Medical Forum / Diseases and Disorders / Diabetes / October 2005
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swarfmaker - 11 Oct 2005 19:14 GMT Just been to see my DN this afternoon and I'm a very happy bunny. Latest testresults are Chol 3.9 HDL 1.4 LDL 1.4 BP 140/60 Weight 77Kg down from 89Kg in March and best of all ...
HbA1c 5.1
But........
I still can't equate this a1c with the queer numbers I get in the morning. This morning FBG 10.2 after a breakfast of porridge 8.2 at 90 minutes
Iain, in Pudsey
Nicky - 11 Oct 2005 21:35 GMT > Just been to see my DN this afternoon and I'm a very happy bunny. > Latest testresults are [quoted text clipped - 4 lines] > Weight 77Kg down from 89Kg in March > HbA1c 5.1 Nice! And a lovely HDL/trigs ratio too.
> But........ > > I still can't equate this a1c with the queer numbers I get in the morning. > This morning FBG 10.2 after a breakfast of porridge 8.2 at 90 minutes Yeah. How you're getting an A1c of 5.1 with those figures is beyond me too - not to mention why you're eating porridge for breakfast! You have read all the stuff about why ever going over 7.8 is a Really Bad Idea, haven't you? http://www.geocities.com/lottadata4u/bloodsugartargets.htm
You might be able to push that FBG down a bit too - have you tried a carb/protein snack at bedtime, and/or a glass of wine?
Nicky.
 Signature A1c 10.5/5.6/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg
Jenny - 12 Oct 2005 15:34 GMT > Yeah. How you're getting an A1c of 5.1 with those figures is beyond me too - > not to mention why you're eating porridge for breakfast! You have read all [quoted text clipped - 5 lines] > > Nicky. Nicky,
Because the A1c test is a measure of glycosylated hemoglobin, it is possible to register a low value if you have an infrequent genetic hemoglobin variant that doesn't stick to glucose well or if your hemoglobin cells are not living as long as usual.
People in this category are called "low glycosylators" and need to use a fructosamine test, rather than the A1c to track their blood sugar performance over time.
OR, they need to test after meals, as this poster is doing and see what is really going on.
We should never forget that the A1c test is used as an estimate in situations where people won't test, and is an estimate only. Even the ADA guidelines explicitly state that the A1c is not accurate enough to be used for diagnosis.
--Jenny
http://www.geocities.com/lottadata4u/ Type 2 Diabetes info http://www.geocities.com/jenny_the_bean/ Low Carb info
swarfmaker - 12 Oct 2005 19:27 GMT > Yeah. How you're getting an A1c of 5.1 with those figures is beyond me > too - not to mention why you're eating porridge for breakfast! You have [quoted text clipped - 5 lines] > > Nicky. Nicky, I hear what you're saying about the porridge. Apart from bread its about the only thing I can stand at 6am. and I need to eat something with the Metfartin. The thing that most concerns me is the inconsistancy of what the meal does to my BG. Sometimes it might raise me over 3 points, like last Wednesday, FBG 7.1 then 90 minutes later 10.6, other days, like yesterday FBG 10.2 then 8.2 90 minutes later. On the whole 66% of FBG results are <=7 and 15% of 90min PP <=7 Since 1st April the average FBG is 7.0 and 90 Min PP is 8.9 I always try to have a small snack before bed but I'm not a lover of wine and very rarely touch it. I'm just off to look at the site you mentioned and will get back to you when I've read it. Regards, Iain
Yolande Smith - 12 Oct 2005 20:12 GMT . and I need to eat something with
> the Metfartin. You'll find the "fartin" much less if you have a protein breakfast - as I know from experience.
Yolande >
Nicky - 13 Oct 2005 08:19 GMT >> Yeah. How you're getting an A1c of 5.1 with those figures is beyond me >> too - not to mention why you're eating porridge for breakfast! You have >> read all the stuff about why ever going over 7.8 is a Really Bad Idea, >> haven't you? http://www.geocities.com/lottadata4u/bloodsugartargets.htm
> Nicky, I hear what you're saying about the porridge. Apart from bread its > about the only thing I can stand at 6am. and I need to eat something with > the Metfartin. Ah, I know that one - I changed to flaxseed porridge when the quack added metformin, because an egg-and-bacon breakfast didn't keep it down. (It does now, though - as soon as the met was in my system, I could eat what I wanted.) Flaxseed porridge requires thought and concentration for 10 minutes once a fortnight, then the ability to pour boiling water into a bowl at 6am
: ) The inconsistency is very odd, though, and might be an indidcation of something wrong / different going on. Are you able to correlate stress/illness/difference in preparation to the high spikes?
Nicky.
 Signature A1c 10.5/5.6/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg
swarfmaker - 13 Oct 2005 17:42 GMT > Ah, I know that one - I changed to flaxseed porridge when the quack added > metformin, because an egg-and-bacon breakfast didn't keep it down. (It [quoted text clipped - 6 lines] > something wrong / different going on. Are you able to correlate > stress/illness/difference in preparation to the high spikes? The only explanation I can come up with is that I might be going a bit low during the night and then suffering a liver dump just before I wake up. I take a small carb snack before going to bed at about 11pm to try to avert this but it doesn't seem to be working.
Iain, T2 in Pudsey
Nicky - 13 Oct 2005 20:01 GMT > The only explanation I can come up with is that I might be going a bit low > during the night and then suffering a liver dump just before I wake up. I > take a small carb snack before going to bed at about 11pm to try to avert > this but it doesn't seem to be working. You may need to increase the fat & protein intake of the snack. I used to religiously down 3oz wine and a handful of nuts at 11pm, too - the theory is that the liver metabolises alcohol in preference to everything else. It then goes for the carbs - but absorption of these is delayed by the fat. Finally, some of the protein is converted to carbs - and by that time it's 4 or 5 am and you've managed to blunt the dump. So the theory goes!
Nowadays I seem to have lost the morning liver dump altogether - a great relief!
Nicky.
 Signature A1c 10.5/5.6/<6 T2 DX 05/2004 1g Metformin, 100ug Thyroxine 95/74/72Kg
Jenny - 13 Oct 2005 16:56 GMT >>Yeah. How you're getting an A1c of 5.1 with those figures is beyond me >>too - not to mention why you're eating porridge for breakfast! You have [quoted text clipped - 8 lines] > about the only thing I can stand at 6am. and I need to eat something with > the Metfartin. I'm with you on not being able to face protein first thing in the morning.
Do look into the RyVita sesame crackers. They're much lower carb than porridge or bread, taste like bread, and with an ounce of cream cheese or some sugarless peanut butter you have a breakfast that will work without a lot of carbs. Very easy, too.
--Jenny
http://www.geocities.com/lottadata4u/ Type 2 Diabetes info http://www.geocities.com/jenny_the_bean/ Low Carb info
swarfmaker - 13 Oct 2005 17:44 GMT > I'm with you on not being able to face protein first thing in the morning. > > Do look into the RyVita sesame crackers. They're much lower carb than > porridge or bread, taste like bread, and with an ounce of cream cheese or > some sugarless peanut butter you have a breakfast that will work without a > lot of carbs. Very easy, too. Thanks for the tip Jenny, I'll ask SWMBO to look out for this product in the supermarket.
Iain, T2 in Pudsey
Patti - 13 Oct 2005 19:06 GMT >Do look into the RyVita sesame crackers. They're much lower carb than >porridge or bread, taste like bread, and with an ounce of cream cheese >or some sugarless peanut butter you have a breakfast that will work >without a lot of carbs. Very easy, too You have the same breakfast as I do! Sometimes I use cream cheese, sometimes Tesco's cheese and spring onion sandwich filler and sometimes egg mayonnaise. Also a slice of boiled ham. At least it *feels like breakfast! Patti Penzance, Cornwall On 16u Levemir @ 8pm and 10u Levemir @ 8 am Novorapid as required Perindopril, aspirin, Simvastatin, 300mg Quinine Sulphate & 75msg Thyroxin. A1c 5.7
Alan S - 12 Oct 2005 01:30 GMT >Just been to see my DN this afternoon and I'm a very happy bunny. >Latest testresults are [quoted text clipped - 14 lines] > >Iain, in Pudsey Hi Iain
Congrats on the good numbers - and particularly on that weight loss!
However, like you, I can't understand that FBG and A1c relationship; more importantly, I don't understand why you continue to eat porridge at breakfast. Read this: http://www.alt-support-diabetes.org/NewlyDiagnosed.htm
Another slight anomaly is the "pulse pressure" difference of 80 between your diastolic and systolic. Is that normal for you, or a once-off?
I don't want to unnecessarily alarm you, but if that's your normal number, you might want to read these reports before discussing that with your doc:
Relation of pulse pressure and blood pressure reduction to the incidence of myocardial infarction http://hyper.ahajournals.org/cgi/content/abstract/hypertensionaha;23/3/395
Is Pulse Pressure Useful in Predicting Risk for Coronary Heart Disease? http://www.circ.ahajournals.org/cgi/content/full/100/4/354
Pulse Pressure A Predictor of Long-term Cardiovascular Mortality in a French Male Population http://hyper.ahajournals.org/cgi/content/full/30/6/1410
Cheers, Alan, T2, Australia.
 Signature Everything in Moderation - Except Laughter.
Donna Evleth - 12 Oct 2005 18:10 GMT > From: Alan S <loralweightandcarbs@optusnet.com.au> > Organization: self [quoted text clipped - 4 lines] > I don't understand why you > continue to eat porridge at breakfast. This is why breakfast is the hardest meal, in my opinion. We all have a mental image of what is "right" to eat for breakfast. For me, it is something bread-like, but of course not bread because of my celiac disease and now the carb problem. I did rice cakes, but at breakfast they spike me, although once I feel I am stabilized, I may go back to them on an irregular basis.
For some people, porridge IS breakfast. I can truly sympathize. This morning I ate smoked salmon and yoghurt. Was it good for me? You bet. Was it what I really wanted for breakfast? No way. What I really wanted was not to have either celiac disease or diabetes, and be able to eat a croissant slathered with good imported British marmelade, and a cup of coffee with milk and sugar. But I can't. So I make do with what I can.
But I also loved porridge in my younger days. So hard to give up.
Donna Evleth
swarfmaker - 12 Oct 2005 20:34 GMT Comments inline.
> Hi Iain > [quoted text clipped - 5 lines] > continue to eat porridge at breakfast. Read this: > http://www.alt-support-diabetes.org/NewlyDiagnosed.htm I have read that Alan. My problem is that apart from bread, which is a great big No NO, the only thing I can face in the morning is porridge. Now this is supposed to be a slow release carb and as such should not be spiking me. I've tried eggs in the morning but I'm afraid I just can't face cooking anything at 6am. but I do have to eat some carb with the Metformin. My greatest concern is the inconsistancy of either going up or down Post breakfast. Please see my reply to Nicky for details.
> Another slight anomaly is the "pulse pressure" difference of > 80 between your diastolic and systolic. Is that normal for [quoted text clipped - 3 lines] > normal number, you might want to read these reports before > discussing that with your doc: This is a one off I think. Last time I had it checked it was 130/80 IIRC
I should know all of this sort of stuff as I am an RGN, although retired 13 years ago due to sustaining an injury at work. I used to deal with T2 patients on a daily basis, although I didn't specialise in the field. Its amazing how you forget things when you leave a career.
Regards, Iain, T2 in Pudsey
Alan S - 12 Oct 2005 23:01 GMT >"Alan S" <loralweightandcarbs@optusnet.com.au> wrote <snip>
>>Read this: >> http://www.alt-support-diabetes.org/NewlyDiagnosed.htm [quoted text clipped - 4 lines] >I've tried eggs in the morning but I'm afraid I just can't face cooking >anything at 6am. I'll attach my "boilerplate" at the bottom of this message.
You say you can't face cooking, and you can only face porridge.
I'll be blunt. On what you can "face", it's time you faced reality - or you'll be facing the 'opathy sisters: retinopathy, neuropathy and nephropathy. I found I've been repeating myself lately with this comment: "It's amazing what I learned to like once I realised that my life depended on it!".
How hard is it to break an egg into a mug, slurp a little milk in, whisk roughly with a spoon, and nuke in the microwave for a minute?
>but I do have to eat some carb with the Metformin. No, you don't. I now take 500mg at breakfast - and still eat as few carbs as possible before lunch. This morning was a hamburger patty and a single fried egg.
Now, some ideas for brekky:
Breakfasts With Minimal Carbs
1. Egg. The humble egg can be cooked in so many ways: poached, fried (minimal oil in a non-stick pan), normal omelette (beat it lightly while cooking), fluffy omelette (seperate, whip the white with a spoonful of water, fold back with filling and yolk), scrambled with a little milk, frittata (sort of a heavier omelette with filling), and baked. Use fillings, cheese, fresh herbs if you can, dried if you can't.
2. Meat. Bacon, Ham, small steak, hamburger patty (watch the fat), chicken, prosciutto, hot dogs and so on. Can be fried, grilled/broiled, chopped after cooking and added to omelettes, frittata or scrambled eggs. For bacon or other fatty meats, drain on absorbent paper before serving.
3. Fish. Smoked, canned or fresh. Can be poached, fried, as a mornay (easy on the thickener), mixed in a stir-fry etc. Same for seafood.
4. Mushrooms. Small ones can be sliced and cooked with onions, herbs , garlic etc and a little oil and a smidgin of flour for a gravy. Large ones can be filled with bolognaise or napoli sauce (or whatever you like), topped with grated cheese and baked in the oven. Also another good omelette filling.
5. Casseroles and stews - beef, lamb, chicken, mince (ground beef) etc can be pre-prepared and divided into individual breakfast sized serves. Put them in small plastic containers in the freezer and zap one in the microwave for breakfast. Check the carbs in the recipe to check suitability. Beef bourgignon, Irish Stew (watch the spuds), chicken fricassee, whatever your favourite is. Always test at 1 hr the first time with casseroles - thickeners are usually the carb culprits for high BGs.
6. Leftovers - slices of roast meat, re-heated or cold, re-heated chops etc
Cheers, Alan, T2, Australia.
 Signature Everything in Moderation - Except Laughter.
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