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In a message dated 10/31/00 5:38:40 PM US Mountain Standard Time,

cew@... writes:

<< I've just had two slices of wholemeal bread with margarine and tasty

cheese plus a cup of coffee. I 1/2 hours later my BG was 7.5 (135). Is this

an acceptable level after this amount of time? >>

Craig, I'd like to see you off the margarine. Just saw a study saying its use

is associated with health problems. I can't give you anything more specific

now, from the road. #1 - with the cheese on the bread, you don't need

margarine or butter. #2 - if you do need the " butter effect, " clarify the

butter ... as in melt the butter in a pan and drain off the clear to use and

toss the solids in the bottom of the pan. That is, as far as I can tell over

the years, a good approach. There are even cool gizmos to help you separate

the solids from the clear.

Susie

P.S. I think your pp numbers are fine.

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In a message dated Wed, 1 Nov 2000 3:40:44 AM Eastern Standard Time, " Craig

Weavers " writes:

<<Thanks Carol. Your input is appreciated, I guess that I will have to aim

for lower levels.

Craig,

I was dxed Jan 99; it has taken time and lots of testing to figure out what

foods work for me. Since a DM dx is overwhelming, I decided to set one simple

goal...to normalize my bgs. I figured that other health issues would fall

into place.

I started modifying meals and even eating patterns and soon my Hba1cs were in

the 4.9-5.4 range. As a " side effect " , my bp, weight, and liver enzymes all

normalyzed.

Just stock up on strips and test away! Watch for patterns.

Carol T

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> I've just had two slices of wholemeal

> bread with margarine and tasty cheese

> plus a cup of coffee.

> I 1/2 hours later my BG was 7.5 (135).

> Is this an acceptable level after this

> amount of time?

Yes, Craig. No AGEs will have formed in that time. Of course, the 135

was probably the BG on its way down from some higher level or might

even have been the BG on its way up, delayed by a little late stomach

emptying - you can't really tell on the basis of one reading.

The only way to be sure is to take a BG reading before you start to

eat and then every 15 minutes for up to 120 minutes. You plot the

readings on squared paper and then draw the best line through the

points. Since with bread, it will fall more or less at the same rate

as it went up, you can easily estimate the point at which it turned

over to come down again. If the peak was not more than 180 then you

are in good shape.

Generally speaking, though, the meal you describe is not the kind you

want to make a habit of. Nutritionists recommend that you eat some

vegetable and/or fruit with every meal (tomato, grapefruit, etc.),

the better the mix, the flatter the BG curve.

Also it pays to be sceptical about whole wheat bread - the only

really reliable way to be sure of it is to buy the raw grains and

grind them up yourself and bake your own bread.

In Germany, we can't trust the bakers not to fake it.

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Re: Is this too high?

> wrote:-The only way to be sure is to take a BG reading before you

start to

eat and then every 15 minutes for up to 120 minutes. You plot the

readings on squared paper and then draw the best line through the

points.

Thanks I had never thought of graphing the reading as you suggest.

Generally speaking, though, the meal you describe is not the kind you

want to make a habit of

Point taken. I have been feeling considerably better since being more

consistent with exercising each day. I wanted to see how the levels would

go eating the bread, as for me that seemed to put it up considerably in the

past.

From where I started, when first diagnosed, the readings were off the

meter.It simply said " HIGH " and wouldn't register a number.I was sort of

hoping that the current numbers might be OK.

I guess anything is an improvement from my starting point.

Regards,

Craig

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Re: Is this too high?

> Craig, I'd like to see you off the margarine. Just saw a study saying its

use

is associated with health problems. I>

Yeah, Thanks Susie! I know I need to keep of the margarine & other fat. I've

always suspected that it's not very good for us...one minute they're telling

us it's bad; the next that it beneficial. I guess having diabetes also puts

a whole new slant on fat consumption too!

I'll certainly heed your advice however. I guess that I was mainly trying

what I thought was a high fat, high carb combination to see what it would do

to my Bg's...by the way, it tasted nice too! Dual benefits!

Enough from me, enjoy the rest of your trip.

Kind regards,

Craig

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, you might be astonished at the things they put in bread to make

it black, I have even heard of chocolate.

You might consider getting a Forschner sharpening steeel for knives and

sundry. The one I bought is coated with silicon carbide, a worthy tool.

Sam

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> You might consider getting a Forschner

> sharpening steel for knives and

> sundry. The one I bought is coated with

> silicon carbide, a worthy tool.

No deal, Sam. I use a blunt old Japanese bread knife. If THAT can't

cut the bread then I know that it will be too hard for my teeth. In

my time I have broken two teeth on the hard crust of hand-made whole

wheat bread, once was when we were living in Italy and nothing could

persuade me to go to an Italian dentist so I just had to suffer.

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> , you might be astonished at the

> things they put in bread to make

> it black, I have even heard of chocolate.

Over here they use beetroot juice or malt or both and I have even

heard of them using molasses. At least those things are more or less

natural. No doubt you can get some commercial chemical bread darkener

but I try not to buy the shop-made bread anyway. I have an old-

fashioned flour mill that has to be turned by hand (the label

say's: " Make bread the way your grandmother used to make it! " ). It

offers so much resistance that I use up about 150 kcals grinding up

750 grams of rye, and sweat up one clean T-shirt.

Our bread looks like bread, tastes like bread but doesn't quite smell

like bread. It smells like yeast. All the recipes I have call for " 1

packet of dry yeast " but yeast comes in all sizes of packet from 10 g

up to 100 g (or even more for the wet sort). I just can't find the

right mix.

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> ****For me this is way to high of

> a peak. I prefer to stay under 140.

How do you determine the peak, Barb? There is no way to do it with a

single reading, that I know of. And was the 140 an arbitrary choice

or is that a recommendation from somewhere?

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In a message dated 00-11-01 17:07:27 EST, you write:

<<

Hi Vicki,

I find that the timing of my peaks vary greatly depending on what kind of

food it is. Do you find this also?

>>

Yes, . But generally I peak at four hours (as opposed to most people

who peak at 2) V.

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In a message dated 10/31/2000 4:38:41 PM Pacific Standard Time,

cew@... writes:

<< I've just had two slices of wholemeal bread with margarine and tasty

cheese plus a cup of coffee.

I 1/2 hours later my BG was 7.5 (135).

Is this an acceptable level after this amount of time?

>>

Try having some bacon and eggs for breakfast and see what your reading is

then.

135 is too high for me......I keep it at 100 or less. Since you were

extremely high though, 135 is good for now. You are just on your way down

Craig! = )

Meniowl@...

type2,dx7/99,low-carbs & water walking

(last A1c 5.3) Normal range 4.8-6.0

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> << he diabetics always

> seem to have a fasting BG around 200 and, after meals, go up to 280

> or so and stay up there for hours. >>

>

> Yikes! That is very high!

No, , that's NOT " very high " for an untreated type 2 diabetic -

I believe that is about average. Don't forget that glucose doesn't

usually appear in the urine until the blood glucose reaches around

200 mg/dl and many diabetics first know that something is wrong when

they start having to run to the bathroom 20 times a day.

I believe that clinical reports often compare various treatments (and

also the response of a non-diabetic) with an untreated diabetic so

that they have a significant improvement to work with and so they do

not get confused by the effects of other medication.

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> Yes, . But generally I peak at

> four hours (as opposed to most people

> who peak at 2)

It really does depend on the type of meal, Vicki. If you eat a low

glycemic meal there won't be any peak worth mentioning but a flat-

top. I really can't imagine anybody in good control having a

genuine " peak " after two whole hours, mine are always in the range 30

minutes to 60 minutes. A real " peak " at 4 hours after starting to eat

screams out " gastroparesis " to me! I seriously question the " most " in

your " most people who peak at 2 " .

I think that all this comes from the belief that the close

correlation between HbA1c and the 2-hour post-meal BG has led to that

reading being called a " peak " erroneously when it is, in fact just an

arbitrary time borrowed from the oGTT because it suites the routine

in a clinic.

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wrote:

<< I can't help thinking that some of us are over-cautious. >>

Why shouldn't we be over-cautious?? I have been diabetic since I was

thirteen and I plan on getting through many, many years complication free!

I have read (as I am sure you have, too) many books on diabetes and not one

fails to mention complications. Like complications are a given when it comes

to diabetes. It doesn't have to be that way, though. It just takes us being

a little " over-cautious " at times.

D.

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In a message dated 11/2/00 2:58:48 AM US Mountain Standard Time,

lists@... writes:

<< I think that all this comes from the belief that the close

correlation between HbA1c and the 2-hour post-meal BG has led to that

reading being called a " peak " erroneously when it is, in fact just an

arbitrary time borrowed from the oGTT because it suites the routine

in a clinic. >>

It was my understanding that the test subjects were tested repeatedly at

various times following meals, and that they were followed for many years.

That is how they in fact determined the correlation between the two-hour

postprandial readings, in particular, and HbA1c and complications. It took

years of observation to arrive at these conclusions.

Susie

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> The greatest correlation is between the

> two-hour postprandial reading and HbA1c,

> according to research. The 2-hour pp also

> correlates best with the odds of diabetes

> complications. So testing at 2 hours would

> be most likely to predict our HbA1c, as well

> as the threat of future health problems,

> according to researchers.

I have that study report somewhere, Susie, and they did not look for

the " best " predictor of HbA1c but wanted to determine whether the 2-

hour measurement was " better " correlated with the HbA1c than the

fasting BG was. To do that they also compared it with the 5-hour pp

reading. The findings were that both the 2-hr pp and 5-hr pp readings

were better predictors than the fasting BG.

But they did the test on diabetics that did not have good control

(the best were in the group HbA1c 7%-8.5%).

They did not find that the 2-hr pp reading is correlated with the

risk of complications, just mentioned that other studies show that

the HbA1c is correlated with the risk of complications.

I don't dispute that, how could I? But I do dispute most vigorously

that the 2-hr pp reading represents a " peak " , it does not. It is a

measure of the tail down after the peak. Hence, giving rise to the

claim that it is the long tail that gives time for AGEs to form, not

the peak, which is usually of very short duration and hence

relatively harmless.

I know that the jury is still out on that last one but the " experts "

over here seem to be pretty confident that is the way it will turn

out when secured data become available (maybe they have by now).

(I know you didn't bring all your references with you on vacation,

Susie, so I am taking advantage of you while I can!)

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2 hour readings are affected by 2 things, how many carbs eaten in what

form, and the bodies ability to recover from a peak. I found my peak was

about 60-90 minutes, and the 2 hour told me my ability to bring it down.

Now i seldom test, having learned when I need to test.

I do see a correlation between fasting and my previous days control, but

remember I am on no meds and try to keep my sugars even all day even

until bedtime. Sam

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Thornton wrote:

> The WESDR [1] indicated that 98% of all Type 1 diabetics showed a

> more or less pronounced diabetic retinopathy after at least 15 years

> of diabetes of which half of them went on to develop a proliferative

> diabetic retinopathy.

and he wrote

> I have resigned myself to getting retinopathy in a few more years,

Boy! What a bowlful of sunshine this is! If I took the view that I " resign "

myself to this, I may as well give up entirely and forget all this testing,

measuring and analyzing. What's the point! I have only 4 yrs left... (so far

there are no changes to my eyes).

Of course, the point is to look after ourselves as best as we possibly can,

achieve the best bg control as we possibly can, and maybe we can beat these

statistics.

Mark Twain said,

" There are three kinds of lies: lies, damn lies, and statistics. "

I hope to make this one a lie ;)

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, have you had a really good, snot slinging, screaming and moaning cry

yet?

Try it. We've all been here. I lay in the floor off and on for several

days, crying, insisting that I was going to die, and that when I died, I'd

have no legs. We've really all been there, let us help you.

This is a big change in your life, and you've got to deal with it just like

any other big change. Say goodbye, officially, to what used to be, and

welcome what is to come. Get all your feelings out in the open so you can

deal with them, then let them be. Stress, depression, fear, anger, and for

many people, a sense of mourning, all accompany a diagnosis of any chronic

illness.

Have a good crying screaming fit, if it helps. Then, tomorrow, we'll start

over on building your new life.

Robin G.

>From: cariapat@...

>Reply-To: diabetes_integroups

>To: diabetes_integroups

>Subject: Re: Re: Is this too high?

>Date: Thu, 2 Nov 2000 22:36:54 EST

>

>hiya All or anyone:

>

>I am really down in the dumps over trying to get all this right.........

>what

>do you do when you get depressed....just tough it out????

>Damn I was doing so good, have been testing before and after meals and

>trying

>to really adjust my foods to lower my carbs........but been stressed at

>work

>noticed that my levels were staying steadily up for me......

>So got home, had dinner and have just be down and crying....thinking about

>the statistics of complications and etc.....hate to be a whiner.......many

>on

>here are so much worse off than me.....but didnt know who else to talk to

>about my diabetes than all of you here...........

>hugs

>

>

>

>

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> Boy! What a bowlful of sunshine this is!

> If I took the view that I " resign " myself

> to this, I may as well give up entirely

> and forget all this testing, measuring and

> analyzing. What's the point! I have only

> 4 yrs left... (so far there are no changes

> to my eyes).

OK, I know I laid it on a bit thick, , but I was just trying to

inject a little realism into the discussion. Sticking your head into

the sand is one strategy, but you open yourself up to disappointment

later. I prefer to plan realistically and then enjoy the good news

that sometimes comes - it takes all kinds to make a world.

Luther said that even if he knew that the world would come to

an end tomorrow, he would still plant a tree today. Some people laugh

at the idea of putting reading glasses on the eyes of the dear

departed as he lies there in his coffin, but you never know!

> Of course, the point is to look after

> ourselves as best as we possibly can,

> achieve the best bg control as we possibly

> can, and maybe we can beat these statistics

The pleasure of beating the statistics is what keeps a lot of us

going, me too. Even if the odds are a bit long - they are still

better than the odds against not getting into a serious road accident

in the next few years, not the way I drive now, anyway.

> Mark Twain said,

> " There are three kinds of lies: lies,

> damn lies, and statistics. "

> I hope to make this one a lie ;)

Did they have medical studies in his day? He might have wanted to

include those as a fourth kind.

He also probably didn't realize that statistical lies, given a shot

of multiple linear regression analysis, can miraculously turn

into " good predictors " !

And don't forget it still isn't a certainty - you could be in that

other 2% - and we still don't now if living in Wisconsin had

anything to do with it!

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