Intro - Hello

J David Anderson said:

Hello group.

I haven't been lurking at all, just downloaded a couple of
thousand posts and have been reading through a few.

I have been diagnosed with type two diabetes, hence my
interest. At present I am in the middle of a spat between
my MD who says I have type 2 non insulin dependant -
nothing much to worry about - and a Registered Nurse, who
is a diabetes education specialist who says that I will
probably be insulin dependant and need to be very
concerned. So I have been googling around trying to
determine which of them is correct.

The reason I went for a check-up was headaches, a frequent
and urgent need for urination, abnormal tiredness after
what should be more than sufficient sleep (up to 12 hours),
continual hunger leading to snacking, something that I had
never done before, constant thirst, I simply could not
drink enough, (I could stand in the shower and drink the
water indefinitely) and pain in hands and feet. I had
simply presumed that all of these symptoms were side
effects of the medication after bone graft surgery and the
related ongoing drug regime, but they continued after I
stopped all medication.

I am in my forties and was told when in my twenties that I
was hypoglycemic. I often suffered from low blood sugar
crashes until I modified my diet. During the interim I had
little problem as long as I didn't neglect to eat for a day
or two at a time as had been my earlier wont.

I did an oral GTT and I didn't think that my results were
that bad, as all of the horror stories seem to relate to
people testing in the twenties or above, but my information
is sketchy and pretty old. My fasting test was 8.8, my one
hour was 11.1 and my two hour was 5.9. My doctor says this
isn't too bad, but that I need to "keep an eye on things",
and the nurse wants me to have far more intensive testing.

I am fit for my age, 6', 180 pounds, ran 5-8 Kilometres
daily until recently when I was fairly badly injured in a
traffic accident and lost a knee, I still ride, kayak and
walk the 5-8 K with my knee in a CTi brace. I eat well,
don't smoke and basically don't see how I can improve my
diet or lifestyle. For a few months after bone grafts and
other joint surgery, I was on prednisone and I have been
told that this may be what shifted me from hypo- to hyper-
glycemic. Does anyone have any experience of this?

How do I determine whether my Doctor or the Diabetes nurse
is right? Are those figures nothing much to worry about or
cause for concern?

I would be interested in any thoughts or personal
experiences.

Regards

David

Hi David

Welcome to the group.

I'll be brief, because others will be along.

Has the nurse given any specific reasons for the different
diagnosis? Is the doctor aware of this difference of
opinion? If not, I would see the doctor first. It sounds
very odd to me.

There is only one way to resolve a "spat" like that if it
continues. A third opinion. I would be asking the doctor for
a referral to an endocrinologist if it is really worrying
you. The specialist should have the expertise and the
information to resolve the issue. What medical
system/country are you in? That may have a bearing on where
you can go for resolution.

Until they do get it right, don't worry unduly unless you
are getting BG swings (hypo and hyper) sufficient to cause
problems. I'm not an expert on prednisone induced diabetes,
but I've read sufficient to know it's a possibility. We have
a couple who post here who may be able to help. Another
thing to ask your endo.

Now, as to what you can do in the interim. Obviously, as you
are fit, it's not so much the quantity you are eating as the
type of food. For the best advice I can give, go and read
Jennifer's "test,test,test" advice at: alt-support-alt-support-Open ↗
diabetes.org/Newly%20Diagnosed.htm . It's worth reading
twice. It works.

As the majority of posters are from the US, be aware that
you need to multiply your mmol numbers by 18 to compare with
their mg/dl numbers. So, your numbers above would be FBG 8.8
(160), 11.1 (200) one-hour and
5.9 (105). I usually round it to the nearest 5. The rest of
the world, including Oz, use mmol.

Good luck with the diagnosis.

Cheers, Alan, T2 d&e, Australia. Remove weight and
carbs to email.
--
Everything in Moderation - Except Laughter.

On Wed, 26 May 2004 19:14:09 +1000, you , J David Anderson

Quoted post said:

present I am in the middle of a spat between my MD who says
I have type 2 non insulin dependant - nothing much to worry
about - and a

I'd think he's being a little too flippant ....

Quoted message said:

Registered Nurse, who is a diabetes education specialist
who says that I will probably be insulin dependant

Make that *MAY BE* .... while some T2's use insulin as well
as medication (I'm one of them) it's not a foregone
conclusion ...

Quoted message said:

and need to be very concerned. So I have been googling
around trying to determine which of them is correct.

To some degree, both of them - if you're diabetic, you have
to take it seriously, but it's not a sword of doom hanging
over your head ..

Quoted message said:

but my information is sketchy and pretty old. My
fasting test was 8.8, my one hour was 11.1 and my two
hour was 5.9. My

Fasting of 8.8 would worry me ....

Quoted message said:

I would be interested in any thoughts or personal
experiences.

You'll get plenty of those here ....

Welcome to the club that nobody wanted to join ...

--

]- "I am a man of many parts, ]- unfortunately most of them
are no longer in stock" ]-
------------------------------------------------------------
----------
To reply by e-mail, move the Gnu from the address to the
subject line.
------------------------------------------------------------
----------

On Wed, 26 May 2004 19:14:09 +1000, you , J David Anderson

Quoted post said:

present I am in the middle of a spat between my MD who says
I have type 2 non insulin dependant - nothing much to worry
about - and a

I'd think he's being a little too flippant ....

Quoted message said:

Registered Nurse, who is a diabetes education specialist
who says that I will probably be insulin dependant

Make that *MAY BE* .... while some T2's use insulin as well
as medication (I'm one of them) it's not a foregone
conclusion ...

Quoted message said:

and need to be very concerned. So I have been googling
around trying to determine which of them is correct.

To some degree, both of them - if you're diabetic, you have
to take it seriously, but it's not a sword of doom hanging
over your head ..

Quoted message said:

but my information is sketchy and pretty old. My
fasting test was 8.8, my one hour was 11.1 and my two
hour was 5.9. My

Fasting of 8.8 would worry me ....

Quoted message said:

I would be interested in any thoughts or personal
experiences.

You'll get plenty of those here ....

Welcome to the club that nobody wanted to join ...

--

]- "I am a man of many parts, ]- unfortunately most of them
are no longer in stock" ]-
------------------------------------------------------------
----------
To reply by e-mail, move the Gnu from the address to the
subject line.
------------------------------------------------------------
----------

Without going into details about management of diabetes, I
suggest you err on the case of caution. When you develop
diabetes it is important that you tackle it as soon as
possible - that you are diagnosed as soon as possible and
tackle it. Case stories are full of doctors who say "we'll
keep an eye on it" or "I wouldn't be concerned", where in
actual fact they should have taken urgent action. I'g go
along with the Registered Nurse you saw. Learn all you can
about this disease. Stay with this newsgroup.

Henry Australia

"J David Anderson" <[email hidden]> wrote in
message "]news:[email hidden]...

Quoted message said:

Hello group.

I haven't been lurking at all, just downloaded a couple of
thousand posts and have been reading through a few.

I have been diagnosed with type two diabetes, hence my
interest. At present I am in the middle of a spat between
my MD who says I have type 2 non insulin dependant -
nothing much to worry about - and a Registered Nurse, who
is a diabetes education specialist who says that I will
probably be insulin dependant and need to be very
concerned. So I have been googling around trying to
determine which of them is correct.

The reason I went for a check-up was headaches, a frequent
and urgent need for urination, abnormal tiredness after
what should be more than sufficient sleep (up to 12
hours), continual hunger leading to snacking, something
that I had never done before, constant thirst, I simply
could not drink enough, (I could stand in the shower and
drink the water indefinitely) and pain in hands and feet.
I had simply presumed that all of these symptoms were side
effects of the medication after bone graft surgery and the
related ongoing drug regime, but they continued after I
stopped all medication.

I am in my forties and was told when in my twenties that I
was hypoglycemic. I often suffered from low blood sugar
crashes until I modified my diet. During the interim I had
little problem as long as I didn't neglect to eat for a
day or two at a time as had been my earlier wont.

I did an oral GTT and I didn't think that my results were
that bad, as all of the horror stories seem to relate to
people testing in the twenties or above, but my
information is sketchy and pretty old. My fasting test was
8.8, my one hour was 11.1 and my two hour was 5.9. My
doctor says this isn't too bad, but that I need to "keep
an eye on things", and the nurse wants me to have far more
intensive testing.

I am fit for my age, 6', 180 pounds, ran 5-8 Kilometres
daily until recently when I was fairly badly injured in a
traffic accident and lost a knee, I still ride, kayak and
walk the 5-8 K with my knee in a CTi brace. I eat well,
don't smoke and basically don't see how I can improve my
diet or lifestyle. For a few months after bone grafts and
other joint surgery, I was on prednisone and I have been
told that this may be what shifted me from hypo- to hyper-
glycemic. Does anyone have any experience of this?

How do I determine whether my Doctor or the Diabetes nurse
is right? Are those figures nothing much to worry about or
cause for concern?

I would be interested in any thoughts or personal
experiences.

Regards

David

J David Anderson wrote in message <2hj5csFdi7fmU1@uni-
berlin.de>...

Quoted message said:

Hello group.

I haven't been lurking at all, just downloaded a couple of
thousand posts and have been reading through a few.

I have been diagnosed with type two diabetes, hence my
interest. At present I am in the middle of a spat between
my MD who says I have type 2 non insulin dependant -
nothing much to worry about - and a Registered Nurse, who
is a diabetes education specialist who says that I will
probably be insulin dependant and need to be very
concerned. So I have been googling around trying to
determine which of them is correct.

The reason I went for a check-up was headaches, a frequent
and urgent need for urination, abnormal tiredness after
what should be more than sufficient sleep (up to 12 hours),
continual hunger leading to snacking, something that I had
never done before, constant thirst, I simply could not
drink enough, (I could stand in the shower and drink the
water indefinitely) and pain in hands and feet. I had
simply presumed that all of these symptoms were side
effects of the medication after bone graft surgery and the
related ongoing drug regime, but they continued after I
stopped all medication.

I am in my forties and was told when in my twenties that I
was hypoglycemic. I often suffered from low blood sugar
crashes until I modified my diet. During the interim I had
little problem as long as I didn't neglect to eat for a day
or two at a time as had been my earlier wont.

I did an oral GTT and I didn't think that my results were
that bad, as all of the horror stories seem to relate to
people testing in the twenties or above, but my information
is sketchy and pretty old. My fasting test was 8.8, my one
hour was 11.1 and my two hour was 5.9. My doctor says this
isn't too bad, but that I need to "keep an eye on things",
and the nurse wants me to have far more intensive testing.

I am fit for my age, 6', 180 pounds, ran 5-8 Kilometres
daily until recently when I was fairly badly injured in a
traffic accident and lost a knee, I still ride, kayak and
walk the 5-8 K with my knee in a CTi brace. I eat well,
don't smoke and basically don't see how I can improve my
diet or lifestyle. For a few months after bone grafts and
other joint surgery, I was on prednisone and I have been
told that this may be what shifted me from hypo- to hyper-
glycemic. Does anyone have any experience of this?

How do I determine whether my Doctor or the Diabetes nurse
is right? Are those figures nothing much to worry about or
cause for concern?

I would be interested in any thoughts or personal
experiences.

Regards

David

1. Insulin Dependence:

Actually, insulin dependence is not a lot to be concerned
about. If you are an adult-onset Type 1 (T1), you are headed
towards insulin and there's nothing anybody can do about it.

If you are an adult-onset Type 2, everything you do to
preserve your health will incidentally slow your progression
towards insulin dependence. However, if you have the disease
long enough, you will almost certainly become insulin
dependent. Your goal is to need multiple daily insulin shots
at age 120, not age 50.

The danger an adult-onset T1 faces is a consequence of
ignoring his blood sugars (bG). If your honeymoon ends and
your sugars soar without you noticing (cause you weren't
testing), you can go into Diabetic Ketoacidosis (DKA) which
is life-threatening. That's something to be concerned about
but is easily avoided if you monitor your bG as recommended
by most docs.

2. Are you Adult-onset T1 or T2 ?

Your nurse seems to think you may be adult-onset T1 because
of your body build and history. (Like me for instance). That
suggests that you are in a honeymoon which will end in an
immediate need for multiple daily insulin injections. In
general, the older you are when it hits, the longer the
honeymoon. A 3-year old can have a 1-week honeymoon. At age
53, mine lasted 3-5 years.

Adult-onset T1 are the most common type of T1. We outnumber
Juvenile-onset T1 by at least 2:1. However, we are swamped
by the numbers of adult-onset T2. Thus, many docs
automatically diagnose all adult-onset Diabetics as T2.

That diagnosis sorta works out. Most of the time (95 -
98%) he's right. The rest of the time, the mis-diagnosed
T1 tries the diet, exercise, and oral meds for a while
(the Honeymoon), then finds that he must use insulin to
control. The last few months or year can be very, very
unpleasant (like me for instance) if he delays going on
insulin, or mostly uneventful if he is paying attention
and willing to switch.

I am sort of going with the doc in this one. Hypoglycemia is
a symptom of slowly developing Type 2 diabetes. Prednisone
is notorious for accelerating the standard Type 2 Diabetic
Progression. IOW, you have had T2 symptoms for years and
have a history which explains emerging T2 despite not
displaying the overweight, apple-shaped body and sedentary
lifestyle characteristic of a younger person developing T2.

3. ". . . .MD who says I have type 2 non insulin dependant
- nothing much to worry about . . ."

[censored]. Type 2 Diabetes is worth worrying about. The
earlier you figure out you have it and the harder you work
to fight it, the easier, happier, more pleasant and longer
your life will be.

No matter if you are T1 or T2, you are in for a life-long
fight. If we get lazy and sloppy, we die young, in pain. Use
aggressive and diligent self-management and you can live a
near-normal life.

Diabetes is one of the odd diseases in which the patient
does all of the work and most of the management. The docs
mostly sit on the sidelines cheering us on. The more you
learn and the faster you learn about this disease, the
better your prospects.

Your doc makes me a bit nervous. He seems a bit casual about
this situation. Folks in your position should:

a. Have their cholesterol monitored and use meds if
they can't hit targets

b. Have an immediate "Diabetic Eye Examination" looking
primarily for retinopathy

c. Have their blood pressure monitored and use meds if
they can't hit targets

Some targets:

Total cholesterol less than 200 (much less is
preferred) LDL less than 130, (100 or less preferred)
HDL greater than 45 (the higher the better)
Triglycerides less than 150 (the lower the better)
Triglycerides/HDL ratio less than 3.0
c.a. less than 120/80

Keep coming back. Folks around here have "been there, done
that" and been treated by a mix of docs ranging from superb
to awful. It's worth listening to our experiences.

Regards
Old Al

hi, David

welcome to the group no one wants to join

the first thing i did was look to see if OldAl had replied
to you he has....... there isn't a word i would change, and
there isn't anything i can add to his wisdom

take care of this disease and you will not have to worry
about extreme complications as a side affect of diabetes

kate
--
Join us in the Diabetic-Talk Chatroom on UnderNet
/server irc.undernet.org --- /join #Diabetic-Talk More
info: diabetic-talk.orgdiabetic-talk.orgOpen ↗

"J David Anderson" <> wrote in message berlin.de...

Quoted message said:

Hello group.

I haven't been lurking at all, just downloaded a couple of
thousand posts and have been reading through a few.

I have been diagnosed with type two diabetes, hence my
interest. At present I am in the middle of a spat between
my MD who says I have type 2 non insulin dependant -
nothing much to worry about - and a Registered Nurse, who
is a diabetes education specialist who says that I will
probably be insulin dependant and need to be very
concerned. So I have been googling around trying to
determine which of them is correct.

Quoted message said:

Regards

David

In article said:

I have been diagnosed with type two diabetes, hence my
interest. At present I am in the middle of a spat between
my MD who says I have type 2 non insulin dependant -
nothing much to worry about - and a Registered Nurse, who
is a diabetes education specialist who says that I will
probably be insulin dependant and need to be very
concerned. So I have been googling around trying to
determine which of them is correct.

If your doctor actually said to you that diabetes -- of any
kind -- is "nothing much to worry about," then run, don't
walk, to another doctor. Diabetes IS something to worry
about and take care of. Whether you use insulin now or later
or never isn't the issue. Diabetes does damage to your body
in many different ways and must be kept under control. In
addition to monitoring your blood sugar, your doctor has to
watch your blood pressure and cholesterol (we're prone to
both being high), keep an eye out for protein in your urine
or other signs of kidney damage, make sure your eyes are
checked for damage, and keep an eye on your feet. All those
things are needed whether or not you're on insulin or any
other diabetes medications.

--
Lord, make me an instrument of your peace...
where there is hatred, let me sow love.

remove "spamtrap" for e-mail

Alan said:

Quoted message said:

I did an oral GTT and I didn't think that my results were
that bad, as all of the horror stories seem to relate to
people testing in the twenties or above, but my
information is sketchy and pretty old. My fasting test was
8.8, my one hour was 11.1 and my two hour was 5.9. My
doctor says this isn't too bad, but that I need to "keep
an eye on things", and the nurse wants me to have far more
intensive testing.

I am fit for my age, 6', 180 pounds, ran 5-8 Kilometres
daily until recently when I was fairly badly injured in a
traffic accident and lost a knee, I still ride, kayak and
walk the 5-8 K with my knee in a CTi brace. I eat well,
don't smoke and basically don't see how I can improve my
diet or lifestyle. For a few months after bone grafts and
other joint surgery, I was on prednisone and I have been
told that this may be what shifted me from hypo- to hyper-
glycemic. Does anyone have any experience of this?

How do I determine whether my Doctor or the Diabetes nurse
is right? Are those figures nothing much to worry about or
cause for concern?

I would be interested in any thoughts or personal
experiences.

Regards

David

Hi David

Welcome to the group.

I'll be brief, because others will be along.

Has the nurse given any specific reasons for the different
diagnosis? Is the doctor aware of this difference of
opinion? If not, I would see the doctor first. It sounds
very odd to me.

Hi Alan

The nurse wants me to see an endocrinologist and ignore what
my MD is telling me. She says that I need to be taking
medication to control my BGL right now.

My MD says that an entire new industry has sprung up that
hinges on unnecessary diagnoses of diabetes involving
patients who aren't diabetic, but simply need to modify
their lifestyle. According to him there are a great many
people who have higher than normal blood glucose readings
who are not truly diabetic but merely unhealthy - nutrition
wise. Also, according to him, many Doctors are creating
diabetics by beginning treatment before it was necessary
rather than pushing their patients to take control of their
own health.

He tends to mock the Nurse, saying that by some never ending
series of miracles all of these critically ill people, who
have no previous awareness of their illness, manage to
arrive at her clinic and start receiving pharmaceutically
aided treatment just in time to save their lives. They can't
delay for a day or two, let alone a month or two and let
their bodies try to cope with the illness by use of
appropriate lifestyle, exercise, and diet changes. I can
kind of see his point.

He claims that if he tested every one of his patients every
day for a year, each one of them would at times be
considered diabetic. He says that in my case, I should keep
an eye on it, give myself time to rid my system of the
effects of several months of drugs and chemicals and I will
almost certainly have a very good chance of going back to
normal because I am basically healthy. He also says that if
I had been overweight and sedentary, he might have a
different opinion. He is not a young guy himself, well into
his sixties, but has specialised in sports medicine for much
of his career. Says that he knows what he is doing.

He doesn't want to put me, or anyone else, on medication
unless it is last resort as he claims medication is a crutch
and the body will stop trying to repair itself. He believes
that good medicine consists of helping nature, not forcing
it to change. He did have me purchase a MediSense Optium
monitor, but he only wants me to use it once or twice a week
at the same time and under the same conditions, unless I
begin to feel distinctly ill, then use it and call him if
the reading are abnormally different. He has me reducing my
carb intake (it was quite high, I love garlic & cheese
wholegrain rolls with meals) but has made no other
suggestions re diet. I have cut back on the rolls and
noodles (Singapore Noodles, the only unhealthy thing I eat -
I love them!) and increased the seafood and mushrooms. It
was reflected immediately in a lowered post prandial
readings, but I am still high.

He inspires confidence in his ability to maintain health in
his patients. The nurse seems to think that as soon as you
test high, you need pharmaceutical intervention.

Quoted message said:

There is only one way to resolve a "spat" like that if it
continues. A third opinion. I would be asking the doctor
for a referral to an endocrinologist if it is really
worrying you. The specialist should have the expertise and
the information to resolve the issue. What medical
system/country are you in? That may have a bearing on where
you can go for resolution.

I like my MD and do believe that he might have the right
approach. In the meantime, I will learn as much as I can and
monitor myself carefully, much more than the couple of times
a week that he suggested.

My biggest concern is the fatigue, followed closely by the
increased urination requirements. The increased thirst is
not a major problem, I only drink mineral water, not soft
drinks or alcohol. Long car trips could be a problem.

Quoted message said:

Until they do get it right, don't worry unduly unless you
are getting BG swings (hypo and hyper) sufficient to cause
problems. I'm not an expert on prednisone induced diabetes,
but I've read sufficient to know it's a possibility. We
have a couple who post here who may be able to help.
Another thing to ask your endo.

Now, as to what you can do in the interim. Obviously, as
you are fit, it's not so much the quantity you are eating
as the type of food. For the best advice I can give, go and
read Jennifer's "test,test,test" advice at: alt-support-alt-support-Open ↗
diabetes.org/Newly%20Diagnosed.htm . It's worth reading
twice. It works.

I had a look at that, but I already exceed the suggestions
as I have been enthusiastically involved in good nutrition
and fitness for nearly twenty years. Ever since reading some
Adele Davis books when I was first married.

I eat organic vegetables, fish, limit red meat, I base my
diet around Asian/Japanese food, drink no milk, but do eat
hard cheeses and drink red or white wine with meals. A full
third of my intake is fresh fruit and as a hobby, I make my
own wholegrain Rye bread, grow my own vegetables, and set
fish and crab traps and so I am sure that most of my food is
fresh and healthy. Many of my friends consider me a bit
eccentric as the time and expense of all this far exceeds
supermarket prices for fresh food. It requires a good deal
of time and exercise outdoors and so has its own rewards.

I supplement with vitamins and minerals, I take Glucosamine
(most runners my age do) I drink a litre or so of Magnesium
Bicarbonate per day and have been doing so for several
years. Until quite recently I was considered the epitome of
good health and fitness in a mature man. All that has now
changed. I feel as though I have suddenly become an old man.
My MD says that in a year or so, I will be fully back to
normal, the physical injuries healed and the diabetes gone
and be ready for the next Masters Games. The nurse says get
used to it, it is only going to get worse.

Quoted message said:

As the majority of posters are from the US, be aware that
you need to multiply your mmol numbers by 18 to compare
with their mg/dl numbers. So, your numbers above would be
FBG 8.8 (160), 11.1 (200) one-hour and
5.9 (105). I usually round it to the nearest 5. The rest of
the world, including Oz, use mmol

I didn't think about that Alan, I am so used to glancing
at headers to see where posts originate that I forget
that unless you give your location, many people will have
no idea. Particularly since news individual has stopped
using full headers. I was aware of the different
measuring systems.

I am also in Australia. Queensland, on the Gold Coast at
Runaway Bay.

Regards

David

J David Anderson said:

I am also in Australia. Queensland, on the Gold Coast at
Runaway Bay.

Hi David.

I snipped for brevity, but I did read it all.

You may have missed the point on the referral to the
"test, test, test" system. It is not so much about what
you eat now, but what that is doing to you an hour and two
hours after you eat it. As far as BGs go, it is neither
healthy or unhealthy food, it is simply food that spikes
you - or doesn't.

The nutritional value of that food is a seperate, although
also important, issue.

If you are testing a lot, try using the routine that
Jennifer suggests. You may get some surprises.

On doctors, what do you have to lose by seeing the endo? I
can't say whether your doc or your nurse is right;
personally, I lean towards an impartial umpire. I try to
avoid meds for personal reasons, but I also try to avoid
complications. Get the third opinion. I think you would
profit by closely reading OldAl's advice, particularly
considering your lack of obesity, and Henry's warning;
incidentally, Henry's also from Oz.

I live in Pottsville Beach and I'm going to be shopping with
swmbo in Tweed City tomorrow between 2 and 4 if you are able
to meet for coffee. email direct (see sig) if you are
interested.

Or, if you want to send me your phone number, I'll give
you a call.

Cheers, Alan, T2 d&e, Australia. Remove weight and
carbs to email.
--
Everything in Moderation - Except Laughter.

"J David Anderson" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Hello group.

I haven't been lurking at all, just downloaded a couple of
thousand posts and have been reading through a few.

I have been diagnosed with type two diabetes, hence my
interest. At present I am in the middle of a spat between
my MD who says I have type 2 non insulin dependant -
nothing much to worry about - and a Registered Nurse, who
is a diabetes education specialist who says that I will
probably be insulin dependant and need to be very
concerned. So I have been googling around trying to
determine which of them is correct.

The reason I went for a check-up was headaches, a frequent
and urgent need for urination, abnormal tiredness after
what should be more than sufficient sleep (up to 12
hours), continual hunger leading to snacking, something
that I had never done before, constant thirst, I simply
could not drink enough, (I could stand in the shower and
drink the water indefinitely) and pain in hands and feet.
I had simply presumed that all of these symptoms were side
effects of the medication after bone graft surgery and the
related ongoing drug regime, but they continued after I
stopped all medication.

I am in my forties and was told when in my twenties that I
was hypoglycemic. I often suffered from low blood sugar
crashes until I modified my diet. During the interim I had
little problem as long as I didn't neglect to eat for a
day or two at a time as had been my earlier wont.

I did an oral GTT and I didn't think that my results were
that bad, as all of the horror stories seem to relate to
people testing in the twenties or above, but my
information is sketchy and pretty old. My fasting test was
8.8, my one hour was 11.1 and my two hour was 5.9. My
doctor says this isn't too bad, but that I need to "keep
an eye on things", and the nurse wants me to have far more
intensive testing.

I am fit for my age, 6', 180 pounds, ran 5-8 Kilometres
daily until recently when I was fairly badly injured in a
traffic accident and lost a knee, I still ride, kayak and
walk the 5-8 K with my knee in a CTi brace. I eat well,
don't smoke and basically don't see how I can improve my
diet or lifestyle. For a few months after bone grafts and
other joint surgery, I was on prednisone and I have been
told that this may be what shifted me from hypo- to hyper-
glycemic. Does anyone have any experience of this?

How do I determine whether my Doctor or the Diabetes nurse
is right? Are those figures nothing much to worry about or
cause for concern?

I would be interested in any thoughts or personal
experiences.

Sorry you had to join our group. Your age would likely put
you as a type 2. But your weight would likely put you as a
type 1. Keep in mind that not all type 2's are overweight
though. So you seem to be one of the rare ones. I think
there are tests that can be done to try to determine whether
you actually have type 1 or 2. But I think the usual course
of action is to try oral meds, diet and exercise first and
then move on to insulin if those things don't work. If your
Dr. says type 2 is nothing to worry about, you need another
Dr. Type 1 and type 2 are both different things, but both
are cause for worry.

--
Type 2 users.bestweb.net~jboveOpen ↗

<snip>

You indicate you are eating a lot of fruit (high fruit
sugar) and home-made bread. You really need to follow
Jennifer's advice on testing
- so you can get the portion size to fit your needs. How
else do you find out if your slice of bread has more carbs
than you can handle? (Many homemade breads are denser than
the American store bought with ~15 g of carbohydrates per
slice. Also, my experience is that it's hard to slice
homemade breads as thinly as the commercial bakeries do.)

2) Your doctor will not have to live with the complications;
you will. How aggressive do you want to be? High bg
levels impair healing so you may take longer to get back
into your previous running shape unless you get those bgs
down as soon as possible.

Many find their bodies get comfortable with their current bg
levels. Without meds, they find themselves in a plateau that
diet and exercise doesn't break. With meds, they get to
normal levels and then can maintain normal bgs with diet and
exercise alone (no more meds for a while).

3) If you are a late-onset type 1, you may be able to use a
small amount of insulin for several years and lengthen
the time your pancreas still functions.

Cindy Wells (Your current doc has forgotten one thing -
those with unhealthy lifestyles who lower bg values with
diet and exercise will have their bg go back up if they ever
return to the old habits. A true non-diabetic would not have
a problem with a few days of junk foods.)

On Thu, 27 May 2004 12:14:05 -0500, Cindy Wells <[email hidden]>
wrote:

Hello Cindy

Quoted message said:

<snip>

You indicate you are eating a lot of fruit (high
fruit sugar)

According to Diabetes Australia ( they have just mailed me a
"Welcome to the Club package"😉 there is no problem
whatsoever with eating fruit, in fact they make strong
reference to the "Sugar Myth", the belief that diabetics
should avoid all sugar at all cost.They say to avoid sugary
snacks that have no nutritional value and may also have high
fat levels, but to follow current healthy eating guidelines.

Quoted message said:

and home-made bread. You really need to follow Jennifer's
advice on testing
- so you can get the portion size to fit your needs.

I am testing Cindy, I did say that I am ignoring my Doctor's
instructions in that regard. If for no other reason than I
am an intensely curious person.

Quoted message said:

How else do you find out if your slice of bread has more
carbs than you can handle?

Because long before this episode I had a very strong
interest in nutrition and can tell you the nutritional
value, carbs, protein, fats, minerals, amino acid breakdown,
etc., etc., of everything that I eat. I started making my
own bread in order to have a product that is more
nutritional than the purchased variety.

Quoted message said:

(Many homemade breads are denser than the American store
bought with ~15 g of carbohydrates per slice. Also, my
experience is that it's hard to slice homemade breads as
thinly as the commercial bakeries do.)

I make rolls, not loaves and have better control that way.

Quoted message said:

2) Your doctor will not have to live with the
complications; you will. How aggressive do you want to
be? High bg levels impair healing so you may take longer
to get back into your previous running shape unless you
get those bgs down as soon as possible.

I have already had a small degree of success and hopefully
can look forward to more.

I had my day in hospital today with an endocrinologist and
he supports my Doctor, not the Diabetes Ed. Nurse. He has
diagnosed me as type 2 but says that I am experiencing
"spikes" and they could confuse some people and make them
believe that I am type 1. He needs further tests etc., to
determine why. I am testing very painstakingly (pun?) on
awakening, before each meal, at 1 & 2 hour intervals after
each meal, plus before and after exercise and before sleep.
I am logging the total carb, fat, protein and type of each
meal I eat. I have cut out coffee ( not that I drank very
much) but am continuing to drink tea.

I have yet to find out more about the spikes that he refers
to and see if I can make sense of them. The only other thing
that was a bit of a shock is that I have high blood pressure
at the moment as well as all the other problems. I have been
borderline hypotensive until now and this is a real
surprise. I am told that this is the main cause of my
headaches, not the high glucose. I appear to have managed to
go from both hypoglycemic and hypotensive to hyperglycemic
and hypertensive, albeit over a space of years for the
hyp**glycemia.

Quoted message said:

Many find their bodies get comfortable with their current
bg levels. Without meds, they find themselves in a plateau
that diet and exercise doesn't break. With meds, they get
to normal levels and then can maintain normal bgs with diet
and exercise alone (no more meds for a while).

Well I will try to avoid meds at all costs. If I can't then
I will have to live with it, but at the moment I will
continue with diet and exercise.

Quoted message said:

3) If you are a late-onset type 1, you may be able to use a
small amount of insulin for several years and lengthen
the time your pancreas still functions.

Quoted message said:

Cindy Wells

Quoted message said:

(Your current doc has forgotten one thing - those with
unhealthy lifestyles who lower bg values with diet and
exercise will have their bg go back up if they ever return
to the old habits. A true non-diabetic would not have a
problem with a few days of junk foods.)

It wasn't a matter of a few days of junk food, it was
several months of hospitalisation and bed rest with all
manner of drugs, many of them NSAIDs, some steroids, plus
synthetic narcotics, all without the ability to exercise.

Regards

David

ps, I will do some Googling on the subject shortly, but can
anyone tell me about spikes?

Alan said:

J David Anderson said:

I am also in Australia. Queensland, on the Gold Coast at
Runaway Bay.

Hi David.

I snipped for brevity, but I did read it all.

You may have missed the point on the referral to the
"test, test, test" system. It is not so much about what
you eat now, but what that is doing to you an hour and two
hours after you eat it. As far as BGs go, it is neither
healthy or unhealthy food, it is simply food that spikes
you - or doesn't.

The nutritional value of that food is a seperate, although
also important, issue.

If you are testing a lot, try using the routine that
Jennifer suggests. You may get some surprises.

On doctors, what do you have to lose by seeing the endo? I
can't say whether your doc or your nurse is right;
personally, I lean towards an impartial umpire. I try to
avoid meds for personal reasons, but I also try to avoid
complications. Get the third opinion. I think you would
profit by closely reading OldAl's advice, particularly
considering your lack of obesity, and Henry's warning;
incidentally, Henry's also from Oz.

I live in Pottsville Beach and I'm going to be shopping
with swmbo in Tweed City tomorrow between 2 and 4 if you
are able to meet for coffee. email direct (see sig) if you
are interested.

I am sorry Allan, I was amusing myself playing doctors and
nurses all day today and didn't see your post in time to
contact you.

I have a friend in Pottsville that I haven't seen for some
time. Dianna Fisher. It is a rather small village down
there, perhaps you know her?

Quoted message said:

Or, if you want to send me your phone number, I'll give
you a call.

I will email you a little later, perhaps we can meet another
time. I am often down as far as Palm Beach, perhaps we could
work something out then, or maybe I should make a day of it
and arrange to visit Dianna, it has been a year or two.

David

J David Anderson said:

On Thu, 27 May 2004 12:14:05 -0500, Cindy Wells
<[email hidden]> wrote:

Hello Cindy

<snip>>

Quoted message said:

I am testing Cindy, I did say that I am ignoring my
Doctor's instructions in that regard. If for no other
reason than I am an intensely curious person.

<snip>

Quoted message said:

I make rolls, not loaves and have better control that
way. <snip>

Here in the U.S. sometimes that is not a help. Muffins and
rolls can be 3-5 times more carbohydrates than a single
slice of bread. (Super-sizing got everywhere around here
so it does influence my judgment.) As to the "sugar
fallacy", in my experience, it isn't a fallacy. All
digestible carbohydrates start breaking down with saliva
so my body doesn't care about the vitamin content until
well after the carbs hit my blood stream and the insulin
response has occurred.

Quoted message said:

Regards

David

ps, I will do some Googling on the subject shortly, but
can anyone tell me about spikes?

I assume the endo was talking about the post-meal peaks. The
time to maximum bg results will vary depending on your
meal's makeup and your digestive system (especially in cases
of gastroparesis). Some meals may peak at 30-45 minutes
after eating. Different people have different limits on what
is an appropriate bg goal after meals (at various times).
10.0 (180 on my meter) is the limit some new diabetics aim
for at 1 hour after a meal. At two hours, everyone should be
below 6.7 (120). Other people use a goal of 7.8 (140) at the
one hour point.

If you have a meal with a lot of fat, sometimes you get good
results at the 1 and 2 hour point but go above 7 (126) after
those two hours of monitoring.

Cindy Wells (whose initial testing routine included a few
extra tests at 30, 45, and 90 minutes just to find where
that peak seemed to be - but I was doing extended testing to
find out if my headaches correlated with bg. I found that I
needed small meals with protein and fats even with higher
fiber carbohydrates; this kept my bg in a specific range
throughout the day - with no peaks or valleys.)

J David Anderson said:

Alan said:

J David Anderson said:

I am also in Australia. Queensland, on the Gold Coast at
Runaway Bay.

Hi David.

I snipped for brevity, but I did read it all.

You may have missed the point on the referral to the
"test, test, test" system. It is not so much about what
you eat now, but what that is doing to you an hour and two
hours after you eat it. As far as BGs go, it is neither
healthy or unhealthy food, it is simply food that spikes
you - or doesn't.

The nutritional value of that food is a seperate, although
also important, issue.

If you are testing a lot, try using the routine that
Jennifer suggests. You may get some surprises.

On doctors, what do you have to lose by seeing the endo? I
can't say whether your doc or your nurse is right;
personally, I lean towards an impartial umpire. I try to
avoid meds for personal reasons, but I also try to avoid
complications. Get the third opinion. I think you would
profit by closely reading OldAl's advice, particularly
considering your lack of obesity, and Henry's warning;
incidentally, Henry's also from Oz.

I live in Pottsville Beach and I'm going to be shopping
with swmbo in Tweed City tomorrow between 2 and 4 if you
are able to meet for coffee. email direct (see sig) if you
are interested.

I am sorry Allan, I was amusing myself playing doctors and
nurses all day today and didn't see your post in time to
contact you.

I have a friend in Pottsville that I haven't seen for some
time. Dianna Fisher. It is a rather small village down
there, perhaps you know her?

Quoted message said:

Or, if you want to send me your phone number, I'll give
you a call.

I will email you a little later, perhaps we can meet
another time. I am often down as far as Palm Beach,
perhaps we could work something out then, or maybe I
should make a day of it and arrange to visit Dianna, it
has been a year or two.

David

Hi David

Sorry - maybe know your friend by sight but not name. Seeing
my periodontist in Bundall on Monday week (7th June) at
10:30 am, possibly see you for coffee or lunch then?

Best to contact me off-list now; I suspect we're boring the
other readers:-)

Cheers, Alan, T2 d&e, Australia. Remove weight and
carbs to email.
--
Everything in Moderation - Except Laughter.

J David Anderson said:

According to Diabetes Australia ( they have just mailed me
a "Welcome to the Club package"😉 there is no problem
whatsoever with eating fruit, in fact they make strong
reference to the "Sugar Myth", the belief that diabetics
should avoid all sugar at all cost.They say to avoid sugary
snacks that have no nutritional value and may also have
high fat levels, but to follow current healthy eating
guidelines.

Hi David

To answer your later question on spikes. The spike is simply
the rise in your BGs after food. What matters is the size of
the spike. You said you are testing a lot now. My early
definition of an unacceptable spike is anything over 8 (145)
at one hour or 6.5 (115) at two hours after eating. Nowadays
I've reduced my personal definition to 7 (125) and 6
(110) respectively.

Another definiton of an unacceptable spike is what you get
at one hour if you follow Diabetes Australia's dieticians
advice on carbohydrates.

Use those tests you are doing to go back to the food that
caused the result and review what you ate to minimise the
spike next time.

Since you seem to be into the heavy analysis bit, check out
Derek Paice's "Diet and Diabetes" at diabetes.about.-diabetes.about.-Open ↗
com/library/mendosagi/DiabetesAndDiet.pdf .

Cheers, Alan, T2 d&e, Australia. Remove weight and
carbs to email.
--
Everything in Moderation - Except Laughter.

"Cindy Wells" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Quoted message said:

I make rolls, not loaves and have better control that
way. <snip>

Here in the U.S. sometimes that is not a help. Muffins and
rolls can be 3-5 times more carbohydrates than a single
slice of bread.

I thought she meant "I make rolls & can control the serving
size better" than with slices (which can be difficult to
make uniform & thin) bj

On Fri, 28 May 2004 13:54:34 -0500, Cindy Wells <[email hidden]>

Quoted message said:

J David Anderson said:

On Thu, 27 May 2004 12:14:05 -0500, Cindy Wells
<[email hidden]> wrote:

Hello Cindy

<snip>>

Quoted message said:

I am testing Cindy, I did say that I am ignoring my
Doctor's instructions in that regard. If for no other
reason than I am an intensely curious person.

<snip>

Quoted message said:

I make rolls, not loaves and have better control that
way. <snip>

Here in the U.S. sometimes that is not a help. Muffins and
rolls can be 3-5 times more carbohydrates than a single
slice of bread.

There is no reason and no logic to a dinner roll containing
more carbs than a similar quantity, by weight, from a loaf
of bread. I sometimes make muffins as well, savory not
sweet; pumpkin or carrot muffins as a rule. I know the exact
carb and calorific values of them as well.

The entire point of my making my own rolls is to know and
control just how much carbohydrate, what type of
carbohydrate, how much sugar, salt and yeast etc., goes into
my food. Plus a nice crusty roll, hot from the oven has much
more appeal than sliced bread.

I was making rolls long before my type2 diagnosis. The
dough, before proving, is divided equally into roll portions
and so there is little variation.

It is not a difficult thing to do nowadays with the wide
variety of auto-breadmakers available. You select your
ingredients, Rye with whole grains for me, set the machine
to dough, not bread, remove the dough when finished, (about
fifty minutes), roll it, divide it, and then, after proving,
refrigerate it and bake for fifteen minutes before each
mealtime. Simple, tasty, and a very accurate record of the
carb intake from that source.

Some years ago, I bought a device called a Sentron Health
Scale. It is similar in shape, and about two thirds the size
of an old fashioned portable typewriter. It has a flat
weighing platform on top and a computer style keyboard in
font. You weigh any type of food and then set the readout to
display weight in ounces or grams, plus Carbs, Calcium,
Calories, Fat, Cholesterol, Poly-Unsaturated fats, Protein,
Fibre, Iron, Sodium etc.

When preparing a meal, you weigh each of the ingredients and
the machine totals them, so that you have an accurate
breakdown of the nutritional value of each meal. After
several years of preparing food using this scale, you find
that your instinctive knowledge of the nutritional knowledge
of food and complete meals is as good or better than most
dieticians. It is a wonderful device, but I became so used
to values of the portions I normally prepare ( I am the cook
in my household) that I seldom need to use the machine. I
will haul it out if I experiment with an entirely new
recipe,although even then I have a pretty good idea of how
it is going to work out.

Quoted message said:

(Super-sizing got everywhere around here so it does
influence my judgment.) As to the "sugar fallacy", in my
experience, it isn't a fallacy. All digestible
carbohydrates start breaking down with saliva so my body
doesn't care about the vitamin content until well after the
carbs hit my blood stream and the insulin response has
occurred.

They don't for one second refute this, they just say the
idea that it is necessary to avoid natural sugars in your
diet is wrong. They do no more damage than other
carbohydrate foods, that the danger in sugar foods or snacks
is in the (usual) high added fat value, not the sugar
itself. That is why eating fruit is ok, no added fat, just
fructose. Chocolate for instance, is high in fat, sweet
cakes, the muffins you mentioned earlier, things like this
could be bad, but fruit is not.

Quoted message said:

Quoted message said:

Regards

David

ps, I will do some Googling on the subject shortly, but
can anyone tell me about spikes?

I assume the endo was talking about the post-meal peaks.

Actually he was referring to periods of time where I tested
much higher than other. Since I first was tested I have had
days where I am very high when testing at the same reference
times, and days where I am only slightly above the max
accepted cut-off points for being diagnosed diabetic.

What he actually said was "you seem to be spiking on some
days but not others, we will have to find out why". I am
logging everything that I eat as well as my readings and
seeing him three times a week for the next week or two.

I have been given test glucose drinks several times aside
from the full OGTT and sometimes I have had readings go
through the roof and other times a much more moderate climb
in levels. These are the "spikes" that concern him. He has
requested a series of tests and biopsies for the pancreas
and adrenal glands, all scheduled for Monday and Tuesday.

Quoted message said:

The time to maximum bg results will vary depending on your
meal's makeup and your digestive system (especially in
cases of gastroparesis). Some meals may peak at 30-45
minutes after eating. Different people have different
limits on what is an appropriate bg goal after meals (at
various times). 10.0 (180 on my meter) is the limit some
new diabetics aim for at 1 hour after a meal. At two hours,
everyone should be below 6.7 (120). Other people use a goal
of 7.8 (140) at the one hour point.

At the moment I am higher at the one hour point and lower at
the two hour point than those figures.

Quoted message said:

If you have a meal with a lot of fat, sometimes you get
good results at the 1 and 2 hour point but go above 7 (126)
after those two hours of monitoring.

I don't eat much fat, I have been eating low fat (low, not
none) for so many years that to eat fatty foods, i.e.,
potato crisps, makes me feel bloated and nauseous. I still
like the taste of potato crisps but after a handful or so I
go right off them. I guess that you can make your body adapt
to almost anything. I used to love fatty foods when younger,
but I was always a skinny person so I guess that it didn't
do me too much damage.

I am testing (for the endocrinologist) before each meal,
then at one hour, then at two hourly intervals until the
next meal. This is only temporary until he gets a handle on
things. He has warned me that further down the track he may
strictly limit my diet to various test foods for a day or
two at a time and have me testing every fifteen minutes. I
can either do it myself or be hospitalised for a week or
two. Fun, fun, fun. I hope that it doesn't come to that. He
at least seems competent and thorough. Thank God for medical
insurance.

Quoted message said:

Cindy Wells (whose initial testing routine included a few
extra tests at 30, 45, and 90 minutes just to find where
that peak seemed to be - but I was doing extended testing
to find out if my headaches correlated with bg. I found
that I needed small meals with protein and fats even with
higher fiber carbohydrates; this kept my bg in a specific
range throughout the day - with no peaks or valleys.)

My endocrinologist has recommended that I go back to eating
five small meals per day rather than three larger ones, but
not yet. I used to do this, I know that it is healthier, but
I stopped because it was inconvenient in several ways. It
also means more finger pricking. Hmmm.

David

Alan said:

Quoted message said:

I have a friend in Pottsville that I haven't seen for some
time. Dianna Fisher. It is a rather small village down
there, perhaps you know her?

Quoted message said:

Or, if you want to send me your phone number, I'll give
you a call.

I will email you a little later, perhaps we can meet
another time. I am often down as far as Palm Beach,
perhaps we could work something out then, or maybe I
should make a day of it and arrange to visit Dianna, it
has been a year or two.

David

Hi David

Sorry - maybe know your friend by sight but not name.
Seeing my periodontist in Bundall on Monday week (7th June)
at 10:30 am, possibly see you for coffee or lunch then?

Best to contact me off-list now; I suspect we're boring the
other readers:-)

No problem Alan, check your email.

Regards

David