As some of you may have noticed my blog postings dropped to zero across June; to be quite frank I’m unsure this trend will not continue. On May 24th I received the results of a routine blood workup and the results truly threw me for a loop! My previous blood screening was on March 30, 2015 just prior to reconstructive surgery on my severely fractured left radius and ulna; it showed no abnormalities other than some very slightly elevated cholesterol values. However, the latest results showed an A1c value of ‘14’ and a blood glucose (BG) value of 383 mg/dL; my A1c in the previous blood sample was ‘5.5’!! I was crushed to learn I now was a diabetic dealing with late onset Type 2 diabetes. Just three months earlier I was diagnosed with hypertension and had been working via meds and lifestyle changes to get that under control. But now I was hearing from my doctor I had two months to get my BG values down into the 95 mg/dL to 115 mg/dL range or we’d be having ‘the i-word’ discussion. To say I was in shock would be a bit like calling Denali a ‘big hill’.
For three days I remained in denial just unable to grasp what this meant and paralyzed by the concept of being insulin dependent. Then I finally retreated from my fog, decided I had no choice and immediately started clearing the house of all high carb foods especially those composed of simple carbs. I needed almost a week to complete this process during which my canine companions feasted on ice cream, peanut butter and crackers among other items. From some friends who were dealing with the disease and from a couple of diabetes forums on-line I began my education regarding the disease while awaiting the arrival of my Bayer ‘Contour Next USB blood glucose meter’, lancets, test strips and similar. To my surprise I learned managing diabetes starts with managing one’s carbs; calories just don’t factor in. I’d tried the Atkins Diet in the 90’s without success as I just couldn’t handle cutting my carbs (CHOs) to double digit grams per day. While I have a real sweet tooth I discovered far more than sweets I craved starch while on the diet; I truly missed breads, rolls, corn, peas, most kinds of squash, potatoes and, of course, the sugars from apples, bananas, oranges, pears and similar foods. Knowing this I girded my loins to once again face their absence but this time I was driven by the fear of becoming insulin dependent rather than just trying to lose fifteen pounds.
I’ve now put in a month of monitoring everything going into my mouth – yes, even water and no CHO foods – and 24 days of morning testing of my BG levels. About two weeks into this lifestyle change I met with a nurse at the local clinic to review all my data. Being rather AR coupled with a love of analyzing data via spreadsheeting and graphing I had kept fastidious logs and she was very pleased. I talked with her about dietary options, ‘substitutes’ for high CHO foods and how this was going to become not just a diet but a complete lifestyle shift. I’d already made such a dramatic lifestyle change when, after starting my hypertension meds, I began a program of stepping and within seven weeks had worked myself up to between 11,500 and 13,000 steps/day, every day. Now I was faced with another major lifestyle shift; the days of unfettered or even controlled consumption of simple CHOs were history! I made these lifestyle modifications not because I wanted to but because I had to do so.
For me, and I’d bet this is true of other ‘new’ diabetics as well, the most frustrating thing about the disease is its ‘person specific’ nature. Sure, ya know you have to monitor and control your daily CHO intake but just what is a ‘good’ amount of daily CHOs? I found some info on a medical hospital website suggesting for someone of my size and weight somewhere around 140 grams CHOs/day was a good number; I set this as my target. Hah, eating this many carbs kept my BG levels in the 160 mg/dL to 180 mg/dL range! I visited a couple of online diabetes forums and found many attendees claimed to being forced to drop their daily CHO intake to under 50 grams CHOs to really make a dent in their numbers. Seeing this I decided to set my daily limit at 40 grams CHO/day. Success!! Within five days my morning (fasting) BG levels were in the 95 mg/dL to 125 mg/dL range which for me was a huge shift. For the first time since given the diabetes diagnosis I was feeling I could beat this disease through just diet and exercise.
Then I learned of the ‘person specific’ piece of the puzzle. I’ve come to recognize managing the disease isn’t just about total daily carb intake; it is also about the kind of carbs, how your body deals with said carbs and even when you eat these carbs. Because of this I’ve started a ‘Do Not Eat’ list of foods I’ve learned will really spike my BG values. My first experience with this concept was when I was just craving something sweet so I had two tablespoons of Jif Extra Crunchy Peanut Butter in the evening. At the time I was trying to hold to an under 140 grams CHO/day target; those two tablespoons contributed 38 CHOs and I finished that day at 151 total grams of CHOs. But, much to my chagrin, when I did my morning ‘stick’ the next day my BG had jumped from 254 mg/dL to 283 mg/dL! I was flummoxed until I remembered hearing that everyone is a bit different regarding how their bodies handle certain sources of carbs. I had just seen evidence that my body couldn’t deal with all the sucrose in the Jif! That remains entry number one in the aforementioned ‘Do Not Eat’ list. This also reinforced the importance of logging everything one eats in excruciating detail until you have a good understanding of foods with ‘good’ carbs versus those with ‘bad’ carbs. I’m also beginning to understand that time of day can play a definite role in the next morning’s BG reading when consuming carbs. I can get by with a single slice of bread but only if I eat it early on like right after I do my morning stick which is around 07:00. If I wait until noon or later it will elevate the next morning’s reading.
And, finally, there’s the natural variability of one’s system to toss into the mix. I’ve seen a couple readings which were elevated for no discernible reason. Wonderful, on top of all the other puzzle pieces we can now add the dreaded ‘unk-unks’ (unknown unknowns)! But this is all part of managing diabetes. One must be very aware of one’s dietary regime and understand the impacts – negative and positive – that our food choices have upon our bodies. Just a month into this lifestyle shift I already look back fondly to the days I just tried to stay roughly aware of my daily calories in an effort to exert a modicum of control over my weight! But I’ve also learned about the very real damaging effects diabetes can produce and I want no part of those along with insulin dependence. So I’m struggling to manage my late onset Type 2 diabetes through diet and exercise along with Metformin HCl.
To this point it appears I am succeeding although I still struggle with ‘peaks and valleys’ regarding my daily BG levels; I often joke the graph is beginning to resemble a profile of The Alaska Range. Most of this is due to my continuing learning process regarding what are my body’s ‘good’ carbs versus ‘bad’ carbs. Sadly, this is a very tedious and slow process but if one wishes to learn about the aforementioned one can only change one variable at a time regarding foods, total daily CHOs, time of day consumption and similar. For now I appear to be able to hold my daily CHO intake to a minimal 40 grams; this means a very restricted diet and often leaves me feeling a bit weak and spacey in the morning as well as dealing with fatigued legs when I start my stepping. But I can push through these inconveniences and if I just eat something like a few ounces of fresh strawberries these symptoms disappear. At such a level my weight loss, originally initiated when I started doing 9,500+ daily steps, has really accelerated. I desperately need to lose more weight both for the diabetes and especially for the hypertension. However, I do not believe I can hold this daily CHO level for a long time – and it probably wouldn’t be healthy even if I could – so my current plan is to continue this limit across the next few months while I learn what constitutes my ‘good’ carbs versus ‘bad’ carbs. And who knows, maybe I’ll even drop another 15 to 20 pounds!
If there’s any real value to this lengthy piece I hope it will encourage others out there dealing with Type 2 diabetes to really try to manage the disease via lifestyle changes. If I can do so – and believe me, I’m the poster child for ‘age accentuated inertia’ – then anyone can! At least, for those who are younger, you are more flexible regarding making major lifestyle shifts. A friend and fellow diabetic shared something with me which really resonated; she said ‘as diabetics we do not seek what works but rather what doesn’t work’. This is so spot on!! If my morning BG level is in the acceptable range I probably will not review what I ate the previous day but if it is above that 125 mg/dL limit I will pore over my food logs seeking an explanation. To this point I’d have to say the desperation brought about by my diabetes diagnosis has now turned into a kind of deliverance; deliverance from an unhealthy lifestyle and habits. If I can live out my ‘golden years’ in better health and with more lust for life simply by eating better and exercising more than my diabetes diagnosis could truly be my deliverance…