11 ms·

Blood sugar patterns to master as a type 2 diabetic

182 points by NuclearTide 7y ago

Medicalidiot 7y ago
One of the most important parts of diet we fail to educate the public on is glycemic index vs glycemic load. Index is essentially the raw score for how drastically a particular food will raise blood sugar. Glycemic load looks at the totality of what one eats then predicts what the effect of one's blood sugar will be. For example eating sugar with fat will spike blood sugar less than simply eating sugar. Further reading: https://www.health.harvard.edu/diseases-and-conditions/the-lowdown-on-glycemic-index-and-glycemic-load https://www.health.harvard.edu/diseases-and-conditions/the-l...
- chewz 7y ago
  > For example eating sugar with fat will spike blood sugar less than simply eating sugar. You mean chocolate bar or any dessert.
  - Spooky23 7y ago
    Or milk.
  - iserlohnmage 7y ago
    I've read one that most food that make one addicted is a good combination of sugar and fat, which is decided by our genes.
    - brian_cunnie 7y ago
      > make one addicted ... I think you're on to something. I think the large portion of people have an addiction to certain foods. My first inkling was when my friend, Dr. Ross, said to me, "None of my type II diabetic patients are able to control it with diet. They all need medication." (His patients are all upper-middle class, well-adjusted for the most part). I've seen it with my dad (type II), an ex-marine (type II), a marketing executive (type II). In all cases they were eating french toast with maple syrup (the crack cocaine of type II diabetics). It was something they knew they should not be eating, and yet they were. These are people with discipline and strength, and yet they are unable to stick to a diet. What gives? Rather than blaming them, we should ask, "Why is this so hard for them? Why can these people who can do so many things, not eat properly?"
  - jokoon 7y ago
    The opposite being a soda, which is close to sugar water, which makes sugar being absorbed very quickly.
- kszxgz 7y ago
  Glycemic Load = GI * carbohydrates (g) ÷ 100. Accordingly, the GL in the example would only decrease if fat replaced some of the sugar. GL does not consider the totality of food intake but can be calculated for individual foods. (https://www.gisymbol.com/what-about-glycemic-load/ https://www.gisymbol.com/what-about-glycemic-load/) What you are referring to may be the glycemic response, which, apart from GL, also depends on the intake of fat and protein among other things. Adding fat and protein does indeed reduce the glycemic response: "It is generally accepted that adding fat and protein to carbohydrate reduces glycemic responses by delaying gastric emptying and stimulating insulin secretion (1,2). These effects have a number of possible implications for human nutrition, such as supporting the role of high protein or high fat diets in the management of diabetes (3,4) or being a source of criticism for the application of the glycemic index to mixed meals (1,5)." https://academic.oup.com/jn/article/136/10/2506/4746688 https://academic.oup.com/jn/article/136/10/2506/4746688
  - woodandsteel 7y ago
    Agreed. What glycemic load gets at is the concentration of carbohydrates. So for instance, watermellon has a high glycemic index because it has a form of carbohydrate that moves quickly into the blood stream. But it doesn't spike your blood sugar hardly because there is so little total carbohydrate.
- tagh 7y ago
  I think a bigger issue is that GI is only defined over 2 hours after eating. The four-hour GI is always higher and a much better indicator of high blood sugar exposure (due to eating that food). After all, pizza is low GI if you only measure it over 2 hours.
lo_fye 7y ago
Watch YouTube videos by Dr Jason Fung. He cures type 2 diabetes with diet.
- iserlohnmage 7y ago
  I read it once and the part of what causing Type 2 Diabetes seems reasonable to me, however his advocate for extended fasting (namely, 36h+) sounds too aggressive.
  - theNJR 7y ago
    More Western people should do multi day fasts. It really changes your relationship with food. Plus a million other positive things.
    - qwsxyh 7y ago
      Yes, it changes your relationship into a disordered one. HN, the website where willingly starving yourself for days on end is not an eating disorder
      - jdietrich 7y ago
        I'm no fan of fad diets, but a lot of Westerners have a real problem with simply not knowing what hunger feels like. A lot of people are so habituated to large portions and frequent snacking that they're never meaningfully hungry, just somewhere on the spectrum between "reasonably sated" and "physically incapable of ingesting another morsel". Their eating habits have fundamentally broken the connection between food and sustenance. They've lost the ability to usefully distinguish between the body's natural hunger signals and other motivations for eating like habit, boredom and emotional self-soothing. I'm not wholly persuaded by the claims made about the health benefits of intermittent fasting, but I do think it's a potentially useful psychological experience if you have a problematic relationship with food.
        k__ 7y ago
clumsysmurf 7y ago
There was a small study giving oral carnosine (2g/d) to participants to study whether "carnosine supplementation in individuals with overweight or obesity improves diabetes and cardiovascular risk factors". https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21434 https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21434 The supplement has been readily available for years, has anyone here had good experiences with it?
trevyn 7y ago
I’ve heard that cutting out nearly all carbohydrates from the diet basically causes permanent remission of type 2 diabetes. Is this true?
- Hendrikto 7y ago
  If you don‘t eat carbohydrates, you don‘t need insulin, so it is no disadvantage that you cannot produce it. Calling that a remission is far fetched though.
  - donatzsky 7y ago
    Anecdata and all that, but I have seen quite a few reports of people overcoming their t2 diabetes through low-carb diets. Whether they were actually cured is harder to say.
    - magic_beans 7y ago
      They still couldn't eat a high-carb food item without seeing a drastic spike in blood sugar. So: not cured of t2, but in remission.
  - pohl 7y ago
    “...that you cannot produce it.” It sounds like you are conflating type 1 and type 2. The mechanism of the latter begins with insulin resistance.
  - noarchy 7y ago
    >If you don‘t eat carbohydrates, you don‘t need insulin, so it is no disadvantage that you cannot produce it. That doesn't sound right at all. Protein produces both a blood sugar and an insulin response.
  - tagh 7y ago
    You still need insulin to digest protein and for general living throughout the day, even when fasting. It'd be more accurate to say "if you don't eat carbohydrate, you need less insulin, so your insulin requirements may be met by your (degraded) pancreatic output." On remission: if your Type II diabetes is in the early stages, and is largely due to lifestyle, then a lower carbohydrate diet could help you lose weight and improve insulin sensitivity. If your insulin sensitivity reaches the point where your pancreas' produced insulin is adequate (even for high-carb meals), then you've beaten the disease. This is the remission they speak about.
thrway190616 7y ago
I have a question in case there are any experts here. What is the mechanism of this: >On the other hand, high-intensity, short-duration exercise (like weightlifting, sprinting, and rock climbing) will spike your blood sugar temporarily, but keep your blood sugar lower overall for a period of time afterward: What exactly happens here, in as much detail as someone could reply. (For the first part, "spike your blood sugar temporarily".) Thank you.
- erkkie 7y ago
  I believe this is a cortisol response that makes sure you get the most energy usage out in a short spike. https://idmprogram.com/closer-look-cortisol-hormonal-obesity-xxxx/ https://idmprogram.com/closer-look-cortisol-hormonal-obesity...
- londt8 7y ago
  Also adrenaline
- will_brown 7y ago
  There are two types of exercise aerobic and anaerobic. Aerobic is easy exercise (walking, jogging, etc...) where the body can supply enough oxygen to oxidize glucose to convert to energy. During Anaerobic or high intensity exercise the body can not supply enough oxygen, so a bunch of things happen including: 1.) the body begins needing to rely on lactic acid for energy instead of oxygen/glucose, and 2.) while the lactic acid is being used for energy the glucose (blood sugar) builds up (lactic acid also builds up which is why intense exercise can not be sustained for long periods).
  - audiometry 7y ago
    I measure blood ketones and glucose. After heavy weight training (10-15 reps total of between 85-92% max), invariably my blood sugar is higher and ketones lower. This seems to be a standard response. I wouldn’t say I feel lactic acid after powerlifting, but I am generally beat a bit. I generally stay in ketosis.
  - funnybeam 7y ago
msiyer 7y ago
Type 2 diabetes is reversible. Avoiding oil, animal fats and sugar will show instant results. For better results raw fruits and vegetables are great. I have seen diabetes reverse in my mother's case. Edit: The geniuses downvoting should explain the reason.
- whb07 7y ago
  This.... is one way to do it, but it’s got nothing to do with the list you provided. Don’t confuse “oils, animal fats” with things like a fast food meal.
  - msiyer 7y ago
    I am not confused. Fast food is bad because it contains excess amounts of oils and animal fats and a lot many other things. Oils are bad. They are especially bad after heat is applied to them.
    - Hendrikto 7y ago
      > Oils are bad. Oversimplified blanket statements are bad.
      - msiyer 7y ago
        Can you please try cutting out oil from your diet for 2 weeks? You will see what I mean.
- dhimes 7y ago
  Not downvoting, but not everybody can reverse it. For some it's linked to obesity and such, but others have a perfectly healthy body weight and still have diabetes. There seems to be quite a bit of individual variation.
  - msiyer 7y ago
    >>Not downvoting, but not everybody can reverse it. I am OK with people downvoting as long as they reason it out. Here in HN, people are not willing to accept that changing food habits can reverse most lifestyle disease. There are two types - Type 1 and Type 2. Type 1, where pancreas do not produce enough insulin, is not reversible as per current understanding. Type 2 is reversible, at least up to a point (maybe, a few decades). >>For some it's linked to obesity and such, but others have a perfectly healthy body weight and still have diabetes. Yes, this is true. Cells become inefficient in processing sugars and blood glucose levels may spike. This can happen in lean people and obese.
akshaykarthik 7y ago
This is interesting, what tools are available to measure one's blood sugar and chart it throughout the day? I find it's pretty inconvenient to measure and report it accurately enough to get these trend lines with my regular meter.
- ScottFree 7y ago
  You need a continuous glucose monitor, like Freestyle Libre or Dexcom. Here's a writeup of somebody that goes into detail about what's involved: https://medium.com/@justin_d_lawler/continuous-glucose-monitoring-the-first-four-weeks-7a6aa5fdb06e https://medium.com/@justin_d_lawler/continuous-glucose-monit... The sensors aren't cheap. Last time I looked, you wore them for 1 week at a time and they were $80 a pop.
  - GiorgioG 7y ago
    The Freestyle Libre is good for 14 days at a time, and as far as I know costs $110-120 for a 2-pack. No it's not cheap, but it's not as expensive as the Dexcom. My son wears a Dexcom (type 1 diabetic) and my dad wears a Libre (type 2 diabetic.) The Dexcom is far more expensive, but it's the only one that will integrate with my son's insulin pump.
  - pimeys 7y ago
    And about 450€ per transmitter that lasts for three months. Using open source tools you can extend the sensor lifetime to 2-3 weeks and transmitter to 6-9 months and I advice to read on that and try tools like xDrip.
rev12 7y ago
Dude looks pretty damn thin for a T2D. Yes, thin people can get T2D but it's not common. Hope he had his antibodies checked.
fitnesshealth 7y ago
Today, we are going to discuss the normal digestion of carbohydrates, and the abnormal digestion that results in Diabetes Type 1 and Diabetes Type 2. When you eat a carbohydrate source as bread, potato, etc…Your body can see it either as a simple structure or a Complex; by the means of that, the body does not see bread or potato, instead; the body sees it as compounds. Thus, the body either find these compounds Simple and easy to use or Complex and needs to get simpler. In both scenarios, your body translates it into a source that it can be used for building up itself or as an Energy source. For energy, the cells mostly use the Simple form of carbohydrates which is glucose. Then the glucose is absorbed through the mouth, stomach, and gut to your bloodstream, to be distributed and taken up by every cell in the body. Let’s discuss how particularly Glucose is absorbed in mouth, stomach, and gut. To breakdown complex structures there are tools and helpers that our body uses called “Enzymes”. In the mouth, there is an enzyme called “Salivary Amylase”, which provides our body with the needed glucose from complex compounds. More Knowledge: https://www.fitnesshealthforever.com/health-tips/overview-for-normal-glucose-digestion-and-diabetes-mellitus/ https://www.fitnesshealthforever.com/health-tips/overview-fo...

182 points by NuclearTide 7y ago

One of the most important parts of diet we fail to educate the public on is glycemic index vs glycemic load. Index is essentially the raw score for how drastically a particular food will raise blood sugar. Glycemic load looks at the totality of what one eats then predicts what the effect of one's blood sugar will be. For example eating sugar with fat will spike blood sugar less than simply eating sugar. Further reading: https://www.health.harvard.edu/diseases-and-conditions/the-lowdown-on-glycemic-index-and-glycemic-load https://www.health.harvard.edu/diseases-and-conditions/the-l...

chewz 7y ago
> For example eating sugar with fat will spike blood sugar less than simply eating sugar. You mean chocolate bar or any dessert.
- Spooky23 7y ago
  Or milk.
- iserlohnmage 7y ago
  I've read one that most food that make one addicted is a good combination of sugar and fat, which is decided by our genes.
  - brian_cunnie 7y ago
    > make one addicted ... I think you're on to something. I think the large portion of people have an addiction to certain foods. My first inkling was when my friend, Dr. Ross, said to me, "None of my type II diabetic patients are able to control it with diet. They all need medication." (His patients are all upper-middle class, well-adjusted for the most part). I've seen it with my dad (type II), an ex-marine (type II), a marketing executive (type II). In all cases they were eating french toast with maple syrup (the crack cocaine of type II diabetics). It was something they knew they should not be eating, and yet they were. These are people with discipline and strength, and yet they are unable to stick to a diet. What gives? Rather than blaming them, we should ask, "Why is this so hard for them? Why can these people who can do so many things, not eat properly?"
- jokoon 7y ago
  The opposite being a soda, which is close to sugar water, which makes sugar being absorbed very quickly.
kszxgz 7y ago
Glycemic Load = GI * carbohydrates (g) ÷ 100. Accordingly, the GL in the example would only decrease if fat replaced some of the sugar. GL does not consider the totality of food intake but can be calculated for individual foods. (https://www.gisymbol.com/what-about-glycemic-load/ https://www.gisymbol.com/what-about-glycemic-load/) What you are referring to may be the glycemic response, which, apart from GL, also depends on the intake of fat and protein among other things. Adding fat and protein does indeed reduce the glycemic response: "It is generally accepted that adding fat and protein to carbohydrate reduces glycemic responses by delaying gastric emptying and stimulating insulin secretion (1,2). These effects have a number of possible implications for human nutrition, such as supporting the role of high protein or high fat diets in the management of diabetes (3,4) or being a source of criticism for the application of the glycemic index to mixed meals (1,5)." https://academic.oup.com/jn/article/136/10/2506/4746688 https://academic.oup.com/jn/article/136/10/2506/4746688
- woodandsteel 7y ago
  Agreed. What glycemic load gets at is the concentration of carbohydrates. So for instance, watermellon has a high glycemic index because it has a form of carbohydrate that moves quickly into the blood stream. But it doesn't spike your blood sugar hardly because there is so little total carbohydrate.
tagh 7y ago
I think a bigger issue is that GI is only defined over 2 hours after eating. The four-hour GI is always higher and a much better indicator of high blood sugar exposure (due to eating that food). After all, pizza is low GI if you only measure it over 2 hours.

lo_fye 7y ago

Watch YouTube videos by Dr Jason Fung. He cures type 2 diabetes with diet.

iserlohnmage 7y ago
I read it once and the part of what causing Type 2 Diabetes seems reasonable to me, however his advocate for extended fasting (namely, 36h+) sounds too aggressive.
- theNJR 7y ago
  More Western people should do multi day fasts. It really changes your relationship with food. Plus a million other positive things.
  - qwsxyh 7y ago
    Yes, it changes your relationship into a disordered one. HN, the website where willingly starving yourself for days on end is not an eating disorder
    - jdietrich 7y ago
      I'm no fan of fad diets, but a lot of Westerners have a real problem with simply not knowing what hunger feels like. A lot of people are so habituated to large portions and frequent snacking that they're never meaningfully hungry, just somewhere on the spectrum between "reasonably sated" and "physically incapable of ingesting another morsel". Their eating habits have fundamentally broken the connection between food and sustenance. They've lost the ability to usefully distinguish between the body's natural hunger signals and other motivations for eating like habit, boredom and emotional self-soothing. I'm not wholly persuaded by the claims made about the health benefits of intermittent fasting, but I do think it's a potentially useful psychological experience if you have a problematic relationship with food.
      - k__ 7y ago

clumsysmurf 7y ago

There was a small study giving oral carnosine (2g/d) to participants to study whether "carnosine supplementation in individuals with overweight or obesity improves diabetes and cardiovascular risk factors". https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21434 https://onlinelibrary.wiley.com/doi/full/10.1002/oby.21434 The supplement has been readily available for years, has anyone here had good experiences with it?

trevyn 7y ago

I’ve heard that cutting out nearly all carbohydrates from the diet basically causes permanent remission of type 2 diabetes. Is this true?

Hendrikto 7y ago
If you don‘t eat carbohydrates, you don‘t need insulin, so it is no disadvantage that you cannot produce it. Calling that a remission is far fetched though.
- donatzsky 7y ago
  Anecdata and all that, but I have seen quite a few reports of people overcoming their t2 diabetes through low-carb diets. Whether they were actually cured is harder to say.
  - magic_beans 7y ago
    They still couldn't eat a high-carb food item without seeing a drastic spike in blood sugar. So: not cured of t2, but in remission.
- pohl 7y ago
  “...that you cannot produce it.” It sounds like you are conflating type 1 and type 2. The mechanism of the latter begins with insulin resistance.
- noarchy 7y ago
  >If you don‘t eat carbohydrates, you don‘t need insulin, so it is no disadvantage that you cannot produce it. That doesn't sound right at all. Protein produces both a blood sugar and an insulin response.
- tagh 7y ago
  You still need insulin to digest protein and for general living throughout the day, even when fasting. It'd be more accurate to say "if you don't eat carbohydrate, you need less insulin, so your insulin requirements may be met by your (degraded) pancreatic output." On remission: if your Type II diabetes is in the early stages, and is largely due to lifestyle, then a lower carbohydrate diet could help you lose weight and improve insulin sensitivity. If your insulin sensitivity reaches the point where your pancreas' produced insulin is adequate (even for high-carb meals), then you've beaten the disease. This is the remission they speak about.

thrway190616 7y ago

I have a question in case there are any experts here. What is the mechanism of this: >On the other hand, high-intensity, short-duration exercise (like weightlifting, sprinting, and rock climbing) will spike your blood sugar temporarily, but keep your blood sugar lower overall for a period of time afterward: What exactly happens here, in as much detail as someone could reply. (For the first part, "spike your blood sugar temporarily".) Thank you.

erkkie 7y ago
I believe this is a cortisol response that makes sure you get the most energy usage out in a short spike. https://idmprogram.com/closer-look-cortisol-hormonal-obesity-xxxx/ https://idmprogram.com/closer-look-cortisol-hormonal-obesity...
londt8 7y ago
Also adrenaline
will_brown 7y ago
There are two types of exercise aerobic and anaerobic. Aerobic is easy exercise (walking, jogging, etc...) where the body can supply enough oxygen to oxidize glucose to convert to energy. During Anaerobic or high intensity exercise the body can not supply enough oxygen, so a bunch of things happen including: 1.) the body begins needing to rely on lactic acid for energy instead of oxygen/glucose, and 2.) while the lactic acid is being used for energy the glucose (blood sugar) builds up (lactic acid also builds up which is why intense exercise can not be sustained for long periods).
- audiometry 7y ago
  I measure blood ketones and glucose. After heavy weight training (10-15 reps total of between 85-92% max), invariably my blood sugar is higher and ketones lower. This seems to be a standard response. I wouldn’t say I feel lactic acid after powerlifting, but I am generally beat a bit. I generally stay in ketosis.
- funnybeam 7y ago

msiyer 7y ago

Type 2 diabetes is reversible. Avoiding oil, animal fats and sugar will show instant results. For better results raw fruits and vegetables are great. I have seen diabetes reverse in my mother's case. Edit: The geniuses downvoting should explain the reason.

whb07 7y ago
This.... is one way to do it, but it’s got nothing to do with the list you provided. Don’t confuse “oils, animal fats” with things like a fast food meal.
- msiyer 7y ago
  I am not confused. Fast food is bad because it contains excess amounts of oils and animal fats and a lot many other things. Oils are bad. They are especially bad after heat is applied to them.
  - Hendrikto 7y ago
    > Oils are bad. Oversimplified blanket statements are bad.
    - msiyer 7y ago
      Can you please try cutting out oil from your diet for 2 weeks? You will see what I mean.
dhimes 7y ago
Not downvoting, but not everybody can reverse it. For some it's linked to obesity and such, but others have a perfectly healthy body weight and still have diabetes. There seems to be quite a bit of individual variation.
- msiyer 7y ago
  >>Not downvoting, but not everybody can reverse it. I am OK with people downvoting as long as they reason it out. Here in HN, people are not willing to accept that changing food habits can reverse most lifestyle disease. There are two types - Type 1 and Type 2. Type 1, where pancreas do not produce enough insulin, is not reversible as per current understanding. Type 2 is reversible, at least up to a point (maybe, a few decades). >>For some it's linked to obesity and such, but others have a perfectly healthy body weight and still have diabetes. Yes, this is true. Cells become inefficient in processing sugars and blood glucose levels may spike. This can happen in lean people and obese.

akshaykarthik 7y ago

This is interesting, what tools are available to measure one's blood sugar and chart it throughout the day? I find it's pretty inconvenient to measure and report it accurately enough to get these trend lines with my regular meter.

ScottFree 7y ago
You need a continuous glucose monitor, like Freestyle Libre or Dexcom. Here's a writeup of somebody that goes into detail about what's involved: https://medium.com/@justin_d_lawler/continuous-glucose-monitoring-the-first-four-weeks-7a6aa5fdb06e https://medium.com/@justin_d_lawler/continuous-glucose-monit... The sensors aren't cheap. Last time I looked, you wore them for 1 week at a time and they were $80 a pop.
- GiorgioG 7y ago
  The Freestyle Libre is good for 14 days at a time, and as far as I know costs $110-120 for a 2-pack. No it's not cheap, but it's not as expensive as the Dexcom. My son wears a Dexcom (type 1 diabetic) and my dad wears a Libre (type 2 diabetic.) The Dexcom is far more expensive, but it's the only one that will integrate with my son's insulin pump.
- pimeys 7y ago
  And about 450€ per transmitter that lasts for three months. Using open source tools you can extend the sensor lifetime to 2-3 weeks and transmitter to 6-9 months and I advice to read on that and try tools like xDrip.

rev12 7y ago

Dude looks pretty damn thin for a T2D. Yes, thin people can get T2D but it's not common. Hope he had his antibodies checked.

fitnesshealth 7y ago

Today, we are going to discuss the normal digestion of carbohydrates, and the abnormal digestion that results in Diabetes Type 1 and Diabetes Type 2. When you eat a carbohydrate source as bread, potato, etc…Your body can see it either as a simple structure or a Complex; by the means of that, the body does not see bread or potato, instead; the body sees it as compounds. Thus, the body either find these compounds Simple and easy to use or Complex and needs to get simpler. In both scenarios, your body translates it into a source that it can be used for building up itself or as an Energy source. For energy, the cells mostly use the Simple form of carbohydrates which is glucose. Then the glucose is absorbed through the mouth, stomach, and gut to your bloodstream, to be distributed and taken up by every cell in the body. Let’s discuss how particularly Glucose is absorbed in mouth, stomach, and gut. To breakdown complex structures there are tools and helpers that our body uses called “Enzymes”. In the mouth, there is an enzyme called “Salivary Amylase”, which provides our body with the needed glucose from complex compounds. More Knowledge: https://www.fitnesshealthforever.com/health-tips/overview-for-normal-glucose-digestion-and-diabetes-mellitus/ https://www.fitnesshealthforever.com/health-tips/overview-fo...