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Medical Forum / Diseases and Disorders / Diabetes / January 2008

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Confused. Is there a doctor in the house?

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Andy <q> - 06 Jan 2008 14:53 GMT
I've had an interesting breakfast reading today.

Someone explain?

Pre-Meal: 105 mg/dl (6:31AM)

9 oz. (cooked) marinated flank steak. So I paid the sat. fat and
cholesterol taxes!!!

After-Meal (1 hour) 91 mg/dl (8:31AM)
After-meal (2 hours) 93 mg/dl (9:32AM)

My 14 day average 115

Am I pre-diabetic or type II?

One thing is I stopped eating whole grain whole wheat bread. Doc said eat
whole grain carbs. Brown not white. Is this what's making the difference?

So is this low carb garb for real?

Am I pre-diabetes or for real type II?

Confused,

Andy

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ray - 06 Jan 2008 15:47 GMT
> I've had an interesting breakfast reading today.
>
[quoted text clipped - 11 lines]
>
> Am I pre-diabetic or type II?

Does it matter what it's called? It would appear that you might have an
insulin resistance problem.

> One thing is I stopped eating whole grain whole wheat bread. Doc said eat
> whole grain carbs. Brown not white. Is this what's making the difference?

The only bread I touch is Oroweat Double Fibre - significantly less net
carbs. I also find low carb tortillas now.

> So is this low carb garb for real?

It works quite well for a number of us. It seems that with insulin
resistance there are often three solutions that work: diet, exercise, oral
medication. It usually (but not always) requires at least two of those,
sometimes all three. I'd suggest you also start an exercise regimen if you
haven't already.

> Am I pre-diabetes or for real type II?

What's in a name? Have you talked with your doc?

> Confused,
>
> Andy
Susan - 06 Jan 2008 16:57 GMT
> I've had an interesting breakfast reading today.
>
[quoted text clipped - 4 lines]
> 9 oz. (cooked) marinated flank steak. So I paid the sat. fat and
> cholesterol taxes!!!

Not with flank steak, you didn't; it's extremely lean.

> After-Meal (1 hour) 91 mg/dl (8:31AM)
> After-meal (2 hours) 93 mg/dl (9:32AM)
[quoted text clipped - 13 lines]
>
> Andy

Andy, you're a for real type two, who can eat protein and fat with
veggies, not starches, and stay in non diabetic, undamaging numbers.

You're still DM because if you eat the bread, you'll still go high.

Susan
Andy <q> - 06 Jan 2008 17:39 GMT
Susan said...

> Andy, you're a for real type two, who can eat protein and fat with
> veggies, not starches, and stay in non diabetic, undamaging numbers.

Susan,

Doc never told me the undamaging numbers. Are they the "normal" range on
the box of test strips? What?

Doc just said eat whole grain bread and brown rice, etc. What should I do
make sandwiches rolled in romaine lettuce?

I dusted off and reassembled my old Nordik Trac ski machine. I was such a
klutz on it. This could take practice. I couldn't ski for a minute.

I'm also very low on calories. I rarely get over 1,000 a day. My diet
software has me assigned 2,700 daily calories. How can anyone eat 2,700
when I'm trying to lose weight? Eat at McDonalds three times a day? :(

Best,

Andy

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Jackie Patti - 06 Jan 2008 18:18 GMT
> Doc never told me the undamaging numbers. Are they the "normal" range on
> the box of test strips? What?

IMO, under 70-110 is good premeal and 100-140 postmeal.

Some people are stricter than that and aim for even lower numbers.  I am
OK with lower numbers when they occur, but don't aim for them myself.

> Doc just said eat whole grain bread and brown rice, etc.

Since hubby is on the road and my daughetr mvoed away, I rarely make
bread anymore, but when I did, I started with wheat berries.

I can tell you categorically that even when you begin with whole wheat
berries, you don't make "whole grain" bread since the first step is
grinding he grain.

I can also tell you that while my bread is way healthier than anything
you can buy in the store and tastes awesome, it spikes my bg.  I can't
really eat it myself.

> What should I do
> make sandwiches rolled in romaine lettuce?

I do that a lot myself.  I also buy low-carb tortillas sometimes.
Mostly, I don't eat sandwiches though.

A bit of nice deli roast beef or ham or some chicken salad or tuna salad
goes on a salad as a topping rather than in a sandwich as a filling.

> I'm also very low on calories. I rarely get over 1,000 a day. My diet
> software has me assigned 2,700 daily calories. How can anyone eat 2,700
> when I'm trying to lose weight? Eat at McDonalds three times a day? :(

I sometimes eat under 1000/day; depends on appetite.  Rarely, I might
get up to 1800/day.  But more normally in the 1200-1400 range.

I don't really care what software says about how much I should eat.  I
figure appetite variation is pretty darned normal.

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Susan - 06 Jan 2008 20:46 GMT
> Susan,
>
[quoted text clipped - 10 lines]
> software has me assigned 2,700 daily calories. How can anyone eat 2,700
> when I'm trying to lose weight? Eat at McDonalds three times a day? :(

I eat about 1000-1200 per day, too, even when very active.

You should eat proteins, veggies and healthy fats.  Have the lettuce on
the side of a steak or chicken. Top a big salad with grilled chicken,
steak or fish, have olive oil dressing.  Eat omelettes for breakfast,
with veggies and cheese, but no toast.

Read this web site from top to bottom, it'll answer your questions:

phlaunt.com/diabetes.

Susan
Andy <q> - 06 Jan 2008 22:00 GMT
Susan said...

> Read this web site from top to bottom, it'll answer your questions:
>
> phlaunt.com/diabetes.
>
> Susan

Susan,

That's a ton of reading. I tried to read as much as I could but reading too
fast helped me forget to fast.

Looks like a wonderful site.

I heard talk about the bad ADA and they sound kind of wrong?!!

Thanks,

Andy

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Jackie Patti - 07 Jan 2008 14:21 GMT
> That's a ton of reading. I tried to read as much as I could but reading too
> fast helped me forget to fast.

Sometimes, it can help you remember fast too.  ;)

> Looks like a wonderful site.

I think so.  If I were to take some serious time to put together all my
thoughts and ideas about diabetes, Jenny's site is nearly exactly what
I'd build.  But since she did it, I don't have to.  ;)

> I heard talk about the bad ADA and they sound kind of wrong?!!

Well, the ADA is a big organization, so it stands to reason there'd be
some people within it who are right and some who are wrong, same as any
group.

When I was diagnosed, what confused me about the then-current ADA
recommendations was that they were completely opposite to veterinary
recommendations.  Somehow, what diabetic humans needed for optimum
health was different from what every other animal needed.

That made me curious.  At the time, I knew little about diabetes, but I
had a pretty good research library to use since I was a biochemistry PhD
candidate.  I did a lot of reading about how different foods affect
blood glucose and came to my own conclusions about the healthiest diet
for me.  My diet had little correlation to what the ADA said at the time.

Amusingly, it also had little correlation to what I do now!  It's been
twenty years, research has progressed on a lot of topics, and we know a
lot today we didn't know back then.  Conclusions change as research
progresses and that's how it should be.  Back then, I didn't know trans
fats were bad, I didn't know how important phytochemicals were, I didn't
know about diurnal rhythms and why I didn't *actually* have to eat every
4 hours round the clock to control my bg, and I didn't have a meter so
never really knew if I was achieving my goals.

My ideas have evolved, but so have the ADA's.  I remember... a year or
two after my diagnosis, I saw a newspaper article that the ADA was
changing it's recommendations.  They had decided that starch was nearly
equivalent to sugar in a biological sense.  That seemed pretty obvious
to me, starch is just a big polymer of glucose, so it was pretty
obviously the same in the body.  But the conclusion the ADA made from
that was that it was OK for diabetics to eat sugar after all.

I really have no idea if the ADA's current recommendations are better as
I lost interest in the organization back then.  I came to the conclusion
that I was much better at reading research and deciding what was good
for me than they were.

Course, we have bg meters now, so diabetics no longer have to read the
science literature themselves to discover what is best; we can just go
ahead and find out for ourselves without any understanding beyond what
our meter says.

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sphynx.red@gmail.com - 08 Jan 2008 17:01 GMT
>Andy wrote:
> I heard talk about the bad ADA and they sound kind of wrong?!!

The American Diabetes Association is a wonderful organization.  They
do a huge amount, especially for children with Type I diabetes.

  But. They. Are. Wrong. On. Most. Of. Their. Dietary. Advice.

The ADA takes wonderful advocacy positions, fighting for better health
care coverage for diabetics.  For better insurance coverage of meds,
pumps, testing supplies.  For better physician and nurse education on
diabetes.  For more research money to understand diabetes.

  But. They. Are. Wrong. On. Most. Of. Their. Dietary. Advice.

The ADA does a huge amount to raise public awareness of the problems
of diabetes, to get people to get checked for blood sugar problems, to
get diabetics to have regular eye exams and foot exams.

  But. They. Are. Wrong. On. Most. Of. Their. Dietary. Advice.

The ADA has brought crucial legal help to diabetics who've faced
criminal charges for their behavior during hypoglycemic episodes.
They regularly keep innocent people out of jail.

  But. They. Are. Wrong. On. Most. Of. Their. Dietary. Advice.

The ADA supports important research.  Indeed, some solid research
demonstrating the health benefits of low-carb diets have had ADA
sponsorship.  The ADA is a godsend.

  But. They. Are. Wrong. On. Most. Of. Their. Dietary. Advice.

The ADA's dietary advice is no worse than the other professional
organizations.   In several ways, it's actually better.  But get your
dietary advice elsewhere.

Where?  Well, if you've read phlaunt.com/diabetes, you know that a lot
of us follow low-carb diets and like Dr Richard K Bernstein.  His
'Diabetes Diet' has good recipes, meal plans and philosophy.
 http://www.amazon.com/Diabetes-Diet-Bernsteins-Low-Carbohydrate-Solution/dp/0316
737844


There are others.  Honestly, though, I get most of my low-carb recipes
out of 'Joy of Cooking'.  Start out with meat/fish/poultry, add oil,
add nuts, add butter, add low-carb veggies, add seasoning.  The result
will be low carb and you don't have to look up anything in a table.
If you know how to cook, you should be able to build a low-carb
omelette for breakfast without looking at a recipe book.

Andy, there's more to say about carbs, hyperinsulemia, diets,
atherosclerosis than can fit into one post, or even one book and one
website.  Keep coming back here, asking questions.
Adam Becker Sr.
Kurt - 08 Jan 2008 18:53 GMT
On Jan 8, 9:01�am, sphynx....@gmail.com wrote:

> >Andy wrote:
> > I heard talk about the bad ADA and they sound kind of wrong?!!
[quoted text clipped - 32 lines]
> organizations. � In several ways, it's actually better. �But get your
> dietary advice elsewhere.

LOL. In case you were trolling, the change of thread title paid off in
getting a response from me.

But seriously, your refrain here is merely your opinion and saying
several times doesn't make it right.  The ADA's dietary advice is
helpful to millions and could help more if they abandon their regular
way of eating, lose weight, and increase their activity level.  But
what the ADA offers - and they do offer more than one approach - are
general guidelines that also advise that people need to work with
their healthcare team to determine their particular needs.  Like most
dietary approaches I've found that most people here who criticize them
haven't really read them and instead are just parroting what others
here say.  Not saying that is true in your case, just that it goes on
quite a bit here.

> Where? �Well, if you've read phlaunt.com/diabetes, you know that a lot
> of us follow low-carb diets and like Dr Richard K Bernstein. �His
> 'Diabetes Diet' has good recipes, meal plans and philosophy.
> �http://www.amazon.com/Diabetes-Diet-Bernsteins-Low->Carbohydrate-Solut...

Well, thanks for adding that because it explains the position from you
are posting.  It's okay to have a differing point of view, but to
condemn an opposing school of thought so vociferously and firmly
because you don't agree with it is doing everyone a disservice,
although it will make you more popular in this newsgroup.

I've read Dr. Bernstein and find most of what he has to say unusable
for my individual needs.  As far as the phlaunt...well, that's an
amateur site and Jenny IMO is coming from a very specific agenda that
taints her selective citations.

Everyone needs to find something that works for them. If Dr. Bernstein
works for you then that's great.  I've found just about any diet
approach will work if a person honestly sticks to it and combines it
with an exercise program that's designed for their needs.

Kurt
Cheri - 08 Jan 2008 19:34 GMT
Kurt wrote in message <16af7417-216d-47e7-8246-

But seriously, your refrain here is merely your opinion and saying
several times doesn't make it right.  The ADA's dietary advice is
helpful to millions and could help more if they abandon their regular

*****************

I'm sure it is, I just don't happen to know one of those millions IRL
when it comes to type 2's. :-)

Cheri
sphynx.red@gmail.com - 08 Jan 2008 20:15 GMT
> Kurt wrote in message <16af7417-216d-47e7-8246-

>I've found that most people here who criticize [the ADA] haven't really read them and instead are just parroting what others here say.

Umm, true.  Welcome to USENET, where 90% of everything is crap.  Your
statement also applies to Atkins, Ornish, Taubes, Karl Marx, Plato and
the Bible.

> The ADA's dietary advice is helpful to millions and could help more if they abandon their regular way of eating,..

True.  Here on a.s.d, most of the regular posters who have normalized
our blood sugars use a low-carb approach.  If you go over to, say, the
Joslin boards (sorry, don't have a link handy) you can meet type II
diabetics who are 'in the 5% club' on moderate carb diets, carb
exchange diets and the like.  From my experience, tho, they uniformly
avoid fast carbs - white rice, pasta, beer AND ESPECIALLY SUCROSE AND
HFCS.  They build their diets around starches like lentils, whole
grains, and raw starchy vegetables like carrots.

It's interesting that Atkins and Ornish both agree on a few points -
and one of them is 'AVOID HIGHLY REFINED CARBS AND ESPECIALLY TABLE
SUGAR.'  (and the ADA agrees on-again off-again.)  I advocate low-carb
for the best bg control.  But I'd certainly agree that people would
just give up the most highly refined carbs, (without changing the
percentage of carbs in their diets) they'd be over half the way home.

Back to Andy - don't believe me.  Don't believe the ADA.  Don't
believe Atkins.  Don't believe Kurt.  Trust your body.
Get yourself a good blood glucose meter.  Eat what you consider to be
a healthy breakfast.  Test yourself at 45 min after the beginning of
your meal, then again at 2 hours.  If you can keep your postprandials
below 140 mg/dl, then your diet is mostly OK.  If your bg goes higher
than that, change something.  Rinse, wash, repeat.

Adam Becker Sr
Andrew B. Chung, MD/PhD - 08 Jan 2008 22:04 GMT
The problem is in the **amount** that folks are overeating rather than
in what they are eating:

http://HeartMDPhD.com/BeHealthy

sphynx....@gmail.com wrote:

> >Andy wrote:
> > I heard talk about the bad ADA and they sound kind of wrong?!!
[quoted text clipped - 49 lines]
> website.  Keep coming back here, asking questions.
> Adam Becker Sr.
Quentin Grady - 08 Jan 2008 22:42 GMT
G'day G'day Adam,

 Are you by any chance suggesting the ADA get most of their dietary
advice wrong?  <grin>

I wonder if this is true for T1s?
I'm a T2 so the question is a matter of curiosity only.

Their local representative suggests they MIGHT be better than the
standard American diet SAD and thus would represent an improvement for
the majority of people.  The Women's Health Initiative showed low fat
even when carefully supervised could not outperform SAD.  

The generally accepted pattern adopted by most T2s who post here
outperforms SAD with ease.

I think Andy will get the message if he hasn't already.

Best wishes,
Quentin.

This post not CC'd by email

>>Andy wrote:
>> I heard talk about the bad ADA and they sound kind of wrong?!!
[quoted text clipped - 49 lines]
>website.  Keep coming back here, asking questions.
>Adam Becker Sr.

Signature

Quentin Grady       ^  ^  /
New Zealand,       >#,#< [
                   / \ /\    
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

DonnaB shallotpeel - 10 Jan 2008 08:30 GMT
In alt.support.diabetes on Sun, 06 Jan 2008 11:39:02 -0600 in Msg.#

> Doc just said eat whole grain bread and brown rice, etc. What should I do
> make sandwiches rolled in romaine lettuce?

Sometimes I eat low-carb bread for sandwiches. Usually if I eat bread it's
the 'Perfect 10' Bagel. And, early on I discovered making roll-ups of meat,
cheese, condiment, etc. Although I may eat the meat & cheese rolled up &
dipped in mustard, etc. or whatever on a plate. I grew up a big bread eater.
I never would have dreamt of doing it this way. But, now, except for special
occasions, special breads, eh, it's no big deal. Yeah, who am I & what have
I done with Donna Bridges?!!!!

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DonnaB shallotpeel

"Television's perfect. You turn a few knobs, a few of those mechanical
adjustments at which the higher apes are so proficient & lean back & drain
your mind of all thought. And there you are watching the bubbles in the
primeval ooze." - Raymond Chandler

W. Baker - 10 Jan 2008 16:44 GMT
: In alt.support.diabetes on Sun, 06 Jan 2008 11:39:02 -0600 in Msg.#

: > Doc just said eat whole grain bread and brown rice, etc. What should I do
: > make sandwiches rolled in romaine lettuce?

: Sometimes I eat low-carb bread for sandwiches. Usually if I eat bread it's
: the 'Perfect 10' Bagel. And, early on I discovered making roll-ups of meat,
[quoted text clipped - 3 lines]
: occasions, special breads, eh, it's no big deal. Yeah, who am I & what have
: I done with Donna Bridges?!!!!

I use low carb pits tht are avalable in my neighborhood and usually have
6=8 grams of carb vs 31 in regualar ones.  I also get low carb tortillas
and sometimes make wraps or use them as a "quick and dirty" base for
pizza.  I crisp them in the oven for that purpose.  They both freeze well,
so you can kep them on hand

Wendy
Andrew B. Chung, MD/PhD - 06 Jan 2008 17:36 GMT
> I've had an interesting breakfast reading today.
>
> Someone explain?
>
> Pre-Meal: 105 mg/dl (6:31AM)

Higher than normal.

> 9 oz. (cooked) marinated flank steak. So I paid the sat. fat and
> cholesterol taxes!!!
[quoted text clipped - 5 lines]
>
> Am I pre-diabetic or type II?

The only thing definitive that can be written based on the above
information, which you have posted in ASD, is that you have insulin
resistance (IR) which is also known as metabolic syndrome (MetS).

Be hungry... be healthy... be hungrier... be blessed:

http://TheWellnessFoundation.com/BeHealthy

Prayerfully in the infinite power and might of the Holy Spirit,

Andrew <><
--
Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
Friend to the KING of kings and LORD of lords.
John - 06 Jan 2008 17:50 GMT
<q> wrote in message news:Xns9A1D6491BF229cotd@216.196.97.136...
> I've had an interesting breakfast reading today.
>
[quoted text clipped - 22 lines]
>
> Andy

Andy, apparently, once diagnosed as diabetic, you're always a diabetic even
though you may get your BG numbers in control. I've wondered about the same
thing myself. Even though my numbers are now normalized, even though a bit
higher than when I was on Glipizide, I still consider myself T2. My pre meal
numbers are usually mid 90s before breakfast and mid 80s before dinner. My 2
hour PPs are invariably below 110 and I rarely see a 1 hour above 130. I do
not low carb per se but I limit my carb intake and rarely eat processed
foods.

Just looking at those numbers, one would say that I have no metabolic
problems. However, If I were to pig out on a real carby breakfast, I would
bet that my BGs would shoot up to over 200.

John C.
Julie Bove - 06 Jan 2008 19:28 GMT
<q> wrote in message news:Xns9A1D6491BF229cotd@216.196.97.136...
> I've had an interesting breakfast reading today.
>
[quoted text clipped - 18 lines]
>
> Am I pre-diabetes or for real type II?

You can't assume you have pre-diabetes after a no carb or low carb meal.
What you are is a diabetic who is in control.  But start eating those carbs
again and your BG will skyrocket.
Andy <q> - 06 Jan 2008 20:14 GMT
Julie Bove said...

> You can't assume you have pre-diabetes after a no carb or low carb meal.
> What you are is a diabetic who is in control.  But start eating those
> carbs again and your BG will skyrocket.

Julie,

I can do that. My highest mg/dl was 189

I was talking to #1 BUD and he agrees that since I'm totally sedentary that
exercise is a mandatory "magic bullet." I know you and everybody says so.

The Nordik Trac ski machine is a good start. I starting off easy. I'll do 5
minutes, 4 times a d, 3 days a week. I just finished 5 minutes. It has
readouts for heart rate (finger clip connection) calories, distance, time,
etc. Which complements my diet exercise section. The pedometer keeps the
same records except  it keeps hundreds of days of records and I DO walk.
And it charts the data nicely.

I know it works since my uncle sent me before and after photos and his gut
was gone. I have to get rid of mine.

My next issue to address is good calorie dense food. A piece of celery is
practically negative calories just chewing the stuff. And I used to have a
huge breakfast and skip lunch and have a late afternoon snack and skip
dinner. I better get used to three meals a day.

Guess I should google for diabetic recipe sites. Got a favorite?

Thanks,

Andy

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Andrew B. Chung, MD/PhD - 07 Jan 2008 00:19 GMT
> Julie Bove said...
>
[quoted text clipped - 18 lines]
> I know it works since my uncle sent me before and after photos and his gut
> was gone. I have to get rid of mine.

Here's how to do it:

http://HeartMDPhD.com/BeHealthy

Be hungry... be healthy... be hungrier... be blessed:

http://TheWellnessFoundation.com/BeHealthy

Prayerfully in the infinite power and might of the Holy Spirit,

Andrew <><
--
Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
Bondservant to the KING of kings and LORD of lords.
Nicky - 07 Jan 2008 22:36 GMT
>Guess I should google for diabetic recipe sites. Got a favorite?

There are some excellent ones - but if I'm looking for a new recipe, I
google "recipe low carb <whatever>" and see what comes up...

Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6%  BMI 25
Michelle C. - 06 Jan 2008 19:41 GMT
> I've had an interesting breakfast reading today.
>
[quoted text clipped - 25 lines]
> --
> All Posts Blocked From: @yahoo|@gmail|@hotmail

Well, Andy, I know it's great to have our labels on straight, but
really the difference between the two is kind of superfluous.
Prediabetes and diabetes are on both on the diabetic spectrum and the
treatment is the same--keep those BG numbers as close to normal as you
can.  The biggest difference is that people who have not progressed as
far on the diabetic spectrum can achieve those lower numbers with less
medical intervention than those who have progressed farther.

As for cutting out the whole grain bread, all I can say is that is
what I had to do.  My body didn't seem to differentiate much between
white bread and whole grain--they both spiked me.  Same for whole
grain rice and white rice.

Congrats on the great numbers, Andy!  You're doing things right!

Best regards,
Michelle C., T2
diet & exercise

www.musicbydalelynch.com
Ozgirl - 06 Jan 2008 22:10 GMT
I am diabetic and an all protein meal will give me similar results.
Yes, low carb really is the real deal when it comes to bg control, weight
loss and dampening down of insulin resistance.

<q> wrote in message news:Xns9A1D6491BF229cotd@216.196.97.136...
> I've had an interesting breakfast reading today.
>
[quoted text clipped - 22 lines]
>
> Andy
 
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