Observation: Diabetes, Metformin (Glucophage) and Ketosis

Hi Folks;

this week I made a very interesting observation that some of you may find
useful. Please remember this is just an observation based on one week and
should be viewed in that light.

I am a type 2 diabetic, diagnosed about 2 years ago. I have been low carbing
(around 20 carbs a day) consistently for the last 2 years in a very
successful effort to control my blood glucose and cholesterol levels.
Although successful in controlling my diabetes I have lost very little
weight low carbing and have found it difficult to get into ketosis. Once in
ketosis (usually induced by fat fasting) anything above 20 carbs would kick
me right back out. I talked to my "Pro Atkins" Dr. about this and her
position was that often diabetics simply have a really hard time loosing
weight due to the extra insulin in their systems. Insulin apparently signals
your body to store fat and even when in ketosis too much insulin can break
down the process. Diabetics may not respond as well as non diabetics to the
insulin lowering effects of a low carb lifestyle because their body may need
to produce significantly higher levels of insulin than non diabetes to
manage glucose levels. The only thing that I have found to be effective for
weight loss has been "fat fasting" and that only marginally. My experience
has been that if I dropped 5 lbs "fat fasting" then I would put 4 of it
right back on ;(.

Last weekend I read several articles about Metformin and its effect as a
weightless agent for diabetics. As chance would have it I take Metformin (2
x 850 per day) and have never had any significant weightloss that I could
attribute to it. As an experiment (and I DO NOT RECOMMEND YOU DO THIS
BECAUSE YOU MIGHT JUST KILL YOURSELF!!!) I upped my dosage from 2 x 850 a
day to 3x 850 a day. The results over the last week have been notable. First
I have been in serious ketosis (strips are at the very darkest end of the
range) for the first time in my low carbing experience. I have never been
able to get more than the slightest hint of ketons on the strips. Secondly I
have dropped 3-4 lbs since last Sunday. Thirdly I am not chronically hungry
all of the time and that is very weird indeed. And forthly... I feel a
little smarter / sharper than I usually do (that could be from the Holliday
Inn Express I stayed in though .

I am well aware that one week in the life of a low carber is nothing more
than a bump in the road but I thought I would share this with you. The only
other thing that MIGHT have something to do with my experience this week is
that I started taking CLA (Conjugated Linoleic Acid, a weightloss supplement
of arguable value) a couple of weeks ago. I intend to stop taking the CLA
this week to see how things go without it.

Ill post my continuing experience with this next week.

CSmith

Chris Smith wrote in message 1065999000.977003@savina...
Hi Folks;

. . .(snip). . .Although successful in controlling my diabetes I have lost
very little
weight low carbing and have found it difficult to get into ketosis. Once in
ketosis (usually induced by fat fasting) anything above 20 carbs would kick
me right back out. I talked to my "Pro Atkins" Dr. about this and her
position was that often diabetics simply have a really hard time loosing
weight due to the extra insulin in their systems. Insulin apparently
signals
your body to store fat and even when in ketosis too much insulin can break
down the process. . . .(snip). . .
Last weekend I read several articles about Metformin and its effect as a
weightless agent for diabetics. As chance would have it I take Metformin (2
x 850 per day) and have never had any significant weightloss that I could
attribute to it. As an experiment (and I DO NOT RECOMMEND YOU DO THIS
BECAUSE YOU MIGHT JUST KILL YOURSELF!!!) I upped my dosage from 2 x 850 a
day to 3x 850 a day. The results over the last week have been notable.
First
.. . .(snip). . .

Ill post my continuing experience with this next week.

CSmith

There are hundreds of thousands, perhaps millions of diabetics taking 3
x 850 mg metformin per day. That is the standard "maximum" dose.

Many folks find that 2 x 850 mg is about the minimum "effective" dose.

Your experiences do not seem too unusual in light of these other folks'
experiences.

I applaud your inquisitive and aggressive approach to the disease. Keep it
up. Unfortunately, diabetes is a disease in which the patient has to do
most of the control and all of the work. The docs mostly sit on the
sidelines cheering us on and writing occasional prescriptions. Your best
chances of living a normal, pain-free life lie in this type of approach. .
..though I hope you remember that arbitrarily upping your dosages is a bit
risky.

Regards
Old Al

On Sun, 12 Oct 2003 18:49:53 -0400, "Chris Smith"
wrote:

As an experiment (and I DO NOT RECOMMEND YOU DO THIS
BECAUSE YOU MIGHT JUST KILL YOURSELF!!!) I upped my dosage from 2 x 850 a
day to 3x 850 a day. The results over the last week have been notable. First
I have been in serious ketosis (strips are at the very darkest end of the
range) for the first time in my low carbing experience.

Simply by posting this you have recommended it to some desperate
overweight lo-carber out there. Did you check with your own doctor?
Would one of the lo-carbers reading this crossposted message please
explain the lo-carb dfinition of "Ketosis"? and why you would want to
willingly enter it?

Cheers Alan, T2, Oz
--
Everything in Moderation - Except Laughter.

"Chris Smith" wrote in message
news:1065999000.977003@savina...
Hi Folks;

this week I made a very interesting observation that some of you may find
useful. Please remember this is just an observation based on one week and
should be viewed in that light.

I am a type 2 diabetic, diagnosed about 2 years ago. I have been low
carbing
(around 20 carbs a day) consistently for the last 2 years in a very
successful effort to control my blood glucose and cholesterol levels.
Although successful in controlling my diabetes I have lost very little
weight low carbing and have found it difficult to get into ketosis. Once
in
ketosis (usually induced by fat fasting) anything above 20 carbs would
kick
me right back out. I talked to my "Pro Atkins" Dr. about this and her
position was that often diabetics simply have a really hard time loosing
weight due to the extra insulin in their systems. Insulin apparently
signals
your body to store fat and even when in ketosis too much insulin can break
down the process. Diabetics may not respond as well as non diabetics to
the
insulin lowering effects of a low carb lifestyle because their body may
need
to produce significantly higher levels of insulin than non diabetes to
manage glucose levels. The only thing that I have found to be effective
for
weight loss has been "fat fasting" and that only marginally. My experience
has been that if I dropped 5 lbs "fat fasting" then I would put 4 of it
right back on ;(.

Last weekend I read several articles about Metformin and its effect as a
weightless agent for diabetics. As chance would have it I take Metformin
(2
x 850 per day) and have never had any significant weightloss that I could
attribute to it. As an experiment (and I DO NOT RECOMMEND YOU DO THIS
BECAUSE YOU MIGHT JUST KILL YOURSELF!!!) I upped my dosage from 2 x 850 a
day to 3x 850 a day. The results over the last week have been notable.
First
I have been in serious ketosis (strips are at the very darkest end of the
range) for the first time in my low carbing experience. I have never been
able to get more than the slightest hint of ketons on the strips. Secondly
I
have dropped 3-4 lbs since last Sunday. Thirdly I am not chronically
hungry
all of the time and that is very weird indeed. And forthly... I feel a
little smarter / sharper than I usually do (that could be from the
Holliday
Inn Express I stayed in though .

I am well aware that one week in the life of a low carber is nothing more
than a bump in the road but I thought I would share this with you. The
only
other thing that MIGHT have something to do with my experience this week
is
that I started taking CLA (Conjugated Linoleic Acid, a weightloss
supplement
of arguable value) a couple of weeks ago. I intend to stop taking the CLA
this week to see how things go without it.

Ill post my continuing experience with this next week.

CSmith


I'll throw this in for what it's worth.
I am type 2 diabetic.
I'm one Metformin 3x 850mg per day. Glyburide 2x 5mg per day and Avandia 8mg
per day.
I can't tell you about my ketosis levels but I have been on under 80 carbs
(60 net) and usually about 1/2 my daily calories from fat for 4 months now
and have lost pretty consistantly 2 to 3 lbs per week.
Not sure what that all says about anything but it's more data to work with.
This diet in that period dropped by A3C blood results from 243 to 131.

Garth
310/265/195

Chris:
(snipped)
I am a type 2 diabetic, diagnosed about 2 years ago. I have been low carbing
(around 20 carbs a day) consistently for the last 2 years in a very
successful effort to control my blood glucose and cholesterol levels.
(snipped) The only
other thing that MIGHT have something to do with my experience this week is
that I started taking CLA (Conjugated Linoleic Acid, a weightloss supplement
of arguable value) a couple of weeks ago.

Between Old Al and Garth, you can see that your metformin dosage was not
all that unusual. I suppose the questions are how good was your blood
glucose control with 2x850mg/day and what is your lipid profile like.

Some CLA occurs naturally in milk and other dairy products. The make up
of CLA as sold as a supplement is not the same as found in dairy
products. CLA competes with the essential fatty acids for the same
elongation and desaturase enzymes. It is important to understand that
your cell membranes are what you are tampering with using CLA therapy.
One of my sons is overweight and I would not recommend that he use CLA.
As a matter of fact I mentioned it to him and cautioned him against it's
use.

Frank

wrote:


Simply by posting this you have recommended it to some desperate
overweight lo-carber out there. Did you check with your own doctor?
Would one of the lo-carbers reading this crossposted message please
explain the lo-carb dfinition of "Ketosis"? and why you would want to
willingly enter it?

Cheers Alan, T2, Oz
--
Everything in Moderation - Except Laughter.

Alan, posting stuff like this and discussing it is what we *do* in the
DM newsgroups.

There is only one definition of ketosis...the body is producing ketones
as a byproduct of catabolizing fat for energy.

The body's cells are "fed" either by glucose or FFAs. When one "wants"
to enter ketosis, one is trying to change the body's reliance on glucose
to a reliance on FFAs. The method is usually through a very low carb
eating plan. Without sufficient available glucose, the body breaks down
adipose fat for energy, and you lose weight. A byproduct is ketone
bodies, which are usually measured with a urine dipstick. It is evidence
of the change.

For a Type-2 who hydrates sufficiently, it is usually safe, as T-2s have
sufficient insulin almost by definition. In a T-1, it can be dangerous,
leading to DKA. The difference is that a T-1 often gets into ketosis as
a result of *insufficient* insulin.

Jim

--
Join us in the Diabetic-Talk Chatroom on UnderNet
/server irc.undernet.org --- /join #Diabetic-Talk
More info: http://www.diabetic-talk.org/

If you have decided to try the ultra low carb approach, you might consider
the approach used by another low carb advocate, Dr. Bernstein in "Diabetes
Solution". He says if ultra low carb is not getting the desired weight
loss goal then cut back on the amount of food eaten. Because fat has
about twice the energy per measure as does proteine, that is the logical
macro food area in which to reduce. In the end, while tinkering with macro
food ratios can have an effect, total calorie intake will decide weight
status. The weight loss effect of the med you use is a temporary one, as
I recall reading. Weight loss and bg control are only indirectly
connected, an ultra low carb diet where one gains weight is quite possible
based on a given calorie intake and weight maintenance at another level is
not strange at all at another calorie intake level. You can not decide at
all, especially given the short time, that the increased med does anything
to your insulin level. I'm sorry to say that to lose weight one needs to
eat less as some final measure, even with ultra low carb intake. Some
people take even less of your med after having lost weight because a
lowering of bg levels comes with weight loss. When all is said and done,
one loses weight with less energy intake.

this week I made a very interesting observation that some of you may find
useful. Please remember this is just an observation based on one week and
should be viewed in that light.

I am a type 2 diabetic, diagnosed about 2 years ago. I have been low carbing
(around 20 carbs a day) consistently for the last 2 years in a very
successful effort to control my blood glucose and cholesterol levels.
Although successful in controlling my diabetes I have lost very little
weight low carbing and have found it difficult to get into ketosis. Once in
ketosis (usually induced by fat fasting) anything above 20 carbs would kick
me right back out. I talked to my "Pro Atkins" Dr. about this and her
position was that often diabetics simply have a really hard time loosing
weight due to the extra insulin in their systems. Insulin apparently signals
your body to store fat and even when in ketosis too much insulin can break
down the process. Diabetics may not respond as well as non diabetics to the
insulin lowering effects of a low carb lifestyle because their body may need
to produce significantly higher levels of insulin than non diabetes to
manage glucose levels. The only thing that I have found to be effective for
weight loss has been "fat fasting" and that only marginally. My experience
has been that if I dropped 5 lbs "fat fasting" then I would put 4 of it
right back on ;(.

Last weekend I read several articles about Metformin and its effect as a
weightless agent for diabetics. As chance would have it I take Metformin (2
x 850 per day) and have never had any significant weightloss that I could
attribute to it. As an experiment (and I DO NOT RECOMMEND YOU DO THIS
BECAUSE YOU MIGHT JUST KILL YOURSELF!!!) I upped my dosage from 2 x 850 a
day to 3x 850 a day. The results over the last week have been notable. First
I have been in serious ketosis (strips are at the very darkest end of the
range) for the first time in my low carbing experience. I have never been
able to get more than the slightest hint of ketons on the strips. Secondly I
have dropped 3-4 lbs since last Sunday. Thirdly I am not chronically hungry
all of the time and that is very weird indeed. And forthly... I feel a
little smarter / sharper than I usually do (that could be from the Holliday
Inn Express I stayed in though .

I am well aware that one week in the life of a low carber is nothing more
than a bump in the road but I thought I would share this with you. The only
other thing that MIGHT have something to do with my experience this week is
that I started taking CLA (Conjugated Linoleic Acid, a weightloss supplement
of arguable value) a couple of weeks ago. I intend to stop taking the CLA
this week to see how things go without it.

Ill post my continuing experience with this next week.

CSmith

Nice A3C numbers


"GACB" wrote in message
...


"Chris Smith" wrote in message
news:1065999000.977003@savina...
Hi Folks;

this week I made a very interesting observation that some of you may
find
useful. Please remember this is just an observation based on one week
and
should be viewed in that light.

I am a type 2 diabetic, diagnosed about 2 years ago. I have been low
carbing
(around 20 carbs a day) consistently for the last 2 years in a very
successful effort to control my blood glucose and cholesterol levels.
Although successful in controlling my diabetes I have lost very little
weight low carbing and have found it difficult to get into ketosis. Once
in
ketosis (usually induced by fat fasting) anything above 20 carbs would
kick
me right back out. I talked to my "Pro Atkins" Dr. about this and her
position was that often diabetics simply have a really hard time loosing
weight due to the extra insulin in their systems. Insulin apparently
signals
your body to store fat and even when in ketosis too much insulin can
break
down the process. Diabetics may not respond as well as non diabetics to
the
insulin lowering effects of a low carb lifestyle because their body may
need
to produce significantly higher levels of insulin than non diabetes to
manage glucose levels. The only thing that I have found to be effective
for
weight loss has been "fat fasting" and that only marginally. My
experience
has been that if I dropped 5 lbs "fat fasting" then I would put 4 of it
right back on ;(.

Last weekend I read several articles about Metformin and its effect as a
weightless agent for diabetics. As chance would have it I take Metformin
(2
x 850 per day) and have never had any significant weightloss that I
could
attribute to it. As an experiment (and I DO NOT RECOMMEND YOU DO THIS
BECAUSE YOU MIGHT JUST KILL YOURSELF!!!) I upped my dosage from 2 x 850
a
day to 3x 850 a day. The results over the last week have been notable.
First
I have been in serious ketosis (strips are at the very darkest end of
the
range) for the first time in my low carbing experience. I have never
been
able to get more than the slightest hint of ketons on the strips.
Secondly
I
have dropped 3-4 lbs since last Sunday. Thirdly I am not chronically
hungry
all of the time and that is very weird indeed. And forthly... I feel a
little smarter / sharper than I usually do (that could be from the
Holliday
Inn Express I stayed in though .

I am well aware that one week in the life of a low carber is nothing
more
than a bump in the road but I thought I would share this with you. The
only
other thing that MIGHT have something to do with my experience this week
is
that I started taking CLA (Conjugated Linoleic Acid, a weightloss
supplement
of arguable value) a couple of weeks ago. I intend to stop taking the
CLA
this week to see how things go without it.

Ill post my continuing experience with this next week.

CSmith


I'll throw this in for what it's worth.
I am type 2 diabetic.
I'm one Metformin 3x 850mg per day. Glyburide 2x 5mg per day and Avandia
8mg
per day.
I can't tell you about my ketosis levels but I have been on under 80 carbs
(60 net) and usually about 1/2 my daily calories from fat for 4 months now
and have lost pretty consistantly 2 to 3 lbs per week.
Not sure what that all says about anything but it's more data to work
with.
This diet in that period dropped by A3C blood results from 243 to 131.

Garth
310/265/195

Hi Chris,

To lose weight it is paramount to know how many calories are eaten per day.
Atkins is about weight loss for non-diabetics. For diabetics, check out Dr
Bernstein. His emphasis is on BG control with low carb, weight loss,
exercise, meds and consistent eating habits. I've been following his method
for three years, with excellent results. I stated with 30-40 g per day and
my A1c came down to 5.4. Now I eat about 50-70 g per day and the A1c is 5.7.
I love low carb and I would never go back to high carb. All my numbers are
good and I feel great, despite or because of DM.


Fred Henzi

67, T2, 144 lbs, low carb, no meds.


"Chris Smith" wrote in message
news:1065999000.977003@savina...
Hi Folks;

not true.

i've been in moderate ketosis from a 3 day fast
not my choice either. insulin was at almost
a null, .2u/hr for basal needed no bolus
as i wasn't eating. bolused when I started
getting too high during stress times though.

i was hydrated also, didn't help. again ymmv.
be t1 or t2.

"J.C. Hartmann" wrote in message
...
wrote:


Simply by posting this you have recommended it to some desperate
overweight lo-carber out there. Did you check with your own doctor?
Would one of the lo-carbers reading this crossposted message please
explain the lo-carb dfinition of "Ketosis"? and why you would want to
willingly enter it?

Cheers Alan, T2, Oz
--
Everything in Moderation - Except Laughter.

Alan, posting stuff like this and discussing it is what we *do* in the
DM newsgroups.

There is only one definition of ketosis...the body is producing ketones
as a byproduct of catabolizing fat for energy.

The body's cells are "fed" either by glucose or FFAs. When one "wants"
to enter ketosis, one is trying to change the body's reliance on glucose
to a reliance on FFAs. The method is usually through a very low carb
eating plan. Without sufficient available glucose, the body breaks down
adipose fat for energy, and you lose weight. A byproduct is ketone
bodies, which are usually measured with a urine dipstick. It is evidence
of the change.

For a Type-2 who hydrates sufficiently, it is usually safe, as T-2s have
sufficient insulin almost by definition. In a T-1, it can be dangerous,
leading to DKA. The difference is that a T-1 often gets into ketosis as
a result of *insufficient* insulin.

Jim

--
Join us in the Diabetic-Talk Chatroom on UnderNet
/server irc.undernet.org --- /join #Diabetic-Talk
More info: http://www.diabetic-talk.org/