# Do the 'Professionals' really know best?



## loloy321 (Jan 29, 2011)

I was told by my consultant, diabetic nurse and nutritionist to have 3 big main meals a day and to stop testing so much. I was also told to 'forget' about testing etc and to run my bloods high for a while - maybe for hypo unawareness. But im so unhappy wiht it. This morning after my 'big' breakfast my blood is now 15! I prefer having a small breakfast and then maybe having a snack of toast with say 3 units of insulin later on as I find having smaller meals controls my blood better. But they said don't do this as insulin is overlapping each other and thats why i get the hypos. In fairness the past 2 weeks were good by the fact i had hardly no hypos. so at least thats sorted. but the high blood is getting me down  what does evetone else do? have 3 main big meals a day or smaller more frequent meal?? thanks


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## Steff (Jan 29, 2011)

It is best to try and eat all your meals of the day morning noon and night time meals preferably in the afternoon i have a snack of a sandwitch but as for stopping testing as much then thats just rude, your a type 1 you need to test as much as you need to end of! Im no expert as im a type 2 but if your happy and by the sounds of it you are doing things right then do so, its your diabetes do what feels right to you.


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## ukjohn (Jan 29, 2011)

Ask them if it would help them if you ate your 3 big meals in one then only test once  Some of these medical people are frightening.
I understand 3 healthy meals spread evenly over the day is best, with light snacks in between if required, as for testing, thats up to the individuals needs, but I would say a minimum of 4 times a day.

John.


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## Robster65 (Jan 29, 2011)

Hi loloy.

Without knowing your complete history and lifestyle, it's hard to say what's best for you but I've always had 3 main meals a day, with flexibility on timings and quantities and adjusted boluses to suit. Assuming you're on MDI (basal/bolus) you should be able to time the meals to suit your schedule.

As for testing, it's not untypical of the doctors to try and minimise it for cost reasons. As for overlaps, it's a very real concern and one that I found to be a problem once I took on board what was being suggested and experimented a bit. It may be that they have the right ideas but don't always appreciate the way real life interferes with their idealistic textbook regimes.

If you can space out your meals as much as poss (4hours+?) then you should avoid the overlaps and then try to adjust your insulins to gradually reduce the highs one at a time.

The pros don't know everything but generally you can find one that knows most of it and then you may need to agree o do what they suggest but make your own adjustments to suit your life. 

Rob


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## AnnW (Jan 29, 2011)

ukjohn said:


> as for testing, thats up to the individuals needs, but I would say a minimum of 4 times a day.
> 
> John.



I wish I could... I've been told I'm overusing the strips and the doc has refused to give me anymore... full stop. I am seeing my nurse on Tuesday and see what she thinks , she asks to see my diary with my tests in so she may notice the stop. I was told to test at least twice a day but now I have no idea at all, and no strips to use anyway at the moment


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## Ellie Jones (Jan 29, 2011)

In this case I would say that they aren't being very wise or helpful in your ability to control..

As you say it seems that the method you eat stacks the insulin causing a hypo...  There's a reasonable simple solution to resolving this problem...

Teaching you how to carb count and adjust your dose accordanly to prevent insulin stacking causing an hypo!

Actually it's far better to have smaller meals with snacks if necessary than larger meals over the day..

As the more insulin you have to use to cover a larger amount of carbs, the more unperdictacble the insulin asorbtion becomes..  Causing unstable highs and hypo's...

I would ask you team to be sent on a carb counting course, if they don't do one perhaps it's you need to ask to be refered to a different clinic who's more interesting in teaching good control management rather than trying to install a regime that suits them cutting there short term cost (reduction of test strips)


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## Jon (Jan 29, 2011)

AnnW said:


> I wish I could... I've been told I'm overusing the strips and* the doc has refused to give me anymore*... full stop. I am seeing my nurse on Tuesday and see what she thinks , she asks to see my diary with my tests in so she may notice the stop. I was told to test at least twice a day but now I have no idea at all, and no strips to use anyway at the moment



Mine only want me to test twice a week.
More to do with NHS budgets i would suggest.


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## donnarob (Jan 30, 2011)

Hi Ann
That's outrageous, I find testing is like a security blanket for me now, I test at least 5 times/per day and my Norwegian doctor encourages me to do so.  How on earth are you supposed to know what you are doing if you don't test?  The other day, I felt decidedly dodgy and my monitor was reading below 3.  I tested again, in case there was a mistake, but it only went up to 3.2.  Without the monitor, I wouldn't have known what was happening.  In this case, I ate some chocolate.  On hindsight, I think female hormonal surges had something to do with this as I spiked later on in the day (over 10).  Hadn't eaten anything out of the ordinary and looking back my glucose diary, had done exactly the same a month ago.  Who says female hormones don't affect bg levels.  The doctors seem oblivious to this. 

Donna


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## grandma (Jan 30, 2011)

Well Hi
I was told to run my bloods high for a while to get the hypo awarensee back.
I dident like being high all the time and felt realy unwell.
I have 2 main meals a day and not many snacks.
Its only these last few weeks from SEP. that things are starting to be not that bad.
I have done some moning on hear as they ill tell you. I thought that I was ok before and that I felt better with the lows but I did have a lot fo hypos.
I test about 10  -  15 times a day. So its outrageous that they have told you not to test as much. Carb counting is the best thing that has helped me and you need to test to do this. I am feeling better and my HbA1c has come down from 9.8 to 7.6 even with being high for a few months.
Get them to send you on one of the carb counting caurses.
Good look


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## loloy321 (Jan 30, 2011)

thanks everyone for replying. I am on a waiting list for a DAFNE course so that should help me alot. Plus I didnt eat any bread for my breakfast this morning, I had porridge and an apple. My blood was 7 two hours later. perfect. And the nutritionist told me to have bread with my breakfast - even though I told her I cant eat bread in the mornings - did she listen to me?? no! I had bread with my breakfast for the last two weeks and my blood was always high after it. So I wont be listening to her advice anymore!


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## Lizzzie (Jan 30, 2011)

Point, one, in favour of the professionals:

Always LISTEN. Listening is important and costs you nothing. (Professionals IS the correct word - they have training we don't - so they don't need the insulting commas around them).

BUT Point two, if favour of your own experience:

On the other hand, YOU are the one with type one diabetes and they are not with you all the time so don't know as much about YOUR control as you do, so there are bound to be occasions when what they are saying  (which is, after all, only as good as current diabetic theory for the 'average' person) is completely at odds with what you know about your own body.

Rather than working AGAINST these people, can you work with them? e.g. by saying very patiently, 'i know you said this about eating bread, but actually I found that when I ate bread for breakfast this happened, and when I didn't eat bread then this happened, so I don't understand why you are still telling me to eat bread....?'

This MAY get a useful response from them, which fills in something you hadn't thought of. If it doesn't get an intelligent or useful response, then you are still free to go your own way, but at least you've listened and given them a chance.

(It has taken me nearly 2 years to listen to the doctors telling me that I am letting my sugars run too low.  If I DO listen to them, I sometimes finish up with a BG of 14 2 hours after eating, which to my mind was always far too high.  But only recently I saw a different consultant who actually explained to me WHY they were saying this. So I went away, grit my teeth and did as he said..... and I still have a perfectly reasonable HA1bc AND my hypo awareness is slowly improving).


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## Lizzzie (Jan 30, 2011)

If you can't work with them, change hospitals and find someone you CAN work this. After all, this is your health we're talking about.


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## loloy321 (Jan 30, 2011)

i was not insulting the 'professionals' by the use of commas - i was merely pointing out that they dont always know right. this is not an insult - no one is perfect. i did say to them about the bread but i was told this should not happen! I also used to split my basal dose - take half in the morning and the other half in the night - i was told in no uncertain terms this was wrong and i would change it back. which i did.


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## Adrienne (Jan 30, 2011)

Lizzzie said:


> Point, one, in favour of the professionals:
> 
> Always LISTEN. Listening is important and costs you nothing. (Professionals IS the correct word - they have training we don't - so they don't need the insulting commas around them).



Mmmmm sorry but I totally and utterly disagree with this.   In my time I have met so many 'trained professionals' who are completely useless.  They may have training and know the text books back to front but so many are not up to date, still put little kids on mixed insulins (which are not used in the rest of Europe as not much good) as it is 'easier for the schools'.   I put that in quotes as I have heard that said myself by a few so called professionals.   

There are some great teams out there.   However for example where I live there are two hospitals in different directions and both the paediatrics teams give out bad, dangerous advice.    Many many families transfer to other hospitals for 100% better care.   It is awful out there.   So, yes I agree with you, listen to your team but always always without a doubt question absolutely everything, if you are not happy with the answer do some research and if you find your team is not up to date with their knowledge then go elsewhere.  It is your health and your life, not theirs, it is just their job.


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## bev (Jan 30, 2011)

Adrienne said:


> Mmmmm sorry but I totally and utterly disagree with this.   In my time I have met so many 'trained professionals' who are completely useless.  They may have training and know the text books back to front but so many are not up to date, still put little kids on mixed insulins (which are not used in the rest of Europe as not much good) as it is 'easier for the schools'.   I put that in quotes as I have heard that said myself by a few so called professionals.
> 
> There are some great teams out there.   However for example where I live there are two hospitals in different directions and both the paediatrics teams give out bad, dangerous advice.    Many many families transfer to other hospitals for 100% better care.   It is awful out there.   So, yes I agree with you, listen to your team but always always without a doubt question absolutely everything, if you are not happy with the answer do some research and if you find your team is not up to date with their knowledge then go elsewhere.  It is your health and your life, not theirs, it is just their job.



Hi Adrienne,
I couldnt agree more. I know there are some great teams out there - but there are some teams giving useless advice and even telling people not to bother testing if they dont like the results - what is good about that sort of advice. Just because a person has a Medical Qualification doesnt necessarily mean that they know what they are talking about and doesnt mean that they are listening to their patient.Bev


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## chrismbee (Jan 30, 2011)

_Professional means _being paid to do something - unfortunately, it carries no guarantee of competence.  It is a sad fact that being employed as a healthcare professional does not necessarily make a person expert in any discipline.  A limitation of any newly-qualified doctor is that they do not necessarily have extensive personal experience; at the start of their career their knowledge comes from a mixture of theory and whatever experience they may have been exposed to during training.

My experience of doctors is that very few that I have met over the years have a deep understanding of diabetes and it's various forms, let alone how it affects individuals - one or two have impressed me in the 28 years that I have had diabetes.  This is not a deliberate slur on doctors' abilities, it is merely an observation of factual limitation.  The wise doctor will readily acknowledge his or her own shortcomings and seek guidance from more senior (ie. more experienced) colleague before making any absolute decrees to a patient.

I have noticed many references to frequency of testing since joining this forum - it was even a hot topic of discussion yesterday, during our get-together in Oxford.  Essentially, if you don't measure, then you can't manage, or to quote Lord William Kelvin in full:

_'When you can measure what you are speaking about and express  it in numbers, you know something about it; but when you cannot measure  it, when you cannot express it in numbers, your knowledge is of a  meagre and unsatisfactory kind'._
However, measurement comes in many forms.  Whilst blood tests are the most accurate and immediate form of measurement available to us as individuals, we can also take information from other factors eg. how we feel, thirst, confusion, lethargy, toiletary requirements.

Sir Isaac Newton also hypothesised that you cannot measure anything without affecting it.  For example, the very act of acquiring a sample of blood puts the body under additional stress and could affect the reading!​
As a final theory to this (long) reply, if funds were unlimited, I doubt whether any doctor would advise against regular and repeated testing.


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## mcdonagh47 (Jan 30, 2011)

loloy321 said:


> I was told by my consultant, diabetic nurse and nutritionist to have 3 big main meals a day and to stop testing so much. I was also told to 'forget' about testing etc and to run my bloods high for a while - maybe for hypo unawareness. But im so unhappy wiht it. This morning after my 'big' breakfast my blood is now 15! I prefer having a small breakfast and then maybe having a snack of toast with say 3 units of insulin later on as I find having smaller meals controls my blood better. But they said don't do this as insulin is overlapping each other and thats why i get the hypos. In fairness the past 2 weeks were good by the fact i had hardly no hypos. so at least thats sorted. but the high blood is getting me down  what does evetone else do? have 3 main big meals a day or smaller more frequent meal?? thanks



As a matter of interest 
1. how many tests aday were you doing ?
2. had you lost your hypo awareness feelings ?


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## Lizzzie (Jan 30, 2011)

Forgive me Loloy321, that wasn't a personal dig at you - I was just checking because in my case the problem was definitely my understanding, not their advice - although the way I understood their advice (or possibly the way they communicated it!) the first 50 times or so led me to dismiss it.

If you have genuinely made sure that the problem is them and not a case of you dismissing like I did,  and tried with their suggestions and found them not to work, and they are not suggesting anything new to build on this, then this is a rubbish situation and you need to change health professionals. Is there a different hospital / GP / dietician / DSN you could use?

A  relationship where you feel that you can't trust your own doctor / nurse / dietician to give you advice that takes your own personal control into account, or where you don't feel listened to, or that they are treating a text-book and not you, is a bad one and a true waste of your time (because your visits won't change anything for you) and far more NHS resources than the odd pack of strips!

Adrienne, I agree with you entirely there. I still think it's mighty important to listen because if you don't hear, you might miss out.  And just because someone makes one or two apparently stupid suggestions, it doesn't mean they won't come up with something different what they understand the situation better.   Once you've listened, you can then decide for yourself if you're going to act on what you've heard.    (it's a 2-way process though... it only works if they're listening to you, too).


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## Adrienne (Jan 30, 2011)

Lizzzie said:


> Adrienne, I agree with you entirely there. I still think it's mighty important to listen because if you don't hear, you might miss out.  And just because someone makes one or two apparently stupid suggestions, it doesn't mean they won't come up with something different what they understand the situation better.   Once you've listened, you can then decide for yourself if you're going to act on what you've heard.    (it's a 2-way process though... it only works if they're listening to you, too).



Absolutely I totally agree. Listen to them but not necessarily do it


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## everydayupsanddowns (Jan 30, 2011)

Loloy

hope you manage to get on the carb counting course soon. I have very strong opinions on the lunacy of T1s being put on insulin therapy without being taught to measure and control their carbs. While you are waiting you could look up the BDEC e-learning course which will get you started.

Like Robster says, I find it easier to stay stable keeping insulin doses at least 4 hours apart. But I would also agree with you that smaller meals reduce the margin for error in the calculated dose. 

If you know that the dose is right for the carbs you are eating (in that you come down into range by the next meal/4 hours later) but find you are spiking up uncomfortably high in the meantime, you can try injecting a little earlier so you insulin has a chance to get going. Of course, this will be very hard to spot with your snacks/doses between meals since they add a whole new set of variables. 

I guess one approach is to focus on one thing first (eg reducing the number of hypos) and then add other things (say reducing post meal spikes) once you've made progress on the first issue. 

Hope you find a way forward which suits you soon
M


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## Alan S (Jan 30, 2011)

G'day all

I'm well aware of the problems you face with the post-code lottery in the UK when it comes to type 2 test strip support. In life everything has a price. You may have to make the decision which price you will eventually pay - cash or health?

Do whatever you must to get the correct support from the NHS. But if the NHS will not support you, then you have to decide how much your health is worth and whether you can afford *not* to buy your own strips elsewhere. 

Trying to manage type 2 diabetes without testing to see what is happening to your blood glucose levels after you eat is like trying to fly through the Alps in a blizzard without instruments. You may end up landing safely, but the odds are against you. That meter is your guiding instrument in navigating your diabetes journey.

I am lucky enough to have cheaply available test strips, so I was able to apply this technique in full (click on it): *Test, Review, Adjust*

If you have to ration your strips, this may be your better option: *Testing on a Budget*

I am writing to the T2s. I cannot understand how any physician who denies test strips as requested to a T1 can sleep nights. 

PS If the edit appears twice, I'm still learning your system here


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## Caroline (Jan 31, 2011)

I am under my GP for my diabetes care. My neighbour who shares the same GP is under the hospital. His words to me were since I was so much more capable and less prone to panicking than her I didn't need such specialist care.

The bit that gets me is if I see the doctor or the nurse, I get a 5 minute appointment if I'm lucky and told if I have any concerns I am more than capable of working it out for myself.

I appriciate my GP has a large catchment area with lots of patients, but if I want more than 5 minutes of his attention for me I have to book a double appointment...


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## alisonz (Jan 31, 2011)

When I saw a new doctor at our practice ten days ago I said to him that I felt since diagnosis I had just been left to get on with it, his reply was well thats what we do let you get on with it! As a T2 still a reasonably newbie to this "problem" it doesn't inspire much faith in the medical profession. 
A few days ago I went to the hospital for pre=op blood tests, was asked had anything changed since the last lot so I explained I had been diagnosed T2, instant reaction was well they won't do the op unless you have "good control" did I have good control? My reply? I don't know I'm not allowed to test! Its a no win situation really!


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## Andy HB (Jan 31, 2011)

alisonz said:


> When I saw a new doctor at our practice ten days ago I said to him that I felt since diagnosis I had just been left to get on with it, his reply was well thats what we do let you get on with it! As a T2 still a reasonably newbie to this "problem" it doesn't inspire much faith in the medical profession.
> A few days ago I went to the hospital for pre=op blood tests, was asked had anything changed since the last lot so I explained I had been diagnosed T2, instant reaction was well they won't do the op unless you have "good control" did I have good control? My reply? I don't know I'm not allowed to test! Its a no win situation really!



I think, in their terms, good control would be getting an HbA1c less than 6.5%. However, as you say, unless you can test to see how you're progressing from day to day, it could be a bit of a lottery.

Andy


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## donnarob (Jan 31, 2011)

Alan, is your book available to buy on Amazon yet?  As a relative newbie to this, I'm eager to get my hands on it. 

Donna


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## novorapidboi26 (Jan 31, 2011)

Strange being told you muct have bread with breakfast, for what reason exactly............


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## everydayupsanddowns (Jan 31, 2011)

Alan S said:


> G'day all



Hi Alan

Nice to see you on here!

Look forward to reading your comments and contributions over the coming months.

M


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## donnarob (Jan 31, 2011)

Caroline, 

I find that the doctor sums you up on your day of diagnosis.  Mine said in November that she didn't expect to see my bg levels coming down this side of Christmas.  When I went for my first review last week, she was very pleasantly surprised and told me I'd proved her wrong!  Is this every doctor's view on Type 2 diabetics?   Once my hbaic had come from 10.5% to 6.5%, I noticed her attitude changing which beggars the question, do doctors think we brought this on ourselves and therefore up to us, to make an effort to change things for the better? 

Donna


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## mcdonagh47 (Jan 31, 2011)

novorapidboi26 said:


> Strange being told you muct have bread with breakfast, for what reason exactly............



The usual advice is to have "some" starchy carbs with every meal (especially T1s) in order to stabilise rollercoaster bgs - hypers and hypos all the time. From what that the OP said she seems to be suffering that. Also since we don't know how many times a day she was testing I feel its a little unfair to criticise the Endo and DSn for suggesting she test a bit less. They have access to her medical notes - we don't.


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## C*5_Dodger (Jan 31, 2011)

novorapidboi26 said:


> Strange being told you muct have bread with breakfast, for what reason exactly............



Dear novorapidboi26,

I can't see what the reason is. It's been said elsewhere that eating some carbs helps stabilise your BS so you don't get hypers/hypos but that, at least to me, doesn't seem right  If you could somehow match your insulin to your carbs, both in amount and timing there would be no problem. The only trouble is this just does not seem possible. However, if you drastically reduce your carbs, then the effect of getting the insulin dose wrong would matter much less. The outcome would be much more stable BSs. We don't have to eat carbs - *we choose to!*

Regards  Dodger


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## everydayupsanddowns (Jan 31, 2011)

I think there's a lot in that Dodger...

Any meal over about 90g in carbs I find significantly harder to get right and usually have to split the dose to spread the insulin activity over a longer dual-wave style period. I've also read a rule of thumb which suggests a maximum individual bolus (or part of a split dose) of 7u. Obviously that's a challenge if your ratio is 2u:10g, and I don't follow that all the time, but I have major problems with boluses over 10u as my digestion just can't keep pace with the peak of insulin activity. I end up going hypo after the meal, then gradually creep skywards as the food is digested over time.

M


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## Robster65 (Jan 31, 2011)

Surely Dodger, we've evolved to eat carbs, along with protein and fat, but it's the way they're processed and the proportions that have changed.

The bread issue may well be a legacy from the old ideas of starchy carbs being essential for control, rather than the more recent GI/GL based diets to reduce the spikes, which, as dodger says, are lessened further by eating a smaller amount.

Rob


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## mcdonagh47 (Jan 31, 2011)

everydayupsanddowns said:


> I think there's a lot in that Dodger...
> 
> Any meal over about 90g in carbs I find significantly harder to get right M



Dodger in the past has said he eats less than 30g of carb a WEEK. Is that what he means by "drastically reducing " carbs ?


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## C*5_Dodger (Jan 31, 2011)

Robster65 said:


> Surely Dodger, we've evolved to eat carbs, along with protein and fat, but it's the way they're processed and the proportions that have changed.
> 
> The bread issue may well be a legacy from the old ideas of starchy carbs being essential for control, rather than the more recent GI/GL based diets to reduce the spikes, which, as dodger says, are lessened further by eating a smaller amount.
> 
> Rob



Dear Rob,

You are absolutely right when you say that "it's the way they're processed and the proportions that have changed". However, some hunter/gatherers do without carbs entirely, just because we can tolerate carbs it does not mean that we must eat them! The traditional Inuit think that carbs are animal food. Westerners who lived with them for years thrived on a no-carb diet. There are traditional cultures that have a lot of carbs in their diet, but what they don't eat is highly processed high GI foods as you stated. When I say we can tolerate carbs I am talking about non-diabetics. We are broken  Some authorities characterise diabetes as an inability to properly deal with carbs, and they say why eat something you can't deal with 

Regards    Dodger


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## FM001 (Jan 31, 2011)

Without a shadow of doubt you are far better having 3 main meals a day rather than snacking and covering with insulin every time.  The potential in over-lapping insulin doses and hypo's is greatly increased with snacking and eating smaller meals more frequent, by having breakfast, dinner and a evening meal you are spacing your insulin out and giving the previous dose time to exhaust itself.  Carbohydrates are a essential part of a healthy balanced diet and should be included in every meal, moderate consumption is advisable and will enable you to inject slightly less insulin and avoid the dreaded post food hypo's, I can highly recommend you all read about using the glycemic index to find which carbs are the most healthiest and kinder to blood glucose for us diabetics.


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## C*5_Dodger (Jan 31, 2011)

mcdonagh47 said:


> Dodger in the past has said he eats less than 30g of carb a WEEK. Is that what he means by "drastically reducing " carbs ?



Dear mcdonagh47,

I don't recall saying 30g/week, but if you've checked my posts, so be it. I reckon I eat somewhat less than 100g/week and after 14 years of low carbing cannot detect any problems other than mild neuropathy and background retinopthy and it is argued that these happen when you eat too many carbs. The amount of carbs you can tolerate needs to be determined on an individual basis, e.g a type 1 could lower carbs until getting the amount of insulin wrong was not significant. i.e. no hypers/hypos

Reagrds  Dodger


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## Andy HB (Jan 31, 2011)

donnarob said:


> I noticed her attitude changing which beggars the question, do doctors think we brought this on ourselves *and therefore up to us, to make an effort to change things for the better?*



I'd argue that for some type 2's that is patently the case (i.e. the highlighted bit, whether we bring it on ourselves is a moot point).

But the docs are there to help that process along and not hinder it (isn't their motto "do no harm"?)

Andy


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## mcdonagh47 (Jan 31, 2011)

C*5_Dodger said:


> Dear Rob,
> 
> You are absolutely right when you say that "it's the way they're processed and the proportions that have changed". However, some hunter/gatherers do without carbs entirely,



LOL - hunter/gatherers "gather" carbohydrates by definition - roots,leaves,tubers,seaweed,fruits,berries etc


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## AlisonM (Jan 31, 2011)

Andy HB said:


> .../But the docs are there to help that process along and not hinder it (isn't their motto "do no harm"?)
> 
> Andy



I'm afraid some of them may have forgotten that part of the Hippocratic oath. I sometimes wonder if the word 'hypocrisy' comes from the same root?


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## Ergates (Jan 31, 2011)

On the other hand, as said earlier in this topic, it's wise to listen first.  The professionals have a lot of training and experience that can lead them to make better judgement calls, despite being fallible humans as we all are.  Don't forget they are the source of stuff like carb counting for us.

One of the biggies is them being better equipped to spot patterns and trends from bG monitoring.


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## everydayupsanddowns (Jan 31, 2011)

C*5_Dodger said:


> e.g a type 1 could lower carbs until getting the amount of insulin wrong was not significant. i.e. no hypers/hypos



The only comment I'd make about that is that there is a point at which reduced carbs can end up being a bit problematic for a T1, and that I don't think that full-on low carb is a particularly easy option. If all your doses are down to, say 2u, then (if still on MDI and using standard delivery devices) your only options are to reduce dose by 50% or increase by 33%.

I think most often amounts of food eaten are fairly habitual. There's the possibility of eating vastly different quantities at every single meal, but frankly that's quite hard work and my appetite certainly isn't that varied. But neither would I want to be cornered into *having* to have (or not have) certain amounts at certain times of day, every day.

As with all things D it's about finding a method which works for you, most of the time, can be adapted/extended to suit special occasions/occasional treats and which still allows you to live a [relatively] normal life. What that means in practical terms will of course be as varied as each of us


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## C*5_Dodger (Jan 31, 2011)

mcdonagh47 said:


> LOL - hunter/gatherers "gather" carbohydrates by definition - roots,leaves,tubers,seaweed,fruits,berries etc



You are ofcourse always correct. (well nearly!)  BTW I have looked at my past posts but can only find a reference to 130g per week of carbs . Can you point out the post containing 30g ?

Regards


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## mcdonagh47 (Jan 31, 2011)

C*5_Dodger said:


> You are ofcourse always correct. (well nearly!)  BTW I have looked at my past posts but can only find a reference to 130g per week of carbs . Can you point out the post containing 30g ?
> 
> Regards



Sorry Dodger - you are probably right - I must have left the 1 off !
but don't you think that, as a T2 not on medication let alone insulin, you are a bit out of your depth advising T1s on carb and insulin ratios ?


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## C*5_Dodger (Jan 31, 2011)

mcdonagh47 said:


> Sorry Dodger - you are probably right - I must have left the 1 off !
> but don't you think that, as a T2 not on medication let alone insulin, you are a bit out of your depth advising T1s on carb and insulin ratios ?



Strictly speaking, you make a good point, but surely something so obvious as reducing carbs means that mistakes in using insulin will be less serious, is not too serious. Anyway, it's only my opinion. see below. Maybe the T1s can better decide rather than us T2s

Regards  Dodger


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## C*5_Dodger (Jan 31, 2011)

everydayupsanddowns said:


> The only comment I'd make about that is that there is a point at which reduced carbs can end up being a bit problematic for a T1, and that I don't think that full-on low carb is a particularly easy option. If all your doses are down to, say 2u, then (if still on MDI and using standard delivery devices) your only options are to reduce dose by 50% or increase by 33%.
> 
> I think most often amounts of food eaten are fairly habitual. There's the possibility of eating vastly different quantities at every single meal, but frankly that's quite hard work and my appetite certainly isn't that varied. But neither would I want to be cornered into *having* to have (or not have) certain amounts at certain times of day, every day.
> 
> As with all things D it's about finding a method which works for you, most of the time, can be adapted/extended to suit special occasions/occasional treats and which still allows you to live a [relatively] normal life. What that means in practical terms will of course be as varied as each of us



As a T1 you are right in pointing out the practical difficulties. Everyone needs to do what works best for them. I've already been chided by a T2 but this is much more to the point. 

Regards   Dodger


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## novorapidboi26 (Jan 31, 2011)

Types 2s in my opinion are less fortunate than type 1s and would benefit from a carb free or low carb diet, type 1s can stretch and be more flexible with the carbs, hence more fotunate, however regardless of type we all suffer from a condition which forces us to watch what goes in our mouths....


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## FM001 (Jan 31, 2011)

mcdonagh47 said:


> Sorry Dodger -
> but don't you think that, as a T2 not on medication let alone insulin, you are a bit out of your depth advising T1s on carb and insulin ratios ?





That's absolutely right as it's evident by Dodger's postings that his knowledge of type 1 and insulin ratio's work is sadly lacking.  Most modern QA insulin's need something to work on to prevent hypoglycemia, if you were to eat a protein rich meal with low carb veg then the likelihood of hypo's is very real-even in small doses; also protein on its own without carbs does to turn to glucose in the body by around 50-60% and will raise blood glucose so the benefits are very few.  Moderate consumption of carbs and eating a well balanced diet is by far the healthiest option available, provided the patient is aware of their insulin ratios then excellent control is more than achievable.


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## everydayupsanddowns (Jan 31, 2011)

toby said:


> Most modern QA insulin's need something to work on to prevent hypoglycemia, if you were to eat a protein rich meal with low carb veg then the likelihood of hypo's is very real-even in small doses; also protein on its own without carbs does to turn to glucose in the body by around 50-60% and will raise blood glucose so the benefits are very few.



I think moderation is the key word. We can't say low carb is the answer for everyone, any more than we can say low carb won't work. 

I believe protein conversion to glucose improves if carbs are restricted, but it's still likely to be too slow for the profile of a rapid analogue insulin. So much so that most of us can ignore protein and only need to consider carbs (this has not always been the case, I think the 'lines' system included protein in the overall counting). 

GI/GL can help a great deal, but I've spiked some days eating low GI foods, while supposedly high GI (eg mashed potato) have left my post meal levels beautifully in range.

It would be great if someone could just tell us THE way to manage it, but D is a very individual condition. Not only do we all set our own expectations and acceptable levels (outside or within the guideline ranges) but one person's perfect answer would be another person's complete disaster. 

Pain innit.


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## Robster65 (Jan 31, 2011)

The biggest problem I now find is that, while on MDI we can vary the timings and quantities of insulin, the profile is fixed, varying randomly with injection sites, metabolism, ad infinitum.

This makes it veyr hard to eat a truly 'varied diet' since we need to find foods (primarily carbs) that approximately match the profile of the bolus. This is really where the snacking vs main meals issue comes in. If you want to graze through the day, you'd be better off with a split basal, adjusted to match a constant stream of carbs through the day and lowered at night, but I wouldn't want to try it without an ambulance on standby ! 

Ineresting debate, especially the T1/T2 differences with carb requirements.

Rob


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## alisonz (Jan 31, 2011)

My practice nurse told me today that as a T2 I don't need to worry about carbs


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## everydayupsanddowns (Jan 31, 2011)

alisonz said:


> My practice nurse told me today that as a T2 I don't need to worry about carbs



OOOOOPS! 

That's a very scary thing for a type 2 to be told. Practice nurses seem to have very little (if any) actual training in diabetes care/management sometimes. At least with a DSN you know they've had to undergo several years-worth of specialisation. And even then they can come up with some howlers. That one though deserves to go on a list of 'Stupidest comments made by a HCP' list. 

Imagine if you just took their word for it. No actually don't. It's not a nice thought at all.


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## Robster65 (Jan 31, 2011)

I suppose in relative terms, carbs are less of a concern than the practice nurse herself 

Rob


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## Ellie Jones (Jan 31, 2011)

C*5_Dodger said:


> Dear mcdonagh47,
> 
> I don't recall saying 30g/week, but if you've checked my posts, so be it. I reckon I eat somewhat less than 100g/week and after 14 years of low carbing cannot detect any problems other than mild neuropathy and background retinopthy and it is argued that these happen when you eat too many carbs. The amount of carbs you can tolerate needs to be determined on an individual basis, e.g a type 1 could lower carbs until getting the amount of insulin wrong was not significant. i.e. no hypers/hypos
> 
> Reagrds  Dodger



Now why did I know without looking that doger is T2 diabetic?

Neuropathy and background retinopathy hasn't anything to do with carbs per sa, it's completley to do with raised blood glucose levels not the diet being eaten as such..

Ah well the game was totally given away by assuming that hypo/hypers are totally caused by carbs and miss matched insulin injection....

There are many factors that at any one point of time can effect our control causing hypers and/or hypo's which have nothing to do with the insulin we injected or the carbs we've eaten...

Stress, exercise, ambilent temperature, excitment, infection, injury, shock just some of the factors outside our control not quantable but go a long way at faffing up our carefully calculated insulin injection causing the hypo or hyper suffered...

Avoiding carbs per sa isn't the answer to good control either, as they could be a lot of problems with long term low carbing which even though those that preach this way of life won't admit this concern over the diet, but one got to wonder why do they tend to take so many supplements after all if you eating a healthy balanced deit all your bases should be covered with your nutrient requirements so no need to supplement!


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## FM001 (Jan 31, 2011)

everydayupsanddowns said:


> I think moderation is the key word. We can't say low carb is the answer for everyone, any more than we can say low carb won't work.
> 
> I believe protein conversion to glucose improves if carbs are restricted, but it's still likely to be too slow for the profile of a rapid analogue insulin. So much so that most of us can ignore protein and only need to consider carbs (this has not always been the case, I think the 'lines' system included protein in the overall counting).
> 
> ...




Your right there is no reason whatsoever to count protein when eating carbohydrates unless the it was covered in breadcrumbs or a pastry.  Not for everyone but the glycemic index is a useful tool to determine how fast carbohydrates will raise blood glucose, I have a type 2 friend who moved to Australia and he says that the authorities there advocate using the GI method in controlling diabetes of all types, my bet would be that it may not applicable to those who are diet controlled but for those on meds and insulin it is certainly worthy of investigating.

The only true way to manage diabetes is by experimentation, as you say we all react differently to the food we eat and also to the insulin we inject, there isn't a ''one-size fits all'' approach, only by recording and analysing one's results can we hope to gain good glucose control and this requires patience, time and determination.


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## Pumper_Sue (Jan 31, 2011)

toby said:


> Your right there is no reason whatsoever to count protein when eating carbohydrates unless the it was covered in breadcrumbs or a pastry.  Not for everyone but the glycemic index is a useful tool to determine how fast carbohydrates will raise blood glucose, I have a type 2 friend who moved to Australia and he says that the authorities there advocate using the GI method in controlling diabetes of all types, my bet would be that it may not applicable to those who are diet controlled but for those on meds and insulin it is certainly worthy of investigating.
> 
> The only true way to manage diabetes is by experimentation, as you say we all react differently to the food we eat and also to the insulin we inject, there isn't a ''one-size fits all'' approach, only by recording and analysing one's results can we hope to gain good glucose control and this requires patience, time and determination.



Toby, I suspect you will find eating a lot of protien causes quite a high blood sugar reading in many diabetics. If I eat a carb free meal then my insulin requirement's are not a lot dif than eating a carby meal. Being a pumper I just spread the insulin over a fair few hours. The same aplies for eating a fatty meal I actually need twice as much insulin as I would for carbs.
Hence I avoid fatty and high protien meals.
GI/GL every diabetic no matter what type needs to be aware of it.


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## FM001 (Jan 31, 2011)

toby said:


> Your right there is no reason whatsoever to count protein when eating carbohydrates unless it was covered in breadcrumbs or a pastry.





Pumper_Sue said:


> Toby, I suspect you will find eating a lot of protien causes quite a high blood sugar reading in many diabetics. If I eat a carb free meal then my insulin requirement's are not a lot dif than eating a carby meal.





Sue, you'll have to read my quote again to see that I am in agreeance with what you have wrote above.   Toby.


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## margie (Jan 31, 2011)

The answer to the original question is some do and some don't.

When I became diabetic and started to inject - I was told that if I wanted to adjust doses to do it in units of 2 as less than that had no therapeutic effect. This did not make sense to me and now of course that is not the perceived wisdom. 

There are some very good professionals out there, some bad and many in between. It can be hit and miss as to who you end up with.


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## C*5_Dodger (Jan 31, 2011)

Ellie Jones said:


> Now why did I know without looking that doger is T2 diabetic?
> 
> Neuropathy and background retinopathy hasn't anything to do with carbs per sa, it's completley to do with raised blood glucose levels not the diet being eaten as such..
> 
> ...



Dear Ellie,

I can't believe what I just read! *It is carbs that raise blood sugar*, as you say raised blood sugar cause retinopathy and neuropathy. 

Regards  Dodger


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## Alan S (Jan 31, 2011)

I've browsed back through this thread and read every post. It's been fascinating, because I doubt you have another thread here which offers such a spread of opinions on almost everything that concerns us as diabetics: "professionals" and their wisdom - or lack of it; carbs and their need - or lack of it; whether T2 brought it on themselves; the need to take protein into account - or not; and several other aspects.

I hope you don't mind if I offer some very brief thoughts by responding to some of those in following posts. I'll keep it very brief by using links to other posts I've made, but I'm happy to debate points in detail if anyone wishes to.

First, thanks to Chrismbee for leading me to this quote; I can't believe I haven't come across it before but I'll use it often in the future:

_'When you can measure what you are speaking about and express it in numbers, you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind'._ ~LORD KELVIN

I did a quick search and found a couple of other variants:

_"If you can measure that of which you speak and can express it by a number, you know something of your subject; but if you cannot measure it, your knowledge is meager and unsatisfactory."_
and
_"When you can measure what you are speaking about, and express it in numbers, you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind; it may be the beginning of knowledge, but you have scarcely in your thoughts advanced to the state of Science, whatever the matter may be."_

Whichever way it is worded, it should be forcibly branded on the forehead of every professional - whether doctor, nurse or accountant - denying test strips to diabetics. Actually, for those accountants, I would brand them in a different region.


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## Ergates (Jan 31, 2011)

novorapidboi26 said:


> we all suffer from a condition which forces us to watch what goes in our mouths....



On forums that can apply to what comes out too.


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## Alan S (Jan 31, 2011)

Lizzzie said:


> Point, one, in favour of the professionals:
> 
> Always LISTEN. Listening is important and costs you nothing. (Professionals IS the correct word - they have training we don't - so they don't need the insulting commas around them).
> 
> ...


I agree. Listen to the experts. But remember they are not just doctors, nurses or diabetes educators. They are also fallible human beings.

As a person with diabetes, never forget that the person who will be most affected by poor advice from any source will be you ? not me, not your doctor, but you. In my opinion, more than nearly any other condition, the success of management of diabetes depends on the diabetic. So, while medics can advise and prescribe ? it?s your decisions and your actions that will decide your future.

I expand on that here: *Experts*


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## Ergates (Jan 31, 2011)

One thing I do like about the proliferation of the internet, and forums like this one, is that it has become much easier to access information.  Of course lots of it is wrong, but the internet also teaches us all at becoming better at judging what advice is good and what is bad.

Always maintain that sceptical questioning attitude, and look deeper into anything that doesn't seem to add up.


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## Alan S (Jan 31, 2011)

donnarob said:


> Alan, is your book available to buy on Amazon yet?  As a relative newbie to this, I'm eager to get my hands on it.
> 
> Donna


It's on Amazon here: *What on Earth Can I Eat?: Food, Type 2 Diabetes and YOU*

I believe delivery to the UK is about US$4 but I'm not sure of the delivery timing. If someone knows those details, please let me know. I hope it will appear on Amazon.co.uk eventually, but I haven't been told whether or when that will happen.


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## Alan S (Jan 31, 2011)

everydayupsanddowns said:


> I think there's a lot in that Dodger...
> 
> Any meal over about 90g in carbs I find significantly harder to get right and usually have to split the dose to spread the insulin activity over a longer dual-wave style period. I've also read a rule of thumb which suggests a maximum individual bolus (or part of a split dose) of 7u. Obviously that's a challenge if your ration is 2u:10g, and I don't follow that all the time, but I have major problems with boluses over 10u as my digestion just can't keep pace with the peak of insulin activity. I end up going hypo after the meal, then gradually creep skywards as the food is digested over time.
> 
> M


Mike, I never give dietary advice to T1s. For myself, 90gm CHO in one meal? Wow!

One of the first books I bought after my own T2 diagnosis was Bernstein's Diabetes Solution. Some think his methods extreme; I can't say, because I've never followed his ultra-low-carb method. But I did learn a lot that was very valuable to me at that time and proved to be correct over the years - for me. 

One chapter that had a big impact on my thinking was *Chapter 7, The Laws of Small Numbers* (available free on that link) which opens with "Big inputs make big mistakes; small inputs make small mistakes.?

If you haven't read it already, I think you would find it very interesting.


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## Ergates (Jan 31, 2011)

Oooh, on a big exercise day I might consume as much as 600g of carbs.


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## Alan S (Jan 31, 2011)

Toby wrote:


> Without a shadow of doubt you are far better having 3 main meals a day rather than snacking and covering with insulin every time.  The potential in over-lapping insulin doses and hypo's is greatly increased with snacking and eating smaller meals more frequent, by having breakfast, dinner and a evening meal you are spacing your insulin out and giving the previous dose time to exhaust itself.  Carbohydrates are a essential part of a healthy balanced diet and should be included in every meal, moderate consumption is advisable and will enable you to inject slightly less insulin and avoid the dreaded post food hypo's, I can highly recommend you all read about using the glycemic index to find which carbs are the most healthiest and kinder to blood glucose for us diabetics.


Without a shadow of a doubt one of the good things I've noticed about this forum is the way each person's diabetes type is noted on the left.

Each of us is different. For those  non-insulin-using type 2s, like me, who suffered in the early days post-diagnosis from reactive hypos, *grazing* with many small meals and snacks was and is an excellent solution.


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## Alan S (Jan 31, 2011)

alisonz said:


> My practice nurse told me today that as a T2 I don't need to worry about carbs



It seems that some professionals use the word practice in it's other sense. Find another nurse until that one takes off the "L" plates.


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## Pumper_Sue (Jan 31, 2011)

Alan S said:


> It's on Amazon here: *What on Earth Can I Eat?: Food, Type 2 Diabetes and YOU*
> 
> I believe delivery to the UK is about US$4 but I'm not sure of the delivery timing. If someone knows those details, please let me know. I hope it will appear on Amazon.co.uk eventually, but I haven't been told whether or when that will happen.



I believe it was 18 - 33 days for delivery Alan, by snail mail


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## Adrienne (Jan 31, 2011)

Alan S said:


> Without a shadow of a doubt one of the good things I've noticed about this forum is the way each person's diabetes type is noted on the left.
> 
> Each of us is different. For those  non-insulin-using type 2s, like me, who suffered in the early days post-diagnosis from reactive hypos, *grazing* with many small meals and snacks was and is an excellent solution.



I agree.   Dietry advice for type 1 and type 2 differ hugely.   

Also then between type 1 and type 1 it differs and between type 2 and type 2 it differs.   So what works for one does not work for another.   

I am reading all these posts and wasn't going to comment as none of them apply at all to someone who pumps, so again that is different.

With a pumper (as my daughter is), you can pretty much eat what  you want, when you want, you just need to know how to use the insulin to your advantage ie with the dual waves (given insulin in percentages and spread out over a period of time).    So all very different and you can eat no carbs or all carbs.  It really makes no odds, you just make the food work for you.

To keep blood levels ok from breakfast to lunch time the best meal is yoghurt and fruit, that's it.  Bolus for it but pretty guarantee no spike.  If you spike then the basal is possible wrong.   This was part of a study in the USA and I then tried it with my daughter and it worked, spot on.


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## Alan S (Jan 31, 2011)

Andy HB said:


> I'd argue that for some type 2's that is patently the case (i.e. the highlighted bit, whether we bring it on ourselves is a moot point).
> 
> But the docs are there to help that process along and not hinder it (isn't their motto "do no harm"?)
> 
> Andy


A moot point indeed; reinforced by the media and woefully misleading guidance "for their own good" from the health-care industry to the general population. This was written from an Australian and US perspective; I'm not sure if it's valid for the UK: *Type 2 Diabetes and the Shame Game*


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## Alan S (Jan 31, 2011)

Pumper_Sue said:


> I believe it was 18 - 33 days for delivery Alan, by snail mail


Aaarghh! 

Sorry about that. I'm sure it would be quicker in reality; it's taking a bit less than two weeks to get it across the Pacific and the Atlantic isn't as wide


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## Alan S (Jan 31, 2011)

Pumper_Sue said:


> Toby, I suspect you will find eating a lot of protien causes quite a high blood sugar reading in many diabetics. If I eat a carb free meal then my insulin requirement's are not a lot dif than eating a carby meal. Being a pumper I just spread the insulin over a fair few hours. The same aplies for eating a fatty meal I actually need twice as much insulin as I would for carbs.
> Hence I avoid fatty and high protien meals.
> GI/GL every diabetic no matter what type needs to be aware of it.



Over the past eight years on several forums I've noticed that the people who report a need to take protein into account for post-prandial peak blood glucose levels invariably use exogenous insulin. For those who inject insulin, taking protein into account can be quite important; for those who don't it appears to be waste of time. JMO.


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## everydayupsanddowns (Jan 31, 2011)

Alan S said:


> Mike, I never give dietary advice to T1s. For myself, 90gm CHO in one meal? Wow!



Thanks for the link. Have heard a lot about Mr Bernstein, especially from T2s, so will be interested to read a little.

Meals of that size would be unusual for me, (more usually 130-150g a day). However I can cope with 140g in a single meal with a little careful dose splitting. What I find slightly shocking is that the 'guideline' amounts for a normal diet that you see on UK food packaging often list daily carbs as around 240g. Which would mean 80g per meal every meal.

Oh and incidentally the next quote you pulled which begins 


> Without a shadow of doubt you are far better having 3 main meals a day...


was from Toby I think, not me. Not bothered by it, but you might want to correct the attribution.

M


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## Alan S (Jan 31, 2011)

everydayupsanddowns said:


> Thanks for the link. Have heard a lot about Mr Bernstein, especially from T2s, so will be interested to read a little.
> 
> Meals of that size would be unusual for me, (more usually 130-150g a day). However I can cope with 140g in a single meal with a little careful dose splitting. What I find slightly shocking is that the 'guideline' amounts for a normal diet that you see on UK food packaging often list daily carbs as around 240g. Which would mean 80g per meal every meal.
> 
> ...


Sorry about that - I'm still learning this place. Corrected - I hope.

PS Bernstein is a Type 1 engineer who pioneered the use of post-prandial testing, back when meters needed a backpack to carry one around. When the doctors refused to listen to him he went back to school at the age of 45 to become a fully qualified doctor so that they would. Unfortunately, most of them still don't.


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## everydayupsanddowns (Jan 31, 2011)

Alan S said:


> Sorry about that - I'm still learning this place. Corrected - I hope..



No probs. And nice to know where I'd heard that figure of 7u from (which I mentioned earlier in this thread), I think it was from a post of TerryG's on DSF, now I know it's a Bernstein


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## RachelT (Jan 31, 2011)

*Do whatever works for you!*

I wonder what the average length of thread is before it turns into a type 2 carb war? (<---sarcasm applied liberally...)

I'd like to agree with Adrienne, every diabetic is different, it's obvious to me that there are differences between any two of us who have type 2, but i'd expect the same to be true for type ones.

Personally i can't see why any type one can be told off for test too much, as long as your Hba1c is under control and you're not suffering from hypos a lot, surely whatever you're doing is right (that's true for type 2s as well in my oppinion, whatever works for you is what you should do.) However i've no idea what your local health authority or PCT has decided that the "average" type 1 should do. Don't worry, they won't be around for that much longer anyway, then your GP will get the final say....in mu case i wonder if he knows what he's going to say.
Your GP has to be a special type of doctor, he has to know a bit about everything he is likely to encounter, but that doesn't leave him a lot of time to learn about any particular disease/condition in a lot of detail. My GP is supposed to be the diabetic specialist (ummmmm....if you say so....) my cousin, however is also a GP but specialises in Sport Medicine. 
You've always got the right to change your doctor and get a second opinion if you want.


As for who has it worse? Nobody...both types are pains in the proverbial. T1s have to stick a lot of needles in themselves and are at a higher risk of scary hypos, T2s have to go through the whole food rigmarole. And the non-diabetic populous generally can't tell the difference, and label us all wrongly.


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## Ellie Jones (Jan 31, 2011)

Bernstien and his diabetic solution...  Not a man I'm impressed with at all, I'm more than just a diaebtic!

His theory about small numbers is pretty common sense, but I really disagree with his numbers suggested, I think that each individual needs to chose the amount of carbs they have so it's suit them and their lifestyles (something Bernstiens seems to forget, that diabetic are actually human, and diabetic management isn't just about numbers!)

I'm T1 and the thought of eating 90g of carbs in one sitting is *WHAT* but that's because I've never been a big eater plenty of carbs in one meal for me is about 30g or 40g very rarely any higher..

But what I found to be one of the biggest problems is the lack of understanding of how our food reacts with us...  The GI index is very useful indeed as a tool to working it out...  So are our test meters which can further identify problem foods or combination of foods..  Enabling us to work with our food intake and medication for the best result possible..


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## everydayupsanddowns (Jan 31, 2011)

Ellie Jones said:


> Bernstien and his diabetic solution...  Not a man I'm impressed with at all, I'm more than just a diaebtic!
> 
> His theory about small numbers is pretty common sense, but I really disagree with his numbers suggested, I think that each individual needs to chose the amount of carbs they have so it's suit them and their lifestyles (something Bernstiens seems to forget, that diabetic are actually human, and diabetic management isn't just about numbers!)
> 
> I'm T1 and the thought of eating 90g of carbs in one sitting is *WHAT* but that's because I've never been a big eater plenty of carbs in one meal for me is about 30g or 40g very rarely any higher..



Sounds like you've worked out your own 'low-moderate carb' version which works for you Ellie, and while you may not like some of what Bernstein says (and I can't comment on that cos I've only read that extract) you do seem to be adhering to his 'small numbers' principles with good success.

I'm pretty sure <100g carb a day (say 2x30g and 1x40g) _is_ classified as low carb  [ducks and runs for cover]


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## Ellie Jones (Jan 31, 2011)

everydayupsanddowns said:


> Sounds like you've worked out your own 'low-moderate carb' version which works for you Ellie, and while you may not like some of what Bernstein says (and I can't comment on that cos I've only read that extract) you do seem to be adhering to his 'small numbers' principles with good success.
> 
> I'm pretty sure <100g carb a day (say 2x30g and 1x40g) _is_ classified as low carb  [ducks and runs for cover]




First time I've been called a low carber been called many things related to diabetes even down to being a murder!!!  But never a low carber..

But I do eat all types of carbs from the good to the bad, I don't follow a high fibre/low fat diet nor an high fat diet fall somewhere in between..  

My biggest problem with diabetes is that I am very insulin sensitive, I unit of insulin will drop my BG by over 7mmol/l's


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## katie (Feb 1, 2011)

C*5_Dodger said:


> Strictly speaking, you make a good point, but surely something so obvious as reducing carbs means that mistakes in using insulin will be less serious, is not too serious. Anyway, it's only my opinion. see below. Maybe the T1s can better decide rather than us T2s
> 
> Regards  Dodger





novorapidboi26 said:


> Types 2s in my opinion are less fortunate than type 1s and would benefit from a carb free or low carb diet, type 1s can stretch and be more flexible with the carbs, hence more fotunate, however regardless of type we all suffer from a condition which forces us to watch what goes in our mouths....



I have tried low-carbing and I'm affraid it just doesn't work for me as a type 1. I would bolus for the tiny amount of carbohydrate I had with each meal and my levels would just be completely random.

That said, I would say reducing the amount of carbs/types of carbs you eat can definitely gain you better control.

And I can't see how it can harm any Type 2's as long as they are making there own insulin. Less carbs should equal better levels.


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## bev (Feb 1, 2011)

Alan S said:


> It's on Amazon here: *What on Earth Can I Eat?: Food, Type 2 Diabetes and YOU*
> 
> I believe delivery to the UK is about US$4 but I'm not sure of the delivery timing. If someone knows those details, please let me know. I hope it will appear on Amazon.co.uk eventually, but I haven't been told whether or when that will happen.



Hi Alan,
I am not a moderator - but advertising on here is not allowed - I am sure a moderator will be along soon to take this off.Bev


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## everydayupsanddowns (Feb 1, 2011)

bev said:


> Hi Alan,
> I am not a moderator - but advertising on here is not allowed - I am sure a moderator will be along soon to take this off.Bev




Hi Bev

To be fair to Alan it was in response to a direct question from a forum member. I've 'met' him on other forums and from what I can tell he is a genuine forum type, happy to freely offer suggestions based on his own experiences, and not just out to advertise.

Perhaps a PM would have been more within the rules? Having said that I never minded Northerner letting us know about the 'Sugar Free' poems book with his work in.

M


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## bev (Feb 1, 2011)

everydayupsanddowns said:


> Hi Bev
> 
> To be fair to Alan it was in response to a direct question from a forum member. I've 'met' him on other forums and from what I can tell he is a genuine forum type, happy to freely offer suggestions based on his own experiences, and not just out to advertise.
> 
> ...



Hi Mike,
I just thought that as Northerner was taking a break, perhaps another moderator needed a reminder. It doesnt really matter how you know Alan or whether he is genuine or not - I was not making a personal attack on him - I am sure he is a very genuine and informative person - but as I have been a member on here for two years - I have been made aware of the rules many times and advertising ones own material for profit-making purposes is definately not approved of. When a moderator has needed to remind people in the past - they always do it on the forum as it lets everyone know what the rules are - so I was just copying what has been done in the past. I did not intend to offend at all.Bev


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## everydayupsanddowns (Feb 1, 2011)

bev said:


> Hi Mike,
> I just thought that as Northerner was taking a break, perhaps another moderator needed a reminder. It doesnt really matter how you know Alan or whether he is genuine or not - I was not making a personal attack on him - I am sure he is a very genuine and informative person - but as I have been a member on here for two years - I have been made aware of the rules many times and advertising ones own material for profit-making purposes is definately not approved of. When a moderator has needed to remind people in the past - they always do it on the forum as it lets everyone know what the rules are - so I was just copying what has been done in the past. I did not intend to offend at all.Bev




I didn't think you were out to make an attack at all, but I was just trying to put myself in the shoes of someone who'd only been posting here for a few days and might have not read your comment in the light of a) knowing you as a
genuinely nice person and b) lots of experience of the finer ins and outs of this forum's etiquette.


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## Andy HB (Feb 1, 2011)

Advertising per se is certainly frowned upon and will be stomped on vigourously.

However, I see no reason to remove some more helpful advertising so long as it is clearly in context with this forum and its behaviour.

Thanks for the heads up Bev, but can you please use the report button in future rather than replying in the thread. If something needs to be removed it helps if we don't have to clear it from any quoted reply too.

Andy


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## bev (Feb 1, 2011)

Andy HB said:


> Advertising per se is certainly frowned upon and will be stomped on vigourously.
> 
> However, I see no reason to remove some more helpful advertising so long as it is clearly in context with this forum and its behaviour.
> 
> ...



Hi Andy,
I will keep out of it in future - I thought I was helping in the absence of a Moderator.


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## Andy HB (Feb 1, 2011)

I'm closing this thread now because it has gone somewhat off subject.

Andy


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