Eat what you want and bolus like crazy?

Ken,
Thanks for taking the time to explain your thinking. As a new T1 I have been very confused about what consititutes “normal” BG. It has been very helpful to look at the research and it makes me realise that I can relax a bit of my control. I had been flipping out if I go over 140, even for a few minutes but it looks like that’s OK occasionally. I’m lucky in that I still am making insulin and I want to preserve that as long as possible, but I also want to eat a healthy, balanced diet. I can manage without injecting insulin but would have to follow the Bernstein diet so closely that I couldn’t have fruit, dairy products or higher carb vegetables. It’s a matter of finding the correct dose, which can be tricky in the honeymoon phase. The key for me is keeping the carbs reasonably low and then lots of testing and exercise.

Before diagnosis, almost my entire diet consisted of veggies and carbs. Now I’m so paranoid about going low on the insulin, I’ve cut back in portions and foods, so I don’t have to take but a unit or two of insulin at a time. Most times, I trade off having a higher BS with the food intake than increasing the insulin to match. I do not recommend this for anyone else, but I can’t quite overcome the fear of going low or gaining tons of weight. I’m sure time will help with this.

yes,Ken - I agree with you, and I think it is important to keep after meal blood sugars not too high, but I think shooting for anything less than 130 or 140 sets you up for lots of lows.

I have started using a bit more insulin and then testing more so that I can catch myself if I am going low and eat something else. So I will do 5 units instead of 3 and maybe even manage some dessert. It works for me. I think it’s a bit different from what Ken was saying because I don’t eat all at once, but wait to make sure that I haven’t miscalculated. I had found that I was going high 3 hours after meals with Novolog, so I switched to regular and that works much better for my “grazing” style of eating. I really don’t mind going a bit low since it gives me a chance to eat more! My endo recommended upping my meal-time insulin so that I could try to gain back some weight.

I’m a T2 on insulin and i wish i could do just that, but i can’t get away with it because i’m on lantus and take my insulin
once a day. :frowning: When I do cheat it really shows, so i “TRY” to behave myself.

I will start on a pump next May and when I do I will add more fruit.Fruit makes my sugar go high so I avoid it…I will also add in that piece of cake or that doughnut.But,I don’t think my diet will change much.

I work with a guy who has been diabetic and uses the pump and has NO control over is diet. He eats all the worst foods, bagels, muffins, cookies, candy, grinders. His numbers go from the 300s to the 40s. Then back again. I’m not enough of a “foodie” to absolutely HAVE to have my little comfort foods and what not. This disease scares the hell out of me and I plan on keeping my numbers between 80 and 120 all day every day as much as I can. I know it won’t be every day but I’ll try like hell to make it happen. Eating “whatever I want” seems like guaranteed disaster to me. Thinking about the complications of this disease make the hair on my neck stand on end. I can live without donuts. I wouldn’t want to live without feet or my eyesight. I already had a disciplined diet upon diagnosis so it hasn’t taken much to get my butt right in gear. I eat less than 60 grams of carb a day. To me it seems like a no brainer that excessive carb intake will equal to disastrous blood sugar numbers. Indulge maybe once in great while but I don’t think reckless eating habits with the expectation that insulin makes all sins forgiven is very sound. Just my opinion

Don,
I understand your fear of this disease. We all go through that when we are first diagnosed. But I’d like to encourage you to not overly stress out about it. Sure blindness, kidney failure, and amputations are bad, but those are worse-case scenario’s and are not at all inevitable. Believe it or not, there are T1’s in the world that seldom or never test their BG, often forget (or choose not) to take their insulin, eat as if they want to help Diabetes kill them early, never exercise, and go for years without any medical visits. Those are the T1’s (hovering in the BG 250 - 500 range much of their lives) that make T1 look so scary. Sure, it’s a bad disease (we’ve lost the functioning of a major part of our endocrine system) and we need to take it seriously. But basic healthy eating, monitoring BG, never skipping insulin, proper carb counting, regular medical checkups, exercise, and not smoking should enable you to live a long, complication-free life.

Here’s a very inspiring story of a 90 year-old lady (one of the first to enjoy the benefits of insulin) who’s had T1 for 83 years:
After All These Years: 83 Years of Living Well With Diabetes: Glady…

When you read about her (and others like her) and realize they didn’t have: glucometers, fast-acting insulin, pumps, CGMS, A1C tests, or any of the other many benefits we now have (with more to come in the next decade) it helps lessen some of the unnecessary self-imposed stress we can put on ourselves.

Hey, Karen…you may want to check out the Raging Hormone discussion. A number of us were either diagnosed, or notice major BS changes or insulin needs with hormonal changes in the middle years.

Libby, I just read Dr. Bernstein’s book. He recommended eating 6grams breakfast, 12 grams lunch and 12 for dinner. Just want to be clear that you are talking about 20 to 30 grams per DAY, not per MEAL? We are finding we cannot keep her postprandial highs down after eating (my 10 year old niece is Type 1 and two hours after eating is close to 300 a lot of the time). We have pre-bolused and keep adjusting her Insulin to Carb ratio. But if we feed her based on the higher part of her carb recommendation (30grams to 70 grams per meal), she spikes high and can go low later from all of that insulin. So we are going to experiment with four meals of 40 to 50 grams and see what happens. I find it hard to believe that a growing child could follow the Bernstein diet and thrive, grow, etc. But no reason in the world why an adult can’t follow it if they can. Perhaps a modification between Dr. Bernstein’s advice and the obviously incorrect advice given to Type 1s that they can eat anything they want, and just bolus for it. It’s not working for us…

Such a restricted low carb diet is not usually recommended for children but there is definitely a compromise possiblity. I do about 20g per meal and when I snack on more than 5g I need to take insulin to cover. So I do one low carb snack in the morning, and eat a yogurt and apple in the PM for which I take 4 units of insulin. This keeps me at about 80 all day. But I still have quite a bit of pancreas function so it is probably different for me.

I try to eat healthy as much as possible, but I don’t restrict my sugar intake particularly. I don’t really care for ice cream, and I prefer wheat flour to white and brown rice to white. That probably helps. :slight_smile: I bolus as needed for high-carb meals, which mostly works fine. I get numbers in the 200s once or twice a week, and higher than that once a month-ish. I run low more than I’d like, but since I’ve been on the pump, my ratio of lows to other BGs has much improved. My last A1C was 5.9.

My life at work is extremely hectic and I often find myself snacking throughout the day and eating very irresponsibly. I’ve been known to take 7+ shots of Novolog in one day.

The key is really to know what snacks are okay, and exactly how much insulin is needed to cover them. I can’t use simple carb/insulin ratios, since it seems like different types of carb affect me in greatly different ways, so I have a specific regimen of things I like to eat (including vending machine candy bars and such) and am acutely aware of their specific effect on me.

I also tend to bolus extra to cover post-meal highs, despite not being on a pump. It’s an extra shot, which is annoying, but it’s helped me get my A1c below 6.

I definitely eat what I want and bolus accordingly - while I don’t limit myself, I do take my current BG into account and I wait for my bolus to start kicking in before I eat something that I know will make me skyrocket. I’m pumping Humalog and have had great luck with waiting 20-30 min for the bolus to start dropping me before I dig in - I also just got hooked up to my CGMS a few weeks back, and it’s really great to be able to see when the insulin really starts to peak, that has helped me immensely and I’d definitely recommend it.

My A1C is currently at 6.7, and of course I’m working on getting that even lower (I have a hunch the CGMS will make this easier) - I am sure I would have a much easier time achieving an A1C in the 5s by avoiding all the sugary goodness, but I firmly believe that happiness, a well-balanced diet, and lots of exercise are just as important. And my energy levels are just not the same without carbs. I am a bona fide sugar fiend. Plus, artificial sweeteners scare the hell out of me!

I wish I could eat what I want but can’t. I’m on a once a day insulin (lantus and an oral med) and I have to watch what I eat. That’s not to say that I don’t cheat once in while. I’m a T2 and have been fighting my numbers for over a year now (I had sugery last year and that’s when my sugars started going up) and have just now gotten them within a normal range. AAAwwwwww!!! ice cream, snickers and cake, Oh my!!! LOL

I don’t have to wait until May to go on the pump.Yahoo! There was a cancellation and I got in to see my doctor.I should be a full fledged pumper by May.Praise the Lord.

My ration has always been around 7/1(except during the “honeymoon” period!!! I was doing some reading online and realized that this is actually a bit higher. Why is this?? I was diagnosed at age 17 and am now 25… I work out a few days a week, and a good weight for my height… but do use a lot of insulin (I guess)… I’ll check out the raging hormone page.

Eek!!! My A1C usually runs around 7.3. My endo says as long as I’m below 8 he’s happy!!!

It’s funny that I just came across this forum discussion of yours, as I’ve just had the embarrassingly obvious realization that I can’t just eat whatever I want and give myself insulin for it. That would describe, pretty much to a tee, my approach for the last 15 years, and at least for me, the results have not been positive. I’ve been on an insulin pump for the past 5 years and, for some reason, I thought this meant that I didn’t have to pay nearly as much attention to how much I ate. I mean, I could so easily count the carbs and give myself a bolus. A bowl of pasta? Well, it’s 90g of carbs, so I’ll give myself 9 units of insulin. No problem! Can I have some french bread to wipe up my marinara?

Turns out, this has not worked at all for me. I think it’s completely fine to every now and then indulge in something that you know probably isn’t the best for your blood sugar/will be difficult to bolus, but my goal now, among many others, is to choose smartly when I do treat myself. If I’m going to have a cookie, it should be a cookie that isn’t too high in fat and for which I know the exact carbohydrate. Otherwise, I don’t think the negative consequences are worth that brief, delicious moment. So, I guess I would say I am a recent convert to the “avoid sugar as much as possible” side. Really, it’s more like the “avoid large amounts of carbohydrate as much as possible” side.

Hi Laura…after 5 years of T1, I have pretty much come to the same realization. I have been trying to limit carbs, and have lost weight in the process. I guess for me, the whole carbs/insulin/fat connection is true. I certainly am not low cal-ing it. I eat lots of nuts, eggs, cheese, as well as as much protein as I want. My endo seemed unconcerned when I wondered if my diet was doing anything negative to my lipid levels. He said we’ll check before my next 3 mo appt.
My A1c went down a bit…I struggle with menopausal raging hormones affecting my #'s, but I am heading in the right direction. The treats are really appreciated when we allow them, eh? Good luck to you. We should probably check out the recipe sites!