Was Dr. Atkins right?

Type 1 and LADA New to Type 1 Diabetes
21

Dear Gerri.

Vitamin D deficiency was found at the end of last May. I am supplementing with 1200 units of D3. Will have Vit D measured again.

I could ask him for a prescription for R and do some testing to see if it is better that the rapid.

Have to ask if retinologists exist in our corner of Siberia? If they do it would be great. Safeway (yes the food stores) took pictures of my retina and an expert from Quebec called me to teel me they were fine 4 years ago. I should ask the diabetic care person there if they are doing this again.

I could also do with only rapid injected every hour in very small dosage. Like a pump. High dosage of Lantus is easier and does not seem to lead to any lows so far. May have to cut more if I loose weight. A 60/40 split Lantus/rapid would be less extreme. Again I am controlling on hunger and not BG directly. The choice of control variables does not seem to matter since less insulin=less hunger=less food=better BG anyway.

Nevertheless that is a good question: Is there an optimal Lantus/ rapid ratio?

I could ask him how to get to 5.5% but if he called 6.2% spectacular ( this in British means very good) he will probably say unnecessary and not to waste his time. But still worth asking, no ?

Dont seem to have a dawn phenomena I dont get up that early.

How could I justify a C-peptide test and anti-bodies at this late stage? Any ideas? They would have been precious 10 years ago.

GP and I will do something about blood pressure and possibly cholesterol.

TSH and free T4 will be checked.

Liver function and spot urine sample also. I like the 24 hour composite idea much better but not sure if allowable if spot one ok? I dont see that it is skin off any bodies nose except for the patient, the more so if female.

Symlin no available in Canada . Metformin my body does not like. Any other stuff that you can add to insulin to curb appetite?

22

Think it’s worthwhile to have your Vit D level tested again. Do you know what your level was in May?

Not sure if you’re teasing, but dawn phenon doesn’t have to do with what time you wake up:)

Don’t believe there’s an ideal basal/bolus ratio because everyone’s chemistry is so different. Again, I don’t know how this works with Type 2s.

My internist & endo said my previous A1c of 6-something was great, too. Said he wished his other diabetic patients were doing so well. I stuck to my guns & said I want to be as normal as possible & would with his help. Did he want to help me or not? Told him that diabetic complications scared me witless & that I was committed to doing the best I could. If my doctor said not to waste his time because I wanted a lower A1c, I’d tell him that it was my body, not his time at risk!

I wouldn’t start messing around with changing your insulin type until you’ve got weeks of records charting your post meals numbers. You’ve got some of your own insulin to be taking such low rapid acting doses, or maybe it’s just all that Lantus. R may be too slow for you. Know it takes a lot of strips, but I tested at 2 hours, 3 hours & 4 hours to see exactly what was going on. Needed to do this for days to know if there was a real pattern. Then for two weeks, I tested at 2 hours & 4 hours. A couple of highs or lows isn’t enough to tell. In my case, it’s a moderate case of gastroparesis. At 2 hours I was great, at 4 hours & after my BG was high. This isn’t the way it’s supposed to be, of course.

Please don’t inject rapid acting every few hours no matter how small the dose! First of all, the rapid acting will be doubling up on itself. Lasts about 4 hours in the body. You do the math.

Best thing to do is not to snack, count carbs, test, record & evaluate. Keep all variables to a minimum. Try to eat at the same time, same portions.

Retina photos aren’t a good way to diagnose. Does your endo examine your eyes? Mine does, but still nowhere like an opthalmologist exam. I haven’t been to the retinologist yet. My endo eye exam consists of light in my eyes (after dilation), following a pointed light around the room, flashing lights in peripheral vision & the famous grid test. You can find the grid test on-line & do this yourself. All you do is stare at a grid to determine if any lines are missing. Missing lines means damage.

My regular urine test was fine, but still had a 24 hour collection. 24-hour tells a lot more & important for all diabetics. Since you’ve never had this done, seems justified.

I’d think that if you’ve never had a C-peptide & antibody done, or it’s been years, it would be justified to get a picture of where your Type 2 stands & to have this as baseline. How much insulin are you producing which tells, as a Type 2, how resistant you are. Do you have antibodies & maybe a Type 1 now, or 1.5?

Isn’t Byetta an appetite suppressant? Some people have gastric problems with this drug.

23

Dear Gerri.

Not sure if byetta is available in Canada and if it is a suitable add on to insulin. I will ask.

I will ask the Endo about C-peptide and antibody tests. He may well agree. Would be nice to know if I am producing any insulin and are insulin resistant or not producing any with minimal insulin production. However not sure what is to be done for resistance. Could ask about the time release metformin, see if body is happier with that.

Come to think of it I had tests done on my eyes like you describe in the context of a cataract operation scheduled next April. Doctor said both eyes need doing then. He did not say anything about retinal damage and I did not specifically ask. I will try and ask him what was the propose of these tests and if did they find any retinal damage. I think I filled in a medical history and you assume they would have told me about problems.

Pumps overlap the insulin since they inject continuously. I am aware of the kinetic curve of insulin that the effect does not wanish after 1 hour but persists for up to 4.

I can test for gastroparesis like you said a good idea. Trial and error testing with different insulins may be a dificult way to go about this. I think if I have the basal dose correct and the 2 hour reading is good I dont think it would go back up at 4. But you never know and you wonder if this phenomena can occur in the future.

I managed to loose or misfile the result sheet of last May’s so cannot tell the exact nb for the vitamin D but will try to find it or get a duplicate from the Endo in February…

No I was not pulling your leg about the dawn phenomena. My sleep habits are so poor I am not sure my body knows when it is dawn. I do have high blood sugars in the morning if I have a large midnight snack. The more so if high in carbs. A small piece of cheese is ok. 1 slice of bread would not. Otherwise now on the low carbs morning BG is good.

I will ask about basal/bolus, so far I dont see anything wrong in maximizing the basal as long as you dont go low and dont get hungry.

Thaks a million for your input. A lot of things to think about in the battle against diabetes. I can understand the bewilderment of the new patients. Even for a veteran like me this site has opened my mind to a lot more than I ever knew before.

24

Have to reply to my own reply because there’s no reply button on yours. So, hope you see this.

Nope. Pumps don’t deliver a continuous suppy of rapid acting insulin. People bolus for meals. Pumps do deliver a continuous stream of basal insulin, which is the same as injections. Overlapping rapid insulin without food is a prescription for a severe hypo. So, no experimenting with giving yourself small doses every hour, ok?

Dawn phenomenon happens, if it happens, whatever time you wake up irregardless of time of day. Lots of info here about this. If your fasting BG is good (unless you’ve eaten the wrong bedtime snack), then you don’t have this.

Byetta can be taken with insulin.

Would certainly hope doc would have mentioned retinal damage.

You’re right–mazimizing the basal & minimizing the rapid acting is fine, as long as you’re getting good results.

Glad to have helped!

25

Dear Gerri.

Thanks will do all.

26

I do not believe Dr. Atkins’ diet is a healthy one for adults. I only have experience as a caretaker for a Type 1 child, and carbs are not severely restricted. Obviously, for diabetic children Atkins is out of the question. I am open minded and curious about the effects of long-term carb restriction for adults. I would like to know if you can remain healthy long-term if you chose to follow a severely restricted low carb diet. Atkins’ diet is loaded with saturated fat. Does anyone really know the long-term effects of an extremely low carb diet such as Atkins, without excessive protein, and restricting saturated fats? If such a diet is safe, there are times one might choose to follow it, such as for periods of unexplained high blood sugars that seem resistant to insulin. If blood sugars can be managed on a moderate-carb diet or high-carb low-glycemic diet, what other reason would someone chose such a restrictive diet permanently? Know very little about Type 2, but I believe there is a genetic component to Type 2. Not sure if going low carb can prevent Type 2.

27

Read Dr. Bernstein’s book Diabetic Solution. There are also sections from his book on www.diabetesincontrol.com. Dr. B has been Type 1 for 50 years. He’s one of the low carb gurus & has been eating extremely low carb for decades.

Low carbs diets don’t have to be excessive in protein (not sure what you consider excessive), but they are high in fat.

Lots of info you can find on-line about the myths of low fat diets. Leading researchers now believe it’s high carb that causes unhealthy lipid profiles, not saturated fats. There’s also a lot of interesting current research on the low-glycemic index & how these really weren’t calculated properly.

High carb is pretty much high carb regardless of glycemic index for Type 1.

Most people can’t maintain good BG control on high carb diets or even on moderate carb diets. Of course, these are relative terms. What’s good control, how many carbs is high or moderate:) If it’s ADA guidelines for good control, many argue their A1c recommendations are way too high & don’t prevent complications.

28

Dear Jan.

No diet will cause you to have really bad lipids as having high blood sugar does. I think that the paramount thing to do is keep the BG in the normal range as much of the time as possible. If you pancreas still works well and you are no too insulin resistant then go for the carbs as long as the above is satisfied.

ADA has lousy guidelines for good blood sugar control so that they can accomodate their high carb diet.

29

I feel really strongly about this, and I’ve been writing about it for a while.

Eating a high protein high fat diet can definitely be very healthy, though clearly some people can handle it better than others, but there are good and bad proteins and fats. You might know about how vegetable oils are terrible because they have too much omega 6’s and are often rancid-- we should instead eat high quality butter, coconut oil, or olive oil. Similarly, grass fed beef and free range chickens and eggs have good omega 3/omega 6 ratios, but industrial meat has all sorts of weird stuff in it. Processed hot dogs, sausages and lunch meats have nitrites, which are known carcinogens, but grass fed beef hot dogs are awesome for you. Margarine has strange chemicals in it, butter is a real food.

Whatever you believe causes diabetes and other health problems that plague the Western world are, clearly processed food is having a negative impact. We can’t eat all this processed crap laden with low quality fat and protein (or low quality carbs for that matter) along with a bunch of chemicals and expect to get healthy, especially if we don’t eat enough veggies to get the enzymes, vitamins, minerals, etc that we need. That’s what any diet should do - make us healthy.

I just wish the diabetic community, the low carb community, and natural/primal food community got together, and that there was a wider consciousness regarding the negative aspects of modern food processing. This would definitely help people avoid the kinds of foods that make us unhealthy and can lead to type 2. Sure some people can handle this processed crap than others and they don’t get type 2, but this stuff negatively affects the health of everybody.

You all should check out http://youtube.com/undergroundwellness , http://modernforager.com , http://marksdailyapple.com , and my website - http://newfoodview.com

30

Hey Sam,

Thanks for writing what you did. I feel as you do. We’ve been brainwashed regarding fat intake, carbs & our health has paid the price. Hydrogenated oils, rancid fats, the canola oil scam–ugh. Eating the right fats is crucial to good health. Wild caught fish, grass fed beef, venison, buffalo, free range poultry & eggs, & nuts are the way to go & not worry about saturated fats. Just wanted to add a caveat to those in the US because the US Dept of Ag guidelines for free range are rather loose. If possible, research the source. Lucky are those outside the US where food is respected & not full of as much crap.

31

Well…it would have prevented it for me being type 1, I also doubt it would prevent it in the majority of type 2 diabetics, but it is a good diet for diabetics to follow as it helps to stabilize blood sugar.

32

I’m with you. Long before I was diagnosed with diabetes, I was eating as much REAL food as I could. I even taught my husband how to read food labels & ingredient lists… he was amazed at how much CRAP even “healthy” food has in it. Why does canned soup need high fructose corn syrup and 6 other ingredients with unpronounceable names? Frozen food is even worse - I’ve seen ingredient lists for seemingly simple foods that are easily 20 or 30 items long.

Even meat is hard to buy. In my small town, it’s difficult to get pork without added “flavor enhancers.”

One thing you didn’t touch upon was the price of eating well. I’d love to buy nothing but Niman Ranch (or similar quality) meat… but even though we earn a very decent living, I can’t justify $20/pound for meat all the time. The “cheap” stuff - beans & rice - are too carby for us diabetics. Fresh fruits and vegetables are pricy and don’t last long in the fridge. The unfortunate reality of modern food processing is that it has provided us with plenty of cheap, unhealthy food. And for some people, getting off that “cheap” train is economically unfeasible.

33

Well I have been eating saturated fat like crazy lately on my version of Atkins I will go for a blood test in the near future. I have a good long term record of the lipids. Diet does matter. Eating less than you expend makes them much better. If lipids a problem I am then not sure what to eat fish only. People dont like canola which has lipids similar to olive oil or grape seed oil. I had a book on fatty acids but cant find it. Seems to be a problem with too high ratio of omega 6 / omega 3 causing inflammation.

34

Wild caught fish is no longer an option as we have nuked wild fish stocks and if we buy them we will contribute to their extinction.

35

Anthony, I just wrote about the omega 6/omega 3 situation in a recent post, but you’re totally right. Canola’s saturated/mono/polyunsaturated fat ratio isn’t the worst, though it’s not as good as olive oil… But it is uses some of the weirdest genetically modified produce, and it is prone to breaking down and becoming rancid during processing or cooking. That’s why it goes through a deodorification process at the end of processing- to remove the foul smell from being rancid.

Here’s the omega fatty acids post anyway http://tudiabetes.com/forum/topics/omega-3-6?page=1&commentId=5…

Oh and about fish- it’s not like most factory farmed fish production is sustainable… It’s awful, they use unnatural foods and strange chemicals. But I agree, the depletion of fish stock is a huge problem.

36

Dear Sam.

Also the fish farms are in the estuaries of famous wild salmon rivers and the sea lice comming off the farmed salmon attach to the wild smolt returning to sea and kill them. So fish farming contributes to the extinction of wild fish. Funny outcome, it was supposed to protect wild fish.

Wild fish stocks are no longer sustainable. Cod fish in the Gulf of St-Lawrence totalled by the seals. And Salmon in trouble world wide except were there is no commercial fishing.

37

Your mentioning statins turned me on…be careful! Statins are prone to cause muscle weakness in the hips and legs, hindering your exercising efforts. I know it is a cholesterol drug and I have taken several types. I now don’t take any…don’t need the problems it can cause. I walk a mile on most days (at 68, a mile for me is sufficient). When I started (on my own) with this disease, I struggled with getting it under control because of the statins. I dropped them and went to the walking track and in a little less than a year, I lost fifty pounds. My weight is still down and the BG is in control. As for a low-carb diet,…I don’t dare do that. If you have any kind of exercise program you need the carbs for energy. Some fats are energy producing too, but not like carbs. The more carbs you eat…protein should be considered as part of the meal. I eat walnuts and pecans because they are a good source of protein. They are high in fats, but not a single mg is cholesterol. In fact they help lower the LDL (bad cholesterol) and stabilized the HDL (good).

38

The thyroid is dependent on potassium. Broccoli, bananas, some potatoes are high in potassium. You will run into trouble in determining what to eat if you try to satisfy the amount of carbs, fat, sodium, protein, et.al in your diet. You might find yourself left with nothing to eat.

39

Dear Barbie.

There is a salt replacement called NoSalt that I bought at Safeway some years ago. It is potassium chloride. The chloride makes it taste salty and the potassium is good for you instead of more sodium.

A fellow Calgarian diabetic at a course said I guess the only thing safe to eat is cardboard. This is only good if you are a goat. Well there is a human commestible cardboard called sauerkraut.

Love walnuts not in season at Costco here so we bought hazelnuts instead not as yummy but dog eats hazelnuts for some reason.

Not good news about the statins my doctor will want to put me on some I predict should I resist?.

Good job on the weight loss how did you do it?

40

Barbie,

You can definitely do low carb & exercise. I do. 50% of the protein we eat turns to glucose.