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  #16   ^
Old Tue, Dec-30-03, 04:10
eevee's Avatar
eevee eevee is offline
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Posts: 1,663
 
Plan: Free-range
Stats: 161/154/140 Female 65
BF:
Progress: 33%
Location: King Country New Zealand
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Quote:
e...I take it you're not using any type of basal (long acting) insulin in your current regime?
I'm not sure why you would think that Lisa...I use protophane twice daily along with Novorapid. Surely you aren't thinking it will hold me at 4.5 for 3 hours. Eve
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  #17   ^
Old Tue, Dec-30-03, 07:48
Lisa N's Avatar
Lisa N Lisa N is offline
Posts: 12,028
 
Plan: Bernstein Diabetes Soluti
Stats: 260/-/145 Female 5' 3"
BF:
Progress: 63%
Location: Michigan
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Quote:
my FBG was 110. this LC tortilla has a total of 11 g carbs and 8 grams fiber per whole thing, making 3 g of active carbs per serving, and i ate half of it. this will make about 1.5 g of carbs +about 1 g in egg beaters. very low carb breakfast, and still BG spiked very high. on the contrary, i can have FBG sometimes much higher, around TOM, like 135. then i'd have BF with 2-3 bran-a-crisp crackers, some PB and greek lc yougurt. and my 1h BG will be around 90-100. it's a mistery for me but too low carbs and high protein/fat food makes mt BG worse.


Well...comparing those two breakfasts via Fitday, we get the first breakfast with approx. 20 grams protein, 5.5 grams fiber and 2.22 grams fat
The second breakfast has 14.53 grams protein, 9 grams fiber (assuming 2 bran a crisp crackers) and 16.12 grams fat. Add another cracker and you'd have 16.53 grams protein and 13 grams fiber.
Your second breakfast isn't significantly lower in protein, but is higher in both fiber and fat (yes, carbs too), so it would enter your system more slowly than the first breakfast.
I'd be interested in what happens to your blood sugars when you eat a meal that is low in fiber, fat and protein, but higher in carbs and when you eat a breakfast like the second one, do you ever check your blood sugar at around 3 hours? Because of the fat and fiber in the second breakfast, your blood sugars may be going up well after you have checked.
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  #18   ^
Old Tue, Dec-30-03, 08:15
Lisa N's Avatar
Lisa N Lisa N is offline
Posts: 12,028
 
Plan: Bernstein Diabetes Soluti
Stats: 260/-/145 Female 5' 3"
BF:
Progress: 63%
Location: Michigan
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Quote:
I use protophane twice daily along with Novorapid. Surely you aren't thinking it will hold me at 4.5 for 3 hours. Eve


Well...the protophane should last about 15 hours and acts as your basal level of insulin would if you were still producing your own insulin. The purpose of long acting insulin such as Protophane is to cover blood sugar rises during the fasting state (overnight and between meals). The Novorapid only lasts for about 5 hours and starts working in about 20 minutes.
No, I wouldn't expect the Novorapid to keep you at 4.5 for 3 hours, but with the Protophane and the Novorapid combined, neither would I expect to see it jumping well over 200 unless the dosage needed adjusting or you were eating more carbs than your insulin could cover. It could also be that your body is neutralizing more of the long acting (or short acting) insulin than anticipated; Dr. B suggests that anything over 6 units at one site at one time causes the body to neutralize quite of bit of the extra dose and if you need more than 6 units to split the injection into 2 or more sites.
Something else that Dr. B mentioned is that warmer weather (it is summer down there right now, right?) requires higher insulin doses.

Last edited by Lisa N : Tue, Dec-30-03 at 10:59.
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  #19   ^
Old Tue, Dec-30-03, 11:42
dina1957 dina1957 is offline
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Posts: 1,854
 
Plan: My own
Stats: 194/000/150 Female 5'5"
BF:Not sure
Progress: 441%
Location: Bay Area
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Quote:
Originally Posted by Lisa N
The second breakfast has 14.53 grams protein, 9 grams fiber (assuming 2 bran a crisp crackers) and 16.12 grams fat. Add another cracker and you'd have 16.53 grams protein and 13 grams fiber.
Your second breakfast isn't significantly lower in protein, but is higher in both fiber and fat (yes, carbs too), so it would enter your system more slowly than the first breakfast.
I'd be interested in what happens to your blood sugars when you eat a meal that is low in fiber, fat and protein, but higher in carbs and when you eat a breakfast like the second one, do you ever check your blood sugar at around 3 hours? Because of the fat and fiber in the second breakfast, your blood sugars may be going up well after you have checked.

Hi Lisa:
i never have more than 1 tbs PB, which is 3 grams of fat and greek yougurt is non fat variety, containining 15 g protein and 6 g carbs. as for bran-c-crisp, each has only 2 g fiber, meaning 6 g fiber for 3 crackers.
i try to eat a small meal every 3-4 hours daily and always check before and after, so i wouldn't miss BG raise in 3 hours. this shcedule suites me better, keeping my BG steady. i also count my calories and try to keep it under 1600 a day and keep my fat not greater than 30% since i have more carbs, otherwise, i'm gaining weight. all my meals contain some protein and low in fat but always high fiber with lots of salads, lc veggies and some bran crackers. i alo allow myself few slices of low GI fruit or some berries daily. but again, always with a protein and some fat, like nuts or cheese.
i assume you speak about starchy carbs meaning low fiber and high carbs, liek white bread and such but i didn't eat this kind even before low carbing, so i wouldn't dare. it's just against my philosophy. the only treat containing white sugar i allow myself, is sometimes 1 square of 85% dark chocolate. it has barely 1 g of sugar.
Thanks,
Dina
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  #20   ^
Old Tue, Dec-30-03, 16:56
Lisa N's Avatar
Lisa N Lisa N is offline
Posts: 12,028
 
Plan: Bernstein Diabetes Soluti
Stats: 260/-/145 Female 5' 3"
BF:
Progress: 63%
Location: Michigan
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Quote:
my FBG was 110. this LC tortilla has a total of 11 g carbs and 8 grams fiber per whole thing, making 3 g of active carbs per serving, and i ate half of it. this will make about 1.5 g of carbs +about 1 g in egg beaters. very low carb breakfast, and still BG spiked very high.


Dina...that was a 22 point rise from you FBG; well within Dr. B's standard for no more than 30 points following a meal and then a return to normal levels and even I wouldn't consider that a spike. Yes, it's higher than you'd like to see it, but you also started out higher. I'm curious why you check at 30-45 minutes since your blood sugar can continue to rise for up to an hour after you eat, or longer depending on the meal.
Personally, I'd be a little suspicious of the Egg Beaters. The nutritional info I found states that 1/2 cup has 50 calories, 10 grams of protein, 0 fat and 1 gram of carb. That's 40 calories from protein with the remaining 10 having to be carb, or 2.5..round up to 3. 1.5 + 3 = 4.5 (round up to 5) which would raise the average diabetic's blood sugar 15-25 points (3-5 points per gram of carb). I'm also a little curious what they add to it since my carb counter book lists 1 egg white at 3.5 grams of protein, so by their protein declaration, 1/2 cup is less than 3 whites, but it also states that 3 egg whites should equal less than 1 gram of carb (0.3 grams each, or 0.9); I'm coming up with almost 3 by doing the math.
Either way, the 30 grams of carb or less per day seems to be working well for me since my blood glucose seems to be pretty much pinned in the mid 80's for the past several weeks even through TOM, using low carb bread (11 grams total with 8 fiber for 3 net) and CarbSmart ice cream through the holidays. I'll be having an A1c drawn on Friday, so that will tell me how accurate my meeter readings have been.
I guess we all can only do our best when it comes down to it.
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  #21   ^
Old Tue, Dec-30-03, 20:41
dina1957 dina1957 is offline
Registered Member
Posts: 1,854
 
Plan: My own
Stats: 194/000/150 Female 5'5"
BF:Not sure
Progress: 441%
Location: Bay Area
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Quote:
Originally Posted by Lisa N
Dina...that was a 22 point rise from you FBG; well within Dr. B's standard for no more than 30 points following a meal and then a return to normal levels and even I wouldn't consider that a spike. Yes, it's higher than you'd like to see it, but you also started out higher. I'm curious why you check at 30-45 minutes since your blood sugar can continue to rise for up to an hour after you eat, or longer depending on the meal.
Personally, I'd be a little suspicious of the Egg Beaters. The nutritional info I found states that 1/2 cup has 50 calories, 10 grams of protein, 0 fat and 1 gram of carb. That's 40 calories from protein with the remaining 10 having to be carb, or 2.5..round up to 3. 1.5 + 3 = 4.5 (round up to 5) which would raise the average diabetic's blood sugar 15-25 points (3-5 points per gram of carb). I'm also a little curious what they add to it since my carb counter book lists 1 egg white at 3.5 grams of protein, so by their protein declaration, 1/2 cup is less than 3 whites, but it also states that 3 egg whites should equal less than 1 gram of carb (0.3 grams each, or 0.9); I'm coming up with almost 3 by doing the math. Either way, the 30 grams of carb or less per day seems to be working well for me since my blood glucose seems to be pretty much pinned in the mid 80's for the past several weeks even through TOM, using low carb bread (11 grams total with 8 fiber for 3 net) and CarbSmart ice cream through the holidays. I'll be having an A1c drawn on Friday, so that will tell me how accurate my meeter readings have been. I guess we all can only do our best when it comes down to it.

Lisa:
i've read that the highest spike is after 30-45 minutes after a meal, my 2h pp is much better, mostly 80-90. i also think that for a good H1C spike shortly after a meal is more important than checking 2-3 hours after, this would be my next before-meal testing. as for 2 h pp it's never been higher than 120 even after a regular meal. my FBG is what identifies me as a diabetic, not the H1C.
the egg beaters i use have 30 calories per 1/4 cup with 6g protein and less than 1 g of carbs. it's 99% egg whites, guarm gum, color (beta carotine including) and a bunch of vitamins, which may be contribute to extra 2 calories, not fitting into the equation. as for carbs counting, i don't bother with such a precise count anymore since 30g it's too low for me anyway, i need at least 60 to keep ly liver happy otherwise it's working overtime, and doesn't know when to stop. as i said we are all different. what works for insulin resistant doesn't work for insulin deficient and wise versa. BTW, i've looked at your daily food in your journal, and just wondering, what is your actual calories intake? it seems like starvation level to me unless you eat greater quantities of everything. also, it seems a bit low on fiber too, mostly protein and fat. when i was on 30 g carbs daily, i got horrible muscle cramps almost every night.well, it looks like we all can do only this much when trying to stay healthy.
thanks,
dina

Last edited by dina1957 : Tue, Dec-30-03 at 20:45.
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  #22   ^
Old Wed, Dec-31-03, 07:06
eevee's Avatar
eevee eevee is offline
Senior Member
Posts: 1,663
 
Plan: Free-range
Stats: 161/154/140 Female 65
BF:
Progress: 33%
Location: King Country New Zealand
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It is very nice of you Lisa to take trouble over my diabetes, but I'm afraid that unless you ever need to take insulin you will never fully understand just how text-book theories are nothing more than that...real people just do not live text-book lives. Every minute of every day is different to every other minute of every other day, and saying that x+y=z does not resolve the matter. Do Dr Bernstein's/your calculations take into account age, thyroid, body weight, I/R, high red cell count, liver...you name it...no, they don't, and they are the things that make us real people and not standard issue text books.

I am quite intelligent, and have been dealing with this condition for 30 years now. I have a very good idea of how many types of insulins affect/affected my condition ......and not one of them behave ideally...even the producers of insulin will not state anywhere near as emphatically as you, just how their insulins will behave.

Again, I thank you for your efforts, but for me, and many,many,T1s like me, the text book will remain no more than a questionable guide, and that maintaining a bG of even 5.0 can only be momentary...either on the way going down, or going up. A pump basal may be better at holding it, I don't know, but I'm starting to wonder if that is a myth too.

All the best for 2004 ..... Eve
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  #23   ^
Old Wed, Dec-31-03, 08:49
Lisa N's Avatar
Lisa N Lisa N is offline
Posts: 12,028
 
Plan: Bernstein Diabetes Soluti
Stats: 260/-/145 Female 5' 3"
BF:
Progress: 63%
Location: Michigan
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Quote:
i've looked at your daily food in your journal, and just wondering, what is your actual calories intake? it seems like starvation level to me unless you eat greater quantities of everything.


Hi Dina and thanks for the concern, but according to Fitday yesterday I had a little over 1,300 calories, 56 grams total carb with 26 grams fiber for a total of 30 net carbs. I try to keep my calorie level between 1,300 and 1,500; right around 10x my goal weight, sometimes higher but never lower. I get about 70% of my caloric intake from fats (butter, mayonnaise, olive oil). Yesterday, the percentages broke out as 69% fat, 21% protein, 10% carbs with almost half of those carbs coming from fiber. The reason I'm keeping it low right now is that I'm trying to get past a set point; a weight that I spent a lot of time at on the way up and my body is resisting going below now. I'm also very busy right now staying home with my 2 girls over their Christmas break from school and meals, with the exception of dinner are kind of catch as catch can. When I'm at work, my meals are far more regular.
I know it might look a little low because I don't always give the measurements for how much of things I eat (like butter and mayonnaise), but I do keep careful track on Fitday to make sure that I get enough (vitamins and minerals also through the nutritional reports on Fitday). Trust me...I'm not starving.
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  #24   ^
Old Wed, Dec-31-03, 13:31
dina1957 dina1957 is offline
Registered Member
Posts: 1,854
 
Plan: My own
Stats: 194/000/150 Female 5'5"
BF:Not sure
Progress: 441%
Location: Bay Area
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Quote:
Originally Posted by Lisa N
Hi Dina and thanks for the concern, but according to Fitday yesterday I had a little over 1,300 calories, 56 grams total carb with 26 grams fiber for a total of 30 net carbs. I try to keep my calorie level between 1,300 and 1,500; right around 10x my goal weight, sometimes higher but never lower. I know it might look a little low because I don't always give the measurements for how much of things I eat (like butter and mayonnaise), but I do keep careful track on Fitday to make sure that I get enough (vitamins and minerals also through the nutritional reports on Fitday).

Hi Lisa:
If you weight goal is 145 pounds, you need 145*13=1885 calories at least even if you don't exercise at all. 10 calories per pounds is just to for your body to perform simple functions to survive, like breathing, growing nails and hair, etc. even if you don't work out, you need at least 13 calories per pound. if you exercise 3-4 times a week for an hour, mutiply by 15. if you workout almost every day, by 20. also, it's advisable to start with a certain caloric intake based on your current weight, and then gradually cut it down while losing weight. another good calculation is to know what is your body fat % and calculate Lean Body Mass. IMHO, your caloric intake is way too low for your current weight and this tells your body that you are starving, so it will try to conserve evry calory rather than burn it. if you want to get past set point, full your body into thinking that you have enough food and calories, and it will start burning more. also, and it's more important, you are losing lean body mass more than fat%. you know they say"starve the fat and feed the muscle" in order to maintain lean body mass, you'd need more protein. trust me i'm speaking from experience, done this too before.LOL it' so tempting to eat less and see the pounds melting away initially but it will fire back later since most of the weight loss is from muscle, not fat.
one slip in your diet for any reasons, and the weight is coming back in a form of pure fat. LOL i'm not sure if you exercise but this is a huge benefit with weight, or shall i say, fat loss, which should be our goal. especially, weight training. scale weight is obsolete, fat % is more meaningfull, AFAIK. so, good luck to you and hope this works for you in a long run.
Happy NY,
Dina
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  #25   ^
Old Wed, Dec-31-03, 14:07
Lisa N's Avatar
Lisa N Lisa N is offline
Posts: 12,028
 
Plan: Bernstein Diabetes Soluti
Stats: 260/-/145 Female 5' 3"
BF:
Progress: 63%
Location: Michigan
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Thanks again for your concern, Dina, but I've been doing this for going on 3 years now and I think I know my body pretty well. According to Fitday, my basal (based on age, gender, etc...) is 1,300 and that is the point that I try to not go below. I know from experience that if I were to eat 1,900 calories a day, I would either gain or for sure not lose; 1,800 is the max I can do for weight loss, but for maintainance, I will most likely be more in the area of 2,000. In the past on low fat diets, I managed to gain on 1,200 calories per day, so my metabolism is fairly slow; add to that perimenopause (I'm 42), PCOS and diabetes and it makes weight loss fairly difficult (read what Dr. Bernstein has to say about PCOS and weight loss at his website or his newest edition of his book). Most days, I'm around 1,400 to 1,500 and since I've been paying more careful attention to calories and staying in that range, I've been losing pretty steadily (9 pounds since Thanksgiving), so my body seems pretty happy with what I'm doing right now as well. I'm getting adequate protein, more than adequate RDA of every vitamin and mineral that Fitday lists and from the way my body is responding, adequate calories as well.
My current goal is listed as 145, but I'm 5' 3", so could probably go well below that (probably down to 125). I'm shooting for 145 for now and will decide when I get there whether or not I want to lose more based on how I look and feel. I may be perfectly happy at that weight or I may want to lose a bit more. Won't know until I get there. My goal is really more of a size (10/12) than a weight.

Quote:
it's advisable to start with a certain caloric intake based on your current weight, and then gradually cut it down while losing weight.


And this is exactly what I have done. I lost pretty well at 1,800 calories when I weighed 260. I don't weigh 260 anymore.
I'll have to find the post, but someone e-mailed the Atkins center asking how many calories per day (based on body weight) and the response was that a person could safely go down as far as 10x their goal weight as long as their goal weight was a reasonable one.

I've also calculated my minimum protein requirements via Protein Power and lean body mass and I make sure to get my minimum amount (about 75 g per day, usually between 80 and 100). It's normal to lose some lean body mass as you lose weight simply because your muscles don't have to carry such a great load anymore, but eating adequate protein to support your lean body mass should keep that to a minimum.

Last edited by Lisa N : Fri, Jan-02-04 at 07:53.
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  #26   ^
Old Wed, Dec-31-03, 15:59
Lisa N's Avatar
Lisa N Lisa N is offline
Posts: 12,028
 
Plan: Bernstein Diabetes Soluti
Stats: 260/-/145 Female 5' 3"
BF:
Progress: 63%
Location: Michigan
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It occurs to me that we have gotten far off topic of the original post in this thread which was Type1's excellent A1c results.
I stated my opinion that the ADA should change it's recommendation that "tight control" isn't for everyone and that an A1c that is currently considered acceptable for a diabetic of 7.0 or less (type 1 or 2) is still too high. That's still my opinion, since the current standards are leading diabetics into a lifetime of complications and early deaths, I believe unecessarily. From my own experience, I can tell you that I was far more stressed when my blood sugars were out of control than I have ever been attempting to achieve Dr. Bernstein's definition of "tight control". According to my last A1c, I'm not there yet, but I'm hoping that my next one this Friday will show me that I am or have at least moved closer to that goal.
What everyone decides to make their own personal blood sugar targets and how to achieve them is up them and their physicians, but I still hold to my opinion that an A1c of 7, or even 6 on an ongoing basis will lead to problems sooner or later while an A1c of 5 or lower consistently will significantly delay or even possibly prevent/reverse diabetic complications. Personally, I'm shooting for those lower numbers because I firmly believe that my long-term health and quality of life depends on it.
I know A1c doesn't give the whole picture and every day blood glucose readings play an important part as well since blood glucose needs to remain elevated for a longer period of time than 2-3 hours to show up on an A1C, some speculate that it could take an elevation of up to 24 hours to affect A1c readings from what I've read but I think that's stretching things a bit. Based on that, daily monitoring is very important, both fasting and post-prandial, in aiding us as a guide towards keeping blood sugars in the normal range as much as possible.

Last edited by Lisa N : Wed, Dec-31-03 at 16:09.
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  #27   ^
Old Wed, Dec-31-03, 19:35
eevee's Avatar
eevee eevee is offline
Senior Member
Posts: 1,663
 
Plan: Free-range
Stats: 161/154/140 Female 65
BF:
Progress: 33%
Location: King Country New Zealand
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Type 1....I think your A1c results are excellent, but I wonder if you had to endure many lows to achieve 4.5%. Was 5.5% not a more comfortable WOL ? Maybe having some of your own insulin protected you from lows?
As I make none of my own I can't judge, but on the other hand this WOL I feel will help me achieve a daily average of around 110(A1c 5.5%) mark.
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