Sweet Geek

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The Patient's Voice Project

This was my submission to the Patient’s Voice Project. It is a study that is polling diabetics for their experiences controlling their diabetes via diet.

I am 29 and was diagnosed with Type 2 diabetes in December 2010 with an A1c of 10.7 and a fasting blood sugar of 397. I also had a liver panel done and my #’s were quite high, GGT over 300, AST/ALT in the 100’s (they had been for years but this time they were significantly higher).  I was diagnosed by my endocrinologist during some routine blood labs, though if anyone had been paying attention to my symptoms I probably would have been diagnosed 15 years ago… I have had symptoms of high blood sugar since I was a child. I was an athlete until college, and didn’t start my big decline (and weight gain) until I switched from my mid-western diet of eggs, steak, butter and potatoes to a “heart healthy” diet of pasta, rice, bread, fruits and vegetables.

I was put on Glipizide to bring down my blood sugar. The doctor recommended to me that I cut out all grains and dairy because of my other autoimmune disorder but I wasn’t in a place to understand or listen at the time. I was devastated by the diagnosis and it took me months to even accept that it really was diabetes and not a temporary side effect of my other illnesses.

Unfortunately after giving me such great advice, she referred me to a Certified Diabetes Educator (CDE) / dietician. I was told to not eat sweets, and instead eat “heart healthy” whole grains, complex carbohydrates and fruits. Cut the fat and stick to small portions of lean meat. “Everything in moderation”! I questioned her about what makes my blood sugar high and was told “being fat”. If I lost the weight and exercised more, I would cure my diabetes. Also it was important to keep a steady stream of carbohydrates coming in so that my liver didn’t decide all on it’s own to raise my BG. I wasn’t sure I believed her but she wasn’t interested in debating or explaining. So for the next 3 months I followed that diet religiously. I had 30-45g of carbohydrates per meal plus 3 snacks a day of around 15-30g of carbohydrates, averaging around 200g per day and 1200 calories.

When I was diagnosed I had already lost 20lbs and I continued to lose weight while on this diet. However my fasting blood sguar was still always above 200 and I think the weight loss was still due to high blood sugar. I lost a ton of muscle and a bit of fat, going from 233lbs to 223lbs. My new A1c was 7.2 which was an improvement but still poor control.

I still felt like I was dying, drinking liters of water a day, too tired to walk a mile, sleeping 10+ hours a night and was always hungry. That’s when I found an online diabetes forum. There I was finally exposed to the information that carbohydrates raise blood sugar! Something that my doctor, dietician and all the American Diabetes Association (ADA) materials had neglected to mention… After more research online, reading The Diabetes Solution, Gary Taubes and watching Fat Head, I decided to try a low carb diet, mostly styled after Dr. Berstein and Atkins.

Now I was eating 1500-1700 calories a day, with total (not net) carbohydrate count of under 30. It was transformational, not just with immediate results but by changing how I would view food for the rest of my life. Very quickly I had to stop taking Glipizide due to hypoglycemia. The doctor and nurses were very against me stopping but I ignored them.The weight really started coming off and according to my body fat monitor it was finally fat and not muscle. I suddenly had energy for the first time in years!

I followed this diet for 3 months and it was easy to stick with! Food was my friend again, steak a long lost lover. :-) Afterwards my A1c was 5.6 and my fasting BG finally came down to around 100. My weight had gone from 223 to 205. My liver values were still elevated but not as high. I never went back to the dietician.  When they heard about my diet, the nurses at my doctor’s office verbally abused me, saying that I was killing myself, was non-compliant, etc. They told me to eat toast for breakfast instead of eggs, rice instead of buttered broccoli. I tried to explain what I had learned, citing research studies, explaining that the lipid hypothesis was being debunked right and left by recent studies but they wouldn’t listen. It was a nasty experience and I haven’t gone back to that doctor because of it.

I was still hungry for more information, now that I had my “eyes opened”. I learned about Paleo and LCHF. I increased my saturated fat intake, cut out low carb crutches (like fake breads, sugar free desserts) and stopped eating grains and legumes completely. I was at 75% fat, 20% protein and 5% carbohydrates. NOW I knew what it felt like to be healthy, for the first time in my life. What felt like good energy 3 months ago was nothing compared to this. I now sleep 7-8 hours a night, and sleep better. I discovered that while previously I was a slob, I am now a house cleaning fanatic. I took up weight lifting and walk to work. I have hobbies beyond watching TV! Most importantly, my fasting blood sugar dropped to 70-83, my postprandial is now 85-110. My weight has dropped even further from 205 to 194, all fat it seems.

I haven’t had my A1c retested because I can’t find a doctor willing to work with my LCHF diet. So my choices are to lie to my doctor, using them just to get what I need (blood tests and test strips paid for by insurance) or go it on my own hoping to eventually find a doctor more open to alternative diets. I did recently see a hepatologist about my liver, and still don’t have a diagnosis. My guess is non-alcoholic fatty liver which hopefully will resolve itself as I stick to a low-carb paleo diet.

Summary: The standard ADA advice was sending me to my grave. Diabetic patients have a right to all available diet options, backed by science not politics.