Boom! The impossible happens again

Type 2 diabetics are supposed to become a little bit sicker every year – that’s considered normal. Recently I saw another example of the opposite.

This spring one of my new diabetic patients had a long term blood sugar (A1c) of 68 mmol/mol, which is worryingly high (normal is between 31 and 46). The other day the same patient returned for a follow-up visit and I got a nice surprise. The new A1c was 32. Not dangerously high anymore. Not only normal, but lower than for most non-diabetics. Impossible, or at least incredible.

The weight had also improved, as had the cholesterol profile and the blood pressure.

The difference? The patient had started a strict LCHF-diet. No sugar, no bread, pasta, rice or potatoes. And no exceptions. That’s how to make the impossible happen. Boom.


PS: An HbA1c of 68 mmol/mol using the new IFCC units is the same as 8,5 % using the old DCCT units.


  1. FrankG
    Great news Doc! I am pleased for that patient (although I'm going to find the new A1c units confusing for a while!).

    I have Type 2 myself and belong to several Diabetes forums. The question of "whether Type 2 is inevitably progressive" comes up quite often. In general the response these days seem to be along the lines of "Yes... if you follow the standard dietary advice, but not necessarily so if you switch to LCHF". This approach invariably means fewer (or lower doses of) medications and their side-effects as well.

    It strikes me as barmy that while we with Type 2 Diabetes are controlled to an higher standard for blood pressure and cholesterol profile, it is acceptable for us to sail along with higher than normal blood glucose (almost as if there is a different "normal" blood glucose level for those with Diabetes) and yet controlling my blood glucose to nearer normal levels is (I have found) the best way to manage my blood pressure and cholesterol profile.

  2. Lezlee
    How about posting a conversion calculator for HbA1C on your website.
    Reply: #15
  3. Jordan M.
    And people still say fat causes diabetes... So the cure is the poison? lawl.
  4. Peggy Holloway
    That is good news. I wish that my sister could have the same results. After 12 years of LC, her fasting blood sugar is still too high, often over 200mg. Her readings drop through the day and don't seem to be affected by what she eats. She is now trying to increase her fat intake, treat what may be yeast overgrowth, and get off some of her meds that may be affection her blood sugar. We are hopeful.
  5. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    A general idea of how to treat high blood sugar in t2 diabetes:

    1: A strict low carb high fat diet

    If necessary:
    2: Metformin

    If necessary:
    3: Victoza

    Of course there are also a lot of other smaller factors that may need to be taken care of, and exercise may help too.

  6. March 2010 my blood sugar was 478. I took metformin and got real sick. Switched to low carb. Now my blood sugar hovers between 85 and 95 daily. My doctor considers me "cured". As a nice side effect of LC, I lost 170 pounds. My triglycerides are down to 35. I got married in January. He was diabetic and went LC with me this spring. He has lost 50 pounds and the doc considers him no longer diabetic. I enjoyed proving to people that me no longer being diabetic is NOT a fluke, I had the same results with my hubby. :-)
    Reply: #14
  7. Dr. Andreas Eenfeldt, MD Team Diet Doctor
    Wow. Congratulations!
  8. OneMoreIssueToSolve
    On diagnosis, immediately did the research and switched to (V)LCHF.

    within 18 months..

    Last A1c - 30 mmol/mol
    Lost 44lbs
    Reversed background retinopathy
    Reversed neuropathy

    But, for the life of me, the lowest I have managed to get my triglycerides is 1.9 mmol/l.

    Despite all the researching, I’ve not been able to find an answer to this issue. The only “answer” I had is that it is “genetics at work”.

    Can anyone point me to some relevant research please? :-)

  9. Jenny D.
    Dr. E - quick question: I just had a full blood panel workup, and everything looks really good except my A1c. I've been eating (V)LC for 3 years, and modified to (V)LCHF 2 years ago. Fasting glucose: 81 mg/dL / total cholesterol: 301 mg/dL / triglycerides: 68, but A1c at 5.2%. I'm only 32 and am very faithful to the diet...any ideas?? Thx!
  10. Zepp
    Im not Andreas.. but what is the problem?

    A1c is at the bottom of scale.

    Fasting glucose is normal.

    Triglycerides is low.

    Total cholesterole dont say that much.. it could be high HDL.

    And your low triglycerides predict that.

  11. Jenny D.
    @ Zepp:

    Thanks for the review & reply. I'm not worried about cholesterol...this test didn't break down 'b' vs. 'a' pattern LDL particles, but previous tests have shown my type 'b' to be <10% of total LDL. I'm only worried about the A1c. The "normal" range from the lab shows A1c should be between 0.0 and 5.6%. My MD says he wants it under 5.0%. Can't figure out why that would be higher than ideal. Thx!

    Reply: #13
  12. Zepp
    I realy cant figure out why he want it to be lower?

    Its in normal range for a healty non diabetic.

    "For people without diabetes, the normal range for the hemoglobin A1c test is between 4% and 5.6%. Hemoglobin A1c levels between 5.7% and 6.4% indicate increased risk of diabetes, and levels of 6.5% or higher indicate diabetes."

    And you eating LCHF, then you dont eat that much carbs.. a big part of your glucose is made of your own body.. to a limit it like to have.

  13. AR
    have you had feeling of fatigue , dizziness when you did low carb. I have been diagnosed in 12/15 at 11.2 a1c when I was 138 lbs for 5.3 height. after 4 months of diet and exercise my current reading is 5.9 a1c, 118 lbs but I am lately feeling lethargic , fatigued , can't go to gym , overall energy is drained. I regularly check my fasting BG and lately it is above 100 and sometime 118. PP BG is within the range below 145 mostly. I am not sure what is happening to me.
  14. Xelda
    For conversion charts, I found two useful websites: provides a calculator/converter provides an easy to use table with HbA1c Old to HbA1c New units

  15. Andrew
    Hi. I’m slim and have eaten what I believed to be a healthy diet for years. A so called balanced diet. I’ve just turned 50. Diagnosed with type 2 five years ago. No history in the family. My fasting bloods are 7.5 morning and 5.5 evening. I’m now on gliclazide. I have no symptoms of the diabetes. . Do you think that someone like me with this profile can reverse it? I’ve been on LCHF for a week and am very happy with it.
  16. HENO
    Quisiera saber si la neuropatia diabética mejora con la dieta cetogenica?
    Reply: #18
  17. Kristin Parker Team Diet Doctor

    Quisiera saber si la neuropatia diabética mejora con la dieta cetogenica?

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