NewdestinyX
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. I've heard good and bad things about regular insulin. You have to get the dosing just right to prevent hypos too. But if it works for you - cool!Caleb Murdock said:Grant, you and I seem to agree on everything. Diabetics should start insulin early (why wait until you have permanent nerve damage?), and it should be fast-acting insulin. In your case, you are using a very fast-acting engineered insulin; in my case, I am using regular insulin (I don't have insurance here in the U.S., and regular is cheapest). All this means is that you can eat one large meal on your shot, whereas I can eat two smaller meals on my shot. It's really the same thing. [q
Well this isn't entirely accurate. Almost no T2's have adequate pancreatic help for their fasting either. The fasting is what breaks first in fact.. but...A lot of people take Lantus because they are in love with the idea of taking one shot a day, but Lantus is designed to cover your body's fasting needs, not your meals. Most type-2 diabetics have enough pancreatic function to cover their fasting needs;
..YES! quite right.. T2's have 'broken first phase insulin responses - so if it's from their liver's dumping before a meal (fasting) OR from a cortisol release causing the liver to dump early am (fasting) OR after eating a carby meal -- suffice it to say - it's the first phase insulin response that's pretty badly broken by the time full diabetes has set in and creates the elevated BG levels. The 2nd phase insulin response which helps pull us back down to fasting levels is what most T2's have enough pancreatic help for unless they're particularly obese which complicates things.it is their meals that their pancreases can't handle.
Well slow acting insulin was never meant to cover meals. It's not for meals at all so it would only have given you massive hypos if you took enough to cover for meals. Your fasting numbers would have been WAY low. Even at 100lbs overweight when I started - the most Lantus I could take was 32 units without getting bad hypos. I settled in a 28 units and over 2 years worked my way to 'no units'. Don't need the Lantus anymore.(When I took Lantus, I discovered that I would have to take a daily shot of 90 units to cover my meals adequately.)
OH PRECIOUS TRUTH!!! Somebody else gets my point I've tried to make on SOOOO MANY forums. I couldn't state it better. One of the other big lies on forums is that IF YOU GO ON INSULIN YOU'LL GAIN WEIGHT!. What a terrible myth. People ONLY gain weight on INSULIN when they OVERUSE IT, OVEREAT STILL or start massively obese and can't get 'ahead of the curve', if you will. Using insulin resets our bodies to 'normal'. And as you rightly say -- no middle aged sedentary person needs 2500 calories a day. Not even close.I agree also about carbs. What the fast-acting insulin does is it turns our bodies back into more-or-less normal bodies. A middle-aged non-diabetic can't eat 250 grams of carbs a day without gaining weight.
Exactly.. Except I didn't have to watch things as much when I was young and more active. What I think you could more accurately say there is that we need to watch our intake like we did BEFORE we started getting diabetic. Diabetes does a terrible things as it's in onset: We start to overeat a little - and add a few pounds - though not diabetic yet.. Then as the genes allow the beginnings of the disease, which is a breakdown of the communication between pancreas and liver, to occur - the sugar from our food starts to stay in the blood and NOT GET DEPOSITED to OUR BELLY as quickly. We do get fatter, 80% of us T2's, but much slower. SO this lulls us into thinking we can eat 3000+ calories a day and 400-500grams of carbs and hey -- just a little more love handles. BUT insulin return us to NORMAL.. AND WOW -- can the weight come on REAL FAST if we eat ANYWHERE NEAR what we did prior to the onset of the disease.On insulin, we have to watch what we eat just as we did when we were younger.
Almost EXACTLY my experience. Except my numbers are 90/120/150'ish. And I use a little less insulin than my ACTUAL I:C ratio would call for. So I allow my numbers to be 5 - 5.5mmol fasting - and go up as high as 8.3 mmol and then after two hours can still be 6.6 and I don't take any more insulin than would create that outcome after 2 hours. So I take about a 1:20 ratio of fast acting rather than what would make for 'perfect numbers' if I use my 'actual' 1:11 ratio.and And I agree about the numbers you quote also. My experience is this: If I average more than 200 carbs a day, I gain weight. If I eat about 180 carbs a day, I plateau (but then, I need to lose weight). If I eat about 150 carbs a day, I lose weight very, very gradually.
You're not alone in your approach to carbs. Food, for many people, is their main stress reliever. They don't drink or smoke but love a good starchy meal. And there are 'good feeling endorfins' released by many foods especially chocolate. I would see a therapist eventually about these kinds of ties to food as that can be very helpful. But so many diabetics who go so low in their carbs list in their signatures that they're also on 'anti depressant meds'. I think -- no wonder.... :roll: ..trying to be sensitive too..150 carbs a day is my goal. My problem is that I'm an emotional eater, and sweets are my best friend. I've just gone through 3 months of eating over 200 carbs a day, and I gained 5 lbs. I am trying to get my carbs under 200 now.
He is an extremist and considered a dangerous influcence by almost everyone in the endocrinology field. I believe for good reason. He makes people flirt with hypos by his goals and he says to have stay healthy you need to virtually eliminate carbs. Be assued he is ALONE in the medical field and I consider him a quack. Other don't. But very few follow his idea to the letter and yet they still invoke his name as a 'leader' in developing their thinking. Sheesh... I don't get it. But -- each to his own.. My kids and wife's A1c's are all in the mid to high 4s. None of them are at 4.3. There are several books that show normal A1c's starting at 3.9. So Bernstein is not just making this stuff up out of thin air. My doctor says most of his non-diabetic patients are between 4.5 and 4.9 - and though he has to follow the AMA guidelines in telling me what 'normal is' - he acknowledges that he'd like me in the mid to high 5s and not 6.5-7.0 - if I can get there; mostly because of retinopathy issues which are getting more and more widespread because of pre-diabetes and the ADA's looser guidelines allowing people to think that 6.5 is 'normal' - which it isn't. With regard to 'retinopathy' complications -- not even 5.3 is 'normal'. -- almost normal.. but not.I've had some thoughts about the original topic of the thread. How low is too low for an A1c? Someone said that Bernstein recommends 4.3%, but in my opinion, Bernstein is an extremist.
Yes, we agree on all things Bernstein. He's 'alone' in his field. For good reason in my self-educated view.A normal person's BS may be 90 (5.0) with peaks of 125 (6.9) after meals, but Bernstein wants his patients to be at 83-90 at all times (4.6-5.0). Thus, the A1c that he considers to be optimal is lower than even a normal non-diabetic would have. So my view is that 4.5% is low enough for anyone. (Just a reminder: The A1c test measures a different blood factor than a glucose test measures, so the numbers are not equivalent -- an A1c of 4.5% is equivalent to an average blood glucose of 4.6. An A1c of 6% is equivalent to an average blood glucose of 7.)
There is a good balance of people here, Caleb, with different control regimens and general respect for one another. Better than the other big American forums I've visited. And there is no doubting that lower our carb intake IS effective in controlling this disease. So I can't push back on people who choose to try that method before any other method. And additionally - for so many people in mid-life, when T2 tends to set in, the idea of BEATING THIS DISEASE BY LIFESTYLE CHANGE sets up a GREAT mid life self-challenge - that's akin to an Australian 'walkabout' or 'pilgrimage' across the Pyrinees(sp?) Montains like that new American movie is about. You're at a little later stage in life I think I noticed and may have to accept some limitations in terms of the activity you can do - but I got diagnosed at 48 - and became and avid cyclist and really found it to be a mid life project getting back to my high school weight and being fitter than most people my age. It's been a great journey. But I admit this year's been harder.. I've been 'regressing'.. The good news - is ALL the work HAS paid off and I am used to eating about 1500 calories a day and 80-100g of carbs.. So I'm not totally off the wagon -- just feeling like I need a break from all the INTENSE focus on my eating and exercise. I'm 'tired'. I need a break.. So I'm gonna take one. But I really HAVE retaught myself to eat. It's quite liberating. I am no longer 'ruled by food'. And you'll get there too. But be hard on yourself at the beginning. Even though a lot of people on these forums were 'alarmists' (in my view) at the beginning of my journey -- the 'alarm' bells they sounded -DID HELP jumpstart me in the right direction. Even some of the 'scare-mongering - if I'm honest with myself -- was helpful as a means to an end (though I'm not alarmist to newbies here at all). Sadly though - there are WAY more T2's NOT taking their disease seriously than ones that are. I'm glad for people who tell me to 'hang in there' and keep reminding us that carb over-indulgence IS a problem for a T2 diabetic. It just is.