A Look Back at the Year

Tonight is New Year's Eve, and we've just come back from an early party at the senior citizens' group. I was lucky that there were big bowls of green salad on the buffet table, so I filled my plate. Then I topped the salad with 1/4 c. of potato salad, just to see what would happen. In addition, I had a bite-size cheesecake treat and 2 oz. of red wine at "midnight" (which was actually 9 p.m.). Two hours later, now at home, my blood glucose reads at 107. Of course, I did walk a total of three blocks to get to the party and back, so I'm sure that helped some. Now I will take 5 units of Humulin (insulin) and a 500 mg berberine capsule.

I have decided to continue the berberine (1500 mg a day) through the month of January while I ramp up my walking protocol. We'll see what happens. This weekend I am beginning reading the book, Walk With Ease, written for people with arthritis. It outlines a 6-week program to establish a lifelong walking routine, beginning with just 10 minutes a day--or once around the block--3 to 5 days a week and working up to 40 minutes. I can do this! When I have reached my time goal, then I can start thinking again about steps.

In 2015 (based on my own records), I reduced my average daily blood glucose from 147 to 118. But, obviously, average daily blood glucose based on the readings I take at various times during the day, does not equate to A1C, which is said to represent average blood sugar over a 3-month period. I figured that because, in reality, I must have had blood sugar spikes at times during the day when I did not take a reading with my blood glucose meter. The biggest disappointment is that my A1C did not go down. Not at all. It has stayed at 7.0, which is an actual average blood glucose of 154.

The best thing that happened was that I lost 22 lbs between January 4 and December 27. I went from 1800 calories a day to 1100, and I dropped from 124 grams of carbohydrates per day (which was well within ADA guideliness) down to an average of 27 grams at the lowest point, with an average of 33 grams. And that--the combination of low calories and low carbs--is the "magic" that causes weight loss, even though it did not seem to lower my blood sugar.

I stopped taking simvastatin and glipizide early last January (for reasons detailed in my earlier blog posts). I temporarily stopped metformin in November and replaced it with berberbine, and the jury is still out on that one. Eliminating metformin has greatly reduced my need for Depends whenever I leave the house.

During the year I have continued with Migrelief (a combination of magnesium, B-2, and feverfew) and added butterbur, in my ongoing attempts to reduce frequency of migraines. I added B-12 in case I'm low due to eating mostly vegetarian, and I added iron so I would still be eligible to give blood at Optiscan (a local research facility that develops instruments for diabetes). In the fall, after reading Dr. Ron Rosedale's book, The Rosedale Diet, I added alpha lipoic acid, which, interestingly, didn't seem to affect my blood sugar readings but--whether coincidence or not--I have had fewer instances of migraines since I've been taking it!

Another disappointment is that my cholesterol has gone up instead of down. However, I keep reading articles about how the total cholesterol measurement is not as crucial as the ratio of total cholesterol to HDL (the "good" kind). And that I should be more concerned about my triglycerides than cholesterol.

One surprising positive last summer, after 6 months of eating low-carb high-fat, was that my thyroid test showed that I now need a lower dosage of thyroid medicine. Both my liver and kidney functions have improved slightly. My calcium, magnesium, and potassium are all in the normal range; so I'm apparently not malnourished on a low-carb high-fat lifestyle!

I've been told that cholesterol will remain high while one is losing weight. I've also read that there are certain drugs that prevent one from losing weight, such as beta-blockers, which I'm taking for migraine prevention, and antidepressants (so I've stopped taking Paxil).

I began 2015 with the full intention of finishing reading Richard K. Bernstein's Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars, but got bogged down in the material about intense body-building exercise. It didn't seem as relevant to me as other lifestyle issues. I read Jimmy Moore's Cholesterol Clarity and Keto Clarity. I have downloaded numerous cookbooks and recipe books (mostly free for my Kindle) and purchased one hard copy of Jimmy Moore's The Ketogenic Cookbook. I'm now in the middle of reading Dr. Eric Westman's New Atkins for a New You: The Ultimate Diet for Shedding Weight and Feeling Great.

My intention for 2016 is to continue eating the way we have been eating: low-carb, high-fat, moderate protein. I'm pretty confident about that. My added focus (which I fully intended to get serious about after Kampmeeting last summer but didn't) is exercise. Starting with walking. I have put a new battery in my pedometer and have made a list of upbeat music to load into my iPod for my walks. If last year was the Year Without Carbs, this year will be the Year of Movement!

Stopped Glipizide

I have been uneasy about glipizide for some time, since glipizide stimulates the release of insulin from the pancreas. I have come to view glipizide as something that is forcing my pancreas to produce more insulin when my problem is insulin resistance. Over the past several months, I have gradually decreased my dosage from 15mg/day to 10mg and now 5mg and have not noticed any perceptible change in my numbers. On this day, I decreased my dosage to 0mg.

January Health Status

I am an obese Type 2 diabetic. I am hearing-challenged and sight-challenged. I'm also a chronic migraineur. Like many diabetics, I have also been diagnosed with and am on prescription medication for high blood pressure, high cholesterol, and high triglycerides. I have nasal allergies. I also have frozen shoulder (right side) due to an injury I sustained in a fall last November.

I am on 8 prescription medications, including metformin and glipizide, and 13 drugstore medicines and supplements, 7 of which were ordered by my doctor but I can't get them by prescription because they are now available over the counter.

My goals for the next four weeks are to:

• Keep a full food journal, including macronutrient percentages
• Stay below 100g carb/day for this month
• Exercise (walk or ride) 30 min./day 6 days a week

A Short History

My Type 2 Diagnosis

I was diagnosed with Type 2 diabetes in September of 2000, just before going on a weekend campout with a group of women. I remember that when I told Dr. John Duge, our pastor, I bemoaned that I would never be able to have Almond Roca again, and he laughed, thinking that I was very funny. I was working in San Francisco at Degenkolb Engineers then, and I walked around the city streets during my lunch hour on a route that I carved out for myself, and then I came back to the office and ate lunch at my desk, being very careful to pack lunches that met the ADA dietary guidelines of 150 grams of carbohydrates per day. On breaks, I drank Diet Dr. Pepper. For the first few years, I was able to manage to keep my A1C under 7.0 with just diet and exercise.

I haven't dug through my old logs yet to see when exactly I went astray, but at some point I was put on Glucophage (metformin) and, later, Glucotrol (glipizide), with increasing dosages until I was taking the maximum of each. And, later still, I was put on insulin, starting with 5 units once a day until it got to be where I am now, at 40 units in the morning and 50 units at bedtime. It was a wake-up call to me when a Pharm.D. suggested I might want to order larger syringes that would hold more than 50 units!

Weimar Reversing Diabetes Retreat

In the fall of 2004, I attended a 3-day Reversing Diabetes retreat, conducted by Weimar Institute. I was familiar with the Weimar Diet from 20 years before when I had my kids on the Feingold Diet, which eliminates artificial colors, flavors, and preservatives, plus testing for salicylate intolerance. We were living in North Dakota at the time and were not able to find any bread that was suitable so I learned to make whole-grain bread with dates and avocados since Weimar prohibited all processed sugars and oils. But the Weimar Diet was vegan and we still ate eggs and dairy products. (We were not quite ready for translation.) After attending the Reversing Diabetes seminar, I was certain I could follow it if (1) I had all day to spending cooking and (2) I had enough time to walk five miles a day, seven days a week. So "Reversing Diabetes" was something I put on the back burner for when I retired, which I thought would be sometime after age 70.

Looking for Weimar on Facebook

But life has a way of interrupting one's plans. I lost my job when I was just 5 months past age 65, and my whole world turned upside down. We had to move to a less expensive place. I was hysterical, thinking I would now have to do grocery shopping at WalMart instead of the snooty Nob Hill. I found myself on Medicare and Social Security. It took more than a year for me to "get over" this total life devastation (and I'm not sure I'm really "over it" yet), but at some point I had to accept that this is the way it is and is going to be from now on and just deal with it. I had to realize that this is the retirement life I had fantasized about but it just didn't happen on my own terms. Nor with sufficient financial support. But what I lacked in money I now had in time. Time to spend all day cooking, planning what to cook, and cleaning up after cooking. Time to go for a daily five-mile walk along the bay front, on level asphalt, two-and-a-half miles from my new home to the marina and back.

In the spring of 2013 I decided to look for a Facebook support group, should it exist, of people who had attended a Weimar Reversing Diabetes program. None existed, only a Facebook Page promoting the NEWSTART® Lifestyle Program, and I signed up to subscribe to their email newsletter. But, in searching the term "Reversing Diabetes" on Facebook, I found some discussion groups that I could join. I also searched "Reversing Diabetes" on Amazon and found a number of books that looked promising that I downloaded to my Kindle. And so my journey began.

Finding a Different Kind of Reversing Diabetes

In the beginning, I read a lot and I "listened" a lot in the groups. I began to get the sense that the real key to diabetes control--and maybe even reversal--was carbohydrate control: greatly reducing carb intake. That made sense to me. What was harder to wrap my head around was the idea of high-fat along with low-carb. I learned that if you lower your carb intake enough, your body will start to burn fat for energy. Now that made sense to me, because excess glucose (from carbs--sugars and starches) had been stored as fat anyway for whenever you didn't have enough glucose for energy. I settled on two Facebook groups that made the most sense to me: Reversing Diabetes and The Vegetarian Low Carb Diabetic Healthy Diet Society, both closed groups. Over time, I discovered that the Reversing Diabetes group had a single focus: that of low-carb high-fat and the recipes containing meat were all kinds of meat, clean and unclean. It was just easier to say I was a vegetarian than to try to explain why I ate beef and chicken and salmon but not pork and shrimp and catfish. The Vegetarian Low Carb Diabetic Healthy Diet Society was pretty esoteric, with a lot of ethnic foods using ingredients that I do not normally stock in my kitchen.

Creating an Adventist Diabetic Community

Then I got an idea to start my own Facebook group and call it Adventist Vegetarian Diabetics, which would include diabetics who understood the Seventh-day Adventist position on vegetarianism and "clean meats." I was hoping against hope that I might find someone who had gone through the Weimar Reversing Diabetes program and could share their success with the group. So, in June 2013, I added a dozen or so of my Facebook friends who I knew were current or former Adventists and were diabetic and put out invitations for anyone interested to join the group.

Experimenting with Low-carb High-fat

In the fall of 2013 I decided to give this LCHF (low-carb high-fat) idea a try, though I was sure I would never be able to get as low as 20-30 grams of carbs a day as the most successful ones in the groups seemed to be doing. I figured if I could get my carb intake down to <100 grams/day, that would be a first step. So in the first several months I watched my A1C go down from 7.5 to 7.1 to 6.8. At that point, that was "good enough" for my doctor, so she stopped having me get the A1C test every 3 months. I convinced her, though, that I needed to test at least three times a day and that I needed a prescription for 300 test strips every three months, and she complied with my request.

Year of Recipe Testing

In the summer and fall of 2014, our vegetarian daughter moved in with us in order to go to a local college, and so I put the low-carb approach on hold temporarily and focused on the vegetarian aspect. We stopped the Hebrew National® beef franks and ate more baked potatoes and Bob's Red Mill ten-grain hot cereal and bean thread with our bok choy tofu stir-fry. But we did have a lot of okra and raspberries and a green salad almost every day that she ate with us. I still cooked "from scratch" and used a lot of coconut oil and olive oil, but I didn't have time to keep a food journal.

I spent most of 2014 experimenting, trying new recipes, trying low-carb foods, trying high-carb foods, and testing to see how things affected my blood sugar. As with Feingold, I seemed to have to make the same mistakes over and over before I could become truly convinced of cause and effect. I asked a lot of questions and posted a lot of opinions on Adventist Vegetarian Diabetics and got very little response, and that was discouraging. I began to wonder if anyone was reading what I was posting. At one point I was so discouraged I fleetingly thought of just deleting the Facebook group, but when I even hinted toward that in a post, I got enough responses of encouragement to keep going with it. However, since it seemed that what people want most was information--especially recipes--and really did not want to have group conversations, I made the group Public: anyone on Facebook could see the posts and the member list, but only members ccould post. After a short time--and a member poll--I changed it back to a Closed Group.

Re-evaluating Goals

Now, as 2015 begins, it's time to re-evaluate not only my personal goals but the goals and purpose of this online community (even if the "community" feels a bit one-sided!). Perhaps my poll questions should not be for the purpose of gaining statistical data about the members, since such a very small percentage of the members even respond to the polls. Perhaps the purpose of a question--whether responded to or not--should simply be for the purpose of getting the members to think about a particular aspect of managing their diabetes. So I will be diligent in presenting a new question weekly and will not be concerned at all how--or if--it is responded to!

Today I'm beginning the food journal, again with a goal of <100 grams carbs per day and 70% of calories from fat. Thus begins my new diabetes journey.