I've been away ploughing through the archives (hint to the OCDers:
Giganews holds around 4 years of text posts (and around six months of
binaries), much easier to browse than Google though you will need
plenty of disk space even just for the overviews).

Thanks to you kindly folks and the information you have posted, and of
course the application of Test Test Test, I now have a spectacular
graph of my progress, thanks also to Jos Creusen's Grafiek

http://www.creusen-software.nl/

a bit of a funky old database, but then I'm used to funky old
databases, remember when the icon for Borland Paradox was a Pair O'
Ducks? but produces most excellent graphs in which my GP is well
pleased.

I've also been doing the same with my Blood Pressure in boring ol'
Open Office.

Disclaimer 1: I am not and never have been diabetic - technically -
however that information from my previous doctors has proved
completely useless - I have been suffering from Impaired Glucose
Tolerance and the associated Reactive Hypoglycemia as far as I can
tell since childhood, comparing symptoms with meter readings.

Disclaimer 2: there are some freaky genetics in the family.

One of father's brothers was a Type 1, but despite the crappy insulins
and lack of testing facilities he remained in good control and
relatively side-effect free and lived into his seventies: otherwise no
other diabetes on that side of the family. Most everyone lived long
lives and died of cardiovascular stuff though without metabolic
syndrome-type symptoms.

One of my mother's uncles was also diabetic, since he was skinny, on
insulin and poorly controlled (several amputations etc.) I'd always
assumed he was also Type 1, however due to genealogical research by
some aunts it appears there were a string of Type 2 diabetics in my
mother's mother's family, all skinny and exclusively male. Other than
them (and a suspiciouly high number of children who died between 0 -
16, including all my siblings who died before or shortly after
(premature) birth) most everyone lives to a great age and dies of
cardiovascular stuff, though with varying degrees of
metabolic-syndrome type symptoms.

The freaky bit is that the skinnier folks do somewhat worse than the
fatter ones.

My suspicion is that we mostly all inherit that part of the "thrifty"
gene set which turns excess carbs into lipids, and the ones who also
deposit the lipids as fat don;t suffer as much damage as the ones
whose lipids remain rattling round in the circulation.

Examples: mother has become a tiny wizened monkey-like creature
exactly like her aunt. She's had high BP forever but no other
metabolic symptoms at age 92 (but she has had Crohn's disease, and now
has some malabsorbtion problems, and side effects from long term
steroid usage, her BG does go up while on the Prednisolone but not to
diabetic levels and (so far) reversibly) One of said aunt's daughters
is a large florid-faced woman just like my grandma, and recently at 80
was told she has "the blood pressure of a thirty-year-old": meanwhile
her younger slimmer fitter sister has had the gallstones, bad lipids
and high BP like me.

There's worse: my cousin is another string-bean (like me), a great
walker( like me), also a runner (not like me) and the last couple of
times he's visited he's nodded out after his meal exactly like I used
to do, and he is now (in his sixties) on an ACE and statin. I've tried
to get through to him what has helped me but so far without success,
much like me he was born and raised on the Healthiness of Whole Grains
and is also a vegetarian so is somewhat resistant to changing his
diet.

There's worse still: one of his daughters, in her thirties, also
nodded out after eating a couple of visits back. She is not only a
walker and a runner but also a swimmer, and in fact an athlete - world
class within her age-group - and is extremely fit (in all senses of
the word <sigh>)

She has been a bit more amenable to changing her diet, being as how
she has considerable knowledge of nutrition and metabolism, and sports
medicine, and has discovered that it is principally wheat which does a
number on her - much as my improvements have come not just from
reducing starches in general to a non-spiking level, and largely
eliminating wheat, and especially NOT mixing wheat with other carbs in
the same meal, and switching to lower-GI things like oatcakes and
ryebread, so she has found a major improvement by switching to
ricecakes and other non-wheat grains.

All YMMV of course, I can't handle rice cakes, nor can I eat bananas
which she troughs down (I used to love bananas <sigh>) or orange juice
(I used to love orange juice <sigh>) in the context of her energy
output: but this seems interesting since there is a small but
significant minority here, including Type 1s, who have similar
problems with wheat. My thought is that perhaps a genetic difference
in digestive enzymes is to blame, in my case it *appears* that the
wheat is converted to glucose excessively quickly, and *in parallel*
with any other carbs eaten at the same time. More on wheat in a later
post.
 
My hope is that the information I have learned here will filter
through her to her father and all three of us will gain . . . and that
this will serve to show up the cluelessness of certain self-elected
"experts" who would claim that none of us could possibly become
diabetic since none of us are overweight crap-devouring couch
potatoes. (obviously the rest of you, including the genuine experts,
already know this)

So, any road up, I've never had a problem with my fasting BG, and no
Dawn Phenomenon - my fasting numbers have all been 4.1 - 5.8 (74 -
105) but my postprandials have been all over the place,  from 11.5
(210) (do NOT panic-eat on top of a liver dump no matter how starving
hungry you feel <G>) to 3.8 (68) (the lows are usually reactive to a
high).

By testing I have ascertained that somewhere around 15g carbs in the
morning and 30g carbs in the evening will raise my BG by 0.5 - 2 (9 -
30)  - note the variability, presumably a function of insulin
resistance - and around 60 - 100g spread over tha day is doable
bearing in mind that ratio change.

The Healthy Whole Grain breakfast in entirely toxic, guaranteeing my
BG will roller-coaster all day - seems my Phase 1 insulin is
completely hosed but my pancreas can still chuck out Phase 2 in huge
quantities, just not necessarily when I need it to, it has a tendency
to do nothing until my BG goes into the 8 - 10 (140 - 180) range which
is not difficult to achieve, then it goes into panic mode. However
undue exercise at too low BG has a tendency to cause a liver dump
especially in the morning, and agin this will tend to shoot me into
the same range, followed by a catastrophic drop - I get more
hypoglycemic *symptoms* from a rapid drop from 10 to 5 (180 to 90)
than from  3.5 (60) provided I got there slowly.

This has caused me to make friends with the "pizza effect". Not with
real pizza - though that might be suitable fuel for a route march -
but things like oatcakes with peanut or almond butter or cheese, or
ryebread with butter (I had a fright off some ryebread until I
realised a slice was SEVENTY grams - 40g carbs - half a slice works
just right), or something else I discovered by chance, having bought
mixed dried fruit and nuts instead of peppered roasted cashews since
they were in almost identical bags on the same shelf - a small handful
of said mixed dried fruit and nuts with a larger handful of nuts also
provides a slow steady carb input at about the same rate I use the
glucose. Useful snacks for walking, or gardening. Don't knock
gardening, it uses muscles you NEVER use for anything else. Even
vigorous sex (or so I think I remember . . .)

I do have to be a bit careful with nuts though, too many at once and I
can rattle the windows and blow the duvet clean off the bed. Peanuts
are the worst (probably because they aren't "real" nuts) but cashews
aren't far behind, most other nuts are less offensive.

When I first discovered you lot, my BP was heading up around 140/90 or
worse, despite doubling my dose of Losartan. I'd also put on well over
30 pounds, all around the gut, which was pretty amazing as I've always
been a skinny bastard (BMI around 21 - 22, and when I had (undiagnosed
for five years) gallstones I became actually technically
"underweight".

What caused this? Well let's look at my lipids. I'd already had
(cholesterol) gallstones in my twenties but no-one had bothered to
check my lipids since, until my blood pressure started to go up in my
thirties, first occasionally, then permanently.

Total    HDL    LDL    Trigs    Ratio
6.8    0.63    4.22    4.29    6.81    or in American
265    25    165    380    15

I was then put on the Standard Low Fat High Carb Diet

Total    HDL    LDL    Trigs    Ratio
7.5    0.66    5.16    3.7    5.6
293    26    201    328    12.8

I was then naturally accused of being non-compliant with said diet,
when in fact the problem was I WAS complying. The words "diabetic
dyslipidemia" echo around here.

This is me on a Standard Low Fat High Carb Diet and Simvastatin

Total    HDL    LDL    Trigs    Ratio
3.7    0.85    1.9    2.1    2.46
144    33    74    185    5.59

This is me waking up and learning to control the carbs

4.3    1.1    2.4    1.76    1.6
168    43    94    156    3.64

This is me succeeding, after my BG had become substantially normalised

4.1    1.2    2.7    0.44    0.37
160    47    105    39    0.83

so OK the LDL has gone up a bit, but as my GP pointed out since the
HDL, trigs and especially the ratio had improved so much that was
quite acceptable.

During this process I lost all the extra weight, as easily and quickly
as I'd put it on.

So what did I do?

The cynical answer is, I did the exact opposite of what the dietician
told me to do.

The truthful answer is that the cynical answer is quite accurate.

When I was born we had just come to the end of post-war rationing but
there were still shortages of many things. We had an allotment garden
and a copy of Dig For Victory! and my old man used to grow a lot of
vegetables. He insisted on meat three times a day - and occasional
fish - and in retrospect he had a very limited range of preferences,
which we had to follow - he wouldnt allow onions or other veges which
he called "foreign muck" in the house, but we had lashings of all
kinds of greens, fresh potatoes, carrots, proper bread (he was also an
ace baker) and generally a lack of fast and processed foods.

After I left home I discovered all sorts of things like coloured
peppers, garlic, herbs and spices, in fact many of the things Quentin
recommends - though I ate them because they tasted good and looked
pretty rather than for any theoretical considerations. I also became a
vegetarian for a while. Okay I also ate chinese takeaways and packets
of crisps and chocolates, but as occasional things either as "treats"
or becuase I couldn't get proper food. Even when I was a trucker I
would avoid the greasy spoon type cafes, on my nights out I would go
to a good restaurant, or stay with friends (or take them to a good
restaurant) and on my nights home I'd cook, or have friends round, or
visit them. I have been very privileged that almost everyone I know
has been a good cook.

The MAIN thing I was doing wrong as I now realise was believing the
mantra that all meals should be based on Healthy Whole Grains. I used
to put away my brown rice and muesli and crunchy ethnic wholewheat
bread in what I now see as thoroughly toxic quantities FOR ME.

Now I eat mostly the same things but emphasise the veggies, and the
fresh grass-fed meat, and especially the fish, and keep the carbs down
to non-toxic levels. I don't bother with fish oil, I eat the whole
fish: likewise with olives.

Then I wash it down with some red wine. I'm currently running what I
suspect will be a longitudinal study of Jacobs Creek Shiraz vs Chilean
Cab Sav vs Chianti.

About the only thing I have changed in a major way is eating more
salads as opposed to just cooked veggies, now I've discovered the
variety of salad things that aren;t lettuce or cucumber . . .

Also I must thank the inventors of Quinoa, which I toast gently in a
dry pan before adding water and boiling, the red one tastes less like
birdseed and I can substitute it for rice, pasta etc. essentially
without shifting my BG, and thus return a lot of meals to the edible
folder.

I've tinkered with various dietary supplements and other things, based
on something Annette suggested, that it probably wouldn't do any harm
to trial things for a month and see if they made any difference.

Well I never bothered with calcium as the amount of concrete in the
kettle tells me there's more than enough in the water. Likewise this
area is not selenium-deficient (which may be one cause of the
longevity aroiund these parts).

I've trialled magnesium, zinc, chromium nicotinate and cinnamon
without any noticeable or measurable changes (not that this means
others may not benefit, just that they don;t appear necessary *for
me*).

I've trialled Coenzyme Q10 alongside my statin as there are
theoretical benefits but so far have seen few changes.

I'm taking a multivitamin and mineral supplement purely as belt and
braces again with no noticeable difference.

The one thing whch has made a substantial difference (though not
nearly as substantial as the dietary change) is Alpha-Lipoic Acid.
Originally I added it to the Evening Primrose Oil in hopes it might
improve what I suspect to be symptoms of autonomic neuropathy.

When I first tried it for a month my first thought was that I'd gotten
a duff batch of test strips, so I stopped for a month then trialled it
again for three months, then stopped for a further month before
restarting, so I'm now pretty convinced that it''s a real effect.
Please DON'T tell our government or they will make it
prescription-only, then NICE can forbid its use for anyone with an A1c
in single figures.

Basically it knocks ALL my numbers down about 0.5 (10 points). It
blunts my postprandial peaks by about the same amount. Better still it
increases the effect of exercise - my ISO standard walk round the
block which would drop me around 1.5 (30) now drops me over 2 (40).
All my numbers have been an order of magnitude more stable, I'm now
mostly in the fours (70 - 90) and my postprandials rarely go out of
the sixes (under 120)

Downsides: I suspect it may have worsened my gastric reflux, but
thanks to someone's suggestion for smearing bicarb around my gums to
improve the inflammation this seems to alleviate the effect (however
this may also have to do with my GP changing me from Famotidine to
Ranitidine for reasons of cost, and I've just asked to be changed
back: she would have changed me to Simvastatin if I wasn't already on
it, and changed my Losartan to Olmesartan "because it's stronger" -
although when I twisted her arm she admitted it was also for cost
reasons - it also *does* turn out to be stronger, my BP in now
consistently averaging 120/70, both numbers plus or minus ten, and
we're looking at reducing the dose if the improvement continues,)

Also it isn;t cheap, and some of the tabs are horse pills, I can't
decide whether they should be swallowed or inserted. I've now sourced
some smaller 150 mg tabs and am taking 300 mg/day.

Big thanks to Gys (I think) and others for posting some papers about
ALA which gave me a succession of AHA! moments. From the numbers and
the lipid ratio it's obvious my insulin resistance in general has
dropped, but one paper suggests ALA has an effect on the (GLUT4)
muscle transporters, which makes a whole lot of sense.

I've always suffered from "inexplicable" attacks of exhaustion and
lethargy which have now become very explicable through testing: when
my BG drops below 4 I guess there's no longer a sufficient
concentration of glucose in the blood for the transporters to work
properly. The surprising thing is that at the other end I get a tail
off of physical energy starting as low as 6.5 (120) - by 8 (140) I'm
getting quite lethargic and by 10 (180) I am totally pole-axed. My
suspicion is that the transporters crap out when the BG gets too high,
and the surprising thing is that a postprandial spike can have a
knock-on effect for hours.

(My other symptoms, such as the peripheral neuropathy, water retention
and nocturia, itching, skin and eye infections, etc. are all tied to
the magic number 8 (140) and do not return unless I exceed that
number. The only exception being that when I had an infection last
year I was getting some weirdly high numbers like 9.1 and 9.5 (160 -
170) at postprandial+1/2 hour, dropping to "normal" numbers by the 1
hour mark where my BG normally peaks, yet these weren't setting off
any symptoms).

The final thing which has improved is that I no longer seems to do the
liver dumps which used to make overexerting myself in the morning so
exciting. The downside is that this has opened me up to generating
some surprising lows, I've dropped down to 3.5 (60) on several
occasions. So I'm still using the technique of bolusing with slow
carbs plus fat, now to avoid *genuine* hypos rather than liver dumps.

The ALA I'm convinced has set up a "virtuous circle" where it's become
a lot easier to exercise, and the exercise is also a lot more
beneficial.

The other tricks I've learned here are to portion control, within the
parameters of what my meter permits, and (thanks to Gys again, among
others) if I need to eat out or otherwise eat food of unknown
provenance I will carb preload with a small hit of fast carbs around
half an hour before the meal. Mother has things called Amorelli which
are like tiny macaroons made of ground apricot pits and obscene
amounts of glucose - but they're only little, and the mini-spike they
produce kick-starts my pancreas such that a meal which might otherwise
have kicked my up to 8 (140) left me gobsmacked at 5.9 (105) This is
also a good excuse to eat A FEW Doritos (yes you can <G>) it doesn't
always work though, I tried this before a meal in a new pub and ate
too many chips (French Fries) along with the scampi and salad and hit
8.9 (160)

Christmas 1996 I succeeded in eating a full Christmas dinner complete
with some roasted potatoes and roast parsnip and Christmas pudding and
even some Christmas cake with marzipan (for fairly small values of
some) by starting with a preloading snack, washing it down with red
wine and spacing the courses throughout the day: I never went over 7.5
(135) but then I never went below 7.1 (130) so only a prtial success.

Last Christmas I did much the same but with the ALA, and also a
prolonged walk (took the wrong turn on the common, ended up in the
next village and had to schlep all the way back along the road): this
time I maxed out at 5.9 (105) and dropped to 4.6 (80)

So far this year I haven't exceeded 6.6 (120) or dropped below 4.3
(80) though I'm about to have a major purge on the garden which may
proive interesting)

It's going to be a while before I find out what's happened to my A1c
and lipids though as my GP is pleased enough with the graphs "Those
are hardly diabetic numbers at all!" that she's put me onto annual
monitoring. (My previous A1cs were both 5.3 - Snoopy Happy Dance not
required as I've probably never been out of the 5% club due to the RH
- interestingly one came from numbers between 3.8 (70) and 11.5 (210)
the other was from numbers mostly between 4.1 (75) and 8 (150) with
the vast majority between 4.5 (80) and 6.5 (120)

I just had to get new glasses, the optician reckoned the amount my
arms had grown shorter was purely due to ageing. He also did some
retinal photos with a new all singing all dancing digital camera, and
when I stopped seeing jupiter and all its moons he showed me the
photos enlarged to an alarming degree: no signs of any damage so far.

I also got a nearly clean bill of health from the podiatrist: sailed
through the filament test with the exception that I swore he'd poked
me twice in a couple of spots where he'd only poked me once. The
tuning fork wasn't so good, both my big toes and parts of both feet
failed to detect the vibrations. However my pulses are still good and
the athlete's foot has almost completely cleared up, there's some nail
fungus though and I have some Lamisil Once. Haven't had any neuropathy
symptoms for a long while now.

I haven't lost any more weight - but my belt goes in an extra notch.

Big thanks to most everyone here

especially Frank Roy (Jefferson), Gys, Susan, MarkD among many others
for their selection of interesting scientific papers

(although you'll have to employ several staff to read all of their
posts and cites)

David Mendosa who doesn;t post much but has quite the best website

http://www.mendosa.com/

Kate for her invaluable list of Free Veggies

http://www.diabetic-talk.org/freeveggies.htm

Annette and especially Quentin for dietary information

Alan and Jenny among many others for pushing proactivity (and their
useful websites)

Jennifer for Test Test Test

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

Maggie for this

http://www.sequin.pwp.blueyonder.co.uk/Downloads/openlet.htm

Above all, Old Al for his ability to make complex things easy to
understand

and for pushing this paper on newbies

http://www.medscape.com/viewprogram/145

though old it's still relevent (and while you're on Medscape read some
of the other papers BUT take heed of the sponsors <G>)

Ah hell, thanks to all of you just for being you

EXCEPT

for the trolls, fuckwits, scammers, spammers, control freaks,
personality disorder cases and players of Usenet Performance Art

and a special Turd On A Stick Award for the small group of disruptors
whose continuing carefully targeted personal attacks have been
responsible for so many of the above leaving, but who have entirely
failed to post anything worthwhile or relevant let alone even a tiny
fraction of the support and information that is now missing

AND WHO ARE PROUD OF THEIR ACHIEVEMENTS

meanwhile more newbies come on board and pick up on the proactivity
mantra (even if several of them are called Helen)

I'll put the bad stuff in another (OT) post