Observations from a newbie

I have come to believe that hunger[when not caused by long time deprivaion of food]. Is largely habit.
I believe that we in the affluent countries confuse appetite with true hunger.
I have got into the habit of eating very little food at any one time. I'm not sure what"feeling full" is like any more and I'm certain I don't often feel truly hungry. thus many people who overeat[ not that I'm suggesting your son overeats!] have become accustomed to having large portions of food frequently and feel deprived if they don't get it. They are not physiologically hungry, just psychologically hungry.
Anything psychological can be turned. So if someone wants to be less hungry, it's possible to make that so. It may not be easy, but going through a period of eating very little will make the brain used to small meals. It may not be easy, but I'm sure it's possible. I'm not in any way specially strong willed, but gradually, I've made it my way.
At the moment my T1 husband has been ill for about a month with an infected diabetic foot ulcer. The antibiotics make him a bit maueseous and he's been eating very little. In fact I'm trying to tempt him to eat more. He's lost about 10kg [22pounds] in weight in the time, which he can afford to lose and says he's not going to gain it back now he's out of the habit of eating large meals.
Hana
PS I'm not advocating illness as a cure!

Hi,

I did see the antibody tests. The antibody for GAD was the only positive at a very low titer of 5.3 U/ml.There were no IA-2 antibodies There was nothing that showed insulin resistance (no CIAA antibodies). I really think his diagnosis is in a very gray area. I have yet to see the actual lab results for lipids, c-peptide etc., although I asked for them. It seems that their computer never cooperates when I want a printout. The endo did say that the c-peptide level was mid-range, and if he were type2 the c-peptide level would have been high range or higher than normal. As you can tell, I need a better analysis.
We are definitely pursuing low carb even though at times we have underestimated. His insulin needs seem to be much higher than yours which would suggest insulin resistance. I do think that insulin is the best treatment regardless of whether it is type1 or type2, but we still need a better understanding of what his body is doing.
I too found Jenny Ruhl's book to be a valuable resource. I took her advice to heart regarding diet. As soon as you set up the forbidden fruit scenario, the plan is likely to fail.
I will consider using Dr. Bernstein's glucographs. The freestyle meter does not download onto a Mac so I have to enter everything manually anyway.

Interesting food for thought. The part that sounds strange is the statement that if he were T2 the c-peptide would be high or midrange.

My c-peptide is way low and I'm pretty clearly T2. I have enough function left to keep my BG normal when fasting; it's only when I eat that it climbs. So I don't use a basal insulin because none is needed. My morning numbers are typically in the 80s or 90s without doing anything.

Of course it could well be that my beta cells produce so little because I spent 15 years beating them to death with sulfonylureas. At the same time, my insulin resistance is just moderate. It's an unusual day if I use more than 10 to 15 units total.

This disease is nothing if not capricious.

Hi CaryJ

I agree, your endo owes you a comprehensive explanation and copies of your test results. If can't or won't, I would consider looking for a different endo.

You're right, irrespective of his diagnosis, the key objective is normalizing blood sugars. Insulin is without a doubt the most effective tool at your disposal. There is no downside to using it now.

Jenny's perspective on avoiding the forbidden fruit scenario is extremely valid, as long as the "off plan" treats are the exception rather than the rule, and you can maintain the willpower to keep it that way. This is also where a good food scale helps in establishing carb content. I allow myself a treat every couple of weeks on a Sunday evening and have been pretty successful in dosing my Novolog accordingly to keep me in the 80-110 range when I do.

Christopher

Hi Christopher,
Yep, strict meal planning is beginning to pay off. More of my son's readings are in the 80-90 range and we have eliminated the afternoon spikes. His overall average is at 109 which I think might be representative since he tests frequently.
It is interesting to note that low-carb diets seem to be beginning to get mainstream credibility. Dr. William Davis of "Wheat Belly" fame makes very valid points about the harmful modification of wheat genes and other grains too, although he is treated as somewhat of a crackpot by the mainstream media. Certainly the recent, graphic study done by the French of what happens to mice after being fed exclusively with GMO corn has caused people to think seriously about the quality of their food supply and consuming GMO toxic grains. Dr. Robert Lustig in his lecture, Sugar: the bitter truth, says that low carb diets work. He proves that the government backing for cheap, processed food with lots of HFCS and low fiber is the cause for the obesity/diabetes epidemic. The true harmful high fat diet is the high carb diet. (people like Dr. Bernstein knew this decades before) -By the way, love your strategy of getting the right lab tests. If we can have a reliable conduit to get insulin prescriptions etc. it's probably a waste of time to try to find the perfect endo. Besides, my son is getting doctor burnout. He needs a life.

Cary J
I make a menu plan every week and make my shopping list from it. It not only ensures healthy meals, but saves a lot of money.I have saved about £20 per week over previous bills in the 2 years I've been doing it.[I have the written record! I do all the planning in notebooks which I can keep and look back on] And food prices have gone up in that time. It means I almost never have ready food in the house and cook from scratch all the time

Low carb is beginning to catch on. I was sitting in someone's waiting area the other day, picked up a magazine at random, and found an article quoting a researcher at Harvard Medical School. The article's main focus was saturated fats (they're not necessarily bad -- surprise!!!) but he discussed the nutritional issues in sufficient depth to make the point about carbs being the true villain numerous times.

Better late than never, I suppose.