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If you could live with normal blood sugars again today, mimicking the levels you lived with before diabetes, what lifestyle sacrifices would you make to get there?

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~ Background ~

I was diagnosed with T1D in 2003 at the age of 13. Now 28 years old with my wife and first child, I am incredibly grateful for the insights and truths in food I received during the Christmas season last year.  In just the first few months living with these adjustments, they have brought my A1c from 7.3% with lows of 2% to 5.7% with lows reported at just 1.2%. My time-in-range, or the time my blood sugar is between 70-140 mg/dL, has also increased from 38% to 80%+.  As an important side benefit, my weight has decreased from 220 to 195 lbs. I am hopeful to see improvements in my lipid panel in the coming months, though those numbers remain higher than desired.

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~ Misinformation ~

While in the hospital shortly after diagnosis, I recall a specific conversation where I asked the nurse about dietary restrictions. In response to asking if I could drink pop and juice, I was told "As long you cover it with insulin, you can eat anything you want". Now, perhaps I should have known better than to listen to this enabling statement, but when medical professionals tell you something and you're a newbie, it can be easier to listen than to challenge.

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As I grew older, I started to make more intentional choices to include more vegetables and meat in my diet, and eliminate unnecessary sugars, but I continued to operate under the conventional wisdom that there were few hard and fast rules with food for a Type I Diabetic. Consequently, I never saw A1C levels below 7%, and worse, my fluctuating levels left me with less and less energy.

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~ Learning ~

On Dec 28, 2018 I truly started to make dietary decisions that acknowledged the current reality of diabetes care (insulin pharmacokinetic limitations, food and drink absorption realities, and blood sugar responses, to name just a few).

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When my father gave me two diabetes books for Christmas 2018 titled "Diabetes Solution" and "The Diabetes Diet" by Dr. Richard K. Bernstein, I wasn't sure exactly what to make of them. Were they just another book for the shelf, for casual perusal, with the inevitable transition to the "used books" pile within the year, or something more?  The day after opening my gift, my dad asked "So Joe, have you read them yet?", a silly question, I thought, having just received the 400+ pages of text the night before. What I didn't realize is that these books were about to significantly improve my health.

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In particular, I reclaimed

 

  • Introducing smaller amounts of carbohydrate and monitoring my protein intake, since it can ultimately convert to glucose through gluconeogenesis, I found a much smaller increase in post-prandial blood sugar. This truth Dr. Bernstein refers to as "The Law of Small Numbers". The aim? 6g of carbs for breakfast to prevent dawn phenomenon highs. 12g of carbs for lunch, primarily from non-starchy vegetables. 12g of carbs for dinner, similar to lunch. Minimize snacking, but when you do snack, space it away from other meals to prevent food stacking, and follow the 6g / 12g guidance based on time of day.

 

  • Exact "do's" and "do not's" with foods that I previously didn't understand.

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  • The importance of bolusing well in advance of my meals (I aim for 10-15 mins before a meal with Fiasp U100, unless my BG is below 80 mg/dL, then I give insulin just before eating.)

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  • Perhaps, most importantly, I learned that I could live the new dietary decisions within the context of my everyday life! The first week I was at my parents in MN, and received ample support. The second week, I was back at my apartment in CA before my wife was back, but again, I was able to find foods that were easy enough to prepare. The third week, I was on business travel, and thought to myself, "There is no way I will find the food options I need without interrupting my team." Not true. I found a food option every place we went that complied with the general principles of Dr. Bernstein's diet.

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~ My Hope ~

Humbled by the misinformation, and former unhealthy dietary decisions I made for the first ~15 years of my diabetes journey, I hope my story can encourage others towards normal blood sugars today.  Blessed by the incredible love and support I have received, I am inspired to carry on this better way. Through this journey, I hope to walk patiently with you too, as we fight for normalized blood sugars, and improved health that is available to us today.

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~ Acknowledgements ~

Beyond Dr. Bernstein's courageous and persevering witness, and the millions of you who wake to this cross every day, I give so much credit to my family for the knowledge, love, and support they have given me on this journey to newfound health. Thank you, Dad, for the tough love to introduce me to this approach. Thank you, Emily, for courageously accepting this significant lifestyle change, and making it part of our family identity. Thank you, Mike, for your encouragement and continued interest to pair these findings with technologies that could continue to help people like me. Thank you, Tom, for your encouragement and medical tidbits. Thank you, Mom, for keeping Dad in check, and being a constant support. :)

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