Comments on: 100 points, 50 points, you pick the number???

By: Tom Kacy

Tom Kacy — Mon, 27 Aug 2007 13:00:28 +0000

You have to be careful with things that say “sugar free”, “low carb”, “net
carb” etc. They pretty much all contain sugar alcohols (sorbitol, mannitol
etc) and companies like Atkins make it sound like they’re not carbs and
they won’t do anything to your blood sugar. Again, this is definitely a
personal issue. T^hose things most definitely do make my BG shoot up. The
low carb people say that the sugar alcohols are metabolized so slowly that
you won’t notice any significant rise in blood sugar, but for me I might as
well just be eating real sugar. I bet those shakes you had were full of
sugar alcohols and it wasn’t just the protein that spiked you. With
protein, it usually takes several hours before I finally see the rise in my
numbers. With “sugar free” foods, it happens quickly. I’ve used sugar
free/fat free ice cream to treat lows in the past. I know that ice cream
still has some natural sugar (lactose, from milk) in it but the amount I
ate to bring myself back up wasn’t enough to say that it was only lactose
raising my BG. It was definitely all the other sweeteners in it.

Whenever I see a package of any food that says something like “Only 4 grams
net carbs!” I look at the total carbs, and go by that. I tried a couple of
“2 net carbs” chocolate bars this summer that shot me up. The total carb
count was 19, and I used that when calculating my insulin and it worked
fine. If I counted it as only 2 grams of carb, I’d end up high 2 hours later.
–
Liz

By: Tom Kacy

Tom Kacy — Fri, 24 Aug 2007 12:22:06 +0000

When I first heard about Dr. Bernstein’s book (the first one) I went out
and bought a copy. While he does have some good advice, I knew that I
could never follow his plan. It is extremely rigid and I can’t see how a
Type I could follow it and live a normal life. I know that he is a Type I
himself, but he has the luxury of living a monotonous life where every day
is the same. Most people can’t do that. His advice seems better suited
for a Type 2. I even tried, for a short time, to pretty much cut out all
carbs. The first day it went great. The next morning I woke up with
incredibly high BG. My body just doesn’t do well with large amounts of
protein. It seems to convert it to glucose as if I was eating a loaf of
white bread. I know that up to 20% (I think?) of preotein can be converted
to glucose but for me it seemed like 90%. Unlike regular carb-filled
food, the protein could take hours to kick in so I’d be fine for awhile and
then my BG would shoot up. It usually happened during the night and I’d
wake up with BGs in the 300-500 range. I stopped that experiment quickly.

I’m happy that his plan works for some people. I just hate the low-carb
people who tell me that I’m killing myself because I don’t agree with them,
and because I might eat 70 grams of carbs in one meal. Hell, even if I am
killing myself at least I’m not miserable each & every day!
–
Liz

By: Tom Kacy

Tom Kacy — Thu, 23 Aug 2007 00:02:55 +0000

One more thing…
I assume that you keep a log book of some sort, either on paper or
computer. If not, you should. It may seem like a pain but it’s probably
the best diagnostic tool you can have. Write down what you ate & how
much. How much insulin you took, including what type & at what
time. Activity. Indicate if your day was extra stressful, or if you sat
around in your underwear watching TV all day.
I have eaten the same meal for dinner on different nights. Started with
BGs in the same range, taken the same amount of insulin but 2-3 hours later
ended up with different results. I’d go back and check my log and see that
one night I did my laundry, which can really drive my BG down. Another
time I just sat on the couch watching DVDs for 3 hours.
–
Liz

By: Tom Kacy

Tom Kacy — Wed, 22 Aug 2007 05:53:20 +0000

The problem with doing things by the book is that one book doesn’t work for
everyone. This disease really is YMMV. If you’ve done everything the book
suggests and it hasn’t worked, it’s time to throw out the book and write
your own.
If it’s your post-prandial readings that are running too high but you’re
okay during the night or when you’re not eating, then it’s a problem with
the pre-meal insulin. In the past I had used both Humalog & Regular. I
didn’t mix them, but I would sometimes take two injections if I was eating
fast food, or going to a concert and eating at the club where everything
was deep fried. In some cases I would just use Regular, and forget the
Humalog. Since it took longer to work and stayed in my body longer, it
worked better for fat filled meals.
For awhile, when I was on NPH, I was waking up with high morning readings
no matter how I tweaked the dose. I would usually inject it right before
bed, and for awhile I added an extra small shot of NPH with my

dinner. That seemed to work for awhile but then things went funny
again. Then I started drinking beer (mmmmm…… Guinness) with dinner
each night. Definitely more fun than taking an extra shot, but that also
had limited success. I would change my doses constantly and sometimes it
would work (for awhile) and other times I’d end up in trouble.
I was not happy with my pump for the first 8 weeks or so that I had
it. Now, I wouldn’t give it up. I can really fine tune my basal rates,
every hour if I need to. If I see that I’m always going high starting at
5-6pm, I can up my dose then without having to increase it for the entire
day, or half day. If I’m borderline high, at the upper end of my personal
goal, I can take a very small amount of insulin to stop the climb without
worrying about going low. I know that a pump isn’t for everyone, and not
everyone can afford it even with insurance. For me, it has made a world of
difference. For years now I had “good” A1c results, usually in the 5’s,
but it wasn’t from good control. It was from highs being cancelled out by
lows. My last A1c, first since I started pumping, was 5.6. I still had a
bunch of highs & lows, especially during the first 2 months, but they
weren’t as severe as they were on shots. I’m learning how & when to change
my settings better to keep myself out of trouble. If I did have to return
to injections, I think I could do a much better job than before but I know
I’d still run into problems.
I doubt there’s a single diabetic who has had consistent numbers throughout
their life with the disease. Maybe Dr. Bernstein, but I wouldn’t want his
life!
–
Liz

By: Tom Kacy

Tom Kacy — Tue, 21 Aug 2007 11:43:44 +0000

When I was diagnosed, I was in the hospital for 8 days. For the first few
days, I couldn’t do anything because I was hooked up to IVs and monitors
and such. When I was freed from most of them, the doctor kept telling me
that I had to get up and walk around, because when I was released I
wouldn’t just be laying in bed all day. I guess they wanted to see how
activity & insulin reacted. I refused to get out of bed. I refused to
walk the halls. I don’t know why, but I was very stubborn about it (and I
was 19!). The only place I walked was to the shower, when the last IV was
removed. When I was released, I was pretty active that first day and ended
up with a hypo during the night. I really should have paced the halls in
the hospital, I guess.
–
Liz

By: Brianna Dorris

Brianna Dorris — Mon, 20 Aug 2007 12:10:42 +0000

Hello Folks:

Hummmmmmngh, ok so there are variations, but nobody’s been down this path? Played “textbook” and done exactly what all the training says/said but still not getting close enough number-wise?

The short acting can be varied in all kinds of ways, timing it slightly sooner before the meal so its on-board prior to feeding…. micro the dose until you get tighter 2 hours past meal readings… etc. There any other tricks folks can think of that have worked for them??? Nobody been down this road before?

Jeff
[PS Hospitals to “regulate” unless they’re staffed by Diabetes Experts who are trained… no thanks, think I’ll stay home