tag:blogger.com,1999:blog-89677818609331323012024-03-18T00:20:41.956+11:00Type 2 Diabetes - A Personal JourneyIdeas based on my personal experiences in learning how to manage type 2 diabetes. I stress that I am a diabetic, not a doctor nor a dietician. I have no medical qualifications beyond my own experience. Nothing written here is intended as medical advice, and any ideas you may decide to use should be discussed first with your doctor.Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.comBlogger135125tag:blogger.com,1999:blog-8967781860933132301.post-24938407686003273302022-02-13T11:43:00.001+11:002022-02-14T22:19:00.978+11:00Chili<div style="text-align: justify;">My slow cooker breakfast chili.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">Makes 10-12 individual serves.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">I developed this recipe over the past year or so and found a one-cup serve did not spike me at breakfast. Of course, it can be eaten at other times of day if you prefer. </div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Ingredients</b> </div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">All are approximate, American equivalents in brackets.</div><div><ul style="text-align: left;"><li style="text-align: justify;">1kg Minced beef (2-3 lbs ground beef)</li><li style="text-align: justify;">One cup chopped celery</li><li style="text-align: justify;">2 large or 3 medium sliced carrots</li><li style="text-align: justify;">1 sliced medium to large onion</li><li style="text-align: justify;">1 can diced tomato</li><li style="text-align: justify;">3 crushed/minced cloves garlic</li><li style="text-align: justify;">1 crushed or grated knob of ginger</li><li style="text-align: justify;">150gm dry weight (4-5 oz) red kidney beans</li><li style="text-align: justify;">2 tbs paprika</li><li style="text-align: justify;">1 tbs cumin seeds</li><li style="text-align: justify;">1 tbs oregano</li><li style="text-align: justify;">1 quill or 1 tsp cinnamon</li><li style="text-align: justify;">1 cup beef stock</li><li style="text-align: justify;">Chili to taste. I use 2 or 3 very hot birds-eye from my garden. Use your favourite.</li></ul></div><div style="text-align: justify;"><b>Method</b></div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">I set this up in the evening and leave it in the slow-cooker on low overnight. It can also be cooked in a large saucepan on the stove or in the oven but you'll have to work out your own timing for those methods.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">At least 8 hours prior put aside the red kidney beans in a couple of cups of water to soak.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">I use a wok for preparation but any large skillet will do. I use olive oil for medium heat frying. Fry the meat in batches, separating any clumps and add to the slow cooker when browned. At this stage the slow cooker is on high.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">Add a little more oil and fry the onion on medium heat until translucent. Add the ginger and garlic and continue stir-frying. As the onion begins caramelising add the carrot and celery. Stir-fry until those are beginning to soften then add the can of diced tomatoes and all the spices and herbs. When the mixture begins bubbling transfer to the slow-cooker and change the temperature to low.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">De-glaze the wok or skillet with the stock (I sometimes finish the de-glaze with a little red wine) and add the liquid to the slow-cooker. Drain the beans and add them to the mix and stir well. If the mix is too dry add a little water but not too much. Put the lid on and leave it on low for six to eight hours.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">I have a one-cup serve for breakfast next morning and store the remainder, after removing the cinnamon quill, in one-cup containers in the freezer.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;"><b>Options</b></div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">I often add other veges in modest portions if I have them in the fridge: capsicum (bell pepper), cabbage, broccoli, cauliflower etc. Similarly I might add some extra herbs from the garden (thyme, mint, parsley, basil) or other spices (nutmeg, turmeric) for some flavour variations. I have not worked out the carb count but this does not spike me after breakfast. The main carbs are from the beans, onion and carrot if you want to cut further.</div><div style="text-align: justify;"><br /></div><div style="text-align: justify;">Cheers, Alan</div><div style="text-align: justify;">Everything in Moderation - Except Laughter</div>Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com1tag:blogger.com,1999:blog-8967781860933132301.post-53870610357640142952021-08-14T10:45:00.001+10:002021-08-14T10:45:38.625+10:00How Many Grams of Carbs Per Day Should I Eat?<p style="text-align: justify;">How many carbs? What are the limits?</p><p style="text-align: justify;">Now that the diabetes world has begun to wake up to the fact that type 2 diabetes is a condition of flawed carbohydrate tolerance I see this question repeatedly on forums and reddit. The time has come to make a brief but clear statement on that subject. </p><p style="text-align: justify;">It is per meal which matters, not per day. Your blood glucose rises and falls after every meal or snack containing carbohydrates. Your blood glucose is not stored up for one big spike at the end of the day. </p><p style="text-align: justify;">My meter used at my peak after eating guided me to these personal per meal limits:</p><p style="text-align: left;"></p><ul><li style="text-align: justify;">Breakfast: <10gms carb</li><li style="text-align: justify;">Lunch: <15gms carb</li><li style="text-align: justify;">Dinner: 40gms+ carb</li><li style="text-align: justify;">Snacks: the same as the previous meal but not more than 15gm.</li></ul><p></p><p style="text-align: justify;">But those are just <i>my</i> personal limits. Every type 2 has slightly different levels of insulin resistance, first phase insulin response, levels of fitness, other health problems, signalling flaws for glycogen release, dietary limitations, the list goes on. Therefore <i>your</i> limits will be different to mine. </p><p style="text-align: justify;">Discover them using this technique <a href="http://loraldiabetes.blogspot.com/2006/11/when-to-test-one-hour-or-two-hour.html">at your peak timing</a> after meals: <a href="http://loraldiabetes.blogspot.com/2006/10/test-review-adjust.html">Test, Review, Adjust</a></p>Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com5tag:blogger.com,1999:blog-8967781860933132301.post-5400582372772271122019-06-14T11:00:00.000+10:002019-06-14T11:09:06.201+10:00How Does Hyperglycemia Cause Damage And What Can We Do To Avoid It?<div style="border: none; padding: 0cm; text-align: justify;">
<span style="font-family: "arial" , sans-serif; font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">I have read many </span></span><span style="font-family: "arial" , sans-serif; font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">research </span></span><span style="font-family: "arial" , sans-serif; font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">papers since my diagnosis seventeen years ago but until very recently I had never seen a research paper specifically addressing in detail the subject of how </span></span><span style="font-family: "arial" , sans-serif; font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">and why </span></span><span style="font-family: "arial" , sans-serif; font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">high blood glucose levels cause harm </span></span><span style="font-family: "arial" , sans-serif; font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">to our bodies</span></span><span style="font-family: "arial" , sans-serif; font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">. It seems to me that understanding that is basic to finding better ways to maintain long term </span></span><span style="font-family: "arial" , sans-serif; font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">diabetes health.</span></span></div>
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<span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">T</span></span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">his report was published </span></span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">in the Warwick UK University News last month: <a href="https://warwick.ac.uk/newsandevents/pressreleases/new_study_sheds?fbclid=IwAR3PuDwGHMzKOb-poxML3Y1gmh_yVTS6xc1XAgSvLLThXXIlO5_NADXQlqw">New study sheds light on how blood vessel damage from high glucose concentrations unfolds</a></span></span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">. </span></span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">The underlying research study can be found here</span></span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">: </span></span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;"><a href="https://www.nature.com/articles/s41598-019-44358-1">Activation of the unfolded protein response in high glucose treated endothelialcells is mediated by methylglyoxal</a>. </span></span></span></div>
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<span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;"><br /></span></span></span></div>
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<span style="font-family: "arial" , sans-serif;"><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">The scientists were interested in discovering the effects of hyperglycemia on </span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">endothelial cells </span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">and how that </span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">contribute</span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">d</span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"> to the development of vascular complications of diabetes. </span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">They were also looking for methods to reduce those effects.</span></span></span></div>
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<span style="font-family: "arial" , sans-serif;"><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">As I am not a biochemist I found the </span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">Warwick report </span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">analysis of</span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"> the paper </span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">more understandable. This is the section I found particularly inter</span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">e</span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">sting</span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;">:</span></span></span></div>
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<span style="font-family: "arial" , sans-serif;"><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><i>Hyperglycemia is the condition in which an individual’s blood glucose is abnormally high and is commonly caused by diabetes.</i></span></span></span></div>
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<span style="font-family: "arial" , sans-serif;"><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><i><br /></i></span></span></span></div>
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<span style="color: #383838;"><span style="font-family: "arial" , sans-serif;"><i>The researchers confirmed that glucose metabolism in endothelial cells is increased in high concentrations of glucose. They showed for the first time that this occurs because an enzyme that metabolises glucose in these cells, called hexokinase-2 (HK2), degrades more slowly in high glucose concentration and thereby metabolises more glucose than normal. Increased glucose metabolism is the driver of metabolic dysfunction of endothelial cells in model hyperglycemia.</i></span></span></div>
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<span style="color: #383838;"><span style="font-family: "arial" , sans-serif;"><i>They were able to correct this effect using a novel dietary supplement previously developed by the research team called a glyoxalase 1 inducer or Glo1 inducer.</i></span></span></div>
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<span style="color: #383838;"><span style="font-family: "arial" , sans-serif;"><i>They also found that the HK2 effect was the major mechanism increasing formation of a reactive glucose-derived substance called methylglyoxal (MG), known to be increased in diabetes and linked to damage to blood cells, kidneys, retina and nerves in arms and legs in diabetes – so-called vascular complication of diabetes.</i></span></span></div>
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<span style="color: #383838;"><span style="font-family: "arial" , sans-serif;"><i>MG binds and modifies proteins, causing them to become misfolded. In this study the researchers identified 222 proteins susceptible to MG modification and this activates a protein quality surveillance system called the unfolded protein response, which removes damaged proteins. When the unfolded protein response is overworked with a high level of misfolded protein substrate it causes an inflammatory response and there is an increased risk of blood clot formation. These processes contribute to blood vessel damage involved in the development of vascular complication of diabetes.</i></span></span></div>
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<span style="color: #222222; font-family: "arial" , sans-serif;">My focus is slightly different. The scientists found a dietary supplement may help; to me that might be useful some time in the future but is much less important than this: “</span><span style="color: #383838; font-family: "arial" , sans-serif;">When the unfolded protein response </span><b style="color: #383838; font-family: Arial, sans-serif;"><i>is overworked</i></b><span style="color: #383838; font-family: "arial" , sans-serif;"> with a high level of misfolded protein substrate it causes an inflammatory response and there is an increased risk of blood clot formation. These processes contribute to blood vessel damage involved in the development of vascular complication of diabetes.</span><span style="color: #222222; font-family: "arial" , sans-serif;">”</span></div>
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<span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">Over the years since I first began using Jennifer’s</span><span style="font-family: "arial" , "helvetica" , sans-serif;"> </span></span><span style="font-family: "arial" , "helvetica" , sans-serif;"><a href="http://loraldiabetes.blogspot.com.au/2009/04/test-test-test.html" style="background-color: white; color: #783f04; text-decoration-line: none;">Test, Test, Test</a><span style="background-color: white;"> </span></span><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">method to modify my menu I have slowly formed the opinion that maintaining peak post-prandial blood glucose levels as close to non-diabetic as I reasonably can is much more important than other tests such as A1c or fasting blood glucose.</span></span></div>
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<span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">I believe this research adds support to my ideas but I emphasise t</span></span><span style="color: #222222; font-family: "arial" , sans-serif;">he following is purely my personal opinion as a long term type 2 diabetic.</span></div>
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<li style="text-align: justify;"><span style="color: #222222; font-family: "arial" , sans-serif;">Our bodies have a natural ability to heal most wounds or damage with time.</span></li>
<li style="text-align: justify;"><span style="color: #222222; font-family: "arial" , sans-serif;">Short term blood glucose spikes above high normal (~8 mmol/l or 140 mg/dl) cause immediate damage. The higher the spike, or the longer it is maintained, the worse the damage. </span></li>
<li style="text-align: justify;"><span style="color: #222222; font-family: "arial" , sans-serif;">I believe that damage can be repaired by our body given sufficient time but repeated frequent hyperglycemia can have a cumulative effect if the damage exceeds the body's ability to repair it in time.The body needs periods of normal blood glucose level to repair past harm. Constantly elevated blood glucose levels, even if only slightly above normal, impair the body's normal healing processes.</span></li>
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<span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">Put those thoughts together and I see a need to concentrate on two separate but allied blood glucose goals:</span></span></div>
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<li><div style="border: none; font-variant-east-asian: normal; font-variant-numeric: normal; margin-bottom: 0cm; padding: 0cm; text-align: justify;">
<span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">I aim to maintain steady blood glucose levels as close as is reasonably possible to non-diabetic. </span></span></div>
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<span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">Avoiding brief blood glucose spikes is wise but nobody is perfect and they will happen. I aim to minimise their frequency and level.</span></span></div>
</li>
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<span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">My personal definition of a non-diabetic range is 4-8mmol/l or 70-140 mg/dl. </span></span></div>
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<span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">In my own experience reducing post-meal spikes also improved my steady levels between meals. For that reason I have concentrated on minimising post-meal spikes as my main treatment goal. I suffer from dawn phenomenon but I do not get too concerned about fasting blood glucose provided it is not too high and peak post-prandial results are good; to me fasting blood glucose is a diagnostic indicator rather than a management tool.</span></span></div>
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<span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">Provided my levels between blood glucose spikes are good I don't get too excited when occasional spikes occur. Instead I try to learn from them and discover the cause and try not to repeat them.</span></span></div>
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<span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">I practise what I preach. My doctor's report has changed very little since I wrote this in 2015</span></span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #222222;"><span style="font-family: "arial" , sans-serif;">: </span></span></span><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #0079d3;"><span style="text-decoration-line: none;"><span style="font-family: "arial" , sans-serif;"><a href="http://loraldiabetes.blogspot.com.au/2015/05/are-diabetes-complications-inevitable.html">Are Diabetes Complications Inevitable? Not necessarily...</a></span></span></span></span><br />
<span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #0079d3;"><span style="text-decoration-line: none;"><br /></span></span></span>
<span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: #0079d3;"><span style="font-family: Arial, Helvetica, sans-serif; text-decoration-line: none;"><span style="background-color: white; color: black; text-align: start;">Cheers, Alan, T2, Australia.</span><br style="background-color: white; color: black; text-align: start;" /><br style="background-color: white; color: black; text-align: start;" /><span style="background-color: white; color: black; text-align: start;">Everything in Moderation - Except Laughter </span><br style="background-color: white; color: black; text-align: start;" /><span style="background-color: white; color: black; text-align: start;">There Is Nothing I Could Eat I like More Than my Eyes</span></span></span></span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com9tag:blogger.com,1999:blog-8967781860933132301.post-14854665013477075192018-01-18T09:26:00.000+11:002018-01-18T09:26:04.020+11:00Slow Cooked Beef Brisket<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">I bought my first
slow cooker a few weeks ago. In the past I used stove-top large
saucepans for slow cooking and braising. The method worked but needed
regular stirring to prevent sticking. When a post-Christmas special
appeared for a very cheap large slow cooker I decided to give it a
try.</span></div>
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<span style="font-family: Georgia, Times New Roman, serif;">I wish I’d bought
one years ago! I have experimented a few times now. I prepare the
veges and meat after breakfast, toss them and some stock and liquids
in the cooker and lift the lid eight or nine hours later for a
delicious dinner.
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<span style="font-family: Georgia, Times New Roman, serif;">This is my favourite
of the recipes I have tried so far. It didn’t occur to me to take
pictures last night; I will add them next time I cook it.</span></div>
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<b><span style="font-family: Georgia, Times New Roman, serif;">Beef Brisket</span></b></div>
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<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: Georgia, Times New Roman, serif;">Ingredients</span></b></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Portion sizes, herbs
etc are flexible. Adjust to suit your own taste.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
</div>
<ul>
<li>1-1.5Kg (2-3lbs)
beef brisket or any similar cut. I prefer a piece at least 2-3cm (1”)
thick and roughly rectangular which fits comfortably in the cooker.</li>
<li>1 large or 2 medium onions,
sliced.</li>
<li>1 large or 2 medium carrots.</li>
<li>1 cup chopped celery</li>
<li>Chopped herbs to
taste. I used parsley, thyme, rosemary and mint from my garden.</li>
<li>2 or 3 bay leaves.</li>
<li>1 teaspoon mild
paprika.</li>
<li>1 cup red wine.</li>
<li>1 can (400gm, ~1lb)
chopped tomato.</li>
<li>1-2 cups beef stock (or
pork or chicken; I make my own from bones and herbs).</li>
<li>2 cloves garlic.</li>
<li>Salt and pepper.</li>
</ul>
<br />
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Optional: 3-5cm (1½
“- 2”) chunks of potato.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: Georgia, Times New Roman, serif;">Method</span></b></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<b><span style="font-family: Georgia, Times New Roman, serif;"><br /></span></b></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Serves 4 or more depending on appetites and portion sizes.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Slice the carrots
lengthways, cut them into rough chunks and place them on the floor of
the cooker to become a base for the meat.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Roughly trim
excessive fat from the beef. Leave some on for flavour. Lightly salt both sides of the meat and place it in the slow cooker. Grate some pepper over the meat to taste.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Fry the onions in
oil in a skillet until soft, add the chopped celery and minced garlic
and continue frying until the onions are starting to brown then
transfer the cooked veges to the slow cooker.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Deglaze the skillet
with the cup of wine and add the liquid to the cooker. Add the paprika, chopped tomato and stock. Stir to mix the liquids and settle the meat
among the veges. If necessary add water sufficient to come just level
with the meat.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Cook on low for 8
or more hours (my cheap cooker has only three heat settings: low, high, keep warm). As my spouse likes potatoes I added some chunks into
the liquid around the meat at the 4 hour mark. Possibly those could
be included at the start.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><b>Serving. </b>
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Gently remove the
meat from the cooker, trying not to remove too much attached liquid and veges
as you transfer it to a cutting board.
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Using a slotted
spoon remove the carrots (and potato if added) from the sauce and
transfer them to a serving dish. Don’t get too fussy if some liquid
and other ingredients stick to the carrots or potato.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Remove the bay leaves and blend the remaining
liquid and contents with a stick blender to become a smooth sauce. Use a potato masher if you don't have a stick blender. It doesn't have to be perfect.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Carve the meat across the grain into
roughly 6mm (1/4”) slices and transfer to a serving dish. Pour the
sauce liberally over the meat.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br />
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Diners serve
themselves from the dishes.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">I have not worked
out the carbs, fat etc but the main carbs are in the onions,
carrot and potato if added. This did not even cause a blip in my 1hr
post-meal blood glucose test.</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;">Bon Appetit</span></div>
<div style="line-height: 100%; margin-bottom: 0cm; text-align: justify;">
<span style="font-family: Georgia, Times New Roman, serif;"><br /></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: Georgia, Times New Roman, serif;"><span style="font-size: 12pt;"><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: black;">Cheers,
Alan, T2, Australia.</span></span><br />
<span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: black;">Everything
in Moderation - Except Laughter</span></span> </span>
</span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-size: 12pt;"><span style="font-variant-east-asian: normal; font-variant-numeric: normal;"><span style="color: black; font-family: Georgia, Times New Roman, serif;">There is Nothing I Could Eat I like More Than my Eyes</span></span></span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com2tag:blogger.com,1999:blog-8967781860933132301.post-4015311694355309232016-10-22T10:08:00.000+11:002016-10-22T10:08:36.715+11:00What is a Balanced Diet For a Type 2 Diabetic?<div style="text-align: justify;">
</div>
<div class="content">
This question came up on one of the forums I am on recently. There were many conflicting responses, often including discussion about various macronutrients (fat, protein, carbohydrates) and micronutrients (minerals, vitamins etc), the evils of sugar, cholesterol and saturated fats, the need for lots of fruit or grains etc etc. A lot of people also went into great detail about maximum and minimum percentages for fats, carbs and protein.<br />
<br />
I believe in KISS, so I try to keep it simple with easy to follow rules for my way of eating. As I have to eat this way for the rest of my life I do not want an excessively complicated food selection system.<br />
<br />
My definition of a balanced diet for a type 2 diabetic (me) is pretty basic and not in terms of percentages of
anything. The basic description is simple, although the personal investigation
creating the way of eating I follow today was fairly complex. The links at the foot of this post describe the journey to this point. <br />
<br />
The simple version:<br />
<ul>
<li><a href="http://loraldiabetes.blogspot.com.au/2006/10/test-review-adjust.html" target="_self">I let my meter show me my carbohydrate limits</a> for the time of day and the meal.</li>
<li>I let common sense and satiety limit my protein and fat portions.</li>
<li>I include a reasonably wide variety of vegetables in my menu, favouring fresh and seasonal vegetables where possible.</li>
<li>I also include fruits but those are limited to minimise blood glucose spikes.</li>
</ul>
<br />
In applying those basic rules for myself I also take these factors into account:<br />
<ul>
<li>Variety in choices of meats, fish, seafood, dairy, vegetables and
fruits makes the menu interesting and also improves the chances of
getting all needed vitamins and micronutrients.</li>
<li>Excess of any macronutrient is not wise.</li>
<li>Excessive restriction of any macronutrient is just as unwise.</li>
</ul>
These links to past posts expand on those points and others:
<br />
<ul>
<li><a href="http://loraldiabetes.blogspot.com/2009/09/food-farmers-and-factories.html" target="_blank">Food, Farmers and Factories</a></li>
<li><a href="http://loraldiabetes.blogspot.com.au/2006/10/test-review-adjust.html">Test, Review, Adjust</a> </li>
<li><a href="http://loraldiabetes.blogspot.com/2009/04/i-wrote-about-the-diabetes-diet-wars.html" target="_blank">Are Carbs Really Necessary?</a></li>
<li><a href="http://loraldiabetes.blogspot.com/2006/11/vegetables.html" target="_blank">Vegetables</a></li>
<li><a href="http://loraldiabetes.blogspot.com/2008/06/grazing.html" target="_blank">Grazing</a></li>
<li><a href="http://loraldiabetes.blogspot.com/2007/03/red-red-wine.html" target="_blank">Red, Red Wine</a></li>
<li><a href="http://loraldiabetes.blogspot.com/2006/11/yoghurt.html" target="_blank">Yoghurt</a></li>
<li><a href="http://loraldiabetes.blogspot.com/2008/10/on-various-forums-i-visit-one-of-most.html" target="_blank">Eggs, Carbs and Cholesterol</a></li>
<li><a href="http://loraldiabetes.blogspot.com/2007/10/cinnamon-spices-herbs-and-similar.html" target="_blank">Cinnamon, Spices, Herbs and Similar</a></li>
<li><a href="http://loraldiabetes.blogspot.com.au/2006/10/food-and-recipes.html">Food and Recipes</a> </li>
</ul>
</div>
<br />
<div style="text-align: justify;">
</div>
<div class="content">
Cheers, Alan, T2, Australia.<br />
<br />
Everything in Moderation - Except Laughter <br />
There Is Nothing I Could Eat I like More Than my Eyes</div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com6tag:blogger.com,1999:blog-8967781860933132301.post-60384319257309388972015-12-12T11:01:00.000+11:002015-12-12T11:14:56.395+11:00Small New York Baked Low Carb Cheesecake<div style="font-family: inherit; text-align: justify;">
<br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: medium;"><a href="http://3.bp.blogspot.com/-jhA_BMJV-08/Vmtd5LlkkOI/AAAAAAAAKhc/bCz3lBvuyVc/s1600/DSCF6931.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="265" src="http://3.bp.blogspot.com/-jhA_BMJV-08/Vmtd5LlkkOI/AAAAAAAAKhc/bCz3lBvuyVc/s400/DSCF6931.JPG" width="400" /></a></span></div>
<br />
<br />
<span style="font-size: large;">I posted the recipe for a delicious </span><span style="font-size: large;"><b><a href="http://loraldiabetes.blogspot.com.au/2012/08/new-york-baked-low-carb-cheesecake.html">Large New York Baked Low Carb Cheesecake</a></b> based on one posted by Angie, Granny Red, on the ADA forum a couple of years ago. It is a rather big cheesecake which I cut into 16 portions of 6gms carb each. </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Since then I have experimented several times with a reduced size because I found the large cake was too big for our needs. This is the recipe for those who prefer a smaller cake. The size reduction not only cuts the cost in half but is a little easier to prepare and needs less cooking time. The slight increase in egg proportions also tends to make a creamier texture.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I have modified the Splenda and sugar proportions as a reasonable compromise between my wife's sweet tooth and my need to keep the carbs down. Feel free to adjust that to suit yourself as the carb count will be directly reduced as you reduce the sugar. The nutrition count is based on the listed details.<b> </b></span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b>Ingredients</b></span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b>Crust</b> </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">1 cup almond flour or meal</span>
</div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">2 tablespoons(tbsp) Splenda</span><br />
<span style="font-size: large;">1 </span><span style="font-size: large;">tbsp sugar</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">4 tbsp butter, melted<b> </b></span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b>Filling</b> </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">12 oz (375gm)
cream cheese</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">1/3 cup Splenda</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">2 tbsp
sugar</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">2 eggs</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">1 teaspoon(tsp) vanilla extract </span>
</div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">1/2 tsp lemon extract or
a good squeeze of lemon; orange can be substituted as a variation.</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">8 oz (300ml) sour
cream</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Note: the eggs,
cheese and sour cream need to be at room temperature. If the cheese
is too stiff to beat easily, sit the containers in warm water for a
little while until the cheese softens.<b> </b></span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b>Method</b></span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b>Crust Base</b> </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Use extra butter to
grease an 8 or 9 inch (20-25cm) spring-form pan. I also put a circle
of greased brown paper on the bottom to be certain the cake does not
stick; this step may not be necessary if you use a non-stick pan. </span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;">Mix the splenda and
almond flour (sometimes I make my own coarse version from almonds in
the blender; it works just as well) with melted butter, press evenly
onto the bottom of the pan for a thin layer without holes and press
any excess up the sides of the pan. If you don't have enough almond
flour to go all the way up the sides don't worry; it's not really critical as long as the base
is covered. Set the pan aside while mixing the
filling.<b> </b></span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b>Filling</b> </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Beat the cream cheese
until light and creamy, keeping the mixer on a low-medium setting
throughout the beating and mixing process. Add the mixed splenda and
sugar a little at a time and continue beating until creamy.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Add one egg at a time
and beat briefly after each egg. When the eggs have been mixed
into the cream cheese add vanilla and lemon extract (or lemon juice)
and mix briefly until just combined. Add the sour cream last and beat
briefly until fully incorporated.<b> </b></span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b>Baking</b> </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Pour the mixture into
the springform pan. Bake at 300 F or 150C for about 40 minutes then
check to see if it is set and starting to brown slightly on top. If not, let it cook for
another 15 minutes. Try not to over-cook it as it may become too dry. When it is set and beginning to brown turn
off the heat, prop open the oven door slightly and leave it in the oven for at least an hour. </span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Remove it from the oven and allow it to cool in the spring-form pan to room temperature
before placing it in the fridge until the next day. Don't try to serve it
on the day of cooking; it will not be set properly if you do. Do not be
disappointed if it sinks slightly in the middle. That is normal, or, at
least, it was for the ones I made.</span></div>
<div style="font-family: inherit; text-align: justify;">
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">The result is 8-12 satisfying slices. I individually wrap some in clingwrap for the freezer; they freeze and defrost well.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">
</span>
<br />
<table border="0" cellspacing="0">
<colgroup width="176"></colgroup>
<colgroup span="3" width="107"></colgroup>
<tbody>
<tr>
<td align="left" height="29"><b><span style="font-family: "liberation" serif; font-size: small;">Nutrition</span></b></td>
<td align="center"><b>per serve:</b></td>
<td align="center"><b>8</b></td>
<td align="center"><b>12</b></td>
</tr>
<tr>
<td align="left" height="21">Kcals</td>
<td align="center">3000</td>
<td align="center">375</td>
<td align="center">250</td>
</tr>
<tr>
<td align="left" height="21">Fat</td>
<td align="center">275</td>
<td align="center">34.4</td>
<td align="center">22.9</td>
</tr>
<tr>
<td align="left" height="21">Carb</td>
<td align="center">100</td>
<td align="center">12.5</td>
<td align="center">8.3</td>
</tr>
<tr>
<td align="left" height="21">Fibre</td>
<td align="center">12</td>
<td align="center">1.5</td>
<td align="center">1.0</td>
</tr>
<tr>
<td align="left" height="21">Protein</td>
<td align="center">62</td>
<td align="center">7.8</td>
<td align="center">5.2</td><td align="center"></td><td align="center"></td><td align="center"></td><td align="center"></td><td align="center"></td><td align="center"></td><td align="center"></td>
</tr>
</tbody></table>
</div>
<br />
<span style="font-size: large;">Bon appetit, Alan, T2, Australia.<br />Everything in Moderation - Except Laughter </span>Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com11tag:blogger.com,1999:blog-8967781860933132301.post-91226438882483414432015-09-21T09:08:00.002+10:002015-09-21T09:12:05.670+10:00Fat: The New Health Paradigm<div style="text-align: justify;">
<span style="font-size: large;">I have just read the opening summary of a startling document published by the Credit Suisse Research Institute.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b><a href="https://doc.research-and-analytics.csfb.com/docView?language=ENG&source=ulg&format=PDF&document_id=1053247551&serialid=MFT6JQWS%2b4FvvuMDBUQ7v9g4cGa84%2fgpv8mURvaRWdQ%3d" target="_blank">Fat: The New Health Paradigm</a></b></span><span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">I predict that this publication is going to become one of the most hotly debated documents in the fat vs carbs diet wars this year. The conclusions the authors arrive at are summarised very succinctly on the opening pages.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Their conclusions will not surprise many in the on-line diabetes community as most of us have been saying this for years (for example </span><span style="font-size: large;"><a href="http://loraldiabetes.blogspot.com/2008/10/on-various-forums-i-visit-one-of-most.html">Eggs, Carbs and Cholesterol</a>, </span><span style="font-size: large;"><a href="http://loraldiabetes.blogspot.com/2009/10/cholesterol-fats-carbs-statins-and.html">Cholesterol, Fats, Carbs, Statins and Exercise</a>) but they will cause consternation in many of the world's respected dietetic and diabetes authorities. This is not a journalist's article or a book by an organisation with an agenda or a diet to sell; it is a very well researched and supported scientific paper. </span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Below are abbreviated selections from the summary; these statements are well supported in the body of the document which I am still in the process of studying. I decided to post early to alert readers to the document and allow others to read it in full.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><i>••<br />Triangulating several topics such as anthropology, breast feeding, evolution of primates, height trends in the human population, or energy needs of our various vital organs, we have concluded that natural fat consumption is lower than “ideal” and if anything could increase safely well beyond current levels.<br />••<br />Saturated fat has not been a driver of obesity: fat does not make you fat. At current levels of consumption the most likely culprit behind growing obesity level of the world population is carbohydrates.</i></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><i>••<br />A proper review of the so called “fat paradoxes” (France, Israel and Japan) suggests that saturated fats are actually healthy and omega-6 fats, at current levels of consumption in the developed world, are not necessarily so.<br />••<br />The big concern regarding eating cholesterol-rich foods (e.g. eggs) is completely without foundation. There is basically no link between the cholesterol we eat and the level of cholesterol in our blood.</i></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><i>••<br />Doctors and patients’ focus on “bad” and “good” cholesterol is superficial at best and most likely misleading. The most mentioned factors that doctors use to assess the risk of CVDs—total blood cholesterol (TC) and LDL cholesterol (the “bad” cholesterol)—are poor indicators of CVD risk. In women in particular, TC has zero predictive value if we look at all causes of death. Low blood cholesterol in men could be as bad as very high cholesterol. The best indicators are the size of LDL particles (pattern A or B) and the ratio of TG (triglycerides) to HDL (the “good” cholesterol).</i></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><i>••<br />Based on medical and our own research we can conclude that the intake of saturated fat (butter, palm and coconut oil and lard) poses no risk to our health and particularly to the heart. </i></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><i>••<br />The main factor behind a high level of saturated fats in our blood is actually carbohydrates, not the amount of saturated fat we eat. Clinical trials show that a low carbohydrate diet is much more effective in lowering the level of saturated fat in our blood than a low-fat diet.</i></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
<span style="font-family: inherit;"><span style="font-size: large;">Cheers, Alan, T2, Australia.</span></span><br />
<br />
<span style="font-family: inherit;"><span style="font-size: large;">Everything in Moderation - Except Laughter
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<br /></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com9tag:blogger.com,1999:blog-8967781860933132301.post-64997197561790691612015-09-18T08:34:00.000+10:002015-09-18T08:34:52.472+10:00I Think I May Have Diabetes...<div style="text-align: justify;">
</div>
<div style="text-align: justify;">
<span style="font-size: large;"><i>"I think I may have diabetes....and I don't want to die..."</i></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">The wording varies but I see this question with increasing
frequency on all the forums I read. </span><span style="font-size: large;">I have written replies to these posts so often I felt it was time to archive a standard response. </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">The web is a wonderful source of
information but too often people who really should be asking
questions like this of their doctor are asking strangers on the net. </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">My usual answer is very brief and says exactly that: <b>see your
doctor.</b> I highlighted that because it needs to be emphasised.</span><br />
<br />
<span style="font-size: large;">Unfortunately that isn't always immediately possible for everyone.
There can be many reasons for that. The most common excuses are lack of money, lack of availability of medical support or
simply fear of hearing bad news. </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">For those with an urgent need and obvious hypo or hyper symptoms or who have tested repeatedly high on a glucometer the suggestion changes from "see your doctor soon" to "get to an ER (emergency room) fast". </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">For others unable to see their doctor soon I urge them to at least
make the appointment. Do what is necessary to find the money or
time or courage but not seeing the doctor can turn out to be much
more expensive in the long term. </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Another variant has appeared recently. Some doctors appear
hesitant to diagnose if A1c is OK but fasting or casual blood glucose
are just over diagnostic thresholds even when the patient has some
symptoms. Too many doctors appear to have forgotten that A1c was only
recently approved as a diagnostic tool because the patient can be
diabetic </span><span style="font-size: large;"><span style="font-size: large;"> if other indicators are high </span>despite a normal A1c. I see an
increasing number of posts from people in those circumstances who
were told they are “borderline” - whatever that means - or “you
are not diabetic yet, just eat healthy and exercise and you'll be
fine” without a meter or other advice being prescribed.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">At this point I will remind readers: I am a diabetic, not a doctor, and
only a doctor can diagnose diabetes.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">What follows are suggestions for people whose situation is not urgent, who have a long wait to see
their doctor or who have seen their doctor but are still unsure. </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b>Part 1. Discovery</b></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Obtain a home blood glucose test meter and an adequate supply of
test strips. How you do that will vary depending on your local health
support system. In the US cheap meters and strips are available from
several sources<b>;</b> Walmart's <a href="http://www.walmart.com/ip/ReliOn-Prime-Blood-Glucose-Monitoring-System-Blue/20752266" target="_blank"><b>Relion Prime</b></a> was one of the first cheap meters but you may find others if you search. Note that the cost of test strips will be more important than the cost of the meter in the long term. In Australia you will have to pay full
price until you are officially diagnosed, but check with the chemist
because there are often discount specials.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">When you get your meter read this (click on it): <a href="http://loraldiabetes.blogspot.com.au/2006/10/painless-pricks.html"><b>Painless
Pricks</b>.</a></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"> </span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Test four times a day for two or three days: immediately on waking
(fasting) and one hour after your last bite of breakfast, lunch and
dinner. The results you are hoping for are as follows:</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<ul style="text-align: justify;">
<li>
<span style="font-size: large;">Fasting: 4 to 5.5 mmol/l (Australia, Canada, UK or other
millimole countries) or 70 to 99 mg/dl (USA and other milligrams
countries).</span><br />
</li>
<li>
<span style="font-size: large;">Post-meal: 4 to 8mmol/l or 70 to 140mg/dl.</span><br />
</li>
</ul>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">If all your tests are inside those ranges, relax. Diabetes is most
unlikely to be your problem. Don't throw your meter away because it may be wise to occasionally test in future years to see if anything has changed. In that case be aware that test strips have an expiry date.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">If any of your results are outside those ranges immediately wash
your hands and re-test. If, after re-testing, it is still out of
range just record it the first time. If a second test at another time is out of range
make an appointment with the doctor for qualified diagnostic testing. </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><b>Part 2. Action.</b></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">If your tests were outside the ranges read this while you wait for
your appointment with the doctor:<b> <a href="http://loraldiabetes.blogspot.com.au/2006/10/d-day.html">Getting
Started</a></b></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">For those unable to obtain a meter, this may help while waiting to
see the doctor: <b><a href="http://loraldiabetes.blogspot.com/2008/05/what-to-eat-until-you-get-your-meter.html">What
to Eat at First</a></b></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">Cheers, Alan, T2, Australia.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br />
Everything in Moderation - Except Laughter </span></div>
<div style="text-align: justify;">
<span style="font-size: large;">There is nothing I could eat I like more than my eyes</span><span style="font-size: large;"><br /></span>
</div>
<span style="font-size: large;">
</span>Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com4tag:blogger.com,1999:blog-8967781860933132301.post-70687138300998970362015-08-01T11:24:00.002+10:002022-03-09T17:13:53.593+11:00Blood Glucose Targets 2015<div align="justify">
Several years ago I investigated the different
targets suggested by three major respected US diabetes authorities.
As a result I wrote this: <a href="http://loraldiabetes.blogspot.com/2006/12/hi-all-one-of-things-that-becomes.html"><b>Blood
Glucose Targets.</b></a> My 2006 summary included this comparison
table:</div>
<div align="justify">
<br /></div>
<div align="justify">
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" width="461" />
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Over the years those have changed very little. The
2015 comparison noting significant changes in bold is:
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<img align="left" height="235" name="Object2" 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Sources: <a href="http://clinical.diabetesjournals.org/content/33/2/97.full.pdf" rel="nofollow" target="_self"><b>ADA</b></a>, <b><a href="https://www.joslin.org/info/Goals-for-Blood-Glucose-Control.html">Joslin</a> (up-dated 2018)</b>, <b><a href="https://www.aace.com/disease-state-resources/diabetes/depth-information/type-2-diabetes-glucose-management-goals">AACE</a><span style="color: black;">. </span></b></div>
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The ADA and Joslin now agree on the looser 2hr
post-prandial target of 180(10) and both have also lowered the
threshold for fasting. The AACE guidelines are unchanged. If you read
the details on the linked pages all add caveats concerning relaxation
of targets in case of other medical conditions, age etc.</div>
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Thirteen years after diagnosis, thankfully still
<a href="http://loraldiabetes.blogspot.com.au/2015/05/are-diabetes-complications-inevitable.html"><b>free
of complications</b></a>, I see no reason to significantly change my
closing remarks originally written nearly ten years ago.</div>
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<span style="color: black;">The AACE advise much tighter
post-prandial targets. I doubt that anyone would consider the
</span><a href="https://www.aace.com/" target="_blank"><b>American Association of Clinical Endocrinologists</b></a>, a
professional community of several thousand physicians specializing in
endocrinology, diabetes, and metabolism <span style="color: black;">as a
bunch of fanatical radicals. Nor would they be promulgating
guidelines impossible to be attained by the majority.
</span><span style="color: #3333ff;"><br />
<br />
</span><span style="color: black;">Unfortunately,
nobody but pro-active type 2 diabetics talks much about 1hr PP
targets. My personal logic is that I treat their 2hr as my
recommended max peak for any post-prandial, as I discussed in </span><b><a href="http://loraldiabetes.blogspot.com/2006/11/when-to-test-one-hour-or-two-hour.html">When To Test?</a></b><span style="color: black;"> Those AACE
guidelines then agree very closely with Jennifer's </span><b><a href="http://loraldiabetes.blogspot.com.au/2009/04/test-test-test.html">Test, Test, Test</a></b><span style="color: black;"> advice.</span><span style="color: #3333ff;">
</span><span style="color: black;">Make
your own judgment on which of those guidelines you think will lead to
fewer complications.</span></div>
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<span style="color: black;">Sadly, it appears that only
</span><span style="color: black;"><b><a href="http://www.webmd.com/diabetes/news/20150730/just-1-in-3-seniors-with-diabetes-has-disease-under-control?src=RSS_PUBLIC" target="_blank">1/3 of senior diabetics</a> </b></span><span style="color: black;">are
achieving even the loose ADA targets, but that is a discussion for
another topic.</span></div>
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<br /></div>
<div style="line-height: 100%; margin-bottom: 0cm;">
Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter
</div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com14tag:blogger.com,1999:blog-8967781860933132301.post-59903473335462950272015-06-15T09:38:00.000+10:002015-08-25T09:47:58.870+10:00Comments AllowedI was a little disappointed to notice the lack of comments over the past year or so.<br />
<br />
Recently a friend informed me she tried to comment and was blocked.<br />
<br />
I had not checked my blog settings for years, as I didn't see a need to change them. I was surprised to find Google had changed my settings without my knowledge and comments were now restricted.<br />
<br />
I have changed them back. I welcome comments from anyone, anonymous or named. My only restriction is to moderate them before publishing.<br />
<br />
Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except LaughterAlanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com9tag:blogger.com,1999:blog-8967781860933132301.post-85831322362370299582015-05-01T14:19:00.000+10:002015-05-01T14:24:05.207+10:00Are Diabetes Complications Inevitable? Not necessarily...<!--[if gte mso 9]><xml>
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<span style="font-size: large;">This is a very personal post, reporting on my own recent
reports on three aspects of my health: my eyes, my heart and my other affliction,
leukaemia.</span><br />
<br />
<span style="font-size: large;">I am writing this partly to celebrate but also to
motivate any newly diagnosed type 2 diabetics</span><span style="font-size: large;"><span style="font-size: large;">, shocked
and scared,</span> who have been warned by their doctors of the inevitability of
their diabetes progressing to complications. I suppose some doctors feel they need to do that to scare new people into making lifestyle changes, but too often I find dire predictions of long term complications or heart attacks lead to loss of hope. That can lead to a 'why bother' mentality. </span></div>
<div class="MsoNormal" style="text-align: justify;">
<br />
<span style="font-size: large;">Please, do not give up. I know managing type 2 diabetes can be bloody inconvenient. You will have to make some annoying changes to your life such as pricking holes in yourself, adding some activity to your day, forever watching what you eat and drink and possibly taking meds and insulin. </span><br />
<br />
<span style="font-size: large;">Let me assure you: taking control of your blood glucose levels is worth the trouble. I am just one example of many I read on the better diabetes forums where pro-active type 2s are learning how to take control. </span><br />
<br />
<span style="font-size: large;">Possibly my continuing story will give you hope.</span><br />
<br />
<span style="font-size: large;">I was first diagnosed with <a href="http://loraldiabetes.blogspot.com.au/2008/11/turning-points.html" target="_blank"><b>leukaemia and type 2 diabetes</b></a> in 2002
at the age of 55. I discovered early I could do nothing at all about the
leukaemia; for that reason I concentrated on beating the diabetes. I was thirsty for knowledge. For the
first couple of years I spent a lot of time learning from many wise people, mostly on usenet. Some
were medical professionals but most were experienced diabetics. I learned
something from all of them, even if the main thing I learned was how to tell
good advice from bad because, unfortunately, a lot of it was bad. I still
believe the best advice was Jennifer’s <b><a href="http://loraldiabetes.blogspot.com.au/2009/04/test-test-test.html">Test, Test, Test</a></b>: “Use your body as a science experiment.” </span><br />
<br />
<span style="font-size: large;">I tested and experimented to find what worked for me. On usenet over the next couple of years I gradually changed from reader and student to lay advisor, </span><span style="font-size: large;">passing on information based on my experience. In 2004 I joined some online forums. In 2006 I started this blog. </span><br />
<br />
<span style="font-size: large;">Eventually I wrote a
book based on my experience to help any newly diagnosed people who might not be computer-savvy. Of course, as my suggestions for good type 2 management
differ significantly from the mainstream there will always be critics. In part this is a response to the critics, describing the results of practising what I
preached for the past decade.</span><span style="font-size: large;"></span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><b>Motivation</b></span></div>
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<span style="font-size: large;">We each must find our own motivation for maintaining the discipline. For me, it is my sight. Since the day I first learned about the possible
complications of diabetes my over-riding motivation has been my vision. I came
to accept the possibility of death and I certainly don't want to lose limbs from
neuropathy or kidneys from nephropathy, but the thought of living in darkness
scared me silly. I have tremendous respect and admiration for vision-impaired people
who successfully live with that daily. But I do not want to join them. I am a
reader of books, an appreciator of beauty, a user of computers and above all I want to see my
grand-daughter’s joy as she grows and learns.</span></div>
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<span style="font-size: large;">The tests used by doctors to monitor our diabetes such as HbA1c, fasting blood
glucose and post-prandial blood glucose are all important but they are really
only surface indicators. I use those indicators to set my goals, but they don't directly alert me to dying nerves or optic cells. The acid test is whether complications eventually appear as the years pass. </span><br />
<br />
<span style="font-size: large;"><b>Limbs and Kidneys</b></span></div>
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<span style="font-size: large;">So far neither blood tests nor physical symptoms, including filament tests by my podiatrist, have
indicated any signs of neuropathy or nephropathy. I am hopeful that will continue.</span><br />
<br />
<span style="font-size: large;"><b>Eyes</b></span></div>
<br />
<div style="text-align: justify;">
<span style="font-size: large;">I had some good news last month. It is
over thirteen years since diagnosis and I had not seen the ophthalmologist since
2010. I had a good report then after a scare in 2006 when he discovered minor
scars from healed retinopathy. The scars had disappeared by then. This recent visit was
almost identical to that 2010 consultation.</span></div>
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<span style="font-size: large;">The waiting room was packed. After various eyesight checks on
new strange machines by the assistant, then the anaesthetic drops, followed by
the dilation drops, then another wait, then more tests on machines, I eventually
saw the ophthalmologist. He did a very thorough inspection. He warned me that
as I age (I am now 68) I may start developing cataracts but at this stage I
had no problems apart from inevitably getting older. I wanted reassurance so I asked
specifically about retinopathy, macular degeneration and glaucoma as there is
some family history of the latter. He re-inspected carefully. He expressed no
concern and no evidence of past damage. Then he complimented me on my "superb diabetes control with respect to eye health". I cannot express in the written word how happy that made me
feel. Is there a cloud ten above cloud nine? </span><span style="font-size: large;"> At his request we then spent a few minutes of his valuable time discussing the </span><span style="font-size: large;"><b><a href="http://loraldiabetes.blogspot.com.au/2006/10/test-review-adjust.html">Test, Review, Adjust</a></b> technique.</span></div>
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<span style="font-size: large;">OK, that covers the ‘opathies. None at all. But there is
another lurking danger for diabetics: the heart. </span></div>
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<b><span style="font-size: large;">Heart.</span></b><br />
<br />
<span style="font-size: large;"><span style="font-size: large;">I dropped Lipitor ten years ago; the more I read about statins the less I am convinced of my need for one. </span>My doctor has been
polite and patient with me when I have consistently refused a statin for the
past nine years despite high cholesterol by official standards. My HDL and
triglycerides are fine but my LDL is very high. He suggests that may be because of my low-blood-glucose-spike
(which many interpret as low-carb) way of eating. He strongly recommended I
have a stress echocardiography accompanied by ultrasound of my heart, mainly to
reassure <i>him</i> I am not going to keel over tomorrow. I had those
tests last September. First, the gooey preparation and the ultrasound, twisting to awkward positions. Uncomfortable but not painful. Then walking faster and faster on the treadmill, with wires hanging off me, having problems reaching the heart rate he wanted. Eventually we got there. As I cooled down it was fascinating seeing the movies of my own heart
pumping away on the playback screen of the ultrasound. </span><br />
<br />
<span style="font-size: large;">The
cardiologist was very thorough and pleased with the results. It seems my heart and vascular system are in
fine shape. No problems at all. I will
continue to refuse the statin and eat low-carb, moderate fat, for good blood
glucose levels. I no longer care at all what my LDL is.</span></div>
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<br />
<span style="font-size: large;"><b>Leukaemia</b> </span></div>
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<span style="font-size: large;"> </span></div>
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<span style="font-size: large;">Finally, although I would like to, I cannot forget my Chronic Lymphocytic Leukaemia sitting in the background like the Sword of Damocles. I make no
claims about my diet or lifestyle for that. I’m just lucky I suppose. All of my
indicators have improved over the years until almost all are in normal range. I
still have hypogammaglobulinemia associated with the CLL but one of the indicators for that, IgM,
has crept back into normal range. The IgG and IgA are still low, but oddly I
don’t seem to be catching anything despite wandering the far corners of the world since diagnosis. I saw the </span><span style="font-size: large;">haematologist quarterly at first, then every four months, then every six, now I waste his time annually. </span></div>
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<span style="font-size: large;">The haematologist, ophthalmologist, podiatrist (who displays my book at reception and has sold several copies) and my General
Practitioner tell me to keep doing what I’m doing. </span></div>
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<span style="font-size: large;">That sounds like good advice to me. I will heed it.</span></div>
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<span style="font-size: large;"><br /></span></div>
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<span style="font-size: large;">Cheers, Alan<br />Everything in Moderation - Except Laughter
</span></div>
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<![endif]-->Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com3tag:blogger.com,1999:blog-8967781860933132301.post-57680323215353661832014-09-20T12:04:00.000+10:002014-09-20T12:04:09.915+10:00Catering For Different Tastes When Cooking<div style="text-align: justify;">
<span style="font-size: large;">I see variations on this question asked many times on the various forums I am on:</span></div>
<div style="text-align: justify;">
<blockquote class="tr_bq">
<span style="font-size: large;"><br /></span>
<i><span style="font-size: large;">Being head cook and bottle washer, I have a question. Having D, I need certain foods, my son has become a meat and potatoes guy, my wife eats most anything, except a variety of veggies. I do not want to have to cook 3 separate plates to satisfy all. How do you cater to each taste, or do you? Is there a happy middle?</span></i></blockquote>
</div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">The same problem occurs for the person who is not the cook but does not want to offend the person who is. This may help those people: </span><span style="font-size: large;"><b><a href="http://loraldiabetes.blogspot.com/2006/11/cooking-as-survival-skill.html">Cooking as a Survival Skill</a></b>. But I realise that is not possible or practical for some.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Here is my own method for dealing with the situation. I am the cook in our household, mostly just for the two of us. Mum is invited for dinner a couple of times a week. </span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">It is important to keep in mind that I am the only person with diabetes. Although I may believe others would benefit from my way of eating it is not my role or place to force them to eat as I do. We each have our own food likes, dislikes, aversions or allergies.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">I am diabetic and careful about carbohydrates but otherwise omnivorous. My wife has a very limited menu, by choice, and a long list of foods she detests. For example, she will not eat fish or seafood, eggs, steak, many vegetables, milk, the list goes on. Her likes are basically meat (other than steak), starchy vegetables, peas, tomatoes and silverbeet (chard). My mother is omnivorous but, like most people, has a few foods she prefers to avoid.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">If I restricted myself to cooking only the foods we all like my menu would become very limited and boring. I also actively seek to include fish and a wide range of seasonal vegetables in my diet. Therefore, at most meals for the two of us I cook three types of foods. Those I can eat, those my wife will eat, and those we both eat. The other night was a typical example. In the <b><a href="http://loraldiabetes.blogspot.com/2011/10/kitchen-essentials-steamer-saucepan.html" target="_blank">steamer</a></b> I had potato and pumpkin (winter squash) simmering in the bottom section with silverbeet, carrots, cabbage and broccoli in the top. I cooked two loin lamb chops under the grill (broiler) for her and when they were almost cooked I seared and fried a fillet of Atlantic Salmon in a small skillet for myself.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">At the table I put the salmon on my plate, the lamb chops on hers, and all the vegetables on a platter in the middle. We served ourselves from the platter. She had most of the potato and silverbeet; I took most of the rest.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">When my mother or other people are dining with us I use the same method. I find out whether anyone has specific protein likes or dislikes and serve that appropriately, letting them select their own vegetables and starches from the centre of the table. For major feasts such as Christmas dinner everything is served buffet-style for diners to select as they wish.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">It really isn't as difficult as it sounds, with a small amount of extra thought and effort keeping everyone at the table happy and healthy.</span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com0tag:blogger.com,1999:blog-8967781860933132301.post-4203122710204012002014-07-22T09:13:00.000+10:002014-07-22T09:13:46.012+10:00It Must Be OK - It's Sugar-Free! Wrong!<div style="text-align: justify;">
<span style="font-size: large;">A very brief post to emphasise an important point.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">When we</span><span style="font-size: large;"><span style="font-size: large;"> as diabetics</span> are choosing foods for the menu or checking the ingredients of a recipe, sugar should be treated as just another carbohydrate. It is more concentrated than most carbs but my meter has repeatedly shown me it is the total carbs that count, not just the sugar content, </span><span style="font-size: large;"><span style="font-size: large;">when I test my blood glucose after eating</span>.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Food products which are marketed as sugar-free are very rarely carbohydrate-free. In fact, more often than not they have just as many carbs as the sugared versions. I encountered a classic example of this a couple of days ago when I saw a large display in my local Aldi store promoting 'healthy' sugar-free products. </span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">These are photos of just some of the products. Sorry about the smart-phone quality of the pics; the carb counts are clear enough. I'll let them prove my point.</span></div>
<br />
<span style="font-size: large;">99.5% Sugar-free Shortbread = 67.9% carbohydrates</span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: large;"><a href="http://4.bp.blogspot.com/-1033ir9Y64Y/U82YUQvAMuI/AAAAAAAAJKQ/x5r5-4iPUmI/s1600/IMAG0324.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-1033ir9Y64Y/U82YUQvAMuI/AAAAAAAAJKQ/x5r5-4iPUmI/s1600/IMAG0324.jpg" height="320" width="191" /> </a></span></div>
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
<span style="font-size: large;">99.5% Sugar-free Chocolate Digestive Biscuits = 61.3% carbohydrates</span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: large;"><a href="http://1.bp.blogspot.com/-WJilhqrGCSg/U82YjyR7ccI/AAAAAAAAJKg/37FwdGy_7GQ/s1600/IMAG0325.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-WJilhqrGCSg/U82YjyR7ccI/AAAAAAAAJKg/37FwdGy_7GQ/s1600/IMAG0325.jpg" height="191" width="320" /></a></span></div>
<br />
<span style="font-size: large;">99.5% Sugar-free Wafer Biscuits = 62.4% carbohydrates</span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: large;"><a href="http://4.bp.blogspot.com/-a74g4Z16izI/U82YqS3s9EI/AAAAAAAAJKo/wxGsajKg1co/s1600/IMAG0328.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://4.bp.blogspot.com/-a74g4Z16izI/U82YqS3s9EI/AAAAAAAAJKo/wxGsajKg1co/s1600/IMAG0328.jpg" height="191" width="320" /></a></span></div>
<br />
<span style="font-size: large;">99.5% No Added Sugar Dark Chocolate = 57% carbohydrates</span><br />
<br />
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: large;"><a href="http://1.bp.blogspot.com/-cAODxep-MeA/U82YzB2AFOI/AAAAAAAAJKw/An5jPB40hGw/s1600/IMAG0329.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://1.bp.blogspot.com/-cAODxep-MeA/U82YzB2AFOI/AAAAAAAAJKw/An5jPB40hGw/s1600/IMAG0329.jpg" height="320" width="191" /> </a></span></div>
<div class="separator" style="clear: both; text-align: left;">
<br /></div>
<div class="separator" style="clear: both; text-align: left;">
<span style="font-size: large;">The piece-de-resistance. Sugar-free Mixed Fruit Drops: </span></div>
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: large;"> <a href="http://3.bp.blogspot.com/-aSOUDNrcQIQ/U82YNDl0PYI/AAAAAAAAJKI/KYTzRHBKgMg/s1600/IMAG0322.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-aSOUDNrcQIQ/U82YNDl0PYI/AAAAAAAAJKI/KYTzRHBKgMg/s1600/IMAG0322.jpg" height="191" width="320" /> </a></span></div>
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
<div class="separator" style="clear: both; text-align: justify;">
<span style="font-size: large;">I could not believe this one when I turned the can over. There was no added sugar, so it must be healthier than other fruit drops...yeah, right. </span></div>
<div class="separator" style="clear: both; text-align: justify;">
<span style="font-size: large;"></span></div>
<div class="separator" style="clear: both; text-align: justify;">
<br /><span style="font-size: large;">It is 93% carbohydrates.</span></div>
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
<div class="separator" style="clear: both; text-align: center;">
<span style="font-size: large;"> <a href="http://3.bp.blogspot.com/-KFmCmdgtyl0/U82YV3-wSyI/AAAAAAAAJKY/yt2kCXpeAI4/s1600/IMAG0323.jpg" style="margin-left: 1em; margin-right: 1em;"><img border="0" src="http://3.bp.blogspot.com/-KFmCmdgtyl0/U82YV3-wSyI/AAAAAAAAJKY/yt2kCXpeAI4/s1600/IMAG0323.jpg" height="191" width="320" /> </a></span></div>
<div class="separator" style="clear: both; text-align: center;">
<br /></div>
<div class="separator" style="clear: both; text-align: left;">
<span style="font-size: large;">Always read those labels, folks. </span></div>
<div class="separator" style="clear: both; text-align: left;">
<br /></div>
<div class="separator" style="clear: both; text-align: left;">
<span style="font-size: large;">Che</span><span style="font-size: large;">ers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter</span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com0tag:blogger.com,1999:blog-8967781860933132301.post-74919858875256978732014-05-10T09:58:00.000+10:002014-05-10T09:59:09.394+10:00Do Doctors Matter?<div class="usertext-body may-blank-within" style="text-align: justify;">
<div class="md" style="text-align: justify;">
<span style="font-size: large;">I feel this is a very important point needing emphasis for the many type 2 diabetics I know participating in diabetes web forums, social media groups and similar online support groups.</span><br />
<br />
<span style="font-size: large;">I have seen this question posed too often lately:</span><br />
<i><span style="font-size: large;"><br /></span></i>
<i><span style="font-size: large;">"Do doctors matter other than for renewing prescriptions?"</span></i><br />
<br />
<span style="font-size: large;">The questioner usually complains about poor support (in their eyes) from their medical advisors and praises the help and support they have received from other diabetics on the web.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I understand where they are coming from. I have seen some abysmal diagnostic, testing and dietary advice by medical professionals reported on many forums by newly diagnosed people. I have seen those same people turn their lives around using suggestions from experienced people on those forums. </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I still unequivocally believe our doctors matter and must always be our primary source of medical information. </span><br />
<br />
<span style="font-size: large;">I have learned a great deal about type 2 diabetes over the past
decade but I do not pretend to have medical qualifications even though
in some specific areas, such as testing or diet for type 2, I may believe I know
more than some doctors.</span><br />
<br />
<span style="font-size: large;">
</span><span style="font-size: large;">I know my own limitations. If and when the time comes for more
medication or insulin the doctor will be the first person I consult. After I consult him I may use the web or ask questions on forums to research the meds he prescribes to decide
whether or not I will choose to follow his advice. But I will always see him first.</span><span style="font-size: large;"> </span><br />
<br />
<span style="font-size: large;">If your own doctor does not meet your needs it is time to find another better doctor, not to simply ignore your doctor's advice.</span><br />
<br />
<span style="font-size: large;">On the rare occasions I decide not to follow prescribed advice after doing my own research I will also let him know and discuss
it further with him before acting; as I have for the statins my doctor prescribes but I
choose not to take. </span><br />
<br />
<span style="font-size: large;">The final decision deciding the action to take is mine but I would be a
fool to weigh anonymous advice on the web higher than the qualified
advice of my doctor without a lot of thought and discussion with him.</span><br />
<br />
<span style="font-size: large;"><span style="font-size: large;">The web is an incredible, wonderful and very useful information
source but it is not always easy to sift the wheat from the chaff nor do we always have the training or experience to do that sifting wisely. The web will never replace the ability of a good doctor to
interact with and personally treat a patient.</span></span><br />
<br />
<span style="font-size: large;"><span style="font-size: large;">Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter </span></span></div>
</div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com0tag:blogger.com,1999:blog-8967781860933132301.post-63128522421223124192014-04-22T15:35:00.002+10:002014-04-22T17:15:04.135+10:00Must I test Before Meals Too?<div style="text-align: justify;">
<span style="font-size: large;">Over a decade ago I learned this advice from a wise lady named Jennifer: </span><span style="font-size: large;"><b><a href="http://loraldiabetes.blogspot.com.au/2009/04/test-test-test.html">Test, Test, Test</a></b>. These days I endeavour to pay it forward by passing that on to every newly diagnosed person I encounter who is prepared to read it or listen to it. In that respect I am a testing evangelist ‘spreading the word’ although I do not press the point if the person does not want to hear it. My reasons are simple: twelve years later I am still awaiting the development of complications. When I look back to the day I first read it in 2002 I am quite convinced reading those words saved my life. </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">Not all want to hear it, nor do those who do always accept it. By far the two most common reasons for resistance are inconvenience and cost of the initial level of testing. Although I do not consider it a high level of testing new people do because their doctors either did not recommend testing at all or suggested only once or twice a day. Although my usual response to those objections is to point out everything has a price and failing to test sufficiently now may have a much higher health cost in later years, I fully accept that both points can be valid for individuals. </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">If the new type 2 diabetic leads a busy life, at home or at work or both, it can be a major inconvenience to put everything on hold for five minutes one and two hours after every meal. Add fasting and bedtime tests and you have a minimum of eight tests per day, more if snacks are included. That is swiftly reduced when discovery of the post-prandial peak enables reduction of post-meal tests from two to one, but that is still five to eight tests daily. Personally, I tested up to 20 times a day in that first week but I had the luxury of being retired at the time with government-subsidised test strips.</span><br />
<br />
<span style="font-size: large;">The good news is that such a high level of testing is not necessary for very long as the personal food<b>-</b>effect data-base grows from the results. I discuss that in detail in </span><span style="font-size: large;"><b><a href="http://loraldiabetes.blogspot.com.au/2013/01/im-new-type-2-do-i-really-have-to-test.html">I'm a New Type 2. Do I Really Have to Test so Much?</a> </b>But for a new person the initial high testing load I suggest can be quite daunting.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">The other objection is also valid for many. In some countries test strips can be either very expensive or restricted in prescribed quantity </span><span style="font-size: large;"><span style="font-size: large;">for type 2s</span> by insurers or misguided doctors. When it can cost up to a dollar a test, ten tests a day can be a very significant drain on a limited budget. Some solve the problem by buying less expensively on the web, with associated risks including possibly dishonest suppliers and passed expiry dates; others search for the cheapest meters and strips available to them. Some of those can be good (I read good reports on forums about the Walmart Relion, but I have not used it myself) but in general ‘you get what you pay for’ tends to be true in any marketplace.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">Those are the reasons I wrote </span><span style="font-size: large;"><b><a href="http://loraldiabetes.blogspot.com.au/2007/04/teting-on-budget.html">Testing on a Budget</a></b>. The method works less rapidly, but it still works eventually and uses a lot less strips.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">With that background I quite deliberately choose not to recommend testing before meals to newly diagnosed people. Persuading a new person to test whose doctor did not even suggest a meter is hard enough, persuading them to test as Jennifer suggests is more difficult. Adding even more tests before meals can be pushing the envelope too far.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">Those who promote testing before the meal tend to ignore that aspect. They suggest testing after meals is a waste of time if the person does not also test before the meal. Their logic is that without the pre-meal test the rise in blood glucose caused by the meal cannot be accurately known. That last part is technically true but I do not think it is of sufficient value to add those tests to the load. Knowing the trends for the actual peaks reached, without knowing the pre-meal base levels, was quite sufficient for me to swiftly modify my menu for good post-meal blood glucose levels.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">Pre-meal testing adds three to five tests daily to the high level of testing I suggested. As I mentioned earlier my primary reason for not recommending pre-meal testing is that it is difficult enough to convince newly diagnosed type 2s, shocked and scared from their diagnosis and nervous about poking holes in themselves, to test peak-post-prandial at all when the doctors do not prescribe it. It is even more difficult to convince them to do it as often as suggested in </span><span style="font-size: large;"><b><a href="http://loraldiabetes.blogspot.com.au/2009/04/test-test-test.html">Test, Test, Test</a></b> or </span><span style="font-size: large;"><b><a href="http://loraldiabetes.blogspot.com.au/2006/10/test-review-adjust.html">Test, Review, Adjust</a></b>. My first aim is to persuade them to do that much. Adding even more tests to that advice can be counter-productive.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">A motivated minority follows the pre-meal testing advice but, sadly, being told to add even more tests is the last straw for some. They revert back to the ‘test fasting and pre-dinner, if at all’ advice they heard from their doctor and drop the idea of post-meal testing altogether.</span></div>
<div style="text-align: justify;">
<br />
<span style="font-size: large;">In my own case I tested pre-meal a few times in the first couple of weeks but soon found those tests became boringly predictable, apart from the odd crazy result. Later I started to understand why some of those results weren't crazy. Many factors, not just food, affect the pre-meal level: <a href="http://loraldiabetes.blogspot.com.au/2009/02/i-ate-nothing-why-are-my-bgs-high.html" target="_blank"><b>dawn phenomenon or liver dumps</b></a>; exercise; stress; other medical conditions and medications; infections and illness; or excessive time since the last meal to mention just some. The same carbohydrate input at the same time of day may cause quite different rises if the pre-meal test was affected by those factors because the ingestion of the food may cause other reactions in the body as well as some becoming blood glucose. </span><span style="font-size: large;"><span style="font-size: large;">As a personal example </span>I suffer from dawn phenomenon. My post-breakfast one-hour level is often lower than my fasting level because the low-carb meal stopped the liver dump without adding to the load.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">More significantly, I found that my trends for the post-meal peak after identical meals at the same time of day were remarkably consistent regardless of the pre-meal tests. The delta or rise was sometimes very different, but the absolute level reached was rarely off the trend line. Try it yourself to see. My logic is if I reach levels I do not like, such as 10 mmol/l (180 mg/dl), it didn’t matter much whether I started at 5 (90) or 8 (133) – I still went too high and I should review the menu. Following that logic worked pretty well for me. M</span><span style="font-size: large;"><span style="font-size: large;">inor variations are ironed out a</span>s I do not base decisions on one test but on the trending effects of many.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">I do not use insulin or an insulin-stimulating medication. For those that do, your doctors or educators will advise whether pre-meal testing is necessary to calculate doses. That is a quite different reason for testing.<span style="font-size: large;"> </span></span><br />
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">If
you have the time, motivation and cash to support pre-meal testing as
well as one or two tests after every meal, plus fasting and bedtime, do
it. But I see no need to, especially in the first few weeks. </span></div>
</div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">For the rest of us I consider pre-meal testing to be usually a waste of a test strip unless it was prescribed by your medical advisor for their information. The only time I test pre-meal apart from my pre-breakfast fasting is occasionally an hour or two after lunch or dinner to see if I can have a dessert. If I am high, the answer is no. If not, I might indulge in a treat.</span><br />
<br />
<span style="font-size: large;">Cheers, Alan, T2, Australia.</span><br />
<span style="font-size: large;"><br />Everything in Moderation - Except Laughter </span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com0tag:blogger.com,1999:blog-8967781860933132301.post-65166656314155889692013-12-03T08:42:00.002+11:002013-12-03T08:50:02.814+11:00Simple Low Carb Soups II - Asparagus<div class="post" style="text-align: justify;">
<div class="inner" id="msg_65995">
<span style="font-size: large;">My Simple Spargelsuppe. </span><br />
<br />
<span style="font-size: large;">I call
it that because I never ate asparagus soup until I wandered around
Germany in spargel season in 2003. I wasn't sure I'd like it, but one
day we stopped in a village where it was the only thing on the lunch
menu, with crusty bread. I discovered I loved it. We don't get those big
whitish German asparagus, but our local green ones with the purplish
heads aren't bad either.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">This is very similar in technique to the mushroom
soup. I usually buy my asparagus in small bunches, which is the way they
appear in our supermarkets:</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><img alt="" class="bbc_img resized" height="351" src="http://community.diabetes.org/t5/image/serverpage/image-id/1894iAD4713AF831273E0/image-size/original?v=mpbl-1&px=-1" style="cursor: pointer;" width="237" /></span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I buy three bunches, eat a couple and reserve one for soup. Soup preparation is almost identical to the mushroom soup. </span><span style="font-size: large;"> This makes two or
three serves.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Fry
an onion in olive oil and butter until caramelising. Add the roughly
chopped asparagus spears, reserving the tender tips, and cook until they start to sweat. Add about a litre/quart of stock (chicken or vegetable) and
simmer for about 30 minutes. If you aren't sure how much stock to use,
begin with a little less. You can always add more later. Season with
salt and grated pepper. </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">When the asparagus is tender purée the soup and return the reserved
tips to it. Return the soup to the stove for five minutes to cook the
tips, stirring if necessary to ensure the thicker soup does not stick.
Adjust for consistency; second time around you will know exactly how
much stock to use.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I am a parsimonious type that hates waste.
When I eat the other bunches I snap off the "woody" ends. I keep those woody stubs in the fridge for the soup. When I make the soup I slice off and discard the really
woody ends from the stubs and simmer the slightly softer remainders in
some chicken stock while preparing the main soup. Just before I return the reserved asparagus tips I purée the "woody" part
thoroughly so that any stringy bits disappear. I add that purée to the main pot.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Add a dollop of cream to each bowl when serving. </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I have a few variants of this recipe. My favourite is to add an equal
portion of broccoli, reserving some small florettes in the same way that
I reserve the asparagus tips, for an asparagus and broccoli soup. I
adjust the stock quantity accordingly. I also vary flavour using nutmeg
and/or garlic.</span><br />
<br />
<span style="font-size: large;">Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter
</span></div>
</div>
<div class="smalltext modified" id="modified_65995" style="text-align: justify;">
</div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com0tag:blogger.com,1999:blog-8967781860933132301.post-63498269743214781872013-11-28T11:13:00.000+11:002013-11-28T15:32:27.590+11:00Simple Low Carb Soups I - Mushroom<div style="text-align: justify;">
<span style="font-size: large;">Mushroom Soup</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">This is based on about 250gm or 8oz mushrooms. It's
hard to be precise on the quantity, because I usually make soup when
the mushrooms have been left in the fridge or pantry too long and have
dried out, so they weigh less than when bought. If they aren't dried
out, they become a breakfast omelette instead. I make soup with leftovers as I don't like waste.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">For
soup I don't bother peeling the mushrooms. If the mushrooms are very
dry, soak them in enough chicken stock to cover them for a while until
they are soft again; if not don't bother. Strain the liquid off and
retain it.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Fry a medium/large sliced onion in a couple of
tablespoons of olive oil and a nob of butter until just starting to
caramelise. Sometimes I add a clove of garlic, but not always. Chop the
mushrooms roughly and add to the onions, frying gently. Cook briefly,
then add about a litre/quart of chicken stock (including any reserved
liquid) and bring to a simmer. Season with salt (mushrooms need a little
extra salt), grated black pepper and the secret ingredient: some grated
nutmeg to taste. Simmer for about half an hour; longer if the
mushrooms were originally very dry. I like some texture; before I use
the stick blender I strain out about a half cup of the mushrooms and
reserve them. </span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">I blend the soup, not quite to puree, and
return the lumpy bits. If the result is too thick, add more stock and
cook it in for a little while. If it is too thin, simmer a bit longer to
reduce it. When serving add a large dollop of real cream in the centre
of the soup in each bowl.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">The only significant carb content is the onion. That allows me to have a slice of buttered bread with it. </span><br />
<br />
<span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter<i>
</i></span></span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com2tag:blogger.com,1999:blog-8967781860933132301.post-45929825331553490052013-11-13T10:08:00.000+11:002013-11-13T10:08:10.927+11:00Tammy's Story<div style="text-align: justify;">
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<![endif]--><span style="font-size: large;"> Occasionally I come across inspirational stories on forums. I like these stories because I am sure they help new people believe that the light at the end of the tunnel is not necessarily a train heading their way.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Tammy posted her story last month on the ADA forum. </span><span style="font-size: large;"><span style="font-size: large;">I received her permission to post it </span> here. I hope it helps someone who has stumbled across this blog, newly diagnosed, scared and wondering what lies in their future.</span></div>
<div style="text-align: justify;">
<i><span style="font-size: large;"><br /></span></i></div>
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<i><span style="font-size: large;"><span style="font-size: x-large;"><span style="font-family: "Times New Roman","serif";">My
Story: Tammy</span>
</span></span></i></div>
<br />
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<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">I will never forget that morning. It was Tuesday, May 29th, 2013 and was
two days before my 42<sup>nd</sup> birthday. My doctor called to tell me I had
diabetes and I needed to see my endocrinologist right away. My A1C was 10.7 and
this could not wait. My heart was racing, and I really don't remember driving
home. <span>I cried all the way home in a
complete state of panic.</span></span></span></i></div>
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<br /></div>
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<i><span style="font-size: large;">
</span></i></div>
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<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">My name is Tammy and I am a registered nurse, having spent most of my
career working in ICU. Two years ago I started working per diem, once I was
accepted into grad school. It is stressful! I am in my last year of the nurse
practitioner program and am so excited to be graduating next year!</span></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<br /></div>
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<i><span style="font-size: large;">
</span></i></div>
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<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">At the end of last semester I started having
panic attacks with chest pain during finals</span><span style="font-family: "Times New Roman","serif";"> and I was always tired -
always! That’s part of working and going back to school, right? Wrong!</span></span></i></div>
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<br /></div>
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<i><span style="font-size: large;">
</span></i></div>
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<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">After my finals were over, I went to the cardiologist - my exam was fine,
my EKG was fine. He wanted me to come back for an echocardiogram and sent me
for tons of blood work, including an A1C. I was diagnosed with PCOS when
I was about 20 yrs old, which is basically a hormonal imbalance (simplified),
which causes irregular periods and CAN predispose you to diabetes. I told my
doctor that my endocrinologist told me two years ago I was insulin resistant
and my fasting glucose was 114.</span></span></i></div>
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<br /></div>
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<i><span style="font-size: large;">
</span></i></div>
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<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">I was always afraid of getting diabetes but really never thought it
would happen. Diabetes doesn't run in my family. My parents are both healthy, I
exercised off and on, and although I loved carbs, I ate a lot of fruits and
vegetables and considered myself mostly healthy.</span></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<i><span style="font-size: large;">
</span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">That same day I made an appointment with a nutritionist, a Certified
Diabetes Educator, and saw my endocrinologist. He started me on Metformin 500
mg two times a day and said, "You need to lose 20 or 30 pounds and then
you can come off the medication.” He gave me a prescription for another A1c to
repeat in eight weeks.</span></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<i><span style="font-size: large;">
</span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">Nothing made any sense to me</span><span style="font-family: "Times New Roman","serif";">. The only
symptom other than the fatigue was a dry mouth. <span>That’s it</span>. I had such minor symptoms that it could have been
ANYTHING!</span></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<br /></div>
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<i><span style="font-size: large;">
</span></i></div>
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<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">The nutritionist changed my life. I began exercising consistently and
writing down every single thing I put in my mouth. I began Googling everything
I could find on diabetes, causes, symptoms, and of course, complications. <span>I came across the ADA Forum, this wonderful
website, where I read stories for hours, and I never imagined I would learn
this much from complete strangers. It is such a wonderful feeling to be among
others who share your story, who relate to your concerns and who understand
your pain.</span></span></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<br /></div>
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</span></i></div>
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<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">In eight weeks I lost 25 pounds and my A1C
went to 6.5.</span><span style="font-family: "Times New Roman","serif";"> I am now exercising daily, four miles on the treadmill, and eating lots
of veggies. To date, my A1C is 6.0, I have lost 40 pounds, and although I am
not yet at my goal, I am close. What keeps me going is not the weight loss but
the desire to be healthy. <span>I have never
looked or felt better!</span></span></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<i><span style="font-size: large;">
</span></i></div>
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<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">It is a very scary diagnosis, but here I am four months later and I'm
doing what I need to do! What I have learned throughout this ordeal is that <span>we have a lot more power than we realize when
it comes to managing this illness. </span>I refused to take on the "poor
me" attitude at diagnosis. I said to myself "Ok, I've got this, and I
am going to learn as much as I can to stay on top of things and live a long and
healthy life." Of course there are days where you just want to give up,
but I just let those feelings pass on by and I keep on moving forward.</span></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<br /></div>
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<i><span style="font-size: large;">
</span></i></div>
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<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif";">When I saw my endocrinologist a few weeks ago, he gave me the option of
going off the Metformin, but we agreed that since Metformin treats PCOS and
I've done so well on it, we are going to decide together when I see him in
three months if I should continue or just try to manage it with diet and
exercise. Either way<span>, I am very proud
of what I have accomplished in a short time.</span></span></span></i></div>
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<br /></div>
<div style="text-align: justify;">
<i><span style="font-size: large;">
<span style="font-family: "Times New Roman","serif"; line-height: 115%;">If I can do it, you
can do it too! (Believe me) Best of luck in your journey, we can all do this
together </span></span></i><img alt="" src="data:image/png;base64,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" /></div>
<div style="text-align: justify;">
<i><span style="font-size: large;"><span style="font-family: "Times New Roman","serif"; line-height: 115%;"> </span></span></i></div>
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<span style="font-family: "Times New Roman","serif"; font-size: large;">Thanks Tammy.</span><br />
<br />
<span style="font-family: "Times New Roman","serif"; font-size: large;">Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter<i>
</i></span><br />
<span style="font-family: "Times New Roman","serif"; font-size: large;"><i><br /></i></span>
<span style="font-family: "Times New Roman","serif"; font-size: large;"><i><br /></i></span></div>
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Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com0tag:blogger.com,1999:blog-8967781860933132301.post-39274968469630778662013-10-24T10:26:00.000+11:002013-10-24T10:26:59.593+11:00Konjac and Shiritaki Noodles<div style="text-align: justify;">
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<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">I have heard and read this question many times: "what food can I eat
to lower my blood glucose levels?"</span></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">My standard
answer has always been to advise that there is no such food and the dietary way to lower
blood glucose levels is to select carbohydrate portions that do not raise blood
glucose levels excessively. </span></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">I may have
to add a caveat to that response in future. For the past three years I have
been making occasional experiments with an unusual food called Konjac. This
food has several other names in different parts of the world.</span></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">Scientific: Amorphophallus konjac. Also known as:</span></span></span></div>
<ul style="text-align: justify;">
<li><span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">Konjac</span></span></span></li>
<li><span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">shiritaki</span></span></span></li>
<li><span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">Glucomann </span></span></span></li>
<li><span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">devil's tongue</span></span></span></li>
<li><span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">voodoo
lily</span></span></span></li>
<li><span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">snake palm</span></span></span></li>
<li><span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">elephant
yam </span></span></span></li>
</ul>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">You can read
more about the plant and its variants here on wiki: <b><a href="http://en.wikipedia.org/wiki/Konjac" target="_blank">Konjac</a></b>
and <a href="http://en.wikipedia.org/wiki/Shirataki_noodles" target="_blank"><b>Shiritaki noodle</b>s</a>.There are
several forms: powder, noodles, gel and cake. The version available locally to me is
noodles, which are packaged in a brine solution. </span></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<div class="separator" style="clear: both;">
<span style="font-family: inherit;"><span style="font-size: large;"><a href="http://1.bp.blogspot.com/-nE59O3Rmk8g/UmhV-bvlRxI/AAAAAAAAIYw/xHCe0YaYfRQ/s1600/DSCF8535.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><br /></a></span></span></div>
<br />
<div class="separator" style="clear: both;">
<span style="font-family: inherit;"><span style="font-size: large;"><a href="http://1.bp.blogspot.com/-PNefLpGeDdg/UmhV6VZmaoI/AAAAAAAAIYo/0o3fw20DJDg/s1600/DSCF8530.JPG" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="300" src="http://1.bp.blogspot.com/-PNefLpGeDdg/UmhV6VZmaoI/AAAAAAAAIYo/0o3fw20DJDg/s400/DSCF8530.JPG" width="400" /> </a></span></span></div>
<div class="separator" style="clear: both;">
<span style="font-family: inherit;"><span style="font-size: large;"><a href="http://1.bp.blogspot.com/-nE59O3Rmk8g/UmhV-bvlRxI/AAAAAAAAIYw/xHCe0YaYfRQ/s1600/DSCF8535.JPG" style="margin-left: 1em; margin-right: 1em;"><img border="0" height="300" src="http://1.bp.blogspot.com/-nE59O3Rmk8g/UmhV-bvlRxI/AAAAAAAAIYw/xHCe0YaYfRQ/s400/DSCF8535.JPG" width="400" /></a> </span></span></div>
<span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">The noodles
look like pasta but are quite different in texture. After draining, separating and rinsing
to remove the slightly fishy odour they have a slippery feel and are more chewy
than the equivalent spaghetti or fettucine. They do not soak up sauce juices in
the same way as pasta, consequently I have learned to reduce my sauces more
when preparing konjac dishes. </span></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">Despite
those differences, my experiments show that for me they are a taste worth
acquiring. These are extracts from posts
on the ADA forum since I started experimenting with konjac. </span></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;"><br /></span></span></span></i></div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<i><span style="font-family: inherit;"><span style="font-size: large;">1.</span></span></i></div>
<div style="text-align: justify;">
<blockquote class="tr_bq">
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">I rinsed
120gm (4oz) Konjac several times and then let it drain in a sieve for 30
minutes. In my wok I
stir-fried 2/3 cup of shredded cabbage and half a medium sliced onion in a
splash of peanut oil. When the onion was starting to caramelise I added 50gm
shredded ham, warmed it through and then transferred the ham and veges mix to
my serving bowl.</span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">I fried the
Konjac in a tablespoon of peanut oil until the noodles started to separate and
dry out and occasionally "popped". They never went hard or dry, but
became a little more springy and less moist. I returned the veges and ham to
the mix. I continued to stir as I cooked for a couple of minutes until the
veges were softened and thoroughly mixed with the noodles. I transferred it to
the bowl, adding 15gm (1/2 oz) of shredded cheddar and a splash of cream,
stirring it well. </span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">It was
surprisingly good. The noodles shape was similar to thin spaghetti but the
texture was chewier and springy. The noodles seemed to have no flavour of their
own but took on the flavours of the other foods in the recipe.</span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">Here comes
the good news. </span></span></i></div>
</blockquote>
<blockquote>
<ul>
<li><i><span style="font-family: inherit;"><span style="font-size: large;">Pre-meal:
5.8 </span><span style="font-size: large;">mmol/L (105 </span><span style="font-size: large;">mg/dl)</span></span></i></li>
<li><i><span style="font-family: inherit;"><span style="font-size: large;">45 minutes
post-meal</span><span style="font-size: large;">: 5.3 </span><span style="font-size: large;">mmol/L (96 </span><span style="font-size: large;">mg/dl)</span></span></i></li>
<li><i><span style="font-family: inherit;"><span style="font-size: large;">75 minutes
post-meal: 5.3 </span><span style="font-size: large;">mmol/L (96 </span><span style="font-size: large;">mg/dl)</span></span></i></li>
</ul>
</blockquote>
<blockquote>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">The
post-meal numbers may have been aided by 150ml (5oz) of Shiraz between the end
of the meal and the 45 minute test.</span></span></i></div>
</blockquote>
</div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt; text-align: justify;">
<i><span style="font-family: inherit;"><span style="font-size: large;">2.</span></span></i></div>
<div style="text-align: justify;">
<blockquote class="tr_bq">
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<i><span style="font-family: inherit;"><span style="font-size: large;">The
next experiment with Konjac was not quite as successful. But it was
educational. </span></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<i><span style="font-family: inherit;"><span style="font-size: large;">I made up my usual bolognaise sauce, using some
mince steak (ground beef to the trans-Pacificans). I browned the meat, then
added a cup of my <b><a href="http://loraldiabetes.blogspot.com/2006/11/napoli-sauce.html" target="_blank"><span style="color: blue;">Napoli Sauce</span></a></b> and cooked
it for a while to incorporate it. When used as a sauce with pasta it is
delicious with a dusting of grated parmesan.</span></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<i><span style="font-family: inherit;"><span style="font-size: large;">I prepared 200 gm of the Konjac noodles in the same
way, rinsing, draining, separating and lightly frying in olive oil. However,
when I added the sauce and tried to “cook it in” as I usually do with wheat
pasta the mixture stayed too liquid. Unlike pasta, Konjac noodles do not absorb
the sauce liquid.</span></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<i><span style="font-family: inherit;"><span style="font-size: large;">The result was edible but chewy and not terribly
appetising. Next time I will cook the Konjac longer and reduce the sauce a lot
more, to thicken it and remove a lot of the liquid. After the meal I drank my
usual glass of Shiraz.</span></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal; margin-bottom: 0.0001pt;">
<i><span style="font-family: inherit;"><span style="font-size: large;">On the other hand, the good news was:</span></span></i></div>
</blockquote>
<blockquote>
<ul>
<li><i><span style="font-family: inherit;"><span style="font-size: large;">Pre-meal: 5.7 (103)</span></span></i></li>
<li><i><span style="font-family: inherit;"><span style="font-size: large;">1hr post-meal: 5.5 (99)</span></span></i></li>
</ul>
</blockquote>
</div>
<div class="MsoNormal" style="line-height: normal; text-align: justify;">
<i><span style="font-family: inherit;"><span style="font-size: large;">3. </span></span></i></div>
<div style="text-align: justify;">
<blockquote class="tr_bq">
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">Two days earlier I bought a Thai green Chicken curry
for dinner. It was a large serve and I only ate half of it, followed by
my usual glass of wine post-dinner. I was 5.4(97) pre-meal and 6.9(124)
after. I expected that because there is always some starch in the local
Thai curries. </span></span></i></div>
</blockquote>
<blockquote class="tr_bq">
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">We decided to have the leftover Asian meals for dinner two nights later. This time I
prepared about 125gm of Konjac noodles first by rinsing, draining and
pan-frying until they were dried out but still supple. I added them to the
re-heated Thai chicken curry, which was exactly the same size as the previous
serve. The resulting dish was quite tasty, although I still prefer other
noodles for taste and texture at the moment.</span><span style="font-size: large;"> </span></span></i>
</div>
</blockquote>
<blockquote class="tr_bq">
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">I was a little high before the meal at 7(126); I can't recall why but
presumably had a forgotten snack. Or maybe it was gremlins. Here is the
surprise:</span></span></i></div>
<ul>
<li><i><span style="font-family: inherit;"><span style="font-size: large;">1hr: 5.8 </span><span style="font-size: large;">(105</span><span style="font-size: large;">)</span></span></i></li>
<li><i><span style="font-family: inherit;"><span style="font-size: large;">2hr: 6.3 </span><span style="font-size: large;">(114</span><span style="font-size: large;">)</span></span></i></li>
</ul>
</blockquote>
<i><span style="font-family: inherit;"><span style="font-size: large;">4. </span></span></i></div>
<div style="text-align: justify;">
<blockquote class="tr_bq">
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">Continuing the trial...</span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">I had leftover meatball casserole for lunch. It is a fairly
low-carb recipe, but I had it on a slice of toast which added about 15gms of carb. On past experiments at that time of day I would
have expected that combination to raise me from my usual pre-meal of 5.5-6
(100-108) to somewhere between 7(126) and 8(144).</span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;">I added 120 gm of Konjac noodles, preparing them in the same way as
before.</span></span></i></div>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<ul>
<li><i><span style="font-family: inherit;"><span style="font-size: large;">Pre-meal: 5.8</span><span style="font-size: large;"> (105</span><span style="font-size: large;">)</span></span></i></li>
<li><i><span style="font-family: inherit;"><span style="font-size: large;">1hr Post-meal: 6.8 </span><span style="font-size: large;">(123</span><span style="font-size: large;">)</span></span></i></li>
</ul>
<div class="MsoNormal" style="line-height: normal;">
<i><span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></i></div>
<div class="MsoNormal">
<i><span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">I still can't form any definite conclusions, beyond the fact that Konjac
definitely does not increase my blood glucose levels and may
limit or even decrease the effects of other foods. But still only
"may".</span></span></span></i></div>
</blockquote>
</div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><br /></span></span></div>
<div class="MsoNormal" style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;"><span style="line-height: 115%;">Since
those early experiments I have continued to use konjac once or twice a
month together with low-carb ingredients. In almost every case my
post-meal blood glucose was equal to or lower than my pre-meal. </span></span></span></span><br />
<br />
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">Last night I ate the same recipe as experiment #1, using 150gm of chopped bacon instead of ham. I also added a few strands of my wife's wheat fettucine to provide a better texture; probably about 15gms of extra carb. I probably made the portions too large, we were very "full" when we finished the meal. My pre-meal level was a little high at 7.6 (134) as I had indulged in a cookie half an hour earlier. My one-hour post-meal was 6.7 (120).</span></span></span><br />
<br />
<span style="font-family: inherit;"><span style="font-size: large;"><span style="line-height: 115%;">I emphasise that these experiments were personal and may only apply to me. My only recommendation is to do your own experiments if you are interested in trying this food. I have no commercial interest in any firm selling konjac in any of its various forms.</span></span></span><br />
<span style="font-family: inherit;"><span style="font-size: large;"><br /><span>Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter
</span></span></span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com2tag:blogger.com,1999:blog-8967781860933132301.post-42926329898537812942013-09-21T09:47:00.001+10:002013-09-21T15:40:19.053+10:00Stress and Blood Glucose Levels.<div style="text-align: justify;">
<span style="font-size: large;">Stress, like blood glucose
spikes, has an insidious effect on the body. I am not qualified to go
into the biological aspects of stress, but over the past three weeks
I have certainly been forcibly made aware of the physical and mental
consequences.</span>
</div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">I have also been reminded
that I have not cured my diabetes over the past decade; at best I
have maintained good control. Control which can swiftly degrade under
stress. </span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">I post my story partly
as an explanation to the people on various forums who may have
wondered at my absence over the past month, and also as an example to
others undergoing stress to reassure you that you are not alone, we
all experience our own personal tragedies and stresses. I am not
looking for sympathy, I have already received a great deal of
support. My intention is to show that this can happen to anyone. If
your numbers are rising when under stress, the cause is not always
poor diet or inadequate medications. Resolving or dealing with the
causes of the stress are just as important. </span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">To set the scene, my usual
fasting blood glucose over the past few years has been in the range
5.5(100) to 6.5(117). I suffer from <a href="http://loraldiabetes.blogspot.com/2009/02/i-ate-nothing-why-are-my-bgs-high.html" target="_blank"><b>Dawn Phenomenon</b></a> so I am reasonably happy with that. My A1c has been in the low 6% range. In
contrast, for the past two weeks I have not seen a fasting blood
glucose under 7.5(135) and if my A1c was tested right now I doubt it
would be under 7%. </span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<b><span style="font-size: large;">Physical stress. </span></b>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">Three weeks ago I was
cooking sausages on the barbecue raising money for our local
Neighbourhood Centre, something I have done twice a month for several
years. After cooking several hundred sausages I had to empty the hot
drained fat container and carelessly spilt some on my hand, mainly my
right index finger. The doctor said it was second and possibly third
degree burns. That placed my system under some stress as it slowly
healed; I took the final bandages off yesterday, but I am still
applying ointments. At least I can type with two fingers again. I
noticed that my fasting numbers immediately rose about a mmol
(18mg/dl) – and stayed up.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<b><span style="font-size: large;"><br /></span></b>
</div>
<div style="text-align: justify;">
<b><span style="font-size: large;">
</span></b></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<b><span style="font-size: large;">Financial stress. </span></b>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">Just before I burned my
hand I arranged tradesmen to renovate my bathroom. Plumber,
carpenter, tiler etc. I am an experienced home handyman so the
budget was based on doing most of the preparation work – removing old
tiles, shower screens, cabinets etc – myself. Suddenly all that had
to be done at tradesmen's rates. The budget has blown out.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<b><span style="font-size: large;"><br /></span></b>
</div>
<div style="text-align: justify;">
<b><span style="font-size: large;">
</span></b></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<b><span style="font-size: large;">Personal stress. </span></b>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">About three years ago my
younger brother was diagnosed with cancer. Over the next couple of
years he underwent chemo but made the wise decision to spend as much
time as he could travelling with his family and enjoying life between
chemo sessions. He did not change his bright, happy character at all.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">Three days after I burned
my hand my brother's wife rang to say we needed to go to the
hospital, two hours away. When we arrived it became clear he would
not be leaving hospital alive. We stayed for a couple of days, then
returned home. On return we received an email that one of my wife's
best friends had died in hospital, also from cancer. </span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">Four days later my
brother's pain left him. Two days later we attended my wife's
friend's funeral. Two days ago we went to my brother's funeral. Some
time during that period we discovered that the bathroom renovation
required more extensive work than we first realised. It didn't really
seem that important now.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">This morning my fasting
blood glucose was over 8(144). However, my bandages are off, I will
continue to grieve but the worst is over, and today is a new day. In
reviewing the past few weeks I realise that I also let my usual
dietary regimen slip. Not surprising, but that is something I can
change. </span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">It's time for me to begin
again, testing, testing.. </span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;"><br /></span>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">
</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">I know that there will be
people reading this who are going through situations far worse than
mine. I hope that my story helps a little by letting you know you are
not alone.</span></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<br /></div>
<div style="margin-bottom: 0cm; text-align: justify;">
<span style="font-size: large;">Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter
</span></div>
<span style="font-size: large;">
</span>Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com2tag:blogger.com,1999:blog-8967781860933132301.post-1268114879599600342013-07-26T14:47:00.000+10:002013-07-26T14:47:36.613+10:00For UK Type 2s: A Petition to Make Test Strips Available to People With Type 2<span style="font-size: large;">This is a brief but important post. I know I have some readers in the UK.</span><br />
<br />
<span style="font-size: large;">For those not aware of it, test strips are severely restricted for type 2s in many NHS districts. The terrible paper by <a href="http://www.bmj.com/content/early/2006/12/31/bmj.39247.447431.BE" target="_blank">Farmer et al</a> back in 2007 is often used to support this. I comment on a later paper citing that one here: <a href="http://loraldiabetes.blogspot.com.au/2008/04/is-testing-worthwhile.html">Is Testing Worthwhile?</a> </span><br />
<br />
<span style="font-size: large;">This excerpt from <strong><a class="imgScanned" href="http://www.england.nhs.uk/wp-content/uploads/2013/06/SDN-transcript-2013-06-06-pm.pdf" rel="nofollow" target="_blank">a recent speech</a></strong> by the head of the NHS suggests there may be a brief opportunity to get this changed. </span><br />
<br />
<span style="font-size: large;">After the expected introductory words this appears:</span><br />
<div class="usertext-body">
<blockquote class="tr_bq">
<div class="md">
<i><span style="font-size: large;">"I went to see my GP, they
did all the stuff, they said, yes, you've got diabetes. It's quite a
difficult thing, I think, particularly for someone, a healthcare
professional, someone who has worked in the NHS, to kind of reflect on
that and say, right, I have an illness now, a condition which could
involve me losing my limbs, my kidneys packing in, having a heart attack
and probably dying of a stroke."</span></i></div>
</blockquote>
<span style="font-size: large;"> If you read it you'll see why I left out the next sentence. Then he says:</span><br />
<blockquote class="tr_bq">
<span style="font-size: large;"><i>"one of the things they
gave me was a monitoring machine, so I take my blood glucose levels four
times a day and I have a little chart that I put them on. Now I'm not a
stereotype here, but give me a chart and a target and a trajectory and
I'm absolutely -- I'm absolutely with you. They could have designed --
they could have absolutely designed that interaction for me and I have
been absolutely at it since then."</i> </span></blockquote>
<span style="font-size: large;">A friend of mine who runs a UK forum has started a petition to Sir David. I invite UK readers to read it; if you agree, please sign it. </span><br />
<br />
<span style="font-size: large;">Click here: <b><a href="http://www.change.org/en-GB/petitions/david-nicholson-chief-executive-of-nhs-england-make-blood-glucose-test-strips-available-to-people-with-t2-diabetes" target="_blank">David Nicholson, Chief Executive of NHS England: Make blood glucose test strips available to people with T2 diabetes</a> </b></span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">There is a short window of opportunity. He retires from the post in a few months.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;"><span>Cheers, Alan</span></span>
<span style="font-size: large;"><span><br />Everything in Moderation - Except Laughter. </span><br />There is nothing I could eat I like more than my eyes.</span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com0tag:blogger.com,1999:blog-8967781860933132301.post-73001541177848299232013-05-08T08:52:00.000+10:002013-05-08T08:52:21.103+10:00George's Story<div style="text-align: justify;">
</div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">Here is another inspirational story from a cyber-friend who posted this on the ADA forum recently. I asked his permi<span style="font-size: large;">ssion to post it here because I believe our success stories help others<span style="font-size: large;">, especially newly diagnosed people w<span style="font-size: large;">ho fe<span style="font-size: large;">ar an<span style="font-size: large;"> unknown future. </span></span></span></span></span></span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div align="JUSTIFY" style="border-bottom: 1.00pt double #000000; border-left: none; border-right: none; border-top: none; padding-bottom: 0.07cm; padding-left: 0cm; padding-right: 0cm; padding-top: 0cm;">
<br />
</div>
<div align="JUSTIFY">
<br />
</div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: x-large;"><b>My Story: Lucky to Have Diabetes</b></span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"> </span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">Hi. I am George_M. What follows is my story, and why I feel so
lucky to have diabetes.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><strong>In August of last year, I was feeling like I had been
blessed with a wonderful life.</strong> After a disastrous first
marriage, I had found the woman of my dreams, and we had enjoyed 23
years of happiness together. My life had its full share of bumps in
the road, but those all seemed behind me now. After many years of
working 60+ hour weeks, my wife and I were both retired. We had the
time and sufficient retirement income to care for our needs and some
of our desires. We had a long period of caring for her mother, which
was very difficult and emotionally exhausting, but her mother had
passed away peacefully at age 95 a few months before. We were able to
indulge our joint passion for traveling to interesting places.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">I get an annual physical exam. The last two had been OK, nothing
much to worry about. Triglycerides and cholesterol were somewhat
high, and my doctor advised me to cut fat out of my diet. <strong>And,
oh, one other little thing. My fasting blood glucose in 2010 was 99.
In 2011 it was 101.</strong> My doctor said that was getting somewhat
high. If it went up more she would diagnose prediabetes. She said I
should lose weight.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">I was normal weight for my first 50 years, but weight had
definitely become a problem for me the last 20 years. <strong>I
gradually put on 140 pounds over 10 years. </strong>I lost that all
in one year on Weight Watchers, then gradually put it all back on
over the following 10 years. I was constantly very hungry, even an
hour or two after eating a very large meal. Now the doctor was
telling me to lose weight. Well, OK, I would try.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><strong>Then, about two months later, the most miraculous thing
happened!</strong> I started to lose weight, without any particular
effort! I lost about three pounds per month, for 10 months. This
is great, I thought, my doctor will be very pleased. I
figured my body must have changed as I got older and was naturally
shedding weight.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">Then I went in for my annual checkup in August 2012. The doctor
listened to my heart and lungs, said how pleased she was about the
weight loss and sent me to the lab to have blood drawn. A couple of
days later, I got an email from the hospital that my lab test results
were available. I logged on. Most of the tests were about where they
had been the year before. <strong>But my fasting blood glucose was
235.</strong> The lab put a note in the report that they assumed the
test was not fasting. The problem was, I knew it was a fasting test.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">What did this mean? I did some research on the internet and found
out that <strong>I had type 2 diabetes. </strong>How could this be?
There was no diabetes in prior generations of my family. My brother
has type 2 and is on insulin, but he had been exposed to Agent Orange
in Vietnam, and the government says that if someone who was exposed
to Agent Orange develops diabetes, the presumption is that it was
caused by the Agent Orange. I had not been exposed. How come I had
diabetes? <strong>And what happened to that prediabetes, where I
could know that this was serious and make some changes to keep it at
bay?</strong></span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">A couple of days later, I got a phone call from my doctor’s
secretary. She said my fasting blood glucose was high, that I should
avoid sweets and cut back on starches for the time being and come
back in two more weeks to repeat the tests. By this time, my head was
spinning. Did this mean I couldn’t travel anymore? Would I need
insulin right away? What about amputations? Blindness? Kidney
disease? Heart attacks and strokes? My brother has had two strokes
due to his diabetes and needs assisted living, and I have to handle
all his financial affairs because he is unable to. Would I end up
like that shortly? <strong>I felt like the bottom had just dropped
out of my life and I was falling. </strong></span></span>
</div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">Then I found the forum section of the American Diabetes
Association website. <strong>There were many people there who were
handling their diabetes successfully, and they were going on to live
pretty normal lives despite diabetes.</strong> Two of them, LizzyLou
and Alan_S, had taken the time to set up blogs where they have a huge
amount of information about diabetes and how to live with it. I spent
several days reading and digesting that information, and also reading
threads on different topics on the type 2 forum.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">At my follow-up visit, the lab drew more blood. I had changed my
diet quite a bit, so my fasting blood glucose came back 156, but <strong>my
A1C was 10.1. This only told me what I already knew: I had diabetes.
</strong>My doctor referred me to a nurse practitioner and a
nutritionist. She also wanted to prescribe Metformin ER, 500 mg twice
a day. I thought I would be able to get my blood glucose down with
diet and exercise, so I resisted the Metformin. We compromised on one
500 mg pill per day.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">The visit with the nurse practitioner went OK, although I had the
impression that I knew more about diabetes than she did. The
nutritionist advised a diet with 240 to 300 grams of carbohydrates
per day. I told her that I was already eating a diet with about 20
percent of those carbs, and I was doing quite well on it. She warned
how bad that diet would be for me, and I went on my way.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">When I reduced the carbs in my diet, the huge raging hunger that I
had been experiencing for the last 20 years went away. I became
mildly hungry sometimes and moderately hungry for an hour or so
before meals. This made losing weight much easier. When I was
diagnosed, my doctor told me to lose 90 to 100 pounds (in addition to
the 30 pounds I had lost without trying before diagnosis). <strong>In
just over seven months, I have lost 75 more pounds.</strong> My
triglycerides and cholesterol have come down, despite doing the
opposite of what my doctor had told me to do to bring them
down—eating a higher-fat, lower-carb diet. I had been exercising
almost every day (mostly walking) for the past 10 years, so I just
became more consistent doing that. <strong>This is what works for me.</strong></span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">I wrote my relatives to tell them that I had diabetes and that
there was a strong genetic link. My only other sibling, my sister,
wrote back that she had prediabetes, that she was taking Metformin
and that her latest A1C had gone up to 6.5. All of us either had
diabetes or prediabetes.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">I did want an endocrinologist who specialized in diabetes to treat
me. <strong>There were a few little things in my past that might have
been warning flags, had I only known.</strong> I didn’t like the
feeling that I should have known more and done things differently,
and I didn’t want to be having those same feelings in 10 years
about what I was doing today. I did some investigating, picked a
great endocrinologist and made the next available appointment for
about six months after diagnosis. When I answered her questions about
what I was doing, her eyebrows went up. <strong>“Where did you
learn all that?”</strong> she asked. I told her about the
Association’s website. She said “That’s amazing. Normally, I
have to tell my patients to do all these things you are already
doing. I have to argue with some of them. You are already doing those
things.”</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">I spent a month or so just reading on the Association’s website.
<strong>I felt it was time to try to repay the enormous debt that I
owe to the many people there who have helped and befriended me—by
trying to help others who are not as far along the path as I was.</strong>
I have been doing that for about six months now, mostly trying to
offer encouragement and telling others what has worked for me.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">I am 69 years old, and many of my friends are about my same age.
We are all starting to develop medical issues. I have friends with
Parkinson’s disease, cardiovascular disease, crippling arthritis,
multiple sclerosis and other serious conditions. I got a disease that
made it both necessary and much easier to lose weight, exercise and
lower my cholesterol, blood pressure and triglycerides. <strong>My
disease has not imposed any serious limitations on my life activities
yet, </strong>and I hope to have many more years before it does.
Unlike many other diseases, what I do can have a big impact on how my
diabetes goes, so I get to be largely in control.</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;"><strong>And that is why I feel lucky to have diabetes.</strong></span></span>
</div>
<div align="JUSTIFY" style="border-bottom: 1.00pt double #000000; border-left: none; border-right: none; border-top: none; padding-bottom: 0.07cm; padding-left: 0cm; padding-right: 0cm; padding-top: 0cm;">
<br />
</div>
<div align="JUSTIFY">
<br /><br />
</div>
<span style="font-family: inherit;"><span style="font-size: large;"><strong></strong></span></span><div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">Thanks George.</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-family: inherit;"><span style="font-size: large;">Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter
<strong><br /></strong></span></span></div>
<span style="font-family: inherit;"><span style="font-size: large;">
</span></span>Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com0tag:blogger.com,1999:blog-8967781860933132301.post-66491936060241786182013-05-03T15:12:00.000+10:002018-10-29T09:18:35.092+11:00Type 2 Diabetes and the Shame Game<div style="text-align: justify;">
<span style="font-size: large;">Some time ago I repeated on this blog three guest posts originally published<span style="font-size: large;"> on</span> dLif<span style="font-size: large;">e:</span> </span></div>
<ul class="posts">
<li><b><span style="font-size: large;"><a href="http://loraldiabetes.blogspot.com.au/2008/11/diabetes-diet-wars.html">The Diabetes Diet Wars</a></span></b></li>
<li><b><span style="font-size: large;"><a href="http://loraldiabetes.blogspot.com.au/2008/11/miracles-and-wonders.html">Miracles and Wonders</a></span></b></li>
<li><b><span style="font-size: large;"><a href="http://loraldiabetes.blogspot.com.au/2008/11/turning-points.html">Turning Points</a></span></b></li>
</ul>
<div style="text-align: justify;">
<span style="font-size: large;">I re-posted them here to ensure that they did not disappear if the dLife editors chose not to archive them.</span>
<span style="font-size: large;">Since then I have written a couple of guest posts for DiabetesMine and CarbSmart. For similar reasons I will post them here occasionally to ensure they do not disappear. </span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">This was publish<span style="font-family: inherit;">ed on </span>DiabetesMine in 2011. It is a topic which rears its ugly head a little too often. </span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<b><span style="font-size: large;"><a href="https://web.archive.org/web/20110115181125/http://www.diabetesmine.com/2011/01/type-2-diabetes-and-the-shame-game.html">Type 2 Diabetes and the Shame Game</a></span></b><span style="font-family: inherit; font-size: large;"> (edit Oct 2018. Healthline took over Diabetes Mine and the direct link has gone. The link now goes to the Wayback Machine archive) </span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-family: inherit;"><br /></span></span>
<span style="font-size: large;"><span style="font-family: inherit;">Ignorance may not be bliss after all, and there are occasions where it
can be downright dangerous to a type 2 diabetic. But there are some
times in life when it can be useful. For me, one of those occasions was
April 2002 when my doctor advised me of my diagnosis with type 2
diabetes. </span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-family: inherit;">At that time I was blissfully ignorant of diabetes in all its forms.
So I never suffered diagnosis guilt. Sure, I was overweight, but in my
country at that time we weren’t bombarded with commercials earnestly and
incorrectly telling us “for our own good” that diabetes is caused by
obesity. Just as importantly, the lack of that media barrage meant none
of my relatives or friends or any of the type 1s I met at my local
support group sneered at me for causing my own condition. I never wasted
any time or effort on guilt or recriminations.</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-family: inherit;">I didn’t realize it at the time, but I had a major advantage over my
American friends, whom I met later on diabetes forums. Far too often
over the past eight years I have encountered misery and depression as a
consequence of the “blame game” in newly diagnosed type 2s; conditions
which often interfered severely with their diabetes management. I reckon
that is a direct result of media campaigns, often well-intentioned,
which make it abundantly clear that new type 2 diabetics are just as
guilty of a self-inflicted wound as the soldier who shoots himself in
the foot to avoid a battle. And just as shameful, placing an enormous
load on the nation’s healthcare system.</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-family: inherit;">It is also becoming a divisive wedge between type 1 and type 2
diabetics on forums and in the media. We should be working with a common
purpose where our needs intersect — not fighting each other. We are
increasingly seeing complaints from type 1s who should know better but
who get upset at being “lumped together in the public mind” with those
fat, old, lazy slobs like me: the type 2s.</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-family: inherit;">From my reading, it is becoming increasingly clear to me that the genetic
tendency to diabetes is related to the genetic tendency to obesity, and
which comes first is becoming a chicken-and-egg argument. There is a
correlation between obesity and diabetes, correct. But correlation is
not causation. And that is irrelevant here anyway. What really matters
is that all those idiotic commercials promoting weight loss to prevent
diabetes are a counter-productive waste of money; they do not lead to
weight loss, they only reinforce the blame game. Worse, they often lead
the viewer to sites promoting “low fats and lots of whole grains” diets.
It’s hard to imagine a more rapid path to the unwanted goal. They’re
essentially recommending a high-carb diet for people with diabetes or a
strong tendency towards developing it.</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-family: inherit;">To the type 2s reading this: drop the guilt. Whatever the reason for
your condition, there isn’t a darn thing you can do to change the past.
What matters is what you will do today to improve your future.</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-family: inherit;">To the type 1s reading this: stop the blame game. Join with the type
2s in your community; in unity you can strive for better research and
support for all types. Division in the tough world of medical research
funding is never fruitful.</span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-family: inherit;">And to the people who put those stupid ads on our television screens:
you should be ashamed of yourselves. Spend that money investigating
the true causes and better treatments for the two separate afflictions
of obesity and diabetes in the Western world. You could start by
looking at the drastic changes in carb:fat:protein ratios in our menus
since WWII. But that’s a subject for another day.</span></span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com0tag:blogger.com,1999:blog-8967781860933132301.post-68914063873216970922013-04-02T13:59:00.001+11:002013-04-02T13:59:51.191+11:00What's In a Name? Am I a Diabetic or A Person With Diabetes?<div class="usertext-body" style="text-align: justify;">
<div class="md">
<span style="font-size: large;">A very brief post today about a regularly recurring question. Lately I have seen several posts on different forums from people getting upset about being referred to as a diabetic.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">The bard put it, as usual, so well:</span><br />
<blockquote class="tr_bq">
<div style="margin-bottom: 0cm;">
<span style="font-size: small;"><i>What's
in a name? that which we call a rose<br />By any other name
would smell as sweet;<br />So Romeo would, were he not Romeo
call'd,<br />Retain that dear perfection which he owes</i></span></div>
</blockquote>
<div style="margin-bottom: 0cm;">
<span style="font-family: inherit; font-size: small;"> <i>Romeo and Juliet, Act II, Scene II, by William Shakespeare.</i></span></div>
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I don't get precious about labels. Many will disagree with me, but I also tend to be a bit old-fashioned about many of the politically correct terms that have entered our language since I went to school.</span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Context matters. I rarely care about the word that is used to refer to me if the context is appropriate and the speaker or writer's intentions are good. For example, I am:</span><br />
<ul>
<li><span style="font-size: large;">a father</span></li>
<li><span style="font-size: large;">a son</span></li>
<li><span style="font-size: large;">a brother</span></li>
<li><span style="font-size: large;">a husband</span></li>
<li><span style="font-size: large;">an engineer</span></li>
<li><span style="font-size: large;">ex-RAAF</span></li>
<li><span style="font-size: large;">retired</span></li>
<li><span style="font-size: large;">ex-military officer</span></li>
<li><span style="font-size: large;">a pensioner</span></li>
<li><span style="font-size: large;">aged 66 </span></li>
<li><span style="font-size: large;">an oldie</span></li>
<li><span style="font-size: large;">a senior </span></li>
<li><span style="font-size: large;">an ancient </span></li>
<li><span style="font-size: large;">a child (to my mother) </span><span style="font-size: large;"><br /></span></li>
<li><span style="font-size: large;">a traveller </span></li>
<li><span style="font-size: large;">a seeker after wisdom </span></li>
<li><span style="font-size: large;">an omnivore </span></li>
<li><span style="font-size: large;">a curmudgeon (at times </span><span style="font-size: large;"><img alt=":smileyhappy:" class="emoticon emoticon-smileyhappy" id="smileyhappy" src="http://ada.i.lithium.com/i/smilies/16x16_smiley-happy.gif" title="Smiley Happy" />) </span></li>
<li><span style="font-size: large;">a man </span></li>
<li><span style="font-size: large;">a baldy </span></li>
<li><span style="font-size: large;">a six-footer </span></li>
<li><span style="font-size: large;">a diabetic</span></li>
<li><span style="font-size: large;">a leukaemiac </span></li>
<li><span style="font-size: large;">a hypogammaglobulinemic</span></li>
<li><span style="font-size: large;">and many other things</span></li>
</ul>
</div>
</div>
<div style="text-align: justify;">
<pre><span style="font-size: large;"><code></code></span></pre>
</div>
<div style="text-align: justify;">
<span style="font-size: large;">All of them are descriptively accurate, none define me. I object to
none of those words in the proper context. To me the intent in context
of the writer or speaker is far more important than any of the specific
words. I cringe sometimes when I see the unwieldy "person with diabetes"
or eve<span style="font-size: large;">n </span></span><span style="font-size: large;"><span style="font-size: large;">"person with type 2 diabetes"</span> when diabetic<span style="font-size: large;"> or</span> "type 2" may be simpler, more succinct and probably more apt, especially when used by a medical professional, another diabetic or some-one who cares for the diabetic. There are times when the longer description may be more appropriate, but not many in my opinion.</span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;">Stop worrying so much about words. If a word offends you, look deeper than the word to discover the cause before reacting.<span style="font-size: large;"> </span>Be more concerned about correcting ignorance than the words used to display it. For years I used my own version of <a href="http://rationalwiki.org/wiki/Hanlon%27s_razor" target="_blank">Hanlon's Razor</a> before I found others had discovered it before me: </span></div>
<blockquote class="tr_bq">
<ul>
<li><i><span style="font-size: large;">Never assume malice when stupidity will suffice.
</span></i></li>
<li><i><span style="font-size: large;">Never assume stupidity when ignorance will suffice.
</span></i></li>
<li><i><span style="font-size: large;">Never assume ignorance when forgivable error will suffice
</span></i></li>
</ul>
</blockquote>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-size: large;"><span style="font-size: large;"><span style="font-size: large;"><span style="font-size: large;">There are more important things in life and diabetes.</span></span></span></span></span></div>
<div style="text-align: justify;">
<br /></div>
<div style="text-align: justify;">
<span style="font-size: large;"><span style="font-size: large;"><span style="font-size: large;"><span style="font-size: large;"><span style="font-size: large;">Cheers, Alan, T2, Australia.<br />
Everything in Moderation - Except Laughter
</span> </span></span></span></span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com2tag:blogger.com,1999:blog-8967781860933132301.post-85625557897950196772013-01-05T14:00:00.000+11:002019-08-23T08:49:25.642+10:00I'm a New Type 2. Do I Really Have to Test so Much?<div style="text-align: justify;">
<span style="font-size: large;">I see that question a lot. </span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">The answer is no, nobody <b>has</b> to.
</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">But I believe it is wise to. Your meter, properly used, is the bright beacon that will light your way through the dark and confusing maze of food advice that bombards type 2 diabetics. You will get advice from every side. If you have not encountered the Food Police yet, you will. Expect to be told that you should change your diet in all or any of the following ways: low fat; low carb; lots of wholegrains; lots of fruit; vegetarian; vegan; raw; no red meats; avoid sweeteners; sugar-free; no dairy; add expensive herbs and supplements; the list goes on and on. What is right and wrong for you? Is no food safe?</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Let your meter guide you to the answer. </span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">There is no doubt that the <b><a href="http://loraldiabetes.blogspot.com.au/2009/04/test-test-test.html" target="_blank">Test, Test, Test</a></b> method is a lot of testing at first when compared with the minimal testing prescribed for type 2s by most doctors. But I believe it is well worth it. The investment of time and test strips in a concentrated effort in the short term has tremendous long term benefits that will last you the for the rest of your hopefully longer, healthier life. And, fairly swiftly, the need to test so much is reduced. The initial period is the heaviest testing load because at that stage you have a blank slate. As you fill in the blanks the load swiftly decreases.</span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">I recommend the following intensive testing routine for people newly diagnosed with type 2 diabetes. It can also be very useful for those who have been diagnosed for a while but who feel they have "hit the wall" in their progress towards good control. </span><br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">For the first couple of days test fasting blood glucose (on waking, before breakfast) and also at one and two hours after absolutely everything you eat, unless you eat again before the second test. That includes breakfast, lunch, dinner and all snacks. This may help if you are not used to testing so much: <b><a href="http://loraldiabetes.blogspot.com.au/2006/10/painless-pricks.html">Painless Pricks</a></b></span></div>
<div style="text-align: justify;">
<span style="font-size: large;"><br /></span></div>
<div style="text-align: justify;">
<span style="font-size: large;">Log everything on the menu including drinks, sides and portion sizes. Every evening spend a few minutes reviewing that log and use it to plan the following day's menu with a view to achieving better results. </span></div>
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<div style="text-align: justify;">
<span style="font-size: large;">Some people are adamant that you must also test before
meals. I agree that it may help to know the starting point when
assessing a rise, but I do not think it is necessary to add an extra
half a dozen tests every day to an already heavy initial load when the
other tests will still achieve your goal. </span> </div>
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<span style="font-size: large;">On the evening of the second day take some time to review all the results. Some of them will seem crazy, but you should see some patterns emerge. The first thing to look for is the timing of your most consistent peaks. That may be a little different for breakfast, lunch and dinner. Is it closer to one hour or two? If you can pick the most consistent peak time then replace the one and two hour tests with just one test at the peak time after each meal. If the peak time is unclear then continue to test at one and two hours and re-assess each evening until it is clear. If necessary add tests at 30 or 90 minutes to be sure; you won't need to do those for long.</span></div>
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<span style="font-size: large;">Use of the peak post-meal time reduces your test load to fasting and peak time after every meal and snack. My own peak time is about one hour after my last bite, but yours may be different.
Over the next few days, using this <b><a href="http://loraldiabetes.blogspot.com.au/2006/10/test-review-adjust.html" target="_blank">Test, Review, Adjust</a></b> technique you should be able to discover several "safe" menus for various meals. You will also find that some meals are OK for the morning but not for the evening or vice-versa. Treat breakfast, lunch and dinner as quite separate results. </span></div>
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<span style="font-size: large;">When deciding your goals I suggest you start with the targets suggested in <b><a href="http://loraldiabetes.blogspot.com.au/2009/04/test-test-test.html" target="_blank">Test, Test, Test:</a></b></span></div>
<blockquote class="tr_bq">
<span style="font-size: large;"><i><span style="color: #330000;">Fasting............................Under 110<br />One hour after meals.......under 140<br />Two hours after meals.....under 120</span><br /><br /><span style="color: #330000;">or for those in the mmol parts of the world:</span><br /><br /><span style="color: #330000;">Fasting............................Under 6<br />One hour after meals......Under 8<br />Two hours after meals....Under 6.5</span></i></span></blockquote>
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<span style="font-size: large;">Do not be distressed if your starting numbers are much higher. It took you a long time to develop your diabetes; you should not expect to correct those numbers overnight. </span><br />
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<div class="separator" style="clear: both; text-align: center;">
<a href="https://i.pinimg.com/474x/4c/c6/3f/4cc63f94d502dfaea92a7b213194cd0d--diabetes-quotes-type--diabetes.jpg" imageanchor="1" style="margin-left: 1em; margin-right: 1em;"><img border="0" data-original-height="286" data-original-width="165" src="https://i.pinimg.com/474x/4c/c6/3f/4cc63f94d502dfaea92a7b213194cd0d--diabetes-quotes-type--diabetes.jpg" /></a></div>
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">Give yourself some time. It may take a few weeks, or even a few months, but the investment in strips and testing you make now will pay you dividends for years or decades. Eventually, when you find you can easily hit those targets consider revising them as I did. See my present targets at the foot of <b><a href="http://loraldiabetes.blogspot.com.au/2009/04/test-test-test.html" target="_blank">Test, Test, Test.</a></b> </span><br />
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<span style="font-size: large;">Proceed cautiously if you use insulin or one of the insulin-stimulating medications. You do not want to go from hyperglycemia to hypoglycemia. Make modest adjustments to your carbohydrate intake, test the results and continue modest changes every meal until you achieve your goals. Eventually you may need to discuss reduction of your insulin or medications with your doctor as the numbers improve.</span> <br />
<span style="font-size: large;"><br /></span>
<span style="font-size: large;">During the second week repeat some of those safe meals. Before your post-meal test try to guess what the result will be. If you can usually predict good results note that menu for future use; you will only need to test after that meal occasionally in future for reassurance. That removes another test from your day.</span>
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<div style="text-align: justify;">
<span style="font-size: large;">Gradually, over successive weeks, your knowledge of safe meals and food portions will grow and your need to re-test them will reduce. Fairly swiftly you should be able to plan menus that you know in advance will not cause blood glucose spikes; as a consequence your need to test so often will drop quite dramatically within a few weeks.
Also, as my fasting blood glucose became fairly predictable I reduced that to just a couple of times weekly. </span></div>
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<span style="font-size: large;">You are building a database that is unique to you. I know it seems like a lot of effort at first, but believe me it will be worth it. </span></div>
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<span style="font-size: large;">These days I sometimes don't test for several days unless I am trying a new menu item or a new restaurant.
If you have insufficient strips, time, or motivation to do it that intensively, that is OK. This will work too, but it will take a lot longer: <b><a href="http://loraldiabetes.blogspot.com.au/2007/04/teting-on-budget.html" target="_blank">Testing on a Budget</a></b></span><br />
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<span style="font-size: large;">Cheers, Alan</span><br />
<span style="font-size: large;"><br />Everything in Moderation - Except Laughter.
<b><br /></b></span></div>
Alanhttp://www.blogger.com/profile/02868809225921579099noreply@blogger.com4