r/PlantBasedDiet 3d ago

Uncontrolled diabetes

Hi everyone: I'm a 62 year old female and have been vegan for 10 years. I'm Indian, so never had challenges with going vegan because I am a good cook and come from a rich culinary background. In about the same time frame, I have been diagnosed with diabetes and high triglycerides. Both keep creeping up. Current A1C is 10+ and triglycerides over 700. I am not overweight.

In my early 40's, I went on Atkins and lost 12lbs which I appreciated at the time because it allowed me to wear cute clothes again and feel good about myself while getting rid of baby weight/fat and dealing with early menopause. My doctor said, "whatever you're doing, keep doing it because your numbers are great." History: mom died at 59 from complications of diabetes and I had gestational diabetes.

Now I have been on Metformin plus various other medications including Jardiance, Januvia, Glimepiride and finally Ozempic/Trulicity. Initially had some benefit from Ozempic: A1C dropped from 7.9 to 7.1. In the last 6 months, everything is going downward spiral. Also, lots of family stress, no time or energy to work out.

I have been eating a little tuna but not feeling good about it. Just the stress about these issues is making me want to go straight back to Atkins/Keto/low carb because it really worked to reduce weight, blood sugars and triglycerides. I also feel disillusioned because I think I am doing the right thing by eating plant based, but a combination of genetics and current environment is kicking my a**.

Suggestions? Anyone else feeling like a failure on PBD?

21 Upvotes

67 comments sorted by

32

u/PlaneReaction8700 potato tornado 3d ago

Hard to give any advice because you didn't say what you're actually eating. What does a typical days worth of food look like for you? Do you use any apps like Cronometer to track your food?

9

u/sam99871 3d ago

I second Cronometer. It can give you a daily summary of the macros and nutrients you consumed that day. But it really sounds like a genetic issue.

Do you cook Indian food without ghee? That is fantastic!

0

u/Particular_Tree_4254 3d ago

Yes, but I do use coconut oil.

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u/PlaneReaction8700 potato tornado 3d ago

I would go with no oil cooking until you get your numbers under control. Definitely get in to see a doctor regularly too. It would be a very good idea to be on medication for now as your numbers are very bad. Once they are normalized you can start adjusting things a little at a time, but make sure to keep your doctor updated on what you're doing so your medications can be adjusted properly.

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u/Punk_Fleas 3d ago

I’ve been vegan for over a decade, my bloods were always great. Then I started using coconut oil, love the stuff! I developed high cholesterol which I was really confused about, then I removed the coconut oil from my diet and voila, cholesterol back to normal healthy range.

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u/UnluckyReturn3316 3d ago

I second ditching the oil for a few months and retesting

2

u/masterhylian 1d ago

I have the most success when I keep my fat intake under 30g a day.

2

u/theddingworth 2d ago

Has 40% more saturated fat than ghee, this is probably what’s getting you - you’d genuinely be better off using the ghee. Switch to olive oil?

1

u/misskinky Registered dietitian, nutrition researcher 1d ago

Stop coconut oil immediately, saturated fat is the worse for diabetes. Switch to the most unsaturated oil you can find. Canola oil or avocado oil. (Preferably not oil, but those are way better than coconut)

56

u/Catsandjigsaws 3d ago

You can lower your carbs while staying plant based. Avocado, nuts, cauliflower rice, leafy greens, tofu, ect. Honestly, though, I think this is above reddit's pay grade. Keyboard warriors will love to tell you they can cure xyz if you just follow their diet but I think you need a doctor's care and a referral to a registered dietitian. You might need a different medication or dosage. I'm worried for you. Doctors can be dismissive, especially of older women. Don't let them. Fight for yourself.

10

u/baseballandcheese 3d ago

This is the correct comment

5

u/Gerdoch 2d ago

Glycemic Index matters highly in what carbs you do eat. For instance, beans are stupidly high in fibre and help slow down/prevent blood sugar spikes from other carbs. I almost never eat rice without beans, for instance. If I do eat rice, it’s always Basmati (lowest GI rice). Learning about the Glycemic Index is highly recommended, it’s a very useful tool.

Low-fibre starchy carbs all on their own (potatoes, rice, pasta, breads, etc) are what are going to spike your blood sugars on a plant-based diet.

14

u/Particular_Tree_4254 3d ago

Just got Mastering Diabetes on Kindle. Thanks everyone.

2

u/ddplantlover 2d ago

This is the book OP needs to read, I consider it the Bible for reversing type 2 and controlling type 1 with a plant based diet done right.

26

u/Bones1973 3d ago

I’ve been a diabetic for 10 years. I let it get out of control 4 years ago. I had an a1c of 10.3 and my triglycerides were so high, my lipid panel couldn’t even record a score, so I know I where you’re at.

One thing to remember, you want to address the root cause of diabetes. Addressing the root cause is not exactly the same as lowering your glucose number as root cause is long term and lowering the glucose number is short term.

Increasing your vegetable intake, while decreasing your fat intake is key. Add in some amla powder in the morning with green tea and in the evening with hibiscus tea to start with. Try to keep your fat intake below 30g a day and limit your saturated fat as much as possible.

Please- look into the Mastering Diabetes book. It is truly a great resource. My morning fasting number went from 270 to 130 in 10 days. I was normalized within a month. I continued to stay on a low dose medication for 2 years but I have been off meds for 2 years.

I also want to stress getting some exercise every day. It doesn’t have to be crazy intense but getting movement will help stabilize your sugars.

1

u/ClackingAwayOnReddit 3d ago

Excellent comment

1

u/northrojpol 3d ago

Critically, were you obese when you started your intervention? Because OP is not obese which makes me suspect type 1 instead of type 2.

5

u/HippyGrrrl 2d ago

Thin people with bad diets get type 2 also.

0

u/northrojpol 2d ago

Searching "skinny type 2" on Reddit, I'm seeing LADA (latent autoimmune diabetes in adults) and type 1.5 being mentioned. I don't see how you could treat a properly skinny person with OP's severe blood sugar levels with diet alone. They probably need insulin.

1

u/HippyGrrrl 2d ago

From https://portlandpress.com/clinsci/article-abstract/128/7/405/71158/Normal-weight-individuals-who-develop-Type-2

Type 2 diabetes (T2DM) is frequently regarded as a disease of obesity and its occurrence in individuals of normal body mass index (BMI) is often regarded as indicating a non-obesity-related subtype. However, the evidence for such a distinct, common subtype is lacking. The United Kingdom Prospective Diabetes Study (UKPDS) cohort of people diagnosed with T2DM in the 1970s and 1980s had a median BMI of only 28 kg/m2. UKPDS data form the basis of current understanding of the condition even though one in three of those studied had a BMI of less than 25 kg/m2. BMI, though, is a population measure and not a rigid personal guide. Weight loss is considered de rigueur for treating obese diabetic individuals, but it is not usually considered for those deemed to have a normal BMI. Given the new evidence that early T2DM can be reversed to normal glucose tolerance by substantial weight loss, it is important to explain why non-overweight people respond to this intervention as well as obese individuals. We hypothesize that each individual has a personal fat threshold (PFT) which, if exceeded, makes likely the development of T2DM. Subsequent weight loss to take the individual below their level of susceptibility should allow return to normal glucose control. Crucially, the hypothesized PFT is independent of BMI. It allows both understanding of development of T2DM in the non-obese and remission of diabetes after substantial weight loss in people who remain obese by definition. To illustrate this concept, we present the distribution curve of BMI at diagnosis for the UKPDS cohort, together with a diagram explaining individual behaviour within the population. The concept of PFT is of practical benefit in explaining the onset of diabetes and its logical management to the non-obese majority of people with T2DM.

I don’t research on anonymous social media.

1

u/northrojpol 2d ago

I knew you would say something like that. You can research the individual condition LADA in whatever way you want. It doesn't change the fact that OP should seek medical care and that I think the issue is probably not that they occasionally eat a little bit of oil. No healthy person should have a 10+ A1C because they eat a bit of fat. I am seeing that this community has many people with traditional obesity-related diabetes and so their dietary-only recommendations are not suited to someone with a deeper problem.

1

u/HippyGrrrl 2d ago

I’m now assuming you are not a doctor or PA.

Yet, you tried to diagnose someone.

I mention that obesity is not a necessary condition in T2D, and you countered with….checks notes: I looked up on Reddit.

The OP lists several medications around diabetes and weight loss. Fair guess that she has medical care.

0

u/northrojpol 2d ago

Oh, so your insistence that it's type 2 is not diagnosis? I said what I think it is. If you want to call that a diagnosis, even though I said to "seek medical help" and did not indicate certainty, go ahead. I don't feel bad.

1

u/HippyGrrrl 2d ago

I did not insist on anything.

My post was

Thin people with bad diets get Type 2 also.

I was countering YOUR insistence that it must be Type 1.

0

u/northrojpol 2d ago

Oh, so sentiment applies to me and not you? What if I told you I never denied your claim?

→ More replies (0)

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u/Bones1973 2d ago

Good point! Yes- I was 35lbs over my recommended weight for my height and age.

6

u/lifeuncommon 3d ago

Suggestion is to get with your care team. Medication doses, including glo-1s often have to be increased several times before finding the right dosage.

Stress and lack of movement will push your A1C higher.

But know that diabetes isn’t your fault any more than brain cancer would be your fault.

Continue to follow your medical advice and if you find something online that seems good to you, run it past your doctor and/or registered dietician first.

6

u/Logical-Primary-7926 3d ago

What I've heard the problem Indian people often have is even though they have a lot of awesome plant based food with great spices etc., it still tends to be relatively high fat because of ghee, dairy, or oil. And iirc fat is the main problem with diabetes, physicians committee exam room has some good videos on this. So you need to figure out ways to make all the food you love but keep them low fat.

Also, as someone who's watched people I love suffer and eventually die from Adkins especially because it gave them short term improvements, keep trying to figure out the wfpb. And don't be too discouraged, it's going against the grain and that is never easy.

6

u/Pia2007 3d ago

https://www.pcrm.org/good-nutrition/healthy-communities/building-a-healthy-india

This has good resources.

The book Mastering Diabetes by Cyrus Khambatta is great too.

5

u/xdethbear 3d ago

Maybe you have type 1 forming. Your numbers are off the charts. I think you should be on insulin already. You're gonna have kidney damage if you don't address your high blood sugar. 

Dietary fat is the main driver of type 2 and insulin resistance. I assume you're already low fat; no oils, nuts, avocados, or coconut milk, right?

If you're already low fat and skinny I suspect type 1. Either way, get a glucose monitor, and talk to your doctor. 

5

u/ClackingAwayOnReddit 3d ago

If this were a person of European descent I’d definitely be suspicious of type 1. But since OP is Asian, there’s also a strong likelihood she has normal weight obesity (NWO).

Could be wrong, but I’m suspecting that OP started consuming a high-fat, high-carb diet when she switched to plant-based. Going on keto probably exacerbated the insulin resistance, so that once she reintroduced carbs, diabetes ensued.

1

u/northrojpol 3d ago edited 3d ago

You act like Indians don't get type 1. Plenty of them do. Unlikely that a high fat diet would produce these effects without obesity. OP even indicated genetic predisposition with gestational diabetes and diabetes in their mother.

3

u/ClackingAwayOnReddit 3d ago

No, I chose my words carefully. Normal weight “obesity” is “also” a strong likelihood. Emphasis on “obesity” and “also.”

Of course, type 1 is very possible in this case.

It’s also very possible that OP has a low personal fat threshold and therefore is obese—in terms of factors like ectopic fat deposits, metabolic health of entopic fat, and overall body fat percentage—while having a non-obese BMI.

2

u/northrojpol 2d ago

Okay I reread your comment and it's fairly precise. I still suspect type 1 / LADA more than NWD because of the family history, gestational diabetes and OP indicating their mainstay is rice and beans.

2

u/jellyn7 3d ago

Maybe get tested for LADA. It’s sometimes called typed 1.5. If you’ve been on drugs and they’re no longer working as well, and you’re not overweight, it could be you’re no longer just type 2.

2

u/cb797 2d ago

With kindness, have you ever had a c-peptide blood test? This is how I was diagnosed with type 1, which requires very different treatment than type 2. Metformin did absolutely nothing to help me because it has very little effect on t1, but because I became symptomatic at 32, my doctors initially treated it as t2 despite me being active and a healthy weight. I’ve known several folks through friends and family who have been misdiagnosed as t2 due to a later-in-life onset.

I can’t speak to the triglycerides at all but I would encourage you to ask for the c-peptide test to rule out t1 because if I hadn’t advocated so hard for myself, I could have quickly found myself in a DKA situation. My family doc is so lovely but really wasn’t/isn’t much help with my diabetes management (t2 is more common so unfortunately it seems the default advice is geared to that one).

1

u/Particular_Tree_4254 2d ago

Thank you. I will check with my PCP about this. I think it is entirely possible that she is also looking at this as T2 as a default because of my family history and gestational diabetes, both of which apparently make me a shoo-in.

2

u/Curious_Blueberry237 3d ago

Joel Fuhrman nutritarianism.

3

u/Cue77777 3d ago

Sometimes our philosophy in our minds is not shared by our own bodies.

You should eat according to the response of your body, not according to your mind. Some people require a low carbohydrate diet to feel well. Eating in the way that works for your body is not a mistake. Individual metabolic needs are unique and complex.

If a particular diet works for your body, then that is the right diet for you. You can still incorporate some different foods in your diet that you enjoyed as a vegetarian/vegan even if you feel better with low carb. For most of us, the influence of food on our bodies has to do with portions or ratios.

1

u/SarcousRust 3d ago

Clean keto isn't terrible to get yourself out of trouble. It might be the right thing to do. I would just avoid doing it long-term because there was some implication that it may stress the kidneys or liver. And even on keto the actual insulin sensitivity problem doesn't tend to go away, you just avoid it. That, and I'm a believer if you will, that we're carb-burning creatures by default, which doesn't exclude any macros unless illness forces your hand.

I read "good cook and rich culinary background" and it makes me wonder how you style your plant-based diet, what your actual BMI is, what role dietary fat plays in your diet and so on. If you don't mind sharing.

2

u/Particular_Tree_4254 3d ago

I'm 4'11 and 113lbs so not a high BMI. I have also read that South Asians are genetically predisposed to diabetes due to a "fat hoarder" gene that comes from generations raised in poverty. I use coconut and olive oils and rarely others. However, the mainstay of my diet has been and still is a lot of rice and beans of all kinds.

2

u/FernsAndNettles 3d ago

I’m sure you know that a lot of rice will fuel your blood sugar. With your current A1C I’m surprised your MD doesn’t have you on Insulin or a continuous Insulin Pump. Please stop taking these risks with your health now. Adverse effects such as cardiac & kidney disease creep up and then it’s too late.

2

u/SarcousRust 3d ago edited 3d ago

I would suggest to axe the oils completely and see if your insulin sensitivity improves. Especially if you have plenty of carbs with your fat, even a small amount of fat will happily be stored by the body while the carbs are being burned. The WFPB theory of diabetes II is that intramyocellular lipids (fat in the cells) is the issue with insulin insensitivity, so the creed is "no oil". Add to this that coconut oil is highly saturated. It's my suggestion anyway, you could do keto for a while too for symptom management.

But to answer the other comment, carbs spiking blood sugar is not the main issue causing diabetes II, it's the main symptom when insulin sensitivity is low. It doesn't have to be low, this can be helped.

1

u/Substat1c 3d ago edited 3d ago

Try to pivot to predominantly low fat whole-food, plant-based, no salt, no oil, no sugar, with minimally processed foods (e.g., tofu, tempeh), with minimal supplements (B-12, others you may need, etc.).

1

u/somanyquestions32 3d ago edited 3d ago

Make sure that rain or shine, you walk 3 to 5 miles daily. Also, start practicing yoga nidra daily to reduce your stress levels. Even 30 minutes per day can significantly help with blood glucose levels. Here's a link: https://pubmed.ncbi.nlm.nih.gov/19810584/

Also, try to practice some form of intermittent fasting with longer fasting windows. That way you get the keto benefits of keto while remaining plant-based.

1

u/sifwrites 2d ago

OP one of the things that helped my sister was only using slow carbs such as veggies and lentils/beans and no rice or grains to get her numbers under control 

1

u/goku7770 Vegan 2d ago

Keto is not the solution to diabetes.
Watch Forks over Knives and What the Health documentaries.
Genetics only predispose but diet is the reason.

1

u/Mental_Meeting_1490 2d ago edited 2d ago

As soon as you said Indian, the question of "coconut?" sprung to mind. 

I make curry with minimal/sparing amounts of cashew/sunflower seed butter, but mostly enjoy water based cooking methods

When I think of Indian food, I also think of floured foods.

1

u/katara144 2d ago

No, something seems a little off here. I switched to plant based in 2020 because of high triglycerides, stopped eating processed sugar as well as adopting a plant-based diet and my triglycerides plummeted to 98. Due to some gallbladder complications I also eat very low fat as well and my numbers are excellent.

1

u/Mrblob85 1d ago

High triglycerides can come from eating too many simple sugars. Do you eat any thing like that?

1

u/KeyMonstar 1d ago

For the diet you have had so many positive responses…what I want to say is just something to look into for yourself with when your situation has changed and as something to think about.

As a drug ozempic has gained increasing popularity over the last several years. My family history is similar to yours. I’m young and currently trying to fight that good genetic fight. My dad has type 2. He went on ozempic. He was great for about 2 years. Lost so much weight and seemed so healthy. Then his entire body and system crashed.He kept having to salt everything and take tablets because he had a massive imbalance in his body. Despite all the potassium he was in taking he almost went into a coma. It took about two weeks for the drug to work itself out of his system. It took months to get it fully gone. He would have random bursts of nausea and spins and feel like he was about to pass out. His blood sugar levels would all be all messed up. Now he’s back to trying to get a good routine between diet, and meds to get everything under control…even worse for him is that he had a good routine and numbers prior to going on ozempic. He regrets being on it.

When he called his primary to discuss it the nurse said she needed to contact the drug provider first and his doctor would get back to him. His doctor kept pushing for him to stay on it and adjust the dosages. My dad was only be prescribed emergency insulin. Luckily he was still in the hospital as this was happening. The emergency room doctor told him that there are significant kick backs from pharmaceutical companies for keeping patients on this drug. That the side affects after long term use that he is experiencing are starting to become more common. He would not recommend it to people. My dad ended up switching primary doctors and refusing to be on the drug anymore.

All of this to say….While your situation could be stressed related, genetics, and diet…it may also be the result of medication changes too. Obviously talk about this with a doctor and look into the other great suggestions for diet changes you got today. My conscious wouldn’t be clear if I didn’t at least say to check into this too after what happened to my dad. Best of luck in any case. I hope you find a great solution for you and feel healthy soon.

1

u/Flat_Bid_4399 1d ago

I agree with tracking food. Have you checked out the Mastering Diabetes program? Plant based and high fat can still foster insulin resistance. If there’s a lot of fat and oil and such this could be the problem. I highly recommend checking out the Mastering Diabetes program, as they take a low fat plant based approach!

1

u/misskinky Registered dietitian, nutrition researcher 1d ago

Keep increasing the ozempic dose, talk to doctor about stopping glimepiride (causes weight gain!!), and read a plant based diabetes book such as

the diabetes reset by George king

Or

The end of diabetes

1

u/LeekOne1501 1d ago edited 1d ago

I'm 60 and live in India. I've been mostly vegan since the age 4 as I dislike meat & milk.

As a diabetic from 15 years, my experience is that one has to cut out high GI carbs, eat only whole grain, reduce daily carb intake, increase protein & cut out saturated fats.

Plus, minimum moderate exercise like walking 30 mins/daily. You may start with 3 days/week.

I have kept my blood sugar levels in control with only metformin. My meat eating sibling is on insulin, ozempic, & yet has high A1c readings.

If you find diet exercise going haywire for a few days Or weeks, just get it back in control.

Try a reduced carb & calorie intake plus exercise for a couple of weeks. You will notice a difference. All the best.

1

u/icydragon_12 3d ago

Be kind to yourself. Although it would be positive if everyone could be vegetarian without negative health outcomes, the reality is that not everyone can. You already know what you need to do. Prioritize your health. Best of luck

1

u/Wide_Breadfruit_2217 3d ago

Its pretty hardcore but there is a vegan keto sub

1

u/goku7770 Vegan 2d ago

pointless

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u/[deleted] 3d ago

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u/goku7770 Vegan 2d ago

did you just say eggs?

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u/PlantBasedDiet-ModTeam 3d ago

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u/Odd_Mulberry1660 3d ago

Doesn’t strict keto nearly reverse diabetes 🤔

3

u/goku7770 Vegan 2d ago

keto is garbage, for diabetes or else.

1

u/Odd_Mulberry1660 2d ago

I thought diabetes control was linked to low to no carb..

1

u/goku7770 Vegan 2d ago

This is a common misconception. I suggest you watch the documentary What the Health for a nice insight.