Saturday, August 11, 2007

One for the Road

Today's Song, Stuck on Repeat

... as I finish up the last 20 pages of the latest round of GW line edits. Fitting song for the last push of this, I think.

Burning Bridges - Christ Pureka

This is a story of burning bridges
and allowing time to pass
this is a story of forgiveness
and breaking things in my hands
this is a story of understanding
you can't choose who you love
and this is a story of soft skin
and rats in the walls

well you can't just pass along
the pain that comes around
you'll go dizzy until you fall
and I know you didn't mean to let me down
but you let me down so hard

this is a story of loaded glances
and leaning in too far
this is a story of vague advances
and confessions in smoky bars
so now I am walking down the sidewalk
and I am singing to myself
and I'm going to leave it all behind me now
'cause I don't need this,
I just don't need this

and you can't...

these memories are talking and talking
and I'll do anything to shut 'em up
I've got the pillow over my head
but they won't stop
no, no they won't stop

some fantasies are never meant to be
realized at all
and some regrets could be prevented
if you read the writing on the wall
oh and sometimes you say "you know nothing can happen"
and then she leans over and lifts off your glasses
and the next thing you know you're just tangled and guilty
and you've got a head full of liquor and perfume
oh and when did you leave me
and when did you find her
and tell me is this just what you wanted...

Fats, Carbs, Sugar and Inflammation

My last day in the hospital last year, I spoke with a nutritionist about my new "diabetic diet."

For those of you unfamiliar with how diabetes works, a short general explanation: I have an autoimmune disease which was triggered by "who knows what" but likely some kind of virus that told my immune system that the cells in my pancreas that produce insulin were foreign cells and needed to be slaughtered ruthlessly. Insulin is the stuff that enables your cells to pull the sugar/glucose out of your blood and use it for energy. Everything you eat is converted by your body into some amount of glucose, but the amount of glucose depends on the type of food you eat. Vegetables, meat, eggs, cheese, any sort of protein, these foods all have a really, really low to 0 glucose conversion rate. I can eat cheese to my heart's content and not worry about my glucose levels.

I have to take a shot of insulin every time I eat a substantial meal (snacks like cheese, small amounts of nuts, some carrots, I usually don't bother, cause it doesn't affect my sugar by more than like 10 points or so). The insulin clears the glucose out of my blood by enabling the cells to process it; the cells sweep the glucose out of my bloodstream, and all is well. High blood sugar, or consistently having high blood sugar (particularly over 180/200 or so), means your body gets sluggish, you can't think properly, wounds take longer to heal, and your body slowly breaks down because it can't get enough energy from the food you're eating; all that sugar's still stuck in your blood, turning you into one big slushy. Being a slushy is very uncomfortable. Believe me, I know. Eventually, when you get over, say 700 or 800 or 900, you go into a coma and eventually die because your heart and brain can't get enough energy to survive.

Complex carbs like straight sugar, juice, donuts, bread, pasta, stuff like that, that's all pretty much pure glucose. Your body just immediately converts it all into sugar. Pizza is often the worst to deal with, because the absorbtion of glucose is slowed by the cheese, so by the time your insulin whot hits (30-90 minutes after you take the shot) and you think you've got it all covered, you get a slow spike overnight or during the day and end up with another high number. It's complicated and a pain in the ass. Anyway, high sugar foods tend to give me headaches for the hour or so I eat them before the insulin kicks in, so as a general rule, I avoid them. They also make my life miserable insofar as trying to calculate the right amount of insulin to take, cause I don't eat them all the time and so don't have a correct set amount (except for, say, pancakes, which I eat on weekends. Because I eat a pancake every weekend, I know the exactly right amount to take, and I use whole wheat flour, so the glucose is absorbed slowly, and doesn't give me that sugar-spike headache).

So, now, knowing all of this, you would think that the overwhelming recommendation for diabetics, then, would be to eat a low carb diet, right? I mean, that's what I do: it avoids sugar spikes and means I use less insulin and have less glucose in my blood at all times. Sure, there's the occasional splurge, but for the most part, living on tortillas instead of bread is a great idea if you don't want to feel like a sluggish lump all day. Surely, doctors recommend this kind of thig?


Well, wrong as of about 1940 or so. Prior to that, and especially prior to the advent of insulin in 1921, people realized that those t1 diabetics who ate a low carb diet and exercised vigorously lived longer than those who didn't.

What changed?

The food pyramid. Farm subsidies. Our American obsession with all things corn-related began, and we started ingesting high fructose corn syrup and filling stuff with carb-laden fillers. Suddenly, carbs were in and fat was out, and Americans started suffering from a lot of health problems like heart disease and diabetes that they hadn't seen much before. Some of that, of course, was due to the fact that we didn't use to live as long. But some of that was because high levels of glucose in your bloodstream will wear down your arteries over time; they create a higher level of inflammation in your arteries, which increases your body's resistance to insulin, which means your body pumps out more insulin, which means you become more resistant, and the more insulin you produce, the more weight you gain, the more insulin resistant you become, the more insulin you produce, the more weight you gain... and etc.

In this study out of Hamburg, Germany, researchers recently compared artery inflammation (which is correlated with the breakdown of said arteries) and how severe it was based on one of three kinds of fast food meals from McDonald's that they ate: high fat, medium fat, low fat.

They honestly thought that the low fat meal was going to have less of a damaging effect on arterial damage. I mean, less fat, less damage, right?

So there are big differences in the fat grams of each meal, but if you actually look at the carb count for all three meals: it's exactly the same.

The result?

All three meals damaged arteries in the same way.

As Jackie pointed out in the comments section to another post, inflammation and insulin resistance are linked. The more inflammed your arteries (which is what happens when they have to process a lot of glucose produced by ingesting lots of carbs), the more insulin resistant you are. I highly suspect that this is why taking a couple of vicoden for the past week has resulted in sugar numbers that have not once tested above 120. Even during a "good" week, I'll have a 130 or 150 number on occasion. The last number I saw that was over 120 (134) was on the 30th of July (have I also mentioned that that extreme hunger I've been experiencing all day has been totally nipped in the bud? I'm not hungry until lunch, am full before I finish eating lunch, and not hungry again until dinner: you know, like a normal person. I've been desperate to figure out why I was suffereing from this extreme hunger all the time, and living without it is... is... really nice).

As one response to the study says:

... eating is an inflammatory event just like breathing. We have to do both, but we pay the price. During inflammation the endothelial cells don’t function optimally. So getting rid of the huge load of carbohydrate and the accompanying inflammatory effect of the food (and, don’t forget, high glycemic carbs are the most inflammatory of all the macronutrients) inhibits the normal action of the endothelial cells. Anyone with half a brain and a rudimentary knowledge of the nutritional aspects of physiology would have predicted that the FMD would have declined about the same with all of these meals.

And another response to a wealth of other studies on inflammation:

What the nutritional research appears to conclude in the aggregate is that the processes involved in the things we worry about (e.g. cardiovascular disease etc.) are actually inflammation-based and linked to both existing levels of bodyfat (primarily visceral fat) along with insulin. Consumption of fats -- from plant sources, fish, and "good saturated" fats -- ameliorates much of these processes, and controlling carbohydrate intake does the rest. I even read a new study yesterday about the link between inflammation and cancer. Substances such as TNF-alpha and IL-6 are starting to look very nasty indeed, and these are definitely linked to visceral fat deposit and carbohydrate intake.

What I find stunning, then, is that 1) diabetics, like me, are still told to eat a high carb, low fat diet (what saved my numbers was reading Dr. Berstein's The Diabetes Solution, written by a t1 who's done a lot of study on the effects of low carb diets and diabetics) 2) never once told to, say, take a couple aspirin or ibuprofen every day to cut down on inflammation caused by eating and therefore even out my numbers cheaply.

Instead, my last endo wanted to give me blood pressure medication that made me dizzy (my blood pressure was already low to begin with), get me on metformin (which costs a shitload more than aspirin, let me tell you), and I've been searching desperately for some kind of anti-depressant cocktail that might in some way assuage my appetite.

Hundreds and hundreds of dollars worth of drugs....

You know how much I paid for my generic version of vicoden?