New to Forum, and Diabetes

[swirlygirl]

Hello everyone. I know most people do their introductions in another place, but I'm really focusing on low carb and diabetes and want to make this area my forum home.

I've done low carb off and on for the past decade. Recently (the past 2 years) I've been under a lot of stress (both good and bad). I moved, had our home flooded, got married, changed jobs, started a new degree program. And although I've felt happy about a lot of things that were happening, I have never experienced this much sustained stress in my life. Which leads to....

A few months ago, I reached a health low. I was at my highest weight ever (178) and constantly exhausted, irritable, and sick with something. I had regular immobilizing headaches, and a significantly reduced ability to focus mentally. I started getting chronic yeast infections too.

My doctor really didn't have much to say, besides, "Take an Advil."

My blood sugar (not fasting) showed up as 139, so she didn't even mention diabetes could be a problem... until I started to have sugar in my urine. I saw the results of the urine test last week, and have been on a strict low carb regimen ever since. I also bought a meter and began testing my own blood sugar.

I haven't been back to my doctor, as she's very traditional, and wants me to see an Endocrinologist in her office that I fear may be equally traditional. I live very near Dr. Bernstein, and I'm going to try to get an appointment with him.

In the mean time, I'm self treating. I have some questions:

1) My blood sugar is very high in the morning (155-188), and then back to 100 in the afternoon, with a rise again in the evening to the 130s or 140s. Is there anything I can do about the morning numbers while I wait for my appointment?

2) I've noticed my BG readings going down each day that I'm on the plan, but only by about 5-10 points each day. What have other people experienced as improvements while on the low carb plan? I'm feeling a lot better than a week ago before starting this diet/exercise plan, but not "normal" yet, as I remember it...

Thanks!

[CarolynC]

Welcome, swirlygirl. I know all too well how stress and emotions can affect blood sugar levels. (Yesterday, I got very upset about something and my blood sugar went from 103 to 170 in one hour in late afternoon without having eaten since lunch.)

Low carb took my waking FBG into the 150s fairly readily, but then the drop slowed and to get into the 90s and 100s in the morning took about another month. I think that exercise helps a lot in leveling out the numbers.

[swirlygirl]

Thanks! I've also noticed that exercise helps me a lot, and I'm being pretty good about getting to the gym in the morning about 4x a week + I walk 30 minutes 4x a week. I DEFINITELY feel better following a workout. I'll keep watching this month, and hopefully the morning numbers will keep coming down.

[RobLL]

If you can spare the time (and we have noticed you have a pretty full plate :D haha, bad pun on this site), you should read Dr. Bernstein's book. He generously shares all of his insights. You might discuss your concerns with your doctor, and say that you are going to eat low carb, and you want normal blood sugars. Good luck with all you are doing, I am impressed. Rob

[dancinbr]

Welcome.

You are on the right track.

Low carbing is a definite help to lowering all those numbers along with exercise.

However, you probably will need some medical attention as well.

If you consider going to Dr. Bernstein understand that you buy into his program.

At minimum he is out of network on your insurance or simply not covered.

His fee for his plan, which extends over several visits and many months is in excess of $6000.

Best wishes to you.

I am 50 miles away. I have talked to his office. I have his book.

So far, I am doing well with getting my numbers down following his written advice and also visiting this forum frequently and learning from others.

I have a Doctor who is willing to work with me as I self-manage my diabetes.

He believes that is a great combination when a patient becomes educated and works hard on their own issues. He will assist.

You should be able to find a Doctor who is willing to do that if your Doctor isn't.

Ralph

[swirlygirl]

Thanks Ralph. One of my concerns is taking this treatment under my health care plan. I don't want problems getting coverage in the future. Are you in NY, and do you know if getting the "diabetes" label is an issue in this state? I haven't been officially diagnosed by my regular doctor, as my BG has always been under 140 when I'm in the office. Thanks.

[dancinbr]

Thanks Ralph. One of my concerns is taking this treatment under my health care plan. I don't want problems getting coverage in the future. Are you in NY, and do you know if getting the "diabetes" label is an issue in this state? I haven't been officially diagnosed by my regular doctor, as my BG has always been under 140 when I'm in the office. Thanks.

I live out in Smithtown, NY about 50 miles from Dr. B's office.

Talk to them on the phone. They are very friendly and do understand the issue of insurance. Cost is a major consideration. So it has to do with just how bad off are you?

Try reading his book and seeing if you can manage using his book; I have with reasonably good success.

140 is a diabetic by the way.

Officially an A1C over 7.0 is a diabetic, my Doc said over 6.0 is not good. I told him over 5.0 is not good.

I ask him what a normal person's A1C is and as Dr. B says it is under 5.0 and usually 4.2-4.6.

So why don't we strive to be "normal" with whatever approach we find works for us.

Some of us have gone all natural and it works.

Some of us have good exercise habits and that helps tremendously.

Some of us strictly adhere to the 6-12-12 carb regimen that Dr. B advocates and this DOES work. It is following it long term that for many may be an issue.

I follow the 6-12-12 as close as possible. There are days when I am right on and they are good BG days; no surprise. Then there are days, that my human side simply wants to enjoy and my carb count goes up.

Dr. B tries and does succeed in his theory of small numbers and keeps a very tight control on BG swings. He believes in a level line by doing whatever you have to do. This is particularly relevant to a T1 since a T1 diabetic uses both basal insulins such as Lantus or Levemir and also uses fast acting insulins such as the regular, Humalog and/or Novolog. You must become very knowledgeable on what foods do what to your BG and when; not all foods are created equally. So lots to learn; I know I am still learning and everyone sharing here helps each of us in our own journey.

I went back and read Dr. B's section on insulin injections and have adjusted my technique based on his recommendations. I have now introduced an overnight insulin injection to help my FBG in the morning.

Lots to learn.

Best wishes,

Ralph

[Rose1942]

Hi Swirleygirl - welcome to this forum, it's great.

I second the suggestions of those above who recommend Dr. Bernstein's book. It is so very valuable in understanding the disease and the management of it. When I first learned I had diabetes only a few months ago, I was at a loss to figure it out, because my family practitioner (like yours) was so nonchalant about it, and just steered me to the ADA website and a nutritionist, who was no help at all, and said to come back in 3 months. HAH, like that's good management!

The first book I was lucky enough to happen upon is called 'Good Calories, Bad Calories' by Gary Taubes. You will see a lot of references to this book here in these forums on low carbing, And it is available in bookstores, public libraries, and at Amazon.com (see below).

But then I discovered Dr. Bernstein, and his book - and that was the key to how I started to manage my sugar. Believe me, if you follow his protocol, you will see some improvement. You do need to be diligent about it at least for a month or two until you get to know how various foods and quantities of food, and timing of meals etc. will affect you. Everyone is different, some can have virtually no carbs at all, especially while trying to get to normal sugar levels, and some can take a few more. But it is best at first to be pretty strict about it, and then to tweak it with care if you dare :)

I saw my blood glucose level off to around 100 post prandial (after meals) in just a couple of weeks. That is - if I did NOT cheat! Even a small cheat would raise my sugar up to over 120 which I considered my personal cutoff (still do). Dr. Bernstein urges us to go for a goal of true normal which is around 83 mg/dl but that is something I have not attained yet with any regularity. I think it takes time. I am satisfied with 100 for now as it is a huge improvement over the 140-150 and more before low carbing, but will continue to go for that 83 if I can. Not everyone can, by diet alone, but we can try!

You should keep a chart for your own reference, of what you eat and how it affects your sugar - I usually test at about 2 hours post prandial and I can look back and see what I ate. This way you can pinpoint pretty well what spiked you after awhile. After a week or two you begin to see patterns, like times of day that your sugar is high no matter what you eat, etc. and of course what foods might be responsible when you see spikes. It's very exciting the first time you see a whole day of pretty darn good readings, and you see that you've done the work and it's verified on your meter!

Here is a link to Dr. B's book at Amazon:
http://www.amazon.com/Dr-Bernsteins-Diabetes-Solution-Achieving/dp/0316167169/ref=pd_bbs_sr_1?ie=UTF8&s=books&qid=1205194610&sr=1-1

And also a link to Gary Taubes book also on Amazon:
http://www.amazon.com/Good-Calories-Bad-Gary-Taubes/dp/1400040787

[Rose1942]

Swirlygirl, once again I found a link for you - LOL I will have you surfing aorund like mad. But this one is an actual web excerpt from Dr. Bernstein's book - it is a comprehensive list of what foods you can and cannot have on his diabetes diet. I notice that you are now doing Atkins - that is not necessarly going to be the same as the diet specifically for diabetics, though many do use that I guess. Particularly if you should buy Atkins products as many of them are definitely not suitable for us. This way you can get an idea if what you are doing is right for your sugar because he gives you a lot of info about sugar that when I first read it I went - 'who knew?'

Another big difference between Dr. B and Atkins is that in the diabetes diet there are no phases - no induction and then adding back carbs etc. It is the same from Day 1 to 'Forever'. He does allow that people may feel free to experiment somewhat to find their own diet tweaks, but mostly to achieve normal blood sugars you do have to stay within the guidelines always.

(The link below is excerpted from his 2000 edition - some things are different in his current edition, which is the one I posted above on Amazon, but the general idea is the same.)

Hope this helps you :wave:

http://209.85.165.104/search?q=cache:wewopH-Cq5wJ:www.diabetes911.net/readit/chapter_10.pdf+Dr.+Bernstein+%2B+diabetes+%2B+%27the+no+no%27s+in+a+nutshell%27&hl=en&ct=clnk&cd=1&gl=us

[CarolynC]

Another big difference between Dr. B and Atkins is that in the diabetes diet there are no phases - no induction and then adding back carbs etc. It is the same from Day 1 to 'Forever'.
Sometimes I read posts on this board from Atkins users and I think that "forever" is easier. We don't have to figure out how to move up the OWL carb ladder, determine our critical carb level, or determine what to eat for maintenance and pre-maintenance. :)

[swirlygirl]

Thanks all. I have read the Bernstein book from cover to cover, and I've found it very educational. I even spoke to his office to try to make an appointment (he's just up the street from me), but it would be very difficult for me to pay his fee ($6000+). So.... now I'm swirling my way around the web, and through personal recommendations to find a doctor who can help me.

After a week on Dr. B's protocols, my BG levels are really getting lower. I still have headaches and low energy, but I'm hoping this will change soon.

Do others experience these things when their blood sugar levels are "resetting"?

[Korban]

Several weeks ago after I had started taking bg's regularly I was running 240-285 and spiking over 300. I went to a 20 carb per day diet and saw no changes for almost 4 days. On the 4th day, I measured a 212 (all values are morning FBG's). On the 5th - 7th days I was down to 140-150. On that day I went to my internist and he put me on Lantus (also glipizide). Am getting closer at controlling 24 hours a day except still having problems with dawn phenomena.

Bottom line for me - with the more normal bg's I have a much better mood (less depression) and a lot more energy. I was sleeping all the time before. Now it is rare that I will take a nap. I have heard others say they had lower energy, etc. Oh, I have maintained for the last 4 weeks 20 - 27g carb per day.

Of course, YMMV.

/smile

[dancinbr]

Several weeks ago after I had started taking bg's regularly I was running 240-285 and spiking over 300. I went to a 20 carb per day diet and saw no changes for almost 4 days. On the 4th day, I measured a 212 (all values are morning FBG's). On the 5th - 7th days I was down to 140-150. On that day I went to my internist and he put me on Lantus (also glipizide). Am getting closer at controlling 24 hours a day except still having problems with dawn phenomena.

Bottom line for me - with the more normal bg's I have a much better mood (less depression) and a lot more energy. I was sleeping all the time before. Now it is rare that I will take a nap. I have heard others say they had lower energy, etc. Oh, I have maintained for the last 4 weeks 20 - 27g carb per day.

Of course, YMMV.

/smile

Hello,

I started Levemir about two months ago now. I have my day time BG's pretty well controlled and my levels get down into the 80s just like a normal non-diabetic person.

I was also still having issues with the dawn phenomena, but I went back and re-read Dr. B's book section on insulin. After my head stopped spinning, what I learned was the most effective way for insulin injection is one shot in the AM and one shot in the PM; the PM shot being no more than 9 hours before the AM shot.

My morning injection is 35units, my evening injection is 14 unit. I just started my evening injection and my dawn phenomena began to diminish immediately.

This morning my BFG was 96; yipppeeee...

The reason for two injections daily rather than one is the AM injection works for about 18 hours, while an overnight works only 8-9 hours. Don't ask me why? I am still learning about insulin. However, I take Dr. B's word for it.

I took several weeks finding my AM dose creeping up on it every third day until I finally found a dose that gives me lows during the day in the 80s. Yesterday, my low went down to 72. I felt fine.

The same for PM I started with a lower dose and so far found that 14 units may be enough to keep my BG from going up overnight.

Now, please understand these are my numbers NOT yours. You must find your own right numbers.

I hope your Doctor gave you good instructions as well. You are supposed to start with a low dose and every 3 days increase it by 3 units until you achieve your target daytime goal; mine was 85 about 4 hours post prandial (after meals).

My target for BFG in the morning, right now, is under 100. I may tweak this more over time. Right now, I want to let everything settle in and see what happens.

You should also learn how much your BG levels go up per carb.

Mine is roughly 1 carb will raise my BG 1 point. But this is VERY DEFINITELY different for each of us. This you will figure out over time and understanding what foods to what to you and how quickly.

Best wishes,

Ralph

[dancinbr]

Oh and one more thing Dr. B's recommendation on injecting insulin is to not do more than 7 units in one site. I use my belly and my thighs. He recommends against thighs since most people have very little fat there. Well, I still have too much fat. I am working on that too.

Down to 265 heading for 240 this year.

So my morning injections is 5 shots in different sites 7 units per shot.

My evening injections is 2 shots in different sites 7 units per shot.

You must move around on your body so the area doesn't break down from too many injections in the same site.

I have plenty of area too move around still !! :D

[Korban]

Thanks Ralph. I use two injections as well per Bernstein. My present doctor on my last visit handed me a scrip for Lantus and said start at 20 and move up til you get 100 bg in the morning - then come back and see me in 4 months...hehe. I am in the process of looking for another doc. :) The Bernstein book has been invaluable to me as well as this forum.

I take 11/9 but haven't yet followed Berstein's recommendation of 7 max at one site... probably should though.

/smile

[Charran]

After a week on Dr. B's protocols, my BG levels are really getting lower. I still have headaches and low energy, but I'm hoping this will change soon. Do others experience these things when their blood sugar levels are "resetting"?.

Swirlygirl- This was someting for me personally that never went away until I started adding more carbs to my plan. Of course, every person's body is so, so different. For you, it might be a temporary thing and go away as your body adjusts. I went 6 months without things changing. Just keep an eye on it, see how you're feeling and adjust as needed.

[MizKitty]

Welcome swirlygirl!

I think you're very lucky (not to mention smart) to have stumbled onto the truth about how a diabetic should eat so soon after diagnosis, and not falling prey to the ADA diet recommendations that nearly every doctor, endo and nutritionist will spout, and as a result suffering through years of worsening diabetes.

As to your question about how fast you can expect your blood sugars to drop, that varies for everyone. Mine dropped about 75% of the way in the first couple months, but are still improving to this day, 19 months later. Of course, in that time frame I've come off of glipizide, actos and insulin, and been able to reduce my metformin. And I had a LOT more weight to lose than you, too.

But my point is, don't get discouraged or think you're doing something wrong if it doesn't happen overnight. Takes a while for a metabolism to heal.

Much good luck to you! Glad you've joined us.

[dancinbr]

Welcome swirlygirl!

I think you're very lucky (not to mention smart) to have stumbled onto the truth about how a diabetic should eat so soon after diagnosis, and not falling prey to the ADA diet recommendations that nearly every doctor, endo and nutritionist will spout, and as a result suffering through years of worsening diabetes.

As to your question about how fast you can expect your blood sugars to drop, that varies for everyone. Mine dropped about 75% of the way in the first couple months, but are still improving to this day, 19 months later. Of course, in that time frame I've come off of glipizide, actos and insulin, and been able to reduce my metformin. And I had a LOT more weight to lose than you, too.

But my point is, don't get discouraged or think you're doing something wrong if it doesn't happen overnight. Takes a while for a metabolism to heal.

Much good luck to you! Glad you've joined us.

Miz Kitty - Wow I finally grasped how much weight you have lost and that gives me hope.

I have dropped 35 over the past 15 months. I am hoping for 240 by end of year. Clearly, your weight drop helped. I also believe I am insulin resistant.

On my next battery of tests, where I am hoping for a lower A1C near or under 5.0, I am also having my c-peptide to see just how much function I have.

Weight loss should help me a lot as well.

Swirlygirl - Just keep doing what your doing, learn, adjust, measure, low carb and you will get better and better.

As you gain more experience and come to know your own body, you will make decisions proper for your lifestyle.

Ralph

[eddiemcm]

Some people don't do well on 6-12-12.I'm
one of those people.Time made no difference.
I always felt crappy on Bernstein's plan.50 grams
of carbs per day works well for me.We are all
a bit different.
Eddie

[RobLL]

Some people don't do well on 6-12-12.I'm
one of those people.Time made no difference.
I always felt crappy on Bernstein's plan.50 grams
of carbs per day works well for me.We are all
a bit different.
Eddie

Reading between the lines in his book, I suspect that he tolerates deviations in his formula in patients - anyone know? I do wish he would discuss this in a future edition. I tolerate onions and tomatoes, and a fairly large amount of them. They were staples before, and almost staples now in my cooking. Without them I probably would be at 6-12-12, but with them I stay easily within my goals of 90-100, except for exercise.

[Rose1942]

Truly, everyone is different. So many of you say that when you give up carbs like on Bernstein's diet, you feel crappy. Yet I have found it to be the other way around, for some reason. I digest 'no carb' better than carb, as a rule, and have more energy. I get that sluggish feeling if I eat carbs now. They seem heavy to me since I've been basically off them. Go figure.

But I do add a little carb in sometimes, now that I've figured things out a little. I too can tolerate tomatoes but not in large amounts like Rob. I can also tolerate a little whole wheat bread as long as I don't overdo it. So one day I made myself a real honest to goodness BLT - wow. Bacon, lettuce, a couple of thin slices tomato, mayo, on ww toast (cut the crusts off to make it somewhat smaller). I was in Heaven and it didn't mess with my sugar much at all. I don't indulge in cheats that often, but now and then you just need a sammich..........

Rob .... Bernstein does say someplace in the book that patients should feel free to develop some of their own parameters with the diet if the changes don't trigger a big sugar response, as long as they pretty much maintain it in the larger sense. So yes - he does accept some variations.

[dancinbr]

Truly, everyone is different. So many of you say that when you give up carbs like on Bernstein's diet, you feel crappy. Yet I have found it to be the other way around, for some reason. I digest 'no carb' better than carb, as a rule, and have more energy. I get that sluggish feeling if I eat carbs now. They seem heavy to me since I've been basically off them. Go figure.

But I do add a little carb in sometimes, now that I've figured things out a little. I too can tolerate tomatoes but not in large amounts like Rob. I can also tolerate a little whole wheat bread as long as I don't overdo it. So one day I made myself a real honest to goodness BLT - wow. Bacon, lettuce, a couple of thin slices tomato, mayo, on ww toast (cut the crusts off to make it somewhat smaller). I was in Heaven and it didn't mess with my sugar much at all. I don't indulge in cheats that often, but now and then you just need a sammich..........

Rob .... Bernstein does say someplace in the book that patients should feel free to develop some of their own parameters with the diet if the changes don't trigger a big sugar response, as long as they pretty much maintain it in the larger sense. So yes - he does accept some variations.

Yes, Dr. B will work with you even if you do consumer more carbs.

What he constantly emphasizes is the theory of small numbers. So if you stay within reasonably small numbers and can tolerate more carbs without blowing your BG up to tremendous values then he will work with you.

He will do whatever he can to help a diabetic achieve healthiness and optimum control of the disease.

Do I need to lose weight; yes and I am doing so slowly. Being LC at around 30-60 for me and ocassionally up to 100 is keeping me from gaining and the pounds leak off slowly and that is fine by me.

I called up his center yesterday and he answered. That is the second time I actually spoke to him directly.

I was concerned about my Accuchek Aviva meter. This is the meter that he does recommend. I also called Accuchek. They are sending me some control fluids and we are going to test the meter. I am noticing readings that change back to back. Accuchek says it can vary by 10% and that the accuracy of the meter is roughly 10%. That seems a bit more.

Dr. B says back to back numbers should give you the same number.

So we will see.

Ralph