How I eat anythng I want/ dawn Phenom


(jdjim) #21

I have been doing the same and I’m T-1 for 53 years. My only issue is the reasonably accurate calculation of the carb content in foods. We do like to eat well in nicer restaurants, plus my wife is a very good (creative) cook. On those occasions it can be difficult to measure the carbs and my blood glucose level may spike. Then I play the game of wondering if the carbs were more quickly metabolized and the on-board insulin will deal with it OR if I need to pump a little more insulin to counteract a carb miscalculation. It can be a challenge to balance. That said, I am enjoying a nice IPA while I’m writing this.


(Janice) #22

Hi Jdjim, I take what I think I am going to need, if it’s not enough I’ll add a little later. A tomato beer sounds good about now, it’s been years but today it was 115 degrees and a cold one sounds good. I do the best I can counting carbs but I don’t worry about it, it can always be adjusted…I am using an Omni Pod so adjusting is easy to 1/10 of a unit, can’t measure that on a syringe… If I stay below 200 I am ok, I don’t sweat it., usually around 140 to be safe. I lost all symptomology of Hi and Low , several years ago, so higher is safer for me. Enjoy your IPA. Tell your wife hi for me, Greg and I will be celebrating our 50th anniv . this Dec. Have a great day. Bye Jan PS: If your on a pump then you Insulin on board will be figured into what you need to add based on you new carb amount.


(tomlinn) #23

Jan, I had a further question relating to Afrezza. Sometimes when my BG is high [>200 or so] and/or trending up at 150 on my CGM i will take 4 u using Afrezza. Generally it will promptly bring down BG but sometimes it does not and BG remain stubborn so i wait and bolus by my pump [OmniPod]. So my question is whether you have had experience with Afrezza and if so have had similar experiences and if so what if anything you might have done about it. Thanks so much. Tom


(Janice) #24

Hi Tom, it’s been a while, since I’ve used Afreerza. My question to you is : what time of the day, and if this could possibly a Dawn Phenomenon, and yes this can happen at other times beside dawn. If your BS stays stubborn sometimes you need to eat a little something, sounds strange I know, and I have had to do just to jump start my body to get back to normal. Dawn Phenomenon is when you liver will deposit sugar into your blood because it has been a while since you have eaten and it thinks you are starving, usually happens early in the am, but can happen at any time and the only way to stop it is to eat. Another thing at least for me, I am extremely allergic to insulin and sometimes it just doesn’t work, I have had to Piggy-Back injections because the first one got lost somewhere, why or how this happens no one is sure, but I have my theory. Hope this helps, not much I know but sometimes things just don’t work. Let me know. Bye jan


(PeteTheDiabetic) #25

Jan, I am glad you figured out so precisely, how to balance your sugars with your measured insulin doses. I have been type one for 46 years and have to tell you that we are all different. Your 1 nit of whatever kind of insulin you use, (I don’t think you said), is fine for you, I’m glad, but it doesn’t work that way for everyone, I have anxiety and panic attacks that will raise, or lower my BS and I never know until an hour or 2 later. Even if we were not diabetics, we would still tend to have different matabolisms and endocrine-ish differences in the way we use sugar, I think you have some good points though. I like your comment about it not being the sugar as much as not enough insulin. I think a lot of us have been afraid of taking to much. Pete


(Janice) #26

I absolutely agree, my point being is that we are all different and we need to figure out what works for each of us, my comments were to give someone a starting place instead of just saying no I can’t do that. I am extremely allergic to all insulin, but my reference would be to Humulog or Novolog, the most common ones used… 64 Years ago I was instructed or terrorized with the “This is going to happen if you do this or don’t do this” Fear can be a great teacher of a total detriment to life. I try hard to enjoy life, have what I want and do it with the least amount of complications. We all just have to figure out what works for us, and not let fear rule our lives. Have a great day, I’m off to enjoy myself and try to stay out of trouble. Bye jan


(Janice) #27

Pete, the insulin to carb ratio is a place to start, not carved in stone, but if you don’t know, this gives you a starting point to adjust according to the way your body works. Not meant to be perfect Sorry if I upset you not my intention, I just have a problem with people that say I can’t have that, you can have anything you want as long as you do it correctly, according to your own body’s requirements… Stress can raise and lower your BS, it is just one of those things, , we all handle stress differently… My body has never been precise and it never read the instruction manual, had to do my own manual. . I don’t have a problem with your point of view, just trying to explain how to have what we want without messing up. Forgive me if I upset you. but after 64 years with this condition I have learned what I can do, not much that I can’t do… Bye jan


(Janice) #28

Pete- FYI I am not the one that came up with the insulin to carb ratio, this seems to be the standard formula, discovered by some one else, I am just passing along the info. Do with as you wish, Have a great day, enjoy life. It’s your choice. Bye Jan


(Alex) #29

As a type 1 if I eat what I want my bs shoots up in the 300’s. What miracle insulin are you all injecting


(Dennis J. Dacey, pwD) #30

Hi Alex @Alex33martin33, I’ve read your posts and see that in a few short years you’ve had a horrible experience - I feel for you.

Sorry to burst your hopes, but there isn’t “a miracle insulin”. Over more than 60 years living with diabetes I’ve used more than a half dozen types of insulins - some worked better in me than others. Diabetes is a delicate balancing act between activity, food and insulin - and the “GOOD news” [ha, ha] is that, at least for me, very rarely do two days in a row work exactly alike. I’ve gotten to the point where I can do stuff right but it can still be a guessing game.
Following on with what @Joe said, find and listen to a good endocrinologist - pick the best there is. I’ll be here along with others to listen to you vent and offer support and suggestions based on experiences living with diabetes.


(Janice) #31

Hi Alex, I have been a type 1 for 64+ 65 in feb. any way no miracle insulin… What I am trying to say is that my body doesn’t know the difference between a piece of cake and a baked potato or between corn, peas, lima beans, beets and any other goodie you can think of. If you are going to base your. If you figure you need to take xx amount of insulin based on your carb intake. That’s what I do… Basic rule is 1 unit of insulin (humulog, novolog what ever) for every 10 grams of carbs. in addition on basic rule is that 1 unit of insulin will drop your BS by 50 points. [NOTE: These are “Janice Ratios” and may not be suitable for everyone.] Also in addition to the carb/insulin you also need to take into consideration you BS at the time you are going to eat and adjust your insulin to take care of you currant BS… Does that help…I have done this for years and my A1C is 6.8 to 7.3 The basic rule can be adjusted to your own personal needs, it’s just a place to start. You have to remember to keep your BS (no matter why) and your insulin intake in balance, you can’t adjust one without the other. Diabetics don’t have too much sugar we just don’t have insulin… Let me know what you think. I made up my mind years ago that if I had to live with this disease I would not let it rule my life, and I figured how to live with this disease under my terms with some compromise of course. Have a great day, let me know . Bye Jan


(Janice) #32

Alex, seems to be a type-o or incomplete thought in one of my paragraphs, just ignore it. Trying to cook dinner at the same time, Sorry Bye Jan


(Bill) #33

Janice,

When I read your original post this past June I wanted to send a response that clearly indicated that this appears to work for you, but was likely not applicable to others. I still believe that is true, and here is why.

Yes, the obvious problem in T1D is that those of us who have the disorder are not “manufacturing” our own insulin. And, yes, insulin is the “key” that “unlocks” the walls of cells so they can absorb and metabolize glucose; without glucose (or a similarly-metabolized “fuel”) cells starve, tissue systems fail, and we die. So, the “simple” logic suggests that all we need to do is figure out how much insulin we need to take to “cover” what we eat so that ingested glucose is metabolized. That keeps blood glucose levels from going too high and everything is fine. Right?

Wrong!

Did you see what is missing in the paragraph above? Right! There is a whole lot missing. As an example of some of the many things that are missing is this - our greatest risk when blood glucose levels rise is ketoacidosis. Ketoacidosis develops when the body begins to “feed itself” by breaking down fats. The “metabolites” released from fats can be used to feed the body’s cells when insulin is not available. The problem is the other “byproducts” of this process include “ketones.” Ketones are “acidic” so, as they build up in the bloodstream, they change the Ph of blood from “neutral” to “acid.” Tissue systems simply cannot function and survive in an “acid” environment; as the acidity of blood increases, and when it persists long enough, tissue systems can fail irreversibly and we die. It is the change in the Ph of blood that kills people with T1D, not a lack of insulin.

Here’s another important issue missing from the second paragraph - the body uses insulin to feed fat cells before it uses it anywhere else. What? Yes, fat cells have “first dibs” on available insulin. So, when you choose to eat a high carb treat and then “cover it” with a “matching dose” of insulin what are you doing? You’re feeding fat. And if you do this often enough you cause yourself to gain weight. Weight gain increases insulin need, so you end up having to take more insulin to keep your blood glucose level within an “acceptable” range. Getting in the habit of “eating what you want” sets you up to “need” more insulin on a daily basis. You decide if that’s what you want for yourself.

Here’s another issue. Suppose you have a ten-year-old who, every once in a while, has loose and frequent bowel movements after they eat a high carb/high fat treat. What’s going on there? It is likely a food sensitivity issue (e.g., gluten intolerance); such issues are more common in people who have T1D than the general population. When the ten-year-old consumes such a high carb treat their immune system will react and will likely also reduce their sensitivity to insulin - he/she will need more insulin for two or three days until their immune system “quiets down.” They may end up on a “blood glucose level roller coaster” where their blood glucose level is very difficult to stabilize. Now, ask yourself, is a treat worth doing that? And, “gut issues” in a ten-year-old may become more pronounced as they grow older. Is “poking the tiger with a stick” really worth it?

What I am saying with the above (and the many other issues I have not mentioned) is this - for people who have T1D their disorder will be easier to manage if they follow a very consistent diet day-after-day, week-after-week, and year-after-year. Treats? Maybe one every six weeks or so. Yes, it’s boring. And, yes, you “can” feel “deprived.” There are the Janices in the world who discover they can eat what they want, when they want. But until you have “really learned how to manage your disorder,” you are much better off “being boring” (as far as food is concerned). It simply makes diabetes easier to manage and, certainly, more predictable.

Our gut (stomach, small intestine, and large intestine) is a very complicated system. I have barely “scratched the surface” on how it impacts and is impacted by T1D.

Now, as far as your posted insulin-to-carbs ratio is concerned, Janice - I would encourage everyone to see that as “Janice’s ratio” and not a benchmark to work from in establishing your own. Janice’s ratio (1 unit per 10 grams of carbs; 1 unit per 50 mg/dl for adjustment boluses) would kill me in less than a day - the ratio that works for me is 1 unit per 30 grams of carbohydrates assuming a sedentary day. On a more active day the ratio that works for me is about 1 unit per 45 grams or more. And the ratio that works for me on an “adjustment bolus” is 1 unit of insulin per 100 mg/dl of blood glucose. As you can imagine, the basal routines that work for me are less than a unit of insulin per hour (e.g., thirty-five hundredths of a unit per hour overnight).

Janice, I appreciate that you have found a way to be a bit more liberal with your diet. That’s great. But I don’t agree that people with T1D should aspire to such a standard. It seems to me (after 60+ years living with diabetes) that people who have T1D should aspire to finding a formula that allows them to live as well as they can with the disorder. And I also believe they should discover a formula that limits how much diabetes intrudes in the way they want to live given the limitations of the disorder. For me, this means “limiting the intrusion” to no more than fifteen minutes a day. I have accomplished this by carefully following “my routine,” and “restricting” my diet to approximately the same carb loads at each of the meals I eat each day. I do snack, but just to keep me from slipping into hypoglycemia (I “feed” my insulin).

So, I would encourage everyone to “find your formula,” “limit intrusion,” and live your life your way as much as you can given the limitations of T1D management. If you aspire to “eat what you want” you are likely setting yourself up for frustration. Instead, I would encourage you to aspire to develop a formula that allows you to live as well as you can.

Hope that helps.

Bill


(Janice) #34

Bill, I appreciate your opinion, but as I mentioned before I am in my 65th year with this disease, so far my kidneys are perfect, except for 1 kidney stone( dehydration caused) eyes show no signs of Diabetes and that shocks my Optho. Amputee yes but not diabetic related. This is what works for me and others, and after 65 years why change. I was 9 when I was diagnosed, went thru all the doom and gloom lectures., had Polio before that. One thing you have to remember is that we all have different bodies and some of us may have a pre disposition to other things that could or could not be related to diabetes. We all have to find what works for us, this works for me. My biggest problem with being a diabetic is my allergy to insulin. My average BS per day is 140, great place for us older diabetics to be, lower causes me problems. But as I said before my body doesn’t know the difference between cake and beets (your word- carb loads) carb loads can stay the same it’s what makes up the carb loads that can be different… I am not trying to convince you of anything, this is just the way I do it. I was taught how to live a full life and way back when, with a few modifications that is exactly what I do. You do it your way and I’ll do it mine. You appear to have a lot more limits that I do, after 65 years I doubt if I’ll change, when you’ve had this disease for 65 years, contact me an let me know how you are doing. PS: remember, the brain only works on sugar and my brain is working all the time, also a higher BS keeps me from suffering from Neuropathy. Have a great day, keep in touch. Bye Jan Remember we all have to do what “Works for us”.


(tomlinn) #35

Hi Jan…I just logged on after a long time and very much appreciate your response. I have finally accepted the fact that much of this is just plain unpredictable…also that insulin can degrade with time and that attitude is so very important. I have had to take multiple corrections on occasion only to repeat doing so …so i understand how you might conclude that an earlier injection just does not work or ‘got lost’ as you put it. I would be interested in your theory as to how this happens but in the mean time i do want you to know that your earlier post of dosage for meals and to bring down highs was excellent and used successfully when my son and i went scuba diving in Cozumel last week…no problems!


(Alannah) #36

Thanks for this information! I have been waking up with high blood sugar every morning and I watch everything I eat. My doctor said she wasn’t sure why I was having this problem and I have been trying to figure it out. About a year ago I stopped eating a snack after dinner and this is when I started waking up with high blood sugar. What you said about the liver thinking it’s starving makes so much sense! I’m going to try to eat a little snack before bed and see if it helps.


(Janice) #37

Hi Tomlinn. I may need to clarify some things. Regarding Insulin getting lost, I have been taking injections for over 60 years and my tissues are so damaged that the insulin gets stuck in damaged area pockets, never to been seen again… Regarding corrections: if we were non diabetic our bodies would be making corrections continuously so I can see no difference if I do it. By doing so it actually gives me more freedom ( sounds backwards). We have to be able to adjust because life is not stagnant it is constantly changing and we have to be able to handle any situation, no matter what… I am also extremely allergic to insulin, my insulin antibody ratio is quite high, off the chart… Hope this helps. Bye Jan


(Janice) #38

Please keep me posted, OK. Have a great day. Bye Jan


(tomlinn) #39

Thanks so much for the response. I am still learning and continually amazed by the unexpected responses i get from my body…almost as if someone else was at the controls somehow. Thanks again…your insights always help!


(Janice) #40

Your body will do what it needs to do to survive, sometimes you ae just along for the ride. Don’t panic just remember our bodies are amazing creations, enjoy life and the ride.,I have been through Polio at age 3 and became a Diabetic at age of 9. here I am at 74 and still having a great time despite of dying back in 2000. I am amazed at the lengths my body will go to just to survive, of course a stubborn attitude helps. Have a great day, just remember your body will educate you with what it needs, pay attention and you will be fine. Keep me posted. Bye Jan