Good News! Diabetes is now controllable

41

When I was first given a meal plan, a hundred years ago, I absolutely couldn’t deal with the 3 meals and 3 snacks a day idea. It really turned out to be 6 snacks a day, because, I couldn’t eat enough at the meals to actually feel satisfied, let alone full. All I could do was think about food – what time is the next food, what do I need to prepare, eat and still feel hungry, wash the dishes, and it’s already time to think of the next food. Not a way to live.

The best thing reducing carbs and increasing protein and vegetables has done for me is eliminate the ravenous hunger. I’m comfortable with 2 or 3 satisfying meals a day, and I feel no craving for carbs whatsoever at all. And my BGs are MUCH better than they ever were before. No contest.

42

My suggested meal plan, & only 3.5 years ago, was similar. Three meals, two snacks. I was reprimanded for not eating snacks when I turned in my first logs. WTH! That absurd snacking is a throwback to NPH days. And, eating ADA high carb people are constantly hungry, so snacks are built in. I often skip lunch, don’t snack & am not hungry.

43

Don’t mean to hijack the thread, but for some reason I have been WAY hungrier eating less carbs, especially later in the day and at night. Even when I eat other foods, I’m still hungry. It’s been really hard to stick to the past few days. I’m sure my blood sugars going high or low every day doesn’t help, but in the meantime it drives me crazy.

44

Oh oh … I still do the multi-snack thing in order to keep the numbers stable. It seems to work better than meds to stop the liver from pumping out sugar. A spoonful of PB or some cheese will keep the numbers from rising. I often have to choke it down but… it works. Joanne

45

To help Jen hijack the expired backfill…



I think the snacking becomes sort of habitual after a while? I have been cutting carbs back, not “officially” low but around 80ish, and am pretty much replacing small carbs with veggies and small servings of nuts, leaving the toast out at breakfast, etc. .I am not sure I’d say my control has “improved” but it’s less work to get a decent result? I had some wierd patches over the summer but I sort of think that it may have been due to pushing myself to run more as since I’ve cut back to “normal” amounts for a while, things seem really easy to control? I still like snacks though!

46

T1 and T2 are just general classes of complicated genetic predispositions. The level of control is defined by multiple very individual factors:

-residual beta cells. Even some T1 preserve some of their beta cells. An ongoing study of Joslin indicates that there is a significant correlation between residual beta cells and the level of achievable control. The quality of control influences the long term complications. So it might be pure luck in which group we fall. For T2 we know that some might loose many of their beta cells due to the stress of maintaining high levels of insulin production.

-hormonal patterns. In general women have the problem that the period does always influence the glucose levels. The significance of this influence for the quality of control is very individual.

-hormonal patterns 2: the kidney is moderating the amounts of glucose released by the liver. The release patterns are highly individual. Some people release glucose in the morning. Some when they stand up. Some when they have stress. Some when they do sports or work hard. People with better control seem to have a kidney with a more balanced / reliable hormonal pattern. Again pure luck.

-even good control does not guarantee to stay free from complications. A multitude of individual factors determine the capability to cope with the negative effects of non healthy deviations in glucose levels. My ophthalmologist was shocked to learn that one of his patients with very good control still developed complications. So again a little luck is desperately needed for all of us.

Seen from this perspective I think that your statement “can be as well controlled as well as one wishes” can be insulting for many diabetics. If it is all that easy then your A1c should also be in the range of a perfectly healthy human being. But it is not which is true for many of us. So there is more to it than just the tools you have mentioned. In my experience it is less the tools than the knowledge and will to utilize the tools at hand. Even the ordinary pen can achieve good control if the right insulins and applications patterns are used.

47

I was horrified at the meal plan I was given - 45 carbs 3x a day and 2 15 carb snacks.No way could I have eaten that often, nevermind keep anything in control! Just looked at my pump data, I averaged 29 carbs a day over the last month. If I’m hungry,I eat something, but tend to graze most of the time and have one meal.

48

I don’t know where this post will end up LOL

Jen, are you eating enough fat? When you eat low carb fat doesn’t metabolize the same way. Try adding peanut butter (I’m an addict), cheese, whatever you like.

49

Starting a new response, since the ability to reply has been exhausted!

I was wondering if Jen is getting enough protein. When my non-diabetic nephew visited Korea, he observed that they ate a lot of vegetables (plant food) and very little meat, eggs or fish, and they were eating massive amounts ALL the time. In my experience, a vegetable meal leaves me hungry in 2 hours, whereas a meal with a reasonable amount of protein leaves me satisfied for much longer. That was confirmed by one of the presentations I attended at AADE – and SHE had credentials! :slight_smile:

Peetie, for insulin-resistant Type 2’s, the liver dump is indeed a problem, and since there is no way to really prod your reluctant pancreas into secreting insulin when you actually need it, it is a good solution to eat a little bit more often than a larger amount less frequently. If you can tolerate the hassle! :slight_smile:

As for me, I was given the small/frequent eating advice because I started out on R and NPH, and both of them were a LOUSY match for natural BG curves, as well as being pretty unreliably peaky. Keeping a LITTLE something in the stomach pretty much all the time was really the only logical solution to try to avoid highs and lows. Not only did it NOT work very well, well, but it was a pain in the butt, and I hated it. Now, with faster rapid insulins and smoother long-acting insulins, that’s not nearly so much of an issue.

And being able to fine-tune basals on the pump makes it even better, but not everyone has access to a pump, and some people have other issues, such as gastroparesis, for which there really isn’t a good answer, except to watch BGs carefully and act accordingly. For them, an accurate CGM can make life easier, or else a lot of fingersticks. I think they are the first ones I’d give the artificial pancreas to, and then the children would come second. People like me would come last, because as long as I limit the carbs, I really do pretty well. Not as well as some other folk (AR???) but well enough! :slight_smile:

50

I think I eat enough protein, but maybe I should keep a food diary for a few days to see what I’m really eating … I’m not a big veggie fan (though I’m working on it!) so I tend to prefer eating meat or cheese or even nuts to veggies. (Though I’m not a big nut fan, either; I was allergic to them when I was a kid so I think I have a psychological aversion even though I can eat them now!) I actually think having to eat snacks in between meals for the first 23 years of my life (that’s the age I got off NPH and onto Lantus, and before I was diagnosed I ate recess snack and after school, anyway) has really conditioned my body into thinking it NEEDS food in between meals. I hear of other people being able to go 5-6 hours without eating, and I am usually starving if I go for 4 hours with no food, and can feel hungry even just 1-2 hours after eating, which is annoying. Right now I’ve been trying to snack on protein when I am hungry in between meals.

51

good luck glad i dont need all those

52

Yes it is like driving a car with a one minute delay between turning the wheel and the car finally turning,

53

That is actually a really good analogy! And things coming at you constantly so you are constantly having to swerve out of the way. :slight_smile:

54

+1

55

To piggyback on what MyBustedPancreas said, I have to agree that even with the best technology, sometimes things are uncontrollable. Stress causes highs. Illness causes highs. Exercise can cause lows hours (like…8) later. And don’t get me started on the hormones. Some months I’m high for that whole special week. Other months I’m low that whole week.

This is a very reactive disease. By that I mean that much of what we do has to be reactive to our blood sugars. Yes, we can hopefully act to avoid some highs and lows - but it’s just not possible to have perfect (or even close to it) control.

I also don’t like the OP’s comment about how ‘after you learn how, you will be able to enjoy life again’. Once upon a time, I was very very very uncontrolled. But I never felt that I didn’t enjoy my life.

Making these generalized blanket statements doesn’t do much to help others.

56

you are good Anthony :slight_smile:

57

I was eating 15 carbs each time. My I:C ration is 1:5, so that's 3 units. My ISF is 20, so basically 15 carbs would raise me 60 points.

Look at worst case scenario: let's say my BG is 100 and i eat 15 carbs and FORGET TO TAKE A SHOT. My BG will end up at 160. Which is still not so bad.

And the margin of error is so much better. There's no huge carb bomb delayed by fat and protein that hits you at 3am. There's no huge dose of insulin to combat a huge meal that then drops you like a rock because you go for a walk or do some exercise.

Course, eating was not very much fun.

58

I don't see that all the tools are necessary for good control. I do Ok with just MDI's and a meter but I'm T2 and probably have some beta cell function left. All the tools available today are great but do not guarantee success. Everyone's body is different. What works great for some is a struggle for others. I see good people here on this site that are fighting the good fight everyday. Saying that control can be easy with the aid of technology isn't quite fair to them.

I'm glad it's working for you. We all love a success story. Keep up the good work.

Gary S