Re: Something to think about

October 26, 2006

How old was your brother? I read a recent article about running low blood

sugars, and it said it found no loss in function or deterioration of ability

once normal sugar levels were resumed. I am not sure I am quoting the study

exactly. In fact I am pretty sure I am not. I even think I sent a copy of

this study to this list serve. I cannot find my copy, so if I did, would

someone please repost it again.

Something to think about

> For those of you who are trying to run normalized blood sugars there is

> something important to think about. My brother who was diabetic for 48

> years tried to keep normalized blood sugars and kept passing out and

> having

> to go to the hospital. During these times while he was passed out he had

> brain damage occur. So while it is important to have good blood sugars,

> remember Be Careful!

>

> Ruth

>

October 26, 2006

Hi Ruth,

Sorry to seem like I am intentionally picking on you, I am not and appreciate

your feedback and concerns. It gives me an opportunity to explain more to answer

peoples questions.

Secondly it is fine to disagree with me, anyone for that matter, I am here to

simply share information and give it out as food for thought. People can do with

it what they want.

I'd like to point out that passing out and low blood sugars is *not* normalized

at all. A normalized blood sugar is 80 to 90 for all of the time or at least

98%. Secondly, on bernsteins diet you only eat 6 grams of slow carbs for

breakfast, 12 for lunch, and 12 for dinner. Because they are slow acting carbs,

and not quick acting, you only have to dose, for example, 2 units of humalog or

novalog per meal as a type 1 and if type 2 on insulin perhaps 4 units. Dosing 2

units of insulin could rarely, if ever, make you go low or pass out.

Bernstein has a motto that some are familiar with on list... small numbers,

small mistakes, large numbers, large mistakes. That motto means that if you

only eat 12 grams of slow acting carbs, dose 2 units of humalog, that is small

numbers so your low sugar would be small if any. I.E maybe 70. On the flip side,

if you follow the ADA diet of quick acting carbsand eat around 60 at a meal,

dose 8 to 15 units to cover it, those are large numbers and your lows can be

more of a larger mistake.

Regards,

Something to think about

For those of you who are trying to run normalized blood sugars there is

something important to think about. My brother who was diabetic for 48

years tried to keep normalized blood sugars and kept passing out and having

to go to the hospital. During these times while he was passed out he had

brain damage occur. So while it is important to have good blood sugars,

remember Be Careful!

Ruth

October 26, 2006

Hi ,

I'm a bit confused by how the low carb diet and not going low works. I, for

example, take 1 unit of Humalog for approximately 12-15 grams of carbohydrates.

If I were to only eat 6 grams of carbohydrates at a meal, I would somehow have

to give only half a unit of Humalog. If I ate 12 grams that would be about 1

unit.

How to you balance basal insulin like Lantus when you are on so little Humalog?

For me that would be about 2-3 units of Humalog per day! The balance of insulin

is supposed to be about 50% as long acting and 50% as rapid acting to cover

meals. How much Lantus do you take? I am assuming that a type 1 cannot take only

6 units of insulin and not get into trouble. Also, if you eat slow-acting carbs

with lots of protein and fat this usually slows carbs down even more, so how do

you avoid going low immediately after a meal when Humalog peaks, if the food

might take longer to reach your bloodstream?

Also how does exercise work? Right now I have to eat fast acting carbs before or

during exercise, and reduce my rapid and long acting insulin, or else I go low.

If you are taking so little insulin and eating so little carbs, how do you

exercise (such as swimming) without going low?

Jen

October 26, 2006

Hi Harry,

My brother had been doing this between the ages of 48 and 50. It wasn't

the blood sugars causing the brain problems, it was the low blood sugars

causing him to pass out and then while he was unconscious causing problems

with memory and other problems.

Ruth

Re: Something to think about

How old was your brother? I read a recent article about running low blood

sugars, and it said it found no loss in function or deterioration of ability

once normal sugar levels were resumed. I am not sure I am quoting the study

exactly. In fact I am pretty sure I am not. I even think I sent a copy of

this study to this list serve. I cannot find my copy, so if I did, would

someone please repost it again.

Something to think about

> For those of you who are trying to run normalized blood sugars there

> is something important to think about. My brother who was diabetic

> for 48 years tried to keep normalized blood sugars and kept passing

> out and having to go to the hospital. During these times while he was

> passed out he had brain damage occur. So while it is important to

> have good blood sugars, remember Be Careful!

>

> Ruth

>

October 26, 2006

Hi ,

I know you are not picking on me. Don't worry I can take it. The thing

with my brother who also was a type 1 diabetic for 48 years was that when he

was that low, it was much easier for him to crash and pass out. And he was

watching his diet, using slow acting carbs, etc. So you need to be careful!

Ruth

Re: Something to think about

Hi Ruth,

Sorry to seem like I am intentionally picking on you, I am not and

appreciate your feedback and concerns. It gives me an opportunity to explain

more to answer peoples questions.

Secondly it is fine to disagree with me, anyone for that matter, I am here

to simply share information and give it out as food for thought. People can

do with it what they want.

I'd like to point out that passing out and low blood sugars is *not*

normalized at all. A normalized blood sugar is 80 to 90 for all of the time

or at least 98%. Secondly, on bernsteins diet you only eat 6 grams of slow

carbs for breakfast, 12 for lunch, and 12 for dinner. Because they are slow

acting carbs, and not quick acting, you only have to dose, for example, 2

units of humalog or novalog per meal as a type 1 and if type 2 on insulin

perhaps 4 units. Dosing 2 units of insulin could rarely, if ever, make you

go low or pass out.

Bernstein has a motto that some are familiar with on list... small numbers,

small mistakes, large numbers, large mistakes. That motto means that if you

only eat 12 grams of slow acting carbs, dose 2 units of humalog, that is

small numbers so your low sugar would be small if any. I.E maybe 70. On the

flip side, if you follow the ADA diet of quick acting carbsand eat around 60

at a meal, dose 8 to 15 units to cover it, those are large numbers and your

lows can be more of a larger mistake.

Regards,

Something to think about

For those of you who are trying to run normalized blood sugars there is

something important to think about. My brother who was diabetic for 48

years tried to keep normalized blood sugars and kept passing out and

having

to go to the hospital. During these times while he was passed out he had

brain damage occur. So while it is important to have good blood sugars,

remember Be Careful!

Ruth

October 26, 2006

Hi Jen,

very good questions. I'll do my best to answer. My answers will be after your

questions.

*begin quote *

If I were to only eat 6 grams of carbohydrates at a meal, I would somehow have

to give only half a unit of Humalog.

* end quote *

you only eat 6 grams of slow acting at breakfast due to the dawn effect. You get

a few more slow acting carbs from the meat you eat too. Lunch and dinner are 12

grams of slow acting.

If memory serves me you are on a pump? None of Bernstein's patients are on

pumps, he explains that it is lethal to be on one.

* quote *

If I ate 12 grams that would be about

1 unit.

* end quote*

perfect. If you only needed one unit all the better. Bernstein states that a

diabetic should view insulin in the way that the less you take, the better off

you are. Insulin has quite a few negative side effects to it according to dr B.

Large bolis of insulin causes increased blood pressure, strain on the body, and

even weight gain in some.

* begin quote *

How to you balance basal insulin like Lantus when you are on so little Humalog?

For me that would be about 2-3 units of Humalog per day! The balance of

insulin is supposed to be about 50% as long acting and 50% as rapid acting to

cover meals. How much Lantus do you take?

* end quote *

Doctor Bernstein starts type 1 folks on 7 units at the evening and I think 4 in

the morning. He split doses lantus. I personally am on 9 units at the evening

and 2 in the morning but I do not take lantus, I dose ultrelente.

Note: he split doses lantus since according to doctor bernstein the lantus

research was fudged to market it as a 24 hour insulin. It is not. I.E the

research, for example, injected 60 units of lantus in a person so it was forced

to work for 24 hours. However,the person was constantly eating glucose and sugar

to not pass out! It gave them the results that they wanted to market it but it

is not a 24 hour insulin according to doctor bernstein. Many type 1 patients,

and type 2 on it, try to use it as a 24 hour and run low in the middle of the

night since it is such large doses to get the 24 hour effect. I.E you may dose

40 units at night where as doctor bernstein may have you dose 9 at night and 4

in the morning. Big difference between 9 units at night and 40!

* begin quote *

I am assuming that a type 1 cannot

take only 6 units of insulin and not get into trouble.

* end quote *

I run 80 to 90 all the time and never get into trouble. Small numbers, small

mistakes, large numbers, large mistakes. When you do not eat quick acting carbs,

you essentially cannot get into trouble with spikes or lows since your insulin

requirements are cut more than half.

* begin quote *

Also, if you eat slow-acting carbs with lots of protein and fat this usually

slows carbs down even

more, so how do you avoid going low immediately after a meal when Humalog peaks,

if the food might take longer to reach your bloodstream?

* end quote *

Good question Jen. I'll do my best to answer. Bernstein mentions research on his

audio cds between two sets of people. It was not his research but was

interesting and will answer your question. One set of people in the research was

on a low carb diet and ate high fat and meat and the other set ate high carb,

high fat, and low meat. The people who ate low carb/high fat never gained weight

and their lipids were perfectly normal. The other parties who ate high fat/high

carb had extremely elevated lipids/ldl etc. The research showed that when you

eat low carb/high fat, your body metabolizes the fat and uses it since it needs

it. Where as the people on high carb/high fat diets stored the fat since their

body did not need it. This in turn caused their lipids to skyrocket.

So what am I saying? I never have the Chinese effect since the fat that I eat,

eggs, cheese, real butter, etc. my body needs it and metabolizes it when I eat

it so it handles it fine. I even still continue to lose weight eating all the

fat. I am studying my lipids and in 2 months will see the result of the fat.

Most of Bernstein's patients all run ldl of 100 or less with no ldl lowering

medications.

The slow acting carbs I eat are not held back by the fat since my body

metabolizes the fat when I eat it since it needs it.

My two hour posts are always 80 to 90 though btw.

Bernstein had a patient that according to his wife was to thin on his diet. The

wife wanted her husband to gain weight. Bernstein said he did not want to put

quick acting carbos in his diet since that would cause his sugars to no longer

be normalized. So what did he do? He made the guy drink a double shot of virgin

olive oil twice a day spiked with a pinch of rum. This man did this for 3 months

straight. Do you know how much fat is in olive oil? Well, after doing this for 3

months the man did not gain one single ounce of weight. Bernstein was baffled by

it so he called researchers to find out why this would happen. He could not get

an answer and then eventually came across the research with the two groups of

people I mentioned earlier. The man was not gaining weight since his body needed

the fat and metabolized the fat.

* begin quote *

Also how does exercise work? Right now I have to eat fast acting carbs before or

during exercise, and reduce my rapid and long acting insulin, or else I

go low. If you are taking so little insulin and eating so little carbs, how do

you exercise (such as swimming) without going low?

* end quote *

Think of it this way. If you were dosing 2 to 4 units of humalog for a meal, and

a total of 10 units of lantus split 5 evening 5 morning, how could you go low?

It isn't enough to lower you even swimming and so on. Most diabetics go low

since they have *so much* basal and humalog in their bodies to deal with the

quick acting carbs that many lows in exercise is caused to the lingering effect

where humalog lingers past 4 hours and the basal is just way to much. Most type

1 on pumps have to eat a lot due to lows. They take to much basal and always

have to eat for the sake of survival. I.E eat or pass out. I guarantee that if

you dosed only 20 units of insulin a day, as oppose to 60 to 80, you would not

run low if ever/very rare.

This would be a *huge* benefit to you Jen and you would see instant results.

That is, your lows that you experience around exercise would vanish.

btw you are still eating carbohydrates, they are just slow acting on your

sugars. They still do give you energy for exercise and so on.

If you have any other questions, please let me know. I am just here to pass on

the information. I'd like to invite you to order doctor bernsteins audio cds for

type 1 diabetics... a wealth of helpful information. I posted the link a while

back so not sure if you seen it or not.

Regards,

Re: Something to think about

Hi ,

I'm a bit confused by how the low carb diet and not going low works. I, for

example, take 1 unit of Humalog for approximately 12-15 grams of carbohydrates.

If I were to only eat 6 grams of carbohydrates at a meal, I would somehow have

to give only half a unit of Humalog. If I ate 12 grams that would be about 1

unit.

How to you balance basal insulin like Lantus when you are on so little

Humalog? For me that would be about 2-3 units of Humalog per day! The balance of

insulin is supposed to be about 50% as long acting and 50% as rapid acting to

cover meals. How much Lantus do you take? I am assuming that a type 1 cannot

take only 6 units of insulin and not get into trouble. Also, if you eat

slow-acting carbs with lots of protein and fat this usually slows carbs down

even more, so how do you avoid going low immediately after a meal when Humalog

peaks, if the food might take longer to reach your bloodstream?

Also how does exercise work? Right now I have to eat fast acting carbs before

or during exercise, and reduce my rapid and long acting insulin, or else I go

low. If you are taking so little insulin and eating so little carbs, how do you

exercise (such as swimming) without going low?

Jen

October 26, 2006

Hi ,

Thanks for answering my questions. You posed some of your own in your e-mail

so I've answered them below.

*quote*

you only eat 6 grams of slow acting at breakfast due to the dawn effect. You

get a few more slow acting carbs from the meat you eat too. Lunch and dinner

are 12 grams of slow acting.

If memory serves me you are on a pump? None of Bernstein's patients are on

pumps, he explains that it is lethal to be on one.

*end quote*

You are right, I forgot about the dawn effect. I take 1 unit of Humalog to

cover 8-10 grams of carbohydrates in the morning, rather than the 12-15 it

covers the rest of the day.

*quote*

If memory serves me you are on a pump? None of Bernstein's patients are on

pumps, he explains that it is lethal to be on one.

*end quote*

No, I'm not on a pump but am trying to get on one (depends only on whether

insurance will cover it). Right now I'm taking Humalog and Lantus. I'm

surprised he says pumps are letal! Why does he say that? Everyone I've

talked to on a pump has better control than they ever did on shots.

*quote*

perfect. If you only needed one unit all the better. Bernstein states that a

diabetic should view insulin in the way that the less you take, the better

off you are. Insulin has quite a few negative side effects to it according

to dr B. Large bolis of insulin causes increased blood pressure, strain on

the body, and even weight gain in some.

*end quote*

It makes sense to me that more insulin would be worse. What is a " good "

amount of insulin?

*quote*

Doctor Bernstein starts type 1 folks on 7 units at the evening and I think 4

in the morning. He split doses lantus. I personally am on 9 units at the

evening and 2 in the morning but I do not take lantus, I dose ultrelente.

*end quote*

I just recently split my Lantus dose and my evening blood sugars are so much

better. I went for a year and a half without splitting it and was almost

always high at bedtime unless I gave an additional shot of Humalog in the

evening after dinner, and even that often didn't keep me down. I have had to

lower my carb ratio at dinner and also lower my Lantus dose slightly and am

still having lows, so I will probably be reducing it more.

*quote*

Note: he split doses lantus since according to doctor bernstein the lantus

research was fudged to market it as a 24 hour insulin. It is not. I.E the

research, for example, injected 60 units of lantus in a person so it was

forced to work for 24 hours. However,the person was constantly eating

glucose and sugar to not pass out! It gave them the results that they wanted

to market it but it is not a 24 hour insulin according to doctor bernstein.

Many type 1 patients, and type 2 on it, try to use it as a 24 hour and run

low in the middle of the night since it is such large doses to get the 24

hour effect. I.E you may dose 40 units at night where as doctor bernstein

may have you dose 9 at night and 4 in the morning. Big difference between 9

units at night and 40!

*end quote*

I agree that it is not a 24-hour insulin. Every type 1 I know who uses it

has ended up splitting the dose due to high blood sugars at night. It

frustrates me that it's marketed as a 24-hour insulin. The company who makes

Levemir, another new basal insulin, do not claim that it lasts for 24-hours

(they say it lasts 18-24 hours), and also are not marketing it as a peakless

insulin but rather as one with a " gentle " peak.

*end quote*

*quote*

I run 80 to 90 all the time and never get into trouble. Small numbers, small

mistakes, large numbers, large mistakes. When you do not eat quick acting

carbs, you essentially cannot get into trouble with spikes or lows since

your insulin requirements are cut more than half.

*end quote*

I think you misunderstood here. What I meant by I wasn't sure a type 1 could

take only 6 units of insulin a day (this is assuming that the Lantus/Humalog

split is 50/50, if I were to only take ~3 units of Humalog a day) is that I

don't know whether there is a minimum amount of insulin the body needs in

order to keep things going (i.e., suppress glucagon production and ketones,

etc.)? Anything under 20-30 units a day sounds really small. Is there a

minimum amount of insulin you need? On this diet do you take much more basal

insulin than bolus instead of the 50/50 split?

*quote*

Think of it this way. If you were dosing 2 to 4 units of humalog for a meal,

and a total of 10 units of lantus split 5 evening 5 morning, how could you

go low? It isn't enough to lower you even swimming and so on. Most diabetics

go low since they have *so much* basal and humalog in their bodies to deal

with the quick acting carbs that many lows in exercise is caused to the

lingering effect where humalog lingers past 4 hours and the basal is just

way to much. Most type 1 on pumps have to eat a lot due to lows. They take

to much basal and always have to eat for the sake of survival. I.E eat or

pass out. I guarantee that if you dosed only 20 units of insulin a day, as

oppose to 60 to 80, you would not run low if ever/very rare.

This would be a *huge* benefit to you Jen and you would see instant results.

That is, your lows that you experience around exercise would vanish.

*end quote*

Thank you for finally explaining the exercise! That makes more sense now. I

take an average of 40 units total of Humalog and Lantus, 35 even 30 if I am

active. This is currently on a high carb diet which even I admit isn't

always the healthiest (hey, I'm a student, what else can I say). So I am

still a bit confused how you can exercise and not go low, and still not go

high when you don't exercise. For non-diabetics the amount of insulin in

thier body changes and decreases for exercise, which is why we have to

" feed " the insulin when we want to exercise if we don't reduce the dose

first.

*quote*

btw you are still eating carbohydrates, they are just slow acting on your

sugars. They still do give you energy for exercise and so on.

*end quote*

Can you eat a " high carb " diet with only slow acting carbs and get the same

effect? Could you eat a higher number of carbs a day or just the 30g total?

*quote*

If you have any other questions, please let me know. I am just here to pass

on the information. I'd like to invite you to order doctor bernsteins audio

cds for type 1 diabetics... a wealth of helpful information. I posted the

link a while back so not sure if you seen it or not.

*end quote*

I have seen the link, but unfortunately am in university at the moment so

can't afford the $100-some-odd dollars it is (probably more in Canadian,

too). I'm still not fully convinced that a pump won't solve my problems (the

biggest of which is always waking up high no matter what I do, and a second

one though less problematic is going low during exercise which I can

compensate for by reducing insulin and/or having a snack), but I am willing

to listen. Can you give an example of your daily readings and insulin and

diet? How stable is normalized?

How does hormones, stress, illness, and other factors come into this? Does

he believe that there is a random factor involved with blood sugar control?

This " randomness factor " is one of the major reasons why I'm skeptical. Even

if you controlled for food and this caused you to never go high or low even

from exercise, what happens when hormones or a cold or a really

stressful/emotional sitaution hits?

Out of curiosity, I also heard on a diabetes forum where we were discussing

natural disasters and type 1, that somewhere Dr. Bernstein talks about how a

type 1 could survive without insulin if they were ever caught in a situation

where they were stuck for days without it. This is purely out of curiosity:

I live in an earthquake zone and, even though I bring my insulin and

supplies everywhere, I wonder sometimes what I'd do if we ever had " the big

one " that's expected some day. Does he address this on his CDs?

Thanks for all the answers you've provided so far. I may look into seeing if

any libraries around here have his CD sets. I am still not fully convinced

but it wouldn't do any harm to listen.

Jen

October 26, 2006

Hi Jen,

* quote *

surprised he says pumps are letal! Why does he say that? Everyone I've

talked to on a pump has better control than they ever did on shots.

* end quote *

better control typically means around 90 or more units of humalog a day and

eating tons of quick acting carbos and also many swings. Again, my a1c was 5.0

to 5.2 for the past 3 years but my kidneys still declined from 1.7 creatinine to

2.0 due to the swings. He says pumps are lethal since most type ones on them

*constantly* have to eat for survival... they tend to run low often. On his

routine to normalize sugars, you are at the range of 4.5 to 5.0 98% of the time.

* quote *

It makes sense to me that more insulin would be worse. What is a " good "

amount of insulin?

* end quote *

the less you can take, the better. Think of it this way... the less insulin you

take, the less oppertunity you have to get low!

* quote *

split is 50/50, if I were to only take ~3 units of Humalog a day) is that I

don't know whether there is a minimum amount of insulin the body needs in

order to keep things going (i.e., suppress glucagon production and ketones,

etc.)? Anything under 20-30 units a day sounds really small. Is there a

minimum amount of insulin you need? On this diet do you take much more basal

insulin than bolus instead of the 50/50 split?

* end quote *

Refer to my post to Dave. I explain that at my sample meals I dose 4 units of

humalog which in theory I should only dose 1. However, this accounts for the

glucagon effect.

My basal has decreased substantially. Refer to my post to dave.

* quote *

still a bit confused how you can exercise and not go low, and still not go

high when you don't exercise. For non-diabetics the amount of insulin in

thier body changes and decreases for exercise, which is why we have to

" feed " the insulin when we want to exercise if we don't reduce the dose

first.

* end quote *

Simply put, you do not have an excessive amount of insulin in your body that

lingers from dose to dose causing you to low out when exercising. If you dose 20

units at breakfast the peek goes way into the 6 hour even though it is not

noticeable. Dose another 20 units at lunch and the peek lingers some too. Now go

jump in the pool and you will get low from that large amount of insulin

lingering in your body. If you dose 4 units for breakfast, 4 for lunch, and

repeat the same experiment you will see that you will not go low exercising. In

the event after exercising you are high, then you simply dose *one* single unit

of humalog before exercising and it will keep it down. Because you have *no*

quick acting carbos in your body to fight you, your insulin requirements are way

less and you are *so much* more accurate at the dosing. Small numbers, small

mistakes, large numbers, lots of lows!

* quote *

Can you eat a " high carb " diet with only slow acting carbs and get the same

effect? Could you eat a higher number of carbs a day or just the 30g total?

* end quote *

I think what you are asking is can you eat more than the suggest 6 at breakfast,

12 at lunch, and 12 at dinner of the slow acting carbs. Bernstein says in theory

you coudl could eat more but it has been his experience that it makes

normalizing the sugars more difficult so he keeps his patients at those levels

and does not change them. Keeping your carbos and meat constant at each meal is

important to normalize your sugars . I.E you woudl would not eat 6, 30, 12 one

day then 10, 5, 45 the next day of slow acting carbs. this would make

normalizing your sugars impossible. Having those slow acting carbos and meat

portions that same at each meal is crucial to normalizing your sugars.

* quote *

How does hormones, stress, illness, and other factors come into this? Does

he believe that there is a random factor involved with blood sugar control?

This " randomness factor " is one of the major reasons why I'm skeptical. Even

if you controlled for food and this caused you to never go high or low even

from exercise, what happens when hormones or a cold or a really

stressful/emotional sitaution hits?

* end quote *

yeah, he accounts for this a lot. On his audio cds he talks about the flu,

vomiting, menstrual cycle, colds, and so on. On his cds he suggested a

supplement to take for the initial onset of a cold and swears it will knock it

out in 1 to 2 days. I got the product and have been taking it for 1 day and the

initial symptoms of the cold I had, hard to swallow, scratch throat, sugars

starting to elevate, are all gone and my sugars are back in range.

* quote *

Out of curiosity, I also heard on a diabetes forum where we were discussing

natural disasters and type 1, that somewhere Dr. Bernstein talks about how a

type 1 could survive without insulin if they were ever caught in a situation

where they were stuck for days without it. This is purely out of curiosity:

I live in an earthquake zone and, even though I bring my insulin and

supplies everywhere, I wonder sometimes what I'd do if we ever had " the big

one " that's expected some day. Does he address this on his CDs?

* end quote *

I have never heard Bernstein explain that at all in his book nor in his audio

cds.

If you have any more questions, please let me know.

also, please read my post to dave it answers some of your questions too.