I was planning to make the fish tonight, but forgot to go buy red peppers, and we spent so much time talking about Bratwurst and Brötchen and the pommes frites and mayo at the rad shack (translation- rad is what we called locals behind their backs, short for Comrade, and the rad shack was the German diner-like place on post), that I grilled up a few brats and some kraut, soaked some mixed beans that had more dietary fiber than carbs overnight, and then cooked them into a sort of baked bean like dish with a slice of country bacon and some spices and no salt (and they were pretty fucking good- salt is awesome but cutting it down seems to be a big deal for diabetics), and we both agreed that we liked the spinach last night, so we made that again.
There were other carefully controlled meals during the day and I keep making him drink a lot of water to help his kidneys out to make it easier to secrete all the sugar, but here is the good news. His blood sugar was 230 after not eating for eight hours when he got here. In just four days, he woke up at 170, which is still way too fucking high, but then the 1 hr postprandial (spelling) after dinner was 175 and the 2 hr was 157, which is the lowest his blood sugar has been.
This is really quite good news, I think, and the snacking on peanuts and other snacks is working out- we had an apple and a slice of cheddar cheese for one snack, and steady snacks every two hours is really helping steady his blood sugar out. I think.
BTW- thanks for all the comments and the emails, and I haven’t responded to many of the emails because I am busy, but what I have been doing is making my own kind of database with your own stories about your reactions to certain foods and what I am writing down about what he eats and how his blood sugar reacts, but thank you all so much. BTW- really impressed with the Edy’s pineapple fruit bars as a snack- they cause no spike whatsoever. Also, we are going to do the 20 min walk after every meal starting tomorrow because one of you all suggested it.
Tomorrow I break the google researching Type 1.5 diabetes. Thanks again for helping me help my friend. And you know what, I feel better eating this way, so you are helping me as well.
jl
The Cole diet sounds pretty tasty. Glad your friend is doing well.
Edit: and sounds healthful. But, is it slimming? That might be the rub.
Just Some Fuckhead, Thought Leader
I made kraut, potatoes, sausages and pork loin tonight. Was really delicious.
The Dangerman
Check out Grain Brain; I’ve just started it, but as a person with both diabetes and a variety of brain disorders in the Family, I’ll give gluten free a go.
ETA: For those questioning my intelligence last night (hello’s to raven and Stone if they are still up), I probably just lobbed a hanger over the heart of the plate; however, Parkinson’s and an ALS related disease (it was never completely diagnosed) are no laughing matter
The Dangerman
Also, check out David Asprey’s diet; it’s basically Paleo (as is Grain Brain), but this Dude is fascinating on a number of levels
Bill E Pilgrim
@The Dangerman: I read that last summer. I was already pretty convinced by other things I’d read, plus experimentation (lost weight for the first time in years) but the brain science in his was chilling. Also this:
The Dangerman
@Bill E Pilgrim:
Yup. I don’t know if that neurologist is a whack, but there’s plenty of supporting evidence to say he’s not…
…now, Asprey is also into the brain and he IS a bit of a whack (more money than sense; he’s one of the leaders in the biohacking community and, basically, either a crazy fucker or staggeringly brilliant), but they are both saying basically the same thing.
Mnemosyne
@The Dangerman:
If he says that ADHD is caused by grains (and apparently he does), then he’s a frickin’ whack, sorry.
Funny how I went from not having ADHD (because girls didn’t have it, only boys) to having it, only now it’s because of grains and not because it’s a genetic condition and I can identify other people in my family who I inherited it from.
Don’t get me wrong — just as there are people who are lactose intolerant, I’m certain that there are people who are gluten intolerant and grain intolerant. If you have a family history of diabetes and dementia, it is probably worth it for you to cut way back on grains and other carbs.
But it really bugs me when “scientists” insist that if some people are intolerant of or allergic to something, that means it’s bad for everyone, everywhere. My co-worker is allergic to garlic (yes, garlic). Does that mean that garlic is deadly poison and we should all stop using it?
MikeJ
@Mnemosyne: I once met somebody who was allergic to bees and I stopped eating them altogether.
Hal
I’m sure newsmax has a cure for diabetes. Just keep an eye on the headlines.
KG
@Mnemosyne: I’m cuban, we can’t give up garlic… It’s as close as we get to vegetables
Villago Delenda Est
Well, there you go!
Villago Delenda Est
@Hal:
There’s one weird trick (probably mainlining bourbon or something…)
billgerat
Obviously, 100 would be ideal for blood sugar (that is what non-diabetics score at), but 170 isn’t all that high – depending on what his doctor has advised him. For me, my doc says as long as I’m between 100-180, I’m OK.
Scratch
@billgerat:
If you get 100 mg/dL on a fasting blood draw for a doctor, that’s usually an alert to begin watching a person for pre-diabetes, as most fasting blood draws for glucose levels in a non-diabetic should be between 70 to 90 mg/dL. The 180 mg/dL is important in the sense that’s around the level where blood sugar begins to spill into the kidneys and puts more stress on the kidney cells then.
The best information from the evidence we have is that the various types of cellular damage and stress caused by diabetes begin to occur around 140 mg/dL. So it’s probably even better to minimize the amount of time that the blood sugar spikes over 140 mg/dL.
mai naem
You want to aim for 80-100 for the fasting BS because for the vast majority it’s only going to go up during the day. From what I remember reading, if you are eating a reasonable diabetic meal your BS will go up around 40-50 units.
Also for food, cottage cheese is a really well balanced snack food for diabetics. It’s got 12 carbs per half cup, a decent amount of protein and a little fat in the low fat kind. Also a half PBJ with not slathered on diabetic jelly and not slathered on peanut butter..
SuperHrefna
You’re a really good friend, John Cole! I got my blood sugar under control by switching to a whole wheat diet ( and I’ve been a vegetarian since I was 12) but given that the women in my family all seem to get pre-diabetic with age I may have to make more changes in time, so I’m watching your experiments with interest!
billgerat
@Scratch: @mai naem: And that’s why my doc set the 180 as the upper limit for me. The closer you can keep your blood sugar to 90-100 is the best way to stay healthy. And the 80-100 fasting BS is correct also.
WereBear
@Mnemosyne: Grain Brain is about their effect on blood sugar more than the grains themselves. Wheat Belly, which IS about the grains, also does not recommend most of the gluten free grain substitutes because of the blood sugar spikes which come from most starches.
Sounds like John and his friend are doing the best possible way of seeing how food affects them, diagnosed diabetic, or dealing with overweight, or whathaveya. Which is Eat to the Meter.
Have whatever you want… as long as it doesn’t spike your blood sugar. It’s those blood sugar spikes which create our excess fat, overwork the pancreas, and lead to metabolic syndrome. And yes, people can react somewhat differently to different foods, or to levels of processing which can be just as important.
Another book I love, just out, is Death by Food Pyramid, which does the best job ever of explaining how different people can benefit from varying approaches. Some people have the enzymes to digest and extract from a plant-based diet, and so they do well with the common “mostly vegetarian.”
But that same diet is a disaster for me, I’ve tried it. I don’t have the enzymes!
zzyzx
Today is right about at my first anniversary of being dx’d. I went from an A1C of 8 to three straight in the low to mid 5s. The first two were through complete carb/calorie restriction to get me to lose weight and then I moderated while increasing the intensity of my workouts. For me, 45 minutes in the gym (10-15 lifting, 30 cardio with the rule that the cardio has to be intense enough that I can’t complete a whole sentence and I need to be sweating) is enough for me to increase my carb allotment to around 160-200 g a day without having bad numbers.
It’s a three pronged attack: drugs, exercise, dietary changes. The more you do of one, the less you have to do with the others. And then it’s choose your battles with the carbs. Find the ones you need, eliminate those that are just empty calories: for me that’s bread. Haven’t had a slice since, don’t really miss it other than the convenience factor.
Van
@Mnemosyne: Hahaha. The best argument against the ‘Paleo Diet’ is it turns doctors that practice it into raving idiots.
Fuzzy
@Mnemosyne: Allergic to Garlic but hoe does she ward off Vampires?
Honus
@Mnemosyne: I agree. I am gluten intolerant. I had fairly severe symptoms that I thought given my age and family history were heart disease. I went gluten free and less than 24 hours later those symptoms all disappeared. However, I agree with Dr. David Katz (Yale nutritionist) that unless you have the allergy to gluten there is no advantage in a gluten free diet, and considers it a fad. Katz attributes stories of weight loss by gluten free advocates to the limited choices. I know I lost some weight because gluten free meant no fast food on a bun or breads and fried (as well as no beer and no pizza). After I adjusted and found other things I could eat (peanuts, potato chips, French fries) I got back to my “normal” weight.
I get irritated when people say “oh, you decided to go gluten free.” I didn’t decide, I had no choice. I couldn’t walk up a flight of stairs after eating a pimento cheese sandwich because of the chest pain. I really miss good pizza, (substituted hard cider for beer after 45 years) but thank FSM I’m not allergic to garlic.
Honus
Here’s Katz on gluten:
“Gluten is not “bad” for those tolerant of it, any more than peanuts are “bad” for people free of peanut allergy.
Also abounding are home-grown theories about health effects of gluten, including the argument that going gluten-free leads to weight loss. It might, but only because avoiding gluten means avoiding a lot of foods, which in turn tends to mean reduced calorie intake.
Going gluten-free is easier than it once was — due to better food labeling, more gluten-free products, and ever better guidance in print and online.
The effort is well-justified for those who are truly gluten-sensitive. For everyone else, it is at best a fashion statement, and at worst unnecessary dietary restriction that results in folly.”
Kristine
@Bill E Pilgrim: Whole grain bread is lower, in the 50s. Some types of “whole-wheat” bread are nothing more than white bread with caramel coloring. “Whole grain” should be the first ingredient.
http://www.health.harvard.edu/newsweek/Glycemic_index_and_glycemic_load_for_100_foods.htm
Violet
Glad things are going so well for your friend and you too. You’re a good friend, John.
WaterGirl
What Cole is doing here is helping his friend know he’s not alone in this (scary) boat. That’s a great gift.
John, you are a stand-up guy.
bemused
John, you are a good pal. A friend that delivers that much loving tlc is a a keeper.
How does your friend like the cuisine? Changing what you eat especially if you have to do it fairly quickly due to a diagnosis that requires it can be daunting. The taste buds take time to adapt. Over time a lot of the food I used to eat just tastes horrible. Your taste buds learn to recognize the difference between what I call real food and food with too much salt, additives etc. Walking a food line at an event I can even smell rolls that are full of preservatives. I don’t even have to taste it to know. That was a horrifying discovery. If your friend has felt bewildered and a little daunted with changing his menus, he should hang in there. I know I miss very few foods that I have abandoned.
JohnTK
Lean people with Type 2 diabetes – a group whose numbers are relatively small but rising – may be predisposed to a genetic form of the disease that is particularly severe. Some researchers argue that most of these thin patients actually have a medical condition called latent autoimmune diabetes in adults that has been only recognized recently.
More here: http://well.blogs.nytimes.com/2014/01/15/can-heavier-people-really-be-healthier/?_php=true&_type=blogs&_r=1
Mnemosyne
@WereBear:
@Honus:
I think we all agree, for the most part. It just drives me nuts to have to sit one cube over from someone all day who has gotten waaay too into the Primal Diet (because Paleo is so passé, don’t’cha know) who’s constantly telling me that all grains are bad, beans are bad, etc. Yes, okay, I can see that for someone who has a severe allergy to grasses, cutting out grains was a good idea. But I don’t have those allergies, so cutting out grains is not going to be miraculous for me.
(Of course, cutting all grains hasn’t been miraculous for her, either, but she does seem to feel better overall, so that’s good. She just needs to STFU once in a damn while!)
Citizen_X
@Mnemosyne:
Hey hey, now! We weren’t talking about scientists, we were talking about MDs. (ducks)
LongHairedWeirdo
BTW: Why is salt bad for diabetics? It’s complicated.
Near as I can tell, kidney problems are expected.
Normal people with normal kidneys can dump salt *just fine*.
Diabetics are at much higher risk for cardiovascular complications than normal people. Weak kidneys + risk of heart attack anyway makes salt risky because it can lead to higher blood pressure.
Note that the big sources of salt are usually invisible. It’s not the surface salt on your french fries that is the problem. But buy a can of regular tomatoes, and check the sodium content, and try not to cry.
Svensker
Good for you, John Cole.
Reminds me of my favourite story as a kid, about a boy who was helping his friend prepare for the diving championship. They worked really hard together, the boy going the extra mile every time to get his friend to peak. And of course, the boy was tricked into entering the diving contest and won the championship himself, with his friend coming in 2nd.
Yay, you!
taylormattd
Did you post about your friend and diabetes earlier? I feel like I must have missed a post or a comment, but I hope there is an endocrinologist available for your friend.
LongHairedWeirdo
@billgerat:
“Between 100 and 180” is not really good enough… but it might be the best that can be hoped for.
Here’s the thing: anything that mucks with your insulin (which is most blood sugar meds *except* metformin) has two balancing risks. The long term risk of high blood sugar, versus the short term much (much, much, much) higher risk of low blood sugar.
Really low blood sugar can kill you, *fast*, by making you stupid or dizzy (while going down stairs, or driving, etc.), or by going so low it pushes you into other terrible states (i.e.: I don’t know the precise mechanism, but I have been assured it can kill you).
That’s why if you see a person in a diabetic crisis, you give them sugar (unless they’ve explicitly told you otherwise). If you boost their sugar by 50mg/dl when they’re at 800, it’s not really going to hurt them any worse than they’re already hurt, but if you boost their sugar by 50mg/dl when they’re at 20, you might just have saved their life. In either case, you want to get them medical attention *immediately* – if their sugar is too high, the docs will give them insulin (negating the harm the extra sugar did), if it was too low, the docs can stabilize them.
Where was I?
Oh, right.
What a doctor really wants (if they’re current on the research) is to have you *never* go above 140. Okay, but, if you’re diabetic, you’re probably going to go over 140 if you eat any significant carbohydrates, so a better goal is to get you to 140 within two hours of eating.
This is based on the assumption that blood sugar will peak and begin to drop within that two hours. That’s *not* always the case, and the source of some confusion with diabetes management. I’ve heard stories of people who eat beans and the big jump in sugar happens around two hours – but then might subside within an hour of peaking. If that were the case (steady for 1.5 hours, jumping at 2 hours, back to normal in 3 hours), that would be perfectly healthy. But it’s a lot more confusing than “below 140 within two hours of eating.”
Okay: but…
But that “below 140 within two hours of eating” must be balanced against the risks of low blood sugar episodes. They could always get you below 140 if they hit you with enough insulin, but you might die sooner from a blood sugar drop than you would from diabetic complications from slightly-higher sugar.
So, “between 100 and 180” should mean “we can’t give you more blood sugar meds without putting you at risk of low sugar episodes, so this is a decent balance of the risks.”
“But wait!” some people would say. “I’m only on metformin, which has minimal risk of low sugar episodes!” Then the response is, your doctors are doing you dirty (probably by accident, by following old guidelines); try to maximize the time in which blood sugar is below 140mg/dl; 140 is the magic number where harm seems to start occurring.
Danton
Great low-carb recipe:
Saute Italian sausage. Chuck lengthwise into quarters. Saute thinly sliced onion and green pepper until they’re very soft. Add marinara sauce. Cook about 15 minutes.
You can eat this as is or you can slice and grill eggplant and serve it on that.
qaug dab peg
@billgerat: 170 is too high. John your friend probably needs a higher basal insulin dose (the night time insulin). Once his Am fasting glucoses are between 70 and 130 every day, he can tinker with meal time insulin but meal time insulin is what causes low sugars so it’s always best to be conservative with that. DM 1.5 isn’t a diet/exercise sort of diabetes. Please tell me he sees an endocrinologist?
Birthmarker
@qaug dab peg: I believe this is John’s original post about his friend’s health concerns…
https://balloon-juice.com/2014/02/10/dietary-questions/
Cheryl from Maryland
So happy to hear things are working well for you and your friend. And thanks for mentioning apples – that’s another standard snack — apple quarters with a dollop of unsalted fresh ground peanut butter ( the kind you grind in the store and is only peanuts).
ACT
A morning blood sugar of 170 is very good for someone newly diagnosed with diabetes.Your friend is on the right track. Also the Brats were a good idea with healthy sides, rather than the fish. Eating foods he likes with small changes will make it easier to stick to the diatery changes he needs to make. He should get a notebook and start a blood sogar and food diary so he can track his progress. A visual of what is working and not working will make it easier for him to manage his diabetes. Good Luck.