This past Friday marked a milestone. I went in to see Dr. J and found out the results of Wednesday's blood work. My A1c was down from 9.7 in October to 5.9, within shouting distance of normal. When I first started this journey Dr. J put me on a low dose of Lantus, given daily at bedtime to reign in my downward spiral into hyperglycemia. In early December, after looking over my blood sugar log, she suggested I try dosing every other day and then discontinue the insulin altogether if my numbers stayed down. I stopped injecting on New Years Eve, with some trepidation. The insulin had helped so much so quickly that giving it up was like getting out on the trapeze and then seeing the roustabouts roll up the net beneath you. So far, I haven't fallen off the bar, but there are times when I miss that net. It is a scary thing knowing that my blood sugar numbers depend almost solely on what I eat and how much exercise I get. Without the insulin to even out the rough patches, my meter tells me more truth than I want to know sometimes about how I am really living. Nonetheless, getting off insulin was the first goal I had set for myself and, nervous jitters aside, it feels great to get there! The only medication Dr. J has me on is a daily low dose aspirin, with a suggestion that I might look into a fish oil supplement.
I am still following the basic diet rules I outlined two weeks ago. So far, cutting back on carbohydrates is keeping both my weight and my blood sugar numbers headed in the right direction. This morning's weigh in was 185.5. My bathroom scale is not bad, but, like my blood sugar meter, it is better at an average over a period than single precision measurements so round today's reading up to 186 for tracking purposes. Looking back, I have been shedding a consistent two pounds a week for the last three months with diet and minimal daily exercise. To be honest, this has surprised me as much as it has pleased my doctor.
Speaking of exercise, this has not been a great week, despite the good news at the doctor's office. Bad weather, an erratic schedule and a lingering cold have ganged up to kick sand in the face of my best intentions. My walks have gotten shorter, the bike time erratic and the gym time non-existent. The lack of exercise shows up first in my blood sugar numbers. Post-meal highs are a little higher, and recovery times are a little longer. I also notice that while the tire around the waist is deflating, it is going down far more slowly than the rest of the body. If this keeps up, I will look like a skinny guy who swallowed a bowling ball. Embarrassment in front of the full length mirror aside, google "diabetes" together with "abdominal fat" and you will see why I am as concerned about where the weight comes off as how much comes off. And getting it off is not a job for diet alone. Time to ramp up the motivation and face the weight bench again.
Another adjustment I'm making this week is to get on the stationary bike first thing after getting out of bed. This does not make me happy, not being a morning person, but there is a particular reason why I am doing it. I like my daily breakfast of oatmeal and coffee. It is simple and easy to cope with while still half asleep and, having given up doughnuts, pancakes, hash-browns, sausage biscuits and shredded wheat, I just can't bring myself to give up coffee and oatmeal as well. And why should I? Well, without the insulin, the carbohydrates in the morning oatmeal are spiking my blood sugar. Even worse, I just finished reading several papers on the negative (i.e. not good) effect caffeine has on insulin resistance. It appears that my simple low fat, high fiber weight loss breakfast carries a hefty metabolic price tag. The week's experiment is to find out if exercising before eating will flatten out the postprandial highs. This morning, a short intensive session on the bike preceded breakfast. While one day does not a trend make, the 126 on the meter was much better than the 140s and 150s I had been seeing. I will give the full report on the experiment next week. As always, any comments, encouragement and motivational tips are appreciated!