RE: Re: Insulin, etc.

January 2, 2005

In a message dated 1/2/05 1:55:56 PM Eastern Standard Time, DEKEP@...

writes:

>

>It may be what I'll call the " slippery slope " rationalization. If you do it

>once, then can twice be so bad? And if twice is okay surely thrice can't be

a

>problem.

>

>>I experimented with Humalog and got some interesting results. It was easy

to

>use insulin to eat more carbs, but of course that led to more weight, which

>required more insulin to offset IR, and so on. I terminated the experiment

when

>I'd gained about 4 lb. I concluded that using insulin as a way to eat more

>carbs was not a good idea, at least not for me.

>>>>>>

I had to laugh. My weight could vary by 4 lbs in a few hours, give or take.

Personally, I think it's just fine to use insulin so as to allow more freedom

with food. Unfortunately, it doesn't work as seemlessly as it sounds. Yes,

I can inject enough insulin to bring my BG back to a nice 100 4 hours after

whatever food it is I want, but the spike might have been to 250.

In general, you desire to bring your BG back to your before meal BG (assuming

that BG was in range) at the 4 hour mark. You also have a two hour (or 1.5

hour) target, over which you do not want to go - for many people that number is

140 (others have a lower or higher target, depending on their own

circumstances.

So, while I could inject enough insulin to allow my 4 hour number to come

back to my premeal BG to allow for pizza in my life, the 1.5 hour or 2 hour

spike

would be way way way over my target of 140.

I tried having pizza, all in the name of science, for the first time in over

a year. Starting BG was 106. I inject enough insulin to cover the carbs in

the meal, then eat. BG at 2 hours was 213, nowhere near my target. I don't

correct this as I know I still have quite a bit of insulin from my premeal

injection still working in my system. At 4 hours, my BG was 110, back to my

target.

I really wish I could use insulin so that I could eat pizza more often or

pasta or whatever, but for me, and for many others, it just doesn't work that

way. Unfortunately, even injected insulin doesn't, for me anyway, allow for

total freedom.

As for the weight issue, it's not an issue of mine, particularly, and really,

plenty of people do eat a lot differently than low carbing and do fine with

diabetes. People are different and react differently to eating plans.

As for the pizza I had, it was absolutely delicious. Fantabulous. Amazingly

good.

And yeah, I want off this bus too.

Stacey

January 2, 2005

Sky, I am taking regular metformin, 2500mg a day. I understand if you

take the 850s that 2550 is the max. Even with the ER, if you add

another one, I personally would take it at a different time.

Your Q10 should be moved from bedtime to a meal, it needs fat to work.

In fact, you can move the Omega 3 also. I am taking lipitor and 1000mg

of metformin at bedtime. I also take l-arginine at the same time. Wine

about an hour before. This seems to make about a 20 point difference in

my morning numbers - if there has been nothing else to confound the issue.

Do you get up during the night to use the bathroom? You can pop a

couple of pills then, either arginine or one of the mets, just to see

what happens. Your body, your science experiment.

As to using insulin to allow for more carbs in one's WOE, adhering to a

meal plan that allows for 60 to 100 grams of carb a day is a lot better

than trying and failing to keep it down to 30. One can avoid that

slippery slope that mentioned by having a particular goal in mind

as to how much insulin is acceptable. Also falling off the wagon does

not mean staying off the wagon.

Helen

January 2, 2005

At 02:46 PM 1/2/05, Helen Mueller wrote:

>Sky, I am taking regular metformin, 2500mg a day. I understand if you

>take the 850s that 2550 is the max. Even with the ER, if you add

>another one, I personally would take it at a different time.

You mean 850mg? Is that with the extended release? My nurse practitioner

was saying that 2000mg was the limit. But then she also thought it didn't

come in 1000mg pills and the pharmacist said it did.

>Your Q10 should be moved from bedtime to a meal, it needs fat to work.

>In fact, you can move the Omega 3 also.

I was taking the Omega 3 with the CoQ10 thinking that would provide enough

fat. I suppose I could grab a little snack of cheese when I take it.

> I am taking lipitor and 1000mg

>of metformin at bedtime. I also take l-arginine at the same time. Wine

>about an hour before. This seems to make about a 20 point difference in

>my morning numbers - if there has been nothing else to confound the issue.

I stopped all of my supposed BG-lowering (or should I say

insulin-resistance lowering?) supplements about 3 weeks ago to see if I

noticed any difference. Unfortunately about that time I started taking more

metformin, the lipitor, and a new blood pressure med. I guess I'll go a

little longer without the supplements and then start on them again to see

what happens.

>Do you get up during the night to use the bathroom? You can pop a

>couple of pills then, either arginine or one of the mets, just to see

>what happens. Your body, your science experiment.

The metformin ER, I read, reaches maximum plasma levels in 7 hours. That's

the ideal. It apparently can vary to from 5 to 8 hours. I figure if I take

them near midnight the max concentration should be there when I get up

around 7. I've tried the remembering to take stuff at night when I get up

to use the bathroom but that means I need to turn on a light because I'm

afraid if I set the pills out and fumble for them in the dark I'll knock

them on the floor, in the sink, in the toilet or wherever else. Also,

considering that I retire around midnight, I rarely wake up to use the

bathroom until 3 or 4 in the morning (and normally I can ignore that until

I get up unless I've had a lot of liquid the night before)

>As to using insulin to allow for more carbs in one's WOE, adhering to a

>meal plan that allows for 60 to 100 grams of carb a day is a lot better

>than trying and failing to keep it down to 30. One can avoid that

>slippery slope that mentioned by having a particular goal in mind

>as to how much insulin is acceptable. Also falling off the wagon does

>not mean staying off the wagon.

Oh, I'm back on the wagon. It only took one look at that over-200 FBG to

get me back on fast. I've read what folks have to say about using insulin

to allow the occasional indulgence. Makes sense. Still, it would be a joy

to go out with friends once in awhile. I'm not understanding why there's a

spike if you know beforehand you're going to eat a bunch of carbs. Wouldn't

you just shoot for it?

January 2, 2005

> I experimented with Humalog and got some interesting results. It was easy

to

> use insulin to eat more carbs

The real question is how often a person would do this. If one set limits,

for example, " I will only use Humalog once a month or once a year or when

I'm invited to a very special social occasion, it might be possible for

some, but not for others, who would have " very special social occasions "

every night.

The other thing to remember is that when you eat more carbs, you need to cut

back on the fats that are OK for a LC diet. Otherwise your total calorie

intake will go up.

I wish we could just give up eating altogether. It would make it so much

easier. No decisions.

Gretchen

January 2, 2005

Regular metformin comes in 500mg and 850mg doses. I don't know about ER.

As for the supplements, when you decide to start adding back, do them

one at a time, with at least four days between each addition. That will

give you a clear idea of what is working. Remember the effect can be

subtle and might well be synergistic.

When you eat a certain way, say within your own exchange system, keeping

all your foods in a particular family, and then you step outside those

parameters for something different, pizza, cake, whatever, you don't

know how this food will effect you, you don't even necessarily know

what's in it, and dosing is, as best, an educated guess. At worse, you

are way off the mark. The ADA philosophy that a carb is a carb is a

carb is plain baloney and doesn't work. I would say I bat about 50-50,

which means half the time I have to do a correction. Quite frankly,

sometimes it is just not worth the hassle. Other times, it may make the

difference between eating or not at someone's house.

Now by my own exchange system, I mean cauliflower=brocolli=cabbage kind

of stuff. Meat is meat.

Still in all, insulin, added to my orals, has given me the best control,

consistently, over the course of many years.

Helen

January 2, 2005

At 04:51 PM 1/2/05, Gretchen wrote:

>I wish we could just give up eating altogether. It would make it so much

>easier. No decisions.

I'd hate that. I could do that only if I lost my taste for food. Eating is

one of the few pleasures I have left. I don't gamble, take recreational

drugs, or have a sex life. I'd hate to give up food, too. I'd need a LOT

of those singing larks to make that worthwhile.

sky

January 2, 2005

At 04:51 PM 1/2/05, Gretchen wrote:

>I wish we could just give up eating altogether. It would make it so much

>easier. No decisions.

I'd hate that. I could do that only if I lost my taste for food. Eating is

one of the few pleasures I have left. I don't gamble, take recreational

drugs, or have a sex life. I'd hate to give up food, too. I'd need a LOT

of those singing larks to make that worthwhile.

sky

January 2, 2005

At 04:51 PM 1/2/05, Gretchen wrote:

>I wish we could just give up eating altogether. It would make it so much

>easier. No decisions.

I'd hate that. I could do that only if I lost my taste for food. Eating is

one of the few pleasures I have left. I don't gamble, take recreational

drugs, or have a sex life. I'd hate to give up food, too. I'd need a LOT

of those singing larks to make that worthwhile.

sky

January 3, 2005

In a message dated 1/2/05 7:05:30 PM Eastern Standard Time,

skydancer9@... writes:

>

>I'd hate to give up food, too. I'd need a LOT

>of those singing larks to make that worthwhile.

>>>>>>>

And then, as someone else said, I'd want to fry them up in a pan and eat

them...LOL

I'm with you Sky. I enjoy food and wine and cooking, and to give them up

really sounds like being in prison. Actually, I did it for about 8 months about

16 years ago when I went on optifast. It was torture.

I come from people who finish a meal and soon after begin talking about the

next meal. When I travel, one of the most important questions is what are the

good restaurants in the place I'm visiting. I read cookbooks like others read

fiction. I've worked in or owned a restaurant for most of my adult life

(until the last 7 years when I've been out of that business).

I do know a few people, however, who would forget to eat for days at a time

if they didn't have to put up with being hungry or being put in the hospital

for starvation. Why does it seem as though those people never get diabetes?

After years of wars with food, diets, etc., I started really making peace

with food about 10 years ago. Being diagnosed with diabetes is an incredibly

ironic occurrence in my life. Stop obsessing about being thin and about what

food I'm eating only to have to start obsessing about food again.

Psychologically, this first year has been tough.

But give up food? Nope, not me. Though I do agree with Gretchen that in

some ways it would require less of me -- just never eat rather than have to

choose.

Stacey

January 3, 2005