Analysing Xmas

[CherryAA]

1. As my stats below show I have been following a successful LCHF diet to dramatically reduce my Hba1C from 90 to 44 over five months

This Xmas I decided to basically give the diet a break, i.e. eating as much as I wanted, but keeping to LCHF eating reflecting that I could enjoy myself with lovely foods without needing to add sugars or carbs back in.

I have then analysed what happened to my daily average blood sugars using my freestyle libre and my diet using Cronometer.I am guessing that this probably understates the true increase in calories and alcohol given its much harder to do that when someone else is coking and pouring!

I think I have also understood as part of this exercise that my libre is probably more accurate than I was thinking it is and that the very low readings I have seen are actually genuinely low whilst the higher ones really do reflect a laxer diet.

I thought others might be interested in the conclusions I have draw given that I'm probably reasonably representative of a few people on here.

1) When I continue to exercise at a level of 10,000 steps plus with carbs of 20g or less, and a calorie deficit of 1000 to 1200 per day, then my daily average sugar levels continue to go down day on day - I have seen a daily average low of 5.4% so far ( ie hba1C 5% or 31) though I do not know if this represents the lowest I could get my blood sugars as I have not kept it up for long enough to find out yet.
2) When I increase my carb intake to 40g , then this is the level at which my bloods sugars start to rise on average day on day despite the exercise and the calorie deficit ( ave 1000-1200 per day) . i.e. I do need to follow a strict low carb diet
3) The amount of food and carbs I intake in any one day is directly translated into the average reading for the following day and the effect is cumulative, so each consecutive " bad" day simply makes the hba1c worse - however that process can be reversed just as quickly by a few cumulative days of being good.
4) I can limit the effect of a bad day on the cumulative position by simply eating the big meal earlier - a large late meal has a much bigger effect on my long term average sugar level because my body seems ill equipped to dispose of the excess sugar during the night compared to the afternoon.

5) I think I finally understand how I could have got to the reading of 90 or hba1C 10.3% without actually doing anything that awful or even for that long- it was simply the daily deterioration of a few points per day accumulating over time with a too high carb diet. I.e. I managed to go from a daily average BS of 5.4% to 8.7% in 13 days flat ! simply by relaxing a little bit and no longer dieting whilst still being low carb. So if I had " given up my diet" instead of just taking a pause then my Hba1C would start to rise rapidly. Thus this change in diet really does have to be utterly permanent - and any " bad" days have to be treated quickly if I want to stay in the non diabetic range - hence the power of fasting.

6) The best way for me to get my readings down is to stop eating by around 6pm. if I do that then by bedtime I can have readings that stay well in the non diabetic range all night and begin the following day in the same state - this also means that I can then spend the following day in the non diabetic range regardless of the dawn phenomenon.

7) Overindulging in alcohol as I did over New year does a lot less damage to my blood sugar readings, but presumably is causing other bad things to happen.

It will be interesting to see how many days of strict dieting are required to get e back to the low of 5.4 I recorded on 15 Dec, however from the results of the intervening days between xmas and new year it should not be long. (i.e. 8.4 back to 6.4 in five days) . I will be interested to know if I manage to lose the 1.8 kilos put back on or get the blood sugar down first !

Hopefully the analysis will give some of those wondering what the effect of Xmas will have been on their own position.

Interestingly I did an hba1C test on 19th Dec and recorded 6.2% and a another one on 29th Dec and still recorded 6.2% - ie the older average readings I am losing more or less match the higher readings I got over xmas, so hopefully I should be back on track for further official reductions in due course if I can stick to the diet.

Hmmm, I tried to attach a table with each of average blood sugar net carbs calorie deficit and alcohol but I cant mke it readable. No doubt if anyone is interested enough they will let me know it might be worth trying different way

I think I may re-do this process every few months to see if I am becoming any more able to tolerate carbs as I hopefully get thinner.
Hope that helps some one to understand what is happening.
Happy New Year to all

 

[Bluetit1802]

Are you saying you kept to similar daily amounts of carbs as before, or your carbs increased? How much did they increase? I am not talking calories, but carbs.

 

[DavidGrahamJones]

Interestingly I did an hba1C test on 19th Dec and recorded 6.2% and a another one on 29th Dec and still recorded 6.2%

Not really too surprising. If an HbA1c reflects an average for the last 90 days you're looking at 2 90 day averages where 10 of those days weren't the same and 80 days were exactly the same. Your BG during those 2 lots of ten days may have been different, but maybe not enough to changed the average.

My last HbA1c was not according to plan after achieving good results on LC for 4 years. There could be several reasons, eye off the ball, introducing more fat (never agreed with LCHF for me, it doesn't work for me), introducing more nuts. But at least your results have given me some hope that if I am disciplined again for the next 3 months, my HbA1c in April should be good.

BTW, are they HbA1c results from actual blood tests or calculated?

 

[CherryAA]

Are you saying you kept to similar daily amounts of carbs as before, or your carbs increased? How much did they increase? I am not talking calories, but carbs.

OK finally found a way to show the actual figures - I stayed low carb all the time - i.e only had three chocolates and a couple of roast potatoes and carrots, throughout the entire time, no deserts, fruits, or carbs other than those occurring in my normal HCLF diet - I just didn't particularly restrict my intake of meat, vegetables, cheeses or cream. (it was lovely!) My two highest carb days were Dec 25 (62) the and Jan 1st (81) but still under 100 . The increase in calories was mainly meats , smoked salmon , cheeses, thus my protein intake shot up (and alcohol!) .

On Jan 1st having seen what I did to reduce my average blood sugars in the four days after Xmas I deliberately added more carbs in the form of cheese biscuits and frozen berries with milk chocolate to get a high carb reading in a late meal. I want to see if I can replicate the reduction in average carbs in the next few days by going back to the pre -xmas diet. On 4 Dec my overnight fasting was 4.6, yesterday it was already down to 5.2 ( compared to 7.5 after the new years day binge) - after just one day on the diet ( I have not got back into ketosis yet) this suggests the average will come down quickly if I stick to the diet especially once I do get back into ketosis.)

Overall the data suggests to me that its still easy to put weight on on an LCHF diet unless proteins are restricted. keeping combined carbs + proteins under 100 seems to both maximise weight loss and minimise blood sugar for me.

But also if I do go off the rails, then it is not at all hopeless, because in a very short period of time I can reverse the damaging effects of overindulging . The worst situation is just a constant not quite doing enough to keep things in check because every single day that I do that the figures will get progressively worse and thus the Hba1C figure is finally awful from the constant small attrition of the daily averages and increasing fasting blood sugars with no check points.

I guess the 5:2 diet probably works so well because those 2 days cause a short sharp reversal that means that the inbuilt growth in blood sugars for the next five days keeps resetting to the lower level which if the balance is right might mean that your average remains stable overall even though one still might be getting progressively worse average blood sugars on all the intervening days.


14-Dec-16 5.9% 20 Net carbs, 47 Proteins, 67 Carbs + proteins, 0 g Alcohol, 11,333 Steps, (1,112) Calorie Deficit.
15-Dec-16 5.4% 34 Net carbs, 61 Proteins, 95 Carbs + proteins, 0 g Alcohol, 21,702 Steps, (1,354) Calorie Deficit
16-Dec-16 5.7% 22 Net carbs, 58 Proteins, 80 Carbs + proteins, 0 g Alcohol, 5,958 Steps, (1,124) Calorie Deficit
17-Dec-16 5.7% 41 Net carbs, 141 Proteins, 182 Carbs + proteins, 52 g Alcohol, 30,278 Steps, (1,056) Calorie Deficit
18-Dec-16 6.1% 41 Net carbs, 76 Proteins, 117 Carbs + proteins, 0 g Alcohol, 10,265 Steps, (866) Calorie Deficit
19-Dec-16 6.7% 44 Net carbs, 104 Proteins, 148 Carbs + proteins, 3 g Alcohol, 20,801 Steps, (1,089) Calorie Deficit
20-Dec-16 7.1% 34 Net carbs, 99 Proteins, 133 Carbs + proteins, 0 g Alcohol, 10,849 Steps, (908) Calorie Deficit
21-Dec-16 6.7% 20 Net carbs, 147 Proteins, 167 Carbs + proteins, 12 g Alcohol, 8,065 Steps, (744) Calorie Deficit
22-Dec-16 6.8% 27 Net carbs, 55 Proteins, 82 Carbs + proteins, 5 g Alcohol, 12,325 Steps, (1,239) Calorie Deficit
23-Dec-16 7.8% 12 Net carbs, 58 Proteins, 70 Carbs + proteins, 27 g Alcohol, 3,468 Steps, (944) Calorie Deficit
24-Dec-16 7.7% 42 Net carbs, 145 Proteins, 187 Carbs + proteins, 64 g Alcohol, 12,216 Steps, 17 Calorie Surplus
25-Dec-16 7.9% 62 Net carbs, 154 Proteins, 216 Carbs + proteins, 14 g Alcohol, 5,606 Steps, 92 Calorie Surplus
26-Dec-16 8.7% 30 Net carbs, 105 Proteins, 135 Carbs + proteins, 18 g Alcohol, 868 Steps, (318) Calorie Deficit
27-Dec-16 8.4% 32 Net carbs, 217 Proteins, 249 Carbs + proteins, 16 g Alcohol, 10,851 Steps, 34 Calorie Surplus
28-Dec-16 8.4% 40 Net carbs, 146 Proteins, 186 Carbs + proteins, 0 g Alcohol, 4,228 Steps, (300) Calorie Deficit
29-Dec-16 7.7% 28 Net carbs, 102 Proteins, 130 Carbs + proteins, 0 g Alcohol, 10,891 Steps, (1,086) Calorie Deficit
30-Dec-16 7.3% 32 Net carbs, 102 Proteins, 134 Carbs + proteins, 193 g Alcohol, 11,238 Steps, (903) Calorie Deficit
31-Dec-16 6.8% 34 Net carbs, 48 Proteins, 82 Carbs + proteins, 78 g Alcohol, 12,874 Steps, 109 Calorie Surplus ( lunch meal so bs recovered before bed)
1-Jan-17 6.4% 81 Net carbs, 110 Proteins, 191 Carbs + proteins, 0 g Alcohol, 9,329 Steps, 306 Calorie Surplus
2-Jan-17 7.1% 34 Net carbs, 36 Proteins, 70 Carbs + proteins, 0 g Alcohol, 10,293 Steps, (1,112) Calorie Deficit

 

[CherryAA]

Not really too surprising. If an HbA1c reflects an average for the last 90 days you're looking at 2 90 day averages where 10 of those days weren't the same and 80 days were exactly the same. Your BG during those 2 lots of ten days may have been different, but maybe not enough to changed the average.

My last HbA1c was not according to plan after achieving good results on LC for 4 years. There could be several reasons, eye off the ball, introducing more fat (never agreed with LCHF for me, it doesn't work for me), introducing more nuts. But at least your results have given me some hope that if I am disciplined again for the next 3 months, my HbA1c in April should be good.

BTW, are they HbA1c results from actual blood tests or calculated?

If your Hba1C is coming down rapidly like mine has been then I agree that the 10 days lost at the beginning and added at the end should not cause much change to the Hba1C. That would not be the case for me if my Hba1C had already stabilised at whatever level is is going to . The data shows for me that its very easy to get from a non-diabetic to a a diabetic average daily reading so clearly going off the rails needs to be short lived.

The two Hba1C readings were both using the A1C Now home testing kit. However the December one was also confirmed at a medical appointment on the same day, so the systems seems to be quite accurate.

 

[DavidGrahamJones]

The data shows for me that its very easy to get from a non-diabetic to a a diabetic average daily reading so clearly going off the rails needs to be short lived.

Would regular monitoring with a good old BG monitor not achieve the same result and more importantly show peeks and troughs?

BTW, are those self checks expensive, their website seems to have hidden the cost, might be me not seeing the wood for the trees. Interesting because after 4 years of very good HbA1c readings my last one was very weird.

 

[CherryAA]

I used a regular monitor andd ye

Would regular monitoring with a good old BG monitor not achieve the same result and more importantly show peeks and troughs?

BTW, are those self checks expensive,( their website seems to have hidden the cost, might be me not seeing the wood for the trees. Interesting because after 4 years of very good HbA1c readings my last one was very weird.

I used a regular monitor for a start and yes it does show the peeks and troughs.( which you also get with the freestyle) The difference for me in using the freestyle, was that u it becomes easy to see the connection between why the peaks and troughs are as high as they are and for me that is connected to where my fasting blood sugar started that day. I suffer dawn phenomenon that itself also confused the picture. for example I now know that my fasting blood sugar overnight can be quite low ( 4's and 5's) but depending on when I wake up I often find that my " fasting" blood sugar has then changed substantially by the time I take it - i.e. sometimes up to say 7 with no food at all
.
Two fasting bloods sugars of 7 give totally different peaks when I eat . If my fasting blood sugar was on the way down from say 8 at the point I eat, then eating food in the morning causes it to spike a lot and stay there a long time.( e.g 10- 11 for 4 hours ) If my fasting blood sugar had been stable all night at around 5 and increased through DP and then I ate, the resulting food spike is lower and shorter -( 8.5 for 1 hour) the two scenarios then give MUCH higher averages for the first reading compared to the second one yet just doing the finger pricks it seems that one is having a different reaction to exactly the same food which was mystifying. So the trick for me is to makes sure that before I go to bed the number was as low as possible by eating earlier in the day. None of that showed up on the simple blood glucose prick system.

Might be worthwhile investing in a freestyle libre for a bit and seeing if you can work out what changed for you?

On the self tests, yes they are ridiculously expensive - £50 per test, though if you are a "professional" you can buy 10 at once and £10 every fortnight or so doesn't seem so bad.
They have sold me two lots so far without querying it - no idea why they try to fleece none professional users so much.

 

[Bluetit1802]

Would regular monitoring with a good old BG monitor not achieve the same result and more importantly show peeks and troughs?

BTW, are those self checks expensive, their website seems to have hidden the cost, might be me not seeing the wood for the trees. Interesting because after 4 years of very good HbA1c readings my last one was very weird.

The Freestyle Libre gives 24 hour readings. You can scan at will, and also download the log, which shows the reading every 15 minutes, 24/7. You can't replicate this with an ordinary meter no matter how frequently you test. You will always miss the peak, unexpected rises outside the normal post meal testing times, and unexpected falls. If you are currently having problems with a weird HbA1c maybe you could consider splashing out and trying one or two sensors. You will learn a lot, I promise you.

I've never tried a home HbA1c test so I can't comment. I pay very little notice to my HbA1c tests because I am one of those high glycators that make the test a nonsense. I prefer to judge my levels by using my meter and sensors (when I can justify the cost)

 

[DavidGrahamJones]

Might be worthwhile investing in a freestyle libre for a bit and seeing if you can work out what changed for you?

Thank you for the suggestion, I'm geared up for it, having bought one and then left it so long I've had to buy new sensors just before christmas. Just struggling a bit trying to read the manual. but I will get it done soon as next Monday I start a course of hyperbaric oxygen therapy (http://www.chilternsmscentre.org/services-therapies/hyperbaric-oxygen-treatment) which among other things should improve insulin resistance (there is some Japanese research that has looked into it, can't find link at the moment. Also ease muscle pain by getting more energy to the muscle. Seems Wycombe Wanderers use it to help them train harder, although as a friend says "it doesn't show in their results" LOL
I'm also having a c-pep test on Friday along with an insulin resistance test so at least I see what going on with some proper data to start with.
I can see that you're quite keen on getting all the right data together and my original comments were really based on my limited knowledge of statistics. Work in progress though, I'll never be too old to learn, I hope.

 

[CherryAA]

We are all on a journey, hopefully as we learn we share things. There seem to be a number of strategies as to how to get control of diabetes without drugs, - losing weight, low carbohydrate, moderating protein, high natural fats, , intermittent fasting, low calorie and increased exercise I am simply trying to mke sure that as I progress I have kept a recort of the relevant parts so that I personally can see what works for me.
I will take a look at the oxygen treatment in due course. I am fairly sure that my current approach if I can keep t up will result in a low hba1C eventually, in many ways I would like to stick at that first without adding anything else to the mix, to see if I an get to what is my natural lowest number based on stuff I can do myself simply through diet and timing, I assume that eventually I will reach a plateau I just have no idea where that is at present .