The Plan and the Tools

I have to admit my Type 2 Diabetes diagnosis had not surprised me. I was in denial about my weight, lack of exercise, and poor diet. Once I got the news, I didn’t sit around feeling bad about it. I sprung into action. It was as if I gained a few extra points of IQ, recognized my exact position, and made an immediate resolution to beat it. I surprised myself.

The plan was simple. Lose the weight by altering my diet and starting an exercise program. By getting my weight under control, I might get my body’s systems back in balance, and reverse the diabetes. I wanted to take a data driven approach to everything I was doing. I wanted to watch the variables and measure results. I also believed seeing the results, viewing the data, would keep me motivated. If you can’t measure a system, you can’t improve it.

In those few days after my diagnosis I set a weight goal. Given my height and build I should be somewhere between 180 and 220 lbs. So I needed to lose about 50 lbs, a big goal. I had decided that reducing carbs and getting more proteins, an Atkins like diet, would work for me. I had had some success with it in the past, now I had a good incentive to do it right this time.
My weight was the big variable and tracking it would be critical. You can screw up a low carb diet and actually gain weight. Measuring my weight every day would help me fine tune what I was eating. I wanted this data capture to be very simple, so I ended up buying a Whithings Body Scale. Data capture is automatic. You weigh yourself and the scale updates your data over WiFi on the Withings site. You can view the data on their web site or with a free iPhone app. It’s pricy but it simplifies and makes weigh-ins more fun.

The second part of the plan was to get moving again. I did enjoy running in the past but though the easiest thing to do was to start walking. I set aside time every day to walk. The calories I would burn in conjunction with the low carb diet would help me take off the weight. I thought eventually I would start running again as the weight came off. For tracking my exercise and calories burned I chose RunKeeper on the iPhone. I love this app. Again it makes data collection, tracks all aspects of my workout, and keeps me motivated by alerting me to personal bests like “Most Activities in a Week” or “Longest Distance in an Activity”.
For testing and tracking blood glucose I’m using a Contour Blood Glucose Meter and the BGluMon – Blood Glucose Monitor iPhone app. This part of my toolset isn’t so automated but it is simple. The Contour unit it pretty easy to run although it does take some time to getting use to jabbing yourself for blood, but these new monitors require so little blood. (A tip from my doc: stop sticking your fingers. You can get all the blood you need from the outside edge of your palm.) BGluMon is also pretty simple to use and it was the easiest most helpful app I could find to run stats on my blood glucose readings. I’ve shown the graphs it generates of my numbers to my doc during visits. Very handy.

The one big variable I’m not tracking closely is my calorie intake. I can’t seem to find a tool that will help me do this with minimal fuss. My rational here is that if I can keep the carbs out of my diet and if I can keep my meal sizes down, I won’t need to sweat the calories in count. I’d like to fix this eventually.

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The Plan and the Tools

282 – 384

On December 28th 2012 I was sitting in the examination chair in my ophthalmologist’s office. He was jotting down some notes on the eye exam I’d just taken and failed. Since November of that year my distance vision was getting worse. It was so bad I was having trouble reading street signs while driving. Degrading vision isn’t uncommon in 40-somethings so naturally I just needed glasses. Then my doc hit me with some questions.

“Have you been thirsty, like a lot?”

“Yeah.”, I replied.

“Peeing a lot? Especially at night?”

“Yeah.”

I don’t even remember the third question because in that moment I new he was going to tell me. I had diabetes.

2011 was not a great health year for me. Work/Life was out of balance. I had let things go. I flew 100 thousand air miles that year. I was on the road getting little or no exercise. My diet consisted of fast food and big nighttime meals with clients. I had ballooned to 282lbs. I’m not sure what I was thinking, but subconsciously I felt the bill was coming due. I had already set up an appointment with my General Practitioner for the day after my eye doctor. In hindsight I should have flipped those appointments around.

“You are diabetic, or pre-diabetic.”, he said. “Your GP should confirm this. Oh and don’t waste money on glasses just yet. The problem with your eyesight is probably just executes water and glucose swelling the lenses in your eyes. It’s likely to clear up once you get the sugar under control. Ok?”

“Sure.”

“And loose some weight.”

I walked home in a mental fog. When walked in the door I told my wife the news. She wasn’t surprised and didn’t hit me with the “I told you so” routine. She was great. We knew this would mean big changes but the lifestyle modification (better diet/more exercise) wasn’t a bad thing. Still I think I stayed home the rest of the day, sitting on my comfy chair, expecting to literally explode or something. It’s funny. I had had periods of “healthy living” in my life but I had always fallen off that wagon. People always warned me this day would come. It was a wakeup call. Thankfully it wasn’t in the form of a heart attack or something really debilitating. This diagnosis (or pre-diagnosis) seemed like a second chance.

The next day at the GP he checked my blood glucose which came in at a whopping 384. Normal blood glucose is around 100.

“Wow. You are certainly diabetic. Most likely type 2.”, he said raising an eyebrow. “I’ll need to get you on some meds…”

“I can’t fix this with diet and exercise?”, I interrupted.

“No. With these numbers your body needs some help. Take this prescription get it filled and take it immediately. Test your glucose in the morning with this monitor I’m giving you. If it doesn’t go down tomorrow you may need to get to the hospital. It should go down, but call me either way when you test.”

He took some blood for an Ha1c test. It’s a test that yield a sort of 3 month average of blog glucose levels.

I had some questions. He took the time answered them all. Turns out, he is also diabetic. An insulin dependent type 2. He explained his trajectory through diabeties-space. I couldn’t ask for a better doctor/coach for this phase of my life.

“What about alcohol?”, I asked bracing myself for the answer.

“No booze for now. Especially on the medication I’m prescribing now. Later, we’ll see.”

I had expected this. I figured that I’d ask. I know there are diabetics out there that do drink, but I didn’t want to deal with too many variables at once. Shutting down the drinking would be ok for now.

“The best thing you can do right now: take your meds, watch your diet, and loose weight. It can be that simple.”

The next day, I tested. My blood glucose was 200. I called my doc. He was pleased. He told me it should continue to decrease but to call him if it didn’t or if it got too low. No hospital visit for me. My Ha1c number was 14.7%. Not a great number. A non-diabetic person will have an Ha1c number between 4% and 6%.

That’s how it began. I made some big life modifications that day. I bought some tools, started my exercise program, my diet, and started tracking my numbers. I also set a big goal. I wanted off the diabetes medication. I was going to turn my body and the disease around.

282 – 384