Friday, April 10, 2020

Retrospective #419: Reversing Type 2 Diabetes

In 2002, to get me to lose weight, my doctor, largely by accident, effectively discovered a “cure” for my type 2 diabetes. It was, beneficially, a “side effect” of losing weight easily and without hunger. In this post I will recount my doctor’s stunning discovery of this “cure” and how my adoption of this “treatment” evolved over the years.
I was diagnosed a type 2 diabetic in 1986. For the first 16 years my diabetes was treated, according to the ADA’s Standards of Medical Practice, as a “progressive” disease. I ate, according to the Dietary Guidelines for Americans, a “balanced” diet and was encouraged to exercise regularly. My doctor monitored my blood sugar and prescribed oral medications in increasing doses. Eventually, I was “maxed out” on two classes of oral meds and had started a third. I knew that when I maxed out on it, my doctor would advise me I had “graduated” to injecting insulin. 
Then, in 2002, after reading Gary Taubes’s NYT Magazine cover story, “What If It's All Been a Big Fat Lie,” my doctor suggested I try the diet Taubes described to lose weight. As I was leaving his office, my doctor said, “This might even help your diabetes.” It did. In the 1st week, to avoid hypos, I had to eliminate or decrease all the anti-diabetic meds I was taking. I eliminated one and decreased the other 2 by half, TWICE. The diet described was a Very Low Carb diet, just 20 grams of carbohydrates a day. Incidentally, I followed it strictly for 9 months and lost 60 pounds.
With that diet, I counted carbs. I created an Excel table, wrote down everything I ate, just estimating the carb content. Then, four years later, over the summer, I regained 12 pounds, so I began a different program. This time I raised my daily carb intake to 30 grams and also counted protein, fat and total calories, again recording everything I ate. In the next year I lost 100 pounds and, a little later, 20+ more. Then, after a while, I STOPPED COUNTING. It was a lot of work and NO LONGER NECESSARY, BECAUSE, by that time I KNEW WHAT TO EAT AND WHAT NOT TO EAT.
Over the ensuing years I re-gained and re-lost some, using the same principles I learned in the beginning. That included Macronutrient Ratios for food ingested that were a part of the Very Low Carb eating patterns on which I started. The ratios varied somewhat but they were always “Ketogenic.” I settled on 5% carb, 20% protein and 75% fat, mostly saturated and monounsaturated.  On 1,200kcal/day that’s 15g of carbs, 60g of protein and 100g of fat. On such a Very Low Carb, HUNGER DISAPPEARS. You don’t need to eat more because, with a low blood INSULIN level, your body has access to its own fat for energy balance. But you have to EAT less fat for your body to burn BODY fat.
A couple of years ago, while struggling to lose some “re-gain,” I gave up breakfast. I wasn’t hungry at breakfast. I had been eating 2 eggs/2 strips of bacon, then just 3 eggs, with coffee and heavy cream. I kept the coffee and cream. Later, I also gave up lunch. Eating VLC, I wasn’t hungry at lunch either. Lunch had been a small tin of sardines in EVOO, or kippered herring in brine. But I stalled, even on One Meal a Day. I was still eating too much fat.
About a year ago I began full-day fasting. It was suggested to me on Facebook by Megan Ramos, IDM Program Director at Jason Fung’s practice in Toronto. Originally on alternate days (Tue & Thu), it soon evolved to 2-day and then 3-consecutive day fasts. My fast is not a true water fast. It includes the coffee with cream taken with morning pills and a red wine spritzer (5oz red wine + 8oz seltzer) with evening pills. Total 300kcal/day. I lost 60+ pounds, and my A1c dropped from 5.8% to 5.0%. Occasionally I cheated a little (I’m not perfect, LOL), but Metformin handled it.
Most recently I added an after-supper apple cider vinegar “cocktail” to the mix. I got the idea at the first Keto Dudes Festival in 2017. In my wine glass I add 1 Tb Bragg’s apple cider vinegar, a dash of bitters and a couple drops of liquid stevia. I then add ice cubes, swirl the mix and fill the glass with seltzer. My FBG this morning was 87mg/dl, and 18 years after starting Very Low Carb, I have maintained a “non-diabetic” A1c and a more than 150-pound weight loss.
Make no mistake about it: Type 2 Diabetes IS REVERSIBLE. To be clear though, while it is REVERSED, it is NOT CURED. It is IN REMISSION. But, BY THE ADA’S STANDARDS OF MEDICAL PRACTICE, there is no simple blood test (fasting or A1c), that can detect it. YOUR DOCTOR, THEREFORE, CLINICALLY SPEAKING, WILL CONSIDER YOU “CURED.”

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