#42

What is the formula for equating 84 mg/dl to an HbA1c of 4.6%? The only formula I am aware of, that has been shown to not be accurate, is:
(FBG x 3%) + 2.6 = HbA1c.

Also, why would lower average blood glucose be better, as a rule? Lower than 100 mg/dl sounds right, but lower than 84 mg/dl sounds too low unless totally flat over time. Hypoglycemia is no fun in terms of quality of life not to mention health detriments that I know nothing about.

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#43

I tend to agree that there is an optimal level as well as keeping peaks below 8/140. I did get a test result at 4.18% once, but I am not sure that was particularly healthy.

What was interesting wearing the CGM was getting a moving glucose average which gave an arguable HbA1c. Particularly as I could see the effect of 77mg equivalent of Rapamycin.

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#44

Hello.

What do you mean with your last paragraph?

Thank you

#45

@Joseph_Lavelle

Not sure if you are shooting the messenger here

I was referring to a source that @Thiago might want to look at since he said he wanted to research and understand this question better.

My added personal framing was only that that Peter Attia episode seems to suggests that 5.0% HbA1c and glucose spikes above 140 might be higher than optimal if one is truly seeking to optimize one’s glucose.

You can see the whole Peter Attia episode and show notes in the link I had originally pasted above and now have repasted below.

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#46

Is that a question to me? If so there is a topic on this.

#47

Again, the Peter Attia episode linked above lays out why he feels/felt so based on some triangulation of literature

If you end up looking at the episode or reading the show notes I’d love to hear if there is anything you think he is wrong above and if so what and why

[btw, I think he means within bounds, not crazy, crazy low]

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#48

I think the healthspan issue with glucose is clear. High levels of glucose overclock the mitochondria producing more ROS than the endogenous anti-oxidants can handle without mtDNA damage.

That substantially, but not totally, is aging.

The other material short term (under 200 years) issue is senescent cells.

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#49

@Neo No bullets fired. I asked a genuine question. Blood sugar is a concern of mine. I try to get it lower an average. I cannot understand the “lower is better” theme … I believe there is a sweetspot. Hypoglycemia is definitely a bad thing…although I don’t know all the ways it is harmful.

Is it harmful during sleep? My CGM thought so (alarm).

My only experience with daytime hypoglycemia is in “bonking” which is when the liver runs out of glycogen during endurance exercise, and the brain has a “fit” (heart attack symptoms, I’m told). I can attest it is very unpleasant. I thought I was dying the first time it happened. It only happens to me occasionally, and only if I fasted for at least 12 hours and then did HIIT.

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#50

Absolutely agree with your Joe and also like the info and rationale provided by @Neo .

I don’t think the lower is better is necessarily the goal. I’d reframe this to running it as low as possible while not having symptomatic hypoglycemia. For example, when my blood sugar is in the 50’s, absolutely no symptoms at all. With the regimen I use, I still have times with food where I’ll go up to 180 mg/dL if I eat a fair bit of carbs, briefly, but have been running an HbA1C right around 5%.

It’s is more the issue of avoiding side effects. I personally find a combination of GLP-1, SGLT2i, Acarbose seems safe for most people and generally doesn’t lead to symptomatic hypoglycemia. Each of these items has longevity and neurocognitive benefit. However, if there are side effect/hypoglycemia, then it needs to be backed away from.

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#51

Great, all good :+1:

Part of my goal is to have a low variance - so also decrease any steep down movements

In general think

Captures roughly my personal heuristic

(And also that what is optimal for longevity (perhaps the way Mike Lustgarten works out) is not necessarily the as I what is needed/optimal
for an endurance athletes - at least around key endurance work)

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#52

You sure this is a real alarm and not because your body weight ended up on the arm with the sensor for a bit?

I was having that issue, and then I moved the sensor to where the arm is a bit more fleshy a bit “higher” AND closer to the arm pit (as I think Levels suggests) and then I did not have that issue with low glucose alarms on the CGM anyone during night time.

I figured it out once during the day when the alarm went off when I was as lying on a sofa during the day

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#53

On that topic: Are you still doing Pendulum? Did you ever add their Polyphenol Booster?

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#54

I need to replenish my supply. I did not ever use polyphenol booster. I eat ~40 different plants per week.

After my CGM experiment, I am back to using metformin on my non lifting days (which includes my rapa dosing pre and post interval). I also use Farxinga, berberine (switching back to berberine HCL from dihydoberberine), and food order (fat first; eggs typically). And I walk after dinner.

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#55

@Joseph_Lavelle What is the proposal to perform a HIIT fasted? What do you want to achieve with it?

I also don’t see great data about glucose. @Neo Attia talked more, when he was in his metformin phase, no? That time he was more concerned about it

Thank you guys

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#56

I saw this report from a few clients too.

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#57

@DrFraser we also know that less carbs a person eats, an extreme like a carnivore diet, they become “carbs intolerant”, and when they eat more their metabolism just doesn’t know what to do with it. Do you have any thoughts about it?

Thank you

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#58

Fasted HIIT is the only form of exercise that has consistently produced weight loss in clinical studies. For me, it sends my ketone level skyward for several hours.

#59

Yes, stacks of thoughts on this.

First thing, I’m whole food plant based for good reason. It has the highest evidence of anything for promoting longevity. Some debate this vs. Pescatarian, but this was confounded by late hemorrhagic stroke and cognitive decline, which is easily manageable with omega 3’s and B12 optimization.

As a side note, this is one of my concerns with Attia, is that he minimizes diet and maximizes exercise. Both are important, but diet trumps exercise.

The primary cause of T2DM is the amount of animal protein consumed. But once people have T2DM, they focus on carbs. They often end up then increasing the protein they have, and this is the thing that assures they’ll continue to have T2DM. The ADA diet is precisely the diet that assures you’ll continue to have T2DM. Carb intake is relevant for simple carbs, but for complex, that is the primary mechanism where we can see up to 90% reversal of T2DM within 4 years of the diagnosis. You can look at Greger and The Physician’s Committee podcasts for more details on this.

So our diet is probably 40% Complex Carb, 30% each on fat (healthy non-animal) and protein (also all plant based). It is important to optimize B12/Folate/Uric Acid/Homocysteine/Omega 3 index with any dietary pattern.

Getting >1.2 grams/day of standard protein or >1.6 grams/day of WFPB protein is probably the maximum that results in improved muscle.

Limiting saturated fats to <10% of fats consumed is also important.

That would be my quick primer on this.

For folks wanting fiber, WFPB protein, take a look at Zursun and Rancho Gordo Heirloom Beans - awesome protein and fiber, stacks of phytochemicals. Both do a great job.

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#60

Interesting? May I ask what kind of HiT protocol you use when yout do HiT in a fasted state.

#61

I use the so-called Norwegian 4x4 protocol which mimics cross-country skiing:

  1. Short warm-up (~5 minutes)
  2. Four minutes of sprinting at 85%-95% of maximum heart rate or at least at the maximum speed you can sustain for four minutes
  3. Three minutes rest, such as very light walking, to allow the heart rate to decrease
  4. Repeat this cycle (excluding warm-up) four times
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