Hyperglycaemia, weight loss, intermittent fasting, phentermine

Just to update.

I’ve seen an endocrinologist and a cardiologist.

Cardiologist: Stress test came out normal. Diagnosis: “You’re out of shape.” Treatment: Long walks. The cardiologist, like my GP, is a big advocate of bariatric surgery to lose weight. But everyone I know of who has done that has managed to regain the weight (except for the one who committed suicide). I’m not keen on surgery.

Endocrinologist: Has me testing my blood sugar twice daily, starting a week ago. Hate the pricking, but kind of having fun with the bluetooth link between my tester and my iPhone.

In one week, I’ve noticed that my blood sugar is high first thing in the morning, but within range the rest of the day. Will go back after a month and she says she thinks she will start me on medication, depending on what numbers I put up.

Weight loss: After consulting a few people, I went ahead and decided to try the intermittent fasting. So, I’m fasting for 16 hours straight daily, from 10 p.m. to 2 p.m. the next day.

I have lost a little bit of weight, but the biggest change—and my wife commented on this without prompting—is that I’m not completely dead tired in the evenings any more. I am not using the phentermine, but I’ve got it there as an option.

I’m struggling a little with the diet and exercise, but slowly making some improvements. I’m trying to cut out all sweet and starchy foods—including potatoes, rice, corn, etc. So basically trying to stick to meats (including poultry, fish, and seafood), cheese, eggs, and non-starchy vegetables. Looking at the educational materials I have, I am surprised by how many foods are high-carbohydrate that I didn’t expect—like yogurt and nuts.

I’ve never had a big sweet tooth, but I’ve had occasional huge cravings and slipped up and had a couple of minor binges on doughnuts or chocolate. It doesn’t help that my employer offers free unlimited sodas, chips, breakfast cereal, cookies, bars, etc., but on the vast majority of days, I manage to avoid the temptation, sticking to black coffee and ginger-lemon green tea.

Occasionally, the office break room also has fresh bananas, baby carrots, boiled eggs, or cheese, and I take advantage of those when I can. I’m having a lot less diet soda than I used to, replacing that with unsweetened seltzer.

I’m also sleeping on a more regular schedule, 11-7—not that this was a huge problem for me before.

As far as activity increase goes, so far I’m trying to work in more walking and stair-climbing into my daily activities. Work stress is definitely a factor, but I’m trying to figure out ways to deal with it. Although, the ultimate answer will have to be to find a new job.

I’m glad you’re following through on everything. I missed this thread earlier. May I suggest Weight Watchers as another option (or even in conjunction with the fasting)? It will help you learn more about what you are eating, and about what foods work for you.

I thought bariatric surgery had a far better long term prognosis than diet and exercise alone. Even 10 years out a lot of people had still maintained much of the weight lost.

Wait, what? Uncle Google says that a cup of nuts contains 28 gms carbohydrate - so about 7 per 1/4 cup serving. That’s not super-low, but it’s not unbearably high either.

As to yogurt - sure, lowfat yogurt can be bad, because the fat gets replaced with carbs. But full-fat Greek yogurt generally gets pretty high marks from almost any nutrition perspective (except if you are completely avoiding fat or animal products). Fage says that 1 cup of their full-fat plain yogurt has 8 grams of carbs.

I’ve lost 100 lbs in the past year on a ketogenic diet like Atkins but with higher fat ratios. My roommate has his diabetes under control now with the same diet.

The important thing to remember is your diet is for life. You have to make life changing decisions on how you eat and when you sway from that decision you must pull yourself back on course immediately. The best way to handle this for me has been to find a workable diet. Being on a ketogenic diet has made fasting easier because I never feel like my blood sugar is out of whack.

Yeah, a diet has to be pleasurable and satisfying to be sustainable. Here’s my non-expert opinion: First, contrast the advice of several professionals. It looks like you’ve already done that. Be extremely wary of nonsense and vested interests. Second, learn to enjoy healthy foods by overcoming dislikes, discovering new foods and learning new recipes. OP mentions poor diet, so I think this is important. Third, change your habits/mindset. This is the most important, IMO. From the information provided, it seems safe to assume that you no longer need to eat like an active 20-year-old. If so, you have to convince yourself that it’s in your interest to stop eating before you’re full at every meal. That and avoid all binge eating. It’s been a source of pleasure until now, but it’s become a source of misery, because your body no longer needs so much food. That sensation of gnawing hunger will lessen over time.

I definitely would not combine the phentermine with the intermittent fasting. I’ve done two short runs (two-month scripts maybe once a year) of phentermine. In my personal experience, that stuff works best at helping me ‘reset’ my eating habits back to a healthy but standard regimen (three meals a day, mindfulness about carbohydrates, willpower when it comes to snacking). Its efficacy starts wearing off for me right around the end of a two-month prescription.

It’s easy to forget to eat when you’re on the stuff. And since it’s an upper, it helps you work out! Great! But combine those two and it’s not so great - I’ll get lightheaded sometimes and realize that I haven’t been consuming enough calories. I could easily see some serious issues popping up if you’re using it and doing the fasting thing.

diabetics cant go without food for 20 hours. 16 hours is better but its a stretch. At least as far as I know. Being a diabetic type 2.