recent insulin study

[fatbird]

Noblehead you failed to answer my question-93% of type one diabetics do not get to a safe HbA1c >6.5 in old money as reported and is not a safe number-don't you agree? This is a fact as published by the NHS and referenced in my post on this thread.

As for "i believe in fairies but that doesn't make them real. thought u only delt in facts?"

True

FB

 

[noblehead]

Tell me bout it lol, thought is was just me

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To a point

Tell me bout it lol, thought is was just me

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To a point reducing carbs works and insulin usage does decrease (I know this to be true), however as we all know from personal experience and reading others on the forum that when you start to replace the carbs with too much fat and protein it can create more problems than it solves:

http://care.diabetesjournals.org/content/36/4/810.full

 

[fatbird]

Noblehead said "when you start to replace the carbs with too much fat and protein it can create more problems than it solves"

What problems are you referring to?

FB

 

[mo1905]

I clicked on the link that was posted and just saw "47 pages" ! Sorry, I just don't get time or even want to read all that ! I'll carry on managing myself how I see fit


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[noblehead]

Noblehead you failed to answer my question-93% of type one diabetics do not get to a safe HbA1c >6.5 in old money as reported and is not a safe number-don't you agree? This is a fact as published by the NHS and referenced in my post on this thread.

As for "i believe in fairies but that doesn't make them real. thought u only delt in facts?"

True

FB

I've said many a time that the figures are miserable and need to be addressed, however there's a number of type 1's quite happy with levels above this figure and I certainly didn't think I wasn't well controlled when I had an Hba1c of around 7, when I developed retinopathy I had an Hba1c of around 8 and was told to get it down to 7, I did so and I've been clear for the last 8 years, sometimes you can take a horse to water but you can't make it drink, often people don't want to change or are completely in a state of denial.

Anyway you've still not answered my question, do you think I'd get my QA insulin down to 3 units a day if I were to eat 30g?

 

[noblehead]

I clicked on the link that was posted and just saw "47 pages" ! Sorry, I just don't get time or even want to read all that ! I'll carry on managing myself how I see fit


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Sorry Mo I'll try again, it works fine my end:

http://care.diabetesjournals.org/content/36/4/810.full

 

[mo1905]

Sorry Mo I'll try again, it works fine my end:

http://care.diabetesjournals.org/content/36/4/810.full

Sorry Noblehead, yours is fine. I meant the one FB put up !


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[noblehead]

What problems are you referring to?

FB

First off read the article and you'll see why those who VLCHF need quite a lot of insulin for the small amount of carbs they eat. Also, having been on this forum for several years and talking from experience from having low(ish) carbed before it's quite common for low-carb type 1's to have to inject 6-10 times a day compared to those who don't and inject 4-5 times, this is due to the slow rise in bg many hours after eating caused by the slow releaese of protein and the fat content of the meal.

 

[fatbird]

Noblehead you failed to answer my question-93% of type one diabetics do not get to a safe HbA1c >6.5 in old money as reported and is not a safe number-don't you agree? This is a fact as published by the NHS and referenced in my post on this thread.

Comment please.

FB

 

[mo1905]

Perhaps it's the 93% that don't belong to this forum and who don't really care ?


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[noblehead]

Noblehead you failed to answer my question-93% of type one diabetics do not get to a safe HbA1c >6.5 in old money as reported and is not a safe number-don't you agree? This is a fact as published by the NHS and referenced in my post on this thread.

Comment please.

FB

Are you stuck Fatbird, answered the question earlier on but not received a reply to my question, off to bed now so have a good night and do sleep well

 

[fatbird]

Noblehead you did not answer my question. What are your views on the fact that 93% of type one diabetics fail to get to a safe HbA1c.

FB

 

[anna29]

Perhaps it's the 93% that don't belong to this forum and who don't really care ?


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Valid point mo1905 - this could well be possible .

There is/are people that are not into surveys , facts or thesis's at all .
Too much information "overload" for them .
Preferring to stick with what works for them with their own diabetes management .

 

[anna29]

Noblehead you did not answer my question. What are your views on the fact that 93% of type one diabetics fail to get to a safe HbA1c.

FB

Ermmm FB - he has gone to bed !
Give it a rest now eh .

 

[fatbird]

Anna said "There is/are people that are not into surveys , facts or thesis's at all .
Too much information "overload" for them. Preferring to stick with what works for them with their own diabetes management "

I agree Anna but the NHS stats are fact and the information is audited and comes from Doctors files re their patients not from diabetics. Are we to believe the Doctors and their records are not a true reflection on the facts. Are the Doctors and HCPs committing fraud?

FB

 

[anna29]

Anna said "There is/are people that are not into surveys , facts or thesis's at all .
Too much information "overload" for them. Preferring to stick with what works for them with their own diabetes management "

I agree Anna but the NHS stats are fact and the information is audited and comes from Doctors files re their patients not from diabetics. Are we to believe the Doctors and their records are not a true reflection on the facts. Are the Doctors and HCPs committing fraud?

FB

I suggest you ask "them" - if you wish to know this fact , best place/form and source .

 

[mo1905]

Stats, numbers, surveys, percentages can all be "tweaked" or biased. That is also fact. I don't know one way or the other about the 93% or any other graph, stat or quote in the NHS paper. Even if it were all true, so what ? What can we do about it ? No 2 diabetics are the same ! Fact ! 50g of carbs for one may or may not suit the other. We need to look after ourselves first and foremost. I don't really know what you want us to say or do ? Discussion is good but not if it has no benefit or direction.


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[fatbird]

Anna said "I suggest you ask "them" - if you wish to know this fact , best place/form and source"

The facts are here Anna http://www.hqip.org.uk/assets/NCAPO...cess-and-Treatment-Targets-published-2012.pdf

FB

 

[academicdiabetic]

Hi 'fatbird' (love the picture of the bird by the way!)

Re the '93% of (T1s or all diabetics?) not making 'targets' - firstly, thank you very much for rasing this and for posting the link, I'll read the report with interest. Whilst I agree that, individually, we obviously have to do what we feel is best for ourselves, I can't help but feel that establishing objective facts about our health condition (if we can, whether by reading research or doing our own research on ourselves or both) must ultimately help that goal! Otherwise a simple belief in the likelihood of winning the lottery would have most people ending up in pretty dire straits whilst waiting for that probably false belief to materialise..

Anyway, back to the 93% : One question is whether the targets are what they should be. The NICE guidelines, amongst other guidelines, cite particular 'normal' glucose levels to aim for, but they don't cite the epidemiological research these come from (an interesting point here given the flow of the current discussion - anyone who is working to a particular (guideline-based) blood glucose 'target' is already, whether they realise it or not, relying on research that applies to the population, not to themselves, so how does it make sense to be uninterested in research evidence?). ...... Looking through the literature, I have so far been able to find only 3 studies attempting to identify 'normal' population blood glucose levels. Two of these are too small to be useful, the third may be the one NICE is working on and does give the figures they suggest as averages.... the devil is in the detail here, as when you break the figures down by age and gender (as the authors do...) the 'normal' levels are quite different from the 'average' NICE levels quoted... so, for a 'normal' 50 year old woman, for example, the 'normal' level is 14.7 mmol/l not 5mmol/l..... I am not making any claims here for what blood glucose figures 'should be' for anyone.. what I am saying is that without rather more evidence to back up the NICE figures, a lot of people may be aiming for something which is not only not achievable, but possibly 'abnormal', which could at least contribute to the 93% figures.

 

[craig81]

I was referring to the good members of this forum who are pro-active in their diabetes management, some low-carb others don't but we are all take our diabetes seriously and hold good bg control.

As for the TDD amongst type 1 here on this forum, I think you find that people like myself who eat carbs in moderation are on similar or less insulin than those who very low-carb (below 50g a day) so going too low-carb doesn't necessarily mean less insulin. If you consider today I've injected 16.5 units of QA insulin for 160g of carbs which works out at around 1 unit for every 10g of carbs, some low-carbers inject similar amounts but only eat 30g of carbs.....therefore that's a insulin ratio of 1 unit to roughly 2g of carbs, so how woiuld you account for that Fatbird.....which is better do you think and do you think I would keep my current insulin ratio were I to eat only 30g of carbs?

Hi Noblehead. I've been a type 1 diabetic for 20 years and moved to a low carb paleo template diet a year and a half ago. You are absolutely spot on about insulin requirements. Initially when I moved over to low carb, my insulin requirements went as low as 15 units tdd from about 45 units on my former diet. However, after a period where my body adjusted to a fatty acid metabolic pathway and the consumption of nutrient rich food, this low total promptly changed and sits at about 30 units daily- 12 units of that is my basal (levemir). Included within this tdd, however, is the need to inject for green tea and coffee as caffeine raises my blood sugar one hour after consuming it. So again, for me, you are spot on with the amount of injections I take - typically around 7 a day on average. I have contemplated giving up caffeine but...nah I've got to have some vices.

Anyway, with respect to my insulin requirements, it took a while to understand why, but, after a lot of reading, the increase in my insulin needs is largely to do with the insulinogenic nature of the foods I now eat and the bodies adaptation to this style of eating. For example, on a low carb diet, there is a high glucagon response from the body whenever I eat a meal that has protein in it. The body requires insulin to allow the amino acids from protein consumed to enter the cells otherwise they can't be used. Part of this process involves pumping out glucagon to prevent the person eating this diet from suffering hypoglycaemia from the insulin response to the amino acids. Of course as a type 1, I don't produce insulin and so need to inject accordingly, otherwise my blood sugars go high because of this glucagon response. This glucagon response does not happen if I were to revert back to eating a high carbohydrate meal (as glucose is consumed with the insulin there is no risk of low blood sugar in a non-diabetic and no need for the body to pump out glucagon). So, bottom line, for me, is that I calculate for 40% of the protein that I eat and bolus accordingly. Interestingly, I don't seem to get that increase in blood sugars from protein consumption, after a couple of hours, that affects other type 1's on a low carb diet, and so don't need to double bolus for it. And I try and inject twenty minutes before eating as the glucagon response happens fairly quickly. This way I prevent my levels from spiking. And if there is a rise in blood sugar, it tends to happen very slowly. Same with lows.

I'm definitely in the camp where, for me, insulin is hugely beneficial (for obvious reasons), and I tend to dismiss a lot of studies because they are observational and do not take into account lifestyle factors, nutrition, stress, and any underlying inflammation within the body, which I believe is the main reason for diabetic complications (type 1 or 2 although the underlying conditions and risk factors are hugely different). Bottom line for me - inflammation, insulin resistance, and high blood sugars together = big, big problems. I'm less convinced that high(ish) blood sugars by themselves, in the absence of inflammation and insulin resistance is as problematic.