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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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