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  • Rien unlocked the badge Bookworm
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  •   scarney commented on this post about 1 year ago

    I have followed Ken’s no fat and the ‘both-ends’ blood sugar control technique. My last A1C was 5.2%. The endo was very angry, and gave me a stern lecture about how I was imperilling my life. Too bad !

    If I eat the slightest bit of fat, eg some peanut butter on a piece of toast, my sugar will...

    I have followed Ken’s no fat and the ‘both-ends’ blood sugar control technique. My last A1C was 5.2%. The endo was very angry, and gave me a stern lecture about how I was imperilling my life. Too bad !

    If I eat the slightest bit of fat, eg some peanut butter on a piece of toast, my sugar will be elevated for at least 24 hours.

    I am not as religious as Ken about this. I eat a third of a cup of oats in the morning. But I do avoid anything with oil in the ingredients.

    I have eased off a little on the effort to flatten the BGL spikes after a meal. After breakfast it may go to 10 mmol/L (180 mg/dl). I do this so I can do my daily 30km bike ride withouth having to worry about hypos. At the end of the ride my sugar is around 5 mmol/L, which I’m happy with.

    Could Ken and perhaps other T1Ds quantify insulin resistance in units of insulin injected? I know no real life diabetics I can compare myself to. At present I inject 8 units of long acting Levemir a day, and about 8 units of fast acting Novorapid (1 for breakfast, 3 for lunch and 4 for dinner).

    Thanks,

    Rien.

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    • Rien, I am wondering if you would like to tell your story on the Internet. We could do it here in a blog. Let me know if you have an interest. IRien, I am wondering if you would like to tell your story on the Internet. We could do it here in a blog. Let me know if you have an interest. I think your story can encourage others.   More ...
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  • Hi Ken,

    Thank you for describing in detail what you eat and why. The snacks information is also quite useful. 

    How do you take care of your omega-3 needs? I take flaxseed meal and chia seeds.

    I've modified my exercise routine in order to...

    Hi Ken,

    Thank you for describing in detail what you eat and why. The snacks information is also quite useful. 

    How do you take care of your omega-3 needs? I take flaxseed meal and chia seeds.

    I've modified my exercise routine in order to achieve a better A1c. I still walk 6km (one hour) before breakfast every morning. It is lovely to watch the new day break over the Coral Sea. I used to eat some bread before the walk, but that spikes much more than a banana. A banana is a mere pimple on my Freestyle Libre graph. 

    The post breakfast bike ride I've had to halve. I used to ride about 2 hours at high intensity. Now I do just over half the distance at a more leisurely pace. Now that I inject rapid insulin to take care of the breakfast spike, I will go much too low mid-ride. In addition, after injecingt rapid to take care of the lunch spike, I get the mother of all hypos mid afternoon. This is well after the rapid action should be finished. I figure it is the so-called post exercise late onset hypoglycaemia phenomenon, where the liver scavenges all available glucose to replenish the stores that I so inconsiderately depleted during the ride.

    Before starting the 'both ends' method I was injecting 6 units of slow acting Levemir once a day, no rapid at all. The bike ride would take care of the 500gm of carbs I eat every day, and give me an A1c of 5.8%. But, that requires high blood sugars after breakfast before the ride, and after lunch when the liver rebuilds its stores.

    Exercise may be beneficial, but it seems pointless that it requires high sugars for 8 hours of the day. So I'm reducing both the distance and intensity. 

    I currently inject 12 units of Levemir and about 15 of Novorapid per day. I keep a detailed log and tweak insulin dosages. They seem to be trending up.

    My diet is similar to yours, very much starch focused. I do eat more grains, oats, rye and barley. I really love the starch diet and am thriving on it. Is there a reason why you don't seem to eat much grains?

    Every day I get a little better at following your method. My biggest issue is learning to catch the lows in time, and when I do have one (usually mid afternoon), to be calm about it and not eat the fridge empty.

    Thanks again for your information and enthusiasm. You inspire me.

    Rien.

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  • Hi Ken et al.

    I have been following your blood sugar control method for a week now. The software for my Abbott Freestyle Libre glucose monitor has a forecast HbA1c function. It was 5.8% before, but over the last week the estimate dropped to...

    Hi Ken et al.

    I have been following your blood sugar control method for a week now. The software for my Abbott Freestyle Libre glucose monitor has a forecast HbA1c function. It was 5.8% before, but over the last week the estimate dropped to 5.2%! Usually the estimate is pretty close to the actual Lab number.

    I have copied and modified your log for Australian units of measure, exercise and my personal insulin types. It is quite valuable.

    Slowly I'm getting the hang of correctly estimating rapid insulin quantities, catching lows early enough, and taking just enough snacks. It is easy to overdo it, and go high ?.

    I have tried flattening the post-breakfast spike with insulin. While I can do it, I think it's safer to skip breakfast rapid insulin. Straight after breakfast I ride my bicycle 40kms, and I need enough fuel in the tank. Yesterday I injected 5 units, had no spike, but 20km into the ride my sugar was down to 4.0 mmol/L (72 mg/dl). Not enough to get home. I snacked, and then again at the 30km mark, and again when I arrived home. All up I consumed an extra 300 calories, just to keep up with the injected insulin.

    This morning I did not inject. At 20km my glucose was 7.9 mmol/L (142 mg/dl), on its way down after peaking at about 10 mmol/L (180 mg/dl). At 40km it was 4.6 mmol/L (73 mg/dl). No snacking required, and no anxiety about whether I was going to make it without crashing my numbers. I hope the brief spike is not too damaging.

    Thanks again for all the work you have done to document and publicise your method.

    Rien

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  • Hi Ken,

    Thanks for your extensive and informative response. You have definitely challenged me to get rid of my post-meal spikes, and achieve a better sync. My endocrinologist is going to be so unhappy!?

    I will start this new challenge today, probably with the midday meal first. Diabetes never...

    Hi Ken,

    Thanks for your extensive and informative response. You have definitely challenged me to get rid of my post-meal spikes, and achieve a better sync. My endocrinologist is going to be so unhappy!?

    I will start this new challenge today, probably with the midday meal first. Diabetes never gets boring! I mean this in a positive way. I'll just have to work out the practical details. Fortunately I have the Libre flash glucose monitor. It shows me my sugar at any time, a graph, and a trend indicating how fast my sugar is rising or falling, or steady.

    The bike ride will take some logistics. At present my sugar before breakfast is around 4.6 mmol/L (83 mg/dl). I eat, then ride. During the ride bgl goes up to about 9 mmol/L (162 mg/dl). By the time I get home two hours later it is back to 4.6 mmol/L (83 mg/dl). I do not inject rapid at present, and will have to think carefully how I will flatten that spike.

    Sorry about the jargon, bolus means rapid insulin (Novorapid in my case), as opposed to basal (Levemir). I was on Lantus, but it got me in trouble a few times. When I manage to inject into a blood vessel or a skinny spot, instead of slow acting, it becomes fast acting. Scary.

    I am very grateful to you for your blog. It prompted me 18 months ago to switch to a plant based starchivore way of life. It has been a wonderful journey, and I feel absolutely great.

    I have been worried about the spikes, but my endo assures me they will do no damage. I do not quite believe her in that respect.

    I will keep you informed about my progress.

    Thanks again,

    Rien Hofman.

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  • Great post, Ken! I'd love to know your opinion about how to factor exercise into your control system. I'm a T1D, plant based whole foods low fat McDougall style. My A1c hovers around the 5.6 - 5.8%, total cholesterol is about 120 mg/dl. I too have a doctor who tells me my A1c is too low and...

    Great post, Ken! I'd love to know your opinion about how to factor exercise into your control system. I'm a T1D, plant based whole foods low fat McDougall style. My A1c hovers around the 5.6 - 5.8%, total cholesterol is about 120 mg/dl. I too have a doctor who tells me my A1c is too low and dangerous. I'd like to get my A1c to the low fives. I haven't needed to bolus since being plant based. I take 4 units of Levemir at breakfast, and 2 units at the evening meal. I walk 6km (1 hour) before breakfast, and ride my bicycle for 2 hours after breakfast, every day. If I don't exercise, I need 30 units of Levemir instead of 6. Fasting bgl is around 90 mg/dl. After meals, I do get a spike, up to 220 mg/dl. Three hours later it is down to the 70s. That's the effect of both the tiny bit of Levemir and exercise.

    I would like to flatten the post meal spikes, but am concerned about exacerbating the exercise effect with rapid insulin, which would guarantee hypos every time. One option would be to eat smaller meals more frequently. Do you have experience with regular exercise in your regimen? I would love to know your take on this.
    Regards, Rien in Australia.

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  • Welcome Rien,

    We are glad to see you here. I am available to help with any technical issues you might have so feel free to contact me any time. I would love to know how you found us and also to invite you to write an introduction in our discussion forum at  https://www.drcarney.com/discussions/1...
    Welcome Rien,

    We are glad to see you here. I am available to help with any technical issues you might have so feel free to contact me any time. I would love to know how you found us and also to invite you to write an introduction in our discussion forum at  https://www.drcarney.com/discussions/1362-welcomes-and-introductions

    Let me know if there is anything we can do for you.

    thanks, Sean
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