What exactly is "clean eating"

[dnfuss]

The problem with drink a beverage containing artificial sweetener and then testing BG, it's a stupid test.

I'm sorry you think it's "stupid," but that's exactly what diabetics do to see how different things affect their blood sugars. It is quite definitive.

Because it takes weeks for your gut microbiota to change, it isn't an immediate response. (And some take probiotics, who know if this counters the problem?)

That's an interesting theory and could be true. Right now there's no clinical evidence to support it.

I get concerned because I do drink a lot of diet soda, and it has never seemed to really help me lose weight. At best it's just a lot of chemicals that hopefully isn't harmful used to deliver caffeine. (But it's hard to stop.)

You're right that studies have never shown that those using artificial sweeteners lose any weight compared with those who don't. They may, or may not, raise blood sugars in some patients. They may, or may not, increase hunger in some patients. If you don't want to use them, don't use them.

One thing I wanted to know about testing insulin, how much insulin am I producing?

If you really want to know if your pancreas is still producing insulin (and I would guess that it is), take a C-peptide test. That's the gold standard. The serum insulin test doesn't tell you that.

If I am insulin resistant, then losing weight should help a lot, if I don't produce enough insulin then it's a different and more serious problem. (or some combination of the two)

It doesn't really matter how insulin resistant/low insulin producing you are. The problem is not why your blood sugars are too high, it's that they are. The treatment is the same either way: lower your blood sugars by the methods I've previously described. Losing weight is always a good thing if you're overweight. It may or may not have a beneficial effect on your blood sugars.

I am fully convinced lowering carbs will lower BG, but how much do I need to lower carbs in my situation? I don't want to go to a 30 gram per day total unless I absolutely have to.

The only way to know is trial and error. As I mentioned earlier, try going below 100 grams of carbohydrate/day. If that's not enough, try less than 50 grams/day. If that's not enough, try less than 30 grams/day. If that's not enough, add oral agents (metformin, etc.). If that's not enough, add insulin.

Last night I ate 12 bugger king chicken nuggets and a small couple of oz piece of apple strudel, probably about 85-90 grams of carbohydrates total for that one meal, an hour later my BG was 126, I took a short walk for 15 min, BG was 114 after that, when I woke up it was 89. That seems reasonable to me.

If those numbers seems reasonable to you, OK. To me, most of those wouldn't be acceptable numbers and are not the numbers exhibited by those with truly normal blood sugars (the fasting number, in and of itself, is not troubling). And I do seem to recall your describing having post-prandial blood sugars of 177, 156, etc., and fasting blood sugars over 110.

I don't drink enough alcohol to really affect anything longer term, at most 2 beers a week or a margarita with mexican food, sometimes nothing at all for weeks.

Not sure what you mean by "longer term." Alcohol, per se, doesn't raise blood sugar. Its effect is complicated. Its hepatic metabolism is prioritized over carbohydrates, and therefore can delay blood sugar rises. Some alcoholic beverages (beer, sweet cocktails, etc.) also contain lots of carbohydrates and sugars, and these have their own effects. But sounds like bottom line you don't drink alcohol often enough to need to accommodate it in your plan.

The good news for me, I am down from 168 > 162, all fat maybe added in a few lbs of muscle. My first pass goal is ~150 lbs.

That's good news. It may or may not have some beneficial effect on your fasting and post-prandial blood sugars.

 

[Vince]

If you are working to keep your blood sugar in check or manage your weight, you might choose diet soda. ... Unfortunately, even though they contain no actual sugar, they are loaded with artificial sweeteners and other unhealthy additives.
Is Diet Soda Safe for Diabetes? - Healthline
Healthline › health › diabetes-diet-soda

Is Diet Soda Safe for Diabetes?

 

[DragonBits]

If you are working to keep your blood sugar in check or manage your weight, you might choose diet soda. ... Unfortunately, even though they contain no actual sugar, they are loaded with artificial sweeteners and other unhealthy additives.
Is Diet Soda Safe for Diabetes? - Healthline
Healthline › health › diabetes-diet-soda

Is Diet Soda Safe for Diabetes?

Working on both, lowering weight and lowering BG.

I think the following is likely true, but as they said, really difficult to determine for sure.

However, associations observed in long-term prospective studies raise the concern that regular consumption of artificial sweeteners might actually contribute to development of metabolic derangements that lead to obesity, type 2 diabetes and cardiovascular disease. Obtaining mechanistic data on artificial sweetener use in humans in relation to metabolic dysfunction is difficult due to the long time frames over which dietary factors might exert their effects on health and the large number of confounding variables that need to be considered.

Thus, mechanistic data from animal models can be highly useful because they permit greater experimental control. Results from animal studies in both the agricultural sector and the laboratory indicate that artificial sweeteners may not only promote food intake and weight gain but can also induce metabolic alterations in a wide range of animal species.

Artificial sweeteners and metabolic dysregulation: Lessons learned from agriculture and the laboratory

The problem would be that quitting artificial sweeteners, it likely takes a long time to see any improvements, just as when you first use artificial sweeteners it takes a long time for problems to surface. By the time a problem surfaces, it can be blamed on any number of confounding factors.

Maybe become a wino.

Of course, red wine,

 

[DragonBits]

If you really want to know if your pancreas is still producing insulin (and I would guess that it is), take a C-peptide test. That's the gold standard. The serum insulin test doesn't tell you that.

I don't understand that, could you explain in more detail why the insulin test doesn't test insulin?

I get that your pancreas produces proinsulin which gets cleaved and produces an equimolar production of mature insulin and C-peptide.

The c-peptide test is important for those that take exogenous insulin, as it's the only way one can separate out naturally produced insulin Vs exogenous insulin.

This doesn't apply to me.

So it would seem for me, a c-peptide test and an insulin test should show the same results.

If this understanding is wrong, please explain in more detail why this isn't true?

 

[DragonBits]

The only way to know is trial and error. As I mentioned earlier, try going below 100 grams of carbohydrate/day. If that's not enough, try less than 50 grams/day. If that's not enough, try less than 30 grams/day. If that's not enough, add oral agents (metformin, etc.). If that's not enough, add insulin.

By now, I am confident cutting back to 100 grams of carbs would be enough.

DragonBits said:
Last night I ate 12 bugger king chicken nuggets and a small couple of oz piece of apple strudel, probably about 85-90 grams of carbohydrates total for that one meal, an hour later my BG was 126, I took a short walk for 15 min, BG was 114 after that, when I woke up it was 89. That seems reasonable to me.

If those numbers seems reasonable to you, OK. To me, most of those wouldn't be acceptable numbers and are not the numbers exhibited by those with truly normal blood sugars (the fasting number, in and of itself, is not troubling). And I do seem to recall your describing having post-prandial blood sugars of 177, 156, etc., and fasting blood sugars over 110.

Sometimes I think you have a distorted view of what normal blood sugars are. They can spike to 177 given a low level of carbs prior to the carb overload.

=======================================
CONCLUSIONS:

The present data suggests that there is a risk of misdiagnosis of impaired glucose tolerance with only one intake of this extremely low-carbohydrate meal on the evening before testing. The decrease of insulin secretion and the activation of glucose-fatty acid cycle may be considered as the mechanism.

The relationship between carbohydrate intake and glucose tolerance in pregnant women. - PubMed - NCBI

I have been tracking my blood glucose since 1992, in 2009 it was 113, then I went on TRT and lost 40 lbs from 190>150. Then FBG started to hit 86-95. BUT I wasn't on any sort of low carb diet nor was I focusing on longering BG.

My target now that I want to get BG lower is a A1C of below 5 and FB of 85 or lower. (I realize A1C isn't a perfect indicator, just a generally used test). One hour post-prandial of no higher than 130 but move like 120, 2 hour post-prandial should be 100 or less.

I am going to take 500mg metformin twice a day which will help a lot to achieve this, but without metformin I think a1c of 5.2 and FB consistently below 100 isn't hard to do for me.

I am not sure, what is an ideal A1C level? (Assuming no confounding factors).