I'm perilously behind in many small posting projects, and that includes a number of things my great readers have emailed over to me. Trust me: I see everything. Hell, I even have a very complimentary email from Dr. William Davis of Track Your Plaque heroism and fame, as yet unanswered, and that's woefully embarrassing. But I'll get to everything, sooner or later. Man, it has been one busy week.
But, first things first. With all adoration and respect to all readers and supporters of this blogging effort, not to mention the mutual support and help out to those who need it most, this reader is just a bit special to me.
Email from mom, who turns 68 one month from today.
Just about a year ago I went to a new doctor at Kaiser. He seemed different than other doctors I had. He had read my file and was familiar with my history. He said I was the most controlled diabetic he had ever had for a patient. He told me that if I would lose about 15 pounds he would work with me to get off insulin. Another 15 after that and he believed I could get off oral medication and control the diabetes with diet alone.
Well, I tell you, it has been a slow and difficult journey. When you are taking insulin it is so difficult to lose weight. Added to that, I was not totally convinced that low carb was completely ok. I didn't see the need to follow your program completely. I thought moderation was the answer. As I lost weight I slowly decreased the amount of insulin I was taking, but it was still slow, with many ups and downs.
I am now within seven pounds of the first goal the doctor set for me. My insulin was down from 12 N insulin (slow acting) and 4 R insulin (fast acting) in the morning and 16 N insulin and 5 R insulin at night to no R insulin at all and 5 N insulin in the morning an 6 N insulin at night. I thought, "what is 7 pounds, what difference could that make?" So 5 days ago I stopped taking insulin. I also started following your recommendation totally. My blood sugar levels are non diabetic, ranging from 84 to 98. I am taking the supplements you suggested and am totally off grains and all the other things you say are unhealthy for us. I have been off sugars and vegetable oils for a long time.
I think our trip to Puerto Vallarta was the turning point. I could really see the difference in Dad, plus being with you every day, discussing this with you, and feeling the results myself did it for me. I am feeling great. Next week I will go in for blood test and about a week after that I will see my doctor. He said at the beginning of this that when I got off insulin he would change my oral medications till I could get off them. I want that to happen as soon as possible. By the way, in the first 4 days, I lost two pounds, the most I have lost in that amount of time in years and years. I don't think it was water either because I have been continually dieting for years and even changing diets has not resulted in a big water loss in years.
"By the way, in the first 4 days, I lost two pounds, the most I have lost in that amount of time in years and years." Couldn't have a thing to do with the decreased amount of insulin. "A calorie is a calorie." That one's for the theoreticians over practicians, out there.
Well that's wonderful news, eh? Could not be happier or more satisfied. A big part of why I do what I do here is keeping my wonderful parents in good health. Thankfully, they don't follow physician advice blindly. While I wouldn't want them to follow my advice blindly, either, they do know that I have the respect of many respected MD's and other highly educated people in the health field, and they know that I care tremendously.
Mom mentioned dad. Well, he does look great, and at 71, has regained a youthful outlook and activity level. He was out in the sun, the pool, even the ocean every day in Puerto Vallarta. He still has about 30 pounds to go (about 30 lost so far), but he's on his way. He just emailed this morning to say that he just completed his first 30-hr fast, felt great, and couldn't even finish his break-fast steak. He's done a number of 24-hr fasts, so, just as expected, this was a cinch for him.
And, he's becoming quite the efficient fat burner. See, there was some concern in the last couple of weeks, as he began having random, even fasted blood glucose levels of 120-130 and even slightly above, but never over 140, which is the real danger zone. While his A1C remains a reasonable 5.1, randomness was causing worry. My intuitive (i.e., non-medical) thinking was that he's in vastly uncharted territory for modern medicine. How often do doctors deal with high random glucose readings for a patient who has been very low carb for months (paleo style), has dropped 30 pounds, and fasts regularly? Based on my own experimentation with taking my (24-hr) fasting BG from 85 to 115, not by eating sugar, but by going to the gym and hitting the weights hard for 30 minutes, reasoned that the blood glucose can only be coming from body fat mobilization and that his body is fine with the level. In fact, it seems an ideal situation for me. His body is allowing his BG to remain slightly elevated rather than secreting insulin to drive it back into tissues (as fat, of course).
So, I posted an inquiry on Art's private blog, and Dr. Doug McGuff (a reader of this blog; and who just published Body by Science) was kind enough to provide some very useful and interesting information:
WRT your dad’s slightly high glucose reading, I might have a few possible explainations.
1) Was he truly fasted? If he cheated with a little black coffe, the caffeine could have activated phosphorylase and cleaved some glycogen which was released into the blood.
2) His returning insulin sensitivity may have set him up for a variant of the “Somogi phenomenon”. The Somogi phenomenon can occur in diabetics who take too high of a dose of their evening insulin. During the wee hours of the morning hypoglycemia kicks in triggering epenephrine-induced glycogen cleavage which produces an elevation of their AM glucose. With your dad, his improving insulin sensitivity allows him to fully stock his glycogen stores. During his overnight fast, his insulin now works with a vengence, his blood sugar drops enough to trigger glyogenolysis from his glycogen stores, and voila! A transient supranormal rise in blood sugar. A tip off would be if his pillow case or pajamas were a little sweaty upon wakening. The same epinephrine that cleaves glycogen will activate the sweat glands. You may have experienced the same thing when you first started paleo, or when you first tried intermittent fasting. This is just part of the transition from being a sugar-burner to a fat-burner, and IMO is no big deal. Fasting insulin is a much better metric to follow.
Yep. It seems obvious to me, and some may disagree, but if fasting insulin levels are low in the face of an elevated BG that's less than 140 (150 is when tissue damage stats to occur), then that tells me that your body is simply seeing no reason to spike insulin. It's doing just fine. Leave it alone. Moreover, if BG is "elevated" thusly and insulin remains low, then that blood sugar is going to fuel your body's work, which equates to weight loss. To lose body fat, you must first mobilize body fat, which your body then converts to useable energy (glucose), and then uses it.