Type 2 diabetes and victory

[left coaster]

Nice to hear Grant!

I eat a lot of meals like your new breakfast choice, dense, high protein, lots of fat calories. I also live on the coast and tend to eat a lot of fish. At around 20 I realized that dropping high processed carbs made my thinking clearer and my energy more stable so I've been eating this way for a long time. I believe the diet choices have a lot to do with why I show no diabetes signs in spite of having 2 immediate relatives with it. I could be thinner, but otherwise I'm healthy. I also very, very rarely consume high fructose corn syrup, I'm an avid label reader and don't do fast food or soda - that crap is hidden in various label scams, called different things by different companies and difficult to avoid at the supermarket.

[Carl Watts]

My breakfasts have gone from
3 bokomo weetbix + milk (23F/59Carb/18Prot) 315 Calories (leaving me very hungry by 10am most days)
to
Eggs/bacon/mature cheddar cheese/'butter (yum) (81/1/18) 1109 Calories (full)
2 hours after meal b/g 6.2 (great)

Reminds me of a friend that took up smoking to loose weight.

[left coaster]

lol... like a protein bar and sushi are a better alternative. High GI rice with basically no fibre or veg nutrients, and a mystery processed 'protein' bar that is likely sweetened aka junk food. Yer a funny man Captain Watts!

I just reviewed about 20 articles for a Keto section in a paper I'm writing on cognition and aging, there's value in transitioning that direction. Fully Keto I'll probably never get on board with, but a day off from food each week or very low GI diets have a lot of promise in terms of healthy aging in otherwise 'normal' adults.

[hjs]

lol... like a protein bar and sushi are a better alternative. High GI rice with basically no fibre or veg nutrients, and a mystery processed 'protein' bar that is likely sweetened aka junk food. Yer a funny man Captain Watts!

I just reviewed about 20 articles for a Keto section in a paper I'm writing on cognition and aging, there's value in transitioning that direction. Fully Keto I'll probably never get on board with, but a day off from food each week or very low GI diets have a lot of promise in terms of healthy aging in otherwise 'normal' adults.

Indeed. Protein bars are pure crap, left over shitty proteins plus other cheep rubbish, sold with a big margin
Take a few eggs as alternative.

After a night sleep our body is very calm and mostly burning fat, dump carbs in your body and you will interrupt this proces. Sudden spike of insuline and halfway true the morning a dip in energy and most people start snacking.
Eat a fatty, protein rich breakfast and you keep on burning mostly fat, will not interfere with your bloodsugar and will get slow energy for a long time from your breakfast. You just need some water.

[legion]

I am not diabetic but I've noticed that I don't metabolize carbs as well as I used to (I'm 56). For those that like to keep an eye on blood glucose levels (BGL) note that moderate exercise will lower your BGL as your body is consuming sugars during your workout. The opposite is true of intense exercise during which your body will release sugars at a rate about twice the utilization rate, meaning that your body is dumping twice as much fuel in your bloodstream as it will process. When I'm in the anaerobic range my BGL will increase.

For example, this morning my BGL was at 83 about 30 minutes after breakfast; definitely in a healthy range. Shortly after that I jumped on the erg for a 5k and my average heart rate for that row was 141BPM, completing the row a little over 150BPM. In that time my BGL spiked from 83 at the start to 99 at the finish; definitely counterintuitive.

An hour later I went for a 2k row on the erg to verify a suspicion and my BGL at the beginning was 99 but at the end was 88. The difference was that I stayed low in the fat burning range on that 2k row and my average heart rate for that row was 108 BPM finishing at 114 BPM.

I don't work in health care. If you'd like a source for further detail see the following abstract and pay particular notice about 1/2 dozen lines down from the top where it states...

in intense exercise, GP rises seven- to eightfold and GU rises three- to fourfold; therefore, glycemia increases and plasma insulin decreases minimally, if at all.

source: http://www.ncbi.nlm.nih.gov/pubmed/11815492

[jag]

Here goes all the keto nonsense again. Why on earth do normally intelligent people think they need to go into ketosis in order to be healthy? Ketosis is another name for starvation - excuse me, but have we decided to take our diet and exercise advice from anorexics now? It is not a normal state, and the diet book authors who make all their money promoting this diet aren't even eating it themselves. Ketosis is hard - you need to radically slash all the carb you eat down to an absurdly low level that prohibits most normal food like most vegetables, all fruits and all grains and limits your daily carb intake to a maximum of a few cups of broccoli every day. It requires you take vitamin supplements and laxatives because the nutrition value is low. AND it requires you to eat a small amount of protein too, because a large proportion of THAT is converted into carb when your body is starving, which it is since that is just another name for being in ketosis.

There ARE some people that benefit from maintaining a ketogenic diet - specifically some people with seizure disorders. But it is NOT necessary for diabetics, and I know that because I have been living with diabetes for 41 years.

I believe that the best way to treat diabetes is with moderation. Eat a moderate diet, with a mix of healthy foods in moderate amounts, and get as much exercise as you can fit into your normal life. If you have diabetes it is important to maintain a normal weight and adjust the timing and amount of your eating and exercise by testing your blood sugar as often as you need to in order to keep it as close to normal as you can.

[Edward4492]

I'll jump in, diet is a subject I'm very interested in. I've pretty much adopted a primarily paleo style of eating with simple carbs to support my work outs. I'm fortunate to have a relative around the corner with thirty chickens, so every day starts with 2-4 (depending on the size) fresh eggs. Much better than store bought. The rest of the day consists of nuts, fruit, carrots, meat or chicken for lunch. Dinner is whatever my wife cooks; generally meat, chicken, fish, sweet potatoes are a staple and lots of vegetables. Off season there's some junk (I'm not a saint by any means). A glass or two of wine at night, coffee with a little sugar and cream through out the day. My off-season weight stays under 170lbs (six foot tall). I easily diet down for ranked pieces and generally do all of my LWT rankings right after Boston while I'm in prime shape. I can lose six or seven pounds pretty much at will. I am 100% convinced the real enemy is sugar and breads, bagels, pasta, etc. Fats have gotten a bad wrap. My blood profiles prove this out with extremely low tri-glycerides, high HDL (the good stuff) and moderate over-all cholestrol (around 200). I have found that a totally paleo approach rips the weight off fast, but the energy levels fall and the training suffers. Competing as a LWT means a balance must be maintained. Even though I agree that most energy bars are garbage, I've really found that Cliff bars seem to work as a great pre-workout meal. They sit nice in the stomach and seem to keep the energy levels up. Otherwise, i just focus on eating real food.

[jag]

You may call that a paleo diet, but most of the paleo diet book authors would disagree. In any case it certainly isn't a ketogenic diet. Your carb consumption is FAR higher than a ketogenic diet, and your fat consumption is FAR less than a ketogenic diet. It's actually similar to the diet I eat - but I don't put sugar in my coffee and I do have whole wheat bread every day for lunch. I guess the main difference would be that I include more grains with my diet - I have no trouble eating some whole wheat bread, rice and others, though like you I do eat a lot of vegetables. I would call that a moderate diet with lots of whole food, and I'm all for that.

[Shawn Baker]

As someone who has dealt with for years, the tragedy of diabetes (I've amputated plenty of diabetic legs, taken care of their infections, fractures and arthritis), I would strongly consider looking into severe carbohydrate restriction if I were a diabetic- for many people a moderated and or balance diet is fine, but for many diabetics, pre-diabetics, or those that are likely insulin resistant but undiagnosed some form (to include even spending time in ketosis) of carbohydrate restriction is likely to be very helpful- the mounting medical research, thousands of anectodal patients coming off all diabetes medication speaks to the utility of this. I personally spend plenty of time in ketosis and at a lean 245 pounds I can hardly be called anorexic- I taper in occasional carbohydrates for planned intense workouts and seem to do pretty well with it, my energy is very good, health is excellent and am still performing at a very high level athletically despite being nearly 50 (500m row in 1:18.7)- as humans we were designed to well tolerate periods of fasting or we wouldn't of survived- the nearly 500 million diabetics worldwide are testament to the fact that constant unlimited food intake is not necessarily helpful, and I'm afraid diabetics are just the tip of the iceberg, as in my my view and many, many others insulin resistance underlies most other chronic disease (cardiovascular, dementia, cancer, obesity, autoimmune, arthritis etc...both mechanisticaly and epidemiologicly - everything in moderation doesn't work for some (no one advises smoking in moderation!)- for many carbohydrates are just bad news while they are insulin resistant.

[hjs]

Here goes all the keto nonsense again. Why on earth do normally intelligent people think they need to go into ketosis in order to be healthy? Ketosis is another name for starvation - excuse me, but have we decided to take our diet and exercise advice from anorexics now? It is not a normal state, and the diet book authors who make all their money promoting this diet aren't even eating it themselves. Ketosis is hard - you need to radically slash all the carb you eat down to an absurdly low level that prohibits most normal food like most vegetables, all fruits and all grains and limits your daily carb intake to a maximum of a few cups of broccoli every day. It requires you take vitamin supplements and laxatives because the nutrition value is low. AND it requires you to eat a small amount of protein too, because a large proportion of THAT is converted into carb when your body is starving, which it is since that is just another name for being in ketosis.

There ARE some people that benefit from maintaining a ketogenic diet - specifically some people with seizure disorders. But it is NOT necessary for diabetics, and I know that because I have been living with diabetes for 41 years.

I believe that the best way to treat diabetes is with moderation. Eat a moderate diet, with a mix of healthy foods in moderate amounts, and get as much exercise as you can fit into your normal life. If you have diabetes it is important to maintain a normal weight and adjust the timing and amount of your eating and exercise by testing your blood sugar as often as you need to in order to keep it as close to normal as you can.

Ketosis is starvation? Our body has a limited capacity to store carbs, if for some reason we can,t eat carbs the brain can,t get glucose. Instead it our body starts to produce ketones. So this is a back up system.

Carbs in there natural form are never concentrated, nowadays most processed foods have very high % carbs in them. No animal in its natural habitate has that. So this way of eating is very unnatural.

Conversion of protein in carbs. Yes that happens, but not very easy and the amount of protein we can eat and process is not that high. Its very hard to overeat natural protein. Eat a lot and you will be full for a very long time. So in practise not really a problem.

Eating carbs and getting out of ketosis. Thats not really a probem, yes if you eat a high % of carbs our body is programmed to burn sugar. But if you eat low carb, high fat its just the other way around. You get in ketosis very easily.

You can,t eat vegatables? Most greens, certain the leafy ones have a low % of carbs in them, often only a few %. Say you would eat 30 grams of carbs via greens. Say they have 3% carb in them, this means you can eat a full kg of vegatables.

Working out, training, anaerobicly will always burn carbs. So when you are doing this you eat more carbs and still stay in ketosis for most of the day. 100 gr carbs will only give 400 cal. It not hard for a healthy person to burn such an amount in one training, next to fat.

If after anaerobic training you eat carbs, those will easily be stored in the muscle, you will be very insuline sensitive. Once the carbs are muscleglycogen our brain can,t use those anymore. Our brain uses liverglycogen.

If you don,t do much anaerobic work its different, in that case yes, the amount of carbs should be pretty low. But instead of talking al kind of sidesteps, it would be wiser to start using your body.

[left coaster]

I'm into brains, not in a zombie way, but they interest me.

In adults, long before any measurable declines in cognitive skill, there is a decrease in capacity to metabolize glucose (to be stored as glycogen in no-neuronal cells/astrocytes), a phenomenon called hypo-metabolism. During this time the brain compensates by pushing more blood to regions being used in order to maintain cognitive performance for short periods. this blood flow compensation for hypo-metabolism is now understood to precede structural degradation of cortex and white matter. aka - reduced glucose sensitivity in the brain leads to dementia.

We also now know that the brain stores glycogen, through a different process but in a similar manner as muscles, that depletes with intensive interval type exercise or exhaustive endurance exercise that depletes blood glucose. It then glycogen loads, in very large amounts, in response to the depletion. Much more than muscles do (about 60% more in some brain areas), which is really amazing to me.

This indicates that the metabolic system of the brain is plastic, challenging this system to ensure metabolic health is critical. glycogen is basically just a complex glucose molecule that the brain makes by sucking up glucose from the blood stream. It has yet to be proven, but I'm reasonably certain that if your brain glucose system is damaged, glycogen loading in the brain is also damaged, which could lead to reduced glycogen compensation and in all probability continued glycogen depletion and brain atrophy.

If I needed to only eat every other day in order to ensure my brain stayed healthy, that's what I'd do! For me, Type 2 diabetes needs to be reversed by any means possible, the consequences are far too insidious to not take strong measures. Maintaining a compromised neurological state is just not an option for me. I'm a very 'in my head' person though, cognitive processes are probably not as important for everyone.

[GrantM]

I'm not sure what to say really except I have a clearer picture now than before on what is going on which is a good thing so I thank everyone for that.
I thought I was eating healthy, as prescribed by dietitians for my condition. Not one Dr or Physician ever even suggested something like moving towards a keto regime. Just more meds and a loose, avoid sugar and carbs? Even the diets prescribed were full of carbs and low in calories.

Whats done is done, but I have in 7 days gone from
Fat = 39%
Carbs = 34%
Proteins = 27%
to (7 day averaged)
Fat = 62%
Carbs = 9%
Proteins = 29%

The transition has been easy and the carb count will reduce as I continue to log my meals and understand where they are coming from.
My doses of insulin are down slightly, I have reversed the way I eat taking on much more calories during the day (especially breakfast) and eating very lightly at night which is rendering good bgl readings in the morning.I feel quite energized when I get up in the mornings to. Overall bgl results really good and it is much easier to control.
I'm not in the least bit hungry as I was and if necessary my breakfast (+-1000 calories) will sustain me for the whole day if work gets in the way of lunch. No temptation at all or cravings to get a quick takeaway on the road somewhere.
So this guinea pig is quite a happy camper at the moment and I will stick with this and see how it goes in the longer term.
I have been using this Diabetes and Diet tracker app to log my intake and found it very useful and even fun to do.
https://play.google.com/store/apps/deve ... .com&hl=en
Its a paid diabetes version of the free app Calorie counter which just adds the diabetic analysis and report functions.
There are iphone versions.

On the brain from the post above, something I never considered, thought of or was told about as longer term possible complications.
I mentioned my mom is T2 for a number of years. She is getting on now at 77yrs, and was living on her own. Her brain deteriorated rapidly to the point where she could not remember anything, meds, meals, etc and had a number of seizures as a result. She passed out one night while talking to my aunt on the phone in Ireland, who then called my sister who lives close by and they had to break in to her place with the paramedics. She shattered her shoulder in the fall and was unconscious.
She has dementia and is now in a frail care facility really just to ensure she eats well, has her meds and bgl is monitored. She is still physically strong but the mind is nothing like it was and the decline to where it is now was quite rapid and sad to witness.

[Shawn Baker]

Gran, nice work- make sure you let your doc know what you are doing so he can hopefully taper you off your meds. Keep us posted on your progress!

[jag]

Shawn and Left Coaster,

It would be nice if there any truth to the keto diet nonsense so that you wouldn't have to rely on straw-man arguments. But clearly that isn't the case.

Diabetes is a serious disease and it leads to amputations and alzheimers and other serious complications when blood sugars are uncontrolled. Controlling diabetes is a matter of managing your weight, your diet, your exercise, and your medications in order to keep your blood sugar in a healthy range. But controlling diabetes has nothing to do with eating a keto diet, and controlling diabetes certainly does not REQUIRE eating a keto diet. I've been controlling my diabetes for 41 years, and I don't eat a keto diet, and I haven't had any amputations or other complications and my brain is doing just fine, thank you.

Does that mean that I promote "constant unlimited food intake" or lots of "processed foods", as you tried to put those words into my mouth? Gee - no - far from it; in fact the opposite.
If you are overweight with T2, then clearly you need to lose weight to improve insulin resistance. Any diet that allows you to accomplish this by eating less is worth trying. If you want to try the keto diet, then go for it. Personally I think a mediterranean-style diet, with lots of fresh vegetables and fruits is the way to go, but whatever floats your boat. Just please do not pretend that the keto diet is some sort of cure-all for the disease of diabetes - because it certainly is not.

hjs,

I think you misunderstand how difficult it is to actually stay in ketosis. Ketosis is something Type 1 diabetics like me are aware of because of the dangers of ketoacidosis. I recommend you buy some urine or blood ketone strips and test yourself, because based on what you've written I suspect that you are actually not in ketosis at all. I think this is one of the problems with the so-called keto diet - that there are a lot of people promoting this marginal diet and thinking they are living in ketosis when they are actually far from it.

Grant,

This disease is no fun, and I wish you continued success. You are in the unusual condition of having T2 and wanting to GAIN weight; for most T2 like Shawn and Left Coaster it is the opposite. Next time you talk to your doctor you might suggest you get tested for LADA (a form of slow onset T1 diabetes that hits later in life) because about 10% of people diagnosed with T2 have been found to actually have LADA T1. There are blood tests he can order: http://www.diabetesforecast.org/2010/ma ... e-1-5.html
If you do have LADA T1, then tapering off insulin isn't going to happen, so if that is a goal of yours then you might want to be tested simply to know whether that is a realistic possibility.

[hjs]

Jag, I have followed a pretty strict period of staying mostly in ketonis, it was pretty easy for me. But I do workout 6x per week, plus when the weather is ok, cycle a lot. I did use refeeds days, but found it difficult to eat carbs enough. A high fat diet is small is in volume. So te stomach gets small.
The things that did work well, was very hard interval work. With little glycogen anearobic work really suffers. I did race a few 2k s in ketosis. The results where ok.

I started very strict, easily below 50 grams carbs. With my training I use up my glycogen very rapidly.

But one thing I noticed, my sexdrive got less, although not messured it felt my testosterone levels declined.
Another point, socialy eating is difficult.
Another minus is smell, body odeur is not great, my sweat really did smelt not great...
Plus point, I felt very stable, and also my skin was very smooth.

At te moment I use a moderate carb patern though. I gained some weight. Including some fat. I was very lean, now lean.
186 90 ish, now 95 ish. At 90 kg I have veins everywhere, including on my stomach.
At the moment I am clearly not in ketosis. Once you know what it is, its easy to know when you in or not.