ThanksJimi63. Since the very low carb diet was very hazardous for my health, I am not really interested in what keto doctors have to say. It doesn’t mean that they are wrong, but their advice was certainly wrong for me.
I have read quite a bit from doctors on both sides of the fence, and at this point I have walked away from the very low carb voices.
I met with the cardiologist today and I am taking rousuvastatin 20mg and my blood test show that an increased dose would not help. These tests show that the amount of insulin I take is inflammatory and sets off the APOc111 chain that builds an excess amount of small ldl particles that end up as plaque in my main arteries. It has been pretty well established that PCSK9 inhibitors scrub out the particles. However, it may be overkill as I develop very little additional plaque yearly. She is starting me on Zetia and says that we will move up to the more aggressive PCSK9 inhibitors if that does not control these particles. What was most interesting is that she wants me to move from a low carb high fat diet to a protein-based one. A protein diet will be counterproductive in that it takes me about 25% more insulin, IE, more inflammation, but she says I need to counter that by building my upper body through strength training. I was also deficient in Vit b6 & b12 and she wants me to take Folate 5000+ every other day for that.
The bottom line is a slight shift in medication, a larger shift in diet, and shift in exercise. My current ApoB is 74 and we need to get it under 50. My next fasting blood draw with her is on July 6, and we will evaluate these changes at that time and tweak them as necessary. She feels I can get this into control without too much additional effort.
I hope Zetia works for you. What foods did she suggest? How do you know it will require more insulin? Eating a high protein low fat plant based diet didn’t change my insulin needs at all even though I am eating almost 10 times the amount of carbs. In fact I am taking a little less insulin now.
Interesting about the inflammation. I hope that you can bring that down fairly easily.
I haven’t tested my ApoB yet, since I would have had to travel 2 hrs to get to a lab that would do it. I have an appointment with my cardiologist tomorrow morning and I am sure he will ask why I want to know since the best thing I can do for a healthy heart is to eat the way I am eating and to continue exercising.
My echocardiogram sounds like it was good although I do have mild aortic stenosis which I am not happy about, but I guess it is fairly common. I need to find out if there is anyway to control that. Since all of my numbers have gotten so much better with the changes I have made in the last 6 years I doubt that there is anything else I can do.
Before going mostly low carb, high fat, I was on a protein diet and I converted to low carb, high fat, because my BG and A1C’s were consistently lower. I ran a test in the past five weeks and went back to the mostly protein diet and sure enough my BG has been running almost 20% higher. I buy 1lb chicken breasts at BJ’s, cut them in 4 to make 4 oz servings and then make a huge bed of mixed greens, with dressing being chia seeds, sunflower seeds, pumpkin seeds, walnuts. Extra virgin olive oil (certified I get from Europe as it is not controlled in the US and vinegar certified from Modena.
Maybe I am doing something wrong - Time will tell but I will stick with this functional cardiologist if she can stop my plaque from growing. I gave her 1 year to fix this so will see.
My cardiologist said that my echocardiogram looks great. The aorta stenosis is extremely mild, but if it gets worse, in 7-10 yrs I could have the valve replaced with a newer procedure which doesn’t require being cut open. He said that because I am healthy and small I could have that done even in my 80’s. He also said that it has nothing to do with diabetes or cholesterol, it just happens to some people. There is nothing I can do about it.
I volunteered to try PCSK9 again. I tried it before when it first became available, but I was afraid of it. It caused me to have hip pain, but I want to try it again since I can’t take statins. The cardiologist would like to see my LDL below the 78 it is now.
The cardiologist feels like I will live well into my 80’s or longer because of the way I take care of my diabetes.
I started a hiking group for type1 in Seattle, and it’s still small right now, I did one in losangeles thst had about 50 members. This weekend I met an 86 year old type 1 who was diagnosed at 11. She is still totally coherent and fit. She has some mild foot issues. We hiked 6 miles with moderate terrain, and she didn’t flinch . she is a someone to look to as what we can achieve in out later years.
She had poor control for 25 years but keeps thing tight now. I think you can live into your 90s Marilyn, just keep up the fight and don’t slow down
Wow! Timothy she sounds like she is in great shape for anybody over 75. What a great example! Most people with type 1 near me have died before the age of 75, some much earlier. Maybe really tight control really does pay off.
Still snowing on the east side of the mountains.
It’s so nice here sun was out this weekend and it was in the high 40s. Perfect hiking weather really. I think diabetics tend to stop moving when little things slow us down like problems with outer feet or neuropathy arthritis frozen joints which we are all prone to. I think the people who live the longest are the ones who keep moving no matter what. I think that’s what kept me healthier during my early years of moderate-poor control. Lucky for me I love to be outside
I went all out to tame my APOb beast and so far lucked out, actually hitting it out of the park. I increased my protein intake to build muscle mass in my arms and chest, along with strength exercises. Combined Rousovastatin with Zetia. The muscle build was to boost metabolism, which required more insulin at first to control, but after a few weeks went the other way, and now I am on a lower insulin dose than when I started this regimen.
Total Cholesterol at a new low of 119
Triglycerides are a little high at 75 (normally 55-65 range)
HDL is a little low at 66
LDL a new low of 37
APOb is a whopping low 39. I am stoked, as 50 or lower was what I needed to stop plaque buildup in my heart arteries.
LDL particle number 667 is also a new low
Wonderful results CJ! All of your hard work is certainly paying off. I am very happy for you! Your LDL of 37 is outstanding! No wonder your APOB is only 39. I don’t see how heart disease can get you with those kinds of numbers. Mine are good but yours are great!