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runbikestent

Me a diabetic? Are you crazy?

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meyery2k

This is an interesting opinion from Dr. Attia.  This would be pointed more towards a T2 but it explains some of our thinking here in regards to diabetes management.  The perspective from a doctor's POV always fascinates me. ~ Mike

 

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Jeapa

I saw a documentary about a young couple that rowed all the way to Hawaii from California eating LC. They had been training their bodies to be fat burning machines for several months in preparation. I think they broke a record also. I can't remember the name of the movie, but I think Google could find it. So I believe once your body has transitioned to burning fat, the athletic performance is just as good if not better as someone who carb loads. I will look and see if I can find the title. It was a very good documentary.

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Jeapa

I saw a documentary about a young couple that rowed all the way to Hawaii from California eating LC. They had been training their bodies to be fat burning machines for several months in preparation. I think they broke a record also. I can't remember the name of the movie, but I think Google could find it. So I believe once your body has transitioned to burning fat, the athletic performance is just as good if not better as someone who carb loads. I will look and see if I can find the title. It was a very good documentary.

The name of the documentary is Run on Fat, Cereal Killers 2. Check it out. It has a lot of good information for athletes that want to eat LCHF.

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adiantum

The side effects will be good for your triathlon training... controlling muscles & running

 

 

"I am leaning towards Metformin at the moment."

 

 

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holymoly

Feel your pain bro. I basically had the same reaction when I was diagnosed. Initially as T2 by my GP and then definitively as an adult T1 2 weeks later by my Endo.

 

I was young, healthy and fit when diagnosed, and, like most people I thought diabetes was a disease only kids and fat old people got...

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runbikestent

Update:

 

I finally met with the endocrinologist today.  We reviewed my labs, and went over my log of BG that I had been doing consistently over the last 10 days.

 

1.  He thinks I am closer to a Type 1 than Type 2.

2.  He thinks I am not producing enough Insulin, though I am definitely producing some.

3.  He thinks I have some insulin resistance.

4.  He wants to see tight control of my sugars between 70 and 90 when all is said and done.

5.  He thinks that with the correct medication, I can probably have a diet of 100 gms carbs/day, probably not much more.

6.  He is nervous about starting me on Insulin due to the risk of hypoglycemia during a strenuous long workout, such as a hard 20 mile run.

7.  We decided to try Victoza at a very low dose of 0.6 per day. 

8.  I will be wearing a Continuous Glucose Monitor for a few days without the medication to get a real idea of my baseline, then start the Victoza and see what my sugars do.

9.  He said that I should try to stay slim because my A1c will spike to more than 6.5 if I gain 10 pounds.  My BMI 17 or 18 % now.

10.  He said that my pancreas will likely continue to deteriorate over time.

 

I think that was all.  Not so encouraging.  Missing you my old friend, ice cream.

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runbikestent

Sounds like you have T2 not T1. Many people think that being overweight, in many cases, is the cause of T2 diabetes. I think it's the other way around. The body becomes insulin resistant, asks and asks and asks for more carbs and that's what packs on the pounds. If you weren't so active, that could have been the case for you. (Just thinking out loud...) 

 

Will be interesting to see if and if so how your perspective on d changes over time. I'm wondering whether you're a low-fat, whole grain, statin prescribing, stent recommending, whole wheat/skip the meat, ADA/AHA guideline pushing kind of doctor. Or more of an anti-establishment fish oil, vitamin D, low-carb "eat three eggs, skip the toast, play 52 pickup three times a day and call me in the morning" kind of guy. Have you read any of Taubes's books? Read the spacedoc site? Dr. Fung? Forks over knives? (GAH!) Ah well... in any case, good to see a doctor here -- lot of good info here, lot of good people too. As to "courage," it's either that or masochism. Getting your numbers in order and keeping them there takes a lot of finger poking. -- Mike

I am a minimalist doctor.  I hate to prescribe meds.  Most patients are on too many as it is.  I am more the anti-est.. guy.

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meyery2k

It can be said that you are seeing the battle starting to shape up.  I hope you will join in and let us know how you are doing!

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miketurco

Sounds like you have a really good doctor and that's really solid advice. Stick with him. Insulin isn't a drug, exactly, it's a hormone. And it's a good thing. I can't think of a single T2 who's ever said anything about going on insulin other than they wish they had went on it earlier. From there, it's a math thing. You can really dial things in and do a good job. Not easy, but for many people it's doable. 

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Fraser

Mike I generally agree with you on most items, except the one about t2's had wish they had started insulin sooner.

I would clarify that that for those T2' who benefited from using insulin they wished they had started sooner.

I have been dx for 8 years, my A1,c. 5.6. No meds, my major issue is that my BG tends to fall, especially during exercise.

If I used insulin, it would just be pushed even lower.

At least for me there is no benefit for taking medication to lower my BG, I would just have to consume more carbs to compensate.

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TheBigNewt

Yeah you don't wanna be on insulin running sugars of no higher then 90 all the time. You'll end up in a whole bunch of deep dodo. If I had a dime for every diet gimmick I heard I'd be a rich man right now too. Stay away from the cupcakes lol.

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miketurco

Mike I generally agree with you on most items, except the one about t2's had wish they had started insulin sooner.

I would clarify that that for those T2' who benefited from using insulin they wished they had started sooner.

I have been dx for 8 years, my A1,c. 5.6. No meds, my major issue is that my BG tends to fall, especially during exercise.

If I used insulin, it would just be pushed even lower.

At least for me there is no benefit for taking medication to lower my BG, I would just have to consume more carbs to compensate.

 

Absolutely! I've basically halved my insulin over the last three/four months by losing weight and hope to get off it at some point. 

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jwags

I like your doctor, too. I had a fight with my dietician this week because she thinks I am not eating enough carbs. I told her I like to keep my after meal bgs 120-140 and she told me that was too low of a goal. So it is nice to find a doctor who agrees we need to have normal blood sugars. My Endo feels I am a weird Type 2 that acts more like a Type 1. She won't put me on insulin now because she is afraid of hypos, but if I eat more than 25 carbs I spike rather high. So I do have to watch every morsel I eat. My bgs act like I am insulin resistant but I am very thin. I am sure my pancreas will deteriorate too over time.

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miketurco

You're really sharp. You can (probably) put yourself on insulin -- depending on where you live. In CA you can get R and N over the counter for $25/bottle. Don't know if that's something you would want to do but it's an option.

 

The RunBikeStent username -- I just caught that. It's like a decision. "Well, you either you get some exercise and stay in good shape or have heart surgery. The choice is yours... You can Run, Bike or Stent.

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runbikestent

You're really sharp. You can (probably) put yourself on insulin -- depending on where you live. In CA you can get R and N over the counter for $25/bottle. Don't know if that's something you would want to do but it's an option.

 

The RunBikeStent username -- I just caught that. It's like a decision. "Well, you either you get some exercise and stay in good shape or have heart surgery. The choice is yours... You can Run, Bike or Stent.

Ironically, I spent my whole day putting in stents and doing angioplasty on patients with diabetes today, like most days.  Funny thing is that I never paid attention to their A1c's.  Now I find myself asking my patients about their diabetes.

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runbikestent

Update:  I put on my continuous glucose monitor today.  What a cool little device.  But when you first calibrate it, you do it against your BG meter.  It made me wonder the accuracy of the CGM will directly correlate with my meter.  What if my meter sucks.  Then does my CGM constantly give me bad numbers.  Not sure.

 

But still it is cool. 

 

I plan to monitor for 2 days with a low carb diet alone, then start my Victoza injections at 0.6 per day and wear it for another 5 days.  It sounds like people are not really seeing much of a drop in sugars until a few into therapy.  So I wonder if I will even see any drops.

 

fyi:  my BG's on my CGM have been running between 70 and 90 since I have been wearing it for 4 hours, even after a meal ( no carb meal). At the moment it says 62.  Just wondering...

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Cora

RBS, when you get labwork, take your meter to the lab and test to do a comparison. This works better than the ranges of control solution they give you and will also give a good idea of how accurate and precise your meter is when you are low, high, or normal. My Freestyle Lite's have always been very consistent, no matter what my bg range. It's part of why I ditched my CGM about a decade ago (they've improved since then). I knew for a fact my meter was always about 4 - 6% higher than the lab value, and my CGM was off by between 20 and 30%.

 

So calibrate your meter with the lab and then go from there. Remember that with some meters it can take a good  part of the first day wearing the new sensor for it to "settle".

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