Low-Carb Diets and Cycling

[Triskeliongirl]

Anne, one more thing, I apologize if the tone of my posts have been defensive. I just get really tired of folks that criticize what I am doing when it is so clear to me that what I have figured out about my body is huge. I too never would have believed I could cycle at the level I am on this diet (read this thread from the beginning and you'll follow my experiences in real time). I was also aggresive with you, becauase I want others to benefit from this knowledge, and I was concerned about Sarah, but I understand that every body is different. I really mean that. I think that is one of the problems with nutrition recommendations and obesity now. There are people that can really handle carbs and thrive on them and others that don't. I can't assume everyone is like me. And, I am sure that since you think Sarah is doing so well, you also get defensive if I suggest that she try something different. If her blood sugar control is really good, then obviously what she is doing works for her, just as what I am doing works for me. To me, that is what is key for anyone with diabetes/impaired glucose tolerance, regardless of the etiology, maintaining good blood sugar control, which I operationally define as 70-130 (I am usually closer to 80-120, just sometimes on the bike when glycogen stores are very full it goes up to 130, and sometimes it will drop to 70 if many hours have gone by since a meal). I also read an article that trained endurance cyclists perform best with blood sugars around 110-120 on the bike, which while they need to eat to carbs on the bike to ahieve, I seem able to achieve without eating carbs on the bike.

[onimity]

Some DIY health experiments are risky and even downright dangerous. Eating a high glycemic index breakfast and measuring your blood sugar a half-dozen times afterwards is not one of them. If you check my posting history you'll see that every time I have suggested that someone investigate iron supplementation I also urge them to see their doctor and get their ferritin tested, since taking oral iron willy-nilly can be quite dangerous for some people. I do not care for the implication that I am endangering the health of other members here simply by sharing information and advice.

Hi Dianyla,

I respect that you are trying to help people with your advice but this is just patently false. While severe reactions during GTTs are rare, they can and do happen. First, you recommended a glucose tolerance test; that is NOT the same thing as a high glycemic-index breakfast followed by testing. Since you've talked about trying the test with glucose in this thread I don't think it's hard to be confused about your actual recommendation. I think that Triskeliongirl's original post recommended something quite different -- testing response to a reasonable meal -- which may give you some insight into how you respond to real foods but it is quite different since you have to digest and metabolize the food.

You were looking for hyperglycemia, but another possible outcome is hypoglycemia, which can vary from asymptomatic to deadly. And while the latter is very unlikely, it is quite possible to have a severe reaction. Some people produce too much insulin especially in response to a large quantity of simple sugars and can see a huge drop in their blood sugar after an initial climb. Risk of a hypoglycemic reaction can also be increased by numerous common medications, alcohol consumption (which you may still be metabolizing from the previous night), exercise within 24 hours prior, the carbohydrates you were consuming in the days prior to the test, etc. etc. etc. There is a reason your Dr. doesn't just send you home with glucose and a meter to do these tests.

Beyond the test itself, I think the biggest danger is self-testing/diagnosis without involvement of a medical Dr.; I've seen a lot of people harm themselves by doing this sort of experiment and either 1) determining that they don't have a problem when they do or 2) deciding that they understand and can control a problem they 'detect' without seeing the big picture.

My two cents.

Anne

[onimity]

I think that you are right that there are a lot of people out there with undiagnosed diabetes and misdignosed diabetes and that the best possible outcome of this thread is that people may be able to recognize symptoms of a problem which will cause them to investigate further. Specifically that adult-onset diabetes is not necessarily type 2, which a lot of people (including Drs) assume.

"So, I still think its fine for folks to self monitor, but of course the intention is to share the results with their doctor."

I agree, 100%.

Sara's A1Cs have consistently been in the 6% range since she was diagnosed (minus that test at diagnosis) she's been in the low 7s a few times, but that's rare for her. Now that she has been able to tighten her nighttime basal rates and increase her # of BG readings with the CGMS I expect that she will be in the 5% range on her next visit. She has also never had a severe hypoglycemic reaction or been hospitalized. She sees her endo every three months and goes through the full gamut of tests for general health and complications; after 14 years she has no evidence of complications whatsoever and her doctors estimate that she has a less than 5% chance of developing complications in her lifetime if she continues her current level of control.

Your diagnosis must be particularly terrifying to you because of your Dad and I can't imagine what that must feel like for you; all I can say is that things have changed *so much* even since Sara was diagnosed; the insulins that are available are so much better/more predicatble, insulin pumps are a huge help, and the means of testing and ensuring good control are light years from where they were even 10 or 20 years ago.

I got a kick out of your story of riding your bike in to have your glucose tested.

And no, I don't think your tone was (overly) defensive; and I truly didn't/don't mean to come off as telling you what to do. This has been a really interesting thread and I think that by sharing what we all know, we've probably all learned something. You and I both have a lot of personal history from this disease; you react with the knowledge of what diabetes did to your father and how your body is reacting to its circumstances. To me, your diet/response looked a lot like Sara's instinctual reaction in the year leading up to her diagnosis: avoiding sugars/carbs because she felt bad when she ate them, losing weight, etc. So I think it's natural to compare concerns and experience and I hope that I haven't offended you with all of my questions/comments.

Please keep us updated on your antibody tests and progress. I hope that you continue to do well and feel good.

A few random links that you might find interesting:

http://www.insulinfactor.com/graphic..._exercisel.pdf
http://tudiabetes.com/forum (<- there is a forum specific to type 1.5 and an interesting low-carb v. insulin discussion there as well)

Anne

[Dianyla]

Well, I got my hbA1C results back today - 5.4%. So I think I'm in the clear for now, thankfully. I am, however, going to continue with the paleo style diet (modified for athletes) since I have been feeling better and seeing better fasting values. When I'm going paleo, my morning glucose is ~85 as opposed to the 95-105 that I had been seeing.

[Triskeliongirl]

Hi Dianyla- I was wondering about you. Glad you got a good report from your doc. I was very impressed reading the paleo diet for athletes, and think that it is a good choice for you given everything you have told us. I wish I could follow it, its just still a little to carb rich for my body to tolerate, but as I said before, I am really impressed with the qualifications of both co-authors. -eileen

[dinabean]

I know this thread is three years old, but someone directed me to it when I asked a question recently about fueling long rides while on a low glycemic diet. I've been fascinated by everything I've read here -- I was recently diagnosed with Hashimotos Hypothyroidism, my fasting sugars were regularly around 110 and my doctor recommended a gluten-free, low glycemic diet for me, which I have been following for about three months now. I bought a blood sugar monitor (the one from Target, it's house brand, is cheap and the test strips are cheap!) and the food seems to be helping, as my fasting sugar is now more around 90-ish most days.

In any event, are the OPs still around? If so, how are you doing with your diet and exercise? Curious for an update if you're still around.

[Triskeliongirl]

I noticed this thread pop up again. I am doing really well thanks. At this point I have been diagnosed as a mild type I diabetic. Mild because while most type I diabetics make virtually no insulin, I make just enough to maintain glucose homeostatsis without a carb challenge (but still much less than I should, especially when challenged with carbs). Part of why I can maintain glucose homeostasis without much insulin is that tests by a colleague in a research lab revealed that I also have unusually good insulin sensitivity (this is the OPPOSITE of a type II who makes a lot of insulin but doesn't respond well to it). But I am really rather unusual, which is why they don't know how to classify me (and why they call me a mild type I for lack of a better descriptor, since it communicates best that what I have is an insulin defeciency rather than a problem with insulin sensistivity, even though I can manage it without taking insulin).

I still manage it with a low carb/high protein diet and exercise (and lots of glucose monitoring). On the bike, I drink muscle milk lite in my bottles, plus almonds as needed if its a longer or more intense ride. On very long rides (like metric centuries and longer) I've used pretzels.

Recently I started to have problems with the Dawn phenomena, that is slightly higher than normal fasting blood sugars (~110). This correlated with a change from bike commuting (where I was riding 2X a day, am and pm) to morning gym workouts. I found by doing evening (a few hours after dinner) spinervals/trainer workouts instead of a morning gym workout, I am back to low normal blood sugars (~85) in both the post workout evening hours and morning hours. I also noticed that whenever my blood sugars are off even a little my weight also goes up a little (in part because I get hungrier and eat more), but now that I switched my exercise from morning to evening my weight came back down (normalized I call it, that is how I describe how I feel when my hunger/satiety cues are in sync with what my body needs to maintain a healthy body weight).

I also feel best with reduced meal frequency (and find its a painless way to control calories when I need to lose weight), so I use a regimine called intermittent fasting (leangains.com) where I eat a big dinner, but then don't eat anything again until lunch the next day. Basically 2 good meals a day (lunch are leftovers from dinner). The only exception is if I am biking in the morning, then I'll have a high protein pre-ride meal (like 2 chicken sausages), and then my protein shakes and almonds on the bike. I'll also relax it a bit on the weekends, especially with things like alcohol and Lindt 85% dark chocolate (something that's been termed 'flexible dieting').

I also found out recently that I had a vit D defeciency, so now I take a supplemental multi-vitamin, calcium, and vitD every evening with dinner. In the am, I still take my synthroid/cytomel combo for my hypothyroidism (Hashimotos) (150ug synthroid, 5 ug cytomel) and my thyroid numbers look great and I have good energy.