Working Out Diet-Glucose-Insulin/Med Interrelationships

[Guest guest]

GREETINGS --

If you are like me you are probably frustrated by the various ways

diets, especially carb loadings, are established. I am a Type II

diabetic who has been on insulin since I was diagnosed 10+ years

ago. Initially I was provided a version of the diet sanctioned by

the American Diabetes Association (ADA) and combined it with

exercizing (I chose power-walking four miles in an hour six days per

week). The result was poor blood glucose control, weight gain, and

ultimately some diabetes complications. About three years ago I came

accross Dr. Bernstein's book (he is endocrinologist who has had Type

1 diabetes for 50+ years) and changed my overall approach to

diabetes. I also found an MD who was willing to work with me in this

adventure where we helped educate one another to some degree.

I ended up choosing from among three approaches to develop the

dietary strategy I use for managing the blood glucose produced from

the metabolism of the food I consume. I ended up taking bits and

pieces from all three approaches. The first approach involves an

exchange system that has been well covered in the literature and has

been in use for some time by ADA/AHA (one exchange of carbs equals 15

grams). The second is carb counting which is gaining converts as low

carb diets are gaining in popularity. The third is TAG (Total

Available Glucose) that is based on an assumption that 100% of

carbohydrate, 58% of protein, and 10% of fat is broken down in the

body to glucose. The closer you want to control your blood sugars the

more important it is to cover all sources of glucose. In my case,

however, I factor in glucose from carbs and from protein. You need to

adopt an approach where you feel comfortable.

The ratios of carbs, protein, and fat that make up your diet is

another decision you need to make (this is so no matter what type of

Diabetes you have). Two powerful non-profits in the US (American

Heart Association and American Diabetes Association) have been

backing a diet for years that limits protein and fat content –

emphasizing carbs by promoting a diet that includes up to 65% (up

from 45% initially) of the calories a diabetic consumes (and 10-20%

protein and 25% fat). On the other hand Drs. Atkins (of diet fame)

and Bernstein (referred to above) have been promoting Low Carb diets

(30 grams of carbohydrate per day). But their approaches don't factor

in a person's size. Because of my size (currently 6 " 5 " and 235 lbs) I

tend to use percentages – 10-15% of calories as carbs in lieu of a

number of grams or ounces, and a variable split between protein and

fat. It seems to work for me.

As an adult, moderately active, person weighing 140 pounds (my

assumption), it would take approximately 1900 calories per day to

maintain that weight. The possible carb volumes range from 30 grams

(Bernstein) to 230 grams (ADA/AHA) per day. The possible protein

volumes range from 3 oz. (10%) (ADA/AHA) to 15 oz. (50%) (Bernstein).

The glucose volume (and thus the medication requirement) will be the

highest if the ADA/AHA carb/protein/fat configuration is adopted. In

my case I use 10-15% carbs, 50% protein, and the remainder fats –

although I don't factor fat in my insulin calculations. I live a very

sedentary lifestyle for now (due to diabetes complications of old)

and am still in the weight loss mode.

Remember to BE PROACTIVE,

wambo1941