P-O Heidling from Linköping, Sweden, has had type 1 diabetes since childhood. Despite being a “very good” patient, his blood sugar levels increased with the years. He was tired constantly and many more health problems started to sneak up on him.
He emailed me about what happened when he – despite resistance from health care professionals – started eating low-carb about five years ago.
Here’s his story:
The Email Translated from Swedish
I want to share my success story. I feel that there are too few success stories about people with type 1 diabetes.
My diabetes debuted when I was 10 and so this is something I’ve had for almost 35 years. Around 6–7 years ago I began to worry about my health. I suffered from minor ailments that never seemed to end. Taken separately none of these were that serious, but I felt that my sick episodes were becoming longer than my healthy episodes; one episode of dry cough – one week of “well” – followed by two weeks of having a cold – a few days of “well” – followed by an enormous fatigue etc.
When it comes to my diabetes, I’ve always been a very good patient. Super strict with diet and testing, all according to the recommendations from health-care professionals. My blood work results were relatively good for the first 15 years, which I think is because at the time I was very active in sports, and I was still growing. After university, when I started working, I became more sedentary and soon my HbA1c gradually increased. In the late 90’s the numbers were between 9–10 % (73 and 83), but with some focussed efforts I succeeded in keeping my numbers between 8–9 % (63 and 73) during most of the 00’s. Diabetics are advised to keep levels between 7–8 % (52 and 63) so my levels weren’t extremely high, but still a bit too high, over a period of 15 years. Numbers within parenthesis are according to the new IFCC standard, mmol/l.
Eye exams began to show “minor changes”, i.e. no changes that demanded any action there and then, but I found them worrisome.
At this point I started to monitor my blood sugar very frequently. During my testing periods I tested hourly for two weeks, the only exception being night time. I wrote down what I ate with every meal. My thought was to try to understand why my blood sugar wasn’t regulated with all the insulin that I was taking. This has resulted in thousands of blood sugar readings saved from many years back. An ordinary day could look like this:
- Breakfast (low-fat yogurt with muesli, 2 sandwiches), about 16 units of insulin
- Snack (2 slices of crisp-bread with Swedish caviar and a cup of tea)
- Lunch (“working lunch” at a nearby restaurant, 14 units of insulin
- Snack (1 slice of crisp-bread with cream cheese and a cup of tea)
- Dinner (following “my plate” and the dietitian’s recommendation), 16 units of insulin
- Evening sandwich (2 sandwiches with cheese or ham and a glass of milk)
- Basal insulin, 30 units per day
- Sometimes another sandwich before going to bed if I had exercised in the evening, which made me feel a little “sugar low”
This is what my numbers looked like on two typical days in April 2006. Many years ago, I set an upper and lower limit of 9 and 4 %, and the goal was to keep as many readings as possible within this range. In those days this was difficult.
The last years before LCHF, food was a big problem. I was often hungry, but didn’t think the food tasted good. I couldn’t name one single favorite dish, because I had none. It’s actually a terrible curse that I don’t wish upon anyone – craving food, but feeling no joy when eating. Beef tenderloin or plain sausages, it was all the same in my mouth. My own interpretation is that this was my body’s way of telling me to “stop eating all this food, I don’t want it”.
In the fall of 2009 I had to remove an infected wisdom tooth. After the surgery I was prescribed “liquid and light foods” for six weeks so that “the jaw wouldn’t break” (doctor’s words). “What was I to eat then?”, I thought, with all my sandwiches?
I had to radically reduce my insulin doses to avoid my blood sugar going too low. To my big surprise I wasn’t hungry during the day, despite the fact that I ate less. I started to lower several doses and got the same effect, i.e. I ate less, but wasn’t hungry in the same way as before. Before, high insulin doses probably “chemically” convinced my body that I was hungry, which it wasn’t. To me this was an eye opener. I then decided that the goal should be to keep insulin levels as low as possible and adjust food intake accordingly, and not the other way around, which had been the case during all of my previous years of diabetes.
In December 2009 I heard about LCHF from a friend, and after having read up on information at Diet Doctor and Annika Dahlqvist’s blog, I started to eat a strict LCHF diet in January 2010. In April the same year I went in for a routine check-up. My HbA1c number was then at 6.7 %. For the first time in almost 10 years it was within the recommended range. Since then I’ve never had a number “too high” at any of my check-ups.
My diabetes office hasn’t been very supportive during this time. There has been talk about the dangers of saturated fats, statins for the “dangerously high” cholesterol levels, “nobody knows what happens in the long run” etc. I’ve always had to argue back, and by being informed about the latest research that is available at the Diet Doctor’s blog and other blogs, I’ve been able to insist. As my HbA1c is always fine now they don’t have anything to complain about, so my feeling is that they’re letting me be.
What has surprised me the most is that if I were a physician/nurse with a patient that had presented with somewhat elevated levels for 10–15 years, and suddenly discovered that levels were now normal at all check-ups; shouldn’t I then be a little curious and ask “What has happened? What have you done?” Nobody has asked me this. The levels are good, therefore I’m not an interesting case. From all my own readings, all they want to see is often just the levels from “the two last weeks”. This is what they’ve said for 35 years. Looking at series of numbers after breakfast, comparing them to numbers from 2–3 years ago, looking at confidence intervals for numbers between specific hours etc., which is very informative and fairly easy to produce in Excel, has never been interesting to any of my doctors.
Today, a typical day looks like this:
- Breakfast (bacon and an omelet with heavy whipping cream and cheese), 27 units of basal insulin per day
- A snack at late lunch time (a couple of cheese slices with butter, a boiled egg with mayonnaise, tea with coconut oil)
- Dinner (real LCHF food), 2 units of insulin
These are my numbers from two typical days in February 2014.
The latest cholesterol profile showed an Apo B/AI ratio of 0.75, HDL 104 (2.7), total cholesterol/HDL 3.29, which according to good sources is considered good.
So, I’ve gone from being constantly hungry, eating 6–7 times a day, with 4 insulin injections and 76 units of insulin, to always feeling satisfied, eating 3 times a day, with 2 insulin injections and 29 units of insulin. I can also easily list several dishes that I enjoy, as my taste for food has returned. I’m presently taking so little mealtime insulin that I have to return some insulin as the “best before” date has expired. This is because the smallest package contains 5 insulin-injection syringes and that’s more than I use in a year, unfortunately for the health care system.
I’ve lost about 33 lbs (15 kg) and am currently weight-stable at a weight that I’m satisfied with. I lost all this weight without any exercising at all. After the weight loss my energy returned and now I run/walk about 50 minutes a day, but depending on my work schedule I sometimes go for long periods without exercising. Whether I exercise or not my blood sugar stays stable, so supplementing with sugar after exercise is no longer needed.
I haven’t had a sick day since February 2010. I’ve almost stopped monitoring my blood sugar as every time I do a test period my levels are stable. My latest eye exam showed that there were no longer any changes and I was classified “as completely symptom-free”. Others have reported the same thing happening to them.
Overall, I now have a completely different life. A change that not only affects me, but also my family, who instead of a tired, overweight and “food and injection-driven” old man, has gotten an energetic husband /dad, who doesn’t have a problem with waiting to eat for a couple of hours.
Because my blood sugar is always stable.
Once again, thank you for the work you and your team are doing, and for helping me to a new and healthier life.
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