Saturday, April 20, 2019

Retrospective #64: Very Low Carb Eating: Ten Years Later (2012)

In August, 2002, I had been a morbidly obese Type 2 Diabetic for 16 years. My physician had tried for years without success to get me to lose weight on a “balanced” diet. Then, one day he said to me, “Have I got a diet for you!”
At 375 pounds I had been taking progressively more and more oral diabetes medications since my diagnosis in 1986. I was maxed out on micronase (a sulfonylurea), and Metformin, and had recently started takin Avandia in futile attempts to control my progressively worsening blood sugar. When Avandia didn’t work, I was then (in 2002) going to be left with only one option: to become an insulin-dependent T2, injecting basal and mealtime insulin.
It turns out, though, that my doc had recently read Gary Taubes’s, July 7, 2002, NYT Magazine cover story “What If It’s All Been a Big Fat Lie?”  Out of curiosity he tried the recommended Very Low Carb diet advocated in the story (20 grams of carbs/day), and it worked for him. So, he thought it might work for me too, and as he walked me down the hall to schedule a follow-up appointment, he said, “It’ll probably be good for your diabetes too.”
The result: Within a day on this strict Very Low Carb diet, as a heavily medicated Type 2 diabetic I was experiencing “hypos” (dangerously low blood sugars). I called my doctor, and he told me to stop taking the Avandia. The next afternoon, when I had another hypo, he told me to cut in half the micronase and Metformin. A few days later he said to cut them by half again. He then saw me monthly for a year to monitor my blood and other health markers. In the course of that year I further reduced the micronase from 5mg to 2.5 to 1.25mg and finally completely phased it out. I still take Metformin to suppress gluconeogenesis if, as I sometimes do, I eat too much protein at supper.
In the first 9 months on the Very Low Carb diet I lost 65 pounds (1½ lbs./wk.). I then retired from work and kept that weight off for several years. Then, over the course of a summer, I added back 12 pounds (mostly from eating ice cream before bedtime, as I recall). But by this time, I had also been lurking and learning from Dr. (Richard K.) Bernstein’s online Diabetes Forum. I had also read Bernstein’s “Diabetes Diet” and his “Diabetes Solution,” so I decided to try his program (30grams of carbs a day). It was more focused on blood sugar control for diabetics.
On Bernstein I lost 100 pounds in 50 weeks (2lbs./wk.). Altogether I lost 170 pounds, settling in at 205 pounds. I have since regained some of that weight, but frankly I have been “off the ranch” for a while. I am still, however, much healthier than before. I eat Very Low Carb most of the time and have retained most of the health benefits.
My average HDL has more than doubled (from +/- 39 to +/- 84mg/dL) and my triglyceride average has been cut by 2/3rds (from +/- 150 to +/- 49mg/dl). I try to limit my carb calories to 5% of my calories and my protein to 20%, leaving 75% for fat. I do not limit salt, dietary cholesterol or saturated fat. I eat eggs and bacon and coffee with full cream and pure stevia for breakfast, and just a can of sardines for lunch. For supper, it’s just meat or fish and a low carb veggie with lots of butter or tossed in olive oil and roasted. In a restaurant I’ll have a cocktail (or 2) or two glasses of wine. The only dessert I’ll ever eat is berries (with heavy cream) on a very special occasion. I love a cheese plate (without bread or fruit), but it’s just too much food. I always regret it if I occasionally order it.
After the first year, I continued to see that doctor 3 times a year until his unfortunate demise. I went just to get blood tests to monitor my A1c, lipid profile (cholesterol panel), and other tests he wanted to do (kidney, thyroid, electrolytes and EKG). They were all always normal. And my hsCRP, a chronic systemic inflammation marker, plummeted from “high” to consistently less than 1.0 (very low risk of cardio vascular disease).
My new doctor, after studying my chart on my first visit, suggested I see him once a year. I was pleased that was his initial impression of my health, but I said I wanted to see him three times a year, just to keep track of my success.

No comments:

Post a Comment