One Person's Story - ShottleBop

I was diagnosed as the result of a routine physical, in February, 2008. My fasting BG was 127, and my A1c was 6.5. The ADA had not yet issued its recommendation that people with A1cs of 6.5 or more be diagnosed as diabetic; diagnoses were made on the basis of an oral glucose tolerance test (BG ≥200 mg/dL (11.1 mmol/L) at 2 hours) or on the basis of FBG (>126 (7.0 mmol/L)—on at least two occasions). My doctor called me up and asked me to come in for a second test, telling me that, if it were 126 or higher, I would be “diabetic,” and would have to make drastic changes in my lifestyle. For the next week, then, I started cutting out sugar and the like. My second test came in at 123. That made me “prediabetic,” instead of diabetic.

My doctor wrote me a prescription for a meter and strips, and had me go to a prediabetes class, which addressed basic nutrition using the food pyramid approach and recommended the familiar 45-grams-ofcarbs-per-meal approach to diet. My doctor, however, had also told me that I would have to cut out fruits, deserts, and other things that raised my BGs. Taking that as a cue, I ate to my meter. I didn’t count carbs or cut out bread--I mostly cut out desserts, fruits, and white bread, and experimented with wholegrain and Ezekiel breads. I also ate low-fat, cutting out cheese (and hamburger) almost entirely. I used my meter to eat to the AACE’s recommendation that BGs not exceed 140 two hours after eating. I started walking for half an hour or so most days.

Over the first three months, my average FBG settled into the 110-115 range, and my A1c came down to 6.0. I lost 30 pounds. After Passover 2008, though (a week in which I ate almost no grain), I discovered the difference that grain products made in my post-prandial readings. I had not yet bought any books about dealing with diabetes; I finally ordered Gretchen Becker’s book, The First Year: Type 2 Diabetes, on Amazon, which informed me that many people who bought that book also bought Dr. Richard Bernstein’s book, The Diabetes Solution. I found Jenny Ruhl’s website, Blood Sugar 101. I started eating to keep my post-prandial readings below 120. (For me, that peak can come any time from 90 minutes or so to three hours after a meal; only if I eat something with an unexpected load of sugar to I spike in the first hour.) I started logging my blood sugars on SugarStats (www.sugarstats.com).

I found that limiting carbs, in the manner generally recommended by Dr. Bernstein and Dr. Helen Hilts (“No roots, no fruits, no grains, no milk”), worked for me. I dropped another 35 pounds over the next six months, bottoming out at 155.*

I also started exercising. My average BGs immediately dropped into the 100 range. After another year, they dropped to where my average monthly BGs for most months were 90 or less.

At the end of 2011, I got laid off. I started a new job in August, 2012, and got new coverage, with Kaiser Permanente. (Before, I had been with Sharp Reese-Stealy.) My initial PCP worked with me (or at least tolerated my way of doing things) but then left Kaiser. In early 2015, I met my new PCP, gifted her a copy of Dr. Bernstein’s book, and explained to her exactly how I’d maintained my blood sugar levels over the past seven years. She was very concerned about my LDL (270), however. She understood that I’d found that I couldn’t tolerate the stronger statins, and that even exceeding 10 mg pravastatin per day had caused me issues—and she prescribed 600 strips for me, for three months—but, in return, I promised reduce my intake of fat--especially saturated fat—to lower my LDL. (My LDL reacts greatly to the amount of fat in my diet—what I eat can produce a 70-point swing one way or the other, without medication.)

Keeping that promise to my PCP meant increasing either or both of my carb intake and my protein intake. So, I continued to minimize my intake of processed foods, but I added some carbs to my diet, to see whether I could manage my blood sugars while keeping my cholesterol down.

I didn’t go hog-wild eating carbs; I added in some whole grains, and ate the lower-carb fruits (read, “berries”) more often than I had been before (once every couple of weeks or so). Instead of the Cobb salad at my favorite lunch place, I tried the quinoa salad. Instead of gyros meat with my Greek salad at another lunch spot, I tried the falafel. I still ate my Nicoise tuna salads, but I tried to watch my total egg consumption. 

I kept that up for a year and a half. Here was my report (in the Diabetes Forum) on the experiment in July, 2016, just before I resumed my original regime (I started logging my food on MyFitnessPal (www.myfitnesspal.com) in early 2015):

So, folks: a year and a half ago, I left the “Low Carb Daily Menu” thread and started this thread, because I had embarked on a mission to lower the fat in my diet (to try to accommodate the concerns of a new PCP, and to induce her to continue to prescribe enough strips for me to test as often as I like).

While, for several months, I managed to reduce my fats, I have, in the long run, merely changed the composition of my fats, through a drastic reduction in my consumption of cheese and heavy cream. 

For comparison purposes:

For the one-month period PRECEDING the beginning of this experiment (Dec. 19, 2014- Jan. 18, 2015): 

• Average BG: 88 
• Lowest: 61 
• Highest: 110 
• Average FBG: 94.17 
• No. days where all readings <100: 21 
• No. days where at least one reading > 110: 

• Avg daily carbs (including fiber): 52 grams 
• Avg daily protein: 103.09 
• Avg daily fat: 150 grams 
• Avg daily sat fat: 54.3 grams 
• Days sat fat <50: 12 
• Lowest sat fat day: 33 grams

I successfully reduced fat for the first few months: 

For the first month of this experiment (Jan. 19-Feb. 18, 2015): 

• Average BG: 91 
• Lowest: 58 
• Highest: 183 
• Average FBG: 88.14 
• No. days where all readings < 100: 7 
• No. days where at least one reading > 110: 10 
• Avg daily carbs (including fiber): 99 grams 
• Avg daily fat: 94 grams 
• Avg daily sat fat: 19.4 grams 
• Days sat fat > 23: 7 Highest sat fat day: 29 grams 

For the second month of this experiment (Feb. 19-Mar.18, 2015): 

• Average BG: 89 
• Lowest: 57 
• Highest: 125 
• Average FBG: 88.81 
• No. days where all readings < 100: 11 
• No. days where at least one reading > 110: 5 
• Avg daily carbs (including fiber): 103 
• Avg daily fat: 105 grams 
• Avg daily sat fat: 25.4 grams 
• Days sat fat > 23: 16 
• Highest sat fat day: 41 grams 

For the third month of this experiment (Mar. 19-Apr.18): 

• Average BG: 87 
• Lowest: 62 
• Highest: 131 
• Average FBG: 88.07 
• No. days where all readings < 100: 11 
• No. days where at least one reading > 110: 5 
• Avg daily carbs (including fiber): 101.5 
• Avg daily fat: 103.6 grams 
• Avg daily sat fat: 23.2 grams 
• Days sat fat > 23: 13 
• Highest sat fat day: 36 grams

But, by fall of last year, I had pretty much reverted, with respect to fat intake: 

For November, 2015: 

• Average BG: 86 
• Lowest: 64 
• Highest: 151 
• Average FBG: 88.52 
• No. days where all readings <100: 19 
• No. days where at least one reading > 110: 3

• Avg. daily carbs (including fiber): 110.87 grams 
• Avg. daily protein: 120.27 grams 
• Avg daily fat: 148.03 grams Avg daily sat fat: 45.27 grams 
• Days sat fat <50: 20 
• Lowest sat fat day: 24 grams

For the last 30 days:

• Average BG: 91
• Lowest: 66
• Highest: 114
• Average FBG: 91.61
• No. days where all readings <100: 13
• No. days where at least one reading > 110: 2
• Avg. daily carbs (including fiber): 100.03 grams [Highest: 132; lowest: 52]
• Avg. daily protein: 125.8 grams
• Avg. daily fat: 147.03 grams
• Avg. daily sat fat: 46.33
• Days sat fat <50: 19
• Lowest sat fat day: 23 grams

As you will note, I never got my average daily carbs much above 100--and, for the last couple/three months, I’ve greatly increased my intake of fiber, to approximately 40% of my daily total carb intake.

Anyways, even though I’ve doubled my average daily carb intake, I think it’s fair to conclude that my daily reports are better referred to as low-carb results, than here, as part of a “lower fat experiment,” and I will be rekindling an appropriate thread. Please come visit there.

Today (nearly three years after stopping the experiment), my blood sugar levels average about 10 points higher than before I started, and my fasting levels are higher, as well. I also experience far more dawn phenomenon than I ever did--if I lie in bed awake at all, or postpone eating, I see blood sugar readings in the 115-125 range that I hadn’t seen since I was first diagnosed. I don’t know whether that was a result of my year-and-a-half of eating more carbs, because, honestly, my average BGs didn’t appear to change that much over the course of that experiment.

These days, I try to eat in the range of 40-60 grams of carbs a day, approximately 1/3 of that as fiber. I eat fish on a regular basis (tuna salad, salmon salad--smoked herring or sardines for lunch sometimes), as well as a range of other proteins and fats. Generally, I eat whatever I am hungry for, but (mostly, successfully) avoid sugar and most non-veggie carbs. Breakfast is almost always an avocado, a chicken sausage, some raw fresh greens (I’m partial to TJ’s Southern greens blend) and coffee with cream, sometimes some low-carb yogurt. I rely on TJ’s “Just a handful of dry roasted almonds,” or 25 grams of Montezuma’s Absolute Black unsweetened chocolate, for a midmorning or midafternoon snack; I also try to keep macadamia nuts on hand as an alternative. Four days out of five, Mrs. S packs my lunch, and I get a variety of salads—often made with leftovers. On Fridays, lunch is most often a Cobb salad or a Nicoise tuna salad; sometimes a bunless burger with steamed veggies or a side salad. I have homemade low-carb ice cream, based on coconut cream, almost daily. The week before last, on a trip to New York, my son and daughter-in-law introduced me to Kiss My Keto bars—only half the protein in a typical lowcarb bar, such as QuestBars, good-tasting, and very kind to my blood sugars. I bought a box. 

My last A1c (in June, 2018) was 5.4. I keep a spreadsheet of my major stats, and set out below a screencap of the past year. From the left, the columns indicate (after the date): average BG for the month, average FBG (waking up), low reading, high reading, percentage of my readings over 110, and number of days that all my readings were under 100. (That used to be quite common, but for the past year or more has been very rare—just once in the past 30 days.)

I was lucky: I was diagnosed before experiencing any of the complications that can follow consistently high blood sugars, and at a point where I could control my blood sugars without medications. I plan to keep on this path for as long as possible.

* For the past six or seven years, I’ve weighed between 190 and 195—sometimes higher, sometimes, lower.