Diet and excercise....take it for what it's worth.

2 years ago I was at the Mayo Clinic in Minnesota and they had just completed a study about diet and exercise in relation to controlling diabetes. The findings of this study was, in some ways, kind of surprising, at least as far as some of the long, popular held beliefs go. 2 other institutions had also just completed similar studies with the same results.

Diet:

Old wisdom: Carbs are very bad for you. You should avoid them if at all possible.

Study results: Carbs are really good for you, but should be eaten in moderation. A no carb diet can screw you up and bad as a high carb diet. To achieve the best overall, most stable control, a person should strive to consume the same amount of carbs every day, divided equally among each meal. The suggested starting point is 45 grams of carbs per meal. The other thing is that not all carbs are created equal. Simple carbs like those found in sugar are far worse than complex carbs found naturally in foods. Simple carbs will cause spikes in your blood sugar since the body processes these quickly. Complex carbs however are processed slower and while they will still elevate the blood sugar they do it slower without the big spikes because it gives the body more time to use it.

They believe the reason a no carb diet is really not good for you is that your body will "forget" how to process and use sugars, not to mention since it is the "sugars" in foods that provide the energy you need to need your body will start to convert muscle cells into sugar for energy which will lead to other problems.

Exercise:

Old Wisdom: Exercise will always help lower you blood sugar.

Study Results: Exercise during periods of high blood sugar will actually increase your blood sugar. They suggest to test your blood sugar before engaging in any concentrated exercise and if it is really high, 200 or over (US reading) to wait until it drops before exercising. Exercising when your blood sugar is "decent" will help make it better and goes a long way to helping you keep it good in the future. The more exercise you get the fewer high readings you will get.

I guess the title of this post does come off as a little negative sounding. It wasn't intentional. I meant for people to take or leave what I posted to avoid any arguments about what I had said. Some people will cling to "old school" thought about diet and exercise as it relates to diabetes no matter what. In the past few years I have had run ins with so called professionals, including one endocrinologist, who still goes by treatment, diet, and exercise protocols used 30 years ago.

For diabetics diet is such a minefield. A person needs "X" amount of calories per day just to survive but since diabetics are more prone to cholesterol and lipid issues as well as kidney problems too much meat or other forms of protein can be just as harmful as too many carbs.

I was first diagnosed about 10 years ago. I started out on metformin and OK on that but not real well. about 6 months later they added Amaryl. I did really well. My initial A1C was a 12.9. 9 months later it was down to a 7.1.

2.5 years on that drug combo I started to develop a severe rash on my legs. I was taken off the Amaryl first and then put back on that and taken off the metformin when the rash did not go away. Within a week of not taking the metformin the rash was gone. At that point I was placed on Advandia 4 mg along with the Amaryl. My A1C's started fluctuating between 7 and 8.5, so the upped the Advandia to 8 mg and it calmed things down. Started having A1C's consistantly in the low 7's. Not great but pretty good considering I was driving a semi truck at the time and getting exercise was not the easiest, not to mention trying to eat right was always a challenge.

In late 2005 I stopped working to stay home with youngest son when he was 6 weeks old. In early 2006 I started having major back pain and my sleep went to hell. I was only getting 2-3 hours of sleep a day, usually in 45 minute to 1 hour naps because of the pain. My blood sugar went nuts. I could test first thing in the morning and it would read 102, an hour later, with nothing to eat it would be 245, a couple of hours after that it might be 118, but it was high more than it was low. I was taken off the Amaryl and started on Novolog insulin. At first it was a sliding scale and then I was put on a set amount with each meal. Regardless of what I did or did not do my blood sugar was all over the place and my A1C's jumped up to 10-10.5, and that is where they have stayed. I would have several days to a couple of weeks of really good readings but then I would have days and weeks or really high readings. At one point my blood sugar was so high my meter could not calculate it.

The only time I have had good consistent readings in the past 3 years or so was when I was in the hospital, and I think I know why. Everytime I have been in the hospital I have been on IV push pain killers like morphine or demerol so I have been 90% pain free the entire stay, plus I got a lot more sleep. Of course you think I can convince any doctors of this? Not a chance. They all want to think I sit at home all day long eating mashed potatoes with a side of a loaf of bread and a 1/2 gallon of ice cream for desert at every meal.

In late 07 I went to the Mayo clinic to try to figure out why my sugar readings were so erratic. I made a few changes in my diet, per their suggestions, and was advised to be put on a pain treatment regiment. All of this was sent back to my PCP, but I still had to fight tooth and nail to get anything strong enough to even take the edge off. I went to the local pain clinic too and had steroid injections done which just made things 10 times worse.

Anyway as far as what I am currently taking for my diabetes, all I am on is Novolog and Levemir insulins. I take 40u of Novolog at each meal and 100u of the Levemir at bedtime. I am not 100% successful, more like 98%, at keeping my carb intake to 35-45 grams per meal. I only eat 3 meals per day, no snack. 90% of my carb intake comes from fruits and veggies. 2% comes from bread and pasta and 3% from potatoes and rice. My blood sugar is still all over the place. No correlation to what I eat. I have literally eaten the same exact meal for 5 days and taken my blood sugar at the same times for those 5 days and will have reading from 90-280. One day it might be 90-140-100-143-99 (BB,AB,BS,AS,BT) the next day it might be 240-199-283-200) then the following day it will be like it was on day 1 or I will have 2 or three days of the high readings and then boom it will drop.

Anyway I am no longer with the doctor I had been seeing for almost 11 years. I just started seeing an NP, and in October I will be seeing one of the MD's she works with. I am hoping when I get with this new MD I can get some real pain control going and start sleeping better, then maybe everything else will finally start falling into place.