Diabetes Talking

Question:

Happy Holidays to all!  Your group sounds very supportive and informative. I hope you do not mind a few questions. A few facts about me: DX’d 2 years ago as insulin resistant/hypoglycemic, endo said I had been symptomatic and undiagnosed for over 20 years.  GTT 175 mg/dl at one hour and 40 at two hours…2 years ago.  Endo said my phase 1 insulin secretion is totally gone, and will never come back.  BMI around 35 for last 10 years, now down to BMI 31.  Was on 1000 mg Glucophage for a year until it tore my digestive system up.  Now on 30 mg Actos for 4 months.  CVD in LAD last Christmas with stent. (on 25 mg bid Tenormin, 10 mg/day Accupril and 40 mg/day Pravachol) I exercise on an  exercycle at 8 to 9 mets every other day and 20 mins weight lifting on the off days.  Have high anxiety level (from adrenalin and high insulin levels I was told) that is helped considerably since moving my workouts to the AM from afternoon.  Age 48, 6′ 6" height, 275 lbs.  Also have peripheral neuropathy in my feet, about 50 percent of the feeling is gone, and I have balance problems, (can’t walk heel to toe, fail the head back eyes closed arms out ‘drunk balance test’. Have not been able to loose a pound since on Actos, though had a steady 4# month loss on Glucophage.  In fact I gained 8 lbs during the first month on the Actos. I have taken carb counting very seriously, and as I have cut them back over the last two years I have appeared to get more sensitive to them.  Now no sugar, rice, pasta, potato or white bread.  My per meal goal by the endo’s dietician is 40% carbs, 30% protein, 30% fat.  I try to "guard" all carbs with good fat and protein.  But I ate a bare apple for lunch last week and had 185 mg/dl glucose at 1 hr and 85 at hr two.  The wipsaw unsettles me physically and dithers my eyesight some. The Actos has appeared to bring my peak glucose levels down, but has made the swings quicker (is the proper word "more brittle?".  I have a standard test meal that I eat, and the wipsaw that used to happen over three hours now happens over about 45 minutes to one hour since starting the Actos. Now a couple of quick questions, with the goal of helping me to get the weight under better control. 1) There was a good post a while back where the poster (who injected insulin) was able to characterize his insulin resistance by measuring grams carbs ingested and the amount of insulin needed to normalize his glucose. My question is: Does anyone know of a way to characterize with numbers (so comparisons can be made with time) the level of insulin resistance of a person like me? (highly insulin resistant, but not yet type 2….but headed there)..Basically so I can tell if the exercise is helping, and if so by how much. 2) When we measure glucose at 1 hour and 2 hours after a meal is this from the time we start to eat the meal or finish the meal? 3) Does anyone have a reference to a good book that lists food contents (carbs, fat, protein) where the portion size is given by grams.  That is I would like to use weight for all my portion measurements (in grams) and would therefore like to know the carb, fat and protein contensts per gram of say carrot, ground beef, beans….etc. (Have searched the internet, but cant find it.) 4) I aim for not higher than 140 at hour 1 and 120 at hour 2.  I have gotten spikes over 200 at hour 1, and would like to learn to control them to the highest degree.  Is my techniques of continually reducing carb content till I do the right and only way to go?  Am I missing something that your experience would advise me to do different?  Mornings are the worst.  I am down to no more than 20 grams carbs for breakfast to make my targets. Adding fat for me clearly slows down carb digestion,  omlets and believe it or not pizza work great(never break 115 mg/dl), but I do not want to overdo the eggs and cheese fat with the CVD present. Thank you for your courtesy, insight and help. Regards, Dave Courtesy is Contagious!

Response:

on a chair and yelled: Have high anxiety level (from adrenalin and high insulin levels I was told) that is helped considerably since moving my workouts to the AM from afternoon.

This is very interesting.  I did not know that high insulin levels could cause anxiety.  That explains mine…    Thanks for the inadvertent tip…. Ronnie Ruff        http://www.freespeech.org/ronnieruff

Response:

Welcome Dave we are very glad you joined us. Questions are great I just don’t know many answers but the rest here does. I am sort of the welcome committee. Di

: Happy Holidays to all!  Your group sounds very supportive and informative. : I hope you do not mind a few questions. : : A few facts about me: : DX’d 2 years ago as insulin resistant/hypoglycemic, endo said I had been : symptomatic and undiagnosed for over 20 years.  GTT 175 mg/dl at one hour : and 40 at two hours…2 years ago.  Endo said my phase 1 insulin secretion : is totally gone, and will never come back.  BMI around 35 for last 10 years, : now down to BMI 31.  Was on 1000 mg Glucophage for a year until it tore my : digestive system up.  Now on 30 mg Actos for 4 months.  CVD in LAD last : Christmas with stent. (on 25 mg bid Tenormin, 10 mg/day Accupril and 40 : mg/day Pravachol) I exercise on an  exercycle at 8 to 9 mets every other day : and 20 mins weight lifting on the off days.  Have high anxiety level (from : adrenalin and high insulin levels I was told) that is helped considerably : since moving my workouts to the AM from afternoon.  Age 48, 6′ 6" height, : 275 lbs.  Also have peripheral neuropathy in my feet, about 50 percent of : the feeling is gone, and I have balance problems, (can’t walk heel to toe, : fail the head back eyes closed arms out ‘drunk balance test’. : : Have not been able to loose a pound since on Actos, though had a steady 4# : month loss on Glucophage.  In fact I gained 8 lbs during the first month on : the Actos. : : I have taken carb counting very seriously, and as I have cut them back over : the last two years I have appeared to get more sensitive to them.  Now no : sugar, rice, pasta, potato or white bread.  My per meal goal by the endo’s : dietician is 40% carbs, 30% protein, 30% fat.  I try to "guard" all carbs : with good fat and protein.  But I ate a bare apple for lunch last week and : had 185 mg/dl glucose at 1 hr and 85 at hr two.  The wipsaw unsettles me : physically and dithers my eyesight some. : : The Actos has appeared to bring my peak glucose levels down, but has made : the swings quicker (is the proper word "more brittle?".  I have a standard : test meal that I eat, and the wipsaw that used to happen over three hours : now happens over about 45 minutes to one hour since starting the Actos. : : Now a couple of quick questions, with the goal of helping me to get the : weight under better control. : : 1) There was a good post a while back where the poster (who injected : insulin) was able to characterize his insulin resistance by measuring grams : carbs ingested and the amount of insulin needed to normalize his glucose. : My question is: Does anyone know of a way to characterize with numbers (so : comparisons can be made with time) the level of insulin resistance of a : person like me? (highly insulin resistant, but not yet type 2….but headed : there)..Basically so I can tell if the exercise is helping, and if so by how : much. : : 2) When we measure glucose at 1 hour and 2 hours after a meal is this from : the time we start to eat the meal or finish the meal? : : 3) Does anyone have a reference to a good book that lists food contents : (carbs, fat, protein) where the portion size is given by grams.  That is I : would like to use weight for all my portion measurements (in grams) and : would therefore like to know the carb, fat and protein contensts per gram of : say carrot, ground beef, beans….etc. (Have searched the internet, but cant : find it.) : : 4) I aim for not higher than 140 at hour 1 and 120 at hour 2.  I have gotten : spikes over 200 at hour 1, and would like to learn to control them to the : highest degree.  Is my techniques of continually reducing carb content till : I do the right and only way to go?  Am I missing something that your : experience would advise me to do different?  Mornings are the worst.  I am : down to no more than 20 grams carbs for breakfast to make my targets. : Adding fat for me clearly slows down carb digestion,  omlets and believe it : or not pizza work great(never break 115 mg/dl), but I do not want to overdo : the eggs and cheese fat with the CVD present. : : Thank you for your courtesy, insight and help. : : Regards, : Dave : Courtesy is Contagious! : :

Response:

This is very interesting.  I did not know that high insulin levels could cause anxiety.  That explains mine…    Thanks for the inadvertent tip….

Makes sense.  One of the symptoms of a low blood sugar is anxiety. anna t

Response:

much snipped……. 1) There was a good post a while back where the poster (who injected insulin) was able to characterize his insulin resistance by measuring grams carbs ingested and the amount of insulin needed to normalize his glucose. My question is: Does anyone know of a way to characterize with numbers (so comparisons can be made with time) the level of insulin resistance of a person like me? (highly insulin resistant, but not yet type 2….but headed there)..Basically so I can tell if the exercise is helping, and if so by how much.

can’t help on the first 1/2 of this question…… as for does exercise help!…. yes, it improves the condition of the mitochondria which are implicated in utilization of insulin/the mechanics of insulin resistance……. exercise "beefs up" the mitochondria and allows them to operate more effectively……. also, exercise burns up the calories we injest….. what we don’t burn up, we store….. i know that a 30 min brisk walk makes a BIG difference in what food i am allowed (by my body) to eat in the same day, and even into the next day when the weight starts to return, i increase my exercise level before i reduce food intake (unless i feel that my food intake has increased without me being aware of it…… this is why a log book on food can be useful) 2) When we measure glucose at 1 hour and 2 hours after a meal is this from the time we start to eat the meal or finish the meal?

from when we finish 3) Does anyone have a reference to a good book that lists food contents (carbs, fat, protein) where the portion size is given by grams.  That is I would like to use weight for all my portion measurements (in grams) and would therefore like to know the carb, fat and protein contensts per gram of say carrot, ground beef, beans….etc. (Have searched the internet, but cant find it.)

The Carbohydrate Gram Counter by Corine T Netzer (careful, supplies the nutrient info on 100 grams of each food type……. we seldom would eat 100 grams of each food as this book compares the foods) 4) I aim for not higher than 140 at hour 1 and 120 at hour 2.  I have gotten spikes over 200 at hour 1, and would like to learn to control them to the highest degree.  Is my techniques of continually reducing carb content till I do the right and only way to go?

the ONLY right way to go is the way that works for you….. personally, i don’t restrict my carbs the way some people do…… having said that, when we start to look at the details, our diets are really quite similar……. i aim for 50-55% carbs, 25 – 30% protein, and 20 – 30% fat (obviously more than 100% as each meal fluctuates somewhat from the previous days meal)  Am I missing something that your experience would advise me to do different?  Mornings are the worst.

before does modify this back to a more even scale, but that morning sure can be a confusing time……. I am down to no more than 20 grams carbs for breakfast to make my targets. Adding fat for me clearly slows down carb digestion,  omlets and believe it or not pizza work great(never break 115 mg/dl), but I do not want to overdo the eggs and cheese fat with the CVD present.

the margarine, mayonaise, any added fat when a slice of tomatoe will do, or 1/4 cup of chicken broth…… Thank you for your courtesy, insight and help. Regards, Dave

— k t1 13 yr

Response:

Hi Tiger Lily,      All this time I have been thinking that the timing for the post prandial readings begins when you START the meal.  Have I been disadvantaging myself all this time?? Elissa 2

Response:

welcome Dave, all questions are welcome here as are all diabetics and their friends and family. 3) Does anyone have a reference to a good book that lists food contents (carbs, fat, protein) where the portion size is given by grams.  That is I would like to use weight for all my portion measurements (in grams) and would therefore like to know the carb, fat and protein contensts per gram of say carrot, ground beef, beans….etc. (Have searched the internet, but cant find it.)

someone will be here shortly to post a link to a good one but two I use while out of the house are 1. the carbohydrate addicts fram counter by dr’s richard heller and rachel heller and 2. the doctor’s calorie fat and carbohydrate counter which includes 80 fast food chains and restaurants. Both can be found at your local book store and both are pocket sized. Regards, Dave

hope to hear more from you. — Derek type 1, Insulin Pump http://www.diabeticnet.com

Response:

Hi Tiger Lily,      All this time I have been thinking that the timing for the post prandial readings begins when you START the meal.  Have I been disadvantaging myself all this time?? Elissa 2

I think it would depend on whether you were consistent which would mean at least you’ve learned which foods you handle well and which you don’t and also it would depend on how much time you spend dawdling over your meals.  We eat simple meals and usually don’t take more than 10 or 15 minutes. But if you’re talking something like our family holiday meal where Dad started telling stories and the younger generation started getting silly we probably sat at the table for an hour trying to eat without choking because of all the silliness. Then it would make a difference. Carol

Response:

Hi Tiger Lily,     All this time I have been thinking that the timing for the post prandial readings begins when you START the meal.  Have I been disadvantaging myself all this time?? Elissa 2

well, for myself the whole idea is almost a moot point…… takes all of 5 min to down a sandwich…… dinner is the long runner at 20 minutes (i have the time to savour each and every delectable morsel of food)…… in short, i wouldn’t worry, but the Dr’s are looking for the reading from last bite — k t1 13 yr

Response: