4 Things that Helped Lower my A1c from 10% to 6%

My HbA1c has never been terrible over the years but nor has it been particularly exemplary. At an all time high of 10.1% last year I decided to spend a bit of time and effort bringing it down for the next result. Here are some of the simplest and biggest factors that helped me.

1. Pre-bolusing properly
Pre-bolusing is taking fast acting insulin before eating, rather than at the same time. This concept is widely known and common practice for most diabetics, but most of us aren’t seeing much of a benefit, if any, because, like so much of diabetes, it’s easy to forget and hard to balance with the rest of life and we commonly inject only a few minutes before hand. Since even the best fast-acting insulins take at least 10 minutes to start working and don’t reach peak for about an hour, this means we’re essentially gaining a fraction of the benefits to consistent blood-sugars that we would be if we pre-bolus earlier.

I spent a bit of time builidng the habit of bolusing before I even start cooking- typically 30 minutes before hand but sometimes as much as an hour if I know my blood sugar is a little high and I know I’m not going to be interupted or have to do anything between injecting and when I eat. This is important because it’s all to easy to go too far with this practice and start suffering way more hypos because you forget to eat or get distracted by a friend at the door or any other event but with practice and consistency you can build this into your routine and pre-bolus by a lot longer for at least one meal of the day.

2. Eating less carbs
This is probably the first thing I’d recommend for early (but not new) diabetics suffering from high a1cs and high blood sugars. Carbs are the single biggest factor when it comes to insulin and blood sugars and nothing will have more of a positive effect than getting this right. The dietary recommendations in most western countries recommend high amounts of carbs (60% here in the UK) mainly because of fibre, and I could discuss and soapbox in length why I think this is a ridiculous and unhealthy recommendation but suffice to say I’ve personally found no good reason to consume anything more than 5-10% of your diet as carbs.

The internet is awash with low-carb diets and some work better than others for different people. I’ve tried most of them and have concluded that, for diabetes, they’re all different angles with the same principle- less carbs. No matter how you go about it- whether you prefer high protein, high fat, both or any other variation just keep your carbs generally low. Keeping the guidelines as wide as possible leaves you with more room to eat what you want and in my experience, less chance of falling back on high or refined carbs.

Dr Bernestein recommends less than 10g of carbs per meal and the Keto diet tends to recommend less than 50g or 20g of carbs per day. Again, I don’t recommend being so specific because everybody is different, as an 86kg power-lifter recommending 20g of carbs per day for both myself and say a 45kg young girl who does light exercise doesn’t make sense. Eat less carbs and adjust over time to suit your needs and find what you can consistently stick to and you’ll reduce your a1c over time as a result.

3. Eating more fibre and fat
As I said above, other than some circumstances for specific types of people, I find sticking strictly to diets usually doesn’t make sense and eating carbs is still a regular part of my diet, albeit in small amounts compared to most people, but by eating fibre and fats along with the carbs I do eat, I blunt the small blood-sugar spikes even more. For example, I like to eat small amounts of carbs both before and after gym workouts to keep my muscles fueled by glycogen. For this, I choose to eat oats, lentils and other foods which have a combination of high fibre and slow-acting carbohydrates resulting in a very low GI. I then add more fats and fibre wherever possible to effectively lower the GI even further- with oats this might mean coconut oil, pumpkin seeds or macadamia nuts. With savoury meals like lentils or beans this might mean more leafy or fibrous green vegetables, broccoli and the likes.

Other useful high fibre foods or high fat foods that can be included in many simple dishes include flax and chia seeds, avocado, many types of nuts and even some berries.

4. Setting my standards higher (or lower)
Another important thing that helped me lower my a1c wasn’t a physical thing at all but a mental shift. When I was first diagnosed diabetes was still uncommon and advice was sketchy at best. I was told by some doctors that an ideal blood sugar level was between 5.0mmol/L and 7.0mmol/L and others that less than 9.0mmol/L was perfectly healthy. It wasn’t until years later that I came to terms with the fact that the only truly healthy blood sugar range was that of someone with a functioning pancreas, that of someone without diabetes, which is a resting blood glucose of 4.0mmol/L and up to 7.8mmol/L an hour and a half after eating, which means an a1c of below 42 (6%). This is lower than the recommended level for diabetics, presumably because preventing dangerous hypos is a big consideration, but to aim for higher blood glucose levels as a result rather than aiming to be more tight with them seems to be throwing the baby out with the bath water.

Understanding this and coming to terms with the fact that I should be aiming for an a1c of 6% or less and resting blood glucose levels as close to 4.0mmol/L as I could manage suddenly made sense and I no longer felt like I shouldn’t try as hard just because I have a non functioning pancreas and I’ve been labelled as diabetic- in fact it means the reverse, that I should try harder.

When Did You Start

When did you start Photography?
I bought a Sony A5000 in October 2015 but didn’t take anything more than a handful of snaps on auto until extremely basic food photography in May of 2017 which is also around the time I started taking more than a shot every two months. So I’d say 2017 but for the sake of being anal it would be the end of 2015.

When did you start lifting?
I walked into a gym for the first time on the final days of December before 2016. I started off with a handful of arm exercises like dumbbell curls and dumbbell flyes because I had no idea what to do or even how to do basic things, nor any idea how to use any of the machines. I was also extremely self conscious. I began a very loose version of Arnolds Golden Six routine 3 months later (March, 2016) and added Deadlifts another 8 or 9 months later, so somewhere around November of 2016. I started Clean and Jerk in September 2017.

When did you start cooking?
Other than burgers and heating up processed foods, it was probably around the age of 17 or 18 I cooked things that could be considered home cooked meals.

When did you start coding?
I tried HTML and making websites when I was 13 or 14, the first website I remember making was called the Red Alert Construction Yard and was specifically about the video game Command and Conquer: Red Alert. It was a hub of useful information, screenshots and some weird stuff I tried making and I remember gaming hubs didn’t really exist at that point but of course later they became huge.
I discovered PHP at age 15 (so 1999?) and played a game called Planetarion at the time. I wanted to create something similar but also teach myself web programming so I made Colony-Wars.com which was a browser based MMORPG about colonising a planet and mastering technologies and structures to create fleets of ships and attack and defend with nearby planets for resources. I created the majority of it over 2 years but added to it and refined it over time. So I taught myself PHP, MySQL, Javascript and a few other things from 1999-2001.

When did you become diabetic?
I was hospitalised after falling into a coma and diagnosed as a Type 1 diabetic in June of 2001. I woke up 2 weeks later and was discharged 2 days later. I was showing symptoms for approximately 2 months prior.

When did you begin a low carb diet?
I ate very high carb (approximately 150g+ per day) from ages 20-26 but had eaten fairly healthily and probably somewhere around <100g carbs/day before then. I slowly began experimenting but didn't move back under 100g/day until 2016, a few months after I joined the gym. I tried keto for the first time in late 2016 and again briefly in 2017.

How I got to a 200kg Deadlift

This weekend I managed a 200kg Deadlift for the first time. It’s by no means an impressive feat or a high number in terms of the Deadlift, but for someone like me who’s been lifting less than 2 years working on all round strength I have to say I’m very happy about it and after slowing down and taking a moment to reflect on my lifting progress I’m even proud of where I’ve gotten to.

In all flat, boring honestly, getting here hasn’t been difficult, but nor has it been particularly easy and the unexciting reality is that I’ve pretty much done the same thing since the early days and relied on nothing more than simple consistency and fixing any broken links in my chain to progress. Ultimately, no matter what the popular YouTube video titles or fitness industry will try to have you believe with fancy marketing and aggressive phrasing, everything in fitness is pretty simple, pretty easy and, at least from the outside, pretty boring.

With that said, there are some things I wish I’d known sooner, some things that greatly helped me and some general advice I’d like to pass on to anyone who may find it useful. First off, here’s a quick background.
I’ve been lifting for 1 year and 8 months now. I entered a gym for the first time in my life at age 31 with the New-Year-Resolution crowd in January 2017 and started doing Squats somewhere around 3 months in. I quickly progressed in Squats and still feel like I have somewhat of a genetic advantage for the squat in particular- perhaps it’s because I’m Scottish that I’m predisposed towards a short & stocky frame, strong bones and strength, or perhaps it’s because of my love of Oats (Oats & Squats are like Peanut Butter and Jelly) or maybe it’s just that I’m a bit of a short-arse. Whatever it is, the Squat has always been my best lift and was always ahead of the Deadlift for me, though I will say that’s in large part because I didn’t start Deadlifting until a good 8 or 9 months into lifting, mostly because I was loosely adhering to Arnolds Golden Six for almost a year, which is a minimalist routine lacking in a lot of areas, particularly the Deadlift. I reached 180kg x5 on Squat just last week and I haven’t tried a 1RM for a while but I’d guess it’s probably on par with my Deadlift just now, which means this is the first time my Deadlift number hasn’t been lower than my Squat, but again that’s mostly because I’ve focused far more on Deadlift than Squat in the past 2 months and had I been doing both in equal measure I reckon my Squat would still be a good 20kg more than my Deadlift.
After adding the Deadlift somewhere around November 2016- I started at somewhere around a 60kg Deadlift, usually something like 3×5, I quickly progressed up to 150kg by April 2017 with little trouble, mostly because my legs were already strong from Squats (which, for reference, probably went from 120kg to 160kg within this same time period).
In the very early days form was a big issue and something that helped me greatly. Watching YouTube videos and practising in front of a mirror helped me improve somewhat but it wasn’t until I found Joe DeFrancos Video on Deadlift form that I really knew what I was doing. This video is fantastic because it’s ultra simple and minimalist while giving you enough to get a good grip, grip width, foot stance, head and chest control and a great starting position with one or two simple cues.
After reaching 3.5 plates (160kg) on Deadlift I found it difficult to maintain my grip for more than 3 reps and made my first mistake-
I watched some YouTube videos and read some reddit posts and got the idea that avoiding things like chalk and straps was the better choice because relying on those would stop me from improving my grip strength. I spent another month or two adding farmers walks and still failing to grip much more than 150kg for 3 reps. Eventually I relented and made the intelligent choice to buy lifting straps and instantly added 20kg to my Deadlift. I was progressing again and have been adding close to 10kg per month since then.

To recap and surmise, the biggest and best advice I can give from my limited experience progressing on Deadlift is-

  • Take the single cue of pushing against the inner side of your eblows with your knees when you’re new- this will keep you right most of the time and propel your form quick.
  • Adding things like Romanian Deadlifts, Sumo Deadlifts or other variations will help you progress but not as much as simply doing more standard Deadlifts alone (unless you’re particularly weak somewhere). Do more Deadlifts to do more Deadlifts.
  • Stick with whichever grip works best for you. Early on (less than 100kg) this means double overhand for most. Once this isn’t enough (for me that was at 100kg->150kg) you’ll probably want to use a mixed grip. Once mixed grip doesn’t cut it any more (for me this is 150kg and upwards) lifting straps are not to be avoided for ego reasons.
  • If strength is your goal, 3×5 is enough, but lift as often as your body and diet will allow if you want to speed things up. For me this is 2.5x per week with Squats 2.5x per week also, alternating between medium and heavy days to give myself more time to recover.

Diabetic Annoyance #2

Some lucky diabetics in the first world have affordable access to CGMs and Blood Glucose Sensors but the rest of us still rely on old fashioned finger pricking and test strips to find out where our blood levels are and what they’re doing. By finger pricking and testing once before and after having something to eat we can usually keep things nice and level but since most of us eat several times per day and when you add things like exercise to your day those finger pricks quickly add up and having to prick 10+ times in a single day is not at all uncommon.

One of the most annoying things is just how imperfect and inconsistent everything can be- lancets, meters and our fingers all change from day to day and with that inconsistency we often have to prick the same spot multiple times to get a reading. Few things are as annoying in diabetes management as pricking your finger on a low lancet setting like 2 to find out it isn’t enough to squeeze out a drop, bumping it up to 3 and still nothing. Finally out of frustration we move to the other softer side of the finger and bump it up to 4 then give it a squeeze only to find out we’ve accidentally opened the Seven Floodgates of Hell and multiple punctures on our finger start gushing blood like we’re pushing pomegranates through a sieve, airborne squirts and all.

4 Fundamentals of Weight Loss I’ve Come to Realise

1. Failure is an essential part of the process
One of the most common reasons weight loss fails is because it’s seen as a rigid thing which will either succeed or fail. In reality, it’s a process which will both fail and succeed simultaneously, and that’s an essential thing to come to terms with. Whether you decide to dive head-first into fasting or eating at a severe caloric deficit or you take a slow steady approach of eating just 200 calories less for a few months you’re still probably going to fail, and often. Whether that’s failing to record your calories one day or binge eating at the weekend you still have plenty room for error if your goals aren’t too rigid and from those errors and mistakes you realise what you’re good at and what you’re bad at, you come to terms with and get to discover the reasons you binge eat or forget to track because those failures shine a spotlight on your thoughts and choices and actions. Over time as you’ve failed more and more times, you’ll begin to fail less and less often because you’ve found ways to manage those weaknesses or situations.

2. Patience isn’t necessarily a requirement, but consistency is
Most popular weight-loss diets, websites and celebrities will tell you about patience and how you need to slow down to get things right. Others will recommend things like prolonged fasting and tell you that losing weight is healthier or more natural when it’s quicker and that by shortening the time you spend being uncomfortable you’ll maximise your results. The key thing here is that different things work for different people and taking 2 years or 2 weeks to lose the weight you need to are both absolutely fine so long as you reach your result, ultimately only consistency matters- whether you stick to your diet or not depends on the balance of discomfort you’re able to tolerate and the effort you’re willing to put in and finding that balance is a matter of trial and error but you will eventually find the level that lets you remain consistent, and once you’re there you’re set for almost inevitable success.

3. Follow the many AND the few
Facebook groups and Instagram channels are a particularly conflicting and sore point for me- I find them fantastic for finding people who are like me- trying to lose or gain weight and others who have already lost weight and overcome significant challenges, but at the same time they’re full of people following trends, fads and pseudoscience of all sorts from Alkaline/Acid balancing diets to ingesting dangerous chemicals and everything in between. So it’s very important to find people who have succeeded and to listen to their advice because it’s what has worked- but since weight-loss is a multi billion dollar industry and many successful people are willing to distort the truth to sell a product, it’s also important not to trust a damn word they say and check everything.
Similarly, pools of large numbers of people interested in the same outcome are an incredible resource because they can collect and collate relevant information and share their results which can benefit everyone else, but again the herd-mentality is a very real thing and marketing has a big interest here.
So joining and following the masses does offer practicality and benefit, and finding and following those few successful people who have taken the time to document what worked for them can put you on the fast-track and save you from making many mistakes, but for the best results you want to follow both but do plenty of research and make your own best choices.

4. Learn from people doing the complete opposite
Some of the best tips and tools I’ve come to utilise have come directly from people trying to gain weight. Bodybuilders in particular are a group who have spent years honing and crafting their diet and ways of eating to consume anything up to and over 10,000 calories per day. These are people at the uppermost level of ability when it comes to eating and gaining weight and the vast majority of techniques they use can easily be reversed and applied to weight loss.
Adding calorie dense foods like peanut butter to meals can be reversed into sticking towards calorie sparse foods like leafy greens and soups.
Eating more quickly so as not to get full can be changed to eating more slowly and chewing your food for longer so the stomach has time to send signals to the brain letting you feel fuller quicker.

Bonus Point I Forgot to Add: 5. Learn to think long term
Weight gain and loss are a lot like income and finance in that they become more behemoth over time and require more or less effort depending on time scale. The richest people in the world consistently attribute long term thinking and planning as the primary factor to their wealth and that by saving small amounts over time and starting businesses and launching before the products or services become mainstream puts them ahead of the flow and makes it easier to capitalise. Similarly with weight loss, losing a little weight every month involves far less effort than losing the same amount in a week and is usually the better approach. Small consistent changes to diet add up over time and often eating just a few hundred calories below maintenance is enough to get you where you want within a year. While I don’t expect anyone to become the Bill Gates or Warren Buffett of weight loss, I think adapting a longer term attitude and planning for the future as well as the present vastly increases the odds of success.

Silsden Butcher Review

Being on a low-carb diet, a cooking addict, and a massive nerd means I order and try a lot of weird and wonderful products, services and companies online and after trying both MuscleFood and LiveLean a try I heard about SilsdenButchers. All three of these companies use local produce and offer large meat packs intended for home freezing and I’d heard that SilsdenButchers was one of the cheapest options available anywhere in the UK.

Their Background
SilsdenButchers is, as the name suggests, a butchery shop based in England. They boast a 25 year history and their own farm with free range pigs, and have recently moved into online sales, posting daily deals on their Facebook page. The physical butcher itself has great reviews on Google and generally favourable reviews on their Facebook page for online orders, but at the time of writing I couldn’t really find any reviews or information covering their online deliveries. A google search turned out some unsavoury reports of Court fines over hygiene issues just a few years ago, though does seem to suggest they’ve since either met or improved standards. Not an encouraging finding but considering it’s a small, discount and relatively old-school butchery I guess it’s somewhat to be expected but something to be aware of.

My experience
I ordered one of their larger meat packs on the Friday with the idea of trying a little of everything to get an idea of the produce and quality, and with delivery to Scotland coming in at £7 my total came to £97. I ordered over their Live Chat system and, while a little concerned about handing my credit card details to a chat system which can and does save text, I was provided with quick and courteous service and told payment would be taken on the following Monday upon delivery. A few minutes later I was given a ParcelForce tracking number and all was good.. until it arrived a day late, the following Tuesday. Not a big problem, so I accepted the parcel and immediately regretted it when I went to pick it up- the smell of meat was overwhelming and there were several large damp holes in the box. I opened her up and found several of the packages had leaked blood and mixed together inside the package- not a pleasant experience at all. Not only had the packaging on the individual meat trays come lose or torn, but several of the items like the burgers had been flattened and turned into meat pancakes and there was quite an overwhelming smell of meat beginning to turn bad.
I phoned to complain and was asked to send photos to the proprietors phone by text- an annoyance but one I was happy to oblige and explained that I wasn’t willing to eat meat where the blood had mixed and which had been exposed to the elements at least overnight. Several minutes later and I received a call back to explain the package had been delivered by 48 hour instead of 24 hour express by mistake, and was supposed to be shipped in two boxes rather than one, which would’ve alleviated the pancake problem. I was given an apology and a full refund just 3 days later.

ParcelForce Delivery

In short, my experience was poor but I would say that the problem lied with the delivery service rather than Silsden, though I would’ve liked some better quality individual packaging for the meats rather than just Styrofoam trays with clingfilm over the top. All in all I wouldn’t order again, but since the fault lies with the delivery company and the meat, despite being bad, actually looked to be good proportions and quality, I wouldn’t let my story deter anyone from trying them out.

They have plenty range available and offer free delivery to local areas and since delivery time is presumably much quicker to these areas I wouldn’t be put off by my experience. Certainly the price is good- coming in cheaper than MuscleFood and LiveLean on many packages and individual items, which are both considered good value meat sources in the UK. Ultimately they’re a small business trying to make it and I have no hard feelings but due to the history and my experience I wont be ordering again.

Diabetic Annoyance #1 – Too much stuff

One of the most minor but common annoyances of Type 1 diabetes is all the supplies and equipment you need to manage and carry around with you. Compact glucose meters have come a long way since the Ames Reflectance Meter in the 1970s but even still most of them don’t fit in a jacket pocket and are a hassle to remember.

I don’t envy early diabetics who had no means of knowing their blood sugar when out in the world, and I’m glad medicine and technology have moved forward from there and that future diabetics will have less and less things to remember, replace and carry. One big benefit of pumps is that they allow freedom and the ability to be more spontaneous than you might otherwise be, though diabetics on MDI like myself may still prefer pens which can be carried around pretty much anywhere in a pocket. Some products are also moving towards multi functionality of supplying insulin AND monitoring blood sugars- meaning less to worry about and carry, and of course there are now several early iterations of artificial pancreases either built or available taking out more hassle and supplies. As time passes smaller and better equipment and more effective medication is inevitable, but for the time being this is still another thing many of us have to deal with- managing equipment like sensors, infusion sets, blood glucose monitors, test strips, lancets, batteries, chargers and cables, ketone testers, glucotabs or a source of sweets, cases, bandages and cotton balls, basal and bolus insulin pens or vials, sharps bins and plenty more. Here’s a picture of most (yup, not all) of the stuff I use to treat and manage my diabetes and help keep myself together.

Diabetic Paraphernalia

Of course having too much paraphernalia is a laughable problem when compared against not having enough or being unable to afford diabetic supplies, but it’s still a very real annoyance and another small thing we have to deal with so I have to joke about it and show the annoyance of having to manage too many things.