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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.

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[User Picture]From: johnpalmer
2012-03-19 08:51 pm (UTC)
Thank you for telling me; I've been more nervous about all of this than I'm willing to let on, and yours was the first message I received - I really appreciated it!
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[User Picture]From: barbarakitten_t
2012-03-12 04:32 am (UTC)
Oh, john...I feel your pain. Don't stress yourself and do watch your blood sugar. It's a pain in the ass, i know and I am the last person to give advice...but do what I say, don't do what I do.

BTW, if you get your blood sugar under control and make sure you do low glycemic index foods that are healthy and get a good balance of vitamins and minerals it will be okay...and you may help yourself in other ways. (I will send you the link to my blog when I whine...because I am dealing with it too.)

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[User Picture]From: johnpalmer
2012-03-19 09:12 pm (UTC)
Well, it's not so much the blood sugar per se. I can handle blood sugar right now. It's just, how do I handle it? Mostly by eating foods with no measurable glycemic index.

And I don't know what the future will hold. What's doubly annoying is, I can't even try to guess right now. I can't judge how things might be in six months by how they are now, because I'm on such a low carb diet that any sugar will make my blood sugar spike. So, "will I ever be able to have an ice cream soda again?" is answered with "who knows? We won't find out for six months, maybe a year."

I think that's the most frustrating part of it.
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[User Picture]From: wordweaverlynn
2012-03-12 08:19 am (UTC)
Sending hugs. I don't think you're being unreasonable in the least. The rules have been changed, everyone's body is different, and science doesn't know all the answers. Do careful experiments seems wise to me.

My partner abostick59 discovered last December -- while in the ER for deep-vein thrombosis -- that his blood sugar was 432. (This came as a surprise to us all.) He's diabetic but controlling it with diet and exercise.
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[User Picture]From: johnpalmer
2012-03-20 04:01 am (UTC)
Nod. The rules have changed, but they're mostly better (assuming what I've read is correct). For example, they used to call people who had a fasting blood sugar of 110 "very high, but still normal". Now, that's called pre-diabetic because so many people who have that end up diabetic. They used to say that if sugar was back down below 180 in two hours after a meal, that was okay - now they're saying that's too high, 140 or less is what you should shoot for, because >140 two hours after a meal was a big predictor of future problems.

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[User Picture]From: grey_lady
2012-03-12 02:17 pm (UTC)
Interested. It's an area of concern for me, as it runs in the family; I've never been diagnosed with it but I feel sometimes like I'm skirting around the edges of it.
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[User Picture]From: siliconivy
2012-03-12 09:39 pm (UTC)
in part because I have an inner five year old who feels tantrumy about that

this made me both laugh & wince in empathy. I was diagnosed as having type 2 and metabolic syndrome x about, oh, 8 years ago I think. And I'm still in somewhat denial about it, and do get whine-y about it. For the most part, the past 2 years or so my quarterly blood tests have me testing as pre-diabetic/insulin-resistant, except for one, which had me back as diabetic.

But I (quite wrongly, I admit) stopped doing daily glucose checks. Every time I tested, my sugar was normal for whatever part of day I was in. So I would get frustrated with having normal blood sugar test results yet bad quarterly test results.

But you are so right about it being different for everyone, it's all about finding your own personal balance (not that I have, quite yet).

Good luck & congrats on the weight loss!
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[User Picture]From: wyang
2012-03-14 09:12 pm (UTC)

First off, very interested. I'm quiet, but I'm reading on a reasonably regular basis (weekly or so) at LJ. Most of my social networking is Facebook, alas.

Just a spin on what you've said. You say you're a guy who needs to watch his blood sugar. Let me suggest that this isn't anything unusual. As we age, our bodies become a bit less resilient to the various forms of abuse we heaped upon ourselves in our youth.

It may suck getting older... but for all its downsides, it beats the alternative! ;-)

Edited at 2012-03-14 09:13 pm (UTC)
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