Double Checking

As I thought about what was happening with the "Dawn Effect" (if in fact that was what was going on) I was curious about the impact it would have on my HbA1c.  I could conceive of ways that it might rise a bit and of other ways it could drop.  My inclination is it would drop.  It had been a month since I had checked my HbA1c and a lot of medical professionals will say you don't need to check that often because the A1c test reflects blood sugar levels over the past 2 to 3 months.

Well, I disagree - saying the A1c test reflects the past 2-3 months is just a piece of the truth.  The test measures how much of a glycolated protein there is on a person's red blood cells.  Red blood cells can live up to 3 months, hence the medical (and insurance) profession's comments.  In reality, most of them are shorter lived and HbA1c can change significantly in just a month.  So I retested using the Bayer home test and the result was 5.5%, which is an excellent reading (borderline normal).

As I keep studying the data, I am beginning to believe it takes the body 3 weeks or more after stopping a drug to remove the drug and its metabolites and stabilize again without the drug.  I've seen this now with Actos, Metformin, and Exforge (a blood pressure drug).  Most of the literature you'll find speaks of a half-life that is much shorter, measured in hours or days and never weeks.  The may be true at some level if you're measuring blood chemistry.  When you look at the time it takes the body to clear a drug AND return to normal, my experience is 2-1/2 to 4 weeks seems to be what it takes.

So the summary to date after 17 weeks of eating for nutrition and exercising both aerobically 3 times/wk (for about 12 wks) and anaerobically 3 time/wk times (starting July 5) are:

38 pounds lost.
45 mg/d of Actos eliminated
All other meds cut by 50%
Blood pressure typically runs 125/70 or less
Total cholesterol: 125
Fast blood sugars are current running 127 mg/dl (and appear to be dropping at 4 mg/dl per week)

My current fasting blood sugar readings are 51 points lower than when I started the program.  If I add in the estimated reduction that the Actos and metformin were doing my blood sugar drop is probably between 80 and 100 mg/dl lower than when I started.

I've got 37 more pounds to lose.  If the trend lines continue I should be able to control my diabetes with diet alone comfortably in another 10 to 12 weeks (estimate); maybe a bit less.  There is no doubt in my mind that I could be "diet controlled" and meet the FAA's requirements for passing a flight physical (HbA1c <9.0).  The trouble is, there's too much data that says keeping your A1c low reduces complications from diabetes.  The popular simplistic value is 40% fewer complications for every 1% reduction.

When my fasting blood sugar readings are less than 115 and stable, I'll drop my metformin dosage to 500 mg/d. Then I wait and see what happens.  I'd like to see my fasting blood sugar under 110 to quit taking metformin.  Ideally, I would like to see this happen when I weigh between 205 and 210.  Given the current trend line, this seems plausible.  Time will tell.