Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 I've heard that from a lot of people. At least now I'll have someone more on the ball to help me manage my diabetes. He must have skipped that class in med school. Mike Re: Re: new diabetic with questions BGs that high can mean DKA - diabetic ketoacidosis - which usually sends folks to the hospital. You were lucky. But I have less than good faith in your doc who sent you home with BGs that high. Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 > Hi Alan > > I've always had good luck with this doctor for the past 5 years. OK Mike By now, you've read all of the other replies and I'm sure you've also had a few private emails. I'm not going to beat you 'round the head any further. Sit back, take a deep breath, and relax. This is usually a slow-moving disease. It's not been clear from your posts whether you are type 1 or type 2, but your doc obviously doesn't see urgency, so I'm presuming T2 for the moment. I suggested two things in my post, but you only answered one - the doctor. Did you read the link I provided? If not, please do. In case you lost it: http://www.alt-support-diabetes.org/NewlyDiagnosed.htm If you want to keep trusting your doc - fine, that's up to you. However, do a little research on your own body. Please try an experiment tomorrow. Note every morsel you eat (and drink) in a diary and, in addition to any tests the doc wants, test your BGs one hour after you finish eating each meal or snack. Then come back and post the diary and BGs. If you don't want to do that publicly, email me direct. That's it - no drama, just a few extra tests and a log. Good luck, Cheers, Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 On Wed, 6 Jul 2005 14:24:48 -0000, " Mike Brown " wrote: >Hi Alan > >I've always had good luck with this doctor for the past 5 years. So, I hate to change doctors. I have been to this diabetic type class twice now, and she mentioned adjusting my Lantuns. She was out over the holiday and is supposed to call me today. The only thing I may be doing wrong is serving size, so from today on, they will be small. My doctor said 256 isn't bad, as I was 503 in the office and I was also 565 at home once. I had an aunt pass away at 62 with kidney failure, and lived the last 2 years of her life on dialysis. I want to get on top of this disease, because I've seen first hand what it can do. Mike, it is generally accepted that anything over 140 does damage, even if the level is only for a little while. There is increasing evidence that damage starts as low as 120. Using the " better safe than sorry " approach, my limit is 120. Sometimes I miss and go over a little but NEVER EVER over 140. Lantus is to control your basal value, e.g., your fasting BG. It does not and cannot address meals. That is what a fast, short acting insulin like Humalog or Novolog is for. Once you get your basal dose correct (fasting BG in the 85-100 range) leave it alone, other than to compensate for changes in your body. Correct meals with one of the above fast insulins. You need to do two things. One, cut down on the carbs so there isn't so much post-meal glucose to treat and two, get a script for a fast-acting insulin. Your doc simply doesn't know how to treat diabetes. If you like her then stay with her but find someone else for your specific diabetes problem. Or if she's amenable, educate her. One approach might be to tell her that based on your research, you desire to control your BG to near non-diabetic levels and that you need a script for Novolog or Humalog (I prefer Novolog because it is faster) to do that. If she gives you the script without argument, then you're set. There is a standard sliding scale to compute the dose to get your BG under control. Once there, you compute your carb and BG sensitivities (how much insulin it takes to offset a carb and how much to bring your BG down a specified amount.) and dose based on your meter and the carb content of the meal you're about to eat. Then you test at some time after your meal, a time you determine by measuring when your post-meal BG peaks, and administer a trim shot if necessary. This so-called " basal-bolus " method is a NEW way of controlling diabetes, made possible by these wonderful new genetically engineered insulins that have arrived on the market in the past few years. This method approximates what can be achieved with an insulin pump at the small expense of lots of testing and many small shots. A small price to pay for non-diabetic type health, IMHO. Any doc who does not do continuing education specifically for diabetes or read the journals will not know about these techniques. As many of us say more than once a day in various forums, diabetes is an intensely self-managed disease. You can rely on your doc for general guidance if you like, and for the lab tests like the A1C test to evaluate the quality of your self-management but if you rely on the doc for detailed instructions, you'll never gain control. --- De Armond See my website for my current email address http://www.johngsbbq.com Cleveland, Occupied TN Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 256 is alot better than 503, and there could be reasons why our doctor has given you a high target - but it is not good. I have a web page of diabetes information at http://www.geocities.com/tiggernut24/diabetes.html Yours, Dora Austin, Texas villandra@... new diabetic with questions I probably had diabetes maybe 6 months before being diagnosed by my doctor. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 Mike my husband started out with over 700 and they won't be happy until he gets it under 200. He goes in and it is still over 200, after 4 years, and they get really upset with him and tell him and tell him he has to get it to be closer to 100. Don't be fooled, it is better but not good enough. Kathleen >My doctor thinks it's ok since when it was first caught, it was 503. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 Yep. That's the point where I walked out on my diabetes " education " class - never to return again. First thing they say: Avoid sugars! Next thing they say: All carbs eventually turn to sugar. Third thing: Eat all these carbs. You shoulda seen the look on the dietician's face when I asked " So, uh... why are you telling me to eat 45g of sugar? " Priceless. SulaBlue > Thanks... yes, they talk about carbs and you should have x amount for this meal, and so on. Sounds like you hit the nail on the head. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 Yes, type 2 Alan. I have the " newly diagnosed " booked marked. I don't think my MD is going to be playing much of a part in my treatment now. The nurse that runs the diabetic clinic raised my Lantus from 30 to 34 units. And she said she would call this coming Monday to see if that made any difference. I should be able to come up with a decent diary for tomorrow. They told me to wait 2 hours after my evening meal to do my evening test. And do a fasting test when I get up in the morning. I would think I should test more, but both the doctor and the RN at the clinic said twice a day was enough. I can call our HMO and they will send a book out of all the doctors in the plan. I'll check that out. When I was first diagnosed, maybe a day or two later my vision got really blurry. It's improved, but still not as good as it should be. The eye doctor said it wouldn't do any good to make a new pair of glasses until my diabetes stabalizes. I've got a ways to go on that. Thanks again Alan and the rest of the group for listening to my sob story today. Mike Re: new diabetic with questions > Hi Alan > > I've always had good luck with this doctor for the past 5 years. OK Mike By now, you've read all of the other replies and I'm sure you've also had a few private emails. I'm not going to beat you 'round the head any further. Sit back, take a deep breath, and relax. This is usually a slow-moving disease. It's not been clear from your posts whether you are type 1 or type 2, but your doc obviously doesn't see urgency, so I'm presuming T2 for the moment. I suggested two things in my post, but you only answered one - the doctor. Did you read the link I provided? If not, please do. In case you lost it: http://www.alt-support-diabetes.org/NewlyDiagnosed.htm If you want to keep trusting your doc - fine, that's up to you. However, do a little research on your own body. Please try an experiment tomorrow. Note every morsel you eat (and drink) in a diary and, in addition to any tests the doc wants, test your BGs one hour after you finish eating each meal or snack. Then come back and post the diary and BGs. If you don't want to do that publicly, email me direct. That's it - no drama, just a few extra tests and a log. Good luck, Cheers, Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 Yah...but what I'd like to know is...what was her answer?? I'd really like to know how they can justify that. Vicki Re: new diabetic with questions > Yep. That's the point where I walked out on my diabetes " education " > class - never to > return again. > > First thing they say: Avoid sugars! > Next thing they say: All carbs eventually turn to sugar. > Third thing: Eat all these carbs. > > You shoulda seen the look on the dietician's face when I asked " So, > uh... why are you > telling me to eat 45g of sugar? " Priceless. > > SulaBlue > > >> Thanks... yes, they talk about carbs and you should have x amount for >> this meal, and so > on. Sounds like you hit the nail on the head. > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 I seem to remember a stunned deer-in-the headlights look, a very long pause, and then the " Well, carbohydrates are the body's main fuel. " spiel. The only thing I got out of that class was a free meter, thanks to breaking down in hysterics when my insurance gave me the runaround. You see, I'm with United Healthcare. We can't just get a prescription and go down to the pharmacy to get one - we have to go to a medical supply place, even tho the pharmacy would likely be cheaper! The closest medical supply place to me, at the time, was 50 miles, one way, through horrible snarling traffic. And, when I got there - I couldn't *FIND* the place at first, and when I did, they didn't have the one I was prescribed (Lesson learned on calling first!). My insurance is obviously run by idiots. The other medical supply place they tried to send me to was Petticoat Fair. Now, tell me - how many blood glucose meters do you think they have at bra shop? *GRUMBLES* Idiots. SulaBlue > Yah...but what I'd like to know is...what was her answer?? > I'd really like to know how they can justify that. > Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 I've had a ton of email to read Vicki, and I appreciate all the help. Yes, my diet calls for 60 carbs for breakfast, and 60 for lunch. And 75 at the evening meal. So, this is just shooting myself in the foot? What foods and how much will bring my numbers down? I've read about fast acting insulin, which I don't have. Just 34 units of Lantus ever day. Grains are bad for you also? Darn, I've turned into one who eats a lot of oats with Splenda on them...ha It that's bad, I can change. My wife and I are really confused when it comes down to what I should be eating. I've seen first hand what this disease did to my aunt, and I really want to get a handle on it. Mike Re: Re: new diabetic with questions Mike: Did you read the newby letter I earlier attached? It pointed out that carbohydrates -- which turn into sugar in the body -- are as important to avoid, if not more so, than just avoiding sweets. It does sound like you've been fed the traditional ADA line, which calls for a certain number of " servings " of carbs per day. Despite the fact that many professionals think the ADA is the last word on how to manage diabetes, it just ain't necessarily so. The ADA plan encourages people to eat a lot of carbs (absolutely NOT necessary for health) then take meds to reduce high BGs caused by eating those very carbs. IMHO, it makes more sense to avoid those foods -- i.e. high GI carbs -- in the first place. So if you're interested in lowering your BGs, you need to avoid high GI carbs (the fast acting ones, such as anything made with grains, and most root veggies) as well as sugar. My earlier post also pointed out the importance of frequent testing to learn how different foods affect your body. Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 6, 2005 Report Share Posted July 6, 2005 On Wed, 6 Jul 2005 14:44:06 -0000, " Mike Brown " wrote: >Yes, I've had an aunt who passed away a few years ago who was diabetic, and she spent the last 2 years of her life on dialysis. So I'm very well aware this is nothing to play with. This doctor has always been great in everything else, and we've been seeing him for at least 5 years. I'm on 30 units of Lantis once a day. What bothers me, is I've had it in the low 100's even a couple of 80's. I haven't changed my diet or anything and this past week it just keep spiraling up. Are you counting carbs? If not then you should. You probably have loaded up on excess carbs and don't realize it. If you are counting carbs, then any of the following may be the cause: You're about to get sick with an infection. You're under excess stress. Your Lantus has lost its potency from age, heat or both. A lot of people report rises in BG when they're about to get sick, when their bodies are starting to fight the infection. Allergies may cause a similar response. I know that stress sends mine skyrocketing. It doesn't seem to take much at all. Lantus seems to be a picky critter. Even though the circular says it can be stored at room temperature for a month, based on what I've read in my research, I keep mine in the 'fridge. Be sure to warm the syringe to body temperature before shooting, as cold insulin burns. If yours has been sitting out in a hot room for a month or more (at 30 units a day, it'll last longer than a month) then it might have lost its potency. Opening another vial and trying it is the only way to know. I'd do this after I eliminated everything else, however. I'd bet on excess carbs as the most likely candidate. --- De Armond See my website for my current email address http://www.johngsbbq.com Cleveland, Occupied TN Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 How are you supposed to know how different meals affect you if you only test twice a day? Answer: You *CAN'T.* Twice a day might be fine once you get some set meal plans down, composed of meals whose effects you're familiar with. Until then: The doctor and the Rn are both wrong. SulaBlue > > Hi Alan > > > > I've always had good luck with this doctor for the past 5 years. > > OK Mike > > By now, you've read all of the other replies and I'm sure you've also > had a few private emails. > > I'm not going to beat you 'round the head any further. > > Sit back, take a deep breath, and relax. This is usually a slow-moving > disease. It's not been clear from your posts whether you are type 1 or > type 2, but your doc obviously doesn't see urgency, so I'm presuming > T2 for the moment. > > I suggested two things in my post, but you only answered one - the doctor. > > Did you read the link I provided? If not, please do. In case you lost > it: http://www.alt-support-diabetes.org/NewlyDiagnosed.htm > > If you want to keep trusting your doc - fine, that's up to you. > > However, do a little research on your own body. Please try an > experiment tomorrow. Note every morsel you eat (and drink) in a diary > and, in addition to any tests the doc wants, test your BGs one hour > after you finish eating each meal or snack. Then come back and post > the diary and BGs. If you don't want to do that publicly, email me > direct. That's it - no drama, just a few extra tests and a log. > > Good luck, > > Cheers, Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 Mike, I agree with SulaBlue. I'm a newbie myself. Only been diagnosed since March of this year. I had to tell my doctor how often I wanted to test and why. He only had me testing twice a day as well. Once upon rising and once prior to my evening meal. Well for me, both of those numbers were great. It wasn't until I started testing after eating that I found out my numbers were still going way too high. I even told him that I wanted to change the time of day I took my meds to see if that helped. I for one have a great doctor who is not only willing to continue learning but who is willing to let me in some part direct my care. It is very important for me to get this disease under tight control. My family runs rampant with heart disease anyways and this will only affect me further. You have to be pushy to get the care you need sometimes. Either make the doctor you have work for you or find one that will. You are the ultimate player in how well you get this disease under control. To me, this list is a God send. Some of the people are a tad pushy in their views but I feel that it's only because they have everyone's best interests at heart. Ask one question and you may get 50 different opinions. Some of them you'll like - some you won't. Don't let your feelings sit on your shoulders or they are bound to get hurt. But there is a ton of useful information on this list and years of advice from people that have been battling this beast for what seems like forever. Good luck and hang in there. , diagnosed 3/05, type II, Amaryl and Actos <<How are you supposed to know how different meals affect you if you only test twice a day? Answer: You *CAN'T.* Twice a day might be fine once you get some set meal plans down, composed of meals whose effects you're familiar with. Until then: The doctor and the Rn are both wrong.>> SulaBlue Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 Mike, my husband was told to have 40 at each meal and I was told 20 for me. Kathleen I've had a ton of email to read Vicki, and I appreciate all the help. Yes, my diet calls for 60 carbs for breakfast, and 60 for lunch. And 75 at the evening meal. So, this is just shooting myself in the foot? What foods and how much will bring my numbers down? I've read about fast acting insulin, which I don't have. Just 34 units of Lantus ever day. Grains are bad for you also? Darn, I've turned into one who eats a lot of oats with Splenda on them...ha It that's bad, I can change. My wife and I are really confused when it comes down to what I should be eating. I've seen first hand what this disease did to my aunt, and I really want to get a handle on it. Mike Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 This list gave me some great information that may help. I'm on Lantus, and I got a vile at the doctor's office that I have been using, and I think all was well there, when I finally go through with the vile they gave me at the doctor's office, then I started using the one I got at the pharmacy. In reading here, I have read that it is only good for 30 days. So, I have been using some Lantus that was probably around 45 days old. I talked to the pharmacist and picked up a fresh bottle tonight, so I hope that helps. I really don't want to change doctors, but for a doctor who said 265 wasn't bad, then I think we have a problem. I've had it down in the 80's to 120 range several weeks back, then it started this climb. No doubt it will still be high tonight, but I take my shot at 8pm and maybe (I hope) I'll see some improvement. I have to stay on top of this also as heart problems, high blood pressure (I have that also) and the fact that diabetes runs in the family. Wish me luck! Mike Re: new diabetic with questions Mike, I agree with SulaBlue. I'm a newbie myself. Only been diagnosed since March of this year. I had to tell my doctor how often I wanted to test and why. He only had me testing twice a day as well. Once upon rising and once prior to my evening meal. Well for me, both of those numbers were great. It wasn't until I started testing after eating that I found out my numbers were still going way too high. I even told him that I wanted to change the time of day I took my meds to see if that helped. I for one have a great doctor who is not only willing to continue learning but who is willing to let me in some part direct my care. It is very important for me to get this disease under tight control. My family runs rampant with heart disease anyways and this will only affect me further. You have to be pushy to get the care you need sometimes. Either make the doctor you have work for you or find one that will. You are the ultimate player in how well you get this disease under control. To me, this list is a God send. Some of the people are a tad pushy in their views but I feel that it's only because they have everyone's best interests at heart. Ask one question and you may get 50 different opinions. Some of them you'll like - some you won't. Don't let your feelings sit on your shoulders or they are bound to get hurt. But there is a ton of useful information on this list and years of advice from people that have been battling this beast for what seems like forever. Good luck and hang in there. , diagnosed 3/05, type II, Amaryl and Actos Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 That's what the doctor told me, and evidenly he is not too sharp in diabetic care. Mike Re: new diabetic with questions How are you supposed to know how different meals affect you if you only test twice a day? Answer: You *CAN'T.* Twice a day might be fine once you get some set meal plans down, composed of meals whose effects you're familiar with. Until then: The doctor and the Rn are both wrong. SulaBlue Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 Mike, the advice you got from SulaBlue about taking fast-acting insulin matched to carbs for meal was right on. You're never going to get good control using just Lantus. Lantus is a long-acting insulin meant to be used as a basal (background) insulin. If you used a big enough dose to cover for meals, you'd go low other times, which you sure don't want. I really think you need to see an endo. Your doc doesn't seem to know much about controlling diabetes. I think most of us here know more (smile). Vicki Re: new diabetic with questions > > > Mike: > > How long since you were first diagnosed? > > What other meds, other than Lantus, were you placed on? > > Is your doctor a GP or an Endocrinologist? If the former, will your > insurance pay for letting you see a specialist? > > You say your numbers have been going up: are you keeping to a > set schedule of meals, eating about the same amount of carbs > as in the past, and making sure you're not eating more than > before? Numbers going up unexpectedly can, when other > possibilities are ruled out, indicate some sort of infection (be it > as innocuous as a sinus infection or as painful as a UTI) > > SulaBlue > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 I don't know if you've read my " standard newby letter " or not, Mike...just in case you haven't, I'm going to post it here yet again. Please read it carefully - there's lots of good stuff in it -- and follow the links, too. By the time you finish all that, you'll understand why your doctor's advice is way off -- and what to do about it. Here goes: First of all, let me refer you to two of the best books about diabetes. Read 'em and you'll learn a lot: The first one is called " The First Year, Type Two Diabetes, An Essential Guide for the Newly Diagnosed " by Gretchen Becker. Gretchen is a list member and her book is an excellent guide. It's in paperback and available online from Amazon if your local bookstore doesn't have it. The second book is called " Dr. Bernstein's Diabetes Solutions " by K. Bernstein, M.D. You can get it from the library but it's such a good reference that you really should have it in your home library. Dr. Bernstein is a longtime type 1 who controls his diabetes using a lowcarb diet as well as insulin.. Many of us - both type 1 and 2 -- on this list have found great success using his plan or a modified version thereof. . And here's the URL to Dr. Bernstein's website, where there's lots of good stuff: http://www.diabetes-normalsugars.com/index.shtml These two books will give you good basic information on the ins and outs of diabetes management. I would further refer you to an excellent informational website titled " " What They Don't Tell You About Diabetes " http://www.geocities.com/lottadata4u/ If it isn't there for some reason, let me know and I can email you the contents -- I have it in my archives now. I would also refer you to Mendosa's website, where there's a wealth of diabetic information and good links. He also has an online diabetes newsletter which is very good. It's also an excellent source for information about the GI index (glycemic index). www.mendosa.com There's one thing that's sure to make BGs rise and that's carbohydrates. Cutting out high GI carbs is an excellent way to control your BGs and the more you cut, the better. Most of us find that the " whites " -- breads, cereals and pastas, in fact anything made with grain - will raise our BGs. Also, rice and potatoes will do the same. And of course, cakes and cookies and sweets of all kinds, including fruits and fruit juices. Watch out for " low calorie " foods; often they're higher in carbs. Learn to read food labels. Dr. Bernstein recommends about 40 carbs a day total. This is really only for the dedictated low carber and IMHO hard to maintain over the long run. However, I've read that the average American eats about 300 carbs a day, so the truth is somewhere in between. The best thing you can do for yourself (if you haven't already) is buy a meter and use it FREQUENTLY. At the beginning you want to learn how different foods affect your BG and to do this you need to eat one food at a time, testing first...then test one and two hours afterwards. Weigh out the amounts and keep good notes. You'll use up a lot of strips in the beginning but the rewards are definitely worth the expense and bother because in the end, you'll know what foods to avoid and which are okay. Diabetes is a very individual disease and we often say YMMV - " your mileage may vary " -- what works for one may not work for another. You want to aim for postprandial (two hours after meal) BG of 120. Keeping your BGs between 70 and 140 are your goals. If you can do this longterm, you can probably avoid the dreaded consequences of longterm poor BG control...and I'm sure I don't have to list those for you. (I will if you want, though). Here's my own list of pretty lowcarb veggies: Spinach Cauliflower Broccoli Summer squash (zucchini, crookneck) Spaghetti squash Mushrooms Asparagus Greenbeans Cabbage Sauerkraut And of course lettuce and avocados which aren't a veggie but a fruit ..but they're definitely lowcarb. I have a large mixed lettuce salad with avocado every night with dinner. You can eat a reasonable portion (4-6 ounces) of meat, chicken, fish without problem; it's all protein, no carbs. Berries are the lowest carb fruit but even so, you should eat them very sparingly. Here's the website of the USDA, which you'll find very helpful. It has carbs, calories, protein, etc. http://www.nal.usda.gov/fnic/cgi-bin/nut_search.pl It's helpful to have a food scale. A cup measure isn't nearly so accurate. I use a Salter scale. It weighs in both grams and ounces and cost me somewhere around $35. I got mine at a local gourmet shop but they're available online too. Just do a Google search for " Salter food scales " . The A1C is a test that measures your average BG for a three-month period with slightly more weight given to the latest month. All diabetics should have this test every three months. And you should ask for, and keep, copies of all your lab reports. Good luck. And keep those questions coming. There's a really steep learning curve at the beginning of your diabetes education but hang in there -- it will all make sense eventually. And remember -- the only stupid question is the one you didn't ask. Vicki, diabetic since 1997, A1Cs comsistently under 6 for a long time, no complications, planning on forever no complications, smile. RE: Re: new diabetic with questions > Mike, my husband was told to have 40 at each meal and I was told 20 > for me. > > Kathleen > > I've had a ton of email to read Vicki, and I appreciate all the help. > Yes, > my diet calls for 60 carbs for breakfast, and 60 for lunch. And 75 at > the > evening meal. So, this is just shooting myself in the foot? What foods > and > how much will bring my numbers down? I've read about fast acting > insulin, > which I don't have. Just 34 units of Lantus ever day. Grains are bad > for you > also? Darn, I've turned into one who eats a lot of oats with Splenda > on > them...ha It that's bad, I can change. My wife and I are really > confused > when it comes down to what I should be eating. I've seen first hand > what > this disease did to my aunt, and I really want to get a handle on it. > > Mike > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 It's not a sob story, Mike...unfortunately it's the way most doctors seem to treat diabetes. Which is why there are so many diabetics with diabetic complications. And which is the reason most of us old-timers stick around here. To counteract that and get you all pointed in the right direction. Vicki Re: new diabetic with questions > > > > > Hi Alan > > > > I've always had good luck with this doctor for the past 5 years. > > OK Mike > > By now, you've read all of the other replies and I'm sure you've also > had a few private emails. > > I'm not going to beat you 'round the head any further. > > Sit back, take a deep breath, and relax. This is usually a > slow-moving > disease. It's not been clear from your posts whether you are type 1 > or > type 2, but your doc obviously doesn't see urgency, so I'm presuming > T2 for the moment. > > I suggested two things in my post, but you only answered one - the > doctor. > > Did you read the link I provided? If not, please do. In case you lost > it: http://www.alt-support-diabetes.org/NewlyDiagnosed.htm > > If you want to keep trusting your doc - fine, that's up to you. > > However, do a little research on your own body. Please try an > experiment tomorrow. Note every morsel you eat (and drink) in a diary > and, in addition to any tests the doc wants, test your BGs one hour > after you finish eating each meal or snack. Then come back and post > the diary and BGs. If you don't want to do that publicly, email me > direct. That's it - no drama, just a few extra tests and a log. > > Good luck, > > Cheers, Alan > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 Much appreciated! Mike Re: Re: new diabetic with questions It's not a sob story, Mike...unfortunately it's the way most doctors seem to treat diabetes. Which is why there are so many diabetics with diabetic complications. And which is the reason most of us old-timers stick around here. To counteract that and get you all pointed in the right direction. Vicki Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 > Yes, type 2 Alan. > > I have the " newly diagnosed " booked marked. <snip> Don't just bookmark it. Print it out. Act on it. > > They told me to wait 2 hours after my evening meal to do my evening test. And do a fasting test when I get up in the morning. I would think I should test more, but both the doctor and the RN at the clinic said twice a day was enough. > Mike, you need to make some decisons. Knowledge is power. A lack of knowledge is ignorance. Testing increases your knowledge. You're intelligent. I leave the rest to you. Cheers, Alan Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 45 day old, out on the counter? Could be the source of the problem, ayup! BTW, if that's the case, might not wanna go for 34 if you were doing OK at 30 (staying in the 80-120 range) at 30 Units until you can confirm that it was likely bad insulin. Just a thought. SulaBlue > This list gave me some great information that may help. I'm on Lantus, and I got a vile at the doctor's office that I have been using, and I think all was well there, when I finally go through with the vile they gave me at the doctor's office, then I started using the one I got at the pharmacy. In reading here, I have read that it is only good for 30 days. So, I have been using some Lantus that was probably around 45 days old. I talked to the pharmacist and picked up a fresh bottle tonight, so I hope that helps. I really don't want to change doctors, but for a doctor who said 265 wasn't bad, then I think we have a problem. I've had it down in the 80's to 120 range several weeks back, then it started this climb. No doubt it will still be high tonight, but I take my shot at 8pm and maybe (I hope) I'll see some improvement. > > I have to stay on top of this also as heart problems, high blood pressure (I have that also) and the fact that diabetes runs in the family. > > Wish me luck! > > Mike > > Re: new diabetic with questions > > > Mike, > > I agree with SulaBlue. I'm a newbie myself. Only been diagnosed since > March of this year. I had to tell my doctor how often I wanted to test > and why. He only had me testing twice a day as well. Once upon rising > and once prior to my evening meal. Well for me, both of those numbers > were great. It wasn't until I started testing after eating that I found > out my numbers were still going way too high. I even told him that I > wanted to change the time of day I took my meds to see if that helped. I > for one have a great doctor who is not only willing to continue learning > but who is willing to let me in some part direct my care. It is very > important for me to get this disease under tight control. My family runs > rampant with heart disease anyways and this will only affect me further. > You have to be pushy to get the care you need sometimes. Either make the > doctor you have work for you or find one that will. You are the ultimate > player in how well you get this disease under control. > > To me, this list is a God send. Some of the people are a tad pushy in > their views but I feel that it's only because they have everyone's best > interests at heart. Ask one question and you may get 50 different > opinions. Some of them you'll like - some you won't. Don't let your > feelings sit on your shoulders or they are bound to get hurt. But there > is a ton of useful information on this list and years of advice from > people that have been battling this beast for what seems like forever. > Good luck and hang in there. > > , diagnosed 3/05, type II, Amaryl and Actos Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 At 08:15 PM 7/7/05, Mike Brown wrote: >I have to stay on top of this also as heart problems, high blood pressure >(I have that also) and the fact that diabetes runs in the family. > >Wish me luck! I've never been a believer in luck. I do believe in the results of actions, however. That's called karma in some places. Cause and effect. So rather than count on luck, maybe you should take control and make some decisions that can produce good results later. ??? sky I do not intend to tiptoe through life only to arrive safely at death http://www.skydancers.com http://www.skydor.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 On Thu, 7 Jul 2005 03:33:06 -0000, " Mike Brown " wrote: >Yes, type 2 Alan. > >I have the " newly diagnosed " booked marked. > >I don't think my MD is going to be playing much of a part in my treatment now. The nurse that runs the diabetic clinic raised my Lantus from 30 to 34 units. And she said she would call this coming Monday to see if that made any difference. You need to learn how to adjust your dose yourself. Your body will vary over time so you occasionally have to trim the value. Basically what you want to do is to trim the Lantus to achieve the desired fasting BG. Since you've been so high, I'd start out at say, 110 or 120. Let your body get used to that as you collect data and then take it down. Your objective will be to take it as low as you can without suffering hypos. I've been able to get mine down to 85-90. My doc left it to me to figure out my dose. He knows I'm an engineer and probably would have anyway :-) I started at 10 and went up 5 units at a time, waiting several days between adjustments. I ended up at 60 but as I've gotten my weight down more and my diet under control, I'm back down to 30. Initially I increased the dose every day until I got my fasting level to about 140. Then I waited 3 days between adjustments to allow my body to adjust. During that time I took 3 readings each morning (see another post I just made regarding meters for the reason why) and used the average. Your diet will have a small effect on the basal dose. When I was grabbing my body by the nose and dragging it into compliance, I only allowed 30 carbs a day. I got down to 25 units of Lantus. I've gradually worked up to the point where I now allow 60 carbs/day and 30 units Lantus. My somewhat arbitrary rule is that I eat no more carbs in a meal than 5 units of Novolog will cover. > >I should be able to come up with a decent diary for tomorrow. Great! > >They told me to wait 2 hours after my evening meal to do my evening test. And do a fasting test when I get up in the morning. I would think I should test more, but both the doctor and the RN at the clinic said twice a day was enough. Your doc and the clinic are wrong. Flat wrong. The minimum schedule should be: Fasting in the am as you get up * Before each meal After each meal Bedtime After any snacks * If you have a dawn effect (I fortunately don't), testing in bed will get the true fasting BG and not the dawn effect. I keep my BG meter by my bed and do the initial test after the alarm goes off but before I even sit up. This is just in case a dawn effect ever manifests itself. Instead of the flat 2 hours, you need to measure when your body's post-meal BG peaks. You do that by eating a meal (shooting the necessary short acting insulin if necessary) and then testing every 10 or 15 minutes until you see the peak and then a definite tail to the BG curve. THAT is when you should do your post-meal test. My peak comes at 1.5 hours after the meal and is affected only a little by the amount of fat in the meal. I avoid fast starches (carbs). If you choose to eat fast carbs (corn, flour, etc) then you might need to determine if your peak shifts. > >I can call our HMO and they will send a book out of all the doctors in the plan. I'll check that out. If you like this doc then stay with him. If you desire sufficiently tight control to avoid diabetes' side effects, you're going to have to manage yourself anyway. ly, having a doc that demanded compliance and scolded you every time you made an adjustment for yourself would be detrimental to your overall condition. > >When I was first diagnosed, maybe a day or two later my vision got really blurry. It's improved, but still not as good as it should be. The eye doctor said it wouldn't do any good to make a new pair of glasses until my diabetes stabalizes. I've got a ways to go on that. He is correct. I was bumping 600 when I was diagnosed. My eyesight was shot to heck. I'd just gotten new glasses about 6 months previous and they were already out of date. Now I think I can go back to my previous prescription. My vision improvement is probably the most dramatic thing to come out of my tight control. It's important to realize that what we're telling you on this list regarding control is on the leading edge of diabetes care. In my research I've come across several reasons why docs and educators don't teach the tight basal-bolus method: Don't understand it. Follow the ADA's badly flawed plan Assume patients won't understand the methods Assume patients won't be motivated/aren't smart enough to comply Don't want to give up control to the patient Unfamiliar with the newest insulins You're obviously motivated or else you would not be here asking questions and trying to figure out what's wrong with your present treatment. What's interesting is that this basal-bolus method is what the insulin pump therapy is based on. It uses only a fast insulin and dribbles out the basal dose continuously. The user selects a bolus dose before each meal to cover that meal's carbs. Lantus duplicates the basal dribble by slowly dissolving from the injection site over the period of a day. All you have to do is to get the basal dose correct and then cover your meals with the fast insulin. You can achieve pump-like control at the minor inconvenience of several extra sticks a day. --- De Armond See my website for my current email address http://www.johngsbbq.com Cleveland, Occupied TN Quote Link to comment Share on other sites More sharing options...
Guest guest Posted July 7, 2005 Report Share Posted July 7, 2005 On Thu, 7 Jul 2005 05:02:49 -0000, " Mike Brown " wrote: >I've had a ton of email to read Vicki, and I appreciate all the help. Yes, my diet calls for 60 carbs for breakfast, and 60 for lunch. And 75 at the evening meal. So, this is just shooting myself in the foot? What foods and how much will bring my numbers down? I've read about fast acting insulin, which I don't have. Just 34 units of Lantus ever day. Grains are bad for you also? Darn, I've turned into one who eats a lot of oats with Splenda on them...ha It that's bad, I can change. My wife and I are really confused when it comes down to what I should be eating. I've seen first hand what this disease did to my aunt, and I really want to get a handle on it. Daaaaaaaammmmmmm!!! Your doc hasn't given you a fast insulin?!?!? And you're eating that many carbs?!?!?! Man, is he out of it!!! You need to have a serious chat with him. Or else just get whatever fast insulin is available over-the-counter in your state. Grab this free nutritional database: http://www.nal.usda.gov/fnic/foodcomp/ You can download a copy for either your PC or PalmPilot. Start looking at the foods you like and you'll see just how bad grains are. Worse than pure sugar. I suggest you google for " insulin pump " and read up on what the pumps do. That's what you're going to want to achieve with so-called multiple daily injections (MDI) or the basal-bolus method. --- De Armond See my website for my current email address http://www.johngsbbq.com Cleveland, Occupied TN Quote Link to comment Share on other sites More sharing options...
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