So I figure less insulin, less money, less variation in daily blood sugars and less variation when calculating dosing (as long as I eat the same foods regularly). Obviously, increasing insulin resistance in the long run is the way to go.
I have seen a LOT of recommendations. I was hoping to provide a summary of what I found on some of the methods and get some feedback about what people have found for themselves. As a note, I am excluding diet suggestions from these recommendations, instead focusing on other factors:
A. Exercise - getting in some aerobic and anaerobic activity in every few days. Insulin resistance gained from exercise can wear off over a few days if not kept regular
B. Supplements - since the FDA does not verify efficiency it seems hard to tell if any of these help: - Ubiquinol
- Alpha Lipoic Acid
- Gymnemal Sylvestre
- Omega 3
- Vitamin D
- Fish Oil
C. Meal Timing - eating every 4-5 hours or so. I know this was important on MDI but not sure about pump users
D. Stress - keep stress low
I realize gauging effectiveness is difficult because confounding factors make it nearly impossible to isolate a particular thing as being the primary causal effect. However, I thought maybe some of you out there might have been able to link one of these things to a decreased basal rate over time.
As a note, I do not think it would be statistically valuable to provide feedback of whether of not any of these things provided a TDD decrease because daily food intake could vary that value too much. I am hoping to identify the potential BASAL decrease of these factors. I would love your thoughts
I believe you meant decrease insulin resistance, no?
The impact of exercise on IR lasts hours, not days. I've seen my sensitivity better as long as 12 hours, but by the next day it's pretty much back where it was.
Permanent changes in cardio fitness, on the other hand, usually results in some lasting insulin sensitivity improvements.
Finally, losing excess fat (adipose tissue) is probably the most effective way to reduce IR.
If you look at the three conditions you just listed Dave, you can see how a comprehensive exercise program can really have long term affects beyond the affect of each individual variable.
Just exercising will give you some immediate, but short lasting, IR relief. If you include a weightlifting regime with your regular cardio, you decrease IR through the activity, AND weightlifting increases lean muscle mass to go with the fat burning cardio. Together, increasing lean muscle mass/decreasing fat result in real long term baseline decreases in IR because muscle is simply way more metabolically active than fat even when you aren't exercising.
I've had some success with gymnema sylvestre and also 1 T of apple cider vinegar 2 or 3 times a day. Both made an obvious difference to me, but I have worked really hard on reducing my insulin resistance and my TDD. I'm not sure if it would have seemed so significant if I wasn't already down to around 15 total units a day.
I have gotten down to as low as 10.4 units a day as a regular thing (not there now bc of stress, I think). The things that seemed to make the most difference to me were losing weight, especially the last 15 pounds or so before getting to a BMI of 24, and intermittent fasting. I'm wondering why you say that eating every 4 or 5 hours is helpful. I eat once every 24 hours and I believe it works great for me, but obviously there are a lot of factors I'm not controlling for.
ETA: Probably the biggest factor, of course, is *what* I'm eating, but we don't have to go into that if you don't want. ;)
I think the key is "comprehensive" as FHS put it. You have to go like 5-7 days/ week, not like every couple of days, which might get you 3 times/ week, unless something gets in the way. I agree that I've had the best results when I mix cardio and anaerobic types of exercise. In my head, I've come to look at it as "playing" which 47 year olds don't get many opportunities to do. I figure that when I'm out running or biking or jumping up and down and lifting weights in the basement, it's more fun than working!
I take vitamin D and E and have been eating Shakeology for a while (although I traded that for a road bike recently, I've got a bit of a backorder for a few months...) but that's it. I try to work as many vegetables into my diet as I can, stuff like spinach instead of lettuce in tacos, on top of burgers, in eggs, tuna salad, etc. gets me a couple extra servings/ day and I think that keeps me going.
I take vitamin D and E and have been eating Shakeology for a while (although I traded that for a road bike recently, I've got a bit of a backorder for a few months...) but that's it.
Me? I bought a new car.
Hasn't done a thing for my IR, but my mood has improved markedly!
exercise would be the #1 factor in my opinion and experience, followed closely by diet. I notice a change in my insulin requirements even if i go a few days without exercise-its crazy really. A healthy diet(i know, the definition of healthy diet is very controversial and different for everyone) is also a big factor for me, fairly low carb and high protein/fat keeps my tdd low and prevents me from developing insulin resistance over time. im a pumper and meal timing really has no effect on me. I snack on veggies and nuts quite often between meals with minimal insulin requirements or effect on blood sugar. As for supplements, the only one i take is fish oil and i dont know about its effect on insulin resistance, but i believe it has a huge effect on triglycerides. I had trigs between 20 and 30 on my last 2 chol tests. this is lower than they ever were before taking fish oil.
One other option that you did not mention is resistant starch (RS). I see more and more interest in it and its promises seem attractive. The touted principle benefits are:
I am about half way through the process of adapting and so far it seems to have improved my digestion and bowel movements. If those effects last, that alone is enough for me to continue taking it. I have already verified that it does not seem to raise my BG so it sounds compatible with my very low carb diet.
Do be warned that there is an adaption period, so if you decide to try it, be sure to go slow.
Exercise is my greatest ali. 5 to 6 times a week, either run swim or row. I stay as active as possible the rest of the day (my son is 5). Prior to dxd I ate well, no chips, candy, cereal very little pasta, potatoes, no rice. Now even less, certainly not low carb, just lower. Stress has become my enemy trying to learn how to deal can't eliminate. I'm mdi 12-13u basil, about 7- 9 bolus, I know without the exercise it would be more. My aic has always been under 6, I attribute to exercise. I don't snack never have, meals are about 5 hours apart. I'm not perfect, I have no problem snacking or eating sweets once in a while, couldn't live without it! I take a multi vitamin, vitamin d and fish oil. For me it's the exercise and very little snacking that keeps my numbers low. I haven't been T 1 (rapid onset)for very long but my basil has been very consistent. Hope to keep it that way, it's a lot of work.
Regular excercise helps with the up regulation of the insulin receptors of cells. This up regulation makes the insulin receptor more likely to connect to insulin. This is a long term benefit of exercise.
The cause for insulin resistance is often an excess of glucose in the blood stream that is coming from the liver. The higher level of available glucose makes the insulin receptor less sensitive to insulin (down regulation). This again increases the glucose level and creates a negative feedback spiral. Thus you will need more and more insulin to get the same results. Even for T1 patients it possible to have this predisposition that often manifests as T2. In this situation excercise alone might be insufficient to overcome the resistance aka the need for high dosages of insulin. Here drugs like small dosages of Metformin can help to moderate the output of the liver.
In my personal experience I need to moderate my exercise too. To much exercise per week and growth hormones will greatly amplify my dawn phenomenon. Furthermore my liver seems to be motivated to produce even more glucose then. So I need to keep that in balance.
I appreciate you sharing your data about the vinegar,gymnema and weight loss!
Concerning the regular eating, I was on MDI for about 1 year and ate about 1 meal a day with snacks and never saw much of a problem with a few exceptions that made me move to 2 regular meals a day. Basically after about 7-8 hours of not having a meal I would see a slow increase in blood sugar. Now that I have a pump as a comparison, I would say it that it would look like I had a low basal rating for that segment of time that I would need to increase.
I am using Bob's Red Mill potato starch (available at local grocery stores). Be sure not to get potato flour. I just add it to a cold glass of water and stir it up. I am up to the recommended 4 tablespoons a day and waiting for my body to fully adapt.
Resistant starch has been studied and seems to improve insulin sensitivity. Here's a Google search for scholarly articles.
This one seems to show adding some insoluble fiber may improve things even more.
The potato starch OldTech mentions is cheap, I have ordered some and intend to give it a try. It has to be eaten cold or it looses it's resistant character and would give you a nasty spike.
