[matingara]

Originally Posted by BrianSCohen

If you read Bernstein, he makes a pretty logical argument that while you might be able to "cover" any level of carbs with a correct does of insulin, you can't dispense the insulin in a continuous manner to keep your blood glucose down as it varies. If you eat high carb and dose high insulin your are going to suffer large variances, both high and low even tho you might hit your target at two hours.

Bernstein calls this "the Law of Small Numbers".

It makes sense for T1 and T2 in my opinion.

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[ant hill]

Originally Posted by dar917

Just today at work I had to explain to someone--one of the cake decorators was showing me some new ice cream we got at the store, then she goes oh, you can't have it, you're diabetic! I told her I can have it, I'm on insulin! (I loves me some ice cream.) But she was leaving and I had to get back to a phone call so I had to cut the conversation short. Bah.

Aww darlene, If you were here there is a icecream parlor that you would adore!! I like icecream too and I will take you there.

My sister is like that Darlene and she would make a good mud cake. Here I am drooling and she says "You cannot have that" as if she has done some reading in five minuets on the type 1 diabetes. DOH!!! Yeah right.

[dar917]

Originally Posted by ant hill

Aww darlene, If you were here there is a icecream parlor that you would adore!! I like icecream too and I will take you there.

ahahaha Peter. I will have to come visit Australia so we can hang out some time.

[PERKDOUG]

[Eating whatever and covering with Insulin.] This will guarantee poor glycemic control. Eating whatever, implies medium to large grams of carbs per meal which in turn implies medium to large Insulin doses to cover. You cannot know the exact amount of carbs in a meal, the exact amount of Insulin your are injecting, the exact strength of the insulin and on and on there are uncertainties or "errors in measurments" in every meal "covered". For illustration purposes lets presume the average errors encountered are 10%.
Consider 2 cases:
Case 1: A meal with an estimated 10 grams of carbohydrates with a 10 % error means a + or - error of 1 gram.
Case 2: A meal with an estimated 100 grams of carbohydrates with a 10 % error means a + or - error of 10 grams.
Now I ask you, would you rather have a Case 1 error of 1 gram or a case 2 error of 10 grams. Knowing your "numbers", what blood glucose levels would result from a 10 gram error? Small carb meals result in small errors. Small errors means tighter glucose control. Tighter control means lower A1C. You know what lower A1C gets you. The problem with this simple idea is that most of us love our carbs so much that we are willing to compromise our future health for food pleasure at the next meal and the next meal ect. ect. The pleasure of the moment is more important than our feet, eyesight and kidneys.

[sprzepiora]

For the past two days I was a little lower than my target of 100 like 85 or 90, anyway I had a huge salad and was able to not take any injection for lunch and still come out with great numbers.


It was sweet

[Jan B]

Kind of like xMenace said, your meter won't lie about whether it's a good idea to load up on carbs and insulin.

I also agree with Bernstein's law of small numbers. It keeps the swings to a minimum. Instead of getting 140 or better 2 hours after eating, you can be back at 90-100 (your goal) in 2 hours or less.

When I first started on Humalog, I loved the saying: match the insulin to your life, instead of making your life match the insulin. It's not quite that simple though for a lot of us.

[Gary_W]

Originally Posted by PERKDOUG

[Eating whatever and covering with Insulin.] This will guarantee poor glycemic control. Eating whatever, implies medium to large grams of carbs per meal which in turn implies medium to large Insulin doses to cover. You cannot know the exact amount of carbs in a meal, the exact amount of Insulin your are injecting, the exact strength of the insulin and on and on there are uncertainties or "errors in measurments" in every meal "covered". For illustration purposes lets presume the average errors encountered are 10%.
Consider 2 cases:
Case 1: A meal with an estimated 10 grams of carbohydrates with a 10 % error means a + or - error of 1 gram.
Case 2: A meal with an estimated 100 grams of carbohydrates with a 10 % error means a + or - error of 10 grams.
Now I ask you, would you rather have a Case 1 error of 1 gram or a case 2 error of 10 grams. Knowing your "numbers", what blood glucose levels would result from a 10 gram error? Small carb meals result in small errors. Small errors means tighter glucose control. Tighter control means lower A1C. You know what lower A1C gets you. The problem with this simple idea is that most of us love our carbs so much that we are willing to compromise our future health for food pleasure at the next meal and the next meal ect. ect. The pleasure of the moment is more important than our feet, eyesight and kidneys.

Saying that 'eating what you like and covering' will 'guarantee' poor glycemic control is not always true. In my body, I have a much easier time covering carbs with insulin when they are not slowed down with excessive fat / protein. It is the high fat / high protein meals with a small amount of carbs that give me the most trouble. A big pile of bread and jam I can handle. Yes, I might be odd, but that's the truth.

I do eat less carbs today than I did 2 years ago, but still do 230g of carbs on average each day. I'm happy and healthy and have an HBA1c of 5.8. It can be done with some people. Others find it easier to low carb / impossible not to. Fair enough. But not everyone needs to obey the same rules.

And my reason for eating carbs is not always the 'pleasure of the moment'; I always worry about the fat / protein content of the low carb diet. Whilst I agree with the laws of low numbers etc etc I think that treating diabetes in isolation by doing a diet that suits diabetes is not necessarily the right way to go. If you look hard enough you'll find various bits of research showing that high fat or high protein diets aren't all that good for various bits of your body. Then you'll find other studies disagreeing. Moderation in all things is key (IMO) and whilst many people eat too many carbs the sensible alternative is to cut back, not cut out. Certainly from a variety point of view I would not gladly give up carbs. If there was no other way to achieve control (which may be the case for some folks here) then obviously I'd have to rethink matters but as it is, I'll carry on.

Gary

[shiftzor]

I agree with Gary_W, I have gone from 150g of carbs a day to 230g of carbs a day, I found that I just wasn't eating enough calories to sustain my body and all my activities. I was reading that some people get most people get 40% of their calories from carbs, so personally I would argue that eating a sensible amount of carbs is important, no matter how much I like Bernstein’s theory of small numbers. This depends on how active you and if you want to lose weight. Eating w/e is fine as long as you count those carbs and have a healthy diet i.e. little bit of green stuff and a little bit of the bad stuff.

[solox316]

Well said Gary. I fall into the balance and moderation school of thought, combined with the right carbs and not processed, refined junk food.

[The_QUIET_one]

I do this and it works for me, I have pretty good numbers and I eat healthy in general anyhow so it works for me, basically sure you can do it but dont forget also that you are human you shouldnt go crazy, try to stay healthy and also I would keep away from eating pure sugar or drinking pure sugar unless you are low or if necassary have it with some protein, thats what I do and it seems to work for me.

[PERKDOUG]

Good reply to me, Gary. I am new to the diabetes forums. It would be interesting to know how many other members can acheive an A1C under 6% and eat heavy carbs? Chime in brothers and sisters. And if you are a heavy carb eater and acheive above 6% sound off also.

[bryan42]

Originally Posted by Scrabblechick

It's probably a good thing I'm not on insulin. I like biscuits too well. Heh. Metformin alone keeps me honest about my eating. LOL.

I agree!! We Type 2's have to be more diligent when making food choices. Metformin is the only thing keeping us in line

[xMenace]

Originally Posted by PERKDOUG

Good reply to me, Gary. I am new to the diabetes forums. It would be interesting to know how many other members can acheive an A1C under 6% and eat heavy carbs? Chime in brothers and sisters. And if you are a heavy carb eater and acheive above 6% sound off also.

I've hit 6.0% my last two quarters. If anything, I've reduced the protein in my diet. I have added much complexity and more veggies and fruits. I am avoiding pretty much all food found in a box, all store bought bread, and anything all-white floured. I do agree with Gary that it's easier to dose for carbs when fat and proteins are not involved. Chinese, pizza, even my sirloin last night cause problems.

[poodlebone]

Originally Posted by PERKDOUG

Good reply to me, Gary. I am new to the diabetes forums. It would be interesting to know how many other members can acheive an A1C under 6% and eat heavy carbs? Chime in brothers and sisters. And if you are a heavy carb eater and acheive above 6% sound off also.

I am Type 1 using a pump. I do much better with carbs than protein & fat - especially fat. Fat screws everything up for me. My biggest problem time is morning. You know how a lot of people (both types) seem to have problems with carbs for breakfast? Not me. Every time I try to have protein it comes back to bite me in the butt a few hours later.

This morning I decided to try it. I had an omelet made with Egg Beaters (3 servings), fat free cheese and turkey pepperoni. I also had a low carb tortilla/wrap thing (15g carb, 9g fiber, 15g protein). Final makeup of my breakfast was:

5g fat
21g carb
9g fiber
40g protein

I tested my BG a little less than 2 hours after eating and was 120. Not bad. 1 hour 20 minutes later I was 156. I corrected and was 108 1 1/2 hours later.

I could set a dual wave bolus but whenever I've tried that I end up going low. I would have to remember to set it maybe an hour or so after eating, to cover the next few hours before lunch. Fat obviously wasn't the culprit here, it was the protein.

If I had a big bowl of hot high fiber cereal, or a waffle, or a muffin my BG numbers would have been much more predicatble. They would not have been fine at 2 hours and then gone up. I would have dropped some more before lunch with a meal that was mostly carbs.

I often eat very high fiber hot cereal, like Wheatena with a bunch of extra added wheat bran. It doesn't really slow down the digestion much but it does keep me full (and regular!). I add whatever fruit I have at home which can be fresh, frozen or dried. Very low fat, low protein.

My last A1c was 5.8 and I am usually in the 5s. My highest in the past 10 years or so was 6.4.

I have a pump. I'm Type 1 and very sensitive to insulin. It makes it much easier for me than for someone on injections or oral meds or with bad insulin resistance.

[Gary_W]

Originally Posted by xMenace

I've hit 6.0% my last two quarters. If anything, I've reduced the protein in my diet. I have added much complexity and more veggies and fruits. I am avoiding pretty much all food found in a box, all store bought bread, and anything all-white floured. I do agree with Gary that it's easier to dose for carbs when fat and proteins are not involved. Chinese, pizza, even my sirloin last night cause problems.

Bread is a weird one. Some shop-bought bread I can do fine with, others do spike me badly and it isn't the white vs brown thing that you'd expect.

I recently bought a book called 'bread matters' which goes on a lot about the state of the baking industry, all the enzymes added etc. And I've started making my own sourdoughs. I'm only about 5 loaves in and I must say that none of them spike me that badly at all. The all-rye sourdough is very kind on the blood glucose. But this morning I had the 'Cromaty Cob' with raspberry jam (sorry folks but I did). 100g of bread and 20g of jam. Oh, and some butter. The bread is very dense, and I treated it as French bread in terms of carb counting. In total, I bolused for 73g of carbs. I super-bolused (as I do every morning) and was in range two hours later....

The ingredients of this bread are mostly white organic flour, some plain flour, some wholemeal and a sour made from rye flour. Other than that, it's salt, water and time... It tastes completely different to the shop bought stuff. If only I had the time / organisational skills to always have some on the go. We'll see how long I manage to keep it up

Gary