[Diabetes-talk] Spike.

[Michael Park]

Back from gym and a pre-lunch sugar of 103 and just ready to face the world.

The problem here in South Africa is that if you cannot afford medical 
care, which is the position in which I find myself, you have to depend 
on the government health care system to help you manage diabetes and 
unless as a diabetic, you become educated smartly, you will find 
yourself in a very perilous spot. The average doctor at our primary 
hospitals do not have a clue how to treat diabetes and they will not 
refer you to specialist facilities which can give you the proper 
treatment. Fortunately, I know two very competent diabetologists through 
family contacts and through being an activist for diabetics in this 
country and I get my advice from the two of them. So I just walk into 
the primary facility, shove the script which one of them wrote, under 
the nose of the doctor concerned with the expectation that the 
medication I need, and which has been recommended by a competent 
diabetologist, will be issued. I have had no difficulty in this regard 
since the people concerned, are known to them to be very competent in 
their field--in fact, one of them is the top diabetologist in the 
country and he contributes regularly to international forums of doctors 
who specialise in the treatment of diabetes.

I must also add that proverbially speaking, I have landed with my bum in 
the butter. My diabetes nurse care-giver is a dear friend of ours who 
also goes to our church. If I had to pay her for her services, help from 
her side would simply be out of the question and of course, the same 
also holds true for my biocheneticist who is also in our church.

Regarding fruit, and this is a sore bone of contention I have with the 
dietition at our local hospital, fruit is said to be bad for diabetics 
on the ground that it contains lots of sugar. When one does not have a 
hypo, apples are rightly one of the best, if not the best fruit that a 
diabetic can have. I have eaten so many apples that they are growing out 
of my ears and I am thinking of setting up shop and selling some of my 
produce.

It is true that apples have lots of sugar in them, but apples are among 
those snacks with a high glycaemic load and a low glycaemic index value, 
which in plain English means that apples have lots of sugar, but the 
sugar is a slow absorbing sugar.

I don't want to wax to eloquently about sugar here, but suffice it for 
me to say that all sugars are broken down into glucose. Some take longer 
to break down than others, hence the fact that, in order to avoid all 
the niceties of the Glycaemic Index, I usually just explain to folk that 
I counsel, that there are good sugars and bad sugars. The good ones take 
longer to break down into glucose while the bad ones break down to 
glucose quite quickly.

In my terminology therefore, apples contain lots of "good sugar" which 
is there to help sustain one from meal to meal.

My gripe with the local dietition is that she told one of the folks that 
I am counselling, that apples are bad because they contain lots of 
sugar. The response I meet with when I chat to the chap is this "are you 
a doctor that you can tell me that apples are good for me?" Of course, I 
have no response other than the fact that I know that apples are good 
for one on the basis of the road I have already travelled as a diabetic. 
Of course, my advice is being rejected by this person on the strength of 
what an idiot, who should not even be in practise and who should 
possibly even be shot in public, has told him. So, when he snacks, he 
eats sweets, chocolates and crisps with gay abandon and the sugar tests 
afterwards, speak for themselves. All that I can do in a situation like 
this, is to helplessly sit by and watch this person destroy himself.

Regarding insulin too, I agree with you that it is basically a case of 
each one unto himself. My own view on insulin, for the record, is that I 
personally believe that, come the day, and I will have to ultimately go 
onto insulin. This fact holds no terror for me, although the rider to 
this statement is the fact that as little as I do know about insulin, it 
is something which should be treated with the greatest of respect.

Now one can say all sorts of things about insulin, but I have 
deliberately refrained from taking that course of action, since much of 
what can be said about insulin, belongs to the realm of speculation and 
some of the things might even be old wives' tales. I certainly do not 
wish to indulge in urban legends, spurious statistics and the rest.

However, come the day I do go onto insulin, I want to do it when a 
suitably educated person is around to teach me what to do. For the 
moment, my nurse care-giver is anti insulin, and while I am not familiar 
with her reason for being anti, and I am not decrying insulin either, I 
am quite happy to live with her regime, since between her, my doctor 
friends, my dietition (not the one at the hospital), and my 
biocheneticist, they all have things in hand. All I have to do is to go 
along for the ride and I don't need to fret about anything.

My experience with probiotics and certain claims which my biocheneticist 
makes, make me optimistic about my chances of never going onto insulin 
at all and that I may even come off my sugar tablet in due course. Be it 
as it may, I will only go onto insulin if I absolutely have to.

Nevertheless, I must agree with the sentiment that insulin is the 
greatest inovation in the treatment of diabetes, except perhaps for 
stuff called Byetta, affectionately known as "lizzard spit", which I 
believe, may in certain respects, even eclipse insulin. If folks are 
interested, I am prepared to share information on "lizzard spit" which I 
heard about at a recent educational meeting for diabetics. I will do so 
in a separate post.

Michael Park.
I am not an expert, because "ex" means "has been" and "spert" is "a drip under pressure".


On 2012/03/07 10:35, Bridgit Pollpeter wrote:
> What you say is absolutely correct. I have been trying to explain to
> people for years that you can't take the across the board approach with
> diabetics. So many people think they know what a diabetic regimen should
> be, but diabetes really is an individual disease. Whether type 1 or 2,
> it affects us all in different ways, and so many variables play a role
> that, again, will be different for people.
>
> My doctors are comfortable with my A1-C sitting between 7 and 7.5
> because when I try to get it below 7, it means I'm having more lows than
> anything. I've also had very few food restrictions since being diagnosed
> 27 years ago since I respond quickly to insulin, have a higher
> metabolism and tend to be more active. Now that I'm pregnant, they
> actually keep telling me to eat more food in general, though I feel like
> I'm eating a ton already, grin.
>
> Regardless of being diabetic or not, exercise works differently in our
> bodies. What works for me, might not for you. This is a fact that people
> are just starting to accept though the science has been around for a
> while. Despite this though, any activity is good for diabetics as long
> as you manage things and test frequently.
>
> There are some things that are important for any diabetic to be aware of
> and routines to follow, and in general, certain glucose ranges are the
> target for any diabetic to hit, but it's still very much dependent on
> the person and other health/biological factors.
>
> I've never heard that fruit was bad for diabetics though. I've always
> been encouraged to eat fruit in a day, and that it also makes for a good
> snack. Over my 27 years of being diabetic, the nutrition info always
> reinforced, and important for all diabetics, has been to watch and count
> carbs, incorporate protein into meals and snacks, watch foods high in
> fat especially trans-fat and make sure I'm following an insulin regimen
> in proportion to the carbs I eat, and of course to make "smart" food
> choices. Fruit has always been a food pushed especially in place of
> sugary treats.
>
> Ultimately, a diabetics routine must be specific to that individual and
> established by an endocrinologist. Inevitably things will change and
> your routine will change with you, which is why it's vital for us to
> communicate regularly with our doctors. We can ask advice and
> suggestions from others, but at the end of the day, it has to be about
> what works best for us and our lifestyles.
>
> Having said that though, I don't think it's wrong to be aware of what is
> happening with diabetic research and consider various treatment options.
> In terms of insulin, and I too am no expert, one of the reasons some
> type 2's are placed on insulin sooner rather than later is because at
> some point, many type 2's end up on insulin anyway; all the type 2's I
> know personally have been, or are in, this very situation. If you feel
> your current regimen works, fantastic, but it's also good to be informed
> on other options, and those investigating other options are not wrong to
> do so. I'm a type 1 and there is currently no other treatment option
> than insulin, so I'm very aware of how insulin affects the body, plus,
> I'm pretty sensitive to it. It does work great for some type 2's if
> following a good management system, and some possibly could benefit from
> it. I have nothing against oral meds, I'm just saying don't discredit
> other methods, or discourage others from at least investigating those
> methods.
>
> But really, to each his own, smile.
>
> Sincerely,
> Bridgit Kuenning-Pollpeter
> Read my blog at:
> http://blogs.livewellnebraska.com/author/bpollpeter/
>
> "History is not what happened; history is what was written down."
> The Expected One- Kathleen McGowan
>
>
> -----Original Message-----
> From: diabetes-talk-bounces at nfbnet.org
> [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Michael Park
> Sent: Wednesday, March 07, 2012 12:07 AM
> To: diabetes-talk at nfbnet.org
> Subject: Re: [Diabetes-talk] Spike.
>
>
> I'm a brittle type II diabetic and on tablets. I have very good sugar
> control with just the tablets. This year, as from 1 January to the
> present, for instance, I have only had 3 readings over 180 compared to
> the 5 of last year at the same time. I manage this control without
> starving myself and, to give you a good idea of the sort of control I
> have, my average for the last 180 readings is 119. This is a bit higher
> than the norm that I set myself, namely anywhere between 90 and 117,
> although my averages, when compliant, seldomly drop below 108.
>
> I must stress that my sugar control is one that works for me, and that
> it will not necessarily work for the next diabetic. What I am saying
> here, therefore, is not intended as a definitive solution to the
> problem, but is intended as presenting avenues to explore.
>
> Having said that, there are a number of factors that a type II has to
> bear in mind when controlling his/her sugars. The most important factor
> is to try and determine what your sugar management norms are. These, as
> I already indicated, will differ from person to person. The only way in
> which you will find out what your norm is, is to test regularly, keep a
> thorough diary of your results and then to try and identify patterns.
>
> Once you have identified your patterns, you need to try and refine the
> diet you have been given, in order to re-inforce that pattern, that is,
> assuming that the pattern is a good one. If the pattern is not a good
> one, i.e. if sugars are too high or too low, then various things will
> need to be fine tuned. You may need to vary your diet, or you may need
> to change your medication. Bear in mind that the generic diabetic diet
> simply does not exist in the sense that what may be good for one
> diabetic, may not necessarily be good for another diabetic. As an
> illustration of my point, I have found that I get better blood sugars if
>
> I use rice as my starch rather than potatoes. While I love potatoes, I
> only have those as a treat. For the rest, I stick to rice. I agree that
> the potato thing may not be a problem for other diabetics.
>
> Consequently, in the light of what I have just said, I personally,
> totally reject out of hand, the notion of "fits one, fits all" when it
> comes to sugar management. The general norms laid down for sugar
> management, is therefore, only a point of departure--nothing more.
>
> In short, I manage sugars through diet and exercise and I deal with
> spikes as and when they arise. The advantage of keeping a diary is that
> it is often possible to deal with the cause of spikes whenever these
> arise.
>
> I know that David Mendosa and I would not agree, but I also use fruit as
>
> a means of controlling blood sugar. I have a fruit at breakfast, a fruit
>
> for my midmorning snack and a fruit for an afternoon snack. As far as
> the late night snack is concerned, I have a far greater lattitude as to
> what I can or cannot have. The fruit I usually have is an apple.
>
> Apples have a low glycaemic index value and a high glycaemic load which
> means that the overall effect of apples on blood sugar management, is to
>
> sustain blood sugar levels from one meal to another, so that they will
> not drop too low.
>
> Another factor that could impact on the possibility of sugars spiking,
> could be the medications you are on. These may not necessarily be
> diabetic medication, but could instead, be medication you take for other
>
> problems.
>
> As I intimated in an earlier post to the list, I have recently gone onto
>
> probiotics because my immune system has effectively been fried by the
> quantities of antibiotics I had been taking of late. I have learnt that
> probiotics do tend to lower blood sugars, but other medications again
> may tend to raise blood sugars, thus causing sugars to spike.
>
> In such cases, in the same way as I have to also do, one needs to change
>
> the diet to suit the conditions, but one must make sure that you don't
> starve yourself in the process either.
>
> Spiking blood sugars could also be due to infection. You may not have
> the classical signs of infection, but that does not mean that you must
> rule out the possibility of infection.
>
> If you are about to see the doctor, a test done to measure your blood
> cell count, will be a definite tell-tail sign of infection if your white
>
> blood cell count is up.
>
> There are numerous factors that could bring about a spike in blood
> sugars, both environmental and personal/emotional, but I don't want to
> try and make a complete list of the possible causes here.
>
> The question that remains is the question, what to do if my sugars
> spike? I am going to assume here that spikes are in the vacinity of 180
> to about 280.
>
> One of the things I have often come across in diabetes forums both here
> in South Africa and around the world, is the quick fix solution and I am
>
> afraid that I would not want to be seen dead near some of the solutions
> that have been proposed. The idea is to strike the right balance between
>
> intervention and non-intervention and I personally am of the view that
> if intervention is necessary, it should be an intervention which should
> be as conservative as possible. If the intervention is drastic, this
> could at best contribute to very unstable blood sugars and in the worst
> case scenario, could even drive blood sugars down to dangerously low
> levels. This could most likely be the case, especially if you cannot
> ascertain the cause of the spike in the first place.
>
> Obviously, if you are on insulin and the doctor has given you a sliding
> scale to administer insulin in the case of a spike, it is OK to use that
>
> sliding scale. One would assume that the doctor would take all factors
> known to him, into account when prescribing a sliding scale for the
> administration of insulin.
>
> The sort of intervention which is the safest for type II diabetics not
> on insulin, is just to insure that you drink enough water and if the
> sugar levels don't drop, to make a plan to see the doctor.
>
> Obviously, if you are recording readings say, in excess of 280, you will
>
> most likely find yourself on crisis territory and the doctor may have to
>
> be contacted sooner or later.
>
> What to do if your sugars spike? One of the most important lessons that
> my nurse care-giver has taught me, is to learn to listen to my body and
> as far as it may be appropriate, to just do what my body feels like
> doing. If your sugars are spiking or if they go the other way, and you
> feel tired, that is perfectly OK.
>
> Let me mention that I basically manage my sugars through diet, tablets
> and exercise. My exercise program has been designed by a biocheneticist
> and having familiarised myself with what a competent biocheneticist can
> do, I would strongly recommend that every diabetic should see a
> biocheneticist as part of the treatment.
>
> Michael Park.
> I am not an expert, because "ex" means "has been" and "spert" is "a drip
> under pressure".
>
>
> On 2012/03/07 00:08, Bridgit Pollpeter wrote:
>> Yeah, I think some studies are showing that the sooner type 2's are
>> placed on insulin, the better management they experience. I don't know
>> how many doctors are considering this, and most type 2's I know on
>> insulin were put on it only after the oral meds were not working as
>> well. Is this something a patient can request even if their doctor
>> isn't prescribing it? I'm very unfamiliar with type 2 other than type
>> 2's have some level of functioning of the pancreas.
>>
>> Sincerely,
>> Bridgit Kuenning-Pollpeter
>> Read my blog at: http://blogs.livewellnebraska.com/author/bpollpeter/
>>
>> "History is not what happened; history is what was written down." The
>> Expected One- Kathleen McGowan
>>
>>
>> -----Original Message-----
>> From: diabetes-talk-bounces at nfbnet.org
>> [mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of William and
>> Bernadette Jacobs
>> Sent: Tuesday, March 06, 2012 3:53 PM
>> To: Diabetes Talk for the Blind
>> Subject: Re: [Diabetes-talk] Spike.
>>
>>
>> What are you eating?  Anything different?  Many times cold cereals can
>> be a horrible culprit: pasta, breads, even some barbecue sauces, Are
>> you on oral
>> meds? or just insulin?  From my experience, I find my control,
>> personally,
>> is much better with Insulin.  I use Rapid-acting 15-20 minutes before
>> meals,
>> (on sliding scale) then I use Lantus at night.  I myself have felt
> much,
>> much better taking insulin.  If I had it to do all over again, I'd've
>> gone straight to insulin in the first place.
>>
>> Bernadette M. Jacobs
>> 1st Vice-President of Diabetes Action Network
>>
>> Please consider making a donation to the Diabetes Action Network
>> because
>>
>> Diabetes is the leading cause of Blindness
>> ----- Original Message -----
>> From: "Alan Wheeler"<awheeler65 at windstream.net>
>> To: "'Diabetes Talk for the Blind'"<diabetes-talk at nfbnet.org>
>> Sent: Tuesday, March 06, 2012 4:38 PM
>> Subject: [Diabetes-talk] Spike.
>>
>>
>>> Hi everyone,
>>> For the second time in about a week, my blood sugar spiked into the
>>> 190-200 range. I am going to my doctor on Friday, but in the mean
>>> time, what
>> do I
>>> do
>>> when my sugar has spiked like this? Do I sleep it off (which is all I
>> feel
>>> like doing), or is something else recommended?
>>>
>>> Thanks in advance.
>>>
>>> Alan
>>> "The kind of work God usually calls you to is the kind of work that
>>> you need
>>> most to do and that the world most needs to have done.The place God
>> calls
>>> you to is the place where your deep gladness and the world's  deep
>> hunger
>>> meet."
>>> - Frederick Buechner's definition of "vocation" in his little book
>>> "Wishful Thinking"
>>> Psalms 33:3 Psalms 150:5
>>>
>>>
>>> Alan Wheeler
>>> Lincoln, Nebraska
>>> awheeler65 at windstream.net http://twitter.com/#!/Country_Storm
>>>
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