How Eating Can Make You Hungry

David,

I wrote this in 2000 to a mailing list I subscribe to.

"When I was diagnosed I started out with a very low carb approach to BG control.  I didn't use any one plan,

and my BGs are great too." 

Hello David,

The primary reason I share all of the information below is that I would like to have more information and anything you have written about diabetes and exercise for a person who works out at the very high level I am.

I have followed Dr Bernstein's recommendations in the past.  However, I discovered that I needed more carbs to feel good ... otherwise I felt very weak.  I have followed the guidelines for the South Beach Diet since July, 2004 (good fats, good carbs, lean protein), eating 'lower carb' but not low carb.  That was working well for me, but I was not losing weight.  What I was mostly missing was the exercise component of taking care of my needs.

A year ago I started an exercise program that is often intense, strenuous, and long.  And I do this most days of the week.  The result is that my weight has dropped almost 60 pounds (moving me from the obese to overweight category); and I am much healthier and fitter.  My lab reports are excellent.  My A1C with no medication is below 6.0.  And though I have diabetes, my morning blood sugars are mostly in the 80s to low 90s, with 96 in the morning being a high number for me.  

By the way, when I was diagnosed in 2003 my morning blood sugar (fasting) was 125.  I weighed 269 pounds.  I now weigh 181 and have lost a lot of inches, as well.

Along the way I have learned (often the hard way) about sports nutrition and my needs for even more carbs (both fast carbs and 'slow' or 'good' carbs).  And I have learned how very important it is to take blood sugar measurements prior to exercising, to eat enough carbs for the exercise session, and to eat more carbs afterwards for replenishment of muscle and liver glycogen (stored glucose).

The primary reason I share all of this is that I would like to have more information and anything you have written about diabetes and exercise at the level I am working out.

Thank you, David. 

Linda 

This phenomenon was clearly described in the book Protein Power 1997.

Bernstein's first edition was available in 1998 too.

The diabetes newsgroups have been filled with people describing this phenomenon all this time, too.

Of course, the ADA's "Tight Control" web page STILL omits any use of the word "Carbohydrate". If you got your dietary advice from THEM no wonder this finding comes as an amazing surprise.

I wish someone had told me about that 15 years ago.  I wouldn't have gained that last hundred pounds after I quit smoking and might have put off diabetes for a few more years.   I ate cheerios or oatmeal with fruit and milk for breakfast every day and about 2 hours afterwards I would get faint from hunger.  I tried eating more at meals, so it would last longer, and then still more.  If I ate breakfast as soon as I got up instead of waiting a couple of hours my hunger increased even more.   I did ask my doctor about it and for years while I gained pound after pound all he ever told me was to cut the amount of fat I ate.    He would gripe at me about the weight and the fat in my diet.  I would cry and wish I could just stop gaining more even if I never lost any.  Every thing I bought, if it came in a low fat version I got that instead of regular.   If it came in a whole grain version, that's what I got.  When I got hungry I would get dizzy and shaky so I couldn't seem to cut calories without making myself sick.  (This whole time my fasting glucose was normal and my cholesterol, except for triglycerides, was below normal.  Every year.)  I gave up on trying harder to diet, I thought I would just have to die fat.  

When I started cutting back on carbs for BG control, it never occurred to me that I would lose any weight since the hunger made me sick if I tried to restrict the amount I ate.   I started eating eggs for breakfast every day and it cut my appetite in half.  I even lost weight while still on a sulf. and it didn't make my cholesterol go up, either.  My A1c has been <6% for 38  months now, it started >12%. 

I tried upping the carbs closer to the ADA diet but my hunger and cravings increased again and I gained some back without losing BG control.  Now I'm back eating low carb most of the time and I don't plan to change that again whether I lose any more weight or not.  I just feel better when I don't eat a lot of carb and I don't get dizzy or shaky when I'm hungry unless I have. 

David

Until I started using Symlin, I didn't realize that I'd lost that feeling of fullness. For years I ate pretty much what I wanted, and it really took a lot for me to realize that I was actually full.

With Symlin I got my feeling of fullness back. It takes getting used to, but it really stops me from eating more than I should.

So I think for folks with type 1 diabetes, the issues you describe are made worse by the fact that many (most?) of us not longer get that full feeling when we've had enough.