
Blood sugar patterns to master as a type 2 diabetic - NuclearTide
https://diabetic.fyi/blood-sugar-patterns/
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Medicalidiot
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-l...](https://www.health.harvard.edu/diseases-and-
conditions/the-lowdown-on-glycemic-index-and-glycemic-load)

~~~
chewz
> For example eating sugar with fat will spike blood sugar less than simply
> eating sugar.

You mean chocolate bar or any dessert.

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iserlohnmage
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.

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brian_cunnie
> 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?"

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

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Hendrikto
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.

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donatzsky
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.

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magic_beans
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.

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

~~~
iserlohnmage
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.

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theNJR
More Western people should do multi day fasts. It really changes your
relationship with food. Plus a million other positive things.

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qwsxyh
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

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jdietrich
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.

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brian_cunnie
> not knowing what hunger feels like

True. I found that when I switched to a low-carb diet, my relationship with
hunger changed.

For one thing, I was always hungry: nothing makes you feel full like a good
batch of carbs. But the hunger was similar to a low-grade background noise; it
was fundamentally different than the I-gotta-eat-right-now hunger of the
carbolicious diet.

The other thing I noticed is that since I switched diets (7 years ago), I have
never "bonked" (run into a wall because I was so hungry). I simply get more
hungry, but again, it's more like the background noise gets louder.

That begs the question, "Why not eat more if you're hungry?" The truth is that
eating gets tiresome after a while. I remember spending over and hour shoving
salad into my mouth and finally saying, "I need to get stuff done; I can't sit
here all day eating salad."

Yes, meat can fill me up if I eat enough of it (20 oz. prime rib), but I tire
of meat after a while.

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newvoiceoldphne
Eating more fats will cure the hunger.

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clumsysmurf
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?

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thrway190616
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.

~~~
will_brown
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).

~~~
funnybeam
Not sure this is correct.

My understanding is that anaerobic exercise uses glucose and stored glycogen
to generate energy and produces lactic acid as a by product. Oxygen is not
required for this process but its presence does make glycolysis more efficient
and is needed to stop the lactic acid buildup

Aerobic is certainly not easy exercise. Your body is releasing stored glycogen
from the liver and burning oxygen to clear out lactic acid and starting to
break down fat reserves.

Short duration high intensity exercise actually uses Creatine phosphate stores
in the muscles for energy but this is quickly exhausted

~~~
will_brown
It is correct, just look at the definitions of the terms.

You somehow have 3 types of exercise...aerobic, anaerobic and short
duration/high intensity.

There is only aerobic and anaerobic (short duration/high intensity is
anaerobic - high intensity is going to result in a build op of lactic acid
which in turn will cause the burnout/short duration).

Anyway aerobic means “with oxygen” and anaerobic means “without oxygen.”

~~~
funnybeam
Sorry, I was unclear.

High intensity exercise is generally anaerobic yes, not a third type of
exercise.

I was really querying your point about high intensity exercise using lactic
acid as an energy source. My understanding is that during any exercise, the
muscles will first use creatine phosphate as an energy source and will then
use blood glucose and stored glycogen for energy, and it is the breakdown of
glucose that creates the energy - lactic acid is a by product of this reaction
and is not a source of energy so I don't think this would cause blood sugar
levels to increase?

Any increase in blood sugar levels following short duration exercise would be
due to the body reacting to the fall in glucose levels and so releasing more
from the liver to compensate.

~~~
will_brown
Blood glucose would rise because youre unable to provide enough oxygen to
break it down/convert it into energy (ie more unused glucose accumulates in
the blood).

Lactate/Lactic acid is a byproduct of broken down glucose, but also
temporarily picks up the slack in energy when the body can’t supply enough
oxygen to breakdown glucose for energy requirements. Lactic acid is used in
the mitochondria of cells and keeps the heart pumping during these intense
phases of exercise where the oxygen/glucose can’t do the job...again as lactic
acid is temporarily being used as fuel it would follow glucose builds up as
the body can’t break it down fast enough and is now using an alternate fuel
source.

Creatine as I understand it isn’t a fuel/energy directly, but does facilitate
recycling of energy. Moreover, as ATP (energy) is produced in the mitochondria
and used by the cell it is converted into ADP, but the body/muscles will use
creatine to recycle ADP back into ATP. On its own though I don’t think
creatine is fuel/converted into ATP at any point like glucose/ketones.

~~~
funnybeam
Creatine Phosphate is a fuel - it is converted very quickly and the muscles
only store tiny amounts (enough for a few seconds only), and creatine is used
in recycling ATP as you say.

I didn't realise lactic acid was used to provide energy so thanks for
mentioning this - having looked it up though, this produces tiny amounts
during anaerobic respiration at which time glucose is still the main energy
provider.

Blood glucose may rise because your body has released stored glucose from the
liver, but this takes time - there is a delay between blood sugar levels
dropping (due to the intense exercise) and the liver releasing stores and it
also takes time for the full aerobic cycle to produce significant quantities
of energy and convert that glucose

I am most definitely not an expert here so details may be incorrect, but I
looked into this when I started running. I was focused on how to maintain
energy levels over long distances so may have a different perspective from
someone more interested in weight training or other high intensity/short-
duration exercise.

I found [1] useful as a simple overview of the different energy producing
mechanisms, and [2] goes into far more detail than I can readily understand...

[1] [https://www.acefitness.org/fitness-certifications/ace-
answer...](https://www.acefitness.org/fitness-certifications/ace-answers/exam-
preparation-blog/3256/the-three-primary-energy-pathways-explained)

[2]
[https://en.wikipedia.org/wiki/Bioenergetic_systems](https://en.wikipedia.org/wiki/Bioenergetic_systems)

I would love to see better explanations of how this all works

~~~
will_brown
I’m a runner also...depends what you mean by long distances, but I’d promote
becoming fat adapted and running in ketosis.

I’ve done a full marathon with no fuel (hydration only) in ketosis, pretty
awesome and much better than my glucose/gu runs...of course I’ve had some
amazing long runs out of ketosis but at certain distances the fueling is a
real battle and a battle I’ve lost from time to time. I don’t think there is a
good answer for fueling long distances that will work for everyone it’s all
about personal experimentation and adaptation.

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akshaykarthik
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
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-
monit...](https://medium.com/@justin_d_lawler/continuous-glucose-monitoring-
the-first-four-weeks-7a6aa5fdb06e)

The sensors aren't cheap. Last time I looked, you wore them for 1 week at a
time and they were $80 a pop.

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GiorgioG
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.

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rev12
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.

