- Messages
- 387
- Type of diabetes
- Type 1
- Treatment type
- Insulin
- Dislikes
- not thinking
I remember how it used to be: I'd go to bed each night not knowing whether I'd wake in the morning, or whether I'd be dead.
Not surprisingly, then, I became obsessive about whether I'd eaten enough. I'd get back up out of bed and I'd eat a piece of toast, or whatever. And sure enough, nine times out of ten, I'd wake with blood-sugar in the high teens.
So then I'd take my morning insulin, and I'd immediately go for a long walk. And then I'd wonder whether or not I'd get back safely (I was living in the middle of the countryside), or whether my corpse might not be found by a passer-by a few days later.
Then one day it occurred to me that if I simply dropped the long-acting insulin altogether, and if I didn't take any fast-acting insulin after a certain time in the day, then that would be my problem solved.
The effect of the fast-acting insulin I take, Actrapid, runs out after around 13 hours. So I didn't take any insulin after .... 11.00am!
But then I found, unsurprisingly, that I would get hungry in the afternoon and evening. And I would eat. And my blood-sugar would rise. And then I'd have to go for a long walk in the evening, just to burn it off.
So I asked at the diabetes clinic whether there wasn't a faster-acting insulin. 'Yes', I was told: 'Novorapid', it's called. So I started taking Novorapid at 4.00pm. That way I could ensure that it's effect runs out before I go to bed.
My HbA1c readings improved - and very significantly. I remember a consultant at the diabetes clinic saying: "That's a bit TOO good."
And indeed I was constantly having hypos, especially in the mid- to late afternoon.
Then, by accident, I discovered rye bread: dark rye bread. I happened to move house; and I happened to move close to an excellent baker. And I happened to start eating dark rye bread - because it tasted good.
Suddenly I found I was no longer collapsing to the floor with a hypo every other day. Eating dark rye bread steadily throughout the morning and into the late afternoon makes for effective hypo prevention. (I stop eating rye bread after 4.00pm, for otherwise my blood-sugar rises in the evening.)
So I don't have to 'count carbs'. I don't have to calculate anything. I just eat, on and off, more-or-less all day long: I eat quasi-obsessively. (That includes eating lunch and dinner: I like to cook.)
'Feeding the insulin', it's called. And part and parcel of this practice is that I test my blood-sugar quasi-obsessively.*
But that's far, far simpler - and far more realistic - than quasi-obsessional 'carb counting' and 'dose adjustment'. My typical HbA1c readings of 4.6%, or 27mmol/mol, are testament to that.
'Feeding the insulin' has rightly been described as 'doing it backwards-way-on'. For indeed, if you're not diabetic, then your pancreas's beta-cells would respond to any increase in blood-glucose by releasing insulin. So conversely, if you're diabetic, you can do the reverse: you can first take the insulin, and you can feed it! You can do precisely what a healthy body would do, but backwards.
Or alternatively, you can do what orthodox insulin-dependent diabetology recommends: you can do DAFNE - 'Dose Adjustment For Normal Eating'.
But that's completely unrealistic. For in practice, doing DAFNE inevitably involves complex calculations/guesswork and yo-yoing blood-sugar. And because insulin will be running in one's system at bedtime, doing DAFNE inevitably involves the risk of night-time hypos.
DAFNE doesn't make good sense. The typical insulin-dependent diabetic's typical HbA1c readings are testament to that.
The orthodoxy is misguided and plain wrong. DAFNE is doolally.
* I use meter-read sticks mostly last thing at night and first thing in the morning only. The rest of the time I use Betachek Visual. These visually read strips can be cut with scissors: each strip can be cut into up to five small striplets. And that makes the cost per test a small fraction of the cost of meter-read sticks. (Meter-read sticks cannot be cut with scissors, of course.) Betachek Visual are on the UK Drug Tariff, but there is at present no UK-based supplier. However they can be purchased direct from the Australian manufacturer http://www.betachek.com/uk/store
Not surprisingly, then, I became obsessive about whether I'd eaten enough. I'd get back up out of bed and I'd eat a piece of toast, or whatever. And sure enough, nine times out of ten, I'd wake with blood-sugar in the high teens.
So then I'd take my morning insulin, and I'd immediately go for a long walk. And then I'd wonder whether or not I'd get back safely (I was living in the middle of the countryside), or whether my corpse might not be found by a passer-by a few days later.
Then one day it occurred to me that if I simply dropped the long-acting insulin altogether, and if I didn't take any fast-acting insulin after a certain time in the day, then that would be my problem solved.
The effect of the fast-acting insulin I take, Actrapid, runs out after around 13 hours. So I didn't take any insulin after .... 11.00am!
But then I found, unsurprisingly, that I would get hungry in the afternoon and evening. And I would eat. And my blood-sugar would rise. And then I'd have to go for a long walk in the evening, just to burn it off.
So I asked at the diabetes clinic whether there wasn't a faster-acting insulin. 'Yes', I was told: 'Novorapid', it's called. So I started taking Novorapid at 4.00pm. That way I could ensure that it's effect runs out before I go to bed.
My HbA1c readings improved - and very significantly. I remember a consultant at the diabetes clinic saying: "That's a bit TOO good."
And indeed I was constantly having hypos, especially in the mid- to late afternoon.
Then, by accident, I discovered rye bread: dark rye bread. I happened to move house; and I happened to move close to an excellent baker. And I happened to start eating dark rye bread - because it tasted good.
Suddenly I found I was no longer collapsing to the floor with a hypo every other day. Eating dark rye bread steadily throughout the morning and into the late afternoon makes for effective hypo prevention. (I stop eating rye bread after 4.00pm, for otherwise my blood-sugar rises in the evening.)
So I don't have to 'count carbs'. I don't have to calculate anything. I just eat, on and off, more-or-less all day long: I eat quasi-obsessively. (That includes eating lunch and dinner: I like to cook.)
'Feeding the insulin', it's called. And part and parcel of this practice is that I test my blood-sugar quasi-obsessively.*
But that's far, far simpler - and far more realistic - than quasi-obsessional 'carb counting' and 'dose adjustment'. My typical HbA1c readings of 4.6%, or 27mmol/mol, are testament to that.
'Feeding the insulin' has rightly been described as 'doing it backwards-way-on'. For indeed, if you're not diabetic, then your pancreas's beta-cells would respond to any increase in blood-glucose by releasing insulin. So conversely, if you're diabetic, you can do the reverse: you can first take the insulin, and you can feed it! You can do precisely what a healthy body would do, but backwards.
Or alternatively, you can do what orthodox insulin-dependent diabetology recommends: you can do DAFNE - 'Dose Adjustment For Normal Eating'.
But that's completely unrealistic. For in practice, doing DAFNE inevitably involves complex calculations/guesswork and yo-yoing blood-sugar. And because insulin will be running in one's system at bedtime, doing DAFNE inevitably involves the risk of night-time hypos.
DAFNE doesn't make good sense. The typical insulin-dependent diabetic's typical HbA1c readings are testament to that.
The orthodoxy is misguided and plain wrong. DAFNE is doolally.
* I use meter-read sticks mostly last thing at night and first thing in the morning only. The rest of the time I use Betachek Visual. These visually read strips can be cut with scissors: each strip can be cut into up to five small striplets. And that makes the cost per test a small fraction of the cost of meter-read sticks. (Meter-read sticks cannot be cut with scissors, of course.) Betachek Visual are on the UK Drug Tariff, but there is at present no UK-based supplier. However they can be purchased direct from the Australian manufacturer http://www.betachek.com/uk/store