Progress Towards Reversal and the OGTT

Here are the steps that you will go through on your way to reversal...

1. Firstly get your fasting sugar down to below 6.0 mmo/l (108 mg/dl). This is done by not eating things that put your blood sugar up and by exercise. After this, keep your sugar that low as follows...

    a. Measure the effect of a 45 minute walk (or other 200kcal exercise burn) on your blood sugar. With me it reduced my sugar by around 1.2 - 1.4 mmol/l starting from 6 to 7 mmol/l. 
    b. Measure your sugar just before you get ready to go to bed. End of day sugar and beginning of day sugar are about the same normally - see the graph below.
    c. Do the amount of walking or other exercise required to bring your sugar down to below 6.0. Then go to bed (checking the result occasionally until you are confident) 
    d. You should also wake up with a fasting sugar below 6.
    e. Do this every night, adjusting the walk accordingly, until your morning sugar is 5.8 mmol/l (104mg/dl) or below on a regular basis.
    f.  Doing this will speed up recovery from Diabetic Neuralgia.

2. By doing 40 mins on the treadmill after every meal (20 minutes of sugar reducing moderately fast walking and 20 mins of glycogen burning very fast walking) and 20 minutes of moderately fast sugar reducing walking before bed and by eating nothing with more than 10% carbohydrate by weight, get your fasting sugar down to below 5.3 mmol/l 95 mg/dl.

3. Once your fasting sugar has reached 5.3 mmol/l, 95 mg/dl, or better, then you can start measuring your cerebral sugar addiction/available glycogen storage space with the ONTT. 

Type2 is caused by a lack of Glycogen storage space in your muscles which is caused by an over production of glucose in the liver which is caused by instruction from the brain to the liver to get me more glucose! Because the brain is subconsciously addicted to sugar having had loads of it before your diagnosis - for more on this see the cause.

We have formulated a new test called the ONTT, the Oral Nothing Tolerance Test. It is essentially a Sugar Addiction Test. It works in a very similar way to the OGTT only there is no glucose. You can exercise before you go to bed, then you eat nothing and do no exercise for at least 8 hours (the period of your sleep) and first thing in the morning you measure your blood glucose then 30, 60, 90 and 120 minutes later you measure it again. You can neither eat nor exercise during the 2 hour test. This tells you how successful the liver is at feeding the sugar addiction of your brain when you get up and how successful your pancreas and muscles are at warehousing the glucose over production of the liver as glycogen. It is the brain that tells the liver to make sugar because the brain is the organ that conks out during a hypo. When you have type 2 the brain tells the liver to make too much sugar all day long. The pancreas reacts by releasing insulin which tries to warehouse all that sugar in your muscle cells as glycogen. The warehouse eventually fills up completely and then you get apparent insulin resistance. But really there is no true insulin resistance, the fork lift truck is working fine, you have just run out of storage space because the liver has filled it all up. So the ONTT measures how much space you have left and how addicted your brain is. Here are my ONTT results.

Mins after Waking up  night before 0 mins 30 mins 60 mins 90 mins 120 mins 300 mins Grade
2013August27 na 5.0 5.9 5.4 5.1 5.5 na Not bad
2013November9 na 4.8 na 5.0 na na na Wow!
2013November21 na na na na na na 5.2 Wow!
2013December21 5.3 5.7 7.1 6.3 na na na Fail
2013December22 4.4 4.9 5.0 5.8 6.9 na na Fail
2013December23 5.3 5.3 5.6 5.9 5.6 na na Fixed
2013December24 na 6.2 5.4 5.9 6.4 na na Fail
2013December27 4.8 4.6 5.4 5.7 6.1 na na Fail
2013December31 na 5.8 5.5 4.9 na na na Best

To pass an ONTT your blood sugar for every reading should be below 6.0 mmol/litre, 108 mg/dl. 

On August27, we see how I had a great morning sugar reading. Then the liver tried to murder me with blood sugar but failed because the pancreas kicked in and by 90 mins into the day it had got me back to the waking up level which is phenomenal. I wish I had done these tests earlier. I am plainly recovering from this disease. Mind you I am walking 9 miles per day and either swimming for 30 mins or doing 30 mins of interval situps every day (please do not do situps they can damage your spine - do crunches). 

On November9, I benefited from walking for 35 mins at 6.4 kph (4mph) after a 15 minute climb up from 4.4 kph to 6.0 kph the day before (that is the most high intensity walking I have ever done in one session).  That took my sugar down to 4.5  mmol/l (81 mg/dl). Then the next morning my fasting sugar was 4.8 (86 mg/dl) and after one hour it only managed to increase to 5.0 (90 mg/dl) which means either my liver has stopped trying to murder me or I have so much glycogen storage space that its homicidal efforts have become totally ineffective. These are non diabetic numbers. Really this is the full extension of the findings of the Heriot Watt university High Intensity Interval training paper http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2640399/ . They found that by just doing 4x 30 seconds bouts of high intensity exercise 3x per week for two weeks "insulin resistance" went down by 20%. I have found that by doing 2100 seconds (35 minutes) of high intensity walking at 4 mph on a nice soft treadmill, starting from a blood sugar below 5.0 UK 90 US you become non diabetic certainly for 24 hours.

On 2013November21, I ate nothing for 5 hours after I got up (other than a few nuts) and sugar was 5.2 mmol/l (94mg/dl) at the end of that period. This means that my liver is no longer overproducing. That is an indication that type 2 has ceased and my brain is no longer subconsciously addicted to sugar.  This disease can be beaten. It has taken me a year but mainly because I did not know at first how to do it.

On 2013December21 I failed comprehensively. My sugar before I went to sleep was 5.3 mmol/l. I failed because for the last week I had not been doing any high intensity exercise. I thought I would see what happened if I walked off the sugar after every meal but put nothing in the bank. The results clearly show how valuable the ONTT is. It has revealed that notwithstanding my reasonably good HbA1c, my diabetes has returned temporarily.

On 2013December22 we have a really interesting result. I walked my sugar down to 4.4 the night before by doing 40 mins at 5.4 kph. I did not permit myself to go any faster since I wanted to see if lack of really fast walking was the probelm. I was non diabetic when I woke up and non diabetic for the first half hour managing my sugar perfectly and then I ran out of glycogen storage space and was effectively diabetic for the next hour. This shows that my walking from the previous night only created half an hours worth of glycogen storage capacity in the morning. For plainly my insulin resistance did not jump up 30 mins into the test. So had I done 40 mins of high intensity exercise or 50 mins the night before, then perhaps I might have been non diabetic for an hour after I got up. So there it is. I will test again tomorrow having done lots of high intensity exercise from a platform of low sugar. We should be able to see the disease receding along the test. 

So fixing diabetes is about clearing glycogen storage capacity which means doing carb burning exercise when there is very little sugar in the blood, so that the muscles have to burn their glycogen. In other words it is about glycogen burning exercise. I do wonder whether the brain is not just asking for a sensible amount of blood sugar and in the course of the liver's production of that sugar, the blood obviously supplies it to the muscles as well, and the liver assumes that the muscles will take it up as glycogen. But if they cannot then something appears to go wrong in its calculations. Perhaps it assumes a minimum muscular glucose uptake and when the muscles cannot manage that you become diabetic? These results do not look like a cerebral sugar addiction because for the first half hour the brain did not appear to be addicted. Had it been addicted the sugar would have started going up like crazy in the first 30 minutes. It all looks more like a feedback loop error when the muscles cannot take up any glucose.

On 2013December22 after the ONTT I did the following exercise.

After Breakfast I ramped up from 4.4 - 6.0 kph in the first 12 minutes. Then I did 18 minutes at 6.0 kph. Then 17 minutes at 6.2 kph. Then 13 minutes at 6.4 kph.
After Lunch I ramped up from 4.4 - 6.0 kph in 5 minutes. Then did 15 minutes at 6.0 kph. Then did 15 minutes at 6.2 kph. Then did 5 minutes at 6.4 kph.
After Dinner I ramped up from 4.8-6.0 kph in 5 minutes. then did 15 minutes at 6.0 kph. Then did 15 minutes at 6.2 kph.

This totals to 108 mins of High Intensity exercise (6.0 kph and above). Then I did a slow walk before bed to get my sugar down. 

On 2013December23 I passed once again. The results show that this high intensity exercise fixed my ONTT even starting from a 5.3 evening and morning sugar. So the moral of the story is that you need both the low intensity sugar reducing exercise and the high intensity glycogen clearing exercise. 

On 2013December24 I ate too late the night before and did not do any walking before bed. That is why my sugar was 6.2 mmol/l, 111 mg/dl in the morning. Then I did pretty well considering that I had already failed the test. If you eat too late and do not have time for a walk before bed then wait 20 minutes after dinner before you start exercising and exercise for an extra 15 minutes on top of the normal 40 minutes. In that way you continue the exercise beyond an hour after the meal. That should be almost as good. 

On December27, I had a great night sugar and an even better morning sugar. I am not diabetic at all at night. I waited after dinner for 45 minutes before doing my after dinner walk and did no further walk before bed. This seems to be a great idea for the 3rd walk as it gives the body a chance to work on the sugar in the evening - when there is less diabetic stress than the morning. In fact leaving some time after the meal and before the walk will be my new experiment. However I plainly did not have quite enough glycogen storage space, although as predicted my resurgent diabetes is receding slowly. So my new idea of doing high intensity walking without the low intensity first absolutely does not work. So here is the new regime...

5 minutes after breakfast (staged high intensity glycogen clearing)
3 minute warm up
0-5 mins 4.8 kph
5-15 mins 5.2 kph
15-30 mins 5.6 kph
30-40 mins 6.0 kph
40-45 mins 6.4 kph (or 6.2 if you are tired)

Average speed is 5.6 kph. The first time I tried this routine on December27 my sugar went down to 4.3 mmol/l, 77 mg/dl when I had finished it.

5 minutes after Lunch (staged medium intensity sugar reducing)
3 minute warm up
0-10 mins 4.8 kph
10-20 mins 5.2 kph
20-30 mins 5.6 kph
30-40 mins 6.0 kph

Average speed is 5.4 kph. 

30 minutes after Dinner (staged medium intensity sugar reducing)
0-5 mins 4.4 kph 
5-10 mins 4.8 kph
10-25 mins 5.2 kph
25-35 mins 5.6 kph
35-40 mins 6.0 kph

Average speed is 5.25 kph

This is a total of 125 mins walking per day. There is no need for an extra walk before bed with this routine.

In November I was following the routine below...
4.4 kph for 4-6 mins
4.8 kph for 4-6 mins
5.2 kph for 4-6 mins
5.6 kph for 4-6 mins
6.0 kph for 4-6 mins
6.4 kph for 4-6 mins

My November results were the best, the diabetes had gone in that Month. But came back when I stopped the high intensity exercise to see if I had permanently fixed the disease - I had not!  In December I started trying to fix both the disease and the sugar - possible with the correct exercise combination. Because it must be possible to put your muscles back to the condition that they had prior to becoming diabetic. It seems that by stepping up the speed with time the body does not have time to get into fat burning mode and so burns more carbs than it wants to. With diabetes, everything you do to try and fix the disease the body reacts against. If you try and burn carbs and it has time to learn what you are doing, it will start burning fat instead - to protect your carb reserves - doh! But by stepping up the speed before it has time to settle down, you force it to burn carbs.

On December 30 I remembered that I had stopped taking Cinnamon around 4 weeks ago. So I took a large dose and felt better immediately. I just dissolved a large teaspoonful in boiling water with a teabag and added some milk. This is tea with Cinnamon rather than sugar. I felt better immediately. My toes felt better and my balls stopped hurting. My whole body is a kind of sugarometer. Then I had dinner did not walk it off because I felt so good. I hour after dinner I took my sugar (with no walking) and it was 5.8 mmol/l, 104mg/dl. That is a completely non diabetic result. I only did a small walk before bed (20 minutes).

On December31 I woke up with a sugar at 5.8 mmol/l which is high. But then it just went down and down to 4.9 during the ONTT which is astonishing (for me). This is the effect of Cinnamon. Because to be frank my muscles are better than they have been for the past 20 years but that alone does not fix your diabetes. I am forced to the inevitable conclusion that I do have real insulin resistance. Cinnamon cuts through that somehow. So there is the fix. Cinnamon aided exercise. Fix your muscles and fat with diet and exercise and fix your insulin resistance with Cinnamon. The Cinnamon pills are no good and too small in size. You need 5 grams of the stuff (good new Cinnamon verum (from Ceylon - Zeylanicum) dissolved in boiling water. You can drink it like that or with some milk or with a teabag or however you like. Instead of a spoonful of sugar, make a spoonful of Cinnamon with your tea - twice a day, morning an night. 

So there we have it. The ONTT gives you a great picture of your diabetes. for you cannot cure something that you cannot see. But once you see it you can beat it. In November I was non diabetic due Cinnamon. In December I stopped taking Cinnamon and became diabetic once more. Then on December 30 I took two large doses and hey presto the best ONTT I had ever done on December31.

So that is it folks. I am non diabetic and I know why. I have fixed my muscles and fixed my insulin resistance. Now we can truly move on to the uncharted waters of the maintenance program. Actually it begs the question: Was all that exercise actually necessary had I been taking more Cinnamon? I guess we will find that out with the maintenance program. Happy New Year to all sugarholics! 

OGTT Results

DO NOT PERFORM AN OGTT until you have passed the ONTT at least twice and do not do more than one per month. Here are my OGTT results. I started doing the High Intensity Heriot Watt type exercise on 2013November9. That is how you fix your glucose intolerance. My results were not that impressive until I summoned up the courage to do the test on 15December2013. In all the previous tests except for the one taken on Feb27, I felt awful after the test. On December15, 2013, I felt nothing. As of that date I no longer have type2 Diabetes. I used to get quite nervous about this test because if I fail it, then this whole website and a year of my work is wasted to some extent. The trouble with this was that being nervous causes stress and stress puts blood sugar up - just as chocolate and coffee do - for type 2 is a cerebral and a muscular disease. So the solution I found was to watch a really good engrossing movie throughout the test to take my mind off the results. I watched Man of Steel, during the 2013December15 test. OK it wasn't really good. But it was full of action and very engrossing and Russell Crowe is always good.

OGTT or HbA1c Test Weight BMI Fasting mmol/l (mg/dl) +1 hour mmol/l (mg/dl)   +2 hours mmol/l (mg/dl) +3 hours mmol/l (mg/dl)
Gordon 26Nov2012 Diagnosed 175lb 26.2 18.3 (329)      
Gordon 4Dec2012, Large bowl lentil soup + prawns 171 lb 25.6 6.2 (112) before   14.6 (263) after  
Gordon 16Dec2012, Large bowl chilli 165 lb 24.7 6.0 (108) before   12.0 (216) after  
Gordon 25Jan2013 33mg glucose, 190 ml lucozade 146 lb 21.9 6.4 (115) 15.1 (272) +8.7 10.0 (180) +3.6 6.8 (122) [30 minute walk assisted]
Gordon 1Feb2013 33mg glucose, 190 ml lucozade 142 lb  21.2  5.2 (94)  12.9 (232) +7.7 9.4 (169)   +4.2 7.3 (131) [no walk]
Gordon 8Feb2013 33mg glucose, 190 ml lucozade 144 lb  21.5  5.3 (95)  12.0 (216) +6.7 9.9 (178)   +4.6 4.7 (85) [10 minute walk assisted]
Gordon 18Feb2013 33mg glucose, 190 ml lucozade 142 lb  21.2  5.9 (106)  12.1 (218) +6.2 9.1 (164)   +3.2 7.3 (131) [no walk]
Gordon 27Feb2013 33mg glucose, 190 ml lucozade 142 lb  21.2  6.9 (124) walked to 5.3 (95)  12.4 (223) +5.5 to 7.1 6.5 (117)    -0.4 to +1.2 Passed at 2nd hour
Gordon 5March2013 33mg glucose, 190 ml lucozade 142 lb  21.2  6.2 (112)  17.2 (309) +11 11.3 (203) +5.1 4.9 (88) [no walk]
Gordon 11March2013 33mg glucose, 190 ml lucozade 142 lb  21.2  6.1 (110)  12.6 (227) +6.5 8.7 (157)   +2.6 7.1 (128) [no walk]
Gordon 20March2013 36%OGTT, 137 ml lucozade 139 lb  20.8  5.7 (103)  9.9 (178) +4.2 10.7 (193)   +5.0 Did not measure - Gave up
Gordon 3April2013 HbA1c 139 lb  20.8  5.5% or 37 mmol/mol, which equates to a   6.6 mmol/l (119 mg/dl) 90 day average Considered Normal - but still too high  
Gordon 13April2013 25%OGTT, 95 ml lucozade 139 lb  20.8  5.8 (104)  8.9 (160) +3.1 7.6 (137)   +1.8 Passed at 2nd hour
Gordon 29July2013 33mg glucose, 190 ml lucozade 142 lb  21.2  5.9 (106)  13.4 (241) +7.5 8.3 (149)   +2.4 Almost passed at 2nd hour
Gordon 15August2013 33mg glucose, 190 ml lucozade 143 lb  21.4  4.8 (86)  9.6 (173) +4.8 7.3 (131)   +2.5 Passed at 2nd hour
Gordon 15December2013 33mg glucose, 190 ml lucozade 150 lb  22.5  5.4 (97)  8.4 (151) +3.0 6.4 (115)   +1.0 (130 mins) Aced!
Gordon 17December2013 HbA1c 150 lb  22.5  5.3% which equates to a 6.2 mmol/l (112 mg/dl) 90 day average Considered Normal - but still too high  

For an OGTT, you eat nothing and drink nothing but water for 8 hours (normally at night) and then drink the lucozade and measure your sugar at 0, 60 and 120 minutes. Do not eat anything for 2 hours before you go to bed and then do the test in the morning. A pass is blood sugar being 7.8 mmol/l (140 mg/dl) or below at the 2nd hour.

25Jan is a diabetic result. What if I had ingested not 33 gm of glucose but 66 gm? Where would my sugar have been then?? I seem to be able to get rid of 5.0 mmol/l per hour UK which is 90 mg/dl per hour US, whilst still absorbing glucose. In fact I am metabolizing 11 gram per hour over 3 hours, which is 1.76 grams per litre per hour for my 6 litres of blood, which is 176 mg/dl per hour US or 9.8 mmol/l per hour UK. So in summary, a normal person can metabolise 65.4 grams of glucose in two hours at a rate therefore of 33 grams per hour, whereas I can metabolise 33 grams of sugar in 3 hours at a rate of 11 grams per hour. So my glucose metabolism is 33% of normal as of January 25, 2013. I will keep the above chart updated with my progress.

According to the Newcastle Reversal, OGTT performance improved at the first week and the 8th week and not much at the 4th week. But I had already hit the 15% weight loss target by the first OGTT in the 7th week of the 600 kcal energy balance diet but the 9th week counting from the Diagnosis. So really, I would have expected better. I think perhaps one has to get the 90 day average blood sugar down before the OGTT improves a lot. And the liver fat, the insulin resistance fat, seems to want to go last! Time for more sit ups! However this is a lot better than when I started the diet, when plate of chilli con carne with no rice would take me from 6.0 mmol/l before the meal to 12.0, 2 hours after the meal. I can get rid of 33 grams of glucose in 3 hours which means before I have my next meal! My fasting sugar was too high that day for some reason though. I should have waited until the next day. It is normally 5.8. I must have been stressed about something - although I did the test in the afternoon when fasting sugar is higher than before breakfast or before bed. So another moral of the story is do not embark on an OGTT unless your fasting sugar is non diabetic to begin with (less than 6.1 UK or 110 US).

1Feb is another diabetic result although some improvement on the previous week. I seem to be able to muster more at the start now, but not much more in total. Actually after 2 hours my sugar was up by 4.2 from the start in the second OGTT test compared to 3.6 from the start in the first test, which is worse. The 2 hour results are not diabetic from a 50% test perspective but are glucose intolerant (7.8 to 11.1). I cheated a bit in the first test with a walk in the 3rd hour, because I did not want my sugar high for too long. The second test had no walk. So it is very nice to see some improvement for all the hard dieting and exercise work done! But it looks like I will need a few more weeks to pass the 50% OGTT. 

The 8Feb results are weird. Better in the first hour, worse in the second and way better in the 3rd. It looks like my glucose metabolism started well, took a break and then went into overdrive!

The 18Feb results confirm that pattern of the previous tests. They show a slight improvement over the previous weeks. Given that we started from 5.9, we only rose by 6.2 then fell by 3 then 1.8. The previous three tests had a rise of 8.7, then 7.7, then 6.7 to the first hour, followed by falls of 5.1, then 3.5, then 2.1 to the second hour. I am inching nearer to passing the 50% OGTT. Slow progress however. 

The 27Feb results are amazing. I woke up with a blood sugar of 6.9 because I had a curry laced with ginger the night before. I went to sleep with a blood sugar of 6.2, but ginger delays the absorption of carbohydrate so throughout the night my body was absorbing carbs and not doing any work. Ginger is good at the start of this program for blunting sugar spikes. But once your glucose metabolism improves it can be a hinderance! Certainly do not have ginger the night before an OGTT. I walked my sugar down to 5.3 before the test. My first hour results were bad - probably because walking the sugar down is not really a fasting level. My fasting level was actually 6.9. So I went up 5.5 from my fasting level in the first hour. But on the other hand it was not really a fasting level due to the ginger which delayed the absorption of my evening meal to last throughout the night. But in the second hour I completely aced the test (7.8 is a pass) and I was 6.5. That is why I have been doing all of this diet and exercise. I am now 50% normal and 50% diabetic. This is a massive improvement and a major milestone in my metabolic rehabilitation. Normally I feel really tired during the second hour of the test as my body fights the glucose. This time I felt nothing during the second hour of the test. Something has changed in me. I now know that it was sunlight. I was living in the basement in the hotel I managed and during the second hour I was outside in bright sunlight. I was vitamin D deficient. Sunlight and vitamin D3 improve OGTT results dramatically. One hour in the sun and I was fixed! I did not realise this until 2014September. I did a lot of sunbathing in September2014 and as of 2014Spetember12 I only have to walk for 100 minutes per day to get perfect sugar. Snnlight is more effective than Vitamin D3 alone. Not sure what it does. But it has a monster effect on me.

The 5March result is fascinating. The worst start I have ever had followed by the best finish I have ever had for a failed test (the 4.7 on Feb8 was walk assisted). I have diabetic neuralgia of the groin and balls and bum, which is the worst. Sometimes it causes me to be so weak that I can hardly walk (Ed - It was not diabetic neuralgia - it was multiple fungal infections - both rinworm and candida - all took hold when I had high sugar - finally got rid of them in September 2014). For the 2 days before the test my fasting sugar had been 7.9 and then 6.8 due to the stress of this condition. On the day of the test my fasting sugar was 6.2 which was an improvement so I went ahead with the test. But I still had pretty bad neuralgia, which must also weaken my glucose response - hence the awful first hour result. I believe that I would have passed the test were it not for the neuralgia. So I will have to concentrate on fixing that too. Lots of sleep and lots of walks. I probably passed 7.8 mmol/l at around 2 hours into the test and the neuralgia probably delayed my glucose response by half an hour. Dropping my sugar by 6.4 mmol/l (115 mg/dl) in an hour is a record for me. It seems that if you start badly then you have more in the tank for the later hours. The complications are the reason that we must try to conquer diabetes.

The 11March result would appear to be a fairly accurate assessment of my progress. A failure, but the best 2nd hour result so far for a failure. On Feb27, when I passed, I thought I had no chance after the first hour result, so I forgot about the test completely and just tested myself after 2 hours for the sake of it. I also had a small piece of cream tart in the second hour, the fat of which might have slowed down the glucose absorption in the second hour theoretically. I was shocked when I passed. I think there is a lot of psychology in this. I was not worried at all on Feb27, since I thought I would fail. Worry causes stress which raises blood sugar. Had I started the day at 5.2, then I would have passed the test which is not bad. So 105 days after diagnosis I have nearly 50% normal glucose metabolism. It is slow progress. But it is progress. I would like to find a faster route. Perhaps losing a bit more weight?

The 18March 36% test started as one would expect. A first hour rise of 4.2 from 137 ml is equivalent to 5.8 from 190 ml. But then I got nervous and stressed, since I had to pass that test for credibility reasons, and I totally flunked the second hour. This shows that I probably did genuinely pass the 27Feb test due to having forgotten about it and therefore not being stressed at all. My sugar never goes up in the second hour (even fully diabetic results do not do that). These tests measure stress and sugar. I will have to calm down for the next test. I think I will try a 25% test - hopefully that will not stress me out much. Actually I no longer think it was stress. It was a spurious reading due to sugary blood being stuck in my finger tip capillaries. I should have taken another sample and waved my arms around and clenched my fist a few times first!

The 3April HbA1c was not a bad result. In the UK, I would no longer be regarded as diabetic with that figure for my 90 day blood sugar average. But I am still diabetic, just managing my sugar reasonably well. I need to get the HbA1c down to 5.2% which is 33 mmol/mol which equates to a 6 mmol/l (108 mg/dl) 90 day sugar average. So I do not have too far to go with that. 

The 13April 25% test started again as one would expect. The first hour result was slightly worse than pro rata compared with 18 March (4.2x95/137=2.9 and we had 3.1). Bear in mind that the lower the dose of glucose imbibed the less the urgency given the situation by one's metabolism so one would expect to do worse than pro rata for the smaller tests. Then in the second hour the result was not spectacular but at least I passed. Again I think nerves play a part. Had I taken a 50% OGTT I think the results would have been somewhere around 11.6 in the first hour (pro rata on +4.2 for 137 ml) and 7.6 in the second since I can normally metabolise 4 mmol/l in the second hour. But one does not want to put ones blood sugar up to 11.6 to find out. So I will stay at 25% OGTT for a while longer and improve at this level before I return to the larger tests.

On 29July I decided to go for a 50% OGTT because I am more confident with my new regime. The new regime is to walk off the sugar after every meal down to the point where my 4th toe on my right foot loosens up (normally that means my sugar is around 6.0 UK). Normally this takes 25-30 mins at 2.7-3.0 mph. Then I walk a bit more at 2.7 mph to put some exercise in the bank for the future. Then I do 20 mins at 2.7 mph before bed. The first hour of an OGTT measures how much insulin the pancreas had already produced for its store. The second hour measures how much it can produce during the test and your insulin resistance. The first hour score was not very good 13.4 So I did not have much insulin in the pancreatic bank. But the second hour was pretty good. 8.3 is 0.5 away from a pass which is 7.8 mmol/litre. Had I started at 5.4, I would have passed. This I believe is because I am clearing some glycogen storage space in my muscles by walking more than I need to to fix my sugar. Glucose is stored in the liver and muscles as glycogen. Diabetics do not store the glucose as well as they should so it remains in the blood pushing up the blood sugar. Most of the medical community put this down to 'insulin resistance'. However having less muscle as one gets older is also obviously a factor and so is the storage capacity of your muscle. Perhaps the insulin is working fine but there just isn't enough rooms for the extra glucose you have just digested? I am trying to fix the storage space issue that by burning off glycogen as well as fixing my sugar. I have yet to find the correct speed of walking on my treadmill to do this optimally. But during the second hour of this test I had no organ pain. It felt the same at the 27Feb pass. The second hour result shows either good insulin sensitivity or sufficient storage space for the OGTT glucose to be packed away as glycogen. The first hour result shows too much call on my insulin prior to the test so that I did not have enough insulin in the pancreatic bank. 

Mind you after the test I walked off the sugar. After walking 1 miles in half an hour my sugar was 3.8 mmol/litre (68 mg/dl). I have never seen it so low! I felt a bit woozy. This must have been because I had produced a lot of insulin during the test but failed it either because I did not have enough glycogen storage space or because I had too high insulin resistance. Walking for half an hour would burn off some sugar but it also clears storage space (it does not affect insulin resistance much). So it was the lack of glycogen storage space. The minute some space was cleared, the large amount of insulin in my blood forced the sugar into my muscles. So I have plenty of insulin but not enough storage space. Therefore had I done more exercise in the days or hours before the test, to create storage space, I really do think I would have passed it. Next time I will clear more space before the test. In fact walking before the test is what gave me the pass on Feb27 I now believe. The medical community do not prohibit exercise prior to the test. They only prohibit it during the test. This is because they know that exercise burns glucose. But they do not understand that it also clears glycogen storage space. So you can carry it's benefit forward. In fact that may well be how to fix type 2 diabetes. You just need to put enough exercise in the bank - more than is needed to fix your sugar. That is hard to do. But it can be done. A non diabetic person is just someone who always has enough glycogen storage space for his next meal (and enough insulin and not too high insulin resistance). You can become that person if you burn more sugar prior to the meal than you are going to eat during the next meal (so long as your pancreas has not burnt out).

On 15August I had been running my new routine for a few days. That is to walk 30 mins before and after each meal and before bed. The first 15 mins at a nice easy 2.7 mph and then second 15 mins of each 30 mins at a more hectic 3.2 mph. This is to ensure that the walking burns more carbs than fat. The first 20 mins of any reasonable intensity exercise routine will burn more carbs than fat. But after that you start burning more fat than carbs unless you up the intensity. So 2 hour long slow walks are a waste of time from a diabetic standpoint unless you are trying to lose weight. 

So I walked before the test after I got up. My first hour result was phenomenal, totally non diabetic. I obviously had plenty of insulin in the pancreatic store - which is used in the first hour -  because I had been walking off my sugar so thoroughly in the days before which did not give the pancreas much to do. The second hour result was not great, but was a pass so I will take that. This really validates my new exercise routine. I mean with a 50% OGTT pass and an untested, but it will be a low HbA1c, I am quite some way to reversing this disease. Given that I eat 25% of the carbs of a non diabetic person I can live a non diabetic life with these results. Also my neuralgia has almost completely gone. So there is further to go but I do now know how to reverse Type2 and turn it into a regressive rather than a progressive disease. It is relatively easy to reverse Type 2 if you have it mildly or do not have it too badly and are very overweight. Losing weight will do it. But if you have it badly as I had and were not very overweight at diagnosis, you cannot reverse it merely by losing weight and it is dangerous to think that you can because you can become too thin and that destroys your muscle which makes your diabetes worse, since muscle is where the glucose is stored as glycogen.

This result validates my theory that Type 2 is caused by lack of glycogen storage space rather than insulin resistance. Because walking before the test cannot change insulin resistance much but plainly does create glycogen storage space. Another way of looking at this is that we all have an exercise bank. And Diabetics are bankrupt in this bank. If you walk just enough or take just enough Metformin to fix your sugar you are making sure that your exercise bank account does not go too far into the red. But to fix the disease you have to put the account into the black by doing more exercise than is needed to fix your sugar. And that exercise must be carb burning not fat burning.

When you test your blood sugar by pricking your finger tips make sure you wave your arms around and clench your fist several times first (or play some Rachmaninov on the piano). Micro lancet testing works fine for blood sugar less than 8.0 mmol/l (144 US). But it is not so good when your blood sugar rises above that since the blood becomes sticky and sugar or sugary blood can get stuck in small capillaries in your finger tips. This will give you a spuriously high reading in the second hour if the finger tip does not have good circulation. So shake the hand around madly for a while before the test. Use the index finger on your stronger hand - it will have the best blood supply. Take two readings and use the lower of the two. It will not underestimate after a glucose spike, it will over estimate.

On 15December2013 I completely aced the test. This is because I have fixed my muscles by doing 15 minutes of fast walking at either at 5.6 kph or 6 kph every day tagged on to the end of a sugar reducing 35 minute walk. First you must floor your sugar then do the high intensity stuff. I have put on 10 lbs, hopefully most of it is muscle. Anyway there it is people. I am no longer diabetic. My HbA1c will be around 5% (I will get it tested ASAP - actually it was 5.3% - still too high). You can linearly extrapolate from a 50% OGTT to a 100% OGTT. Had I taken a 100% OGTT my results would have been 11.4 mmol/l (an increase of 6.0 mmol/l rather than 3.0) at the 1st hour and 7.4 mmol/l (an increase of 2.0 mmol/l rather than 1.0) at 130 minutes. That is a pass. It is a fully non diabetic result. But I will not subject myself to a full OGTT.

On 2015July20 my HbA1c was tested at 5.1% (32 mmol/mol) and my Vitamin D was 143 (normal range is 50-200). I have been taking 5,000 IU per day. However I still have to walk 120 minutes per day and eat very low carb (twice per day) to achieve this. My weight is 158 lbs and my height is 5 feet 8 inches so my BMI is 23.7.

A full OGTT will take you right out of Ketosis. So without doubt start only with a 33% or a 50% OGTT.

OGTT Fraction Volume of Lucozade (ml) Wieght of Lucozade (gm) Glucose Content (gm)
100% 380 ml 403 gm 65.4
75% 285 ml 302 gm 49.05
65% 247 ml 262 gm 42.5
50% 190 ml 201 gm 32.7
36% 137 ml 145 gm 23.5
25% 95 ml 100 gm 16.35

Use a kitchen scales and weigh out the lucozade for the fractional tests. We advise to start with an 33% OGTT and move to a 50% OGTT but no further. It is not a good idea to have a 100% OGTT test taking your blood sugar above 12 mmol/l (216 mg/dl). And consult with your doctor at all times. Burn off the lucozade with a walk immediately after the test to stay in Ketosis. Walk or cycle or swim off the glucose calories you ingested after the test is finished even if your body has already dealt with them. 45 mins of moderate pace walking does 200 kcal and one gram of glucose is 4 kcal. So to walk off 33 grams which is 133 kcal you need a 30 minute walk.

HbA1c result interpretation

HbA1c 90 Day Average Glucose mmol/l UK 90 Day Average Glucose mmol/mol UK 90 Day Average Glucose mg/dl US Diagnosis Grade
4.5% 4.6 26 83 Normal Optimal
4.7% 5.0 28 90 Normal Optimal
5% 5.6 31 101 Normal Good
5.2% 6.0 33 108 Normal Good
5.5% 6.6 37 118 Intolerant Needs Work
5.7% 7.0 39 126 Intolerant Needs Work
6% 7.6 42 136 Intolerant Bad
6.2% 8.0 44 143 Daibetic Bad
6.5% 8.6 48 154 Diabetic Terrible
6.7% 9.0 50 161 Diabetic Terrible
7% 9.6 53 172 Diabetic Horrible
7.2% 10.0 55 180 Diabetic Horrible
7.5% 10.6 58 190 Diabetic Catastrophic
7.7% 11.0 61 197 Diabetic Catastrophic
8% 11.6 64 207 Diabetic Diabolical
9% 13.6 75 243 Diabetic Diabolical
10% 15.6 86 279 Diabetic Ring undertaker
11% 17.6 97 314 Diabetic Ring undertaker
11.4% (mine at diagnosis)  18.3 101 329 Diabetic Lucky to be alive

Thanks to http://www.rajeun.net/HbA1c_glucose.html

Here is a very colourful low resolution but highly informative graph of normal typical blood sugar values for 21 people throughout a 24 hour day...


The graph shows that a meal can actually increase blood sugar in a normal person by 60 mg/dl or 3.3 mmol/l.