Wayne Boatwright > wrote:
>Well, "militant" diabetics will definitely not like my method for
>dealing with foods I probably shouldn't eat. On the occasions when I
>choose to eat a food high in carbs, I simply adjust my medication to
>balance it. I've been diabetic for ten years, and extremely well
>controlled for eight years. My BG readings are rarely off target, and
>even then not by much. My A1C levels are consistently below "normal".


I am heartily encouraged. What kind of medication do you take? I assume you're
not insulin dependent. How much more medication do you take after eating high-
carb foods?

Orlando

"Orlando Enrique Fiol" wrote
> Doug Freyburger wrote:

>>Attitude and decisions have a long term effect. A decision is made that
>>turns to action. The action turns to habit. The habit turns to
>>attitude. The attitude makes and approach easy or difficult.
>
> I don't quite agree with your motivational rhetoric, but your heart is
> clearly
> in the right place.

Hehe he's speaking from a longer view than you have just now. He's right
but you can not see it yet as you are at the start of your first need to
diet convert.

>>I get that you resist viewing sweets and starches as poison, but to you
>>now that is what they are.

Blech, sweets make me feel sick and it was pretty simple in my case to
discover I dislike them after a long ago initial trial.
I have sugar in the house for breadmaking and the occasional desire for a ts
to add to hot tea.

Orlando, when someone makes fresh pasta, have a spoon or so then tell them
(if they didnt know already) that your Doctor doesnt allow more. Give them
puppy eyes at wanting more but refrain and it;s all good.

"Orlando Enrique Fiol" wrote
> cshenk wrote:

>>You have hijacked the thread. We may have to start a new one to discuss
>>his
>>actual questions.

> I think they will hijack a new one as well.

LOL, eventually they will be KF'd here.

>>Geeze, did you even bother to read what *this* thread it about? It;s
>>recipes and how to adapt to new needs.
>>It was going fine until the ASD folks came over.
>
> For them, any thread with me in it is a forum to push pre-diabetic
> compulsive
> testing, complete with orchestrated predictions of all the doom and gloom
> that
> will befall me if I don't do it immediately.

I saw that.

USA does not mandate or even offer suggestions at your level to test
regular. Your Doctor is doing reasonable test care levels for your result
level and has given you enough information to go on. I saw another say the
UK doesnt either at your level.

My take is you are just being smart and adapting a bit to keep what is a
pre-diabetic level label, where it is. Let me know if I missed a beat
there?

"Wayne Boatwright" wrote

> Well, "militant" diabetics will definitely not like my method for
> dealing with foods I probably shouldn't eat. On the occasions when I
> choose to eat a food high in carbs, I simply adjust my medication to
> balance it. I've been diabetic for ten years, and extremely well
> controlled for eight years. My BG readings are rarely off target, and
> even then not by much. My A1C levels are consistently below "normal".

Thank you Wayne! You are further than he is but you are a foodie and that's
what he needs just now. He's not on any meds (nor needs he anyt just yet).

Pass your favorite recipes to him?

(Orlando, you will like Wayne, he's cool people).

cshenk > wrote:
>Orlando, when someone makes fresh pasta, have a spoon or so then tell them
>(if they didnt know already) that your Doctor doesnt allow more. Give them
>puppy eyes at wanting more but refrain and it;s all good.

You're absolutely right. I know I shouldn't care what people think when I
refuse their cooking, but I do.

Orlando

cshenk > wrote:
>Thank you Wayne! You are further than he is but you are a foodie and that's
>what he needs just now. He's not on any meds (nor needs he anyt just yet).

I already take Metforman twice a day.

>Pass your favorite recipes to him?

I'd love that.

>(Orlando, you will like Wayne, he's cool people).

I've known that for years, but he never emails me. *grin* I empathize with him
about getting David to take more control.

Orlando

On 8/19/2010 6:12 PM, Wayne Boatwright wrote:
> Well, "militant" diabetics will definitely not like my method for
> dealing with foods I probably shouldn't eat. On the occasions when I
> choose to eat a food high in carbs, I simply adjust my medication to
> balance it. I've been diabetic for ten years, and extremely well
> controlled for eight years. My BG readings are rarely off target, and
> even then not by much. My A1C levels are consistently below "normal".
>
Hear, hear. I do much the same, my A1C levels are consistently at 6 or
below, corresponding to a BG reading of 120 or less, that's considered
high normal but I can live with it. I've been a Type II for sixteen
years this month Wayne. I shoot 42 units of Lantus daily and three to
four units of Novolog before a meal. Works for me.

In article >,
Orlando Enrique Fiol > wrote:

> Wayne Boatwright > wrote:
> >Well, "militant" diabetics will definitely not like my method for
> >dealing with foods I probably shouldn't eat. On the occasions when I
> >choose to eat a food high in carbs, I simply adjust my medication to
> >balance it. I've been diabetic for ten years, and extremely well
> >controlled for eight years. My BG readings are rarely off target, and
> >even then not by much. My A1C levels are consistently below "normal".
>
>
> I am heartily encouraged. What kind of medication do you take? I assume
> you're
> not insulin dependent. How much more medication do you take after eating
> high-
> carb foods?

"Insulin dependent diabetes" seems to be an obsolete term:

http://www.emedicinehealth.com/diabetes/article_em.htm

It was a synonym for what is now usually called Type 1 diabetes. It is
confusing, because some Type 2 diabetics (like myself and most of my
older relatives) are dependent on insulin.

Taking pills after eating too many carbs is probably not a good idea.
The first kind of pill I took, required 14 hours to take effect. For
people who had dinner as the biggest meal of the day, it was recommended
to take it first thing in the morning.

Regular insulin takes between 15 minutes and a half hour to take much of
an effect. It should be taken *before* eating.

--
Dan Abel
Petaluma, California USA

Omelet > wrote:
>How do you define "normal"? Many restaurants now have menu items that
>cater to this type of diet, and I've had no trouble getting them to make
>substitutions for me.

I define normal as not deliberately excluding any food group.

Orlando

Omelet > wrote:
>Portion control is the key to that.
>ONE cookie, not the whole box...
>But that takes will power. <g>

I've never had trouble controlling sugar portions because I don't crave sweets
very often or to excess.

Orlando

"Wayne Boatwright" > wrote in message
.250...
> On Thu 19 Aug 2010 07:02:38p, Dan Abel told us...
>
>> "Insulin dependent diabetes" seems to be an obsolete term:
>>
>> http://www.emedicinehealth.com/diabetes/article_em.htm
>>
>> It was a synonym for what is now usually called Type 1 diabetes.
>> It is confusing, because some Type 2 diabetics (like myself and
>> most of my older relatives) are dependent on insulin.
>
> I do not need to take insullin.
>
>> Taking pills after eating too many carbs is probably not a good
>> idea. The first kind of pill I took, required 14 hours to take
>> effect. For people who had dinner as the biggest meal of the day,
>> it was recommended to take it first thing in the morning.
>
> Actos, for example, does take a considerable time to be effective and
> is for insulin resistance. Glyburide, OTOH, is relatively quick
> acting, usually within a half hour or so.
>
>> Regular insulin takes between 15 minutes and a half hour to take
>> much of an effect. It should be taken *before* eating.

There is a class of drug (forget what it is called) like Prandin and
Starlix. They are short acting drugs and meant to cover the carbs in your
meal. I tried Starlix on a regular basis and it had no effect on my
whatever in terms of blood sugar. However, I know some diabetics who take
it only on special occasions when they are eating higher carbs than usual.
I think these meds are prescribed both ways.

I take max doses of Amaryl and Metformin in addition to two types of
insulin. I have at times accidentally taken my meds twice. I keep extra
meds in my purse because it is common for me to eat dinner out. I keep my
pills at home in a divided compartment container. So when I get home, what
I should do is take the dinner pills from there and put them in the
container in my purse. But what I have done is pop them in my mouth and
take them, given that sometimes I space out. This can make me very sick to
my stomach. But it can also lower my blood sugar quite nicely. If I could
do this all the time, I probably would because it does work well. But...
Seeing as how I am already on the max dose of each med. I can't do that.
Or I shouldn't.

Wayne Boatwright > wrote:
>Actually, I believe that diabetics who are
>controlling their disease by diet alone have the most difficult time.
>It's a tedious balance at best. Most do bettrt with starting a low
>dose of one of the medications for insulin resistance. That may be
>enough. If not, then stepping up to a low dosage of a medication to
>stimulate insullin production would probably be the next step.
>Either or both medications may need to be titrated up to
>maintainreasonable BG levels.

I've only been taking my current Metforman dosage for a month and a half, so it
might be too early to tell.

>My endocrinologist doesn't believe in deprivation, particularly for
>non-insulin dependent Type 2 diabetics like myself.

Do you mean carbohydrate deprivation?

>Gaining a thorough understanding of how carb intake and medication intake
>achieve a balance takes some time, but it is certainly possible.

I figured so.

>I don't really make special recipes, as such. I eliiminate sugar (or
>substitute Splenda) where the actual use of sugar is not essential.
>It often is essential to certain types of baking.

Fortunately, my partner doesn't bake a lot and I rarely eat sweets out. We use
Splenda or Truvia for everything around the house that needs sweetening.

>I make it a practice to never eat more than one carb rich food item at a meal,
if at all; e.g.., I don't eat both bread and potatoes together.

Same here, last Sunday notwithstanding. *grin*

>I include a lot of low-carb vegetables with most meals. I think you
>can see where I'm going here.

We already eat very similarly.

>OTOH, I have no qualms about baking
>and eating pie or cake as long as I plan ahead. Planning is
>everything.

I likewise plan. If I'm going to have a slice of pie or cake, I don't eat carbs
for the rest of the day and am sure to surround that dessert with plenty of
protein and vegetables.

>I haven't really followed the entirety of this thread, but if he has
>not already, I would suggest that Orlando seek out a top
>endocrinologist and a dietician who specializes in working with
>diabetics. Just any old doctor or dieitician won't do.

I'm working on that. It will be tricky since my GP will have to write me a
referral to a specialist, which will imply that I'm dissatisfied with her
medical advice.

Orlando

Wayne Boatwright > wrote:
>Metformin is generally effective in the system within 10 days to 2
>weeks. what dosage are you taking? I'm taking 1000mg twice a day.

I'm only taking 500 mg. twice a day.

>My doctor feels that almost all diabetics should have
>some amount of carbohydrates. A total lack of carbohydrates produces
>a state of ketosis, which can in many individuals be quite dangerous.

I probably get all the carbohydrates I need from fruit and whole grains.

>You're off to a good start there, Orlando.

Not according to the testing Nazis.

>It happens. :-) I find it hard to eat a plate of spaghetti without
>some Italian bread.

That would make me feel pretty sick. *grin* I eat spaghetti with salad or
sauteed vegetables.

>She shouldn't think that, as she herself should know than an
>endocrinologist knows far more about diabetes than anyone in general
>practice, just as she should refer you to a neurologist if she
>suspected a never disorder. You might approach it by asking her how
>she would feel about your seeing an endocrinologist and diabetic
>dietician to get a more in-depth education about your disease. I
>would also emphasize how satisfied you are with her treatment in
>every other way.

That sounds like a good plan.

Orlando

Wayne Boatwright > wrote:
>What are your numbers? When and how often do you test?

I don't test at home yet. My last fasting blood glucose value was 117 and I
test either every month or every two months. You probably think I should get a
talking glucometer and begin testing at home.

Orlando

"Doug Freyburger" > wrote in message
...
> Orlando Enrique Fiol wrote:
>> Doug Freyburger > wrote:
>>
>>>Part of that is an issue you mentioned in a different post in this
>>>thread:
>>>At least you put the word "normally" in quotes. For you, any diabetic,
>>>anyone with insulin resistance or hypoglycemia or any low carber, it
>>>does not work to view sweets and starches as normal.
>>
>> I resist this because I want them to continue to be normal for me. I
>> don't want
>> to think of lovingly prepared food as poison.
>
> Attitude and decisions have a long term effect. A decision is made that
> turns to action. The action turns to habit. The habit turns to
> attitude. The attitude makes and approach easy or difficult.
>
> I get that you resist viewing sweets and starches as poison, but to you
> now that is what they are. Sweets and starches trigger insulin release
> that drives carb cravings so there's a biochemical drive for them when
> we eat them. When we avoid them the biochemical drive goes away. Keep
> the mental resistance and you'll always be tempted to have enough to
> turn on the insulin roller coaster again.
>
> Part of being a foodie is appreciating fine foods. Consider that does
> not have to equal appreciating foods that interfere with your health.
> Being a foodie can include specializing in certain types that are
> beneficial to your health.
>
> Focus on what you can't/shouldn't eat and you make it harder. Focus on
> what you can/should eat and you make it easier. Focusing on what you
> can/should eat is consistant with being a foodie - In your case a foodie
> who has decided to change specialties.
>
> A cheese souflee' can be as lovingly prepared as a chocolate souflee'.
> An unsweetened berry and cream frappe' can be as lovingly prepared as a
> cream brulee' with berries. Spagetti squash with an herb sauce will
> almost always be more lovingly prepared than noodles with random sauce.

Excellent response and exactly right!!!


--
--
https://www.shop.helpforheroes.org.uk/

In article >,
Orlando Enrique Fiol > wrote:

> Wayne Boatwright > wrote:
> >Metformin is generally effective in the system within 10 days to 2
> >weeks. what dosage are you taking? I'm taking 1000mg twice a day.
>
> I'm only taking 500 mg. twice a day.
>
> >My doctor feels that almost all diabetics should have
> >some amount of carbohydrates. A total lack of carbohydrates produces
> >a state of ketosis, which can in many individuals be quite dangerous.
>
> I probably get all the carbohydrates I need from fruit and whole grains.
>
> >You're off to a good start there, Orlando.
>
> Not according to the testing Nazis.

It's pretty hard to know exactly what your situation is right now, and
it's impossible to predict the future. What we all know is that you are
well on the road to diabetes, and that it is almost always a progressive
disease. If your doctor has diagnosed you as pre-diabetic, and says you
don't need to test right now, that's your best information for now.
Things will probably change, though. Your "good start" now will not be
sufficient, once the disease progresses. Testing is an extremely
important tool.

Of course, few of us know what testing means for you. For most of us,
we can walk into any drugstore and pick up a glucometer. Five minutes
of instruction, and we know how to use it. But "any drugstore" won't
have a talking glucometer, and for most of us, even with a machine that
talks, there's still a visual component.

--
Dan Abel
Petaluma, California USA

Omelet wrote:
>
> Portion control is the key to that.
> ONE cookie, not the whole box...
> But that takes will power. <g>

For certain people certain foods trigger an addictive behavior pattern.
Will power is irrelevant. When there's an addictive behavior pattern
the answer that works is avoidance. That's why I call certain foods
personal poisons.

My biggest trigger food is wheat. Even a small amount of wheat and for
me it will trigger eating everything in sight. I'm out of control. A
week of avoiding wheat, that and a bunch of other features stopped. For
me tere's no such thing as portion control when it comes to wheat. The
only portion I can control in any form is zero.

I've been avoiding wheat since 21 Jul 1999 and across that decade the
symptoms have gotten a lot less. I can now eat a bowl of soup of the
day cream of something that was thickened with a little bit of flour and
not go on a binge or get other symptoms. I can now have a small portion
of deliberate dose and not binge, as long as I don't get dosed twice in
the same month. But it I allow my exposure to become common I know what
will happen. Binge time.

> Interestingly enough, I've pretty much lost my sweet tooth over the past
> few years. I really don't crave nor want sugar any more. I almost
> can't even stand the smell of sugar.

On the other hand as I age my reaction to sweets increases independent
of my tastes. I react more strongly. The stronger I react the more I
need to think avoidance not moderation. A sweet cookie made with rice
flourand chocolate chips, or a high fiber rye cracker with cheese? Rich
and savory for me needs to beat sweet. Taste-wise it always has but
when I was young it was a matter of tastes. Now it gradually becomes a
mandate from my body.

Orlando Enrique Fiol wrote:
>
> I define normal as not deliberately excluding any food group.

Another cognitive tool -

I define food as stuff that does not cause me problems, unfood as stuff
that does cause me problems.

Since we are all different we all have different lists for what is food
and what is not. Having been diagnosed with diabetes you now have a
different list of foods and unfoods now.

Wasa fiber rye cracker, cheddar cheese spread. The new one in the
fridge is the smoke favored one. Munch. Yum. Now that's a dessert
item for me.

Doug Freyburger > wrote:
>For certain people certain foods trigger an addictive behavior pattern.
>Will power is irrelevant. When there's an addictive behavior pattern
>the answer that works is avoidance. That's why I call certain foods
>personal poisons.

I totally get that. But, I don't have addictive responses to any foods. I don't
binge on anything except cherries; I swear! Give me pounds of cherries and I'll
eat them all. Give me a loaf of bread, pasta, or other starches and I'll only
want a little bit. This has always been true for me.

>My biggest trigger food is wheat. Even a small amount of wheat and for
>me it will trigger eating everything in sight. I'm out of control. A
>week of avoiding wheat, that and a bunch of other features stopped. For
>me tere's no such thing as portion control when it comes to wheat. The
>only portion I can control in any form is zero.

I get that again, but for me, I'm trying to bargain here rather than get down
to zero.

Orlando

In article 0>,
Wayne Boatwright > wrote:

> On Thu 19 Aug 2010 09:29:19p, Orlando Enrique Fiol told us...
>
> > Wayne Boatwright > wrote:

> >>Actually, I believe that diabetics who are
> >>controlling their disease by diet alone have the most difficult
> >>time. It's a tedious balance at best. Most do bettrt with
> >>starting a low dose of one of the medications for insulin
> >>resistance. That may be enough. If not, then stepping up to a
> >>low dosage of a medication to stimulate insullin production would
> >>probably be the next step. Either or both medications may need to
> >>be titrated up to maintainreasonable BG levels.
> >
> > I've only been taking my current Metforman dosage for a month and
> > a half, so it might be too early to tell.
>
> Metformin is generally effective in the system within 10 days to 2
> weeks. what dosage are you taking? I'm taking 1000mg twice a day.

I'm on the same dosage. The package insert says that 2,500mg is max,
but based on my small sample size, 2000 seems about it for serious
diabetics. And some folks can't tolerate that much.

> >>My endocrinologist doesn't believe in deprivation, particularly
> >>for non-insulin dependent Type 2 diabetics like myself.
> >
> > Do you mean carbohydrate deprivation?
>
> Yes, exactly. My doctor feels that almost all diabetics should have
> some amount of carbohydrates. A total lack of carbohydrates produces
> a state of ketosis, which can in many individuals be quite dangerous.

Let's do some serious thinking about this. A crucial nutrient is
calories. People die from starvation. Most of us on this group will
never be at any risk for starvation, but still, calories are an
important part of our diet. There are three basic sources for calories:
carbs (which in the last few years has been expanded to include sugar),
fat and protein. Some fat is necessary, but getting a significant
portion of our calories from fat is a bad idea. Same thing with
protein. That only leaves carbs (I'm ignoring alcohol). So it's not
that carbs are evil, or shouldn't be part of our diet. The problem is
that refined carbs aren't so great, and it's the *excess* carbs that do
us in. One of the things a dietician can help us with, is to control
our carb intake. If we consume a plate consisting of 2 cups of white
pasta, we've blown it (note: does not apply to triathletes in
training!). That's six carb units, way more than most people should
have in any one meal. On the other hand, for most people on a
maintenance diet, 1/3 cup of white pasta and one piece of white bread
(each one carb unit on my diet) is not enough carbs for a normal meal.
Excess carbs are a double whammy for diebetics. They spike the blood
sugar and cause weight gain. Excess weight seems to directly relate to
diabetic symptoms.

> >>Gaining a thorough understanding of how carb intake and medication
> >>intake achieve a balance takes some time, but it is certainly
> >>possible.
> >
> > I figured so.

Diabetic educators like to talk about the main factors in diabetes
management, and how they relate together (the "balance" that Wayne
mentions). In order of importance, first to last, they a

1. diet
2. exercise
3. testing
4. medications

> >>I don't really make special recipes, as such. I eliiminate sugar
> >>(or substitute Splenda) where the actual use of sugar is not
> >>essential. It often is essential to certain types of baking.
> >
> > Fortunately, my partner doesn't bake a lot and I rarely eat sweets
> > out. We use Splenda or Truvia for everything around the house that
> > needs sweetening.

The "new" thinking is that sugar is just another carb. A look at the
glycemic index tables show that sucrose (common table sugar) actually
has a lower glycemic index than white bread or potatoes. I'm not much
for sweets, but when I make or eat them, I just use sugar.

> >>I make it a practice to never eat more than one carb rich food
> >>item at a meal, if at all; e.g.., I don't eat both bread and
> >>potatoes together.

We all have to do what works for us, psychologically.

> It happens. :-) I find it hard to eat a plate of spaghetti without
> some Italian bread.
>
> >>I include a lot of low-carb vegetables with most meals. I think
> >>you can see where I'm going here.
> >
> > We already eat very similarly.

Vegetables have two things going for them. They have important
nutrients that we need, and they fill our stomaches. I find it really
hard to stop eating, so having a full stomach is a big help to me.

> >>OTOH, I have no qualms about baking
> >>and eating pie or cake as long as I plan ahead. Planning is
> >>everything.
> >
> > I likewise plan. If I'm going to have a slice of pie or cake, I
> > don't eat carbs for the rest of the day and am sure to surround
> > that dessert with plenty of protein and vegetables.

A small serving of pie or cake is not enough carbs for the day, for many
diabetics. It can't be just ignored, but as long as it is counted in, I
would think that it is OK.

> >>I haven't really followed the entirety of this thread, but if he
> >>has not already, I would suggest that Orlando seek out a top
> >>endocrinologist and a dietician who specializes in working with
> >>diabetics. Just any old doctor or dieitician won't do.
> >
> > I'm working on that. It will be tricky since my GP will have to
> > write me a referral to a specialist, which will imply that I'm
> > dissatisfied with her medical advice.
>
> She shouldn't think that, as she herself should know than an
> endocrinologist knows far more about diabetes than anyone in general
> practice, just as she should refer you to a neurologist if she
> suspected a never disorder. You might approach it by asking her how
> she would feel about your seeing an endocrinologist and diabetic
> dietician to get a more in-depth education about your disease. I
> would also emphasize how satisfied you are with her treatment in
> every other way.

Another suggestion is to ask her *when* she thinks it would be
appropriate for you to be referred to both. As a pre-diabetic, she may
feel that the specialized knowledge and experience isn't necessary quite
yet.

--
Dan Abel
Petaluma, California USA

Wayne Boatwright wrote:
> Orlando Enrique Fiol told us...
>> Wayne Boatwright > wrote:
>
>>>My endocrinologist doesn't believe in deprivation, particularly
>>>for non-insulin dependent Type 2 diabetics like myself.
>
>> Do you mean carbohydrate deprivation?

There's a matter of extent. Targetting as close to zero carbs as
possible can take folks to 10 grams per day and that's not good for
anyone except using very specific dietary rules like viewing raw seal
eyeballs as a delicacy. Any ketotic diet can easily be called carb
eprived, but so can a moderate low carb diet near 100 grams per day.

There are also diet systems that call starchy foods carbs not
vegitables. Go to nearly any restaurant in America and they standard
dinner plate has meat, some sort of lower carb veggie and some sort of
high starch veggie. There's little or no down side to anyone to skip
the high starch entry on that plate.

> Yes, exactly. My doctor feels that almost all diabetics should have
> some amount of carbohydrates. A total lack of carbohydrates produces
> a state of ketosis, which can in many individuals be quite dangerous.

At caveat from a low carber -

Benign dietary ketonuria is automatically limited and beneficial.
Metabolic damage ketoacidosis as unlimited and extremely dangerous. The
problem is the test strips that are available only give an extremely
rough scale with very little accuracy. Someone not diabetic with no
risk of ketoacidosis never needs to care that they might not tell
between the two. Diabetics at risk can't afford the risk that a light
positive reading might be the starting point of a runaway change. By
the time the next test is done at the next urination the damage could be
severe. It helps to understand that one is caused by short term
successful predator eating the other caused by long term successful
herbivore eating but the risk remains for diabetics.

Combine with blood sugar readings and the risk goes way down. Benign
dietary ketosis, the result of a successful predator diet, comes with
low stable blood sugar and low ketones. Ketoacidosis comes with high
both. Only worth it for folks who understand the differences very
clearly.

"Wayne Boatwright" wrote
> Julie Bove told us...

>> There is a class of drug (forget what it is called) like Prandin
>> and Starlix. They are short acting drugs and meant to cover the
>> carbs in your meal. I tried Starlix on a regular basis and it had
>> no effect on my whatever in terms of blood sugar. However, I know
>> some diabetics who take it only on special occasions when they are
>> eating higher carbs than usual. I think these meds are prescribed
>> both ways.
>
> I'm not familiar with either Prandin or Starlix, Julie. I'd like to
> research them.

I googled a bit. Nothing really specific if they seemed better on a short
search which doesnt mean they aren't.

> I'm also not familiar with Amaryl, but I do take Metformin. I don't
> take insulin, but David does, along with Metformin and Glyburide.
> I'm still working on his getting better control, but his problem is
> the food he eats, not the medication, and he is very resistant to
> change, as I have posted here before.

Might he need the insulin pump by now? Diet control is always better but
not everything can be corrected in all cases with that.

Dan Abel wrote:
>
> Let's do some serious thinking about this. A crucial nutrient is
> calories. People die from starvation. Most of us on this group will
> never be at any risk for starvation, but still, calories are an
> important part of our diet. There are three basic sources for calories:
> carbs (which in the last few years has been expanded to include sugar),
> fat and protein.

Okay so far.

> Some fat is necessary, but getting a significant
> portion of our calories from fat is a bad idea.

Nope. The studies that showed more fat gives more problems all used
high carb as a background. If you cut a calorie of carb and add a
calorie of fat there's no problem all the way to very low carb levels.
As long as carbs are low fat is not an issue. The problem is not the
fat. The problem is the sum of fat and carbs. Of course that summary
also says low fat isn't a problem either - True for non-diabetics not
completely clear for diabetics depending on issues like glycemic load.

Caveat to anyone who reads the above and wants to think low carb equals
no carb - Nope to that. Going below about 50 grams of carb from
veggies for longer than a few months triggers the thyroid to reduce T3
output among other changes. Caveat to anyone whjo reads the above and
wants to think they can eat a stick of butter as a snack - Nope to
that either.

> Same thing with protein.

There's a minimum protein needed for cell burning. Above that it's
burned as fuel with fairly little storage capacity. Burn enough as fuel
and a lot of urea and/or uric acid is produced. Not good for kidneys
that might have been already injured by high blood sugar bouts.

> That only leaves carbs (I'm ignoring alcohol). So it's not
> that carbs are evil, or shouldn't be part of our diet. The problem is
> that refined carbs aren't so great, and it's the *excess* carbs that do
> us in. One of the things a dietician can help us with, is to control
> our carb intake. If we consume a plate consisting of 2 cups of white
> pasta, we've blown it (note: does not apply to triathletes in
> training!). That's six carb units, way more than most people should
> have in any one meal. On the other hand, for most people on a
> maintenance diet, 1/3 cup of white pasta and one piece of white bread
> (each one carb unit on my diet) is not enough carbs for a normal meal.
> Excess carbs are a double whammy for diebetics. They spike the blood
> sugar and cause weight gain. Excess weight seems to directly relate to
> diabetic symptoms.

There are worse and better ways to pick what to get the extra calories
from. Basically think about how much carb your body can take and then
adjust the fat-to-carb portions for the same total calories.

> Vegetables have two things going for them. They have important
> nutrients that we need, and they fill our stomaches. I find it really
> hard to stop eating, so having a full stomach is a big help to me.

And veggies taste good. Brocoflower with a sauce of melted sheep milk
cheese.

"Orlando Enrique Fiol" wrote
> cshenk wrote:

>>Thank you Wayne! You are further than he is but you are a foodie and
>>that's
>>what he needs just now. He's not on any meds (nor needs he anyt just
>>yet).
>
> I already take Metforman twice a day.

My apologies then for mis-representing it. I thought you were on none. 'My
bad'.

>>Pass your favorite recipes to him?
>
> I'd love that.
>
>>(Orlando, you will like Wayne, he's cool people).
>
> I've known that for years, but he never emails me. *grin* I empathize with
> him
> about getting David to take more control.

I'm just as frustrated with a husband who refuses to follow the diet he
needs. Cholestrol and salt issues and insists on getting hot dogs at the
local 7-eleven. DAILY. Grr.

Wonder if they'd object if I took an uzzie over and wiped out the hot dog
cooker? ;-)

On 8/20/2010 4:14 PM, Doug Freyburger wrote:

> Wasa fiber rye cracker, cheddar cheese spread. The new one in the
> fridge is the smoke favored one. Munch. Yum. Now that's a dessert
> item for me.

Doug, have you tried the Wasa multi-grain with a wedge of Laughing Cow
herb and garlic Lite cheese spread on it? That combo has become my very
favorite snack lately. lots of fiber, some calcium and not much fat or
even total calorie count.
--
Janet Wilder
Way-the-heck-south Texas
Spelling doesn't count. Cooking does.

"Wayne Boatwright" wrote
> cshenk told us...

>> Thank you Wayne! You are further than he is but you are a foodie
>> and that's what he needs just now. He's not on any meds (nor
>> needs he anyt just yet).

Correction, he mentions meds now. I am unsure if he should be but he is
under Doctor care.

> Thanks, Carol. Actually, I believe that diabetics who are
> controlling their disease by diet alone have the most difficult time.

I can believe it. I predate them having any meds for hypoglycemia (old biddy
;-) and diet was all there was to work with.

> It's a tedious balance at best. Most do bettrt with starting a low
> dose of one of the medications for insulin resistance. That may be
> enough. If not, then stepping up to a low dosage of a medication to
> stimulate insullin production would probably be the next step.
> Either or both medications may need to be titrated up to
> maintainreasonable BG levels.

That makes total sense and I'm very interested in how the current
information on this runs.

> My endocrinologist doesn't believe in deprivation, particularly for
> non-insulin dependent Type 2 diabetics like myself. Gaining a
> thorough understanding of how carb intake and medication intake
> achieve a balance takes some time, but it is certainly possible.

Makes sense to me. I gather it's never exactly the same between people as
well.

>> Pass your favorite recipes to him?

> I don't really make special recipes, as such. I eliiminate sugar (or
> substitute Splenda) where the actual use of sugar is not essential.
> It often is essential to certain types of baking. I make it a
> practice to never eat more than one carb rich food item at a meal, if
> at all; e.g., I don't eat both bread and potatoes together. I
> include a lot of low-carb vegetables with most meals. I think you
> can see where I'm going here. OTOH, I have no qualms about baking
> and eating pie or cake as long as I plan ahead. Planning is
> everything.

This makes sense. Especially the veggies combination. I am not a diabetic
but I have to watch sugars for other reasons (not related to weight loss)
and I do it the same.

> I haven't really followed the entirety of this thread, but if he has
> not already, I would suggest that Orlando seek out a top
> endocrinologist and a dietician who specializes in working with
> diabetics. Just any old doctor or dieitician won't do.

He may or may not have those options, depending on health care policy and
income. (haven't a clue there on his circumstances)


>> (Orlando, you will like Wayne, he's cool people).
>
> Thanks, Carol. That was kind of you to say...and you are, as well!

Snicker, kudos where warrented!

On 8/19/2010 8:07 PM, Omelet wrote:
> Orlando, there are all kinds of sweet recipes available to low carbers.
> :-) There are many products that cater to that lifestyle and are quite
> good! Most of the products are aimed specifically at diabetics. There is
> actually a small grocery store section dedicated to it.
>

There is a Yahoo group for low carb recipes. I included one that was
posted this morning.

http://health.groups.yahoo.com/group...?yguid=2755392

Becca


Southwest Squash Casserole
From Laura Dolson

This summer squash casserole comes out similar to a corn casserole,
partly because the yellow squash is put through a food processor, making
it sort of corn-like. A similar, but different-flavored, squash
casserole is my Italian Squash Casserole.

INGREDIENTS:
~1¾ lbs yellow summer squash
4 green onions, chopped (keep white and green parts separated)
1 small can chopped green chiles (about 6 oz)
2 cloves garlic, pressed or minced
1 Tablespoon oil
1/3 cup sour cream
2 eggs, beaten
1½ cup shredded cheese (Monterey Jack and cheddar work well; use Jack
cheese with spicy peppers, if you like)
Salt and pepper to taste
~1 teaspoon worth sugar substitute

PREPARATION:
Heat the oven to 375° F.

1) Cut the squash into 1 to 2-inch lengths, and run through a food
processor, using the large blade. Alternatively, you can grate the squash.

2) Heat oil in a large skillet.
Sauté the white part of the green onions in the oil for 1 to 2 minutes,
then add the squash and green part of the onion. The idea is to get
quite a bit of the moisture out of the squash. Season with salt and
pepper to taste, (use seasoned salt, if you wish) and cook for an
additional 5 to 6 minutes.

3)Push the squash toward the outside of the pan, add a trace of oil in
the center, and sauté the garlic for 30 seconds or so. Mix it all
together and turn the heat off.

4) Transfer the squash mixture to a casserole dish (2 quarts or so). Mix
in the can of green chilis, one cup of cheese, and the sour cream. Taste
for seasoning. If you like it spicier, add a little powdered chile.

5) Add the eggs and mix together. Scrape down the sides of the casserole
dish. Sprinkle the other half cup of cheese on the top.

Bake for about 20 to 22 minutes, until cheese turns a golden brown.

Makes 8 servings as a side dish.

Nutritional Information: Each serving has 4.5 grams effective
carbohydrate plus 2 grams fiber, 9 grams protein, and 172 calories.

Janet Wilder wrote:
> Doug Freyburger wrote:
>
>> Wasa fiber rye cracker, cheddar cheese spread. The new one in the
>> fridge is the smoke favored one. Munch. Yum. Now that's a dessert
>> item for me.
>
> Doug, have you tried the Wasa multi-grain with a wedge of Laughing Cow
> herb and garlic Lite cheese spread on it? That combo has become my very
> favorite snack lately. lots of fiber, some calcium and not much fat or
> even total calorie count.

Laughing Cow cheese rules! Being wheat intolerant I'll stick with the
wheat-free wasa options. I've seen the multi-grain one and it smells
good.

"Orlando Enrique Fiol" wrote
> Wayne Boatwright wrote:

>>What are your numbers? When and how often do you test?
>
> I don't test at home yet. My last fasting blood glucose value was 117 and
> I
> test either every month or every two months. You probably think I should
> get a
> talking glucometer and begin testing at home.

I suggested testing too but it can be the easy sort where you just 'pee on a
strip' now and again. Not as accurate as the fancy sort, but will still show
a high.

"Dan Abel" wrote
> Orlando Enrique Fiol wrote:

> Of course, few of us know what testing means for you. For most of us,
> we can walk into any drugstore and pick up a glucometer. Five minutes
> of instruction, and we know how to use it. But "any drugstore" won't
> have a talking glucometer, and for most of us, even with a machine that
> talks, there's still a visual component.

Dang, missed that. Yeah, he's gonna need help even with the simple 'pee on
it' strips because they hve to be color matched to tell what they say (and
they at least used to not give much detail).

Call me blonde ;-)

cshenk > wrote:
>Dang, missed that. Yeah, he's gonna need help even with the simple 'pee on
>it' strips because they hve to be color matched to tell what they say (and
>they at least used to not give much detail).
>Call me blonde ;-)

Blondes aren't dumb. See, this is why I'm so reluctant to test. Every which way
I consider it will require much more effort on my part than sighted people
expend. I'm happy to do that when it becomes necessary, but I'm not convinced
it is yet.

Orlando

Wayne Boatwright > wrote:
>He'd probably choose his death bed over being fitted with a pump,
>especially since he still thinks his problem is minor. I cnly hope.
><sigh>

For the record, I'd gladly take a pump over injections, should I get the
choice.

Orlando

cshenk wrote:
>
> "Orlando Enrique Fiol" wrote
> > cshenk wrote:
>
> >>Thank you Wayne! You are further than he is but you are a foodie and
> >>that's
> >>what he needs just now. He's not on any meds (nor needs he anyt just
> >>yet).
> >
> > I already take Metforman twice a day.
>
> My apologies then for mis-representing it. I thought you were on none. 'My
> bad'.
>
> >>Pass your favorite recipes to him?
> >
> > I'd love that.
> >
> >>(Orlando, you will like Wayne, he's cool people).
> >
> > I've known that for years, but he never emails me. *grin* I empathize with
> > him
> > about getting David to take more control.
>
> I'm just as frustrated with a husband who refuses to follow the diet he
> needs. Cholestrol and salt issues and insists on getting hot dogs at the
> local 7-eleven. DAILY. Grr.
>
> Wonder if they'd object if I took an uzzie over and wiped out the hot dog
> cooker? ;-)

Just clean up after yourself LOL.

In article 7>,
Wayne Boatwright > wrote:

> On Fri 20 Aug 2010 03:53:44p, cshenk told us...

> > Might he need the insulin pump by now? Diet control is always
> > better but not everything can be corrected in all cases with that
>
> He'd probably choose his death bed over being fitted with a pump,
> especially since he still thinks his problem is minor. I cnly hope.

A minor problem, and he's on insulin? They say doctors make the worst
patients...

Frankly, I don't understand the pump. Other than the convenience
factor, which might be major, how is it better than the one injection
for baseline (long-acting) and one injection (regular) before each meal?
Perhaps Janet can weigh in here.

I'm on twice a day now. The doctor threatened me with four times a day,
but I got my diet straightened out enough that my numbers looked better.

--
Dan Abel
Petaluma, California USA

>
> cshenk wrote:

>> I'm just as frustrated with a husband who refuses to follow the diet he
>> needs. Cholestrol and salt issues and insists on getting hot dogs at the
>> local 7-eleven. DAILY. Grr.
>>
>> Wonder if they'd object if I took an uzzie over and wiped out the hot dog
>> cooker? ;-)
>


Encourage him to take out a very large life insurance policy....

gloria p

On 8/20/2010 5:53 PM, cshenk wrote:

> Might he need the insulin pump by now? Diet control is always better but
> not everything can be corrected in all cases with that.

My DH loves his pump. He has the best ever control with it and enjoys an
occasional serving of what used to be a no no food because he can cover
for it.

He is not a minimal carber. A normal meal will contain between 15 and 30
grams of carbs, all paid for by the pump. I'd say that between 75 and
100 grams per day is close to his normal diet. Portion control is a big
part of they way he eats. I have also learned what spikes him (through
his testing) and he is willing to test for new things I want to try. The
insulin permits corrections if something new doesn't work for him.

I think having a spouse who is knowledgeable and able to count carbs and
give him the count before a meal is a big help to him. I also try to
keep his diet varied so he is never bored with the same thing all the
time. We are true foodies here, but we are responsible foodies.

--
Janet Wilder
Way-the-heck-south Texas
Spelling doesn't count. Cooking does.

On 8/20/2010 6:34 PM, Doug Freyburger wrote:
> Janet Wilder wrote:
>> Doug Freyburger wrote:
>>
>>> Wasa fiber rye cracker, cheddar cheese spread. The new one in the
>>> fridge is the smoke favored one. Munch. Yum. Now that's a dessert
>>> item for me.
>>
>> Doug, have you tried the Wasa multi-grain with a wedge of Laughing Cow
>> herb and garlic Lite cheese spread on it? That combo has become my very
>> favorite snack lately. lots of fiber, some calcium and not much fat or
>> even total calorie count.
>
> Laughing Cow cheese rules! Being wheat intolerant I'll stick with the
> wheat-free wasa options. I've seen the multi-grain one and it smells
> good.

Sorry. Forgot about the wheat thing.

Have you tried the little round ones (I think they used to be "Baby
Bels) that Laughing cow makes. They have a light one with red wax on it.
These keep so well that we take them with us on airplanes as a snack or
even on car trips.

For my birthday, last Friday, I brought some to my Pilates class at the
gym. A lot healthier than cupcakes :-)

--
Janet Wilder
Way-the-heck-south Texas
Spelling doesn't count. Cooking does.

On 8/20/2010 7:46 PM, Orlando Enrique Fiol wrote:
> Wayne > wrote:
>> He'd probably choose his death bed over being fitted with a pump,
>> especially since he still thinks his problem is minor. I cnly hope.
>> <sigh>
>
> For the record, I'd gladly take a pump over injections, should I get the
> choice.
>

My DH loves his pump, but it isn't automatic. You do have to know your
blood glucose and how many carbs you are going to be eating.

You do know that there are continuous glucose monitors that are
implanted and work with pumps? With your limitations, maybe you should
consider a CGM. I think Minimed makes one.


--
Janet Wilder
Way-the-heck-south Texas
Spelling doesn't count. Cooking does.

Janet Wilder > wrote:
>You do know that there are continuous glucose monitors that are
>implanted and work with pumps? With your limitations, maybe you should
>consider a CGM. I think Minimed makes one.

I would readily get one tomorrow if I could. That sounds great!

Orlando

On 8/20/2010 9:14 PM, Dan Abel wrote:
> In .185.247>,
> Wayne > wrote:
>
>> On Fri 20 Aug 2010 03:53:44p, cshenk told us...
>
>>> Might he need the insulin pump by now? Diet control is always
>>> better but not everything can be corrected in all cases with that
>>
>> He'd probably choose his death bed over being fitted with a pump,
>> especially since he still thinks his problem is minor. I cnly hope.
>
> A minor problem, and he's on insulin? They say doctors make the worst
> patients...
>
> Frankly, I don't understand the pump. Other than the convenience
> factor, which might be major, how is it better than the one injection
> for baseline (long-acting) and one injection (regular) before each meal?
> Perhaps Janet can weigh in here.


For one thing, he doesn't have to shlep needles with him, trying to keep
them at a decent temperature in the heat of way-the-heck-south Texas. :-)

The main advantage of the pump is that it acts much more like a normal
pancreas than injections. It releases a steady stream of insulin for a
basal and then a calculated bolus to cover meals.

The pump provides a baseline, but it does it on a much wider scale than
injections. Since baseline insulin needs can change with just the amount
of activity, having several changes in the baseline over a 24 hour
period that coincide with activity levels is a big plus with the pump.
That means no liver dumping.

As for meal time dosing, it's not much different with the pump. You need
to know your pre-prandial BG reading and you need to know how many carbs
you are going to eat. Those numbers are put into the pump and *it* does
the calculations, releasing the proper amount of insulin.

The other thing the pump does well is a, for lack of a better term, step
dose. If we are at a restaurant or on a cruise where the meal takes a
long time, dosing the entire bolus before the meal can give you a low if
you haven't gotten to the whole amount of carbs yet. The pump can
calculate and dispense a gradual dose to cover over a longer meal period
if you program it to. This also works for a fatty meal which will slow
the absorption of the carbs. It has multiple programs that make bolusing
not only easier, but smarter.

He did the multiple injection thing and had no problems with it, but
when the endo suggested he try the pump he did and now you would have to
pry it off his body. He would never give it up.

> I'm on twice a day now. The doctor threatened me with four times a day,
> but I got my diet straightened out enough that my numbers looked better.
>

From what we have dealt with, the best control on injections was basal
and meal coverage bolus. Of course that was at the point when they took
him off all oral meds as his pancreas had really taken a beating and he
has congestive heart failure (from Avandia) which doesn't go well with
oral meds.

He credits the pump for giving him a new lease on life. If we are going
on a long cruise or trip and it might be difficult to eat as well as
he'd like to, the endo will reprogram the pump to assist him in keeping
his BG down.

The pump has had his A1Cs at a consistent 6.2 for several years. (Endo
does not want it lower than 6)

He would highly recommend the pump to anyone who asks. It's given him a
freedom and an ability to control his BG that just wasn't there before.
--
Janet Wilder
Way-the-heck-south Texas
Spelling doesn't count. Cooking does.