[Diabetes-talk] Spike.

[Alan Wheeler]

Reading this brings up a couple of things.

First, would anyone be interested in me posting an old article "Carbohydrate
counting and the exchange list" by Ann Williams?

Secondly, is there an accessible copy of the exchange list available?


 

-----Original Message-----
From: diabetes-talk-bounces at nfbnet.org
[mailto:diabetes-talk-bounces at nfbnet.org] On Behalf Of Bridgit Pollpeter
Sent: Wednesday, March 07, 2012 10:58 AM
To: 'Diabetes Talk for the Blind'
Subject: Re: [Diabetes-talk] Spike.

Hmmm... That's very odd you've been told fruit is bad for diabetics.
Since being diagnosed at age 4, and I'm now 30, fruit has always been a part
of my diet and encouraged by medical professionals. With any food containing
carbs, you have to fit it into your carb allotment for the day, but I've
never, never been told to avoid fruits, and I've seen several endos, nurse
educators and nutritionist over the past 26-1/2 years, and they always
encouraged fruit.

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 9:27 AM
To: diabetes-talk at nfbnet.org
Subject: Re: [Diabetes-talk] Spike.


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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