3

votes

Hack my next step.

Answered on August 19, 2014
Created September 17, 2011 at 11:20 AM

Im a 6'7" ginormous (fatter than Im willing to admit publicly) recently diagnosed diabetic. I have a scheduled appointment to meet with the local Diabetes guru MD in October, but I'd like to get a handle on this myself before then, so I can avoid medication.

Last week I swore off starches and sugars, went to 'as close to full on paleo as I can afford' diet, and cut my blood sugar from 240-270 range to the 125-150 range. I am feeling better, have more energy, and am getting things done.

Then constipation kicked in. So I upped my dietary fiber by upping my leafy green intake, and restarted supplementation (I hadn't done so for years), so constipation became manageable.

But now I need to figure out the next step. I am stuck at 125-150mg/dl blood sugar, and haven't trimmed any weight at all this week. Sometimes my blood sugar is higher after I fast than before..

Diet right now consists of beef in various forms, chicken with skin, green veggies (mostly kale, various greens, spinach, brocco, cauliflower, brussel sprouts, asparagus), the odd pepper, onion or garlic clove, 1 avocado per day for fat and fiber, bacon, eggs, salsa (low carb type), a few almonds here and there, and a couple of ounces of hard cheese per day, plus a couple of teaspoons of psyllium husk. I also drink coffee in moderation (only when I need to stay awake). Total calories average 2000-2400/day. Total carbs/day is about 50, half of that is dietary fiber. Protein averages 150g a day (ideal bodyweight is 100kg), rest of my calories are fat of various types. Im taking in 1-2 gallons of water/day.

I am supplementing fish oil, vit D, C, calcium/magnesium, ALA, and a broad spectrum multivitamin.

10 years ago I did something way less extreme than this and dropped weight insanely fast. Like 10 lbs a week for the first month, and 120lbs in 4 months total. Kept it off for about a year until I could no longer maintain the financial and time overhead for maintenance.

Now nothing is happening. Im sure it has something to do with less muscle mass and more metabolic reistance, but I know that ultimately some of this fat needs to come off if I want to ever get to and stay at safe blood sugar levels 99.9% of the time.

Exercise is a given. A short run with some light resistance training dropped my blood sugar 25 points. But I am dealing with some injuries that are preventing me from doing a lot. Knees are bad, lower back is bad. In fact even my mildly increased activity level has flared up my old back injury to the point where I need advil constantly just to sleep or even sit and work.

So besides exercising as much as I can, is there anything you would tweak? Any problems with cutting out a meal here or there? I have always been told that not eating every 6 waking hours or so is counterproductive...

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 19, 2011
at 06:00 AM

Don, I don't think your comment is helpful, what about the mice starved to death without being able to lose body fat in the experiment shown in "Why We Get Fat" by Taubes? 0 calories is pretty restricted, and you could definitely "get at" their fat.

11838116de44ae449df0563f09bd3d73

(655)

on September 18, 2011
at 07:59 PM

Your not on a severe calorie restricted diet if you can "get at" your body fat.

11838116de44ae449df0563f09bd3d73

(655)

on September 18, 2011
at 07:45 PM

I suggest losing the nuts and cheese for now. Also no snacking.

Medium avatar

(39831)

on September 18, 2011
at 05:50 PM

Yeah, I wouldn't bother with any running or lifting, fasted or not. You likely have more muscle in one leg than I have in my entire body, so you may as well just take the most advantage of that with walking. You may need to gradually ramp up the volume to avoid blisters, foot pain etc. A good pair of shoes is worth its weight in gold.

6120c989fd5b69f42a0834b69b87955b

(24553)

on September 18, 2011
at 08:57 AM

In response to both the ibuprofen and diabetes, I would add NAC (n-acetyl-cysteine) to your supplement list. It has outperformed Metformin for reducing insulin resistance (without the side effects, need for a prescription, or pricetag), and also protects your body from the collateral damage that might come from long term ibuprofen use. Best of luck!

08cc3168845201b71e14751163b28940

on September 18, 2011
at 06:33 AM

The fasting exercise is a great idea and not something I had even considered. Seems like a great way to force a fat metabolism to get started.

08cc3168845201b71e14751163b28940

on September 18, 2011
at 06:26 AM

This advice was actually of immediate help. I went back and sort of did a mental inventory of what exactly I did the last time I dropped a lot of weight and realized that I was taking in a lot more carbs than before, even though they were all green veg. In the last day I upped my fat and lowered my carb count considerably and the bs is already starting to drop again and I appear to be entering a fat burning state. As for water exercise, I wish that was an option. I will likely have to settle for walking, elliptical and light resistance training for now.

08cc3168845201b71e14751163b28940

on September 18, 2011
at 06:18 AM

@Ryan Youd think I was on a severely calorie restricted diet from my weight, which is off the charts, but I find that whole calorie in/calorie out thing doesnt really apply to me, and never has. As for the actual number, its currently 521. I dont throw it around because I find that is a number which boggles the mind of most people, and they have no frame of reference.

08cc3168845201b71e14751163b28940

on September 18, 2011
at 06:11 AM

At this point, I am self diagnosed, though a persistent BS of 290 on multiple testers, associated with finger and foot tingling, thirst and frequent urination is pretty much a dead give away from what I understand from my research. I have an appointment with an MD soon, but I am unsure I am willing to do any glucose testing. That situation was kind of frightening, and I dont want to be anywhere near that level of bs again. Ill check out the Bernstein forum. Thanks for the info.

100fd85230060e754fc13394eee6d6f1

(18696)

on September 17, 2011
at 09:51 PM

I would agree with most of this, especially keeping fat levels high (55% is lower than I would go -- I aim for 65-80%) The only point I really differ on is increasing nuts. I and others I know can't lose weight with even small amounts of nuts.

667f6c030b0245d71d8ef50c72b097dc

(15976)

on September 17, 2011
at 01:01 PM

the older we are, and the more weight-loss and weight-gain we've done in the past makes it harder and slower to lose weight I believe. If it's taken years to get to this point it may take years to ditch it. Take your time, commit to a lifestyle and keep eating well. Your diet sounds good, though you may just be taking in too many cals at 2500ish.

C1c86f42410cd4788bd9c5cf801dcd8f

(2246)

on September 17, 2011
at 12:03 PM

The funny thing about the internet is that no one really knows who you are. Well I can understand that you do not want to give your current body weight, at your height, with the calories you are eating. If I was to take a stab at your weight, I would say you are in a severe calorie restrict diet. Weight will help people understand your situation better.

C1c86f42410cd4788bd9c5cf801dcd8f

(2246)

on September 17, 2011
at 12:01 PM

The funny thing about the internet is that no one really knows who you are. Well I can understand that you do not want to give your current body weight, at your height, with the calories you are eating. If I was to take a stab at your weight, I would say you are in a sever calorie restrict diet. Weight will help people understand your situation better.

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9 Answers

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2
Ca1150430b1904659742ce2cad621c7d

(12540)

on September 17, 2011
at 11:37 AM

Ok, first, one thing that helped me was increasing my healthy fats (coconut oil, raw-milk butter and ghee, avocados, nut oils) to about 55% of my daily intake of calories, and keeping my protein intake to around 40%, with carbs only making up about 5% of my daily calorie intake.

Intermittent fasting is actually a good thing -- at least it has been for me. I am pretty inconsistent about meals, and my rule of thumb is "if I'm not hungry, I don't eat -- if I -am- hungry, I eat enough to not be hungry any more, and then stop"... not enough to be FULL, but just enough that I'm not hungry any more -- then, when I get hungry again, I can eat if I want... but sometimes, I choose not to, and that seems to help, too.

In addition, if I were doing this for me, I'd:

  • drop the dairy completely (even a little cheese can contribute to ongoing inflammation in the beginning when switching to paleo).
  • increase my nut consumption to about 1/4 cup or more a day, -
  • if possible, switch to swimming or water-based exercise -- since being really large is already a strain on joints, including the joints of the spine, and the jarring on the body from running is going to increase overall inflammation and make it really hard for the body to heal itself. --

08cc3168845201b71e14751163b28940

on September 18, 2011
at 06:26 AM

This advice was actually of immediate help. I went back and sort of did a mental inventory of what exactly I did the last time I dropped a lot of weight and realized that I was taking in a lot more carbs than before, even though they were all green veg. In the last day I upped my fat and lowered my carb count considerably and the bs is already starting to drop again and I appear to be entering a fat burning state. As for water exercise, I wish that was an option. I will likely have to settle for walking, elliptical and light resistance training for now.

100fd85230060e754fc13394eee6d6f1

(18696)

on September 17, 2011
at 09:51 PM

I would agree with most of this, especially keeping fat levels high (55% is lower than I would go -- I aim for 65-80%) The only point I really differ on is increasing nuts. I and others I know can't lose weight with even small amounts of nuts.

11838116de44ae449df0563f09bd3d73

(655)

on September 18, 2011
at 07:45 PM

I suggest losing the nuts and cheese for now. Also no snacking.

best answer

6
Medium avatar

on September 17, 2011
at 08:07 PM

I mostly agree with Eric that long, low-intensity workouts are better, especially for you, but I disagree that someone in your situation needs any all-out anything. I'm guessing that your triglycerides are very high, which, as I told Jack, will come down rapidly with fasted exercise. Basically, you need to wake up, walk a few miles, eat breakfast, wait until you're starting to get hungry again, walk another mile or so before you eat etc. Always do walking and always do it before meals. You will oxidize all of that excess fat and sugar that is in your blood with your newly active muscle mitochondria and greatly increase your insulin sensitivity. As you do this more, you will increase the size and number of said mitochondria and become far better at maintaining weight and BG levels.

Once your triglycerides and blood sugar drop and you lose a lot of fat, don't stop doing this. Do it for the rest of your life.

Also, don't go back to eating sugar.

08cc3168845201b71e14751163b28940

on September 18, 2011
at 06:33 AM

The fasting exercise is a great idea and not something I had even considered. Seems like a great way to force a fat metabolism to get started.

Medium avatar

(39831)

on September 18, 2011
at 05:50 PM

Yeah, I wouldn't bother with any running or lifting, fasted or not. You likely have more muscle in one leg than I have in my entire body, so you may as well just take the most advantage of that with walking. You may need to gradually ramp up the volume to avoid blisters, foot pain etc. A good pair of shoes is worth its weight in gold.

1
9f86f54aa7772dd038aea7669124f7b4

on September 17, 2011
at 07:56 PM

If you can, drop the caffeine completely. Caffeine blunts insulin sensitivity.

Regular exercise will also increase your body's insulin response. Start with standing as much as you can, and walking. Push until it hurts, rest as many days as needed until you feel mostly recovered, and repeat. If you haven't been very active, much of the pain you are experiencing is likely from weak muscles that are unable to properly stabilize your joints. Resistance training is a fantastic idea to build that muscle, but I highly recommend getting a trainer to make sure you are doing the exercises properly. Also, to avoid flaring up your injuries go for higher repetitions or use isometric exercises instead maximum weight. Think 3x12 or 3x15 reps, with the last set getting tough. Do it three days a week, and change it up. For the best benefit, focus on exercises requiring stabilizing muscles -- in other words, stay off the machines and use the free weights and bars. The movement of an exercise should never hurt.

As your knees and back are bad, I might avoid running for now, especially if you land on your heel and not the ball of your foot. A fast-paced resistance training workout will get your heart rate up just as well and will be much easier on your joints. The key to that is only stopping long enough between exercises to catch your breath. Leave the running until you just have so much energy that you feel the need to run. It will happen!

Fasting is not bad. Keep doing it, occasionally. Your body is still responding to a fast: it's breaking down fat and turning into blood sugar. The fat cells just aren't responding well to the "off" signal of high insulin. Avoiding any blood sugar spike by keeping your carbs very low (as you are) will lower the amount of insulin produced and over time your body will become more sensitive to insulin. It may take months or even years. Again, exercise is key as it increases insulin sensitivity.

1
7e36094a0f7a2fbad24290225405220b

(2064)

on September 17, 2011
at 12:00 PM

Am I right that this is a new regime since last week? In that case don't change anything just yet. A week or so is not long enough to ascertain if anything is working. Give your body a chance to catch up and all will be well.

1
A31b063c5866c08aa9968a8f2f1e9949

(1721)

on September 17, 2011
at 11:53 AM

I'd watch the exercise... not that you shouldn't be doing it, but that high levels of energy output will lower your blood sugar in the short term but also trains your body to burn glucose for energy. You want it burning fat. Look at Mark Sisson's exercise thoughts: http://www.marksdailyapple.com/primal-blueprint-workout-plan-basics/

Basically: Frequent, longer, lower intensity workouts + infrequent short all-out intensity > long, moderate intensity workouts.

As far as the constipation, magnesium... but you already take a calcium/magnesium supplement. I know we split from Dr. Oz's views a lot as a community, but an episode the other day said peppermint tea will make you go. You could try that.

0
08cc3168845201b71e14751163b28940

on September 20, 2011
at 01:59 PM

Thanks for everyone's help. Dropping my carbs to 2 cups greens/day, increasing my fat by adding another avocado per day, and throwing in a tiny bit of exercise got the scale moving (3 lbs in 3 days) and dropped my fasting bs to 109 yesterday. Thats the lowest Ive been. And I am not hungry. I seem impervious to food smells, and I dont want to eat until my body says its ready. Although seeing food does create a response.

Interestingly, about 4 oz of diet soda (couldnt finish it, all of a sudden it tastes disgusting) and 3 cups of brussel sprouts (I thought it was 2) with my steak last night last night kicked my fasting bs back up to 134 this morning. Thats maybe 20g of available carbs ( I thought it was much less, but failed to read the package ). Im afraid to asked what it spiked to 1-3 hours after my meal.

I may need to stay on a 95%-99% fat and protein diet for a long time, at least until I can start processing carbos better.

0
11838116de44ae449df0563f09bd3d73

(655)

on September 18, 2011
at 07:58 PM

Another book/resource to look at is Ron Rosedale's. He feels some diabetics need to limit protein. He's posted here too.

http://drrosedale.com/healthplan.htm

Whatever you do remember you need sleep. No sleep/ no heal. Also you probably want a large amount of Omerga 3's for a few months, plus chromium picolinate. You may want to go to 20/g carbs for a month or so to get the fat loss moving. Use coconut oil whenever possible. It will increase ketones and your energy. Also search the leptin reset here. If nothing else the discipline of the reset will give you the fastest change. My guess is you will start to see the scale move soon.

0
13c5a9f1678d75b93f269cdcf69f14d5

(2339)

on September 18, 2011
at 02:17 AM

Bernstein's diabetic doet is completely compatible with Paleo. He specifies 6 grams of carb at breakfast, 12 at lunch, 12 at dinner.

A new edition of his book is coming out in November, but quite a lot of the book is free online at the Bernstein Diabetes Forum, where you can get plenty of support if needed. The book explains how too much protein can also raise BG.

Were you diagnosed by A1c or OGTT?

08cc3168845201b71e14751163b28940

on September 18, 2011
at 06:11 AM

At this point, I am self diagnosed, though a persistent BS of 290 on multiple testers, associated with finger and foot tingling, thirst and frequent urination is pretty much a dead give away from what I understand from my research. I have an appointment with an MD soon, but I am unsure I am willing to do any glucose testing. That situation was kind of frightening, and I dont want to be anywhere near that level of bs again. Ill check out the Bernstein forum. Thanks for the info.

0
Eb4df3c41d816b7d6c69f63818cfc682

on September 17, 2011
at 12:20 PM

I am very much in agreement with Firestorm. Especially regarding the cheese and the water based exercises. Good luck!

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