Diagnosed with Uncontrolled Type 2 Diabetes

Nutrition
22

Three years ago I was diagnosed with low testosterone and type 2 diabetes and started TRT and did well for 6-8 months and started experiencing a decline. Three years later I would find myself with multiple mineral and vitamin deficiencies. (Iron, potassium, vitamin C and vitamin D)

I feel better when inject T daily or EOD do to low SHBG (14) and feel more even keel on these protocols. It was when I started these frequent injection protocol is when I started becoming deficient because the weekly and twice weekly protocol caused my levels to swing and not respond well to TRT, so I think the minerals and vitamins were spared with levels swinging and not stable.

I naturally have an incredible energy and routinely shock those who underestimate me (6 ft, 235 lbs, thin frame), when natural T is optimal I have explosive strength and can have intense prolonged burst of energy that is sustainable for long periods of time. I would tear up obstacle courses with ease and great balance and agility.

Iā€™m not terribly fatigue scoring TT 97-146 ng/dL these past 5 months, stamina is ok but declining a little bit the longer Iā€™m off TRT. Erections have been very slowly declining as well. Only 6mg cypionate is enough to propel me into crazy energy.

I stopped TRT in April do to the deficiencies and in turned worsened my Type 2 diabetes which has caused gastroparesis dysfunction and my entire GI tract to experience poor absorption, dysfunction of the nerves that propel food through the GI tract. Restarting TRT only worsen everything because demand was increased on everything and I burned through what vitamin C I had quickly as my GI became more dysfunctional that it already is.

My typical diet is chicken, steak on occasion, spinach daily, carrots, asparagus, pepper jack cheese, chicken between bagels and eating out occasionally. I supplement potassium, vitamin C and vitamin D. If I stop the potassium, days later my potassium will be below range, teeth will turn yellow as the magnesium pulls calcium from my bones and teeth.

Restoring potassium be supplementing will see teeth white again within days. Iā€™m assuming I need to eat small meals instead of large ones to keep glucose from rising.

23

@systemlord
My friend, how much metformin do you use currently? I think for your condition 2 grams per day is the minimum.
I would recommend you go and see dr Rob - https://www.renuehealth.com/

He is specialized in hormone replacement and metabolic disorders and I think he will goo very deep into your condition testing you for all that is necessary and taking into account all that.

24

First off, Iā€™m sorry to hear about your ails and I cannot contribute with anything regarding your specific condition other than express my concern.

However, Iā€™d be remiss if I read this,

and didnā€™t follow up. Do you consume any other fats or is it all animal fat? Never any nuts? Olives (oil)? Maybe you cover all of your macros with that, Iā€™m not an expert, but there are certainly fats which arenā€™t included. Omega-3s?

25

My doctor told me that I have fatty liver, everytime I eat I feel nauseous for a couple of hours. My understanding is fatty liver causes swelling in the abdomen, but my doctor keeps going other places for testing and is missing the obvious.

I feel like my days are numbered unless I correct this fatty liver which I believe is slowing blood flow, then eating causes swelling because my liver is having trouble filtering blood fast enough and my doctor isnā€™t treating the fatty liver and is doing nothing because lab testing shows nothing wrong and canā€™t act without lab tests indicating something is wrong.

I can feel hot fluid in my body fat around my belly. I went to the gym this morning and am eating veggies and carbs to fuel my body. My liver is starting to give me skin problems, my liver gets clogged up and skin is breaking out in rashes and hives because of all the garbage plugged up.

My life depends on cleaning up my liver in a short amount of time, how do I clean up my liver quickly?

Thank you.

26

What about fasting?

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27

Not medical advice but Iā€™d look at diet and try switching things up Iā€™m currently on intermittent fasting and keto. Worked wonders for me.

28

Iā€™m eating small meals, could try fasting, but I must drink orange juice do to a vitamin C deficiency. I spend an hour on the treadmill and 30 minutes lifting weights, but had to take it easy because of loose sore joints.

How long do I fast for?

29

I think metformin can help. I know you canā€™t take that. Try berberine. If I remember correctly reducing insulin resistance can help your liver remove the fat.

I have NAFLD. Mild.

When i gain fat and get close to 200 pounds my liver enzymes get elevated. I canā€™t get fat or I am fucked.
Probable part of metabolic syndrome. You also have high triglycerides?

Here ya go Bud You can find a Study to make any argument in ur favor. Now I know why some donā€™t site these type of studies.

30

Allergies to metformin, cough, sore throat and voice changes. This is why my doctor prescribe Glucotrol XL which seems to work.

I havenā€™t had it tested in awhile.

I also seem to be getting spasms in legs, GI tract and sometimes the arms. Severe pain in hands as well, electrical surging pain. Iā€™m thinking sciatica, but my doctors are dismissing it outright and seem to be putting up roadblocks to treatment.

Itā€™s like they want me to go away, I believe itā€™s my lousy insurance.

31

I guess you know that there is no quick fix for NAFLD.

To prevent NAFLD progressing to NASH the most important thing that you can do is life style modifications. Loose weight if you are overweight and follow a low carbohydrate diet. The latter is most important since you seem to have problems with insulin resistance. NAFLD might be a consequence of your situation with DKA, but this is pure speculation. Overall ensuring proper glucose control, as your physician is working towards is priority number one.

Pharmacologically, Metformin is not recommended as a first line therapy. Pioglitazone and glucagon-like peptide-1 (GLP-1) analogues have shown some promising results.
Sylimarin demonstrated some protective effects towards liver fibrosis.

Choline and inositol might play a role in modulating insuline resistance.

Diagnostically, if liver fibrosis is suspected a liver biopsy might be indicated.

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32

With all of the other deficiency based problems youā€™ve had old friend, I would advise that you not go the fasting route just yet.

Low carb, or even keto is a good option for you short term to get this under control. Once you get things back to good, you could start reintroducing a low GI carb source back into your diet along with bringing the protein intake back up (chicken / turkey primarily, and red meats once or twice a week).

Just be sure to utilize good healthy fats (omega 3ā€™s, MCTs, etcā€¦) and not a ton of saturated crap. Your cholesterol will elevate on a keto diet, but you can control your hdl / ldl by choosing wisely.

33

I thought you had diabetic ketoacidosis? I assume you have diabetic ketoacidosis and NAFLD?

NAFLD can cause type 2 diabetes, obesity can also induce NAFLD and type 2 diabetes. NAFLD can be maintained (or some damage even partially reversed) by losing weight if obesity was the prime cause of said pathology.

Donā€™t think so, the two arenā€™t particularly related. However NAFLD typically preemptively induces a high risk state in relation to developing type 2 diabetes, should be noted diabetic ketoacidsis can deplete potassium stores, directly lining up with systemlord claiming potassium supplementation reduced generalised symptoms.

Insulin resistance however, as well as hypogonadism (of which plays a role within insulin resistance through various mechanisms such as promoting the development of visceral adipose tissue, leading to leptin resistance and thus insulin resistance and whatnot) both play a role within inducing obesity. Thus losing weight (of which is required to maintain/prevent further hepatic damage, is going to be difficult (difficult, not impossible)

@systemlord do you by chance have a familial history of health ailments or premature death?

34

By loose joints are you referring to the similar pathology that I have (BJHMS), the feeling of various joints sublaxing during training/at random, generalised joint pain in relation to loose ligaments/connective tissue (hypermobility runs in my family, thankfully not EDS or cardiac pathology aside from accelerated atherosclerosis on a distant side of my family, thankfully my lipids are decent so I donā€™t appear to have inherited such genes)

I donā€™t feel comfortable recommending medication or supplementation due to my lack off qualification and furthermore youā€™re sheer level of sensitivity in relation to most pharmaceuticals, however you need to get insulin sensitivity and BF under control. If you have to restrict caloric intake, restrict it, even if you canā€™t exercise, eating under youā€™re TDEE will induce weight loss. Many people over-eat unintentionally, track youā€™re macros and caloric intake down to every single grain of food you put in youā€™re body, Iā€™d stipulate youā€™re unknowingly eating over maintenance. If you arenā€™t active at all, caloric maintenance can be quite low, hence why physical activity combined with diet (aside from metabolic boosting, esp with HIIT and other mechanisms and whatnot and so fourth and floop) leads to accelerated weightloss.

Walking is good, if you wish to take some strain off youā€™re knees try stationary biking. On a treadmill a slight incline takes quite a bit of pressure off the patellofemoral joint soā€¦ yeet.

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35

Typically obesity/ a sedentary life style increases insulin resistance which leads to an increased fat disposition in the liver. Insulin resistance can however also have different caused then the insulin resistance becomes the trigger a spiral resulting in what then presents itself as metabolic syndrome. NAFLD is considered to be the hepatic manifestation of the metabolic syndrome.

Anyways, itā€™s a chicken and egg problem and he needs professional medical attention. Other than just some general recommendations to discuss with his physician I also donā€™t feel qualified to give any medical guidance.

36

Unreal sticks with his original statement. Obesity is likely the instigating cause of NAFLD, type 2 diabetes (and associated ketoacidosis). However, NAFLD isnā€™t a complication of diabetic ketoadicosis (to my knowledge that is, I could be wrong). However the notion of NAFLD being a manifestation of metabolic syndrome is true, BUUUUUUTTTTTTTTTT, the cause of metabolic syndrome is generally linked to obesity, familial association with metabolic syndrome (look at the rates within aboriginal/Torris straight islander populaces) hints at a genetic component as well as lifestyle factors being culpable.

Itā€™s a domino effect, the most obvious equation to eliminate is the original domino causing said effect (in which case, said culprit is most likely obesity)

37

I did some further reading and the only recommendation that I can give is to get under the care of an MD who is specialized on this topic.

Some life style modifications that are beneficial for treating your NAFLD such as caloric restriction might be very dangerous for your EDKA.

38

Dude, Mert had to ask you literally 5 times to get a straight answer out of you.

MDā€™s donā€™t have time to be misdirected or entertain Wikipedia based hypothesis on what might be bothering you.

I hate to see others suffering, so Iā€™ll tell you this- Get honest with Yourself and your MD. This internet educated arrogance about ā€œDoctors are full of shitā€ is literally going to land your ass in a casket.

The two people that you Absolutely Never want to lie to or withold/obfuscate to are Your Doctor and Your Lawyer.

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39

I donā€™t think anyone said it yet. CHOLINE is key. Look into it.

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40

Dude, you got NAFLD and you are chugging orange juice for a ā€œvitamin C deficiencyā€¦ā€

Go see a doctor and pull your head out of your ass.

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41

Donā€™t panic, lots of people have this condition they just donā€™t know about it(fat in liver) thatā€™s what the docs said to a family member and in your blood it may take 3 months to see improvements. But you can fix it so donā€™t panic.
What I want to ask you, apart from the other symptoms do you feel dizzy or want to throw up when you r running? Have they said anything about regression or other stomach problems?
You must change your diet(avoid fried and junk foods ofc), and lose some weight too, ofc if you drink alcohol stop it immediately.
No medical advice but u could try and consume garlic, grapefruit, green tea, carrots, avocados,green vegetables, apples, or drink a fresh juice of lemon or lime(contain a lot of vitamin C)every morning, also curcumin helps too.