More perspective about blood sugar

imageReading a book called “The Four Hour Body”.  It pointed out that even in really high GI things like Orange Juice, it might take 30 minutes for the full blood sugar thing to take effect.  And pasta, 1.5 hours. This was based on a normie  wearing a CGM and measuring. 

Then, separately? not in the book? doing the math:  100 mg/dL vs 5 L of blood (at best) = 5g of “sugar stored in the blood” buffer.   That’s way less than a meal.

So, I used to think that my blood was like this bucket that sugar got dumped into, and it hung out there till insulin took it somewhere else.  Well, that is kinda what happens, but “bucket” is incorrect.

Its more like a temporary sponge, a small buffer, that happily holds about 5g.  Its a transport.   It can overflow.  at 7.5g, bad things start to happen.  at 15g (300 mg/dL) really bad things happen.

The things that deposit into it:  

Liver during glucogenisis (body saying holy shift too low need more glucose), and digestion.

Things that consume it:

Ah, so here’s the happy little insulin thing.  Insulin definitely acts as the door-knocker that knocks on doors and tells them to open up and let the sugar in.  Which doors, one might ask?

Apparently there’s the doors on the Fat cells.  Yay Fat Cells!  Helping me survive the next famine, when all the little hamburgers are migrating off on the west coast at the In and Out watering hole.

But there’s also another door – the doors in active muscle tissue.

So if you do 40 air squats  (i can do 10, need to build up), that activates something in your muscles, specifically your big thigh quadriceps, that says “HOO BOY does ANYBODY have any GLUCOSE please?” .. and the insulin happily helps deliver it.    Drains the buffer, clears the sponge, ready for more digestion.  Follow that up with some nice pushups – or pullups, dude, if you can do them .. targeting the nice big muscles. Nice big sponges.    Or go walk up 12 flights of stairs.  Oh yeah.

I’m not sure how long after the exercise that receptor (he mentions it in his book, but not at the tips of my fingers) stays on.  I don’t have a CGM to help tell me, and I’m not spending the $, as I’m not type I, its not covered.

I’m also not sure if the action of delivering sugar to the blood is entirely osmosis or not.  Ie, there could be a large store of sugar in your digestive tract at some concentration, and when your blood drops below that concentration, then it migrates over.  Which lends itself to, what gut bacteria exist, and do they consume any of that sugar, and what’s the effects of that.   I don’t know the answers to that.

The point is, 1-2 hours after a meal which might have too much carb, one can use exercise to help “soak up” the sugar.  One does not have to burn that many calories, just activate it enough so that the muscles soak the sugar up.  Note that muscles can only hold a certain amount, though, i think its up to 100g?  your whole body can do about 400g total storage? 

The key numbers I’ve heard is that you want to get down below 140 mg/dL, to prevent certain kinds of cell death; and then below about 100 mg/dL  the body (for normals) stops putting out chunks of insulin; and once the insulin is gone, then your body can get back to finding other sources of glucose, like burning Fat.

What brought this up:

We went to see Marvel Age of Ultron on Wednesday night.    We had Noodles & Co for dinner, and then shared a large popcorn and M&M’s and a coke.   LOTS of sugar.  

After the movie, got home, took my sugar.  If it was over 140, i was going for a walk.  It was 235.   I went for the walk.  Got back 40 minutes and 2 miles later, 171.  Waited 30 minutes.. check again, is my body still dumping it into my system?  No, 146.  So its getting soaked up.  Good.    I don’t feel so helpless.

Note: my perspectives only.   Not a scientist, no research, just reading.  Could be wrong.

I hate Sugar

I hate what sugar does to me.

And by sugar, I also mean simple Carbs like Bread and Donuts.  Especially Donuts.

Yet, here I was again.   Friday Donuts showed up in the office.   “I wonder if it tastes just as good?”  I get tired of the mental battle.  I give in.  Chomp.   The chocolate glazed one is sickeningly sweet.  So I eat the sugar raised one instead, that one is almost perfect.    Slug some more coffee after it. 

Here’s what it does for me, if I am to be honest:

  • In about half an hour, I’m sweating.
  • The places where my muscles are tired and worn, like in my forearms – they hurt.  (wheat has this effect on me)
  • The skin on my feet dries up, goes gray.
  • My eyes change how they focus.  I now have to look through a lower part of my progressive lenses to achieve the same focus.
  • My brain wakes up – it gets excited.
    • But, I think it gets excited in an unorganized, random way.
    • Not as a finely Tuned Tool of Tantamount Thinkstruction.
    • It gets hard to hold a single thought down, instead, I start thinking of everything.
      • This is great for project management.  It is bad for coding.
  • 2-4 hours later, my brain crashes.  Intense sleepiness comes over me.  Its hard to think.
    • I can postpone this crash by sacrificing more sugar to the cause.

Under the Hood

Under the hood, here’s what I believe is happening:

  • I’m a Type II diabetic.  This means that while my body pumps out insulin, the insulin doesn’t work quite as well as it would in a normal person, so the sugar is not cleared from my blood quite as fast.
  • Any meal of more than about 25g of carb, depending on GI index of the food, spikes my blood sugar up beyond the point of my insulin being able to handle it.   I’ve clocked it at 165-200 before.  Which isn’t AWFUL, but it is over 140, the “toxic” level for certain types of cells.
  • With my blood sugar high, various other diabetic things happen – dryness, eyes, possible neuropathy (nerves screaming in pain and then dying) (hasn’t happened to me yet, though I occasionally have an isolated twinge, like a needle prick).
  • Eventually, 2-4 hours later, my body finally gets to the point where its clearing up the sugar.   My brain, used to the influx of sugar, senses things drying up, but it can’t switch to an alternate fuel source yet, and so I hit a wall.   Queue the need for a nap.
    • Sad thing is, it seems to want to crash as the blood sugar drops, not as it gets down to a certain level.  I’ve had crashes when my sugar was dropping at about the 130 range.

Even further under the hood, here’s more of what’s happening:

  • Because I pump out so much insulin, and insulin is a signal to the body, two things happen:
    • Insulin signals the body to store the excess sugar as fat.  This seems to happen around the belly for the most part – BEER BELLY!   (I wonder if its because the sugar didn’t get far from the intestines and then immediately got stored, before it could get further away)
    • Insulin prevents the body from burning fat.    So even if I’m starving, and my body needs energy, if my insulin levels are high, my body won’t burn fat; rather it will burn protein, or go into starvation mode. 
      • I measured this for myself several years ago.  By “this” i mean how my body will ignore the sugar that’s floating around.  Right when I first got diagnosed, and we were experimenting with dosages.  I went off my medications, my average blood sugar levels went up, but I was recording everything that I hate.  I averaged 1800 calories a day, ran, AND I gained 5 lbs, in a month.   I should have lost 5 lbs instead.  Calculations ensued – I deduced that my body was running on 1300 calories a day.  And I felt like crap.

And why the heck do I need a donut anyway?    These answers are specific to my weakness:

  • One author puts it as “Labrador Retriever brain”.  My brain is hooked on the sugar.  It LOVES it.  It was designed to love it.   It craves it.  Precioussssss.    Some folks have tons of willpower – I can have willpower, but it comes and goes in spurts, and if there’s something else big going on, that’s where my attention goes and poof! I’ve given in.
  • There’s a social aspect of it.   I want to belong, I want to participate in the customs going on around me.  I don’t want to be left out. 
  • I have memories of emotional happiness associated with some past occasions involving donuts (and bagels and danishes). (and little smoky sausages, and chocolate wafers, and orange juice, and spaghetti, and french fries, and … )

Recent changes in Diet

Lately, I’ve been listening to the Primal Potential podcast, and I read through the Bulletproof Diet book, and I’m trying something:

  • Bulletproof coffee for breakfast.
    • my body is already at a low level of insulin from my overnight fast
    • keep it at a low level of insulin, and give my body energy in the form of good quality fat
    • turns out, my brain is very sharp when running on fat. 
    • This is not a long term replacement for a real meal; just gets me past breakfast to lunch.
    • OMG trying to find an article that isn’t either a) debunking it or b) selling it, is really hard.  Try for yourself. 
  • Limited Carbs for lunch
    • 25-50g or so.
    • Quest bars
    • Hearts of Palm and Quinoa salad from CostCo
    • Trying to find other things that fit this mold.  Trader Joes has lots of little interesting things.  CANNOT do Panda express (wah)
  • Dinner = moderately healthy, but can go awry (pizza!) if the situation calls for it.

This was my plan till the Donuts showed up this morning. 

New Plan: Surrender

My new plan is to surrender to the donut.  Or the cake, or the pop tart.

  • I will take a plate.  This plate might be decorated or beautiful.
  • I will place said item on the plate, with great solemnity.
  • I will place said plate in the refrigerator.  Or perhaps under a non-see-through-lid in my office.
    • I could label it “Mogwai” – its cute, but watch out when you feed it.
  • at 3pm, I WILL CONSUME THE NOM NOMS ON THE PLATE.

Delayed gratification.  Let my body run without large insulin spikes until after lunch, if possible.   After the lunch spike dies down, then subject it to Donut.   Then the subsequent crash doesn’t affect my work-day.

Reserving the right to eat a bite of the donut, and throw the rest in the trash.  That’s a possibility too.  Preferably at 3pm.

Time Use May 2014

One of those sanity moments where I look at “what am I doing”, and are my priorities in line. (TL;DR: they are not)

My wife and kid went out of town for a week, so I had the opportunity to schedule myself any way I choose.  I have a comparison of “with wife and kid” and “bacheloring it”:

Wife And Kid  (Monday-Sunday)

image

Bacheloring (Tuesday-Saturday)

image

Ob ser v at io n u s

(observation + obvious; black=both; purple=1; blue=2)

  • My work hours were more scattered when the wife and kid were away
  • Work spills over to the weekend if I can’t get all my hours in during the week.   And that is what happens when sleep intrudes into work; which is what happens when entertainment intrudes into sleep.
  • I had more “white space” – time that I’m not doing anything in particular, just being – when the family was away.
  • I spend a significant amount of time in pink (hanging with wife) – I like this.
  • I spend a significant amount of time in green (entertainment, hobbies) – I like this.
  • I do stay up too late doing hobby stuff and watching netflix (entertainment) – at the expense of squeezing sleep.
  • I spent more time eating when the family was away:
    • Mostly, I was cooking up (measuring) batches of soylent and grilling

Not So Obvious

The timeline is not zoomed in enough to see some of the small stuff:

  • I walked the dogs every day while the family was gone.   But it only took 15 minutes.
  • I didn’t get to the gym while they were away.  That’s because my gym time and dog feeding and peeing time conflicted.
  • I spent a lot more time doing errands – cleaning stuff, fixing stuff – while the family was gone.
  • I did not nap at work while the family was gone.

Soylent: Not So Good News

I bought a week’s supply of PeopleChow 3.01 from Doug, with the intent of living on it while the family was away.  I did two trials, with my glucometer:

Trial #1: 1/3 the batch; 100g carb:

  • before: 89 mm/l
  • 30 minutes after:  138
  • 60 minutes after:  168
  • 120 minutes after:  158

Trial #2:  1/6 the batch, 50g carb:

  • before: 93
  • 30 minutes after:  158

The goal? My goal? is to be under 120 after 2 hours after a meal.   I couldn’t do it – too many carbs.

I tried altering the formula to use less corn flour; the result was unpalatable (puke worthy).  I gave up on it.

But what this did was, I started measuring my blood sugar again.

Me: Not So Good News

I’m a lot less able to withstand a carb load than I used to be able to.   Or so it seems.   Today was 40g of carb in some Indian Lentils:

  • Before: 110
  • 2 hours after, even with a walk:  158

And, I can feel it.  I feel puffy, flabby, out of energy, tired.

The Twin Cycle Hypothesis of Etiology of Type 2 Diabetes

imageI did some reading to see what’s new these days in diabetes stuff.  I came across this article, with this pretty cool picture (I could not find a public link, so this is a screenshot):

In a nutshell, it gives me an answer to “what the heck is going on” – and a glimmer that it gives me is, “loose enough weight, the cycle becomes less worse.”   It focuses on some T2 Diabetics who got gastric bypass surgery and radically altered their body fat content and wham! some of the diabetic cycle vanished.

In the past, I had gotten down to 165, which for me is a BMI of about 22.    I felt a lot better then, I was running, working out, having a blast.    But I did not cease to be diabetic. 

Then I saw this line here:

image

For me a BMI of 19 would be 130 lbs.   That’s 50 lbs less than I am right now.      30 lbs less than what I had aspired to get down to at my best.   I have to get down there, AND STAY DOWN THERE, because I’m pretty sure that the last bits of fat to get used up are going to be the ones which are the most troublesome.   Or, I could continue to be reasonably happy yet declining.

Maybe I didn’t drop enough weight that time?

How Hard should I strive?  After all, I could say I’m an old man.  I’m past my prime.   I’m beyond the life expectancy that humans had in the middle ages…

Bottom Line:  I have a Choice to make

My former sponsor’s favorite word – Choices.  Ah, the bliss of not knowing you have a choice.  

I could make a choice to get healthy again.

Which would mean, I need to put exercise back in my schedule.   And logging food.

Which would mean, something has to go.

What Goes?

  • It won’t be sleep.
  • It won’t be work – at least, not yet.  I’m not independently wealthy yet.
  • It won’t be [all of] hanging with the wife.
  • It won’t be Recovery work.
  • It would have to be entertainment and hobby.   There isn’t anything else to let go of.

I’ve been overdoing it.  My brain gets so tired, I just want to numb out with mindless TV watching.. or, my brain gets so obsessed, I have to solve this problem now! (3d printing, blender, and shapeways – I’m looking at you). 

So, sometime soon, expect that all my 3D printing stuff will come to a stop.  Or, it will be relegated to one experiment per weekend (or some other healthy amount).   A check at the posting queue for this blog – actually, the queue is empty right now.   When I post this post, there are no others in the queue after it.

I guess I’ll write one more post for “Shelving the Hobby” – making a list of the irons I have in the fire, so that I can let them go temporarily.   Or not, I can list them here:

  • I have a solution for Agisoft to Blender to Shapeways which involves decimation down to 500, subsurf, and edge creasing.  I have a color print ordered of that.
  • I have a solution for printing initials cubes without supports; I have to slice it, but basically I print it at a 45 degree angle so that all letters are facing “up” (kinda).   I have not actually done this yet.   I have ordered a small (20cm) cube from Shapeways to see how well their printers do the job.
  • I might be doing some silver jewelry via Shapeways involving people’s initials.

Done.  Shelved, will post pictures when they arrive.

I think I have a date with a gym tomorrow morning.   And if my work hours suffer, well, that’s what Sunday afternoons are for.

Randomness: 5:01 A1C

I had been putting off taking my A1C for at least a few months.. knowing that I was slacking off on being regular with my medication, and I had been eating crap and drinking pop.    Last time it was taken was at the doctor’s, I think it was a 6.0 or a 6.2, which is technically really good, I was sure it would be up around 6.5 or 7.0 by now.

So after all kinds of procrastination (I need to do dishes… no, the lawn first… how about some more minecraft… I can’t find my self-test kit…) I finally took it.

5.7 ??? WTFudge?   That’s AWESOME!

I’ve been on a semi-gluten-free diet.  As in, avoiding gluten Sunday-Thursday, and then treating myself on Friday and Saturday.  

“Treating” is a relative word.. “enjoying delicious treats” followed by “twitchyness, and joints that hurt”.  

“Avoiding” is also a relative word.   More like “1 oreo cookie every two days”.    Occasional donut relapses.  Its so hard to turn away when they are placed in front of me.  I could easily be a food addict.. I love my sugar, and eating in general.  (I have been to OA.  I will go if life becomes unmanageable.  They are good folks.)

I think this (relative) lack of gluten in my system.. is what has been saving me.  So I can have that pop without guilt, right?  No, maybe I’ll have a Coke Zero or Diet Pepsi instead.   There’s something in regular Pepsi that I absolutely crave, that I don’t get from regular Coke.  

5:01 And I’m Outta Here

There’s an article going around, I just caught it off the S.H. feed:  

I feel guilty about this. 

  • Very often I am watching the clock, trying to get all my billable hours in to continue justifying the wonderful salary that I’m paid.
  • When I was in my 20’s, I definitely coded for fun.  A lot.    At its worst, my life was: drive to work, drive from work to a college campus and code for 2-3 hours, drive home (125 miles total) and code some more.  Eat at Wendy’s.    I was involved in running an LPMud, and there was a lot of fun stuff to create, and I loved it.
  • I receive a boon of 4 hours of “personal coding time” at work to have fun with.  I look forward to using it every week.   I have two projects to work on it with.  But all it takes is one day where I don’t meet the billable hours, and I loose a little more play time.    Like today: I had to leave early so I could be an announcer at my son’s soccer game.
  • I think the truth is, I have about 6 hours of “natural focus” in me that I can apply towards coding.  After that, my brain just plain shuts down, and it takes a lot of energy to try to kick start it into focusing more.   And because I’m in an environment where there are no meetings, there’s nothing to distract me from coding.. I hit that wall very quickly.  

But I can be proud of myself too:

  • So far, this job has been my best trade:  hours for pay, + in line with the joy of learning good things, + the joy of working with good people.     I’m going to keep on doing it, as long as I am able.   Wrist braces do help, as do adjustible-height desks and larger (25”+) monitors.  #lawn
  • It may take me 50 hours of “clock” time, but I am definitely going to give them their money’s worth.   Because I’m definitely better for it as well.
  • To that end, I’m willing to go at my natural pace during the week.. not push it too hard.. and if I have to work on Saturday, try to do it with as little of a hissy as possible.  Note: not my employer’s request.  My own voluntary contribution. (The hissy is directed at myself)
  • If I do get to noon on Friday, and I have 4 hours of joyful coding time available to me.. queue the Oh Yeah! song by Yello.  http://www.youtube.com/watch?v=Tq0skIEkfUw
  • And I seriously get good stuff done at work.  I am of service, I build things, I am detailed, and my work is solid.    I get it done.
  • When paired up with a more passionate faster developer, I switched gears:  Make sure he is unimpeded, shield him from other’s ineptitude, and watch him shine.     I wouldn’t want to make that my day job, but wow, that was an interesting experience.

Bye Bye iPad

I gave my iPad 1st Gen 3G to my mom.  She needs it for internet access at her store .. so she can show her customers what options they have.    (KCUniforms in Morgantown, WV).  I only twitch a little bit, at night, now that its not here.

The plan is to buy another tablet towards the end of the year, hopefully with the Christmas Bonus.  I haven’t made up my mind yet.. I know for sure it will have a Retina display, but I need to see what Windows 8 goodness comes out in October.   The default would be an iPad3, but there’s some really strong contenders, and honestly I get more done on Windows.  

Entertainment List

There is way more entertainment available to me than I have time for.   This gives me the ability to say “that’s wonderful, but Nope” when new options arise.. like the impending release of Borderlands 2, which has my work buddies all in a tizzy, and the previously released Diablo 3.    My list right now for entertainment is:

  • Brainveg: catching up on Facebook, Twitter, and several blogs including Slashdot Science and Geek{Mom|Dad}
  • TV: shared with wife:  Dr Who, Top Gear America, Grimm.  Thank you Tivo!
  • Music:  Listening to more current music (compared to: 80’s), really enjoying Maroon 5 at the moment
  • Comics: Schlock Mercenary (I just got the new board game!)
  • Games:
  • Books: http://www.warriorcats.com/warriorshell.html  2 more left to read in the original series

Okay.  Family is home.. the game tonight was rough, my kid got tangled up and was the source of a PK; we lost 3-1.  One of his best friends got nailed with 5 seconds left, has a concussion (ouch).  Son and Wife are torturing the opinionated cat upstairs right now (lovingly), I better go and see what’s up.

Cheerio!

Calories In Minus Calories Out


There was a conversation at work. Simplified:

VP (Visiting Person): “What Kind of Cookies do you have here?”
Me: “I don’t know, I haven’t checked. I’m not eating Wheat right now, and that shelf is all wheat.”
VP: “How’s that going? I’ve heard about that.”
Me: “Pretty good. I’ve lost a few pounds even without exercising.”
VP: “Yep, calories in and calories out.”

My brain took off on that conversation. Hence, this blog post.

Normal

The assumption is that people simply control the calories out. “Just work out harder”.

# Powershell
"Normal Situation: "
"Calories In : {0}" -f ($caloriesIn = 2000)
"Calories Out: {0}" -f ($caloriesOut = 2000)
"Net Calories: {0}" -f ($netCalories = $caloriesIn - $caloriesOut)
"Gain/Loose {0} lbs per week" -f ($netlbsperweek = $netCalories * 7/3500)

Normal Situation: 
Calories In : 2000
Calories Out: 2000
Net Calories: 0
Gain/Loose 0 lbs per week

True, but there’s a twist that I found out, due to my type two.

Conjecture for DM2

This is only my understanding of it. It is not proven or fact.

The hidden factor for me was insulin release, and and insulin resistance.

Lets say that for the calories I was taking in, my blood sugars bumped up to the 140+ range. Lets assume that I’m not working out actively at the moment. (when engaged in physical activity, some other form of transport happens, and sensitivity to insulin goes up).

My body is desperately trying to shove this energy into my cells, and is pumping out insulin (all that it has). The insulin has the effect of transmuting some of these calories to stored fat – almost immediately – before I have a chance to use it.

# Powershell
"Actual Situation: (not on drugs)"
"Calories In:  {0}" -f ($caloriesIn = 2000)
"Converted to fat due to high insulin levels: {0}" -f ($insulinToFat = $caloriesIn * 0.15 )   # total guess
"Fat gained per week: {0} lbs" -f ($fatperweek = $insulinToFat * 7 / 3500)
"Body must make do with {0}" -f ($bodyAvailable = $caloriesIn - $insulinToFat)
"Feeling as though only consuming {0} calories - ie, starving" -f $bodyAvailable

Actual Situation: 
Calories In:  2000
Converted to fat due to high insulin levels: 300
Fat gained per week: 0.6 lbs
Body must make do with 1700
Feeling as though only consuming 1700 calories - ie, starving

My evidence for myself:

There were 2-3 months that I went off my medication, but was watching and logging what I ate.
During that time, I ate 1800-2100 calories a day. Yet, I gained 5 pounds in about 4 weeks.

My deduction:
By storing those 5 pounds => that would mean 17500 calories over 28 days = 625 calories a day.
Which meant that I lived on around 1200-1400 calories a day.
And yes, I felt starved the whole time. (not really starved, but you know, the feeling? I have never really starved, except perhaps once)

So what the heck does my medication (Metformin) do?

Everything says “it limits the production of hepatic (liver) sugar”.
What does that have to do with anything?

My understanding (only my understanding) is:
The body MUST MUST MUST not get into a hypoglycemic situation – because the brain dies. Therefore, it monitors it very seriously.

As blood sugar gets too low, it tells the liver to go make some more. Its not an all or nothing – its a gradual release type thing. However, its tuned based on “relative” levels of blood sugar, not absolute levels.

Being diabetic, and having repeated elevated blood sugar levels “reset” what my body thinks normal is. So my body is churning out sugar even when I’m at a comfortable spot, like 110. It thinks 110 is low.

By jumping in and cutting that link (or reducing it, anyway), Metformin allows my “average” sugar levels to come back down to what they are now.. a fasting number of 80 or so.

And once I get down to 80.. and if I watch what I eat, such that any meal, 2 hours after, I’m back under 140 (these are numbers I’ve chosen for myself), my body leaves the second equation, and goes back to the first equation. Or maybe, the 0.15 goes down and becomes a 0.5. I don’t know exactly.

What I do know is: If I stay off Metformin, my weight goes up, and my fasting blood sugar levels go up. If I stay on it, and I eat wisely, they come back down to normal levels.

In Conclusion

All of the above is my explanation to myself.
Its probably wrong. The reality probably has something to do with aliens, monkeys, ninjas, and a turtle.
If you have a better explanation, grand unifying theory of blood sugar, please do post it and point me at it.

Diabetes Type II

I am a diabetic, type II.   I talk more about that on my livejournal.

I was reading a book, Wheat Belly by William Davis, MD.  It made a lot of sense, and fit directly into the knowledge that I already had — just gave me a new term, “AGE”‘s.   This confluence inspired me to put together a visio^H^H^H^H^H creately diagram of the concepts that I knew of so far, about my diabetes.

Here it is (click for full size):

This will probably get updated and reposted over time.  If you have any questions, ask, and I’ll tell you what I understand (but remember: I am NOT a doctor.  Just a geek.  With Diabetes Mellitus Type II.)