Which diet should we all be on?: Keto vs low-fat vs low-carb vs IF vs vegan vs paleo

From all I can gather, and from the podcast I listened to this morning, basically none (diet), or none in particular. If a diet is working for you, fine, stick to it if you want. But know in the end it’s likely, if the diet is extreme in any way, that you won’t be able to sustain it.

Plus, at the end of a year, most every diet leads you to the same place: some weight loss if you keep it up, some weight gain if you don’t.

This morning on my walk I was listening to Leonard Lopate’s podcast from WBAI radio in New York. He was interviewing author Robert J. Davis, PhD about his new book, Supersized Lies: How Myths about Weight Loss are Keeping Us Fat. Not a lot new if you’re no stranger to diets.

Davis, also known as the Healthy Skeptic, wrote the book to debunk what people believe about diets and dieting. The bottom line I took away is our bodies are all different: some diets works well for some people, no diet works optimally for everyone, and the best way to lose weight and keep it off is what we’ve been hearing now for several years: eat healthy, whole foods, veg, fruit, nuts, beans, seeds, grains, dairy, meats, and move. Chuck the processed foods NOW and don’t eat late at night – unless I imagine you work the night shift.

Davis also debunks the myth doctors love to share and we love to feel guilty about: Eat Less, Move More. Exercise, unless you work on a construction site where you’re carrying logs 10 hours a day, does little to aid weight loss. That said, any exercise is a good thing for overall health.

So I would rename the famous mantra: Eat healthy food and move. That really is the end of story. Except of course for all the mega companies that have made, and continue to make, billions of dollars making us think we need special foods or special supplements or special cookbooks or already prepared meals, or frankly to be svelte, skinny, thin.

I can’t quite remember when it was, but somewhere in my youth I reached my all time high weight of 165 pounds. It was likely before I was 18 and diagnosed with type 1 because I remember after my diagnosis in my early twenties I felt I had to lose weight for my health, and I did. I ate less and began running. I only made it to 3 miles, but hey, that’s three miles.

Over the decades I continued to eat healthier foods and smaller quantities (especially after I married a six foot Dutchman who weighed 125 pounds!) and my running became a daily one hour walk. I remember Snackwells in the early days when all we thought about was eating less and being hungry as a natural state. I remember counting calories, giving up salad dressing, and plateauing so, so, many times. But with all that, maybe because it happened over years, my weight came down to 145, where it stayed, then 134, where it stayed and my current, pretty consistent over the past two decades, 124 lbs.

When I did Keto two years ago, I quit as I couldn’t continuously eat that much fat. And I missed everything I normally make out of almond flour. When I did intermittent fasting (IF), basically two meals a day as my first meal wasn’t til 1 PM, and I skipped wine, my weight came down to 117. I loved that, but not enough to keep doing it, as I don’t do it anymore. Instead I have a cup of coffee with cream upon rising and my first meal of the day around 10:30 or 11 am. Trying not to eat after 7:30 PM is tricky as I find I often need something to raise my blood sugar before descending into sleepville.

What works for me may not work for you, but it works for my body, my lifestyle, my environment, my values, and my food tastes. While a fellow type 1-er once yelled at me that not eating bagels was a sacrifice she was unwilling to make, I don’t find it a sacrifice. I make my own scones, biscotti and coffee cake bread out of almond flour which I eat on a daily basis. Overall I’m low carb (not no carb), lots of veg, little fruit, full fat dairy (Fage 5% plain yogurt and cheese) nuts, nut butters, seeds (tahini), rarely grains, fish, some chicken, occasional meat, dark, dark chocolate (combine 85% and 100%) and a glass of vino many nights, along with a 45 minute to one hour walk almost every day. My weight vacillates between 120 and 124 lbs. I’m happy enough.

Bottom line: find what works for you. I would start with the basics: healthy, unprocessed foods, occasional treats – no starvation here or too tight regimes – and move. Again, maybe this doesn’t work for everyone, but I think for now it’s the best we’ve got.

Lilly’s generic form of Humalog now gets even cheaper

Here’s the news straight from the press release

Lilly’s Insulin Lispro Injection (the generic for Humalog), 100 units/mL — first introduced at half the list price of branded Humalog® (insulin lispro injection, 100 units/mL) in 2019 — will now have a 70 percent lower list price than Humalog U-100 starting January 1, 2022.

Insulin Lispro injection can be ordered through all U.S. retail pharmacies. People using any Lilly insulin – including Insulin Lispro Injection – can fill their monthly prescription for $35 through the Lilly Insulin Value Program for people with commercial insurance, or who are uninsured, and the Senior Savings Model for seniors in participating Medicare Part D plans.

Pharmacists can substitute Insulin Lispro Injection U-100 for Humalog U-100 without a new prescription because they are the same insulin. Any retail pharmacy that does not stock Insulin Lispro Injection can obtain it from a wholesaler in 1-2 days.

You can find more particulars on the press release. Personally, I haven’t yet calculated what this means to me. I do use Humalog, and because I don’t use a lot of insulin, I withdraw my dose from Humalog pen cartridges. I scrubbed vials for pens when I was throwing 2/3rds of the vial away after a month. And, when I get a script from my endo for the cartridges, I end up getting more cartridges than the 3 vials I would otherwise get, so for me, it lasts a lot longer.

All I know, is on the surface this seems encouraging that pharmaceutical companies are maybe

Three diabetes books you should know

Yes, that’s my drawing above and below are three diabetes books you should look into. Since yesterday was my birthday. I decided to give you a gift – to remind you that there are 3 great diabetes books you may want to read. And yes, they are mine.

During my time working in diabetes, over these past almost 20 years, I have written three books in addition to hundreds of articles and this blog.

Each book has a different focus and together they make a rich library for managing diabetes. In a nutshell:

The ABCs of Loving Yourself With Diabetes

26 illustrated inspirational essays to make you stronger and more resilient managing the emotional luggage of diabetes, type 1 and type 2. Don’t blame me for the price, Amazon sets it. Buy it used. You’ll love the shot in the arm and the images.

Diabetes Do’s & How-To’s

Go ahead and look inside and see if you don’t find action steps you want to try right now. The book is recommended actions for managing food, exercise, medicine and attitude. Think of it as a coach with Haidee Merritt’s wonderful cartoons.

50 Diabetes Myths That Can Ruin Your Life and the 50 Diabetes Truths That Can Save It

You have to love a publishing house that would let you put an ice cream cone on the cover of a book for diabetes. This book is part of Perseus publishing’s diabetes library. A beautiful comprehensive understanding of diabetes told through the fun of myths and truths. I remember I finished writing it a month before my deadline and was ecstatic. You won’t be disappointed. And the material is classic.

So, I’ll say it again, while it may not be your birthday, give yourself a gift of information, education and support, especially if you feel your management could use a jumpstart or just a little hand-holding. It would be a gift to me to be able to hold your hand through my books.

Getting quiet inside can improve your management

The above article was published today by Beyond Type 1. My sincere thanks to Tierra who interviewed me and Lala who edited the piece.

It captures my recent deepening of my spiritual practice, perhaps the thing keeping me most sane during these hard times, which of course for us, comes on top of managing diabetes.

You may find a few tips to help keep you managing your diabetes, and life, a little more fluidly, make the space within you more still than scattered, and be able to slide out of chaos when you need to.

Finding that quiet place inside is always restorative. Well, that, and a glass of good wine.

Funny diabetes doc, Steve Edelman, opens up

If you’ve been here a while you know I’m a big fan of Dr.s Steven Edelman and Jeremy Pettus. Through TCOYD (Dr. Edelman founded the org.), they’ve been bringing us monthly online conferences that are not only highly practical and educational, but fun. You can sign up for the TCOYD monthly newsletter, that includes online registration for events, here.

Watching the most recent conference, I was struck by Dr. Edelman’s sharing of his own complications and the worries he harbors for the future, living now with type 1 diabetes 52 years. It really touched me when this funnyman, about three quarters of the way through this video below, opened his heart to all of us.

Fiber-full and fiber-healing, it’s amazing what cauliflower can do for crackers

In full disclosure I was sent two packages of Slim and Trim Snacks Cauliflower Crackers. One as pictured above, Dill Pickle. The other their Classic version.

First, I’ll get my objection out of the way, they’re expensive. Almost $10 for a box of 6 crackers (subscriptions make them cheaper). Okay, moving on…they are delicious, nutritious and filling. The company was started by husband and wife, Jennifer and Patrick, after Patrick was hospitalized with life-threatening hypertension. Healed in part by a plant-based diet, Jennifer, a long-time vegetarian, and Patrick, a plant engineer, devoted themselves to creating healing, gut-focused foods.

The husband (mine) can’t keep his hands off them and he, being Dutch, is a connoisseur of all baked bread-like things. He readily agreed, with a mere smear of hummus, one cracker was surprisingly filling.

The crackers are hand made with minimal processing. Made strictly from plant-based ingredients – nuts, seeds, probiotics, herbs, spices and resistant starch – the owners tell me they aid in enhancing the health of one’s microbiome, promoting digestion, reducing inflammation, facilitating weight loss and increased energy, and reducing hypertension, heart disease, and as you can guess, they are extremely diabetes friendly. The star ingredient, cauliflower, is lightly steamed and squeeze-dried.

While I don’t eat crackers often, the husband and I agree these have a uniquely satisfying texture and taste. Jennifer explains it’s from the prebiotic fiber and magnesium from the almonds.

To see more of these little dynamo’s health benefits, and/or order, take a closer look. During these last 18 months of Covid, practically all I’ve bought is socks and masks, little pick-me-ups. These too would make that list.  

How trippy seeing yourself looking back at you

My friend, who lives in Sydney, Australia, just sent me a picture of myself. Yes, that’s me on the screen in a doctor’s waiting room in New Jersey. My friend’s sister was in that waiting room and all of a sudden looked up and saw me staring back at her. The sister sent the photo to my friend, who sent it to me.

Last year in the middle of Covid here in the Northeast, I went to a studio in New Jersey where a film crew shot these two mini educational videos below. Everyone was wearing masks and face shields. It all felt like we were living on the edge, and it was deeply satisfying.

Seems only appropriate to share the videos with you in the comfort of your own home, no doctor’s waiting room necessary.

In under 3 minutes – Thriving with Diabetes

In under 3 minutes – Advocating for Yourself

TCOYD tops up your education on diabetes care

The boys are back at it – Dr.s Stephen Edelman and Jeremy Pittus, my favorite long-distance endos. In show-stopping theatre they make diabetes education fun. Yes, you read that right, fun.

Tune in for a morning (West Coast time) or afternoon (East Coast time) of back-to-school learning, as they coyly put it, to sharpen your knowledge and your A1C.

The date is August 7th. You can read more and register, FOR FREE, here.

The delayed blood sugar rise from fat, how cruel

It’s not only the infamous slice of pizza that can raise your blood sugar hours later: that demonic combo of carbs and fat.

Last night the husband and I went out to eat at our neighborhood place, an Italian pub-like bistro. My normal meal is sharing a starter of bruschetta followed by an entree of salmon with kale and squash. Yes, the bruschetta is carb, but sharing it, not so much and I know how to dose for it.

But last night I threw my cares to the wind and fulfilled my craving for pasta. Maybe a twice a year event. I do make it at home, but that’s the pasta that’s always made out of something low carb, like edamame, which has minimal impact on my blood sugar.

We got our bruschetta starter, which comes with a mound of burrata mozzarella cheese and then we shared spinach/mushroom ravioli in brown butter sauce and black linguini with salmon in tomato sauce. Yikes!

I cannot tell you how delicious my carb lunacy was.

I under dosed for the food just after ordering. I only took 2 units of insulin having an insulin/carb ratio of about 1:17 in the evening. I under dosed on purpose because sometimes I find when the pasta is homemade it doesn’t raise my blood sugar as much as commercially made pasta.

We ate around 6:30 P.M. When I got home around 8 P.M. til I went to sleep just before midnight, I watched my blood sugar on my CGM.

It was well within my target range and very stable until around 9:30 P.M. when it began rising. I took one more unit of insulin. Before bed, shortly before midnight, it was still a very stable 130. The range on my CGM is set between 75 and 150. And, I purposefully do not hear alerts overnight or I would never get a night’s sleep due to compression lows. So if the alert was ringing all night, I do not know.

When I woke, not only was I amazed at the number, 192, which I haven’t seen in years, but amazed how six hours after dinner, my blood sugar jumped 50 points and stayed there all night, for seven hours.

Mildly alarmed, by missing all the alarms instead of taking the 1 unit I do upon waking to blunt the dawn phenomena, I took 2 units and two hours later another unit since it was coming down so slowly. Now it’s a happy-enough 126.

All to say, the combination of carbs and fat is tricky, even for.this 49 year type 1 veteran. Also to say, don’t beat yourself up over the numbers that show up out of nowhere, just work them down, and down, and down, safely.

In future I will at least double my dose when eating this devilish meal, possibly take a long walk after dinner, and maybe, even though I hate the idea, schedule a 3 AM wake up call to check my handiwork.

Lastly, you and I are deserving of no shame, no blame or self-criticism. It’s just diabetes being diabetes.