Can't get bloods in range

[himtoo]

agree with @AmandaD
could you make some enquiries with your care team about the libre ? or CGM ?
the Libre has recently become available on prescription on the NHS.

 

[pegletbee]

I am vlc so I do have to bolus for half my protein as if it were a carb. But if she’s eating enough carbs she might not need to do that. And I prebolus 20 min before as I gluconeogenisis quickly.

 

[pegletbee]

Kirsten - I just came across your remark about bolusing for half your proteins and I am really interested! For 15 of the 17 years I have been diabetic people have told me I'm barmy when I say protein puts my BS up. I do now get grudging acknowledgement that they recognise that large amounts of protein can have some effect (No - actually in my case just normal portions of protein have a significant effect, and thank you very much for calling me an idiot for 15 years) but nobody can give me any more information about how to work out the best way to deal with the issue. Can you suggest any sources of information please. I would be very grateful.

 

[Kristin251]

Kirsten - I just came across your remark about bolusing for half your proteins and I am really interested! For 15 of the 17 years I have been diabetic people have told me I'm barmy when I say protein puts my BS up. I do now get grudging acknowledgement that they recognise that large amounts of protein can have some effect (No - actually in my case just normal portions of protein have a significant effect, and thank you very much for calling me an idiot for 15 years) but nobody can give me any more information about how to work out the best way to deal with the issue. Can you suggest any sources of information please. I would be very grateful.

The Bernstein solution book. I saw this same thing when I was tyoe2 and even more clearly as I’m now LADA and injecting. I don’t know what type you are or what meds. I just inject insulin.
In the ABSENSE of carbs the body will resort to protein for energy in a process called gluconeogenisis. Protein will spike me almost as much and fast as carbs which is why I prebolus. If I take insulin and eat right away I spike fast. I know my insulin starts working at about 20 min and my protein isn’t delayed. I only eat 20 carbs a day. Not net. A carb is a carb to me. If I eat more than 3 oz or fatty animal meat ( like a beef buger or fatty steak, chicken skins) I have to split my bolus and take a bit more around an hour later to pick up the tail end. Fatty meat digests slower than lean meat and if I take the whole bolus I will go low first and then spike. I gravitate toward leaner proteins like Fish, poultry, eggs and rare lean red meats with all visible fat cut off. I also eat only small amounts at one time but I eat 5 times a day. All meals include avocado because for me it marries my protein and insulin as well as carbs.
I have a horrible touchy stomach somthe small meals and small insulin doses works well. I take 1/2-1 unit ( usually 1/2) per meal and eat every 2.5-3 hours as my small doses will run out by then and my liver will be happy to feed me glucose.
Again, in the absense of carbs protein will turn protein to glucose but if you’re eating carbs you most likely won’t see this IF you’re on insulin.
So I dose for half my protein as if it were carbs. 2 oz ( 14g) will act like 7 carbs as most proteins are roughly 7 g of protein per weighted oz.

Hope that helps. And no, you’re not an idiot!!! It’s just one of the intricacies of the lovely Diabetes!

 

[pegletbee]

Wow - thanks for taking the time to explain so fully. I have the original Bernstein book somewhere, which is how I initially went low-carb when I was first diagnosed. I too am LADA, though it took a while - a couple of years if I remember right - for them to decide that. I was persuaded to start eating carbs again when I went on the pump, basically because if there were no carbs to bolus for they had no idea what protocol to follow. Needless to say it led to weight gain as well as to roller coaster blood sugars and a high HbA1C. What I am planning to do now is something of an experiment: keep on eating my 35g of carbs magic breakfast (one scant tablespoon of overnight oats mixed with kefir and as many anti-inflammatories and anti-oxidants as I can cram into it) and go low for the rest of each day. I've only been doing it for a couple of days but I already feel less tired - a result in itself! The consultant is threatening to take away my pump funding and I need to regain some control over my own diet if not my blood sugars. Thanks again for the info. I shall re-read Dr B and see if I can find any other advice anywhere on bolusing for proteins.

 

[Kristin251]

Wow - thanks for taking the time to explain so fully. I have the original Bernstein book somewhere, which is how I initially went low-carb when I was first diagnosed. I too am LADA, though it took a while - a couple of years if I remember right - for them to decide that. I was persuaded to start eating carbs again when I went on the pump, basically because if there were no carbs to bolus for they had no idea what protocol to follow. Needless to say it led to weight gain as well as to roller coaster blood sugars and a high HbA1C. What I am planning to do now is something of an experiment: keep on eating my 35g of carbs magic breakfast (one scant tablespoon of overnight oats mixed with kefir and as many anti-inflammatories and anti-oxidants as I can cram into it) and go low for the rest of each day. I've only been doing it for a couple of days but I already feel less tired - a result in itself! The consultant is threatening to take away my pump funding and I need to regain some control over my own diet if not my blood sugars. Thanks again for the info. I shall re-read Dr B and see if I can find any other advice anywhere on bolusing for proteins.

The Rosedale Diet Is when I first heard of protein raising bg, leptin and insulin
So I followed his protocol of .8 g of protein per kg LEAN body mass divided throughout the day and it worked like a charm. You can get loads of info on his website so no need to buy the book.
Same advice for me when I started injections. Eat 20 carbs per meal. I couldn’t get anywhere close to steady bg. And yup, packed on the pounds. I was ultra low carb many many years before DX so I just went back to that. Also works like a charm. Not many meter surprises. On the other hand I have the same bf every morning. And the same macros at lunch and dinner so I know my bolus. I don’t eat the same proteins but rather the same amount. Always with an avocado wedge and a few small veggies. Even if I don’t ‘get’ my insulin as 1/2 units are small and it’s not that precise, I still never go over a 30 point rise. So not so bad and much safer for me. I love bernsteins laws of small numbers. Small meals, small doses and small room for error. And my stomach sure likes low carb much better.

As far as anti oxidants and anti inflammatories R ALA is wonderful. Just a powerful antioxidant

http://www.lifeextension.com/magazine/2007/10/nu_lipoic_acid/page-01

http://www.life-enhancement.com/mag...update-the-ideal-antioxidant-gets-even-better

It’s best to get the R fraction rather than the regular. Most of us buy it online. It nailed my neuropathy within a week or so. Many many other benefits.

 

[pegletbee]

Great, thanks so much for the advice. I have never heard of lipoic acid before but it sounds very interesting. I have just ordered some on Amazon from a manufacturer I trust. On the subject of the proteins... Just been looking at the book I was given years ago in Holland which contains tables listing the amounts of different things in everything - from carbs and cals to proteins fats and sodium. The amount of protein in the different protein-rich foods varies enormously, from 7g in a 50g egg, through 10g in 50g of almonds and 12.5g in 50g of cheddar to 15.5 in 50g of chicken breast or steak. There's even 1g of protein in 50g of avocado. Do you calculate your 'bolus for 50%' of the protein on the basis of these individual statistics? I can't really see how else to work out the actual amount of protein you're getting in various things.

 

[Kristin251]

Great, thanks so much for the advice. I have never heard of lipoic acid before but it sounds very interesting. I have just ordered some on Amazon from a manufacturer I trust. On the subject of the proteins... Just been looking at the book I was given years ago in Holland which contains tables listing the amounts of different things in everything - from carbs and cals to proteins fats and sodium. The amount of protein in the different protein-rich foods varies enormously, from 7g in a 50g egg, through 10g in 50g of almonds and 12.5g in 50g of cheddar to 15.5 in 50g of chicken breast or steak. There's even 1g of protein in 50g of avocado. Do you calculate your 'bolus for 50%' of the protein on the basis of these individual statistics? I can't really see how else to work out the actual amount of protein you're getting in various things.

To keep things simpler for me I use a stand 7g protein to 56g of the food. I consider that white poultry and lean beef have a bit more and baby shrimp a bit less . I still weigh my proteins and package in two oz baggies and freeze. I don’t count avocado protein as I’m not sure what’s part of it makes everything marry together. If it’s the fat and fiber slowing the protein and the fiber slowing the carbs? That’s my best guess. I don’t eat nuts by the ounce, just a Mac and a pecan a few times a day. I do know that they will raise me AND stop me from dropping if eaten in any quantity. One thing I like in the US is fiber is NOT subtracted because all carbs are carbs to me. For instance here, a 5 oz avocado has 12 carbs and 9 fibers. In the UK is counts as 3 carbs. In my body it counts as 12. I would have to bolus for it and it could still give me a bit of a rise if I don’t have protein with it. Through loads of testing, the best way ( and only way) I stay steady is to base my meals on equalish amounts of avocado and protein and add a few veg and to eat every 2.5-3 hours. Sounds a bit ridiculous and rigid but I actually enjoy eating so eating smaller amounts more often works for me. I need more insulin in that time frame and I need to eat something with it so win win. Much easier in digestion too. I make my bf, take a 2 oz baggie of desired protein out, defrost it in water and add my two oz avo with some chopped veg ( radish celery green onion) and when I’m done with bf and my iPad I make my lunch and put it in my to-go container Then I divide that into two meals. I’m usually at work or on the road at noon and 3 so I have a soft sided cooler with ice packs. Food used to cause me so much anxiety that just keeeping it simple works best for me. I love all protein and avo so works out good. Admittedly Avos are a bit tedious but are required for me and they last quite awhile in the fridge if unopened. I eat one a day so rarely leftovers. Cooking in bulk helps enormously too. I flavor things with herbs, oil, mayo based dressing. My motto with this disease is to keep it simple. Managing bs is enough work.
One of my clients had no energy, depressed, achy etc. I told her about R ALA and told her to get Vit D drops. I just saw her last week and she said I changed her life. She’s full of energy, insomnia is gone and she couldn’t believe the difference it made. When my hubby and I first started we could t believe it either. No need for coffee. It does so many things at a cellular level I will most likely always take it. Did you order the R fraction or the regular? I started taking 100mg 3x a day for a month and all the reasons I was taking it for resolved so now I take 100-200 a day divided. As a warning when I was taking it before bed I gor insomnia si I take it with bf and my first lunch. If you didn’t get the R fraction, then you need 600 mg to equal 300 of the R

And I use www.calorieking.com to look up foods. It doesn’t track them but it’s very reliable. In the beginning I made a list of the foods and hung it inside a cabinet. Now they’re memorized. Short cuts help ease anxiety. So will ALA LOL

 

[pegletbee]

I'm pretty sure I only got the regular, but it is a brand I trust so I will start there, use a higher dose, and research a source of the R version that I'm happy with to follow up when I've used the first lot. I have taken vit D for several years now and initially found it the best thing I'd ever tried for improving resistance to colds, flu, etc., although I feel the magic has waned a little recently - or maybe just the deterioration due to age and rotten diabetes control has overtaken the benefits. Thank you so much for the tip though, it sounds like one of the best supplements I could possibly take, and I also have a friend who has serious problems with neuropathy due to cancer chemo and I know she's going to be very glad to learn about it too. I have no issues (well not many) with ditching the carbs, but I do still like to eat quite a wide variety of foods, and so I'm happy to calculate the protein on the basis of my book and adjust the % I bolus for as needed - as you say, after a while I should remember most of what I need. I will be very interested to see if this return to lower-carb, combined with taking protein into account and the ALA supplement starts to send me in the right direction and helps me to keep the funding for a pump. I dread having to go back to injections and the even poorer control that I used to have. And who knows - I might even manage to lose some weight! Thanks again for all your advice. I will keep you posted on my progress.

 

[Kristin251]

I think you’ll find ala to help with a lot of things. I order mine from www.swansonvitamins.com and I get the double strength 100mg. Just taking more of the regular works too. Mine are more expensive than my husbands regular but seems to work the same. I started on regular before I knew about the R fraction and I used a much lower dose and still saw good results almost immediately

Bolusing for protein and prebolusing will just take a little experimenting and then it should be easy street. I’m sure you’ll lose weight just by lowering carbs and taking less insulin.

Keep me posted to your progress! Fingers crossed.

 

[Carron29]

I been in touch with care team and I have took her off her pump now on levimer for back ground only been 2 days so been a bit high but got 7.1 reading at breakfast bit high at dinner but 6.1 at teatime so will have to see how she goes over the next few days hopefully get some good results

 

[donnellysdogs]

Your daughter has complex medical conditions and these can be additional problems to handle, my complete empathy

May ai ask please, why your daughter went on to pump? We can all have varying reasons. Ie teenager, brittle, high hba1c, hypos etc.

I have also come off pump for past two plus years.. personally I am much happier as cannula failures at the end due to my stupid body was causing me hell...

For me, I am on insulatard and now back to my first jab at 3am every morning and another 2 before I get out of bed at 8am.. (for iinjections) but getting up at 8.30.

It sounds as if your daughters struggles could get her exceptional or individual funding for a cgm. I successfully applied for this for the last 9 months and have been given funding.. about to plan out my evidence requesting continued funding.
From the sounds of your daughterrs health you would be well advised to tequest funding. I use a medtronic huardian connect and it is fantastic.
It also enables parents or hospital to login at anytime and also to get alerts....

In yours and your daughters circumstances, I would say that a cgm would be better for both of you than a pump..

Xx

 

[Carron29]

She went on the pump as she had lots of hypos at the time she was great for the first year but been bad since thats why I took her off it Iam going to ask to meet my diabetic team next week and hopefully she will have good results to show her hba1c use to be in the 7.0 range but has gone up since been on the pump

 

[donnellysdogs]

She went on the pump as she had lots of hypos at the time she was great for the first year but been bad since thats why I took her off it Iam going to ask to meet my diabetic team next week and hopefully she will have good results to show her hba1c use to be in the 7.0 range but has gone up since been on the pump

Photograph the pattern of insulin and the last 24 hours of basal rates you had running..

This has helped me to find MDI and insulin to work better for me..

Ie in pucture it clearly shows when I needed more basal. This. Helps me to get back ground and fast acting insulin working at the right time for me....

Although its over 2 years ago, my body does still have the same needs of a lit more basal at 4-11am to the afternoons and a touch more at 9pm onward. I have to take into account the peak times of acting for my insulatard and bolus's to get that increase innthe mornings but for me personally tresiba that was suggested and trialled was never going to give me good reaults.
A simple photo of my last day of pumping has enabled me well for going back to MDI...

 

[donnellysdogs]

Also , make sure you really log down and monitor everything now daughter is back to MDI..

If your DSN will allow application for funding you need really good, exceptional accounts of what is happening...

 

[Carron29]

I have sorted that now I just give her full amount at bedtime worked ok so far now we ate getting ratios right now got good result this morning 7.1 so pleased with that

 

[Carron29]

I'm writing what she eats what bloods are before and 2 hours after

 

[donnellysdogs]

I'm writing what she eats what bloods are before and 2 hours after

Also just monitor what food is ate.. actually write down each day and especially if ever meds are changed.

Please, please ask about exceptional/individual funding request for you daughter and a cgm...

I use a funded guardian connect cgm and it is absolutely brilliant..

 

[pegletbee]

Thanks - had actually ordered some of the Swanson 100mg R fraction ones just before I read your post. Glad I chose a good one! Already feel better in myself for going back to low-carb and have lost half a kilo in less than a week. BSs still a bit crazy, but you can't have everything in this life. Will let you know how things progress and if I notice that the ALA helps.

 

[Kristin251]

Thanks - had actually ordered some of the Swanson 100mg R fraction ones just before I read your post. Glad I chose a good one! Already feel better in myself for going back to low-carb and have lost half a kilo in less than a week. BSs still a bit crazy, but you can't have everything in this life. Will let you know how things progress and if I notice that the ALA helps.

Excellent. Just something to watch for. If I take it after injecting and eating my bs goes just a tad lower but if I take it away from insulin ( between meals) it can go a tad higher.

Are you in the states?? Walmart sells one much cheaper. It’s nit the R fraction but it’s 200 mg and seems to work just as well. It’s a pretty clean supp as far as other ingredients surprisingly

Congrats on the weight loss!!