Type 2 diabetes..Pump User, issues with irregular blood sugars..?

[davidlee]

My fiance is a type 2 pump User. She is in very good shape/ health. Not heavy, not a junk food eater. However. She has a lot of Problems keeping her levels "stable," She is also on symlin by the way. Setting aside possible over-insuling or under-insuling, can someone recommend a daily routine of food that will help her? I am a health nut, and it's my opinion if she just regulates her eating habits some, she will be more stable.

[Triskeliongirl]

I am a type 1.5 diabetic, and I have been totally able to avoid insulin by eating a very low carb diet. The idea of taking insulin so that I can eat bread and pasta just doesn't make sense to me. I follow the dietary recommendations of the book Dr. Bernstein's Diabetes Solution. http://www.amazon.com/Dr-Bernsteins-...6000466&sr=1-2. She should work with her doctor on this, as she will need to reduce her insulin dosage as she cuts down on the starchy carbs (veggies are OK). I highly recommend her starting there. For cycling, I eat a high protein pre-ride meal, and just drink protein shakes made with protein powder, unsweetened cocoa powder and stevia, and eat almonds on the bike. I have trained myself to run on a high ratio of fat to glucose, and the protein is slowly converted to glucose (by gluconeogenesis) and TCA cycle intermediates that get burned in the muscle, at a rate my body can handle, but it did take me time to adapt. This is a controversial approach, but in my opinion as a biochemist who is living with diabetes the best one. I can ride a century this way, with at most having some supplemental veggies for carbs. Another good book to read is Good Calories Bad Calories by Gary Taubes, especially if you are concerned this isn't a heart healthy approach and to understand the historical perspective of how the pendulum has swung over the years in the treatment of diabetes and obesity http://www.amazon.com/Good-Calories-...6000379&sr=8-1.

Another good resource for her is this forum, full of people living this lifestyle: http://www.diabetes-book.com/cgi-bin/yabb2/YaBB.pl

BTW, I also painlessly lost 35 lb following this diet, it didn't feel like dieting, just like my body weight 'normalized' as I started feeding my body foods that it could metabolize. I eat tons of lean protein (at least 1 g/lb of LBM), and tons of non-starchy veggies (to satiate), but omit all starchy carbs and even fruit, basically any foods that cause my blood sugar to rise too high and stay high too long as measured by my meter. I am also not afraid to eat fat, especially the monounsaturated ones, nuts, avocados, olive oil, etc. But again, I strongly urge her to educate herself about this approach and then get her doctor on board if she wants to do this, as she will surely go hypoglycemic if she doesn't adjust her insulin dosages correctly. If her doc isn't open to this approach, I believe at the Bernstein website is a list of docs that do practice with this approach.

[SouthernBelle]

I come from a line of diabetics on both sides of my family. Eating plans based on the glycemic index are basically what she's looking for. Complex carbs, avoid simple sugars, foods that don't digest too terribly fast.

The one cited above as well as South Beach are based on this.

HTH,

[Andrea]

The above suggestions about food are very good advice.
As far as exercise goes, she'll just need to remember that exercise has an insulin-like effect- the strength of which will be determined by the duration/intensity of the exercise.
So, she'll have to use trial & error to find out what pre-exercise meal gives her enough fuel for a workout, when she needs to eat during a workout to sustain her bg (usually maltodextrin is a good option for sustained aerobic activities >1hr), and what does well for her afterwards to keep bg from getting too low. It will take a lot of poking at first, but once she establishes a routine, she'll probably be able to control her bg and insulin needs with diet and exercise.

[Triskeliongirl]

In my experience even maltodextrin and 'complex carbs' raise my blood sugar too high for too long. Please get her to look at the resources that I recommended. But certainly, a lower carb diet like south beach or protein power would be much better than how I imagine she is now eating, or how the ADA currently recommends that diabetics eat. But for me, going very low carb is the only way I can stay off of medication. If she does want to go 'moderate carb' than a book like the paleo diet for athletes is a good resource.

[KnottedYet]

My mom is a brittle diabetic and was in the trials for the first insulin pumps way back when. (1970's)

+1 on the high protien/complex carbs diet. Mom ate that way before the docs started recommending it, and it really helped.

+1 on carefully watching what happens during exercise.

Also, consider the insulin. Different folks need different insulins. Beef and pork insulin lost effectiveness for my mom just as Humulin came along, which saved her butt.

Is it possible her pancreas is making some insulin of its own? (Mom's is completely dead, so I don't know what that would look like.)

Will your insurance pay for her to go to a diabetes specialist? Unstable diabetes can wreak havoc, and if it goes on you will see effects for years.

Mom's insurance is pretty bad, she goes to Canada for some of her supplies (even paying full price there is cheaper than her co-pay here) and gets her pump sets on eBay.

(I won't give my political opinion on the state of US healthcare when someone gets medical supplies necessary to live off eBay because it's cheaper than buying them with insurance at the pharmacy.)

[davidlee]

In my experience even maltodextrin and 'complex carbs' raise my blood sugar too high for too long. Please get her to look at the resources that I recommended. But certainly, a lower carb diet like south beach or protein power would be much better than how I imagine she is now eating, or how the ADA currently recommends that diabetics eat. But for me, going very low carb is the only way I can stay off of medication. If she does want to go 'moderate carb' than a book like the paleo diet for athletes is a good resource.

What is maltodextrin? Is it bad? When I said that I drink Myoplex MRPs, they said it is all maltodextrin and I should stop.