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Week 1 of my fourth 13 week season: a low glycemic load diet, tracking my weight and blood glucose. You can follow me at my 13 Weeks Facebook page for daily updates, and you can join Fitocracy (free!) and follow my daily exercise, and maybe even start tracking your own.

Diabetes mellitus, especially the type-2 variety that used to be called “adult onset”, is a serious problem that’s been growing along with people’s waistlines. The name comes from “diabetes” (διαβήτης in Greek, and more or less adopted whole into Latin) meaning “to pass through”, and “mellitus” from Latin, meaning “sweetened with honey.” So the name means “pees sweet.” In fact, the test for diabetes was originally to taste the patient’s urine; if it was sweet, that meant diabetes.

This is why doctors are glad they no longer do their own lab work.

Type 1 diabetes is caused when the pancreas stops secreting insulin, for reasons that aren’t completely clear; type 2 happens when the body stops responding to insulin normally. No one is quite clear why that happens either, although an interesting new line of research is suggesting that people with type-2 diabetes have abnormal populations of bacteria in the gut. (I’ll be writing more about this soon, I’ve got a stack of papers full of long Greek-root words to read.)

Whatever the cause, the effect is that your blood sugar goes too high. This has a lot of bad effects, including a greater risk of heart disease and strokes, pain and numbness in the limbs, and not to put too fine a point on it, peripheral body parts becoming gangrenous and falling off, leading to slow creeping painful death.

This explains why, when I was diagnosed as actually being type-2 diabetic (familiarly called T2DM in medical conversations) I took it somewhat seriously, leading me to the first of these 13 Week experiments last year. I’ve experimented with several different diets and exercise plans, and lost a little over 30 pounds — followed by a near plateau of very slow weight loss. I was rather more successful with controlling my blood glucose — a little too successful back in April, in fact.

So, at the end of this most recent experiment, I had an HbA1c test, which measures your average blood glucose level over the lifetime of red blood cells. (I explained that in more detail last January.)

For the previous 13 weeks, I changed the diet, adding more carbs and reducing my metformin dose to 500 mg/d to see if I could avoid the hypoglycemic episodes. I was successful; haven’t had another fainting spell. Last Friday I had another HbA1c, though, and it’s up to 6.4 percent, which still counts as good control of the T2DM, but lower would be better. So, after talking with my doc this week, I’ve made some changes in my meds: back up to 1000 mg/d of metformin, back down to 20 mg/d of Prozac, and I’ve cut out the simvastatin completely because my cholesterol is actually low. All this for this 13 weeks; I’ll have another set of blood tests at the end of this 13 week experiment, in December.

Aside: Just making it one thing after another, my current doc, who I really like, just told me that the effects of the Affordable Care Act, and the required changes in paperwork and all, have taken so much time away from doctoring, which she likes, and put so much of her time into doing clerical work, which she hates, that she’s hanging it up in February. I’m starting to look for a concierge doc in this area.

As well as changing the medications, I’ve changed the diet somewhat. I found it very difficult to maintain the “slow carb” diet. I just didn’t feel as good as I had (mostly) on the low carb diet, but I didn’t want to go back to that and have more hypoglycemic episodes. So this 13 weeks, I’m trying a low glycemic load diet.