Type 2 diabetes and victory

[Carl Watts]

https://m.youtube.com/watch?v=ihx3yrAvD3g

Wonderful little documentary on the power of lifestyle intervention on diabetes and obesity- just aired on BBC this Thursday, wish we could do this will all our patients

Great viewing, watched it start to finish.

Being born in the UK and moving out here when I was 7 years old made it feel relevant to me.

A couple of points there, shift work kills your fitness. Did it for 6 months and it totally destroyed my rowing.

Interesting about cancer and 90% of it is not inherited.

And last but not least, true obesity and the blood sugar levels and what is considered "Normal".

[Shawn Baker]

For a very enlightening and easy read about cancer

"Tripping over the truth" by Travis Christifferson is a wonderful distillation of the work of Dr. Thomas Seyfried of Boston College

[GrantM]

Carl I bet with that result you would be able to get your hba1c back into normal levels just by taking more time understanding what you are eating.
Correct, this test is used to give doctors an averaged idea of how you have been over a number of months.

The daily testing us diabetics do is completely different and actually measure glucose levels at that specific time.
This explains it pretty well, and the bgl testing difference in layman's terms
http://www.diabetes.co.uk/what-is-hba1c.html

BGL self testing is very helpful to understand how foods and quantities thereof, are affecting your bgl during the day.
Typically, to get a good idea one would test before the meal, and then 2 hours after, as this gives the digestive system some time and the difference between the before and 2hour after reading provides a pretty clear picture of how you have handled what you have eaten.
If you have a clinic at work they will surely do it for you a few times if you ask or want to.

Nice documentary Shawn, thanks.
Quite an eye-opener for that family.

[jag]

JAG, While admittedly extremely rare, there have been a few documented cases of type 1 diabetics managed by diet alone (low carb), many type 1 diabetics that choose a low carb diets are often able to reduce their insulin requirements. I am often amazed at the extremely high dosages of insulin type 2 diabetics are on these day (I routinely see well over 100 units per day, in my type 2 patients)- they just become increasingly more insulin resistant due to all the extra insulin and then their dosage continues to go up (a vicious cycle). Your recommendations are fairly well aligned with what the ADA recommends, unfortunately for a significant percentage of those patients the carb content is still too high. Of course you can always just add meds and increase dosages to keep the blood glucose in check!!- I am squarely in agreement with Dr. Fung (videos I posted earlier) that for type 2s the more pressing problem is too much insulin production. Also, I routinely utilize carbohydrates depending upon the type of training I'm doing and don't think for many people they are a problem- I also severely restrict them much of the time as well. I think if you have issues with insulin resistance than you should taper down the carbohydrates until it is no longer a significant issue and then add them back in as tolerated. Expirement and see what works for the individual.

Shawn, I just can't let this non-fact be left unanswered, because someone may come along and believe it. This is NOT true - it is NOT possible for a type 1 diabetic to manage by diet alone once they are past their "honeymoon" period. They NEED insulin. I strongly suggest you go back to your medical textbooks for information on this, and stop believing the internet, because you have been misled. It is true that less bolus insulin will be required for T1 diabetics who are eating a very low carb diet, though they still need just as much and typically more basal insulin in return. I hope you're not suggesting that a T1 diabetic should try to minimize their insulin intake - because that is what leads to high blood sugars and potentially diabulemia and all the health risks associated with those conditions.

I think the ADA suggestions are healthy and would recommend them to anyone. By eating the ADA diet I do not have issues with insulin resistance, and in fact I'm the same height as you but weigh significantly (20%) less.

[Shawn Baker]

Jag- I'm not advocating Type 1 diabetics come off insulin as it is a very different entity from type 2 diabetes. However, I think it is worth investigating if carbohydrate reduction impacts ones requirement for oral meds and/or insulin.

Just for the record this is a recent study of a type 1 diabetic managed so far 19months without insulin (possibly still in honeymoon phase) but regardless likely to have a much lower exogenous insulin requirement than someone managed with a more traditional diet.

http://www.ijcasereportsandimages.com/a ... l-text.php

I see the full spectrum of diabetic complications and it progressive destructive toll it takes on people's lives despite medications and following the same dietary advice you recommend (again it works for some, but for many it doesn't). Everyone is a bit different with respect to how they respond to meds/diet/exercise etc...- again it just make sense to experiment with diet and see what works best.

As regard to our bodyweight difference I suspect I carry a bit more muscle mass as I come from a fairly high level strength training background and currently sit around 10-12% body fat.

[GrantM]

A moment of weakness.
I've been pretty good over the last 2 or so weeks but craved some bread today.
I had 3 slices of this rye, with unsalted butter, cold beef and lettuce.

Before I had a 6.5. Had 10 units of humalog prior and 2 hours after 11.5

Cant even look a carb in the eye these days.

[left coaster]

An interesting addition to the thread http://www.sciencedaily.com/releases/20 ... 141231.htm

[Shawn Baker]

An interesting addition to the thread http://www.sciencedaily.com/releases/20 ... 141231.htm

Yes there is quite a bit of current thought regarding the "reversibility" of type 2 diabetes- much of it has to do with significant dietary changes

[left coaster]

It does leave me wondering how long it takes to re-establish the fatty pancreas. I'm guessing that maintaining the unhealthy lifestyle could cause a cycle quite quickly i.e. fast a week, recover from type 2, carry on with the norm, get type 2 in a few weeks, repeat... the diet change would likely need to happen right away, along with the maintenance of regular exercise.

[jag]

Jag- I'm not advocating Type 1 diabetics come off insulin as it is a very different entity from type 2 diabetes. However, I think it is worth investigating if carbohydrate reduction impacts ones requirement for oral meds and/or insulin.

Just for the record this is a recent study of a type 1 diabetic managed so far 19months without insulin (possibly still in honeymoon phase) but regardless likely to have a much lower exogenous insulin requirement than someone managed with a more traditional diet.

http://www.ijcasereportsandimages.com/a ... l-text.php

I see the full spectrum of diabetic complications and it progressive destructive toll it takes on people's lives despite medications and following the same dietary advice you recommend (again it works for some, but for many it doesn't). Everyone is a bit different with respect to how they respond to meds/diet/exercise etc...- again it just make sense to experiment with diet and see what works best.

As regard to our bodyweight difference I suspect I carry a bit more muscle mass as I come from a fairly high level strength training background and currently sit around 10-12% body fat.

Shawn, I'm afraid I have to again disagree with your conclusion. The paper as cited is about a single diabetic who was diagnosed as an adult, and adults are known to have longer Honeymoon periods than those diagnosed as juveniles. Several or many months of Honeymoon is not unusual for adults. Furthermore, the paper reports that this single diabetic was free of insulin for 6 months, not 19 months, and notes that it could well be due to his being in Honeymoon period: to quote "Follow-up at sixth month in the case of our patient is relatively short and the positive results may appear as a honeymoon effect."

I doubt very much that the patients you are seeing are actually following the ADA diet. It is much more likely that they are following the standard american diet (SAD), which is a terrible diet made up of tons of processed and fast foods with tons of sugar and tons of saturated fat coupled with virtually no exercise. That said, I do agree with you that it is important for everyone to experiment and find a good and healthy nutritious diet that they will be able to follow in the long-term. The keto diet is way too restrictive for me to follow long-term, but if you think it is healthy and are able to stick to it long-term, then by all means go for it.

As far as body weight and muscle mass, who knows (I will point out, though, that I rowed heavyweight crew in college so I'm not a newcomer to strength training). The point I was trying to make was simply that I consider myself one example of a long-term (41 years and counting) diabetic who eats pretty much following the ADA diet, while successfully maintaining blood sugar, body weight and muscle mass. And all, I think I should add, with the help of my C2 rowing machine, which is why we're all here in the first place.

[Shawn Baker]

Jag- sorry I linked the wrong type 1 study- here is the 19 month study

http://www.ijcasereportsandimages.com/a ... l-text.php

Agreed- do your own self expirement and see what works regarding diet- also interestingly some new studies are coming out that indicate that tightly controlled blood glucose in type 2s may not correlate with better overall long term health outcomes- so another wrench thrown into the diabetes equation (some suggesting that controlling hyperinsulinemia is the real goal)

[GrantM]

I have honestly learnt more about this disease in the last few weeks in this thread than I have in the years of living with it.
For that I really thank everyone for their contributions.

I have been trying to pack 2600Cal a day, but often below 2000 as it is difficult as I am not that hungry anymore and sitting at a desk and driving or flying to one meeting after the next is not exactly manual labor, so have had a bit of a rethink.
I can have a high cal breakfast with nothing more than a snack for lunch, if needed, to easily see me through the day with good bgl. Still very small dinner. That already strips out 7 units of humalog I would normally use during the day.
Getting a better handle on the after breakfast bgl's as well but still dropping a bit to much after insulin, so either a little less or a sneaky carb thrown into the mix, will get there.
So am backing off to around 2000cal/day for now (which seems to be what my average has been anyway). Been getting home late quite often and not exercising as much as a result, so going to try and switch that up as well with a morning or 2 thrown in to compensate. That should help me maintain the intensity I want, then I can eat more calories as needed.
I have actually lost half a Kg despite trying to add
7 day averaged

dt.jpg (72.37 KiB) Viewed 8278 times

Was not feeling very good today so going to the GP tomorrow for some bloods and a overall checkup, not hba1c, just standard stuff to make sure what I am doing is not doing anything else that's not cool.

[legion]

If your classified as obese, for which the number is all over the place from 25% upwards (personally I tend to think of it at 35% and above... blah blah blah

I can't help but think you're trolling this group, Carl. If you have a 38" waist you're nowhere near fit unless you're 7' tall. You also can't make up parameters for what is fit.

My home electricity bill was upwards of $120.00 but personally I tend to think of it as about $40.00 so I'll pay that...

Not trying to game you here but you don't get to pick your own health statistics. It may be uncomfortable to view your own health and mortality in objective terms but you might want to consider it; statistics can be overlooked but only you wind up paying the price.

[Shawn Baker]

http://www.uab.edu/news/innovation/item ... -diabetics

Way to go UAB

[GrantM]

Thx Shawn

The first rule of HFLC is we are not supposed to talk about it, apparently

Well I took hjs's initial advice offered as a trial run (and others) a month ago and a BIG thanks is in order, at least in the short term!

Low carb high fat is the best route for people with sugar problems. Teach your body to use fat instead of carbs.
Search for ketonic diets.

I'm obviously still very diabetic, but my bgl's are much more in check and manageable (significantly so I would state). I still require my insulins, but less, maybe 25% as it stands now is a good average, despite packing in more calories/day! Actually its a struggle to get more cals in cause I am full, so have backed off a little. I used to be starving all the time.
After 2 years or so of self dis-interest (as indicated in my first post) I had zero control, even when trying to revert. I acknowledge this is my fault and in the process made it worse.
Never the less, in my humble opinion just from my own singular experience, more emphasis needs to be directed to this sort of eating plan for people like me, more so than the traditional just forget sugar and eat less carbs. It's not nearly a strong enough message!
Obesity is nowhere near my issue, I'm hovering just above a lite weight.

Jag mentioned LADA (thx), I have a sneaky suspicion I might be there, but reduced carbs is certainly helping my cause. Time will tell in Feb.

I'm also checking my ketone levels on and off with the urine strips (not highly accurate but a gauge nonetheless). Certainly in the keto range, not DKA, sometimes it drifts out to normal if I check after exercise, not sure why?
My cal intake daily now is comprised of less than 5% carbs. I have not felt any worse coming off much higher carbs, apart from a bout of flu going round the office.
Also taking a multi vitamin daily for good measure.
I have had a few wobbly low bgl's along the way which I am (i think) starting to understand, some days the insulin seems to be more effective than others, but getting there. Not an issue as long as I don't overdo the dose at night.
So in short its working for me from a diabetes perspective.
I still row like a granny though, but working on that too.