Anyone see anything wrong with this

[Brian23]

I am 27 years old, type 1 or LADA, 5'11 and weigh 135 lbs(have gained 6 pounds since adding humalog March 17th). I take 8-10 units of lantus a day and 3-4 units of humalog with meals and snacks (usually about 15-20 units of humalog a day). I have been trying to gain weight and my Endo told me the only way to gain weight is to eat more calories and carbs. I was trying not to eat as many carbs to prevent spikes (I would spike to 350 mg/dl when I would eat too much) . So my Endo added humalog and told me I could eat more. I work shift work and here is an example of my daily diet. I have only been on humalog for a month and i am still trying to figure out my carb/insulin ratio.

5:10 am: (112 mg/dl) just woke up
6:35 am: ate 2 biscuits with jelly,sausage and 8oz orange juice
6:44 am: 4 units of humalog
8:50 am: (138 mg/dl)
11:00 am: Hamburger, chips, lemon pie
11:20 am: 4units of humalog
11:25 am: 10 units lantus
1:30 pm: (92mg/dl) the ate a couple of starburst
3:00 pm: cheesy popcorn
4:20 pm: (113 mg/dl)
4:22 pm: Cap'n crunch cereal and milk
4:30 pm: 1 cup of ice cream and then 4u humalog
7:00 pm: (53 mg/dl) seem to be more sensitive to insulin in evenings
7:15 pm: a little orange juice, subway sandwich(wheat bread) and pretzels
7:22 pm: 3 units of humalog
8:45 pm: (92) then ate about 5 starbursts
10:18 pm: (58mg/dl) then ate cereal and milk
10:40 pm: 2 units of humalog, then ate chips and cheese dip
11:45 pm: (179 mg/dl) bout to go bed.

Then I woke up this mourning @ 9am at 103 mg/dl. I am gaining weight with my new diet (I have put on 6-8 pounds since March 17th) but does anyone see a problem with the way I eat? I have always liked to eat and always ate what I wanted with out gaining weight (I have always been thin), but I lost 12 pounds when I began having symptoms. I love eating and would like to continue to eat like this a: because I like to eat, b: to put weight back on. I would like to get up to 150 pounds. Any criticism would be taken as a positive. Please feel free to chime in.

[Evermont]

Eating carbs to gain weight? OK, but you want quality carbs. You could improve many things about your diet - seriously. Are you trying to gain body fat or muscle weight? If muscle then I would recommend finding much healthier alternatives to things like Captain Crunch for example (that's not real food). I get a lot of carbs too but mine come in the form of whole fresh produce and some whole grains.

Strength training is key, and good fuel that supports it is also key. I recommend a balance of quality carbs, quality proteins, and quality fats. If you're not sure what I mean by that then by all means ask - or crack a book/web site on basic nutrition. You might take care not to over-do your cardio exercise while building muscle but I would still do a little. Work hard at strength training, but do it right (proper form) and be patient - it takes time. Consider a trainer.

[Scratch]

Yeah, what kind of weight are you trying to gain?

It seems far better that if you're going to gain weight, you put it on mostly in the form of muscle.

[xMenace]

5:10 am: (112 mg/dl) just woke up
6:35 am: ate 2 biscuits with jelly,sausage and 8oz orange juice
6:44 am: 4 units of humalog
8:50 am: (138 mg/dl)
11:00 am: Hamburger, chips, lemon pie
11:20 am: 4units of humalog
11:25 am: 10 units lantus
1:30 pm: (92mg/dl) the ate a couple of starburst
3:00 pm: cheesy popcorn
4:20 pm: (113 mg/dl)
4:22 pm: Cap'n crunch cereal and milk
4:30 pm: 1 cup of ice cream and then 4u humalog
7:00 pm: (53 mg/dl) seem to be more sensitive to insulin in evenings
7:15 pm: a little orange juice, subway sandwich(wheat bread) and pretzels
7:22 pm: 3 units of humalog
8:45 pm: (92) then ate about 5 starbursts
10:18 pm: (58mg/dl) then ate cereal and milk
10:40 pm: 2 units of humalog, then ate chips and cheese dip
11:45 pm: (179 mg/dl) bout to go bed.




I'll give you my unfiltered opinions.


8oz orange juice - too spikey. Cut back to 4oz.

Hamburger, chips, lemon pie - Sugarwise ok, but it is guaranteed to help the heart disease.

cheesy popcorn - dump the cheesy and make fresh popcorn. Add butter and salt. I try to avoid any processed foods.

Cap'n crunch cereal and milk - tastes great but is brutal on sugars. Very processed. Avoid processed.

Pretzels - At some point you'll want to watch your saltintake. Diabetes is a high risk factor for heart disease. High salt is throwing more gas on the fire.

5 starbursts - why? Yo weren't low. Bad habit.

cheese dip - see cheesy popcorn.


All in all it's a bad diet. Way too much processed food, no fiber, no fruits, and no veggies.

[Lizzie G]

Hi

Having a look at what you eat, what I would suggest is this....you are having trouble with stability as the foods you are eating vary greatly in their glycaemic index and hence how long you take to peak after food, so whilst you expect to peak after the OJ etc, when you eat the cheesy fatty things and ice cream, your food takes a while to hit your system, allowing you to go low whilst your digestion catches up with your insulin....

Leading on from this Im going to say something very controversial (as ever!). Whilst your objective to gain weight, it sounds like you need to focus on figuring out a) your carb ratios at different times of day/levels of exercise etc and b)how the different foods react with your body and the timing of your rapid acting insulin relative not just to the quantity of carb but it's GI, fat content etc. To do this you will probably need to reduce what you eat in the short term, or at least eat very similar foods, in order that you can isolate the factors, see what different things do, so that you can gradually build up what you eat, and know pretty much exactly what it will do to your body...in my opinion, increasing what you eat and covering it with big boluses without being totally sure what its going to do is taking un-necessary risk of hypos and not getting good control. You need to have a clearer picture of what each thing does in isolation before you add so many factors into the mix that you cant see whats doing what. Think of your body as a bit of a science experiment, remember at school, you would isolate one factor to see how it changed the results, and keep everything else constant...ok so im a big geek, but this stuff has really helped for me.

Finally, id recommend you see a good dietician who will advise you on choices that are good for you.

Good luck!

[soso]

I would think a bit of fruit and veg in there would be a good idea... Diabetes aside, that didn't strike me as a very good diet, but I think you know that...lol......

We would all like to eat as much and whatever we want... I could fancy any one of those items occasionally, but all in one day and as a habit, even if I wasn't D I would expect it to catch up with me one day... Try some nuts, high in calories but still good for you and at least they are veggie based..avocado's good whack of calories.. and if you like the taste sardines are not bad either.. also cheese, good old fashioned cheese with apple...
bon appetit

[shiftzor]

Adding to xMenace: Don't forget chips, they are lethal things, covered in fat and full of carbs. Fat makes things unpredictable, carbs in chips will spike your bg, however they won't take effect immediately as your body breaks the fat down first, leading to a spike later in the day. Biscuits tend to be full of carbs and will spike your bg.

I thought I would also spot the good things, which are: milk, cheese (small quantities and get the real thing not processed cr*p which has no nutritional value) and the subway (not all that good unless you had lots of veg).

Alternatives:
Brown bread (be careful not all bread born equal)/Pasta/Rice/Spaghetti, Noodles, Fruit, Veg, Meat, Bran, Oats and Nuts

But all is not lost: healthy diet = little bit of everything, including the bad stuff and the green stuff. Take up a sport that you enjoy and eat more protein, that way you will gain muscle mass = weight, helping you control your bg in the long run. :D

[Lizzie G]

Adding to xMenace: Don't forget chips, they are lethal things, covered in fat and full of carbs. Fat makes things unpredictable, carbs in chips will spike your bg, however they won't take effect immediately as your body breaks the fat down first, leading to a spike later in the day. Biscuits tend to be full of carbs and will spike your bg.

I thought I would also spot the good things, which are: milk, cheese (small quantities and get the real thing not processed cr*p which has no nutritional value) and the subway (not all that good unless you had lots of veg).

Alternatives:
Brown bread (be careful not all bread born equal)/Pasta/Rice/Spaghetti, Noodles, Fruit, Veg, Meat, Bran, Oats and Nuts

But all is not lost: healthy diet = little bit of everything, including the bad stuff and the green stuff. Take up a sport that you enjoy and eat more protein, that way you will gain muscle mass = weight, helping you control your bg in the long run. :D


couldnt agree more....eat well with your focus on fresh fruit and veg, lean mean, plenty of lentils and pulses, healthy fats such as olive oil, avocados, oily fish, but NEVER deprive yourself of a little of what you enjoy, you will be miserable....

[xMenace]

I'll add that coming up with good diets is a major challenge for most of us. There are so many bad food-like substances out there that taste great. Temptation is always nipping at our heels.

I'm still promoting this book. Michael Pollan on The Hour with George Stroumboulopoulos on CBC (http://www.cbc.ca/thehour/video.php?id=1992)

Getting there is harder, but I'm doing pretty well.

Breakfast:
- 1 slice homemade multigrain raison bread, toasted
- 1 cup of milk

Lunch
- 1 slice homemade multigrain raison bread, toasted
- 1 banana
- 1 orange

Supper
- 2 hunks of meatloaf
- 1 large sweet potato
- 1 cup milk

Snack tonight for hockey
- probably a piece of leftover homemade pizza with the works. Maybe some popcorn.

Lacking some morning and lunch protein and some veggies. I typically have these, pb at bf and cheese at lunch, but it was a busy morning. I had a 45 minute walk before eating my orange. I also had a few chocolate eggs sometime. I was busy. BGs were great all day, 5.4 to 6.7, except am PP was 9.7 mmol/l. Add about 6 cups of coffee with milk and a bottle of water.

Comments welcomed.

[MJM]

Brian,
That diet you listed is a recipe for disaster. Heart problems are a major concern for diabetics. As someone else suggested, make an appointment with a dietition. As a diabetic you are more susceptible to all kinds of illnesses and problems. The first priority for you is to do everything in your power to avoid the occurance of such problems, and a good diet is the first rung of the ladder. You eat the right food now, and in 20 years time the chances are that you will still be healthy. You continue to eat what you are eating and you may not be around in 20 years time. I'm sorry to be so blunt, but, those are the facts. Look after the problem areas, and the heart is the most problematic area for diabetics. Go see that dietition.

[davef]

Brian,

From time to time since I was DX'ed last November I have thought that being on insulin would give me more freedom to eat things I'm being careful not to eat as I could bring my BG down with insulin, but the more time I live with this disease the more I realise that for me it has been a blessing in disguise. I'm eating far better than I ever did, I'm much more educated about what I eat and I know that just because I could compensate with insulin (if I was on it) would not make it right or anywhere near sensible. I'm certain that if I hadn't been diagnosed I would still be gaining weight and marching quickly down the road towards a heart attack.

Can I be certain I won't have complications (including cardiac problems)? no, but I can da*n well do my best to avoid them.

So, you asked "Anyone see anything wrong with this", well yes I can, okay so you are putting on weight, which is one of your aims, but I don't think you are necessarily doing it in the way your Endo would approve. There doesn't seem to be any real defined meals in you day, hamburger at 11am, but no sign of an evening meal?

I would agree with many of the suggestions you have been given and would definitely recommend you speak to a dietician and work a plan. You can gain the weight in a much healthier and controlled way.

Please do seek medical advice,

[ant hill]

Breakfast:
- 1 slice homemade multigrain raison bread, toasted
- 1 cup of milk

Lunch
- 1 slice homemade multigrain raison bread, toasted
- 1 banana
- 1 orange

Supper
- 2 hunks of meatloaf
- 1 large sweet potato
- 1 cup milk.
For what you do John, That is the ideal meals that's for an office person.

Brian,
That diet you listed is a recipe for disaster. Heart problems are a major concern for diabetics.
;) Indeed.

[REDLAN]

it appears you are a grazer. While this is OK, the modern insulins like humalog work better with distinct meals, and a period of fasting afterwards - this gives your insulin a chance to bring your blood sugar back down again.

breakfast - you appear to spike a bit afterwards - you may be better having less orange juice and substituting something else - as Xmenace suggested.

I think you hit the nail on the head - working out your carb/insulin ratios, will help enormously with your control.

I agree with Evermont about the muscle issue - if you want to build muscle then you need to exercise them. You will get muscle growth when you put on weight, simply because they have to carry more weight, but it's not as much as if you exercise them. However if you are very thin, then there is nothing wrong with putting on more subcutaneous fat (fat stored beneath the skin) - it is believed to help you recover faster from illnesses.

There seems to be some criticism of your actual diet. Personally I think it sucks. Too much processed food - but I only say it sucks from a taste perspective not a health one. ;)

Hamburger, chips, lemon pie - Sugarwise ok, but it is guaranteed to help the heart disease.

actually there is no relationship between consumption of saturated fats (i.e. fats from animals), and incidence of heart disease. There was only one study that showed such a relationship - Ancel Keys and the Seven Countries Study. In it he showed that rising fat intake was associated with increased risk of heart disease. There was only one flaw - he could have chosen 7 other countries and shown the exact reverse! Generally most studies appear to show that higher fat intakes are associated with lower rates of heart disease - the effect however is quite small, and probably not significant.

Diabetes is a high risk factor for heart disease. High salt is throwing more gas on the fire.

first statement is true, but I believe (but don't have any proof) in type 1 is linked to the high risk of kidney disease (which is caused by persistent high BG). The second statement is a popular myth. In clinical studies of people with hypertension, dietary salt reduction will typically produce a drop in blood pressure of between 1 and 2 mmHg (some studies have produced as much as 4 mmHg). A typical BP monitor can not detect a change in BP that small - (typical accuracy levels are +/- 2 mmHg). There are a group of people with a genetic variation that have what is known as salt sensitive hypertension, but they comprise a very small subset of the population.

on the chips and fat issue - I eat chips without too many problems. The fat slows down the absorption of carbs, which helps my insulin work better. If you do experience problems - usually you get a hypo (fat slows down carb absorption so much that the insulin has nothing to work against), followed by a prolonged high - I find splitting my dose works pretty well. Take half the dose as normal, and then take the other half later - typically I find the hour mark about right for things like pizza.

What matters most about your diet is not so much what you eat, but that you eat as wide a variety of foods as possible. A bit of everything. And try some of the non-processed stuff - it does taste nicer - honestly :D

[Emm]

Why are you injecting AFTER you eat?

I can only handle carb-laden meals if I give the insulin a head start. The insulin you inject doesn't even start doing anything for at least 10 minutes - so by the time you're taking it you're heading for a big meal spike!

I agree with others here - some vegetables would be a good thing. And a little less of the processed / junk food.

I tend to think that fat is ok in a diet - I reckon we were 'had' on the old 'fat makes you ill' idea. It's overdosing on carbs we need to be careful of, in my most humble opinion.

[Real4]

5:10 am: (112 mg/dl) just woke up
6:35 am: ate 2 biscuits with jelly,sausage and 8oz orange juice
6:44 am: 4 units of humalog
8:50 am: (138 mg/dl)
11:00 am: Hamburger, chips, lemon pie
11:20 am: 4units of humalog


Insulin, even the fast acting types like Humalog take some time to begin working. The package advice is 15 minutes but I find it more like 20 to 25. It is far better to take the insulin that much BEFORE a meal rather than after. That way the insulin is "kicking in" as the glucose from the food is going into circulation. With the way you are taking the Humalog, you will be spiking very high before the insulin has a chance to do anything. BTW, your menu menu is very high in fast acting carbs - Orange Juice is taking to contradict a low; it's just NOT a normal, healthy drink for a diabetic!

[REDLAN]

Orange Juice is taking to contradict a low; it's just NOT a normal, healthy drink for a diabetic!

I've never understood why people use OJ for a low blood sugar. The normal unsweetened stuff is a fairly slow acting carb - it's got a GI of around 50 which is considered to be a medium GI - this is less than boiled potato or white bread.

on the issue of injecting before or after food - there is a high individual variation in absorption rates of the newer faster acting GM insulins. I inject at the same time as I eat, and it seems to work fine. I do know someone who injects 15 to 20 minutes after they eat, otherwise they go low.

[UpNorth]

My reaction to this... Where's the FOOD?!? All i could see was junk :eek: Things even non diabetics shouldn't eat too much of... Eat more vegetables and fresh foods!

As for injecting insulin, i mostly inject after eating so i don't inject too much or too little since i never know beforehand how much i will eat...

[Razo681]

on the issue of injecting before or after food - there is a high individual variation in absorption rates of the newer faster acting GM insulins. I inject at the same time as I eat, and it seems to work fine.

Ditto on that. I tried injecting after once, because I forgot my pen, it wasn't pretty. Plus it will scew your later tests because you've already missed the high.

Besides what other's have said I really agree with the "where's the food" comment. It just takes learning, and finding what you like to eat that isn't so bad for you. Do you live alone? I could see being alone and trying to cook for yourself kinda hard. I'm lucky because my wife is very very good with nutrition with herself and by association it gets passed on to me. Maybe if you could find a buddy or someone who wants to do the same sorta things (lift weights) etc.. you could do those things together. Thats the only way I get motivated to do anything it seems.

[Scrabblechick]

I had to do a double take at the food choices, myself.

In general, my day looks a lot like this:

Breakfast: one trail mix bar or container of yogurt, coffee. (I am not a big breakfast eater)

Lunch: Varies, but might be a can of vegetable soup, with a salad; a wrap sandwich w/ low-carb wrap and good lettuce on the sandwich; homemade curry chicken salad with a few crackers on a bed of lettuce.

Supper: Also varies, but salad usually starts the meal. LOL. Baked or broiled fish with broccoli maybe, or if we go out, I get something with salad in the name.

For snacks, I'll eat a handful (not 2 or three) of nuts, a piece of good Swiss cheese, a container of s/f Jell-O, a slice of deli meat or a s/f fruit popsicle.

Not that I don't eat the occasional cheeseburger and fries. Fries don't bother me, even several hours later. But I limit my intake and eat 2 bites of the burger with the bun. Then I take the meat off and eat it.

I'm still gauging what kind of fruit I can eat that won't spike my BG. However, when the peaches come in this summer, I don't care. Peaches are my absolute favorite fruit and a late freeze killed them ALL last spring. I'll just have a peach for lunch and not worry about it. LOL.

[volleyball]

Brian, I am going to throw out some controversy myself. You are 27, not in the same age bracket as me or many of the posters. And you are underweight, something at least I do not share with you.
I think your breakfast is all wrong. The sausage is fine, a few oz of OJ maybe but the biscuits and jelly all wrong. Get yourself some long burning carbs.
I have no problem with burgers. As long as they are lean. It's the bun and chips that is the problem.
Have the pie but wait a little while after meals to eat. I'd even say have some more pie in the evening and skip the pretzels.

I think the goal of putting on a few pounds has been realized. You have not raised the danger of heart problems one bit. You're not middle age, overweight and been abusing your body for years. Some of have. Just don't make a habit of it.
Now it's time to do heavy weight low rep lifting to build some muscle. If you're that thin and it's your body type, let it be. Don't force yourself to put on too much muscle.

[Brian23]

Thanks for replying and trying to help. I am a very new diabetic (diagnosed in June) and I am under weight. I do not have high blood pressure or any other health affects yet(and hope i never will). I have been trying to gain weight but also trying to eat a little better. I still like to snack but I have been incorporating some fruits and veggies along with more beef and chicken and I usually eat subway 3 times a week. I am not just trying to put on muscle, I would not mind putting on some fat as well. I guess i need to make an appt. to see a professional about my diet. Once again, thank you for your reply.

[Eddy]

I do know someone who injects 15 to 20 minutes after they eat, otherwise they go low.


With most foods, I must mix R (even N) with my rapid, or I'll go hypo. For whatever reason, insulin acts quickly in me; aspart lasts 1h 15m, R lasts 2h, and N lasts 5.5h.

Dates supposedly are very high glycemic. I must wait 10 minutes after eating them to shoot aspart, or I'll go hypo. Raisins, however, work best if I pre-bolus by 10-15 minutes.

*shrug*