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RE: A thread for diabetics - 8/3/2010 5:51:00 PM   
ProlificNeeds


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quote:

ORIGINAL: angelikaJ

With the context, it seems as though she was referring to post # 114?

Yes it was a FR, was regarding #113 and #114 wherein they mention using candy or chocolate for lows.

lazy posting on my part.

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RE: A thread for diabetics - 8/4/2010 9:07:08 AM   
Moonhead


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quote:

ORIGINAL: thornhappy

Look down at the lower right.  She's talking to angelika using fast reply.

True dat. I beg your pardon, ProlificNeeds.

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RE: A thread for diabetics - 8/4/2010 10:02:24 AM   
angelikaJ


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quote:

ORIGINAL: Moonhead


quote:

ORIGINAL: thornhappy

Look down at the lower right.  She's talking to angelika using fast reply.

True dat. I beg your pardon, ProlificNeeds.


As it turns out, she was... in fact, posting to you.

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RE: A thread for diabetics - 8/4/2010 10:11:29 AM   
LadyNTrainer


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Status: offline 		A question to experienced Type 1 diabetics out there.   I do much of the cooking and almost all of the meal choosing in my household for both of my partners.  One is a cyclic low carber like me and one is a Type 1 diabetic on a pump.  The other low carber is a good cook in his own right and is basically my sous chef.  The diabetic is not as good in the kitchen and does more cleanup. 

The two of us who are more diet-conscious tend to eat almost exclusively protein and vegetables with some lowfat/nonfat dairy.  We basically don't mess around with starch, other than small portions of slow-burn carbs like raw oats or brown rice or a piece of lightly cooked sweet potato before workouts, and we don't touch sugar except in tightly controlled amounts for post-workout glycogen replenishment.  The diabetic is usually okay with the meals I select that involve things like fish + steamed broccoli with a bit of grated Parmesan, or chicken + salad vegetables and raw vegetables, and that's all I am used to having or cooking in a meal.  However he often ends up having to take glucose tablets.  I've made some effort to have more carb portions available for him (brown rice, baked hard squash, etc) that I mostly do not eat, though it's been tough for me at times to have that food at table and not partake myself.  That part I can live with, or solve by pre-making and freezing portions of brown rice and/or healthy but reasonably starchy veg that can be microwaved for him alone, but I have a few questions as to what is actually most optimal for his health.

How many carbs does a type 1 diabetic actually NEED in practice, assuming he can adjust his insulin pump at will?   Is it better for him to eat low carb and healthy as I do, and take glucose tablets if his blood sugar crashes, or is it better for him to steadily consume slow burn, low glycemic index healthy carbs like whole grains?

He used to be in the habit of eating candy and cookies to up his blood sugar, but I broke him of that and switched him to the lower calorie, zero fat glucose tablets when medically necessary on top of a healthy diet of protein and vegetables + natural whole grain/vegetable carb sources.   I've read over a fair bit of research, but I'd like input from experienced diabetics in how they have succeeded in optimally managing both their body condition and their needs for dietary carbohydrate, both low and high glycemic index.


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RE: A thread for diabetics - 8/4/2010 11:05:07 AM   
ProlificNeeds


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quote:

to eat low carb and healthy


As long as a person is getting their normal dietary needed carbs (we all need at least some in our diet) the idea is to keep your diet routine and consistant. Meaning, the insulin is set for a certain level, you have to feed that insulin level each day to avoid lows.

Caveat - 'feeding your insulin' is actually a negative term, because what insulin does is push those sugars into your blood stream, in effect, causing weight gain if your sugar intake exceeds what you burn on average per day. So while you need to balance the food and insulin, make sure it's at a level where you won't be gaining or losing weight at an unhealthy level.

Highs and lows in general are bad, over the long term they can inhibit more effecient performance from other parts of your body. So 'consistency' (I can't use that word enough) is always ideal for a diabetic.
First suggestion, try spacing small carb and complete protien meal servings throughout the day. Instead of a weaker chicken broth based soup you might go for some sort of legume and vegetable soup. Certain combinations of legumes and vegetables can make for really hearty soup bases that will stick with you on a slower digestion rate.

Fiber fiber fiber! Try adding a good dose of whole grain fiber in the morning if that's not already on the menu.
Supertime was my worst when I was on heavier insulin doses, two hours after I'd be facing a low. Even adding some healthy carb like sweet potato or whole grain rice may not be enough. If there are lows later, try keeping granola bars (or just loose trail mix) around for snacking, it'll linger longer in the system then a quick cookie or sugar tablet fix, and the healthy nutrients off the nuts and seeds never hurt.

Ultimately you want to fit the insulin to his diet, not his diet to the insulin, that can cause problems. Healthy is always best, going by the national food guide for reccomended intakes, and making sure his exercise and calorie intake perday are always consistent (when possible, life always throws us curveballs) will help weed out the roller coaster of highs and lows.

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RE: A thread for diabetics - 8/4/2010 11:12:59 AM   
Toppingfrmbottom


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quote:

ORIGINAL: angelikaJ


Or is it that changing your diet and adding exercise requires discipline and committment and effort?




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RE: A thread for diabetics - 8/4/2010 2:02:22 PM   
angelikaJ


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quote:

ORIGINAL: Toppingfrmbottom

Yes.

quote:

ORIGINAL: angelikaJ


Or is it that changing your diet and adding exercise requires discipline and committment and effort?





Aren't you worth that?

I think you are, but what I think doesn't really matter, does it... .

There are some days and sometimes more than just a day when I have pretended I wasn't a diabetic.
And at the end of that interval, the hard truth is the awareness that making the choice to eat as if I wasn't has done damage to my body.

Pretty poison.

You have a chance of NEVER becoming a diabetic.

I can't say that if someone had been able to warn me back when I could have stopped this terrible disease from ever starting I would have, but I would like to think so.

The good news is that being pre-diabetic means you don't have to make drastic changes; no pills, no shots, no daily finger sticks.

Just following a healthier life style... in small changes, that when sustained will make a big difference... if maintained over time .

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RE: A thread for diabetics - 8/4/2010 2:20:08 PM   
Moonhead


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Status: offline 		All I'd add to what PN says, is that if the type 1 diabetic is having to load up on glucose tablets, then he obviously isn't getting enough carbs at mealtimes. That's a problem waiting to happen right there.

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RE: A thread for diabetics - 8/4/2010 3:09:10 PM   
LadyNTrainer


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quote:

ORIGINAL: ProlificNeeds
As long as a person is getting their normal dietary needed carbs (we all need at least some in our diet) the idea is to keep your diet routine and consistant. Meaning, the insulin is set for a certain level, you have to feed that insulin level each day to avoid lows.


Thank you for taking the time to respond.  In truth, I don't *need* carbs, and the normal healthy human metabolism functions very well on extremely limited carbs, as evidenced by the general health and fitness of primitive peoples living in either seasonal or year-round ketosis where the primary sustenance sources are meat and fat with very limited greenery and little to no starchy or sugary foods.  Except for heavy workout preparation on a bulking cycle, I'm personally fine eating almost nothing but protein and fibrous (mostly green/leafy) vegetables, and for the most part that is what I do.  It's also what primitive humans evolved to do most of their lives, seasonally in temperate climates and year round in extreme climates.  My own diet basically consists of meat (mostly that which I kill myself, either wild or small farm organic grass raised), green and leafy vegetables, occasional berries, lowfat/nonfat dairy, nuts and a few treats here and there for variety.   I use a small amount of whole grain, etc, just before some kinds of workouts, but not daily, and not very much as a rule.  My carb-up meal is 1/4 cup of raw oats or brown rice, maybe 1/2 cup when I'm bulking.  That's a big bolus of carbs for me, the absolute most carbs I'm likely to eat at a sitting in a given week.  Most of my meals contain from 5 to 20 carbs, usually on the much lower end, and I don't do carby snacks at all.

My diabetic submissive's dietary needs are not the same as mine, so what I need to figure out is how low on the carbs he can reasonably go assuming he adjusts his insulin accordingly. 


quote:

Caveat - 'feeding your insulin' is actually a negative term, because what insulin does is push those sugars into your blood stream, in effect, causing weight gain if your sugar intake exceeds what you burn on average per day. So while you need to balance the food and insulin, make sure it's at a level where you won't be gaining or losing weight at an unhealthy level.


He's trying to lose weight and get generally fitter, though his long work hours and lack of energy make joining me in workouts difficult for him.  His specific issue is not one I've dealt with very frequently before; I am much more used to training type 2 diabetics.


quote:

Ultimately you want to fit the insulin to his diet, not his diet to the insulin, that can cause problems. Healthy is always best, going by the national food guide for reccomended intakes, and making sure his exercise and calorie intake perday are always consistent (when possible, life always throws us curveballs) will help weed out the roller coaster of highs and lows.


I appreciate your sensible recommendations and generally feel the same way myself, except that the national food guide is IMO full of shit and is not in any way, shape or form what Homo sapiens evolved to be eating.  I don't follow it; that is too many carbs for me, and too many carbs make me bloat and feel like crap even if they're from healthy sources. 

I eat somewhere between low carb and Paleolithic/Primal depending on how much physical activity I'm doing.  My primary partner/sub eats the same way and works out with me.  The question is whether my other partner who is diabetic can safely eat the same food as us if he adjusts his insulin lower, or whether I need to work harder to stock more healthy carb sources in the house and make sure he gets a carb source at every meal that my primary and I can't eat ourselves.


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RE: A thread for diabetics - 8/4/2010 3:30:36 PM   
LadyNTrainer


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quote:

ORIGINAL: Moonhead
All I'd add to what PN says, is that if the type 1 diabetic is having to load up on glucose tablets, then he obviously isn't getting enough carbs at mealtimes. That's a problem waiting to happen right there.


Mmm.  He is a grown-up and has been managing his diabetes for his entire adult life, so I've always accepted his word when he says a meal I make is sufficient for his needs and his current level of insulin.   In practice, the low carb meals I make for the rest of the household seem to be causing a fair amount of glucose tablet consumption, which does not strike me as an entirely good thing.  There is nothing stopping him from cooking his own food or grabbing prepared food from the pantry in addition to anything I make, other than the fact that he's not that skilled a cook and his sometimes insane work hours leave him limited time and energy. 

So.  Force feed him regular portions of whole grains, sweet potato, baked squash, legumes, lowfat dairy, etc? The other two of us occasionally consume small quantities of these things, and we really do like them a lot, and that's where part of the problem comes in.   I'd prefer that stuff not be on the table if I can't have it, as it will make mealtimes quite unpleasant for me.  Cooking what I can't eat isn't fun either.  Obviously his medical needs have to be a high priority, so if there should always be a carby dish on the table for him at mealtimes, I'll figure out ways to make single serving portions ahead and freeze packets for him. 

He has also done silly things like eat high carb meals when I am not around to make him eat better, though I've explained as to how his ass will be subject to a very serious paddling if he ever knowingly abuses his blood sugar levels again to the point that he is useless to me for the evening.  Since he knows how to manage his condition, and actually works in a related research field, I have generally allowed him to make determinations as to what and when he needs to eat rather than micromanaging.  However I'm not sure he is always making the best decisions despite his unarguable scientific know-how, so a little reality checking from other experienced type 1 diabetics will come in handy in figuring out when paddle should meet ass. 


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RE: A thread for diabetics - 8/4/2010 3:53:33 PM   
angelikaJ


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quote:

ORIGINAL: LadyNTrainer
 

The two of us who are more diet-conscious tend to eat almost exclusively protein and vegetables with some lowfat/nonfat dairy.  We basically don't mess around with starch, other than small portions of slow-burn carbs like raw oats or brown rice or a piece of lightly cooked sweet potato before workouts, and we don't touch sugar except in tightly controlled amounts for post-workout glycogen replenishment.  The diabetic is usually okay with the meals I select that involve things like fish + steamed broccoli with a bit of grated Parmesan, or chicken + salad vegetables and raw vegetables, and that's all I am used to having or cooking in a meal.  However he often ends up having to take glucose tablets.  I've made some effort to have more carb portions available for him (brown rice, baked hard squash, etc) that I mostly do not eat, though it's been tough for me at times to have that food at table and not partake myself.  That part I can live with, or solve by pre-making and freezing portions of brown rice and/or healthy but reasonably starchy veg that can be microwaved for him alone, but I have a few questions as to what is actually most optimal for his health.

How many carbs does a type 1 diabetic actually NEED in practice, assuming he can adjust his insulin pump at will?   Is it better for him to eat low carb and healthy as I do, and take glucose tablets if his blood sugar crashes, or is it better for him to steadily consume slow burn, low glycemic index healthy carbs like whole grains?




He needs an appointment with his endocrinologist.

You aren't a specialist in the care of diabetes.
He needs to re-evauate his diet and his insulin with his doctor.

I am sure you are on the right track and he is much better off, but he has to learn how to adapt medically from how he used to eat to how he is eating now.

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RE: A thread for diabetics - 8/4/2010 4:29:25 PM   
ProlificNeeds


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Status: offline 		LNT: It's always hard for those of us who love our naughty foods, to get over them. While you don't need to treat him as a child, he might welcome the help in disciplining his foods. I know I personally am a bit relieved when I have someone to slap my hand in a weak/lazy moment and want to fall back onto old eating habits.

Apologies for the food guide comment, I'm canadian perhaps our guide is different. The guide the dieticians gave me has vegetables and fruit as the bulk of daily intake, not carbs. The general meal potion guide they suggested is almost half your meal should be fruit/vegetable catagory and the other half divided between your strach/carb/grains and your meats. I had assumed it was a general standard perhaps it was more diabetes specific food guide they were showing me.

< Message edited by ProlificNeeds -- 8/4/2010 4:30:16 PM >

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RE: A thread for diabetics - 8/4/2010 5:16:32 PM   
LadyNTrainer


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quote:

ORIGINAL: angelikaJ
He needs an appointment with his endocrinologist.


He just about is one, though his research field leans in a slightly different diabetes-specific direction.  He generally ends up educating his doctors and updating them on the most recent papers in his field, upon some of which his name can be found in the credits. :/  However, his extensive scientific knowledge does not appear to be translating into consistent wisdom when it comes to day to day personal management. 


quote:

You aren't a specialist in the care of diabetes.


Nope, and he actually is, though his specialty is research and not patient care.  This makes it interesting for me as his dominant to overrule him even when I am fairly sure that he is not always making choices that are congruent with the knowledge he has.  Generally I don't, but this isn't having ideal results.


quote:

He needs to re-evauate his diet and his insulin with his doctor.


Some people think they know better than their doctors; this guy actually does.  His doctors tend to nod and read the latest research papers he points them to and prescribe whatever he says to prescribe.  He basically sets up his own care parameters, and I have no doubt that they're backed by very good research.  I'm just not sure any amount of knowledge as to what he should be doing on a day to day basis is going to translate to him doing it consistently, not unless I'm enforcing it.  Which is difficult to do when I'm not generally willing to overrule a specialist in his own field, even when I suspect he's making choices that are more about laziness or giving in to temptation than they are about the knowledge he has of what really is best.


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RE: A thread for diabetics - 8/4/2010 5:18:55 PM   
LadyNTrainer


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quote:

ORIGINAL: ProlificNeeds
Apologies for the food guide comment, I'm canadian perhaps our guide is different. The guide the dieticians gave me has vegetables and fruit as the bulk of daily intake, not carbs. The general meal potion guide they suggested is almost half your meal should be fruit/vegetable catagory and the other half divided between your strach/carb/grains and your meats. I had assumed it was a general standard perhaps it was more diabetes specific food guide they were showing me.


Similar to the US, and that's still way too many carbs for me, far more than any primitive or Paleolithic human would have evolved to consume regularly.  However I'm sure the needs of a type 1 diabetic are going to be different.  


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RE: A thread for diabetics - 8/4/2010 6:57:42 PM   
ProlificNeeds


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quote:

ORIGINAL: LadyNTrainer

Similar to the US, and that's still way too many carbs for me, far more than any primitive or Paleolithic human would have evolved to consume regularly.  However I'm sure the needs of a type 1 diabetic are going to be different.  



To be fair, primitives and paleolithic humans would just die if they had failing internal organs. Natural selection/survival of the fitest has a way of breeding out silly things like hereditary dysfunctions or diseases.
I know low carb diets work and can be very healthy, but I just don't know how an insulin user could do without a consistent supply. I don't know of any other foods besides carbs that will stay with you for a longer duration and put out a steady slow supply of sugars for your blood stream.

You could make him take up bird dieting! constant eating of small portions!

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RE: A thread for diabetics - 8/4/2010 7:53:23 PM   
Toppingfrmbottom


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Status: offline 		It's nice to know you think that.

I've just been tested for the last month of blood sugars and the dr said all appears normal. In the past sugars have been a bit higher than they'd like to see. So does being all normal for the last couple of months mean we're doing something right, or that there wasn't anything to worry about for the times the tests had been higher than they would of liked in the past?

quote:

ORIGINAL: angelikaJ




Aren't you worth that?

I think you are, but what I think doesn't really matter, does it... .




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RE: A thread for diabetics - 8/4/2010 8:13:13 PM   
angelikaJ


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quote:

ORIGINAL: Toppingfrmbottom

It's nice to know you think that.

I've just been tested for the last month of blood sugars and the dr said all appears normal. In the past sugars have been a bit higher than they'd like to see. So does being all normal for the last couple of months mean we're doing something right, or that there wasn't anything to worry about for the times the tests had been higher than they would of liked in the past?

quote:

ORIGINAL: angelikaJ




Aren't you worth that?

I think you are, but what I think doesn't really matter, does it... .





Unless you were eating much better before when your sugars were higher, it means you should keep on doing what works.

It is hard to exercise when it is hot out.

Tfb, you know the right way to eat and that you should exercise.

Good habits become easier to stay with as you do them.





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RE: A thread for diabetics - 8/4/2010 9:13:00 PM   
gigi08


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Status: offline 		LadyNTrainer,
My biggest concern with all of this is not so much adjusting his food/carb intake; but adjusting his insulin. If he is having lows...especially lows on a regular basis and/or around meal times then the simple answer is he is taking in too much insulin. Regardless of whether he is using a pump or injections he has too much. I am sure you know that lows are very critical so this should be addressed as soon as possible. If he is educated as you describe then he should be consulting with his dr about cutting back his insulin intake. Once he has his insulin adjusted to avoid the lows regularly then I would work on adjusting his meals/carbs. I think you may be playing a dangerous game of yo-yo trying to adjust his carb intake to prevent his lows. He may end up putting on unwanted weight and then will have another battle. There has been some very good advice given; but please keep in mind that type 1 diabetes is very individualized. What works for one may fail another - hormones, other health issues, meds, weight, metabolism, stress, etc etc all have a play on sugar levels. I wish you and yours all the best for his health and well being for all of you.

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RE: A thread for diabetics - 8/5/2010 4:45:34 PM   
Toppingfrmbottom


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Status: offline 		Only thing that has really changed is I have become a bit of a water hound. It's hot, so I am always drinking water or ice tea. And the advice nurse said a lot of h20 can help keep sugar levels down.

I suppose I also eat a bit less microwavable foods also.

Yes, good habbits once you start and get them into place are so invaluable. I don't have ice cream and cookies or anything super sugary and sweet, never really did care for the sweet treats, and it's like now, even just one doughnut or something leaves me feeling thirsty, and it's sooooooooo not worth eating the sweet stuff most times.

quote:

ORIGINAL: angelikaJ



Unless you were eating much better before when your sugars were higher, it means you should keep on doing what works.

It is hard to exercise when it is hot out.

Tfb, you know the right way to eat and that you should exercise.

Good habits become easier to stay with as you do them.






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RE: A thread for diabetics - 8/5/2010 4:55:31 PM   
dcnovice


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quote:

However, his extensive scientific knowledge does not appear to be translating into consistent wisdom when it comes to day to day personal management.


Portia said in Merchant of Venice that she'd rather have ten pupils than follow her own instruction.

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