Tag Archives: diabetic diet

Why Dr. Bernstein is an American Hero and Why Doctors Should Be Curious About Him

My colleague at Diabetes Daily, Maria Muccioli, Ph.D., wrote an excellent and in-depth coverage of a remarkable study on very low-carb diets for treating type 1 diabetes in children.

The study found that a group of type 1 diabetic children following a very low-carb diet à la Dr. Bernstein style were not only experiencing normal blood glucose levels (this is nearly unheard of in type 1 diabetes) but also growing well (a top concern as macronutrient intake of carbs is widely believed to be essential for growth in children).

The researchers of the study looked at children from a Facebook group called Type1Grit. This group consists of adults with type 1 diabetes and parents of children with type 1 diabetes who all follow Dr. Bernstein’s regimen. This regimen includes very low-carbohydrate intake but so much more–put just any type 1 diabetic on a very low-carb eating plan, and I promise you’ll likely not get the results you are hoping for–though if you pay close attention to blood sugars you may notice some interesting things regarding the statistical range of error after giving smaller amounts of insulin. It’s about more than low-carb eating. Low-carb is essential to the plan but to do well, there are more things to do and understand. One must understand how to use and adjust insulin properly, understand how different physical activity impacts blood sugars, and so on. The Type1Grit group does so well because they utilize Dr. Bernstein’s decades’ long expertise to guide them (which is all in his book) and like any good support group, they help each other stay focused, informed, and motivated.

Some people on social media have voiced strong opinions against the group due to some of their outspoken members. It is my hope that we focus on content over delivery when it comes to important matters. After all, if fellow thinkers had rejected Issac Newton’s findings simply because he was a jerk (and according to the book I’m reading my kids about him he was) wouldn’t that be a shame? Personally, I strive to be gentle with others because I am quite sensitive. However, I also try not to put my feelings above critical thinking, and I think that serves me well. I also hope that the communication of a few doesn’t cause some to dismiss the whole group or worse–a promising idea. That said, I have not personally observed anyone from that group being rude to others, though some have been quite open and blunt with their opinions and I have observed a very strong response to that, in general. I do not consider an opinion shared in a straightforward manner to be rude.

My Personal Story Following Dr. Bernstein’s Advice

I have followed a loose version of Dr. Bernstein’s protocol for about a decade, further lowering carbs and adding in more of his advice gradually over the years (I now follow his advice very closely). His logic struck me like lightning when I read his book, Dr. Bernstein’s Diabetes Solution. In particular, I was deeply moved by a line that said something about how people with type 1 diabetes “deserve normal blood sugars”. Dr. Bernstein’s protocol includes the use of Regular insulin to cover high protein meals versus faster analog insulin such as Humalog or Novolog. In fact, after using a CGM (continuous glucose monitor) for the first time recently, I quickly saw how my Humalog was a bit too quick and potent at mealtime and then a bit too short hours afterward, so I bought Novolin R at Walmart for $24 and have improved my blood sugar levels. This is to stress how following Dr. Bernstein’s protocol is about more than just reducing carbohydrate intake.

Many years ago, I found immense value in attempting just a little bit of Dr. Bernstein’s advice. Small changes like lowering my carbohydrates and understanding how to use my insulin better led my A1c to drop from 8-9% down to 6%. Before this, just covering high amounts of carbohydrates with insulin had mostly succeeded in making me fat, tired, depressed, and anxious (oh and with protein spilling into my urine as an 18-year-old in her “prime” of life). You have to understand how terrible this was for me–I was a bright-eyed kid who was intelligent, hopeful, hardworking, patient, and super determined. In a few short years, diabetes messed with my potential–I didn’t recognize myself anymore. It’s particularly sad to spend years recovering as a young adult when you’re supposed to be at peak performance and potential due to your youth and energy.

Dr. Bernstein, who many dare call a “quack” or “nutjob” saved my life just as he saved his own. My A1c hasn’t touched 6% in many years. I have a wonderful husband. We have twins who are about to turn 9. I’m still trying to reverse some of the consequences of very high blood sugars from my first 10-12 years with diabetes. What if I didn’t have to?

What Actually Does More Harm?

People tell me that eating low-carb will hurt my cognitive abilities. Do they know that studies indicate that typically managed type 1 diabetes may do that, anyway? Type 1 diabetes (with the average management of 8.2% A1c in the U.S.) has been shown to possibly lower intelligence and negatively affect memory and speed. Low-carb in the long-term may hurt my cognitive abilities (I haven’t seen anything to indicate this possibility though) but what if it just takes the place of what high blood sugars would have done to my cognition? And what if low-carb additionally helps protect my cardiovascular health and my kidneys and my eyes–oh and allow me to have healthy children! Do you know how fortunate I am that I turned things around when I did? I have children because of the information that turned my health around just in the nick-of-time. I can’t begin to describe the level of rage I might have had I never had children yet discovered that Dr. Bernstein has been trying to tell the world about his successful method for decades.

Where is Our Curiosity?

If you find Dr. Bernstein followers as angry or overly-passionate, this may help explain why: Unnecessary suffering is a tragedy. We’re in a country whose founders had been curious and open to acknowledging ideas that are worthy, pushing those ideas to the top where they can be put to the test and then accepted as the best ideas because they can create the best outcomes. This is the great thing about Western Civilization. The embracing of objective principles which allow the best ideas to rise because even if they come from someone we can’t stand, we know that ideas, critical thinking, and truth reign over all else and push us towards progress. Dr. Bernstein’s protocol isn’t an expensive training center and it’s not just for the elite of the world. He thrives using a cheap insulin in the same country where people die because they don’t know they can change their dietary habits and purchase cheap over-the-counter insulin in most states and survive.

From an economic and financial viewpoint, Bernstein’s protocol is also a stunning success. I don’t use an insulin pump or a CGM (I only got to test one out) and yet I can achieve my glycemic targets. I don’t need any apps, certified diabetes educators, or expensive technology. I don’t anxiously await a closed-loop hybrid insulin pump system because I don’t need it. I put all my energy into my simple but effective daily lifestyle. Providers who want to see healthier patients, please read Bernstein’s book. Your lower income patients may not want to follow the regimen in part or entirely but those who are willing deserve to know how to thrive with diabetes despite being poor or lower middle class, like me. I give myself excellent care for cheap–doesn’t that peak your interest?

People are justifiably angry over insulin prices but what about the medical community’s unwillingness to be curious about one doctor’s personal plan to keep himself at peak health and fitness well into his 80s? Without curiosity, what on earth then drives a doctor to investigate the issues in each patient as well as find the proper and least harmful solution? I tell my doctor how I managed a huge drop in A1c for the first time in my life and he has no questions regarding how I did it? I read doctor responses to research that shows a teeny tiny improvement in A1c and now they think “this shows wonderful promise and we should look into it further!”? I basically told my doctor I might have just saved my own life and drastically improved my quality of life, and he’s like “meh”. I told another how I did it and he said, “good for you.” Yes, good for me, but what about some of your patients who are as I was, struggling to get a halfway decent hold on their blood sugar and suffering? What about them? Don’t you have an obligation to check this out? This gives my doctor less work, by the way! For a decade now my doctor does nothing to manage my diabetes–he just orders labs. Aren’t doctors wanting more patients that can manage their blood sugars and don’t need them so desperately at all hours?

It Takes “Too Much Discipline” or “Restraint”

Nothing terrible ever happened by being disciplined. Think of all the amazing people out there and from history–what could they have accomplished without discipline? Probably nothing but a few moments of greatness. Discipline encompasses you within a realm of potential greatness. And if you create a system, discipline isn’t a show of willpower as much as you just loyally following your regular routine.

Much research backs up the potential of the ability to defer gratification. Who is more likely to become successful? The person who can restrict themselves from their impulses and short-lived desires, right? Let me put it this way: who would you rather marry? Someone who can keep their impulses in check or someone who can’t? Or who would you rather be? Someone who doesn’t overeat or someone who regularly does? I remember having hearts in my eyes when my husband told me “I never overeat”. I have long struggled with overeating, and when he said this, I was impressed by him and thought, “wow, I want to be like that.” I believe this is the empowered response. I could have given the common humorous response of “ugh, you make me sick” but where would that have gotten me? Instead, I tried to learn from my husband and improve myself.

I also think the healthy response is to admire someone like Dr. Bernstein for what he has accomplished against great odds. Dr. Bernstein is respected by so many because he created a well-functioning system to get himself thriving and generously shared his findings with others. In fact, as an engineer, he became an endocrinologist so that he could help others after he figured out how to save himself. He should be regarded as an American hero, whether you want to do what he recommends or not.

I believe in freedom and personal rights. I’m an immigrant who is incredibly happy to live in the U.S. Growing up when I found something challenging and I didn’t want to face it, my dad would say “Are you an American or an American’t?” I would often roll my eyes but, yes, I’m an American and believe I have the power to set my mind to improve myself if I want and I’m grateful for those who have set their minds to things and laid out paths before me. Thank you, Dr. Bernstein. I may never reach your astounding level of discipline but what I have been able to achieve with your advice has been most valuable to me and my family and I am forever grateful.

En fin, I’m certainly not saying you should do what he does or what I do. And I can respect wherever you are on your journey. I’m saying that Dr. Bernstein’s method has shown undeniably incredible potential and results and the general lack of curiosity and investigation on behalf of the global medical community makes absolutely no sense to me. There are now thousands of people doing it and doing it well.

Newton supposedly struggled with his ego and an inability to face criticism or questioning during his lifetime. Let’s have his overwhelming curiosity without the pride, his determination to dig and experiment properly without his emotionally unstable and anti-social ways.

I will leave you with one more thought:

Just a little bit less damage sustained is a great deal to the person enduring it, especially when they still have many decades ahead of them.

Why I Understand Low-Carb Proponents for Type 1 Diabetes

Some people are very strong supporters of a low-carb diet for people with type 1 diabetes (or any diabetes). Historically, this group of people has not been well-received by many with type 1 diabetes or those who have children with type 1 diabetes because of the way that insulin can be utilized to not deny a person certain foods and the joy they bring.

I can sympathize greatly with the idea that we all deserve a treat from time to time and I can understand why some want to eat what they want and just learn to manage with their insulin timing and dose. I can certainly see why raising a child with type 1 diabetes and having them never eat sugar or many carbs can seem like a daunting and almost cruel route.

I’ve long made the case for reducing carbohydrates on a personalized level. For example, I do believe that some people cannot feel well or thrive on an extremely low carb or ketogenic diet (I can’t) so it makes sense to take symptoms in consideration. I do think that facts indicate how reducing carbs increases the chances for more stable blood sugar levels but, there are different degrees one can take when it comes to carb intake. I’m not extremely low carb but I have a low enough carb intake that my blood sugar management is pretty good, my triglycerides are very low, and I avoid extreme highs and lows on a consistent basis.

The “I can eat that” movement of the past decade has seemingly fizzled out. Or maybe I’m not reading as many diabetes blogs as I used to. Either way, I can’t help but wonder if people have endured experiences like the ones I have which bring me to the conclusion that “yes, I can eat that, but I will likely suffer the consequences of doing so, so in a way, no I can’t eat that”.

Early on, during the first decade or so with type 1 diabetes, these consequences seem acceptable to many of us. The future is far away. As someone who has now lived with type 1 diabetes for over 22 years, I see things differently.

After 20 years with type 1 diabetes, there is a much higher likelihood for a great number of horrible complications. These are ominous when you aren’t experiencing them but when you are…well let’s just say that it is an entirely different story. There is a pain on top of the pain of those complications and it involves the question “What if?” “What if I could have avoided this?” “What if I had just managed to have better blood sugar management during those first 10 years?” “What if I had just ate fewer carbs?” Those questions are brutal. I endure them on a regular basis. I sometimes wish I could relive my childhood and rip all those carbs out of my hands.

So because of those questions and the pain associated with them, I feel that it is a good idea to share with others what I wish I could have done differently so that they may be better armed to avoid the complications I’m getting a taste of now. Everyone should do what they think is right for them, of course but, I didn’t even have a chance growing up because no one said “low carb eating can help you avoid dramatic blood sugar swings” and my healthcare team encouraged eating pasta, oatmeal, and cereals-all the things I avoid like the plague nowadays. (The other negative side effect is I’m now working really hard to learn to trust doctors again.)

I respect any diet a person chooses if it works for them. I totally understand not having the level of willpower required to deny pizza or ice cream on occasion (I haven’t got it). Most people with type 1 have an A1c that is too high, though. I’ve had an A1c between 5- 6% for the last 11 years and stuff is starting to happen. And some of this can’t be alleviated much or fixed with any medication or treatment. I’m only 33 years old. Not everyone is as sensitive as me but we don’t find out until it is too late.

That said, I’m generally doing very well. Life is good and I am healthy enough to do the things I want to do every day. I’m just choosing to recognize that some unfortunate things are starting and I still have many decades to go–and that is terrifying. I’m picky. I want to be AS freaking healthy as a non-diabetic. I don’t deserve less than that…but I know I have to work for it.

Some Dr. Bernstein supporters are kind of known as bullies in the online diabetes community. I hear comments about them where people express annoyance at how passionate they are about pressing others to consider a very low carb diet for type 1 diabetes. While I want people to engage myself and others in a respectful way and most of these low carb supporters have been very respectful to me personally, I have never been able to deny that even when someone is rude, they have a point. An A1c that is at or near normal levels is probably the best defense when it comes to complications.

Yet, at the same time, I acknowledge that I can’t eat as disciplined as I’d like. Well, not that I can’t, but apparently, I won’t, although I do better than I used to which gives me hope about the future. Kudos to those of you who do. You have my bewildered awe and respect and to those of you who struggle like I do, don’t stop trying and please stay open-minded about what you are capable of. Many years ago I saw no way of getting my 9% A1c down until I learned about low carb eating and I slowly began to implement it.

That said, we are all on a different part of our own journey and I support you where you are at. I share what has helped me because I wish I’d known some of these things sooner. Time has a way of flying by and I find it telling that I am not traumatized by a childhood full of insulin shots and finger sticks and being different and having sugar-free jello for my birthday. No…it was those crazy blood sugars.

Saturday 2015 Diabetes Blog Week My Favorite Blog Post

Click for the Favorites and Motivations – Saturday 5/16 Link List.
If you have been blogging for a while, what is your favorite sentence or blog post that you have ever written?  Is it diabetes related or just life related?  If you are a new blogger and don’t have a favorite yet, tell us what motivated you to start sharing your story by writing a blog?  (Thank you Laddie of Test Guess and Go for suggesting this topic.)

 

My favorite blog post: (Because getting this info down took forever and it’s one of the biggest things that helps me…)

Classification of Carbs

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I really believe carb counting alone is insufficient when it comes to my diabetes management.  At least the simple way it’s taught.  It’s just my opinion and I’ll explain why:

I’ve found that for ME, there are adjustments I make for different types of carbs.  These are adjustments beyond just subtracting grams of fiber.  A carb is not a carb.  They vary spectacularly and learning their differences helps me keep my blood sugars in range and helps me decide which carbs to avoid.

I classify my carbs:

-Refined grains

-Sugar/sucrose/plain fructose (no fiber)

-HFCS (High Fructose Corn Syrup)

-Chocolate, ice cream, and other high fat desserts

-Poultry/Meat/Seafood

-Fruits and vegetables

Refined Grains

When I eat anything with processed grains like white rice sushi or pizza or cookies, cake, or crackers, I have to watch out for a post meal blood sugar skyrocket.  It doesn’t happen right away which is why it’s often confusing to dose for these kinds of foods.  For example, last time you had pizza you were high afterwards so this time around you give more insulin, only to get low in the middle-towards the end of your meal.

I find that about 30 minutes after eating anything with refined or processed grains, I have to give another dose of insulin.  An insulin pump option on a dual or square wave bolus works well for a lot of people, but from what I gather, people with and without pumps have a hard time keeping blood sugars in range with processed grains.

Sugar

Eating something like candy made from glucose or sugar or drinking plain 100% juice or sugar sweetened beverage is a bit different.  I find that if I’m going to consume this within a reasonably fast amount time (as opposed to snacking over a period of 30 minutes) then I count carbs and using my 1:15 scale, I give just that amount of insulin.  Then I wait 15 minutes for the insulin to start working (more if I’m not in range).  I find that the insulin cancels out the sugar carbs pretty well and there is no shocking aftermath.

High Fructose Corn Syrup (HFCS)

This one is interesting.  At least for me (remember, this is just what happens in MY body).  I find that candy or beverages made with HFCS works like when I eat refined grains.  But that makes sense to me when I think about corn being a grain!  It’s easy to forget because people serve it to kids and say “eat your veggies”.

High fat desserts

This gets it’s own category because of the large amount of fat (and because they’re my favorite!)  I try to stick with dark chocolate for a low dose of sugar.  I also make sure to buy desserts that do not have HFCS in it as a sweetener.  I try to get the gourmet kind with minimal ingredients and then I count carbs and give insulin in the middle of eating since the fat content really slows down the absorption of most of these foods.  If there is a lot of sugar I give insulin prior to eating as usual.  I’m referring to a dessert like high fat truffles, mostly.

Poultry/Meat/Seafood

I count carbs and then add a tiny extra amount of insulin to my carb count depending on how much I eat.  I don’t have to do this unless I’m really filling up on this protein source.  I love how these foods fill me up and do very little to my blood sugars.

Vegetables and Fruits

I’m a fan of these, especially in terms of carbs.  As you are well aware, the high antioxidant, vitamin, mineral, fiber, and water content of these foods makes them wonderful for our health.  I definitely don’t need as much insulin for these foods.  I count the carbs and then omit for fiber content.  Fruit is something I stick to consuming in it’s natural state and in small quantities.  The sugar in fruit is fructose and too much overloads the liver, causing fatty liver problems.  Oh and it definitely affects blood sugars.  My favorite are cherries, they are very low glycemic.  Have you tried them for a low?  It takes so many!

I know I didn’t talk about legumes or nuts.  I don’t eat legumes anymore.  I think I ate too many as a kid.  I treat legumes like vegetables and I treat nuts like meat.

With any food:  If I eat a lot, I need to give a little extra insulin for the full stomach effect that Dr. Bernstein has talked about in his books.

I adjust for a few other things.  I’ve mentioned them before but here we go again:

BM status.  Eww, I know.  But being backed up might make a person anticipate a need for more insulin.  The opposite of that issue= less insulin.  So watch out for major lows if you get food poisoning!

Stress.  If I’m stressed, I have to give a little bit extra insulin to combat the stress hormones and their affects on my blood sugars.

Exercise.  Different types of exercise require different diabetes management approaches.  Read Ginger Vieira’s book for that info and so much more-even worksheets for getting all these changes right!

PMS.  Days before I start, I need to up my basal insulin.

Sleep.  If I stay up late (past midnight), I have to give some extra insulin (unless I’m active).

Sedentary.  If I’m being sedentary more than two days in a row due to sickness or diabetes burnout or whatever, I definitely have to up my basal insulin substantially (by 30-40%).

Too much artificial sweeteners.  Certain artificial sweeteners in high doses do contain carbs (it’s a small amount per serving so they’re legally allowed to round down to 0) so if you’re binging on diet coke, check your blood sugar and stay alert to a sneaky increase.

That’s all I can think of.  It’s just an example of how you want to be aware of how your body reacts to different types of food and activity.  You can see why I stick with meat/poultry/seafood, vegetables, and fruits.  Much better blood sugar stability and less variability for me.  But when I do splurge, at least being aware of how those foods act differently help me manage them for those occasions.

I write all this out because you can have tighter blood sugar management.  It helps to learn yourself and the foods you’re eating.  Again, get Ginger’s book or ebook and discover how to improve your blood sugars.  I highly recommend it.

Friday 2015 Diabetes Blog Week What I Eat

Click for the Foods on Friday – Friday 5/15 Link List.
Taking a cue from Adam Brown’s recent post, write a post documenting what you eat in a day!  Feel free to add links to recommended recipes/shops/whatever.  Make it an ideal day or a come-as-you-are day – no judgments either way.  (Thank you, Katy of  Bigfoot Child Have Diabetes for this topic.)

 

Here is what I ate one day last week.  It’s pretty typical though I do like to change it up quite a bit:

Breakfast

In a magic bullet blender I put in a handful of frozen berries, a little fresh mint, some kale, chard, spinach, (or other dark leafy greens), some almond butter, chia seeds, and unsweetened coconut flakes.  I drink it up in a wine goblet.

11am I have coffee with a little milk.

Lunch

Kale salad with feta cheese, tomato, red peppers, and olives.  A slice of uncured deli turkey.

3:30pm I have tea time.  Today is a chocolate mint mate with nothing added.

Dinner

Some sauteed mushrooms, potato, squash, in a bed of peas with mint.  A glass of cheap wine.  A hibiscus popsicle.

 

This is a typical feel good day.  There are days when I have pizza with grilled veggies on top and ice cream.

 

Interview with Healthy and Fabulous Type 1

I think everyone has a particular type of person whose lifestyle and successes really “speaks” to them.  Someone who has truly inspired me since I “met” her on Facebook is Ellen Sherman.  Ellen is a wife, mother of two sons, and a 63 year old woman living with type 1 diabetes.   I’d describe her as very healthy, disciplined, positive, and generous.  I am very grateful for the information she has been sharing with me which I now want to share with you.  So kick back and get some free inspiration today :) 

I will let her do most of the talking as I believe this is more powerful in her own words.

Ellen has had type 1 diabetes for 33 years.  Despite always being interested in learning about nutrition, emotional, and physical well-being, Ellen became and thoroughly enjoyed being a High School teacher.   Although diagnosed with diabetes at age 30, she was familiar with the devastating effects of uncontrolled diabetes from watching her grandmother suffer total blindness and amputation before her early death. 

Her diagnosis was a bit complicated:

“At first, I was improperly diagnosed as a Type 11 even though I had none of the characteristics–I was thin and did not have the blood profile of a Type 11. When I saw a highly recommended Endocrinologist, he did a GAD antibody test and other tests that confirmed that I was Type 1.  In addition, I was being treated with an underactive thyroid which is another autoimmune disease prevalent in Type 1 diabetics. By the time I was properly diagnosed I was terribly underweight and struggling with high glucose numbers.  I started insulin immediately and began researching various dietary recommendations that were available at the time.  After months of testing, I realized that if I kept the diet that the ADA recommended I would be taking more and more insulin, thus increasing my chances for insulin resistance and destroying whatever beta cells I had left.  I was determined to find a different approach that worked for me.  At first it was trial and error, but with time I realized that I had to make considerable lifestyle changes to achieve my goal, to remain complication free and live a long, healthy life.” 

Ellen started testing herself and keeping a journal.  She took up weight training to build muscle mass and made aerobic exercise a part of her daily life.  She tested before a meal and two hours after a meal and came up with her own diet plan.  She read Dr. Bernstein’s Diabetic Solution and incorporated many of his ideas.  She says Dr. Bernstein himself was kind enough to speak with her over the phone to answer any questions she had.  Ellen doesn’t happen to agree with the high fat/low carb diet for herself in particular so she modified her own diet according to her beliefs about the necessity of preventing cardiovascular disease.

What she did instead:

“I ate lean protein like chicken and fish high in omega 3 and low glycemic vegetables and fruit.  For years I was able to maintain an A1C always between 5.5-5.7 with insulin, exercise, and a rigid but delicious diet. Fortunately, I loved vegetables and used my creativity to prepare meals that were low carb, nutritious, and delicious for myself and my family. For many years I followed this plan of action with considerable success–Cholesterol/HDL/LDL and A1C were well above average for someone of my age and being diabetic.  I was monitored carefully by my internist and endocrinologist.  They began asking me questions about how I was able to maintain such a healthy lifestyle which I gladly shared with them.”

I found out that Ellen has done a lot of giving back to the diabetes community.

“Over the years, I have helped others who have dealt with Type 1 and Type 11 diabetes, especially young children and their families.  I am a firm believer in treating the physical, emotional and spiritual well being of an individual to deal with any chronic illness.  Diabetes is very stressful to the individual and their families.  Stress has a devastating effect on one’s physical health, thus it is extremely important that individuals learn techniques to maintain a positive, problem-solving state of mind.  Through meditation, cultivating the sacredness in everyday life, and  developing cognitive behavioral techniques to overcome anxiety, depression, etc. which comes with dealing with a chronic illness.  In addition, I am a firm believer in the transformative power of mindfulness–staying within the moment.  Without these techniques it is very difficult to maintain the highest level of lifestyle to overcome the effects of diabetes on your body and spirit.  People with diabetes are unable to take time off thinking about how to control their highs and lows by testing, taking insulin and counting carbs.  Thus they need tools to enable them to obtain the peace and spiritual enlightenment to not become a “victim of diabetes”.  I believe that by empowering oneself we are able to become warriors with the strength, discipline, and dedication to control the disease, rather than it controlling us.  When I coach people, I do not expect them to follow the lifestyle that I have chosen. However, if I can teach them a few techniques that enable them to get better control.”

While on maternity leave from teaching, she “got a call from the head of  continuing education from the state department by a women who had heard about me through parents of former students and students who were now working.  She asked me if I was interested in developing a program for the state of New York on motivational techniques, time management, organizations skills and problem-solving techniques.  At first, I hesitated but then I realized that I had many techniques that I shared in my classroom that would be applicable to adults working for the state. All my seminars were based on curriculum that I developed and later approved by my administrator in Albany.   It became a very successful program for employees working at the state building, Stony Brook University, and other facilities that were state run.  In time, I found that it was almost becoming more than a full-time job, and I was being asked by private corporations to speak to their employees.  I continued conducting seminars until a few years after my second son was born and then retired.  After, I was heavily involved in volunteer work in my school district  and then I became interested in helping adolescents and young adults dealing with emotional and physical challenges who were referred to me.  Always on a volunteer basis.  Later I became interested in helping others who were dealing with Type 1 or Type 11 diabetes, again on a volunteer basis. I now do it on a limited basis.  At this point in our lives my husband and I are finally getting the chance to spend more time together.”  

Ellen and her husband, Mark

 

Ellen feels very strongly about daily exercise, saying it should become a part of daily life.  She suggests activities such as “walking, running, bike riding, and some weight training to build lean muscle mass contributing to the better utilization of the insulin you take or are making.”

She is a firm believer in her low carb and low glycemic diet where she eliminates anything white like sugar, white bread, potatoes, and white rice.  Ellen suggests trying to eat “vegetables of every color to maintain glucose control and obtain antioxidants to fight free radicals, cancer, and cardiovascular disease.”

I asked her what all makes up her diet:

“Fruits: strawberries, blueberries; apples.Nuts: -walnuts, almonds, peanuts (handful a day). Lean protein–chicken, turkey, tuna, salmon, sardines, flounder, snapper.  Herbs: cumin, oregano, thyme, rosemary, tumeric, etc.  Olive Oil for cooking and in salads.  In addition, I love to make sandwiches for lunch or egg whites with spinach with my low carb, high fiber tortilla from La Tortilla factory.  I try to eat a salad with very little olive oil and loads of vinegar which works to keep my glucose stabilized with my dinnertime meal.  During the weekend, I allow myself a little more freedom, by giving myself a shot of novolog if it is a higher carb meal.” 

About her diabetes management and insulin intake:

“Right now I take Levemir and split it–morning dose 5 1/2 and evening dose 5 1/2 to 6 units (always adjusting according to glucose readings and a goal of 100 or less fasting/morning reading and 140 or less two hours after meal).  This seems small but I am only 5 feet and I have a lean, muscular body 102-104 lbs. mostly muscle and very little body fat for a female.  I run three to six miles in the morning after having two cups of coffee with milk no sugar until my glucose is down to 80. For lunch I have a Tortilla with tuna or salmon with humus, and whatever cooked vegetable from last night’s meal is leftover, salad and a piece of low fat cheese.  If I am higher than 140, two hours after lunch I run a mile.  My snack around 4 o’clock is two pieces of dark chocolate wedges from Trader Joes, strawberries and cheese, nuts or a piece of an apple.   For dinner I have chicken, fish, and 3/4 of my plate filled with multicolored vegetables, salad with low fat cheese, berries (balsamic vinegar, little olive oil).  I find eating between 6 to 6:30 pm works for me.  My snack after dinner if low enough –sugar free jello/whip cream or a handful of nuts. Throughout the day I test.  I graze on a few nuts or berries if I am heading below 100 before my lunch or afternoon snack.   I test myself 8-10X a day.  I have eliminated my breakfast just recently, as I have found that since I am getting older I need less food to maintain my lifestyle, energy and physical well being.” 

“Overall, I am in excellent health according to my doctors–no complications.  The last time I got my eyes tested by a retina specialist he was amazed I’ve had diabetes for over thirty years.  He saw no signs of complications.  I do not produce any insulin at this time unfortunately, but I am able to maintain a wonderful positive, happy, productive life.    Most importantly, I have tremendous gratitude and attempt everyday to help others in their struggle to deal with a chronic disease or any emotional or physical illness.”

Ellen and her son, David

 

Ellen said something else that really struck me and gave me more energy to continue my blogging:

“One of the most essential ingredients to living a happy life is giving of our time and sharing our knowledge. Hopefully, through your efforts and others more and more people will become aware that they can live a long, healthy life with a chronic disease. In many ways, the challenges and obstacles that I faced throughout my life have been empowering lessons that have given me the strength and motivation to obtain the happiness and serenity I always knew was possible even in my darkest moments.”

Ellen, you’re a true inspiration to me.  I hope to continue to thrive with my diabetes by taking care of myself to the best of my ability and I hope to do it as elegantly as you have with the same empowered and grateful spirit.  Thank you so much for sharing your story with us. 

Note:  Ellen advocates for everyone finding their own path to wellness according to their own individual circumstances and needs.  She acknowledges the fact that we all have different diabetic “profiles”.  I would have to wholeheartedly agree.

Wednesday Revisit: Why Low Carb Works Best for Me

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Back when I wrote this post I thought I was doing a low carb diet because it was so much lower in carbs than my previous diet.  However, I eat a small amount of legumes, sweet potato, and fruits throughout the week and these are high carb foods.  So maybe I eat more of a moderate carb diet while trying to omit processed foods.  I think those are the real culprit for me, anyhow. 

In this post I explain why limiting a lot of carbs helps me keep a low A1c.

Originally posted August 2nd, 2009

Check out: Why Low Carb Works Best for Me

But, I Can’t Eat That

 

I try to say, “I can’t eat that” in all sorts of different ways so other diabetics don’t get told, “But, you can’t eat that?!”  I say, “I’m not hungry” or “I personally don’t do well with that kind of food”, etc.

Truth is, there is a lot I can’t eat.  I mean I can, but my blood sugars pay a price which means my health pays a price which to me translates as a big no-no. 

I could eat pasta for dinner.  I’ll give the right amount of insulin to cover it and I’ll be fine.  Until a little later that is, when my blood sugars start creeping up in the most sneaky way.  Slowly…slowly and suddenly I test before bed and find I’m over 200. 

Frankly, anything white does this to my blood sugars.  ANYTHING.  So, although I could eat a hamburger, I better leave out the bun or I’m going to be sorry later.  Same goes for rice, a sandwich, and cookies.

You know how the “raw diet” has become strongly marketed for type 2 diabetics?  Well, when I stick to a “raw diet” or a “clean diet” I see wonderful blood sugars.  My insulin resistance lowers dramatically.  And I lose weight.   It’s fabulous.  Except for the part where I pay for the groceries.  It’s cheaper to buy the processed stuff for sure!

The way I see it, you have the “right” to eat what you want.  I just think that if you’re not getting good results with a particular food, it should be on your “only once in a while” list.  

Maybe it’s just me, maybe I have nerve damage and it makes me digest food more slowly.  Instead of being a victim to that I just eat differently and I’m fine.  But I guess my point is…I wouldn’t want anyone to scoff at me for turning down pizza.  I have the right to say “I can’t eat that” without people saying I’m fueling a diabetes myth.  Nerve damage affects a majority of type 1 diabetics after a certain amount of years.  I think the figure is 50-70%.  This means I’m not the only one and those who are safe now, may not be later on and they too, deserve to feel free and accepted when it comes to their health choices.

So although it must really be difficult for people to explain over and over and over again that type 1 diabetics can eat anything as long as they give insulin to cover it…the truth is it’s more complicated than that.  Not everyone has this liberty and not everyone will retain it. 

People can handle complicated answers (well…most people).  Next time someone says, “Wait, can you eat that being a diabetic and all?”  If you can then say something like, “Yes, I definitely can because I take insulin to cover the carbs, but this varies from diabetic to diabetic because of other factors.” (I’m sure you could come up with something much better)  Yes, this may leave a poor soul a little perplexed, but, the right thing to do is to tell it like it is instead of make a general statement that is meant to encompass everyone but instead falls short.

The Science Behind Type 1 Diabetes and Weight Gain

 

It’s understandable that any community would prefer to say, “To each his own” when it comes to personal choices like eating preferences.  So I frequently hear diabetics say that they can eat whatever they want and advocate for other diabetics being able to do the same-as long as each person is successfully able to manage their blood sugars.

And this makes sense to me.  It’s true that every person’s diabetes varies from the next. 

Something that also makes sense to me is what Dr. Bernstein calls “The Law of Small Numbers”.

It’s something I figured out before hearing about Dr. Bernstein.  Since a certain percentage of insulin going in us isn’t being absorbed each time, there is a varying error margin.  The more insulin we need to give, the higher the error margin. 

For example when I lost weight, my blood sugars improved, in part because my insulin resistance was lower and I then needed less insulin than before.  When I changed my eating to lower carb intake, I again noticed better blood sugars because I took less insulin and therefore saw a lower margin of error every time insulin was given.  This lower margin of error is nothing short of miraculous on blood sugars.

If I eat a bowl of pasta, I’m personally, going to give about 7 units of insulin.  A certain percentage of this insulin will inevitably not be absorbed efficiently.  This means that after eating, I will most likely have to correct blood sugar with insulin or some sugar. 

If I eat a steak, I give about 1/2 a unit of insulin.  Again, a certain percentage of this insulin will not be absorbed efficiently.  An “X” percentage of 1/2 a unit of insulin is surely to be less than the same “X” percentage of 7 units right?  This means that with the steak, my chances for having a low or high after eating are minimized AND it means that if I do get a low or a high, the low won’t be very low and the high won’t be very high.  So I’m more likely to stay within a better range. 

This is why I don’t feel that a pump necessarily equals better blood sugar control.  If someone is eating all the carbs they want and just correcting with boluses and sugar as needed, then the likelihood for a higher A1c goes up-because of “the law of small numbers”.   

My lowest A1c test result was over 2 years ago and was a 4.6.  My doctor automatically assumed I was having too many lows and should let my “blood sugars run higher”.  “Really? Higher than yours get to be?”, I thought.   I had to explain to him that I had fewer lows during the time reflected in that A1c test than I had during the time my A1c was a 6.8.  I just had more consistent numbers.

The months prior to that 4.6, I was experimenting with low carb eating to see how my A1c would turn out.  Not only did I lose weight, but the greatest thing was how my blood sugars stayed even keel.  The swinging blood sugars stopped, as did my swinging moods.  Of course, there are still plenty of things that affect blood sugars but, for me, eating low carb made post meal 40’s turn into 70’s and 250’s turn into 150’s. 

It’s so much easier to get a 150 down to 100 than it is to get a 250 down to a 100.  Plus, correcting for a 250 means again that because you’re giving more insulin than if you were 150, there is a higher margin of error and a high risk that in a few hours you’ll need more insulin or more sugar. 

This brings me to my next point.  For type 1 diabetics eating a lot of carbs, weight management becomes difficult.  Most of the thin type 1 diabetics I’ve known of are either adults eating low carb diets or children who are still growing. 

How many type 1 diabetic children don’t start struggling with some weight gain once they turn 18 or 21?  Of course there are exceptions to every rule but, for the most part, I’d say that a way to minimize weight gain in type 1 diabetic adults would be to eat fewer carbohydrates.  The yo-yo on blood sugars that a higher margin of error exacerbates translates to more insulin and more sugar correcting.  This directly translates into weight gain. 

I know it’s not what you want to hear.  After all, we diabetics can eat anything we like and just cover with insulin!  Sure…but, I don’t know about you, I like to be thin.  It means less insulin resistance and better glucose numbers and an easier time exercising.  It also means there is less stress on the body in general.  Such as our feet.  What about knees?  10 pounds of weight loss equals 40 pounds of pressure off of your knees.  So the benefits continue on and on.

I’m making a case here because I wish someone had made a case to me when I was in High School.  I was on the Varsity Soccer Team and so I exercised at least 2-3 hours a day.  I was heavier than all the other girls on the team even though I ate less.  Not fair!  I could have been spared a lot of heartache and frustration. 

Back to today.  Currently, major financial restraints have me eating more carbs than I’d like to (more brown rice, less meat) and my daughter being allergic to eggs means I can no longer rely on an egg’s cheap, low carb, and perfect nutrition.  It’s probably why I’m not losing weight right now.  I eat 40% more carbs than I did 2 years ago.

But before all this, here is what used to work great for me:

Breakfast:  One or two eggs

Lunch:  Chicken salad or tuna

Dinner:  chicken/beef/fish and a side of veggies

Snacks:  Beef jerky, raw veggies, nuts, dark chocolate

Several times a week:  small servings of lentils or beans, fruit, green vegetable juice, Ezekiel Sprouted Grain bread.  (I try to make these my low correcting foods if I’m not too low)

Drinks:  Water, herbal teas, coffee (diet soda would work only it tends to make me really hungry)

I admit it isn’t easy or very cheap to eat this way (especially not cheap if buying all this in the organic section).  You get used to it though and dropping pounds and feeling healthier makes it more than worthwhile.  I’ll say it again.  It’s not easy.  You may feel something is missing from your diet.  Yet, if you are having trouble losing weight or if you are trying for a lower A1c, this is the best way I know of to do both.

I share this info because it proved invaluable to me and my health.  You take it or leave it or take a little of it, whatever you like. 

Salud!

10 Thanksgiving Tips for Diabetics

 

As we express our gratitude, we must never forget that the highest appreciation is not to utter words, but to live by them.

-JFK

I think Thanksgiving and respect go hand in hand.  We give thanks on Thanksgiving Day and when we give thanks, we are grateful.  When we’re truly grateful for something we have the desire to maintain it or keep it.  For example, I’m grateful for my husband and children and try to do my part to keep them safe and healthy and happy.  I’m grateful for my current state of health and therefore work to keep it that way.  I’m even grateful for this awesome computer and try to treat it nicely so it doesn’t die on me (even though sometimes I want to throw it out the window). 

So since Thanksgiving and respect are like cousins, I want to propose that although you might look forward to filling up without regrets on Thanksgiving dinner, may you also keep in mind just a few things.

Below are 10 Thanksgiving Day Tips:

1.  Whether you’re religious or not, your body is your temple.  Give it some turkey, veggies, and don’t weigh it down too much with the mac and cheese or neverending bread rolls. 

2.  Be mindful of every bite.  Be grateful for every bite.  I once inhaled 3 pieces of pumpkin pie only to realize, much to my dismay, that I forgot to enjoy a single bite of those 1000 calories!  What a tragedy…

3.  Go for fresh and simple.  Green bean casseroles are yummy, indeed.  But, have you tried plain steamed green beans with a little seasoning and salt?  So fresh and flavorful and a perfect compliment to other heavier foods.  Easy to make too!

4.  Distract yourself from food.  For some reason I eat less on Thanksgiving than I do on the other days of the year.  I’m weird in so many ways, believe me I’m just happy that in this regard, my weirdness is actually beneficial!  Anyway, the reason I eat less is I’m overwhelmed with everything else going on.  I’m bopping along to music, talking and joking with others, seeing what interesting special is on TV, etc.  The point is, I’m not eating too much, and I’m having fun.  You too, can balance out the large meal you’re going to have by getting up after dinner and trading seconds for a fun impromptu dance in the living room.  Or karaoke.  Or whatever, you get the point.

5.  Be picky.  I don’t eat certain dishes every Thanksgiving.  Not because I don’t like them.  It’s just that I like other dishes more.  So by being a little picky, I can reduce lots of calories and carbs and still enjoy some of what I really love-like dessert!

6.  Focus on people.  Ask anyone what they think is most important about a Thanksgiving gathering.  “People, loved ones, family, friends” is usually the answer.  However, we spend tons of money on food, eat tons of it, all at the expense of our health and in the end, don’t our loved ones want to see us healthy and feeling good?  A great way to distract from food is to focus on all the conversations you have with family and friends.  Act like food isn’t the main attraction (even if it is).

7.  Get creative.  I once knew a family that had an interesting way of avoiding over-eating.  Instead of eating and then lingering at a table covered with possible second helpings, everyone would eat slowly and when everybody finished, they’d all get up and help out with clearing the table.  They would just leave out water and wine and sit and talk without all the food tempting them to eat some more.  I thought it was a great idea.  They would soon relocate to the living room for more talking, TV, music, and games.  And everyone went to bed without feeling like a stuffed turkey.  

8.  Tweak holiday meals.  You don’t have to replace your favorite dishes.  You can do a lot of good by just searching for healthier alternatives online.  Try a search, I guarantee you’ll find lots of raved about recipes.

9.  Breathe deeply.  Holidays are stressful.  Lots of heart attacks occur on Thanksgiving and the days surrounding Thanksgiving.  Try to remind yourself to breathe deeply throughout the day and try not to sweat the small stuff. 

10.  Last but definitely not least, don’t forget to test.  In particular, don’t test right before eating, test an hour before eating.  Trust me, you don’t want to find out your blood sugar is high right before eating.  This happened to me once and I sure regretted having to eat dinner all alone at the table an hour after everyone else. 

It may seem a bit much to go to so much trouble for your health on Thanksgiving but, remember, one of the greatest things to be thankful for is your health.  Treat your body like you’re truly thankful for it.  Unlike all that stuffing, it always loves you back in the end.

Check out last year’s post, Be a Grateful Diabetic on Thanksgiving Day.

Soda and Diabetes

 

Firstly, I want to announce that anytime I give a recommendation, it will now be referenced so you can read the science for yourself and know I didn’t make it up.  Then, if you want to tell me you disagree, I’ll ask for your references as well.  We’ll learn more from each other this way, it’s a win-win. :)

I recently read about how just one soda a day hikes up a person’s diabetes risk by a whole lot.  This study concluded that other drinks containing High Fructose Corn Syrup did the same thing.  This would include sweet tea, energy drinks, etc.

An article talking about this study is here

This study showed that people who had one soda a day were more than 25% more likely to get type 2 diabetes than those who didn’t have nearly so much soda (no more than one drink per month).

Most people I know have at least one soda or sugary drink each day.  Does that mean many people have increased their risk for type 2 diabetes by 25% or more?  It looks that way.  So while  type 2 diabetes isn’t caused by too much sugar, it looks like drinks with High Fructose Corn Syrup play some sort of a role in type 2 diabetes incidences, no?

Anyway, it’s not too late to cut out sugary drinks.  No matter who you are or what diabetes you have you can still decide to do this. 

Not only will you significantly improve your health with one step, but you’ll likely drop a few pounds (as long as you don’t make an increase in caloric intake somewhere else in your diet). 

I had a hard time giving up regular soda when I was 11 and diagnosed type 1 diabetic.  I never had more than one soda a week but, still.  I enjoyed that one soda a week.  I didn’t like diet sodas for a while but, eventually learned to absolutely love the taste of Diet Coke.  Then after researching artificial sweeteners I decided to cut out Diet Coke, too.  This was really hard but, after doing so felt so much better and stopped feeling hungry all the time.  Now, I enjoy a Diet Coke about once a month and that’s it. 

The key is just adjusting to a new norm.  Even though it feels impossible to substitute water for sodas or other sugary drinks, it won’t always feel that way. 

Something that helped me adjust was to add lemon or lime juice to my water and to discover herbal teas.  I also enjoy making my own hot cocoa which allows me to control how much sugar goes in.  Over time you’ll be pleased to notice that a regular soda suddenly tastes so sweet it makes you gag.

The point of all this is, A) studies prove you have lots to gain by cutting out or minimizing sugary drinks, and B) I know you can do it!

Start today and if you have a hard time, just minimize your intake very gradually so you hardly notice.

Note: If your blood sugar gets low and you usually drink something sweet to correct it, I suggest 100% natural juice or drinks with sugar and not High Fructose Corn Syrup.  I usually carry 100% orange juice with me at all times.

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