Blood Glucose Boot Camp - Day 3

Day 3 almost done and really excited to be heading for a first all ‘green’ day in weeks. The excitement is twofold. It’s great to see that there are lifestyle levers I can still pull to control my blood glucose levels despite living with unmanaged T2DM for over 15 years. Also, it is great to see that the principles that I set out when starting on this journey are quite solid. Now just need to see where I take this over the next 25 days.

Daily Summary

I quite liked the infographic style summary I made yesterday and will stick with this approach for now.

I was really keen to see how my dawn phenomenon would behave today following fasting intervention and reduction in protein consumption. I started from a very low baseline of 4 mmol/l around 3:00 and just about stayed under 7 mmol/l at the highest point around midday, which conveniently allowed me to stay within my green range.

I was going to go for a 42h fast, but green levels were too encouraging and I broke my fast at close to 24h mark. Did almost a replica of yesterday’s meal (mostly for pragmatic reasons, to use up the produce) and followed by a walk. My schedule today meant that I did my longer walk at lunchtime and the shorter one in the evening. The meal registered as a slight blip on CGM.

The initial results seem to show that my two main levers seem to be a) fasting (less frequent meals, no snacks, plain coffee, and tea allowed as fasting liquids) and b) a more measured approach to protein consumption. While right now I’m happy to see ‘green’ irrespective of exact mechanism, I need to figure out a good way to test these independently so that I can develop better long term understanding.

Have started my next fast. For now, planning to stick to ~24h fast and do one light meal tomorrow evening, but will see how tomorrow morning goes. If the morning spike is controlled, will test what impact two meals with moderate protein content have on my blood glucose.

Key Performance Indicators

In terms of objectives for this intervention, my focus is on bringing down my average glucose levels and get my weight moving closer to my target.

When it comes to average glucose levels, I realised that since I’m doing this over 28 days, I should not only focus on my 7 day average readings, but apply the same overall target to 14 and 30 day readings as well. I would expect 90 day reading to go up slightly over the course of intervention if I can hit my targets. I haven’t yet done my maths to work out what the impact will be. I’ve created a table below to track this data. Unfortunately, I only noted down 7 day average yesterday. At some point soon I’ll get a full data download from CGM to calculate my rolling averages at the same time of the day for all dates to keep this consistent.

Average CGM Glucose

Some really encouraging shifts in 7 day averages. May they long continue and other metrics should take care of themselves.

Weight & BMI

Weight is moving in the right direction, but given Monday’s high reading will most likely struggle to get a weekly average loss to around 1kg taking me to 82.7 kg at the end of this week. Let’s see, not quite giving up yet. The same as for BG levels, will be interesting to see the interplay between fasting and protein intake.

Other Reflections

It is quite exciting to see such a positive impact so soon. For me, the most distressing part was that I didn’t come from a place of overeating carbs. At least not this time. When not fasting, my net carbs totalled 20g or less per day. As I moved to low carb eating, I have been compensating by eating a lot of protein, and it looks like my protein to fat ratio might have been off for my metabolism. The meal timing and frequency also seem to play a key role - all it took was some extra snacks outside my main meals to throw me off the balance. It all kicked off when I allowed myself to finish a good helping of peanuts a few weeks back. Peanuts are now definitely on my banned foods list. I guess I also need to recognise that I’m new to managing my long-term conditions through lifestyle changes and this is all a natural part of figuring what works for me.

You know what I’m even more excited about? My GP appointment tomorrow. I’m really looking forward to finding out my blood test results roughly marking the three months since my adventure started. I’m 95% sure I’ll be able to trial getting off my remaining medication to see what medication free existence looks like. I’ve been cautiously checking out consensus on what T2DM remission looks like and to see what my next set of goals should look like. A position statement from the Association of British Clinical Diabetologists (ABCD) and the Primary Care Diabetes Society (PCDS) looks like a good start: https://doi.org/10.15277/bjd.2019.221.