In Retrospective #329, I related how, in 2016, two major changes in self-management of my then 30-year Type 2 Diabetes marked the beginning of a transition in my blood sugar control. Like many Type 2s who treat Type 2 Diabetes as a “dietary disease” (as I do), worsening blood sugar control is hard to attribute. There is always the question: is it a “compliance” issue with eating Very Low Carb or, as is the conventional wisdom, is it a “natural progression” of worsening Insulin Resistance (IR), especially if carbohydrate restriction is not the main means of control. Whichever, Type 2s need to be both vigilant for changes in control and flexible. I was prepared to change my regimen, first by improved compliance, and then, if necessary, as a last resort, increase my meds. After all, my health is at stake, and control of blood sugar levels, starting with a low fasting blood sugar, is critical.
So, In January I started Andreas Eenfeldt’s 5-part program that I described in #329, and at my April appointment, my doctor agreed to increase my prescription for Metformin to 1500mg/day. I chose that level because I had read somewhere, sometime in the past, that 1500mg/day is where Metformin really begins to work. I hadn’t previously considered increasing Metformin because of pride. Pride from having given up virtually all my oral antidiabetic meds, and not wanting again to be “drug dependent.” As for my doctor not suggesting it, I can only speculate it is because he thought that I wanted to manage my Type 2 diabetes. Or maybe he just didn’t know that much about Metformin.
In retrospect, though, I think the most likely reason he didn’t increase it is that all the doctors and nurses I have seen have considered my Type 2 diabetes already “very well controlled.” After all, my A1c’s have always been low to mid 5s, well below the level of concern of the American Diabetes Association guidelines. And as for my current doctor, I love him, but except for my insisting on it, he would not even have me testing my blood sugars once a day. Now, he’s only interested in my A1c. And when I first went to see him (he “inherited” me from my previous doctor), he suggested I only come to see him once a year. Because I was “very well controlled,” I just needed an annual checkup!
3) The 3rd “tweak” in my regimen (for tweaks #1 and #2 see Retrospective #329) was to add 6 grams of MCT oil (in gel form) to my daily supplements, as a PROPHYLACTIC TREATMENT for insulin resistance (IR) of the brain (Cognitive Impairment). The brain uses about 20% of the body’s glucose supply. Alzheimer’s Disease (AD), like Type 2 diabetes, develops over many years, well before its symptoms become apparent. The brain simply can’t get the glucose it needs due to its Insulin Resistance. Alzheimer’s has thus been described as Type 3 Diabetes. MCT oil, which is 100% Medium Chain Triglycerides (MCTs) extracted from coconut oil and palm kernel oil, goes directly to the liver which converts it to ketones. KETONES ARE AN ALTERNATE FUEL FOR THE BRAIN, and the brain LOVES them. I wrote about AD and Supplemental Ketones in Retrospective #322 and again in #323, #324 and #325.
So, what’s all the hullabaloo about? What’s the breakthrough? The answer: My fasting blood sugars have been TRANSFORMED. They are now ALL below 100mg/dl. WELL below 100. Two weekly AVERAGES in a row of 79mg/dl, range 68 to 92. This transformation began in mid-March, with increasingly regular FBGs in the 90s. By mid-April it was in full swing: Now virtually all my FBGs are in the 70s and 80s, with only an occasional outlier.
And I’ve not been a “perfect” VLC eater. I have even had a little French bread, with butter, at one restaurant meal. And 3 French bread slices slathered with rillette at another, both with no discernible effect on my fasting blood sugar the next morning! Previously, any transgressions as egregious as these would definitely have shown up 12 hours later in my Fasting Blood Glucose (and for a few days later too!) THIS IS VERY LIBERATING.In addition, the impact of starting the day with a FBG in the “normal” range will surely lower my next A1c. And the lower blood sugars mean a lower circulating insulin level, which means more breakdown and burning of body fat. For most people, losing weight is as powerful a motivator as blood sugar control. But when you’re not hungry (because your body is blissfully chugging along on its own fat), you really don’t have a reason or even a good excuse to overeat!
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