Re: Law of Small Numbers and Diabetes

[Guest guest]

rfong_tom3@... wrote:

>the recommended diet IS lower in carbs than the old ADA diet. BUT

>this does not translate into *severely restricted*. as you say,

>there is *lower* v. *low*.

That's where it becomes a matter of perspective, comparison and frame of

reference and why the controversy exists . . . i.e., what I think is " low "

or " lower, " you might see as " severely restricted " or vice versa.

>this reminds of something that a post, which escapes me now, made me

>think. a lot of insulin running around in your system is not a good thing.

As a T1, excess insulin doesn't " run around " in my system because I am not

insulin-resistant. If my system has more insulin (that I've injected) than

there is food (or other circumstances) to utilize it, I definitely have

" too much " insulin and am hypoglycemic with reaction symptoms that must be

treated. If there is " not enough " insulin in my system (to match food or

other circumstances), it shows as elevated blood glucose (BG). T2's who are

insulin-resistant, on the other hand, can have lots more insulin on board

than is being properly utilized, thus " running around. "

That's a major difference between T1 and T2. T2's are often

insulin-resistant which means they have a lot more insulin in their system

(either natural or injected) than is needed but the body cannot utilize it

well/properly and it takes more insulin to do less. T1's are rarely

insulin-resistant.

>i know a number of dieticians are comfortable with the zone and south

>beach (not mine), but i have yet to meet anyone ok with atkins.

More and more docs are recommending much lower carb diets, including South

Beach; many even recommend Atkins . . . even though you haven't met them ;-)

Sandy

T1 - 1979

[Guest guest]

<< That's exactly what I plan to do (and what will happen whether or not

I do any " planning " ) , i.e., " live till death, " and only I can decide what

constitutes " quality of life " to me along the way. >>

TECHNICALLY, since I have been resusitated, doesnt that mean I have lived

past death?

things that make ya wonder... hhmmmmmm

[Guest guest]

<< That's exactly what I plan to do (and what will happen whether or not

I do any " planning " ) , i.e., " live till death, " and only I can decide what

constitutes " quality of life " to me along the way. >>

TECHNICALLY, since I have been resusitated, doesnt that mean I have lived

past death?

things that make ya wonder... hhmmmmmm

[Guest guest]

<< That's exactly what I plan to do (and what will happen whether or not

I do any " planning " ) , i.e., " live till death, " and only I can decide what

constitutes " quality of life " to me along the way. >>

TECHNICALLY, since I have been resusitated, doesnt that mean I have lived

past death?

things that make ya wonder... hhmmmmmm

[Guest guest]

> As a T1, excess insulin doesn't " run around " in my system because

I am not

> insulin-resistant. If my system has more insulin (that I've

injected) than

> there is food (or other circumstances) to utilize it, I definitely

have

> " too much " insulin and am hypoglycemic with reaction symptoms that

must be

> treated. If there is " not enough " insulin in my system (to match

food or

> other circumstances), it shows as elevated blood glucose (BG).

T2's who are

> insulin-resistant, on the other hand, can have lots more insulin

on board

> than is being properly utilized, thus " running around. "

> That's a major difference between T1 and T2. T2's are often

> insulin-resistant which means they have a lot more insulin in

their system

> (either natural or injected) than is needed but the body cannot

utilize it

> well/properly and it takes more insulin to do less. T1's are

rarely

> insulin-resistant.

perhaps another matter of terminology, re. *excess*. wish i had my

notes handy. insulin can become irritating to the vascular system in

*elevated* amounts. this *elevation* is not in terms of adequate

utilization. more food / more insulin or resistance / more insulin,

these are both scenarios that can lead to these so-called elevated

levels.

> >i know a number of dieticians are comfortable with the zone and

south

> >beach (not mine), but i have yet to meet anyone ok with atkins.

>

> More and more docs are recommending much lower carb diets,

including South

> Beach; many even recommend Atkins . . . even though you haven't

met them ;-)

>

> Sandy

> T1 - 1979

this is a place where we do have to make our own decisions on what

the experts say, as they go about contradicting each other.

so far with atkins, i've been looking at the issue of ketosis; i'm

not convinced it's desirable to promote, even if the body has

counter-mechanisms and ketones are a part of normal metabolism, as

i've heard it argued on the pro-side.

as it is now, i'm of a mind that *some* is best. you need *some*

insulin, it is normal to have *some* ketones. something like keto

acidosis is a whole other ball park.

rach

[Guest guest]

Hello Sandy,

One thing is certain and sure, taking ZERO will kill ya

A.S.A.P. ; )!!!

Jeff

[Guest guest]

> As a T1, excess insulin doesn't " run around " in my system because I am not

> insulin-resistant. If my system has more insulin (that I've injected) than

> there is food (or other circumstances) to utilize it, I definitely have

> " too much " insulin and am hypoglycemic with reaction symptoms that must be

> treated. If there is " not enough " insulin in my system (to match food or

> other circumstances), it shows as elevated blood glucose (BG). T2's who are

> insulin-resistant, on the other hand, can have lots more insulin on board

> than is being properly utilized, thus " running around. "

>

WOW your answering like 90% of my questions about type one! Thanks a million

for your posts!

[Guest guest]

> insulin can become irritating to the vascular system in *elevated*

> amounts. this *elevation* is not in terms of adequate utilization. more

> food / more insulin or resistance / more insulin,

>these are both scenarios that can lead to these so-called elevated levels.

Can't imagine how one could have " elevated " levels of insulin if you are

not insulin-resistant . . . if a normal functioning (non-diabetic) system

has increased insulin it is in response to increased call for it by the

body (in response to increasing BG) which immediately uses it . . . and

that is not " dangerous " (for normal people), it's, well, Normal. For

instance, when a non-diabetic person eats lots of candy or a banana split,

lots more insulin is immediately produced to " process " the increasing BG .

.. . vs. the same person eating a plain lettuce salad.

>so far with atkins, i've been looking at the issue of ketosis; i'm

>not convinced it's desirable to promote,

As I understand it, ketosis is the body using fat (and body fat) for energy

rather than readily available carbs. The jury is still out on the long

range effects of that. Yet there is no way to lose weight other than to

burn body fat by eating less (calories) than you are using/burning. So if

you are losing weight, you are producing ketones, no matter what diet you

are following.

>something like keto acidosis is a whole other ball park.

Yup, ketoacidosis is life-threatening and very different from ketosis.

Sandy

T1 - 1979

[Guest guest]

hi sandy! sneaking back as i wait to depart... ;>

> Can't imagine how one could have " elevated " levels of insulin if

you are

> not insulin-resistant . . . if a normal functioning (non-diabetic)

system

> has increased insulin it is in response to increased call for it

by the

> body (in response to increasing BG) which immediately uses

it . . . and

> that is not " dangerous " (for normal people), it's, well, Normal.

For

> instance, when a non-diabetic person eats lots of candy or a

banana split,

> lots more insulin is immediately produced to " process " the

increasing BG .

> . . vs. the same person eating a plain lettuce salad.

as i gather, that would be the issue...*overeating* *all the time*.

so one would not only have the possible problems of becoming

overweight and so forth, but one more...the insulin itself becomes

irritating.

mulling it over, in a way it sort of hints at evolutionary science,

and ideas like *good enough is best* and laws of *diminishing

returns.* the body has coping mechanisms and strategies, but they

function more optimally at certain levels than others.

and so, that all chalks up as a pro in favour of a *lower, healthier

carb diet.*

i have also been contemplating the idea of there being an *upper

limit* of carbs for everyone - which my educators have said there

is. that there is just a point where no matter how much insulin you

could have going, that there is a maximum rate at which glucose can

be taken up. it's sort of interesting, one of the first tips i got

from someone was for a pizza treat...and taking two shots, not just

the one at the start of the meal to handle the pizza. as i think

about it, it does sort of suggest there is a rate of uptake that has

to be dealt with.

> >so far with atkins, i've been looking at the issue of ketosis; i'm

> >not convinced it's desirable to promote,

>

> As I understand it, ketosis is the body using fat (and body fat)

for energy

> rather than readily available carbs. The jury is still out on the

long

> range effects of that. Yet there is no way to lose weight other

than to

> burn body fat by eating less (calories) than you are

using/burning. So if

> you are losing weight, you are producing ketones, no matter what

diet you

> are following.

>

> >something like keto acidosis is a whole other ball park.

>

> Yup, ketoacidosis is life-threatening and very different from

ketosis.

yes, altogether *a new level*. but back to ketosis and low low carb

diet...one of my questions is that it's supposed to be a life-long

way of eating, isn't it? so i wonder how that plays out in

maintenance mode. like that scientist who continued on with really

minimal carbs and had to wear several pairs of pants and shirts,

because his metabolism couldn't keep him warm on those amounts. it

occurs to me that body size matters, so what might keep a rat alive

longer may not keep a person alive longer. or not alive and well.

sends me back to pondering evolution, that man and his pants. like,

what if he were a *caveman*? would he have the energy to make

himself several pairs of pants, or would he just freeze to death

first? the body they speculate is evolved for *caveman* conditions -

scarcity of meat, greater dependence on plants for food - so that

means more carbs than anything. on the other hand, i do believe

early man dropped dead a lot earlier...

oh well. ok. more thoughts. am a geek!

rach

[Guest guest]

I'm going to get into trouble for saying this, but every Diabetes Educator and

nutrition specialist I have consulted regarding this issue have declared that

balance and moderation are the clues......That starvation is not the answer....I

would say that as long as you don't become ill or deficient in any way due to a

vastly lower than normal carbohydrate intake you probably are safe. But, you

need to be aware that in human history this is not the ideal physiological

" balanced diet " ......

[alldiabeticinternational] Re: Law of Small Numbers and Diabetes

rfong_tom3 wrote:

> i will trust you didn't mean to suggest that a diet

>severely restricted in carbs is a good thing for diabetics. the

>*diabetic diet* of severely restricted carbs was killing people off

>early. that is known.

As a matter of fact, more recent thought in diabetic treatment says exactly

that . . . i.e., " that a diet severely restricted in carbs is a good thing

for diabetics. " The standard " diabetic diet " long recommended by the ADA

(and based on the Exchange system) is much higher in carbs, in fact based

on lots of carbs. The difference between those approaches is creating tons

of controversy these days (which is reflected in the various disagreements

on all the diabetes lists and everywhere else). The lower carb approach is

based on the fact that higher carbs create higher peaks in BG and that the

lower the BG peaks, the easier it is to keep BG lower and stable. " Low

carb " eating has lots of variations/degrees. Those who go really low carb,

aim to keep their carb consumption below 50-60 grams of carb per day (from

any source) . . . a more moderate approach is 100 or less (gr of carb per

day) and lots of other personal preference levels. Before insulin was

invented, the standard method of treating diabetes (i.e., to keep BG levels

as low as possible for as long as possible to prolong life) was to nearly

starve the person.

With the new panic re: obesity in the general (USA) population and the

popularity/success of low carb diets such as Atkins and South Beach, there

is ever increasing info and thought that " lower " carb eating is necessary.

How low is " lower " is a comparative thing and perspectives certainly vary

which is the source of lots of controversy these days re: " the right way to

eat " and " for whom. "

Sandy

T1 -1979

[Guest guest]

wrote:

>I think this is definitely a case of YMMV. My endocrinologist and I were

>talking about insulin resistence and the fact that most Type 1 diabetics

>DO develop it over time. I have also been a Type 1 since 1979 (diagnosed

>at the age of 10) and am experiencing insulin resistence. It is one of

>the reasons why I chose to go on the pump . . . My biggest issue now are

>the sudden changes in basal needs in relation to my menstrual cycle . . .

>I also went on the pump to decrease the build-up of scar tissue I've

>experienced from 25 years of MDIs, which is a real issue for me, but not

>to be mistaken for insulin resistence.

For every generalization, no matter how mild or qualified, there are

exceptions. For that reason, it seems that the only constant with diabetes

is YMMV (Your Mileage May Vary) due to differences in everything from

genetic make-up to life events, nurture and the effects of what we eat or

do, as well as endless other possible variables. I think it would be rare

that any 2 people with diabetes (either Type) would react in *exactly* the

same way. Since we have both been T1 since 1979, we are examples of just that:

1) After 25 years as a T1, you mention having some insulin resistance while

I do not. Maybe I will develop it under some conditions or length of time

but maybe not. YMMV.

2) You mention having scar tissue from 25 years of MDIs (Multiple Daily

Injections) but I have none (that I can tell) after 25 years of 2-5

injections per day. YMMV.

3) I am past the stages of BG interaction with menstrual cycle but the

hormonal changes of menopause bring different challenges. YMMV.

It may be that some of our differences stem from the fact that you became

T1 as a child (10 yo) and diabetes had effects on your body during the

formative years and maturation process, hormonal changes, growth . . .

while I did not become T1 until I was 29 (and pregnant) and past those

developmental stages. Just as T1 is very different from T2, as a

generalization, so T1 in in children (and childhood-onset) has very

different effects, ramifications, treatments, etc. than T1 in adults (or

adult-onset). Who knows. YMMV.

I have T1 friends who are thrilled with the effects of using the pump and

highly recommend it. Personally, I am still reticent to be attached to a

device 24/7 and have opted for MDI for now, but that's my own hang-up and

could change.

>btw, do others experience needing different amounts of insulin at

>different times of the day? Every time I see my doctor he asks me if I

>need more or less insulin for food coverage at different meals and I am

>wondering if this is some new discovery as I can't say I've experienced that.

I haven't experienced that (that I'm aware of) though I may be attributing

differences to other factors that are actually applicable to different

times of day? Absolute cause/effect is often difficult, if not impossible,

to determine in the face of multiple variables. I have heard/read

discussions by some T2's that they can " handle " more carbs for breakfast,

less for lunch and little for dinner. For a T1 that could translate into

less insulin required (for similar number of carbs) early in the day vs.

later. Maybe that's what your doc is getting at with his question? (I'm

just guessing.)

Sandy

T1 - 1979

[Guest guest]

> My biggest issue now are

> >the sudden changes in basal needs in relation to my menstrual cycle .

>

OK so Im not crazy in thinking my BS changes with my cycle?? it seems VERY

low the week of and almost to high the week after then normal-ish the other two

weeks