Fasting and exercise

[bellx15]

Hi everyone - I have just discovered that my blood glucose level is in the 'diabetic range' - currently 11.6 fasting BG.

However, my lifestyle has encouraged this. Two or more years ago I went on a bizarre fruit juice 'diet', only to find that it had elevated my FBG to 17!! Normally it would have been about 6.

That time around I stopped the fruit juice, and got into regular exercise, and within three weeks my FBG was down to about 7.5, and falling. I didn't go back for further tests after that. i assumed I had it under control.

This time around I have not been drinking fruit juice, but beer! Too much of it on a daily basis. No exercise whatever to boot. So the question is whether i can pull the same trick off a second time.

Particular question: Periodic fasting (24hrs) is sometimes mentioned as a way to burn off body fat and lead to lowered glucose levels. Is there anything in this?

Any advice, thoughts, suggestions would be welcome. Thanks!

 

[bigheadmike]

if you are having a reading that high on a fasting test you are definatly diabetic, it says to me that your body is unable to cope with your glucose levels, you can either control this dietary or through medication, if you are able to keep a good healthy diet and excercise regime i dont see a need for the medication, you need to see a diabetic specialist to get definitive answers.

there is no such thing as a quick fix, especially if you are going to revert back to old practices.

 

[bellx15]

Hi Mike - thanks for that.

So I am definitely diabetic, then?

I take it you are saying that I can still keep my BG down to acceptable levels, though, without medication.

Does alcohol elevate BG over the long term?
Does carbohydrate?

I'm not sure the NHS does specialists in this - I got the leaflets last time around, but on the diet sheets I don't consume any of the bad stuff listed anyway!! I have a healthy diet. Protein, veggies and very little carbs. Could cut out the bread and potatoes, though.

looking for specific advice - all ideas welcome.

 

[bigheadmike]

i am unable to diagnose you with diabetes. only a MD can.

the NHS does have specialists, nurses and consultants, you should get a referal from your GP.

Alcohol can be consumed as long as your sensible, alcoholic beverages normally contain significant amounts of carbohydrates. When you consume alcohol, the carbohydrates in the beverage are converted into glucose in your digestive system and released into the bloodstream. This gives an immediate rise in your blood sugar levels.

i am unable to say weather you will get away with not taking midication.

i will advise you to go to your GP, push for a diagnosis 1 way or the other, you need to get this under control as early as you can(if there is anything). i wish you good luck,

don't forget diabetes isn't hard to live with and you can do all the normal stuff within reason.

i did 'tough mudder' the other week and was fine, just have to make adjustment and remember the improtant P's (prior preparation prevents **** poor performance)

 

[Northerner]

Hi Mike - thanks for that.

So I am definitely diabetic, then?

I take it you are saying that I can still keep my BG down to acceptable levels, though, without medication.

Does alcohol elevate BG over the long term?
Does carbohydrate?

I'm not sure the NHS does specialists in this - I got the leaflets last time around, but on the diet sheets I don't consume any of the bad stuff listed anyway!! I have a healthy diet. Protein, veggies and very little carbs. Could cut out the bread and potatoes, though.

looking for specific advice - all ideas welcome.

The key is everything in moderation Brian. You cannot cure yourself of diabetes, but you may be able to manage it well by adjusting your diet and including regular exercise (weight loss can also help, if required). Alcohol can affect people in different ways. Whilst the stomach is absorbing the carbs in beer, your levels will likely shoot up, but then whe your liver is processing the alcohol it will stop releasing glucose itself, so it can then have a lowering effect on levels. But as you can see, it's a bit of a see-saw and can lead to difficulties with your pancreas keeping up with everything, so best to be avoided or at least kept to a minimum. People react differently to different things also - real ale pushes my levels high, but strong lager or cider does not.

A 24-hour fast is probably also not helpful as your liver will try to compensate by releasing more of its stores of glucose in response and raise levels anyway. Far better to stick to a diet that is palatable, but that your meter tells you your body can tolerate well. All carbohydrate will raise levels, and again it can be a very personal reaction - some can eat porridge, others can't, which is why it is essential to build up a picture of how you cope personally. There is no one-size-fits-all diet so those sheets you have are only a guideline, and probably don't fit with the majority of people's experiences. You need to learn the principles, do the tests, and tailor your diet accordingly - and keep exercising! 🙂

 

[everydayupsanddowns]

Does alcohol elevate BG over the long term?
Does carbohydrate?

Hi Bellx15

As Big Mike says, no one here can give you a diagnosis (or any other medical advice for that matter!), but... if your GP measured you at 11.6 FBG on more than one occasion I suspect they would suspect diabetes, and at the very least would suggest more tests.

In answer to your questions, no. Alcohol does not raise blood glucose levels (in fact because of the way it interferes with the metabolism it can even cause them to drop in people with diabetes). Beer though, has appreciable amounts of readily available carbohydrate. Not quite as much as fruit juice, but a pint of real ale can be upwards of 20g CHO.

I suggest you book-in to your GP to get some support. If persuing 'diet and exercise' then you will need to watch *all* carb intake. If you are able to test your own BG, a framework like 'Jennifer's Advice' can be very helpful to maximise the effectiveness of dietary changes.

Have a read of this: Test, test test by Alan S

 

[mcdonagh47]

Hi Mike - thanks for that.

So I am definitely diabetic, then?

I take it you are saying that I can still keep my BG down to acceptable levels, though, without medication.

Does alcohol elevate BG over the long term?
Does carbohydrate?

I'm not sure the NHS does specialists in this - I got the leaflets last time around, but on the diet sheets I don't consume any of the bad stuff listed anyway!! I have a healthy diet. Protein, veggies and very little carbs. Could cut out the bread and potatoes, though.

looking for specific advice - all ideas welcome.

two random bgs over 11.1 are sufficient for a diagnosis of Type 2 Diabetes or 2 FBGs over 7.
You would appear to be Type 2 on that basis and it doesn't happen overnight, newly dxed T2s have often been labouring with Insulin Resistance for 5 to 10 years. Insulin Resistance is your main problem as a T2 - you have enough insulin but it isn't working and your Beta Cells in the Pancreas have been working over time trying to keep control. When the Beta Cells hoist the white flag you are dxed with Type 2 Diabetes.

Yes of course the NHS has Specialists "in this" - they are Endocrinologists ( Endos) but you probably won't get to see one, most T2s are fobbed off with Practice Nurses at the surgery. ( T1s are luckier they get to see a formidable group of ladies called Diabetic Specialist Nurses).
Many new T2s are left to flounder for themselves ( its not a sexy, fashionable specialisation) and that's where Support Groups like this come in.
You should also enquire about the course for new T2s called X-Pert Patient Type 2 Diabetes.

As for Carbohydrates .... there are three main Nutrional groups - Carbs, Protein and Fat. The Glucose that your body needs for energy comes largely from Carbohydrates - they are the thing that raises your blood sugar levels. So your daily control is basically all about the amount of carb you eat. The X-Pert Patient course defines a Carb portion as 15grams of carbohydrate ( and that's vanishingly small - 2 new potatoes, a slice of bread,half an apple etc) and it recommends 8 to 15 carb portions a day depending on build and type of work done. If you are sedentary at a computer all day, you are probably near the lower end of that. You should definitely read Jennifer's Smart Advice in the Stickie section ( touted by some as the best advice you are ever going to get).
Another vital ingrediant is exercise and one authority says a two mile walk a day or equivalent exercise is the minimum. You might be able to control it with Diet and Exercise for a few years but with your high figures you might be too far gone for that and need help immediately ( the "wonder drug " Metformin to start with ).

 

[bellx15]

Outstanding advice and information - thanks!

My personal take, based on my past experience of myself, is that there is a great deal I can do to get my BG level down. As I said, I got it down a couple of years ago from 17 to around 7.5 in a matter of a few weeks. I just stopped drinking fruit juice and went for a vigorous walk almost every day. The GP was somewhat surprised at my success. So, based on that, I told him yesterday that before thinking about medications I again want to try to get to grips with this using diet and exercise. that's what i am doing now.

Let's be clear, then. I need clear and simple things to follow at the moment, especially while I am drowning in a marital roller coaster.

Alcohol in itself does not lead to long-term elevation of BG

Carbohydrate intake is the key to short-term BG management (in conjunction with exercise).

Am I right so far?

And finally - what does cause the BG to rise in the long term?

Thanks again - all of you. I really appreciate this support.

 

[mcdonagh47]

And finally - what does cause the BG to rise in the long term?


.

Loss of Beta Cells - even when you establish good control the Beta Cells of a T2 are silently dying off. The rate of that ( faster or slower) determines the rate of the "progression" of the condition.

 

[bellx15]

So what causes loss of Beta cells?

This is interesting.

http://www.diabetologia-journal.org/Lim.pdf

In a nutshell, it finds that Type 2 Diabetes is reversible with diet alone.

 

[Mark T]

So what causes loss of Beta cells?...

If anyone knew the exact reasons exactly why, I expect they would be very popular/rich person since as far as I've been able to tell no-one seems to have found conclusive proof of exactly what causes diabetes.

Maybe it's genetic, maybe it's chemicals, maybe it's too many calories... search on the web enough you'll probably find 100 answers.

However, if you can regress your diabetes then good luck to you! Some people can take control through diet alone - just remember that if you push your body it will probably come back again and again. You have to hold to a eating and exercise regime that you can hold in the long term.

Not everyone can take control through diet alone. This isn't a failure in the individual it's just that each person and how the disease impacts them is unique.

 

[bellx15]

OK - fair comment. But you do know of people who have taken control by diet and exercise?

I don't think i have much to lose by trying it. lucky I like boiled veggies!

 

[mcdonagh47]

So what causes loss of Beta cells?

Basically raised levels of Glucose is the culprit... but check out this article or Google "Beta Cell Apoptosis"

http://diabetes.diabetesjournals.org/content/54/suppl_2/S108.full

 

[Mark T]

OK - fair comment. But you do know of people who have taken control by diet and exercise?

I don't think i have much to lose by trying it. lucky I like boiled veggies!

There are a few on the forums who did take control with diet and exercise.

So yes, give it a try. But it's not nice to boil and eat vegetarians 😉😛

 

[mcdonagh47]

OK - fair comment. But you do know of people who have taken control by diet and exercise?

I don't think i have much to lose by trying it. lucky I like boiled veggies!

Diet and Exercise is the first strategy for most, if not all, T2s. NICE ( and DiABETES UK) recommends a three or six month trial of D&e only and that's to see if it works and also because new T2s need to understand the absolute necessity for lifestyle changes. Having said that, unfortunately there is no actual diet for new T2s, in general we are recommended to a low GI, Mediterranean style diet ( lots of salad and good oils). Most new T2 just get Heart Healthy diet advice simply because T2 diabetes is effectively treated as sub-species of Heart disease since that is the main threat.
But it doesn't stop there, whatever regime you are on,D&E still forms the basis. It isn't a choice of Meds or D&E - D&E is a commitment for life.
But you have to remember that Denial is not just a river in Egypt - you have a serious condition that has the potential to affect all your bodily functions and you need to come out at it with all guns blazing. For many T2s D&E alone is not a realistic or feasible project. By the sound of it you have had Type 2 Diabetes for several years and your Doc has been lax in not tackling it before now. The Diabetes might not let you decide that you are just going to follow D&E alone.
Type 2 Diabetes, Hypertension, and Hypercholesterol are three issues that ride together - you need to hit each one hard if you suffer from them. The average T2 a few years in, can expect to be on a couple of meds for bgs, a couple for high blood pressure and something to keep the Cholesterol under 4. There's a whole sophisticated and effective pharmaceutical armoury available to you if D&E is insufficient.

 

[Robster65]

Something else that will contribute, to some degree, to raised BG levels is stress. I noticed from your earlier comment that your life is in some turmoil.

Your body will be maintaining a higher BG in case you need to defend yourself or sprint. It hasn't caught up with modern life yet so is still expecting something big to try and eat you. Cortisol keeps your BGs higher than normal.

If your diet includes very little carb now and you're seeing fasting BGs of 11.6 then I suspect you'd struggle to cut out enough to drop to 'normal'. 6 is ok but 7.5 isn't. Better would be 4 or 5.

In the long term, alcohol in excess can also contribute to pancreatitis, so watch the quantities, whether beer or spirits (which are generally carb free).

Rob

 

[Northerner]

Great explanation mcdonagh 🙂

 

[bellx15]

OK - more great advice. Thank you!

I am going to try the low calorie diet (mostly green veg) and exercise for a couple of weeks or so, to see whether it works. The report said it brought BGs down to normal after a week (I realise that is not a cure), so it won't take me long to at least see whether it looks right for me to pursue.

 

[Northerner]

OK - more great advice. Thank you!

I am going to try the low calorie diet (mostly green veg) and exercise for a couple of weeks or so, to see whether it works. The report said it brought BGs down to normal after a week (I realise that is not a cure), so it won't take me long to at least see whether it looks right for me to pursue.

Having such a restricted calorie and low carb diet will almost inevitably bring your levels down within a week, but that doesn't really tell you anything because it's not a sustainable diet. The report you quoted was a very small preliminary investigation with (as far as I know) no long term conclusions or follow up of the participants (only 11 people). We have a couple of people who have followed it (or are currently following it) with the consent and guidance of their doctors. You can read about thier experiences here:

http://www.diabetessupport.co.uk/boards/showthread.php?t=24339

The main hope of the study was that the benefits would be sustained even when the participants returned to more normal eating patterns, I think the jury is still out on that. It may give you a kick start though, but as I said I don't think a week would be sufficient to gain any long term benefit.

 

[bellx15]

Good morning -

Northerner - all points taken. I am only trying to find out how well I react to certain changes in my habits. Here is my revised take on what I am going to do:

Firstly, I'll control my diet and do some good exercise every day. This will be a sustainable routine, given a little discipline, so if it works i will be able to keep the BGs down to normal levels just by following that regime. I am hoping this will be enough. Since Monday morning (seeing the GP) I have cut out beer and kept to a low-carb, reduced calorie normal diet. I have also been out yesterday for some good walks. All sustainable.

Results.

FBG From GPs test (taken 10 days ago) 13.1, Yesterday 11.6, Today 10.2.

So it's already going down and I am not doing anything extreme. I am fairly hopeful that I can get things back to normal just by continuing with this regime.

If not, I'll have a go at the 600-calorie diet, or a milder form of it. I was very impressed by SmithGareth's determination - well done that man!