Diabetes

[Herbie Hancock 7341]

Ah gotcha. I did not remember him saying it that strongly. The main takeaway I had is that he asserts that not all calories are created equal, which I think is common sense.

But all calories are equal because a calorie is simply a unit of measure. All foods are not created equal, but that’s not what he and a lot of other heretics like Jason Blaha, Paul Saladino and Shawn Baker are saying.

[jimmyjazz 45877]

Yeah, a calorie is a unit of heat (more specifically, energy).  I'm no nutritionist, but a calorie is definitely a calorie.  (I think I recall from undergrad thermo that a food calorie is actually a kilocalorie, or maybe the other way around.)

[harpercollins 394]

I need to go back and read. I thought the main premise was that calories out and calories in are not independent variables, and that reducing caloric intake would cause weight loss initially, but eventually the body would adapt and reduce caloric expenditure (beyond the predictable decrease associated with not having as much mass).

this is what you’re saying has been debunked?

[TwiceHorn 31429]

16 minutes ago, harpercollins said:

I need to go back and read. I thought the main premise was that calories out and calories in are not independent variables, and that reducing caloric intake would cause weight loss initially, but eventually the body would adapt and reduce caloric expenditure (beyond the predictable decrease associated with not having as much mass).

this is what you’re saying has been debunked?

I think that's fairly accurate.  But there are people with metabolic disorders that just stay fat.  They tend to be borderlne diabetic with blood sugar and insulin production and utilization issues.

And, while a calorie is a calorie in terms of energy, as noted, 200 or 300 calories of quality food -- protein, fat, complex carbs -- can be a better dietary choice than 100 calories of poor food -- processed simple carbs.  So the food that contributes those calories makes a difference.

[jimmyjazz 45877]

34 minutes ago, harpercollins said:

I need to go back and read. I thought the main premise was that calories out and calories in are not independent variables, and that reducing caloric intake would cause weight loss initially, but eventually the body would adapt and reduce caloric expenditure (beyond the predictable decrease associated with not having as much mass).

It seems to me that's saying the caloric deficit is not wholly defined by the reduction of caloric intake, which could be true.  I wonder if it's really true for someone who remains as active as they were before dieting?

[Dbeasy 15039]

FWIW, I focused heavily on glycemic index for a few years but found thru measurements that blood sugars did not fully align with the glycemic index. Some low GI foods would produce high sugars and vice versa. Over time I just figured out which foods produced the worst results and tried to moderate those. 

[jimmyjazz 45877]

2 hours ago, Dbeasy said:

Over time I just figured out which foods produced the worst results and tried to moderate those. 

Does that likely vary from person to person?

[PRONG HORN 3128]

On 6/20/2024 at 8:39 PM, Herbie Hancock said:

Jason Fung is one of the biggest quacks on the face of the earth. Please for the love of god do not promote his fuckery. You’re making the dude upthread that doesn’t know the difference in Type 1 and 2 seem like an intelligent creature (he’s not).

 

 

I may not be very smart but I know when I'm being an ass on a thread (often).  This isn't one of those times.  If you can rattle off all your fav youtube nutrition gods why don't you offer Jimi something useful instead of being an ass. 

 

 

8 hours ago, harpercollins said:

I need to go back and read. I thought the main premise was that calories out and calories in are not independent variables, and that reducing caloric intake would cause weight loss initially, but eventually the body would adapt and reduce caloric expenditure (beyond the predictable decrease associated with not having as much mass).

this is what you’re saying has been debunked?

 

 

I just selected this part of your quote and searched Google.  "reducing caloric intake would cause weight loss initially, but eventually the body would adapt".  You're right.

 

 

5 hours ago, jimmyjazz said:

Does that likely vary from person to person?

 

It does appear that whole wheat pasta is probably better than regular pasta, but neither appears to be particularly problematic.  Similarly, most fruits aren't particularly bad (watermelon and pineapple seem to be exceptions, which sucks, because she loves those two).

I just want her to be able to enjoy as much of her old diet as possible.

 

 

Probably.  That's why it's good to test with a glucometer.  Wheat pasta night vs. white pasta night.  Assuming all other variables are as identical as possible.  Sauce, sides, drink, etc.  Being on meds would have a huge factor to play.  Much less to near non-existent worry than if you try to go the drug free route.  Doc would more than likely advise against drug free for lots of reasons but I'm sure there are diabetic message boards to lurk.  

 

 

[jimmyjazz 45877]

One interesting development:  she had been sleeping poorly, and thought it might be due to caffeine consumption, so she cut that out and her sleep did improve a bit.

Then she got this diagnosis and the doc put her on metformin -- wham!, she's sleeping like a baby.  Her improvement in mood is substantial.  Could it be coincidence?  Maybe.  Somehow I doubt it.

On my journey, learning about glycemic load (as opposed to just focusing on glycemic index) is starting to shed light on effective dietary restrictions.

[PRONG HORN 3128]

1 hour ago, jimmyjazz said:

One interesting development:  she had been sleeping poorly, and thought it might be due to caffeine consumption, so she cut that out and her sleep did improve a bit.

Then she got this diagnosis and the doc put her on metformin -- wham!, she's sleeping like a baby.  Her improvement in mood is substantial.  Could it be coincidence?  Maybe.  Somehow I doubt it.

On my journey, learning about glycemic load (as opposed to just focusing on glycemic index) is starting to shed light on effective dietary restrictions.

 

Mood is a big one for people who stabilize their blood sugar levels throughout the day.  It’s a common one.  Good for her.  Keep researching so you can reduce or remove Metformin if that’s your route.  Good docs always want to prescribe as low a dose as possible hopefully they mentioned that in some way.  Or said they’ll do another A1C in a few months to adjust dosage.  The diet might help get her numbers low enough so doc feels safe to lower.  I don’t know of any message boards for diabetics and their food/meds journey. 

[jimmyjazz 45877]

1 minute ago, PRONG HORN said:

Mood is a big one for people who stabilize their blood sugar levels throughout the day.  It’s a common one.  Good for her.  Keep researching so you can reduce or remove Metformin if that’s your route.  Good docs always want to prescribe as low a dose as possible hopefully they mentioned that in some way.  Or said they’ll do another A1C in a few months to adjust dosage.  The diet might help get her numbers low enough so doc feels safe to lower.  I don’t know of any message boards for diabetics and their food/meds journey. 

The doc told her she was being started on 25% of max dosage.

[jimmyjazz 45877]

Update:  wife is on Jardiance (once a day) and metformin (full dose, half each twice a day).  We don't have a useful A1C number yet but her blood sugar is routinely in the mid-100 range, which is a massive improvement.  She had gained "weight" over the years, going from tiny (when I met her) to classic 50 YO mom bod, but it turns out a bunch of that was just inflammation.  The reduction in said inflammation is astonishing -- she's not down to her dating weight yet but she's getting close enough that I'm starting to worry about getting my own shit together.  Dammit.

[Herbie Hancock 7341]

So you can tell by the info whether it’s type 1 or 2, but didn’t offer any dietary basics that op asked for?  
my post boiled down to general low carb diet advice basically telling op to get educated on carbs, insulin spikes, and glucose.  
 

 
 

Just wanted to circle back here and have you google the two medications Jimmy’s wife has been prescribed, and then have you tell us if those are for Type 1 or Type 2 diabetes.

[jimmyjazz 45877]

2 minutes ago, Herbie Hancock said:

Just wanted to circle back here and have you google the two medications Jimmy’s wife has been prescribed, and then have you tell us if those are for Type 1 or Type 2 diabetes.

The irony here is that her doc hasn't even told her what type she has.  I'm sure they are capable of making the basic diagnosis, but holy smokes getting a return phone call has been ridiculously difficult.  We're looking forward to getting set up with a true specialist and a dietician.  (Further irony, my wife has a degree in Nutrition from UT-Austin, so I'm of the opinion she should be able to manage this going forward just as soon as she gets taught the details.)

[Herbie Hancock 7341]

The irony here is that her doc hasn't even told her what type she has.  I'm sure they are capable of making the basic diagnosis, but holy smokes getting a return phone call has been ridiculously difficult.  We're looking forward to getting set up with a true specialist and a dietician.  (Further irony, my wife has a degree in Nutrition from UT-Austin, so I'm of the opinion she should be able to manage this going forward just as soon as she gets taught the details.)

This is going to be a really really dumbed down explanation so bear with me: Type 1 (also known as juvenile diabetes) is insulin dependent and is only controlled via exogenous insulin as the pancreas has ceased functioning. Type 2 (also known as adult onset diabetes) is where the pancreas isn’t making enough insulin. It typically comes from being overweight (how much isn’t exactly known), but the main culprit is poor dietary choices over a significant amount of time. The good news is that with the medications above and a good RD (registered dietician), your wife may and actually most likely will be able to rid herself of the medications entirely after she gets everything ironed out and is able to stick to a healthier dietary regimen.

[jimmyjazz 45877]

4 minutes ago, Herbie Hancock said:

This is going to be a really really dumbed down explanation so bear with me: Type 1 (also known as juvenile diabetes) is insulin dependent and is only controlled via exogenous insulin as the pancreas has ceased functioning. Type 2 (also known as adult onset diabetes) is where the pancreas isn’t making enough insulin. It typically comes from being overweight (how much isn’t exactly known), but the main culprit is poor dietary choices over a significant amount of time. The good news is that with the medications above and a good RD (registered dietician), your wife may and actually most likely will be able to rid herself of the medications entirely after she gets everything ironed out and is able to stick to a healthier dietary regimen.

Thanks, that clarifies some things for me.  She was never particularly "overweight" although she would have been happy weighing maybe 20 lbs less.  She's always eaten pretty well, but there was certainly a sugar component via lots of fruit and a fair amount of breads & other carbs.  She has never been a drinker (or drugger).

The diagnosis wasn't fun, but she now sees that there will be an upside and of course it's good to keep these kind of health issues front and center.

Edited July 8 by jimmyjazz

[harpercollins 394]

Fun fact: my granddad contracted a bad case of flu as an adult that left him with Type 1 diabetes (which at that point was known almost exclusively as juvenile diabetes).

A 36 year old nasa engineer with 8 children at dx, he bio-hacked his way to health for more than 50 years, finally dying at almost 87 years old. He was one of the first patients to use a portable insulin pump in the 70s. He was always an early adopter of technology. I miss him greatly.

[tx 3 putt 76859]

Her dr hasn’t told her diabetes type or A1C ? 
 

how is that even possible ?

[jimmyjazz 45877]

6 hours ago, tx 3 putt said:

Her dr hasn’t told her diabetes type or A1C ? 
 

how is that even possible ?

She has her initial A1C, it was obviously high, I don't remember the exact number but over 10%.  The doc says the most important thing is to see how it responds to the medication.  Her initial fasting blood sugar was 350-ish, but now she routinely tests in the mid-100 range, 6X per day, so I'm pretty confident the medication is doing its thing, along with big changes in diet (mostly cutting bread & potatoes, and to some degree fruit).

[Orale 1087]

Are there sugar substitutes that don't cause bad gas and other stomach issues? I'm pre-diabetic and buy sugar free sweets to sate my sweet tooth and some of them do a number on my stomach. Some don't. I need to be better at tracking which particular sweeteners do this. 

[Rip76 4924]

On 6/17/2024 at 6:55 PM, jimmyjazz said:

Wow, thanks.  I'll look into the Mediterranean diet.

The Mediterranean diet is solid.

[Horn of Gabriel 1614]

On 7/8/2024 at 2:15 PM, jimmyjazz said:

Thanks, that clarifies some things for me.  She was never particularly "overweight" although she would have been happy weighing maybe 20 lbs less.  She's always eaten pretty well, but there was certainly a sugar component via lots of fruit and a fair amount of breads & other carbs.  She has never been a drinker (or drugger).

The diagnosis wasn't fun, but she now sees that there will be an upside and of course it's good to keep these kind of health issues front and center.

If she's on metformin it's 99.999% gonna be Type 2.   Which was always going to be anyway considering her age and genetics and the population at large.  9 out of 10 diabetics are Type 2.  Type 2 usually presents later in life, and can be managed via diet and lifestyle - sometimes even eliminating the need for drugs, but not always.  Type 2 is strongly genetically typed, so your kids will need to look out for it.  Certain populations (Native American, Hispanic) are more susceptible.  Type 2 you usually still make your own insulin, just your body becomes less and less sensitive to it.  Drugs like metformin can increase your sensitivity, as can weight loss and changing your diet.  Most Type 2's don't require supplemental exogenous insulin, but those who can't/won't make the lifestyle changes might require it.  Type 2 is where the diabeetus memes come from.   

Type 1 (formerly "juvenile") diabetes typically presents in childhood/teens, but over the past few decades later incidences in life have become more common.  I was diagnosed Type 1 at 29 years old, and didn't have symptoms until that year.  Type 1 is not strongly genetically typed, my kids have only a ~3% elevated chance of getting it because I have it.  They don't know the cause of Type 1, it's an autoimmune condition and theories range from a virus to environmental to stress.  Regardless in Type 1 your body attacks your insulin producing cells and kills them off so as someone said upthread you must take exogenous insulin - as I do via an insulin pump.  My insulin sensitivity however is fine, I just don't make any.

[jimmyjazz 45877]

Thanks, all of this is helpful.  She has responded super well to metformin and Jardiance, as well as changes in diet.  We've been real strict about daily net carb intake, I'd say she's under 60 grams at this point.  Her fasting blood sugar was ~ 350 before she started all this and now it's typically 105-155 depending on time of day, etc.  She's lost almost 10 lb and looks quite a bit different, to me it seems as if she might have had a fair amount of inflammation.  I'm not saying it's been a fun ride but she feels much better and likes the physical change so I think we can probably stick with this as a general lifestyle.

[closetohumping 17431]

Can’t wait to read this thread.    Have you found fasting and eliminating carbs helpful?

[jimmyjazz 45877]

48 minutes ago, closetohumping said:

Can’t wait to read this thread.    Have you found fasting and eliminating carbs helpful?

No fasting, and it's impossible to unwind what effect diet changes have had relative to medication.  I'm pretty sure she's stuck with both for life, but at least they caught it relatively early.

[closetohumping 17431]

Just now, jimmyjazz said:

No fasting, and it's impossible to unwind what effect diet changes have had relative to medication.  I'm pretty sure she's stuck with both for life, but at least they caught it relatively early.

Yes.  I’m not a doctor but I’ve heard type 2s, if they’re strict can basically be off meds

[jimmyjazz 45877]

4 minutes ago, closetohumping said:

Yes.  I’m not a doctor but I’ve heard type 2s, if they’re strict can basically be off meds

I hope that turns out to be the case.  The diet doesn't seem to be too big an issue, but it's an effort, nonetheless.  I have a few severe food allergies, so adding in her limitations has definitely forced some compromise.  I see more takeout in our future because it's more difficult to cook a common meal for both of us at this point.

[closetohumping 17431]

8 minutes ago, jimmyjazz said:

I hope that turns out to be the case.  The diet doesn't seem to be too big an issue, but it's an effort, nonetheless.  I have a few severe food allergies, so adding in her limitations has definitely forced some compromise.  I see more takeout in our future because it's more difficult to cook a common meal for both of us at this point.

Be careful with restaurant food. Lots of hidden cals

[closetohumping 17431]

Curious about the groups thoughts about caffeine.  Seeing alot of differing opinions on line

[jimmyjazz 45877]

We were told that caffeine can interfere with the way insulin is used in the body.  In my wife's case, she was always a cream and sugar coffee drinker, so we eliminated coffee for her.  That was her only source of caffeine in her diet, so it's impossible to tell how it might affect her since we could never separate the caffeine from the sugar.

Change the amount of caffeine consumed and check blood sugar?  Obviously, I'm not a doc.

[South Austin 52431]

50 minutes ago, closetohumping said:

Curious about the groups thoughts about caffeine.  Seeing alot of differing opinions on line

My former father-in-law is Type 1, first diagnosed when he was early teens and now approaching 80.  Party of his longevity has that he's lived a pretty disciplined life -- no alcohol, regular insulin, timely meals, and he's always been physically active and is relatively thin.  But he drinks at least 6 Diet Cokes a day, along with about a pot of coffee in the morning, for whatever that's worth.

[closetohumping 17431]

On 7/18/2024 at 8:42 AM, jimmyjazz said:

I hope that turns out to be the case.  The diet doesn't seem to be too big an issue, but it's an effort, nonetheless.  I have a few severe food allergies, so adding in her limitations has definitely forced some compromise.  I see more takeout in our future because it's more difficult to cook a common meal for both of us at this point.

I’ve been avoiding doing bloodwork as I have not been perfect but finally bit the bullet and went.  Basically cut my sugar in half!!    My blood level now is barely pre diabetic. Huge win. 

[jimmyjazz 45877]

47 minutes ago, closetohumping said:

I’ve been avoiding doing bloodwork as I have not been perfect but finally bit the bullet and went.  Basically cut my sugar in half!!    My blood level now is barely pre diabetic. Huge win. 

That's great to hear.  My wife's combination of meds and diet are doing the job -- she tests 6X a day and typically falls between 105 and 150, depending on, well, who knows?  We're figuring out which foods cause issues.  For some reason, potatoes don't seem very problematic, so that helps.  Breads are pretty much off limits.  HEB has a line of low carb tortillas she says are pretty good, so we go with those occasionally.  It's a pretty dramatic lifestyle change for sure.

[closetohumping 17431]

43 minutes ago, jimmyjazz said:

That's great to hear.  My wife's combination of meds and diet are doing the job -- she tests 6X a day and typically falls between 105 and 150, depending on, well, who knows?  We're figuring out which foods cause issues.  For some reason, potatoes don't seem very problematic, so that helps.  Breads are pretty much off limits.  HEB has a line of low carb tortillas she says are pretty good, so we go with those occasionally.  It's a pretty dramatic lifestyle change for sure.

Thank you. Been less than perfect and absolutely I’ve had some lapses but I’ve turned things around these last 6 months.  My doctor was pretty much mad at me until this.  
 

cut out rice, pasta, bread.   I’ll eat low carb bread and tortillas.  Avoid fruit.  Training for 10k and eventually a half marathon.  

[Herbie Hancock 7341]

Run? For fun?? Diabetes is no longer your biggest issue as it appears you have developed a serious mental illness.


J/k……kinda

[Herbie Hancock 7341]

That's great to hear.  My wife's combination of meds and diet are doing the job -- she tests 6X a day and typically falls between 105 and 150, depending on, well, who knows?  We're figuring out which foods cause issues.  For some reason, potatoes don't seem very problematic, so that helps.  Breads are pretty much off limits.  HEB has a line of low carb tortillas she says are pretty good, so we go with those occasionally.  It's a pretty dramatic lifestyle change for sure.

Glycemic index aka how fast your body digests and absorbs a food. What affects that is the nutrient content of a food (protein, fats, fiber). Potatoes are much lower on the scale than bread, and thus your BGL won’t rapidly rise and subsequently crash like with bread due to a more steady digestion and absorption rate. Ezekiel bread has a significantly lower GI than Mrs. Baird’s, but much like the carb balance tortillas nothing tastes as good as the real thing.

[jimmyjazz 45877]

31 minutes ago, Herbie Hancock said:

Glycemic index aka how fast your body digests and absorbs a food. 

Yeah, I've become half obsessed with learning about glycemic index and glycemic load.  When I say potatoes aren't a problem what I mean is that they seem to cause lower blood sugar spikes than the equivalent load of, say, white rice.

We're even digging into the differences between things like type of rice -- brown is best, but basmati is close, jasmine and white rice are both bad.  (Don't get me started on "basmati is white", it must just be a different grain type that happens to be less damaging.)  I wish I could get her to try beans again (pinto, black, kidney).  She is skeptical that the fiber content helps, but it certainly does, because it's a carb that is not absorbed by the body.  Baby steps.

[tx 3 putt 76859]

6 hours ago, closetohumping said:

I’ve been avoiding doing bloodwork as I have not been perfect but finally bit the bullet and went.  Basically cut my sugar in half!!    My blood level now is barely pre diabetic. Huge win. 

my lady a1c was 6.1, about two months ago 

[closetohumping 17431]

21 minutes ago, tx 3 putt said:

my lady a1c was 6.1, about two months ago 

NICE

5 hours ago, Herbie Hancock said:

Run? For fun?? Diabetes is no longer your biggest issue as it appears you have developed a serious mental illness.


J/k……kinda

15 minute walk lowers the glucose in a hurry.  Pretty incredible.  Also fasting.

4 hours ago, Herbie Hancock said:

Glycemic index aka how fast your body digests and absorbs a food. What affects that is the nutrient content of a food (protein, fats, fiber). Potatoes are much lower on the scale than bread, and thus your BGL won’t rapidly rise and subsequently crash like with bread due to a more steady digestion and absorption rate. Ezekiel bread has a significantly lower GI than Mrs. Baird’s, but much like the carb balance tortillas nothing tastes as good as the real thing.

Correct.  The bread isn't even close to as good.  

[Saint Tacky 1613]

The "iLet Bionic Pancreas" has been a game changer for me. 

At first, being connected to a pump made me feel like a tetherball, constantly aware of the device. But it quickly proved its worth. All I have to do is input an estimate of the carbs in my meal (usual, more, or less) and that’s it. The device takes care of the rest—administering, monitoring, and making any corrections. It automatically adjusts my dosage to keep me within range, adding or reducing insulin as needed.

What makes it "bionic" is its ability to learn my needs over time and adapt. It communicates with my Dexcom G7 and makes all the dosing decisions based on my history—no carb counting, no correction factors, and no manual adjustments.  The lone drawback -- and it is a significant one -- is cost. I was able to get in on a deal for the device through my endocrinologist, but the cost of the supplies is egregious. 

[jimmyjazz 45877]

Any recs on a truly comprehensive database for glycemic index and glycemic loads of various foods?  All I've found are skeletal at best.

[PRONG HORN 3128]

2 hours ago, jimmyjazz said:

Any recs on a truly comprehensive database for glycemic index and glycemic loads of various foods?  All I've found are skeletal at best.

 

 

 

database for glycemic index and glycemic loads of various foods?

 

 

 

[PRONG HORN 3128]

3 hours ago, jimmyjazz said:

Any recs on a truly comprehensive database for glycemic index and glycemic loads of various foods?  All I've found are skeletal at best.

 

It's about whose research you trust.  Put macaroni and cheese and make sure you're searching United States. it gives info for Kraft's product.

 

Quote

We are the home of Sydney University Glycemic Index Research Service (SUGiRS). We are an established commercial GI testing laboratory, where we test foods for their glycemic index, insulin index, satiety response, and other metabolic parameters. We also do other analyses such as in vitro starch digestion assays. SUGiRS has an established reputation for quality, speed and flexibility.

 

 

[txduck87 985]

my lady a1c was 6.1, about two months ago 

My doc is starting to give me shit about mine at 5.6.

I’m 58. Is he a quack?

I thought under 6.5 was good and I was doing well. Very focused on diet and exercise.

[Jerry Callo 8694]

9 minutes ago, txduck87 said:

Is he a quack?

user name checks out

[tx 3 putt 76859]

2 hours ago, txduck87 said:

My doc is starting to give me shit about mine at 5.6.

I’m 58. Is he a quack?

I thought under 6.5 was good and I was doing well. Very focused on diet and exercise.

under 5.9

just cut back on carbs (any white food) and start walking 

[Mac8111 2105]

Is there a preferred device/ system to capture your blood sugar levels daily?

[jimmyjazz 45877]

9 hours ago, Mac8111 said:

Is there a preferred device/ system to capture your blood sugar levels daily?

My wife has a continuous monitor that is embedded in her upper arm.  It talks to a bracelet that can communicate with her phone.  It's pretty cool, and a whole lot easier than 6X manual tests per day.

[tigol 2395]

On 8/19/2024 at 9:12 AM, jimmyjazz said:

Yeah, I've become half obsessed with learning about glycemic index and glycemic load.  When I say potatoes aren't a problem what I mean is that they seem to cause lower blood sugar spikes than the equivalent load of, say, white rice.

We're even digging into the differences between things like type of rice -- brown is best, but basmati is close, jasmine and white rice are both bad.  (Don't get me started on "basmati is white", it must just be a different grain type that happens to be less damaging.)  I wish I could get her to try beans again (pinto, black, kidney).  She is skeptical that the fiber content helps, but it certainly does, because it's a carb that is not absorbed by the body.  Baby steps.

You might find this helpful regarding potatoes and pasta:

https://www.vidanutrition.com/low-carb-pasta-rice-potatoes/

[jimmyjazz 45877]

4 hours ago, tigol said:

You might find this helpful regarding potatoes and pasta:

https://www.vidanutrition.com/low-carb-pasta-rice-potatoes/

Thanks, I have seen a couple of references to that.  Right now she isn't allowed to consume any carbs but berries, but when she gets through this "study", she will probably be able to consume small amounts.