Re: Law of Small Numbers and Diabetes--Low Carb Type 2

[Guest guest]

GREETINGS --

I am a Type 2 who was placed on insulin the day I was diagnosed 10+

years ago. I followed the ADA diet (and exercised) but gained weight

and had poor blood sugar control. In my case (I am still insulin

resistant), and I count carbs -- and I need one unit of insulin (I

use Humalog)to offset every 8 grams of carbs and one unit for one

ounce of protein-- and I need to inject insulin (I use Lantus) to

cover most of my basal needs. The carbs that I do eat are generally

low glycemic fruits and vegetables. By choice I limit my carbs to 10-

15% of the calories I consume which is an adaptation of Dr.

Bernstein's recommended strategy (I am 6'4 " and weigh 230#) and have

normalized my blood sugars doing this.

wambo1941

In alldiabeticinternational , dnevessr@a... wrote:

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

> wambo1941@y... 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@a...

> Opinions expressed are solely

> my own and should not be

> mistaken for

> Professional advice.

>

>

>

[Guest guest]

Hey Joe---You sound a lot like me (I am 6'3 " )....my only problem is that this

year I got a small ulcer on a toe and my walking has been restricted so I have

gained about 20 lbs.....I am about to end my busy season at work, so I will get

back on my bike and hope to get back to my normal 230, or if any luck, maybe a

little lower---When I was diagnosed in 97 I had an untreated diabetes induced

weight of 195, but on a diabetic diet and meds and now insulin I climbed to 230.

I have been up to 250 before, and down to 230, so I hope I can do again. For

each 15gr carb I need 4 units Humolog plus I take 100 units Lantus before bed

and metformin---(I am classic example of Metabolic Syndrom including Cardiac

Arrest)....ROLF

[alldiabeticinternational] Re: Law of Small Numbers and Diabetes--Low

Carb Type 2

GREETINGS --

I am a Type 2 who was placed on insulin the day I was diagnosed 10+

years ago. I followed the ADA diet (and exercised) but gained weight

and had poor blood sugar control. In my case (I am still insulin

resistant), and I count carbs -- and I need one unit of insulin (I

use Humalog)to offset every 8 grams of carbs and one unit for one

ounce of protein-- and I need to inject insulin (I use Lantus) to

cover most of my basal needs. The carbs that I do eat are generally

low glycemic fruits and vegetables. By choice I limit my carbs to 10-

15% of the calories I consume which is an adaptation of Dr.

Bernstein's recommended strategy (I am 6'4 " and weigh 230#) and have

normalized my blood sugars doing this.

wambo1941

In alldiabeticinternational , dnevessr@a... wrote:

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

> wambo1941@y... 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 productsâ? " for

> example vegetable soupâ? " 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@a...

> Opinions expressed are solely

> my own and should not be

> mistaken for

> Professional advice.

>

>

>

[Guest guest]

Rolf Utegaard wrote:

>For each 15gr carb I need 4 units Humolog plus I take 100 units Lantus

>before bed and metformin---(I am classic example of Metabolic Syndrom

>including Cardiac Arrest)....ROLF

That's about the same dosage ratio that I generally use for Humalog.

But the amount of Lantus you take speaks loudly that you happen to be T2

with insulin-resistance. As a T1 (who makes NO insulin), I usually take

25-26 units of Lantus daily (and no oral diabetes meds). 100 units of

Lantus would put me in an ER (with a glucose drip IV) very quickly with

severe hypoglycemia. That's a major difference between T2 and T1.

Sandy

T1 - 1979