Type 2 Diabetes and KETO
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@kim_m_kk
“I think I need a new doctor”. - I think you do too.
Not sure where you are but doing some Keto research I have come across a couple of sights for on-line assistance and/or that list pro-Keto doctors by city. I posted three below as an idea. The last one is in Montreal, Quebec, Canada. I know there is one in Toronto, Ont as well. Probably loads around and maybe in your area if you look. Good luck!!!!!
https://www.virtahealth.com/about/inkinen
https://healclinics.com
http://nutriaclinic.com1 -
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I am in Dallas Texas I looked at a couple of those sights but really only found nutritionist and chiropractors. Those are good but I need a physician to help manage diabetes2
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@kim_m_kk I dropped fenofibrate because I wasn't keen on getting gallstones as a side effect. What I did do was substitute the fenofibrate with fish oil pills. Right now, I'm taking the Kirkland Fish Oil pills from Costco. They contain about 300mg of Omega-3. I take one in the morning after I eat breakfast, and one after dinner. I read that Omega-3 can help lower cholesterol and/or triglyceride levels.
I started the switch from fenofibrate to Omega-3 about 3.5 weeks before my blood test showed that my triglyceride levels were lowered from that 327 number to 93. Now, I'd like to think that taking those pills are helping, but it sure beats potentially getting gallstones.0 -
I am in Dallas Texas I looked at a couple of those sights but really only found nutritionist and chiropractors. Those are good but I need a physician to help manage diabetes
@kim_m_kk - here is one of the lists I found for Texas. I know some of these are nowhere near you, but I didn't want to delete any.
TEXAS
Dr. Vincent Bellonzi (Austin)
Dr. Gerardo Bueso (Houston)
Dr. Avery Carpender (Dallas)
Dr. William Curtis (Corpus Christi)
Dr. Daniel Flaming (Van Alstyne)
Dr. Lowell Brad Hays (Irving)
Dr. Steven Hotze (Katy)
Carrie Johnson (Katy)
Dr. Charles Mabray (Victoria)
Dr. Carlos Menendez (San Antonio)
Dr. Marlene Merritt (Austin)
Dr. Will Mitchell (Austin)
Dr. Luan Pho (Allen)
Dr. Amy Proffer (Amarillo)
Dr. Kota Reddy (Sugar Land)
Dr. Brian N. Sabowitz (San Antonio)
Dr. Jenny Seger (San Antonio)
Dr. David Simonak (Fort Worth)
Dr. Jason Venn (Frisco)
Dr. Dean Zincone (Seguin)
They are on this page: http://lowcarbdoctors.blogspot.com/
Right hand column by state. Most have a link...
And you want an Endocrinologist to manage your Diabetes, not just a primary care doctor... Endocrinologists who are trained in Diabetes Management will have more knowledge than a standard doctor.0 -
Thanks - I looked at that list but the one in Dallas is not a medical doctor and the one in Irving it seems is not longer at the practice. I have never been to an endo although I have thought I might should.0
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Well, that stinks, frankly. @kim_m_kk
It looks like Dr. Hays moved to Houston. I'm guessing the one in Fort Worth being off Beach Street isn't worth the hour or so drive?
I grew up in Irving, so I'm familiar with the metroplex, but I've been gone from Texas over 12 years now, so most of my doctor experience is outdated.
You should be able to make a list of doctors or Endos you are interested in, call up and ask to have a 5 minute phone interview where you can ask if they are low carb friendly, specialize in diabetes, and find out if you'll be compatible in how they approach you, make suggestions, etc... Good luck!0 -
@kim_m_kk - It looks like Dr. Hays still has an office location in Irving, but is primarily in Houston...
Might be worth calling the Houston office just to ask.
https://www.vitals.com/doctors/Dr_Lowell_Hays.html
EDITED TO ADD: It might be worth calling and talking to Dr. Carpenter, and ask her if she works with anyone else to manage diabetes, etc. in your area. It won't hurt to ask (or maybe doing an initial consult, if it's affordable). Also, you'd be surprised what Chiros choose to learn these days. My stepmother's brother is one, and he's a few steps short of a full functional medicine degree just to his own passion at doing things the more natural way when possible, etc.0 -
I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.0
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I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.
@2t9nty
@ralflott1 -
I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.
I use the Relion Prime. It seems to give reasonably good predictions of A1C when I enter the numbers in mySugr. The strips are $17.88 for 100 at Walmart.2 -
I am not opposed to Chiropractic care but I need someone to help manage my mess at this point. Even reducing my meds I am getting lows. Two today had to eat carbs to correct. Anyone have a recommendation for a meter with cheap strips. I am going to be out of strips before I can renew my script.
@2t9nty
@ralflott
@kim_m_kk -
1. Here are a couple recent round-ups of glucose meters:- https://www.diabetestechnology.org/surveillance.shtml
- https://www.consumerreports.org/products/blood-glucose-meter/ratings-overview (subscription req.)
Of the inexpensive meters that were top-rated in both studies, I have tried only the FreeStyle Freedom Lite and Bayer Contour NEXT. I really like the Contour NEXT and bought 3 of them recently on Amazon for $25. You can get large quantities of soon-expiring strips for the Contour NEXT from Amazon or eBay at very good prices, if your insurance doesn't cover them. (Don't get the plain Contour - it's not the same animal.)
2. Your idea of getting an adequate supply of test strips is spot on!
If it were me......
I would test rigorously - upon waking, before each meal; 30, 60, 90, 120 minutes post meal; and before bed for maybe a week so that you can get a handle on how your meds, diet, and exercise affect your BG levels. This will also be great info for your (new) doctor. You would need 10-12 strips per day for the initial period until you've got these relationships established to your satisfaction.
Article on using glucose meters:
How to prevent diabetes and heart disease for $16
https://chriskresser.com/how-to-prevent-diabetes-and-heart-disease-for-16/
(Note - the meters recommendations in the above article are pretty dated.)
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Off topic.....
3. If you haven't had full bloodwork and your insurance permits, it might be a good idea to fill in some blanks. Hopefully you can find a competent doctor (preferably a younger endo, IMHO), but if that will take time, perhaps you can get your current one to order whichever additional tests you might need. At a minimum, I would think you might want to get a complete blood count, HbA1c (or, better, fructosamine, which gives you a more recent average and more quickly shows changes in your BG from changes in diet and meds), a comprehensive metabolic panel, a hepatic panel, Vit. B12, Vit. D, CoQ10 (and possibly thyroid tests, depending on your history).
4. Lipids - my $.02
Keto experts and researchers Stephen Phinney and Jeff Volek emphasize that your LDLs and other lipid tests may initially appear to show worsening numbers - but this may be a transient thing that has nothing to do with your long-term health or lipid management! It's common to experience rising lipids as you begin your keto journey as a result of your body processing and disposing of the material stored in the fat cells you're burning as you lose weight. For that reason, it's best not to overemphasize lipid tests until your weight has stabilized and you've been at goal weight for a while.
The bigger lipid picture would be revealed in an advanced lipoprotein test. The advanced lipid test my endo orders is the "NMR Lipoprofile", which shows the breakdown of LDL and HDL subgroups. He also orders "Apolipoprotein A1" and "Apolipoprotein B." He also ordered Lp(a) one time in order to check for a genetic issue affecting my whacky lipids.
Triglycerides and ApoB tend to correlate pretty well with a real culprit - small, dense LDL particles. These nasty sdLDLs in turn tend to correlate with heart disease. The relationship between triglycerides, ApoB, and sdLDL varies between individuals, and the standard lipid panel just doesn't yield this sort of info. Before leaping to conclusions from triglycerides alone, if it were me, I'd want to get the more complete test. It can probably wait, but I really wish I'd gotten a snapshot of my full lipid picture when I started keto!
5. Another possible test....
If you've got a lot of cardiac risk factors, you can always consider asking for a coronary artery calcium (CAC) scan, which actually shows in a CT image whether you have any calcified plaque in your arteries. Judging from your youthful appearance, I would guess you'd have a comforting score of 0, which would reinforce the idea of not being too hasty with lipid management as your body goes through the healing process you're treating it to!
Good luck!!
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PS Here are a couple short vids explaining how your lipid profile might get temporarily whacky when you're in the weight-loss phase of keto.
https://youtu.be/MNfjkTyBUdQ
https://youtu.be/mZ-deF9I31s
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Wow thanks for all the advice. I had blood work done on dec 13. So pretty recently. My a1c was 7. I took myself off one of my diabetic meds altogether because. I have an appointment with a new dr in a couple weeks. We will see how keto friendly they are but ultimately my choice. My youthful appearance might be deceiving as I am 43. Still young but maybe not youthful anymore. Lol1
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Well my journey had an interesting twist. Very scary too. If you are on Jardiance be careful. Good news my a1c is 6.1. Bad news I just got out of the hospital from dka. I am now off all meds but of course my sugars are higher. Ugh.2
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Whew! Glad you're out of sick bay!
I'm totally perplexed by the DKA scenario, as all the diabetes docs seem to say that it only happens with very high BG (in "real" life, that is, not thinking about all the meds). But your A1c would suggest an average BG of maybe around 140. ?? So, I'm wondering.... was your recent BG extremely high?0 -
No I haven’t had a blood sugar reading over 200 in months. My blood sugar when I arrived at the ER was 99. I have been really working on keeping my blood sugar in range and being healthy since I saw 7.4 as my a1c in early December. The only explanation I was given was the Jardiance. I spent two days in icu and two days in a regular room. Was scary.1
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No I haven’t had a blood sugar reading over 200 in months. My blood sugar when I arrived at the ER was 99. I have been really working on keeping my blood sugar in range and being healthy since I saw 7.4 as my a1c in early December. The only explanation I was given was the Jardiance. I spent two days in icu and two days in a regular room. Was scary.
Jardiance has a side effect warning for DKA. Sorry you had to go through that.1 -
It is apparently a rare side effect of Jardiance that generally happens within 2 weeks of starting the medication. I had been taking it since June.1
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That takes the, um, cake.
So the gurus at the ADA are worried about the relatively-remote possibility of hypos if they stop recommending carb-laden meals and snacks, yet their website and magazine are loaded with ads for profitable diabetes meds that carry the relatively-remote possibility of DKA.....2
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