Re: Mike's Breakfast

[Guest guest]

Ok, no more wheat bread, even though the carbs are low.

Insulin is 34 units of Lantus I take at 8pm every night.

[Guest guest]

On Fri, 8 Jul 2005 17:10:50 -0000 " Mike Brown "

writes:

> Ok, no more wheat bread, even though the carbs are low.

>

> Insulin is 34 units of Lantus I take at 8pm every night.

>

>

What do you consider low carb?

Now I know you are overloaded with information right now so I have a

suggestion. Forget EVERYTHING your medical professionals have told you

for now.

With that sone take somethings into consideration.

1- Eating what your medical professionals have told you to eat has not

worked out too well, has it?

2- You need to understand some basics which go against what your doctors,

dietitians etc. have told you.

All carbs are not the same. 20 carb grams of potatoes and 20 carb grams

of lets say green beans will not react on your bgs the same way. Gee 10

carb grams of raw carrots will react differently than 10 carb grams of

cooked carrots.

No one said this DM control thing was easy, just that it was necessary.

You keep bringing up 565 bg number. With all due respect, there is

nothing you can do about the 565, it is in the past. But there is plenty

you can do about your bg #'s today and tomorrow.

Lets stick to breakfast for now. Grains and most type IIs do not get

along regardless of the #'s of carbs on the label. Wheat bread (and you

did not say whole grain wheat bread) comes from a grain, same for oatmeal

- oats are a grain. It appears that your body cannot tolerate grains now.

This might change in the future as you get to learn about different

grains and try some other grains but for now, no grains. That means, no

bread, muffins, pancakes, pasta, bagels, english muffins, oatmeal, corn

meal and I think grits (is grits from a grain?)

Now that was easy wasn't it. Now protein doesn't have any grains so you

can have meat that is not breaded or on a piece of bread/roll/rollup etc.

You can have fish, egg, hard cheeses. What a bout a cheese omelet for

breakfast tomorrow? If that isn't enough what about a cheese omelet with

some meat for breakfast?

I'm sorry that it will not add up to 60 carbs for brekfast but your bg

numbers will be much better.

Counting carbs is not the weight watchers diet, which I understand to be

that you can eat anything as long as doesn't exceed 30 points a day and

that is not 30 carbs a day but some kind of point system. Since all carbs

are different and react differently you have to be more selective about

what carbs you eat.

Starches such as potatoes, corn, rice, peas have the kind of carbs that

raise your bgs to a higher level and keep them high for an unhealthy

amount of time. So for now, none of these foods should be included in

your diet.

So for now what about keeping it simple. Protein, green veggies except

peas but like broccili, grean beans salad greens, a little fat and keep

your carb count to, for now, maybe 100 grams a day. See how your bgs

react to this plan and then you can cautiously add things to see how they

react to you.

Just a thought.

[Guest guest]

How low? What is the total carb count per slice - from the label? We

have to deal in real numbers, not subjective assessments. What you

think is low might be 23 carbs/slice. That's not low. 3 is low.

CarolR

Mike Brown wrote:

> Ok, no more wheat bread, even though the carbs are low.

>

[Guest guest]

At 02:21 PM 7/8/05, Carol wrote:

>How low? What is the total carb count per slice - from the label? We

>have to deal in real numbers, not subjective assessments. What you

>think is low might be 23 carbs/slice. That's not low. 3 is low.

3 carbs per slice is what this bread has. I like it.

You can buy it online and many stores also carry it:

http://tinyurl.com/c7za5

I mention this bread a lot, so want to assure you that I don't work for the

company or get any kickback in the form of free loaves of bread (or

anything else). I just like the bread. One of the few LC breads I've found

that isn't too sweet. I just had a BLT sandwich made with some. Yum.

sky

[Guest guest]

On Fri, 08 Jul 2005 14:31:45 -0400, Sky

wrote:

>3 carbs per slice is what this bread has. I like it.

>You can buy it online and many stores also carry it:

>http://tinyurl.com/c7za5

>

>I mention this bread a lot, so want to assure you that I don't work for the

>company or get any kickback in the form of free loaves of bread (or

>anything else). I just like the bread. One of the few LC breads I've found

>that isn't too sweet. I just had a BLT sandwich made with some. Yum.

I see the 7 carbs per slice on the label. But I also see that the

first non-water ingredient is whole wheat flour. That raises my alarm

flags.

What does your meter say? have you tested this bread in isolation?

Just eaten a slice or two without anything else and measured the BG

impact? I'd go to the trouble of finding some of this if I knew the

label was accurate.

The more I read labels and then eat to my meter, the more I'm

convinced that some manufacturers have figured out how to radio the

nutrition tests.

---

De Armond

See my website for my current email address

http://www.johngsbbq.com

Cleveland, Occupied TN

[Guest guest]

On Fri, 8 Jul 2005 13:49:03 -0400, Samante

wrote:

>

>On Fri, 8 Jul 2005 17:10:50 -0000 " Mike Brown "

>writes:

>> Ok, no more wheat bread, even though the carbs are low.

>>

>> Insulin is 34 units of Lantus I take at 8pm every night.

>>

>>

>What do you consider low carb?

>

>Now I know you are overloaded with information right now so I have a

>suggestion. Forget EVERYTHING your medical professionals have told you

>for now.

>

>With that sone take somethings into consideration.

>

>1- Eating what your medical professionals have told you to eat has not

>worked out too well, has it?

>2- You need to understand some basics which go against what your doctors,

>dietitians etc. have told you.

is absolutely correct. Shocking, eh? To think that doctors

can be dead wrong about a major area in medicine. With diabetes, this

seems to be the rule rather than the exception.

Trying to take fixed doses of insulin and then 'eat to the insulin' is

equally outmoded and wrong.

Consider how a non-diabetic body works. Trucking along between meals,

after digestion is complete, the islets in the pancreas excrete a

baseline amount of insulin, just enough to keep the BG in the " sweet "

range, usually 75-95. The islets also store some insulin.

When the non-diabetic eats something containing glucose or other

carbs, the rise in BG causes the pancreas to dump stored insulin.

This is the phase 1 response. Then it secretes a continuous level of

insulin as long as there is glucose in the blood to process. When the

BG drops again into the sweet range, it start tucking away insulin for

the next meal.

In a Type II, the islets can't keep up for various reasons. Since

they can't supply the needed base level of insulin, they can't store

up any insulin for a phase 1 dump. Most type IIs have little to no

Phase 1 response. Therefore when a type II eats, the first thing that

happens is a spike in BG. If there is still enough beta cell activity

then maybe the islets will be able to increase production to

eventually process all the glucose. Maybe not, it just depends. In

any event, there is a long period of time where the BG is elevated.

Elevated BG is what causes all the bad side effects of diabetes.

Now consider your situation. Your pancreas cannot come near to

keeping up with demand as indicated by your >500 reading when you were

diagnosed. You're taking Lantus, a very slow release and long lasting

insulin, as a basal or base load. This should bring your fasting BG

down to the normal range but it does NOTHING, repeat NOTHING for the

post-meal spike.

To cover the post-meal (postprandial in medical jargon) spike, you

need additional fast acting insulin, equivalent to the natural Phase 2

response. This must be injected before the meal. The amount injected

is directly proportional to the number of carbs in your meal.

Short and fast insulins include Humalog and Novolog. At this moment,

Novolog is the fastest for most people. Even faster ones are on the

way.

The problem is, you're not shooting anything to cover your meals. So

your BG rises throughout the day as each meal piles on more carbs.

Now your doc may hold the common but mistaken belief that your

pancreas might recover some functionality once some of the load is

taken off it. Mine had that notion. If your pancreas did recover

then it could provide some or all the meal cover. Mine didn't recover

a bit. My research indicates this to be the normal situation. By

the time most Type 2s are diagnosed, there is irreparable damage done

to the pancreas.

What kind of control is possible? Near-non-diabetic BG levels. I

regulate my Lantus dose to keep my fasting BG between 85 and 100,

closer to 85. I shoot Novolog to cover my meals. I have measured my

carb sensitivity and know that I need 1 unit of Novolog to cover every

13 grams of carbs. I never let my post-meal BG rise above 140 and I

try to keep it below 120. I measure 1.5 hours after my meal and if I

see BG higher than 120, I'll add another unit or two of Novolog to

cover it.

That's a lot of testing and a lot of injections but I think it worth

it for the benefits. Benefits include the complete reversal of the

eye damage, the beginnings of neuropathy in my feet, the aches in all

my joints and muscles and the recovery of at least as much energy as I

had 15 or 20 years ago. My total cholesterol which was in the 500s

has dropped to exactly normal, as have the other lipids. BG in the

range you're talking about clouds your thinking and dulls the brain.

You'll be amazed at how much clearer things become when you regain

control.

Covering carbs is half the program. The other half is limiting

carbs. If you haven't already, please buy the Bernstein book, read it

and take it to heart. He has >50 years of personal experience and

thousands of patients that prove his methods work.

One of his basic concepts is the Law of Small Numbers. What this

means is that if you deal with small numbers, you're not likely to

make mistakes that matter.

If you pack in a meal with 200 carbs and have to shoot 15 units to

cover, then you've set yourself up for a mistake. Usually a hypo.

You might mis-estimate the number of carbs. You might mis-estimate

the necessary insulin. If you make a small mistake, percentage wise,

the absolute value of the mistake can be large and that can lead to

either a hypo attack or very high sugar post meal.

Maybe the meal only had 150 carbs. At 13 grams of carbs per unit

(using my numbers), you'd have over-shot 4 units. Again, using my

numbers, at 15 BG points per unit of insulin, you'll undershoot your

target by 60 points. If you shot for 100, you'll hit 40, deep in hypo

territory. If you shot for 85, then maybe you're going to end up in

insulin shock.

OTOH, if you eat only, say, 30 carbs and only have to shoot 2 units of

insulin, then a mistake is unlikely to matter. Suppose you guessed

wrong by 50% on the carbs and there were only 15. That would have

called for only 1 unit of insulin. You took 2 units, a 50% error.

BUT. That extra single unit will only put you 15 points (using my

numbers) lower than your target, likely NOT to put you low enough for

a hypo. If your target was 100, you'll hit 85. If it was 85, you'll

hit 60. Maybe a mild hypo, maybe not.

I set my target to 100 and then trim to 85 if necessary. I seem to

overestimate the number of carbs in the meal so trimming usually isn't

necessary.

This is all stuff you have to work out for your own body. That's why

no set plan can ever be developed that will work out-of-the-box for

everyone.

This is where the ADA method is at its worst. It tells you to eat

lots of carbs according to a set formula and then shoot lots of

insulin to cover it. No wonder so many people so fear hypos!!!

I limit myself to about 60 carbs per day and no more than 5 units'

worth per meal. I try to keep the per-meal carbs low enough that 3 or

less units of Novolog will cover.

Since I'm used to eating to this level, a " splurge " for me might be 90

carbs. Still low enough that the Law of Small Numbers still applies.

I don't splurge very often, maybe once a week.

As I said yesterday, this so-called " basal-bolus " treatment and low

carb diet is state-of-the-art in diabetes management, far ahead of the

medical establishment. It is backed by tremendous volumes of research

that somehow don't make it into the recommended practices from the

ADA.

>>YOU<< and not your doc are going to have to implement this

management plan. You'll have to either pressure him into writing a

script for Novolog or else you'll have to work with the slower

insulins that are over-the-counter. I'd get the script, either from

him or from your new doc.

I was pretty shell-shocked when I was diagnosed, as I didn't have any

of the usual indications of high sugar. About the only thing that

made me wonder was that wounds didn't heal very fast, but then again,

that had been a problem all my life.

My doc didn't understand the basal-bolus method. He wanted me to use

a sliding scale, where I dosed a fixed amount of Lantus and then shot

Novolog according to a sliding scale of BG values that went up to

400!!! and to test a couple of times a day. Fortunately I got the

tools I needed, scripts for lots of strips, Lantus and Novolog, to do

it the right way.

I used the sliding scale for about a day while I hit the net and a

nearby medical library to research. Everything I read in the

literature that wasn't out of date pointed to keeping BG as low as

possible without hypo'ing. It seemed like the natural thing to do to

this engineer to measure and adjust, measure and adjust. Just like a

closed loop feedback control system. Turns out I independently

rediscovered the basal-bolus method used by insulin pump wearers.

It won't be your doc that loses the limbs. It won't be your doc that

goes blind. It won't be your doc who sits hung off a dialysis machine

three times a week. It won't be your doc that has a heart attack.

That person is YOU. YOU take care of yourself or else you suffer the

consequences. The only way you can take care of yourself is to

aggressively self-manage your care. Even the most up-to-date doc

isn't going to be there at every meal telling you what to do. That's

about as in-your-face as I can put it.

My motivation is that I've already suffered kidney damage from the

years of high sugar before my doc woke up and caught it. I don't

intend to suffer any more damage. In fact, it looks like they're

slowly recovering.

What is YOUR motivation?!?!

---

De Armond

See my website for my current email address

http://www.johngsbbq.com

Cleveland, Occupied TN

[Guest guest]

At 02:15 AM 7/9/05, Neon wrote:

>I see the 7 carbs per slice on the label.

Did you subtract the fiber?

> But I also see that the first non-water ingredient is whole wheat

> flour. That raises my alarm

>flags.

>

>What does your meter say? have you tested this bread in isolation?

Yep. Virtually no impact at all.

>The more I read labels and then eat to my meter, the more I'm

>convinced that some manufacturers have figured out how to radio the

>nutrition tests.

I've had no problems with this bread.

sky

[Guest guest]

,

Out of curiosity, do you find your insulin-to-carb and carb-to-bg-rise ratios

constant

throughout the day?

I find my ratio is about 1 carb = 5 pts bg rise in the am. 1 carb = 1.5 pts bg

rise at lunch

and 1 carb = 1.5 to 2 pts bg rise in the evenings. So, in the morning I need

*roughly* 1U

of Humalog for every 2 carbs. In the afternoons I only need 1U of Humalog for

every *10*

carbs!

SulaBlue

> What kind of control is possible? Near-non-diabetic BG levels. I

> regulate my Lantus dose to keep my fasting BG between 85 and 100,

> closer to 85. I shoot Novolog to cover my meals. I have measured my

> carb sensitivity and know that I need 1 unit of Novolog to cover every

> 13 grams of carbs. I never let my post-meal BG rise above 140 and I

> try to keep it below 120. I measure 1.5 hours after my meal and if I

> see BG higher than 120, I'll add another unit or two of Novolog to

> cover it.

>

> That's a lot of testing and a lot of injections but I think it worth

> it for the benefits. Benefits include the complete reversal of the

> eye damage, the beginnings of neuropathy in my feet, the aches in all

> my joints and muscles and the recovery of at least as much energy as I

> had 15 or 20 years ago. My total cholesterol which was in the 500s

> has dropped to exactly normal, as have the other lipids. BG in the

> range you're talking about clouds your thinking and dulls the brain.

> You'll be amazed at how much clearer things become when you regain

> control.

>

> Covering carbs is half the program. The other half is limiting

> carbs. If you haven't already, please buy the Bernstein book, read it

> and take it to heart. He has >50 years of personal experience and

> thousands of patients that prove his methods work.

>

> One of his basic concepts is the Law of Small Numbers. What this

> means is that if you deal with small numbers, you're not likely to

> make mistakes that matter.

>

> If you pack in a meal with 200 carbs and have to shoot 15 units to

> cover, then you've set yourself up for a mistake. Usually a hypo.

> You might mis-estimate the number of carbs. You might mis-estimate

> the necessary insulin. If you make a small mistake, percentage wise,

> the absolute value of the mistake can be large and that can lead to

> either a hypo attack or very high sugar post meal.

>

> Maybe the meal only had 150 carbs. At 13 grams of carbs per unit

> (using my numbers), you'd have over-shot 4 units. Again, using my

> numbers, at 15 BG points per unit of insulin, you'll undershoot your

> target by 60 points. If you shot for 100, you'll hit 40, deep in hypo

> territory. If you shot for 85, then maybe you're going to end up in

> insulin shock.

>

> OTOH, if you eat only, say, 30 carbs and only have to shoot 2 units of

> insulin, then a mistake is unlikely to matter. Suppose you guessed

> wrong by 50% on the carbs and there were only 15. That would have

> called for only 1 unit of insulin. You took 2 units, a 50% error.

> BUT. That extra single unit will only put you 15 points (using my

> numbers) lower than your target, likely NOT to put you low enough for

> a hypo. If your target was 100, you'll hit 85. If it was 85, you'll

> hit 60. Maybe a mild hypo, maybe not.

>

> I set my target to 100 and then trim to 85 if necessary. I seem to

> overestimate the number of carbs in the meal so trimming usually isn't

> necessary.

>

> This is all stuff you have to work out for your own body. That's why

> no set plan can ever be developed that will work out-of-the-box for

> everyone.

>

> This is where the ADA method is at its worst. It tells you to eat

> lots of carbs according to a set formula and then shoot lots of

> insulin to cover it. No wonder so many people so fear hypos!!!

>

> I limit myself to about 60 carbs per day and no more than 5 units'

> worth per meal. I try to keep the per-meal carbs low enough that 3 or

> less units of Novolog will cover.

>

> Since I'm used to eating to this level, a " splurge " for me might be 90

> carbs. Still low enough that the Law of Small Numbers still applies.

> I don't splurge very often, maybe once a week.

>

> As I said yesterday, this so-called " basal-bolus " treatment and low

> carb diet is state-of-the-art in diabetes management, far ahead of the

> medical establishment. It is backed by tremendous volumes of research

> that somehow don't make it into the recommended practices from the

> ADA.

>

> >>YOU<< and not your doc are going to have to implement this

> management plan. You'll have to either pressure him into writing a

> script for Novolog or else you'll have to work with the slower

> insulins that are over-the-counter. I'd get the script, either from

> him or from your new doc.

>

> I was pretty shell-shocked when I was diagnosed, as I didn't have any

> of the usual indications of high sugar. About the only thing that

> made me wonder was that wounds didn't heal very fast, but then again,

> that had been a problem all my life.

>

> My doc didn't understand the basal-bolus method. He wanted me to use

> a sliding scale, where I dosed a fixed amount of Lantus and then shot

> Novolog according to a sliding scale of BG values that went up to

> 400!!! and to test a couple of times a day. Fortunately I got the

> tools I needed, scripts for lots of strips, Lantus and Novolog, to do

> it the right way.

>

> I used the sliding scale for about a day while I hit the net and a

> nearby medical library to research. Everything I read in the

> literature that wasn't out of date pointed to keeping BG as low as

> possible without hypo'ing. It seemed like the natural thing to do to

> this engineer to measure and adjust, measure and adjust. Just like a

> closed loop feedback control system. Turns out I independently

> rediscovered the basal-bolus method used by insulin pump wearers.

>

> It won't be your doc that loses the limbs. It won't be your doc that

> goes blind. It won't be your doc who sits hung off a dialysis machine

> three times a week. It won't be your doc that has a heart attack.

> That person is YOU. YOU take care of yourself or else you suffer the

> consequences. The only way you can take care of yourself is to

> aggressively self-manage your care. Even the most up-to-date doc

> isn't going to be there at every meal telling you what to do. That's

> about as in-your-face as I can put it.

>

> My motivation is that I've already suffered kidney damage from the

> years of high sugar before my doc woke up and caught it. I don't

> intend to suffer any more damage. In fact, it looks like they're

> slowly recovering.

>

> What is YOUR motivation?!?!

>

>

>

> ---

> De Armond

> See my website for my current email address

> http://www.johngsbbq.com

> Cleveland, Occupied TN

[Guest guest]

On Sun, 10 Jul 2005 16:03:04 -0700, " whimsy2 "

wrote:

>Excellent post, ...can I save it in my archives and pull it out when

>applicable if you're not around?

>Vicki

Oh sure. Help yourself. I basically put into my own words what

Bernstein says. I'm pretty sure he has the chapter that covers the

Law of Small Numbers on his website in a pdf that you can also

download. He's been nice enough to put the core concepts up for

download so that even if you don't have the book, you can learn the

concept.

---

De Armond

See my website for my current email address

http://www.johngsbbq.com

Cleveland, Occupied TN