Living in Diabetes Denial

I was diagnosed with type II diabetes in December, 2002, eight and a half years ago. I immediately lost some weight, but when I saw there was no immediate health problems, I slipped back into my old ways.  This probably happened some time during the summer of 2003.

Beginning in 2005, for whatever reason, I lost a lot of weight on Weight Watchers and my blood sugars went down dramatically. In fact, I stopped taking medicine. (Note, however, my lipid profiles only improved somewhat; my overall score was low, but my LDL was high, my HDL was low, and my triglycerides were quite high). Then, since Weight Watchers is what Gary Taubes called a "semi-starvation" diet, when I quit starving myself, my weight came back on and my diabetes came back with a vengeance. I followed WW religiously from November, 2005 until May 2007. Then I regressed and gained back much of the weight I lost. I just pretended I didn't have type II diabetes and ate what I wanted to eat, without concern about the effects it was having on my body. I guess you could say, I was in deep denial. By May 2008, my blood sugars were terrible again.

During June, 2010, I had an episode of reactive arthritis, which was treated with Prednisone and my blood sugar readings rocketed from the already high range (180-190) to the stratospheric (350 to 450). At this point, I had to start injecting insulin to try to counter the effects of Prednisone. I visited my physician during the fall of 2010 and she put me on a regimen of slow acting and fast acting injectable insulin. This was the beginning of my exit from denial, but I was still partially in denial.

Of course, I was hanging around the 300 to 310 weight range and felt fat, tired, and awful. I was having trouble sleeping and had no energy most of the time. Doing normal tasks, like walking, was getting harder and I started to come to the realization that I would die. I started reading about the complications of type II diabetes and it is not pretty.

In desperation, I started Weight Watchers again in January, 2011. But after four weeks of strict adherence to the program, I had only lost 0.8 pounds, not my normal WW experience. At first, I thought it was the new WW program, so I tried reverting to the old WW program.  That didn't work, either. Then I read a blog entry on Instapundit.com that changed my life. The author, Glenn Reynolds, linked to the book, Why We Get Fat by Gary Taubes. I downloaded it on a Saturday, February 12, and finished listening to it by the next day. I realized I was not losing weight on WW because of the insulin I was injecting. I now understood, thanks to Taubes' book, that if I wanted to have any hope of losing weight again, I had to get off insulin, and the low carb lifestyle Taubes described seemed like it would do the trick. So I started low carbing on February 14, 2011.

It did. That's why I have started this blog, to share with others who are struggling with weight or diabetes the method that has proven extraordinarily successful for me. I am no longer in diabetes denial; I am off injectable insulin and back on Metformin. I will be weaning myself from that as soon as I lose another 30 pounds or so. My blood pressure fell substantially, within a few days, and my blood sugars are now near normal. My new low carb lifestyle has very literally saved my life.

Now when I know about friends or acquaintances who are diagnosed with type II diabetes, but who are in deep denial, I want to reach out to them and tell them there is hope, that they can control the disease and lead a mostly normal life. A low carb diet is the key. Yes, it requires sacrifice, but it is worth it. But I also realize they must get past denial. The earlier it is treated, the better, before the pancreas is too compromised.

My plea: get out of denial and start dealing with your type II diabetes.

Diabetes Update

I am sure my physician will be more than pleased on my next visit.  My blood sugars are down, I am not using injectable insulin anymore, my lipid profile is improving, and I am losing weight.

That said, pleasing my current physician is not my goal, as she is following standard medical guidelines that will still leave me with diabetic complications if I use her goals and ranges.

I am reading a really interesting book called Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars.  I will review it more properly when I have finished, but he is a big advocate of achieving normal blood sugar levels for everyone, including type I diabetics.  He advocates a low carb diet and a combination of weight loss, exercise, medication, and insulin to achieve normal blood sugars.  Some people can achieve normal levels by weight loss alone; some by weight loss and exercise; some by weight loss, exercise, and oral medications; and some by weight loss, exercise, oral medications, and/or insulin.  By his definition of "normal" (that is, blood sugar levels of non-diabetics), I have a bit of work to do, but I am willing to put forth the effort.

When I lost 115 pounds on Weight Watchers, I was able to get off medications completely.  I am hoping that is still the case, but we will see.  As it is now, I can see a dramatic effect on blood glucose levels by hardly eating any carbs and by exercising.

Weight Loss, Insulin Update

I am not sure what happened last week, but I have lost another 3.6 pounds this week, for a five week total of 16 pounds, or 3.2 pounds per week on average.  Here is a chart of my weight loss progress.

Also, I stopped taking insulin a while back, and my blood sugars are very good, with the slight exception of the fasting blood sugar first thing in the morning.  Recently, that has been in the 120-125 range, and it should be below 110 for a diabetic and about 90 for a non-diabetic.  I am not sure why that is high, as I am hardly eating any carbs at all, usually fewer than 20 grams of carbs per day, and most of those in the form of green or leafy vegetables.  My blood sugars one hour after a meal are almost always lower than 120 and two hours after are usually between 100 and 110.  They should be below 140 one hour after and below 120 two hours after a meal, so I am in good shape here.

I will be reducing my dosage of Janumet this week, from two pills a day (morning and evening) to one pill per day (just in the morning) and I will see what happens.

Another Insulin Update

My blood glucose levels remain well within the normal range, except for the fasting blood sugar in the morning, which has been over 130.  One hour after a meal it is usually 120 or below and two hours after a meal, it is 110 or below, sometimes dropping as low as 90.  That is really, really good, better than anything I have experienced in a long time.  I don't understand the morning reading, though.  I will have to keep watching what is going on there.  It is nice not to have to inject insulin every day, though.  I am still on the Janumet tablets, but over the next few months, I will try to wean myself off of them.

Insulin Update

Well, it's been three days now since I stopped injecting insulin.  How has it gone?  First, the base line.  My physician (an internist) tells me that two hours after a meal, it should be 165 or below.  Another expert says it should be 120 or below within two hours after a meal, and that "normal" people are usually 100 or below within two hours after a meal.  Each of the past three days, I have been between 110 and 118 one or two hours after a meal.  So while I am not quite normal (you all knew that anyway), I am well below the threshold set by my physician and her diabetes educator, and below what the other expert cited above suggests.  The blood sugar reading one to two hours after a meal is the best predictor of health (less than 120) or complications (greater than 140) and experts suggest this is the most important indicator to follow.

Fasting blood sugars, or your reading first thing in the morning, for normal people are between 70 and 85.  My physician says a "normal" reading is between 70 and 110.  Anything above 110 is a cause for concern.  My fasting blood sugars have been on the high side, averaging 134 for the past three days.  I am seeing if some of the foods I am consuming are affecting that blood sugar reading and if that doesn't come down, I will probably go back on a low dose of insulin for a while.  However, the critical indicator, less than 120 one to two hours after a meal, is fine, so I will wait and see for the next few days before resuming injections.

One month ago, despite injecting 26 units a day of Lantos a day, my blood sugars were all much higher.  Today, they are in much greater control than they have been in for years, and I believe the low carb diet is working.  It may just take a bit of time to get my readings into the normal range.

Here is a handy one-page flyer from the Blood Sugar 101 website, that explains what to do to lower your blood sugar levels.

Stopping the Injections

Today I have stopped injecting insulin.  I have been dropping two units a day, from a high of 26 units of a long acting insulin called Lantos, to six units yesterday.  My blood sugar has been steadily dropping on my carnivore diet and I have been closely monitoring the change.  I will continue to monitor it closely and see what happens.  I am still on Janumet, a combination of Januvia and Metformin, 1,000 mg twice a day.  If the blood sugars stay down, my next task will be weaning myself off of the Janumet.  Which I have every reason to expect they will.  Wow, will that save me a lot of money!  It costs about $65 per month for the Janumet and about $75 per month for the Lantos.  That much savings will easily pay for all the extra protein I am consuming.