This is a monthly update on my glycemic management of type 1 diabetes (T1DM) using Humalog and now Tresiba insulin injections with a ketogenic whole-food diet and resistance and aerobic exercise.
If you feel you might benefit from some individual attention and suggestions for achieving success with blood sugar control for type 1 or type 2 diabetes and/or losing excess body fat, I can assist you with a personal consultation via Skype. See the Coaching page for more info.
Last month I did an interview with Ross Wollen on asweetlife.org titled “Interview: Dr. Runyan is the Diabetic Ketogenic Athlete.” You can read it here.
I wrote an article for DietDoctor in July titled “What you need to know about a low-carb diet and your kidneys.“ You can read it here.
My books are available for purchase: The Ketogenic Diet for Type 1 Diabetes also available on Amazon in print, and my other book, Conquer Type 2 Diabetes with a Ketogenic Diet, is also available on Amazon in print.
Glycemic Results For November 2019
My November 2019 glycemic results were a new record: the best blood sugar results since my diagnosis of type 1 diabetes in 1998. I also started taking Tresiba on November 22, 2019 in hopes of further reducing my blood glucose variability. It is too early to know if it will, but by next month, I should have an answer. My back injury healed and I resumed olympic weightlifting on November 6, 2019.
The graph below shows all the blood glucose measurements and daily insulin dose totals for November 2019.
My blood sugar goals are shown in Table 3. below. I used as my measure of normality, a standard deviation of blood sugar of less than 25.2 mg/dl (1.4 mmol/l). This value was measured in 434 metabolically healthy subjects in China as reported in this study.
The table below shows my monthly mean body weight, mean total daily insulin dose, mean basal insulin dose, mean bolus insulin dose, and the mean bolus insulin dose for each meal and the bedtime bolus insulin dose which I started using a few months ago to try to improve my fasting blood sugar while keeping the basal insulin dose constant. Diluting my Humalog 5:1 helps to give precise doses with meals and at bedtime.
The table below shows my blood glucose variability data including the monthly mean blood glucose, the standard deviation of blood glucose, the coefficient of variation, the calculated HbA1c, and the percentage of blood glucose values < 70 mg/dl, between 70 and 130 mg/dl, and > 130 mg/dl.
As you can see, for November 2019 I have reached all my goals. Additionally, my total daily insulin dose is satisfactorily low and stable. I have never been confident that I could actually accomplish these goals. I think my attention to details that I previously thought would not make much difference has paid off. These details include consistency of my very low-carbohydrate diet from day to day and consistency of daily exercise, both aerobic (walking 2.5 miles twice daily) and weightlifting 2 hours daily, and the use of diluted Humalog to more precisely dose bolus insulin. I will be interested in seeing if changing from Lantus to Tresiba will further improve my standard deviation of blood glucose and coefficient of variation results. I would also like to eliminate all blood glucose values below 70 mg/dl. BTW, I took a total of 2 Smarties candies (12 grams of glucose) for the month of November which I think is also a new record.
My current daily macronutrients are 44 grams of carbohydrates (10 grams of fiber) (5% of energy), 185 grams of protein or 2.5 grams/kg/day (26% of energy), and 230 grams of fat (69% of energy).
If you have questions or topics you would like me to write about, leave them in the comments. Till next month…