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Tfs

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Tfs

 two weeks ago my husband was a perfectly normal healthy non-smoker non-drinker 195 pounds very active call for softball bike writer walking overall not a horrible eater he had a massive heart attack did not even know he had the heart attack was not a typical was diagnosed with Pneumonia  not sure you ever have that pneumonia  but that’s another story has minor symptoms finally let us to the ER after we noticed his foot swelling doctor said he had a massive heart attack also at that time they diagnosed him with type one diabetes of course were freaking out Dr says he’s lucky to be alive none of this has made any sense to us I think it times and more worried about the diabetes then I am the heart as he seems to be doing well with all his vitals his first test of the morning is around 150 after breakfast at spikes to around 250 Even though in small portions he’s lost about 20 pounds they say they don’t want him to gain weight overnight but he needs to gain weight he’s looking frail comments thoughts questions all appreciated i’m wondering if after his body has time to help from the heart attack is it possible the diabetes my slack off the hospital food he’s getting seems to include things I can’t believe he’s allowed to eat Brad’s fruits and potatoes Even though in small portions he’s lost about 20 pounds they say they don’t want him to gain weight overnight but he needs to gain weight he’s looking frail comments thoughts questions all appreciated

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Kit

Hi Tfs, welcome to the group.

 

I've been trying to post an answer for a but now and the system just seems to keep rejecting it.  This is a test to see if a small answer will go through.

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Kit

Well the test went through but not the full post.  What a pita.

 

Anyway, I'll do a short version.

 

Our body's convert carbohydrates into glucose.  The pancreas produces insulin to help escort that glucose into the cells.  With the lack of insulin, the body believes it is starving (which it is despite how much you eat).  It then starts to cannibalize itself, breaking down muscle tissue into glucose.  Which, because of the lack of insulin, the body still cannot use.  This is the cause of the weight loss.  Once he gets his BG levels under control, he should be able to stabilize his weight, and gain back any weight he should need.

 

I recommend a few books.  I do not use insulin personally (T2) but many here recommend these highly.

 

Using Insulin by John Walsh
Think Like a Pancreas by Gary Scheiner
They will be invaluable tools.
 
I wish you both the best.  Feel free to ask any questions you may have.
 

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Tfs

Thanks Kit. How do you not need insulin......my hubby seems hungry all the time .....how will we ever know if his BG levels are controlled and how long does this usually take.......I'm just so darn frustrated with this entire ordeal

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Kit
8 minutes ago, Tfs said:

Thanks Kit. How do you not need insulin......my hubby seems hungry all the time .....how will we ever know if his BG levels are controlled and how long does this usually take.......I'm just so darn frustrated with this entire ordeal

 

I am a Type 2 diabetic.  I produce insulin just fine, but my body is unable to make use of that insulin (called insulin resistant).

 

I can understand your frustration.  As you and your husband move forward, it will get easier.  There is a lot of learning early on.  Once he gets the hang of things, it will become easier.

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Kit

I forgot to answer "how will we ever know if his BG levels are controlled and how long does this usually take".

 

That is actually the BIG question.  My personal goal is to achieve as normal BG levels as possible.

 

His endo should give him goals.  My personal goals are to have an AiC of under 6.0.  An A1C is basically an average of your BG numbers over approximately 3 moths period.

 

In general, to achieve this, you have the following guidelines

 

Fasting and pre meals under 100

1 hour post meal under 140

2 hours post meal under 120

 

Since he is on insulin, I would give a little wiggle room.  While chronically high BG levels can cause all sorts of problems in the long term, hypoglycemia can be immediately deadly.  It is better he run a little higher that what I gave above than he have some bad lows.  (A low is anything under 70).  While I personally would not freak out over a 68, depending on what he has eaten and how many caerbs he has eaten, it would mean a number of things.

 

As I mention before, the books I cited will be an invaluable tool.

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dowling gram

Hi and welcome

 

Diabetes is scary at first but the more you know the easier it becomes. Gaining control of his blood glucose will also help his heart. Kit is a great teacher and I suggest you take her advice and get those books.

Both Kit and I are type 2 and type 2 treatment is different than type 1 but there are some similarities. The main difference is that type 1 always needs insulin, type 2 can often manage with diet alone or with diet and oral meds.

Diet can help type 1 too to take less insulin but that's something you can control once he's out of the hospital. You will fast discover that most of the medical community knows very little about diabetes control. Hence the high carb diet that they think will help him gain weight when in fact it is driving up his blood glucose and preventing him from gaining weight.

 

Don't be afraid to ask any questions you may have or just come here and read some posts that you think may help.

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JohnSchroeder

Hi Tfs and welcome!  Hospitals are notoriously bad at diet and insulin dosing.  If you are still there, do what needs to be done to get out, and then the better control and learning can continue.

 

There is so much to learn and I don't know where you are already in terms of education... so just going to name a handful of things that I would consider helpful for new diabetics.

 

  • If you haven't already, find an endocrinologist to be your new diabetes doctor.  Primary care doctors generally don't know enough to really help much.
  • He will need to be taking TWO types of insulin on a daily basis.  A basal (examples are Lantus, Levimir, Tresiba) and a Bolus (examples are Novolog, Regular, humalog, apidra, affrezza)
  • There are two ways that your blood sugar increases.  The most obvious one is the food you eat.  This is what your bolus insulin is meant to cover. The dosage of your bolus insulin is variable depending on what you eat and what your blood sugars are already.  He will need to learn how much bolus insulin to take to cover what he is eating.  A doctor can give starting points, but this is something that diabetics themselves really need to be in charge of and able to experiment, learn and adjust over time.  The second way your blood sugar increases is your liver steadily releases glucose into your bloodstream.  At least relatively steadily.  Many people (myself included) often see spikes in their blood sugar in the morning from this without eating a thing.  This is what your basal insulin is meant to cover.  If your basal dose is correct your fasting blood sugar should be relatively steady.  I use my overnight numbers as a litmus test of this.  Assuming I haven't eaten anything for a couple hours before bed, whatever blood sugar I go to bed at I expect to wake up relatively close to.  If my blood sugars are falling overnight, I've got too much basal.  If they are going up overnight, too little.
  • I said it before, but the doctor and the hospital will give you good starting points, but it really is a condition you will do best to learn to manage yourself and just use the doctor as a safety net and a RX writer.

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JohnSchroeder

Probably should have mentioned, my experience is with multiple daily injections rather than using a pump.  Not sure what you guys are going to be doing there. The fundamentals are basically the same though.

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JohnSchroeder

Another bullet point.   There is a sentiment or thought you might have regarding T1 diabetes.  I can eat whatever I want as long as I take the insulin to cover it.  While technically true... it's not realistic in practice.  That's a bit like saying I am going to make a hole in one every time or hit every 3-pointer I shoot.

 

When you eat more carbs, you have to take more insulin.  But when accounting for how long it takes the insulin to kick in, how long it takes for various foods to break down and raise your blood sugar and how much, the reality is that it's much easier to miss than to hit.

 

Its much easier to just eat low carbs and keep your blood sugar steady instead of it looking like a roller coaster.

 

I've recently come to realize that if I do splurge with something like cereal or donuts one morning, I'll even see an increase the next morning because my liver has more carbs stored with which to dump.  My level went from about 65 to 150 last week without me eating a single thing for breakfast.

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Tfs

There inlies the hard part figuring out what he can eat to keep it steady and not allow food boredom to kick in

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Fraser

Food boredom is a mind thing.  There are stilll lots of food choices in a low carb diet.  Maybe not some of the choices you a use too, but there are choices. 

 

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Kit
6 hours ago, JohnSchroeder said:

Hi Tfs and welcome!  Hospitals are notoriously bad at diet and insulin dosing.  If you are still there, do what needs to be done to get out, and then the better control and learning can continue.

 

 

Tell me about it.  I have a picture of my brother in the hospital.  He's sitting up in bed eating his diabetic approved meal, cereal and french toast.

He was once in the upper 60s (barely considered hypo) when they tested him and gave him his evening insulin (right before dinner).  Dinner was on its way but they freaked out and had him eating graham crackers and drinking apple juice when his tray was brought in.

 

 

1 hour ago, Tfs said:

There inlies the hard part figuring out what he can eat to keep it steady and not allow food boredom to kick in

 

 

This is where his meter is his friend.  Early on I kept a pretty strict log of what I ate (including macros), what meds I took, and how my BG levels reacted to it.  I'd tweak a meal, drop some things, add others, and try it again.  After a while I had build a pretty good list of foods that played nice with me and foods that did not.

 

This can be a bit of an individual thing since we each react a little differently, but I react badly to the following

All grains.  Whole wheat, steel cut oats, brown rice, corn, etc.

Most fruits.  There's a reason its called natures candy.

Legumes:  These are a bit in the middle for me.  I can tolerate small amounts once in a while, but will start to have problems if I eat more or more frequently.  Not all legumes are equal.  Some have better carb counts, fiber content, etc than others so make sure to look up the nutritional information.

Root vegetables - for the most part, no (like potatoes, even in small amounts).  Some people can handle sweet potatoes, but I can't.  Same with beets sadly.  Funnily enough I usually don't have any problems with onions, though I don't eat them in large quantities.  Radishes are surprisingly low in carbs, taste amazing roasted, and sub pretty well for potatoes in soups or stews.  Some people shred them and use for hash browns.

 

But again, this is where testing and recording comes in to play.  The more information he gathers, the easier it is to look back at that information and figure out what works well for him and what does not.

 

Diet and variety.  Its actually not that difficult and we make a major mistake in thinking our common diets are varied.  They almost always aren't.  They usually consist of meat, starch, and some small token vegetables.  I personally just drop the starch and add a lot more vegetables.

 

Search around for low carb or keto recipes.  While he doesn't need to go that extreme, they can give you a lot of good ideas on how to drop carb counts without making things boring.

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dowling gram
22 minutes ago, Tfs said:

There inlies the hard part figuring out what he can eat to keep it steady and not allow food boredom to kick in

 

At first yes. He will need a glucometer to test his blood glucose. It takes a lot of testing to find out what raises your blood glucose and what doesn't because every diabetic is different. It will take researching the carbs in things and label reading but after you know it becomes second nature and it"s not so hard.

I was about to list foods to avoid but Kit beat me to it

 

Fortunately we have computers and the internet and lots of sites with low carb recipes as well as our recipe section. 2 of my favorite sites are "all day I dream about food" and "I breathe I'm hungry" Many of your usual recipes can be adapted to low carb. I'm never bored with the food I eat and I'm always finding new ways and things to cook. I find I eat better with low carb than I did before. Everything I make now is from fresh food so I can control the carbs.

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meyery2k

Tfs - Welcome.  You will find no better advice.  I have only been here 2 years but I have been able to manage my diabetes without insulin or medication (I am a Type 2 as well).

 

I used to love the carbs but, once my eyes were opened, I eat much more interesting food now that I am not tied to the idea of needing a starch with every meal.

 

We went out to eat today to celebrate my son's birthday and I had a wonderful burger with no bun.  While that sounds uninteresting, I find I like it better because I can taste everything else.  So what if I need a knife and a fork?

 

Check out the recipe suggestions here and you will see some great ideas.

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Bar&In

Sorry to hear about your husband’s heart attack. As for the T1D it will become second nature with time through research and trial and error. Just glad he’s ok after the heart attack. 

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Tfs

Thank you.  I just can’t believe how much sodium there is in all the foods we eat/drink 125 mg in a cup of 1% milk. Who knew??? And ohh those carbs

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Bar&In
18 hours ago, Tfs said:

Thank you.  I just can’t believe how much sodium there is in all the foods we eat/drink 125 mg in a cup of 1% milk. Who knew??? And ohh those carbs

 

It is ridiculous! You never realize it until you have to and start reading labels. I played hockey until I was 29 and ate whatever but when I turned 30 and a year removed from playing full time I was diagnosed T1D. At this point I was shocked in regards to nutrition and what I was actually putting into my body back in the day. I’d recommend your husband look into low carb high fat then possibly transitioning into the keto diet for best results. I prefer keto but it’s difficult at times to remain in it so I just have been doing low carb of late (40-50g daily) (keto I was doing 20g daily). It seems impossible at first but just as you realize how many carbs, sodium, etc. are in common foods you also realize the endless amounts of great foods one overlooked over the years. In addition Pinterest is great for delicious ideas low on carbs, especially when it comes to desserts. Finally, once one gets away from high carbs for a couple months the cravings are removed and much easier to maintain. Like I stated earlier, it will become much easier with time and become second nature. Best of luck moving forward. 

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Bar&In

Forgot to add original comment, as for milk I’d recommend switching to almond milk. A regular serving of milk has around 13 carbs compared to only 1 carb in almond milk. Your husband doesn’t want to be drinking his carbs! 

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Kit

Sodium is a natural mineral.  Its in water, the ground, etc.  Plants absorb some small amounts of sodium from the soil.  Animals absorb small amounts of sodium from the plants they eat as well as the water they drink.

 

Benefit - These are normally rather small amounts.  The majority of the sodium we consume doesn't come from natural sources like I mentioned above.  Nor does it come from what we add at the table or the cooking process (unless you are salt obsessed).  The vast majority of the sodium we consume comes from processed foods.  And the large majority of those processed foods are rather high in carbs.

 

Dropping your carb count has the added benefit of dropping a lot of the added sodium, preservatives, and other junk manufacturers stick in their products.  Convenience foods might be convenient, but they have never really been healthy despite what the boxes might say.

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