Sunday, December 18, 2016

Type 2 Diabetes, a Dietary Disease #359: Ten years ago, I had a relapse (Part 4)

In Parts 1, 2 and 3 of this series (#356, #357 and #358), I described how I lost 170 pounds on Very Low Carb diets. I related how it all began after my doctor read “What if It's All Been a Big Fat Lie?,” a 2002 NYT Sunday Magazine cover story. He tried the diet to lose weight. After losing 17 pounds, my doctor suggested I try it, also to lose weight. Unfortunately, my doctor soon regained all his lost weight when he went back to eating “normally.” He would afterwards ask me, “What do you eat?” and “How do you do it?” I said, “It’s no secret.”
He also said though, “It might even help your diabetes.” He was sure right about that. Of course, neither of us knew at the time how much it would help my diabetes, but I you’ve read Parts 1, 2 and 3, you know what happened: my Type 2 Diabetes went into total remission. He would probably say that I was “cured,” because I no longer had any symptoms discoverable by the routine lab tests. I am, however, still a Type 2 diabetic because I have Insulin Resistance. I am Carbohydrate Intolerant. That still leaves the questions, “What do you eat?” and “How do you do it?” That’s what Parts 4 and 5 are about.
Ten years ago this past summer, after several years of maintaining my weight at about 315 pounds, I relapsed. I regained 12 of the 60 pounds I had lost on Atkins Induction. That’s when, in October 2006, I started on the Bernstein program for diabetics. I built an Excel table (Fig.1) to keep track of the carbs I ate.
But Bernstein also requires that you limit protein, since some amino acids (digested protein) are glucogenic (can be made into glucose by the liver). So, after a few months on Bernstein, I built a new table (Fig.2) to add protein, and then fat, calories, blood sugars (4 times a day) and weight. I used an online program to get the numbers for everything I ate. It took about a half hour a day at the start, then a little less with practice.
I weighed myself daily, but only noted the change weekly. In the beginning, while I was learning the effect that different foods had on my blood sugar, I took a morning fasting blood sugar (FBG) and a 2 hour post prandial. I also took one in late afternoon (usually my daily low reading) and another 2 hours after supper. Now, since I know about carbs, I only weigh-in daily and take a FBG in the morning to get a weekly average.
I kept a detailed food log for a few years, until I learned what I could eat and what I couldn’t. It was also a good way to show me the price I paid when I ate something I knew was taboo. It had another effect too. Besides the shame and guilt I felt, and the disappointment with myself for the “lack of discipline,” it always ruined my averages. If you’re completely honest with yourself, and record everything, the numbers don’t lie. That was probably more devastating than the guilt! You’ve got to be totally honest with yourself. You have to record everything you eat and drink. No rationalizing. No forgetting! And then, you have to face the truth.
After a while, you won’t need to keep records. You figure out what works. You learn, and then you know that eating certain foods will not spike your blood sugar. And others will. You know that eating fat and limited protein with nil carbs, will not leave you hungry. You will also be able to fast easily because YOU WILL NOT BE HUNGRY. When lunchtime rolls around, you will ask yourself, “Am I hungry?” and if the answer is “no,” it will be easy to skip that meal, or eat a smaller meal, without hunger. And, you will lose your “sweet tooth.”
None of this is to say that you will not want to eat something for reasons other than real need (hunger). For example, the sight of food is a tremendous stimulus for me. It has been my downfall more times that I can count. Nervous eating, bored eating, habit (mealtimes), social events, social convention, (fellow workers and family members) all present challenges. But, need is the only biological imperative, and real hunger is what drives that need. And if you are in a state of mild ketosis, described as “ketoadapted” (Google it!), your body is content with burning body fat for fuel. So, my new mantra is to ask myself, “Am I hungry?” If the answer is “no,” I try not to eat. But, if I succumb for whatever reason, I eat a small meal of just protein and fat.

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