Re: Allowed amounts (Marilyn)

[Guest guest]

> ... what this means is it was

> close to the amount of carbs a

> diabetic in normal eating pattern

> ... is allowed to eat for one

> meal.

I had a feeling that is what you

meant, Marilyn! But didn't you

agree that we weren't going to

tell people what they were

" allowed " to eat and what not?

Didn't you agree that everybody is

different and has different

requirements? Otherwise, who needs

nutritionists? They could just

print it out in a pamphlet to be

handed out to one and all for ever

more!

For one, I certainly would not let

anybody tell me what I am " allowed "

to eat and what not! This might be

a part of one particular

nutritionist's personal notions for

one particular patient but I have

never seen any *evidence* for any

general limit *per meal*. These

things average out over the day or

in some cases over many days.

> Sometimes, with some meals, it is

> easy to have some now, then wait

> an hour or two and have the rest

> of your portion. This causes less

> of a spike in BG's.

I certainly do not accept that idea.

That way you are extending the

period of elevated BG past the

minimum time for AGEs to form and

are more likely to get a contribution

to your HbA1c out of it, not less.

The relationship is not linear. I

have tried dividing a standardized

meal into parts and spreading them

out over a period. It was clear to

me that there is an elevated BG

" overhead " per sitting. In other

words, if a particular meal on a

particular day causes a particular

person's BG to rise to a maximum

(here I mean the real maximum, not

just the reading at any particular

time) of 40 mg% above baseline for

the whole meal, dividing it into

two parts will result in each half

reaching a maximum not of 20 mg%

above baseline but, for example,

30 mg%. The sum of the parts is

more than the whole.

According to my results, there is

a significantly greater (30% greater)

" total area under the curve " from

breaking up a carbohydrate-heavy

meal into parts than from eating it

all in one go and waiting 4-5 hours

before eating the next meal.

I believe that this is because the

diabetic glucose response is

asymmetric - it rises much faster

than it falls (whereas in a non-

diabetic both take place at about

the same rate). So by dividing a

meal into parts, a diabetic gets

two or more slow falls ( " tails " )

instead of just one and hence a

significantly higher total average

elevated BG than they would get

from eating all at one sitting -

and it is the time-average

elevated BG over several days,

and not a spot BG reading taken

at any particular time that has

been shown clinically to correlate

the closest with the HbA1c.

> So by watching the carbs amounts,

> I can pretty much tell what a meal

> is going to do to me.

I think that you mean you get a

good idea of what your BG meter is

going to indicate when you decide

to take a reading some time after

but by a long way that is not the

whole story of " what a meal is

going to do " to you! You may have

a BG meter but you do not have a

glycosylation meter!

To me, steering your nutrition on

the basis of isolated BG meter

readings is like steering a car by

glancing at the fuel gauge every time

you turn a corner! In the long run,

it is not going to give optimum

results.

I am just giving my personal views

on the subject, Marilyn (just like

the nutritionists do!) as a Type 2

diabetic and I don't expect anybody

to agree with me but the basic

objection to claims that there is

an " allowed " way for diabetics to

eat remains the same. There must be

a better expression for it than

that! If you claim that it is

" recommended " then you might want

to say who recommended it and on

the basis of what evidence.

Regards