A Re-Introduction and aQuestion About Snacks on P1 -- from a lurker -- very long

[Guest guest]

Hi all,

I've been a lurking member of this group for a number of months now.

I did write an intro post and did start Phase 1 of the SBD but

unfortunately was not able to progress forward due to my needing to

return to the hospital unexpectedly. I was in a serious car accident

in May 2005 -- I fractured three vertebrae in my neck, fractured my

T12 and had a spinal fusion surgery at T12 as well, followed by two

weeks of inpatient rehab, three cycles of outpatient rehab, and four

months on disability from work. I had some problems not long after

joining this group that necessitated a return to the hospital to

undergo a slew of tests. Everything ultimately turned out all right

(I was suffering what I still suspect were TIAs, but nothing was found

to be amiss; I'm convinced that it was simply the result of so much

trauma and injury to areas so close to my spinal cord that affected me

more profoundly than I anticipated it would), but I was in the

hospital for nearly a week and naturally didn't have the best choices

in terms of diet in front of me.

To re-introduce myself a bit, I'm a Type 1 (insulin-dependent)

diabetic, and I use an insulin pump. My car accident was actually the

result of my falling unconscious from unexpected hypoglycemia on my

way to work. I crashed and totaled my car and (obviously) did a lot

of damage to my own self, but -- and for this I am more thankful than

I could ever truly express -- I didn't involve anyone else in the

accident, something I seriously doubt I could have accepted (the whole

" responsibility " aspect of living with such a intensely, highly

self-managed condition) without a lot of work on my part. But anyway ==

I am not overweight; I'm fairly healthy, and even slightly

underweight, although I have gained some weight since my time in the

hospital and rehab. My reason for deciding to use the SBD was an

effort to find a way of eating that would be beneficial to someone

attempting to control diabetes. I would like to be able to decrease

my bolus insulin (i.e., my meal doses) since using less insulin

results in less fluctuation in blood sugars and less swings from low

to high to low again. I manage my diabetes intensively, but after my

time in rehab, when I was very limited in my food choices, I adopted

eating habits that I haven't been able to completely turn around even

after four months back at work and four months attempting to

reintroduce my former way of eating back into my life. I

feel...unhealthy...and out of control. Although it didn't hurt for me

to gain a bit of weight, I don't feel comfortable having gained that

weight because it wasn't a healthy weight gain. I am still in

considerable pain nearly all day every day (my back muscle strength is

virtually non-existent at this point), and although I know that I need

to get into the gym and start exercising, which can only benefit me

(I've tried doing some of the exercises I learned in PT at home, but

it's difficult to adapt most of them without certain equipment that is

no longer available to me). I just feel...out of shape...and very

sluggish and unhealthy. It's time for me to do what I had intended to

do when I initially joined this group, more importantly in conjunction

with re-establishing a workout routine that is so critical to my

well-being right now. I used to work out intensely but cancelled my

membership to my former gym (where they offered spinning, my favorite

cardiac workout) and now belong to a small all-female gym in my town.

It's no more than a five-minute drive from my apartment, yet I can't

seem to get myself there. I am tired, I am hurting, and I am

frustrated and disgusted with myself. I know that ultimately, working

out is the ONLY thing that will help me to start regaining my muscle

strength, but it can be so hard sometimes. I'm also just starting

school again (Spring semester) after having been out of school since

just before my accident (I missed both the summer and fall semesters),

and I'm trying to slowly readapt to both working and attending school.

I know that I need to add exercise back into that picture. But again

-- the pain is sometimes so intense and makes me so physically weak

and exhausted. Enough of my whining, however.

Here's my current 'dilemma': I AM going to be starting P1 of SBD

again, because I really do want to be able to follow this way of

eating, which I feel is the best WOE for a diabetic -- Type 1 or Type

2. I do occasionally eat fish, but I don't eat meat or poultry and

haven't for seven years. I even feel a profound discomfort when I eat

fish, but I reintroduced fish into my diet because I didn't like

" bulking up " my meals with starchy carbohydrate. More carbs, more

insulin. I really love the fact that beans are allowed on even P1 of

SBD, because they're another source of protein that I can turn to. If

I don't eat fish (and again, it's not that often that I do), my source

of protein is usually 1/2 to 1 ounce of cheese mixed in with a salad,

a veggie meat (TVP), nuts, tofu, peanut butter (right now I have 1T PB

on live grain bread for breakfast nearly every day) and eggs. It's

one thing to attempt SBD as a vegetarian, it's another to attempt it

as a T1 diabetic vegetarian. I can't do pasta, no matter how many

times I've attempted to " fake it out " with using combination/extended

boluses on my pump, so most pasta dishes are out for me when I reach

P2. I can do it; it will simply take a lot of planning and thinking

out of the box on my part. My question is regarding the necessity of

" snacks " on P1. I understand that the basic concept behind the snacks

is to insure that blood sugar levels and insulin levels remain steady

throughout the day. Is it absolutely essential and critical for

someone like me, whose body doesn't *make* any insulin on its own, to

eat two snacks per day, which will only result in my needing *more*

insulin to cover the snacks (unless they're pure protein, provided

that they're not so much protein that they too raise my blood sugar)?

If this mechanism is already " broken " and unlike a Type 2 diabetic,

there is nothing that I can do diet-wise that will repair it, in that

changing the way that I eat will not level out the insulin in my blood

because there IS NO NATURAL INSULIN in my body -- do I need to

force-feed myself twice more a day simply because the diet dictates

that I should? Eating three meals is plenty for me most days, and one

of the things that I am most frustrated with is that throughout my

time at home, I started eating more frequently throughout the day,

which only resulted in my using increasingly more insulin to cover

that extra food I was taking in. I don't want to take five bolus

doses of insulin per day if I don't need to.

Can I do this without the snacks, since I really have no need to

retrain a part of my body that is already permanently damaged and will

never work properly? I'm just trying to make sense of this and I

can't seem to come up with the answer on my own. I'm looking to all

of you for advice. I read all of the messages here and I have learned

so much and have saved so many of the tips, ideas, advice and recipes

in my own personal files. I'd be grateful for any guidance you can

offer -- if you've even managed to read this far.

I do apologize for the length of this post. I'm not known for my

ability to keep things brief. Thanks for your help.

[Guest guest]

Welcome back! With the medical conditions that you are bringing to the table, I

think you should check with your doctor about your questions regarding snacks

and desserts.

MB

A Re-Introduction and aQuestion About Snacks on P1

-- from a lurker -- very long

Hi all,

I've been a lurking member of this group for a number of months now.

I did write an intro post and did start Phase 1 of the SBD but

unfortunately was not able to progress forward due to my needing to

return to the hospital unexpectedly. I was in a serious car accident

in May 2005 -- I fractured three vertebrae in my neck, fractured my

T12 and had a spinal fusion surgery at T12 as well, followed by two

weeks of inpatient rehab, three cycles of outpatient rehab, and four

months on disability from work. I had some problems not long after

joining this group that necessitated a return to the hospital to

undergo a slew of tests. Everything ultimately turned out all right

(I was suffering what I still suspect were TIAs, but nothing was found

to be amiss; I'm convinced that it was simply the result of so much

trauma and injury to areas so close to my spinal cord that affected me

more profoundly than I anticipated it would), but I was in the

hospital for nearly a week and naturally didn't have the best choices

in terms of diet in front of me.

To re-introduce myself a bit, I'm a Type 1 (insulin-dependent)

diabetic, and I use an insulin pump. My car accident was actually the

result of my falling unconscious from unexpected hypoglycemia on my

way to work. I crashed and totaled my car and (obviously) did a lot

of damage to my own self, but -- and for this I am more thankful than

I could ever truly express -- I didn't involve anyone else in the

accident, something I seriously doubt I could have accepted (the whole

" responsibility " aspect of living with such a intensely, highly

self-managed condition) without a lot of work on my part. But anyway ==

I am not overweight; I'm fairly healthy, and even slightly

underweight, although I have gained some weight since my time in the

hospital and rehab. My reason for deciding to use the SBD was an

effort to find a way of eating that would be beneficial to someone

attempting to control diabetes. I would like to be able to decrease

my bolus insulin (i.e., my meal doses) since using less insulin

results in less fluctuation in blood sugars and less swings from low

to high to low again. I manage my diabetes intensively, but after my

time in rehab, when I was very limited in my food choices, I adopted

eating habits that I haven't been able to completely turn around even

after four months back at work and four months attempting to

reintroduce my former way of eating back into my life. I

feel...unhealthy...and out of control. Although it didn't hurt for me

to gain a bit of weight, I don't feel comfortable having gained that

weight because it wasn't a healthy weight gain. I am still in

considerable pain nearly all day every day (my back muscle strength is

virtually non-existent at this point), and although I know that I need

to get into the gym and start exercising, which can only benefit me

(I've tried doing some of the exercises I learned in PT at home, but

it's difficult to adapt most of them without certain equipment that is

no longer available to me). I just feel...out of shape...and very

sluggish and unhealthy. It's time for me to do what I had intended to

do when I initially joined this group, more importantly in conjunction

with re-establishing a workout routine that is so critical to my

well-being right now. I used to work out intensely but cancelled my

membership to my former gym (where they offered spinning, my favorite

cardiac workout) and now belong to a small all-female gym in my town.

It's no more than a five-minute drive from my apartment, yet I can't

seem to get myself there. I am tired, I am hurting, and I am

frustrated and disgusted with myself. I know that ultimately, working

out is the ONLY thing that will help me to start regaining my muscle

strength, but it can be so hard sometimes. I'm also just starting

school again (Spring semester) after having been out of school since

just before my accident (I missed both the summer and fall semesters),

and I'm trying to slowly readapt to both working and attending school.

I know that I need to add exercise back into that picture. But again

-- the pain is sometimes so intense and makes me so physically weak

and exhausted. Enough of my whining, however.

Here's my current 'dilemma': I AM going to be starting P1 of SBD

again, because I really do want to be able to follow this way of

eating, which I feel is the best WOE for a diabetic -- Type 1 or Type

2. I do occasionally eat fish, but I don't eat meat or poultry and

haven't for seven years. I even feel a profound discomfort when I eat

fish, but I reintroduced fish into my diet because I didn't like

" bulking up " my meals with starchy carbohydrate. More carbs, more

insulin. I really love the fact that beans are allowed on even P1 of

SBD, because they're another source of protein that I can turn to. If

I don't eat fish (and again, it's not that often that I do), my source

of protein is usually 1/2 to 1 ounce of cheese mixed in with a salad,

a veggie meat (TVP), nuts, tofu, peanut butter (right now I have 1T PB

on live grain bread for breakfast nearly every day) and eggs. It's

one thing to attempt SBD as a vegetarian, it's another to attempt it

as a T1 diabetic vegetarian. I can't do pasta, no matter how many

times I've attempted to " fake it out " with using combination/extended

boluses on my pump, so most pasta dishes are out for me when I reach

P2. I can do it; it will simply take a lot of planning and thinking

out of the box on my part. My question is regarding the necessity of

" snacks " on P1. I understand that the basic concept behind the snacks

is to insure that blood sugar levels and insulin levels remain steady

throughout the day. Is it absolutely essential and critical for

someone like me, whose body doesn't *make* any insulin on its own, to

eat two snacks per day, which will only result in my needing *more*

insulin to cover the snacks (unless they're pure protein, provided

that they're not so much protein that they too raise my blood sugar)?

If this mechanism is already " broken " and unlike a Type 2 diabetic,

there is nothing that I can do diet-wise that will repair it, in that

changing the way that I eat will not level out the insulin in my blood

because there IS NO NATURAL INSULIN in my body -- do I need to

force-feed myself twice more a day simply because the diet dictates

that I should? Eating three meals is plenty for me most days, and one

of the things that I am most frustrated with is that throughout my

time at home, I started eating more frequently throughout the day,

which only resulted in my using increasingly more insulin to cover

that extra food I was taking in. I don't want to take five bolus

doses of insulin per day if I don't need to.

Can I do this without the snacks, since I really have no need to

retrain a part of my body that is already permanently damaged and will

never work properly? I'm just trying to make sense of this and I

can't seem to come up with the answer on my own. I'm looking to all

of you for advice. I read all of the messages here and I have learned

so much and have saved so many of the tips, ideas, advice and recipes

in my own personal files. I'd be grateful for any guidance you can

offer -- if you've even managed to read this far.

I do apologize for the length of this post. I'm not known for my

ability to keep things brief. Thanks for your help.

Please send your recipes for inclusion in the Files to the Moderator at:

South-Beach-Diet-Getting-It-Right-owner

Reminder: The South Beach Diet is not low-carb. Nor is it low-fat. The South

Beach Diet teaches you to rely on the right carbs and the right fats-the good

ones - and enables you to live quite happily without the bad carbs and bad fats.

For more on this Way Of Eating please read " The South Beach Diet " by Arthur

Agatston, MD. ISBN 1-57954-814-8

[Guest guest]

-- You *REALLY* need to sit down with your doctors and work

through this.

The foundation of the SBD is solid nutrition; whole grains instead of

processed grains, lots of vegetables, healthy fat intake and so forth. This

foundation can be used to build any healthy diet. I would think you could

work with a nutritionist that specializes in diabetes to come up with

something that fits well with your needs.

[Guest guest]

<< The foundation of the SBD is solid nutrition; whole grains instead

of processed grains, lots of vegetables, healthy fat intake and so

forth. This foundation can be used to build any healthy diet. I

would think you could work with a nutritionist that specializes in

diabetes to come up with something that fits well with your needs. >>

Hi ,

Thank you for your comments. Actually, that's the way that I've been

eating most of my adult life, which is a big part of the reason the

SBD appeals to me: it so closely mirrors so many of the food choices

I would make myself on any given day. I NEVER eat processed " white "

foods, i.e., white bread, white rice, etc., I eat the most dense whole

grains available to me. I eat more servings of low glycemic

vegetables than is recommended by nearly any diet plan since the focal

point of most of my lunches and dinners is an enormous salad with

dark, leafy greens and other nutritious veggie choices. The only time

that I eat the whites is if I occasionally indulge and treat myself to

a bagel (not a common occurrence, since I need to again " fake out " my

insulin using a combination bolus spread over a longer period of

time). If I *do* eat pasta, on the infrequent occasions that I don't

eat a low carb pasta, I wouldn't touch the white and only eat whole

wheat. I never order it out at restaurants. Not worth the problems

that I experience with the elevated BGs the next morning. I've tried -

- it just doesn't work for me.

My concern with talking to a nutritionist/dietician who works with

diabetic patients is that unfortunately they all continue to follow

the American Diabetes Association manner of thinking, and that diet is

NOT what I would consider healthy for any diabetic, nor does it take

into consideration the fact that as an individual, I have different

needs and different likes and dislikes and different responses to the

next person, and since I use not only carbohydrate counting to

calculate my pre-meal bolus doses of insulin, but I also often

use " TAG " -- total available glucose, which also takes into account

the amount of protein consumed at that meal, the ADA plan is NEVER

going to work for me. I had a spirited discussion with one of of the

women who worked in the dining room where I was a patient during my

inpatient rehab, as one day, literally overnight, I discovered that I

had been taken off my " regular " meal plan, which is the way that I

always choose to eat, and given an 1800-calorie ADA meal plan,

complete with " X " number of carbohydrate choices or exchanges per

meal. I was infuriated and frustrated when this happened. That so

many people in the medical profession who deal with diabetes on a

regular basis are still so ignorant when it comes to how to properly

manage this condition, and even more unforgivable, so ignorant when it

comes to formulating a healthy WOE for each individual patient, I have

very little faith that speaking to my doctor or anyone she refers me

to won't be more than a waste of time.

My whole goal in starting SBD was to re-balance my carbohydrate

intake, something that needs rebalancing after being so off-kilter for

the past eight months, as well as (with any luck) reduce my bolus

insulin so that I would reduce the chance for wide swings in either

direction. I really don't need a dietician to tell me what is or

isn't healthy, balanced nutrition -- I've been eating the way I eat

now since long before my diagnosis, and I know what I should and

shouldn't avoid. I've been there, I've done that, and I have a whole

collection of tee shirts.

Thank you, though, for taking the time to read my message. I don't

feel that I need a doctor's advice in determining what I should and

shouldn't eat, as I've been eating a varied and healthy diet for a

very long time. The only difference in my doing SBD versus truly

returning to my former WOE (former meaning prior to my car accident)

would be the inclusion of even more healthy carbs and the curbing of

some of the indulgences that I do still occasionally make.

[Guest guest]

Well, I can understand where you're coming from. As a heart

patient, I wouldn't listen to dietitians myself. Case in point -- my father

had a heart attack (two actually) and his dietitian told him to reduce his

sodium intake...to 4,000mg a day. Even the US RDA is only 2,400mg.

I can't say that I am familiar with the ADA's standard diet, but from what

you say in your post, it sounds like you are/were already eating the SBD

way, minus the higher carb-content foods that are allowed on P2 (such as

pasta). Diabetes (1/2) is an area of nutrition that I still need to work

on. My primary, nutritional focus is on low GI/GL and vegetarian nutrition

(for obvious reasons -- it's just the healthiest way to eat). I *THINK*

that most of that works well for diabetics as well -- correct?

You say you want to start the SBD to re-balance your carb intake but do not

have weight to lose. The focal benefit of P1 is to bring blood glucose

under control by stabilizing hormonal secretions. That's primarily insulin

related but includes other chemicals in the body which work through the

whole hunger-eating-digestion bit. I'd wager P1 would have limited benefit

for you, all things considered. Instead, I'd think focusing on building a

healthy, low-GI diet plan would be the answer.

If you were not yet familiar with healthy eating, the GI, and so forth then

I could see how the SBD would help you. It sounds to me like you're already

WAY ahead of that learning curve. So, how do you see the SBD helping you?