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Permalink Reply by Cynthia D on April 2, 2010 at 8:47am

Good common sense.

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Permalink Reply by Kristin on April 2, 2010 at 9:03am

I did the bolus and eat whatever I want routine for a few years. I checked my blood sugar often and corrected. Doing this, I was able to keep my A1c between 7.2 and 8.2, which I considered OK.

We now know that this means that my "average" blood sugar is causing damage to my organs (anything above 140 mg/dl or 8 mmol/L does).

I could not get my blood sugars low enough by eating whatever I wanted and bolusing to correct the errors, but those habits are hard to break. But I'm working on it. I'm following a stricter diet and finally have my A1c under 7, but still need to get it lower.

I guess the experience of how much you can bolus and eat what you want can vary from person to person, but my experience is that I cannot do that and have normal blood sugars.

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Permalink Reply by Kristin on April 2, 2010 at 9:06am

Another thing that improved my control a lot is waiting 15-20 minutes after bolusing before eating. This varies from person to person a lot. Some people will get dangerous lows if they wait that long, but it works for me. If you are seeing post-meal highs, you might try waiting 5 minutes, then 10, ... until you are seeing numbers below 140 2 hours after eating AND not going low while eating.

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Permalink Reply by Cheryl on April 2, 2010 at 9:26am

Kristin,

The only way we could find to get David's A1C under 7 was to always do an overnight check. Typically David will have a BG rise overnight. Some basal increases have been put into place, but the overnight rise is inconsistent, so we have had to be careful with the increases, to prevent any overnight hypos. A few night a week, when I check on him his BG is exactly where it should be, while on other nights it is on the rise. We now catch those increases each and every night, which finally brought his last A1C down to 6.7.

Cheryl

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Permalink Reply by Brunetta on April 2, 2010 at 9:37am

Kristin, I am learning to bolus 15-20 minutes before eating unless I am in the 70's....It does help with post-prandial spikes. I know all about the "eat what you want and then correct "regime..Although I have never been fond of the sugary cake cookies pop routine, I like fresh fruit and crunchy snacks like corn chips, and those types of foods can also spike you pretty high, and are sometimes hard to bolus properly for. I have found that frequent blood sugar testing combined with reasonable, healthy eating is the key. I am at an a1C of 7.0, but not under yet.. Still working at it!!! When I bike regularly, I can get A1C's at 6.2 or even lower.
We have no idea what this poor woman did or did not do in her early years as a diabetic. She just said she drank regular pop and gave her self a "little bit" of insulin to compensate for it . What is a "little bit"? Was she carb counting and testing both before and after the consumption of the soda? Did she know that a bottle of non-carbonated Crystal Light, zero carbs, tastes just as good? Who knows?

I do know that the sheer drudgery of carb-count-bolus-basal-test-test-test gets both commonplace and cutthroat to your mind...You know what to do but get so tired of it....This video, though quite shocking, tells us what the "for real" ramifications of poor control could be...

God Bless
Brunetta
42 years type one diabetes

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Permalink Reply by Kathyann on April 2, 2010 at 9:48am

Maybe I will try that. I've been noticing that my morning BGs have been getting higher. Maybe waiting before eating will help me too.

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Permalink Reply by Kristin on April 2, 2010 at 9:53am

Start with just 10 minutes and check often to make sure you don't go low!

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Permalink Reply by marvin on April 2, 2010 at 10:12am

insulin supposedly helps us keep BG levels low, or at least to the normal range.. in the video, she maybe taking insulin to compensate for what she ate but the question is, was her insulin enough to cover what she just ate..? also, she's a diabetic, and im just wondering why she still eating cakes or drinking regular soda...

for me, i think, insulin alone wouldnt help you, lifestyle changes, low glycemic diet, and exercise is the way to go..

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Permalink Reply by Gerri on April 2, 2010 at 10:42am

Is scary.

Agree with the others that eating-what-you-want & attempting to cover it with insulin doesn't work well. If it was a perfect equation, in theory it should work. But, we all know from experience that it doesn't. Even with perfect carb counting, higher doses are unpredictable in action. There are too many variables that cause highs/lows. Unfortunately, most people aren't told this, or how to time a bolus either.

"Cheating" regularly isn't a road to success. I'm not a disciplined person by nature, but no food is worth it to me to be on BG roller coaster. I have enough of that without cheating & don't want to take large insulin doses.

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Permalink Reply by Gina on April 2, 2010 at 10:47am

So what I think you are saying is: even if we use insulin to cover eating a piece of cake or pizza per se, and we keep our sugars in check, that it is wrong, and will still adversely affect us? What would be the scientific reason for this? Maybe I'm misunderstanding? I hope so? I can't eat lettuce for the rest of my life ;) I would think that since non-diabetics can eat whatever they want and their pancreas will compensate with insulin does to match, we could do the same?

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Permalink Reply by Gerri on April 2, 2010 at 11:11am

What I was saying that it's extremely difficult to do this right & I don't know many people who can without over or under doing it. Hey, if someone can correctly bolus for pizza or cake without highs or lows, that's great if they can handle the calories. Doesn't usually work out this way.

We can't compensate with insulin as non-diabetics can. Attempting to imitate a functioning pancreas with injected insulin is far from an exact science. If it were, we'd all have a formula, have normal A1cs & no complications. Injected insulin doesn't include components found in natural insulin, like amylin or C-peptide for starters. The action of injecting doesn't absorb consistently like having your own insulin being metered out in perfect natural doses as needed. A normal person may have a rise, but BG quickly comes down to perfect. How long does it take us to see a correction from a high or a low? Not only are highs damaging, but the swings from high to low are very damaging.

It's a fallacy to think we can eat as non-diabetics do.

The other problem with higher insulin doses, other than unpredictable results, is weight gain since insulin is a fat storing hormone. That becomes a vicious cycle because increased weight means still higher doses.

No one should live on lettuce or has to:)

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Permalink Reply by Gina on April 2, 2010 at 12:24pm

Thanks for clarifying. I was in no way implying we can compensate or eat, or function as non-diabetics do! In no way. Believe me. I am more than fully aware of this (unfortunately!) I just wanted to make sure that my occasional pizza, or fries etc wasn't harming me as long as I'm correcting properly. Which I thought was the case, but if you knew something I didn't, well, I was going to hop on board!! I am a worry wart to the fullest!

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