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Medical Forum / Diseases and Disorders / Diabetes / March 2006Bad advice
I am giving exams this week and wanted to take a book to read while students are working on their exams. Bernstein is high on my list of "want to read" books, but I didn't want to carry anything that heavy (literally and figuratively) with me, so I picked a very small book from the many unread paperbacks on my bookshelf. This one is called "Understanding Diabetes," by Marie Clark. Wow! Talk about bad advice. For example, I found this advice on page 72: "Base your meals on starchy foods -- fill up on these. This means such foods as bread, potatoes, rich, pasta, noodles, oats, crackers, breakfast cereals. These all provide starch, fibre, vitamins (especially B) and minerals." Then, on page 77, I found this: "Some airlines offer 'special diabetic' meals on the plane. It is actually better to avoid them because they can be low in carbohydrate -- caterers often do not realize that balance is the main thing, not cutting down on carbohydrate. Also it is a good idea to take extra caroyhdrate in your hand lugage." I still have a lot to learn, but I have learned enough to know where this book should go. Into the trash! MaryL Wow! Talk about bad advice. For example, I found this advice > on page 72: "Base your meals on starchy foods -- fill up on these. This > means such foods as bread, potatoes, rich, pasta, noodles, oats, crackers, > breakfast cereals. These all provide starch, fibre, vitamins (especially B) > and minerals." That was excellent advice in 1972 for a type 1 diabetic on insulin who was injecting a huge dose of insulin once a day without access to a blood sugar meter. For anyone in today's world though . . . But that's the advice I was getting from my doctor in 1998, which is why picking up Bernstein back then and reading his pages full of common sense advice about carbs and blood sugar--immediately verified by my brand new blood sugar meter, changed my life, and probably saved my eyes, nerves, kidneys and the rest of it. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control :: MaryL wrote: :: Wow! Talk about bad advice. For example, I found this advice [quoted text clipped - 6 lines] :: who was injecting a huge dose of insulin once a day without access :: to a blood sugar meter. For anyone in today's world though . . . I don't see why that was excellent advice in 1972 for a T1. Explain, please? :: But that's the advice I was getting from my doctor in 1998, which is :: why picking up Bernstein back then and reading his pages full of [quoted text clipped - 8 lines] :: http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood :: Sugar Under Control > :: MaryL wrote: > :: Wow! Talk about bad advice. For example, I found this advice [quoted text clipped - 9 lines] > I don't see why that was excellent advice in 1972 for a T1. Explain, > please? I think she did; home meters weren't available, higher doses of insulin were used, and lows were harder to predict and control. Carbs kept type 1s from hypos and all that can ensue. Susan :: x-no-archive: yes :: [quoted text clipped - 17 lines] :: insulin were used, and lows were harder to predict and control. :: Carbs kept type 1s from hypos and all that can ensue. That's actually more info. Still, I don't see why one couldn't do essentially the same thing with smaller doses of insulin and carbs. I don't claim to understand T1s, though. :: Susan On Wed, 8 Mar 2006 20:21:46 -0500, "Roger Zoul" <rogerzoul2@hotmail.com> Huffed and Puffed the following into the madness of usenet: >:: I think she did; home meters weren't available, higher doses of >:: insulin were used, and lows were harder to predict and control. [quoted text clipped - 3 lines] >essentially the same thing with smaller doses of insulin and carbs. I don't >claim to understand T1s, though. They do NOW. With the help of meters. People have been injecting insulin long before BG meters existed. The earliest home testing was urine testing. The problem with that was that by the time even small amounts of glucose showed up in the urine at a level that could be tested it was already far to high in the person Blood and was over the renal thresh hold. Which is somewhere around 150 mg/dl if I remember correctly. I was told back then that small amounts were fine but to avoid large amounts. So for quite a number of years, following the standard of advice at the time I was keeping my Blood glucose around 150 or higher almost all the time. When the testing standards changed and BG meters came out I brought it down. And that's when I found that I needed larger and larger doses of the type insulins that were available to me at the time. But the dietary advice still did not change, eat lots of carbs. Funny thing, when your BG is always high like mine was, you are not eating much of anything. So it wasn't the diet that was the problem. Thankfully they came out with rDNA type insulins which actually worked for me.  SignatureMâck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o ô) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins Jesus never hated anyone. :: On Wed, 8 Mar 2006 20:21:46 -0500, "Roger Zoul" :: <rogerzoul2@hotmail.com> Huffed and Puffed the following into the [quoted text clipped - 27 lines] :: problem. Thankfully they came out with rDNA type insulins which :: actually worked for me. Thanks for the info, Mâck. So there is a historical standard-of-care thing involved here, too. On Thu, 9 Mar 2006 08:44:55 -0500, "Roger Zoul" <rogerzoul2@hotmail.com> Huffed and Puffed the following into the madness of usenet: >:: On Wed, 8 Mar 2006 20:21:46 -0500, "Roger Zoul" >:: <rogerzoul2@hotmail.com> Huffed and Puffed the following into the [quoted text clipped - 30 lines] >Thanks for the info, Mâck. So there is a historical standard-of-care thing >involved here, too. absolutely. What we consider to be the acceptable standards today are nothing like what was acceptable when I was first diagnosed. There were "mavericks" in the field who advocated tighter control and lower carb diets but they were frowned upon for the longest time by the main stream docs and the ADA. The ADA is only just beginning to change it's literature on lowering carb consumption and distinguishing between type 1 diets and type 2 diets. SignatureMâck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o ô) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins Jesus never hated anyone. Ma?k <stopthespam@shootspammers.com> wrote: : On Thu, 9 Mar 2006 08:44:55 -0500, "Roger Zoul" : <rogerzoul2@hotmail.com> Huffed and Puffed the following into the : madness of usenet: : >Ma?k wrote: : >:: On Wed, 8 Mar 2006 20:21:46 -0500, "Roger Zoul" [quoted text clipped - 31 lines] : >Thanks for the info, M?ck. So there is a historical standard-of-care thing : >involved here, too. : absolutely. What we consider to be the acceptable standards today are : nothing like what was acceptable when I was first diagnosed. There [quoted text clipped - 3 lines] : it's literature on lowering carb consumption and distinguishing : between type 1 diets and type 2 diets. When I ws diagnosed type 2 in the mid 80s the doctor I finally worked with, who was a researcher as well as treating people, was encouraging tight control, which seems to have been quite new at eht time and he said that we stil don't have all teh research in on its value, but you should aim for it. I had no meter, just teh bg Chemstrips, which gave a kidn of general bg level, so you knew if you went high or low, but without much precision. Wendy >The ADA is only just beginning to change >it's literature on lowering carb consumption Slightly. > and distinguishing between type 1 diets and type 2 diets. I hope you are correct. I haven't noticed any change on that one yet on their web-pages. Is there different advice being promulgated directly or via educators? Cheers, Alan, T2, Australia. d&e, metformin 2x500mg SignatureEverything in Moderation - Except Laughter. > >The ADA is only just beginning to change > >it's literature on lowering carb consumption [quoted text clipped - 6 lines] > one yet on their web-pages. Is there different advice being > promulgated directly or via educators? As you probably already know about me, I believe that the ADA has some excellent advice for someone who is new to diabetes. Using their internal search engine there is also an abundant amount of information for those who are more experienced and want to dig further. What I've noticed in terms of "changes" is they drive home the point more than ever before about the individual and working with a professional team to determine one's particular needs. A friend of mine was just diagnosed this week (Type 2) and is a bit overwhelmed. I sent her to diabetes.org (and will tell her about this place soon) and espcially to their "diabetes learning center" which is a very simplistic, but clear primer for someone who has just been hit with "the news." Here's a slice from that site within a site that is clear and seems to jive with what many in here are saying. This is one of the first pages that greets a viewer: - You can still eat the foods you love. - Watch serving sizes, especially for carbs. - No two meal plans are alike -- see a dietitian to make your very own meal plan. - Check your blood sugar to see how your food choices affect blood sugar. - If your meal plan isn't working for you, talk to your dietitian about making a new one." Best, Kurt ::: The ADA is only just beginning to change ::: it's literature on lowering carb consumption [quoted text clipped - 24 lines] : : - You can still eat the foods you love. People shouldn't 'love' foods, IMO. : - Watch serving sizes, especially for carbs. That's good. : - No two meal plans are alike -- see a dietitian to make your very own : meal plan. That's true, though I'm distrustful of dietitians. : - Check your blood sugar to see how your food choices affect blood : sugar. Good. Didn't mention frequency though, but I'd guess that's elsewhere on the site. : - If your meal plan isn't working for you, talk to your dietitian : about making a new one." Why is it that a dietitian is the only option recommended? There are a LOT of good sources for making meal plans for diabetics. : Best, : Kurt > Why is it that a dietitian is the only option recommended? There are a > LOT of good sources for making meal plans for diabetics. > > : Best, > : Kurt When I was first diagnosed, my doctor gave me prescription for the outpatient diabetes education series offered by one of the local hospitals (a prescription because my insurance covers the training when it is prescribed but not without a prescription). One of the sessions included individual meetings with a dietician/nutritionist. She advocated what I considered to be a high level of carbs, and I had already started to learn about the relationship between diabetes and carbs. She was very skeptical about everything I said. I still see her when I go to some of the evening meetings, and she seems to be genuinely pleased that I have lost so much weight and have my BG under tight control (and have not needed any medication for a year), but she is still highly dubious about the relationship to carbs and still advocates far more carbs than I am getting. MaryL ::: Kurt wrote: :::: [quoted text clipped - 17 lines] :: but she is still highly dubious about the relationship to carbs and :: still advocates far more carbs than I am getting. That was exactly my experience with a dietitian. Frankly, too many of them just don't get it for me to trust them as a group. > ::: Kurt wrote: > :::: [quoted text clipped - 17 lines] > :: but she is still highly dubious about the relationship to carbs and > :: still advocates far more carbs than I am getting. > That was exactly my experience with a dietitian. Frankly, too many of them > just don't get it for me to trust them as a group. They are rote trained in a simplified model of human nutrition by people who were themselves trained to teach that material to them. The number of institutional steps and time lags between a modern understanding of nutrition which takes into account recent research mean that in general it would hard for them to be less than fifteen years out of date. It's not their fault. It's the fault of an ossified educational bureaucracy which regarded major revisions of scientific opinion as so unlikely that they didn't need to devise a method of coping with them. In fact I suspect those in charge do realise the problem, and are currently sitting in committees asking each other "But how can we revise our guidelines without opening us to the charge that we've been giving positively harmful advice to some people? And are you really sure that if we just wait another fifteen years the scientists won't change their minds back again?" SignatureChris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] >> >The ADA is only just beginning to change >> >it's literature on lowering carb consumption [quoted text clipped - 38 lines] >Best, >Kurt Hi Kurt. I'm underwhelmed I'm afraid. It's a start, no more. In that same section, this is still the "Rate your plate" advice - and no mention is made anywhere of different dietary needs for T1 and T2, only of different insulin and meds needs. How difficult would it be for them to have seperate sections? http://www.diabetes.org/all-about-diabetes/chan_eng/i3/i3p3.htm "Meal Improvement: Rate Your Plate An easy way to plan meals is to rate your plate: Is about one-fourth of your plate filled with carbs such as bread, noodles, rice, corn, fruit, and milk? Is one-fourth of your plate filled with main-dish (protein) foods such as meat, poultry, fish, or meat substitute? Is at least half of your plate filled with vegetables (salad or cooked vegetables such as carrots, broccoli, or spinach)?" At least they now add this at the end - but they still want carbs as a quarter of the plate: "Because how much you eat can make a big difference in your blood sugar level, especially with foods high in carbohydrate. There's no need to skip these foods -- just watch those serving sizes!" Surely the premier diabetes advisory and research organisation in the world can do better. Here, in full, is their "Carbs count" section. See if you can find the bit that says to test to find out how much they count: http://www.diabetes.org/all-about-diabetes/chan_eng/i3/i3p2.htm "Carbs Count! A key message for people with diabetes is "Carbs Count." Foods high in carbs (carbohydrates) -- bread, tortillas, rice, crackers, cereal, fruit, juice, milk, yogurt, potatoes, corn, peas, sweets -- raise your blood sugar levels the most. For many people, having 3 or 4 servings of a carb choice at each meal and 1 or 2 servings at snacks is about right. Remember to keep an eye on your total number of servings. For example, if you choose to have dessert, cut back on potatoes. Round out your meals with a serving of meat (such as fish or chicken) or meat substitute (such as beans, eggs, cheese, and tofu) about the size of a deck of cards and vegetables (such as broccoli or lettuce). There's no limit on vegetables that are raw or made without fat. Here is a meal that has 4 carb choices. (pic of plate of food) The carb choices are in bold print. 3 small tortillas (3 carbs) with meat, salsa, lettuce, and chopped tomato 1/3 cup of rice (1 carb) Serving sizes make a differencetake a look at the serving size guide below. Carb Choice Serving Size Example(each has 15 grams of carb) Bread 1 slice 1 small tortilla Starchy side dishes rice or noodles 1/3 cup 1/3 cup spaghetti corn 1/2 cup 1/2 large ear of corn Fruit 1/2 cup or 1 piece 1 small apple Milk 1 cup (8 ounces) 1 carton Sweets 2-inch square 1 small piece of cake Amount to equal 15 grams of carbs (check the food label) 2 small cookies Cheers, Alan, T2, Australia. d&e, metformin 2x500mg SignatureEverything in Moderation - Except Laughter. > >As you probably already know about me, I believe that the ADA has some > >excellent advice for someone who is new to diabetes. Using their [quoted text clipped - 31 lines] > > I'm underwhelmed I'm afraid. Don't be afraid. :) > It's a start, no more.In that same section, this is still > the "Rate your plate" advice - and no mention is made > anywhere of different dietary needs for T1 and T2, only of > different insulin and meds needs. How difficult would it be > for them to have seperate sections? That's a question you would have to ask them. They do separate Type 1 and Type 2 on the very first page but obviously they do not see the dietary needs for the two different types the same way as you, and many here, do. Perhaps they will align themselves more to your way of thinking in the future, but that's yet to be seen. > http://www.diabetes.org/all-about-diabetes/chan_eng/i3/i3p3.htm > "Meal Improvement: Rate Your Plate [quoted text clipped - 11 lines] > At least they now add this at the end - but they still want > carbs as a quarter of the plate: Again, they have come up with this plan based on what they, as an organization, feel is good advice. Is it good for you? For me? Maybe not. But for the masses who are much different at managing their diabetes (if they do at all) it is probably a huge step in the right direction for basic nutrition. Is it right to aim for the broadest target and forget those of us on the fringe who really tighten down the screws in our quest to manage this disease? Sorry I ask so many questions that I do not know the answers to. > "Because how much you eat can make a big difference in your > blood sugar level, especially with foods high in > carbohydrate. There's no need to skip these foods -- just > watch those serving sizes!" Many here choose portion control over elimination. Personally, I don't. But that's just me. > Surely the premier diabetes advisory and research > organisation in the world can do better. Maybe they feel this is their best advice to the general diabetes community. My feeling has always been that the ADA site is a good starting point for general information. If someone is going there to get specific diabetes advice for their particular needs then they are making a big mistake. > Here, in full, is their "Carbs count" section. See if you > can find the bit that says to test to find out how much they [quoted text clipped - 6 lines] > potatoes, corn, peas, sweets -- raise your blood sugar > levels the most. > For many people, having 3 or 4 servings of a carb choice at > each meal and 1 or 2 servings at snacks is about right. [quoted text clipped - 31 lines] > Amount to equal 15 grams of carbs > (check the food label) 2 small cookies I see your point and they should probably put more emphasis here on testing to see how the foods affect your numbers. They do discuss that but redundancy here wouldn't hurt. I have been accused in here on more than one occasion of being a cheerleader for the ADA. I do think they have a good general site but I wouldn't shake my pom-poms at them and shout "Give me an A, give me a D...." It's a big organization and they do bear quite a burden since they are, as you say, the premier diabetes advisory and research organization in the world, to offer up to anyone with diabetes a wealth of important and healthy information. I'm sure in some areas they really do come up short. Hopefully there will be more people like you and me who are micromanaging our diabetes to outstanding results that can alert them to how they can do better. Best, Kurt ::: As you probably already know about me, I believe that the ADA has ::: some excellent advice for someone who is new to diabetes. Using [quoted text clipped - 69 lines] : diabetes (if they do at all) it is probably a huge step in the right : direction for basic nutrition. I disagree completely with you. The diabetic masses will never read this. The masses, who have diabetics that is, largely don't get information online. Also, the masses are on pill or insulin mainly due to eating poorly and not following even this advice. The easier thing to do for the masses is to tell them to cut their total carb intake drastically and avoid certain foods. They'll gain control and come off meds (largely, for T2s, anyway). http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3529 Is it right to aim for the broadest : target and forget those of us on the fringe who really tighten down : the screws in our quest to manage this disease? Sorry I ask so many : questions that I do not know the answers to. But that's not what they're doing and what they are doing isn't working. This stupid advise is what's helpong people to kill themselves slowly while raising healthcare costs. :: "Because how much you eat can make a big difference in your :: blood sugar level, especially with foods high in [quoted text clipped - 3 lines] : Many here choose portion control over elimination. Personally, I : don't. But that's just me. The masses will not be able to do portion control. Only a few can truly handle that while eating goodly amounts of carbs. Hence, elimination (though not really elimination because you can eat fibrous veggies) is how carb portion control is handled. :: Surely the premier diabetes advisory and research :: organisation in the world can do better. : : Maybe they feel this is their best advice to the general diabetes : community. Who is they? Obviously, they aren't diabetics who are interested in long life. My feeling has always been that the ADA site is a good : starting point for general information. If someone is going there to : get specific diabetes advice for their particular needs then they are : making a big mistake. There are so many other options that I don't see why anyone needs to go there. I will tel you that the masses aren't. [snip] : I see your point and they should probably put more emphasis here on : testing to see how the foods affect your numbers. They do discuss : that but redundancy here wouldn't hurt. The fact of the matter is that so much testing isn't needed if you don't eat so many carbs (perhaps not true for a T1). One actually gets improved quality of life in that one can maintain health, eat in a normal fashson, and not have to stick so often. For this, one simply has to quit "loving" foods (ie, give up carby foods). : I have been accused in here on more than one occasion of being a : cheerleader for the ADA. I do think they have a good general site but [quoted text clipped - 4 lines] : are, as you say, the premier diabetes advisory and research : organization in the world, So? What that means is they have the potential to do great harm. With masses, the odds will always lean toward doing more harm than good. Hence, what info they dispense is critical. And they fail miserably, IMO. to offer up to anyone with diabetes a : wealth of important and healthy information. "Healthy information"? I'm sure in some areas : they really do come up short. Hopefully there will be more people : like you and me who are micromanaging our diabetes to outstanding : results that can alert them to how they can do better. You really do sound like a poster boy, Kurt. Why? > ::: As you probably already know about me, I believe that the ADA has > ::: some excellent advice for someone who is new to diabetes. Using [quoted text clipped - 71 lines] > > I disagree completely with you. Oh horrors! :) >The diabetic masses will never read this. > The masses, who have diabetics that is, largely don't get information > online. Also, the masses are on pill or insulin mainly due to eating poorly > and not following even this advice. The easier thing to do for the masses > is to tell them to cut their total carb intake drastically and avoid certain > foods. Easier? Don't think so. Who will tell them that? What is your definition of drastically? How will they know which foods to avoid unless they test to find out which foods affect them the most? >They'll gain control and come off meds (largely, for T2s, anyway). What one eats is important, but exercise plays a huge factor with control and management, too. > http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3529 > [quoted text clipped - 4 lines] > > But that's not what they're doing and what they are doing isn't working. How do you know this? Based on what? > This stupid advise is what's helpong people to kill themselves slowly while > raising healthcare costs. Pretty serious charge. So you assume that the people you speak of are following their advice? > :: "Because how much you eat can make a big difference in your > :: blood sugar level, especially with foods high in [quoted text clipped - 5 lines] > > The masses will not be able to do portion control. If they can't do that then they probably won't be able to drastically reduce their carb intake as you suggest. >Only a few can truly > handle that while eating goodly amounts of carbs. Hence, elimination (though > not really elimination because you can eat fibrous veggies) is how carb > portion control is handled. It's an ongoing debate/confusion in here about what a goodly amount of carbs really is. Many here have said they eat a moderate amount of carbs which I've seen the numbers 100-120 as what many consider "moderate." It would help if you assigned some numbers or percentages to your definitions. > :: Surely the premier diabetes advisory and research > :: organisation in the world can do better. [quoted text clipped - 4 lines] > Who is they? Obviously, they aren't diabetics who are interested in long > life. Do you really believe that the leading organization for diabetes isn't interested in helping people with diabetes live a long life? Wow. > My feeling has always been that the ADA site is a good > : starting point for general information. If someone is going there to [quoted text clipped - 3 lines] > There are so many other options that I don't see why anyone needs to go > there. I will tel you that the masses aren't. What are the other options, Roger? If you say their professional medical team I would agree with you. The ADA is a reference site, not a doctor's office. My advice is first and foremost to see and listen to your medical team. If you ever have the time you can take a look at what my personal diabetes "pyramid". This is how I see the pecking order of my diabetes management. (sorry for the long link but someone told me that a tinyurl doesn't archive very well. http://groups.google.com/group/alt.support.diabetes/browse_frm/thread/cfe6aa40bb 39ef23/3a5cf488be40eb76?q=kurt+pyramid&rnum=3#3a5cf488be40eb76 > [snip] > [quoted text clipped - 7 lines] > and not have to stick so often. For this, one simply has to quit "loving" > foods (ie, give up carby foods). Easier said then done and I don't know what most professional medical people would think of your advice to just "give up carby foods." And from what I read here, most still do test quite often. My definition of quite often is 4-8 times a day. > : I have been accused in here on more than one occasion of being a > : cheerleader for the ADA. I do think they have a good general site but [quoted text clipped - 20 lines] > > You really do sound like a poster boy, Kurt. Why? And you sound like you have blinders on and the only way to deal with diabetes is to eliminate all but a few carbs from one's diet. Nowhere do you mention exercise or working with a professional medical team, Roger. Why? Look, we obviously differ in terms of how we feel about treating diabetes. That is one of the good things and bad things about this newsgroup. Some of us get so attached to our methods and opinions that it's hard to see any other way. I do not work for the ADA but I find much good in what they do and what they say. You don't feel that way? Fine. There is room for both of us here. No doubt I will do nothing to change your opinions and I can assure you that you will not change mine. The best we can both do is be honest and truthful with our opinions and smart enough to be clear when communicating to newbies that they are in fact just opinions and we are not doctors. Best, Kurt > It's an ongoing debate/confusion in here about what a goodly amount of > carbs really is. Many here have said they eat a moderate amount of > carbs which I've seen the numbers 100-120 as what many consider > "moderate." It would help if you assigned some numbers or percentages > to your definitions. The best number of carbs is what an individual can handle without raising the bg's significantly at any point after food ingestion. It should be a regimen that provides more than sub optimal nutrition, it should be something a person can live with to prevent failure. And it should be an amount that doesn't put further stress on sick beta cells. It should be something that covers all the above even when sick, injured etc. If one is very active then the basic sick/injured plan can be adapted to cover the extra activity. If the optimally-nutritional, carb-modified diet doesn't allow excellent bg control then it is time to explore more/different exercise and meds. In my opinion no plan should be less than optimal in nutrition. ::::: As you probably already know about me, I believe that the ADA has ::::: some excellent advice for someone who is new to diabetes. Using [quoted text clipped - 86 lines] : will they know which foods to avoid unless they test to find out which : foods affect them the most? Come now...there's plenty of published work on doing this. Where does one start? Dr. Bernstein? Dr. Atkins. Geez... :: They'll gain control and come off meds (largely, for T2s, anyway). : : What one eats is important, but exercise plays a huge factor with : control and management, too. Refer them to the books I've mentioned. There are plenty of others, too. http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=3529 :: Is it right to aim for the broadest ::: target and forget those of us on the fringe who really tighten down [quoted text clipped - 5 lines] : : How do you know this? Based on what? See the link above. :: This stupid advise is what's helpong people to kill themselves :: slowly while raising healthcare costs. : : Pretty serious charge. So you assume that the people you speak of are : following their advice? I remember the advice that was given to me, and the advice that is still given now, the fear of fat, sat or not, and the almost encouraging nature of pushing folks to so-called whole grains, etc. :::: "Because how much you eat can make a big difference in your :::: blood sugar level, especially with foods high in [quoted text clipped - 8 lines] : If they can't do that then they probably won't be able to drastically : reduce their carb intake as you suggest. Wrong. Cutting carbs is the easy path to portion control for many T2s. Not everyone, but many. :: Only a few can truly :: handle that while eating goodly amounts of carbs. Hence, elimination [quoted text clipped - 6 lines] : "moderate." It would help if you assigned some numbers or percentages : to your definitions. My purpose here in this ng is not to set guidelines...there is lots of information available on how to go about this, why must I do so here? You want to protect the ADA by forcing me to tell them exactly what to put on their website when this information is widely available? Should I point out to you that I'm a well-controlled T2 who has used this information? Should I point out to you that I'm no exception (as far as usenet is concerned, that is)? :::: Surely the premier diabetes advisory and research :::: organisation in the world can do better. [quoted text clipped - 7 lines] : Do you really believe that the leading organization for diabetes isn't : interested in helping people with diabetes live a long life? Wow. Yes. For some amazing reason, they have blinders on. :: My feeling has always been that the ADA site is a good ::: starting point for general information. If someone is going there [quoted text clipped - 5 lines] : : What are the other options, Roger? See above, Kurt. If you say their professional : medical team I would agree with you. That could be BIG trouble. That your problem - you just buy the party line hook, line, and SINKER. The ADA is a reference site, not : a doctor's office. My advice is first and foremost to see and listen : to your medical team. There you go with that again...the pat answer, given by those who seek to cover their a.ses rather than pass out useful info. : If you ever have the time you can take a look at what my personal : diabetes "pyramid". This is how I see the pecking order of my : diabetes : management. (sorry for the long link but someone told me that a : tinyurl : doesn't archive very well. I will look, but not tonight. http://groups.google.com/group/alt.support.diabetes/browse_frm/thread/cfe6aa40bb 39ef23/3a5cf488be40eb76?q=kurt+pyramid&rnum=3#3a5cf488be40eb76 :: [snip] :: [quoted text clipped - 12 lines] : from what I read here, most still do test quite often. My definition : of quite often is 4-8 times a day. I don't care what your advice is, or what definitions you use. But most diabetics need to drastically cut carbs and increase exercise. Remember, most of the people are on SAD before getting dx, so even going to 120 g per day is a drastic cut. Think for a moment about people drinking cokes all day, eating junk food, pasta, rice, etc. They are eating excessive carbs in addition to excessive calories. That ADA site recommends bagels, BAGELS. Control is so much easier to achieve is one isn't playing with fire and dancing around the issues. Again, I don't need to state numbers here because there are better places to get such info. ::: I have been accused in here on more than one occasion of being a ::: cheerleader for the ADA. I do think they have a good general site [quoted text clipped - 24 lines] : And you sound like you have blinders on and the only way to deal with : diabetes is to eliminate all but a few carbs from one's diet. Is 40g a day a few carbs? Perhaps it is you who needs to work on definitions. Nowhere : do you mention exercise or working with a professional medical team, : Roger. Why? 1) This info is well known and easy to find (and the ADA could point it out). I don't need to mention it in this post. 2) Professional medical teams can be bad news if the main person - the patient, isn't up on his/her game. Why depend so heavily on others when it is first and foremost, the patients resonsibility? : Look, we obviously differ in terms of how we feel about treating : diabetes. That is one of the good things and bad things about this : newsgroup. Some of us get so attached to our methods and opinions : that : it's hard to see any other way. Hey, I started out as a new T2 working it from their way. I found my way to where I am now. I did the LF thing and followed their recs, but that doesn't mean they aren't poor. Hence, I have both perspectives to work from. Apparently, you only have one. I do not work for the ADA but I find : much good in what they do and what they say. You don't feel that way? : Fine. There is room for both of us here. No doubt I will do nothing : to change your opinions and I can assure you that you will not change : mine. The best we can both do is be honest and truthful with our : opinions and smart enough to be clear when communicating to newbies : that they are in fact just opinions and we are not doctors. So? How many doctors don't have a clue about treating diabetes? Plenty don't. : Best, : Kurt > Come now...there's plenty of published work on doing this. Where does one > start? Dr. Bernstein? Dr. Atkins. Geez... Well, that's where we differ. I've read both of these "commercial" books and wouldn't recommend their advice to anyone I know with diabetes. All in my opinion of course. I don't buy any organization or school of thought "hook, line, and sinker" as you have accused me of. Nor do I dismiss the advice of my endocrinologist because in your opinion he represents "the man." We all have to do what we feel is right and I truly do respect your decision to investigate and follow what you feel is the best way to treat your diabetes. Best, Kurt >> Come now...there's plenty of published work on doing this. Where does one >> start? Dr. Bernstein? Dr. Atkins. Geez... > Well, that's where we differ. I've read both of these "commercial" > books and wouldn't recommend their advice to anyone I know with > diabetes. All in my opinion of course. If I was allowed to keep only one book on diabetes it would be Bernstein's. I found much more helpful advice and explanation there than in any other single source (I'm counting asd as a multiple source :-) I can understand someone preferring another book, but you say you wouldn't recommend it to anyone you know with diabetes. Sounds as though you think it's seriously bad. What do you find so bad about it? SignatureChris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] >Again, they have come up with this plan based on what they, as an >organization, feel is good advice. Is it good for you? For me? Maybe >not. But for the masses who are much different at managing their >diabetes (if they do at all) it is probably a huge step in the right >direction for basic nutrition. Kurt, if I were the friend you've just sent off to a website that caters for the lowest common denominator, I'd be well peeved with you. Nicky. SignatureA1c 10.5/5.4/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg > >Again, they have come up with this plan based on what they, as an > >organization, feel is good advice. Is it good for you? For me? Maybe [quoted text clipped - 4 lines] > Kurt, if I were the friend you've just sent off to a website that caters for > the lowest common denominator, I'd be well peeved with you. Well, I happen to think that the ADA is a good starting point so I owe it to my friend to advise her to go there. I don't think they cater to the lowest common denominator, but they do offer someone who was just diagnosed a place to "begin" to understand this complex disease. Do you remember when you were first diagnosed? I do. Lots of information to try and absorb. My feeling is that it's her doctors job to help her with those first steps. I also worked it out that within 2 days she got in to see my endo who specializes in diabetes. No simple task as he is one of the best and very busy. I'll tell her about this place after she gets in control and has a better understanding about this disease. There is a lot of good information here by people who have had diabetes for many years, but there are also a lot of posts from scammers, spammers, and trolls. She's smart, she'll be able to navigate, but for right now I'm advising her to take it slow and listen to her medical team that she is assembling. I can do that in good conscience and don't think down the road she will be peeved about my initial advice. Best, Kurt >> "Kurt" <kurtwheeling1965@hotmail.com> wrote in message news:1141970438.093490.86920@i40g2000cwc.googlegroups.com... >> >Again, they have come up with this plan based on what they, as an >> >organization, feel is good advice. Is it good for you? For me? >> >Maybe not. But for the masses who are much different at managing >> >their diabetes (if they do at all) it is probably a huge step in >> >the right direction for basic nutrition. >> >> Kurt, if I were the friend you've just sent off to a website that >> caters for the lowest common denominator, I'd be well peeved with >> you. > > Well, I happen to think that the ADA is a good starting point so I owe > it to my friend to advise her to go there. I don't think they cater > to the lowest common denominator, but they do offer someone who was > just diagnosed a place to "begin" to understand this complex disease. > Do you remember when you were first diagnosed? I do. Lots of > information to try and absorb. What if the ADA was the only place that person ended up going to for information? What if they had high bg's and were now sitting around a 7.0-7.5 A1c as a result of eating, let's say the rate-your-plate-regimen? Let's say their doctor looks at their lower A1c and says great! You are doing well. Do you think that person would change anything? After all, a large diabetic association recommends the regimen, the doctor justifies it by the pat on the back but still the patient progresses and gets complications. From personal experience amongst type 2's I know outside of internet, they accept the complications as part and parcel of their condition. They have diabetes and therefore they expect all the complications that go with it because... their doctor said they were doing well, the ADA (and similar organisations) laid out the diet etc. I have no problem telling friends about the ADA and the likes but point out that they need to educate themselves further and adapt diet and exercise to achieve an A1c that gives them a better chance of avoiding complications. A good doctor is not one who pats a person on the back for having sub optimal bg's. But the average new diabetic doesn't know that. > >> "Kurt" <kurtwheeling1965@hotmail.com> wrote in message > >> [quoted text clipped - 29 lines] > What if the ADA was the only place that person ended up > going to for information? Why would that be the only place they go? If they were diagnosed by a doctor they would (or should at least) be given some basic information. When I was diagnosed I was told about a number of diabetes programs and encouraged by my doctor to enroll in them as well as read, read, read. But hypothetically, let's say someone is diagnosed and left on their own and went only to the ADA site. I still contend there is some very good basic information there. If they are online they would also have the ability to google a lot of information, especially the other major diabetes organizations such as Joslin. >What if they had high bg's and > were now sitting around a 7.0-7.5 A1c as a result of eating, > let's say the rate-your-plate-regimen? It would probably be an improvement, but not in keeping with the recommendations on the site. The ADA advises: "The better your glucose control, the less likely you are to develop complications of diabetes. An A1C in the sevens (7s), however, does not represent good control. The ADA goal is less than 7 percent. The closer your A1C is to the normal range (less than 6 percent), the lower your chances of complications. However, you increase your risk of hypoglycemia, especially if you have type 1 diabetes. Talk with your health care provider about the best goal for you." >Let's say their > doctor looks at their lower A1c and says great! You are > doing well. Do you think that person would change anything? I can't speak for doctors that would settle for 7.5% being a good thing. No doubt there are some that think it is, but it's not in keeping with what the ADA advises. > After all, a large diabetic association recommends the > regimen, the doctor justifies it by the pat on the back but > still the patient progresses and gets complications > From personal experience amongst type 2's I know outside of > internet, they accept the complications as part and parcel > of their condition. That's unfortunate, but like with most diseases there are far too many that just ignore their condition and consider failure as inevitable. ASD is filled with those who don't feel that way. >They have diabetes and therefore they > expect all the complications that go with it because... > their doctor said they were doing well, the ADA (and similar > organisations) laid out the diet etc. That's your feeling, but let me ask you this: If someone with diabetes is willing to just get all their health care needs from the ADA site and chooses to ignore the goals the ADA sets and their advice to work with a doctor, dietician, and exercise...do you think they are really going to follow the diet on the site? My feeling is they would not. If they had the kind of discipline to change their woe they would, like you and so many others here do, go in search of finding out exactly what they need to do to achieve the best health possible. > I have no problem telling friends about the ADA and the > likes but point out that they need to educate themselves > further and adapt diet and exercise to achieve an A1c that > gives them a better chance of avoiding complications. Excellent advice and that is also what I did when I talked to my newly diagnosed friend. >A > good doctor is not one who pats a person on the back for > having sub optimal bg's. But the average new diabetic > doesn't know that. Agreed. And I don't doubt for a minute that there are many GP's who miss the boat with their advice because diabetes is not their speciality and they are not up on the most current thinking. The average new diabetic, IMO, is not like the people in here. And there's the rub. Many doctors complain that they have a hard time getting their patients to follow their instructions and advice. Not just in diabetes, but with health in general. How many people are obese yet will do nothing about it? How many people smoke and even though they know that it is killing them, refuse to quit smoking? How many sedentary people know they should do some kind of exercise but it's just too inconvenient? And on and on... I'm not defending doctors who settle for less than perfect, but do we put the burden of that soley on them? Maybe doctors need to be trained more in "tough love"...but how heavy handed can they be without totally alienating their patient? We have had this "discussion" about the ADA in here many many times and I keep seeing the same arguments on either side. Probably a good reason for that as there are two sides to most issues. I'd like to end this post with a question to you, Ozgirl, before I use up all the available bandwith on Usenet :) Would you recommend this newsgroup to someone who just found out they had diabetes on the first day of their diagnosis? Best, Kurt > I'd like to end this post with a question to you, Ozgirl, before I use > up all the available bandwith on Usenet :) Would you recommend this > newsgroup to someone who just found out they had diabetes on the first > day of their diagnosis? Absolutely. Birds of a feather stick together and all that. The friends I associate with are similar people to me. They are tough-skinned, they can discern, they have similar sense of humour etc. If the person was not a friend I would still recommend it but tell them that it's not alt.support.huggies andkissies and to expect to find good and bad, politeness and rudeness etc. But some damn good information :) I don't think you can beat the immediacy of usenet, chat rooms etc when you need to know something now. You can learn in a few hours of back and forthing what might take you a month to find out from your doctor. What about the person who accidentally takes a hefty dose of short acting insulin at bedtime instead of long acting. I've seen it happen, I've seen that person talked through the "incident" and then off to bed. It doesn't replace ringing the emergency room but the advice can be just as quickly obtained. Someone wants some examples of filling but low carb snacks. Why wait weeks for the dietician when you are hungry (but unsure) right now? Having seen Jennifer's advice I wish that had been the first thing I saw for diabetes management. > > I'd like to end this post with a question to you, Ozgirl, > before I use [quoted text clipped - 26 lines] > unsure) right now? Having seen Jennifer's advice I wish that > had been the first thing I saw for diabetes management. Thanks for your well worded answer. Personally I would never recommend this newsgroup to someone until they first spent some time under the guidance of their doctor and doing some exploratory searching on their own, at their own pace. This place is a good source of lots of information, but it is unfiltered and presented without knowing the person's needs who is on the receiving end of it or the credentials of the person giving it. Someone who is confused about diabetes and newly diagnosed will not know the good information from the bad at first. It's a virtual Tower of Babel in here with many loud voices who have found what works for them and believing that is the only way. Yes there is the obligatory YMMV tacked on, but it is often times preached from a bully pulpit. Does that mean the reader has to buy it? Of course not. I wouldn't have wanted to come here when I was first diagnosed because not only did I not have all the answers like some here seem to proclaim, I didn't even have the mindset to ask the right questions. The one good thing about this disease is that you don't have to know everything on the first day of diagnosis. Advice here can be helpful but it also could be misleading and dangerous. Your example about someone who took a hefty dose of short acting insulin by mistake and came here to find out what to do is frightening to me. The first call should be to their doctor, the second to the emergency room. Coming to an unmoderated newsgroup filled with lots of strangers with no medical credentials is no place to get advice about insulin dosages when time is of the essence. By the time they got a response they might already be in severe hypo land. I'm sure it's happened here and luckily, as you report, the person got good information. But what if the first person to answer him or her was one of our resident nutjobs and gave them bad info? Now, after someone has had time to work with their doctor and do some searching at their own pace, then I would have no problem sending them here. But, selfishly, I would have them read what I wrote and is posted on the ASD site, right after they read Jennifer's advice. http://www.alt-support-diabetes.org/kurt.htm Like I said, after my friend gets her bearings I will send her this way. I'm sure she will benefit from the diversity of opinions and advice. Like you, I too hang with birds of my feather. She's an actress who once played someone with diabetes on TV...and ironically is now one. :( Best, Kurt > Personally I would never recommend this newsgroup to someone until they > first spent some time under the guidance of their doctor and doing some [quoted text clipped - 11 lines] > some here seem to proclaim, I didn't even have the mindset to ask the > right questions. I've heard people chatting about their disorders in bus queues, in supermarkets, cafes, and pubs. I've heard some incredibly stupid and ignorant advice being given, and in some cases, gratefully received. It seems to me that the problem of being given bad medical advice by a friend, relative, or shop assistant, is both very much more widespread and more serious than getting it from a newsgroup. What do you think should be done about that problem? SignatureChris Malcolm cam@infirmatics.ed.ac.uk +44 (0)131 651 3445 DoD #205 IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK [http://www.dai.ed.ac.uk/homes/cam/] >> Personally I would never recommend this newsgroup to someone until >> they first spent some time under the guidance of their doctor and >> doing some exploratory searching on their own, at their own pace. >> This place is a good source of lots of information, but it is >> unfiltered and presented without knowing the person's needs who is >> on the receiving end of it or the credentials of the person giving >> it. Someone who is confused about diabetes and newly diagnosed will >> not know the good information from the bad at first. It's a virtual >> Tower of Babel in here with many loud voices who have found what >> works for them and believing that is the only way. Yes there is the >> obligatory YMMV tacked on, but it is often times preached from a >> bully pulpit. Does that mean the reader has to buy it? Of course >> not. I wouldn't have wanted to come here when I was first diagnosed >> because not only did I not have all the answers like some here seem >> to proclaim, I didn't even have the mindset to ask the right >> questions. > [quoted text clipped - 6 lines] > > What do you think should be done about that problem? Go to the ADA and have the bad advice justified? Hearing it from so called authoritarians makes the advice seem better to a lot of people. As you said, there are many instances of people chatting to each other about their diabetes and treatments. I had this loud mouthed, obese man come up to me in a Chinese restaurant a few years ago. He was sitting at his table at first with what looked like his two young adult children. He was calling out "I am excited!" about once a minute while looking around the room - the young ones looked highly embarrassed. Then he wandered around from table to table chatting. When he reached mine, he said, "I am a diabetic!". I said what a coincidence, so am I. We got chatting about treatments, diet etc and he walked away a subdued man. I felt sorry for bursting his bubble but he said I gave him food for thought. At the end of his meal he held up his boiled rice bowl to show me he hadn't touched it, then smiled. i didn't snip because you had too many points to be brought out i was one of those people who followed (like a lamb) the advice of my nutritionist and the CDA (Canadian) for what to eat.... the CONCEPT of eating lower carbs didn't EVEN DAWN on me until i read of it in these newsgroups (mhd and asd)........... now, i didn't agree with ultra low carb, but i have cut my carbs to 100 gms a day, and i'm doing a lot better for that decision .......... so, in short, to answer your last question, i sure wish that when i was a newbie that there WAS this newsgroup to come to, to learn about how different people manage their diabetes, and to take what fit for me from those experiences and use that information to manage my diabetes kate type 1 18 years (now reusing her needles and her lancet too ! ! ! ) SignatureJoin us in the Diabetic-Talk Chatroom on UnderNet /server irc.undernet.org --- /join #Diabetic-Talk More info: http://www.diabetic-talk.org/ http://www.diabetic-talk.org/freeveggies.htm I have no medical qualifications beyond my own experience. Choose your advisers carefully, because experience can be an expensive teacher. "Kurt" <.com> wrote in message googlegroups.com... > > > >> "Kurt" <kurtwheeling1965@hotmail.com> wrote in message news:1141970438.093490.86920@i40g2000cwc.googlegroups.com... > > >> >Again, they have come up with this plan based on what > > they, as an [quoted text clipped - 129 lines] > Best, > Kurt > I'd like to end this post with a question to you, Ozgirl, before I use > up all the available bandwith on Usenet :) Would you recommend this > newsgroup to someone who just found out they had diabetes on the first > day of their diagnosis? Are you kidding? - OF COURSE! Nicky. SignatureA1c 10.5/5.4/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg : > On 9 Mar 2006 15:59:22 -0800, "Kurt" : > >- You can still eat the foods you love. [quoted text clipped - 16 lines] : > : > I'm underwhelmed I'm afraid. : Don't be afraid. :) : > It's a start, no more.In that same section, this is still : > the "Rate your plate" advice - and no mention is made : > anywhere of different dietary needs for T1 and T2, only of : > different insulin and meds needs. How difficult would it be : > for them to have seperate sections? : That's a question you would have to ask them. They do separate Type 1 : and Type 2 on the very first page but obviously they do not see the : dietary needs for the two different types the same way as you, and many : here, do. Perhaps they will align themselves more to your way of : thinking in the future, but that's yet to be seen. : > At least they now add this at the end - but they still want : > carbs as a quarter of the plate: : Again, they have come up with this plan based on what they, as an : organization, feel is good advice. Is it good for you? For me? Maybe [quoted text clipped - 4 lines] : screws in our quest to manage this disease? Sorry I ask so many : questions that I do not know the answers to. : > "Because how much you eat can make a big difference in your : > blood sugar level, especially with foods high in : > carbohydrate. There's no need to skip these foods -- just : > watch those serving sizes!" : Many here choose portion control over elimination. Personally, I : don't. But that's just me. : > Surely the premier diabetes advisory and research : > organisation in the world can do better. : Maybe they feel this is their best advice to the general diabetes : community. My feeling has always been that the ADA site is a good : starting point for general information. If someone is going there to : get specific diabetes advice for their particular needs then they are : making a big mistake. : > For many people, having 3 or 4 servings of a carb choice at : > each meal and 1 or 2 servings at snacks is about right. [quoted text clipped - 17 lines] : > carbs) with meat, salsa, lettuce, and chopped tomato 1/3 cup : > of rice (1 carb) : I see your point and they should probably put more emphasis here on : testing to see how the foods affect your numbers. They do discuss that : but redundancy here wouldn't hurt. : I have been accused in here on more than one occasion of being a : cheerleader for the ADA. I do think they have a good general site but : I wouldn't shake my pom-poms at them and shout "Give me an A, give me a : D...." : It's a big organization and they do bear quite a burden since they are, : as you say, the premier diabetes advisory and research organization in [quoted text clipped - 3 lines] : micromanaging our diabetes to outstanding results that can alert them : to how they can do better. : Best, : Kurt Ihave sniped much of Alan's quotes of lists, etc, for brevity. After reading the series in the NY Times a few weeks ago , aobut the epidemic of type2 diabetes tht is mostly incontrolled going on in my fair city, I can see teh ADA's point. Many peole just don't want to give up their usual eating patterns adn favorite foods adn will just not make any changes if they think it must be all or nothing, even knowing, form horrible example, what diabetes cn do to you. The kind of gentle approach, like "rate your plate" gives soemthing easy adn lets eole still eat some of their favorite strches, but in a limited quantity. It also helps those cooking for a family to be able to eat teh same fods as the family but with a different balance of the foods. ( I did something like that when I was first diagnosed and ws loosing 60 lbs and bringing my bgs back to normal. Of course, I ws not serving fods with heavy sauces, lots of butter, etc adn we ate light desserts like a piece of fruit or aslice of melon. For many peole out there, a simple, not as demanding set of regularions will still be a challange, but one they can meet. If we were to throw jennifer's advice at them or demand either a more rigin eating pattern or lower carbs, we would loose them entirely. Better try to get the masses of diabetics into better control than make them feel it is just all too much and letting all control go. Most ADA advice is not for us, who want to take stronger control over out disease, but , as Kurt says,, it is god for beginners and for resistant folk who are afraid they will have to give up everything they like. As many poor folk seem to be in high risk groupw, either from diet or ethnicity, lets let them get some control, easily, and without scaring them away. I thik hthat may be a great deal of what is behind the ADA recommendations. I srill see no reason why they can't separate type1 and type 2 diet recommendations. Wendy On Fri, 10 Mar 2006 07:52:18 +1100, Alan S <loralweightandcarbs@optusnet.com.au> Huffed and Puffed the following into the madness of usenet: >>The ADA is only just beginning to change >>it's literature on lowering carb consumption [quoted text clipped - 9 lines] >Cheers, Alan, T2, Australia. >d&e, metformin 2x500mg Well at least via educators. SignatureMâck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o ô) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins Jesus never hated anyone. > That's actually more info. Still, I don't see why one couldn't do > essentially the same thing with smaller doses of insulin and carbs. I don't > claim to understand T1s, though. First, there would still be the problem, without meters, of balancing one against the other. Second, for a type 1, the glucose from protein also must be countered with insulin, unlike us type 2s, who show no rise from it. Susan :: x-no-archive: yes :: [quoted text clipped - 8 lines] :: protein also must be countered with insulin, unlike us type 2s, who :: show no rise from it. Absolutely. But it still seems, from an engineering standpoint, that using less of both is better. I guess those in the medical profession don't (or didn't) view things that way. > Absolutely. But it still seems, from an engineering standpoint, that using > less of both is better. I guess those in the medical profession don't (or > didn't) view things that way. I don't disagree, but that is kind of tangential to what Jenny's point was. Susan :: x-no-archive: yes :: [quoted text clipped - 6 lines] :: I don't disagree, but that is kind of tangential to what Jenny's :: point was. Well, I didn't take exception to her point, I was trying to understand its origins. Thought a history of glucose meters might interest those in this discussion. It's facinating! http://www.mendosa.com/history.htm Jennifer > Thought a history of glucose meters might interest those in this > discussion. > > It's facinating! > > http://www.mendosa.com/history.htm It certainly is! Thanks for posting the link. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control > Thought a history of glucose meters might interest those in this > discussion. [quoted text clipped - 4 lines] > > Jennifer I don't know about that guy. He thinks Lifescan meters aren't accurate. Dave >> Thought a history of glucose meters might interest those in this >> discussion. [quoted text clipped - 8 lines] > >Dave Let me put it this way Dave. Let's hold a poll. Tick the appropriate box: Which David do you trust most for advice on diabetes: o A. David <David@invalid.com> o B. David www.mendosa.com/ Would you like to put that to the test? Incidentally, I'm not denigrating your knowledge on pumping, insulin etc - just implying that he has a wider range of diabetes knowledge. Nobody's perfect. But on the list of those I'd trust for diabetes information David Mendosa is up there in the top ten, with people like Edward Reid, Charly Coughran, Jim Hartman, Quentin Grady, Gretchen Becker and a very few others. And, as far as I know, he's not a doctor either; nor are Gretchen or Quentin. I don't know about the others. Cheers, Alan, T2, Australia. d&e, metformin 2x500mg SignatureEverything in Moderation - Except Laughter. >Thought a history of glucose meters might interest those in this >discussion. [quoted text clipped - 4 lines] > >Jennifer My favourite quote from his interview with Suther: "I think she has passed on now, she was 99 when I met her, in the '60s," If she hasn't - I want to know what she eats:-) Cheers, Alan, T2, Australia. d&e, metformin 2x500mg SignatureEverything in Moderation - Except Laughter. >:: x-no-archive: yes >:: [quoted text clipped - 12 lines] >less of both is better. I guess those in the medical profession don't (or >didn't) view things that way. And still don't - mainly because less of both must mean more fat proportionally. Cheers, Alan, T2, Australia. d&e, metformin 2x500mg SignatureEverything in Moderation - Except Laughter. :: On Thu, 9 Mar 2006 11:34:16 -0500, "Roger Zoul" :: <rogerzoul2@hotmail.com> wrote: [quoted text clipped - 17 lines] :: And still don't - mainly because less of both must mean more :: fat proportionally. Yep, there's that too! > :: MaryL wrote: > :: Wow! Talk about bad advice. For example, I found this advice [quoted text clipped - 9 lines] > I don't see why that was excellent advice in 1972 for a T1. Explain, > please? Roger, Well, if you are injecting a large dose of insulin once a day--an insulin which is a mix of long and short acting insulins--and have no way of measuring your blood sugar, there is always the danger of hypos unless you keep pouring a steady stream of carbohydrate down the hatch to mop up the large amounts of injected insulin. Don't forget that this was long before DCCT and its then radical idea that Type 1s would avoid complications by keeping their A1cs below 8%. That was a radical idea when it emerged, and it only became mainstream after many years of study showed a profound difference in the complications between those who kept their blood sugars lower and those who didn't. But the ability to do that was only made possible by the advent of home blood sugar meters. I think that happened sometime in the 80s. I know that I saw my first blood sugar meter in the labor suite during my second gestational diabetes pregnancy in 1985 when the nurse kept coming by and sticking me with a huge, painful lancet to get blood for one. It never occurred to me this was something you could have at home and use to check your blood and my doctor certainly never mentioned you could do this. --Jenny http://www.phlaunt.com/diabetes Diabetes Info http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood Sugar Under Control :: Roger Zoul wrote: ::: Jenny wrote: [quoted text clipped - 19 lines] :: hypos unless you keep pouring a steady stream of carbohydrate down :: the hatch to mop up the large amounts of injected insulin. Well, that makes more sense. I realize that life is a lot different for a t1 than a t2, but it still seems that *not* eating all of those carbs and *not* having to use a large dose of insulin would be better than doing so. I suppose a t1 might still need insulin even if not eating carbs, but isn't even a small dose better than a large one? You still have some amount of long/slow acting insulin, right? Also, will a t1 still need a lose dose of insulin even if eating very little carbs? :: Don't forget that this was long before DCCT and its then radical idea :: that Type 1s would avoid complications by keeping their A1cs below [quoted text clipped - 3 lines] :: and those who didn't. But the ability to do that was only made :: possible by the advent of home blood sugar meters. Interesting. :: I think that happened sometime in the 80s. I know that I saw my first :: blood sugar meter in the labor suite during my second gestational [quoted text clipped - 3 lines] :: use to check your blood and my doctor certainly never mentioned you :: could do this. Thanks. :: --Jenny :: :: http://www.phlaunt.com/diabetes Diabetes Info :: :: http://www.alt-support-diabetes.org/newlydiagnosed.htm Get Your Blood :: Sugar Under Control >I realize that life is a lot different for a t1 than a t2, but it still >seems that *not* eating all of those carbs and *not* having to use a large [quoted text clipped - 3 lines] >right? Also, will a t1 still need a low dose of insulin even if eating >very little carbs? To answer your last question, yes. Remember, Type 1's don't make any insulin, and a certain amount is required for basal metabolism. Before the basal/bolus regimen (Lantus/Humalog etc.), all we had were insulins that had "peaks." Therefore, we had to time our food to coincide with these insulin peaks. It was easy to get into a pattern of "feeding the insulin" and as a result, gaining weight. :: On Wed, 8 Mar 2006 20:17:38 -0500, "Roger Zoul" :: <rogerzoul2@hotmail.com> wrote: [quoted text clipped - 9 lines] :: To answer your last question, yes. Remember, Type 1's don't make any :: insulin, and a certain amount is required for basal metabolism. BTW, that last sentence should have read: "Also, will a t1 still need a high dose of insulin even if eating very little carbs?" I think you got that, though. :) :: Before the basal/bolus regimen (Lantus/Humalog etc.), all we had were :: insulins that had "peaks." Therefore, we had to time our food to :: coincide with these insulin peaks. It was easy to get into a pattern :: of "feeding the insulin" and as a result, gaining weight. Very interesting. Thanks. On Wed, 8 Mar 2006 20:17:38 -0500, "Roger Zoul" <rogerzoul2@hotmail.com> Huffed and Puffed the following into the madness of usenet: >I realize that life is a lot different for a t1 than a t2, but it still >seems that *not* eating all of those carbs and *not* having to use a large [quoted text clipped - 3 lines] >right? Also, will a t1 still need a lose dose of insulin even if eating >very little carbs? If a type 1 does not inject insulin at all, in a couple of days they will suffer severe DKA, coma and death. The human body is ALWAYS in need of some background insulin. Hence a type 1 taking injections uses 2 types long acting and short acting. Long acting insulins are meant to cover the bodies needs between meals including that time you are asleep. short acting is for meals and corrections. SignatureMâck©® Deltec CoZmore Pumper Type 1 since 1975 http://www.alt-support-diabetes.org http://www.diabetic-talk.org http://www.insulin-pumpers.org "To announce that there must be no criticism of the President, or that we are to stand by the President right or wrong, is not only unpatriotic and servile, but is morally treasonable to the American public." ...Theodore Roosevelt (o ô) --ooO-(_)-Ooo-------------------- "I don't know half of you half as well as I should like; and I like less than half of you half as well as you deserve." ....Bilbo Baggins Jesus never hated anyone. :: On Wed, 8 Mar 2006 20:17:38 -0500, "Roger Zoul" :: <rogerzoul2@hotmail.com> Huffed and Puffed the following into the [quoted text clipped - 14 lines] :: meant to cover the bodies needs between meals including that time you :: are asleep. short acting is for meals and corrections. Thanks for the info. Yes, I do get that T1s need to get insulin and even a diet low in carbs would still end up with glucose in the blood. I was just wondering about the large dose to cover large carb loads, that's all. It's still an academic issue for me, as I'm a t2 with good control. >:: On Wed, 8 Mar 2006 20:17:38 -0500, "Roger Zoul" >:: <rogerzoul2@hotmail.com> Huffed and Puffed the following into the [quoted text clipped - 14 lines] >:: meant to cover the bodies needs between meals including that time >:: you are asleep. short acting is for meals and corrections. > Thanks for the info. Yes, I do get that T1s need to get insulin and > even a diet low in carbs would still end up with glucose in the > blood. I was just wondering about the large dose to cover large carb > loads, that's all. It's still an academic issue for me, as I'm a t2 > with good control. I am not aware that the average type 1 takes large amounts of insulin. Nowhere near what an insulin resistant type 2 needs. :: Roger Zoul wrote: ::: Ma¢k wrote: [quoted text clipped - 28 lines] :: of insulin. Nowhere near what an insulin resistant type 2 :: needs. The "large" comment was in reference to what the recommended practice was before BG meters became a common tool for every diabetic. I think it largely doesn't apply now, though I do hear of diabetics eating carby foods and compensating for it with more insulin. |
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