Type 2 Diabetes | Jonathon Sullivan

[stef]

In the first installment of our series on Type II Diabetes, Sully discusses the basics of the disease: What it is, how it happens, why it's bad, and how it seems to be getting worse.



Episode Resources

In the second installment of our series on Type II Diabetes, Sully discusses the medications commonly (and some not-so-commonly) prescribed for this disease.



Episode Resources & Transcript

[Cheesepuff]

Remarkably good. A must see video.

[Bluefan75]

I do have one complaint. I'm not patient enough to wait for part 2, and especially part 3. :-)

Very informative video.

[Scottm]

Hi Jonathon,

Since you are covering Type 2 Diabetes, can you do an interview with Jason Fung of IDM as part of this series and give a review of his "Reversing Type 2 Diabetes" procedure/processes and if it is a positive holistic anti drug way of life , how we may integrate it with a starting strength lifting lifestyle for the grey haired army?

Regards
Scott


Dr. Jason Fung – The Obesity Code Podcast

[Adam Levine]

Thank you for this. Diabetes is actually my main reason for training, and this video along with the Iron Age video is very informative.

One struggle I've been having is balancing the short-term vs. long-term blood sugar goals in my program, and I was hoping you could discuss it in a future article/video.

I understand that muscle mass improves insulin resistance, but gaining muscle mass is a long-term project. Does the kind of muscle mass (strength or hypertrophy) make a difference? The word "glycogen stores" thrown around when talking about hypertrophy certainly sounds like a good thing, but it might not be.

The other issue is that to gain muscle mass, you generally need a caloric surplus (at 5'10" and 180#, I certainly do). I did that on LP, and found out that if I eat enough to gain a pound a week, my blood sugar will go up pretty dramatically - it went from an average morning/fasting sugar of under 100 before LP to over 120 when finished. That's bad in the short-term, but I probably gained 6-8lb of lean body mass, good for long term. This happens even if my diet is good from a diabetes standpoint - no refined sugar, 6-7 meals a day, buckets of fiber, and of course, lower carb, higher protein.

After LP, I cut the diet back. On maintenance, it went down to high 110's. I was disappointed, hoping it would go back to what it was pre-LP, but it didn't.

Now I'm trying a cut, just because I want to see what it does to my blood sugar. It seems to be dropping further, now in the low 110s, but I need to stick with it a few more weeks.

This makes the whole "what to do" - turning this information into any kind of prescription, kindof muddy. Turning this kind of knowledge into a prescription or guide would be extremely valuable information and not something I cannot easily find outside of quack keto-or-vegan-peddlers.
- Hypertrophy or strength?
- LISS or HIIT or just active rest?
- Cut to help blood sugar now, maintain, or bulk to add muscle mass and help blood sugar later?

Right now, I'm just guessing and using myself as a guinea pig to find out what happens.

-->Adam

[Jonathon Sullivan]

I think "muddy" is a good word.

We'll have more to say about this stuff in Part 3, but you might be a little disappointed, because the answer is:

It depends.

We know this: losing fat mass, increasing muscle mass, and exercise are all good things, for all comers, in diabetes. Exercise is particularly powerful, because muscle glucose uptake is insulin-independent during exercise. This is huge. And we know that both resistance and aerobic exercise are good for Type 2 diabetes.

What we don't know is: what is the best dietary and exercise regimen for any one individual?

Now. This is exactly the same question that we have about insulin and other antidiabetic medications. As you'll see in part 2, the number of antidiabetic medicines has exploded in recent years, working at multiple pathophysiological targets. What are the best ones for you? It depends. It depends on your HbA1c, your symptomatology, whether you are a primarily insulin-resistant or insulin-deficient Type 2 diabetic, your post-prandial insulin response (if any), your basal insulin requirements, etc.

So even with as well-established, well-studied, and ubiquitous approach as insulin therapy, choosing the right insulin (short- or long-acting, etc) and the right insulin regimen (AM, PM, BID, post-prandial, basal) is a highly individualized affair requiring careful investigation of the patient and a lot of care.

All the more so with exercise and diet. It just depends, and it depends on a lot of things, including some things you can't control. You are doing the right things, and you are taking a smart approach--you are using your glycemic control as a training variable and a training outcome. That's way cool.

And you are asking the right questions. But only you and your doctor can answer them, over time. You've made a good start.

[Adam Levine]

Thank you, and that's OK - I'm slowly figuring stuff out.

So far (at least for me):

Useless: Vitamin C, Chromium, Garlic
Mildly beneficial: Active rest, LISS/cardio-boxing, <130g net carbs/day
Strongly beneficial: HIIT/treadmill sprints, cutting diet, 6tb/day of benefiber (way beyond normal dose)
Negative effect: Bulking diet, too many carbs, cheat meals
Don't know: Cinnamon, Taurine, Lifting, Muscle Mass, Keto. No way I'm doing Keto.

It's good knowledge - I'll probably ask the doc for Metformin before I try to bulk up again.

[Mark Rippetoe]

You "bulked up" once already?

[Adam Levine]

You "bulked up" once already?

A little on LP, yes. I'd like to keep going with bulking as an intermediate since it worked well. The only reason I stopped was the bltopped blood sugar issue.

[Mark Rippetoe]

"Bulked up" to what bodyweight/height?