Tag Archives: diabetes and low carb

Calling Things by Their Proper Name and Why High Blood Sugars Always Make You Feel Bad

Dr. Stephen Ponder, an endocrinologist living with type 1 diabetes, has been posting thought-provoking questions on Facebook. One of the latest questions was: “How often do you say “good” or “bad” when talking about blood sugar (or an A1C)? If not, then how do you describe them? Should kids use “good” and “bad” when talking about their sugar levels?”

I thought I’d answer in the form of a blog post since this sparked a whole long train of thought for me.

Confucious supposedly said, “The beginning of wisdom is to call things by their proper name.” If something causes you harm–for example, as high blood sugar does, then I hesitate NOT to call it a “bad” blood sugar because it simply is, whether we acknowledge it or not. I believe it would be bad for my health if I didn’t identify, accept, and name the truth on a regular basis. It’s hard to swallow but my reality needs to be very much imposed on me if I am to act in my best interest.

Houston: We Have a Problem

People email me all the time asking what the secret is to my pretty good diabetes management and how I have the discipline for it. Honestly, any good I derive from my actions begins with calling things by their proper name. That means that I admit that eating what I want and covering it with insulin doesn’t work well enough (for me). I openly say that low carb for type 1 diabetes is the only way I know of, to get close to achieving normal blood sugar levels, a healthy weight, and safety from severe hypoglycemia. And I say that not having normal blood sugar levels is physiologically harmful because we know it is. If it weren’t, no one would be diagnosed with pre-diabetes with a 6% A1c level but, they are every minute of every day. It is on that basis that I call a 6.5% harmful and deem it not good enough for me.

If I don’t acknowledge that something is “bad” or “not good” then I don’t follow with the appropriate response or actions which have to do with changing those blood sugars or anything else. We need to apply judgment in our daily lives. It’s necessary. I have to be able to admit to myself when I’ve mistreated a loved one or I’ll certainly continue to do it. I have to be able to admit when I’m overeating, or I’ll keep gaining weight. And I have to be able to say “no, that’s not good for me” or I will suffer various potentially unlimited consequences. What is it they say to those with an addiction? “You must first admit there is a problem.”

High Blood Sugars Makes You Feel Bad Even if You’re Told Not to Feel Bad

I understand parents of children with diabetes don’t want to use “good” and “bad” in relation to blood sugars or diabetes management in part because the child didn’t have anything to do with getting such a brutal condition and we don’t want them to feel bad about themselves due to diabetes. And I do support the effort many parents put into saying things like, “It’s not that you did anything bad, it’s that this isn’t working and we need to figure out what will work better.” There is still an acknowledgment that something isn’t working and the troubleshooting can begin and the child can feel better, physically, mentally, and emotionally.

Personally, the main reason I didn’t do what I should do as a kid to manage my blood sugars is that doing what my parents and I were told to do didn’t ensure my success, at all, and made me feel sick and anxious anyhow and thus I acted out of hopelessness, by lying about my blood sugars, not doing my blood sugar testing, and sneaking sugary foods to self-medicate. I knew what my high blood sugars meant for my future, and in the immediate moment, my self-esteem took a hit. High blood sugars (especially really high blood sugars) make you extremely sluggish, make your saliva thick and foamy, your thinking slow, and make you not look and feel generally healthy (albeit subtly, at first) Let’s face it, anything that is a detriment to health is a detriment to outwardly attractiveness. I remember thinking that I was totally ok with my ears sticking out–there was nothing I could do, and they functioned properly, but I wasn’t ok with the weight gain I was experiencing from the way my diabetes was being managed. I wasn’t ok with becoming less attractive due to diabetes nor slower as I played sports which requires you to compete using your energy and speed. I couldn’t prove to myself or anyone else how just how good I could be. Not getting results for your efforts because of diabetes makes a person crazy. And successful diabetes management relies on the most effective efforts, not the most industrious ones.

For those without diabetes, think of how you feel about yourself when you’ve been injured or come down with a bad cold–you’re knocked down a few pegs, right? Even if people are kind to you and don’t make you feel bad about any of it. Admit it, you feel less attractive, less productive, and you may feel motivated to do whatever it takes to get yourself back to feeling good, even doing things that you were not willing to do before that experience. I believe many people with diabetes, including children, are in an impossibly precarious situation when their blood sugar management is less than ideal. This is particularly true once they learn what elevated blood sugars can do to them over time or once the negative effects stack up over the years. No, it’s not fair, or whatever, but all I know is my “good” diabetes management began when I admitted to myself that my diabetes management was “bad” and that if I were willing to make some sacrifices in the name of tight blood sugar management, I may have a ticket to health and happiness. It’s been more than worth it, which is why I keep annoyingly banging this tired drum.

Is it Possible to Do Better?

I am partial to diabetes management for adults and children which makes it easier for them to be successful with their diabetes. No matter how much you tell a person they are “good,” if their blood sugar levels are often high, they are going to be feeling poorly much of the time, and that is going to make them feel “bad,” regardless. It’s very hard for us to separate how we feel, physically, from how we feel, mentally. One follows the other. Feeling unhealthy does not lend itself to feeling good and it never will. Do some people who don’t feel healthy manage to feel good and happy? Yes, but this is a feat not accomplished by most, and while children amaze us with their resilience alas, they do grow up, and many will suffer the weight of high blood sugars and blood sugar variability and fear of hypoglycemia as evidenced by personal social media accounts and all the studies pointing out rates of anxiety and depression in adults with type 1 diabetes.

This is why I encourage the attempt at a low carb diet for anyone with type 1 diabetes. Thanks to those who do very low carb diets, we’ve learned that it is possible to do better with glycemic control. Did you know that for a long time no one did better than a 4-minute mile and experts said it was impossible and once Sir Roger Bannister did, many others followed suit soon after? That’s because we can only accomplish what we believe is possible. I’m telling you that I’m not special, I don’t have more discipline than you, and it is possible to achieve very tight and safe, blood sugar control.

You can’t easily feel good about yourself if you don’t feel good physically and you likely can’t feel too good physically if you don’t have blood sugars as close to normal as possible. For more: check out the Sir Roger Bannister of the type 1 diabetes world: Dr. Richard K. Bernstein.

To conclude, I don’t worry about good/bad and any similar terminology, I worry mostly about my outcomes and my actual experience. It’s surprising how happy I can be while honestly telling myself that something is “bad”. That’s because I then put my energy into finding what makes it “good” and focus on that, instead.

(If you manage your blood sugars well without low carb and you’re happy and healthy, I’m not directing this to you.)

Why Dr. Bernstein is an American Hero and Why Doctors Should Be Curious About Him

My colleague at Diabetes Daily, Maria Muccioli, Ph.D., wrote an excellent and in-depth coverage of a remarkable study on very low-carb diets for treating type 1 diabetes in children.

The study found that a group of type 1 diabetic children following a very low-carb diet à la Dr. Bernstein style were not only experiencing normal blood glucose levels (this is nearly unheard of in type 1 diabetes) but also growing well (a top concern as macronutrient intake of carbs is widely believed to be essential for growth in children).

The researchers of the study looked at children from a Facebook group called Type1Grit. This group consists of adults with type 1 diabetes and parents of children with type 1 diabetes who all follow Dr. Bernstein’s regimen. This regimen includes very low-carbohydrate intake but so much more–put just any type 1 diabetic on a very low-carb eating plan, and I promise you’ll likely not get the results you are hoping for–though if you pay close attention to blood sugars you may notice some interesting things regarding the statistical range of error after giving smaller amounts of insulin. It’s about more than low-carb eating. Low-carb is essential to the plan but to do well, there are more things to do and understand. One must understand how to use and adjust insulin properly, understand how different physical activity impacts blood sugars, and so on. The Type1Grit group does so well because they utilize Dr. Bernstein’s decades’ long expertise to guide them (which is all in his book) and like any good support group, they help each other stay focused, informed, and motivated.

Some people on social media have voiced strong opinions against the group due to some of their outspoken members. It is my hope that we focus on content over delivery when it comes to important matters. After all, if fellow thinkers had rejected Issac Newton’s findings simply because he was a jerk (and according to the book I’m reading my kids about him he was) wouldn’t that be a shame? Personally, I strive to be gentle with others because I am quite sensitive. However, I also try not to put my feelings above critical thinking, and I think that serves me well. I also hope that the communication of a few doesn’t cause some to dismiss the whole group or worse–a promising idea. That said, I have not personally observed anyone from that group being rude to others, though some have been quite open and blunt with their opinions and I have observed a very strong response to that, in general. I do not consider an opinion shared in a straightforward manner to be rude.

My Personal Story Following Dr. Bernstein’s Advice

I have followed a loose version of Dr. Bernstein’s protocol for about a decade, further lowering carbs and adding in more of his advice gradually over the years (I now follow his advice very closely). His logic struck me like lightning when I read his book, Dr. Bernstein’s Diabetes Solution. In particular, I was deeply moved by a line that said something about how people with type 1 diabetes “deserve normal blood sugars”. Dr. Bernstein’s protocol includes the use of Regular insulin to cover high protein meals versus faster analog insulin such as Humalog or Novolog. In fact, after using a CGM (continuous glucose monitor) for the first time recently, I quickly saw how my Humalog was a bit too quick and potent at mealtime and then a bit too short hours afterward, so I bought Novolin R at Walmart for $24 and have improved my blood sugar levels. This is to stress how following Dr. Bernstein’s protocol is about more than just reducing carbohydrate intake.

Many years ago, I found immense value in attempting just a little bit of Dr. Bernstein’s advice. Small changes like lowering my carbohydrates and understanding how to use my insulin better led my A1c to drop from 8-9% down to 6%. Before this, just covering high amounts of carbohydrates with insulin had mostly succeeded in making me fat, tired, depressed, and anxious (oh and with protein spilling into my urine as an 18-year-old in her “prime” of life). You have to understand how terrible this was for me–I was a bright-eyed kid who was intelligent, hopeful, hardworking, patient, and super determined. In a few short years, diabetes messed with my potential–I didn’t recognize myself anymore. It’s particularly sad to spend years recovering as a young adult when you’re supposed to be at peak performance and potential due to your youth and energy.

Dr. Bernstein, who many dare call a “quack” or “nutjob” saved my life just as he saved his own. My A1c hasn’t touched 6% in many years. I have a wonderful husband. We have twins who are about to turn 9. I’m still trying to reverse some of the consequences of very high blood sugars from my first 10-12 years with diabetes. What if I didn’t have to?

What Actually Does More Harm?

People tell me that eating low-carb will hurt my cognitive abilities. Do they know that studies indicate that typically managed type 1 diabetes may do that, anyway? Type 1 diabetes (with the average management of 8.2% A1c in the U.S.) has been shown to possibly lower intelligence and negatively affect memory and speed. Low-carb in the long-term may hurt my cognitive abilities (I haven’t seen anything to indicate this possibility though) but what if it just takes the place of what high blood sugars would have done to my cognition? And what if low-carb additionally helps protect my cardiovascular health and my kidneys and my eyes–oh and allow me to have healthy children! Do you know how fortunate I am that I turned things around when I did? I have children because of the information that turned my health around just in the nick-of-time. I can’t begin to describe the level of rage I might have had I never had children yet discovered that Dr. Bernstein has been trying to tell the world about his successful method for decades.

Where is Our Curiosity?

If you find Dr. Bernstein followers as angry or overly-passionate, this may help explain why: Unnecessary suffering is a tragedy. We’re in a country whose founders had been curious and open to acknowledging ideas that are worthy, pushing those ideas to the top where they can be put to the test and then accepted as the best ideas because they can create the best outcomes. This is the great thing about Western Civilization. The embracing of objective principles which allow the best ideas to rise because even if they come from someone we can’t stand, we know that ideas, critical thinking, and truth reign over all else and push us towards progress. Dr. Bernstein’s protocol isn’t an expensive training center and it’s not just for the elite of the world. He thrives using a cheap insulin in the same country where people die because they don’t know they can change their dietary habits and purchase cheap over-the-counter insulin in most states and survive.

From an economic and financial viewpoint, Bernstein’s protocol is also a stunning success. I don’t use an insulin pump or a CGM (I only got to test one out) and yet I can achieve my glycemic targets. I don’t need any apps, certified diabetes educators, or expensive technology. I don’t anxiously await a closed-loop hybrid insulin pump system because I don’t need it. I put all my energy into my simple but effective daily lifestyle. Providers who want to see healthier patients, please read Bernstein’s book. Your lower income patients may not want to follow the regimen in part or entirely but those who are willing deserve to know how to thrive with diabetes despite being poor or lower middle class, like me. I give myself excellent care for cheap–doesn’t that peak your interest?

People are justifiably angry over insulin prices but what about the medical community’s unwillingness to be curious about one doctor’s personal plan to keep himself at peak health and fitness well into his 80s? Without curiosity, what on earth then drives a doctor to investigate the issues in each patient as well as find the proper and least harmful solution? I tell my doctor how I managed a huge drop in A1c for the first time in my life and he has no questions regarding how I did it? I read doctor responses to research that shows a teeny tiny improvement in A1c and now they think “this shows wonderful promise and we should look into it further!”? I basically told my doctor I might have just saved my own life and drastically improved my quality of life, and he’s like “meh”. I told another how I did it and he said, “good for you.” Yes, good for me, but what about some of your patients who are as I was, struggling to get a halfway decent hold on their blood sugar and suffering? What about them? Don’t you have an obligation to check this out? This gives my doctor less work, by the way! For a decade now my doctor does nothing to manage my diabetes–he just orders labs. Aren’t doctors wanting more patients that can manage their blood sugars and don’t need them so desperately at all hours?

It Takes “Too Much Discipline” or “Restraint”

Nothing terrible ever happened by being disciplined. Think of all the amazing people out there and from history–what could they have accomplished without discipline? Probably nothing but a few moments of greatness. Discipline encompasses you within a realm of potential greatness. And if you create a system, discipline isn’t a show of willpower as much as you just loyally following your regular routine.

Much research backs up the potential of the ability to defer gratification. Who is more likely to become successful? The person who can restrict themselves from their impulses and short-lived desires, right? Let me put it this way: who would you rather marry? Someone who can keep their impulses in check or someone who can’t? Or who would you rather be? Someone who doesn’t overeat or someone who regularly does? I remember having hearts in my eyes when my husband told me “I never overeat”. I have long struggled with overeating, and when he said this, I was impressed by him and thought, “wow, I want to be like that.” I believe this is the empowered response. I could have given the common humorous response of “ugh, you make me sick” but where would that have gotten me? Instead, I tried to learn from my husband and improve myself.

I also think the healthy response is to admire someone like Dr. Bernstein for what he has accomplished against great odds. Dr. Bernstein is respected by so many because he created a well-functioning system to get himself thriving and generously shared his findings with others. In fact, as an engineer, he became an endocrinologist so that he could help others after he figured out how to save himself. He should be regarded as an American hero, whether you want to do what he recommends or not.

I believe in freedom and personal rights. I’m an immigrant who is incredibly happy to live in the U.S. Growing up when I found something challenging and I didn’t want to face it, my dad would say “Are you an American or an American’t?” I would often roll my eyes but, yes, I’m an American and believe I have the power to set my mind to improve myself if I want and I’m grateful for those who have set their minds to things and laid out paths before me. Thank you, Dr. Bernstein. I may never reach your astounding level of discipline but what I have been able to achieve with your advice has been most valuable to me and my family and I am forever grateful.

En fin, I’m certainly not saying you should do what he does or what I do. And I can respect wherever you are on your journey. I’m saying that Dr. Bernstein’s method has shown undeniably incredible potential and results and the general lack of curiosity and investigation on behalf of the global medical community makes absolutely no sense to me. There are now thousands of people doing it and doing it well.

Newton supposedly struggled with his ego and an inability to face criticism or questioning during his lifetime. Let’s have his overwhelming curiosity without the pride, his determination to dig and experiment properly without his emotionally unstable and anti-social ways.

I will leave you with one more thought:

Just a little bit less damage sustained is a great deal to the person enduring it, especially when they still have many decades ahead of them.

When Diabetes News Overwhelms You

I write about 6 articles a week for Diabetes Daily.

Most of what I do is share information regarding diabetes news and a great deal of that is comprised of studies that effectively help us learn more about the effects of diabetes on our bodies.

If it depresses or overwhelms you to read this types of news, believe me, I completely understand. I felt sick for the first few months of doing this kind of writing because every piece of what seemed like bad news gave me a strong negative physical reaction. I quickly realized I needed to do two things: compartmentalize and use actions to attack my fears.

What many of these studies iterated to me was that I needed to find a way to avoid as many high blood sugars as I could. One of the reasons I feel so strongly about this is that I’ve already dealt with the negative effects of prolonged high blood sugars and if I had been diagnosed last year, I’d likely feel a little less motivated to employ some serious interventions. Yet, maybe not, who knows.

Time and too many high blood sugars has taken it’s toll and I must fight to win back as much health as is humanly possible. I’m stubborn, as I’ve said before many times, and I want not just so-so health, but I want to be as healthy as a healthy person without diabetes. Will I achieve that? Probably not to the degree I’d like but I believe in striving for the best possible outcome, so that when I fall a little short, I’ll still be in a great place and proud of my efforts.

So how did I compartmentalize? Well, I started to read these harrowing news stories almost as if I was outside of my body and I didn’t personalize anything of the data for myself. For example, if I was looking at how many people with type 1 diabetes suffer kidney damage after a certain number of years with type 1, I did not allow myself to apply that to my many years with type 1. I basically pretended I didn’t have diabetes while I read and wrote about this. It sounds robotic, and it certainly kind of is, but my sanity is crucial to my overall health so I needed to get through the information, log it into my brain, and keep it there as pieces of useful data available to guide or influence my future decisions.

Now for the real important bit–attacking fears with action. The best way I know of to feel more in control and more motivated about a situation is to act on it. Action needs to be fueled by knowledge and caution, of course, but action is THE catalyst for any positive outcome we might enjoy. No one ever lost weight by thinking about it or wishing for it.

Here’s the dialogue that plays out in my brain:

What is my fear? That i’ll develop any number of complications.

What causes diabetes complications? If I’m going to generalize and I am, it’s high blood sugars both acute and prolonged over time.

So what should I do to manage my fear? Avoid high blood sugars.

How do I avoid high blood sugars? For about 8.5 years i’ve written about Dr. Bernstein and his low carb recommendations for people with type 1 diabetes. I’ve lowered my carbs gradually over the last 13 years and seen much fewer highs as a result. I’ve continued my efforts to the point of following a very low carb diet in a more consistent manner and i’ve seen even fewer episodes of high blood sugar and fewer episodes of low blood sugar, too. Also, the catastrophic highs and lows are nearly non-existent.

Fewer highs and lows have literally been the remedy to my fears. Now, I still have fears about certain aspects of this condition and I get tired of living with diabetes, but just like any human, I can’t expect to live without fear, I can only hope to manage it in a way that lets me accomplish what I want and be happy with my life.

Each time I read or write about diabetes, I keep it impersonal but I save the information away to use when I need motivation or information with which to make a decision.

I hope that you, too can consider new information carefully versus letting it alienate you from something that might help. Don’t be afraid to talk to a healthcare professional about what you read, too. Some studies are not as reliable as they seem. Others are funded by the very companies that stand to make a profit.

Remain skeptical but don’t turn away from information–it might be just what you need.

The Case for Lowering Carbs, Part 3

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First off, isn’t my type 1 sister, Ana’s art work (above) fantastic?  Will you Like her Facebook Art page pretty please?  Thank you!

I’ve been discussing my reasons for lowering carbs in Part 1 and Part 2.

It’s also Fabulous Friday and part of what I try to promote is that we treat ourselves right and that includes eating for our health.  That doesn’t mean you have to eat like me.  My point is it’s never a bad idea to assess what we eat and make improvements here and there.

A reader suggested I share my typical carb count for the day and some sample meals.  I thought it was a great idea so:

(Keep in mind each line is one meal, I don’t eat all of this at once, they’re different options ;)

Breakfast:

-One fried egg

-Slice of ezekial sprouted whole grain bread with almond butter or low fat cream cheese.

-Omelet that includes spinach, tomato, and any other vegetable lurking in the fridge.

-One whole grain pancake made with a lot of low fat cottage cheese, shredded apple, and blueberries so that the grain content is low.  The kids love these.

Snack:

-Some fruit (usually berries, and lately, the frozen organic ones)

-Low fat cheese

-Raw vegetables with hummus

-Flat crisp bread with goat cheese

-Avocado slices with salt

-Handful of almonds

-Kale chips

Lunch:

-Salad with vegetables such as onion, celery, spinach, radish, purple cabbage, broccoli and some chicken or fish or tuna topped with salt, pepper, extra virgin olive oil, and vinegar.

-Ezekial whole grain bread with almond butter and a side salad

-Lettuce wrap filled with sprouts, black beans, boiled egg, and broccoli (sounds crazy but it’s so good!)

Dinner:

-Tortilla (the low carb ones are pretty good) wrap with vegetables like cucumber, carrots, asparagus with some chicken or fish.

-Very small amount of brown rice, brown pasta, quinoa, or legumes with loads of vegetables (I only have this on days I work out a lot)

-Turkey burger (no bun) with a side of peas and pearl onions

Dessert:  (optional)

-Chocolate (usually 70% cacao and up)

-Fruit (my favorite fruit dessert is some frozen mango or papaya with lime)

-Sweet potato cubes with a little butter

-Occasional beer/wine/liquor (I steer clear of fruity cocktails because the sugar load is so high)

Beverages:

-Water

-Tea (I love Tulsi, Peppermint, and Chamomile-though I’m allergic to Chamomile so I no longer drink it)

-Almond milk (unsweetened)

-Water with lemon or lime squeezed in

-Teeccino Herbal Coffee (Because I can’t handle much caffeine) with a little cream (I like Horizon half and half organic creamer in Hazelnut or Vanilla, only 2 grams of sugar per serving)

-The occasional Diet Coke

By the end of the day I’ve typically had about 50-75 carbs.  I choose what to eat based on how hungry I am.  For me, hunger is best treated with some carbs so I leave those meals on the list involving a little grains for those days when I have a larger appetite.  There are days when I’m not very hungry and on those days, I just enjoy blood sugar heaven.  My focus is to go by what my body is telling me.  Once a month I’ll splurge and have up to about 200 carbs in a day, usually in the form of some Ben and Jerry’s.  And yes, my body tells me to do that, sometimes :)

In general, I find I can add a little bit of carbs as long as they’re not processed and still do ok, like fruit or vegetable carbs. Those tend to match up with the insulin and cancel each other out. Whereas the complex carbs are what give me a headache with their long life span. Processed food carbs are the worst because they increase my insulin resistance for the entire day and totally make me gain weight in the long run. I really limit those if I want to stay sane :)

Well this is me just sharing some thoughts that have been long brewing. Thanks for reading. And if you have thoughts, please, I’m all ears.  Also, I could use food suggestions, I love changing things up!

Have a great weekend!

Wednesday Revisit: The Wisdom from Bruce Lee

 

 

 As you think, so you shall become.

~Bruce Lee

I can’t help but be a fan of Bruce Lee.  Much of what he said was such intelligent philosophy.  He advocated for respecting one’s body and taking care of it.  He also advocated for increasing one’s success in any matter by removing variables rather than adding variables.  This post is about how I did just that and found out he was on to something.

Originally posted on August 29th, 2009

Why Should a Girl Care About What Bruce Lee Had to Say?

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