My Story so far

[Reba]

Thanks for the link. I appreciate the information. I am also a LADA and any information is helpful.

 

[Iowaboy]

Hey, @Iowaboy -

I am going into my 4th year as a 1.5 - I ended up in ICU for 5-days. Had both antibodies in my blood. I have been insulin dependent and with careful following as close to Dr. B's protocols ( just more veggies and less protein ) and measuring my glucose 4 to 6 times a day and exercise, I've been able to keep my A1C between 4.8 and 5.3 - For me and others alcohol drives my BG down dramatically - even higher alcohol percentage of pints of craft beer - but of course for me this leads to overeating.

After reading this thread here are my thoughts:

1. The A1C doesn't necessarily accurate as one a test and there can be a 1/2 percent error in the test itself
2. Also, individuals life span of their hemoglobin cells can range from 80 to 160 days or so ( not sure of these numbers are exact but there is a variability ).
3. If you listen to Dr. B's podcast he believes a normal A1C should be in the 4.2 to 4.8 range
4. You can do your own glucose tolerance test by drinking 75g of glucose water tablets and measure your blood glucose every 15 to 30 minutes ( to help smooth out the error % ). I start at 5am and read until 9am - going out further than the normal 2-hours in my case was very enlightening - I try and do my own once every quarter.
5. Is there a history of diabetes in your family?
6. I've looked into the diets of Dr. Bs, Dr. Ornish , the traditional Japanese diets etc ... and one thing that stands out especially in Dr. Bs and Dr. Os case they are really not so much low fat diets or low carb diets as they are low calorie diets and some would even say very low calorie diets. I think this is one of the keys that is really missed by us diabetics.
7. I've been using smart watches for my running and I believe that for many of us the Basel Metabolic Rate BMR is way too high - mine is over 2,000ca and from checking at it it is about 500 to 600 calories too high. But if I am eating between 1,400 to 1,600 calories a day - with no exercise - I am hungry all the time.

3-weeks ago, my brother who is in his mid 50s, fit, no fat, takes statins, baby aspirin for the last 15-years. He is a marathon swimmer and long distance bike rider, survived a massive heart attack with a triple bypass. One major artery was 100% plugged - the week before he had raced a 400-mile bike race - and the others were 60% to 75%. The question was how could this be?

The cardiologist said that as we age, we should all assume we have at least one artery plugged and manage your life as if you did have one.

I think that this is a good strategy when it comes to diabetes. Assume that as we age we have increasing metabolic syndrome, decrease in our ability of our beta cells to function correctly, of course exercise ( have your read what Dr. B has said about it?) and most importantly, cut down on the total calories we eat each day.

Great post and I really appreciate all the information! Wow - I think it is incredible you have kept your A1C so tightly controlled. That is fantastic! I have read Dr. B's book but I need to read it again. There is so much information it is hard to absorb all at once.

No, there wasn't any history of diabetes in my family - or at least I thought. After I started asking around, I learned of a relative who was diagnosed as pre-diabetic but was able to change diet/lose weight and currently has an A1C in the normal range. In talking with my father, apparently he has had a borderline A1C for years (who knew?).

I do think you are right that low calorie is critical. The body just isn't designed to intake a huge amount of food. I am curious - do you target a certain number of carbs a day? Also, curious why you do a glucose tolerance test every quarter. If you are already using insulin, does that give you helpful information? Or do you do that to adjust the amount of insulin you need?

I am so sorry to hear about your brother. I hope everything is OK. The more I read about extreme exercise, the more I realize that the body simply isn't designed for the extremes, and that includes running marathons. I have decided to adjust my fitness goals, and cut back on the running some but increase the strength training. I will still continue to run during the warmer months, but I think the marathon running has been detrimental for a number of reasons.

I feel like my eating is getting into more of a routine recently. I am testing levels twice a day currently, after I get up and 2 hours after dinner. My fasting in AM has been 80-90, usually on the lower end if I exercise the night be for. My 2 hour post dinner has been running 95-105. Also fairly happy with that. Will see where the A1C is when it is re-checked in January.

 

[Alexandra100]

Great post and I really appreciate all the information! Wow - I think it is incredible you have kept your A1C so tightly controlled. That is fantastic! I have read Dr. B's book but I need to read it again. There is so much information it is hard to absorb all at once.

No, there wasn't any history of diabetes in my family - or at least I thought. After I started asking around, I learned of a relative who was diagnosed as pre-diabetic but was able to change diet/lose weight and currently has an A1C in the normal range. In talking with my father, apparently he has had a borderline A1C for years (who knew?).

I do think you are right that low calorie is critical. The body just isn't designed to intake a huge amount of food. I am curious - do you target a certain number of carbs a day? Also, curious why you do a glucose tolerance test every quarter. If you are already using insulin, does that give you helpful information? Or do you do that to adjust the amount of insulin you need?

I am so sorry to hear about your brother. I hope everything is OK. The more I read about extreme exercise, the more I realize that the body simply isn't designed for the extremes, and that includes running marathons. I have decided to adjust my fitness goals, and cut back on the running some but increase the strength training. I will still continue to run during the warmer months, but I think the marathon running has been detrimental for a number of reasons.

I feel like my eating is getting into more of a routine recently. I am testing levels twice a day currently, after I get up and 2 hours after dinner. My fasting in AM has been 80-90, usually on the lower end if I exercise the night be for. My 2 hour post dinner has been running 95-105. Also fairly happy with that. Will see where the A1C is when it is re-checked in January.

Hello Iowaboy, good to read your update. Your results sound excellent to me. You must be doing something (lots!) right. IMO increasing your strength training and reducing the LSD marathon training is a good idea, but it might be a pity to cut out the running altogether in the winter. Unless of course you prefer to substitute some other vigorous aerobic training that you can do inside away from the weather. I think the latest theory is, that it is more healthful in general to do some sort of interval training rather than long gentle miles. I really like the approach suggested by these people: https://www.ntnu.edu/cerg/advice It is not aimed at diabetics in particular. Their idea of 4 x 4 minute intervals suits me timewise, yet I feel I get a real workout doing them. This also fits with Dr Bernstein's advice, though he does a somewhat different workout, but he is categorical that truly vigorous training, both aerobic and weights, benefits diabetics hugely, provided they are in shape to do it, which in your case you manifestly are.

 

[Iowaboy]

Update: So I got my A1c repeated about a week ago, which is around 4 months after I made significant diet changes. Current A1c is 5.3, down from 5.7. So, I definitely made an improvement, but I will admit that I was hoping it would be lower. Currently, my fasting glucose is around 82-88, and 1 hour post dinner glucose is around 105-110, with 2-3 hour post meal being in the high 80s or low 90's. I am exercising 30-45 minutes a day 6 days a week, alternating between strength training and aerobic. BMI has stabilized at 21.8. I eat about 25 grams of carbs for breakfast, 25 grams for lunch, and 30 to maybe 50 for dinner (higher number if I eat black beans or lentils). The vast majority of the dinner carbs are veggie or legume carbs. I have found many new recipes and things to try, so have really adjusted to this new lifestyle. Have even done quite well when out to eat. Yet, I still feel I can do better, just not sure next step. Should I just give it more time - will my body continue to adjust to the lower carb diet?
I could cut some carbs from breakfast but this current diet works pretty well with my lifestyle.
I could increase my exercise more, but then I could lose more weight, and I don't think that would be healthy.
Or should I just be content with my current numbers? I just worry that with LADA, that 5.3 will gradually rise over time even if all else stays the same. Frustrating.

 

[runner2009]

@Iowaboy
Sounds fantastic a 5.3 and BMI of 21.8 that is awesome. What is your fasting BG?

After I wrote in this thread I started researching the Dr. Valter Longo's Longevity Diet and his Fasting Mimicking Diet ( 5-days a month you fast with about 800 calories a day ). Two big differences in the FMD portion is that you eat about >9% protein and there is what is called a refeeding portion after 5-days where much of the benefits occur.

I won't go into the science here you can learn about it on youtube. But bottom line is that the diet is a modified Mediterranian diet with only vegetable fats and fish. Again the hallmark here is one eats only .31g to .37g of protein per pound of body weight and minimal amounts of dairy and meats.

The fasting portion is supposed to mimic what it would be like to do a water fast. Because of the higher healthy fat content, you do come into ketosis. Other hallmarks are that there are a number of changes to one's cells and metabolism and the weight being lost is not lean body mass but visceral fat and fat between the muscles.

Dr. Longo warns that if you have diabetes you need to do this only under an MD's supervision. I can attest to this as I did not adjust my Cumadin and ended up with an INR of 6.8.

I started out on the LD and then did the FMD which I extended to 15-days. I definitely was in ketosis by the 3rd day and my fasting BG was in the mid-70s and most of the days I was in the low 80s.

Maybe because of the ketones, I became totally hypo-unaware. Prior to the diet, I was using between 20 to 30 units of 75/25 lispro. By the 3rd day, I completely stopped taking any insulin. I have yet to take any insulin since the initial FMD. I am eating now about 650 calories 3-times a day. Without the ketones, my fasting BG is between 90 to 95mg/dl.

I am getting ready to do a glucose tolerance test but it seems that I still have a weak initial insulin response but a surprisingly robust secondary insulin release?

What is actually occurring I am not sure but they do have mouse studies that reversed diabetes - I just got my A1C back and I was a 5.0 with an LDL of 50 - but I am sure the fasting made some impact.



PS

My brother had a triple bypass and was in ICU for 3-weeks. He is out and they believe because of his extreme cardio fitness that he will make a full recovery he supposedly has an LV ejection fraction of 50 and they are very happy.

 

[Iowaboy]

@runner2009

My fasting BG has been pretty consistently 83-85, higher if I don't exercise the day before. I have looked back at my labs for the last 5 years, and fasting BG as always been in this range. I wish I knew what it was 10 or 15 years ago.

I did some reading on the FMD diet and it looks very interesting. It sounds like you have had great success with it. Please let me know how your GTT turns out, will be interested to see if you see a difference in insulin response. I am not sure I could sustain a diet like the FMD - those 800 calorie days would definitely be a challenge, especially during the warmer weather and running season.

For now, I am going to continue to try to refine what I am doing. I convinced my endo to let me try a FreeStyle Libre for a few months. I am hoping that will allow me to better assess my diet to figure out what works and what doesn't work. I will be focusing on what food combinations minimize the 1 hour peak. I thought I was doing OK, but I am sure there is room to improve. I have also considering spreading the carbs out further throughout the day, so I would like to try that and see if it helps.

I have been reading about morning fasting BG, and it doesn't seem easy to affect this. It seems like the FMD diet helped your fasting BG. I am going to try some simple things like drinking more water. It seems like even something like hydration can plan a role - and I definitely don't drink enough. My exercise increases from 30 to 45 minutes starting on Monday, and I will return to running as well shortly, so maybe the increased exercise will help. It's definitely a journey.

So happy to hear to hear that your brother should make a full recovery!! That's incredible! Is he still planning to continue the high level of cardio? I would imagine they would want him to significantly cut back, at least for some period of time.

 

[Iowaboy]

Went back for follow-up this week. Diet is holding steady at around 60-70 grams of carbs a day.
Repeat A1c is 5.3, so it seems to be holding steady at that number which is great.
I asked for a repeat of the GAD antibody, as I was curious if it had changed now that my A1c has stabilized.
To my surprise the GAD antibody is back in the normal range.
Not quite sure what to make of it other than it can't be a bad thing!!
So continuing with my current low carb diet and we'll see what happens. Still using the FreeStyle Libre.