Law of Small Numbers and Diabetes

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In a message dated 7/19/2004 5:49:08 AM Pacific Standard Time,

wambo1941@... writes:

Joe, what a great post. It makes so much sense to me. I fall into the type

2 category, and still produce some insulin I guess, because I can generally

test well (less than a 40 point raise, which I am told is my target) after most

meals. Seeing it qritten down like this, explaining the differences between

type 1 and 2, makes it clear why type 1's would avoid them. As a type 2, we

have no problem with the amount of carbs I post. So, I guess the answer is for

type 1's to avoid recipes all together, and eat plain fare. As for type 2's,

we have no problem with the recipes I send, as we do not have to tighten the

grips on carbs so tightly. Make sense? Sorry to the type 1's out there, I do

not desire it to be this way, but I see no alternative.

Typically, 150 grams of carbohydrate would be a good-sized bowl of

cooked pasta. You may think that by reading the ingredients label on

the package you can precisely compute how much of the dry pasta you

must weigh out to dispense exactly 150 grams of carbohydrate. Now, if

you're a nonobese type 1 diabetic who weighs 150 pounds (68

kilograms) and makes no insulin, 1 gram of carbohydrate will raise

your blood sugar by about 5 mg/dl. By using methods that we'll later

describe, you can calculate exactly how much insulin you must inject

to keep your blood sugar at the same point after the meal as it was

before the meal. This may sound elegant, but it will rarely work for

a high-carbohydrate meal.

What neither the ADA nor the package tells you is that food producers

are permitted a margin of error of plus or minus 20 percent in their

labeling of ingredients. Furthermore, many packaged products—for

example vegetable soup—cannot even match this error range, in spite

of federal labeling requirements. So even if you perform the

necessary calculations, your blood sugar after the meal can be off by

a carbohydrate error of 5 mg/dl multiplied by ± 30 grams (± 20

percent of 150 gm), or by a whopping ±150 mg/dl for just this one

meal. If your target blood sugar level is approximately 85 mg/ dl,

you've now got a blood glucose level anywhere between 235 mg/dl and 0

mg/dl. Either situation is clearly unacceptable.

Let's try another example. Say you're a type 2 diabetic, obese, and

make some insulin of your own but also inject insulin. You've found

that 1 gram of carbohydrate only raises your blood sugar by 3 mg/dl.

Your blood sugar would be off by ±90 mg/dl. If your target blood

sugar value is, say, 90 mg/dl, you're looking at a postmeal blood

sugar level of anywhere from 180 mg/dl to 0 mg/dl. That's one of the

many problems with the ADA guidelines. Big inputs and big

uncertainty.

Marilyn

Moderator for

Diabetic_Recipes

dnevessr@...

Opinions expressed are solely

my own and should not be

mistaken for

Professional advice.