Follow me as I try to tackle diabetes

[dalebert]

DISCLAIMER: I'm not a doctor and this is my personal layman's opinion and my personal chosen approach to getting healthier. I'll be consulting my doctor along the way.

For the short attention spans, just read this summary--
LDL cholesterol recently tested at > 200 which is extremely high. Tested positive for diabetes. Following up with regular blood glucose monitoring and a low-carb diet (contrary to common wisdom for high cholesterol which is to go low-fat, which means lots of carbs). I'm expecting this to lower my cholesterol. I believe it's a symptom of my diabetes which is not being controlled rather than seeing my high cholesterol as the result of eating fat and cholesterol. This thread will chronicle my results. If I suddenly stop posting, it might mean I died (kidding! mostly...)

Longer version--
I thought I was living a pretty healthy lifestyle and I guess I was for a "normal" person with a normal insulin response, but I got a red flag when my cholesterol was really high in a recent blood test. I had read many things about cholesterol being regulated by your body, particularly your liver, and if it's off, it's likely a symptom of a problem rather than something that happens from eating fat and cholesterol. A diabetic friend suggested I take an a1c test--$9 at Walmart. I did and it came back positive for diabetes. If you have ANY thoughts like you have symptoms, even minor, or high cholesterol, TAKE THIS TEST. IT'S JUST $9 AND IT MIGHT SAVE YEARS OF YOUR LIFE! I'm going to follow up with blood glucose monitoring to confirm as well as with my doctor next visit (as should you if your test is +). I'll be checking my blood sugar after all meals to see how my body responds to different foods. In the meantime, I'm doing what my diabetic friend did when his cholesterol was even higher than mine (yikes!) and which worked perfectly for him. I'm going on a very low-carb diet; < 30 g / day.

A little history--
I went kind of low-carb (<100 grams a day) several years ago and immediately experienced a dramatic health benefit. Little did I realize that I was showing signs of diabetes even then--fatigue almost all the time but particularly after eating was a big one. I needed a long nap every afternoon shortly after lunch and I couldn't stay up late at night to save my life. Within about 3 days of taking most carbs out of my diet and replacing them with protein, fat, and fiber, I was suddenly able to stay awake all day easily and even stay up late at night when I wanted and just sleep in a little in the morning without it being a major disruption to my sleep patterns. I was sleeping LESS at night as well and waking up feeling completely rested. My allergies faded quite a bit as well along with headaches. This made no sense to me. I chalked it up to a gluten sensitivity which may have been slightly off the mark. I'm thinking that high-gluten foods probably also tend to be high-glycemic. The volume that I ate seemed to matter.

Now--
Over time my diet deteriorated. I convinced myself gluten was my primary problem and cut it almost completely out of my diet but I continued to eat rice and corn-based things fairly regularly and I would cheat fairly frequently with sweets like ice cream or gluten-free baked goods. That said, I still feel like my diet has been fantastic compared to most for a person with a normal, healthy insulin-response. I've now been on <30 g/day for just a few days and already my allergies and asthma symptoms already seem to have dwindled despite it finally being Spring and I have more energy again. I haven't been napping like I did before going low-carb several years ago but that has been starting to happen some days again on my low-gluten but moderate carb and occasional cheat-with-sweets diet.

So we'll see how this works out. It's a bit of an experiment considering I'm going against the advice of my doctor who simply prescribed lipitor and suggested I go low-fat, though he only knows my cholesterol is high. He didn't even think to test me for diabetes, which btw, BLOWS MY MIND! Why don't they do this immediately when cholesterol is high considering how cheap and easy it is to test? This experiment may be a flop or I may even find out the test was not accurate. Regardless, I'll let people know here.

Wish me luck.

[DriftingCrow]

Good luck Dalebert! 

[dalebert]

Are you a derpabetic like me?

That's my (obnoxiously judgmental) word for when you did it to yourself with your diet and lifestyle. Some people are born diabetic (not derpabetics), and others are made. It seems to be happening to a lot of people. If you already know you're diabetic and are taking necessary measures to control it, then you've probably graduated from the offensive term. Depending on your genetics, you may be more or less prone to it. If you're not prone to it, then maybe you have a fantastic insulin response and can eat lots of bread, pasta, rice, cake, candy, etc. and never have your blood sugar spike above 100 your entire life. If not, every time you tax your insulin response by raising your blood sugar, you may be damaging it irrevocably. I appear to be in the middle somewhere. If I'd known, I should have been eating a (reasonably) low-carb diet for much of my life. Now I probably have to eat a more drastically low-carb diet to avoid health problems.

You absolutely have to pay attention to glycemic indexes if your insulin response is damaged. Here's a handy chart of sweeteners. Most of them are just out of the ball park completely, but a few, like Stevia, actually seem okay. Here's another chart for many commonly-eaten carbohydrates. My understanding is these numbers are obtained by diabetics eating those foods and then checking how it affected the blood glucose levels. High = BAD. Many of the numbers are surprising. Certain carbohydrates, like bread, crackers, etc. are actually already turning into sugar in your mouth just from saliva, and what isn't is rapidly turned to sugar in your stomach.

I'm avoiding just about everything on the second list until I can start monitoring my levels better to see how my body is reacting to them.

[dalebert]

My sister just got the a1c test when I told her I was positive and is also diabetic, though just barely past the "official" number so doing a little bit better than me. I don't know how good the accuracy is but I understand that if you test past 5.8, that's a pretty solid indicator. Some people argue for 5.7 as a clear indicator of diabetes. It doesn't hurt to know so you can follow up with a doctor for assurance.

My sister's a big fan of bread she makes from milling the grains herself, which may be fantastic stuph... if you have a healthy insulin response.  She taught me and I used to mill my own grain and make it all the time not realizing it was poison for me. I told her to just check her blood sugar after meals to find out if it's actually a problem for her. I can't imagine that it wouldn't be considering even whole wheat bread has one of the highest glycemic indexes of anything. It's higher than a snickers bar. I guess the fat in the candy bar slows it's digestion and absorption. *shrug* That's just a guess though. No idea. Maybe her bread has a lot more fiber than the stuph on the grocery shelves but I'm pretty sure it was still contributing to serious health problems for me when I was eating it regularly.

[Sarah Louise]

With an A1C of 5.8, its mostly just eating reasonably and exercising.  I doubt the doctor would put you on orals and definitely not insulin shots.

Good luck, I hope you stay at that level.

[ErinWDK]

Dalebert,

See your doctor and get a real medical lab test for HbA1C.  I wouldn't trust a $9 test at Walmart for anything more than to send me to the doctor.

There are a lot of things that can be done.  Cutting carbs is one.  Exercise is a better one.  The biggest one is see the doctor!

Here's the best to you in dealing with this!


Erin

[dalebert]

With an A1C of 5.8, its mostly just eating reasonably and exercising.  I doubt the doctor would put you on orals and definitely not insulin shots.

Sorry, I was talking about my sister and I forgot to mention her result. It was 5.9. 5.8 is apparently what they use to diagnose it as diabetes. I agree though that diet and exercise should be able to control it. Mine was 6.4 and that's what I'm doing.

See your doctor and get a real medical lab test for HbA1C.  I wouldn't trust a $9 test at Walmart for anything more than to send me to the doctor.

I've now put in bold the line where I said I was going to do that. I can understand you not seeing it since it's kind of lost in the middle of a long post and some folks probably just read my summary. I also recommended others do the same and not rely on that test, but it's a good starting point if you're having some symptoms like high cholesterol or fatigue. And some folks can't afford to see a doctor trivially whereas the test might convince them to go. Mine's hard to see quickly. It's the VA, after all. I'm not doing anything drastic in response. I'm eating what I believe to be a healthier diet regardless and taking long, vigorous walks every day. I've now received glucose monitoring gear and that should help me to confirm it or not and give me some data to take to the doctor. I'm starting off very conservative with my eating but I'm going to venture into low glycemic carbs in moderation at some point and test to see what it does to my levels.

But to be completely honest, If he tries to prescribe drugs, I would probably want to continue what I'm doing first before I resorted to that. I feel like doctors are just a little too quick to try that before healthier measures. So I kind of feel like it's important to do but not a crazy rush since it's not going to change my behavior, not right away at least.

[dalebert]

Yesterday was my first day of monitoring. I've been on an extremely low-carb diet so far. Again, maybe I'll venture into some low-glycemic carbs in moderation after a while but I'm being ultra-conservative to start. I only tested at the one hour mark after eating (because I failed to order extra lancets--DERP!) and my levels were in the 80s all day. That doesn't surprise me considering what I'm eating and it corresponds to how good I feel.

I really don't understand this and I'm just speculating, but my asthma and allergies, which have re-emerged in the last year or so with a vengeance, have rather suddenly seemed to all but vanish completely this last week since I changed my diet. I've looked puffy in general, especially in my face. My face looks leaner to me now. I feel like I look 10 years younger. I understand blood sugar spikes are very inflammatory which may be why they damage your circulatory system so that makes me wonder if I was making minor allergic reactions much worse by piling general inflammation on top of them. I imagine if you're allergic to something, having your sinuses and lung tissue inflamed all the time would make them much more sensitive to those allergens. Again, I'm just speculating. I'll ask my doctor about that too.

This may be a little weird. I have been wheezing and out of breath for months now and been seeing several specialists about that. I'm scheduled for a breathing test before they can start giving me immunotherapy shots. I have practically no symptoms now to speak of so I wonder how that will go. I guess I'll explain to that doctor about the test and maybe he can get an appt going with my GP to follow up.

[Sarah Louise]

I urge caution as you move forward.  Sometimes people go overboard in their approach.

You mention your in the 80's all day and test after one hour.   The normal testing is two hours after a meal and a good reading would be anywhere from 100 to 130.  A reading of only 80 after one hour could indicate you have gone too far in your reduction of carbs.  Having lows can be as dangerous as having high readings. 

Make sure you see a doctor and get them to diagnose you as diabetic then see a good dietician.

[antonia]

Ditto, I'm a Type 1 Diabetic and I strongly urge you to go in and get checked and go see an endocrinologist and get a referral to a dietician and an eye doctor.

Recommended carb intake is 45gr per meal for women and 60g for men with diabetes and the more complex the carbohydrates the better.

Remember that Type 2 diabetics are also susceptible to hypoglycemia and unless you want to pass out and possibly die you need to be careful.

I urge caution as you move forward.  Sometimes people go overboard in their approach.

You mention your in the 80's all day and test after one hour.   The normal testing is two hours after a meal and a good reading would be anywhere from 100 to 130.  A reading of only 80 after one hour could indicate you have gone too far in your reduction of carbs.  Having lows can be as dangerous as having high readings. 

Make sure you see a doctor and get them to diagnose you as diabetic then see a good dietician.

[dalebert]

I should point out that my results do not officially put me in the range for diabetes. A pharmacist said anything under 7 is "fine". But then I found out that 6.5 is the criteria for diabetes so I'm not sure where she's getting that idea. I think most of the people who take the test are already diagnosed diabetics and that's considered okay for them. A healthy person should still be not much higher than 5 and diabetics who aim for healthy numbers will generally do better, at least according to a growing community of medical researchers.

My sister just sent me this article.

I've been on this few carbs before for several weeks with no problems though, as I already said, I'm going to figure out what I can safely eat by monitoring my responses and I imagine I will decide to loosen that a bit. When you say 100-130, I think you mean what is expected for diabetics. My understanding is 80s to 90s is normal for a non-diabetic and that those healthy people would almost never go over 100 even if they pigged out on sweets. I believe the doctor who invented the idea of personal glucose monitoring, who was a type 1 himself, set his personal target at 84 and he lived into his 70s which was unheard of for the medicine of the time. He bucked the conventional wisdom in a lot of ways and inspired a lot of the changes that seem to be coming down the pipeline of new medicine.

[Jill F]

This is totally doable.  When I was sick a couple of years back, I put up an A1C of 10.5, and the doc declared me diabetic.  This was not actually the case for me, but I started taking really good care of myself because I have a cousin who didn't and she's about to be minus a foot.

Monitoring what you ate and what your blood glucose was afterward is a good idea.  I did this religiously and ended up cutting carbs permanently.  I lost a lot of weight quickly, and I noticed my numbers going down a bit.  If you can lose 10% of your body weight, I guarantee the numbers will go in the right direction.  Also, an hour of brisk walking every day dropped my numbers to where I had to eat constantly to keep my blood sugar up, and I ended up going off all medications while still checking my blood glucose religiously.  It was fine.  I showed my log to my new doctor, and he thought the numbers looked normal.  I went out one night and had a carby dinner, checked my blood sugar one hour later and it was 155, which really bummed me out.  My doctor told me that "normal" people can have brief spikes up to 200.  As long as it drops within an hour or so, you're OK.  An hour after the 155, it was 85.  Anyway, I know now that I have a potential for a problem later on and I have adjusted my lifestyle accordingly.

Lose weight.
Eat smart.  Three meals a day and a snack before bed.
Get exercise.  Cardio and weights.  Building muscle improves insulin resistance.
Don't cut out carbs completely.  If your body isn't processing them regularly, you can end up making the problem worse.

Of course for me, losing the weight and gaining muscle dropped my endogenous estrogen and raised my T to where my dysphoria went through the roof and forced my transition...

[dalebert]

A trans lady friend of mine just told me that she's diabetic due to HRT. Has anyone heard of that? This was a new one for me.

This thread has gotten long enough that I can't remember if I said it. A friend of mine tested around 10 with EXTREMELY high cholesterol. He got them both down without medications and is now on a 30g per day low-carb diet--6g breaky, 12g lunch, 12g dinner. I don't think I will have to be that drastic but he keeps all his numbers in a healthy range like that, including cholesterol. He eats bacon and eggs every day for breakfast and nothing but meat and vegetables the rest of the day. His highest spike is 110 and he's not thrilled with it (It may be higher during the hour after eating. That's after minimum 1 hour). He feels he could do better if he'd caught it earlier.

Also, an hour of brisk walking every day dropped my numbers to where I had to eat constantly to keep my blood sugar up, and I ended up going off all medications while still checking my blood glucose religiously.  It was fine.  I showed my log to my new doctor, and he thought the numbers looked normal.  I went out one night and had a carby dinner, checked my blood sugar one hour later and it was 155, which really bummed me out.  My doctor told me that "normal" people can have brief spikes up to 200.  As long as it drops within an hour or so, you're OK.  An hour after the 155, it was 85.

It was the opposite for me. For years, I needed to eat very frequently and I could tell my blood sugar was dropping regularly even without testing it. At the time, I was pretty clueless about diabetes, but when I watched Fathead, that's when I had suspicions that I was prediabetic (turns out I was). Then I dropped to <= 100g/day and I could soon go many hours without eating and feel fine. I started sleeping better at night and stopped needing naps every day. I started waking up every day not hungry for breakfast until Noon. I gradually creeped up to a bit more carbs, maybe 150, though much less than the average person, but cheats with sweets 2 or 3 times a week. I thought I had it under control until just recently when my cholesterol was tested.

There is growing evidence that lots of type 2s can go into remission (I hear the word "cure" bandied about, but that's misleading), and actually recover a degree of their body's regulating mechanisms by more strictly controlling their glucose spikes. My friend is just an anecdote but there's growing data out there. Maybe a reason doctors might say that glucose spikes are okay is because they've seemed unavoidable for diabetics under old-school methods of control, but there's growing evidence that diabetics can control those spikes better and, in turn, control the illness better. It seems many doctors lower the standard for us instead of raising them, which seems odd to me.

[dalebert]

My glucose readings have been much better than expected. It's enough to question whether I did the test correctly or it may just mean that my case is a mild one. Either way, changes in my diet in response have seemed very good. I wonder if my results would be different if I hadn't started monitoring after having dramatically altered my diet for a while, i.e. maybe I should have been testing while I was still being very bad. All my diabetic-like symptoms seem to grow over time as I eat badly and seem to rapidly improve when I clean up my act.

I was seeing a doctor about another minor problem that I don't care to go into, but he asked me if diabetes ran in my family. I told him about my diabetic grandmother and that I had tested positive on the hba1c and said to see my doctor, of course, and I will.

I hope I get to come back here and say "I'm not diabetic!" We shall see. The only downside is I thought I'd found the cause of my cholesterol issue and that may be more like trying to sword-fight a fart.

[dalebert]

I hope I get to come back here and say "I'm not diabetic!" We shall see.

Well, no. Oh well. My friend came over and brought his meter so we could compare readings between them. Then we both downed 20oz of soda, about 77 grams of carbs. I spiked at about 140 in an hour verified on both meters. Fortunately, it dropped at 1.5 and 2 hours. That's a good sign that mine hasn't progressed too far but I definitely would not get 140 without some sort of issue. I probably haven't been using my meter quite right and I think we figured out what I was doing wrong.

So yeah. Still prediabetic but not a horrible case of it. Very manageable. I'm going to experiment with some resistant starches shortly and test how I react to those. Will update, as usual.

[Jill F]

Dreamfield's pastas are your friend.

140 isn't horribly bad for that much sugar after an hour, but I agree that it's smart to watch out, because these things do progress if you don't.

[dalebert]

140 isn't horribly bad for that much sugar after an hour, but I agree that it's smart to watch out, because these things do progress if you don't.

You're right. It's really not bad for what I drank and I'm glad that my case seems to be pretty mild. Of course, I don't want it to spike that high or I doubt I will get my cholesterol under control as well as other related health problems.

Last night I went to a party. My friend had said that whisky actually lowers his blood sugar, so that was my drink of choice. I checked one hour after about two shots worth and it was 77. I expected to be mid-80s because I'd eaten dinner just a couple hours before plus I had just snacked on some feta and pepperoni that someone brought. Then after a couple more, I'd dropped to 69, the lowest I've tested since I started a couple weeks ago. So uh... I ate just a little bit of chips and hummus at that point. hehe. Do not try this at home! I do not recommend whiskey for controlling BGLs. 

[dalebert]

BTW, I don't think I mentioned the reference. My friend (his case is much worse than mine) who has been helping me through this got his blood sugar levels and cholesterol levels under control without drugs or insulin following the guidelines put out by Richard K. Bernstein, MD. He's got several books out. He's been a type 1 diabetic since he was 12. He's now very healthy in his 70s. Not everyone can control it without drugs or insulin. It depends on how bad it is and how far it's progressed. Dr. Bernstein himself has to use insulin, but he dramatically reduced how much he needs and he keeps his blood sugars in the normal non-diabetic range. That seems to be at the foundation of his philosophy--that diabetics should try to keep their blood sugar in the normal range or as close to it as possible and that all the complications from diabetes are tied to that.

I'm really encouraged that by watching what I eat carefully, I can mostly stay in the 80s after a meal. I believe Bernstein sets the ideal target at 84. I haven't read his books yet; just getting the info second-hand from my friend. It seems unnecessary for me since I seem to have a handle on it with some basic adjustments to my diet but I may read them at some point anyway, even if just so I can help my friends and relatives who discover they have a problem.

Dreamfield's pastas are your friend.

What BGLs do you reach after eating it? I'm pretty optimistic about Miracle Noodles. I understand they're practically all fiber and almost zero effective calories. Maybe Dreamfield's is similar. The cool thing is there is no need to guess when you have a meter. If I found I could eat it without spiking my sugar about the 80s, then I would eat them. I don't really crave noodles that much anymore but I may try them both at some point just so I can post my results.

[LordKAT]

My story is backwards I think. a1c says I'm low. After 3 whiskey and sours, my blood sugar was so high that the meter took forever and was like 252. I went to the doctor on advice of my friend who is diabetic, They seemed to see no cause for alarm.      It has been checked several times since then and a1c remains low.

[dalebert]

After 3 whiskey and sours...

FWIW, sour mix is loaded with sugar so that doesn't surprise me IF you're diabetic. I was drinking mine with nothing but a squirt of lemon juice. Maybe that was just a fluke because 252 is higher than any non-diabetic should hit no matter what they consume and the a1c is a pretty good indicator. Very occasionally my meter says something ridiculous like 24. I just do a new reading more carefully--make sure my skin at the site is clean and dry, make sure I give it enough blood, etc. The 252 may have just been a fluke, a slight error in how you did the reading or a glitch in the meter, or it's possible the a1c was a fluke. Maybe do it again sometime if you're at all worried. *shrug*

Oh, disregard that last part. You've already checked it several times. That incident was probably a fluke.