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progress update

Progress update #13

Welcome to the thirteenth instalment of my regular update series where I review what does and doesn't work on the journey to type 2 diabetes remission.

Progress update #13
Roast chicken with too much root veg and tomato salsa gives me a whopping glucose spike. This needed a higher protein and green veg to carb ratio. One day I'll get a good picture of a deer! And... even a tiny portion of nuts and berries blows up my dawn effect glucose.

This week has been good, but not great. It's been a bit frustrating that my 7-day average glucose levels started creeping up again. I have managed to get it back under control but it's taken a lot of effort.

Wrestling control of glucose levels

If you look at last week's newsletter, I was getting to a daily average glucose of 4.5-4.8 mmol/L which was starting to get worryingly low, especially after my hypo-edging escapades of continuing my full day fast on Thursday evening. Even though metformin isn't generally considered to cause hypoglycaemia, I was worried about having a hypo episode, so I decide to not take my metformin for a couple of days but rather than settling on an average of around 5.0 mmol/L for a day, I started getting large dawn effect spikes so my daily average has gone up again to 5.7 mmol/L which I'm not happy with.

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Speak to a medical professional about any fasting regimes you might want to try, especially if you are on glucose-lowering medication as there is a high risk of hypoglycaemia.

Daily glucose graphs and averages for each day

Friday morning spike is what I expect from my morning gym session. Saturday was good despite having a lot of red wine. Sunday was fine until my partner prepared dinner with more potatoes than I'd normally have. I had quite a sedentary day and didn't get my usual 12k steps in which didn't help.
Monday morning double spike is from a tiny portion of yoghurt, nuts and berries, followed by my gym session. I haven't had such bad dawn effect for several weeks now so it's been a bit annoying. I'm suspicious that the sausages I've got from the local butcher have sugar in them and that's what's caused the Tuesday morning spike on a non-gym day. Wednesday I skipped the yoghurt and even tinier portion of nuts and berries but still a significant spike during my gym session (I can normally have this breakfast with no problem). I had a large portion of beef bolognaise with lentils on Wednesday evening to prepare for a full fasting day on Thursday. All of my evening spikes are much lower, despite me eating a lot more than breakfast or lunch.

I reinstated the metformin from Monday and have had to do another full day fast again on Thursday to reboot my system. For me, this seems to be the best way to correct a stubbornly rising glucose baseline.

Despite fasting all day, my dawn effect peak spike was still hitting around 6.5 mmol/L which is why I needed to fast for the whole day to bring down my glucose baseline.

Avoiding the polyol pathway

In his book 'Nature Wants Us to Be Fat', Dr. Richard J. Johnson suggests keeping blood glucose ideally below 120 mg/dl (6.6 mmol/L), or at least below 140 mg/dl (7.7 mmol/L) to avoid activating the polyol pathway. The polyol pathway is the body's way of creating fructose from glucose, and as excess fructose contributes to metabolic syndrome, obesity, and type 2 diabetes, it's best to avoid having this pathway activated for prolonged periods of time. It is also a contributing driver of diabetes complications. Personally, I start looking at things if my glucose levels go above 7.0 mmol/L. I know some things will take me above that (such as a very rare dessert or a pint of lager) so I'm not too worried about occasional peaks, but I start analysing anything that can be taking me over 7 mmol/L on a daily basis where I'm not expecting it to do so.

Alcohol

Alcohol consumption is just as bad, if not worse, than fructose as it blocks the liver with fat as well as triggering the polyol pathway. I'm still drinking too much, but I've managed to get my weekly units down to 48, just under my target of 50 (down from 58 the week before). I've been trying to find an app that will log alcohol units accurately as MyNetDiary does a great job of calculating macronutrients but has no option for logging alcohol units. I've been using the Drinkaware app but it's annoying that you can't log custom measurements - so if I've got 235ml of wine left in the bottle it makes me choose 175ml or 250ml, making it impossible to keep accurate records, but it is a good way of keeping a general tab on where I'm up to while I'm drinking. I'll keep trying other apps to see if anything works better.

This week I found that having a couple of brandies one evening was better than hitting the red wine, as I find it easier to stop after a couple. Next week's goal is to have at least three dry days and to keep under 40 units, which works out as:

  • 3 bottles of wine
  • 2 pints of lager
  • 4 measures of spirits
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Drinking alcohol is not recommended for managing type 2 diabetes but if you are going to drink, then spirits and wine have less sugar than beer and especially cider. Pay attention to sugars in mixers. Even tonic is high in sugar so try to stick to soda water where possible. Sugar-free soft drinks are not good because they cause dehydration and make you hungry as well as having other health implications such as losing calcium from bones.

Million step challenge

I'm up to 890,000 steps now, and have averaged 13,016 daily steps this week. I only need to average 4,600 steps per day for the remaining 24 days so hopefully the weather will stay reasonable and I can avoid any injuries. It's been one of the more enjoyable tasks for my attempts at reversing type 2 diabetes... much more fun than weighing all my food and booze! It's helped me find new places, pubs and local producers that I wouldn't have known about otherwise. I also really enjoy alternating my gym mornings with long walk mornings.

For my long walk morning on Thursday I had a recce around Rivington Terrace Gardens and the Pinetum (place with pine trees 😅). The Japanese lake was showing that we've not had enough rain this year, even though it feels like it never stops threatening to rain when I go out for a walk.

Gym

I'm keeping up with my three-times-a-week routine of weight training and cardio on the exercise bike. I fell a few seconds short of my 9km target in 20 minutes on Wednesday because I'd had a bottle of wine the night before - would make sense to avoid alcohol the day before the gym.

Did you know that Bolton has been making shoes for Olympic athletes for over 100 years? In 1961, Norman Walsh left J W Foster & Sons (the precursor of Reebok), to boldly establish his own brand. You can still buy performance footwear designed and made in Bolton from Walsh today.

Shop normalwalsh.com

Released in 1981 for harriers competing in the New York Marathon, the Ensign quickly became known for its durable performance and minimalist design. While many brands were experimenting with new technological materials, Norman Walsh stuck to his “less is more” approach. Featuring a Vibram Moreflex outsole with a thick wedge in the midsole for a cushioned heel strike, the Ensign provided both comfort and flexibility. The lightweight upper offered full-foot support, making it ideal for marathon training and races.

My new Ensign trainers have helped me keep my step count up without causing me blisters and tendonitis.

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