“The key to living with Diabetes lies in taking responsibility, owning the condition and being accountable. It’s not about blame and it’s not about excuses. It’s not something outside of your own body. You have to own it and be proud of it. Embrace it and live it. Diabetes is a reason to be healthy and fit; it’s a motivation not an excuse.” (Jason Lonergan)
This is the story of Jason. Husband, soon to be Father, 3 hour marathon runner and type 1 Diabetic. Jason came to see me about 2 months ago to fine tune his nutrition and his story is so exceptional I asked if I could share it with the world.
Let’s start at the beginning. Jason was not diagnosed until the age of 21, (1992) but his 2 brothers and Mother were diabetics so he was all too familiar with the condition. Growing up, Jason said his family would focus on eating 6 meals per day, all centred around carbohydrates, as instructed. His brothers and mother would eat a set portion of carbohydrates per meal and inject insulin accordingly. The main dietary advice outside of the standard dietary recommendations, was to avoid all sugar and sweets unless treating a low, in which case bread and honey with an iced coffee or cake were generally used. There was no preventative advice offered to Jason because 3 out of 5 members of the immediate family already had the condition and so Jason was deemed unlikely to develop it based on statistics.
Prior to diagnoses, Jason went off to boarding school and distinctly remembers eating a lot of filler foods like white bread with every meal and copious amounts of dairy. His school life was extremely active both mentally and physically, playing every sport known to man and doing well in class. In his early 20s, the habits of a typical bachelor began to set in. Although still very active, something was creeping up on him without his knowing. A weeklong skiing trip with mates turned into an unforgettable occasion for all the wrong reasons. By the end of the week, some tell-tale symptoms had set in including unquenchable thirst, the constant desire to pee, hunger and over the proceeding weeks, blurred vision, a mottle coloured tongue. After a few weeks of this, the penny dropped and Jason suspected diabetes. Unlike many people, Jason understood diabetes and the symptoms, which was lucky. Jason tested his own blood sugar levels using his Mum’s monitor and sure enough the levels were sky high (24mmol/ml). After a phone call to the family’s Endocrinologist Jason had his first shot of insulin, which has been an undeniable part of his life ever since. There was no face to face appointment at this time; simply a verbal diagnosis of type 1 Diabetes and a prescription for insulin. The family Endocrinologist knew that Jason was in good hands with his Mum. An appointment was arranged a few weeks later and a trial of high carbohydrates with moderate insulin dosage was established. Jason was informed to stay safe and run the BG levels towards the higher spectrum of 8-12mmol/L without concern until he settled into a pattern and learnt how his body reacted to the so many facets of diabetes control. Jason says that everyone is different and all diabetics need to take their own initiative in understanding what works and doesn’t work for them.
Over the following years, Jason continued in much the same fashion. He followed what would have been considered a fairly healthy diet; low in fat, moderate protein and carbohydrates from wholegrains, dairy, fruits and cereals. The whole theme was focused on eating carbohydrates. ‘That’s what we counted at every meal’, Jason says. He felt healthy, looked healthy and was happy. There was never any suggestion to learn more about diabetes, there was no cure and treatment processes were slowly getting more efficient and mobile. That was about it. Just keep on doing what you’re doing is what Jason heard time and time again.
Early in his years of being a diabetic, Jason consulted a diabetes dietician to learn more about the disease and how to manage it better. He was given a basic explanation of what diabetes was and how a diabetic must eat carbohydrates and manage BG levels with injecting insulin. Most importantly avoid quick acting carbs like sugars etc. Recommendations were made to consume diet soft drinks or artificially sweetened foods to compliment the every day diet that was and still is the common way. He was instructed to eat more carbohydrates before and after training to ‘top up’, keep his fat intake low and bolus with insulin accordingly for the carbohydrates on the plate. Besides ‘eat a slice of bread instead of a donut’ this was the extent of the nutrition advice Jason received and it didn’t help with diabetes management or his overall health. “Nutrition as I understand it now, was never suggested’, says Jason. At this point, his HbA1c* was sitting around 7.5 to 7.8, which is quite good and often meant his advisors didn’t consider providing him with any further assistance, considering Jason as doing everything right. There were far more challenging patients to work with, they felt, so he was advised to just keep on doing what he was doing.
In 2010 Jason’s Endocrinologist reviewed his long term HbA1C results to discover a marker indicating Coeliac Disease. At this point, Jason was unaware this was even being tested and was shocked to see that his Endocrinologist had never mentioned it before. Apparently long-term diabetics are very susceptible to developing Coeliac’s Disease. “I didn’t even know what it was, let alone, that Diabetics are very susceptible”, says Jason.
After a biopsy Jason was officially diagnosed Coeliac. Jason was now challenged with not being allowed to eat glutinous foods such as bread, pasta, cereals, and many, many other foods that contain gluten. Jason had NO SYMPTOMS, no noticeable irritable bowl, lack of energy, foggy brain, bloating or any noticeable deficiencies. But capturing this disease early meant that it was manageable and not health threatening. As long as all gluten was never consumed, Jason could live as well as he had been. “The question is, why wasn’t this ever mentioned before, why was I never told to reduce gluten and manage my diet to protect from developing this disease, when there is a known link between diabetes and coeliac disease?” There were no dietary recommendations given, except contact the Australian Coeliac Society and start learning from there. That’s it.
Jason was convinced that there was still a better way to manage diabetes, and now coeliac disease as well. So he took matters into his own hands. He consulted an open minded dietician specialising in improved athletic performance including aspects such as muscle development, fat loss, eating the right forms of fat, protein and carbohydrates for athletes. This dietician encouraged more balanced meals; including good fats and protein and less starchy carbohydrates. Portion sizes were also reduced and over a period of 18 months, Jason became leaner, dropping 8kg of body fat and gaining 5kg of lean muscle. At 70kg, his body composition was spot on for running fast. By this stage Jason had competed in many triathlons, half marathons and 3 full marathons. His times were getting faster and faster and it wasn’t because of his training alone. The diet was helping him.
Alongside the work Jason did with this dietician, he began looking for other sources of information to better manage his condition. He stumbled across The Wellness Guys podcast (episode 27 with Mark Sisson to be precise) and a whole new world of wellness opened up. The constant stream of free information available astounded Jason and he began to truly understand complex issues including cholesterol, the impact of saturated fats, the importance of sleep and food quality. He had an ‘ah hah’ moment, saying to himself that “it’s all got to be simple, life has to be simple, eating has to be simple, it’s got to be about ‘just real food’ and nothing processed, nothing man made.” That clarity has stuck with Jason every since. This was the catalyst for more changes including a switch to mostly organic foods including grass fed meats, more animal fat sources, high quality dairy and fermented foods and a complete shift away from processed foods including cereals.
From a numbers perspective, Jason’s results continued to improve. He found that his blood sugars were more stable with less ‘high’ highs and ‘low’ lows. His HbA1c dropped to range between 6.7 & 7.0 and his blood cholesterol continued to improve; HDL increased and LDL came down. With each visit to his Endocrinologist, he would ask (and continues to ask) ‘what can I do better?’ And despite improving with each visit the answer is always the same; ‘I’m not sure Jason, you are doing everything you can. You are doing better than everyone else. Just keep doing it’. ‘Why, when my results are getting better and better and I’m telling my Endocrinologist that its my diet helping me achieve these amazing results, that my Endocrinologist glazes over and is stumped as to what to say or do?’, asks Jason. ‘There’s no connection between nutrition and better health or better diabetes management it seems….but why?’
The next big ‘ah hah’ moment was when Jason began to consider fat as a potential fuel source for his running, instead of glucose. It made sense from a diabetic perspective and he began experimenting. In 2013 he ran a marathon on nothing but 4 salt tablets and water, finishing in 3 hours 8 minutes. His pre-race fuel was a combination of macadamia butter on Gluten Free toast plus a little salt. His blood glucose reading at the start of the race was the same at the end (around 5.7mmol/L). In 2014 Jason completed another marathon in 3 hours, 1 minute. This time Jason prepared his own gels to fuel himself during the race. His homemade gels were made of real foods like chia seeds, coconut milk and oil, blueberries, salt and a small amount of banana. This is when the idea of fuelling with fat was tested and Jason felt it was working. Jason began working with me in April 2015 and we are refining an LCHF nutrition approach (low carbohydrate high fat) to keep him well fuelled for his exercise and reduce his dependency on insulin. Last week, he ran a total of 100km and did 4 yoga classes. His longest run was 32.5km which he did using water alone. Here are Jason’s comments below:
“This was a big week running wise. In the past month I’ve increased my weekly Km dramatically from 50-55km to 70km up to 82km to 94km to 101km this week. I ran on Sat with very little fatigue and finished the last 8km at my marathon race pace of 4min 5sec to 4min 10sec/km and felt I could have kept running once finished. I felt no hunger, no weakness and still plenty of energy when completed. I tested by BG straight afterward at 7.8mmol/L, it was excellent. I had a simple coffee before another 1hr 15min of YOGA. I have not had as much energy in Yoga for a long time. I was more focused, more in tuned with the movements and held my positions with much better form than I feel I have done in the past few weeks. When I was finished I was not hungry but was looking forward to having something to eat. I had plenty of energy still and felt very clear minded with no soreness in the legs which I usually do after a long run. Particularly in the achilles tendon area. I spent the rest of the day on my feet at the shops and only felt tired from about 3pm onwards.”
Jason’s energy, vitality, mental clarity and running performance have been exceptional for some time and they only seem to improve with each step forward. With the recent tweaks to his diet, he feels calm and confident and well satiated. He hopes to further reduce inflammation, training stress, and his dependency on insulin. We hope that his HbA1c will continue to come down. Still hungry for more knowledge, this month Jason is really focusing on his gut health, aware that a healthy gut is imperative for wellness on all levels. Homemade kefir and sugar free kombuchi are on the brew as are sauerkraut and kimchi.
Jason said he cried when he was first diagnosed, back in 1992, but that was the only time he felt down about being Diabetic. The shock was overwhelming at first as he thought he was eating well, based on the standard diet recommendations, he was active in both work and sports, his weight was excellent and he had a healthy outlook. But ever since then, he has embraced his condition, using it to stoke the fire of desire to be as healthy and as fit as he possibly can be. Jason says some of his piers will comment that he is a little fitness fanatic and that they couldn’t do what he does. Jason simply says with a smile, that he has to, because he is a diabetic. So rather than use his condition as an excuse to not get out there and do extraordinary things, he uses it as a reason! “That usually shuts them up. But in truth, I do it because I want to live for a very long time. Not only that, I want to live very well for a very long time. There’s too much good out there to miss by being sick and guided into early aging by ignoring the real benefits of eating, exercising, and living intelligently. Everyone can do it, it’s a choice we all have.”
He is disappointed that the information he has learnt in recent years wasn’t offered to him much earlier. He’s had to find the information himself; no medical expert has ever mentioned that diet or nutrition can help you live well. Like so many of us, he wonders why nutrition and lifestyle are not an integral part of diabetes management. Diabetes is a condition directly affected by the food one eats… and yet a conversation about diet is often overlooked. Furthermore, why is carbohydrate reduction looked on with disdain by so many health professionals, when diabetics are incapable of processing carbohydrates effectively? These are some of the questions that we need to address and implement subsequent changes to achieve effective management of this condition. Managing diabetes is not about the foreseeable development of Coeliac Disease, amputating limbs or laser eye surgery; rather, these are the consequences that we can collectively work together to avoid in the first place.
Please know that this article is intended to inspire you as the reader and open your mind to some new possibilities. This is not individual medical advice and you should always consult qualified health professionals before changing your diet, lifestyle or medications. This is not intended as a dig at modern medicine on any level; insulin is a lifesaver for diabetics and in some cases, so is surgery. However, it is time to acknowledge that diet and lifestyle education must become an integral part of the health care system. The management of chronic diseases, Diabetes and beyond, will benefit enormously and people’s quality of life can be improved immeasurably. Whether you are a Diabetic yourself or not, there is no doubt that Jason’s story is inspiring and I am sure you join me in thanking him for sharing it with us. As Jason has attested, knowledge is empowerment and will enable you to do some extraordinary things if you see opportunities as opposed to obstacles in your path.
*HbA1c levels are not influenced by daily fluctuations of blood sugar levels; they reflect the average glucose levels over the prior six to eight weeks and as such they are a key measurement for diabetics. Complications are lessened if HbA1c is below 7 and normal is considered to be below 6.