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bookDiabetes articles about daily topics that affect those living with diabetes. There is a lot of information about diabetes and hopefully you find this information useful in your everyday life. Here we have compiled a list of older articles from our previous "The Diabetes Network" along with links to blogs and articles, an extended reading archive. You can use the search in the top-right menu to search for specific articles.

 

Study challenges "carb counting" in diabetes

NEW YORK (Reuters Health) - How many carbs you eat might be less important for your blood sugar than your food's glycemic load, a measure that also takes into account how quickly you absorb those carbs.

That's the conclusion of a new study of healthy adults, which questions the way people with type 1 diabetes determine how much insulin they should take before meals.

In type 1 diabetes, which affects about 3 million Americans, the pancreas doesn't produce sufficient amounts of the hormone insulin, which helps ferry sugar from the blood into cells. So people with the disease are quickly overwhelmed when the sugar in their food hits the bloodstream.

To avoid the dangerous blood sugar surge, diabetics inject insulin before a meal -- usually based on how many carbohydrates they will be downing.

But the new study, by Jiansong Bao at the University of Sydney in Australia and colleagues, hints the number of carbs alone might not be the best way to go.

Instead, the so-called glycemic load of a food, which also takes into account how quickly it makes the blood sugar rise, might work better. Foods with soluble fiber, such as apples and rolled oats, typically have a low glycemic index, one of the contributors to glycemic load.

The researchers took finger-prick blood samples from 10 healthy young people who ate a total of 120 different types of food -- all with the same calorie content. They also had two groups of volunteers eat meals with various staples from the Western diet, such as cereal, bread, eggs and steak.

The glycemic load repeatedly trumped the carb count in predicting the blood sugar and insulin rise after a meal.

"It suggests that the methods used to assess carbs in persons with type 1 diabetes might benefit from some rethinking," said Dr. Edward J. Boyko, a diabetes expert at the University of Washington in Seattle who wasn't involved in the study.

But he said it wasn't certain the findings would hold up in people who aren't completely healthy.

"In the U.S., 60 percent of people are overweight or obese so we don't know how the results would apply to them or to persons with diabetes," he told Reuters Health.

The glycemic load is calculated by multiplying the amount of carbs in grams per serving by the food's glycemic index divided by 100. The glycemic index for a variety of foods can be found at www.glycemicindex.com/.

Foods with a low glycemic index cause the blood sugar to rise slowly, and so put little pressure on the pancreas to produce insulin.

Writing in the American Journal of Clinical Nutrition, the researchers say their findings also suggest that eating foods with high glycemic loads could be linked to chronic disease like type 2 diabetes - which does not require insulin injections -- and heart disease by raising blood sugar and insulin levels.

But that is not clear from the study, which only looked at blood sugar and insulin changes up to two hours after a meal, said Boyko.

"It would just be speculation whether a dietary change like this would help people with type 2 diabetes," he told Reuters Health.

Long-term effects and other nutrients in the food might also be important for disease risk, for instance. And the most important problem remains pure and simple overeating, according to Boyko.

"The excess weight is the main thing we ought to focus on," he said. "The simplest message would be, eat less."

Sources include
http://www.reuters.com/article/2011/03/11/us-study-challenges-carb-counting-diabet-idUSTRE72A8JB20110311

http://www.anzctr.org.au/ACTRN12610000484044.aspx
http://www.ajcn.org/content/early/2011/02/25/ajcn.110.005033.abstract
http://www.ajcn.org/search?author1=Jiansong+Bao&sortspec=date&submit=Submit

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Things That Make Me Go Hmmmmm

I have a headache and can't imagine posting anything too insightful, so instead here are the things running through my diabetic brain right now:

1) How did I manage to keep such awesome BG numbers Thanksgiving Day and the following days, while still enjoying in my favorite homemade pumpkin cheesecake, pecan pie, pumpkin pie, and chocolate caramels (yes, I indulged in all of the above)?

2) How come after getting back to work and my normal routine, including a good and sweaty spin session this morning, now my BG numbers are so high? I hope I am not getting sick.

3) Why have I been hungry all day, even after eating half a bag of almonds during the day and big fettuccine alfredo meal? Normally, it would be because of my workout this morning and my muscles storing up all the glucose they can, but then I would expect lower BGs, which as #2 indicates is not the case.

4) Why did pricking my fingers hurt soooo bad last week? No matter which finger I tried? Thankfully, that has come and gone.

5) Why does the nursing room at work always have to be in use when I want to check my BG and/or take some insulin? I guess some people actually need to use it for it was intended.

6) When will taking insulin in a public restroom ever become normal and not gross to me?

7) How come sometimes when I poke myself I bruise or bleed or it just really hurts, while other times I feel nothing?

8) Maybe having a pump would help solve many of my questions/issues? But then which pump, how much would it cost, how difficult would changing infusion sites be, how would I hide it under my clothes, etc???

Well on that note, I think it's time to schedule another appointment with my CDE!

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Practice, Practice.....

I expected the "I'm free".....I didn't expect the second line. It made me realize how different he must feel all the time. So....I'll have to add another positive to MDI!!:)

This morning I began teaching the rest of the family how to take care of J.J. on MDI. When J.J. was first diagnosed they were all really too shocked and scared to want to learn. We didn't push them, but hoped they would step up. Eventually they did.....to a point of wondering if it was too much!:) Today they jumped in.....no fears(o.k. a few!)......but they have much more confidence now that they could give a shot without really, really messing up.


I had them practice using an old Lantus vial, used syringes and a clementine. Granted they can't pinch the skin of a clementine, but I had them simulate the effect. I also wanted to make sure they understood what calibration was on the syringe. I would throw out a dosage amount and ask them to draw it up for me. Thankfully I did that, because both of the girls thought the first line was "one" not "zero". So they would have been a unit off!!


J.J. even wanted to give it a try. I drew up the dose and let him inject it. Right now he's a little clumsy, being he's only 7 and his dexterity isn't quite what it will be in a few years......but I think he could do it. I don't think I'd let him draw up the insulin yet, but we shall see! For now he's where he should be.......out in the dirt pit......FREE...to be....a REAL BOY!!!!:)

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Invisible Illness Week - Sept. 13-19

Via Karen at Bitter-Sweet Diabetes, I am posting this to raise awareness of Invisible Illness Week. Despite 20 years with the ups and downs of living with bigD, I don't think I've ever considered myself ill - I guess that goes to show just how invisible it is; even to me! But, I have been struggling with my feelings about living with an invisible disease and whether I can come to peace with adding someone to my team who would make type 1 diabetes much more visible, but no better understood, to the rest of the world. I'll post more about that later. In the meantime, it's Meme time:

30 Things About My Invisible Illness You May Not Know...

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Why this but not that?

I work as a CPA, but do not prepare federal income tax returns as part of my work. Never have; I just don't want to specialize in that. Around this time of year, as April 15th approaches, lots of well meaning friends express concern about "how busy you must be this time of year". This is in spite of me having told many of them previously that I don't do taxes. I do not find this to be upsetting at all, and have plenty of patience and grace to extend to those friends, as I'm sure they extend to me on other things.

Contrast that with how I feel when those same well meaning friends make comments about my diabetes. You know what I'm talking about....things like "oh, I forgot, you can't eat that, can you?", or "you need to eat your lunch right on time, don't you?" That in spite of me having told them previously that Type 1 diabetes is not so much about what I cannot eat or when I eat (thanks to my pump), but about matching insulin with what I do eat and my activity level. Why do those questions still cause a flood of emotions, and leave me often reliving the comment long after it is made? I do my best to extend grace to those friends, and in my head realize it's unrealistic to expect them to remember much about my diabetes. But it's a battle to fight through those initial emotions to get there sometimes.

Both are sterotypes of sorts, but one leaves me feeling judged, and the other does not. How about you, have you found a dichotomy in how you respond to D related comments vs. comments about other aspects of your life?

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Eggs,bikes,and Tylenol PM

I have been struggling with some higher blood sugars lately. About 10 days ago, it got suddenly worse. My postprandials had been going higher for awhile, but then my fastings started to hover in the 130s. I became worried enough to contact Janet and then Dr. Bellin about the situation. After some discussion, it was decided to try a lower carb breakfast and to try not to worry about it too much. I know that stress can cause higher BGs, and seeing those high numbers was definitely causing some stress. This all occurred right before Labor Day weekend and it was decided to wait a few days and see if my numbers improved. If not, it might be time to try some insulin. It would break my heart a little to do this, but would bring down my numbers for sure.

When I told Gary about this, he asked if my sleeping problems might have something to do with the higher numbers? I realized that he might be right about that. So I started taking 2 Tylenol PMs at bedtime. I had been taking them before, but only if I really felt that I needed to. Its been almost a week now since I started all of this and my numbers are better. I know its not very scientific to try three things at once, but at that point, I was ready for any good idea.

So now, I'm having higher protein and fewer carb breakfasts, bike rides or long walks during the day, and Tylenol PM at night. My fastings are definitely better. I'm still having some higher postprandials, (200-250) but not as many. The exercise really helps. I'm planning on tapering off of the Tylenol PM and keeping up with the breakfasts and the exercising for awhile. I'm keeping a close watch on my weight during all of this.

The Labor Day weekend was wonderful. I was really hoping that I would be too busy to worry about my BGs too much, and it really worked out that way. We had a wedding on Saturday. We went to Kelly's Island with some friends on Sunday. We had fun playing some horseshoes there. And on Monday, we went kayaking on the Maumee River and then staffed a Donate Life Ohio booth at the Fulton county fair. Blake Shelton was playing in the background.

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