The dead hand of the father: diabetes

from Kickbike & Kettlebell

I’ve been working myself up for the past two weeks as I’ve been dealing with a new sentence:"
You have diabetes!"

I have been “pre-diabetic” for – as much as any one knows – 2 years, but I fear the spate of ill health and torrid Summer strains has tipped me more toward more pathology.

The context is that my father was diabetic – never looked after himself; was overweight +++ ;on insulin injections; and died under a massive coronary on a Gold Coast bus 25 years ago at 70 years of age.

There’s enough anecdotal evidence to suggest that his mother was probably diabetic too, but undiagnosed.

The family curse appears to be Diabetes mellitus type 2– fortunately – rather than the insulin dependent variety ( my father moved onto insulin injections because he did nothing to arrest the disease’s insidious consequences). This legacy has been at the back of my mind for some time and since I took my father as a antithesis model I thought I was ahead of the beast: overweight but not morbidly so, always exercised, very considerate of my diet, etc.

I’d been following a Low Glycemic index diet for several years and thought that I was ticking all the right boxes. That I have had Fibromylagia for the past 25 years meant that my health picture was always going to be complicated by its pervasive physiological presence. But despite that , within the limits of my illness , I always pushed the envelope in regard to activity and exercise.

Amitriptyline’s double edged sword

What crippled my aspiration was my obvious failure to lose weight. – once I’d gained it.

For many years I had been taking various low doses of Amitriptyline.

Normally prescribed as an antidepressant, it is also used in conditions like Fibromyalgia as an analgesic. In fact it is the only intervention I’ve found that has had any impact on the severity of my condition.

Among the many side effects of Amitriptyline what do we find?

  • amitriptyline may raise or lower blood sugar!
  • amitriptyline may promote weight gain (in fact many Fibro sufferers who stop using it give up the drug because of this one side effect)
  • taking moderate to high daily doses of antidepressants for more than 2 years is associated with an 84% increased risk for diabetes, according to a large observational study.
So you can guess what my first act was: getting off amitriptyline. I nonetheless delighted in a few hallucinations as I slowly rolled back the dose.

Now "clean", so to speak, what's my plan as I gotta have a plan, right?

The plan

Even before the recent news I had done my homework. So i did more, so much more that this has become an obsession these last few weeks as I try to get a handle on an approach that can help me survive (in the manner I am accustomed).

This isn't so easy as the standard advice for diabetics is contrary and confusing. In fact, diabetes treatment and diet is a hot potato. At issue it seems to me -- and I had been treated accordingly by my doctor (before I dropped him and got another) -- was a preferred arrogance that doctor knows best and all Davy has to do is take the tablets and do a bit of this and that in way of lifestyle and diet.

So much for 'diabetic education'.

Fortunately I now attend a Indigenous Health Clinic and since diabetes is a plague among Aborigines and Torress Strait islanders -- among all Indigenous peoples world wide in fact -- you get treated very differently. While I feel extremely privileged to share this service as I'm a Migloo as Celtic as they come --

Migloo:An Aboriginal word describing not only a white person, but a white person who is interested in Aboriginal culture. It originates from the Mayi-Kutuna language of the Leichhardt River area of north Queensland where it meant ‘a person’. It has now been adopted nationally by Australian Aboriginals. In Aboriginal folklore, the migloo was the great white hunting whale of the ocean, hence the term being used to describe white people.
my medical situation raises a few questions that may have a lot to do with my 'treatment'.

Diabetic Democracy

The first resource you get access to is a blood testing kit. This tool is a liberator because it empowers you to fiddle with your food intake in order to drive down your blood glucose readings. The daily pricks makes diabetes management democratic. No power is ever gained, you see, without shedding blood.

Unfortunately in this case it has to be your own.

But then when I began to consider what may be the constituent of my everyday consumption that blows out my blood glucose readings, something that the Glycemic Index folk do not address directly , I was struck by the self evident fact that carbohydrates are the problem. It's not about "good" (low GI) or 'bad' (high GI) carbohydrates so much as too much carbohydrate per se.

GI is only part of the story and it deceived me.

So now, and researches and daily experiments proceed, I'm trying to reduce the amount of carbohydrate I consume in any given day. An average diet with bread, pasta or rice maybe notches up a consumption of over 300 grams of carbohydrate per day -- in fact grains feed most of humanity as it is from them that we get most of our caloric intake. I'm aiming for a reduced intake of 70-150grams per day. This puts me in the chomping cuisine sphere of the Atkins Diet and the Paleo diet aficionados.
The modern dietary regimen known as the Paleolithic diet (abbreviated paleo diet or paleodiet), also popularly referred to as the caveman diet, Stone Age diet and hunter-gatherer diet, is a nutritional plan based on the presumed ancient diet of wild plants and animals that various human species habitually consumed during the Paleolithic—a period of about 2.5 million years duration that ended around 10,000 years ago with the development of agriculture.
Faddish? That's what I would have said until I started doing the background reading. The documentation is impressive despite the fact that such diets seem to be so ideological. Nonetheless, there is a group of diabetic researchers -- especially the endocrinologist Richard K. Bernstein -- who have clocked up the glucose inhibiting miles and come out with the same sort of recommendations.

So with my lancet in my hand and merrily prick prick pricking I've been going aggressively low carb for the past two weeks. It's too early to summarize the glucose figures, or settle upon a trend, but despite my increased fat consumption my weight is falling.

I am turning into hunter gather man.

There are quite a few issues raised by this shift that I'd like to explore in later posts -- especially environmental and human history ones -- but for now I'm seeing how much of the grain lifestyle I can hang onto, especially sourdough bread and home brewed beer. Among Paleo adherents there are some considered pragmatists who don't see it so much a loin cloth lifestyle change that is absolutely exclusive of everything post-Paleolithic. The real point of the dietary exercise is the impact what you put in your mouth, and don't put in your mouth, has on you.

And today the doc was supposed to tell me where my treatment was at but he didn't show. I thought I'd get a forbidding sentence but instead I get a window of opportunity to exploit diabetic democracy for another week or so.