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Re: Re: Drugs vs diet/exercise

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Kat, My morning numbers are different at different times(Dawn Phenomenon).

I Have taken Lantus 60 units at 8 PM.

I test at 4:00 AM and I am 100 + or - 15 mg/dl's. by 8:30 I am at 165.

I control this by eating breakfast at 6:00 AM and taking my Humalog to cover

the carbs in breakfast.

It is very important for me to get the right basel of Lantus for the Humalog

to work properly.

I have found out the the higher the Lantus units the shorter the duration of

the Lantus.

After I started taking 56 units the lantus stopped working in 20 to 21

hours. Then I had to cover the

2 hours with Humalog, which seemed impossible. I now have split the Lantus

into 2 shots

1 at 8:00 PM and 1 at 8:00 AM. This has caused both the Lantus shots to last

24 plus hours.

I think this is why so many people have problems with Lantus. The company

sticks with the 24 hour duration.

My experience shows different . YMMV

S Wilkinson

-----Original Message-----

From: katakaniki

> > Glucophage XR 1500mg, Actos 30mg, Lantus 24 units, and Novolog 24

> > units. I see no difference in my numbers if I take the drugs or

> > not. This is why I am so frustrated. My morning BS was 165 3

years

> > ago when I was diagnosed and it is still 165.

>

> And what would happen if you went up on the Lantus? Slowly, of

course. Some

> people with extreme insulin resistance need 100 U or even more.

My doctor increases my Lantus by about 2 units every time I see

her. I don't think it's fast enough because it does nothing. Does

everyone who uses insulin get a lower morning reading or do I just

have to accept that my morning numbers will always be high? I am

thinking that my doc must be very conservative. Kat

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My Doc is very conservative too. He started me on 10 units of Lantus at bed

time, when that did nothing he increased it to 15. What made a huge

difference for me was reading this list and deciding to do 15 units in the

morning and 15-25 at night, depending on my bg numbers. As far as Doc

knows I am still on 15, but I will see him in about 8 days and I will have

to spill the beans then.

Jo in Minnesota

Want to know what Memory of Monroe ie Rescue Does? Visit

http://memoryofmonroe.com/2004.htm and get ready to smile. Want to see

ie notecards? Visit http://www.ibdoggone.com/note_cards.htm

Re: Drugs vs diet/exercise

>

>

>

> > > Glucophage XR 1500mg, Actos 30mg, Lantus 24 units, and Novolog 24

> > > units. I see no difference in my numbers if I take the drugs or

> > > not. This is why I am so frustrated. My morning BS was 165 3

> years

> > > ago when I was diagnosed and it is still 165.

> >

> > And what would happen if you went up on the Lantus? Slowly, of

> course. Some

> > people with extreme insulin resistance need 100 U or even more.

>

> My doctor increases my Lantus by about 2 units every time I see

> her. I don't think it's fast enough because it does nothing. Does

> everyone who uses insulin get a lower morning reading or do I just

> have to accept that my morning numbers will always be high? I am

> thinking that my doc must be very conservative. Kat

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Kat, you need to introduce more consistency into your treatment, so that

you will have a valid base from which to make comparisons.

Why don't you sit down and think hard about a woe that you will be able

to maintain? Say, somewhere in the neighborhood of 60 to 100 grams of

carb a day. Write down those foods that " call to you " , and bring them

to the list. Perhaps we can help you with some replacements that will

be kinder to your bgs.

Be prepared to do a lot of testing.

Please send us more information on what you eat on the different days,

high and low carb days, your insulin usage and your numbers.

Are you taking a set amount of novalog?

Diabetes is basically a self treated disease. Are you ready to do some

experimenting on your own - outside of the doctor's protocol? She may

not like it; however, will not be able to argue with results.

While you may never be able to get the morning numbers you would like,

certainly you will do better than the 160s. But, it is work, and you

have to commit to it. Strips, time and money.

Are you ready? We have a lot of hard won knowledge here and would be

glad to share with you.

Helen

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Kat, you need to introduce more consistency into your treatment, so that

you will have a valid base from which to make comparisons.

Why don't you sit down and think hard about a woe that you will be able

to maintain? Say, somewhere in the neighborhood of 60 to 100 grams of

carb a day. Write down those foods that " call to you " , and bring them

to the list. Perhaps we can help you with some replacements that will

be kinder to your bgs.

Be prepared to do a lot of testing.

Please send us more information on what you eat on the different days,

high and low carb days, your insulin usage and your numbers.

Are you taking a set amount of novalog?

Diabetes is basically a self treated disease. Are you ready to do some

experimenting on your own - outside of the doctor's protocol? She may

not like it; however, will not be able to argue with results.

While you may never be able to get the morning numbers you would like,

certainly you will do better than the 160s. But, it is work, and you

have to commit to it. Strips, time and money.

Are you ready? We have a lot of hard won knowledge here and would be

glad to share with you.

Helen

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> My doctor increases my Lantus by about 2 units every time I see

> her.

That's ridiculous unless you see her every week. My endo told me to start

with 2 units but I quickly went up and ended up at 30 units.

> thinking that my doc must be very conservative.

Yes.

Gretchen

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,

Many doctors are hip to the split now. I'm curious to know why you say that

the company sticks to the 24hours?

I split my Lantus dose also. Works very well.

-Sandy

S Wilkinson wrote:

I now have split the Lantus

into 2 shots

1 at 8:00 PM and 1 at 8:00 AM. This has caused both the Lantus shots to last

24 plus hours.

I think this is why so many people have problems with Lantus. The company

sticks with the 24 hour duration.

My experience shows different . YMMV

S Wilkinson

-Sandy

Metaphors and Analogies of High School Students

" She had a deep, throaty, genuine! laugh, like that sound a dog makes just

before it throws up. "

" Long separated by cruel fate, the star-crossed lovers raced across the grassy

field toward each other like two freight trains, one having left Cleveland at

6:36 p.m. at 55 mph, the other from Topeka at 4:19 p.m. at a speed of 35 mph. "

---------------------------------

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Yahoo! Netrospective: 100 Moments of the Web

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All their information shows that Lantus has a 24 hour duration. They do not

mention that

it might only last 18 to 24 hours.

-----Original Message-----

,

Many doctors are hip to the split now. I'm curious to know why you say

that the company sticks to the 24hours?

I split my Lantus dose also. Works very well.

-Sandy

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Replying to what you wrote Gretchen:

LC products have fewer carbs than other products, but they do have some

" fast " carbs that cause peaks. And I find that it's quickly falling BGs that

cause intense hunger.

Try eating more LC, low-GI veggies like broccoli, grean beans, spinach, etc.

.................................

I have been eating a lot of Atkins products (expensive tho) because I have

trouble digesting things like broccoli, spinach etc. I do eat salad with regular

salad dressing (the fatty kind) and that does not upset my digestive system too

much, but I use the LC products a lot - maybe that is not a good thing?

.................................................................

Don't ever let yourself get ravenously hungry. When that happens, it's too

easy to eat too much. Carry LC snacks like boiled eggs or chicken legs or

nuts or pickled veggies so you can avoid the LC snack bars.

...........................................................

I get stomach aches from anything hard cooked - like eggs or roasted meat -

how about cold cuts - those I can digest..

.............................................

If you find you need carbs, just make sure they're slow carbs like

vegetables or nuts instead of skim milk, mashed potatoes, and snack bars.

...........................................

anything else you can suggest for slow carbs besides veggies and nuts? I do

eat nuts and can digest them. I obviously have a problem with what I can eat and

what I can digest - have a Celiac test next week and sure hope that is negative.

Barb in NH

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Replying to what you wrote Gretchen:

LC products have fewer carbs than other products, but they do have some

" fast " carbs that cause peaks. And I find that it's quickly falling BGs that

cause intense hunger.

Try eating more LC, low-GI veggies like broccoli, grean beans, spinach, etc.

.................................

I have been eating a lot of Atkins products (expensive tho) because I have

trouble digesting things like broccoli, spinach etc. I do eat salad with regular

salad dressing (the fatty kind) and that does not upset my digestive system too

much, but I use the LC products a lot - maybe that is not a good thing?

.................................................................

Don't ever let yourself get ravenously hungry. When that happens, it's too

easy to eat too much. Carry LC snacks like boiled eggs or chicken legs or

nuts or pickled veggies so you can avoid the LC snack bars.

...........................................................

I get stomach aches from anything hard cooked - like eggs or roasted meat -

how about cold cuts - those I can digest..

.............................................

If you find you need carbs, just make sure they're slow carbs like

vegetables or nuts instead of skim milk, mashed potatoes, and snack bars.

...........................................

anything else you can suggest for slow carbs besides veggies and nuts? I do

eat nuts and can digest them. I obviously have a problem with what I can eat and

what I can digest - have a Celiac test next week and sure hope that is negative.

Barb in NH

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Replying to what you wrote Gretchen:

LC products have fewer carbs than other products, but they do have some

" fast " carbs that cause peaks. And I find that it's quickly falling BGs that

cause intense hunger.

Try eating more LC, low-GI veggies like broccoli, grean beans, spinach, etc.

.................................

I have been eating a lot of Atkins products (expensive tho) because I have

trouble digesting things like broccoli, spinach etc. I do eat salad with regular

salad dressing (the fatty kind) and that does not upset my digestive system too

much, but I use the LC products a lot - maybe that is not a good thing?

.................................................................

Don't ever let yourself get ravenously hungry. When that happens, it's too

easy to eat too much. Carry LC snacks like boiled eggs or chicken legs or

nuts or pickled veggies so you can avoid the LC snack bars.

...........................................................

I get stomach aches from anything hard cooked - like eggs or roasted meat -

how about cold cuts - those I can digest..

.............................................

If you find you need carbs, just make sure they're slow carbs like

vegetables or nuts instead of skim milk, mashed potatoes, and snack bars.

...........................................

anything else you can suggest for slow carbs besides veggies and nuts? I do

eat nuts and can digest them. I obviously have a problem with what I can eat and

what I can digest - have a Celiac test next week and sure hope that is negative.

Barb in NH

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> The more Lantus you use, the shorter duration so many type IIs could

> only have as much as 16 hours of effective cover.

I feel that for me, Lantus has a tail, although I haven't investigated

thoroughly. I take it at 9 a.m. But if I stop it for some reason, my

fastings are still low the next day. If I resume it again, my fastings are

still higher the next day, as if it's the combination of the tail from the

old shot plus the new shot that gives the correct amount for me (about 30U a

day).

> My last conclusion is strictly a personal one. IMHO, in spite of Aventis,

> Lantus is a good product for me BUT I do not feel comfortable putting my

> diabetic needs in the hands of a company that does not understand their

> product or understand that one insulin program fits all DMers.

I suspect that the researchers at the lab understand this, but the drones

who answer the telephone only know what they've been told. It's the same at

any of these companies. If I call LifeScan I'll get the usual song and dance

about the plus or minus 20%, did I wash my hands, bla bla bla. In order to

get any real information, I have to ask to speak with a supervisor or their

lab person. sometimes I get through and get real information; sometimes not.

Gretchen

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> The more Lantus you use, the shorter duration so many type IIs could

> only have as much as 16 hours of effective cover.

I feel that for me, Lantus has a tail, although I haven't investigated

thoroughly. I take it at 9 a.m. But if I stop it for some reason, my

fastings are still low the next day. If I resume it again, my fastings are

still higher the next day, as if it's the combination of the tail from the

old shot plus the new shot that gives the correct amount for me (about 30U a

day).

> My last conclusion is strictly a personal one. IMHO, in spite of Aventis,

> Lantus is a good product for me BUT I do not feel comfortable putting my

> diabetic needs in the hands of a company that does not understand their

> product or understand that one insulin program fits all DMers.

I suspect that the researchers at the lab understand this, but the drones

who answer the telephone only know what they've been told. It's the same at

any of these companies. If I call LifeScan I'll get the usual song and dance

about the plus or minus 20%, did I wash my hands, bla bla bla. In order to

get any real information, I have to ask to speak with a supervisor or their

lab person. sometimes I get through and get real information; sometimes not.

Gretchen

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> The more Lantus you use, the shorter duration so many type IIs could

> only have as much as 16 hours of effective cover.

I feel that for me, Lantus has a tail, although I haven't investigated

thoroughly. I take it at 9 a.m. But if I stop it for some reason, my

fastings are still low the next day. If I resume it again, my fastings are

still higher the next day, as if it's the combination of the tail from the

old shot plus the new shot that gives the correct amount for me (about 30U a

day).

> My last conclusion is strictly a personal one. IMHO, in spite of Aventis,

> Lantus is a good product for me BUT I do not feel comfortable putting my

> diabetic needs in the hands of a company that does not understand their

> product or understand that one insulin program fits all DMers.

I suspect that the researchers at the lab understand this, but the drones

who answer the telephone only know what they've been told. It's the same at

any of these companies. If I call LifeScan I'll get the usual song and dance

about the plus or minus 20%, did I wash my hands, bla bla bla. In order to

get any real information, I have to ask to speak with a supervisor or their

lab person. sometimes I get through and get real information; sometimes not.

Gretchen

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Did the Lantus rep you talked to have an East Indian accent? LOL.

Thanks for the response and no it was not too long. It was very observant and

astute of you to notice the changes you needed to make.

Novo- do they make novolog and novolin? I was very happy with the novolog

products. Then alas- had a change in insurance company and was forced to switch

to Humolog. This works just as well for me but it was a major bummer to have to

switch from a med. I felt so confident in.

Samante wrote:

I am not but I might have an answer to your question. Aventis is new

to the insulin business. Before they came up with Lantus they were known

as the manufacturer of Allegra, the allergy medication. IMHO Lantus is a

good product but I have had type I long enough to be cautious when a new

insulin comes out, to proceed with caution and if necessary, talk to the

When Lantus came out I was very interested in this insulin and had my

first vial within 24 hours of it being released to retailers. I had read

a great deal about Lantus, read the inserts, went to the Lantus web site

and I took my first shot at bedtime that first day and all heck broke

out. I had a really bad hypo at 2:30 AM the very first night. Second

night the same thing. I tweeked and tweeked and still, every night for

three solid weeks my dog would wake me up to the shakes like I had the

DT's and soaking wet. Finally I called Lantus and asked some questions:

Can I take the one shot earlier than bedtime? Answer: You MUST take it at

bedtime. Can I split the one shot into 2 shots? Answer: You MUST only

take only one shot. How do you know that Lantus last for a full 24 hours

in EVERY DMer? Answer: It lasts for 24 hours in EVERY DMer, it has no

peak, it requires only one shot and it must be taken at bedtime. These

are the benefits of Lantus.

After that conversation with Lantus I realized that they were clueless

about YMMV and that they really didn't know everything there was to know

about their product. Sooo, I moved my one shot to 9:30 PM (after

experimenting with different times) and tested, tested, tested and talked

to lots of other Lantus users, both type I and II and came to the

following conclusions.

1-Lantus has a varying duration, depending on how much you use.

The more Lantus you use, the shorter duration so many type IIs could

only have as much as 16 hours of effective cover.

2-Lantus can be more effective for those using larger doses by spliting

the shots into 2 12 hour shots that are taken first thing in the AM (7 -8

AM)

and then the other shot 12 hours later.

3-Lantus DOES have a peak. While it is a much lower peak than NPH, it is

still a peak and if your bedtime is like me, later than the normal

assumed

bedtime of most, the delayed activation period of an hour and a half

plus the little peak can cause nasty hypos regardless of the study Lantus

just

put out that DMers using Lantus do not have middle of the night hypos.

My last conclusion is strictly a personal one. IMHO, in spite of Aventis,

Lantus is a good product for me BUT I do not feel comfortable putting my

diabetic needs in the hands of a company that does not understand their

product or understand that one insulin program fits all DMers. So, even

though Aventis has just introduced a new bolus insulin to compete with

Novolog and humalog, I am not even curious about it and I am looking

forward to Novo getting final approval for detimir, which is supposed to

be on a similar line with Lantus. When detimir comes out I will cross my

fingers and hope that it works well for me so I can say bye bye to

Aventis. Novo has been in the insulin business since 1926 and they have

served me well so I trust them, which for me is important.

Sorry my response was so long.

On Tue, 8 Mar 2005 07:43:56 -0800 (PST) Sandy

writes:

>

> ,

> Many doctors are hip to the split now. I'm curious to know why you

> say that the company sticks to the 24hours?

>

> I split my Lantus dose also. Works very well.

>

> -Sandy

>

> S Wilkinson wrote:

>

> I now have split the Lantus

> into 2 shots

> 1 at 8:00 PM and 1 at 8:00 AM. This has caused both the Lantus shots

> to last

> 24 plus hours.

> I think this is why so many people have problems with Lantus. The

> company

> sticks with the 24 hour duration.

> My experience shows different . YMMV

>

> S Wilkinson

>

>

>

>

>

>

>

>

>

>

>

>

>

> -Sandy

>

> Metaphors and Analogies of High School Students

> " She had a deep, throaty, genuine! laugh, like that sound a dog

> makes just before it throws up. "

> " Long separated by cruel fate, the star-crossed lovers raced across

> the grassy field toward each other like two freight trains, one

> having left Cleveland at 6:36 p.m. at 55 mph, the other from Topeka

>>

>

>

-Sandy

Metaphors and Analogies of High School Students

" She had a deep, throaty, genuine! laugh, like that sound a dog makes just

before it throws up. "

" Long separated by cruel fate, the star-crossed lovers raced across the grassy

field toward each other like two freight trains, one having left Cleveland at

6:36 p.m. at 55 mph, the other from Topeka at 4:19 p.m. at a speed of 35 mph. "

---------------------------------

Celebrate Yahoo!'s 10th Birthday!

Yahoo! Netrospective: 100 Moments of the Web

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Gretchen, do you also use a bolus insulin for meals? Sue

> I feel that for me, Lantus has a tail, although I haven't investigated

> thoroughly. I take it at 9 a.m. But if I stop it for some reason, my

> fastings are still low the next day. If I resume it again, my fastings

> are

> still higher the next day, as if it's the combination of the tail from

> the

> old shot plus the new shot that gives the correct amount for me (about

> 30U a

> day).

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I have using Lantus and, overall am quite satisfied with it. It seems

to last the full 24 hors for me, but that might be because I only use

38-40 units. That said, I have had one nasty hypo while using it. A

couple months ago, I took my usual 40U shot at about 11:30 p.m. and

went to bed. About 1:00 am I woke up, sweaty and confused, and headed

to the kitchen. My wife saw me and wondered what i was doing but could

not get any meaningful response from me. I apparently decided to check

my blood sugar but was unable to operate my Freestyle tracker meter (a

PDA that has a freestyle meter attached to it). She called the

Paramedics who found my BS level was 46! After being given 25 gms of

glucose which raised my BS to about 180 and I had pretty well

recovered, I declined a ride to the ER. What caused the event, IMHO, I

think that I nicked a blood vessel and a large portion of the Lantus

got into the blood stream. I did have a fairly good sized leakage of

blood from the injection site. As a result and with the concurrence of

my Doctor, I switched my Lantus injection to the morning, with the idea

that if I was going to have another hypo, I wanted to have it while I

was awake and could do something about it before it got too bad. So

far, so good, no hypos to test this with.

Detimir, according to my Doctor, is a long acting basal insulin and

will be able to be injected twice a day (like UL), and can have the

morning and evening doses adjusted (again like UL) to suit the

individual's needs. Should be even better than Lantus in that respect.

>

> 3-Lantus DOES have a peak. While it is a much lower peak than NPH, it

> is

> still a peak and if your bedtime is like me, later than the normal

> assumed

> bedtime of most, the delayed activation period of an hour and a half

> plus the little peak can cause nasty hypos regardless of the study

> Lantus

> just

> put out that DMers using Lantus do not have middle of the night

> hypos.

>

> My last conclusion is strictly a personal one. IMHO, in spite of

> Aventis,

> Lantus is a good product for me BUT I do not feel comfortable putting

> my

> diabetic needs in the hands of a company that does not understand their

> product or understand that one insulin program fits all DMers. So, even

> though Aventis has just introduced a new bolus insulin to compete with

> Novolog and humalog, I am not even curious about it and I am looking

> forward to Novo getting final approval for detimir, which is supposed

> to

> be on a similar line with Lantus. When detimir comes out I will cross

> my

> fingers and hope that it works well for me so I can say bye bye to

> Aventis. Novo has been in the insulin business since 1926 and they have

> served me well so I trust them, which for me is important.

>

=+=+=+=+=+=+=

Maurer

Type II diabetic since 4/87

(diet, exercise, & meds)

Insulin dependent Type II since 9/04

(diet, exercise, Lantus, Humalog, & Metformin XR)

=+=+=+=+=+=+=

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is Novolog the NPH? I wonder if you have to have a prescription for it

>

>

Novo supplies 80% of the insulin in the world. Eli Lilly supplies 80% of

the insulin in the US. While NPH, R and other non script insulins are

pretty much the same, Novolog is different than Humalog. I have found

that Novolog has a quicker start up and a longer duration.

--

I'm not yet where I need to be, but praise God, I'm not where I used to be!!

Lynda

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On Wed, 09 Mar 2005 08:49:10 -0600 LCB writes:

>

> is Novolog the NPH? I wonder if you have to have a prescription for

> it

>

Novolog is a short acting bolus insulin. Novolin is the Novo-nordisk

brand name for human insulins like NPH and R.

> >

> >

> Novo supplies 80% of the insulin in the world. Eli Lilly supplies

> 80% of

> the insulin in the US. While NPH, R and other non script insulins

> are

> pretty much the same, Novolog is different than Humalog. I have

> found

> that Novolog has a quicker start up and a longer duration.

>

> --

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On Wed, 09 Mar 2005 08:49:10 -0600 LCB writes:

>

> is Novolog the NPH? I wonder if you have to have a prescription for

> it

>

Novolog is a short acting bolus insulin. Novolin is the Novo-nordisk

brand name for human insulins like NPH and R.

> >

> >

> Novo supplies 80% of the insulin in the world. Eli Lilly supplies

> 80% of

> the insulin in the US. While NPH, R and other non script insulins

> are

> pretty much the same, Novolog is different than Humalog. I have

> found

> that Novolog has a quicker start up and a longer duration.

>

> --

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> I have been eating a lot of Atkins products (expensive tho)

Atkins products are not only expensive, but they often contain fast carbs,

albeit in small amounts, because the Atkins diet is designed for

nondiabetics who are more concerned with daily carb counts than with BG

rises. Someone on Atkins could, for instance, eat the daily carb ration at

one sitting without violating the rules of the diet (I think). That wouldn't

work for someone with diabetes.

[bTW, if you *do* like Atkins stuff, the discount store next to the

Brattleboro Coop was selling Atkins muffin mixes for 10 cents and some other

LC products at heavy discounts. I think because the LC fad has peaked, a lot

of stores are stuck with LC products that aren't selling.]

> I have trouble digesting things like broccoli, spinach etc.

That does make it more difficult.

> I use the LC products a lot - maybe that is not a good thing?

Some of the LC products are OK, and some aren't. You have to read labels

carefully.

> I get stomach aches from anything hard cooked - like eggs or roasted

meat - how about cold cuts - those I can digest..

Some cold cuts are injected with sugar, and a steady diet of cold cuts isn't

healthy, but if that's all you can tolerate, it's better than bread and

crackers.

> anything else you can suggest for slow carbs besides veggies and nuts?

If you can't tolerate meat and can't tolerate vegetables and can't tolerate

starches because of the diabetes, you've got a tough nut to crack. I hope

you're not celiac. Do you know *why* you can't tolerate meat and vegetables?

Gretchen

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> I switched my Lantus injection to the morning, with the idea

> that if I was going to have another hypo, I wanted to have it while I

> was awake

That's why I take it in the morning. I live alone.

Gretchen

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In a message dated 3/9/2005 3:32:50 PM Eastern Standard Time,

bam817@... writes:

> If it is true, then I am going for the big bucks - gonna become a big time

> celebrity who can survive on eating virtual food :)

> Barb in NH

>

If I remember it correctly, Dr Bernstein once said that some people have to

survive on virgin olive oil.

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Atkins himself spoke of his way of eating as the perfect way of eating for

diabetics. It is against the rules of the diet to have all your daily carbs in

one sitting...you're supposed to break up and spread the carbs throughout the

day to avoid BG surges.

Gretchen wrote:Atkins products are not only expensive, but

they often contain fast carbs,

albeit in small amounts, because the Atkins diet is designed for

nondiabetics who are more concerned with daily carb counts than with BG

rises. Someone on Atkins could, for instance, eat the daily carb ration at

one sitting without violating the rules of the diet (I think). That wouldn't

work for someone with diabetes.

---------------------------------

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Yahoo! Netrospective: 100 Moments of the Web

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