Type 2 diabetes and victory

[Shawn Baker]

I'd be inclined to agree with Henry on this stuff- in my mind pre-diabetic would worry the heck out of me and I would seriously look at LCHF or ketogenic diets- pre-diabetes is just part of the gradual spectrum of the disease whose prevalence is likely far more than we estimate and a common pathway for most chronic diseases

[left coaster]

I'd be inclined to agree with Henry on this stuff- in my mind pre-diabetic would worry the heck out of me and I would seriously look at LCHF or ketogenic diets- pre-diabetes is just part of the gradual spectrum of the disease whose prevalence is likely far more than we estimate and a common pathway for most chronic diseases

Yup, including brain hypo metabolism (thought to be glucose based) that is increasingly recognized as a preclinical indicator of dementia/Alzheimer's. I would be taking it VERY seriously as well. The challenge is that transitioning to a ketogenic diet takes days, if not weeks, and from what I've read the transition really sucks. Then, when you're there, it is necessary to maintain indefinitely. A small reversion back to eating carbs and your body flips back right away, we're programmed to prefer glucose as an energy substrate. Another challenge not emerging yet is that keto diets depend almost exclusively on the liver to convert the fuels that keep blood glucose stable. If you're liver isn't in optimal health, this could be tricky.

Personally, I think a very low glycemic index diet (LCHF) is more realistic and sustainable... you'll probably go Keto with some regularity on long endurance bits, and suffer the serotonin sedation, but at least there will be fuel in the tank for higher level work.

[GrantM]

Thanks for the feedback and advice hjs
Yesterday my calories were made up of

Fat = 35%
Carbs = 25%
Proteins = 40%

My average over the last week is
Fat = 39%
Carbs = 34%
Proteins = 27%

It needs work, but is relatively easy to adjust. Most of my carbs are coming in at breakfast.

[Carl Watts]

Dug up the paperwork.

HbA1c: 41 mmol/mol ( < 41 ) H

Suggests I'm at the upper limit. Tested in August 2014 and October 2015, identical numbers but then again no change in diet. Both tests non-fasting.

Not too worried about it really, have changed the diet but if the numbers don't shift downwards, then either.

a) I cannot do anything about it.
b) Its just a normal reading for me.

Will leave it a while before I get re-tested its an annual full health check I go for. Really only need to panic if it starts moving upwards.

Low risk patient here on other fronts, never smoked and if I can get a body fat percentage starting with a "1" then I'm going to be very happy.

[GrantM]

Good to keep an eye on it.

1 was 20 years old and just finishing my 2 yrs national service. I remember this vividly because the day I flew home I went straight to the hospital where my mother had been booked in for tests for a few days. She was then diagnosed with type 2 diabetes.
Since then whenever I went to the doctor I always asked for a blood glucose check. Its quick and takes a few seconds to get a result. (clinics at work/chemists/etc will all do this finger prick test for you)

Some 14 or 15 years later I was fine one day, the next an incredible thirst and constantly urinating. I knew then exactly what it was. Went to the Doctor, readings off the scale.
Ironically I had been to the doctor a month or so prior and my b/g was normal.

Managed to control it for a while with oral meds and better diet but on insulins the last few years. Its not a disease that really gets better.

The keto diet intrigues me, my only concern from the readings is the impact (if any) it will have on a diabetics organs (kidneys, and liver) Ketosis ---> ketoacidosis.. It seems the 2 are quite different and ketosis is perfectly ok?
In theory though, if I can survive on fat and practically no carbs it makes perfect sense and I'm all for it, as the fat has practically zero impact on b/g levels.

[hjs]

Some 14 or 15 years later I was fine one day, the next an incredible thirst and constantly urinating. I knew then exactly what it was. Went to the Doctor, readings off the scale.
Ironically I had been to the doctor a month or so prior and my b/g was normal.

Managed to control it for a while with oral meds and better diet but on insulins the last few years. Its not a disease that really gets better.

The keto diet intrigues me, my only concern from the readings is the impact (if any) it will have on a diabetics organs (kidneys, and liver) Ketosis ---> ketoacidosis.. It seems the 2 are quite different and ketosis is perfectly ok?
In theory though, if I can survive on fat and practically no carbs it makes perfect sense and I'm all for it, as the fat has practically zero impact on b/g levels.

Its something different.

Also carbs in itself are not evil, but overeating them is, we have only limited room to store carbs, as muscle glycogen and liverglycogen. If those stores are full, and without much phycical labour those often are, the body has no easy place to store them. And they will be stored as fat.
Eating carbs every means getting an insuline spike, eat carbs often will give manny. Getting those with full glycogen stores means the insulin can,t do its job proberly, and we get insuline resistant. D2 is the next step.

Carbs, if eaten, are best after exercise at that time there is room, the muscle have space. At other times fat and protein are better choices. Those burn slowly and do hardly influence our bloodsugar. They also have less volume, so you need less of those. In short if you work out hard, carbs are ok, depending on how much you burn. If not carbs need to be used very carefully.
The liver gets fructose, only the liver can proces it. In processed foods/drinks there are lots of fructose to find. Cheap and the most sweet sugar kind. This will not influence bloodsugar levels, but the liver has limited space to store glycogen. So overeat fructose and you get a fatty liver, just like lots of alcohol will do.
Remedy, only fructose in natural form, greens/ some fruit, for the rest, skip em.

Trying ketosis for a while is a good thing, it will teach you a lot about your body. Not everybody works great on it though. And it limits what foods you can eat enormously. Its great to get very lean, without hunger.

[GrantM]

Trying ketosis for a while is a good thing, it will teach you a lot about your body. Not everybody works great on it though. And it limits what foods you can eat enormously. Its great to get very lean, without hunger.

Thanks for the time taken to respond and the information provided. It really is food for thought and appreciated.
Honestly I believed I was consuming less carbs but in reality its well higher than I expected. As a result I was also struggling to get enough calories in just to maintain without pushing sugars out!

I have adjusted the diet already, stocked up on the good fats and will see how it goes.
1 unintended consequence was a real hypo low at 4am, waking up sweating and shaking like a leaf. I need to be more careful.
Never ever had a low like that .
I ate really well during the day and the night before (fat rich) but the carbs were not there and the meds the same.

Cut back on insulin and eating more calories. Winning.
I'm already pretty lean (185cm@77kg), and am doing some weights on the side along with the erg.
My 1 aim is to bulk up to 85kg, so taking on some extra calories now that it seems doable.
Lets see how it goes.

[hjs]

Your welcome, it takes some time to get used to a change, make sure you eat enough if you want to gain weight. And yes carbs are everywhere, easy to get a lot of them. After a while on low carb your bloodsugar should get very stable. But ofcourse I don,t know how your situation exactly is and if you still produce insuline yourself?

[GrantM]

Your welcome, it takes some time to get used to a change, make sure you eat enough if you want to gain weight. And yes carbs are everywhere, easy to get a lot of them. After a while on low carb your bloodsugar should get very stable. But ofcourse I don,t know how your situation exactly is and if you still produce insuline yourself?

Was able to control for a number of years with just oral Glucophage and diet, but over time it became harder and the levels went higher. My physician said it would.
I think the lights are pretty dim in the pancreas and have been for a while as I have been on both rapid (humalog) and long acting (lantus) insulin for some time.
I ate very late the night of the low which is not unusual for me along with normal dose of of both jabs. The Humalog did it with less carbs around.
I tended to overeating in the evenings which caused higher morning readings, so was expecting it to drop based on what I was eating, just not as much as it did, considering it was a pretty decent helping of food.

I am on 2/3rds my normal dose for the day so far with good control and feeling quite well fed Early days but I will stick with it, not being hungry is cool

Just got home so off for a 5k on the erg.

[jag]

I've had Type 1 diabetes for 41 years. I first got it about six months before I started college, where I first went out for our inter-collegiate crew team and rowed for a couple years. So I have a LOT of experience rowing with diabetes. When I was first diagnosed there were no blood sugar meters, no insulin pumps, the A1c test did not yet exist, and we were injecting animal insulin once a day. So clearly the technology of managing this disease has changed a lot in the time I've been living with T1.

I use the C2 rowing machine to stay in shape, and have owned a machine for many decades (I still have a Model A, though I also have a newer machine that I use instead). I am now rowing on the erg 5K, three times a week, and have been for several years. I supplement that with running 5K or so when I'm motivated and the weather is warm (New England slush isn't much fun to run in). It is part of my routine now, and it it very important in keeping my insulin sensitivity high.

I do not agree with the ultra-low-carb, ketosis fad that has taken hold in the past five years or so. Staying in ketosis requires you to only eat about 30g of carb per day; and eating that small an amount of carb requires you to stop eating a lot of foods and food groups that I consider healthy and that I eat every day (things like whole wheat bread, and fresh fruit, and vegetables like tomatoes and tomato sauce and corn, etc). I don't think a diet made up of only eggs and meat with a little bit of lettuce is good for me, though some people clearly disagree. As a T1 I need to inject insulin every day to stay alive. So I balance the insulin I take against the food that I like to eat, and it works well.

I'd be happy to answer any questions about diabetes, or erging with diabetes. One tip: erg before you eat a meal (I do it either before lunch or after I get home from work before dinner) - that way I can use the carbs I am eating with my meal to rebuild my glycogen.

[GrantM]

Hi Jag

Thanks for the input.
It must have been difficult 'back in the day' to manage something like this effectively.

I will give the keto a whirl for a while and see if its doable.
Even if not full keto the carb intake will reduce a lot and hopefully I get some better control.
I move around a lot for work and its darn difficult to eat correctly in those instances.
The last few days I have managed to pack in calories, and not feel at all hungry with pretty good control.
Yesterday my intake 61/18/21 (fat/carb/prot) today so far 62:13:25, although my lunch was not enough calories as I was at an airport waiting for my flight, it was inline with the plan. Which leaves me with a hefty meal later to meet the calorie target for the day.
I actually need to eat more during the day and less in the evening, something I need to address but something that is so difficult with work.

I'm with you on the bread, man I love bread, just some freshly baked rye bread with butter is delicious.
Last nights dinner had all this yummy chicken butter juice that was just begging to be mopped up with some bread, I ended up just drinking it

I'm a little reluctant (not sure why) to increase my rapid insulin dose without the doctor agreeing to it.My plan is to go back to the physician in the new year, after I have at least a full 3 months of reasonable control to assess bloods and hba1c for instance to get a picture of where I am now.
The last year or 2 my apathy and lack of paying enough attention to this is going to cost me, i know that.

My energy levels are up thanks to the better refocusing myself again and taking control, the erg really helps and I need to get back on my enduro bike again and get out there.

From the erg perspective, right now I am just building some fitness by trying to spend a regular amount of time on it. I'm not going to win any races
5km 4-5 times a week with some gym inbetween for now. I plan to mix it up a little later with a 10km included and drop a 5 for a 2km blast.
HR is down a bit but muscles are sore, legs let me down so much.
My stroke rate sits comfy 22-24, need to up that to work the heart a bit harder and ease of on the muscle

Thanks for the tip on eating vs exercise time it makes sense. I hit the erg right after work so it fits well with my routine.

[Shawn Baker]

https://m.youtube.com/user/drjasonfung

These are probably worth looking at as a diabetic

[left coaster]

Great string of video's Shawn!

For those with time to kill, and an interest in the role fructose plays in fatty liver (identified as an issue by the presenter Shawn shared), perhaps check out this link. High fructose corn syrup was introduced to stabilize the price of sugar in the 70's, this presenter argues it is a poison, fructose is ethanol without the buzz lol.

https://www.youtube.com/watch?v=dBnniua6-oM

[Carl Watts]

What isn't something that someone is calling a poison ?

I have noticed the fact if you stop eating the result is death so you just have to do the best you can with your diet. Pretty much everyone knows what they should be eating, actually doing it is a whole different story.

Have moved to Sushi for lunch, a protein bar every day and possibly a shake thrown in if its too hot and I really cannot face food after a row in the evening.I have found a hard training row is generally a big appetite suppressor, this is not the case the next day your generally chasing anything that moves with a spear and are repaired to eat it your so hungry The odd one out for me was swimming for 60 minutes, I came out of the pool changing rooms with the spear ready to go.

Will let you know how that stacks up in terms of the training.

[GrantM]

Thanks for the videos, will watch them over the weekend.

From my side I thought I knew what I was eating but since really breaking it down in fine detail recently I'm still trying to pick my jaw up off the floor.

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)

Have packed in the calories already (aiming for 2500/day), can have a good lunch and a light dinner (a goal) as most of my calorie intake done in the day when I need it.