Diabetes

[Rambler]

Johnnie, is she checking her blood sugar? If not, she needs to. Get her a kit at CVS or Rite Aid or Walgreens for 10-15 bucks. If her blood sugar is much over 100 first thing in the morning before eating or drinking, she'll need to check with her doc about upping the metformin or adding another drug. If it is beyond 120, I'd get her to the doc within a few days. If it is a lot higher than 120, get her in to the doc urgently.

Not a doc, but have a couple diabetic friends. Maybe Rich or Meadbh will chime in on this one.

R

[haha]

Quote:

Originally Posted by DFW_M5 I realize the AIC is a time based average, but normally my Dr does both the fasting glucose test and AIC from the same blood draw (quarterly). May be other Drs do it differently.

It's not that A1c must be non-fasting, it's that it need not be done on fasting blood.

Ha

[eytonxav]

Quote:

Originally Posted by haha It's not that A1c must be non-fasting, it's that it need not be done on fasting blood. Ha

Yes, I am well aware of that Ha

[haha]

Sorry; I thought I was responding to a misunderstanding. This is all quite complicated, and doctors often seem to not particularly want us to understand what is going on.

I really do not see the point of the fasting blood sugar test anyway, unless the person's home meter readings show morning highs. If FBS is high, the patient probably has already damaged his pancreas. Best quick and dirty test would be to drink a Coke and an hour later have blood drawn. When glucose is coating the cells, the cells don't ask are you fasting or not.

Years ago my Dad's doc put him through glucose tolerance tests every so often. Why? Did he think that Dad was going to suddenly stop being diabetic? Fat chance.

Ha

[eytonxav]

Quote:

Originally Posted by haha If FBS is high, the patient probably has already damaged his pancreas. Ha

I don't think that high FBS necessarily means you've damaged your pancreas. I am one of those that gets a glucose dump from the liver early in the morning due to Dawn Phenomenon which I believe can even affect non-diabetics. The good news is my quarterly A1Cs have been rock steady at 5.5 since first being diagnosed with T2 in August 2008. Unfortunately, I have been a carb lover most of my life, and should probably be reducing my carbs even more which is something I believe you have astutely pointed out in various posts. Ideally, I'd like to see my A1Cs closer to 5.0. Its a tough disease, but with proper care/monitoring, good nutrition and exercise to maintain a healthy weight and LBM, one can live a long and active life.

[rescueme]

Quote:

Originally Posted by haha Sorry; I thought I was responding to a misunderstanding. This is all quite complicated, and doctors often seem to not particularly want us to understand what is going on.

As I mentioned previously, the condition requires the patient to be either act as their own "doctor", or learn to "push" to get the right info.

Most general practice doctors do not know much about long term maintenance of the condition (the exception for me of course is that my PCP's mother had T2, and my PCP cared for her for many years).

Very few PCP's have a good background in endocrinology, and many areas of the country have few endocrinologists available for those that have a "run of the mill" T2 (as I do).

As I said, I was diagnosed slightly over ten years ago. Over that time (just speaking for myself), the success of managing the chronic condition was primarily my responsibility (I will kill for a slice of pizza ), with the "assistance" of my PCP who orders the BT's.

It's not a disease that you can just sit back and let others (e.g. doctors) take care of you. You must be an active participant, and sometimes your own research will allow you to become your own "specialist".

- Been there - still there (still kicking) ...

[eytonxav]

Quote:

Originally Posted by JOHNNIE36 Been reading this thread now and then and I am concerned about DW. She has type 2 diabetes and takes metformin medication. However, I think she is getting worse instead of staying at a normal level, whatever normal should be. In the last year she is getting worse. Tired all the time, drinks six to seven bottles of water daily plus three or four Diet Cokes. Got her up this morning at 7:45 to watch her sewing shows and she fell asleep watching them. Not the first time that happened. I have never been around a diabetic before and don't know what to look for. I wouldn't know if she is having some kind of attack or if her actions are normal for a Type 2. Oh yeah, always hot. Turn on the fans! What's the A/A set at? Need some feedback. Thanks in advance.

Hi Johnnie,
Your DW should certainly be monitoring herself with a meter and getting periodic blood tests (probably quarterly) from her Dr. If she is seeing a recent change with respect to any of these: energy level, excessive thirst, change in eye sight, weight, numbness in hands/feet, it would be prudent to see the Dr. ASAP. Of course some of these symtoms may not necessarily be caused by diabetes, but I would take action and get her checked out.

[eytonxav]

Quote:

Originally Posted by rescueme As I mentioned previously, the condition requires the patient to be either act as their own "doctor", or learn to "push" to get the right info. Most general practice doctors do not know much about long term maintenance of the condition (the exception for me of course is that my PCP's mother had T2, and my PCP cared for her for many years). Very few PCP's have a good background in endocrinology, and many areas of the country have few endocrinologists available for those that have a "run of the mill" T2 (as I do). As I said, I was diagnosed slightly over ten years ago. Over that time (just speaking for myself), the success of managing the chronic condition was primarily my responsibility (I will kill for a slice of pizza ), with the "assistance" of my PCP who orders the BT's. It's not a disease that you can just sit back and let others (e.g. doctors) take care of you. You must be an active participant, and sometimes your own research will allow you to become your own "specialist". - Been there - still there (still kicking) ...

^^^ These comments are right on target, good post.

[rgarling]

Quote:

Originally Posted by DFW_M5 I don't think that high FBS necessarily means you've damaged your pancreas. I am one of those that gets a glucose dump from the liver early in the morning due to Dawn Phenomenon which I believe can even affect non-diabetics. ...

"High FBS" and damage to b cells -- of course this depends on how high your level is in the morning. If you are over 100, you should be concerned. Normal healthy individuals do have an increase in blood sugar in the early morning. e.g. from about 85 to 90.

Take a look at this chart: What is a Normal Blood Sugar?

[eytonxav]

Quote:

Originally Posted by rgarling "High FBS" and damage to b cells -- of course this depends on how high your level is in the morning. If you are over 100, you should be concerned. Normal healthy individuals do have an increase in blood sugar in the early morning. e.g. from about 85 to 90. Take a look at this chart: What is a Normal Blood Sugar?

My FBS are ususally below 110, but I also take a BP medicine at bedtime which may affect it some. But, I still need to lower my carbs for better results.

[rgarling]

Quote:

Originally Posted by DFW_M5 ... I still need to lower my carbs for better results.

Low carb is good, but intermittent fasting appears to be even better for correcting metabolic issues. Combining the two would be very powerful.

[eytonxav]

Quote:

Originally Posted by rgarling Low carb is good, but intermittent fasting appears to be even better for correcting metabolic issues. Combining the two would be very powerful.

I have not heard of intermittent fasting before, so I googled it:
Intermittent fasting - Wikipedia, the free encyclopedia

This sounds more like a weight loss type diet, and not sure there is valid evidence to support it. I am not concerned about being overweigh, so will continue to work towards less carbs and slower digesting ones.

[haha]

Quote:

Originally Posted by rgarling Low carb is good, but intermittent fasting appears to be even better for correcting metabolic issues. Combining the two would be very powerful.

I wonder if you can give a link or reference ideally to some studies that look at this WRT metabolic (particularly sugar) issues.

Ha

[rgarling]

Quote:

Originally Posted by haha I wonder if you can give a link or reference ideally to some studies that look at this WRT metabolic (particularly sugar) issues. Ha

Here are some links, but not specific to correcting diabetes:

intro 1: Intermittent Fasting - The Something Awful Forums

intro 2: The Blog of Michael R. Eades, M.D. » Fast way to better health

(by the way, if you have an interest in low carb, you MUST bookmark the eades blog: The Blog of Michael R. Eades, M.D. )

intro 3: Welcome to the Fast-5 website | Fast-5 Life

intro 4: Intermittent fasting diet for fat loss, muscle gain and health (Martin Berkhan)

===============
I am going to extrapolate a bit.

If you take this information:
The Newcastle study: Crash course diet reverses Type 2 diabetes in a week - Telegraph

which is a very low calorie intervention, and change it a zero calorie intervention; you will likely accelerate the process (say maybe down to 3 days or so, which is a safe upper limit for a fast). You would then come out of the fast, using an Eades-style, low carb diet. Alternatively, you could just fast until your blood sugar dropped below ~100 (or a max of 3 days), and then go to low carb. It is also possible (likely), that repeated short fasts (like one of the IF protocols) would reach the same result.

The good thing is that after a period of adaptation (similar to low carb), the IF style of eating is extremely easy to maintain.

[rgarling]

Quote:

Originally Posted by DFW_M5 ... This sounds more like a weight loss type diet, and not sure there is valid evidence to support it.

With IF, you will likely lose weight if you have a weight problem. Rather than a diet, intermittent fasting is a more natural eating pattern that puts things back the way they are designed to be. It is a technique that NORMALIZES abnormal conditions.

Quote:

Originally Posted by DFW_M5 I am not concerned about being overweigh, so will continue to work towards less carbs and slower digesting ones.

Diabetes is serious, as is high blood pressure. Being overweight is a risk factor. I encourage you to work as hard as you can to maintain your health.

[eytonxav]

Quote:

Originally Posted by rgarling With IF, you will likely lose weight if you have a weight problem. Rather than a diet, intermittent fasting is a more natural eating pattern that puts things back the way they are designed to be. It is a technique that NORMALIZES abnormal conditions. Diabetes is serious, as is high blood pressure. Being overweight is a risk factor. I encourage you to work as hard as you can to maintain your health.

rgarling, Interesting stuff for sure, thanks for the links. Still seems like a radical approach to me that needs more study. Couldn't IF (eg 3 day fast) stress one's system to go into a catabolic state? I can't imagine that would be a good thing.

No reservations about working hard to stay healthy, and to that end, keeping my macro nutrients where I want them is my biggest challenge. But on the fitness/exercise front, I'm doing pretty well and am down to about 15% BF with good cholesterol/triglyceride/BP #s.

[rgarling]

Quote:

Originally Posted by DFW_M5 ... Couldn't IF (eg 3 day fast) stress one's system to go into a catabolic state? ...

IF protocols usually involve fasts of at most 24 hours. Most people that use IF typically end up with about a 4-6 hour eating window each day; however, there is a lot of variation in the length of the fast (perhaps ~16 hours on the short side, and 36 hours on the long side). The system boils down to a simple idea: periodically, you must give your body time to operate in its 'fat burning' mode.

Fasts beyond 24 hours are also effective. A study involving a 48 hour fast has shown no decrease in metabolism (and actually a slight increase). In an extended fast, the body doesn't need to use muscle tissue until about 3 days. The newcastle study suggests diabetes can be cured with an extended fast. Interestingly, there is a (good) theory that a 7 day fast will kill certain types of cancer cells (particularly cancer of the brain). Yes this paragraph sounds wacky.

[FIRE'd@51]

Quote:

Originally Posted by DFW_M5 The good news is my quarterly A1Cs have been rock steady at 5.5 since first being diagnosed with T2 in August 2008. Unfortunately, I have been a carb lover most of my life, and should probably be reducing my carbs even more

Quote:

Originally Posted by DFW_M5 My FBS are ususally below 110, but I also take a BP medicine at bedtime which may affect it some. But, I still need to lower my carbs for better results.

Just curious. If your A1c has been a steady 5.5, which is an average blood sugar of 112, and your fasting is around 110, it seems to me that you are probably not spiking very much after meals, unless your A1c is being distorted by "lows". Why do you think you need to further reduce your carbs?

[FIRE'd@51]

Quote:

Originally Posted by rgarling IF protocols usually involve fasts of at most 24 hours. Most people that use IF typically end up with about a 4-6 hour eating window each day; however, there is a lot of variation in the length of the fast (perhaps ~16 hours on the short side, and 36 hours on the long side). The system boils down to a simple idea: periodically, you must give your body time to operate in its 'fat burning' mode. Fasts beyond 24 hours are also effective. A study involving a 48 hour fast has shown no decrease in metabolism (and actually a slight increase). In an extended fast, the body doesn't need to use muscle tissue until about 3 days. The newcastle study suggests diabetes can be cured with an extended fast. Interestingly, there is a (good) theory that a 7 day fast will kill certain types of cancer cells (particularly cancer of the brain). Yes this paragraph sounds wacky.

I hope you are recommending IF to non-diabetics. Diabetics are encouraged to eat their meals at regular times without skipping meals.

[rgarling]

Quote:

Originally Posted by FIRE'd@51 I hope you are recommending IF to non-diabetics. Diabetics are encouraged to eat their meals at regular times without skipping meals.

If you are taking drugs, you need to take your doctor's advice.