fructosamine which I believe is available only to vets in the UK. There's a little evidence that high fat diets lead to higher A1c due to the cells living longer and having more time to become glycated at "normal" BG levels.

I forgot to add the bit when we were told we could no longer decide whether to see a doctor or a nurse, the receptionist made that decision. Said receptionist refused me an A1c "because you aren't diabetic". I got the phlebotomist into trouble by asking her to add it, and the full lipid panel. The nurse who gave me the results told me I had NOT had an A1c when my records showed I had, and told me "we don't test your cholesterol again once you're on your statin". I eventually managed to see the GP who was not totally pleased. Fortunately since then the Practice Manager has been replaced and the staff actually seem to be interested in health again, they even volunteered to print out my last test results without any arguing.

In the end anyone with disrupted BG, and a LOT of people with disrupted lipids and high BP, obese or not, need to be proactive NOW rather than wait until too late. I suspect the current push to diagnose fewer diabetics later in the progression, and undiagnose them again when they gain control (I've even heard of a few Type 1s being undiagnosed and having their insulin cancelled, which should lead to a charge of attempted murder) makes their statistics look better. What better way to deal with a diabetes "epidemic", much like increasing women's dress sizes to disguise the obesity epidemic.

Concise huh! I don't know the meaning of the word!

Latest test results - HDL 1.4, trigs 1.1 but LDL went back up to 4.2, it dropped like a stone from the hyperthyroid. I'm perfectly happy with that, I'm of the age where higher LDL is protective, but guess what will be blamed. I'm under no illusions that I'll hit 70, my mother's brother wasn't much older than me when he had his heart attack. I'm aiming to make mine rapidly fatal too, I've seen too often the alternative.

@chris c 

Some story there Chris thanks, as for your childhood illnesses I too had the ones you mentioned plus whooping cough and scarlet fever. Given your experience I guess I was lucky in the fact by my late teens I had no health problems and and that remained the case until after a very traumatic time in my life I was diagnosed with diabetes in my sixties.

Now I'm definitely not your bog standard type 2 diabetic not overweight with a BMI of 21.8, no family history in fact I had none of the classic signs my cholesterol was in the normal range I've always had low trigs, no indication of visceral fat from blood tests and BP was fine. I was picked up on a routine blood test that my surgery carries out on the over sixties even the practice nurse was bemused. I reckon the stress a tentative link to anti depressants and diabetes brought about my diagnosis.

So what happened when I saw my GP it appears according to him I have mild  diabetes and was prescribed statins (that's another story), aspirin and told to follow a heathy low fat diet as per DUK one size fits all dietary advice, seeing my energy requirements are >3000 cals a day that means over 375 carbs daily  even the most most ardent anti's that defend the duk/nhs eatwell plate would not find that sustainable.

What an amazing story, @chris c

Thank you so much for sharing it with us. I'm still shuddering over the medical incompetence from go to whoa.

chris c wrote:My mother claimed I was "full of energy" when I was little. Some of the photos I found after she died seem to agree.

Just after starting school over fifty(mumble) years ago, I caught mumps, followed before I came out of "quarantine" with chickenpox. Shortly after finally returning to school I was off again with the measles.

Whether this damaged my pancreas or was coincidental I don't know.
I DO know that there are two lines to one side of my family - long lived healthy folks who die of CVD at an advanced age, and diabetics and (probably) undiagnosed diabetics/prediabetics who die young of CVD, often after amputations and despite being on insulin, and an above average number of children who die before or soon after (premature) birth like my siblings. Curiously these are mostly male and all skinny. So chronic IR is an obvious factor.

Anyway, I restarted wetting the bed, mainly in the wee small hours. I also developed soaking night sweats and attacks of trembling and shaking mostly soon after going to bed.

Hmmm, what disease is associated with nocturia and nocturnal hypoglycemia? Of course, anxiety and neurosis, and hypochondria. Obvious!

Well to be fair diabetes was much less common then, I was obviously not Type 1 and had few characteristics of classic Type 2 - never been overweight - and MODY and other genetic forms were not known, so my symptoms were blown off. I also became extremely skinny.

Later I started fainting, or feeling faint, mainly in assembly or soon after. Also sometimes I would be unable to keep my eyes open a couple of hours after lunch, and would run out of energy both physical and mental. seemingly at random.

In retrospect I'd like to go back and check but I STRONGLY suspect the days when I fainted/felt faint were when I had cornflakes for breakfast and/or walked to school and they days I didn't were when I had bacon and/or got a lift. Likewise I'd like to know what I had on the days when I did, and did not, crash out.

I spent most of my life suffering from mild but chronic and annoying symptoms like skin, eye, sinus, gum and fungal infections, and thrush.
Decades ago I discovered that if I went on a long walk or did other prolonged exertion I would crash both physically and mentally after two - three hours, and learned to take sandwiches, chocolate, Kendal Mint Cake, coffee with sugar etc. to revive myself.

Again in retrospect I realise I was getting reactive hypos, and then overtreating them, leading to another a few hours later. Likewise the childhood problems improved greatly when I had my "bedtime drink" stopped - this was Horlicks, Ovaltine, Milo or cocoa made with milk and sugar.

My mother was an excellent cook, albeit with a fairly limited range, mainly meat and three or four veg (and fish on fridays!) and puddings and cakes. We always had bread and butter. My father baked amazing bread, a skill I learned (oh the irony!)

When I went to college in the early seventies I was suckered into an Ornish-style high carb low fat grain based vegan diet. I stopped because it failed to improve my health, and most of my friends, including my ex-wife, were excellent cooks with a very wide range of diets, but all still based on low fat and Healthy Whole Grains, including my home-baked bread for which I was notorious, home made muesli (ditto) and brown rice, man!

In my twenties I started suffering from symptoms which friends, colleagues and other sufferers assured me were gallstones, but my GP was adamant I had no such thing, I was not "in fact" rolling on the floor in agony passing them and even my jaundice was "psychosomatic". Likewise friends, colleagues and other diabetics suggested my symptoms were diabetes. This just got me a diagnosis of "pretending to be ill for sympathy". Obviously I was too stupid to notice I never got any - and yet so intelligent that even in early childhood I was not pretending to have symptoms of anything else.

After five years I finally had the gallstones removed (does anyone remember Surprise peas? that's what they resembled.) I was told they were cholesterol and blamed for not eating a "low fat" diet, which I already WAS eating. A couple of the hospital consultants were actually quite clueful, one of them was at least part way to understanding "metabolic syndrome" years before Gerald Reaven, though obviously he also blamed this on "too much fat". He also noted that I had low HDL, high LDL and very high trigs, but told me as long as I kept my LDL down with a low fat diet the trigs would be no problem. This was not true then and still isn't true, but it continues to be believed.

It was ten years later that a GP checked my lipids again and found they were exactly the same, which he described as "weird" without considering why. I was sent to a dietician who was obsessed with eliminating every trace of fat from my diet and replacing it with more carbs. When this obviously failed I was accused of "failing to comply" with the diet and put on these new-fangled statins. They dropped the LDL but left the HDL and trigs where they were, but GP was content with this. Fortunately they didn't give me any side effects.

Around this time my BP started going up so BP meds were added. For the first time in my life I started gaining weight, all around my middle (seen Ian Beale in East Enders recently?) I became semipermanently exhausted and constantly hungry. My infections became constant and my gums got so bad that teeth started falling out.

The "anxiety" and "neurosis" were rediagnosed as "depression" (and of course "side effects of antidepressants". Tricyclics helped, albeit with side effects. SSRIs had only a temporary effect. Effexor worked very well and was free of side effects and withdrawal effects, NOT the case for some folks. Again in retrospect the cause was not addressed - the body reacts not just to a hypo but to an impending hypo by releasing cortisol, epinephrine and norepinephrine, but not serotonin. In fact it worked so well I was then told I was never depressed but "only" had a Personality Disorder, which was untreatable and incurable. Oh and I had "strange blinking behaviour", no thought that my eyes were brimful of sorbitol from the constant BG spikes.

Fortunately I moved and finally met a half clueful GP. Previously they had either dipped my preprandial urine or checked my fasting BG. She gave me a GTT in which I scored 10.7 after an hour but was back to 7.8 after two hours. AT LAST she agreed this was not normal, although definitely not diabetes: she told me to treat myself AS IF I was already diabetic - and then gave me the standard high carb low fat diet leaflet which curiously was exactly the same diet I'd been given verbally over a decade earlier. She also told me "we" didn't approve of patients testing their BG - well of course not as it would demonstrate the harm done by the diet.

I went online and was fortunate to meet the likes of Jenny and Alan and the above advice. I also discovered hundreds if not thousands of well-controlled diabetics, many of them maintaining control for decades without progressing.  Also a significant proportion of non-overweight diabetics and a small but significant number with exactly the same set of symptoms as me. I learned that reactive hypoglycemia results from a lack of Phase 1 insulin so the BG shoots up after eating carbs, but the Phase 2 is unaffected and stops the BG from reaching diagnostic levels. Then once the insulin starts it fails to shut down properly, hence BG rebounds low. This does NOT show up on an HbA1c, the prolonged periods of low BG counterract the high spikes - which are still high enough to do "diabetic" damage. While A1c correlates to microvascular complications, BG spikes correlate with MACROvascular complications, such as CVD.

The postprandial BG testing showed clearly what was obviously occurring all my life, and also showed what to do to make it stop. Initially I was limited to about 15g carbs at breakfast and around 30g by evening.

After doing this for a while my BP actually came down, I lost all the weight I'd gained, my HDL DOUBLED and my trigs fell to about 1/10 of what they were. Trigs/HDL went from nearly 7 to under 1. In UK numbers around 1.3 and less indicates no pathological insulin resistance. The result was that my carb limits changed, strangely at breakfast I am now limited to about 10g carbs but my evening I can do 50 - 80g and on occasion more. Not that I do this often as I suspect the IR would return if I made it a habit.

Generally I aim at around 50g/day which gives me a VERY wide range of food. Following "paleo" and similar research I eliminated wheat, sugar/HFCS and trans fats, grossly reduced all other grains and Omega 6 seed oils and stopped being afraid of saturated fats. My HDL went up and my LDL came down by around the same amount. All of my symptoms, including some I didn't realise I had until they stopped, improved. I used to get tooth decay and needed regular fillings and scrapings which were always blamed on "too much sugar". Well OK I ate too much sugar FOR ME, but never as much as the Government's recommended 70 - 90 g/day. The culprit was the savoury carbs I loved. Without them I seldom even need plaque scraping. Interestingly after my recent wheat binge my teeth felt quite hairy and became hard to clean for a couple of days.

My mood swings stopped and as for physical energy, i routinely go 6 - 8 hours without even thinking of eating, and have gone 9 hours or more while walking carrying several kilos of photographic gear. I threw out the chocolate from my camera bag as it went mouldy.

I eat breakfast of a buttered oatcake with smoked salmon or similar, and a couple of cups of coffee. My main meal may be any time from late afternoon to late evening and consists of meat, poultry, game, fish and a wide range of vegetables. I eat a lot of seasonal stuff - I demolish a pheasant or partridge roasted wrapped in bacon a week with brussels sprouts and chestnuts, or purple sprouting, in winter, and silver darlings (what we call herrings) in season. All year I eat grass-fed beef, lamb. other fish, pheasant breasts and venison from the farm shop freezer, multicoloured peppers, garlic, mushrooms, herbs, spices, red wine, 85% chocolate, crab, prawns, nuts etc. etc and other seasonal stuff like asparagus, samphire, runner beans. "Processed" food consists of oatcakes (Nairns which unlike some other brands have no added wheat), coffee, Splenda, tinned fish in brine, butter, olive oil and occasionally locally produced cold pressed rapeseed oil. Oh and tomato puree and toasted sesame oil. I can't handle many fruits except berries which I have with double or clotted cream, ground flaxseed and brandy. Oh I forgot the cheese, Wells Alpine from over the border in Narflk and somerset Brie among others. Strangely I prefer skimmed milk purely for the flavour and texture, otherwise absolutely nothing "low fat".

However I'm under no illusions that I'm not going to be dead soon, I'm over 60 now and spent fifty of those years at high cardiovascular risk. Naturally when I DO die this will be blamed on the last decade of low carb high fat and not on the previous years when I dutifully followed a low fat diet while disintegrating.

Recently I started getting a new bunch of symptoms which have turned out to be hypERthyroid, not the much more common hypOthyroid. My BP went through the roof and the circulation to my feet was affected leading to my nearly losing a toe, before this was diagnosed and is now being treated. Strangely this has NOT been blamed on "not eating enough starch", although one GP did assure me I am not and never have been either diabetic OR prediabetic. Allegedly he is very highly regarded, well he may be a good diagnostician and may be excellent with acute diseases but is terminally clueless about metabolism and chronic disease. He assured me that "the only thing that matters" is A1c, and that BG spikes after eating are "perfectly normal". NO!!! Just because they have become common doesn't make them normal! Obesity is common but no GP, even the fat ones, would call THAT normal.

I know enough diabetics who have tested friends and family and found exactly the same as Richard Bernstein - who used to test meter salesmen - genuinely normal people have VERY tightly controlled BG. Once that control starts to slip you are On The Diabetic Progression. The earlier you can catch this and do something about it the easier it is to control. Which is obviously why the current Rule is that diabetes must only be diagnosed by a A1c over 6.5%. As you no doubt know, since ACCORD doctors have been instructed not to use "intensive control" to reduce A1c below 6.5%, or whatever the hell that is in new currency. Many doctors and PCTs take this to mean they must INCREASE the A1c of their diabetics. They don't realise the world of difference between using heroic amounts of medication, including ones that have been BANNED, on the results of a high carb low fat diet, and using no or minimal meds on an appropriate low carb diet. They don't appear to have been told about EPIC-Norfolk or the huge New Zealand study which shows a linear relationship between A1c and CVD, starting from truly normal numbers (below 5%). But then what is laughably called "Evidence-Based" medicine is actually dumbed down one-size-fits-all dogma based medicine.

Everything I have done is endorsed by doctors in other countries and backed by research "hidden in plain sight" on PubMed. It doesn't always work for everyone, but it does for the vast majority, not just diabetics/prediabetics but obese people, people with CVD and other diseases, members of the "fitness community", endurance athletes. Which is a LOT more than can be said for high carb low fat, which predominantly works for the bank balance of the Foodlike Substance Manufacturing Industry (Michael Pollan) and the drug companies who market the antidotes.

What can I say Chris, a mega post and so chuffed to see you here after all these years.

I recently took some time offline, which gave me the chance to do more Real Life and also read some of the thousand or two research papers i'd downloaded and was previously downloading several times faster than I was reading them. I'd been online for some 20 years - anyone else remember Compuserve? Or Demon when it was a tenner a month and they actually admitted when things broke and told you what they were doing to fix them?

When I got back, there you were!

Graham, sounds very much like it's your pancreas that was broken rather than your metabolism in general. I'd be tempted to suggest you get a c-peptide and GAD test in case it's slow onset Type 1/LADA except after all this time that's unlikely. Were you ever on steroids? Steroid induced diabetes is temporary at first and becomes permanent later, but I've noticed one or two of those hugely obese male diabetics who lose a mass of weight and subsequently seem able to eat a high carb diet may have used (or abused) steroids, which makes me think it may be reversible over a longer period than usually considered.

May well be other drugs, possibly SSRIs or statins, or a lot of other potential factors. Skinny diabetics often have many of the same metabolic factors as fat ones, but without the obesity, but some don't. Did it begin suddenly?

A friend with a highly similar set of symptoms to mine was told for years by his GP that he was "not diabetic yet" without really considering what the "yet" meant or getting any advice on how NOT to become diabetic. Simply because he likes gadgets he bought a BG monitor and was amazed at his postprandials. At least his GP has the largesse to apologise for his naivety in believing "only" fat people could become diabetic. Of course that belief means that any estimates of percentages of non-overweight Type 2 are underrestimates.

chris c wrote:Graham, sounds very much like it's your pancreas that was broken rather than your metabolism in general. I'd be tempted to suggest you get a c-peptide and GAD test in case it's slow onset Type 1/LADA except after all this time that's unlikely. Were you ever on steroids? Steroid induced diabetes is temporary at first and becomes permanent later, but I've noticed one or two of those hugely obese male diabetics who lose a mass of weight and subsequently seem able to eat a high carb diet may have used (or abused) steroids, which makes me think it may be reversible over a longer period than usually considered.

May well be other drugs, possibly SSRIs or statins, or a lot of other potential factors. Skinny diabetics often have many of the same metabolic factors as fat ones, but without the obesity, but some don't. Did it begin suddenly?

Thanks Chris

I thought about the possibility of LADA due to my inability to gain weight but I agree after over seven years I would have expected some deterioration in my BG, whilst my fasting levels have always been on the high side my pps have been good. A1c has been pretty consistent though I have never managed to get it <6, that's probably down to the extra protein that comes with a high calorie diet. l'll ask my DSN about the c-peptide and GAD tests but I don't hold out much hope they seem to be cutting back (still get my strips though ), on my last review they only tested TC and HDL no trigs or LDL.

No I've never been on steroids or any other drugs until I was put on anti-depressants and sleeping tablets the year prior to diagnosis, and yes it did come on suddenly I had no symptoms it was only through a routine blood test it was picked up. 

I reckon the SSRIs along with the trauma could have been responsible I know that's only conjecture but it's the only plausible answer I can come up with

Yes I recall someone else who blamed his onset on stress, both physical and mental. It sounds like something party trashed your pancreas and then stopped. Most Type 1 children go from normal to "die without insulin" in days. I've seen some adult onset LADAs take a couple of years but not that long - and some definite Type 2s progress much faster. Lots more variation than Conventional Wisdom admits.

I wonder if it wasn't my pancreas but the ability to produce GLP-1 which calls for the insulin which is broken. Either way the treatment is exactly the same - avoid dieticians at all costs!