Blood Glucose Levels Over the last Three Months

Here are my blood glucose numbers over the past three months. I have been fasting the last week so the number are lower during the fast. This is an average of 113, and a HbA1c of 5.7. The normal range for level for hemoglobin A1c is less than 6%. Note that I am still taking Metformin. I am also doing High Carb, Healthy Fats plus Intermittent Fasting.

Another fast so soon?

I started a new fast on Sunday so I am at day 4 now. So far it is going very well. Not very hungry and not too grouchy (that I can tell). I’ve dropped off half the weight I regained over the four days of eating.

Stopped taking Metformin on the third day of this fast. My blood sugar numbers are up a bit but still on the low end. By dinner time last night my Blood Sugar was 88.

Considering starting up some exercise. Not for weight loss, it might in fact hinder some weight loss. More to work on my Blood Pressure. I have had a nice mountain bike since 2007 but I rarely ever ride the bike. So I bought a trainer which is attaches to the rear tire and turns the bike into a stationary bike.

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One of my Keto/fasting heros, Tom, uses an ap called Kinomap. It lets you ride in different places in the world where people have recorded videos of their rides.

I pulled the bike out of the basement, cleaned it off and pumped up the tires. Hopefully I will be in riding shape by Spring. There’s a great bike trail very near to here,

GREAT ALLEGHENY PASSAGE ®

150 miles of biking and hiking from Cumberland, MD to Pittsburgh, PA

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Blood Sugar Measurements

I’ve noticed that every so often I get a blood sugar reading in the 120’s.  Nothing to be alarmed about but when you’ve gotten used to being in the 90’s mostly it seems out of place. I’ve also started to wash my hands and retest after the number. I’ve noticed that the second reading is quite a bit lower.

For instance, when I woke up at 6:41 I tested and got 122. I then got up washed my hands and retested at 6:52 and my number was 109. Two hours later my number is 93. The 93 may be partly attributable to the Metformin I took when I got up.

 

Daily Status – 2016-08-29

Today is the third day I have been off Metformin. My Blood Glucose numbers have tended up but not horribly. About 10 increase. I am no longer seeing numbers from 95-115 and am now seeing numbers from 105-125 instead. Not too bad really. If the upward trend continues I will add back in Metformin. If it flattens out I will stick with removing Metformin. If Metformin reduces gluconeogensis by 33%, I really don’t see it in my own numbers. I should be seeing numbers that are 33% higher not 10% higher.

Work scale shows I am down 23 lbs since Aug 5th. I started about July 31 (four weeks now). Not sure what my initial weight was but my guess is that I am down about 30 lbs so far.

I am going out for dinner with the kiddos tonight so it will be out to somewhere that I can do LCHF easily. We have done Jimmy John’s (order the lettuce wrap and the JJ Gargantuan) as well as Five Guys Burgers and Fries (skip the fries and order the burger “bunless”). Harder to find suitable choices at places like Applebee’s.

Still doing the Intermittent Fasting (IF). Yesterday I ate from 5 PM to 6:30 PM with a final snack at 8:30 PM of some ParmCrisps.

 

Daily Status – 2016-08-28

I am now at my 1992 weight. I remember the weight very well since I had started a new job with a very tight deadline. It meant I worked 60 hours a week for the first six weeks of the job. The company brought in pizza for us every night and I gained weight. When I got around to weighing myself that meant I was up. That’s the number that I remember. The good news is that I am at that weight now. Not too bad to be at the same weight I was at 24 years ago.

Wish I had weighed myself at the start of this. I am down more than 20 lbs so far for sure.

Didn’t take Metformin yesterday. My waking Blood Sugar was 101 which is a bit higher than yesterday. I am going to try this out for a couple of days to see if there’s a change.

Still doing LCHF+IF (of course).

 

One Week Off Insulin

I’ve been off Insulin for a full week now.

So why am I still alive? After all, I needed 100 units a day on the average just one month ago. But here I am. Still Alive!

So did I just decide to ignore my Blood Glucose levels and am I on the edge of dying? Hardly. I’m still checking multiple times a day – mostly now in disbelief at how well my blood sugar is being regulated by my body. My high today was 124 and my low so far today is 109. I never got numbers like that before day after day on Insulin.

For dinner last night I took the kids out to Five Guys Burgers and Fries. I skipped the fries. I ate a bunch of peanuts and more importantly had my burger “bunless”. The choice to replace the bun with lettuce was a good one since it took away about 40 grams of carbs and left about 1 gram. The fat ratio was good and the jalapenos, etc didn’t add much to the carb count but they did add to the flavor.

All of that made my Blood Sugar at 103 around bedtime.

Addendum : Still taking Metformin. Not out of the T2D woods yet.

My Last Chart???

I shut off my Insulin Pump 36 hours ago.

Insulin Levels-2016-08-17

My Blood Glucose numbers have been great.

ABG-30day-2016-08-17

This will be my last Insulin dosage chart since I am no longer on Insulin. I am still on Metformin.

I will probably post numbers like these:

7 day average – 123
14 day average – 124
30 day average – 137

The LC-HF plus IF dieting has been going great. Easy to do. I don’t get hungry until after 2 PM which is when my blood sugar goes down to around 104 or so.

 

Ketosis and Insulin Levels

Noticed this morning that my body was out of ketosis. My detection method is the metallic taste in my mouth when I am in ketosis. Now, 2 hours later I am back in Ketosis. My pump delivers .5 U/hr between 4 AM and 12 PM. The rest of the time I am pumping .25 U/hr.

I am not adding any bolus today so that I can try to understand the effects. I took a Metformin 850 mg when I got up so part of the following effect may be from the Metformin. Numbers were up early on but I am watching the numbers over the day.

  • 7:20 – 130
  • 8:20 – 154
  • 9:20 – 130
  • 10:20 – 116
  • 11:20 – 118
  • 12:30 – 127 (physically active – working in the kitchen)
  • 1:20 – 118
  • 2:20 – 108
  • 3:20 – 111
  • 5:40 – 113

I have gotten pretty much the same response when I used Insulin so why use Insulin?

 

Mayo Advice #4 – Ask the doc for more pills

Here’s the full text of this next piece of advice (Avoid weight gain while taking insulin) from the Mayo Clinic website.

Ask your doctor about other diabetes medications. Some diabetes medications that help regulate blood glucose levels — including metformin (Fortamet, Glucophage, others), exenatide (Byetta), liraglutide (Victoza) and pramlintide (Symlin) — may promote weight loss and enable you to reduce your insulin dosage. Ask your doctor if these or other medications would be appropriate as part of your diabetes treatment plan.

I like the goal – reducing Insulin dosage. When I started Insulin my doctor wanted to take me off Metaglip. Only part of that made sense. The Glipizide part of Metaglip is a Sulfonylurea which stimulates the release of more insulin from the pancreas. But we’ve already determined that too much insulin is the problem. Sulfonylurea drugs also decrease insulin resistance which they would pretty much have to do in order to help the extra insulin work.

The diabetic care nurse knew more about the drug than the doctor did. I was able to convince the doctor to prescribe Metformin which the doctor was convinced could not help since my pancreas (he said) no longer produces insulin. He clearly had the meds mixed up. But he has told me since then that as long as it is working for me (and it is) that he will keep prescribing it.

I was on Byetta (Exenatide) which was getting decent results when the diabetic nurse recommended I go to the “gold standard” of care which is insulin with the pump. The mechanism of Byetta is (wikipedia source).

  1. Exenatide augments pancreas response
  2. Exenatide also suppresses pancreatic release of glucagon in response to eating…
  3. Exenatide helps slow down gastric emptying
  4. Exenatide has a subtle yet prolonged effect to reduce appetite…
  5. Exenatide reduces liver fat content

Byetta has some side effects that bother people enough to get them to stop taking it. It’s a shot, like Insulin, so there’s that inconvenience.

I have no experience with the other classes of drugs but if the drug’s net effect is to increase the level of insulin in your blood then it’s bad. Good that it is reducing your blood sugar. Bad that the insulin is what does the damage.

From what I can tell, Metformin is one of the best and it only gets you half way to normal. So yes, ask your doctor about these drugs but focus on the question of whether or not the drug increases the insulin level in your blood. If so, be skeptical.

 

Reducing Insulin Results in Weight Loss

So if insulin causes weight gain then it would seem to logically follow that reducing insulin will result in weight loss. We know this is the case because if we just stopped taking our insulin we would lose a lot of weight fast*. However, getting rid of your need for external sources of Insulin is a great goal.

In my case, I lost 50+ lbs in six months before I was diagnosed with T2D. That was the body’s natural way of trying to handle the high blood sugar problem. Adding medications just pushed my weight up. That was true with just Metformin. Could this be because the study that the Metformin causes weight loss concept was built on a study of psychiatric patients not on diabetics? Other studies based on pre-T2Ds are equally questionable since their weight loss could be due to poorer control over their blood sugar levels.

This all makes the advice of the typical MD even more absurd when they tell you that “When you get your sugars in order you will be able to lose weight.” How is that even remotely possible when I have to use astronomical amounts of insulin to keep my sugar under control?

Standard Warning

*Stopping your Insulin cold turkey can be bad and people die from doing this. I feel like I need to say this because there are dumb people out there. Don’t drop your Insulin alone for weight loss even if that weight loss itself is good for you. There are other ways. Make sure you monitor your blood sugar level closely no matter what treatment you use.