Long term commitment

I've been a diabetic for 26 years, I've had every new diet plan foisted upon me like I'm the mouse in a lab..... but for some reason when there is a new insulin I don't hear about it for ages.

So after reading about, and listening to how it's being administered to my friends daughter (see previous post), I ask my doc about it. "Why haven't I heard about this before," I ask? 

"Yes," she replies, "whatever your insulin regime you get when first diagnosed.. well many get sort of stuck with that." Uh, yea. 

Anyway, doc and I decide to try out this new fangled Lantus. I've been using it for 3 days now, and the effects were immediate. I'm taking 14 units (start with 20% less than the total NPH used daily) before bedtime, and then I use Regular or Humalog before meals. While before I was seeing higher readings late in the evening, I'm seeing much better control now, and if I miss a meal, or want to miss a meal, I don't see any rise in my BSL! Cool. 

I'm still dealing with the wackiness that comes whenever you change your insulin regime, but it looks very promising. Lantus supposedly has no peak, i.e. it won't make you crash at 4 in the afternoon. So far, that's just what I'm seeing. 

Please download and use my spreadsheet for keeping track of your own Blood Sugar Levels. Numbers format (Mac) and Excel (Windows).

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Numbers

Wow! I haven't posted since July!? I guess I was so insolent that I just couldn't bother.... or, actually, I was busy with life. Anyway......... some new things of interest in the last couple of months.  A friend's daughter was diagnosed with Type 1 over the holiday season which coincided with my new efforts to get even more control over my diabetes. I also created an Excel and Numbers document to help me (and them) keep track of the Blood Sugar levels, and I offer it to any of you to use free! (Please download them and give me feedback to make these spreadsheets better.)
The first thing I did for my friend was give them a copy of "Dr. Bernstein's Diabetes Solution." Yes, the good doctor can come across as a tad bit full of himself, but good information is good information. When I first read Dr. Bernstein's book in the 90's it literally changed my life. I stopped being afraid of fat and meat and started having the most regular BSL's that I'd ever had. I've been doing well for lo these many years (27 years with Type 1); I've never been hospitalized, nor had any severe complications. I'm no expert, but I do O.K. 

However, I have noticed a regular pattern of up and down, a sort of sine wave, not drastic, but I do want to tame it.

So I created a spreadsheet over the holiday break that will track my daily averages, and display them in a graph on a month by month basis. Please download the Excel template (for PC users), or the Numbers template (Mac users). Use them and send me feedback! (Right now they just graph 

your Blood Sugars, if any of you can incorporate carb data in a way that's useful, please do it and send me a copy of the template). 

Enter your BSL's in the "Dailies" sheet only, do not enter data in the "Monthly Average" sheets, the graphs will form automatically as you enter data on the "Dailies" sheets. It should be pretty self-explanatory. 

A little re-wind here. After I bought the Bernstein book for the friends, I read through some chapters to see what's up in the new edition. I read that NPH, the insulin I've been using for most of my 27 years on insulin is a sort of laughing stock. Bernstein hates it, and the doctor at UCSF here in San Francisco, that my friend has been seeing for his daughter, well, she just shook her head in a 'tsk tsk' fashion... a "them poor fools" kind of pity head shake. Why am I the last one to get the scoop!? Turns out most people (including the newly diagnosed daughter) are on a "long lasting insulin," like Lantus, for the base line dose, and a quick acting insulin, like Humalog, for meals. I've been using NPH mixed with Regular and using Humalog to fight high sugars. Some would say "if it works don't fix it," and I would agree. But that damned sine wave that I spoke of earlier needs to be dealt with. So I've made an appointment with my Kaiser doctor and will be grilling her endlessly on why I'm still using an outdated insulin regime. Stay tuned.

Today's moral: you can't depend on your doctor, no matter how much you like them, to always be on top of your maintenance. YOU are the ultimate manager of your affliction. 

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Just do it.... eat well!

When I was diagnosed, we were still peeing on strips and trying to compare the color to a hue on the side of the bottle. Very ineffective, and sort of like putting the "Dip" sign after you've hit the dip in the road.

"You mean all that delirium and confused rambling wasn't just me? Oh, it was me, just on a hypoglycemic rant... thanks."

But in some ways being diabetic has helped me understand, intimately, what happens when I eat (fill in your favorite food item here). The same thing happens to you normals as well, just not as drastically. Any of us can eat anything, remember that. Some things just have a more deleterious effect on us diabetics than on the normals. The key is figuring out how much of what foods you can handle.

It's simple. Really. Do this at least 2 hours after a meal, and 2 before your next meal.
1. Check your Blood Sugar Level.
2. Eat or drink some item, but only that one item. Use the scale here and measure out a specific amount. A 12 oz. beer, or a single slice of bread, or 6 oz of good chocolate.
3. Check your BSL at intervals of 15 min., 30 min., 1 hour, and 90 min.
4. Note how you feel. Pay close attention to small physical changes.

This will give you a large amount of information about how you react to various edible comestibles. This kind of information can not be had by using the general guidelines from the ADA of even a "qualified" dietitian. They use very general guidelines that cover everybody, but not you specifically.

This brings up another point that I think gets overlooked. Your attitude about food and your relationship to it is as important to your health as anything! I mentioned chocolate above, well actually, I mentioned "good chocolate."

I am blessed to live in San Francisco where I have easy access to really good, fresh produce; meat that comes from animals that were not mistreated or filled with horrible medications, that were allowed to eat grass, or dig for grubs, to live and eat as they are supposed to. I know that not everyone in the this country has that kind of quality around them year-round. I come from the front range, and when I was growing up we didn't have access to such quality food. But even Denver and Colorado Springs has a "Whole Foods" now. More and more of you have access, and shame on you if you are not taking advantage of it. Eating only the highest quality food you can afford actually helps you eat less! When your mouth is happy and truly satisfied, you'll eat less because you'll feel full faster. When you eat slowly and only when seated (not when you're driving or walking down the street) you'll eat less because the message from your stomach will say your full before you've overeaten. Eating food that is made in a lab, or food that is very low on the flavor scale is actually dangerous for you! Eating the highest quality food you can get your hands on is not being a food snoot, your health and survival depend on it. Can you eat chocolate? Absolutely. Can you eat two pounds of cheap waxy Hershey's? Not if you want to live. Can you have 4 to 6 ounces of El Rey or Valrhona? Sure, after you've done the steps above to figure out just how much you really can eat.

If food is where you turn for solace, or reward, or you feel guilty after eating said chocolate.... well, you've got a small problem in your head. If you're diabetic and you have this odd association with food, you've got extra trouble.

Respect yourself, and following that logic, learn to cook. Really. (What else do you have to do? Watch 10 more hours of mindless TV programming?) Respect the animals that died to feed you (don't over cook or otherwise destroy their flesh). Buy organic whenever possible. Eat eggs and chickens from a place where they are allowed to be chickens. Chickens are omnivores, they eat scraps, worms, grains, etc. They should not be kept in a wire cage in a shed! Seriously! How stupid are we? Don't buy eggs and meat from places that can't tell you where they source it from (Safeway, Albertsons, King Soopers, etc.). For some of you this will require some thought and planning, but I bet you that there is someplace nearby that can provide you with quality foodstuffs.


Cordon Bleu, asparagus, a couple slices of bread,
and a Grüner Veltliner! Life is good.
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That sticky coating

It never fails, someone always looks aghast and asks aloud, "how can you eat like that," or "I didn't think you were allowed to eat that." I guess they mean well. They're not bad people, they're just confused. I can't fault them for that, with all the contradictory info that hits the papers and gets forwarded endlessly via email; all the "cleansing" diets ("it'll help push things through and get me all clean"); all the low-fat or no-fat fears based on science that itself is later proven to be shoddy. Who knows anything anymore? All I know is what I've done to myself, not in the name of science, but in the name of self preservation.

I was diagnosed as diabetic (type 1, the real deal!) in Dec. of 1981 at the age of 16. In a week I had lost over 13 lbs off of my 6'4", 165 lb frame, I couldn't stop drinking water, ice tea, anything! I was fatigued beyond belief, had the worst case of "cotton mouth," and when I went to the base hospital (we were military) I had a blood sugar level of 785. I was checked in immediately. At the time it seemed life was over, or at the very least, really confusing. Keeping a diary of everything I ate, translating it into fats, carbs, proteins, practicing how to give myself shots with an orange and a 10 gauge needle (OK, it just seemed like a 10 gauge), and peeing.... christ, every 20 minutes these people would come in and take a load of blood and then ask me to pee into yet another cup! Anyway, you get the picture. If you're a diabetic you really get the picture.

Let's make a long one short, I had a great doctor, and loving friends and family. We managed. I'm not going to go into the details of what I call the "dark ages" of diabetic home care, suffice it to say that things are much better now. Except for the endless misinformation about how and what you should eat, that my friends has gotten worse... much worse.

When people see me eating like a normal human they often wonder if I'm going to kill myself. Well, no, I'm not. The truth is I'm probably healthier than most of these "normal" people and hopefully I can help a few of you get past your fears and confusion with a few practical examples. I'll likely contradict the American Diabetes Association and upset many of you. Just remember, I'm not a doctor and I don't play one on TV. I only tell you what I've done, if it works for you great, if it makes your life a little less rigid, even better!

Welcome to The Insolent Diabetic.

Now go have a beer and some bacon fat!
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