RE: bs peaks vs plateau

June 13, 2001

Is the 70-110 in the morning - a fasting rate? I try never to go over

140 after eating. I only went over once and haven't done it again. I range

about 90-95 in the morning. Is that OK? Thanks so much. Winifred

For myself, I would find neither of those scenarios acceptable, but I

don't

know which is worse in the long run.

I strive for never going over 140, even after eating Less is better.

I really believe that any time spent above the level of the normal

non-diabetic (70-110mg/dl) carries an increased risk for complications in

the

long-run. This is just my opinion, and probably flies in the face of what

most

of the medical community believes. Largely they are happy if we stay under

150mg/dl fasting.

T2, 4/98, controlling with low-carb diet only for 3 years

June 13, 2001

hi Vicki, I have yet to meet a type 1, child or adult who could possibly keep

that

kind of control. It is great to aim for always in the normal range, but there

are

far

to many contributing factors in T1 to get that kind of stability. It is great

to

try as

hard as you can though. Just don't let the anxiety of not being in the normal

range

cause your bs to rise further.

, mom of T1

whimsy2@... wrote:

> As a type 1 I've found it practically impossible not to peak over 140. And

> I'm trying Really Hard. Any other type 1s out there who can keep peaks under

> 140?? Vicki

>

> In a message dated 01-06-13 16:36:03 EDT, you write:

>

> <<

> I really believe that any time spent above the level of the normal

> non-diabetic (70-110mg/dl) carries an increased risk for complications in the

> long-run. This is just my opinion, and probably flies in the face of what

> most

> of the medical community believes. Largely they are happy if we stay under

> 150mg/dl fasting.

> >>

>

> Website for Diabetes International:

> http://www.msteri.com/diabetes-info/diabetes_int

>

> Post message: diabetes_int

> Subscribe: diabetes_int-subscribe

> Unsubscribe: diabetes_int-unsubscribe

> List owner: diabetes_int-owner /

> http://groups.yahoo.com/group/diabetes_int or try:

> http://www.yahoo.com > Join A Group > diabetes_int > Join This Group

>

June 13, 2001

<< > Anyone have a guess or opinion on which is worse. A high peak of lets say

> 190 that goes away within two hour or a plateau slow rise say that goes to

> 160 and stays there for 4 hrs or so. >>

Its the average that's the problem....

Take 190 for 2 hrs with a 110 for another 5 hrs...

190 x2 + 110 x5 =

380 + 550 = 930 divided by 7 = 132.85

160 x4 + 110 x3 =

640 + 330 = 970 divided by 7 = 138.57

the longer your bs is elevated, on average is what causes the problem.

Because that's when damange is done to the cells by the ketones. (ketones

that form when the bs is high).

Also this is what the dr's measure, over the long run, is the average....

June 13, 2001

In a message dated 01-06-13 20:38:53 EDT, you write:

<< It is great to aim for always in the normal range, but there are far too

many contributing factors in T1 to get that kind of stability. It is great

to try as hard as you can though. Just don't let the anxiety of not being in

the normal range cause your bs to rise further.

>>

Thanks for the kind words, . No, I don't let it stress me...I'm just

jealous of all those type 2s out there who cut carbs and watch their A1Cs go

from 12 to 6 in three months. On the other hand, I don't have to deal with

overweight and food cravings, smile... Vicki

June 13, 2001

Tom,

Very well said. Regardless of the woe, support for the end result is why

we are here and comaradie is what we need. I also didn't take Barbs post as

arrogant. I find her to be pretty level headed and respectful of other

people's positions. Besides, we don't want to start beating up on people

again. Especially our moderator. She is liable to run off and leave us and

then we would all be in a pickle, LOL.

Kim

>

>Reply-To: diabetes_int

>To: <diabetes_int >

>Subject: RE: Re: bs peaks vs plateau

>Date: Wed, 13 Jun 2001 14:59:09 -0700

>

>Regarding the long term safety of diet alternatives, there are no long term

>placebo controlled studies for any of them -- including the high carb, low

>fat diets pushed by much of the medical profession. In fact, it is

>practically impossible to construct such a study. However, keep in mind

>that anecdotal evidence is real evidence and is really scientific evidence.

>Scientists do not just ignore observations because they have not yet

>devised

>a way to systemically test them. The anecdotal evidence, in this

>particular

>case, is real scientific evidence that low carb eating works for at least

>some people over long periods of time.

>

>Next, while I am not Barb the moderator, I really do not see the statement

> " It's my health and my life, " as arrogant. Rather, to me, it implies that

>each of us is responsible for our own health -- as much as we would like

>to,

>we cannot really delegate that responsibility to our doctor, etc. Barb did

>not say she was responsible for my, or anyone else's, health but for her

>own. She did not say that someone who decides to follow a different WOE

>cares less about their health.

>

>One thing that is clear from available evidence, and is becoming more clear

>as more studies are made, is that high blood sugars are harmful. Peaks of

>190, or 4 hour runs of 160, are both harmful. We may not know which is

>worse, but neither is good. Do we really disagree on this (regardless of

>how we eat)?

>

>The article referenced below:

>

>http://diabetes.medscape.com/mosby/AmHeartJ/2001/v141.n03/ahj1413.06.fixm/ah

>j1413.06.fixm-01.html

>

>From the American Heart Journal, titled " Impaired Fasting Glucose

>Concentrations in Nondiabetic Patients With Ischemic Heart Disease: A

>Marker

>for a Worse Prognosis " adds to the evidence that " impaired " glucose levels

>not even high enough to be diagnosed as diabetic still lead to measurably

>increased mortality, particularly from heart disease.

>

>So, no matter what one thinks is the way to get there, the evidence keeps

>piling up that better control (i.e., really normal blood sugars) means a

>longer, healthier, life and decreased medical expenses. Isn't that why we

>are here on this list -- to support each other in controlling this @#@%%

>condition?

>

>Tom the Actuary

>

>Website for Diabetes International:

>http://www.msteri.com/diabetes-info/diabetes_int

>

>Post message: diabetes_int

>Subscribe: diabetes_int-subscribe

>Unsubscribe: diabetes_int-unsubscribe

>List owner: diabetes_int-owner /

>http://groups.yahoo.com/group/diabetes_int or try:

>http://www.yahoo.com > Join A Group > diabetes_int > Join This Group

>

June 13, 2001

--- GayRghts@... wrote:

>

> << > Anyone have a guess or opinion on which is

> worse. A high peak of lets say

> > 190 that goes away within two hour or a plateau

> slow rise say that goes to

> > 160 and stays there for 4 hrs or so. >>

>

> Its the average that's the problem....

> Take 190 for 2 hrs with a 110 for another 5 hrs...

>

> 190 x2 + 110 x5 =

> 380 + 550 = 930 divided by 7 = 132.85

>

> 160 x4 + 110 x3 =

> 640 + 330 = 970 divided by 7 = 138.57

>

> the longer your bs is elevated, on average is what

> causes the problem.

> Because that's when damange is done to the cells by

> the ketones. (ketones

> that form when the bs is high).

>

> Also this is what the dr's measure, over the long

> run, is the average....

>

Right when i was first diagnosed 11 years ago, the

doctor did nothing because my average was 10 what he

called borderline and which left me with

multi=poly=neuropathy....the longer it stays high the

more damage to your body! it took me many years to get

all this stuff figured out. we didn't have support

groups like this then....this is great. my rule of

thumb is get the sugar down as soon as possible! hope

i can help. thanks jude

=====

http://trialwatchers.com

true crime all the time

__________________________________________________

June 14, 2001

Patsy- I know where you are at. I have become somewhat anorexic because I

can't bear anymore bacon, eggs,steak etc. That is why I sometimes feel weak-

beacause I don't eat at all! My bs does stay low with only low carb but I

am trying to figure out how to live like this. Hence the " splurge " of some

toast this morning.

I bought those protein bars too. I ate 1 and the rest are in my food cabinet

.... pretty yucky. Lucky for me I don't have to cook for anyone else. That

must be really hard. Tonight I had some raspberries and whipped cream with

splenda. It was delicious but I didn't stay awake long enough to see what it

did to my bs.

<<HI,

I think that there should be something said about the QUALITY of ones life.

Eating this high protein diet is for the birds..I'm sick of it and I've only

been on it 3 weeks.

I'm at the point now that I would rather not eat at all if I have to spend

the rest of my life eating like this...It has taken my blood sugar down..but

it goes up and down with drastic elevations , even when I eat all protein.

I certainly don't FEEL better..I feel worse..have no energy at all now.

When I was eating what I wanted to eat I felt better..more energy, not as

depressed.

To make matters worse, my husband is not diabetic so he can eat anything he

wants and I have to continue to make the starchy foods for him...I feel like

I'm being crap when I'm making all this good food for him and I can't eat

one bite of it. and I hate those protein bars too...

There is alot to be said about the quality of life also. This diet is making

me miserable..Sorry for ranting like this ..just had to get it out...

Patsy>>

June 14, 2001

Hi T- so have there been any studies/tests on occassional high peaks

(with otherwise low bs around 100) vs higher bs with lower peaks? I can't

believe no one has done studies on high peaks. It is so confusing to me!

I woke up tonight at 2 am so I tested and was at 98. So I assume most nights

I am at 100, if I don't eat at all I stay at around 107. So when I do eat-

if I eat a carb- and jump to 190- how do I know how damaging that is? My

guess is that at least 12 hrs out of the day I am at 100 or lower. Maybe 4-6

hours I am bet/ 120 -160(after meals with few carbs) My jump to 190 today

was experimental and " high " for me. I am trying to decide whether to

include some carbs into my diet and risk the high bs of 190. I can

definately eat low carb all day but I think I need the occassional splurge.

<<Here is where the long-running battle between low carb and ADA really

hits. , there is no total consensus on this board or anywhere

in the diabetes world.

Those of us who do higher carbs but limit fats would argue THAT THERE

IS NO DOCUMENTED EVIDENCE THAT LONG-TERM VERY LOW CARB DIETS ARE

SAFE, so the people on this board who respond ARROGANTLY, as even the

MODERATOR of this board just did, are (IMHO) out of line. When she

says " It's my health and my life, " that's pretty arrogant, as though

anyone who disagrees doesn't care about their health and their life

There are many on this list who assume that long-term low carb is

safe, but the evidence on that is " anecdotal. " For example, Dr.

Bernstein will say " It works for me and my patients. " To the

scientific community, that's " anecdotal. " To be scientific you have

to try multiple groups and control each one, keeping and publishing

statistics. It's difficult and expensive.

The problem is that everyone who has enough money to run controlled

scientific studies assumes that low carb isn't safe, so they will not

even run such tests.

Dr. Bernstein hasn't run such tests, and Atkins has not yet been able

to do it, either. I assume they don't have the resources.

T>>

June 14, 2001

Vicki- thanks for posting this- I find hearing everyone staying under 120

makes me feel like I am not doing enough. I too try hard!-

ps - Tommorrow I am having filet mignon and spinach

<As a type 1 I've found it practically impossible not to peak over 140. And

I'm trying Really Hard. Any other type 1s out there who can keep peaks

under

140?? Vicki>

<<

I really believe that any time spent above the level of the normal

non-diabetic (70-110mg/dl) carries an increased risk for complications in

the

long-run. This is just my opinion, and probably flies in the face of what

most

of the medical community believes. Largely they are happy if we stay under

150mg/dl fasting.

>>

June 14, 2001

Thanks for this info- ok both are bad. So that means I can never eat bread.

I sometimes feel that I am safest sleeping!

Regarding the long term safety of diet alternatives, there are no long term

placebo controlled studies for any of them -- including the high carb, low

fat diets pushed by much of the medical profession. In fact, it is

practically impossible to construct such a study. However, keep in mind

that anecdotal evidence is real evidence and is really scientific evidence.

Scientists do not just ignore observations because they have not yet devised

a way to systemically test them. The anecdotal evidence, in this particular

case, is real scientific evidence that low carb eating works for at least

some people over long periods of time.

Next, while I am not Barb the moderator, I really do not see the statement

" It's my health and my life, " as arrogant. Rather, to me, it implies that

each of us is responsible for our own health -- as much as we would like to,

we cannot really delegate that responsibility to our doctor, etc. Barb did

not say she was responsible for my, or anyone else's, health but for her

own. She did not say that someone who decides to follow a different WOE

cares less about their health.

One thing that is clear from available evidence, and is becoming more clear

as more studies are made, is that high blood sugars are harmful. Peaks of

190, or 4 hour runs of 160, are both harmful. We may not know which is

worse, but neither is good. Do we really disagree on this (regardless of

how we eat)?

The article referenced below:

http://diabetes.medscape.com/mosby/AmHeartJ/2001/v141.n03/ahj1413.06.fixm/ah

j1413.06.fixm-01.html

From the American Heart Journal, titled " Impaired Fasting Glucose

Concentrations in Nondiabetic Patients With Ischemic Heart Disease: A Marker

for a Worse Prognosis " adds to the evidence that " impaired " glucose levels

not even high enough to be diagnosed as diabetic still lead to measurably

increased mortality, particularly from heart disease.

So, no matter what one thinks is the way to get there, the evidence keeps

piling up that better control (i.e., really normal blood sugars) means a

longer, healthier, life and decreased medical expenses. Isn't that why we

are here on this list -- to support each other in controlling this @#@%%

condition?

Tom the Actuary

June 14, 2001

Just a question for all of you - Do you test one hour after you start

eating or one hour after you finish eating? I know it sounds like a dumb

question but sometimes it takes me 1/2 hour to eat because of interruptions.

Thanks so much. Winifred

-----Original Message-----

Thanks for the kind words, . No, I don't let it stress me...I'm just

jealous of all those type 2s out there who cut carbs and watch their A1Cs

go

from 12 to 6 in three months. On the other hand, I don't have to deal

with

overweight and food cravings, smile... Vicki

June 14, 2001

In a message dated 01-06-14 15:30:11 EDT, you write:

<< It just keeps going up and down..I can't seem to keep it at one level. >>

Hi, Patsy...I can understand your frustration. The Glucophage may help with

this but you need to take if for a few weeks before it'll take effect. Also

your dose may need to be upped, but this has to happen gradually or you may

get GI symptoms.

A lot of type 2s have found they can get better control with insulin. Giving

injections isn't as scary as it sounds - and it can eliminate all those ups

and downs once you get the dose correct. You might give this some thought.

Meanwhile, give the Glucophage a chance; it might just do the job. BTW,

cottage cheese, while not high carb, isn't exactly lowcarb either. And when

you start the day with a high BG, as you did, eating a carby breakfast isn't

going to help. Do you have anything against eggs? They don't have any carbs

to speak of ...you could have one or two with sausage or ham or bacon for

breakfast instead of the cottage cheese. Also, there are a couple of good

lowcarb cereals that you can get online...one is called Protein Crunch...it's

a little pricy but it's very filling and quite tasty. Vicki

June 14, 2001

In a message dated 01-06-14 15:30:11 EDT, you write:

<< Glucaphage taken at night.

I live in a neighborhood that is not very good for walking so I don't

excercise except for the daily chores that I do.I used to love working in my

yard but I just don't have the energy anymore. >>

When your blood sugars get down to a more normal range, your energy will

return and you'll start to feel good again. This is a worthy goal, smile.

Vicki

June 14, 2001

maryato@... wrote:

>

> Tom wrote

> > Regarding the long term safety of diet alternatives, there are no

> long term

> > placebo controlled studies for any of them -- including the high

> carb, low

> > fat diets pushed by much of the medical profession. In fact, it is

> > practically impossible to construct such a study.

>

> Hello...I'm back. Sorry I made one provocative response, then

> disappeared. I just don't have time in my life right now to engage

> in all the back-and-forth e-mails.

>

> Anyway, long term dietary studies can never be placebo-based, because

> people know what they're eating. You can't give one person a steak

> and another a piece of bread and have them think they're eating the

> same thing, of course.

>

> >However, keep in mind

> > that anecdotal evidence is real evidence and is really scientific

> evidence.

> > Scientists do not just ignore observations because they have not

> yet devised

> > a way to systemically test them.

>

> No, I don't agree that anecdotal evidence is real evidence. For

> example, a naive person joining this list might assume that there's a

> strong anecdotally-based consensus in favor of low carbing. If you

> stay on the list long enough, though, you'll find that non-low

> carbers get frustrated with the list and leave the list. Therefore

> new-comers do not hear from many old-timers for whom low carbing does

> not work.

>

> That is why I continue to lurk on this list most of the time, and

> chime in only whenever a relative newcomer is struggling with low

> carbing, where the low carbers pile on insisting that low carbing is

> the only way. I want to ensure that the other point of view is

> available at least minimally.

>

> You may notice that I've never tried to talk a happy low carber out

> of low carbing. I only chime in when a new person is struggling. I

> don't want them to throw up their arms in frustration and decide that

> they are a failure, then go away from the list and be lost.

>

> I, for example, believe strongly in exercise and want to make it a

> central point in my life. I cannot possibly exercise without carbs

> in my system. Low carb leaves me dizzy, faint, emotionally on edge,

> etc. Yes, these are symptoms of hypoglycemia; I guess I'm prone

> to " pseudo-hypoglycemia " since the symptoms happen even with normal

> blood sugars. On low carb it's even difficult for me to climb a

> couple of flights of stairs.

> T

Thank you for saying this so eloquently ! Maybe that's the main

reason I stay here also. This list was started as a list for all

diabetics, but there has been many a fervent push to turn it into a low

carb list..

I don't try to convert others either, I simply say what works for me.

smile.

--

Dave - 5:33:57 PM

T2 - 8/98 Glucophage, NPH, H

-

Davors Daily Aphorism:

I'm dangerous when I know what I'm doing.

--

Visit my PhotoPage:

http://zing.com/album/pictures.html?id=4292795721

June 14, 2001

Math was never my strong suit but I can see that they are pretty equal.

Thanks

<< > Anyone have a guess or opinion on which is worse. A high peak of lets

say

> 190 that goes away within two hour or a plateau slow rise say that goes to

> 160 and stays there for 4 hrs or so. >>

Its the average that's the problem....

Take 190 for 2 hrs with a 110 for another 5 hrs...

190 x2 + 110 x5 =

380 + 550 = 930 divided by 7 = 132.85

160 x4 + 110 x3 =

640 + 330 = 970 divided by 7 = 138.57

the longer your bs is elevated, on average is what causes the problem.

Because that's when damange is done to the cells by the ketones. (ketones

that form when the bs is high).

Also this is what the dr's measure, over the long run, is the average....

June 14, 2001

I agree- I know me and if I don't find some relief from this no carb stuff I

will quit all the way. I am looking for a nmiddle ground.

<< for me its impt to have occassional splurges, they do not greatly

affect my overall HBA1C, and they keep me on the low carb food plan for the

most part.

I choose ones that will give me a peak, vs a extended high because i believe

that it's impt to get back to normal as soon as possible.

I try not to obsess over this stuff thou. I 'd end up in the looney bin if i

kept at this so rigidly.

>>

June 14, 2001

Sort of like the glass being half full or half empty- you have a positive

outlook- I need it ! Thanks-

<<For me....there are things i cannot eat....(besides my stolen

bites)....but

there is so much more that I can eat......and so many more things I can do

now that I feel better!! All in all life is better for me on this

lifestyle than before.....

ressy>>

June 14, 2001

Getting back to the specific matter addressed in the subject line, as far as

I can determine, we really do not know whether high peaks in themselves are

more or less harmful than lower plateaus that produce equivalent " average "

blood sugars. One reason is that we do not know all of ways that our

condition produces complications.

The point has been made that is our average blood sugar that really matters.

This is true, but it may or may not be the whole truth. Average blood

sugars are what affect our HbA1c levels, and high HbA1c levels are generally

accepted to be a major cause of complications. But we do not know if they

are the only cause. In particular, we have little or no available evidence

regarding how harmful high transient blood sugar episodes may be in

themselves. We also do not know what the effects are of transient hypo

episodes.

What would be really interesting would be well structured studies of

complications among diabetics with really good control (say, HbA1c levels

less than 6.0) comparing those who attain these levels in different ways --

say with relatively stable readings v. with peaks and valleys and/or those

with high peaks v. those with more modest plateaus. Such studies might be

more likely now that continuous blood sugar monitoring is now becoming

possible. They are much harder to construct using discrete measurements

since peaks can be missed.

One problem getting such studies done is that the financial incentives may

be limited. Many studies are financed by pharmaceutical firms with a drug

to market.

I believe that there have been some studies done indicating that high blood

sugar levels are, in themselves, toxic to beta cells (the cells that produce

insulin), but my recollection is that these studies used cells in a

laboratory, so their applicability to " real life " is not clear.

We are reasonably sure that people with fully functioning endocrine systems

do not have really high peaks (or valleys), but, instead, have relatively

stable readings. For me, absent other evidence, this is a reason to try to

attain stability (that is, a non-diabetic or normal pattern), as much as

possible. Note the " as much as possible. " This might also be stated as " as

much as is reasonably achievable without causing other, greater, risks. "

This is one of the individual judgment issues we face where we can use each

other's support. And there is no one answer to what is reasonably

achievable.

The discussions we have on these matters can be worthwhile because they can

produce information useful to us as we make the important lifestyle

decisions diabetes has forced on us.

Tom the Actuary

June 14, 2001

Tom - I know you are right but I guess I am just feeling sorry for myself.

Alot of my friends who I tell about my Diabetes say " well at least you can

control it " . My Dad just died of cancer which none of us could control.

<<But , we still can eat lots of good things. And we can taste, smell,

see, walk, talk, run, think, sing, and cry -- and sleep and wake up. And

more.

And we are more likely to do these things better and longer if we can

control our blood sugar levels, which is generally possible, even if it's

not fun. That's the reward. We are blessed. Lots of other conditions do

not give one the option of such control and quality of life.

Tom the Actuary>>

June 14, 2001

Good to know I am not alone!

<<

That's what I said when I got that jelly doughnut from Dunkin Doughnuts

this morning.. I usually just get the black coffee, but.... it's been a

while.

Now back to the ball game.

--

Dave - 3:27:54 PM

T2 - 8/98 Glucophage, NPH, H>>

June 15, 2001

Hi, Patsy...you've got the right idea...try something then test, pretty soon

you'll find stuff that works for you. At the beginning it pays to test a LOT

-- a half hour, an hour, 90 minutes and 2 hours after eating just to find out

when you peak. Again, everyone's different.

BTW, protein will raise BGs too, but not like carbs.

Oh yes, watch out for the frozen fruit...lots of it has sugar added.

Strawberries are good now...they're the lowest carb fruit, then raspberries.

Why not use fresh?

Vicki

a message dated 01-06-15 18:12:38 EDT, you write:

<<

I'm eating all protein for breakfast now but my bs still goes hight every

morning around 9 or 10 o'clock. I'm giving up cottage cheese but I bought a

container of plain lowfat yogurt but I can't eat it plain..I need to add

something to it to make it taste better so I bought some frozen fruit,

sunflower seeds , 5 g carbs for 1/4 cup and I add some equel to it. It taste

great and I only eat about a cup of it..it doesn't effect my blood sugar

like the cottage cheese does.

Patsy

>>

June 15, 2001

Hi Vicky,

I know now that I can't eat anything in the mornings with carbohydrates in it.

I would like the cereal but what do I do about the milk for it because milk

raises my blood sugar?

Today my bs has stayed in the high hundreds..at 5:35 it was 142 before I ate. I

had chinese vegetables with some kind of sauce..don't know what it was..and 4

large shrimp..I want see if my bs goes up from eating that because I love

Chinese food.

I'll check bs again at 7:30pm.Thanks for all the great information.

Patsy

-- Re: bs peaks vs plateau