Why oh Why?

The story - brief version (which is sooo hard for me)
Last Nov. V (the hubs) stubbed his toe.
It didn’t heal.
He didn’t want to go the doc before Christmas so he waited…
Things got busy, toe got worse; then better; then worse.
He went in Feb.; got antibiotics.
They didn’t work. He went back, had some blood tests, and was sent to see a bone specialist.
Blood tests came back, everyone in a panic because his blood sugar was over 600… So they scheduled an appointment for the following week, (I love this panic and wait routine)
We thought the appointment was for an office visit. It was for a hospital stay.
Did I mention that we live in France? I speak barely passable French, V even less. Why we are here is another story for another time.
The French like to keep you in their clutches once they get their hands on you. He was in hospital for 3 weeks while they tended his toe, got his blood sugar under control and tried to figure out why he was suddenly a T2 diabetic.
Turns out he wasn’t.
They did scans and xrays and MRI’s and blood test and bone biopsies.
They sent him home, with an appointment to see a surgeon in 2 weeks. (we, totally clueless)
The surgeon told him he had a benign tumor that had destroyed his pancreas and needed to be removed immediately. Surgery scheduled for 3 weeks later.
We went home and frantically tried to get ready for the surgery and convalescence.
Did I mention that we had just bought a 300 year old French farmhouse to restore? That didn’t have a kitchen? And that we were sleeping on camp beds in a construction zone? With 3 acres of property that hadn’t been touched in 3 years?
So, he had his pancreas removed, was still on the super duper antibiotics that made food taste awful, stayed in hospital for another 3 weeks, they wanted him for more because he lost too much weight…
His readings are all over the place: from night time lows of 50 to yesterday’s record high of 405 (he was a bad, bad boy - can’t let him out of my site for a minute),
The dietitian wants me to feed him loads of carbs - more than he can eat. The (very limited) books I’ve found say match the insulin to the diet rather than the diet to the insulin.
In short: I/we need help.
So, we are here.

Hello Katie:

Goodness! I’m so sorry to hear you and your Hubby’s sad story. What a shock for both of you.

Yes, the Dieticians still suggest the higher carb meals. These can work for People who are more physical or on medications. But the new trend in diets and recommended, are smaller portion meals or lower carb meals. These can help some Diabetics lose weight along with their exercise routines, keep their sugars under better control and stay off medications longer for Type 2’s or lower the dosage for Type 1’s and 1.5’s.

Welcome!! There are many Members here who will be able to answer your particular questions and we can help in many ways. I hope that you enjoy your stay with us. :slight_smile:

Hello Katie!

I am very glad that you found this community. I think it will be a great help to you and your husband!!

I’m sorry to hear about all the struggles that you went through! I am an American living in Hungary (my husband is Hungarian). So I also do doctor’s visits in broken Hungarian. I can definitely relate to how this affects the experience.

First of all, your instincts are exactly right-- your husband does not need to be on a high carb diet, certainly not eating more than he can or wants to eat! Unfortunately this idea is preached in the USA as well-- so it’s not only because you are in France. My dad was just diagnosed in the USA and was told the same thing.

Since your husband no longer produces insulin, the most important skill that you both can learn is carbohydrate counting. Once you learn to count carbohydrates, then you can figure out how much insulin he needs to cover different amount of carbohydrates (for example, for me, it is 1 unit of insulin for 13g of carbs). I think that the default value is 1 unit of insulin for 15g of carb and then test and see. If he goes high, he needed more insulin. If he goes low, he needed less insulin.

What types of insulin is he using? What is his dose? I have a book that can recommend ratios to start with based on that information. (DISCLAIMER: OF COURSE, you should do this with a doctor, but given that the doctors might not work on the same system, you might need to do some things on your own. I moved to Hungary after 1 year with type 1 diabetes and I have always set and adjusted my own insulin doses. My current doctor does not like this!).

There are a few good books that I can recommend:

The links go to the Amazon UK website. Not sure how much shipping would cost to France. Much of the info is also available on the web at Gary Scheiner’s website (click here) or John Walsh’s website (click here).

Kristin’s suggestions are right on. I’m just writing to give you my sympathy and to suggest that this is an OPPORTUNITY - use all those wonderful VEGGIES in the marche. Use the situation to learn French fast! Your French neighbors will show you how to cook their marche foods if needed. Use the word “comment” with a question in your voice as you hold the veggie. They will hover around you if you use the words Mon mari est tellement malade! They all know the word diabetes, too. I remember cooking there with an electric hot plate and a box that set over the hot plate for an oven.
Your husband may drop a few pounds and his insulin need will drop with the pounds as he eats those veggies. Keep portions the same from day to day and you will get control of the amount of insulin needed - and you will reduce those swings in blood sugar. He may still have high sugars from any infections of wounds, too. Pull stuff off the internet to teach both of you how to count carbs, then use them sparingly as you start. Remember he can eat all the protein he wants. Look of “Bernstein diet” on the internet. Increase his protein to keep his weight up. And keep coming back to this site. There’s a lot of knowledgeable people here. Have you tried the BBC site for some quickie French? A bientot.

I also like Blood Sugar 101 by Jenny Ruhl…a wonderfully knowledgeable and helpful member here.
Good luck…keep us posted.

They’re concerned because V lost so much weight and they want him to gain. He’s quit happy with his current weight so we have a bit of a difference of opinion… And large meals make him ill. Probably due with the reconstruction of the intestine after the pancreas removal. I’d happily stuff him with carbs - if they could give me a good reason to.

I’m learning that my close guesses, which have always done just fine for calories / weight control, don’t work for the carbs. The idea of a ratio of insulin to carbs is so logical - why don’t they tell me this? Instead I’m told to make sure he has X carbs at every meal… Which isn’t working.
He’s using NovoRapid in the mornings; NovoMix 50-50 at noon and Humalog Mix 25-75 at night.
He’s taking quite a bit less than they told him to, and he’s using small injections of the Rapid when he has highs or has a snack. We were told that he could never have a snack.
I’m a little concerned that the 2 Mixes aren’t going to give the right kind of control - any thoughts? Do I have a clue as to what I’m talking about?
He’s going back in hospital next week so they can ‘check him over’ and I’m worried that all our work to get it under control is going to be ignored.
He’s using less insulin every day but I think this is because he is healing (surgery was 7 weeks ago) and getting back to an active lifestyle. I expect it will level off - sort of.
I have Think Like a Pancreas - now I need time to read it. Thanks for the other recommendation.

Thanks, added to my list!

Fortunately, we have always had a healthy diet and eaten lots of veg… Which is why all this carb loading they were pushing on us was so horrid. In the hospital they were giving him huge plates of pasta, with bread, rice pudding, yogurt… and making him eat. He started flushing down the toilet when they left the room…
We need to get better at the carb counting. The big things - pasta, rice, bread, are easy, but, I’m learning, they are small amounts in things I wouldn’t expect: chili powder, chicken stock, onions…

I think that “Think Like a Pancreas” and “Using Insulin” make similar recommendations-- so if you have one, you probably don’t need to invest in the other.

I have never used insulin “mixes”, but from what i have learned from other members here, they can be very difficult. And there is not a good reason to use them-- as I think that better options are available. If you use insulin mixes, you also need to stick to a strict schedule, which isn’t true for all insulin regimines. For example, I would recommend Levemir (long acting, basal insulin) combined with a fast-acting insulin (humalog, apridra, or novorapid).

When I was diagnosed in the USA in 2003, no one even thought about introducing mixed insulins. I was started on Lantus (similar to Levemir, but I have heard that most people have better experiences with Levemir) and Humalog. This is referred to as the ‘un-tethered regime’, click here, which is most similar to an insulin pump, without the insulin pump. (You may want to consider an insulin pump in the longer term.)

I think that you should request to be on a different type of insulin and avoid the mixes. If this doctor won’t agree, then try to find a different one. I know people in France who are on this Levemir/ Novorapid combo. You take the Levemir twice a day (some people only once) and then the Novorapid (or Humalog or Apidra) when you eat and you decide the amount based on what you eat and what your blood sugar is. It takes a little knowledge about food and learning about insulin, but you seem very capable of handling that. And it provides a much more flexible lifestyle with better control, in my opinion.

Dear Katie.

Very brave of you guys to move to France without a very good knowledge of French. With my doctor we speak the same Queen’s English being from different parts of the empire but I still wonder if he hears more than 20% of what I say.

Carbs are a puzzle to me It could be that all the diabetic expert that have pussed high carb diets will have to die before the carbs are pronounced toxic for diabetics.

Again there are different kinds. You can look up glycemic index which is an atempt to measure how fast a carb containing food turns into blood sugar. For me breads especially the French bagette will turn into pure blood sugar as soon as they mix with my saliva. It is way worst that eating sugar with a spoon. Most rice and patatoes also. German pumpernickle is much better but I did not see any in France and did not dare ask for some in case they remember the battle of Verdun.

Lettuce and cabbage is also pure carb but does not turn into blood sugar very fast.

You’re right on. Go back to your healthy diet! I know of no French bread that is low in carbs. 2 inches of half of a longitudinally sliced baguette could be used to see what it does. The butter wouldn’t count - or sour cream on it - or olive oil on it. I’d put that piece at about 15 grams. See what it does three hours after lunch and then you’ll be able to give its equivalent in test results. I’ve done whole pages of food equivalents for myself. But his would be different. Test before and test an hour after eating it. Then you’ll have an idea of what breads do.
You can make your own yogurt, but the milk is a carb. At least that way you don’t have sugar plus.
Also…Ask the pharmacien what he suggests about low low carbs in the French stores. Usually a bit of the bread and a quarter cup of the wine … a beautiful diet!

This is a good site to get nutrional info on:
Calorie King