DrFraser pegged it: My pancreas is a lazy thing and inappropriately sits around using TikTok even when my BG, in the morning, rises to a (12-hour fast) 158.
Most then say: “Well, you are simply insulin resistant.” Yet, in fact I’m about as insulin sensitive as a person can get.
It’s odd, and I’ve seen it with others, usually I suspect, elders. It’s a very inappropriate dawn phenmenon, so my pancreas must sleep in early AM, as it get’s its act in gear later in the day.
CPS beats solid T2DM anyday, though I realize that’s the direction I’m heading in.
Any thoughts on my using (which I ordered today from Jagdish) rapamycin? I’ve read where that can increase BG and have read where it does not. Rapa + Met, then after a while try Rapa + Met + acarbose?
Because metformin is not expected to do much for your glucose levels, given your underlying insulin sensitivity, I’d think it would not in anyway protect against any adverse metabolic effects rapamycin could cause in the area of glucose. Not everyone has worsening of their glucose with rapamycin - but it is common, and I think dose related - or probably more likely serum level and metabolism related.
However, if you are looking at getting your blood sugar down, I’d discuss with endocrine on DPP4 vs. SGLT2.
I see a lot of relaxed attitude with some people on this just — “We’ll watch it and recheck in 6 months.” It depends on the doctor.
I’d generally like to see the HbA1C sub 5.0% if trying to optimize longevity and cognitive decline. But you’ll need to negotiate with your doctors. Even if they won’t Rx - it is a valid question - “Do you think I’ll cause myself harm if I were to start an SGLT2 or DPP4. Furthermore, if I were to, which one would be the better choice?”
Would it make sense to skip Metformin on workout days and/or the day after/before?
I also find that a light HIIT-like workout causes PEM/fatigue for me. It seems to start later e.g. after eating or the next day. Just walking does not normally cause it.
I don’t know if metformin has anything to do with it but I found recently about mitochondrial function, ATP which may also be involved with PEM. I was not taking Metformin on workout days though I’d sometimes forget and accidentaly take it.
It will be interesting but I have little faith that I’ll get any substantial answers, especially if I indicate that I’d like to do rapamycin.
Trying to read up on it is difficult. I don’t have insulin resistance so what I have seems to be a sort of sub-set.
I’ve read rapa causes diabetes and have read that it doesn’t. Chronic versus episodic exposure may be a huge factor.
“Is glucose intolerance a part of therapeutic effects of starvation-like drugs such as rapamycin? And may such condition be not only benign but also prevent true diabetes and its complications? Although these questions are very intriguing, the answers are not immediately crucial. Simply, the most rational anti-aging schedule is an intermittent (rather than chronic) administration of rapamycin [53, 80]. First, this will eliminate potential side effects. Second, intermittent administration of rapamycin may in theory rejuvenate stem and wound-healing cells and (in contrast to chronic treatment) improve wound healing [80]. And intermittent administration of rapamycin extended life span in mice [81-86]. Also, brief treatment with rapamycin does not affect mTORC2 [87].”
Remember too that my A1C is normal, so if I were to start taking rapa, w/ the go slow, start low, well, any increase in BG would simply lead to my stopping it.
I could even take it for 4 days, wait a day then work out on two-days. I do a bit of HIIT cardio but have not experienced any PEM/fatigue, actually the opposite–I feel very energized.
I have been taking about 600mg of NMN which was interesting. My cardio (remember I’m 74) Zone 2 is about 108-120 and it was easy to push to 130 in a sort of 3 minute HIIT. But, after taking the NMN for a few days I had trouble getting up beyond 120. Using mets/cphour. it seemed that my cardio has gotten more effecient. In other words, I was still doing 500 cals/hour and seeing 112 Bpm whereas the prior week when I did 500 cals/hour on the elliptical I was getting up beyond 124.
My husband has been overweight and diabetic for 30+ years, the whole time on metformin. He’s now 67 years old and BG had been increasingly difficult to control. He wanted to try rapamycin, but decided not to until/unless he could address that issue. He started a whole foods diet (with complex carbs) along with acarbose at a dose of 50-100 mg before each meal 3 times a day. His A1C fell from 7.8 to 5.4 within 3 months, his fasting glucose is now consistently in the 90s, and his BG after eating averages around 150. It’s been a miracle for him. He’s been taking 5 mg weekly rapamycin for about 10 weeks now and continues to maintain good BG control. He cut his metformin dose in half.
The only side effect he had initially was gas, but his body adjusted and it doesn’t happen anymore. I should also mention that he did great with his diet (along with some exercise) and lost about 30 lbs. So it was a combination of the acarbose and diet.
The 5 mg of rapa has had no adverse effect on anything. His BG and lipids continue to steadily decrease. Triglyceries are down to 52 and LDL is 67, all-time lows for him, and that’s without statins.
What motivated him to get serious was that he had some numbness in his knee, then an EMG nerve study, and was diagnosed with mild diabetic neuropathy. The numbness has also diminished considerably.