Greetings from a 4/4 T1DM Apoe4 forum newbie!!

[AndrewYoung]

Hello everyone!

I'm new to the forum and grateful for all the work that everyone contributed to create this haven.

I'm a dad of a two year old, and another baby coming soon (so happy!). My family depends on me to provide. And of course I want to be with them and my wife - physically and mentally - for a long time as they make their way through life.

I'm a 53 year old 4/4 carrier with T1DM (for 27 years) and finding it very difficult to get my A1c below 6%.

I eat plant-based mostly whole food with the exception of wild salmon weekly. Recently had an NT-ProBNP of 150, to my surprise and concern. VO2 Max is 37. I'm lean (6 foot, 160 lbs). Exercise consistently (strength, HIIT, and aerobic). Live in the mountains (5400 feet) and love it here. Have moderate sleep apnea (14.7 events per hour) and lobbying for a CPAP that Kaiser didn't approve.

Experiencing some minor short-term memory issues (so far).

Does anyone else in the community have any advice or suggestions about how I can protect/improve my cognition or health? (Have read/listened to most of Dr. Bredesen's books and Dr. Bernstein's).

Are there any people with Type 1 diabetes among us?

Thanks for your part in this community...

Andrew

[Tincup]

My non T1 two cents.

Have moderate sleep apnea (14.7 events per hour) and lobbying for a CPAP that Kaiser didn't approve.

Have you tried taping your mouth during sleep? It can, in many mild to moderate sleep apnea cases, dramatically reduce the number of events. In this post there are three heart rate vs time graphs. The upper is over night. The first third is without tape, the last two thirds (ish) is with tape. The second graph is a zoomed view without tape. You can see apnea patterns in beat to beat heart rate data. You can see the patterns here. The third graph is with tape and notice how much smoother it is. This is the tape I've used for many years. 200 strips for $13. "Breath" author, James Nestor, uses a small piece vertically. I use the whole strip horizontally. Search on Nestor and mouth or sleep tape & you should find a number of hits.

Does anyone else in the community have any advice or suggestions about how I can protect/improve my cognition or health?

Nick Heath a PhD & T1D has a breathing site. Nick has found that slow breathing has helped his blood sugar control materially.

I'm not T1, though know a number in the low carb community. Have you seen this Nature paper? It is on T1 written apps to link a CGM with a pump. An Aussie engineer friend, Marty Kendall, has a T1 wife and he helps here use this approach. More links to Marty's work in the 2nd part of this post.. The first part of this post is on Zone 2 training. Dr. Peter Attia, in one of the linked podcasts notes he as a T1 patient who does a lot of Z2 exercise after meals and only needs about 9 units of insulin/day. Any exercise will move GLUT 4 transporters to bring glucose into muscle without insulin, but Z2 seems to be the sweet spot such that it is not intense enough to cause the liver to release glycogen. With some of what Marty has learned from his wife's data, my T1 friend agreed. You can explore the links at the bottom of the post to see some of this.

I assume you are familiar with the Type 1 Grit FB group?

RD Dikeman of Type 1 Grit goes through Marty's book here.
"RD’s Type 1 Grit Facebook Group has been a Godsend, helping followers like my wife, Moni, and I understand how to control blood sugars with nutrition.

During our years on this journey, RD has become a great friend, inspiration, and mentor.

RD and I recently discussed my book, Big Fat Keto Lies, and the ways each lie can negatively impact people with type 1 diabetes. "

Welcome & let me know if you have questions.

[TPE]

Hello everyone!

I'm new to the forum and grateful for all the work that everyone contributed to create this haven.

I'm a dad of a two year old, and another baby coming soon (so happy!). My family depends on me to provide. And of course I want to be with them and my wife - physically and mentally - for a long time as they make their way through life.

I'm a 53 year old 4/4 carrier with T1DM (for 27 years) and finding it very difficult to get my A1c below 6%.

I eat plant-based mostly whole food with the exception of wild salmon weekly. Recently had an NT-ProBNP of 150, to my surprise and concern. VO2 Max is 37. I'm lean (6 foot, 160 lbs). Exercise consistently (strength, HIIT, and aerobic). Live in the mountains (5400 feet) and love it here. Have moderate sleep apnea (14.7 events per hour) and lobbying for a CPAP that Kaiser didn't approve.

Experiencing some minor short-term memory issues (so far).

Does anyone else in the community have any advice or suggestions about how I can protect/improve my cognition or health? (Have read/listened to most of Dr. Bredesen's books and Dr. Bernstein's).

Are there any people with Type 1 diabetes among us?

Thanks for your part in this community...

Andrew

Good evening, Andrew,

As the Support Team Intern I have the good fortune of officially welcoming you to the site. This is a knowledgeable, giving and supportive community and we're so glad you're here.

First of all, congratulations on the upcoming birth of your child! What a wonderful gift and playmate for your two year old. It sounds like you live a full and happy life.

You prioritize good, consistent self care with diet and exercise and have managed your Type 1 Diabetes for many years. You have a great start learning more about improving cognitive health by reading/listening to Dr. Bredesen's books. Chances are, others on this site will share knowledge and experience regarding your questions. In the meantime I can share several tools & resources to help you get the most out of your experience if you would like to explore the site in more detail. The Primer is a detailed and informative resource written by a practicing M.D. with ApoE4/4. It includes information about the biochemistry of the ApoE4 gene and offers a variety of research-based prevention strategies.

Some helpful tips to navigate the site include the How-To Guide. It includes topics such as navigating the forum, private messaging, and searching. One great tip is using the quote (") button when replying to a post. Using the button will automatically alert the member of your response.

If you are interested in finding APOE4 Practitioners in your area our wiki is a wonderful resource and contains a link on searching for a practitioner: Searching for a Healthcare Practitioner, a list of APOE4 aware practitioners: APOE4 Aware Healthcare Practitioners and APOE4 Aware Health Coaches: APOE4 Aware Health Coaches. Many of them offer a remote practice as well as in-person services.

If you are interested in learning more about other members check out Our Stories.

There is now so much more known about the impact of nutrition, lifestyle and other genetics on the development of Alzheimer's and so many resources to help support those with higher risks in making choices that can help avoid developing the disease. There are many people well into their 60s and 70s living very full and cognitively healthy lives while being 4/4 as well. You've come to the right place to receive valuable resources.

Andrew, all the best as you explore ApoE4.info. I'm so glad you have joined this forum. Please feel free to reach out any time. We look forward to hearing from you again.

Warmly,
Therese (TPE)

[mike]

I'm a 53 year old 4/4 carrier with T1DM (for 27 years) and finding it very difficult to get my A1c below 6%.

Welcome Andrew. I'm a 4/4 with T2D who produces very little Insulin. I'm curious what your insulin regimen is and typical daily carb intake. It is not just the absolute value of your A1c, but possibly more critical is the amount of variation. If you are still having large swings, then that is something you could address with diet. Extra low carbs means less variation and need for insulin. Make sure to get enough protein for your weight to maintain muscle mass and add fat to increase your calories to maintain weight.

[AndrewYoung]

Thanks so much for your thoughtful replies, @Tincup, @TPE, and @mike!

@Tincup, those are some outstanding references. I am following up on them all. I am mouthtaping as of last week, and it seems like I feel better afterwards (whether that is placebo or no). Need to compare my O2 Saturation this week with before. Your reply is a real treasure...

@mike, sounds like you are close to experiencing T1D. I use Jardiance/Empagliflozin, 15-18 units of insulin per day and my standard deviation is around 21. I eat about 60-80 g CHO per day.

How much protein do you suggest?

[mike]

@mike, sounds like you are close to experiencing T1D. I use Jardiance/Empagliflozin, 15-18 units of insulin per day and my standard deviation is around 21. I eat about 60-80 g CHO per day.

How much protein do you suggest?

Yes, most Docs think I am, but insulin has not worked for me...

The amount of protein you need will vary depending on who you ask. It is something you will need to experiment with. You generally need more if you are trying to build muscle.

SD = 21 is your difference between high and low BG? That seems low. can you give me your normal high and low levels? Have you tried eating less Carbs? You could experiment by cutting carbs by 25% and upping protein and fat to make up the calories. Could maybe lower need for insulin.

[AndrewYoung]

Hi @mike, I believe SD is + and - 21 from the mean if I recall my stats class (which was my worst subject). My target range on my dexcom is between 80 and 120 (although I do diverge).

Thanks for your suggestion about switching carbs and protein/fat. I need to change my go-to foods.

Anything I can do to support you too?

[mike]

How far do you "diverge" in a normal day? If you were staying between 80-120, then that would be a good range. I also wouldn't complain too much about an A1c of 6%...possibly more important is how high your peaks go.