Type 2 Diabetes: more weight OR higher reps?

[Flying_tiger]

Started CrossFit in 2006 (and enjoyed the Rippetoe videos), tried Wendler in late 2013 and before 2014 was over I was on Starting Strength, haven't left since. I have the Blue and Gray books, pencil notes, dog eared, and highlighted.

51 years old, four days a week currently programming Starr ascending 5s plus assistance exercises (Monday Deadlift/ chin ups, Tuesday Press / LTE, Thursday Squat / Romanian DL, Friday Bench / Barbell row)

Frustrated to find Ive become Type 2 diabetic (although lipids & BP have improved under strength training).

I remember Rippetoe mentioning he had experimented with higher reps with a client that had sugar issues to positive effect. My question is in order to drive my blood sugar and A1C down should I continue to add weight to the bar OR learn more about the higher reps experiment? Yes I want to get stronger BUT I'd rather not be on Rx diabetic medication.

At BW 219 and 6'1" and shrinking work sets are DL 305, Press 140, Squat 275, Bench 200 (down from my "highs" of DL 335, Press 160, Squat 315, Bench 225... the price for enjoying getting older is injury, stress, and crappy sleep. Happy to pay it, beats the alternative.)

Appreciate you thoughts and recommendations.

[Hayden-William Courtland]

I am inclined to say that sleep and nutrition are the primary drivers here, not the training. How much sleep are you getting? What is your nutrition like?

[Flying_tiger]

Getting 8+ hours of sleep consistently, mostly uninterrupted. I love Santana’s Nutrition LP and get 200 to 225 grams of protein daily (slightly lower some Sundays because I’m lazy). About half is supplements, rest is varied protein sources.

This has been the case for about a year plus.

Prior to that it was a train wreck: 3-4 hour round trip commutes on to of 10-12 hour workdays. Uneven diet. Crap sleep and little of it (about 3 years)

[Kevin_Slidell]

This hits home with me, i would love to hear more about this.

[Hayden-William Courtland]

Getting 8+ hours of sleep consistently, mostly uninterrupted. I love Santana’s Nutrition LP and get 200 to 225 grams of protein daily (slightly lower some Sundays because I’m lazy). About half is supplements, rest is varied protein sources.

This has been the case for about a year plus.

Prior to that it was a train wreck: 3-4 hour round trip commutes on to of 10-12 hour workdays. Uneven diet. Crap sleep and little of it (about 3 years)

What are your total calories looking like?

[Elle]

The objective is to lower blood glucose. High blood glucose occurs when you eat carbs at a rate that's higher than your body can shove them away into body fat or muscles.

You can lower blood glucose by putting less carbs in your body (the biggest bang for your buck) or by burning more. Also by lowering stress (cortisol).

You can increase the glycogen storage capacity of your muscles by increasing muscle size and strength, which you've been doing.
You can increase the amount of glycogen you burn by spending more time in HR zone 3 and above. So I would say extending your exercise time (more volume) is probably the better of the two options you've offered.

But really the main thing is to stop eating so many carbs, or to eat lower glycemic carbs so that your body has more time to dispose of them (reduce the spike), or at the very least target them immediately before exercise. You can also try intermittent fasting.

Ideally you'd do a mix of all of these, with the first target being the elimination of white flour and sugar. The goal would be to work down to 150-200 carbs a day, YMMV on the exact count. The Primal Blueprint does a pretty good job of explaining the carb thing without going too extreme.

[Elle]

200 to 225 grams of protein daily (slightly lower some Sundays because I’m lazy). About half is supplements, rest is varied protein sources.

Also, I'm curious what the sweetener source in your protein supplement is. That could really add up. Especially since big slugs of protein can also impact insulin.

Both sugar and sucralose can contribute to insulin resistance. A better option would be something sweetened only with stevia or monk fruit (I like Jocko Mölk personally).

Sucralose Affects Glycemic and Hormonal Responses to an Oral Glucose Load | Diabetes Care

[Flying_tiger]

Thank you Elle. Exactly the kind of info I was hoping to get. I’ve never been much of a sweets guy, and I tend to be mindful of high / low glycemic index values.

I have tried intermittent fasting (noon until 8pm) but find it difficult to get to 200+ grams protein when I do. I use True Nutrition blend whey isolate, low or no sweetener.

I’m going to keep pushing my work set weight up, and use assistance as part of volume. I’ve removed contaminant from my coffee, and will find other ways to reduce or eliminate low quality carbs

[Elle]

It sounds like you're doing a lot of the right things. Diabetes sucks but it's definitely essential to get it under control for long term health and continued ability to make gains - even if it means dialing back protein/carb intake or doing other things that are sub optimal for strength gains (assuming you are "fundamentally strong" and just looking to push the limits).

I would definitely recommend spending a week or two tracking every single food you eat. Carbs can be sneaky and you might be surprised by your results. My preferred tracker is Cronometer because it measures net carbs and micronutrients.

You could also try a different type of IF, for example 24 hours once a week (I do this on my second rest day), or 3 days once a month. Just have to find what is best for your lift. Fasting has some protection mechanisms against lean body mass (eg increased HGH and autophagy), so you don't need to "make up" the protein intake lost on those days. But it does "pause" recovery from exercise, so you are going to have to be careful to work it around your training.

I'm happy to help where I can. I have to follow a ketogenic diet for medical reasons (my body can't process glucose) so I have a geeky passion around how it all works. I'm trying to avoid suggesting keto/carnivore because it really is sub optimal for lifting weights, and I don't think it's necessary, but it is incredibly effective at combatting diabetes, so might be worth doing for a month or so just to get things under control.

One of my favorite overall health podcasts is the Peter Attia Drive, and episode 59 talks in an accessible way about "what is diabetes and what to do about it."
#59 - Jason Fung, M.D.: Fasting as a potent antidote to obesity, insulin resistance, type 2 diabetes, and the many symptoms of metabolic illness - Peter Attia
But Attia has a lot of good info on his site about reversing insulin resistance for people who aren't willing to sacrifice performance.
This one gets even more in depth but is specifically aimed at elite athletes;
#85 - Inigo San Millan, Ph.D.: Mitochondria, exercise, and metabolic health - Peter Attia

[Flying_tiger]

Update: I’m down to normal range. Will check again in 30-days. Changes made include nothing but water after 8pm... usually... cutting out snacking in favor of eating a meal every 3 hours, learning carb load of various foods to limit unintentionally loading up, adding weight to the bar even if only a pound, and consistently doing assistance exercises . Thank you to everyone who commented