By the Numbers: An Awesome Doctor Visit

Three months is not a long time, but it can be a lifetime if the changes made in those months matter.

I last went to my doctor’s office on November 12, 2015. I see the CRNP (Certified Registered Nurse Practitioner.) Their ability to provide services varies from state to state, but they do have prescription-writing authority in Pennsylvania. I like my CRNP very much. Her willingness to be open to more than one modality is far better than the PA (Physician’s Assistant) I had seen previously.

In any case, my November visit was not good. I knew it wouldn’t be. I had already tested my A1C with a home kit, and it matched the lab test from the office. It was 8.4. That’s crazy high. Sure, I’ve talked to people who had 11, 12, even 13, so it’s not the highest possible. But 8.4 is terrible. Living with a chronic A1C of 8.4 is a recipe for losing toes, going blind, increasing odds of cancer, losing kidney function, and dying young. There is also a mounting pile of evidence linking depression to high blood sugars.

When I scheduled that visit, I knew what the tests would show. I wasn’t getting new information. And I knew what I needed to do. But I was also so scared by the numbers, I was willing to lower my blood sugar by ANY MEANS NECESSARY. I went away with a prescription for metformin, 500mg, twice daily.

The plan was to take it briefly just to help me get started. Plans changed. I never took one pill. I decided to go two more weeks and see if I needed it. I started eating very lowcarb on November 9, and started a detailed food log on November 17. I take photos of everything I eat, with notes. I test my blood sugar several times a day. All of this is is a set of weekly documents I save in google docs. They may be made public eventually to be of help to anyone interested. For now they are shared with my “coach” Kory, who was diagnosed as a Type 1 in adulthood. Kory’s diagnosis is different than mine, as he was a lean athlete with type one, but the treatment is the same: maintain low blood sugars.

The first week of tracking, I was just happy to see blood sugar readings under 140. Having spot checked the last few weeks and waking up with 180 averages, 140 was a decent target. But it was not the ultimate target.

<edited here – I removed a long rant against the ADA that I have done many times. I’ll save the how and why for another post.>

Over the last three months, my diet has been consistent. My morning blood sugars as well as my post-prandial (after meals) have stabilized and stayed low.

In the first 9 days of February, my fasting blood sugars have ranged from 77-94.

Now – an important note for anyone reading – this is where I need to be careful in appearing to suggest that no one should take drugs. I am fully aware that not everyone’s body is the same, and that not everyone’s ability to bounce back from a compromised pancreas is the same. Not everyone can refuse the metformin or other drugs and get into safe blood sugar ranges right away. HOWEVER – I will emphatically say that avoiding a diet that raises blood sugar will be the #1 priority in healing this condition. For some that may be done in conjunction with a certain dosage of drugs. So many people who do this have reported a step down in dosage, leading to an elimination of the prescription altogether. It may not happen overnight, but it happens faster than you can imagine. So yes, I can only speak for myself, but I am not unique. On the other hand, eating a diet that raises blood sugar (and yes, I believe the current ADA guidelines irresponsibly recommend such a diet) will more often that not yield an up-down cycle of spikes followed by drug intervention, a cycle which never gets broken.

So here I am three months later, and the numbers are awesome.

My healthcare provider was happy with my progress, and said I could teach her patients some things, and at the end of a short visit, said “Well go on then. You don’t need me.” The only pushback I got was when I reported that I test my blood sugars an average of six times a day. That probably sounded a bit OCD. I was advised that is not necessary. I explained that it won’t be all the time, but for the first several weeks/months, I needed to get a true handle on how everything I eat affects my body. So I test before a meal, an hour after, two hours after. I test in the morning, I test if I’ve gone 10 hours without eating. I have a picture with many data points. There is a simple bumper sticker piece of wisdom among diabetics who take control: Eat to your meter. Simply put, if it raises your blood sugar too much, don’t eat it. Testing often helps determine what that is. Nothing has been a surprise. High carbohydrate foods, even non-processed and complex carbs, spike my blood sugar. Once again: I am not unique.

<another big edit here. I cut a huge explanation of how I eat, which will be a whole post of its own>

So here they are – the results.

The picture at the top shows the laboratory confirmation of my home test.

A1C is officially 4.8. This is a drop from 8.4. This is significant. And awesome.

My metabolic panel showed all other markers within the acceptable ranges.

And my cholesterol – AKA lipid panel. I actually had to encourage my practitioner to order that one. She didn’t think I was at risk. I didn’t either, but I wanted to see concrete evidence that a lowcarb highfat diet would not destroy my lipid panel. I especially wanted to see if I had low triglycerides.

Total cholesterol “should be” under 200. (This is still debatable, but appropriate for other posts.) – Mine: 173.

Trigs should be under 200. Mine: 80.

I am confident that continuing the course of a highfat lowcarb diet is the course of action for me to maintain stable low blood sugars, and that it is not throwing off some other aspect of my health that is now out of whack. There is no such thing as an essential carbohydrate. There are many essential fatty acids. This is not news. But it is not mainstream. Yet.

Diabetic? Join the revolution. Take control of your health, rely less (or not at all) on chronic drugs, and let food be thy medicine. It’s tasty.