Hi Richard,
Thank you for your reply! I typed food instead of fruit - sorry. I meant if you are also eating fruits like apples, mangos or bananas?
Hi,
Thank you for your advices! It would be interesting to check his BEE.
We have checkups every three months and I am glad he is growing and gaining weight just in the perfect right way. I am always trying to give him a variety of different foods and I am happy because he is a very good eater! He will eat all kind of veggies, mushrooms or fruits, nuts, meat, fish, and different grains like quinoa, Amaranth, miller, barley and steelcut oats. I have to bolus way before he eats those grains or starchy carbs otherwise he will rise up over 250 and he cannot eat more 12-18g of carbs per meal, if we donāt want to have him massive highs.
We check his ketones from time to time, thatās what I was most worried about, so we increased the carbs a bit.
How is your sons diet? Do you restrict the carbs and how is his bloodsugar control?
Hi Richard,
You said that with you,
"Retinopathy and neuropathy were diagnosed. " in 1998.
Where are the places that have them like neuropathy.
(One location is obviously with the eyes. Is it with with both eyes ?)
How serious are the Retinopathy and neuropathy conditions of yours then ?
You have been in good control since 1998. you said that those complications are under good control due to 5.4-6.4 range A1C.
Do they disappear ?
I havenāt had any complications yet. I am wondering
with my HbA1c in 7.3 to 7.8 range for the last 6 years,
is it about time to have complications ?
I was in good control the previous 10 years. Later a lot of
trouble with failed infusion sites. SIGHā¦
What do you mean by the complications are under good control ?
I am really concerned about the complications.
Thanks.
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@Diane_Jones, insulin resistance was diagnosed in 1998, but the retinopathy and neuropathy were diagnosed several years later. A neurologist used an EMG test to diagnose neuropathy, and an opthalmologist diagnosed the retinopathy. Neither of those complications were very bad, they were in the beginning stages. My using a pump, starting in 2007, caused my retinopathy to disappear. The pump enabled me to narrow my BG range, so I had fewer lows and highs. The spots of retinopathy disappeared, and have never returned. The neuropathy is still in my feet and legs, but there is very little pain, and I do not need any medication for it. Good control of your BG, without a lot of pronounced highs and lows, and consistent A1cās below 7.0 (preferably below 6.5), will make the complications much likely to occur.
Complications can occur at any stage of diabetes if the control is not good, but it seems that they are more likely to occur after having T1D for a very long time. I belong to a Facebook group for people who have been T1 for 50 years, or more. Most of them did not have any complications during their first 30 or 40 years. I did not have my problems until I was T1 for 60+ years. Now I have been T1 for 72 years, and the neuropathy is my only complication. I am not especially concerned since the neuropathy seems essentially stable. I feel some numbness in my feet and legs, and sometimes some mild tingling, but there is nosignificant pain, and no medication involved.
Hi Richard - May I ask: how do they diagnose insulin resistance in a type 1?
@Fulmar2, I started using more and more insulin even though my carb intake had not changed. That, and a lot of weight gain over a few months led to my doctor making that diagnosis. I started taking oral meds along with the insulin to help with the insulin resistance. Metformin and reduced carbs led to my using less insulin, and I lost the weight I had gained. The resistance improved, but I will always have some resistance.
Hi again, if your son has a 5.6 and is eating healthy, gaining weight with normal ketones then it sounds like you are doing really well with his care. My son likes sweeter foods in general so he eats things like cheez-its, cheerios, strawberries, whole grain sandwiches, yogurt, bananas, and corn but not so many vegetables or salads. I guess his taste buds are different so I donāt try to force him to change anything at the moment bc his Hgaic has been pretty good, usually hi 5ās to low 6āsā¦ His sister who is not diabetic enjoys salads and healthier fare, so it would be great if they could swap diets! Anyhow he eats 45-55 grams a meal and is on pump with Novolog. His Hgaic was actually lower on multi dose shots before we got the pump but the pump is just more convenient in general. As far as BEE, my father who is a Pediatrician told me to make sure he is meeting caloric requirements to avoid ketone formation, and ensure growth. We use Precision Xtra for serum checking, usually daily and sometimes more often when he is sick or out of range. I think Type 1ās throw ketones more than Type 2ās in general so it is always a concern of mine too. It sounds like the kind of diet your son enjoys could potentially be suited for R. I have used R instead of log from time to time and I find that while it does peak farther out, it is also easier to stop lows (with R). I wish they made a R for our pump! But I have been contemplating splitting his bolus with R and log when he eats a really low glycemic index food. I read that the first lady who advocated for the ADA lived until her 70ās and she used all three insulins- log, R and Lantus, so we decided we wanted to try R too when he was getting multi-dose shots. The only drawback we found was that Lantus and R peaking together caused lows in my son so they shots had to be spaced apart time wise. Anyhow just wanted to mention since your son is prob eating lower glycemic index than my son in general.
Yes, i am very happy, he eats all that things. He does have a little ketone production sometimes. As soon as I introduce more carbs and at protein and fat to the meal he will just be very high and low later on. Yesterday he was 330 and 48, but maybe he is getting sick. He has a Medtronic pump, and we want to stay with itā¦ so I think No R for us. We use dual blouses a lot. Wish you all the best.
Thanks wish you the best too.
Hi Richard,
Here are my thoughts about low carb diets. If it works for you, Great! It might be the answer to all your problems. But like you I donāt worry too much about it. I was also old school early on it was the exchange diet. Which really was just a balance type of diet. A little bit of every āfood groupā for each meal. That is where I learned to use mustard on my lunch sandwich so I could use the fat exchange for something else instead of mayo on the sandwich. And itās where I also learned to love pickles. As a child, you loved āfree foodā! Carb counting really didnāt come into my life until the mid 80ās I think. And that was just counting not reducing.
And while I agree that diabetes would be so very easy if we didnāt eat or exercise and just sat quietly all day. But that is not life, so we learn about what works well for us. And yes, I will agree that less carbs is easier. But I love my carbs. Love them! Yesterday I had a restaurant burger with fries and cole slaw! Yeah 100 carbs in one sitting! It was great!!! I find with a long enough pre bolus, I can pull most of them off. And on those days when I donāt eat anything or just one meal, it is easier. Yes, it is so much easier if I donāt eat but food is so much fun. I do so enjoy a good burger, or pizza or nachos. Sometimes I make it work and sometimes I donāt but It has worked for me.
47 years in, pumping for about 27 years and just some background retinopathy back in the late 80ās but has been cleared up since. So, I just keep plugging with my balanced diet. Each and everyday is just another experiment. And find what works well for you and donāt worry about what everyone else is doing. MDI vs pump-whatever works, low carb vs all carb-whatever works, CGM vs meter-whatever works, exercise before meals vs after meals-whatever works. Each of us are a new daily experiment. Find what works for you!
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Hello @Sally7, I like your post. When I eat a burger at a fast food place, I toss the thick top of the bun. The good stuff on the bottom of the bun still tastes great. I can order a small amount of fries, and my wife eats half of them. That meal does not cause me any problems.
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and isnāt that carb loaded meal so much fun!!! I love a good burger with fries! And see how we come up with tricks to make things work! PWD are some of the smarted people and some great problem solvers!
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Well said, Terry!
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@justlookin- I read in another post that you keep your A1C at 5.1- could oh share with me how you do that- it seems you follow mostly a Keto diet right? Do you have any recommendations for books on this diet- or if you have the time could you share with me what a typically meal plan looks like for you for 1 day ?
Iām struggling with getting my A1C down and Iād love any input. Thank you.
Hi Erika
keeping this a1c is maiy due to keto diet, which i follow strictly. i also do intermittent fasting, meaning only 2 meals to cover a day, and longer periods with stable levels.
i make small frequent adjustments to blood sugar. And test quite frequently.
i follow ketogains keto approach. I also follow Dr Bernstein. Check out Bernstein Diabetes University on utube.
Breakfast, if i eat it, is typically eggs. Luch and dinner are always meat and low carb veges. I do bake. my favorite snacks are home made low carb seed crackers.
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watch this
Nina Teichholz, red meat
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do you have any recommendations for books, websites, or literature to start the Keto diet and get some basic recipes?
Also have you ever gone into ketoacidosis or DKA? I asked my dr. about this diet and her concern was ketoacidosis, I have never before had any issues or complications with diabetes, ketoacidosis, or dka.
Thank you so much for your time in responding, I really appreciate this.
Erika
Erika, i like the works by Marty Kendall at optimising nutrition facebook page. Same for Ketogains.com. Diet doctor also has great info. I follow a keto diet targeting 25g or less of carbs, about 100g of protein, and the fat that comes with my food. typical 60 to 80g per day. My diet is mainly eggs, non starchy veges, non sweet fruit ļ¼eggplant, cucumber, capsicum etcļ¼ and meats. i dont make keto treats for myself ļ¼almond flour and coconut flour based goodsļ¼, but i do for my daughtersā¦ www.alldayidreamaboutfood.com has some great recipes.
i have never been in dka. Diabetic ketoacidosis is very different from nutritional ketosis, which is adaptive and normal and beneficial when eating low carb. I still need insulin. i still monitor sugars closely. i occassionally have to correct low blood sugars ļ¼i have hugely variable insulin requirements accross my cycleļ¼.
i suggest careful testing of basal insulin dosing. Descriptions for doing this in the book āthink.like a pancreasā. You can also look for this at Bernstein Diabetes University, on utube. I use mostly basal.insulin, and typically only small doses of bolus. i target to keep my blood sugars in the 80 to 95 range as much as possibleā¦ this means small corrections of bolus insulin if i notice sugars creeping up.
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Thank you!!! Sorry. Two more questions.
Do you work out and if so how do you keep blood sugar for dropping
And are you on a pump ( if yes which one) or insulting injections ( if yes which insulin(s) do you use. )
Thank you again. This has all been so helpful
Erika Krueger-Santos, LMFT
Licensed Marriage and Family Therapist
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hi Erika
i am on mdi, using levemir and humalog. i use a freestyle libre from time to time to catch patterns and trends.
i work.out 5 or 6 days a week ļ¼currently enrolled for my second time in the ketogains bootcamp.programmeļ¼. This combines keto diet ļ¼focusing on higher proteinļ¼, with short sessions of heavy weight training, and some Hiit sessions.
i find i go high during weights and short intense exercise. i have to dose before working out to match the exercise high. late afternoon i tend to go a bit low, sometimes, but can typically address it with a small snack, or a cup of coffee, which will push numbers up slightly.
In the past when i was doing endurance workouts, i was typically fine during exerciSe, but would go low later. On those days i would reduce basal insulin, and just do corrections, if necessary, using one or two units ofhumalog.
if you go low during exercise, iād suggest trying a protein snack 30 mins or so before exercise. I use a low carb protein drink call isopure. i.like dutch chocolate flavour. i have to dose a small amount of insulin for this. you may or may not need to. we become our own experiments as we learn.to manage diabetes.
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