Sunrise never bores, is always new.
Guess what my favourite colour is?
Sunrise never bores, is always new.
Guess what my favourite colour is?
I’m a Fujifilm camera fan.
Sometimes I wish they’d have a zoom lens that doesn’t weigh a ton and cost a fortune.
So I picked up the diminutive Sony HX90V. It’s ultra zoom lens sees forever, it weighs nothing, and can be had for not too many shekels.
It has a watercolour feature.
It makes the ginger cat sympatico.
This silly picture illustrates exactly how it feels when the type 1 diabetes silver bullets have turned out to be bullshit. 😜
My endo is going to be pleased with me, at last.
Four years since diagnosis, I think that maintaining close to normal blood sugars for a T1D is for, umm, well, others.
After four years with a dud pancreas, fifteen thousand blood sugar checks and six thousand injections, I have come to believe that higher than normal blood sugar is not the bogeyman, that fat damages protein 23 times more than glucose does, that glycation damage can be reversed, that insulin is implicated in causing retinopathy, that glucagon, not insulin, is the master hormone, that insulin makes me fat, that the body doesn’t need insulin to uptake blood glucose, and that high carb in the form of fructose is regenerative.
As I said before, my body feels much better with higher blood glucose.
Time for a new n=1 experiment.
I’ve stopped injecting Novorapid (fast acting insulin) before meals and snacks.
I inject 9 units of Levemir (long acting insulin) at night, and 5 in the morning. That’s enough to keep gluconeogenesis within bounds.
Today is Day Three.
Day One after breakfast, the spike was briefly up to 14 mmol/L (250 mg/dl). I withstood the impulse to inject. At 10 am it was around 6 mmol/L (110 mg/dl). I had a cup of coffee with sugar and milk, and by noon it was 5.4 mmol/L (97 mg/dl) and crashing.
That will do me.
A similar pattern occurred in the afternoon and evening, with much flatter spikes. Day Two was similar.
Fasting sugar this morning – Day Three – was 5.7 mmol/L with a flatline Libre during the night.
This is on a high carb (fructose), moderate protein, low fat vegetarian diet. Apart from the one or two spoonfuls of liver I occasionally crave.
No more hypos, no more anxiety about hypos, no more waking up every hour and a half to check sugar, no more nightmares!
Five less injections every day.
What’s not to like?
Welcome to free range sugar.
About a year ago I trialled a method to flat-line my blood sugar graph. This is based on thinking that not only higher than normal average blood sugar is bad, also the after meal spikes are detrimental.
The method involves working out how much insulin one needs to inject at each meal to flatten the spikes, as well as how much to inject to control the body’s ongoing glucose manufacturing activity. Then one needs to inject a little more insulin, so that the sugar content of the blood is always trending down. To stop sugar from going too low, one needs to eat a controlled amount of carbs at regular intervals, e.g. a date, or a glucose tablet.
Basically it’s insulin needle in one hand, sugar in the other. Alternate all day. Prick and eat.
I managed to get a near normal HbA1c: 5.2%. You healthy pancreas people have a number in the high fours.
Proudly, like a school kid with a good report card, I did a show and tell of my nice result to my endocrinologist.
She had a fit.
Diabeasts are not to have these numbers. Around 7 is better.
She obviously has secret knowledge that high blood sugars are good, and so are spikes. Or that the risks of low sugars – sudden death – outweigh the risk of high sugars – eventual loss of limbs, blindness, heart disease etc followed by an early death. This then is expected, and fits the normal course of the disease.
And that is the problem in the weird world of type 1.
Who and what to believe.
There are no certainties to grab hold of and work from. Not even the underlying assumptions of the disease and it’s management are clear, let alone agreed on.
Carbs are good. Carbs are bad.
Fat is good. Fat is bad.
Sugar is good. Sugar is bad.
Fruit is good. Fruit is bad.
Dairy is good. Dairy is bad.
Cholesterol is good. Cholesterol is bad.
High blood sugars are bad. Low blood sugars are bad.
Flat-line is good. Rollercoaster is bad.
The flat-line method didn’t work for me. Sure, I got good results. But it seems pointless to inject insulin for one’s cup of coffee in the morning to avoid it’s spike, then go for a walk, only having to stop every 15 minutes to check blood sugar and eat sugary food to avoid passing out. Because walking enables more uptake of blood sugar by the body.
Is high blood sugar a cause or a symptom?
Sometimes I despair of all the crap.
Frankly, I feel much better with higher blood sugar. Makes me sleep like a baby.
Radical doubt, of everything that is said or written about diabetes, is my way of staying sane.
It ain’t necessarily so!😤
I try to keep my blood sugar above 4.0 mmol/L (72mg/dl) at all times.
Especially during the night.
Occasionally I stuff up, and it dips into the threes. A little too much insulin injected, a bite or two less into my pie hole at dinner, or a slightly faster pace or longer distance during my daily walk will do it.
Rarely do I sleep through a hypoglycaemic episode.
Instead, I have vivid dreams about food and my inability to get it.
Or, deeply frightening nightmares.
My wife’s response: “There, there, it’s all OK, now go and check your sugar”.
In Diabetes 101 I was taught that:
Insulin is the master hormone that controls the uptake of glucose by the body. Glucagon is merely an emergency standby.
It would appear that since the 1970s Professor Roger Unger and others have shown this model of insulin action to be incorrect.
In actual fact:
Glucagon is the master hormone. It is always on as an evolutionary measure protecting the brain. Insulin turns it off when required. Not the other way around.
A complete 180° reversal of what is taught as gospel truth to new diabetes. G-d knows why, maybe.
I’m trying to get my head around how I can put this glucagon-centric model to good use, to better my management of diabetes.
Please leave a comment if you have already worked this out. Other comments welcome too, of course! 🤩
When I was diagnosed with type 1 diabetes about four years ago, the doctor was blunt.
“If you don’t keep your blood sugar under control, then you will get diabetic complications: blindness, loss of limbs, kidney failure, heart failure, nerve damage, and last but not least: impotence.”
Doc set the goal, but offered no path.
The standard diabetes management offered by Annabel, my credentialled diabetes educator, wasn’t going to cut it. Still, I am very grateful to her for her care.
The search for a path that would lead to stable blood sugars and death by old age began. I had nothing to lose and tried anything.
Always hoping to avoid doc’s dire warning.
Ellen Davis’ and Dr Runyan’s ketogenic diet delivered good blood sugars, but made me ill with off the scale cholesterol levels.
Dr Bernstein’s version of this diet wasn’t much better.
I call him Doctor Killjoy. Carbs are evil, and you can only have ONE cherry tomato with your salad.
I pursued the low carb high fat path for 18 months.
An epic fail.
My new endo yelled at me, for having close to normal blood sugars (!) and sky high cholesterol.
She challenged me enough to change tacks.
Then I found new hope offered by the plant doctors – McDougall, Barnard, Greger, Fuhrman, Carney et al.
“Give up animal based foods and eat only very low fat plants. Focus on starches, and you will reach your goal.”, they said.
It worked, for a while. Blood sugar was fairly stable, weight went down, insulin usage down, and cholesterol: how low can you go?
For two years I cheerfully deprived myself of fructose, protein and fat.
Slowly, the kilos lost were regained, and they brought lots of buddies along for company. Calorie intake declined steadily. I became cold. I peed gallons all night every night. Insulin usage higher than ever. Blood sugar creeping up. No resilience to the common cold. Heart rate slowed to a ponderous 46 beats per minute. I felt like a bear going into hibernation.
Upside: I farted my own private hole into the ozone layer. The local sewage plant needed an upgrade to cater for my thrice daily epic dumps.
I allowed this n=1 experiment to go on for far too long. I probably damaged my metabolism.
So, it’s so long to the plant doctors, and thanks for the farts. You may stick your starch up your bony bottoms, and inflict your ideology on some other sucker.
Where to from here?
Dunno, but tonight the childbride will take me out to celebrate with a high calorie, high carb, high sugar, high protein, high fat and therefore maximum pleasure dinner: pizza followed by pavlova.
When properly fed I’m ready for it!
The most fearsome boss I ever worked for was of the view that precision of thought is impossible without precision of language.
Was he right?
I have diabetes.
The term is meaningless. It conveys no useful information.
It does not define the cause, symptoms, treatment and prognosis of my condition.
There are many types of diabetes. One is reversible by going for a walk. Another by giving birth.
There is no cure for mine. Only feeble attempts at management in order to postpone the inevitable for a while: death through disability.
The current discourse is flooded with the diabetes meme.
99% is irrelevant, if not damaging, to me. Especially internet doctors and ‘experts’ who spruik a cure or management regime for ‘diabetes’.
A tropical tribesman who has no word for ‘snow’ can be excused.
My wife’s work means she is Someone. I, as housekeeping spouse, am Noone.
Wherever we go together, she is greeted, her well-being inquired after.
I am invisible.
My usual response when people make a fuss of her: “I’m good too, thanks.”
I’m on an aeroplane hurtling from hither to yon at dizzying height and breakneck speed. The plane is full.
A voice inquires: “Something to eat?”, while a cardboard box lands on my tray table.
Time for the ritual.
I take the phone out of my bag, and scan my sensor. Hmm, sugar’s a bit high.
I unwrap the goodies that is lunch, guess at what’s in it, and do a stab in the dark as to how much insulin I need.
I find my insulin pen and a new needle. I unwrap the needle, and screw it onto the insulin pen. I dial 2 units. I aim the needle toward a spot unoccupied by people. I press the button. A squirt of insulin arcs up, just missing seat 12C on it’s descent.
Nothing like the smell of insulin on a crowded flight.
Slowly I unbutton my shirt. I reach my hand into my pants, and pull out a roll of, well, fat.
I dial 6 units of insulin.
I gently prod the white flab with the point of the needle, looking for a spot without nerves. Usually a blood vessel hides behind a nerve. Don’t want the drama of blood on a full plane with 180 passengers and crew.
The needle finds a spot, and in it goes. I push the button, and count to 10.
Then the reverse happens, unscrew needle, secure and stow pen, store needle in safe place, return all my diabetes sh*t to my manbag, push the aforementioned roll into it’s usual spot, button up my shirt, and tuck it neatly into my pants.
Ready for lunch.
The bloke next to me is hoovering up the contents of his box, oblivious of the medical intervention that took place 20 centimetres from his face.
The hostie chants “Something to eat?”, right behind me.
The lady 35 centimeters to my left across the aisle intently studies her iDevice.
Not a thing. Not the needle, not the squirt, not the naked belly, not the almost blood.
I am invisible!👻