Bureaucratic Frustration

Priscilla Ballou said:

My question was basically rhetorical, a challenge to Alan (who aparently believes that carbs are
essential) to back that up. He hasn't.

I keep seeing people making assumptions about the necessity of eating carbs based on decades of
brainwashing, and I am challenging it whenever I can.

I have no concerns about the longterm effects of not eating white rice, pasta, potatoes, white
bread, cake, pies, cookies, and so on. Gosh, I might get a Devils Food cake deficiency! Oh, dear.
That's worrisome. NOT.

Priscilla

I didn't feel it necessary when others, particularly Annette, had "backed it up" so well in dietary
terms. There are also other "needs".

This may sound repetitive, but I do believe in (almost) everything in moderation. I don't think I'll
get a Devil's Food Cake deficiency. I do miss Pavlovas, Lamingtons, Anzac biscuits, Devonshire teas;
the list goes on. I doubt you miss any of those :-) They would all probably exceed my daily carb
"needs" in a single serve.

But I do still eat some root veges, the odd slice of bread and PB, and a whole variety of other
cereals, veges and carbs in small quantities
- and in as many interesting variations as possible. Sometimes, it's worth remembering, food is
eaten as part of a lifestyle, not just for survival and medicinal reasons. It is possible to marry
both the physical dietary requirements as a diabetic and the pleasures of eating for enjoyment;
that also meets a need.

If I am going to make the effort to extend my life beyond the predictions of the medical fraternity,
then I am bloody well going to enjoy it. I have no intention of becoming some sort of spartan
ascetic. Even if I didn't live longer on zero carbs, it would certainly be boring enough to feel
like eternity.

Cheers Alan, T2, Oz dx May 2002, diet and not enough exercise.
--
Everything in Moderation - Except Laughter.

"Priscilla Ballou" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

I keep seeing people making assumptions about the necessity of eating

carbs based on decades of brainwashing, and I am challenging it whenever I can.

Quoted message said:

I have no concerns about the longterm effects of not eating white rice,

pasta, potatoes, white bread, cake, pies, cookies, and so on.

Quoted message said:

These are not the only carbs around. bj

Priscilla Ballou said:

In article said:

It took many years for my endo to come around to PP testing. I'm talking only about my case, for
all I know she doesn't recommend PP tests for any of her patients. Recommending a patient test 5
- 8 times a day could be an insurmountable obstacle for a doctor. Look at all the problems some
newbies here have testing at all!

It may take a few malpractice suits to convince her that *some* of her patients just need the
information and are willing to participate in their own treatment. To withhold information as
vital as the importance of PP testing from a newly diagnosed diabetic is pretty clearly
malpractice, to my eye.

Priscilla

Like I said, in my case.

She was more concerned with preprandial testing for determining insulin dosage. Occasional
postprandial testing was what she originally suggested, but she knows I test postprandially on a
regular basis. She told me originally (that's almost 10 years ago) I should be aiming for maximum 2
hr postprandial of 10 mmol/l (180). She has since lowered those numbers from 10 to 8 mmol/l. I have
no idea what she recommends for her T2 patients or her other T1s. I don't talk to them.

We don't need to discuss testing frequency, she know I test a minimum of 5 times a day. She writes
the scrips for the strips with regularity. My last visit we mainly discussed the arterial
remodelling action of ACE inhibitors and ARBs because I just started on Altace.

She has never given me advice outside of the current CDA recommendations, so your suggestion of
malpractice is ridiculous.

Vicki

In article <[email hidden]>,

bj said:

"Priscilla Ballou" <[email hidden]> wrote in message news:vze23t8n-
[email hidden]...

Quoted message said:

I keep seeing people making assumptions about the necessity of eating

carbs based on decades of brainwashing, and I am challenging it whenever I can.

Quoted message said:

I have no concerns about the longterm effects of not eating white rice,

pasta, potatoes, white bread, cake, pies, cookies, and so on.

Quoted message said:

These are not the only carbs around.

Of course not.

Priscilla

"Alan" wrote ...

I didn't feel it necessary when others, particularly Annette, had "backed it up" so well in dietary
terms. There are also other "needs".

This may sound repetitive, but I do believe in (almost) everything in moderation. I don't think I'll
get a Devil's Food Cake deficiency. I do miss Pavlovas, Lamingtons, Anzac biscuits, Devonshire teas;
the list goes on. I doubt you miss any of those :-) They would all probably exceed my daily carb
"needs" in a single serve.

But I do still eat some root veges, the odd slice of bread and PB, and a whole variety of other
cereals, veges and carbs in small quantities - and in as many interesting variations as possible.

Sometimes, it's worth remembering, food is eaten as part of a lifestyle, not just for survival and
medicinal reasons. It is possible to marry both the physical dietary requirements as a diabetic and
the pleasures of eating for enjoyment; that also meets a need.

If I am going to make the effort to extend my life beyond the predictions of the medical fraternity,
then I am bloody well going to enjoy it. I have no intention of becoming some sort of spartan
ascetic. Even if I didn't live longer on zero carbs, it would certainly be boring enough to feel
like eternity.
_______________________________________________________________

I think if I tried hard enough, I could devise a diet for myself that had a very low carb intake.
But, like you, I don't think I would enjoy it very much. What I have done is try to reduce my carbs
to such an extent that I can maintain good numbers while still enjoying what I eat. And as I'm sure
you are aware, that takes quite a bit of tweaking.

My problem with the "medical establishment" continues to be their insistence that 175, 200, and 250
carbs a day is a healthy way to eat for diabetics. Study after study has shown that this is just not
the case, and without the use of sustaining amounts of medicine, can lead to some pretty nasty
complications. Most type 2s here understand that a diet that contains between 60-100 carbs a day is
more than enough to satisfy the "need" for glucose in the brain and little enough to help keep the
high BG numbers in check. Of course, each of us is different, but those numbers seem to be working
for the majority.

Arnie -

On Sun, 9 Nov 2003 18:20:03 -0500, "Arnie Macy" <[email hidden]>

Quoted message said:

I think if I tried hard enough, I could devise a diet for myself that had a very low carb intake.
But, like you, I don't think I would enjoy it very much. What I have done is try to reduce my carbs
to such an extent that I can maintain good numbers while still enjoying what I eat. And as I'm sure
you are aware, that takes quite a bit of tweaking.

My problem with the "medical establishment" continues to be their insistence that 175, 200, and 250
carbs a day is a healthy way to eat for diabetics. Study after study has shown that this is just
not the case, and without the use of sustaining amounts of medicine, can lead to some pretty nasty
complications. Most type 2s here understand that a diet that contains between 60-100 carbs a day is
more than enough to satisfy the "need" for glucose in the brain and little enough to help keep the
high BG numbers in check. Of course, each of us is different, but those numbers seem to be working
for the majority.

Arnie -

Arnie, we are going to have to be careful here. Someone will start thinking I'm writing your posts -
or you are writing mine :-) Of course, the real reason we seem to be in agreement is that you are
obviously incredibly intelligent.

Cheers Alan, T2, Oz dx May 2002, diet and not enough exercise.
--
Everything in Moderation - Except Laughter.

Priscilla Ballou said:

In article <[email hidden]>, Alan

Quoted message said:

I'm fairly new at this T2-management business. I'm also a very rusty retired engineer.

I occasionally think sort of like Spock, much to the frustration of those around me. A few
thoughts for others more experienced and qualified than me to consider:

1. To a simplistic person, it's obvious that hyperglycaemia is not good for long-term health.

2..Hyperglycaemia is an excess of glucose in the bloodstream.

3. A number of things can cause an excess of glucose in the bloodstream. One of those things is
an excess input of carbohydrates without an appropriate response by the body to produce
insulin at the right time.

4. Excess input can be countered either by decreasing the input, or acting on the excess with
insulin or drugs to minimise the effect.

5. Excess use of drugs or insulin can have undesirable side effects.

6. Inadequate intake of carbohydrates can also have undesirable side effects.

7. Therefore, calculation of the approriate intake of carbohydrates to meet minimal requirements
but create minimal excess glucose is desirable.

8. Testing and monitoring blood glucose levels, after input of carbohydrates, is necessary to
assist determination of what is the appropriate maximum. Other testing, of energy levels and
physical and mental health is needed to determine minimum requirements.

When I think that way, I am astounded that so many doctors, scientists and dietitans have
promoted very different treatments for so long, and government authoritities in many different
nations still push the "3 or 4 15g carb serves at every meal" diet for diabetics together with
drugs and insulin.

What is it I am missing? I know the post-prandial studies are out there, why don't they read
them? Why don't they see it? How do we (if any agree with me) change it?

Venting frustration.

You're not missing much. I still am curious, though, as to what constitutes an "inadequate intake"
of carbohydrates. What essential nutrient can you get from carbohydrates and from nowhere else and
that you'd be missing if you cut carbs way back?

The problem with cutting back too much on the carbs is that most people (diabetic or not) end up
feeling crappy. I believe that essential level of carb intake depends very much on activity levels.
For a sedentary person, eating <= 0.1% of their weight in carbs each day could be fine. In my
experience, too low of a carb intake (~100 g per day in my case) can impair both mental clarity and
athletic performance. When I was first diagnosed with diabetes and did not use insulin, I controlled
BG by eating a low-carb diet. I quickly lost about 15 pounds (was not overweight to begin with) and
ended up cutting my swim practices from 5000 yds to 2000 or 3000 because I ran out of energy very
quickly. I believe it was a problem of not having enough stored glycogen. The only quick way to
replace glycogen stores is to eat some carbs.

In article <[email hidden]>,

Priscilla Ballou said:

In article <[email hidden]>, Vicki Beausoleil <[email hidden]> wrote:

Quoted message said:

Quoted message said:

It took many years for my endo to come around to PP testing. I'm talking only about my case, for
all I know she doesn't recommend PP tests for any of her patients. Recommending a patient test 5
- 8 times a day could be an insurmountable obstacle for a doctor. Look at all the problems some
newbies here have testing at all!

Quoted message said:

It may take a few malpractice suits to convince her that *some* of her patients just need the
information and are willing to participate in their own treatment. To withhold information as
vital as the importance of PP testing from a newly diagnosed diabetic is pretty clearly
malpractice, to my eye.

It is from mine as well, but I doubt that it is according to the current laws. Doing what physicians
"normally" do is not malpractice according to the current legislation, and very few endos do PP
testing, and the current political view is that "unnecessary" testing should not be done.

--
This address is for information only. I do not claim that these views are those of the Statistics
Department or of Purdue University. Herman Rubin, Department of Statistics, Purdue University
[email hidden] Phone: (765)494-6054 FAX: (765)494-0558

"Alan" wrote ...

Arnie, we are going to have to be careful here. Someone will start thinking I'm writing your posts -
or you are writing mine :-) Of course, the real reason we seem to be in agreement is that you are
obviously incredibly intelligent.
____________________________________________________________________

You are just too funny, Alan. A good sense of humor goes a long way around here.

Arnie -

Alan said:

When I think that way, I am astounded that so many doctors, scientists and dietitans have promoted
very different treatments for so long, and government authoritities in many different nations
still push the "3 or 4 15g carb serves at every meal" diet for diabetics together with drugs and
insulin.

What is it I am missing? I know the post-prandial studies are out there, why don't they read them?
Why don't they see it? How do we (if any agree with me) change it?

So let me answer this question with a dose of healthy conspiracy theory.

Mind you, in a conspiracy, the right hand doesn't have to know what the left is doing.

The answer to your question may be in the following quote from your question: "... push the "3 or 4
15g carb serves at every meal" diet for diabetics together with drugs and insulin."

1) Those drugs and insulin are very rewarding financially. Billions of dollars are at a stake.

2) It's very easy to imagine that the drug companies -- or some people in the drug companies - would
not be happy if sales of drugs and insulin were diminished.

3) We see the enormous influence drug companies have over congress and the President by the closure
of the borders to competition, the forbidding the government to negotiate drug prices, and the
criminally high prices of drugs in the US.

4) The drug companies give tens of millions to public official and political parties, and spend
millions on lobbyists and benefits.

5) As someone had said, "Diabetes is a very good disease... no one is ever cured, no one dies
(quickly) and everyone spends oodles of money on drugs."

Conclusions?
--
M. Pann "We should always be disposed to believe that which appears white is really black, if the
hierarchy of the Church so decides." [Ignatius of Loyola, Spanish founder of the Society of Jesus
[Jesuits], Exercitia spiritualia, 1541]

In article said:

Alan wrote:

Quoted message said:

Quoted message said:

When I think that way, I am astounded that so many doctors, scientists and dietitans have
promoted very different treatments for so long, and government authoritities in many different
nations still push the "3 or 4 15g carb serves at every meal" diet for diabetics together with
drugs and insulin.

Quoted message said:

Quoted message said:

What is it I am missing? I know the post-prandial studies are out there, why don't they read
them? Why don't they see it? How do we (if any agree with me) change it?

Quoted message said:

So let me answer this question with a dose of healthy conspiracy theory.

Quoted message said:

Mind you, in a conspiracy, the right hand doesn't have to know what the left is doing.

Quoted message said:

The answer to your question may be in the following quote from your question: "... push the "3 or 4
15g carb serves at every meal" diet for diabetics together with drugs and insulin."

It is NOT a drug company conspiracy, and not truly a conspiracy at all. I know some of the
arguments, and for someone who misuses statistics as most medical researchers, and especially
government people, do, the bad statistical arguments against cholesterol and fats in the diet are
accepted as gospel. Too many medical people cannot believe that a low-fat high-carb diet could be
worse than doing the exact opposite.

Dietary cholesterol has little effect on body cholesterol, and dietary fats have even less effect on
blood lipids, except VERY temporarily. We have NO evidence that a low fat diet is better than a high
fat one with the same number of calories, just reasoning from the "obvious". Good analysis often
rejects the obvious, and it is now difficult to avoid "low fat" products which are highly enriched
with carbohydrates.

The carbohydrate sector of the food industry probably makes more from this attitude than the drug
companies.
--
This address is for information only. I do not claim that these views are those of the Statistics
Department or of Purdue University. Herman Rubin, Department of Statistics, Purdue University
[email hidden] Phone: (765)494-6054 FAX: (765)494-0558

Alan said:

(BL 1204) said:

Anyway, most engineers think like Alan. Just read Bernstein on the "law of small numbers." Of
course, the body is a dynamic organism. So nothing is simple.

BL

I think you may have just insulted most engineers - but it's too complicated for me to be sure.

Not really, most practical engineers tend to simplify a problem to the simplest manageable level and
solution . They then monitor the situation and ajust the solution as needed.

BJ (Engineer)