Coming back from my 'break' from Diabetes...

[NewdestinyX]

Hello all,
I've missed you! My recent absence has been two fold. Mainly - I ended up taking another part time job in addition to my full time to help make ends meet - but the timing of the start of that new part time situation collided with my last semester of a degree I've been working on and made any 'forum time' impossible. But the other angle that I talked a little about in other threads before 'ducking out' in mid August - was that I felt I needed, after my 2 year anniversary of Dx, a BREAK from this disease. Now what the heck does THAT mean..

Well -- I needed a break from the insanity of being a Type A personality with things like this and testing 9 times a day and getting crazy about the difference between a 5.6 and a 5.2 mmol. And all the 'deprivation' in the lowER carb eating lifestyle. As I've said in the past - I've met so many of you that when you got your DX and learned you had to 'eat differently' - transitioning from carbs to fat/protein based and all 'those types' of foods - more veggies etc -- was pretty easy since you loved those foods before. For those of us who 'hated' most green based foods and/or had digestive issues too (green veggies and fat are some of the hardest substances to digest) it was a virtual 'death sentence' of ever enjoying eating again.

I adjusted to a 60-100g of carbs a day lifestyle for the 2nd year after dx and in the end between that and a very active cycling and gym lifestyle with exercise lost over 26kg in 2 years and felt pretty ok with life. But I was burned out. So I decided going into the fall I was gonna take a break.

What would that mean? Well I didn't quite know.. I was basically gonna eat 'what I felt I 'wanted'' in each given day and exercise 'when I wanted to'. But I wasn't going to 'hold myself to any standard. With my trusty Novalog flex pen in hand I would use fast acting insulin to cover for each carb I ingested and that's the way life would be.

Well - it's been interesting. The good news - is I'm graduated now - have a little more time and the holidays are near over - where each year I've splurged anyway - at the holidays - and I feel pretty good. My BG levels have been between 5.5 and 8.5 for the whole ride. Rarely under 5.5 (which they were on my strict regimen) and a recent Bayer Home A1c has shown I've slipped two points up to 6.0 from 5.8. I haven't noticed and return of tingling in feet or fingers daily EXCEPT when I went nuts and my BG level hit 9.4-10 on several occasions.

There were some foods I LOVED enjoying daily again like Pretzel rods and two slices of bread on my sandwiches - Chinese Food with all the rice, dumplings, all the rest. And some things I didn't miss and never went back to - like 'real soda' or 'hard candy' or 'soft pretzels'. I did enjoy M&M's and milk chocolate again. And interestingly they really 'tapped' my pancreas to kik in - and if I took the Novalog to cover it would often send my a bit hypo. For me - a real hit of REAL sugar makes my pancreas work 'almost normally'. Weird - but a blessing!!

This morning I started the return to my more 'controlled life style' -- living with diabetes and staying on top of it. Long time at gym -- I'm heading into dinner tonight having consumed about 50g of carbs or so for the day. Feel a little like day 1 of Atkins but not much. I don't expect it to hit until tomorrow if history reminds of anything.

The one pain through this 'care free' period was that even a blood sugar of 5.0 gave me a 'false hypo' feeling. I remember hating that at the beginning.

It was a 'costly break' in the area of weight - which I calculated for upon deciding to take the break. I gave myself 4 months through the holidays and determined I'd be okay with a regain of no more than 6-7kg. I regained 6.8 kg over the 4 months. Never needed larger pants -- my belly just hung over them a little more - Waist size didn't change.

But in the final analysis - it was a very important break - FOR ME. And very needed. I don't regret it AT ALL. It's not for the faint of heart - in the sense - that you'd really need to have fast acting insulin to make it work. Otherwise you could have unhealthy high BG levels during the break period. Some of you will consider 5.5-8.5 as 'unhealthy'. Fine. I won't argue the issue. But my A1c is in a 'maintenance' range and I have no complications and I feel 'rested' - with a little more perspective on my disease and I will approach things with a long view -- knowing that every year or couple of years I will just 'TAKE a BREAK'. No regrets.

Hope all have had a healthy holiday season!

 

[mbudzi]

Sounds like you needed it. Good for you.

Can you tell me where you got your advice for a strict carb regime and the fat/protein lifestyle? I'm trying to find out what is necessary as I'm newly diagnosed but so far have been told to just eat as normal and adjust my insulin. Having read around this seems like very poor advice.

 

[NewdestinyX]

Sounds like you needed it. Good for you.

Can you tell me where you got your advice for a strict carb regime and the fat/protein lifestyle? I'm trying to find out what is necessary as I'm newly diagnosed but so far have been told to just eat as normal and adjust my insulin. Having read around this seems like very poor advice.

Welcome to the forum, Mbudzi! And welcome to the club noone wants to be a member of. :roll: But this journey you're starting is a 'doable' one. You'll see. It will challenge everything you've ever known about eating properly and will require some adjustments that at times will seem impossible to you to bear with - but this time next year - if you're open to some changes you will be healthier than you've ever been and you'll wonder how you ever 'ate' like you used to.

Yes - it is indeed bad advice to simply 'pat you on your head and send you on your way' being told to just 'up your insulin' and eat whatever you want. Or at least it's incomplete information. Your hardest part of this journey will be actually 'challenging' your doctor and diabetic nutritionist on their deepest held 'beliefs' about how a diabetic should manage their life and diet.

Simply put - carbohydrates, from candy to potatoes to rice/bread to green vegetables are all 'sugar' in different packages and they make your blood sugar rise when you ingest them. Green veggies have the least sugar content of all and are considered 'safe' foods for diabetics as they have very low 'glycemic' index (amount of sugar). So simply put as you lower your carbs you lower the need for insulin and you lower your blood sugar. Many people here subscribe to a 'low carb' diet (which necessarily also mean HIGHER FAT - so you can feel 'full' with meals). Fat is not the big bad enemy that doctors and nutritionists make it out to be. In fact you can live your life without a single carb ever eaten. But you will die in you don't eat fat - and plenty of it. Others can elaborate on that for you and you can search for threads on here that discuss the role of fat for the diabetic.

But your doctors are still committed to the idea that you 'need' a LOT of carbs. Actually we 'do' need some carbs for brain food (some here will try and tell you otherwise but the data is very suspect and uncorroborated in the science community). But suffice it to say we don't need candy, cookies, potatoes, pretzels, rice or bread, cakes, cookies, or sugarey drinks. We LOVE those things as they are the spice of life and comfort foods. Everything your body needs can be derived from good fats, protein and green veggies. And if you need some spice to life like I think we all do - you CAN enjoy some of the comfort foods and cover for them with your insulin. There's a Catch22 with insulin though. It does indeed give you control over your blood sugar levels again as if your pancreas were still healthy and you didn't have the disease - BUT the insulin also resets your endocrine system to an 'efficient storehouse for fat' again.. Meaning fat around your belly and thighs, etc.

When we eat more 'sugar' (in any form - remember a potato is no different than a candy bar - they're both SUGAR) than our body needs (and that's not very much) - one of insulin's main jobs it to provide a pathway to store the excess sugar in our blood streams as 'fat' around our middle. The injected insulin you are taking can make you blow up like a balloon if you 'overuse it' to compensate for a high carb intake. So be careful.

To again make a VERY long story short and not to monopolize which I can tend to do - my advice after 2.5 years of this journey is:
1)Get rid of some foods from your life -permanently (sugared sodas or teas, hard candy, etc)
2)Find some 'exercise activity' you can enjoy (walking, cycling, etc) and become committed to it 3-5x a week
3)Try to wean yourself down to about 150 grams of carbs a day (about half what you're probably eating now) - learn to read food labels.
4)Make sure you test often thru the day before meals - 1 hour after meals and 2 hours after meals and learn how your body reacts to certain foods. If you spike - then eat LESS of those foods in your diet.
5)Take it slow - don't freak out and don't let yourself be 'alarmed' by certain voices on this forum and in other places that 'insulin' and some 'carb enjoyment' in your life will KILL you. They won't. That type of talk is 'hype' and scaremongering and some people tend to become 'zealots' for a 'cause' like low carbing and they can 'lose perspective'.

One low carb enthusiast (there are several) whose input to me has been very sensible is 'Vivinem' here on the forum. She's spot on. She's lower carb than I live but she has 'perspective'. There are MANY with perspective here - don't mishear me - but Viv is 'spot on' in my view.

Blessings to you!

 

[viviennem]

Aw shucks, Grant, you made me blush! :wink: Glad you enjoyed your 'holiday' - I'm having a little one over Christmas/New Year.

Mbudzi, you could do worse than have a look at a book called Atkins Diabetes Revolution, by Dr M C Vernon and J A Eberstein. It's based on the late Robert Atkins' weight loss diet, which works well for controlling blood glucose. It's written mainly for Type 2s, but can be relevant for Type 1s as well. Maybe get a second-hand copy, or borrow from the library. Another book is Dr Bernstein's Diabetes Solution, written by an American Type 1.

I'm Type 2, and an Atkins fan, and base my usual diet on his Induction Phase, at between 20g and 50g of carbohydrate each day. You can find the diet I use as a sticky thread on the Low-carb Diet thread under Food and Nutrition on the Board Index - it's called Viv's Modified Atkins Diet.

There is no need to keep your carb intake as low as I do - I have a lot of weight to lose, and this diet is good for weight loss as well as giving me tight control of my blood glucose levels. It suits me - such a low level of carbs doesn't suit others, of whom Grant is one. But if you use the Modified diet food list as a base, and add in extra carbs to the level you want (eg another forum member called Grazer eats between 100g - 150g carb daily), your blood glucose control should improve. As you increase your carbs you can decrease your fat intake a bit, but there is no need to be frightened of natural fats.

You can buy a carb counter book to help you choose the lowest carb foods, but in general it's going brown instead of white - brown rice, brown pasta, wholemeal bread - and keeping your portion sizes small. Some veg are higher carb than others - the same with fruit. I can eat berries, but bananas are a no-no.

I hope the above has given you some pointers, and I also hope that some insulin-using low-carbers will be along to give you (and me!) some extra info about the subject.

Viv 8)

 

[Mothman]

Thank you Grant and Viv for the info in this post.

Ime going to follow a much stricter diet in the New Year, i have already lost 11lb in the last couple of months by just cutting out all the enjoyable things, cakes, biscuits, crisps ets and reducing my carb intake and i didnt find this hard.
Ime not overwight, 94 kilos as of the other day and 6'1''[sorry about metric/imperial mix] which gives me a BMI of 27. However i work physically for a living so i have quite a bit of muscle mass and thats why my BMI is on the high end of the scale.

A lot of people i know are not bothering to do anything about their diabetes other than take the drugs and i dont want to go down that route. Your comments are going to be a great help to me.

I have just ordered the books you mentioned Viv, at a total cost of £7.85 inclusive of post from ABE Books, one of which is coming from the USA.

Once again, a very helpful post for which i am very grateful.

Andy

 

[pianoman]

mbudzi -- your profile says Type 1 and 2 years diagnosed? Some of the remarks above seem more suited to a newly diagnosed (and assumed overweight) Type 2, and as such, may include advice that is inappropriate for your situation.

In any case: if you are taking insulin and want to try a low-carb diet, you will need to be comfortable adjusting your own insulin dose. If (for example) you are on fixed daily or mealtime dose of insulin as prescribed by your HCP, you likely need to consult with them before making significant dietary changes -- as you may already know: unless the insulin and Blood Glucose (BG) are balanced, you risk your BG going dangerously low.

Can you tell me where you got your advice for a strict carb regime and the fat/protein lifestyle?

Viv has kindly already provided some sources. As with any book: I read them and use them as guidelines only, picking and choosing those approaches which make sense to me, and which work for me -- I like to think that I can think for myself, rather than religiously following someone else's dogma. As an example, there may be no need for you to feel bound to the same strict regime that Dr Bernstein follows.. it works for him and many of his patients but you may find you can adapt his approach to your own situation.

There are many on-line resources for a low-carb/high-fat (LCHF) lifestyle... here is one of my favourites -- the blog of Dr Andreas Eenfeldt a Swedish Medical Doctor... http://www.dietdoctor.com/lchf

Large sections of Dr Berstein's Diabetes Solution are available to read for free on-line -- so you could try before you buy http://www.diabetes-book.com/readit.shtml -- some may find his regime too extreme but he has successfully managed his own Type 1 complication-free, for many decades, as well as being a pioneer in many of the things we take for granted these days such as: home BG testing, multiple daily injections (MDI), and carb-counting

As I noted above: if you are not yet comfortable adjusting your own insulin you may want to focus on that first, or at the same time -- what you eat and how much insulin you inject, go hand in hand of course. In this regard, and also by stateside authors (so you'll need to convert the BG and other units) I have seen Using Insulin by John Walsh and Think Like a Pancreas by Gary Scheiner highly recommended reading.

 

[borderter]

This sounds so familiar! over the last decade have decided to have a break from being diabetic ,at docs when he said hba1c is up what have you been doing told him that i had had my non diabetic head on ,always honest but dont think he appreciated my reply however for the last two years have behaved more responsibly to my body and yes it does get easier most of the time but I bet all diabetics have bad moments so just keep on striving for better while forgiving our lapses.Good luck

 

[NewdestinyX]

Thanks, Borderter, for the reply to my orig post. But I don't consider my 'break' a "slip up" at all. It was premeditated and taken on purpose 'with' a purpose. . My numbers never got out of control at all. I just relaxed the regimen sort of as 'a release valve' if you will. Thanks for your thoughts!

 

[mbudzi]

Thanks for the sources. Need to change my profile (new to all this!!) as I am 4 months in. My diabetic team want me to stay on intermediate Humalin, 2 shots a day as i only take16 units a day. But I know it's going to get harder and I want to be educated and have the knowledge to make changes when that hits.

Thanks for the sources. I'll start reading and hopefully get my head around some of the details.

 

[borofergie]

Good to have you back Grant.

I completely agree with your philosophy. DIabetes is a lifelong condition and so whatever approach you take to manage it needs to be sustainable. If that involves being a "hard core" diabetic most of the time, and sometimes deliberately taking your foot off the pedal, then it's much better than getting fatigued and letting your control slip unintentionally.

It sounds as if, even during your "break", your control was much better than the vast majority of diabetics.

Stephen

 

[noblehead]

Sounds like you needed it. Good for you.

Can you tell me where you got your advice for a strict carb regime and the fat/protein lifestyle? I'm trying to find out what is necessary as I'm newly diagnosed but so far have been told to just eat as normal and adjust my insulin. Having read around this seems like very poor advice.

Hi mdudzi,

Reading through your previous posts I see your pushing to go onto the carb counting course DAFNE and looking into the prospect of a basal/bolus regime instead of your 2 shot-fixed dose.

The advice to ''eat as normal'' isn't really good advice at all and some guidance should have be given as to which foods effect bg levels the worst, for example a ''eat as normal'' diet implies that you could indulge in Simple Carbohydrates such as deserts, cakes and sugary snacks, these foods can be eaten as an occasional treat on basal/bolus (MDI) but are better left alone as they are difficult to adjust for insulin wise.

On the DAFNE course you'll learn about matching your insulin to the food you eat but they won't tell you about which foods you should be eating, you could ask to speak with a dietitian prior to or after you have completed the course for dietary advice should you choose, from my own experience I have found them very helpful in all aspects of diabetes management (my dietitian is DAFNE trained )

Books covering the GI diet are excellent in explaining which foods are healthiest and gradually release their energy over a longer period, I've bought two books and each are written by Rick Gallop who is an authority when it comes to all things regarding the glycemic index.


Grant, nice to see you back from your break and good to see your control remained good!

Pianoman, Welcome back too......I thought you would reappear when Grant came back! :wink:

 

[NewdestinyX]

Good to have you back Grant.

I completely agree with your philosophy. DIabetes is a lifelong condition and so whatever approach you take to manage it needs to be sustainable. If that involves being a "hard core" diabetic most of the time, and sometimes deliberately taking your foot off the pedal, then it's much better than getting fatigued and letting your control slip unintentionally.

It sounds as if, even during your "break", your control was much better than the vast majority of diabetics.

Stephen

Thanks, Stephen. Good to hear from you too!. I do in fact, even on a break, eat way differently than I did before dx. Thank goodness! And some talk of this 'addict' aspect. These last few days have not felt like any withdraw at all -- physically. Sure -- I prefer the 'texture' of 'cake' over a chicken caesar salad!!! LOL!!! But all is well - so far.. I'll keep checking in..

Grant, nice to see you back from your break and good to see your control remained good!

Pianoman, Welcome back too......I thought you would reappear when Grant came back!

Thanks, Noblehead! Good to be back.. And, yes, Pianoman has shadowed me now at several forums. I feel like I'm sort of his "Ahab's whale" as it often appears as if he feels called to 'disavow' my every educated AND personal conclusion. :lol: I think he watches for threads I'm in before jumping in.... :?

Need to change my profile (new to all this!!)

And mbudzi, yes - I did not see you were a Type 1 when I originally wrote to you. Making sure your insulin dosing is correct is huge. Be careful as you change your diet. Pianoman was very correct to point that out and I missed it..

 

[Sanober]

Hi Destiny X

glad to see you're back on the forum. When I see your post(s) I love to get a coffee and sit with my feet drawn up on seat of my chair and really read your EPIC loooong forum posts. :lol:

I remember moaning to you about my frustrated attempts at controlling my 'Type 2' Diabetes.

WELL - as suggested by you and some helpful LADA types here, I indeed turned out to be LADA/Type 1.5/Slow onset of T1 in Adulthood. I tested postive on the anti-GAD test. Which I asked for in the end as they gave me Gliclazide and it was doing nothing!

So I'm on insulin and I'm feeling so much better and even put on a few pounds over Christmas/New Year (who doesn't eh).

I'm back to more normalised levels of carbs (for me personally) around 100 - 180g. I will be attempting to get back into exercise but wow amount constant tweaking and adjusting with this insulin business....

Hope all is good with you.

 

[NewdestinyX]

Hi Destiny X

glad to see you're back on the forum. When I see your post(s) I love to get a coffee and sit with my feet drawn up on seat of my chair and really read your EPIC loooong forum posts. :lol:

I remember moaning to you about my frustrated attempts at controlling my 'Type 2' Diabetes.

WELL - as suggested by you and some helpful LADA types here, I indeed turned out to be LADA/Type 1.5/Slow onset of T1 in Adulthood. I tested postive on the anti-GAD test. Which I asked for in the end as they gave me Gliclazide and it was doing nothing!

So I'm on insulin and I'm feeling so much better and even put on a few pounds over Christmas/New Year (who doesn't eh).

I'm back to more normalised levels of carbs (for me personally) around 100 - 180g. I will be attempting to get back into exercise but wow amount constant tweaking and adjusting with this insulin business....

Hope all is good with you.

Great to hear from you Sanober. I'm glad you got a solid diagnosis. That makes all the difference in the world. Knowing that you're 1.5 kinda pushes insulin into the picture no matter what. And let's face it - insulin just gives you more 'choices' period. You do have to watch how you eat. The terrible thing about diabetes T2 and 1.5 (both slow onsets) is that they're developing for YEARS. The slow breakdown of the pancreas and liver communication system (what I believe is central to diabetes T2 and 1.5) creates the situation where we get used to taking in a certain amount of excessive carb calories and the sugar just stays in our blood and doesn't get stored as fat. So we get used to eating a lot and ONLY gaining a little at a time over many years. Yes - we eventually get to obesity -- and often as much as 100 pounds overweight as I was.

But INSULIN makes us VERY honest. It resets the 'fat storage' process to the way a perfectly healthy body achieves it. And I'm convinced there is no mid life adult - who isn't an athlete, that needs more than about 1200 calories a day. We WANT more than that - but we don't NEED it. So when we go on insulin and the body's systems start working normally again -- many gain weight and blame it on the insulin -- as if it's the cause of the gain.. when it's only indirectly a factor. The injected insulin just makes our bodies work 'normally' again. We turn back into EXCELLENT fat storage systems for too many carb calories consumed.

So watch it. Remember -- you don't need as many carb calories as you'd desire. Fat and Protein calories don't really turn into fat in our bellies directly so you can be a little more 'loose' with those calories taken in. As I said -- my little break from lowER carb eating cost me about 6-7 kilograms of weight. And it's taking some time to get it off again.. Moderation in all things is my motto. And let's face it - most middle aged people, even without diabetes will never see the pants sizes they had in high school ever again.. I'm okay with that!! :clap:

 

[Sanober]

Hi New Destiny

You're right I'll need to watch it with the new 'honesty' serum - I think I may be lucky for now as I'm on tiny fixed bolus amounts really with a low dosage background basal - as I seem to be very sensitive to it. So am on 1.5 for breakfast and lunch (unless protein eaten of course) and 2u for dinner .

Even at 1.5 units for a 25g carb breakfast I can go down to 4 mark on the glucose meter in 5 -6 hours or so but better than when I was below 4 at 3-4 hours later when I was on 2u. My busy job means I can't stop and nibble constantly - so usually 5 - 6 hours break between main meals is normal.

The trick for me will be to get back into exercise. The insulin has helped me eat more normally and make me feel better (so many horrible symptoms now gone!) but no point eating normally and not doing any exercise.

Constants adjustments...