sugar intake and svr

Is there some correlation between sugar intake and svr? I am not a big sugar user, but the hot weather goes so well with frozen yogurt during the times I don't feel like vomiting. I was also wondering the same thing about carbs.
Thanks

[pcds]

I have read posts from others who find cool food items, like sherbets, fruit bars, ice cream are palatable.   Too much sugar is not good in general.  Don't want to mess up the pancreas and insulin production.   I worry at times about getting diabetes from this tx.  Diabetes on one illness I prefer hep c over.  At least there is tx for hep C.  I was eating more healthy before tx.  Now I just try to eat what make me feel better.  Cool desert items are on top.  I live in the desert and it's 110 outside.  Of all the reading I've been doing, nothing about SVR and diet.   Just eat along with the riba, with some fat.  Now after tx I may be more seriously looking at foods that help my liver or hinder it.

[Bill1954]

Hi Dave,

I think as long as you’re metabolizing carbohydrates properly, there shouldn’t be any issues. If not, there might be some concern with insulin resistance and its relationship with sustained response.

Do you have a family history of diabetes or any problems with it yourself in the past? Type II diabetes is usually associated with how we metabolize carbohydrates; we develop resistance to our own insulin; the stuff we make doesn’t work efficiently any more.

There are tests like the HOMA IR that can quantify insulin resistance, and a simple fingerstick test can check your blood sugar.

And I tend to agree with pcds; diabetes is a b!tch to deal with; I’ve had to manage it for over 8 years now, and it’s always in the background nagging at me :o).

--Bill

[spectda]

I have no family history of diabetes. My glucose has been a little high. 99-107, but the trial nurse told me the A1c test was normal. I don't know much about the A1c test but she said that is the true reflection of developin insulin resistance, is that true? my glucose seems to have crept up over the years. I have changed my eating habits and lost weight because I have early stages of nash, some macrosteatosis.

Are you able to control your diabetes with diet?

- Dave

[GreatBird]

Protein is essential to rebuild tissue. I found that once I started making sure I had protein with every meal (not a whole lot, but some) I started to feel better. I didn't feel like eating it, but I didn't feel like eating anything. Maybe the feeling better was a coincidence, maybe not. I honestly feel like it helped overall. Bear in mind that people with cirrhosis need to be mindful of where they get their protein from and how they can end up with too much ammonia because of it. But those of us who don't have that kind of liver damage don't need to worry.

Once I thought about it, I realized it made sense that with the onslaught of the tx drugs and how they seemed to be breaking me down that it would be helpful to have protein to build myself back up.

[spectda]

I used to eat those frozen fruit bars from trader joes like they were going out of style. I have really changed my eating habits. We get older and probably too little too late we react.
- Dave

[pcds]

I agree about the protein.  I keep unsalted, roasted almonds around for light frequent protein.  Also used sometimes to add some fat to what I eat with riba.

[spectda]

I have been a vegetarian for 35 years, but over the past 5-6 years my eating habits really declined and I started gaining weight. It's amazing how much crap a vegetarian can put in his mouth. When I first met my wife, she said I was a chipatarian, she said you're a vegatarian who doesn't eat vegetables! I do eat dairy but not an enormous amount. I try to eat rice and beans and tofu a fair amount for protein.

[spectda]

I have the almonds too to take with the riba! healthy way to get some fat and protein.

[Bill1954]

No, the A1c test ‘histories back’ blood sugar levels. It’s also known as a ‘glycated (or glycosylated) hemoglobin’ test, Dave. Wiki has an article on it; this covers the basic principals:
~~~~~~~~~~~~~
“In the normal 120-day lifespan of the red blood cell, glucose molecules react with hemoglobin, forming glycated hemoglobin. In individuals with poorly controlled diabetes, the quantities of these glycated hemoglobins are much higher than in healthy people.
Once a hemoglobin molecule is glycated, it remains that way. A buildup of glycated hemoglobin within the red cell, therefore, reflects the average level of glucose to which the cell has been exposed during its life-cycle. Measuring glycated hemoglobin assesses the effectiveness of therapy by monitoring long-term serum glucose regulation. The HbA1c level is proportional to average blood glucose concentration over the previous four weeks to three months. Some researchers state that the major proportion of its value is related to a rather shorter period of two to four weeks.”
http://en.wikipedia.org/wiki/Glycated_hemoglobin
~~~~~~~~~~~~~~~~
In essence, the A1c test ‘histories back’ our serum blood sugar by measuring how much sugar coats a red blood cell after a known life span of 120 days. Importantly, we need to be very cautious using the A1c test during HCV therapy. The test gives skewed results during HCV treatment because the ribavirin causes hemolytic anemia, and this affects the lifespan of the red blood cell; sometimes dramatically. Again from the same page in  wiki:

“Lower-than-expected levels of HbA1c can be seen in people with shortened red blood cell lifespan, such as with glucose-6-phosphate dehydrogenase deficiency, sickle-cell disease, or any other condition causing premature red blood cell death. On the converse, higher-than-expected levels can be seen in people with a longer red blood cell lifespan, such as with Vitamin B12 or folate deficiency.”

I’m not so sure the A1c result is indicative of insulin resistance, other than indirectly because higher blood sugar values can be attributed to IR at times. Importantly, be sure to discuss the use of A1c with a clinician if they order it during HCV treatment, Dave.

Bill

[GreatBird]

Do you eat eggs? That's also a great way to get protein. Yogurt and cottage cheese are also good.

[Bill1954]

Oops, I didn’t answer your last question. No, I’m about maxed out on oral antidiabetic meds right now. At one point in HCV treatment, I was using a lot of Lantus insulin on top of these too… I don’t seem to need it lately, though.
Bill

[spectda]

Thanks bill-
The result that I got was from pre tx during screening and day 1, but it sounds like it doesn't mean much. Does that mean that the glucose level is much more indicative of developing resistance. Does the 99-107 fasting glucose mean I am likely developing resistance?

[spectda]

I don't eat eggs, I've been eating 4% fat cottage cheese during tx thinking it may help with the riba absorption, perhaps that is not the proper amount of fat though. I eat almonds also for the same reasons that pcds mentioned.

[GreatBird]

I always used my morning egg for the riba absorption and had my evening dose with my dinner which always had a reasonable amount of fat. Not sure about the cottage cheese either. You might look on the carton to see how many grams of fat that translates into in order to tell. It depends (of course) on your serving size.

[Bill1954]

Dave,

Fasting glucose <100 is normal; 100 to 125 is considered pre-diabetic, and greater than 125 (again fasting) is suggestive of a diabetic condition.

Insulin resistance is where the body doesn’t properly/efficiently utilize endogenous (what our body makes) insulin. Because of that resistance, blood sugar often increases unless we intervene somehow; this could be pills to decease IR such as metformin, or possibly injecting supplemental insulin; either one tends to work.

However, it’s quite possible to have virtually no insulin resistance accompanied with elevated blood sugar levels; type 1 diabetics are an example. Their pancreas don’t produce insulin, so their blood sugar rises; but they don’t normally have issues with insulin resistance. Am I confusing you? I’m not sure if I’m saying this correctly. If not, I’ll try a different tact.

A good article that covers all this is here, at the NIDDK site:

http://diabetes.niddk.nih.gov/dm/pubs/insulinresistance/

It’s a bit of reading, but really informative if you believe you might have issues, well worth the read.

--Bill

[Isobella]

When I was tx-ing, I was totally addicted to sugar, as evidenced by my intake of watermelon, raspberry and blueberry licorice.  Fueled also by my intake of fat free frozen yogurt..  I was UND by day 21 and SVR....just had my 1 year post done and will let ya know it that changed. I'm still fighting the sugar cravings because of the possibility of IR.

The A1c test is the definitive diagnostic test for diabetes, or pre-diabetes according to my Pharmacology professor.  Below is a link re:  A1c....it's also a great website for accurate information on just about everything. And it's in easy to read layman's langauge...love it!!

http://www.mayoclinic.com/health/a1c-test/MY00142

Isobella

[Bill1954]

One more thing; a single fasting blood sugar result is about as predictive of diabetes as a single high blood pressure result is of hypertension; not very much. It might be enough to warrant watching it a little closer; serial tests can be conclusive. Do you recall what the A1c results were?

[spectda]

Bill and Isobella-
Thanks for the information. I have some reading to do!
Most importantly from this discussion I have learned that frozen yogurt if your not diabetic appears to be very important to svr! I am glad to hear that.

Isobella that is wonderful that you became und at 21 days. It must have been great to treat knowing that you were having a real result like that and likely to svr.
- Dave

[spectda]

I am not sure what not sure what the results were from the day one trial, just that the nurse said they showed no insulin issue according to ac1. They will tell me numbers, but they won't print the labs for me. I found another test I had in december, the glucose was 100 and the ac1 was 5.7. The highest my fasting glucose was at 107.

[spectda]

I've also eaten a lot of avocados with the riba, probably better then high fat cottage cheese.

[Isobella]

~~~They will tell me numbers, but they won't print the labs for me.~~~~

Bring a pencil and paper, that't what I did =)

[spectda]

I've been writing the most important stuff down each time but not everything. My nurse emails me vl, hgb and anc as soon as she gets it.

[Diane12855]

I read a book called the "Insulin Resistance Diet" which was for people with known Insulin Resistance or with a family history of diabetes and want to make sure they don't get it. The basic premises is you should have half as many grams of protein as you do carbohydrates, and a man should never go over 45 carbs per meal. They encouraged 3 meals and 2 to 3 snacks a day so there is never time for the blood sugar to drop too much. They say that spikes and valleys in blood sugar can lead to problems too. Ultimately you will have to do a lot of label reading, which makes grocery shopping take forever.

Hope this helps,
Diane

[merryBe]

ok, here's what I did not know that is important to know.

Interferon lowers insulin, cancelling it out.

Then the pancreas works harder flooding the body with extra...the cells then overeat...they get tired of overeating so they form a resisitance to the insulin, then the cells can't eat as much, even when the body is full of sugars the cells are starving...

that's why the vlack box warning says  "may cause diebetes (diabetes)"  type 2, insulin resistance can be followed by type 1, worn out pancreas not producing insulin.
And, you can even have both types at the same time.

and the final nail, is insuling interferes with the way interferon works, basicallyneutralizing much of it. So the higher your blood sugar stay, the less chance you will SVR because much of your INF dose is being cancelled out.


so, interferon interferes with insulin, and vice-versa...

what to do....eat less sugar, less calories, eat some fat with each meal to slow absorption, eat foods that have the right glycemic profile.
Read  "the Zone" by dr. Barry Sears...

go to CoWriters journals in Medhelp and read them.
The body craves sugar when the cells are starved, byt the cells can be starved in the midst of plenty.
Get a HOMA done.  PM me if you need more help.

look, a higher BS during tx is not something to get alarmed over, not your numbers, and those will most likely return to normal after tx.
the bigger issue, is folks who aren't well like comfort foods..and sweets are right up there, and nobody tells them that sugars can nix their tx success...

did your doctor tell you??  Nope, or else why ask the question.

[merryBe]

opps almost forgot,,your A1C....can't go by it...why, because it is based or HGB...
when you treat you lose about a third of your red cells and that throws the A1c off...
so your a!c might seem fine, but the HOMA score will tell the tale much better...as it does not rely on a sckewed hgb count.

[copyman]

Not sure about the sugar but I remember reading an interesting article that high lipids, specifically LDL increased the odds of SVR. I thought, for once something that is suppose to be bad for you can actually help with HCV treatment. I think this lipid thing also has something to do with the studies done with statin drugs and TX.

[Isobella]

I posted a link to a video last week and they discussed higher LDLs correlating with SVR.  Vitamin D levels as well.  

[spectda]

Oh well, slighty elevated glucose and low ldl for me! LOL I'll starting eating sticks of butter with my riba and no sugar!

[merryBe]

I would absolutely love to have a discourse with someone about this. There are varying reports on  the LDL part of the equation...not all abstracts agree.

if you are versed in lipid speak maybe we can look at some studies together.
I'd really like to understand the mechanics better, including the hydrophobic cells and why one lipid might be contibuting to a more permeable viron shell.

pm me if you want to be codetectives here.

[jusjames]

let me tell you something about the so called fat content you should have with riba , wait i cant be bothered.

[pcds]

You crack me up!  Us newbies are so desperate for an edge aren't we?  In the end it doesn't matter I'm sure.  It's trying to have some control of this thing inside us.  If outcomes were better for geno 1 we wouldn't be sweating the small stuff.  Your perspective is refreshing.

[jusjames]

;-)

an interesting fact follows

the reccommended amout of fat to take per riba dose is 50 (ish) grams
so 100 grms a day for two meals plus your third meal and any snacks
lets say 125 grm per day .
what is the reccommended amount of fat per day for a man?

70 grms
so dont get hung up on numbers  (too much )
i would never consider taking that much fat in a meal so am i doing it wrong?

every one on tx worries the small stuff what ever Geno they are, you are normal so dont worry...

[copyman]

All, I didn't mean to change the subject of this thread. It just brought to mind the lipid thing since glucose & lipids are part of the metabolic system. It is important for any newbies reading this that many of these posts are just peoples opinions but fact is you should to take fat with RIBA. It helps with absorbtion.  Even a glass of "whole" milk will work.

Merry, I'm not that well versed on the lipid correlation to svr. I just remembered an article I had read and figured it was worth posting. I would be interested in seeing more studies done on it. From what i read there is definitely something with the lipids and HCV replication. Take care