Hi Rien,

Thanks for your progress update!

I suppose you found the Excel version of the log on the Log Blog?

I have been doing this for so many years that it is second nature and I often don't realize that it is indeed quite a learning curve for someone just starting. Additionally, I believe that only the method can be conveyed, but the specifics of the insulins, foods and timing cannot. I believe it is all extremely personal and dynamic. My personal doses are always changing as life changes (not referring to age). In fact, the sample log I placed on the Log Blog is not really a good example because that was taken during a "contaminated" period and is not my best. Still getting over that. (FYI; it took a while to figure this one out, but the contaminate, of all things, turned out to be body lotion! No, I wasn't eating it, but I found that the oil in the lotion absorbs through the skin and induces insulin resistance just as if I had eaten it! Live-and-learn!)

Personally, I do fear spikes and believe they are harmful. Do be patient! The snacks are "medicine" that is a major element of this control method and since there is always a delay, you have to learn, by experience, how to predict and precede the snack type and dose. It took me a few years to figure it out, so don't think a week is being slow! You will have to learn what each fruit's onset, amplitude, ramp-rate and duration is. I believe it is probably different per individual, because there are a zillion different variables that affect each of those specifications which is dependent on what's going on in one's life at the time. It varies with me as my life takes different turns; activity, stress levels, weather, just too many to list. The general characteristic of each fruit remains the same, but the fine-tuning details change and are what's needed to sync the timing and amplitudes.

Every morning, I inject fast insulin (Humalog) first thing out of bed. This counters the "wake-up" glycogen that is output by the liver and expected to be matched by insulin from the pancreas to ramp up metabolism for the wake-up process. That is typically 1 to 3 units. I skip it only if my wake-up BS is below 70 mg/dl.

Breakfast is my largest meal, typically sweet potatoes (largest portions), greens (spinach, etc.), steamed fresh beets, mixed beans and an orange. I take a large Humalog dose about 10 minutes before the breakfast. This sets BS level for about an hour then starts down ramping, which I fill in with a fruit snack (before I actually get low).

Yes! It is easy to overshoot with the fruit snacks! It will take time to learn the timings and doses. Keeping insulin sensitivity as high as possible is important because it shortens the delay of everything. The longer the delays, the harder it is to predict and synchronize everything. If the delay is too long, it will never sync. I have found that fats are the greatest killer of insulin sensitivity. I believe that is rarely known because the slow onset and long duration obscures the connection.

I never worry about calories (carbohydrates) - except to get enough. With the "both-ends" method, I no-longer count calories. And, as far as weight gain is concerned, I have learned by experience and observation that Dr. McDougall is absolutely correct that "The fat you eat is the fat you wear". Regardless how many calories I consume and regardless how much insulin I inject, I never gain an ounce in weight. It is only the fat that gets stored as fat, which I avoid like the plague. I have conducted may experiments to that effect. The latest was at the McDougall Hawaii Adventure where the food was provided. For five days, I stuffed myself miserably full of potatoes, rice, etc., every meal every day. After the end of the week, I had lost 1/2 ounce. In reality - no change. Also, no loss of insulin sensitivity.

I suppose one could say that the "both-ends" method is more tedious than traditional, but I don't feel that way, probably because I have been doing it for so long.  I do however, believe it works. I believe the effort of preventing spikes is what has prevented me from suffering any diabetic complications after all these 30 years. Besides, I find the spikes feel bad - feel damaging.

Please keep us posted on your journey!

Ken

Hi Ken et al.

I have been following your blood sugar control method for a week now. The software for my Abbott Freestyle Libre glucose monitor has a forecast HbA1c function. It was 5.8% before, but over the last week the estimate dropped to 5.2%! Usually the estimate is pretty close to the actual Lab number.

I have copied and modified your log for Australian units of measure, exercise and my personal insulin types. It is quite valuable.

Slowly I'm getting the hang of correctly estimating rapid insulin quantities, catching lows early enough, and taking just enough snacks. It is easy to overdo it, and go high ?.

I have tried flattening the post-breakfast spike with insulin. While I can do it, I think it's safer to skip breakfast rapid insulin. Straight after breakfast I ride my bicycle 40kms, and I need enough fuel in the tank. Yesterday I injected 5 units, had no spike, but 20km into the ride my sugar was down to 4.0 mmol/L (72 mg/dl). Not enough to get home. I snacked, and then again at the 30km mark, and again when I arrived home. All up I consumed an extra 300 calories, just to keep up with the injected insulin.

This morning I did not inject. At 20km my glucose was 7.9 mmol/L (142 mg/dl), on its way down after peaking at about 10 mmol/L (180 mg/dl). At 40km it was 4.6 mmol/L (73 mg/dl). No snacking required, and no anxiety about whether I was going to make it without crashing my numbers. I hope the brief spike is not too damaging.

Thanks again for all the work you have done to document and publicise your method.

Rien

Ken - Thanks so much for all of your efforts. What you are doing is very intriguing and impressive. Would you mind (if you haven't done so already) sharing a sample meal plan for a week. I'm curious what you eat on a day to day basis.

Thanks again!

Trey

This is an answer to KM Idamari's question on the interview page:

Hi KM Idamari,

Yes, I have routine lab work and no, I'm definitely not in ketosis. Not even once since 1989. To be passing ketones, one must be very insulin resistant. I'm not losing weight or fatigued and it's been this way since 1989.

Blood-sugar control of a T1D is open-loop due to the absence of insulin producing beta cells. Therefore, the diabetic, his/herself, must close the control loop. Thus, the resulting blood-sugars are dependent on their control. Whatever a T1D's blood-sugar is - they put it there (whether they realize it or not). My goal is 80 mg/dl with a 70-100 mg/dl limit window. I don't always meet that, but I purposely lean it to the low side. I just take more insulin to keep it that way. My insulin doses are set by the blood-sugar, not the other way around. It's important to note that a healthy non-diabetic's blood-sugar is normally below 90, so that is where I adjust things to keep it there. It has been my goal, from the start, to match or beat normal, non-diabetic blood-sugars.

I have had doctors tell me that blood-sugars spiking over 130 mg/dl (even into the 200's) is not harmful, but I don't believe that. The same doctors also tell me that even with the best possible control, T1 diabetic will still suffer diabetic induced complications, but I realize that is because their control method allow and promote such spikes.

My diet consists of about 5-6% fat, 6-8% protein and the rest is all carbohydrates. A major element of my control is keeping insulin resistance as low as possible. In that effort, I am an obsessive low-fat fanatic. I won't eat anything that contains any ingredient (not even a sprinkle) that has greater than 10% fat calories. No nuts, seeds, avocado, not even oatmeal that has 25% fat. This is to keep insulin resistance down. And it's working. My health and vitality has been on a steady ascent for the past three decades.

Best Regards,

Ken