Next Steps

So, I had an appointment with the NP who works with my doctor today. Things are going forward with the plan we already had in place. That is to say, start the Piqray. Now, the “Big 3” side effects of Piqray are:
1) High blood sugar
2) Rash
3) Diarrhea

The treatments are fairly simple. To treat the high blood sugar (non diabetics have had sugar levels in the 300-400+ range) Metformin is given. Now, Metformin is a generic name for the medication. The brand name is Glucophage, which I like. If you don’t know what it means, it is: gluco (sugar/glucose) and phage (from Greek: eating), or at least from as far as I can determine that’s what it means. Like how autophagy means “self-eating”

To treat rash, Claratin (Loratadine) is given preventatively.
To treat diarrhea, Imodium is recommended, as needed, but not proactively.

I am currently wrapping up a 72 hour fast, as I type this, with about 2 hours or so to go.

Fasting graph, for this 72hr fast (not quite completed)

I’m thinking that my numbers, while great, are not as slow as they have been on long fasts because I was not drinking green tea (unsweetened).

After this, I’m going to keep a close eye on my glucose, via the CGM and fingersticks, as I’m starting my new medication. I’m hoping that I am one of the few that don’t need Metformin. But I plan to track my glucose first, to see what it does, and then take the Metformin only if necessary. Because I have a CGM and do fingerstick tests I can easily keep on top of it, rather than just waiting for a week to do my labs.

On a side note, the pharmacy that supplies the Piqray sent a nice welcome kit. It’s far better than the kit I got with anything else!

Welcome Kit

Stay tuned for updates as to what my glucose does!

PET Scan day

Had my PET scan today. They didn’t like that my glucose was 65 before the scan. The radiology tech had to call the doc to confirm it was OK to do the scan. Its actually a bit low, by a few points (they want a minimum of 70). They actually wanted me to drink some juice after, which I declined, saying that I don’t do juice or sugar. They were concerned that I would pass out on the way home. They don’t get that I run on ketones (maybe I should make a shirt that says that :smiley: )

The blue line is yesterday (when I broke my fast at supper). The red line is today, I’m kinda surprised at how my glucose shot up after waking. I expected it to come back down, but didn’t think it would dip under 70. I do expect it to be a bit weird today, and maybe tomorrow as I eat again.

Fast #3 – Sept 19 thru Sept 22

So I recently undertook another 72 hour fast.  From what I’ve read fasting can be a good thing for the body, as it gives the body a chance to recycle and get rid of broken and dying cells.

In the graph below the blue line is September 19th, when I had dinner and started my fast.  As you can see, my glucose was up and down a bit, but didn’t go higher than 95mg/dL.  I’m not sure why it went as low as 40, but it could have been something going on with the sensor, based the levels before and after that reading.

Continue reading Fast #3 – Sept 19 thru Sept 22

Fasting Success

Recently I undertook a 72-hour fast.  The results were as I expected, and I was able to monitor my glucose with a flash monitoring system.  This is a bit different from a continuous monitor in that the device doesn’t send data directly.  The sensor has to be scanned to pick up the recorded readings.

This chart shows my glucose over the day, from the 22nd (when I ate dinner) to the 25th (when I ate dinner).  I did not eat on the 23rd or the 24th.

You can see that each day when I was fasting my glucose was lower, overall, than the day before.  Because I am eating ketogenic my body produced ketones to compensate for the low glucose in my system.  This is perfectly safe and normal for someone who is fat-adapted (able to use fat to fuel the body, and produce ketones).  I ate supper around 8:30pm on the 25th, so that is why my glucose started going up then.

This chart shows data from 7pm when I ate dinner on the 22nd (blue line) through when I had dinner on the 25th (green line), and then until I woke up to start my day on the 26th.  This was mostly to show that my glucose went back up after eating.

I do want to say that I did not feel any typical symptoms of hypoglycemia, and I was monitoring my ketones.  I actually felt pretty good, and was able to keep up with my normal activities.

August 16-18 Fast (and after)

Starting my fast.
Dinner macros:
Carbs: 13g
Fat: 148g
Protein: 54g
Calories: 1744 (yes, I know it doesn’t add up…off by ~114, not sure why CarbManager did that)

Time (hr) BG BK GKI Notes
T0 83 0.9 5.1 Aug 16, before supper
T1 89 0.8 6.2
T2 89 2.0 2.5
T3 94 2.6 2.0 drank 2tbsp ACV
T12 87 1.2 4.0 Aug 17, 30m after waking
T16 90 0.8 6.3 after shopping
T20 72 2.0 2.0 drinking KetoAide
T24 76 1.1 3.8
T27 71 1.6 2.5 before bed
T36 75 2.6 1.6 Aug 18, 30min after waking
T40 73 2.6 1.5
T43 60 3.7 0.9 feeling good!
T47 53 3.6 0.8 broke fast

2 hours after breaking my fast:
BG 63 (:arrow_up: from 53)
BK 2.6 (:arrow_down: from 3.6)
GKI 1.35 (:arrow_up: up from 0.8)

Woke up to super numbers (August 19). Wish I knew how it happened!
BG 69, BK 5.4, GKI 0.71

Yesterday (August 19) before supper:
BG 60, BK 2.5, GKI 1.3

I’m thinking that I’m going to want to include ACV at night.

August Fast #1

Starting my fast.
Dinner macros:
Carbs: 13g
Fat: 148g
Protein: 54g
Calories: 1744 (yes, I know it doesn’t add up…off by ~114, not sure why CarbManager did that)

Time (hr) BG BK GKI Notes
T0 83 0.9 5.1 Aug 16, before supper
T1 89 0.8 6.2
T2 89 2.0 2.5
T3 94 2.6 2.0 drank 2tbsp ACV
T12 87 1.2 4.0 Aug 17, 30m after waking
T16 90 0.8 6.3 after shopping
T20 72 2.0 2.0 drinking KetoAide
T24 76 1.1 3.8
T27 71 1.6 2.5 before bed
T36 75 2.6 1.6 Aug 18, 30min after waking
T40 73 2.6 1.5
T43 60 3.7 0.9 feeling good!
T47 53 3.6 0.8 broke fast

My 3rd (Not So Great) Fast

Starting a new fast today.

I wasn’t happy with my after lunch numbers, so hopefully my after supper numbers will be better. I really wasn’t happy with my before supper readings. I guess my lunch at Applebee’s wasn’t as good as it could have been (maybe I should have had some MCT oil after).

My numbers really were not great at all *sigh*.  I’m thinking it had to do with what I ate in the two days (4 meals) before the fast.  The next fast I will just eat normally, either that or just up the fat.  My other two fasts had much better GKIs over the course of the two days.

July 25th Macros (for the day):
Fat: 334g
Carbs: 16g
Protein: 110g

July 26th Macros (for the day):
Fat: 302g
Carbs: 12g
Protein: 119g

Time BG BK GKI Notes
0hr 83 0.6 7.7 Lunch
2hr 98 0.3 18.1
4.5hr 95 0.3 17.6

Fasting goal: 48hrs

Time BG BK GKI Notes
0hr 95 0.4 13.2 July 26th,
6.5hr after lunch
1hr 100 0.6 9.3 1hr after supper
2hr 107 1.1 5.4 2hrs after supper
12hr 107 0.9 6.6 1hr after waking, MCT oil
13.5hr 101 0.7 8.0
15.5hr 119 0.3 22.3 after shopping – why so high?, MCT oil
17.5hr 86 0.3 15.9
21hr 72 0.5 8.0 after swimming and in the heat
24hr 79 0.7 6.3 MCT oil
34.5hr 86 0.6 8.0 July 28
37.5hr 89 0.8 6.2
39.5hr 85 0.8 5.9 MCT oil
43hr 75 1.6 2.6 finally a good result
48hrs 71 1.3 3.0 end of fast

A 52 Hour Fast

Starting a fat fast today!  Basically, I eat/drink things that are at least 90% fat and as minimal carbs/protein as I can manage.  Overall, I was really pleased with the results.  I ate normally before and after the fast (it was basically just skipping one meal’s worth of food).  I’m hoping that the autophagy that took place did good things.

Goal: 48 hours

Time BG BK GKI Desc
T0 75 2.2 1.9 July 16
T4 95 2.8 2.4 4hrs after supper
T13 89 3.2 1.5 July 17, MCT oil
T19 88 1.9 2.6 late afternoon, MCT oil
T23 75 1.4 3.0 before fat snack,
“MCT cream” & “MCT butter”
T24 95 1.4 3.8 1hr PP
T26 75 3.8 1.1 3hr PP
T36 85 2.7 1.7 July 18, upon waking
T42 70 2.0 1.9
T47 78 2.8 1.5
T51 74 3.2 1.3
T52 68 3.1 1.2 before end of fast

Fasting for 44hrs

Fasting can induce autophagy, a process whereby old, diseased, and misbehaving cells are eaten by the body to be recycled into new, healthy, and behaving cells.  I decided to do a short fast (44hrs).  I chose 44hrs instead of 48 because I had dinner really late on the 12th (like 10:40pm).  I’m hoping to fast more regularly, and my goal is to get my GKI down even lower during the fast.  I’ll probably do another 48 (or so) hour fast in two weeks, and maybe even occasionally go 72hrs.

Goal 44hrs
July 12 – meal @ 10:40pm
Before Meal: BG 76, BK 1.1, GKI 3.8
1 hour after: BG 94, BK 1.2, GKI 4.4

July 13th
12hr fasted: BG 85, BK 0.6, GKI 7.9
18hr fasted: BG 78, BK 1.0, GKI 4.3
24hr fasted: BG 86, BK 1.7, GKI 2.8

July 14th
31hr fasted: BG 77, BK 2.3, GKI 1.9
36hr fasted: BG 88, BK 3.1, GKI 1.6
44hr fasted: BG 71, BK 3.3, GKI 1.2