|Blogging blood sugar II - What am I?
||[Mar. 11th, 2012|07:38 pm]
Some of you have noticed that there's a word missing from a lot of my discussion here, and the word is the obvious one: diabetic.
Am I diabetic? Do I have diabetes?
Well, right now, that's a tender point, in part because I have an inner five year old who feels tantrumy about that. But also because there's part of me that's royally ticked off at the medical profession about what they say and do about diabetes.
My blood sugar tested above 125. So, some folks will say I'm diabetic, and always will be. And, if I change how my body responds to sugars, so that I can stop thinking about how I eat day to day (but need to exercise more than most), they'll call me "an extremely well controlled diabetic."
And while there are reasons to say that - I'll never be able to *ignore* my blood sugar, and expect to live a healthy life - it's covering up a huge amount of their lack of knowledge.
For many, a high fasting sugar can be reversed, and, sometimes, if no damage has been done, the body will return to more-or-less normal.
And, for people like me, who carry a big load of almost-purely-visceral fat, getting rid of the visceral fat can change, well, everything. Visceral fat affects a lot of parts of the body - it increases insulin resistance, reduces the effects of growth hormone, lowers testosterone (which promotes lean muscle growth, and lean muscles suck up sugars to make glycogen), and is correlated with a lot of things, all of them bad (at least, as far as I know).
But - it's also true that some people develop insulin resistance, and it never really reverses. And, some people have beta cells die off around middle age. And, some people have modestly high fasting sugar, but their beta cells have been clobbered by glucose toxicity, while others have higher fasting blood sugars, and still have more insulin response.
So what am I?
We don't know.
A low carb diet dropped my fasting sugar quickly. In January and February, I was doing what I described earlier, working on sugar deficit - if I exercise enough to burn what carbs I ate, things would have to get better. I might have had 50-150 grams of carbohydrate a day, but I was starting to work out twice a day to make sure I was burning everything I could.
Then, I realized I was being arrogant, and bought a blood glucose monitor.
My fasting sugar was still in the 100s - 110 wasn't uncommon. Here's where I started researching, and that's where I learned the truth. No one could tell me if that was good, bad or indifferent. They could tell me that I was no longer in immediate danger; they couldn't tell me anything else.
So, I went really low carb - Atkins induction: 3 cups of vegetables a day (2-3 cups of greens/salad, with the remainder from other low carb vegetables), < 20 grams of carbohydrate daily. (NB: Psilium had no measureable effect on my blood sugar, so long as I used a "sugar free" fiber supplement. This can be extremely important. Let your inner 12 year old snicker if you must, but I strongly recommend you still supplement your fiber if you try this.)
And, then I was consistently under 100 within two weeks. But what does that say? Nothing - I'm still eating stuff with all the glycemic index of cardboard. And then I learn that low carb eating can increase insulin resistance in the muscles (so they don't suck away precious glucose from your nervous system), and make you much more sensitive to sugar (a person on a very low carb diet will do horribly on an oral glucose tolerance test). (It can also cause a person to have a mildly elevated fasting blood sugar - into the "prediabetic" range, up to about 105.)
So, now I'm going back to how I was in January and February, trying to stay in carb deficit, but also trying to push myself to eat more carbs, and even a few sweets (a tablespoon of dried blueberries, for example). I need to know how my body reacts, and, if I can regain insulin response, it will only happen if my body feels there's a need.
I'm still not ready to accept the label "diabetic" and I feel like it's a bit of a cheat, a bit of whining. And I guess it is... I'm deliberately letting myself whine. But I'm not going to deny the facts. I need to know where my blood sugar is, and what will happen to it based upon my eating and exercise. Failing to do this can lead to long term dangers that are too awful to allow. So, that's what I am - a guy who needs to watch his blood sugar.