Am I doing things well with the control of my glucose?

Dixon's profile photo   02/22/2018 4:51 p.m.

  
Dixon
02/22/2018 4:51 p.m.

I am a debutant and they have not explained everything far there.I am 3-4-3 for novorapid and 11 toujeo units.

I punctuated mythorapid about 10 minutes before each meal (or 5).I don't know if it's ok or should expect something else.They have not explained that.He only told me to eat as soon as he injected her.

Regarding post-componed glucose, I have to measure it 2 hours after breakfast, food and dinner.The key is that at that time it is between 80-130, right?My question is, in that period that passes since you eat until 2 hours, glucose goes up more, right?Isn't it bad for cells to have glucose above those figures, even being only for less than two hours after each meal?

How do they control that?They are injected with what I do, more units are put on ... Those two hours are my main doubt.Thank you

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solaria
02/22/2018 5:03 p.m.

@"Dixon", welcome to the forum.Diabetes is a long -distance race and based on the test and error, each one finds the guideline that is doing well.Mine swear to be a crime to publish them.What I tell you and correct my classmates, is that a postprandial up to 180 is on an optimal margin.The values ​​of 80/130 before the food is very good.Greetings.

Debut 46 â- 2012. DM1. Celiaquía e intolerancia lactosa. Anemia perniciosa.
MiniMed 640g + SmartGuard.

  
Yessica_A
02/22/2018 5:14 p.m.

The ideal would be to have glucose as a non -diabetic that at no time usually rises from 140 but for us it is complicated so some more margin is accepted.Arriving between 80-130 at 2 hours after eating is fine (in diabetics they recommend less than 140 two hours after eating, non-diabetics would be less than 120).
In time from the food to the control you will have higher almost certain but without doing control or using a continuous meter is not known for sure.You may only climb to 130-140.
The one to wait more or less depends on each person and how much hydrate and on what kind you eat it, with which you combine it, etc.It is quite complicated and is done to test and error.If you have a continuous meter seeing the graphs you can adjust the moment of more insulin action with the rise peak of the hydrates you eat and avoid the peak but it is complicated and requires knowing well how each meal affects you and when it startsto effect insulin.That is different in each staff so there is no rule that works for everyone, is to try.
Another option, which is what I do although it is not what doctors recommend is not to eat anything that raises glucose.In my case, not as bread, pasta and other things with flours, rice, potato, things with sugar, etc.Hydrates sack them, some fruit, legumes, nuts, yogurt, etc.In this way I avoid the peaks and I do not need to wait or make calculations, sulked me just before eating and ready.And normally I do not pass from 120 at any time after eating and at 2 hours I am between 80 and 100. But with this the amount of hydrate you eat in the day is quite little and that does not recommend doctors, although I personally believe thatThere is no problem to do it, but that is already a thing of each one.

DM1 desde 2003 | Toujeo + Humalog | FreeStyle 2 | HbA1c 5.5

  
Dixon
02/22/2018 6:18 p.m.

Yesssica_a said:
The ideal would be to have glucose as a non -diabetic that at no time usually rises from 140 but for us it is complicated so something more margin is accepted.Arriving between 80-130 at 2 hours after eating is fine (in diabetics they recommend less than 140 two hours after eating, non-diabetics would be less than 120).
In time from the food to the control you will have higher almost certain but without doing control or using a continuous meter is not known for sure.You may only climb to 130-140.
The one to wait more or less depends on each person and how much hydrate and on what kind you eat it, with which you combine it, etc.It is quite complicated and is done to test and error.If you have a continuous meter seeing the graphs you can adjust the moment of more insulin action with the rise peak of the hydrates you eat and avoid the peak but it is complicated and requires knowing well how each meal affects you and when it startsto effect insulin.That is different in each staff so there is no rule that works for everyone, is to try.
Another option, which is what I do although it is not what doctors recommend is not to eat anything that raises glucose.In my case, not as bread, pasta and other things with flours, rice, potato, things with sugar, etc.Hydrates sack them, some fruit, legumes, nuts, yogurt, etc.In this way I avoid the peaks and I do not need to wait or make calculations, sulked me just before eating and ready.And normally I do not pass from 120 at any time after eating and at 2 hours I am between 80 and 100. But with this the amount of hydrate you eat in the day is quite little and that does not recommend doctors, although I personally believe thatThere is no problem to do it, but that is already a thing of each one.

Thanks for your answer.The problem of not putting much hydrate, is that it should put too many fats since I have kidney stones and I must consume less protein.I also have a high bad cholesterol.I would not eliminate integral hydrates from your diet since they have many benefits.Eliminate white rice if you want, but put some integral.It is what doctors have recommended me.Balance the diet a little.My purpose is that with the help of a Fatsecret type app, I managed to make a daily diet that is between 1500 and 1800 kcal, without spending 135 gr of carbohydrates, 60 gr of protein and 60 gr of good fats.Every day I will make a menu attending to that, taking into account that the carbos that will be of slow absorption and then try that someone who understands nutrition tells me if with my self -taught diet I can fill in all the nutrients and vitamins necessary for the body.I have no appointment with the endocrine until May and I have to eat these months, to see if someone can take a hand, since taking a diet to a nutritionist the same feels bad ... I think that with this diet I will go down weight welland cholesterol and such.I will also control the kidney.Once I get to my ideal weight, I will upload the kcal and therefore it will have to climb carbos and fats, having to climb the fast insulin surely, since now with 1500-1800 kcal I go perfect with 3-4-3.

I have proposed to take this disease very seriously and live every year possible, although with the kidney, diabetes and a breath in my heart, I see it fucked still 25 years.But it will try ...

Thanks again

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EndocrinaAntiNewAge
02/22/2018 7:28 p.m.

Hello @"dixon"

Let's see to see to see ... Where did you get diabetes, renal cramps and the breath in your heart will make you difficult to live many years?With diabetes, with current media, you can live many years without complications.Renal cramps will probably be something passenger that will not give you more problems (and although they gave many problems, it would be difficult for your life to shorten).And the breath in the heart, if you do not have any severe congenital heart disease (which I do not think it is the case), it will not be a problem for you to live many years.So take air and breathe.Tell these concerns to your doctor, you should answer them.Do not stay without asking.If you get nervous at the time of the visit and forget, take a role with pointed doubts (try not to aim more than 5 if it can be hahaha is a joke)

When you say that you are going to take diabetes very seriously, ask yourself the following question: are you going to live for diabetes or are you going to live with diabetes?

I personally believe that starting to make a self -taught diet through the use of apps, thinking of quading daily protein and fat amounts, just debuted, it is to end crazy (it is an expression).I think it is an unrealistic objective to consider life by telling grams of proteins and fats as if you were a severe renal patient on dialysis (that even in those cases it is done so).Your life will be long and full and there will be days that you will go out to dinner out of tapas and almost everything will be protein.There will be days that you feel like a salad and a fideua.And days that you will feel like a chuleton of half a kilo.It is the usual problem: there are patients who spend too much and patients who take everything too much to the letter.When they recommended the low protein diet due to the issue of lithiasis (it may be a little precipitously taking into account that it is the first episode), it does not mean that you eat 60 grams daily protein every day.In these cases it is recommended to reduce animal protein, qualitatively, for example, not eating animal protein more than 1 time.

Another very important point is to keep in mind that your calculations are fine (it is a slightly hyperproteic diet, as they contribute 18% of the calories, and in the lower limit of what is considered usual for carbohydrate content: 40%of total calories).But that the distribution of macronutrients is correct does not equals the diet to be healthy, since those amounts can be ingested based on not eating vegetables and fruit, eating processed meats, refined and sweet farinaces.And yet, many people would agree that eating like this is not healthy.

So, to begin with, I think the key question is What diet did health professionals give you when you debuted? If you want to share it and we can comment.

Regarding the postprandial glycemia controls , the goal is to be less than 180 mg/dl at 2 hours after having started eating.If you start eating at 1, even if you finish at 13:30, the control should be at 3:00 p.m.

The 80-130 objectives are before meals.

Regarding relatively poor diets in carbohydrates, in theory, they would not have to be harmful if they do not involve an increase in animal protein and "bad" fats.What usually goes on practice is that by reducing carbohydrates, people increase the intake of animal protein and we slowly approach the swampy terrain of Mr. Dukan and similar things.That is the mechanism that is believed to be behind to explain the studies that demonstrate association between poor hydrates diets and increased cardiovascular risk.Because making a very poor diet in carbohydrates, without much animal protein, and with healthy fats, is quite difficult.Where fromDo you take no animal protein?Of nuts?Ok, they have healthy proteins and fats, without almost hydrates.Of the legumes?Perfect, they have proteins, but they also have carbohydrates (which is not a "but", but it is an impediment to maintaining the amount of low hydrates).It is true that in Spain we have access to quality fats since we are olive oil producers and we have relatively easy access to fish.But I think the options are limited and the diet becomes poorer.Regarding thinking that we already achieved enough carbohydrates of vegetables and fruits, it should be remembered that the majority of vegetables provide a ration of hydrates for every 300 g of food, and that fruits provide 1-1.5 rations per piece, with whatWhat, if that were our "non -protein" carbohydrate source (to exclude legumes), or we would spend the day eating fruit, or the diet would be very poor in carbohydrates.

Anyway, this is a mess and I know, that is why, if you want, we rewind and comment on the diet that you have prescribed.Regarding going to a nutritionist privately on your own to make a diet before returning, the thing can be complicated a lot, because according to the diet that makes you, they can change your insulin needs a lot.I do not say that I will not adjust them correctly, but I think we would be putting too many variables in the equation ...

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Anaisabel
02/22/2018 9:46 p.m.

Fast insulin is put before starting to eat.If you have a blood glucose of less than 70 you can wear it after food.
For me after a meal, two hours after starting as they have said, being below 180 is fine.
The ideal would be to be 100 always, but then we would not be sick.Try to do things right, but don't live for diabetes.

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Ruthbia
02/22/2018 10:07 p.m.

@"Dixon" little by little... When we debut, the issue of control puts us very black but with the months it is changed as routine always with adequate control.
They gave me a 1700kcal diet with 20 rations of hydrates that in the end leave in 13 and now according to the day without 13, 9 or 20. Combine protein and healthy fats.
Insulin before meals depends on each one, I put it at breakfast 1 hour before breakfast, at the food 20 min and at dinner just when I start dinner.Picos is always based on the type of food.But without a continuous meter or flash difficult to detect.In addition to each one each insulin unit metabolizes us x mg of glucose.
In women we have the problem of hormones that the behavior of insulin changes.
The best thing to start analyzing your body is to eat more or less the same every day and measure before and 2 hours later, so you see if the insulin units are adequate or you have to reduce/expand the dose.

Lada enero 2015.
Uso Toujeo y Novorapid.

  
Yessica_A
02/23/2018 2:21 p.m.

endocrinaantinewage said:

Regarding relatively poor diets in carbohydrates, in theory, they would not have to be harmful if they do not involve an increase in animal protein and "bad" fats.What usually goes on practice is that by reducing carbohydrates, people increase the intake of animal protein and we slowly approach the swampy terrain of Mr. Dukan and similar things.That is the mechanism that is believed to be behind to explain the studies that demonstrate association between poor hydrates diets and increased cardiovascular risk.Because making a very poor diet in carbohydrates, without much animal protein, and with healthy fats, is quite difficult.Where do you get no animal protein?Of nuts?Ok, they have healthy proteins and fats, without almost hydrates.Of the legumes?Perfect, they have proteins, but they also have carbohydrates (which is not a "but", but it is an impediment to maintaining the amount of low hydrates).It is true that in Spain we have access to quality fats since we are olive oil producers and we have relatively easy access to fish.But I think the options are limited and the diet becomes poorer.Regarding thinking that we already achieved enough carbohydrates of vegetables and fruits, it should be remembered that the majority of vegetables provide a ration of hydrates for every 300 g of food, and that fruits provide 1-1.5 rations per piece, with whatWhat, if that were our "non -protein" carbohydrate source (to exclude legumes), or we would spend the day eating fruit, or the diet would be very poor in carbohydrates.

Anyway, this is a mess and I know, that is why, if you want, we rewind and comment on the diet that you have prescribed.Regarding going to a nutritionist privately on your own to make a diet before returning, the thing can be complicated a lot, because according to the diet that makes you, they can change your insulin needs a lot.I do not say that I will not adjust them correctly, but I think we would be putting too many variables in the equation ...

Well look for example I do it like this:
- Little hydrate (between 50-70 gr a day depending on the day, if I put a little more legume)
- Enough protein (in my case about 1.6 gr per kg because I do weights and it is needed more than the sedentary population and also when eating little hydrate it is fine to increase the protein because a part will become glucose), without abusing the animal(What do I understand do you mean the meat, not the fish)
- And the rest good fats (olive oil and those present naturally in fish, nuts, eggs, etc).

In the attached image is what has been my usual menu, varying vegetables, fish and meats.The meat also tries to buy whiter than red and the red one that is fed with grass that has a better lipid profile.And the fish prioritizes those who have less mercury and to be able to be wild (the breeding are more toxic).I also put squid, octopus, mussels and others instead of fish.

With this I get more or less 15% hydrate, 25% protein and 60% fat although it vary a little according to the day.

It allows me to carry very tight glucose controls without rough ups or declines.My target range is 70-120 and I am there 60% of the time and the declines are very soft, rarely under 60 (and is not going down, it is stable, that with anything that eats it quickly).The peaks were up are maximum 180 and it is normally because of the phenomenon of dawn that I can't solve it because it only happens to me a few days and the only solution is if I wake up to get fast but I don't always wake up and I refuse to put on the alarmhours.That already unravels the controls.No months agoI see picos of 300 and very few more than 200 and sudden descents I have only had 2 when I puncture the slow one and catch a capillary.
I don't think it's a diet for everyone but it has worked very well and I don't think it supposes any health problems.In fact I see it much healthier than others in which vegetables are barely eaten and refined flours and oils are used, ultraprocessed ... which is what most people do

DM1 desde 2003 | Toujeo + Humalog | FreeStyle 2 | HbA1c 5.5

  
EndocrinaAntiNewAge
02/23/2018 6:43 p.m.

It is very interesting.Of course the choice of food is the healthiest possible for that distribution of macronutrients.

I understand that these types of diets stabilize the glycemic profile as there is little carbohydrate intake, but there may be other problems.Don't you have more muscle aches than before changing the diet?Have you ever looked at the CK in the analytics?I say it because weight training having muscle glycogen deposits to a minimum increases the risk of rhabdomyolysis, since the muscle, during anaerobic exercise, needs glucose.I already imagine that you will not do a super -estate training to make a frank rhabdomyolysis, but between the strict normality and frank rhabdomyolysis, there is a continuum that can be detected looking at the CK (which marks muscle damage/suffering).

Have you had the option to measure the ketone bodies in blood?There are glucometers that with a special strip, measure beta-hydroxybutirate in capillary blood (the truth is that I do not know to what extent this is to the supply of all patients with diabetes).I say it out of curiosity, we already know that these diets cause ketosis, but it would be good to know if you are about 0.4 mmol/l (which would be acceptable) or around 1.5 mmol/l, which would already seem worrying.I already say, as an experiment.

Another detail, if we know that in the face of a low carbohydrates, an important part of the diet protein becomes glucose (and therefore it is possible to be used as a protein, because you have to extract nitrogen, making it a ammonium, convertThe "skeleton" that remains in glucose by gluconeogenesis, and then convert that ammonium into urea, so that it is then filtered and eliminated by the kidney), would it not be more optimal to reduce the protein a bit and increase the hydrates a bit?

Regarding the vegetable protein vs. Animal or meat vsa fish, cardiovascular risk studies and poor carbohydrates-rich protein diet, distinguish between animal protein and plant protein, not between meat vs. fish.The studies that suggest that fish is healthier than meat, are mostly based on Mediterranean diet, which as you know typically is about 40% carbohydrates with respect to total calories (especially by legumes and whole grains).So assuming that the benefit of fish on meat is maintained in a diet as low in carbohydrates as the one you have designed (15% of the total caloric contribution) could be a bit adventurous.

Link
(This was the study I commented)
when the results were examined with the animal or plant origin of the diet taken into accounts, a significant positive association was seen with loow carbohydrate diets of mainly animal origin, but a statistically significant invent invent association wasCarbohydrate Diets of Mainly Vegetable Origin .In Studies Evaluating the Incaence of Stroke and Ischaemic Heart Disease Among Men In Relation to Protein INTAKE IN THE HEALTH PROFESSIONALS FOLLOW-UP STUDY, STATISTICALLALLLY NON-SIGNIFICANT POSITIVE ASSOCITIONS OF PROTEIN INTAKE WERE REPORTED FOR BOY OUTCOMES;when the results were examined by Animal or Plant Origin of Protein, The Associations Were Positive for Boutcomes for Animal Protein, whereas they were statistical Non-Significantly invent for vegetables for vegetable protein with respect to botch outcomes.

And regarding the WHO protein consumption recommendations, it recommends that half of that intake be of plant origin, at the expense of legumes, cereals and nuts (with which if we follow it it is difficult for the diet to be very low incarbohydrates).

It is of course an issue in which there is a lot of controversy.Maybe in the future we have more data and we can get wet more safely, but for now it isdifficult hehe

Greetings.

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Yessica_A
02/23/2018 10:28 p.m.

Well, the CK has never looked at me, I will tell my endocrine next time.But we have not noticed muscle aches, I find myself the same as before.And as I did it progressively I don't remember noticing anything weird.Anyway, my training is not extreme either.
That is also a day when I get less moisturized because if I put legume it is more.On weekends, which, one day away from home, also put more hydrate.And many days before exercising if I'm going to do some aerobic fruit before.
I have looked at them ketone bodies and have always been low or there have been.But in urine it is more complicated that they appear once you are used to ketosis.The blood strips gave them once years ago when they operated on the teeth of the trial but I do not know if they would give them now without further ado.Online they sell them for an Abbott glucometer that I have at home but they are not cheap, that's why I have never bought them, because if I'm curious to know how many come out.I will ask at the health center if you can give me any to try one of the days I put less hydrate.
Thank you very much for the information, it is lucky to have you for the forum.All endocrine as updated as you could already be.

DM1 desde 2003 | Toujeo + Humalog | FreeStyle 2 | HbA1c 5.5

  
EndocrinaAntiNewAge
02/24/2018 4:22 p.m.

Thank you very much.It is all very interesting and you can always learn things from patients.

Regarding the CK, if you do not notice any discomfort and do not do very extreme training, it is not necessary to expressly ask for it (I said it because sometimes it is requested within some analytical profile, in case by chance I would have ever left you).

Many endocrine are so updated or more than me, but most times because of the lack of time in consultation go to the grain and the pragmatic (in plan "do this and point") and can give impression of "misinformed"or "without concerns" to a patient interested in understanding complex issues.And this is detrimental to the patient's autonomy, I agree.

Greetings!

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