Diabetes Talking

Question:

First of all a thank you to all who contributed to the other thread – I thought a worthwhile and useful discussion. Now my next question. I’ve been trying different foods and combinations over the last few days and comparing results when measuring afterwards.    I’ve also been reading up about glycaemic index etc. Dinner yesterday (turkey, peas and a little fettucine in a creamy sauce worked quite well with peak BG level of 7.7 an hour after and falling after that. Today was some ham and a medium baked potato plus green vegetables and a parsley sauce. I decided to eat all of the potato to see what would happen.   This was still a smaller potato than I have eaten typically in the past. Knowing that potatoes have a high GI (85?) I expected an early glucose peak and higher than yesterday’s. I found a figure of 32 for fettucine. Sure enough, the peak was after an hour at 10.3mmol/l. WHat surprised me was the rapid drop.  At two hours the level had fallen to 4.5 and was still at that level at three hours.   I just did a four hour measurement and the figure has gone up to 5.3 – i.e. about my typical fasting baseline.    I had been pottering about in the garage this evening, but nothing strenuous.   At the 4.5 level I was feeling a little light headed. So…. I expected that there would be a peak that was both higher and sharper.    I didn’t expect that the level would fall to almost 1mmol/l below my fasting level and so quickly. I presume that the recovery back up (I haven’t eaten anything else) was due to glycogen from the liver?   Can anybody explain the undershoot effect?  It didn’t seem to happen yesterday.  Is this a consequence of the height of the peak or an effect of the specific food? Had I eaten less of the potato, would I expect a lower peak over about the same amount of time and less of the undershoot effect? Further question.   I have also been looking at glycaemic load, but can find less information on it.   Are there some good resources?   It seems that this may be a better guideline than GI perhaps?    It appears that GL is GI multiplied by the carbohydrate content, but is this the carbohydrate percentage or amount eaten? Any other comments on this area? thanks again — .andy To email, substitute .nospam with .gl

Response:

- Hide quoted text — Show quoted text – First of all a thank you to all who contributed to the other thread – I thought a worthwhile and useful discussion. Now my next question. I’ve been trying different foods and combinations over the last few days and comparing results when measuring afterwards.    I’ve also been reading up about glycaemic index etc. Dinner yesterday (turkey, peas and a little fettucine in a creamy sauce worked quite well with peak BG level of 7.7 an hour after and falling after that. Today was some ham and a medium baked potato plus green vegetables and a parsley sauce. I decided to eat all of the potato to see what would happen.   This was still a smaller potato than I have eaten typically in the past. Knowing that potatoes have a high GI (85?) I expected an early glucose peak and higher than yesterday’s. I found a figure of 32 for fettucine. Sure enough, the peak was after an hour at 10.3mmol/l. WHat surprised me was the rapid drop.  At two hours the level had fallen to 4.5 and was still at that level at three hours.   I just did a four hour measurement and the figure has gone up to 5.3 – i.e. about my typical fasting baseline.    I had been pottering about in the garage this evening, but nothing strenuous.   At the 4.5 level I was feeling a little light headed. So…. I expected that there would be a peak that was both higher and sharper.    I didn’t expect that the level would fall to almost 1mmol/l below my fasting level and so quickly. I presume that the recovery back up (I haven’t eaten anything else) was due to glycogen from the liver?   Can anybody explain the undershoot effect?  It didn’t seem to happen yesterday.  Is this a consequence of the height of the peak or an effect of the specific food? Had I eaten less of the potato, would I expect a lower peak over about the same amount of time and less of the undershoot effect? Further question.   I have also been looking at glycaemic load, but can find less information on it.   Are there some good resources?   It seems that this may be a better guideline than GI perhaps?    It appears that GL is GI multiplied by the carbohydrate content, but is this the carbohydrate percentage or amount eaten? Any other comments on this area? thanks again

Andy, I have no links to back this up, but some personal experience.  NO doubt someone will be able to post one if necessary. Baking a potato increases it GI.  I first heard about this from an Atkins user.  Since then I have heard about it from other sources. Not sure what you know so far but there is a phase I and phase II insulin response.  Type 2s lack the full phase I response which is what would normally trigger immediately on eating to counteract carbs. However you do have the phase II, also triggered by eating, but a slower long-term release. The baked spud hits your BG hard and fast but is consumed very quickly.   So by the time your phase II response kicks in fully a lot of the glucose has been dealt with.  The phase II response then has little to work on and sends you plummeting. The other food that I have noticed this with particularly is cereal bars due to their surprisingly high level of glucose.  Good for treating a low but only in the very short term. Be particularly wary of these foods after exercising. I assume you have looked at mendosa.com for GI and GL?  Its one of the best starting points and has links to other resources.  There are also numerous books on the subject although I cannot recommend one particularly. Rule for the day : avoid baked potatoes. However, they are a good example of why you should test at 1 hr and not 2.  Latest recommendations are to test at 90 mins since this is the normal peak.  However if I had stuck to 90 or even the recommended 120 mins testing  I would not have seen the baked potato effect. When I was first dxed I went through a phase of knocking out as many starchy foods as possible – bread, potatoes, pasta, rice – and keeping a fairly boring diet for a while.  When introducing new foods I had a better idea of what that single new food did to me in a known combination.  Losing the starches also helped me to bring down my BG.  I introduced starches back in, in limited quantities to a level which I am comfortable with since I now know the effect. You may find this approach useful, but I am sure you can find your own way.  DM and the effects that food have on you are very personal and although there are general "rules" on what is good and bad, you may find that foods which hit others very badly do not affect you as much. You seem to be doing well on your personal journey of discovery.  Keep it up and keep asking those questions Hope this helps VBH T2/UK/A1c 5.6/ 1000Met/Dx Oct-03

Response:

snip The other food that I have noticed this with particularly is cereal bars due to their surprisingly high level of glucose.  Good for treating a low but only in the very short term. Be particularly wary of these foods after exercising.

Mmmm, I’m missing something here – I carry this type of bar as a safeguard against lows when cycling. they quite often get eaten halfway on the ride if I start to get wobbly (4.5 ish). Alternatively I carry a normal size Marathon bar. Fred T2, 2 x 500mg Metformin, 2×80mg Gliclazide 1 x 80mg Valsartan, 1 x 100mg Atenolol

Response:

Andy, I have no links to back this up, but some personal experience.  NO doubt someone will be able to post one if necessary. Baking a potato increases it GI.  I first heard about this from an Atkins user.  Since then I have heard about it from other sources.

It does seem from the tables that baked potato has a much higher GI than other forms. Not sure what you know so far but there is a phase I and phase II insulin response.  Type 2s lack the full phase I response which is what would normally trigger immediately on eating to counteract carbs. However you do have the phase II, also triggered by eating, but a slower long-term release.

I’ll check into that. The baked spud hits your BG hard and fast but is consumed very quickly.  So by the time your phase II response kicks in fully a lot of the glucose has been dealt with.  The phase II response then has little to work on and sends you plummeting. The other food that I have noticed this with particularly is cereal bars due to their surprisingly high level of glucose.  Good for treating a low but only in the very short term.

I don’t tend to eat these, but have started looking for slower release things such as half a slice of wholemeal bread, and perhaps a tiny amount of something sweeter to produce a rapid effect if needed.. Be particularly wary of these foods after exercising. I assume you have looked at mendosa.com for GI and GL?  Its one of the best starting points and has links to other resources.  There are also numerous books on the subject although I cannot recommend one particularly.

I’ve started going through that site but hadn’t found that topic yet. Rule for the day : avoid baked potatoes.

Well yes.    I do quite like them, however, so my next try will be with a smaller one. However, they are a good example of why you should test at 1 hr and not 2.  Latest recommendations are to test at 90 mins since this is the normal peak.  However if I had stuck to 90 or even the recommended 120 mins testing  I would not have seen the baked potato effect.

During these trials I have been testing at 1 and 2 hours so that I can get a feel for peak and rate of decay. When I was first dxed I went through a phase of knocking out as many starchy foods as possible – bread, potatoes, pasta, rice – and keeping a fairly boring diet for a while.  When introducing new foods I had a better idea of what that single new food did to me in a known combination.  Losing the starches also helped me to bring down my BG.  I introduced starches back in, in limited quantities to a level which I am comfortable with since I now know the effect. You may find this approach useful, but I am sure you can find your own way.  

I’ve really started by going for half of the erstwhile amount and adjusting up and down from there.    That has certainly worked for pasta and bread for example. DM and the effects that food have on you are very personal and although there are general "rules" on what is good and bad, you may find that foods which hit others very badly do not affect you as much. You seem to be doing well on your personal journey of discovery.  Keep it up and keep asking those questions

It’s quit elaborious, but discovering what works well and what doesn’t makes it interesting. Hope this helps

Yes it does and many thanks. — .andy To email, substitute .nospam with .gl

Response:

– Hide quoted text — Show quoted text – Rule for the day : avoid baked potatoes. Well yes.    I do quite like them, however, so my next try will be with a smaller one. Maybe a newer one? The GI seems lower for new potatoes and waxy ones. I noticed large-ish "new" pots in Tescos, maybe they’d be better. I can’t eat old pots at all, but I’m looking forward to trying the new spring ones! Incidentally, I noticed a book on the glycaemic load in Waterstones today – I didn’t get a lot of time to flick through, but it looked interesting apart from obviously being a marketing tool – the author is promising "low gl" chocolate bars real soon now. Nicky.

I do wish these people would stick to the science.   The trouble is that it’s too tempting a business opportunity to sell the prepackaged foods for the latest fad diet.   I suppose that books are OK, but the foods are nice repeat business……. — .andy To email, substitute .nospam with .gl

Response:

Rule for the day : avoid baked potatoes. Well yes.    I do quite like them, however, so my next try will be with a smaller one.

Maybe a newer one? The GI seems lower for new potatoes and waxy ones. I noticed large-ish "new" pots in Tescos, maybe they’d be better. I can’t eat old pots at all, but I’m looking forward to trying the new spring ones! Incidentally, I noticed a book on the glycaemic load in Waterstones today – I didn’t get a lot of time to flick through, but it looked interesting apart from obviously being a marketing tool – the author is promising "low gl" chocolate bars real soon now. Nicky. — A1c 10.5/5.7/<6  Weight 95/80/72Kg 1g Metformin, 75ug Thyroxine T2 DX 05/2004

Response:

x-no-archive: yes Going from one extreme to the other looks a bit like Reactive Hypoglycemia which is common in the pre-diabetic phase. http://www.google.co.uk/search?hl=en&q=reactive+hypoglycemia&btnG=Goo…

I wondered about that.   Is Reactive Hypoglycaemia tha official medical term for glycaemia, or are there two different things? — .andy To email, substitute .nospam with .gl

Response:

Incidentally, I noticed a book on the glycaemic load in Waterstones today – I didn’t get a lot of time to flick through, but it looked interesting apart from obviously being a marketing tool – the author is promising "low gl" chocolate bars real soon now. I do wish these people would stick to the science.   The trouble is that it’s too tempting a business opportunity to sell the prepackaged foods for the latest fad diet.   I suppose that books are OK, but the foods are nice repeat business…….

Yeah. But I got a nice reminder of how easy it is to be naturally low-carb today – I’m taking dessert round to a family do tomorrow, and I’ve cooked 2 lots of brownies to be eaten with icecream. One lot came out of a Carbsense packet, one I made from scratch using ground almonds as a base; of course we had to try them, and mine is nicer, for about the same carb count : )  Who needs frankenfoods : ) Nicky. — A1c 10.5/5.7/<6  Weight 95/80/72Kg 1g Metformin, 75ug Thyroxine T2 DX 05/2004

Response:

Yeah. But I got a nice reminder of how easy it is to be naturally low-carb today – I’m taking dessert round to a family do tomorrow, and I’ve cooked 2 lots of brownies to be eaten with icecream. One lot came out of a Carbsense packet, one I made from scratch using ground almonds as a base; of course we had to try them, and mine is nicer, for about the same carb count : )  Who needs frankenfoods : )

Frankenfoods?    I guess you mean synthetically manufactured, preprocessed stuff rather than a manufacturer of little German sausages? — .andy To email, substitute .nospam with .gl

Response:

Frankenfoods?    I guess you mean synthetically manufactured, preprocessed stuff rather than a manufacturer of little German sausages?

Indeed. I’m quite fond of little German sausages : ) Nicky. — A1c 10.5/5.7/<6  Weight 95/80/72Kg 1g Metformin, 75ug Thyroxine T2 DX 05/2004

Response:

Rule for the day : avoid baked potatoes. Well yes.    I do quite like them, however, so my next try will be with a smaller one. Maybe a newer one? The GI seems lower for new potatoes and waxy ones. I noticed large-ish "new" pots in Tescos, maybe they’d be better.

A lot of people find red-skinned spuds easier on the BG levels, too. I find I can have a small [maybe 4 or 5 oz] baked pot if the filling is plenty of tuna mayo, with a non-carby veg [broccoli, sprouts, spinach] or a side salad. I suspect that the relatively high fat content of the mayo combined with the relatively high fibre content of the veg checks the BG rise, but am not certain of that. Incidentally, I noticed a book on the glycaemic load in Waterstones today – I didn’t get a lot of time to flick through, but it looked interesting apart from obviously being a marketing tool – the author is promising "low gl" chocolate bars real soon now.

Name? Author? Price? Maggie — Life is a sexually transmitted disease and the mortality rate is one hundred percent. – RD Laing

Response:

– Hide quoted text — Show quoted text – Rule for the day : avoid baked potatoes. Well yes.    I do quite like them, however, so my next try will be with a smaller one. Maybe a newer one? The GI seems lower for new potatoes and waxy ones. I noticed large-ish "new" pots in Tescos, maybe they’d be better. A lot of people find red-skinned spuds easier on the BG levels, too. I find I can have a small [maybe 4 or 5 oz] baked pot if the filling is plenty of tuna mayo, with a non-carby veg [broccoli, sprouts, spinach] or a side salad. I suspect that the relatively high fat content of the mayo combined with the relatively high fibre content of the veg checks the BG rise, but am not certain of that.

Well, I think I’ll buy some Johnson and Johnson shares, since I am spending so much on test strips at the moment. As a brief aside, the UltraSmart meter seems to work quite well, and I am downloading it periodically and using the graphing.   They have now made the One-Touch software officially available in the UK (although I simply downloaded it from the U.S. (it’s the same), and also got hold of a USB cable for a tenner. The doctor is going to make enquiries about prescription test strips but is pretty sure that the PCT won’t agree to regular prescriptions. A political decision and not his choice. Anyway….. I measured at 30 minute intervals after several dinners this week and seemed to find more or less what you described. I tried smaller quantities of higher GI things such as rice (along with meat, creamy sauce and green vegetables.  I found that the duration of the peak was shortish in much the same way as with a larger amount – i.e. the curve didn’t widen.  Same thing with a baked potato.  A small one with extra bits as you describe, and the peak was 8.5 mmol/l and relatively short again. Another one was a piece of grilled salmon plus five small new potatoes and some green beans.    This one was very successful at 7.5mmol/l peak and a very flat curve. So there seems to be something in the new potatoes idea. I made bread using a low carbohydrate bread mix today.   Basically it is uneatable.   Texture is rubbery and a peculiar taste.   This would be a good way to put people off of bread…..   — .andy To email, substitute .nospam with .gl

Response:

- Hide quoted text — Show quoted text – The doctor is going to make enquiries about prescription test strips but is pretty sure that the PCT won’t agree to regular prescriptions. A political decision and not his choice. This is the same cop-out mine is using. The PCT do recommendations, not mandates. Ask him how much he gets for having someone with a chronic disease on his books. I made bread using a low carbohydrate bread mix today.   Basically it is uneatable.   Texture is rubbery and a peculiar taste.   This would be a good way to put people off of bread….. The only decent one I’ve found is the Carbophobia brand. Got to experiment on home mixes! Nicky.

Have you tried Burgen Soy & linseed bread?  11 carbs a slice and a low GI according to the figures on mendosa.  Its edible and taken in moderation most people can manage it, I beleive. asda have it as do sainsburys.  sainsburys also have another brand of S&L but I have not checked out what the GI is. VBH T2/UK/A1c 5.6/ 1000Met/Dx Oct-03

Response:

The doctor is going to make enquiries about prescription test strips but is pretty sure that the PCT won’t agree to regular prescriptions. A political decision and not his choice.

This is the same cop-out mine is using. The PCT do recommendations, not mandates. Ask him how much he gets for having someone with a chronic disease on his books. I made bread using a low carbohydrate bread mix today.   Basically it is uneatable.   Texture is rubbery and a peculiar taste.   This would be a good way to put people off of bread…..

The only decent one I’ve found is the Carbophobia brand. Got to experiment on home mixes! Nicky. — A1c 10.5/5.7/<6  Weight 95/79/72Kg 1g Metformin, 75ug Thyroxine T2 DX 05/2004

Response:

The doctor is going to make enquiries about prescription test strips but is pretty sure that the PCT won’t agree to regular prescriptions. A political decision and not his choice. This is the same cop-out mine is using. The PCT do recommendations, not mandates.

I suspect that there are recommendations and *recommendations*. Next stop is to identify who the decision makers are in the PCT. To be honest, I would prefer not to have socialised medicine with government delivery at all, pay less national insurance just to cover those who can’t afford treatment, and then make my own healthcare payment arrangements. Ask him how much he gets for having someone with a chronic disease on his books.

Do you think that doctors get specific amounts for this? I made bread using a low carbohydrate bread mix today.   Basically it is uneatable.   Texture is rubbery and a peculiar taste.   This would be a good way to put people off of bread….. The only decent one I’ve found is the Carbophobia brand. Got to experiment on home mixes!

This one was the Atkins one, I think.   The soy content seems to create the taste of cardboard.   What is the content of the Carbophobia one? Nicky.

– .andy To email, substitute .nospam with .gl

Response:

<snip I made bread using a low carbohydrate bread mix today.   Basically it is uneatable.   Texture is rubbery and a peculiar taste.   This would be a good way to put people off of bread…..  

If you have a bread machine, try this one [I don't know how you'd do it the old-fashioned way]: Buckwheat Bread Yield: 16 servings [in 8 slices] 7/8 c water 1 tbs margarine 1 ts salt 1 tbs dry milk 2 tsp sugar 1/4 c buckwheat flour 1 c bread flour 1 c wholemeal flour 1 pk (5/16-oz) fast-acting yeast Put all ingredients, in the order given, into the bread pan, select WHITE bread, and push Start. Makes 1 loaf, 8 slices [1 serving =