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Background¶
My understanding of Diabetes
The best way to view diabetes is to see it as an "allergy" to excessive carbs in the diet of a diabetic and the "allergic reaction" is insulin resistance which in turn results in increased blood sugar levels. Going low carb helps one avoid the "allergic reaction" thus bringing blood glucose in normal range.
I was diagnosed with Type 2 Diabetes in October'2010. Since then I followed all the advice on diet from doctors and health nutritionalists which can mostly be summarised thus:
Popular yet incorrect advice
Minimise fat intake- Eat healthy unprocessed carbs,
- Eat small portions but eat frequently.
- Eat fruits but try eating those with low glycemic index.
Live an active lifestyle - exercise often, lose weight.
There were few variations to above but it generally follows this theme and except for one all others advices are just plain wrong for a diabetic. It did not help in the slightest to reduce my blood glucose reading and so I was to follow this diet along with Metformin - it started with 500mg and went all the way to 2000mg and when that did not help, I was to take this medication alongside Empagliflozin first 10mg and then 25 mg and then there was statin and Linagliptin added to the mix.
While following the diet as recommended by professionals and exercising religiously helped tone my body but all that along with the cocktail of medication and even being a complete teetotaler did not make an iota of difference to my blood glucose readings. They were always way too high hovering between 80 to 100 mmol/mol on quarterly HbA1c results.
The approach that worked for me, as explained below, was complete antithesis of what I was told:
What works for me
- Don't eat frequently and instead fast frequently.
- When you eat, eat foods with low carbs.
- Avoid fruits as they have fructose which does not help.
- Increase intake of good fat to be able to continue with low carb diet
- Include optimum protien in diet.
- Drink lots of fluids.
- Stay active especially on fasting days (Exercise / Walks).
The Awakening¶
Then in October'2020 after another high 86 mmol/mol HbA1c result, I was told that I will have to start taking insulin. This is not where I wanted to be in my early 40s and so, in desperation, I started doing my own reading on trusty old Google and came across the book named "The diabetes code" written by Dr. Jason Fung.
I am a scribd subscriber and the book is readily available there as part of my subscription so there was no barrier to entry and I started reading it. The book explains the concept of diabetes in a simple way and gives the approach of tackling it by means intermittent fasting. The concept was new to me but the more I read the more sense it made. Along with intermittent fasting, the book also talked about reducing the carb intake.
I decided that before I go for insulin, I would like to give this approach a try. So I talked with my wife and the diabetic team at my local surgery about what and how I wanted to proceed. We agreed to take a very careful approach around fasting and see how it goes one day at a time.
Alternate Day Fasting¶
The book talks about Alternate Day Fasting (ADF), One Meal a Day (OMAD) and various other strategies but the ADF option appeared most logical for my use case, mainly because its simple to follow and I would be able to completely switch off food intake for a day rather than bother about cooking one meal each day or keep track of fasting hours and so on.
In order to prepare for ADF, I first had to ensure that my body reduced relying on Carbs for energy requirements. I started initially by reducing carb intake with various food group experiments but the list below can get one started fairly quickly. Once the body is on low carb diet, it starts relying on fat store within the body for its energy source and it is at this point that starting to fast will become easier.
After about 2 weeks of low carb diet, I started my Alternate day fasting and within a week my blood sugar readings were well within the good range (4 mmol/L to 7.5 mmol/L). At this point I was worried that the medication may get me into hypo, so I had a discussion with Diabetic Nurse and stopped medication altogether on 12/11/2020, atleast until my next HbA1c.
Continuous Glucose Monitoring¶
It will be worthwhile to mention that while I was doing all this, I also invested in Freestyle Libre and a transmitter called miaomiao which kind of converts the manual scan solution of Freestyle Libre into a full blown CGM sending data to my phone every 5 minutes. This was important as I was constantly monitoring the effects of each food group on my BG to eliminate any food that would cause a spike.
Tip
Now one does not need to invest in miaomiao transmitter because Freestyle Libre 2 can send data using bluetooth to a phone and so using an app called Diabox one can get data on phone every one minute. Tricky on iphone but pretty straightforward on Android
Latest Libre2 now sends data directly to official app every one minute via bluetooth without need to manually scan each time, so no transmitter or app needed.
Conclusion¶
So the final appraoch that I followed, comprised of two main objectives:
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Fast every alternate day (minimum 36 hours fasting).
- On the day of fasting I ensured I was drinking lots of fluids (4.5 to 5 litres) in form of water, herbal tea, coffee and salted lemon water.
- On fasting days, atleast initially I would feel a bit lethargic but I aimed to walk atleast 1.5 miles (45 minutes) even if it was within the house itself. This became easier as my body got fat adapted and now am able to operate as normal and carry out extended workouts too.
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On non-Fasting day eat a low carb diet with an aim to not exceed the carbs intake by more than 80 gms.
- On the day I ate, I broke my fast after 36 or more hours with roughly 40g of extra mature cheddar cheese and then for the three meals during the rest of the day, I followed a combination of dishes in Recipes section of this site.
- I also tried to keep my non-fasting window between 7 to 12 hours. So if I broke fast at 08:00 AM, I would try to finish eating last meal of the day by 8.00 PM at the very latest.
Around end of Feb'21, I had my HbA1c test after following this for 3 months and for the first time in 10 years my HbA1c was in normal range at 39 mmol/mol that too without any medication whatsoever. This diet with fasting not only allowed me to avoid insulin, but has also resulted in weight loss. I am now about 14 Kgs lighter than when I started.
Info
The fasting part of this process is something each individual will need to tailor to their needs based on how their body is responding but the aim of the recipes on this site is merely to provide some useful vegetarian options that helped me stay low carb on the days I do eat. The nutritional part of concept is also explained succinctly on this link.