Hey Sax,

There are some important goals that you should strive for if you really
want to live a normal life with little or no complications.

First, the normal glucose level should range between 80-120. This is
especially true for a fasting blood sugar. When you check you BG 2
hours after you eat, you should try to keep it below 160. If you see it
rise above 180, then you should eat fewer carbohydrates or increase
your insulin 1 unit at a time until this measurement is at 160 or
below.

Second, one of the most important things that health care professionals
seldom tell you is that you need to develop exercise lifestyle that
consist of a daily routine. If you really want to maintain great
control, you should most likely exercise 5 or 6 days every week. By
exercise, I mean that you want to engage in some kind of aerobic
exercise that will really get your heart really pumping for the whold
time. A lot of excercise may increase the number of low blood sugars,
but that is to be expected.

Third, you really should check you blood sugar before and after every
meal and check it in the middle of your exercise routine to help you
learn to recognize hypoglycemia. Of course any time that your blood
sugar drops below 70, you will need to eat the equivalent of 15-20
grams of sugar and then continue with your exercise routine.

Fourth, make sure that your doctor will allow you to check your
hemoglobin A1c every three months. This lab test should always be less
than 7%; the A1c is a test that will tell you how well you have
controlled your diabetes during the last 3 months. All well informed
professions agree that maintaining an A1c less than 7% will most likely
ensure that you will not develop the complication during your lifetime.

There is no simple set of rules that will work for all diabetics. The
best course of action is to learn how your body handles different types
of food; how it responds to the insulin your take; how you diabetes
responds to exercise + food + insulin. Everything that you do in life
will impact your disease.

Remember that every 3 minutes somebody in American dies from the
complications of diabetes. Take care of yourself, and you will not
become one of these statistics.

Hope this helps.

Diabetic

Read this:
http://www.alt-support-diabetes.org/NewlyDiagnosed.htm

Cheers, Alan, T2, Australia.
d&e, metformin 2x500mg

Saxology wrote in message
<9NNQf.3086$sL2.1431@newsread2.news.atl.earthlink.net>...

  Some more on Diabetic Complications:

1.   One of the often seen effects  (complications ? ? ) of Type 2 diabetes
is premature heart attack.   You didn't mention setting a "goal" for
reducing the Insulin Resistance which is associated with that high risk,
nor a goal for controlling the all too common "lousy lipids"  which usually
accompany Type 2 diabetes.

One could argue that premature heart attack ought to be your #1 concern.
Gruesome as it sounds,   dropping dead of a heart attack after 5 years is a
much worse effect than peripheral neuropathy at 10 years.     Don't panic.
"Often seen" is not the same as "Invariable" but we have no idea of what
your risk level is (which is why I bring up the question.)

Some lipid targets:

      Total Cholesterol/HDL Ratio  <  4
       LDL/HDL ratio < 3
       Triglycerides/HDL ratio < 3

Some hints:

     High HDL is a lifesaver.   One of the best techniques for long life is
picking grandparents with high HDL.

     High Insulin Resistance tends to produce high triglycerides and low
HDL.

     In folks with high Insulin Resistance,   a high carb diet produces
high triglycerides.

    Exercise helps raise HDL.    Daily is best.   Vigorous is best.

2.  Another common effect of Type 2 Diabetes is a steady loss of beta cell
capacity.    In fact,  that's how you were dragged into our Club.
Statistically,   the odds are that you have lost about 50% of your beta cell
capacity and will continue to lose more capacity as the years pass.    That
all too common steady loss means that bG control will become more and more
difficult until multiple daily injections of insulin  (MDI)  become
inevitable.    One could argue that taking steps to fight that loss of beta
cells ought to be your #2 goal.

You fight that loss by:

 a.  Giving the beta cells as much "rest" as possible

      i.   Low carb diet
     ii.   Reduce your Insulin Resistance
    iii.   Use supplemental insulin  (not MDI,  just supplemental)
     iv.  Avoid beta cell stimulators like Sulfonylureas or Meglitinides

 b.  Reducing your production of Free Fatty Acids  (which attack beta
cells)

       i.  Low carb diet
     ii.   Reduce your Insulin Resistance
    iii.   Lose abdominal fat

If you ponder Goals #1 and #2 a bit,  you'll notice that every weapon you
use in that fight will also knock down bG.

On Blood sugar control:

 ". . . And, one more stupid thing, my FBG is dependent upon how hungry I
am.  I can be 95 at 7am and be at 105 by 9 am if I didn't eat anything.  So,
what is the fasting all about anyway. . ."

FbG is controlled by morning hormone effects which prompt your liver to
release glucose and by the balance between your level of Insulin Resistance
and your reduced ability to produce insulin in order to handle the
hormone-induced glucose releases.    Mine is fierce and lasts from 4 a.m to
about 10:30 a.m.    See "Dawn Effect"   "Morning Effect".

" . . .I am worried that having FBG of 80 could mean that I hit a number
like 60 if I try to get my numbers too low. . ."

Both FbG (60 and 80) are considered "normal" in non-diabetics   though 60 is
much less common.    In any case,  you can't force your FbG much below 80
unless you supplement your natural morning insulin supplies somehow.   That
means using one of the beta stimulator pills or an insulin injection at
bedtime.

Some remarks:

  a.  "You have to eat to stop that rise".    Yes,  but you don't have to
eat carb.

  b.   You can also slow or stop that rise via a small shot of rapid
insulin  (Insulin R,  Novolog,  Humalog) as soon as you wake up.    Novolog
or Humalog will work better than Insulin R.    However, note that an
increase form 95 to 105 over 2 hr is not considered a "rise" by most of us.
I have seen a 100 go to 150 and even 200 in that situation.

  c.   If you wish to control pure FbG (immediately upon awakening bG) via
insulin injection,  you must use long-lasting insulin the night before.
Some examples:   NPH,  Lantus,  Levemir.   I suspect that you don't have any
of these in your refrigerator.

  d.  Of course,  the most healthful way of controlling FbG is to reduce
your Insulin Resistance.   That gives your weakened beta cells a fighting
chance to knock your FbG down into the 80-90 range that normal beta cells
"aim for".

  e.  I interpret the wording of your post to mean that you only inject
insulin at 2 hours after a meal if your bG is too high.    Using that tool,
a  "Corrective Bolus",  is a  fine idea.   However, note that many T2 using
insulin will check their before-meal bG and if too high,  inject before the
meal so they don't spike to 200 after the meal.

". . .Goal #1: . . . .avoid the needle. . ."

Folks dragged into our Club should note that insulin is the 800-lb gorilla
of bG control.   It always works.   It can be the diabetic's best friend.
Don't ever avoid turning to it in need.

Stress or illness can double your insulin needs and for many/ most T2,
insulin is the only reliable technique for bG control in those
circumstances.     e.g.   I had major surgery in November.   I peaked at 300
mg/dL in the operating room (surgery is stress).    They gave me insulin and
"knocked it down" to 268.   (Whoopee)   It took me 4 hours of aggressive,
self-directed insulin use to knock my bG down into normal ranges.

My neighbor down the street had major surgery 3 days earlier.    He spent a
whole week mostly above 200 because the dingbats wouldn't use aggressive
insulin therapy on him.

Regards
 Old Al

This seems to be a VERY retroactive "approach" (in inverted comma's because
it's not so much an approach as a "drive-by"). We need to use a very
PROactive approach for good BG control.

You should test BEFORE you eat (anything) and inject before you eat, or at
least immediately after you've eaten. Not at the 2 hours post meal mark.
You're WAY too late with the insulin if that's when you're shooting the
stuff in. Of course, you SHOULD test at the 2 hour point, but that's more a
check to see that you got your dose/food ratio correct. If you're high at
the 2 hour mark, then for sure an injection is useful, but it should only
need to be a small one and next time you eat you should use slightly more
insulin or eat slightly less food.

Of course, this is very tedious and not strictly 100% accurate, but it's the
best we can do. Test, eat, inject, test at 2 hours, adjust. Eventually it
all becomes 2nd nature and requires little thinking aobut.

Sax. my goals are between 75 and under 120 at two hours post prandial.

I test when I wake up and then two hours after breakfast and before
lunch and two hours after lunch and the same for dinner.

As a newby, you might want to test at the one hour period also to see if
your numbers are under 140.  

over 160 is when complications set in.  They have yet full discovered if
a quick spike that goes right down does any damage.  At least that is
what my endo calls me.

Every three months your doctor will want an A1c test to see how you have
done.  Ideally, an a1c under 6 is in a non diabetic stage.  under 5.5 is
even better.  

You have only been at this for seven weeks.  It takes time to get into
control.  It is life changing.

Are you seeing an endo.or a gp

Diabetes is a work in progress .  You might find that once you are in
control, you wll say you have never felt better or been healthier. odd
as that may sound.

Loretta

--
In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled with strife and
terrorism.

You've gotten a lot of very good answers here, so I'll just add one
point worth keeping in mind.

The reason many of us focus on the post-meal number rather than the
fasting number, is that it is by lowering the post-meal number that many
of us are able to lower the fasting number.

When you have high post-meal blood sugars, your beta cells exhaust
themselves pumping out what insulin they can make to bring them back
down. This means they don't have much capacity left to take care of the
background "basal" blood sugar level.

Taking the stress off by avoiding stress allows the insulin you still
make to address the background level.

If you normalize your post meal numbers for a while and still can't get
into a normal range with your fasting blood sugar that is a good sign
that your beta cells are in very rough shape and may need some outside
help.

Quite a lot of recently diagnosed Type 2s are able to get back into the
entirely normal range just by cutting carbs down to where they don't
cause spikes.