A1c and Lipid Panel results after 6 mos. on Atkins
 

Hi, all,

Atkins appears to have helped me dodge a genetic bullet disposing me toward Type 2 diabetes, which runs in my family. Mom, poor soul, ended her life with 15 years of being a poster child for the insulin resistent, carb-addicted, fat-creating metabolism which Dr. A warns is a result of a lifetime of high-carb diet.

I had a heart attack in August '95, and afterwards have been on a combination of statins (Zocor, later Lipitor) plus niacin to control cholesterol. By May of this year, my weight had continued its slow but certain rise, and so I tried Atkins.

By August, I had dropped about 20 pounds. At that time, my year's prescription of Lipitor had expired, and the doctor wanted a lipid panel done before issuing another prescription. When it came back, the cholesterol numbers had improved significantly from those of a year previous, but the fasting blood glucose reading was 147. A subsequent A1c test came back at 7.6, indicating an average BG for the previous three months of 175!

Initially, my physician wanted to start me on some sort of meds to control the blood glucose levels. In that discussion, we discussed the Atkins diet I had been on for the preceding 3 months, and I queried him closely about how and why my BGs could be so high when my diet had been so low in carbohydrates. His answer: (1) though I had lost weight, I was still overweight enough to cause problems, and (2) judging from my family history I still had a significant resistence to insulin.

This doctor, by the way, is not afraid of low-carb diets. He was pleased with my 20 pound weight loss in 3 months, and told me candidly that if I lost another 20 pounds my borderline diabetic condition would very likely vanish. He also encouraged me to persevere in the regular exercise, as this would continue to improve my lipid profile and also reduce my insulin resistence over time. I asked him if I could avoid any new meds for another three months, to see if further weight loss and continued exercise would improve the blood glucose numbers. He agreed.

Today, I got the results back for the most recent blood work, done on the morning before Thanksgiving. I've posted the lipid profile and A1c results below:

. . . . . . . . . . . . . June '02 . . . . . . . . Aug 03 . . . . . . Dec 03

Total cholesterol:-----179---------------142--------------153
HDL:------------------35-----------------45---------------48
LDL:--------------- - 101-------------- --81-------------- 94
LDL/HDL ratio:---- ---2.89---------------1.79------------1.97

A1c --------------- --n/a----------------7.6-------------5.4
Avg. BG in mg/dl ------n/a------------- --175------------104

In the three months since Aug A1c test, I have also lost an additional 10 pounds.

These numbers are, of course, encouraging. In my case, they also need to be read in view of the fact that I have never been out of induction since going on Atkins. Moreoever, with the exception of the first 8-10 pounds of weight loss, all the rest of my weight loss has come through periodic week long fat fasts. Since mid-October, I have been alternating a week of induction with a week of fat fast, and I plan to continue this pattern through the winter. Each fat fast typically results in a loss of 3 to 4 pounds. The one exception to this was last week (a fat fast week), which I "blew off" on Thanksgiving day by eating the full feast with the rest of the family. Last week, in spite of two mega-carb meals on Thanksgiving day (complete with pumpkin pie, lots of cranberry sauce, bready dressing, yeast rolls, and the rest of the culinary disaster), I did not gain a single pound.

The good news in this result is that it provides some evidence that the every-other-week-fat-fasts are not materially affecting my metabolism. They are not, evidently, slowing it down appreciably.

In this past three months, I have regularly taken fasting blood glucose readings most mornings when I get out of bed, and about half the time, I've also taken another BG reading in the evening, about 2 hours after eating supper. I observe that my fasting BGs are their lowest (between 85 and 105) during any week when I am on a fat fast (when my carb intake is confined to about 3 grams in the Half-and-half I put in my large mug of morning coffee). In the weeks when I am on induction (less than 10 grams of carbs daily), my fasting BGs run around 105-115. BGs 2 hours after eating run around 130-150. The BG 2 hours after the second Thanksgiving meal was 167.

I see the doc tomorrow morning to discuss the results referenced above. If he has any further insights to share with me, I'll share them here afterwards.

Homesar
(tofi just lined up your numbers in the chart for easier reading)

Your A1C is great. I am insulin dependent and my last A1C was 7.6, so I have been reading up on low carb and making some changes to my diet and insulin amounts ,so that I can improve my blood sugar readings. I hope that your Dr has good things to say and hopefully you will not require any meds for diabetes.

Hey Homesar, great results on your lipid panel.

Low carb eating has also helped me with control of my Type 2 diabetes and has brought my triglycerides down from 309 to 97. My HDL cholesterol still needs to be higher.

I have a question about the Niacin supplements you were taking. Were they simultaneous with your taking Zocor? I have been taking Niacin supplements for a couple of months and was just this week put on Zocor. The medical information sheet which came with my prescription said to not take Zocor with Niacin as this could increase likelihood of muscle breakdown.

Thanks, Johnie

Hi, Johnie and clb1968,

The doctor, as expected, was most pleased. I forgot to mention that my triglycerides in the past 3 months have dropped from 87 to 67. The doctor says the improvement in the A1c is better than he would have expected from using Actose. So, he's told me to keep on keeping on and check back in another four months. He also tells me I can quit checking my BGs, since my record of them for the past three months show that they are mostly normal (with occasional wanderings into slightly abnormal ranges, which he expects will disappear if I continue on Atkins, especially if Atkins generates another 20 pounds of weight loss).

Several interesting things came out of the conversation with him. As to BGs:

1. He say BGs after eating are a far better early indicator of disposition to diabetes than fasting BGs.

2. He emphasized that sustained exercise is critically important to alter insulin resistence and to change glucose metabolism in pre-diabetic people. Optimum exercise is to get one's heart into the aerobic range for an hour, five days a week.

Johnie, I asked him about your report of the warning on the Zocor packaging. Here's what he tells me about statins generally when combined with niacin:

1. Statins essentially treat only one part of the lipid panel -- the low and very low density lipoproteins. They do not have much effect on HDL or triglycerides.

2. Niacin has its greatest impact on lowering triglycerides and raising HDL.

3. Consequently, when combined with statins (any of them), niacin and statins together give you a much greater punch in cholesterol management than either of them by themselves. He tells me there is extensive research evidence advocating the combination of niacin and statin drugs, and he has several hundred patients who use both. He claims that over the past 15 years of practice, he has only seen slightly elevated liver enzymes in three patients who are taking statin/niacin combos, out of hundreds under his care. All three of these, he says, were also taking numerous other meds for other conditions, and he is not at all sure that the abnormal liver enzymes were caused by either statins or niacin.

Originally, I was put on Zocor after my heart attack in 1995. About 1998, I learned about niacin therapy from a friend, and after researching it, I decided to try it myself. Part of my rationale was, frankly, financial -- I was out of work, had no insurance coverage, and I could afford $12 a month for niacin more than I could afford $70 a month for Zocor. So, I stopped taking Zocor, and began ramping up on niacin, until I reached the highest therapeutic dose without the side effects which typically cause people to stop niacin supplementation (i.e. 3,000 mg daily, in three doses).

Then, I told my doctor what I had done. He checked my lipid panel and noted that my HDL had dramatically improved, and my LDL was only slightly elevated over what it had been when I was on Zocor alone. He strongly urged me to begin Zocor and niacin together, especially as I was tolerating niacin so well (I have no side effects from it at all). Sure enough, my LDL dropped even lower than it had been, my HDL continued to rise slowly, and the combo produced a much better lipid profile than either of them alone had done.

I now combine niacin with Lipitor. Doc says niacin works very well with any statin.

Now, when I asked him about that warning on the Zocor lable, he laughed. "That notice comes from the drug company's legal department. They're always looking for ways to reduce their liability."

"I wondered about that," I said. "In fact, I was wondering if the warning didn't come from the marketing department, which didn't want people taking less Zocor."

"No, no," he countered. "It was actually the marketing department which caused that warning notice to be removed. It happened about a month ago. People like your friend were asking their doctors about Zocor and niacin, and the doctors simply began switching people from Zocor to some other statin. Zocor has taken a real hit in the market place, and they just now removed that warning."

How 'bout them apples? :p

Homesar

How wonderful that so many people are managing health threats with LCing. Congratulations to all of you. And many happy, healthy years to come.

According to my physician, Actos helps lower triglycerides in addition to its beneficial effects on insulin resistance. So, the Actos/Zocor combination seems to be a good one. I'm on it. We redo the numbers in Feb.

My own numbers were "below average risk" in all the blood tests in October. And this after 5 years of LC. haven't lost the weight the way I want yet, but apparently my health is good.

Johnie