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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,869
12/21/14 11:42 A

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I just started re-reading Dr. Richard Bernstein's book. He gradually moves many diabetics to blood sugar levels that are essentially the same as the average blood sugar levels of non-diabetics. The reason for this is that even at mild elevations that are considered in the pre-diabetic range but over 100 damage to your body will definitely occur, just more slowly over the years.
I am personally trying to get as close to that as possible without having to take meds just through diet. It is hard, as even a medium-size apple can sometimes put me over 115.
I also believe that the American way of life includes far too little exercise as a normal part of our daily lives.
This article brought it into focus for me yesterday:
www.marksdailyapple.com/the-asian-pa
ra
dox-how-can-asians-eat-so-much-rice-R>and-not-gain-weight/


It starts by talking about food but then moves on to exercise.

Birgit


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12/21/14 9:26 A

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Finally, my morning fasting levels have come down - I'm averaging about 119, but I've had to start Invokana before this happened.

I'm slowly starting to feel a little bit better, too, but I'm wondering because I've heard stories about how it might not be as effective long-term. I know long-term is subjective because it is still fairy new on the market, but I'm wondering if anyone has been taking this and seen a decline in effectiveness.

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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,869
11/11/14 12:53 P

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Yes, I agree, a visit to a renal care facility would clarify things in a hurry. So would visiting an Alzheimer's/Dementia unit in the local nursing home or watching a video of open-heart surgery where the chest if cut open to save someone's life. This is not to mention the loss of quality of life after a heart attack because part of the heart is dead.
I think most people with diabetes know the connection but are not willing to think about it. Sometimes their doctors make it sound like there is nothing they can do anyhow or their doctors have given up preaching after being ignored for so long.
Dr. Richard Bernstein is such a wonderful example, being in his late 70's (I believe) with type 1 diabetes and in excellent health. The information I've gotten from his forum and book is tremendous. While I do not follow it to the letter I get as close as I can.
Birgit


Edited by: HOUNDLOVER1 at: 11/11/2014 (12:59)
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TRAVELLING_MAN's Photo TRAVELLING_MAN SparkPoints: (132)
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11/11/14 6:07 A

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Thank you, for the encouragement, Birgit. I don't need a lot of prodding to treat my diabetes very agrressively. My mother was a Type 1 for over 50 years and took very good care of herself. But even so, she suffered terribly in the end. I've seen first hand what the disease does long term and am determined to do everything I can to minimize it. I too wish people would take it more seriously and think mandatory visits to a renal care facility to see how many diabetics are there that took "pretty good" care of themselves would be good for many.

HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,869
11/10/14 10:07 A

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Travelingman,
I think you are doing amazing for someone producing no insulin at all. I've never had to take insulin so don't know except second-hand how difficult the fine-tuning can be.
My own blood sugars are ranging from the 70's to the 110's except for occasional values of about 115 in the morning or after extra carbs. I know that even the occasional jump to higher values can do a lot of damage over time as you say. I wish more people took that seriously.
It seems insulin-resistance of the liver is really hard to combat when it happens, especially if it is not consistent like yours. I hope you'll find the resistant-starch helpful. I don't understand exactly how it works yet but it seems to improve insulin-sensitivity, regardless of where that insulin comes from. If it improves insulin-sensitivity in the liver as well as the muscles it may be quite helpful.
Please share how it works for you if you try it.
Birgit

Edited by: HOUNDLOVER1 at: 11/10/2014 (10:08)
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TRAVELLING_MAN's Photo TRAVELLING_MAN SparkPoints: (132)
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11/10/14 12:16 A

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Thanks, Birgit. I will check that out, but my body produces zero insulin and I don't think there is any way to "fire it up". So last night I tried an experiment to illustrate the dawn effect. I was under 85 all day long and at dinner at 1930 eating a high protein, low carb dinner with no long burning carbs and nothing to eat afterwards. At 2200 I was at 63. By 2330 I was at 83 (a little early for the rise for me) and took 3 units of Novolog. At 0200 I was back to 83 and took another 3 units. At 0400 I was at 59 and went to sleep. At 0800 I was back to 101.

None of those are bad numbers but the point is that it takes constant monitoring and injections throughout the night to control well. Most nights I cannot do this and wake up in the morning in the 130-140 range.

Long term, those numbers are going to cause damage to the eyes, kidneys, and circulatory system. I keep waiting for a pump that is paired with a wearable monitoring device that would feedback sugar levels every two hours and deliver insulin accordingly. But so far, I have not seen such a pairing.

HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,869
11/9/14 3:55 P

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I know that for me it works to have a few healthy carbs (from veggies) together with some protein or fat with my evening meal. Not a huge amount, maybe 15 grams of carbs max.
The timing of this my vary with the individual. I know how frustrating it is when your liver cranks out carbs.
I have also started experimenting with resistant starch (from raw potato starch or cooled cooked potatoes) which actually seems to lower blood sugar. It takes lots of measuring blood glucose to see how your body responds.
This article on Chris Kresser's blog was the most helpful on the issue for me.
chriskresser.com/how-resistant-starc
h-
will-help-to-make-you-healthier-and-R>thinner

Birgit

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TRAVELLING_MAN's Photo TRAVELLING_MAN SparkPoints: (132)
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11/9/14 6:46 A

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Hi. New to the forum. Diabetic now for 9 years and have always struggled with Dawn Effect. Been on 10-20 carb diet for most of that time. Sugar level is 60-70 when I go the bed but 120-140 when I wake up. The only thing that I've found will shut it off is a couple of tumblers of gin before I go to bed. I don't like the idea of taking a long acting insulin prior to going to bed because my liver will sometimes not produce the sugar and I don't want to crash in the middle of the night.

What types of things have any with a similar problem found to work?

HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,869
8/11/14 4:25 P

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It seems to be the rule rather than the exception that many doctors (unfortunately including many endos) are not shooting for normal blood sugar levels with their diabetic patients. Any blood sugar level over about 5.2 A1c and any fasting blood sugar level over 100 is less than ideal and puts you at higher risk for many diseases, including Alzheimer's (read "Grain Brain" or join us on the team with that name at Spark), heart disease and all possible complications of diabetes.
Also take a look at the book "Dr. Bernstein's Diabetes Solution". Der. Bernstein, himself a type 1 diabetic advocates normal blood sugar levels for diabetics which he considers to be between A1c of 4.2 and 4.8
My personal goal is to get at least down to 5.
My daily average is already down to under 100 by eating a very low-carb/high-fat/moderate protein diet.
My weight has not changed, always between 130 and 135 lbs., but my % of body fat is down from about 30% to 16%.
I find that if I eat my last meal of the day on the early side (before 7pm) and/or exercise after eating that my morning blood sugar levels are likely about 10-15 points lower.
Also, going overboard with carbs today (over 30 grams/day for me) will cause higher blood sugar levels the next day.
Birgit

Edited by: HOUNDLOVER1 at: 8/11/2014 (16:26)
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LITTLEWIND53's Photo LITTLEWIND53 Posts: 17,180
8/11/14 10:24 A

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Here is an interesting article on the Dawn Phenomena vs Somogyi Effect, although both seem the same, there is a slight difference.

The liver is involved in both scenarios.

It may be worth asking your endo for a 3 day Continuing Glucose Monitoring System test to see exactly when your sugars go through the roof. (She may already have that in the works for you)

Good luck with your test results....

EDIT: Ooops, I forgot to include the link.....
www.dlife.com/diabetes/blood_sugar_m
an
agement/garnero_0106


Edited by: LITTLEWIND53 at: 8/11/2014 (23:32)
Linda

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8/11/14 8:39 A

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I'm awaiting the test results now, to pinpoint exactly why my liver isn't doing what it ought to be doing. However, your story, Birgit, sounds exactly like mine. No matter what I did/ate/whatever, my morning sugars were ALWAYS high. I mentioned the dawn effect thing to the endo, and she said let's first rule out any liver issues.

Actually, the whole process has been rather illuminating. I fist went to my family doctor who did the blood work, saw my A1C was high, prescribed glumetza max dose, reran blood work months later and saw a decrease in my A1C and fasting blood work. She was satisfied with those numbers. My A1C came in after meds, at 6.5 and fasting at 160.

I was NOT happy with those numbers but figured she knew what was what. It wasn't until I saw my eye doctor and he told me my eyes were deteriorating due to high sugar that I got scared enough to seek out an endo.

None of this is new to me, having had gestational diabetes 2x, but I have to wonder how many complications of diabetes could be avoided if more people saw an endo at the onset, rather than just be complacent under the less agressive care of their GP.

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HOUNDLOVER1's Photo HOUNDLOVER1 Posts: 8,869
8/11/14 12:10 A

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I'm glad your endo mentioned that your liver is not functioning properly. The question is what is wrong with what your liver does? Is it insulin-resistant? Do you have fatty liver? Depending on what is wrong there may be many different options.
I know that because my liver is insulin-resistant it produces too much glucose during the night which brings my blood sugar higher than I want it. The only answer for me is ultra-low (20-30 grams/day) carbs. This keeps my glycogen stores fairly empty and keeps my liver from cranking out too much sugar to flood my blood stream in the morning.
Birgit

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FOXSTAR10's Photo FOXSTAR10 SparkPoints: (82,180)
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8/10/14 8:27 P

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I was on Januvia for about a month. This was just to bring my b/s down. Since then I have cut my b/s and blood pressure meds in half by eating low carb.

Joy S

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MRSKATEDUVALL's Photo MRSKATEDUVALL Posts: 2,199
8/10/14 7:54 P

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I have tried both Januvia, and Janumet- similar drugs. My sugars were fine, but janument gave me IBS. I would still be on januvia, but my insurance wants me to try something else first.

LITTLEWIND53's Photo LITTLEWIND53 Posts: 17,180
8/10/14 7:50 P

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Sorry, I was on Metformin and Diabeta (both oral) for years but since I started insulin, I do not take any orals. I have never used Januvia.

Linda

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8/10/14 10:48 A

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So, according to my endocrinologist, my liver isn't doing its job properly and that's the reason my blood sugar levels are ALL over the map, despite max dosage of glumetza and doing everything right diet wise.

Anyone have any experience with Januvia or other similar drugs? I'm only somewhat hopeful that this will actually help balance my blood sugars. Nothing has worked for so long that I'm dubious and would love to hear some personal success (or unsuccessful) stories.

Jenn

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