Frustrated Diabetic

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maybemaybenot -> Frustrated Diabetic (4/15/2011 11:21:56 AM)
This may be more of a rant, but anything anyone can add would be appreciated. I was newly diagnosed with Type 2 diabetes a little over 2 weeks ago. My HgbA1C = 6.3, my blood sugars have been running normal, except for two AM Blood sugars that were 141 & 138. I immediately started carb counting when I got the new diagnosis, but carb counting is new to me. I did the best I could using the guidelines on ADA website and a couple others. Given that I have lost 11 lbs and my blood sugars have been normal, I would say I didn't do too badly, but I wanted to see a dietician to make really understand how to do it just right. I had my first appointment with the Nutritionist today. A complete and utter disaster. She asked my food preferences and dislikes. She asked me what my personal difficulties were with meal planning. My major issue is I just don't like breakfast, more precisely eating in the morning. That has been a life long dislike. But since I got the new diagnosis I have been eating a bowl of Grapenut flakes and a glass of skim milk. < 1/2 in cereal, 1/2 to drink. I told her that at this point in time I could not do better than that at breakfast, but my goal is to be able to do better. Well... she pulls out a looseleaf notebook she made for me. It includes about 14 pamphlets and handouts and 7 tests about nutrition and her pre made meal plan for me. So she and I read pamphlets and I took tests. I did just fine on the tests. She has in the pacet 4 meal logs and wants me to fill each one in. In other words quadruple the same info. Why ? I can tell you I am not about to do it. We didn't converse, we read from pamphlets, except for when I asked a question. Then she pulls out this pre made meal plan and she has decided that 1200 calories is my number. Ok I can live with that, altho I am only 15 lbs over weight. She has assigned me 4 carbs for breakfast, a fruit and a fat. I explain that I cannot eat that much and she says... well then eliminate what you can't eat. I ask if I should re distribute those foods later in the day and she says, " probably not, just don't eat them ". Then we get to the rest of the day where I am assigned only 2 veggie servings for the day. I question this and she tells me that if I want more veggies I can eat salads, but not more actual veggies. I am not talking starchy veggies, I am talking broccoli, carrots, asparagus, cukes, yellow and green squash, that sort of thing. SO I just nodded my head, knowing this is absolutely wrong and said to myself, I will eat as many veggies as I want. At some point the topic of fresh tomatoes comes up and I tell her how much I love tomatoe sandwiches in the summer. Tomatoes, toast a smidge of mayo and I am happy. She tells me that's not a good idea and I shouldn't eat tomatoe sandwiches. Previously she had told me a nice chicken sandwich with 2 slices of tomatoe and some lettuce was good. SO I ask her why the tomatoe sanwich isn't good since it's what she reccomends without the protien. She tells me " It's too starchy, you can have one as a treat once in a while ". SHe has assigned me three snacks and I tell her I would prefer 1 or 2 snacks as prefer not to have a mid morning and afternon snack. She tell me fine eliminate the snacks. I again ask if I should re distribute them and she again says no, just don't have snacks. On this lovely diet plan she has me on: I get more of every food group than I do of veggies, even more fats than veggies. On one of the many tests she had me take, it was about being able to identify what food group foods belonged in. She reads the question from the book: WHat food group does broccoli belong in ". I answer: veggies. This flipping moron telle me that broccoli is a starch. At this point I am aggravated beyond words and tell her firmly that Noooooooo, broccoli is a veggie. She says.. well let's look at the answer sheet and find out for sure. So we do and lo and behold broccoli is a veggie, she replies " i guess you are right, I thought broccoli was a starch " I told her one of my dislikes was pastries, candy, cookies and sweets. I eat them about 6 times a year, if that. She spent a great deal of time educating me on how to make sugar free pies, cookies and cakes and how to wiggle sweets into my diet. That was very helpful. < sarcasm > She wants me to check my blood sugars. I already do this. But her plan is for me to check them pre meal and bedtime and before and after I take my walk. That's 6 fingersticks a day for someone who hasn't been out of range, except twice, in a little over 2 weeks. I think I will just forget about that litle bit of advice too. She got on the salt talk, about limiting salt intake. Believe me I understand that. I explained to her that I have a rare kidney disorder, low blood pressure and that one of the maintainence meds I take is an anti hypertensive and it has to be adjusted cuz sometimes I bottom out. I explained that my nephrologist wants me to add salt to my food. Not tons but a few shakes, as before my kidney disease I ate little salt, except for chips and junk.. About 1000 mg, and he wanted me to increase to 1700-2000 mg. This fool wanted me to go see my nephrologist, explain my new diagnosis and ask him if he would take me off my anti hypertensive, so I could limit my salt intake. Another grand idea. Diabteics are prone to kidney disease, I have kidney disease that is well managed and maybe we should start fucking around with my kidney program. < more sarcasm > I could go on and on, it was a 1 1/2 hour nightmare. And I just did the math on that 1200 calorie diet, which is based on using 2% milk and I use skim, which I told her. I just did the math when I got home and after I " eliminate" her three snacks and half the breakfast she assigned me, I will be gettign about 700-800 calories a day !!!!! I'll be looking like a young Kate Moss before you know it ! LOL Yes, I do have a plan and it is to continue eating the way I have been by referenceing the ADA sites meal plan, going to a different Nutritionist and I do intend to let my PCP know what a flipping moron he sent me to. I'm just disappointed cuz I have questions about the carb counting and exchanging items and I knew after about 10 minutes that this woman would be of no help to me. I did try, but her answers were just wrong, even tho I don't know the answer, I know her answers were ridiculous. And the best thing about this woman is she herself is a diabetic ! The second best thing she told me was as long as I lose weight < about 15 more lbs > and excercise my diabetes will " be gone " in no time. I said, well... it won't really be gone, I will always be considered diabetic or pre diabetic, right ?. She said NO ! Lots of people who are overweight cure their diabetes by losing weight, as long as I keep the weight off you won't be diabetic anymore. She herself is about 100-130 lbs overweight. I wonder why ? Looking at the experience from outside my own little world: What in the world becomes of people who go to her who have no idea about nutrition. At least I am a nurse and have some general knowledge, but what about the poor 70 year old who has no idea about things. Or the 20 year old who is actually a moderate or severe diabetic and new to the whole experience. Anyway... like I said more of a rant. I was just so looking forward to getting my questions answered and getting the whole thing down pat. Ohh well.. another couple of weeks and I hope to have an appointment with a competant educator. mbmbn

angelikaJ -> RE: Frustrated Diabetic (4/15/2011 12:50:43 PM)
you have cmail

DarkSteven -> RE: Frustrated Diabetic (4/15/2011 2:11:01 PM)
Yeah. I told a nutritionist to jump on a lake for far less than that. Look. You're barely diabetic at all. The last thing you should be doing is a radical revision of your diet that could make all kinds of radical effects. Make small changes only, and don't see a nutritionist again.

DeviantlyD -> RE: Frustrated Diabetic (4/16/2011 7:52:41 PM)
She was a nutritionist, not a registered dietician? That might account for part of it as a nutritionist supposedly doesn't need to have the requirements of a dietician. A few years ago I had some health "issues" and that convinced me to change my way of eating. After almost two months of eating differently, I thought it might be prudent to speak with a dietician to ensure I was on the right track. When I mentioned eating peanut butter, she cautioned me saying I shouldn't eat peanut butter because of its high fat content. I didn't voice my opinion, but I disagreed. It wasn't like I was eating copious amounts of peanut butter. And I ate Costco's organic brand. The ingredients are peanuts and salt. No sugar or added oils in the mix. She also advocated eating rice cakes. It was from that point that I realized she and I saw things differently and I didn't pay much attention after that. My belief is that the fewer processed foods one incorporates into their diet the better. That doesn't mean I have eliminated all processed foods, there isn't any way I'm giving up chocolate....LOL...but it's definitely healthier to minimize processed stuff. As for your situation, you mentioned striving towards including a breakfast and I strongly encourage you in that pursuit. I found myself at my best with eating the most in the morning, a fairly sizeable late lunch and then a minimal supper, if any supper at all. I'm trying to get back to that. Good luck!

avena -> RE: Frustrated Diabetic (4/16/2011 10:40:31 PM)
I'd join your rant about the ineptitudes of various supposed 'medical professionals', but that would take a very long post. Instead, I'll try keep it as short and to the point as possible (given my tendancy to ramble aimlessly). I'm not diabetic, but I am insulin resistant due to another condition. I follow a modified diabetic diet, and I think I may have gotten lucky with the dietician I saw when I first started on the whole thing. She told me two things: 1) Try to eat a protein with every meal and snack 2) Cut out as many refined carbs as you can handle without going nuts That's it. I still eat more or less the same as I did before, since I already ate a relatively balanced diet. I just eat whole wheat pasta and bread instead of white, and brown rice instead of white rice. It doesn't sound like cutting out sweets would be a big deal for you, although it was a bit of a struggle for me. I also carry around granola bars and packets of unsalted nuts, for snacks on the fly. I've never understood the whole carb counting thing. I do understand the need to keep blood sugars at a more or less stable level throughout the day, hence the snacking. My diet isn't all that different from the diabetics I know, and as far as I know, none of them worry about carb counting or anything else like that. They make sure their meals are balanced and healthy, with a protein and some form of carb at every meal, and avoid sugar like the plague. Hopefully you get a chance to talk to another Nutrionist, who knows a bit more about what they're doing. Good luck!

wicky73 -> RE: Frustrated Diabetic (4/16/2011 11:15:21 PM)
I can feel for you on being diabetic. I have been a Type 3 diabetic for about 6 months. I went into the doctor because i was feeling good. He ran some tests, took blood work. When he came back he had this very puzzled look on his face. He said for what my glucose level tested at I should have been in a diabetic coma, not walking, talking, and alert. I tested at 718 glucose level. He put me on insulin, then switched me to oral meds, and when my sliding scale goes above my top target level I take the insulin. We tried the carb and calorie counting, but he took me off that. Since getting my levels back to normal range, I range between 70 to 100. I have learned to change some of my eating habits.

DeviantlyD -> RE: Frustrated Diabetic (4/17/2011 1:33:14 AM)
quote: ORIGINAL: wicky73 I can feel for you on being diabetic. I have been a Type 3 diabetic for about 6 months. I went into the doctor because i was feeling good. He ran some tests, took blood work. When he came back he had this very puzzled look on his face. He said for what my glucose level tested at I should have been in a diabetic coma, not walking, talking, and alert. I tested at 718 glucose level. He put me on insulin, then switched me to oral meds, and when my sliding scale goes above my top target level I take the insulin. We tried the carb and calorie counting, but he took me off that. Since getting my levels back to normal range, I range between 70 to 100. I have learned to change some of my eating habits. Holy crap! 718? And that was confirmed? What did you end up doing to get your levels to such an awesome range? I still think that eating more naturally is the way to go...my opinion of course. I saw Michael Pollan on Oprah and his take is that if your grandmother (or perhaps more like great-grandmother depending on one's age) wouldn't recognize it, then it likely isn't good for you. He mentioned too how he doesn't deny himself things like french fries. But when he does indulge, they are french fries he has made from scratch and given the amount of work it takes to do that, he doesn't have fries that often. So everything he said makes sense to me. I also can't help think of the contestants on The Biggest Loser. Over and over again there are people on the show with type II diabetes who, after losing weight, changing their diet and becoming physically active are no longer diabetic. I wonder if the OP embraced this, would she too no longer be diabetic? I think it would be worth trying. :)

Termyn8or -> RE: Frustrated Diabetic (4/17/2011 5:51:26 AM)
Chromium and vanadium are essential here, and while some may have heard that they are essential to life, not all know what for. I suggest reading the following : "Chromium is an essential trace mineral. It occurs naturally in three different forms with one particular form (chromium III) making up the majority of dietary chromium. The average adult body contains between 0.4 and 6 mg of chromium and older people usually have lower levels. There is a wide geographical variation in chromium levels and population studies suggest that the incidence of diabetes and heart disease is lower in areas where chromium intakes are relatively high. Chromium is essential for normal sugar metabolism. It is a component of a compound called glucose tolerance factor (GTF) which works with insulin to move glucose into cells where it can be used to generate energy. Optimal chromium intake appears to decrease the amount of insulin needed to maintain normal blood sugar. Insulin also plays a role in fat and protein metabolism, thus chromium is necessary for these processes to occur normally. Adequate chromium intake is essential to maintain healthy cholesterol levels. Cooking food in stainless steel pots causes chromium to leach into the food if it is acidic and can be an additional source of dietary chromium. Hard tap water can also be a source. Skim milk powder 100g 34 mcg Brown sugar 100g 27 mcg All Bran 100g 26 mcg Ham 100g 26 mcg Cheddar cheese 100g 24 mcg Corned beef 100g 20 mcg Wheatbran 100g 19 mcg Cod, smoked 100g 18 mcg Split peas, dried 100g 13 mcg Soybean flour 100g 17 mcg Pork sausage 100g 16 mcg Beef sausage 100g 15 mcg Mackerel, canned 100g 14 mcg Oysters, canned 100g 14 mcg Wheatgerm 100g 13 mcg Spinach 100g 13 mcg Brown lentils, dried 100g 13 mcg Lamb chops 100g 13 mcg Beefsteak, mince 100g 9.0 mcg Yeast extract 10g 8.7 mcg Yellow butter beans 100g 8.0 mcg Sweetcorn 100g 7.0 mcg Chicken, dark meat 100g 7.0 mcg Potato 100g 5.0 mcg Recommended dietary allowances There is no RDA for chromium. Estimated safe requirements are between 50 and 200 mcg per day. It is difficult to test chromium levels accurately as there are no reliable established tests and it is possible that chromium accumulates in the tissues while being quickly cleared from blood serum. Supplements Chromium supplements are available in various forms including chromium picolinate, chromium chloride, chromium polynicotinate and chromium-enriched yeast. Biologically active forms of chromium such as chromium picolinate and yeast GTF are better absorbed than chromium chloride. GTF is found in brewer's yeast and is considered the most biologically active and absorbable form of chromium. The supplement doses effective in studies are in the region of 200 to 400 mcg per day. Chromium may be more effective if given with niacin, as the nicotinic acid form of niacin is part of GTF." "Vanadium is a trace mineral which has been considered essential for humans since the 1970s. The average adult body contains about 100 mcg of vanadium and it is found in the blood, organ tissues and bones. Vanadium may act as a co-factor for enzymes involved in blood sugar metabolism, lipid and cholesterol metabolism, bone and tooth development, fertility, thyroid function, hormone production and neurotransmitter metabolism. Good sources of vanadium include whole grain breads and cereals, vegetable oils, nuts, root vegetables, parsley, fish, radishes, dill, lettuce and strawberries. The vanadium content of food depends on the soil in which it is grown. Airborne vanadium may also be an important source. Processed or refined foods may contain higher levels of vanadium than unprocessed foods, possibly because of contamination from stainless steel processing equipment. Vanadyl sulfate is the most common form of nutritional supplement. Animal experiments have shown that vanadium can mimic the effects of insulin and reduce blood sugar levels from high to normal. These benefits are seen with low doses and there have been limited clinical trials with vanadium salts in patients with Type II diabetes, indicating that vanadium may have therapeutic potential in the treatment of diabetes.45 (2 Verma S; Cam MC; McNeill JH. Nutritional factors that can favorably influence the glucose/insulin system: vanadium. J Am Coll Nutr, 1998 Feb, 17:1, 11-8) In a study published in 1996, researchers at the Albert Einstein College of Medicine in New York compared the effects of 100 mg/day of oral vanadyl sulfate in moderately obese diabetic and nondiabetic people. The results showed improvements in both liver and skeletal muscle insulin sensitivity in diabetics. Blood fat levels and oxidation were also reduced. Thus vanadium may also be useful in reducing the risk of atherosclerosis in diabetic people." [credit to vitaminsetc] I excerpted because the whole thing would be a huge post. Twenty four minerals are regarded as essential to life, and IMO if they knew what they were doing they would tell you these things. But don't blame the professional, blame the university which is probably being partly supported by drug manufacturers. Insulin is technically a drug as far as they're concerned. I will not get more political than that. If you wish I can copy and paste the two sections into a Cmail. Also if you can supply an email that can take attachments I can send you the whole enchilada in a ZIP file. It covers 21 of the 24 essential minerals in basic HTML, no java or virus, just text. Each section has footnotes (like "2" above) and I checked a couple of them out, they seem legit. I improved my physical condition by going mineral crazy. I had very bad knees and couldn't walk down a flight of stairs without excruciating pain. Supposedly this is permanent and I would probably need knee replacements, but after I barraged my body with minerals, up until about four years ago I could stand straight up from sitting on the floor with my legs crossed, without holding on to anything. I don't think I'll need those replacement knees. I changed the way I ate. I didn't have a potato chip for years, or french fries or almost any carbs. I lost weight and gained strength. What also probably helped was that I took a colloidal mineral supplement. Interstingly there was a warning for diabetics on the label, that it would decrease their insulin resistance. If you're not taking insulin now it is probably not a concern. I took this stuff called Dr. Power's. It looks like a bottle of whiskey, and you do take about a shot a day. There is something like 0.005% alcohol in it, so when you say "for my health" ..........:-) I believe that since chromium and vandium have to do with the pancreas which produces your natural insulin, prolonged deficiency can permanently damage the pancreas. Therefore I assert that the time to do something about it is now. And do it right, give your body what it needs. T^T

kalikshama -> RE: Frustrated Diabetic (4/17/2011 6:10:06 AM)
quote: " i guess you are right, I thought broccoli was a starch " !!! I feel best when I eat lots of protein and minimize simple carbs. The only bread that my body handles well is Ezekial type bread (sprouted, higher in protein and fiber.) I couldn't do cereal and milk, way to low in protein for me. If I had time, I'd make eggs, but lacking the time and appetite first thing in the AM, I make smoothies, which have the added benefit of being portable. Sometimes I don't finish it until 10 AM (I'm up at 6.) For a snack I have a hardboiled egg and some nuts or seeds. My sister, on the other hand, does fine on lots more carbs and less protein. Here's a quiz to determine your nutritional type: http://products.mercola.com/nutritional-typing/ (You may have to register, and they'll send you the newsletter, but you can unsubscribe.)

LafayetteLady -> RE: Frustrated Diabetic (4/17/2011 7:32:08 AM)
I find it a little odd that your A1C was that high when your blood glucose testing is coming up normal. During the last 3 months did you suffer from any type of long term illness or was your kidney problem acting up? As a nurse I'm sure you know that illness and even chronic pain can adversely effect your blood sugar. This nutritionist sounds like a complete idiot. The doctor who told me my blood work showed I was diabetic said "you're diabetic. Change your diet." Then she sent me on my way. I changed doctors. I also attended a 4-6 week class at my regional diabetes center. I also am not a big breakfast eater. I don't like to eat until I've been up for about an hour. The concept of all this eating has something to with regulating your bood sugar, which I'm sure you know. Even just a piece of fruit or a glass of milk with carnation instant breakfast will work. Broccoli does tend to be a higher carb vegetable, but broccoli's benefits outweigh the carbs. Unless of course you are eating a pound or so a day which I doubt. I'm not sure why you would be testing you blood sugar at 2 in the morning unless that was when you were going to bed. When I was first diagnosed, I tested when I woke up (the most important stick of the day), about 2 horus after a meal (to see how quickly my body could process that) and at bedtime. The bedtime reading was to tell me how well my body managed overnight for the morning stick. In my opinion, being "barely diabetic" is like being barely pregnant. You either are or you are not. And of course, as you know, diabetes isn't cured, only managed. I realize weight contributes to diabetes but I think people are too quick to say,"you're overweight, that's why you have diabetes". You are barely overweight. I know people who are seriously overweight and don't have diabetes. But that's my personal rant. My point is that if you were sick for a couple of weeks during that 3 month period, it could set the whole test out of whack. You are a nurse, you know the basics of good nutrition so follow your instincts on that. Check to see where your local regional diabetes center is in your area and sign up for their classes. If your dr. hasn't told you how often he wants you to test your blood sugar, go with either 2 or 3 times a day. Always on wake up, 2 hours after a meal and before bed. If doing 2 sticks alternate with the after meal and before bed. A lot of managed type 1s' don't stick themselves 6 times a day. Then make sure you get another A1C 3 months down the road and take it from there. By the way, I believe the occasional rant is all around good for your health!

Cerebralchatter -> RE: Frustrated Diabetic (4/17/2011 7:46:21 AM)
Nutritionists don't require the level of training of dieticians, never mind doctors. As such you were being advised by someone who had no guarantee of competence. Some are good, some terrible. As to the Chromium and Vanadium. While I wouldn't utterly dismiss that stuff out of hand I will say the evidence base at present shows: 1. A lot of the claims made for those things are in poorly designed studies and thus aren't reliable. 2. For Type 2Diabetics good diet control will have FAR more impact than any amount of chromium or vanadium etc. 3. The best overall treatment for type 2diabetes is diet control and exercise leading to weight loss. I'm a registered MD and i've treated many people who through weight loss and diet managed torrid themselves of the diagnosis. Do those basics and don't worry about nutritional typing or micronutrients. That stuff is more fashion than true medicine ( it has an impact but that impact is usually greatly overhyped and far less than the impact good diet and more exercise will have). This mightn't be a popular thing to say but the double-blinded, methodologically sound evidence base and multiple successfully treated patients backs it up.

Kalista07 -> RE: Frustrated Diabetic (4/17/2011 9:25:16 AM)
This is just my experience and of course, yours may be vastly different, but it is what it is: For the first few years (mmmm 5 or so) that I was diagnosed as type 2 I did not eat much at all. By much I mean way less than a small child. I couldn't understand why my numbers were always out of control and why I continued to gain weight. In the last three months, I finally have become able and willing to eat every two hours and have lost 30 pounds and my numbers are well within control. I eat something (even if it's relatively small) within thirty minutes of being awake..... I can't afford to get caught up in all the carb counting "insanity" because for me then I would start restricting again and it would just go to the other extreme again which is not healthy at all. I hope you continue finding something that is working for you. Kali

maybemaybenot -> RE: Frustrated Diabetic (4/17/2011 10:04:18 AM)
DS: I'm trying not to make huge radical changes that are uncomfortable. I am still playing with foods and times and seeing how they effect my BS. I was very happy with my HgbA1C, as like you said, it means I am just a tich on the diabetic side. I will be starting a new job at the VA Hospital in a few weeks and they have a program and counsiling for employees who are diabetic, so my plan is to go to that program vs going to a dietician again. DeviantlyD: yes she is a registered dietician. I use the terms interchangably,which can be misleading. Sorry about that. As for people losing wieght and no longer having the diagnosis of diabetes : It's not cured by weight loss. You may have normal BS and you HbgA1C may get in the normal range for non diabetics, but it's more like a remission as opposed to not having the disease. If you regain the weight, you will return to base level. So your body really isn't " cured " , you are managing it and keeping it at bay by fueling it properly. That's my simple explanation of it. Believe me, I was thrilled that my HgbA1c was so low, I expected higher and I believe I can get it down, but I will have to be aware of my eating habits/weight for the rest of my life to prevent it from resurfacing. Termy: Altho I am a nurse I use natural medicines more than I use western medicine. I am pretty well versed in Chromium and from my research it would not be a good suppliment for me, due to it's potential for toxicity on the kidneys in people with pre existing kidney disease. While the toxicity is reversable, I would rather not chance it. But thank you for the suggestion. My MD is aware that I have started taking Gymnema sylvestre, an herb shown to lower blood sugar and has very good double blind studies showing it to significantly lower BS in Type 2 diabetics. While my MD does not endorse my herbal approach, he knows I am doing it and is not objecting. LL : Nope, wasn't sick at all. Here's how it all came down. I went for a pre employment physical, they did labs and my BS= 278. That was not a randon, that was a fasting. When I got the results I called my own MD and he sent me for a HgbA1C and urine for creatinine. I went down to the lab the day after getting the results and had not officially started diet changes until that same AM, after the labs were drawn. Since cutting my carbs to 35 Gms/meal my blood sugars have been fine except for those 2 I mentioned. For the first 10 days or so, I tested pre meal and bedtime. "Bedtime" was 11P, even tho I go to bed at 2A. Not sure if that is right or not, but I ate my dinner at 6-7P and figured that was a decent time. I'm a firm believer that illness is a reset button, it means you need to change your lifestyle. Like a big flashing yellow light. My body is telling me that I haven't been taking care of it, and I need to get it back on drive, before I wear out the engine. So... for the way I handle my wellness is to take it seriously and realize that I have an active role in getting better and that role isn't a temporary role, but a change that will be lifelong. It's a physical, emotional and spiritual thing. All three play a part in getting myself to a healthier place. In holistic medicine issues of responsibility and resentment are issues which attack the pancrease. The resentment signal throws off the pancreas by reducing the production of insulin. Sooo, I have to do some self examination, I am unaware of any resentment issues, but I need to look deeper and see if that is present and correct it. I know, I know.. very krunchy granola of me. < shrugs > Thank you all for the feedback. mbmbn

LafayetteLady -> RE: Frustrated Diabetic (4/17/2011 10:39:16 AM)
My understanding of "bedtime" testing was about all the things our bodies do while we sleep, so actual bedtime was important so that the wake up test was more accurate. Of course, that is just my understanding. Likewise, my understanding is that the morning, fasting test is most important. My biggest problem when I was first diagnosed was what to do when it was high. Most people know how to deal with low blood sugar, but high blood sugar is totally different. Last year I lost my insurance for a little over a month and couldn't afford my medication. I regularly had readings well over 300, and there wasn't much I could do. Needless to say without medication for my other health issues, including blood pressure and fibromyalgia, the stress did nothing for those high readings. ETA: No offense CerebralChatter, but the very reason I changed doctors right after being diagnosed was the fact that she dismissed me with "diet and exercise" and nothing else. I have other health issues she was well aware of that make exercise a challenge. Regardless of that, I find that approach to be irresponsible. Even radical changes in diet and exercise will not guarantee immediate results, and in the meantime the health of the patient can be compromised. I much prefer my doctor's realistic approach of giving me medication to help control my blood sugar while I work on the diet and exercise part. Incidently, I have lost 35 pounds in the last six months and guess what happened when I was in the hospital and they were giving me my proper medication? My blood sugar went right back up and only now a month after being discharged are my numbers dropping back down. This leads me to believe, based on all the information regarding diabetes and weight, that my diabetes has little to do with my weight and more to do with other factors that exist for me. Sorry, but I have issues with that kind of thinking. If a patient has very high cholesterol, are you going to send them from your office with nothing more than dietary recommendations? The patient wiith high blood pressure sent away told to cut out salt and stress from their diet and nothing more?

Aynne88 -> RE: Frustrated Diabetic (4/17/2011 11:16:40 AM)
My man has Type 2, and has lost about 80 pounds, he is now no longer insulin dependant and his sugars are generally in the 90/120 range. Losing the weight also got him off Lipitor, which was awesome since his liver enzymes were out of whack from that. We went to an herbologist, she was amazing. Started taking natural enzymes, cleansing, fasting, herbal remedies, of course along with all the western medicine as well, not going to risk that, but even his MD attributes a lot of his improvement to the weight loss, exercise plan and severely limiting alcohol intake. He saw a dietician before this that was an idiot also, she had him so confused and also the plan was so needlessly complicated that is was a turn off from day one. I can't recommend a good quarterly cleansing regime enough, even for a non overweight non diabetic person.

maybemaybenot -> RE: Frustrated Diabetic (4/17/2011 11:29:57 AM)
Thanx for that info LL, I will test at my actual bedtime. A couple of people here < diabetics > have Cmailed me with wonderful advice. And one thing I was told that every persons body is different and you need to find out what foods, times of day, etc work best for your body. Altho I am only a few weeks into this process, I am learning that to be true. As I said my habit was not to eat until mid-late afternoon and have my dinner quite late and have a " little meal " < 1/2 a sandwich or a bowl of soup and crackers around 11PM. So when I got the diagnosis I started eating breakfast at 7:30ishA, lunch at 12:30ish and dinner at 6P-ish. By 10-11P I was starving.. real hunger not craving something. And my diabetic snak just wasn't cutting it. Soo, the last few days I have changed that up a bit and I don't eat until 10A, even tho I am an early riser. Then I have my lunh at 2-3P and dinner between 8-9P. Guess what ? My BS dropped even better. The last three days they have been in the low 80's as opposed to 111-122. I am finding out there is not a one bill fits all and I guess as some one suggested you have to find what controls you best, just like you are saying LL. DS told me not to make radical changes and I did at first in regards to times. It made me feel crappy and not better. Getting on a schedule that is closer to my lifelong habit feels better and has had good results. My guess is that my body knows its own clock and I have to work with that, not try and change it. It's only a couple of days, so we will see. But so far,,, much better in all aspects. mbmbn

maybemaybenot -> RE: Frustrated Diabetic (4/17/2011 11:48:27 AM)
Aynne: I have a Chinese Herbalist in Chinatown < Boston >, whom I have been going to for years. I am fortunate to live close to an Herb farm so I can get the actual herbs fresh and don't have to go in and out of Boston for most of them. I will be seeing him this week about the Diabetes. He is the one who told me to start taking Gymnema sylvestre and will do a full work up when I see him. I am going to ask him about the cleansing, thank you for the suggestion. I think too many people turn up their nose at natural medicine and think it's voo doo. Even for a headache, I take White Willow Bark, not Tylenol or Aspirin. My MD knows, unless it's a true infection or pneumonia.. I won't be taking antibiotics or anything else. I take Western meds for my kidney disease, of course, but I have been on a herbal regime for that too since diagnoisis. And I don't care what any MD says, I have maintained a remission for near 10 years now, which is highly unusual for what I have. My Nephrologist, who is Chinese btw, laughs his butt off at me and mocks me and tells me to come over to his home and mow the lawn and I can eat all the " grass " I want. LOL. He doesn't say it mean, but he is firmly convinced that it has no value. I just keep telling him... well you have 6 patients with my disease and I am the only one who has been able to keep a remission, so something I am doing and you are not.. is working. He just laughs at me, but it's OK we have a good relationship, he just thinks I'm weird. mbmbn

angelikaJ -> RE: Frustrated Diabetic (4/17/2011 12:16:43 PM)
quote: ORIGINAL: LafayetteLady My understanding of "bedtime" testing was about all the things our bodies do while we sleep, so actual bedtime was important so that the wake up test was more accurate. Of course, that is just my understanding. Likewise, my understanding is that the morning, fasting test is most important. My biggest problem when I was first diagnosed was what to do when it was high. Most people know how to deal with low blood sugar, but high blood sugar is totally different. Last year I lost my insurance for a little over a month and couldn't afford my medication. I regularly had readings well over 300, and there wasn't much I could do. Needless to say without medication for my other health issues, including blood pressure and fibromyalgia, the stress did nothing for those high readings. ETA: No offense CerebralChatter, but the very reason I changed doctors right after being diagnosed was the fact that she dismissed me with "diet and exercise" and nothing else. I have other health issues she was well aware of that make exercise a challenge. Regardless of that, I find that approach to be irresponsible. Even radical changes in diet and exercise will not guarantee immediate results, and in the meantime the health of the patient can be compromised. I much prefer my doctor's realistic approach of giving me medication to help control my blood sugar while I work on the diet and exercise part. Incidently, I have lost 35 pounds in the last six months and guess what happened when I was in the hospital and they were giving me my proper medication? My blood sugar went right back up and only now a month after being discharged are my numbers dropping back down. This leads me to believe, based on all the information regarding diabetes and weight, that my diabetes has little to do with my weight and more to do with other factors that exist for me. Sorry, but I have issues with that kind of thinking. If a patient has very high cholesterol, are you going to send them from your office with nothing more than dietary recommendations? The patient wiith high blood pressure sent away told to cut out salt and stress from their diet and nothing more? LL, It is terrible that when you were without your insurance, your doctor did not offer samples. I happen to be lucky; I was diaagnosed in 2005. I have lost weight in the past year and now my A1C without insulin (which I actually started on after being diagnosed) or oral medication (which I have never been prescribed) is in the "prediabetic range". I have even had readings below 70. I had a brief hospital stay in May and found their version of a diabetic diet had more carbs than I ever ate at home.

kalikshama -> RE: Frustrated Diabetic (4/17/2011 12:21:05 PM)
quote: I'm a firm believer that illness is a reset button, it means you need to change your lifestyle. Like a big flashing yellow light. My body is telling me that I haven't been taking care of it, and I need to get it back on drive, before I wear out the engine. So... for the way I handle my wellness is to take it seriously and realize that I have an active role in getting better and that role isn't a temporary role, but a change that will be lifelong. It's a physical, emotional and spiritual thing. All three play a part in getting myself to a healthier place. In holistic medicine issues of responsibility and resentment are issues which attack the pancrease. The resentment signal throws off the pancreas by reducing the production of insulin. Sooo, I have to do some self examination, I am unaware of any resentment issues, but I need to look deeper and see if that is present and correct it. When I got sick in 1999, Carolyn Myss's books were a big help to me, especially "Why People Don't Heal and How They Can" and "Anatomy of the Spirit: The Seven Stages of Power and Healing."

Cerebralchatter -> RE: Frustrated Diabetic (4/17/2011 1:33:25 PM)
LafayetteLady, Well, throwing terms like "irresponsible" around is, in itself, irresponsible. I never mentioned medications one way or the other. Everything you wrote about my supposed attitude to medications was nothing more than you putting words into my mouth, magicking a position out of thin air and then condemning me as irresponsible for taking a stance you created and which I never espoused. If we wish to talk about irresponsible then that's a pretty good definition of irresponsible behaviour. Medications do, of course, have a role to play. That doesn't change the fact that in the long-term diet and exercise which results in weight loss sufficient to bring HbA1c levels and fasting and random blood glucose levels to within the normal range IS superior to taking medications which achieve the same effect in the long term. The key being in the long term. Obviously, in the short term medications have a role to play in ensuring control while diet and exercise take their toll. As to people who cannot be controlled through diet and exercise. Well, obviously control on medications is superior in terms of morbidity, mortality and overall outcome than poor control without medication. On the whole though control through diet and exercise such that weight is lost and blood sugar remains within normal limits ( thus allowing the removal of the diagnosis of DM Type 2 ) is superior through control relying on medications. The reason for this is multifactorial and includes, but is not limited to: 1. Greater responsiveness of the human body to food intake in terms of sugar regulation than tablets taken on a schedule. 2. The fact that weight loss also reduces the risk of many other cardiovascular illnesses, the risk of non-central sleep apnoea and also the risk of many forms of cancer all of which are independently related to weight. 3. Differences in metabolism which occur through exercise which are independent of actual weight level. You may, of course, choose to hold different views and I would not disagree with your right to do so. But there is a certain responsibility involved in giving advice to others. I'm only speaking up because by giving non-evidence based advice to others you may harm their outcome and not just your own. Here's some good summary article references for those interested: Damon, S., M. Schatzer, et al. (2011). "Nutrition and diabetes mellitus: an overview of the current evidence." Wien Med Wochenschr. Overwhelming evidence exists supporting the benefit of lifestyle and nutritional interventions to prevent or delay type 2 and gestational diabetes and improve glycemic control and co-morbidities in patients of all sub-types of diabetes mellitus. Therefore, nutritional therapy is an indispensable and fundamental treatment component, which has to be based on evidence-based recommendations, adapted for dietary intake and medication, and periodically adapted according to diagnosis and individual course of illness. This overview is based on the currently valid evidence-based nutritional recommendations of the European and American Diabetes Associations for the management of diabetes mellitus. It describes the quality and quantity of beneficial macronutrient (carbohydrates, fat, and protein) and micronutrient intake, alcohol consumption, and food groups. Moreover, the evidence for supplements and functional foods is summarized and the role of body weight and different weight loss diets are discussed. The next article shows the benefits in terms of reduction in medications necessary if the patient loses weight and exercises - and reduced meds not only mean financial savings for the patient but also reduced side effects. Anderson, J. W. and M. A. Jhaveri (2010). "Reductions in medications with substantial weight loss with behavioral intervention." Curr Clin Pharmacol 5(4): 232-238. Medical costs of obesity in the United States exceed $147 billion annually with medication costs making a sizable contribution. We examined medication costs associated with substantial weight losses in an intensive behavioral weight loss program. Inclusion criteria were medication use for obesity co-morbidities: hypertension, diabetes, dyslipidemia, degenerative joint disease, or gastroesophageal reflux disease. Group A, 83 obese patients on medications completed 8 weeks of classes, lost 19 kg in 20 weeks. Group B, 100 severely obese patients, lost 59 kg in 45 weeks. Medications were discontinued: Group A, 18%; Group B, 64%. Mean numbers of medications decreased significantly for all co-morbidities. Mean numbers of daily medications, initial and final, respectively were: Group A, total, 3.0 +/- 0.2 (mean +/- SEM) and 1.7 +/- 0.2; Group B, total, 2.5 +/- 0.2 and 0.7 +/- 0.1. Monthly costs for all medications decreased significantly for all co-morbidities and were as follows: Group A, total, $249 +/- 25 and $153 +/- 19; Group B: total, $237 +/- 27 and $65 +/- 12. Medically supervised weight loss is very effective approach for improving cardiovascular risk factors and reducing medical costs. Next is an article which points out the likelihood of having poorer HbA1c etc control the heavier the patient, which may require more insulin and other oral meds --- which often have the side-effect of increasing weight even farther, thus causing the diabetic spiral of poor control, more meds, more weight gain, leading to poorer control and a need for more meds which put on more weight. Obviously, if diet and exercise reduces the weight then you can get this diabetic spiral acting in the other direction and being a positive factor. Mavian, A. A., S. Miller, et al. (2010). "Managing type 2 diabetes: balancing HbA1c and body weight." Postgrad Med 122(3): 106-117. Most patients with type 2 diabetes present with comorbid overweight or obesity. Reaching and maintaining acceptable glycemic control is more difficult in overweight and obese patients, and these conditions are associated with increased risk for cardiovascular and other diseases. Glycemic management for these patients is complicated by the fact that insulin and many of the oral medications available to treat type 2 diabetes produce additional weight gain. However, an increasing number of therapeutic options are available that are weight neutral or lead to weight loss in addition to their glycemic benefits. This article evaluates the evidence from clinical trials regarding the relative glycemic benefits, measured in terms of glycated hemoglobin change, versus the impact on body weight of each medication currently approved for type 2 diabetes. In general, the sulfonylureas, thiazolidinediones, and D-phenylalanine derivatives have been shown to promote weight gain. The dipeptidyl peptidase-4 inhibitors are weight neutral, while the biguanides, incretin mimetics, and amylin mimetics promote weight loss. Trials examining the glycemic benefits of the weight loss agents orlistat and sibutramine are also examined. Awareness of this evidence base can be used to inform medication selection in support of weight management goals for patients with type 2 diabetes. Lastly, while I wouldn't suggest Roux-en-Y bypass without consultation with a surgeon this study shows that following bypass AND cessation of ALL diabetes meds 100% of the patients in this study were euglycemic ( in other words, no longer had diabetes type 2 ) 3 months after their surgery. This in spite of the fact that they were on no meds. Functionally this means that the ONLY reason they could have stopped having diabetes was due to the weight loss caused by the surgery. Obviously there is other stuff about operative risk in this paper but the findings as regards weight loss and its impact on HbA1c and glycaemic control and need for meds are pretty stark. Shah, S. S., J. S. Todkar, et al. (2010). "Diabetes remission and reduced cardiovascular risk after gastric bypass in Asian Indians with body mass index <35 kg/m(2)." Surg Obes Relat Dis 6(4): 332-338. BACKGROUND: Roux-en-Y gastric bypass (RYGB) benefits patients with type 2 diabetes mellitus (T2DM) and a body mass index (BMI) >35 kg/m(2); however, its effectiveness in patients with T2DM and a BMI <35 kg/m(2) is unclear. Asian Indians have a high risk of T2DM and cardiovascular disease at relatively low BMI levels. We examined the safety and efficacy of RYGB in Asian Indian patients with T2DM and a BMI of 22-35 kg/m(2) in a tertiary care medical center. METHODS: A total of 15 consecutive patients with T2DM and a BMI of 22-35 kg/m(2) underwent RYGB. The data were prospectively collected before surgery and at 1, 3, 6, and 9 months postoperatively. RESULTS: Of the 15 patients, 8 were men and 7 were women (age 45.6 +/- 12 years). Their preoperative characteristics were BMI 28.9 +/- 4.0 kg/m(2), body weight 78.7 +/- 12.5 kg, waist circumference 100.2 +/- 6.8 cm, and duration of T2DM 8.7 +/- 5.3 years. At baseline, 80% of subjects required insulin, and 20% controlled their T2DM with oral hypoglycemic medication. The BMI decreased postoperatively by 20%, from 28.9 +/- 4.0 kg/m(2) to 23.0 +/- 3.6 kg/m(2) (P <.001). All antidiabetic medications were discontinued by 1 month after surgery in 80% of the subjects. At 3 months and thereafter, 100% were euglycemic and no longer required diabetes medication. The fasting blood glucose level decreased from 233 +/- 87 mg/dL to 89 +/- 12 mg/dL (P <.001), and the hemoglobin A1c decreased from 10.1% +/- 2.0% to 6.1% +/- 0.6% (P <.001). Their waist circumference, presence of dyslipidemia, and hypertension improved significantly. The predicted 10-year cardiovascular disease risk (calculated using the United Kingdom Prospective Diabetes Study equations) decreased substantially for fatal and nonfatal coronary heart disease and stroke. No mortality, major surgical morbidity, or excessive weight loss occurred. CONCLUSION: RYGB safely and effectively eliminated T2DM in Asian Indians with a BMI <35 kg/m(2). Larger, longer term studies are needed to confirm this benefit. So, as I said, there's a clear evidence base supporting exercise and diet to lose weight as being the safest, most effective treatment for DM Type 2. Sure, in the short term one can take meds while the diet and exercise take hold but those meds have side effects and can be eliminated in most patients with diet and exercise. YOu can, of course, choose to do something different with your life but to call evidence-based medicine "irresponsible" is irresponsible in its own right. With all of that said, I am ONLY replying because I think in a public forum there is an onus to provide evidence-based advice. You are free to do whatever you want with your life and I most assuredly hope that whatever approach you takes works out well for you.

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