[HappyJack]

I have been on a roller-coaster with my weight and continuous muscle loss over the last 10 years. I can diet and loose weight and feel good most of the time or better until I get close (with in 20 lbs.) of my recommended weight range. Then I feel weak and tired. This is with great BS control with A1C in the low 5's. When I start to eat more I feel good again and my BS slowly climbs until I'm in the 7's and heavier and feel bad again. So I start over with diet and tighter control. And it all starts again but it seems that the muscle loss is happening no matter what I do. I was told by a hand doctor that I had muscle wasting and sent to an orthopedic back doctor and found to have spinal stenosis c6/c7 and he wanted to fuse this. I talked to another highly respected nuro surgeon who said I did not need this unless I had shooting pain. Don't have the pain that was described. I do have sensation from my pinky to my elbow on both sides that was found not to be from my back/neck according to a nerve study.

So I have let my diet add a bit more food and have stayed in the 7's and have had my doctor increase my medication. I am slowly loosing weight but am still week. Next A1C from my morning BS levels looks to be in the 6's. I am on Glipizide 10mg twice a day and Jardiance 25mg once a day. But still weak.

Now for the questions. Has anyone had muscle loss for diabetes and how do you treat it or reverse it. Are there medications that are better for this than others. In other words should I ask my doctor to put me on different medications.

Thank you for any help you can provide.

 

[itissteve]

tbh as I read your note, HappyJack, my first thought was about your daily protein intake. I've been reading a few articles lately indicating that many people need more protein than the traditional guidelines prescribe. Do you know (or can you make a good guess) at how many grams of protein you take in in a typical day?

There also are the questions of exercise levels and age, both of which have an effect on muscle retention/loss. The pandemic has altered many fitness regimes. Nothing much we can do about age, but it would be helpful to know whether you're on the older side or the younger side of life.

Do you have an appointment with your doctor yet?

 

[HappyJack]

tbh as I read your note, HappyJack, my first thought was about your daily protein intake. I've been reading a few articles lately indicating that many people need more protein than the traditional guidelines prescribe. Do you know (or can you make a good guess) at how many grams of protein you take in in a typical day?

There also are the questions of exercise levels and age, both of which have an effect on muscle retention/loss. The pandemic has altered many fitness regimes. Nothing much we can do about age, but it would be helpful to know whether you're on the older side or the younger side of life.

Do you have an appointment with your doctor yet?

 

[mbuster]

Hello HappyJack, welcome back.

I see you were trying keto back in 2013, how did that work out? Did you give up on it? If so how long were you on it?

As far as the muscle wasting, have you addressed this with your doctor? Here is an article relating muscle loss to diabetes that came out in February 2019, may be able to find others on the WWW. Fatty liver, NFLD and cirrhosis of the liver can be causes of muscle loss. You should talk to your doctor about other possible causes.

Not sure how you are doing on protein now, but sounds like it wasn't a lack thereof back then. Are you physically active? Anything different when you hit the point of starting to get tired all the time?

 

[HappyJack]

My diet for weight loss was high protein very low carb. I would even count the few carbs in meat and vegetables. Not much fruit until this last time. And no bread until this last time. I did get carbs from yogurt. Some from oatmeal a few times a week. Large portions of egg whites, lean beef, chicken, and fish. And I exercised but the longer I exercised and lost weight the more difficult it became. Diet was 1600-1700 calories as advised by a dietitian at a Diabetic center except I was lower carb and higher protein than recommended. And well over 2k on the way up. Trying for about 1900-2k now with the carbs added. I am 64 and type 2 since 39. Doc seems to have little time other than to decide if and where to send me with the number of folks he has to see to pay the light bill. Not due to see him for another 6 months other than my A1C lab where his nurse calls with results. I could make an appointment but most likely as he sent me to the hand guy who sent me to the ortho guy he will just write it off to the spinal stenosis. So I wanted to see if maybe there was something to do with the diabetic meds I was on or maybe some that were better. They have a device to put in that permits movement but the ortho guy said no just the fixed H metal bone packed surgery. I sleep on my stomach with my head to the side or I cannot sleep and general anesthesia and narcotic pain meds really make me sick. And they can't do a spinal block that high up. But if I can't find anything else I most like will go back to the ortho guy again for another visit.

 

[HappyJack]

I was in the hospital before that with a foot sore and about 280lbs. That high protein thing worked for about 3 years and 120lbs. of weight loss. Then everything fell apart. Well actually about 15-20 lbs. of loss before that. So I seesawed below 200 for years and the last few over 200. But even with the first big loss of weight I lost muscle just more fat so I weighed less and could manage. But as the weight loss slowed the muscle loss did not. Doctor did take me off Asprine and put me on Tylenol but I have had yearly checkups and blood work. Not sure how much of that would show my liver function. I will take a look at the article to see if I can find some help. Think you.

 

[mbuster]

I thought you were asking about meds used to treat muscle wasting in your first post, my bad. Here is a link to diabetes meds on BloodSugar 101 that lists the good and bad about them. you can click on those that you are taking to read about them.

Counting calories sounds logical, but in reality is not a good sure way to go about weight loss because although you can measure the intake and can estimate the output with exercise, you don't know what you're burning just running your body. Too many things affect how your metabolism functions. I was about 70-75 lbs over my ideal weight when I started eating LCHF. I went from 240 lbs or so down to 185 and leveled out. Without changing anything I was doing, I gained back to 195 and leveled out. I wanted to lose that 10 lbs back and a little more. I was in ketosis and thought I should cut calories. I had room to cut some more carbs but wanted to pick up a few more fat calories. So I weighed everything I ate to get a check my ketogenic ratio. I found out that I had been averaging about 3300 kcals a day, picking up my fats, put me up to 4100 kcal. I started losing weight again, even without cutting back on the carbs. You should try picking your calories back up but with protein and good fats without the carbs to see what happens.

 

[mbuster]

Eating low carb can get you into ketosis and too many calories from protein can bump you out. I think that being in ketosis is less important in your case. But not knowing what you are eating, you may want to pick up on salt. Many processed foods contain lots of salt and when cut out, reduces the amount of salt that you were getting and induces tiredness. They call it keto flu, it's not an illness, just an electrolyte imbalance, for lack of a better term.

 

[itissteve]

Thanks for the additional info, HappyJack. mbuster has provided several data sources that could be helpful for you. Most of my initial thoughts about what could be going on with your muscle loss are either addressed by mbuster's comments or no longer apply with the information you've posted now.

I did a Web search for a few things. I have to put in the disclaimer here that neither mbuster nor I are medical professionals. It does not appear the Kobe University study mbuster linked to applies well to your situation. Diabetic amyotrophy seems to manifest itself in areas of the spine other than cervical and the other symptoms don't seem to fit with yours, either. It sounds like you get enough exercise; disuse is not an issue (though, of course, some exercises. like lifting weights, are better for building muscle mass).

It might be worth coming up with a rough count of your intake of potassium, magnesium and (as mbuster mentioned) sodium levels. Of course, coming up with an exact daily intake will be difficult. What I've done for myself is to look at the lists of foods containing the most potassium and magnesium compared to what I eat. I don't eat much of those foods, so I've started taking potassium and magnesium supplements; blood panels that my doctor has ordered show that I'm in the right areas for those minerals.

Finally (for now), I came across this article, which is geared to radiologists, but may be helpful in getting a better picture (uh, sorry...) for what's going on with you. It's full of medical jargon; the short of it (as I see it) is that if you can get some of these images, they might better point to what's going on (or rule out what's not). You may already have had some of these tests in your recent treatment.

I hear you about being referred around to various specialists, and I am aware that many doctors will attribute almost any ailment to whatever chronic disease a patient may have. As I'm sure mbuster will corroborate, we have to be our own medical advocates. If we can help you pinpoint what might be the issue, tests can help confirm or rule out, and that may put you on the road to finding out what's up.

Thoughts?

 

[HappyJack]

I really do not know. I have no butt. My legs are really small in muscle. My left hand has no web meat or muscle. My right hand a little bit. The 101 diabetic med thing that I read I did not find anything about muscle loss and just a bit about weakness. I do have back problems and a S curve if looking at an xray from the back. I thought about the changes with my first big weight loss and was on insulin then switched to oral meds when I was down to injecting 2-3 units. I tried Metformin but it tore my stomach up really bad. I have an appointment with my doctor next Monday and will see what he can tell me. Might ask about going back on insulin but I had muscle loss with that. I try to be as active as I can and walk with my dog most days about a mile and a half. Lifting weights are mostly the same as everything else. The longer I do it the more difficult it gets. May have some very small gains in the beginning but then it just seems I hit a wall that starts to push back at me and the same thing I was doing last week takes way more effort. I am not doing that ultra low carb diet and yesterday I had 1/4 cup steel cut oats with no sugar added coco mix and a heaping teaspoon of peanut butter for breakfast. A baked boneless, skinless chicken breast seasoned with garlic salt and black pepper on 2 slices of no sugar added wheat bread. And last night I had a salad kit and a salmon filet seasoned with garlic salt and black pepper. Bed time snack was a Boost glucose control shake. I am out of fruit now but have on average 3 bananas a week and blue berries. And most times some cut up fruit mix. Some times I have plain yogurt and mix in unsweetened apple sauce. But my store does not carry the yogurt I used to get. Could go back on my egg white omelet breakfast cooked in olive oil with spinach and mushrooms and a dash of hot sauce with salt and black pepper. 90-95% lean beef patty for lunch with green beans and maybe a small amount of brown whole grain rice for lunch. Mixed green salad with a chicken breast like above with out the bread or with steamed broccoli and cauliflower. My snacks are either Boost shakes or Adkins snake bars. I do break my diet when I try to eat more and do the bad stuff. Pizza, burgers, ect. But sometimes just get pork, chicken, or turkey meat with no sauce from the BBQ place. Just keep trying and not doing anything that has any results other than weight gain or loss. Just was thinking that something to do with my diabetes may have broken down and that is not providing what I need to my muscles.

Think you so much for all the time and the replies. I do appreciate it more than you can know.

 

[robidereck]

I realized that your main goal is to feel good. I understand you.