Lower A1c's Increase Death Risk?
morris
really saying? Or just in high risk patients? or...?
Morris
*********************************************************
MSNBC.com
Major diabetes trial halted after deaths
257 patients died after intense therapy to lower blood sugar, NIH
reports
The Associated Press
updated 7:34 a.m. PT, Wed., Feb. 6, 2008
WASHINGTON - An unexpected number of deaths among patients receiving
intense therapy to lower their blood sugar forced the National
Institutes of Health to abruptly cut short part of a major study on
diabetes and heart disease.
The therapy was aimed at reducing to normal levels the blood sugar of
type 2 diabetics at especially high risk of heart attack and stroke.
There were 257 deaths among people receiving intense diabetes
treatment, compared with 203 in the standard treatment group, NIH's
National Heart Lung and Blood Institute said.
More than 18 million Americans have diabetes, with type 2 the most
common form.
Last fall the Food and Drug Administration added new warnings to the
label of the popular diabetes drug Avandia, listing concerns about
heart ailments. However, in Wednesday's announcement NHLBI officials
stressed that they have been unable to link the increased deaths in
the study to any drug, including Avandia.
Some 10,251 people were enrolled in the Action to Control
Cardiovascular Risk in Diabetes study, with an average participation
time of four years.
The participants were in groups receiving three types of treatment,
intensive lowering of blood sugar, lowering blood pressure or reducing
cholesterol.
"A thorough review of the data shows that the medical treatment
strategy of intensively reducing blood sugar below current clinical
guidelines causes harm in these especially high-risk patients with
type 2 diabetes," said Dr. Elizabeth G. Nabel, director of the
institute.
"Though we have stopped this part of the trial, we will continue to
care for these participants, who now will receive the less-intensive
standard treatment. In addition, we will continue to monitor the
health of all participants, seek the underlying causes for this
finding, and carry on with other important research within ACCORD,"
she said in a statement.
Multiple risk factors
The study focuses on treatments for adults with type 2 diabetes, the
most common form, who are at especially high risk for heart disease,
meaning they had at least two risk factors, which include high blood
pressure, high cholesterol, obesity and smoking.
Dr. William Friedewald, professor of Public Health and Medicine at
Columbia University, and chairman of the ACCORD Steering Committee,
said that there were "about 10 percent fewer nonfatal cardiovascular
events such as heart attacks in the intensive treatment group compared
to the standard treatment group. However, it appeared that, if a heart
attack did occur, it was more likely to be fatal. In addition, the
intensive treatment group had more unexpected sudden deaths, even
without a clear heart attack."
The action was recommended by an independent advisory group of experts
in diabetes, heart disease, epidemiology, patient care, biostatistics,
medical ethics and clinical trial design that has been monitoring
ACCORD since it began.
Participants will continue to receive blood sugar treatment from their
study clinicians until the planned trial conclusion in June 2009.
Nabel stressed that diabetes patients should not change their
treatment without consulting their doctor. The American Diabetes
Association agreed and said it continues to encourage control of blood
sugar in treatment of diabetes.
NHLBI said the intensive treatment group had a target blood sugar goal
of less than 6 percent, which is similar to blood sugar levels in
adults without diabetes. The standard treatment group aimed for a
target similar to what is achieved, on average, by those with diabetes
in the United States, of 7 to 7.9 percent.
(c) 2008 The Associated Press. All rights reserved. This material may
not be published, broadcast, rewritten or redistributed.
Paul L
"morris" <morri...@comcast.net> wrote in message
news:3b1bdf96-6870-4661...@1g2000hsl.googlegroups.com...
I'd like to know what "intense therapy" is in this study. Drugs? Diet?
Exercise? All ? This is the key to knowing what this means. I don't
think it was lower a1c that was the problem, it must have been whatever
means were used to get lower a1c.
cheers
Paul
GysdeJongh
news:3b1bdf96-6870-4661...@1g2000hsl.googlegroups.com...
> really saying? Or just in high risk patients? or...?
> Morris
> *********************************************************
Hi morris,
thanks for the link
This is not for speed readers ; I managed to find the whole study and the
protocol > 100 pages :(
Here are my 2 cents :
1) In the ACCORD study there were ONLY patients that had MORE THAN 1 problem
: obesity , smoking , heart , T2D
2) The patients in the intensive treatment group had to lower their A1c with
medication and medical nutrition therapy.See below for the enormous amount
of medication.The medical nutrition theraphy followed the ADA diet
recommandations for a healthy diet
3) So they started with lots of whole grains and carbohydrates in their
diets
4) Thus they were put on insulin , raising their insulin resistance ,
icreasing their BMI
5) The carbohydrates in their diet raised their LDL levels and thus their
symvastin and other drugs medication were increased
5) Within 3 months most of the patients used : a cholesterol drug , insulin
and 1 or 2 other T2D drugs !!!!
This study clearly demonstrates the failure of the current treatment
paradigma's for T2D : eat "healthy" and use all necessary drugs to
compensate for the complications.
I would like to see another group that were given the skills , education
etc to lower their A1c by diet & exercise while minimizing (instead of
maximizing) their drug intake
Maybe Gary Taubes has an opinion on this
I'm not making this up read the original statements by the authors here :
============================================
The news release :
http://www.eurekalert.org/pub_releases/2008-02/nhla-ibs020608.php
They were also enrolled in one of two other ACCORD randomized clinical
trials examining effects of treatments for blood pressure or blood lipids;
those study components will continue. Participants had been followed for 2
years to 7 years at the time the intensive blood sugar control treatment was
stopped.
For both the intensive and standard treatment groups, study clinicians could
use all major classes of diabetes medications available: metformin,
thiazolidinediones (TZDs, primarily rosiglitazone), insulins, sulfonylureas,
exanatide, and acarbose.
"Because of the recent concerns with rosiglitazone, our extensive analysis
included a specific review to determine whether there was any link between
this particular medication and the increased deaths. We found no link," said
William T. Friedewald, M.D., ACCORD Steering Committee Chair and Clinical
Professor of Medicine and Public Health at Columbia University.
The Accord website:
http://www.accordtrial.org/public/index.cfm
The Accord Protocol:
http://www.accordtrial.org/public/protocol_2005-05-11.pdf
Page 54 :
For example, within 6 months of randomization, most intensive group
participants will likely be on 3 or more injections of insulin per day in
addition to 2 or 3 oral agents.
Page 59 :
Self-titration of Anti-hyperglycemic Therapy
Standard therapy participants will be provided with simple algorithms to
allow them to self-titrate their oral therapy or insulin to avoid
hypoglycemia. They will also be instructed to call the clinic if they are
recording frequent low SMBG values (see Table 3.2); if they have any episode
of severe hypoglycemia; if they are experiencing frequent episodes of
symptomatic hypoglycemia (>1/week); or if they have any symptoms of
hyperglycemia. In these instances, therapy can be adjusted.
Page 61 :
Glycemia Medications Available Within ACCORD
The following classes of antihyperglycemic drugs are available within
ACCORD:
a) biguanides (e.g., metformin)
b) secretagogues (e.g., sulfonylureas such as glimepiride and meglitinides
such as repaglinide)
c) thiazolidinediones (e.g., rosiglitazone)
d) alpha-glucosidase inhibitors (e.g., acarbose)
e) insulins (e.g., NPH, ultralente, glargine, aspart, regular).
Page 78 :
Medical Nutrition Therapy
Medical Nutrition Therapy (MNT) consists of weight control and dietary
modification. The American Diabetes Association (ADA) position statement on
"Nutrition Recommendations and Principles for People with Diabetes Mellitus"
reports that "medical nutrition therapy is integral to total diabetes care
and an essential component of successful diabetes management" (ADA 2000a).
Thanks again morris
Gys
Paul L
"GysdeJongh" <jong...@planet.nl> wrote in message
news:47aa3ada$0$25480$ba62...@text.nova.planet.nl...
... and thanks to you Gys for sifting through all that, well, information.
cheers
Paul
Andrew B. Chung, MD/PhD
diabetic.
Lowering HgbA1c with medications invariably increase frequency and
severity of hypoglycemic attacks in our collective clinical experience
among those of us who are practicing physicians.
ACCORD is simply mirroring the reality of clinical experience with
managing type-2 diabetics.
Smarter to lower HgbA1c by eating less, down to the optimal amount
with concomitant downward titration of diabetic medications to avoid
hypoglycemia:
Be hungry... be healthy... be hungrier... be blessed:
http://TheWellnessFoundation.com/BeHealthy
Prayerfully in the infinite power and might of the Holy Spirit,
Andrew <><
--
Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
Bondservant to the KING of kings and LORD of lords.
Jefferson
> Is that what the cessation of the ACCORD Study, announced today is
> really saying? Or just in high risk patients? or...?
It is interesting since many T2s have therapies to control the following:
"The participants were in groups receiving three types of treatment,
intensive lowering of blood sugar, lowering blood pressure or reducing
cholesterol."
If someone has type 2 diabetes and the metabolic syndrome, they are
likely to have therapies for each of the above components. However, the
newsrelease did not attribute the cause to the TZD Advandia which is not
usually a initial T2 therapy. Also only about 7% of the T2DMs reach the
goals for all three control goals.
The therapies Gys cited with his extract cover the whole spectrum of T2
therapies.
Frank
Alan S
Thaks Gys. Those extracts help a lot. I'm still ploughing
through it trying to prepare an acceptable response on this
for an ADA forum thread.
If we are reading the same documents, this is the overall
version of "Methods" for the intensive glycemic management
section. Possibly the most important aspect is that after
"In addition to lifestyle approaches," no further effort
appears to be made to review or modify those lifestyle
approaches. "Intensive" from that point on is defined by
adding medications; whatever works to drive down A1c and
BG's without changing lifestyles further.
I've added some para breaks for clarity. Where odd symbols
appear, they usually mean "less than or equal to" but
context should show it.
"Methods
Details regarding the overall design of ACCORD are described
elsewhere in this supplement.14 All ACCORD participants are
provided with education regarding diet and lifestyle,
glucose monitoring and therapy, and the avoidance and
treatment of hypoglycemia. They are also provided with
antidiabetic medications from a formulary of drugs, as well
as glucose-monitoring equipment.
The ACCORD formulary contains the following drugs,
representing several classes of antihyperglycemic agents:
glimepiride (a sulfonylurea), repaglinide
(a rapid-acting secretagogue), metformin (a biguanide),
rosiglitazone (a thiazolidinedione), acarbose (an
_-glucosidase inhibitor), glargine, neutral protamine
Hagedorn and premixed insulins (longer-acting insulins), and
aspart and regular insulin (shorter-acting insulins).
Participants randomly allocated to the intensive treatment
group are scheduled for monthly visits for the first 4
months and bimonthly visits thereafter, with _1 extra visit
or between-visits phone call. Participants in the standard
glycemic control group are seen at 1 month and then every
2-4 months depending on whether they are also allocated to
the intensive blood pressure control arm of ACCORD, as
described in the report on the trial's overall design
elsewhere in this supplement.14 Additional interactions with
either group are scheduled at the discretion of the clinical
site. HbA1c levels are measured at a central laboratory
every 4 months, and the results are promptly reported back
to clinical sites and to the central database. A Bayer DCA
2000 point-of-care measurement device (Bayer AG, Leverkusen,
Germany) is also available at each site to immediately
estimate participants' HbA1c results when indicated (see the
following discussion).
As noted in the inclusion criteria, described in this
supplement, 14 all participants' HbA1c levels must be
documented to be _7.5% before randomization. Thus, glycemic
interventions are adjusted with the aim of reducing all of
the intensive-group participants' HbA1c levels to _6% and to
either maintain or reduce standard-group participants' HbA1c
levels at 7.0%-7.9%. Investigators and research staff
members are all provided with guidelines regarding diabetes
care and are given flexibility to individualize
interventions (including lifestyle approaches, behavioral
therapies, and self-titration and the adjustment of any of
the glucoselowering drugs) needed to achieve the glycemic
targets of the group to which each participant has been
allocated.
Thus, ACCORD is a trial in which 2 different treatment
policies or strategies (with differing HbA1c targets and not
mandated differential medication use) are being compared.
Intensive glycemic control: In addition to lifestyle
approaches, the pharmacologic antihyperglycemic regimen of
intensive-group participants is initially adjusted so that
_2 classes of agents are provided. As noted in Table 3, the
dosage of _1 class is to be increased, or an agent of
another class is to be added at each visit, whenever (1)
the central laboratory-measured or point-of-care HbA1c level
is _6%, (2) _50% of self-monitored premeal capillary glucose
readings are _5.6 mmol/L (100 mg/dL), or (3) _50% of
postmeal capillary glucose readings are _7.8 mmol/L (140
mg/dL). When a new agent is added, previous therapies are
continued unless there is a specific reason not to do so.
Medications are reduced or withdrawn only because of side
effects, severe hypoglycemia,13 or contraindications. All
combinations of drugs are permitted.
Several tools have been developed to promote the
intensification of therapy. These are available to
investigators, nurses, dietitians, and research staff
members at all sites and include
(1) Web-based patient management tools that allow
investigators to review the latest HbA1c level and drug
regimen of each participant at their sites in comparison
with other participants at the sites;
(2) automated e-mails when a participant's HbA1c level
requires corrective action;
(3) dynamic, Web-based reports that allow investigators to
view the median achieved HbA1c levels and the frequency and
nature of drugs used at their sites relative to other sites
in ACCORD;
(4) weekly e-mailed tips to all sites suggesting methods to
intensify therapy that are prepared by expert ACCORD
clinicians and staff members;
(5) the regular distribution of achieved HbA1c levels in the
intensive group at each site;
(6) regular audit and feedback in which the achieved HbA1c
levels and antidiabetic regimens used at each site are
reviewed by a network expert who is external to the site;
and
(7) annual training meetings that include glycemic
management workshops and lectures.
Finally, point-of-care HbA1c measurements using the Bayer
DCA 2000 are used at each visit to immediately inform
changes in antihyperglycemic therapy; such an approach has
been shown to lead to better glycemic control than awaiting
central laboratory HbA1c levels.15
Standard glycemic control: The antihyperglycemic regimen
of standard-group participants is adjusted to reach and
maintain an HbA1c level of 7.0%-7.9%. Lifestyle and/or
pharmacologic therapy is intensified whenever HbA1c is _8%,
and pharmacologic therapy is relaxed if a participant is
experiencing problems with hypoglycemia or other side
effects. Moreover, antihyperglycemic drug therapies that
promote hypoglycemic episodes (ie, insulin and insulin
secretagogues) are reduced or withdrawn if HbA1c levels
persistently decrease to _7% in patients who are
experiencing hypoglycemia (summarized in Tables 3 and 4)."
Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Latest: LuckyKat
Jefferson
Center Stage? - http://www.medscape.com/viewprogram/8506 or
http://tinyurl.com/2ea8re
1. Spotlight on Risks: Obesity Sidney C Smith, Jr, MDAvailable As:
Slides/Video | Audio
2. Spotlight on Risks: Dyslipidemia Daniel J Rader, MDAvailable As:
Slides/Video | Audio
3. Spotlight on Risks: Diabetes Richard W Nesto, MDAvailable As:
Slides/Video | Audio
4. Spotlight on Risk: Biomarkers Jorge Plutzky, MDAvailable As:
Slides/Video | Audio
5. Spotlight on Mood DisordersCharles B Nemeroff, MD, PhDAvailable
As: Slides/Video | Audio
6. Center Stage in Cardiometabolic Risk Uberto Pagotto, MD,
PhDAvailable As: Slides/Video | Audio
Frank
Quentin Grady
<morri...@comcast.net> wrote:
>WASHINGTON - An unexpected number of deaths among patients receiving
>intense therapy to lower their blood sugar forced the National
>Institutes of Health to abruptly cut short part of a major study on
>diabetes and heart disease.
G'day G'day Folks,
I find it fascinating how a results lead to conclusions.
The patients receiving intensive therapy were more likely to die.
Yet it is a lower A1c that is blamed. Obviously it is misdirection
but why.
The headline (conclusion) doesn't match the research result.
What happens with people who manage a lower A1c WITHOUT intensive
therapy? Surely they have a lower death rate. In the extreme case
non-diabetics have a lower A1c and a lower death rate and are more
likely to survive a heart attack if they have one.
Put simply it isn't the lower A1c that is a cause, it is some aspect
of the intensive therapy. It doesn't appear to be a particular
medication as if one is worse than another rather something common to
the treatment of ALL the participants receiving the intensive
treatment.
IMHO I believe Gys is most likely close to the nub of the matter.
A more accurate conclusion might well be that the standard high carb
diets with intensive medication should be discontinued as they raise
the death rate,
To me the situation as similar to those analgesics like Vioxx that had
to be withdrawn when it was found they also increased the rate of
fatal heart attacks.
Best wishes,
--
Quentin Grady ^ ^ /
New Zealand, >#,#< [
/ \ /\
"... and the blind dog was leading."
Andrew B. Chung, MD/PhD
> morris <morri...@comcast.net> wrote:
>
> >WASHINGTON - An unexpected number of deaths among patients receiving
> >intense therapy to lower their blood sugar forced the National
> >Institutes of Health to abruptly cut short part of a major study on
> >diabetes and heart disease.
>
> G'day G'day Folks,
>
> I find it fascinating how a results lead to conclusions.
Results are supposed to lead folks to concluding.
> The patients receiving intensive therapy were more likely to die.
Because patients were randomly assigned to the various levels of
intensity of therapies to lower their blood sugar, the patients were
not different from those assigned to less intense therapy.
Bottom line:
The patients assigned to receive intensive medical therapy were not
more likely to die so that the discovery that they were more likely to
die upon receiving intensive medical therapy leads those of us trained
in the scientific method to conclude that intensive medical therapy to
lower blood glucose places patients at higher risk for death.
Andrew B. Chung, MD/PhD
Clearly the focus on lowering blood glucose in type-2 diabetics to
improve health is wrong:
http://groups.google.com/group/alt.support.diabetes/msg/eb22e6e360a743cf?
It is time to direct the focus on removing the harmful black fat
(visceral adipose tissue aka VAT) that is the source of the
proinflammatory adipocytokines (PIACs) that are fueling the
inflammatory cascade which is the proximate cause of the insulin
resistance (IR/MetS) that caused the type-2 diabetes from the outset:
Peter C
I would have thought the following heirarchy applied irrespective of
treatment regimes ...
1. high bp, smoking, high chols
2. smoking, high bp
3. smoking , high chols
4. high bp, high chols
Hopefully they distributed the 4 risk factor groups evenly between the three
treatment divisions. It might not make a great deal of sense otherwise e.g.
if they had a higher ratio of smokers in the intensive treatment group.
A bit of a poke in the eye for the six per cent club though ;-)
Nicky
wrote:
>A bit of a poke in the eye for the six per cent club though ;-)
>
You volunteering to go higher and see how well you feel on it?!
Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6% BMI 25
BillW50
Paul L typed on Wed, 6 Feb 2008 15:03:46 -0700:
> I'd like to know what "intense therapy" is in this study. Drugs?
> Diet? Exercise? All ? This is the key to knowing what this means. I
> don't think it was lower a1c that was the problem, it must have
> been whatever means were used to get lower a1c.
You don't think lower A1c was the problem? Think about it for a second.
Lower A1c means lower available fuel for your cells. Thus a lot of cells
starve and die! Which increases the chances that the patient dies too if
too many cells die. So how are you thinking that lower A1c is somehow
healthier? I am so curious?
--
Bill
DX 1992 (ignored till 4/2007)
A1c 4/2007 10.5
A1c 6/2007 7.4
A1c 8/2007 6.8
Andrew B. Chung, MD/PhD
Alan S
<Bil...@aol.kom> wrote:
>In news:tfadnaX-Gp58szfa...@comcast.com,
>Paul L typed on Wed, 6 Feb 2008 15:03:46 -0700:
>> I'd like to know what "intense therapy" is in this study. Drugs?
>> Diet? Exercise? All ? This is the key to knowing what this means. I
>> don't think it was lower a1c that was the problem, it must have
>> been whatever means were used to get lower a1c.
>
>You don't think lower A1c was the problem? Think about it for a second.
>Lower A1c means lower available fuel for your cells. Thus a lot of cells
>starve and die! Which increases the chances that the patient dies too if
>too many cells die. So how are you thinking that lower A1c is somehow
>healthier? I am so curious?
You're serious?
Start here, then do a little checking for more on Google
Scholar: http://www.bmj.com/cgi/content/full/322/7277/15
W. Baker
: In news:tfadnaX-Gp58szfa...@comcast.com,
: --
: Bill
Lower Aic does not mean less fuel. there is always the fat availe eiher
from the diet or from that stored in fat cells , which is more eadily
available if the bgs and the A1cs are lower.
Wendy
Jefferson
>> It is interesting since many T2s have therapies to control the following:
>>
>> "The participants were in groups receiving three types of treatment,
>> intensive lowering of blood sugar, lowering blood pressure or reducing
>> cholesterol."
>>
>> If someone has type 2 diabetes and the metabolic syndrome, they are
>> likely to have therapies for each of the above components. However,
>> the newsrelease did not attribute the cause to the TZD Advandia which
>> is not usually a initial T2 therapy. Also only about 7% of the T2DMs
>> reach the goals for all three control goals.
>>
In well controlled T2DMs the post-prandial state is the biggest
contributor to HbA1c. It is not so easy to get an a1c under 6% without
fairly good post-prandial glucose control. Monnier et al have done
research on this topic and I have posted on it a few times in the past.
Also "What Is the Real Contribution of Fasting Plasma Glucose and
Postprandial Glucose in Predicting HbA1c and Overall Blood Glucose
Control?" - http://care.diabetesjournals.org/cgi/content/full/24/11/2011
"Recent studies indicate that about one-third of American adults and
two-thirds of CAD patients have abnormal glucose homeostasis.[6,7] A
significant proportion of these at-risk individuals will have a fasting
glucose level in the nondiabetic range (<126 mg/dl) but would show
hyperglycemia diagnostic of impaired glucose tolerance (>140 mg/dl) or
diabetes (>200 mg/dl) after an oral glucose tolerance test or a meal.
Continuous linear direct relationships exist between glucose levels
after a glucose challenge and the risks of both CV death and all-cause
mortality.[8] At only 80 mg/dl the CV risk of post-prandial or
post-challenge glycemia begins to increase; by 140 mg/dl, the point at
which we traditionally only begin to classify patients as glucose
intolerant or pre-diabetic, the risk is already increased by 58%[9,10].
(see) Figure 1. Post-Challenge Glucose and Coronary Atherosclerosis
Progression.
Patients with normal glucose tolerance who had a post-prandial glucose
level of <87 mg/dl had coronary regression. The remaining patients had
coronary progression in proportion to the increase in post-prandial
glucose. Data from Mellen et al. [10]." Dietary Strategies for Improving
Post-Prandial Glucose, Lipids, Inflammation, and Cardiovascular Health -
http://www.medscape.com/viewarticle/569077_print
Reference #8 - Cavalot F, Petrelli A, Traversa M, et al. Post-prandial
blood glucose is a stronger predictor of cardiovascular events than
fasting blood glucose in type 2 diabetes mellitus. J Clin Endocrinol
Metab 2006;91:813–9.
The outcomes in the Accord trial seems contradictory to many other
studies.
What is the real answer? The inclusion criteria for intensive therapy
may have the answer. The progression of cardiovascular disease was
advanced in part of the intensive therapy group.
"2.1.a Inclusion Criteria
6. At high risk of CVD events, defined as: A. Presence of clinical
cardiovascular disease. • previous myocardial infarction (MI) • previous
stroke • History of coronary revascularization (e.g., coronary artery
bypass graft surgery, stent placement, percutaneous transluminal
coronary angioplasty, or laser atherectomy) • History of carotid or
peripheral revascularization (e.g., carotid endarterectomy, lower
extremity atherosclerotic disease atherectomy, repair of abdominal aorta
aneurysm, femoral or popliteal bypass) • angina with ischemic changes
(resting ECG), ECG changes on a graded exercise test (GXT), or positive
cardiac imaging study or B. If no clinical cardiovascular disease,
evidence in the last 2 years suggesting a high likelihood of
cardiovascular disease. Specifically, the presence of one of the
following: • Microalbuminuria • Ankle brachial index < 0.9 (by simple
palpation) • LVH by ECG or ECHO • > 50% stenosis of a coronary, carotid,
or lower extremity artery or C. The presence of at least 2 of the
following factors that increase CVD risk: • On lipid lowering medication
or untreated LDL-C >130 mg/dl (3.38 mmol/l) • Low HDL-C (< 40 mg/dl
(1.04 mmol/l) for men and < 50 mg/dl (1.29 mmol/l) for women) • On BP
lowering medication or untreated SBP >140 mm Hg or DBP > 95 mm Hg. •
Current cigarette smoking • Body mass index > 32 kg/m2 Note: Category A
represents secondary prevention participants. Categories B and C
together represent primary prevention participants."
http://www.accordtrial.org/public/protocol_2005-05-11.pdf
Frank
BillW50
Alan S typed on Fri, 08 Feb 2008 12:31:03 +1100:
> On Thu, 7 Feb 2008 18:09:00 -0600, "BillW50"
> <Bil...@aol.kom> wrote:
>
>> In news:tfadnaX-Gp58szfa...@comcast.com,
>> Paul L typed on Wed, 6 Feb 2008 15:03:46 -0700:
>>> I'd like to know what "intense therapy" is in this study. Drugs?
>>> Diet? Exercise? All ? This is the key to knowing what this
>>> means. I don't think it was lower a1c that was the problem, it must
>>> have
>>> been whatever means were used to get lower a1c.
>>
>> You don't think lower A1c was the problem? Think about it for a
>> second. Lower A1c means lower available fuel for your cells. Thus a
>> lot of cells starve and die! Which increases the chances that the
>> patient dies too if too many cells die. So how are you thinking that
>> lower A1c is somehow healthier? I am so curious?
>
> You're serious?
>
> Start here, then do a little checking for more on Google
> Scholar: http://www.bmj.com/cgi/content/full/322/7277/15
I can't read that Alan! I'm an electrical engineer and it is all Greek
to me. Explain in laymen terms how starving the patient by lowering A1c
is somehow healthier? If I starve my goldfish it dies! If I starve my
dog, it dies! If I starve my children (if I had any and I don't have any
dogs either) they die! Are you trying to tell me through some magic of
mumbo-jumbo it isn't true?
BillW50
W. Baker typed on Fri, 8 Feb 2008 01:52:28 +0000 (UTC):
> BillW50 <Bil...@aol.kom> wrote:
>> In news:tfadnaX-Gp58szfa...@comcast.com,
>> Paul L typed on Wed, 6 Feb 2008 15:03:46 -0700:
>>> I'd like to know what "intense therapy" is in this study. Drugs?
>>> Diet? Exercise? All ? This is the key to knowing what this
>>> means. I don't think it was lower a1c that was the problem, it must
>>> have
>>> been whatever means were used to get lower a1c.
>
>> You don't think lower A1c was the problem? Think about it for a
>> second. Lower A1c means lower available fuel for your cells. Thus a
>> lot of cells starve and die! Which increases the chances that the
>> patient dies too if too many cells die. So how are you thinking that
>> lower A1c is somehow healthier? I am so curious?
>
> eiher from the diet or from that stored in fat cells , which is more
> eadily available if the bgs and the A1cs are lower.
That is what I thought too Wendy! But I was told that turning fat into
energy creates a toxin called ketones. Which in laymen terms means it is
a killer. And second of all, if one's BG is dropping fast, converting
fat into energy doesn't happen instantly from what I heard. As it takes
time. And in that time it makes sense that some cells will starve to
death anyway. Do this over and over again and it is no wonder patients
are dying faster.
Alan S
<Bil...@aol.kom> wrote:
Who is talking about starving? That would be A1c=0. Read my
sig: "Everything in Moderation". I agree that you can go too
low. What we disagree on is the definition of that point.
Now, to help define when it starts to get too high, here is
my layman's precis of that paper:
http://www.bmj.com/cgi/content/full/322/7277/15
"HbA1c was continuously related to subsequent all cause,
cardiovascular, and ischaemic heart disease mortality
through the whole population distribution, with lowest rates
in those with HbA1c concentrations below 5%."
Means lowest rates of death occur with A1c less than 5%.
"An increase of 1% in HbA1c was associated with a 28%
(P<0.002) increase in risk of death independent of age,
blood pressure, serum cholesterol, body mass index, and
cigarette smoking habit"
Means that, starting at 5%, your risk of death increases by
28% for each 1% rise in A1c.
I reckon that is pretty darn clear in both medicspeak and
layspeak.
Julie Bove
"BillW50" <Bil...@aol.kom> wrote in message
news:47abb8c9$0$1342$834e...@reader.greatnowhere.com...
Nobody is telling you to starve!
feli...@gmail.com
<heartdo...@emorycardiology.com> wrote:
> friend GysdeJongh wrote:
.
.
.
> > Page 78 :
> > Medical Nutrition Therapy
> > Medical Nutrition Therapy (MNT) consists of weight control and dietary
> > modification. The American Diabetes Association (ADA) position statement on
> > "Nutrition Recommendations and Principles for People with Diabetes Mellitus"
> > reports that "medical nutrition therapy is integral to total diabetes care
> > and an essential component of successful diabetes management" (ADA 2000a).
>
> Clearly the focus on lowering blood glucose in type-2 diabetics to
> improve health is wrong:
>
>
> It is time to direct the focus on removing the harmful black fat
> (visceral adipose tissue aka VAT) that is the source of the
> proinflammatory adipocytokines (PIACs) that are fueling the
> inflammatory cascade which is the proximate cause of the insulin
> resistance (IR/MetS) that caused the type-2 diabetes from the outset:
And visceral adipose tissue is "black fat"....why, exactly?
Procyonophile
BillW50
Julie Bove typed on Fri, 08 Feb 2008 03:56:04 GMT:
Really? How the *hell* am I suppose to get my A1c down to 5 when I am
*only* having 3 glasses of milk a day and a bowl of raw iceberg lettuce
and it still isn't doing it (that is like 300 calories a day, almost all
from the milk)? Worse, my BG is in the 30's at least 3 times a week and
I like it! Personally I think I am sick and I need not to listen to
people and to get more normal. And I think some of you have to redo your
thinking!
Julie Bove
"BillW50" <Bil...@aol.kom> wrote in message
3 glasses of milk? Why milk? That's loaded with carbs. Where is your fat
and protein? And why are you eating iceberg lettuce? There's no
nutritional value in that! Sounds like you need to see a dietician who will
give you a balanced diet!
DonnaB shallotpeel
<47abe1d0$0$1349$834e...@reader.greatnowhere.com>, "BillW50"
<Bil...@aol.kom> wrote:
> Really? How the *hell* am I suppose to get my A1c down to 5 when I am
> *only* having 3 glasses of milk a day and a bowl of raw iceberg lettuce
> and it still isn't doing it (that is like 300 calories a day, almost all
> from the milk)? Worse, my BG is in the 30's at least 3 times a week and
> I like it! Personally I think I am sick and I need not to listen to
> people and to get more normal. And I think some of you have to redo your
> thinking!
How did you end up with that being your regular way of eating?
--
DonnaB shallotpeel, T2 since June 06, USA
"Msitukane wagema na ulevi ungalipo. - Do not abuse palm-wine tappers if you
wish for drunkenness." - Swahili proverb [kanga]
BillW50
DonnaB shallotpeel typed on Fri, 08 Feb 2008 01:04:47 -0500:
> In alt.support.diabetes on Thu, 7 Feb 2008 22:59:57 -0600 in Msg.#
> <47abe1d0$0$1349$834e...@reader.greatnowhere.com>, "BillW50"
> <Bil...@aol.kom> wrote:
>
>> Really? How the *hell* am I suppose to get my A1c down to 5 when I am
>> *only* having 3 glasses of milk a day and a bowl of raw iceberg
>> lettuce and it still isn't doing it (that is like 300 calories a
>> day, almost all from the milk)? Worse, my BG is in the 30's at least
>> 3 times a week and I like it! Personally I think I am sick and I
>> need not to listen to people and to get more normal. And I think
>> some of you have to redo your thinking!
>
> How did you end up with that being your regular way of eating?
Trying to get my A1c down like a good boy! And they are going to kill me
if I keep listening to them. After all, the result of the last study
shows this is true and they had to stop it. Haven't you been listening?
BillW50
Julie Bove typed on Fri, 08 Feb 2008 05:35:35 GMT:
3 glasses of milk a day and that is all the carbs you get per day isn't
loaded with carbs. I bet you any money you have far more carbs than that
a day!
> Where is your fat and protein?
All in the milk. Everything a cafe (a little cow) needs!
> And why are you eating iceberg lettuce? There's no nutritional value
> in that!
It is a vegetable. Something I am told I need.
> Sounds like you need to see a
> dietician who will give you a balanced diet!
My dietician is clueless about diabetes. She thinks I should be eating
lots of carbs and hold my calorie intake down to 1800 per day (yeah
right, like I think 1800 is high). But we were not talking about that.
We are just talking about low A1c scores. And here we talk about 5 as
the magic number. I am thinking that individuals are different and some
don't need an A1c of 5 or 6, some maybe need a bit higher. I am starting
to believe there is no magic number and everybody needs to find their
own magic number (whatever that may be).
Alan S
<Bil...@aol.kom> wrote:
>Really? How the *hell* am I suppose to get my A1c down to 5 when I am
>*only* having 3 glasses of milk a day and a bowl of raw iceberg lettuce
>and it still isn't doing it (that is like 300 calories a day, almost all
>from the milk)? Worse, my BG is in the 30's at least 3 times a week and
>I like it! Personally I think I am sick and I need not to listen to
>people and to get more normal. And I think some of you have to redo your
>thinking!
Bill, you could add 2000 calories to that and barely nudge
your BG's and A1c at all.
Your menu is extreme and dangerous. And not just because of
your BG's. That's malnutrition.
Think carbs, not calories. Think protein and good fats.
Think Non-starchy vegetables, meats, legumes (in
moderation), tofu and a thousand other foods.
And cut out that milk and replace it with soups and
non-carby drinks.
I do agree that you're sick; I'd be very surprised if you
weren't if you're being honest about your menu. I have to at
least harbour a suspicion that you're having us on though.
If you are seriously interested in some suggestions to help.
let me know and I'll try. Or contact a dietician to at least
get a reasonable starting point.
If you just want to argue, that's fine too.
BillW50
Alan S typed on Fri, 08 Feb 2008 17:40:50 +1100:
> On Thu, 7 Feb 2008 22:59:57 -0600, "BillW50"
> <Bil...@aol.kom> wrote:
>
>> Really? How the *hell* am I suppose to get my A1c down to 5 when I am
>> *only* having 3 glasses of milk a day and a bowl of raw iceberg
>> lettuce and it still isn't doing it (that is like 300 calories a
>> day, almost all from the milk)? Worse, my BG is in the 30's at least
>> 3 times a week and I like it! Personally I think I am sick and I
>> need not to listen to people and to get more normal. And I think
>> some of you have to redo your thinking!
>
> Bill, you could add 2000 calories to that and barely nudge
> your BG's and A1c at all.
I would love to go totally carb-less. But I am told that is unhealthy.
Ok, I am just a layman so a few carbs is all I need right? Well how many
do I need?
> Your menu is extreme and dangerous. And not just because of
> your BG's. That's malnutrition.
I thought of that, but what is the warning signs if this is what I am
going towards? Also what else can you think of that would give me really
low A1c readings and won't be dangerous?
> Think carbs, not calories. Think protein and good fats.
> Think Non-starchy vegetables, meats, legumes (in
> moderation), tofu and a thousand other foods.
Ok
> And cut out that milk and replace it with soups and
> non-carby drinks.
Ok. Although I like creamy soups which are higher in carbs. I guess that
is ok as long as I have smaller portions (not a problem, I like less).
Diet drinks with aspartame causes me bad headaches and a big drop in
energy. I have been playing around with drinks with Spenda and that
seems okay with me. Although no long term study has been done with
Spenda I am told.
> I do agree that you're sick; I'd be very surprised if you
> weren't if you're being honest about your menu. I have to at
> least harbour a suspicion that you're having us on though.
No, frankly I just don't like eating period. If I could just pop a pill
a day and be done with it I would. I don't feel hungry or full and I
feel this is just awful (I used to feel both decades ago). Well I do
feel hungry after about 3 or 4 days of not eating... so I don't know
whether to trust my feelings and just eat when I am hungry or just eat 3
meals a day. I have experimented in the past and I just don't know what
works best for me yet.
And the longest I have pulled off the 3 glasses of milk and just lettuce
is just 2 months. I just don't feel too well after that (I catch cold
and flu really easy and feel a bit weak at the end -- muscle mass also
starts to drop off big time). Although most of the early two months I
feel pretty good actually.
> If you are seriously interested in some suggestions to help.
> let me know and I'll try. Or contact a dietician to at least
> get a reasonable starting point.
My dietician is only concern about be dropping 20 lbs (and I weigh 230
lbs and I am 6'1"). Dropping down to 210 lbs doesn't bother me so much
(and I am not going to make it at the end of this month), it is just she
don't seem to know much about diabetes that bothers me the most.
> If you just want to argue, that's fine too.
No I am just being honest. And that is all I ask in return.
Nicky
>That is what I thought too Wendy! But I was told that turning fat into
>energy creates a toxin called ketones. Which in laymen terms means it is
>a killer. And second of all, if one's BG is dropping fast, converting
>fat into energy doesn't happen instantly from what I heard.
Bill, ketones are produced every time fat is converted to energy; they
are absolutely not a toxin, the body is quite happy to burn them
instead. Don't get confused by ketoacidosis, which is where a T1's
body turns on itself in the absence of insulin - that one can be
fatal.
It takes about 3 days to swap your body over from burning carbs to
burning ketones; once that's done, then you'll notice no difference at
all. In fact, you may well already be in ketosis, depending on how big
those glasses of milk are; you need about 120g CHO a day to burn
carbs, less than that and you're using fat.
You absolutely cannot starve individual cells; your body is quite
happy to convert itself into fuel, using anything at hand. When you've
noticed muscle mass being used before, your body will also have been
happily using your heart muscle up; THAT's terribly dangerous. You
would be far better off eating proteins, healthy fats, and a wide
range of vegetables to supplement the iceberg.
Quentin Grady
>In news:tfadnaX-Gp58szfa...@comcast.com,
>Paul L typed on Wed, 6 Feb 2008 15:03:46 -0700:
>> I'd like to know what "intense therapy" is in this study. Drugs?
>> Diet? Exercise? All ? This is the key to knowing what this means. I
>> don't think it was lower a1c that was the problem, it must have
>> been whatever means were used to get lower a1c.
>
>You don't think lower A1c was the problem? Think about it for a second.
>Lower A1c means lower available fuel for your cells. Thus a lot of cells
>starve and die! Which increases the chances that the patient dies too if
>too many cells die. So how are you thinking that lower A1c is somehow
>healthier? I am so curious?
G'day G'day Bill,
Thank you for your entertaining hypothesis. It's jolly nice of you.
It sure helps lighten the mood. So thank you.
I had a little chuckle over the injunction to "Think about it for a
second"
A lower A1c mean fewer damaged cells. The A1c measures the
percentage of cells that are glycated i.e. damaged by sugar. Damaged
cells tend to die rather than healthy cells. I hope that is something
you'll accept and we can have as a basis of agreement.
Cells might well starve when they receive insufficient nutrient. It
happens when they receive insufficient oxygen for example. With some
other deficiencies though they simply become inactive until they
become resupplied. Hopefully this too is part of our shared reality.
Now just what is sufficient nutrient?
With respect to blood glucose it make sense that this is the normal
level of blood glucose found in non-diabetics. Clearly cells are NOT
starving at an excessive rate when the A1c is 5.something else normal
folks would have excessive numbers of cells dying of starvation as you
put it. There is a continuous turn over of red blood cells so even
with healthy non-diabetics some cells die and are replaced. Death of
individual cells is part of health not an indication of imminent death
of the person. the trick is not to raise the turn over rate above
that occurring in a healthy person.
Andrew B. Chung, MD/PhD
The same reason that subcutaneous adipose tissue is white fat.
Truth is simple.
May you and other dear neighbors, friends, and brethren have a
blessedly wonderful 2008th year since the birth of our LORD Jesus
Christ as the Son of Man ...
... by being hungrier:
http://TruthRUS.org/KnowingGOD
Hunger is wonderful :-)
It's how we know what GOD wants, which is what is good.
Yes, hunger is our knowledge of good versus evil that Adam and Eve
paid for with their and our immortal lives.
Those who suffer from the powerful delusion predicted by the prophecy
of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! )
forever ...
http://HeartMDPhD.com/Convicts/CrazyOne
http://HeartMDPhD.com/Convicts/CrazyTwo
http://HeartMDPhD.com/Convicts/CrazyThree
http://HeartMDPhD.com/Convicts/CrazyFour
http://HeartMDPhD.com/Convicts/Bob
... gone:
http://YouTube.com/watch?v=Qb6d_z5C35E
Such will be the demise of all those who refuse to know **and** love
the truth, Who is LORD Jesus Christ:
http://HeartMDPhD.com/Love/TheTruth
Be hungry... be healthy... be hungrier... be blessed:
http://HeartMDPhD.com/HolySpirit/BeBlessed
"Blessed are you who hunger NOW...
... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21)
Amen.
Chris Malcolm
> W. Baker typed on Fri, 8 Feb 2008 01:52:28 +0000 (UTC):
>> Lower Aic does not mean less fuel. there is always the fat availe
>> eiher from the diet or from that stored in fat cells , which is more
>> eadily available if the bgs and the A1cs are lower.
> That is what I thought too Wendy! But I was told that turning fat into
> energy creates a toxin called ketones. Which in laymen terms means it is
> a killer.
If that was the case then losing fat would kill you. Which it doesn't. So that is obviously nonsense.
> And second of all, if one's BG is dropping fast, converting
> fat into energy doesn't happen instantly from what I heard. As it takes
> time.
How much time? A minute? An hour? A day? And what about glycogen
stores? What about gluconeogenesis?
> And in that time it makes sense that some cells will starve to
> death anyway.
Makes sense? Cells won't starve to death if BG doesn't drop below
normal levels. It's quite possible to lose weight while BGs are within
normal levels. So what makes sense to you is obviously nonsense.
> Do this over and over again and it is no wonder patients
> are dying faster.
Continue to think as you have in many of your postings to asd and
there's not much hope of you ever coming to a sensible conclusion
about anything except by accident.
--
Chris Malcolm c...@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]
krom
To say starving yourself is the solution to lowerign blood glucose is like
saying smashing ones face with a hammer is a good way to stop smoking..will
it work?..possible but theres far better ways to get it done.
This is why most here stress testing to find out what carbs and foods raises
you and what ones do not.
For example if i want to eat fruit i know a bannana or apple will spike me
but pineapple and most all berries will not.
So i eath those fruits which dont spike me and the same applies to all foods
i eat.
Theres some beans that will raise..some that wont..so i am basiclaly eating
the same menu as a non diabetic who is eating healthy..just different
choices.
A none diabetic might eat a meal of checiken potato and broccoli...and i
would eat the chicken and broccoli and replace the potato with
cauliflower/potato mix to avoid the spike but im eating jsut as
nutritiously.
I too think you might be having a bit of fun with us but if not then i hope
you will seriously discuss making the choice to modify your diet and test to
see whats best for you.
It is your life at stake.
KROM
"BillW50" <Bil...@aol.kom> wrote in message
news:47ac092f$0$1340$834e...@reader.greatnowhere.com...
feli...@gmail.com
<heartdo...@emorycardiology.com> wrote:
> feliph...@gmail.com wrote:
> > Andrew, in the Holy Spirit, boldly wrote:
> > > friend GysdeJongh wrote:
> > .
> > .
> > .
> > > > Page 78 :
> > > > Medical Nutrition Therapy
> > > > Medical Nutrition Therapy (MNT) consists of weight control and dietary
> > > > modification. The American Diabetes Association (ADA) position statement on
> > > > "Nutrition Recommendations and Principles for People with Diabetes Mellitus"
> > > > reports that "medical nutrition therapy is integral to total diabetes care
> > > > and an essential component of successful diabetes management" (ADA 2000a).
>
> > > Clearly the focus on lowering blood glucose in type-2 diabetics to
> > > improve health is wrong:
>
> > >http://groups.google.com/group/alt.support.diabetes/msg/eb22e6e360a74...
>
> > > It is time to direct the focus on removing the harmful black fat
> > > (visceral adipose tissue aka VAT) that is the source of the
> > > proinflammatory adipocytokines (PIACs) that are fueling the
> > > inflammatory cascade which is the proximate cause of the insulin
> > > resistance (IR/MetS) that caused the type-2 diabetes from the outset:
>
> > And visceral adipose tissue is "black fat"....why, exactly?
>
> The same reason that subcutaneous adipose tissue is white fat.
I am unable to unearth a single reference wihch describes VAT a
being "black".
Perhaps you will provide one or more?
Procyonophile
DarkSentinel
news:fohptq$lpm$1...@aioe.org...
> Bill the amount of carbs a person needs is entirely up to thier system.
>
> To say starving yourself is the solution to lowerign blood glucose is like
> saying smashing ones face with a hammer is a good way to stop
> smoking..will it work?..possible but theres far better ways to get it
> done.
I LIKE that analogy...:)
> This is why most here stress testing to find out what carbs and foods
> raises you and what ones do not.
>
> For example if i want to eat fruit i know a bannana or apple will spike me
> but pineapple and most all berries will not.
> So i eath those fruits which dont spike me and the same applies to all
> foods i eat.
>
> Theres some beans that will raise..some that wont..so i am basiclaly
> eating the same menu as a non diabetic who is eating healthy..just
> different choices.
>
> A none diabetic might eat a meal of checiken potato and broccoli...and i
> would eat the chicken and broccoli and replace the potato with
> cauliflower/potato mix to avoid the spike but im eating jsut as
> nutritiously.
>
> I too think you might be having a bit of fun with us but if not then i
> hope you will seriously discuss making the choice to modify your diet and
> test to see whats best for you.
>
> It is your life at stake.
Agreed. Everyone's metabolism is different. What might spike me, may not
spike you. We must all find our own way, and eat the way that is best for
each of us.
--
T2 - Oct. '96 - Lantus, oral meds, diet
http://www.lockergnome.com/darksentinel
Undo the munge to reply by email
DonnaB shallotpeel
<47abf2c5$0$1341$834e...@reader.greatnowhere.com>, "BillW50"
<Bil...@aol.kom> wrote:
Yes, I've been listening. And, in another post, finally, you replied, to
someone else, that you got this way of eating from the military, although it
seems that you got it as a means of losing weight - not as a way of getting
your HbA1c down. I still have no idea where you got the idea that it was a
way to eat for that purpose.
But, look at the big picture. Why do you want to get your HbA1c down? To be
healthier, longer as a diabetic. How can you do that? By getting the right
balance of medication, exercise & food *for you*. Where should you aim for
with your HbA1c? As low as you can get it *for you* without going too low.
So, now, look at drinking milk & eating iceberg lettuce. How does it figure
into the picture? It doesn't. It's not nutritional. There is no nutritional
value in iceberg lettuce. (There once was a little bit but they've long
since cut & discarded most, if not all, of that.) Iceburg lettuce is
considered a 'free' food in terms of calories. It can give one the pleasure
of chewing, add some fiber & make the stomach feel full, if you're trying to
lose weight or eat smaller portions, etc., etc. So, that leaves you with
dairy only.
Are these the only foods you have access to? Are you allergic to all other
foods? Can you just not stand to eat anything else?
What kinds of supplements do you take?
Jigs-n-fixtures
I know that the pressure required to force a viscous fluid through a given
conduit increases exponentially as a function of the viscosity. I also know
that the viscosity of a solution also increases exponentially as a function
of the sugar concentration.
Thus, the strain on the cardio-vascular system, ( it being just a closed
circuit pumped system), increases exponentially as the sugar concentration
increases.
But your point is still valid. The higher your blood sugar levels, the more
damage you do to the cardiovascular system.
Quentin Grady
>Really? How the *hell* am I suppose to get my A1c down to 5 when I am
>*only* having 3 glasses of milk a day and a bowl of raw iceberg lettuce
>and it still isn't doing it (that is like 300 calories a day, almost all
>from the milk)? Worse, my BG is in the 30's at least 3 times a week and
>I like it! Personally I think I am sick and I need not to listen to
>people and to get more normal. And I think some of you have to redo your
>thinking!
>
>--
>Bill
>DX 1992 (ignored till 4/2007)
>A1c 4/2007 10.5
>A1c 6/2007 7.4
>A1c 8/2007 6.8
G'day G'day Bill,
Your situation is serious, very serious indeed. I hope you'll
appreciate that, sooner rather than later.
Let's start at the beginning. How the "hell" are you to get your A1c
down to 5 when you are "only" having 3 glasses of milk a day and a
bowl of raw iceberg lettuce and that isn't doing it.
How are you measuring your A1c? Most people only have it measured
once a month or even every couple of months. I cannot imagine how
anyone could manage to exist for a month on milk and lettuce for a
month.
Are you by some chance equating home blood glucose measurements with
A1c?
Although one's bg can rise and fall rapidly A1c values only change
SLOWLY. One can't see them going down day to day for instance.
It probably takes a couple of weeks to see any change and then it
wouldn't be much. A1c are affected by blood glucose levels over the
last couple of months.
It will help us to help you if you can explain a few things like that.
How are you gauging your A1c?.
Milk will provide calcium, some saturated fat, some lactose sugar and
some good quality protein. However there are a lot of minerals it
will not provide and essential fatty acids that will not be provided.
It is not well known that the hearts of diabetics run mostly on fats
rather than glucose and fats as for normal people. Thus it is very
important for diabetics to get healthy fats.
How to do this I'll explain in some detail in a few minutes.
Iceberg lettuce has a bad reputation. The plant breeders selected for
mild flavor, crunch and not much else. It has a reputation for being
deficient in most minerals and vitamins when compared with other
vegetables.
Does it deserve this reputation?
As an engineer I suspect you'd like to check out these things
yourself. You'll find the USDA helpful.
http://www.nal.usda.gov/fnic/foodcomp/search/
Here is an extract based on my book, "Nutrition for Blokes" The book
discusses many different diets. This extract deals with a diet that
has worked for many T2 diabetics. Some claim success with other
strategies.
It is important to choose foods that agree with you. If you are
allergic to certain seafood don't eat them. You're a bloke. I expect
a certain level of intelligence. You wouldn't pour diesel into the
tank of a petrol engine car. With that proviso, the simplest approach
is to make a starter kit diet for you and to adjust it as you learn
more about how your body is responding.
The list has been chosen with care and attention to detail. The
reasons are often quite technical but the diet is easy to follow.
Peasant farmers have followed similar diets.
I've added comment to the general outline to help your understanding.
1. Eat high water content vegetables eg cauliflower, broccoli,
courgette, (zucchinis), fennel, onions, tomatoes, eggplant.
These are less than 5% carb vegetables. One can eat these freely
where as one must restrict portions of potato tightly. Put simply
cauliflower has a safety factor of five compared with potato.
2. Eat lean animal protein, eg venison, fish or shellfish.
Any trimmed meat is likely to be a reasonable choice,
3. Eat some vegetable protein eg lentils, chickpeas, soy.
In order to lose weight easily it is essential to get protein levels
above 20% of calories. It is safer if one gets ones protein from a
variety of sources eg a mixture of animal, fish and vegetable
sources.
4. Eat berries, raspberries, blueberries, cranberries,
strawberries. Berries contain about 5% carbohydrate. It is almost
impossible to spike ones blood glucose on strawberries for instance.
Their colours are all beneficial substances.
5. Eat a handful of nuts per day eg almonds, walnuts, hazelnuts.
The brown skins contain substances that reduce heart attacks and nut
consumption gives three to five more years of quality life.
6. Eat some young, low fat cheese eg cottage cheese.
This lowers blood pressure and reduces the incidence of heart attacks.
7. Eat some whole grain rye-based crackers eg Ryvita
This helps ensure healthy regularity.
8. Eat richly coloured vegetables eg tomatoes, bell peppers.
The different colours fill different functions. Orange and yellow are
especially important for maintaining the health of the retinas of the
eyes which are seriously at risk in T2 diabetics.
9. Eat avocados - they deserve to be a food group of their own
or include other source of oleic acid eg extra virgin olive oil,
macadamias
10. Eat small amounts of intensely flavoured fruit sauces
One needs polyphenols to recycle Vit C and Vit E from other foods.
Bill, I hope this helps you as it has helped others.
If you need more explanation please ask.
Andrew B. Chung, MD/PhD
GOD has provided those who work at slaughterhouses to testify to this.
They call the VAT of slaughtered animals...
B L A C K F A T
May dear neighbors, friends, and brethren have a blessedly wonderful
Peter C
> On Wed, 6 Feb 2008 13:45:09 -0800 (PST), morris
>
>
> IMHO I believe Gys is most likely close to the nub of the matter.
>
> A more accurate conclusion might well be that the standard high carb
> diets with intensive medication should be discontinued as they raise
> the death rate,
Difficult to see how you work that out. There was actually a 50%
reduction in deaths from heart problems in the intensive therapy group
as comapred to all T2 diabetics which, other things being equal, would
lead you to recommend that course of treatment for T2s with two of the
four high risk markers in the study - obesity, smoking, high bps, high
chols. It was just that the death rate was slightly better in the less
intensive group.
Since both groups, presumably, were given standard dietary advice,
diet would appear to be a common constant between the two groups and
not a factor that could be used to explain the discrepancy in outcomes
between them.
On top of that it seems that few of the intensive care group actually
reached the target of under 6 A1c, which makes an even bigger nonsense
of the lower A1c claims made about the study. It might be truer to say
that aiming for an A1c of under 6 by means of intensive treatment and
missing the target is more dangerous than aiming for A1cs of 7 to 7.9
with a less intensive regime and hitting the bullseye.
BillW50
Nicky typed on Fri, 08 Feb 2008 08:51:44 +0000:
> On Thu, 7 Feb 2008 20:16:06 -0600, "BillW50" <Bil...@aol.kom> wrote:
>
>> That is what I thought too Wendy! But I was told that turning fat
>> into energy creates a toxin called ketones. Which in laymen terms
>> means it is a killer. And second of all, if one's BG is dropping
>> fast, converting fat into energy doesn't happen instantly from what
>> I heard.
>
> Bill, ketones are produced every time fat is converted to energy; they
> are absolutely not a toxin, the body is quite happy to burn them
> instead. Don't get confused by ketoacidosis, which is where a T1's
> body turns on itself in the absence of insulin - that one can be
> fatal.
Yes I am confusing the two. Thanks Nicky!
> It takes about 3 days to swap your body over from burning carbs to
> burning ketones; once that's done, then you'll notice no difference at
> all. In fact, you may well already be in ketosis, depending on how big
> those glasses of milk are; you need about 120g CHO a day to burn
> carbs, less than that and you're using fat.
That is interesting, as it takes me 2 to 3 days to go without food to
start to feel hungry. And I don't know what CHO means? I Googled it and
I found lots of references, but I still didn't get the meaning.
> You absolutely cannot starve individual cells; your body is quite
> happy to convert itself into fuel, using anything at hand. When you've
> noticed muscle mass being used before, your body will also have been
> happily using your heart muscle up; THAT's terribly dangerous. You
> would be far better off eating proteins, healthy fats, and a wide
> range of vegetables to supplement the iceberg.
What do you think of nutritionists like David Wolfe? I don't remember if
it was he who claimed that one can be very healthy by only eating cacao
beans as your only source of food. I could be confusing David with
somebody else. As this person said that is all they ate for a couple of
years.
I am very puzzled how people can totally disagree with Academia and
still be very healthy. If there is truth in what these people say, than
who can you trust?
BillW50
Quentin Grady typed on Fri, 08 Feb 2008 22:10:03 +1300:
> On Thu, 7 Feb 2008 18:09:00 -0600, "BillW50" <Bil...@aol.kom> wrote:
>
>> In news:tfadnaX-Gp58szfa...@comcast.com,
>> Paul L typed on Wed, 6 Feb 2008 15:03:46 -0700:
>>> I'd like to know what "intense therapy" is in this study. Drugs?
>>> Diet? Exercise? All ? This is the key to knowing what this
>>> means. I don't think it was lower a1c that was the problem, it must
>>> have
>>> been whatever means were used to get lower a1c.
>>
>> You don't think lower A1c was the problem? Think about it for a
>> second. Lower A1c means lower available fuel for your cells. Thus a
>> lot of cells starve and die! Which increases the chances that the
>> patient dies too if too many cells die. So how are you thinking that
>> lower A1c is somehow healthier? I am so curious?
>
> G'day G'day Bill,
>
> Thank you for your entertaining hypothesis. It's jolly nice of you.
> It sure helps lighten the mood. So thank you.
>
> I had a little chuckle over the injunction to "Think about it for a
> second"
>
> A lower A1c mean fewer damaged cells. The A1c measures the
> percentage of cells that are glycated i.e. damaged by sugar. Damaged
> cells tend to die rather than healthy cells. I hope that is something
> you'll accept and we can have as a basis of agreement.
Makes sense to me Quentin.
> Cells might well starve when they receive insufficient nutrient. It
> happens when they receive insufficient oxygen for example. With some
> other deficiencies though they simply become inactive until they
> become resupplied. Hopefully this too is part of our shared reality.
>
> Now just what is sufficient nutrient?
>
> With respect to blood glucose it make sense that this is the normal
> level of blood glucose found in non-diabetics. Clearly cells are NOT
> starving at an excessive rate when the A1c is 5.something else normal
> folks would have excessive numbers of cells dying of starvation as you
> put it. There is a continuous turn over of red blood cells so even
> with healthy non-diabetics some cells die and are replaced. Death of
> individual cells is part of health not an indication of imminent death
> of the person. the trick is not to raise the turn over rate above
> that occurring in a healthy person.
>
>
> Best wishes,
Makes sense to me. One of the speakers in the diabetic education class
mentioned there was one patient she had that had a rare illness (the
name of which she couldn't remember) who had an A1c reading of 1.5. I
sure would love to study this illness more and to see how such a low
glucose level effects one's health.
bj
>
> One of the speakers in the diabetic education class mentioned there was
> one patient she had that had a rare illness (the name of which she
> couldn't remember) who had an A1c reading of 1.5. I sure would love to
> study this illness more and to see how such a low glucose level effects
> one's health.
>
Some people have a condition that makes the A1c not reflect the actual bg
levels; I don't remember the name. Remember, the A1c is *not* an "average
bg" it's a % of [my low-tech version here] how many of your red blood cells
have gotten sticky -- it's *related to* bg (for *most* people, higher bg
leads to more sticky cells) but not the same.
Somebody can undoubtedly explain it more "properly".
bj
BillW50
Chris Malcolm typed on 8 Feb 2008 13:51:27 GMT:
> BillW50 <Bil...@aol.kom> wrote:
>> W. Baker typed on Fri, 8 Feb 2008 01:52:28 +0000 (UTC):
>
>>> Lower Aic does not mean less fuel. there is always the fat availe
>>> eiher from the diet or from that stored in fat cells , which is more
>>> eadily available if the bgs and the A1cs are lower.
>
>> That is what I thought too Wendy! But I was told that turning fat
>> into energy creates a toxin called ketones. Which in laymen terms
>> means it is a killer.
>
> If that was the case then losing fat would kill you. Which it
> doesn't. So that is obviously nonsense.
Then why am I told by experts in the medical field and many here that I
must eat three times a day if not more? I hate eating period! If I have
to eat, I rather eat one small meal a day or two and that is it. So what
are these experts trying to tell me since you are so smart?
>> And second of all, if one's BG is dropping fast, converting
>> fat into energy doesn't happen instantly from what I heard. As it
>> takes time.
>
> How much time? A minute? An hour? A day? And what about glycogen
> stores? What about gluconeogenesis?
If I understand Nicky correctly, in about 3 days.
news:v45oq35uv9067515q...@4ax.com
>> And in that time it makes sense that some cells will starve to
>> death anyway.
>
> Makes sense? Cells won't starve to death if BG doesn't drop below
> normal levels. It's quite possible to lose weight while BGs are within
> normal levels. So what makes sense to you is obviously nonsense.
If the BG are normal, you have fuel for the cells to use. Invalid
argument Chris!
>> Do this over and over again and it is no wonder patients
>> are dying faster.
>
> Continue to think as you have in many of your postings to asd and
> there's not much hope of you ever coming to a sensible conclusion
> about anything except by accident.
Most discoveries are made my accident. And thank you for making my
point. Obviously the medical field doesn't have the necessary knowledge
to treat or cure diabetes as noted by Guys (2/9/2008) post.
news:ndkrq39ki5lqatvfe...@4ax.com
BillW50
krom typed on Fri, 8 Feb 2008 08:45:18 -0600:
> Bill the amount of carbs a person needs is entirely up to thier
> system.
Yes I believe this.
> To say starving yourself is the solution to lowerign blood glucose is
> like saying smashing ones face with a hammer is a good way to stop
> smoking..will it work?..possible but theres far better ways to get it
> done.
I am open to fresh ideas.
> This is why most here stress testing to find out what carbs and foods
> raises you and what ones do not.
Been there and tried that. Sometimes carbs will raise me up and
sometimes the same carbs will not. Part of the cause appears to be the
amount of insulin that is in my body. And checking BG appears to be a
very poor indicator IMHO how much insulin is in your body. Maybe we need
BG and insulin meters.
> For example if i want to eat fruit i know a bannana or apple will
> spike me but pineapple and most all berries will not.
> So i eath those fruits which dont spike me and the same applies to
> all foods i eat.
Been there and tried that. Generally speaking, it tends to be different
depending what the BG was to start with. As if my BG is at say 40, one
banana can raise it up 50 more (90mg/dL). But if I am say at 150mg/dL, a
banana might only raise me up 5mg/dL more.
If this isn't confusing enough, the results are rarely the same. Worse,
my BG will get stuck and I can suddenly eat or drink anything and it
just won't budge. That usually happens in the 150 to 180mg/dL range, but
it has also rarely happens when I am in the 90-120 range. And it isn't
uncommon for me to be stuck for 3 days or more. And I have tried eating
and increasing insulin dosage (not at the same time LOL). And it takes a
very high dose of insulin (almost a double amount) just to get it to
move a little.
> Theres some beans that will raise..some that wont..so i am basiclaly
> eating the same menu as a non diabetic who is eating healthy..just
> different choices.
If that works for you that is great!
> A none diabetic might eat a meal of checiken potato and
> broccoli...and i would eat the chicken and broccoli and replace the
> potato with cauliflower/potato mix to avoid the spike but im eating
> jsut as nutritiously.
>
> I too think you might be having a bit of fun with us but if not then
> i hope you will seriously discuss making the choice to modify your
> diet and test to see whats best for you.
>
> It is your life at stake.
Yes I am serious about diabetes. And doing it so-called right way isn't
working for me very well. As I was untreated for 15 years and most of
that 15 years, I felt much better than I do right now. And having my BG
is the normal range, I feel awful 50% of the time. Meaning severely
lacking energy.
BillW50
bj typed on Sat, 09 Feb 2008 17:37:53 GMT:
Oh okay. That makes sense. So if someone who has some illness that they
have a lower red blood cell count, their A1c reading can be way too low
from their actual average BG levels?
Robert Miles
"BillW50" <Bil...@aol.kom> wrote in message
> In news:v45oq35uv9067515q...@4ax.com,
> Nicky typed on Fri, 08 Feb 2008 08:51:44 +0000:
>> On Thu, 7 Feb 2008 20:16:06 -0600, "BillW50" <Bil...@aol.kom> wrote:
>>
>> It takes about 3 days to swap your body over from burning carbs to
>> burning ketones; once that's done, then you'll notice no difference at
>> all. In fact, you may well already be in ketosis, depending on how big
>> those glasses of milk are; you need about 120g CHO a day to burn
>> carbs, less than that and you're using fat.
>
> That is interesting, as it takes me 2 to 3 days to go without food to
> start to feel hungry. And I don't know what CHO means? I Googled it and I
> found lots of references, but I still didn't get the meaning.
>
Robert Miles
"BillW50" <Bil...@aol.kom> wrote in message
>> This is why most here stress testing to find out what carbs and foods
>> raises you and what ones do not.
>
> Been there and tried that. Sometimes carbs will raise me up and sometimes
> the same carbs will not. Part of the cause appears to be the amount of
> insulin that is in my body. And checking BG appears to be a very poor
> indicator IMHO how much insulin is in your body. Maybe we need BG and
> insulin meters.
>
Invent a way to make an affordable insulin meter and you'll have a
ready market for it.
BillW50
DonnaB shallotpeel typed on Fri, 08 Feb 2008 15:56:21 -0500:
> Yes, I've been listening. And, in another post, finally, you replied,
> to someone else, that you got this way of eating from the military,
> although it seems that you got it as a means of losing weight - not
> as a way of getting your HbA1c down. I still have no idea where you
> got the idea that it was a way to eat for that purpose.
>
> But, look at the big picture. Why do you want to get your HbA1c down?
> To be healthier, longer as a diabetic. How can you do that? By
> getting the right balance of medication, exercise & food *for you*.
> Where should you aim for with your HbA1c? As low as you can get it
> *for you* without going too low.
>
> So, now, look at drinking milk & eating iceberg lettuce. How does it
> figure into the picture? It doesn't. It's not nutritional. There is
> no nutritional value in iceberg lettuce. (There once was a little bit
> but they've long since cut & discarded most, if not all, of that.)
> Iceburg lettuce is considered a 'free' food in terms of calories. It
> can give one the pleasure of chewing, add some fiber & make the
> stomach feel full, if you're trying to lose weight or eat smaller
> portions, etc., etc. So, that leaves you with dairy only.
>
> Are these the only foods you have access to? Are you allergic to all
> other foods? Can you just not stand to eat anything else?
>
> What kinds of supplements do you take?
Well Donna... I am told over and over again that diabetics has to eat 3
times a day. And I have such a hard time making sense out of this. And
for some people like me, I don't even feel hungry until 2 to 3 days
without eating. When you eat 3 times a day, you spike three times a day.
Why not just spike only once a day, isn't that better? Isn't that giving
you better average BG and A1c? Yes I think so.
Yes I believe some people need to eat 3 or more times a day. Heck very
many people I have talked to (diabetics and non-diabetics) have told me
they get very bad headaches when they skip a meal. And I have a hard
time relating to these people because I never ever felt that way in the
last 32+ years.
Supplements? I take a multi called Certagen. I saw Dr. Oz on TV a few
days ago and he said to break multivitamins in half and take both
halves. I thought that was a good idea. But I take a half in the morning
and the other half in the evening before meals.
http://jn9.co.uk/pharmacy/d-455942140-Goldline_Certagen_Tablets_100ct.php
Priscilla Ballou
"BillW50" <Bil...@aol.kom> wrote:
> Well Donna... I am told over and over again that diabetics has to eat 3
> times a day. And I have such a hard time making sense out of this. And
> for some people like me, I don't even feel hungry until 2 to 3 days
> without eating. When you eat 3 times a day, you spike three times a day.
> Why not just spike only once a day, isn't that better? Isn't that giving
> you better average BG and A1c? Yes I think so.
Why do you assume that eating brings a spike? Eating a lot of carbs
will likely cause a spike, but eating protein, non-starchy vegies, and
fat won't cause a spike in most people.
Priscilla
Alan S
On Sat, 9 Feb 2008 13:07:53 -0600, "BillW50"
<Bil...@aol.kom> wrote:
<snip>
>Yes I am serious about diabetes. And doing it so-called right way isn't
>working for me very well. As I was untreated for 15 years and most of
>that 15 years, I felt much better than I do right now. And having my BG
>is the normal range, I feel awful 50% of the time. Meaning severely
>lacking energy.
Bill, before you went on the milk and lettuce diet, what
would you have considered a good breakfast? A good lunch? A
good dinner? What did you eat for snacks?
May I suggest that you re-start there. Pick one to start
with; say, breakfast. Of course, you could keep doing what
you're doing. It's entirely up to you.
I read what you said about variable results, but over time
you can discover trends that may work.
Eat, then test after eating at your spike time (NOT
necessarily two hours, but your PEAK which may be much
earlier) and if BG’s are too high then review what you ate
and change the menu next time. Then do that again, and
again, and again until what you eat doesn’t spike you. You
will get some surprises, particularly at breakfast time. The
so-called "heart-healthy" breakfasts are NOT for most type
2's.
As you gradually improve your blood glucose levels, review
the resulting way of eating to ensure adequate nutrition,
fibre etc are included and adjust accordingly. That is
critical - your present menu is ghastly. Try some breakfast
ideas from here:
http://loraldiabetes.blogspot.com/2006/10/breakfasts.html
Then test again. And again, and again, and again until you
can reasonably consistently predict the out come.
Then move on to lunch. Then dinner.
Best wishes.
Alan S
<Bil...@aol.kom> wrote:
>What do you think of nutritionists like David Wolfe?
I had never heard of him. I wasn't missing anything by the
look of his opening statement:
"World Authority on Chocolate, Raw-Food Nutrition,
Superfoods, Herbal Healing and having THE BEST DAY EVER!"
Another nut. "World Authority"? Spare me.
> I don't remember if
>it was he who claimed that one can be very healthy by only eating cacao
>beans as your only source of food. I could be confusing David with
>somebody else. As this person said that is all they ate for a couple of
>years.
>
>I am very puzzled how people can totally disagree with Academia and
>still be very healthy. If there is truth in what these people say, than
>who can you trust?
>
First, Academia usually disagrees with itself. For example,
see if you can find any other academics who agree with David
Wolfe.
I know who I can trust because I have put the advice I
received into practice and tested the results. I started by
trusting the experts and did exactly what the doctor and
several dieticians and Diabetes Australia prescribed and
taught me.
My testing showed that it didn't work very well.
Then I came to usenet and read everything, filtered what I
read through my own common-sense and started putting some of
those suggestions into practice. I learnt from almost
everyone, but especially some past posters like Jennifer,
Annette and Old Al and some present posters like Quentin,
Frank, Gys, Jim, and so many others that I am unfairly
omitting. Because their advice made sense and when I put it
into practice and tested it - it worked.
So the first person I learnt to trust was myself, to be able
to discriminate between the wisdom and the nonsense.
BillW50
Priscilla Ballou typed on Sat, 09 Feb 2008 15:18:54 -0500:
True Priscilla! But also true is that I take insulin 2 to 3 times a day
like many other diabetics. And I would be very, very happy taking out
all carbs from my food source. Unfortunately, taking carbs out of my
diet almost always causes very low BG. And oddly enough, the lows
generally happen 4 to 6 hours after my regular and NPH injection. I used
aspart and NPH for a month and lows still happens in the same time
frame. I also found if I eat carbs after my injections, I have less of a
chance to have low BG readings 4 to 6 hours later. So how can people
like me avoid carbs and peaks?
Alan S
No, I don't. Presuming the same calories and carbs in the
day, if you break up that one big meal into at least three
of 1/3 the portion size (for me it's 5+) then you change
from one giant spike to lots of little blips. Think about it
a bit longer.
>Yes I believe some people need to eat 3 or more times a day. Heck very
>many people I have talked to (diabetics and non-diabetics) have told me
>they get very bad headaches when they skip a meal. And I have a hard
>time relating to these people because I never ever felt that way in the
>last 32+ years.
>
>Supplements? I take a multi called Certagen. I saw Dr. Oz on TV a few
>days ago and he said to break multivitamins in half and take both
>halves. I thought that was a good idea. But I take a half in the morning
>and the other half in the evening before meals.
>
>http://jn9.co.uk/pharmacy/d-455942140-Goldline_Certagen_Tablets_100ct.php
Have you ever been tested for other types such as LADA or
MODY?
Alan S
<Bil...@aol.kom> wrote:
>> Why do you assume that eating brings a spike? Eating a lot of carbs
>> will likely cause a spike, but eating protein, non-starchy vegies, and
>> fat won't cause a spike in most people.
>
>True Priscilla! But also true is that I take insulin 2 to 3 times a day
>like many other diabetics. And I would be very, very happy taking out
>all carbs from my food source. Unfortunately, taking carbs out of my
>diet almost always causes very low BG.
On milk and lettuce, why are you surprised? Whatever carbs
you are eating, your insulin should be adjusted to balance
that. You are way out of balance.
>And oddly enough, the lows
>generally happen 4 to 6 hours after my regular and NPH injection. I used
>aspart and NPH for a month and lows still happens in the same time
>frame. I also found if I eat carbs after my injections, I have less of a
>chance to have low BG readings 4 to 6 hours later. So how can people
>like me avoid carbs and peaks?
By eating the right portions of carbs, fats and protein and
essential nutrients for your needs and, if insulin is
needed, adjusting the insulin/carb ratio until it is
correct. Beyond that, I'll leave insulin discussion to the
experts.
Balance and moderation Bill. Not extremes in any direction.
Priscilla Ballou
"BillW50" <Bil...@aol.kom> wrote:
There are people here who know how to adjust their insulin injections so
they cover what they eat rather than having to eat to cover their
insulin injections. I trust at least one of them will step in now and
help you out.
Priscilla, T2, diet & exercise
Nicky
>That is interesting, as it takes me 2 to 3 days to go without food to
>start to feel hungry.
That's a pretty classic sign of already being in ketosis; it's a very
useful appetite suppressant. I'm surprised that you are on fixed
insulin doses and managing when eating so little, though.
>And I don't know what CHO means? I Googled it and
>I found lots of references, but I still didn't get the meaning.
Sorry - it stands for Carbon, Hydrogen, and Oxygen - constituents of
carbohydrates.
>What do you think of nutritionists like David Wolfe? I don't remember if
>it was he who claimed that one can be very healthy by only eating cacao
>beans as your only source of food.
I think that nutrition is a very, very young science, and we simply
don't know enough about how our body works to take that kind of risk.
I absolutely agree with Quentin's dietary principles, which allows you
to get a diet rich in nutrients from a wide range of foods - spreads
the risk a bit!
>I am very puzzled how people can totally disagree with Academia and
>still be very healthy.
Which bits of academia? Academics are people too :P
Nicky.
T2 dx 05/04 + underactive thyroid
D&E, 100ug thyroxine
Last A1c 5.6% BMI 25
bj
>> news:47add513$0$1349$834e...@reader.greatnowhere.com...
>>>
>>> One of the speakers in the diabetic education class mentioned there
>>> was one patient she had that had a rare illness (the name of which
>>> she couldn't remember) who had an A1c reading of 1.5. I sure would
>>> love to study this illness more and to see how such a low glucose
>>> level effects one's health.
> bj typed on Sat, 09 Feb 2008 17:37:53 GMT:
>>
>> Some people have a condition that makes the A1c not reflect the
>> actual bg levels; I don't remember the name. Remember, the A1c is
>> *not* an "average bg" it's a % of [my low-tech version here] how many
>> of your red blood cells have gotten sticky -- it's *related to* bg
>> (for *most* people, higher bg leads to more sticky cells) but not the
>> same.
> "BillW50" <Bil...@aol.kom> wrote in message
> news:47ae035e$0$1340$834e...@reader.greatnowhere.com...
>> Oh okay. That makes sense. So if someone who has some illness that they
> have a lower red blood cell count, their A1c reading can be way too low
> from their actual average BG levels?
>
I don't know (so didn't say) that it has to do with blood count. Just that
it has "something" to do with red blood cells. And the A1c result could
(depending on the condition -- not necessarily an "illness" as in "I'm
sick"-- I think there's more than one) be falsely high or low.
bj
Wes Groleau
> I would love to go totally carb-less. But I am told that is unhealthy.
You were told wrong. _Technically_ you don't need any.
HOWEVER, it is impossible to have none and it is almost
impossible to get the vitamins and minerals and calories
that you DO need and not get a moderate amount of carbs
along with it.
--
Wes Groleau
Nutrition for Blokes: Re-engineering your diet for life
http://www.NorthwestAllenTrails.org/QG/
Quentin Grady
<peter.c...@btinternet.com> wrote:
>On 7 Feb, 09:43, Quentin Grady <quen...@paradise.net.nz> wrote:
>> On Wed, 6 Feb 2008 13:45:09 -0800 (PST), morris
>>
>>
>> IMHO I believe Gys is most likely close to the nub of the matter.
>>
>> A more accurate conclusion might well be that the standard high carb
>> diets with intensive medication should be discontinued as they raise
>> the death rate,
>
>Difficult to see how you work that out.
G'day G'day Peter,
Whether it appears easy or difficult depends almost entirely on the
assumptions that are made.
>There was actually a 50%
>reduction in deaths from heart problems in the intensive therapy group
>as comapred to all T2 diabetics which, other things being equal, would
>lead you to recommend that course of treatment for T2s with two of the
>four high risk markers in the study - obesity, smoking, high bps, high
>chols.
By itself it would.
However it is not by itself as you go on to mention
>It was just that the death rate was slightly better in the less intensive group.
Precisely. This is the important point. Recommending high carbs and
then giving an even more intensive treatment to bring the blood
glucose under control is not the optimal strategy. OK, it is better
than doing nothing. It simply isn't optimal.
I'm sure you'll agree with this on reflection.
>Since both groups, presumably, were given standard dietary advice,
>diet would appear to be a common constant between the two groups and
>not a factor that could be used to explain the discrepancy in outcomes
>between them.
Now this is an interesting assumption. The dietary advice given put
the group that received intensive treatment at a disadvantage. Their
intensive treatment had to be MORE intensive, more intensive than
would have been necessary if they had had a diet that restricted
carbohydrate in some way. Then their level of insulin and other
anti-hyperglycemic drugs would have been similar to those in the less
intensive treatment arm. The point is simple. Although they were
given the same dietary advice, the consequences of being given that
advice made what happened to them far from equal.
Put simply it put them in a situation where they were over medicated.
The less intensively treated group were not over medicated.
>On top of that it seems that few of the intensive care group actually
>reached the target of under 6 A1c, which makes an even bigger nonsense
>of the lower A1c claims made about the study.
On this point we agree. It wasn't the A1c that killed some of them.
IMHO it was over medication. Part of the cause IMHO occurred in that
the dietary advice given to them put the intensively medicated group
into a situation where they were over medicated.
> It might be truer to say
>that aiming for an A1c of under 6 by means of intensive treatment and
>missing the target is more dangerous than aiming for A1cs of 7 to 7.9
>with a less intensive regime and hitting the bullseye.
Aiming for an A1c of under 6 by unnecessarily intensive treatment is
dangerous. If one combines exercise and incorporates a diet that
naturally leads to lower post prandial blood glucose levels so that a
less intensive treatment results in a lower A1c then one has a safer
treatment whether or not one achieves getting an A1c below 6.
Thank you for bringing forth this matter for discussion,
Jefferson
http://www.accordtrial.org/public/protocol_2005-05-11.pdf
Table 3.1: Glycemic Targets and Thresholds for Action for ACCORD
Table 3.2 Achieving Glycemic Goals
Figure 3.1 Treatment Algorithm for Intensive Glycemic Therapy Group
(Goal: HbA1c<6%) (This figure can be printed in landscape to get a copy
that is readable. It is page 63 for printing purposes.)
Use titration and diet in the Adobe search feature. Self-titration is
commonly found in this article.
3.5.a Medical Nutrition Therapy Medical Nutrition Therapy (MNT) consists
of weight control and dietary modification. The American Diabetes
Association (ADA) position statement on “Nutrition Recommendations and
Principles for People with Diabetes Mellitus” [Diabetes Care
2000;23(Suppl. 1): S43-S46] reports that “medical nutrition therapy is
integral to total diabetes care and an essential component of successful
diabetes management” (ADA (American Diabetes Association). Physical
activity is a closely related component of diabetes care. MNT is
considered integral to the current study for achieving optimal diabetes
management. (While this protocol was a 2005 version, ADA guidelines were
those in effect in 2000. They probably were not modified throughout this
trial.)
I did not actually find Diabetes Care 2000;23(Suppl. 1): S43-S46, so I
don't know the details of the recommended diet.
>
> I'm sure you'll agree with this on reflection.
>
>
>>Since both groups, presumably, were given standard dietary advice,
>>diet would appear to be a common constant between the two groups and
>>not a factor that could be used to explain the discrepancy in outcomes
>>between them.
Excerpt:
3.2.e Dietary and Lifestyle Interventions All participants will be
provided with the same dietary and lifestyle recommendations to optimize
their glucose control. These will include: a) advice that blood glucose
control may be more critical than weight control in reducing the risk of
complications of diabetes; b) teaching dietary principles including
carbohydrate counting; c) advice to engage in regular aerobic exercise
(if medically fit to do so according to the physician who provides their
medical care); d) teaching the technical and interpretative skills of
blood glucose monitoring; and e) education of participants’ families
regarding the management of hypoglycemia.
(Apparently more than an assumption.)
>
>
> Now this is an interesting assumption. The dietary advice given put
> the group that received intensive treatment at a disadvantage. Their
> intensive treatment had to be MORE intensive, more intensive than
> would have been necessary if they had had a diet that restricted
> carbohydrate in some way. Then their level of insulin and other
> anti-hyperglycemic drugs would have been similar to those in the less
> intensive treatment arm. The point is simple. Although they were
> given the same dietary advice, the consequences of being given that
> advice made what happened to them far from equal.
This would seem to be a good conclusion. The blood glucose swings
post-prandially would be more extensive in the intensively treated group
giving them more of a yo-yo BG effect.
>
> Put simply it put them in a situation where they were over medicated.
> The less intensively treated group were not over medicated.
>
>
>>On top of that it seems that few of the intensive care group actually
>>reached the target of under 6 A1c, which makes an even bigger nonsense
>>of the lower A1c claims made about the study.
>
>
> On this point we agree. It wasn't the A1c that killed some of them.
> IMHO it was over medication. Part of the cause IMHO occurred in that
> the dietary advice given to them put the intensively medicated group
> into a situation where they were over medicated.
>
>
>>It might be truer to say
>>that aiming for an A1c of under 6 by means of intensive treatment and
>>missing the target is more dangerous than aiming for A1cs of 7 to 7.9
>>with a less intensive regime and hitting the bullseye.
>
>
> Aiming for an A1c of under 6 by unnecessarily intensive treatment is
> dangerous. If one combines exercise and incorporates a diet that
> naturally leads to lower post prandial blood glucose levels so that a
> less intensive treatment results in a lower A1c then one has a safer
> treatment whether or not one achieves getting an A1c below 6.
>
In another thread on the same topic I posted: In well controlled T2DMs
the post-prandial state is the biggest contributor to HbA1c. It is not
so easy to get an a1c under 6% without fairly good post-prandial glucose
control. Monnier et al have done research on this topic and I have
posted on it a few times in the past.
Also "What Is the Real Contribution of Fasting Plasma Glucose and
Postprandial Glucose in Predicting HbA1c and Overall Blood Glucose
Control?" - http://care.diabetesjournals.org/cgi/content/full/24/11/2011
Post-prandial glucose control is also more significant risk factor in
cardiovascular events than fasting BG and A1c.
Frank
DonnaB shallotpeel
<vze23t8n-2DB557...@individual.net>, Priscilla Ballou
<vze2...@verizon.net> wrote:
> In article <47ae16f6$0$1342$834e...@reader.greatnowhere.com>,
> "BillW50" <Bil...@aol.kom> wrote:
>
> > In news:vze23t8n-040899...@individual.net,
> > Priscilla Ballou typed on Sat, 09 Feb 2008 15:18:54 -0500:
> > >
> > > Why do you assume that eating brings a spike? Eating a lot of carbs
> > > will likely cause a spike, but eating protein, non-starchy vegies, and
> > > fat won't cause a spike in most people.
> >
> > True Priscilla! But also true is that I take insulin 2 to 3 times a day
> > like many other diabetics. And I would be very, very happy taking out
> > all carbs from my food source. Unfortunately, taking carbs out of my
> > diet almost always causes very low BG. And oddly enough, the lows
> > generally happen 4 to 6 hours after my regular and NPH injection. I used
> > aspart and NPH for a month and lows still happens in the same time
> > frame. I also found if I eat carbs after my injections, I have less of a
> > chance to have low BG readings 4 to 6 hours later. So how can people
> > like me avoid carbs and peaks?
>
> There are people here who know how to adjust their insulin injections so
> they cover what they eat rather than having to eat to cover their
> insulin injections. I trust at least one of them will step in now and
> help you out.
Where is Jackie Patty?
--
DonnaB shallotpeel, T2 since June 06, USA
"Your place is going to be being renovated until the Bush girls are old
enough to drink!" - Jake to Greenlee over closet space, AMC, 7/19/01
krom
Maybe a timed released metformin would stabalise you more?
I dunno just tossing that out there..
KROM
"BillW50" <Bil...@aol.kom> wrote
Peter C
"Quentin Grady" <que...@paradise.net.nz> wrote in message >>> IMHO I
>>>
>>> A more accurate conclusion might well be that the standard high carb
>>> diets with intensive medication should be discontinued as they raise
>>> the death rate,
>>
>>Difficult to see how you work that out.
>
> G'day G'day Peter,
>
> Whether it appears easy or difficult depends almost entirely on the
> assumptions that are made.
>
The group that aimed for A1cs under 6 by intensive treatment achieved a 50%
rate as compared to all T2s. Given that fact your assertion above that "the
standard high carb diets with intensive medication .... raise the death
rate," is just a falsehood. The reverse is clearly true and you should
reconsider that statement you made.
But the average subject in the trial failed to achieve under 6 so what we
really need to see is the results for the minority in the intensive
treatment group that did actually achieve under 6. If they prove to have the
lowest death rate then the issue would appear to be not with the regime (
your assumption ) but with compliance to the dietary and medication
recommendations.
DarkSentinel
news:fom90n$hs9$1...@aioe.org...
Bill, there is no so-called "right way". Each diabetic is different. We have
different tolerances. Different metabolisms, etc. You have to find the best
way for YOU. My way may not work for you. Krom's may not, nor Alan's. It
will be kind of hit and miss, for a while until you figure it out.
As for feeling like crap, I've been down THAT road recently. In fact I had
totally let the disease take over and was letting it kill me. I found
someone that gave me the impetus to change all that, and turned everything
around. Pushed the doc, and had him put me on the Lantus. Problem was, my
brain was used to the 300's level. I would go into severe neurological
hypoglycemia, even though my numbers were in the "normal range". The folks
here will remember the post I made about it. The point I am trying to make
here is that it will pass eventually. Since I have gotten my numbers down
(just checked my meter...14 day average is 116), I have so much more energy
it's not even funny. The depression is gone. I wake up happy every day now.
Just tough it out bud, is the best thing I can tell you. You will not regret
it.
--
T2 - Oct. '96 - Lantus, oral meds, diet
http://www.lockergnome.com/darksentinel
Undo the munge to reply by email
Chris Malcolm
> In news:61352vF...@mid.individual.net,
> Chris Malcolm typed on 8 Feb 2008 13:51:27 GMT:
>> BillW50 <Bil...@aol.kom> wrote:
>>> W. Baker typed on Fri, 8 Feb 2008 01:52:28 +0000 (UTC):
>>
>>>> Lower Aic does not mean less fuel. there is always the fat availe
>>>> eiher from the diet or from that stored in fat cells , which is more
>>>> eadily available if the bgs and the A1cs are lower.
>>
>>> That is what I thought too Wendy! But I was told that turning fat
>>> into energy creates a toxin called ketones. Which in laymen terms
>>> means it is a killer.
>>
>> If that was the case then losing fat would kill you. Which it
>> doesn't. So that is obviously nonsense.
> Then why am I told by experts in the medical field and many here that I
> must eat three times a day if not more? I hate eating period! If I have
> to eat, I rather eat one small meal a day or two and that is it. So what
> are these experts trying to tell me since you are so smart?
What has number of meals got to do with it? You can overeat and get
fat on one large meal a day, and you can undereat and get thin on six
tiny meals a day. What they were probably trying to get across to you
was that spreading your daily food consumption over a larger number of
meals would reduce your post meal BGs. Not only does that help to
avoid diabetic complications, but high post meal BGs plus insulin also
has fattening tendencies.
>>> And in that time it makes sense that some cells will starve to
>>> death anyway.
>>
>> Makes sense? Cells won't starve to death if BG doesn't drop below
>> normal levels. It's quite possible to lose weight while BGs are within
>> normal levels. So what makes sense to you is obviously nonsense.
> If the BG are normal, you have fuel for the cells to use. Invalid
> argument Chris!
I think you're confusing cell nutrition with body nutrition. Fat cells
for example behave quite differently with respect to food, energy,
hormones, etc. from muscle cells. Fat cells don't have to starve or
die to reduce their stored fat, and they don't have to multiply to
increase their stored fat.
>>> Do this over and over again and it is no wonder patients
>>> are dying faster.
>>
>> Continue to think as you have in many of your postings to asd and
>> there's not much hope of you ever coming to a sensible conclusion
>> about anything except by accident.
> Most discoveries are made my accident.
I think you're overgeneralising from personal experience.
> And thank you for making my
> point. Obviously the medical field doesn't have the necessary knowledge
> to treat or cure diabetes as noted by Guys (2/9/2008) post.
It obviously knows a lot more about it than you do.
--
Chris Malcolm c...@infirmatics.ed.ac.uk DoD #205
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]
W. Baker
: "Quentin Grady" <que...@paradise.net.nz> wrote in message >>> IMHO I
Peter,
there has been some further discussion that I have seen in the press about
possible theories as to why the intensively treated group had more deaths
form heart attack (they had fewer attacks than the less intensively
treated group, but they had more deaths). there are plans to try to
analyse this issue to see if they can find some possible answers. Some
have even suggested that, as these wee largely people who already had
heart problems, that the stress of tryng to keep the numbers low, which
apparantly proved difficult for them, and the intense supervision may have
contributed to the deaths. I don't know if this will prove out, but bu is
is possible.
Personally, I keep my bg's down aftr over 20 years from diagnosis by
eating moderate carbs-60-100 a day, taking moderate medication, 1000mg
Metformin EX 2X a day and 1 mg Amaryl at night. I also test a fewtimes a
dya, always fbg, always between 1-2 hours after dinner and, if I have
eaten either differently or unwisely, at other pp times. I follow this a
a successful routine and am not stressed. When I hav a holiday dinnerand
test adn find I may be higher than I want, i don't fret, but just go back
to my regular pattern. The peole in this test were not like me and ay
well have stressed out over trying to maintain the levels of bg they were
beign asked to achieve. After all, they had been unsuccessful at
achieving thee goals before the study began.
Wendy
Alan S
<wba...@panix.com> wrote:
>
>Personally, I keep my bg's down aftr over 20 years from diagnosis by
>eating moderate carbs-60-100 a day, taking moderate medication, 1000mg
>Metformin EX 2X a day and 1 mg Amaryl at night. I also test a fewtimes a
>dya, always fbg, always between 1-2 hours after dinner and, if I have
>eaten either differently or unwisely, at other pp times. I follow this a
>a successful routine and am not stressed. When I hav a holiday dinnerand
>test adn find I may be higher than I want, i don't fret, but just go back
>to my regular pattern. The peole in this test were not like me and ay
>well have stressed out over trying to maintain the levels of bg they were
>beign asked to achieve. After all, they had been unsuccessful at
>achieving thee goals before the study began.
>
>Wendy
I wish you were on the ADA board, or on the design group for
the ACCORD protocols. That key word "moderate" appears
repeatedly there - but what you and I consider moderate some
in other places consider extreme or obsessive.
For example:
"carbs-60-100 a day" is considered extreme by all the
various authorities advising that less than 130gms daily is
very dangerous.
"I also test a fewtimes a dya, always fbg, always between
1-2 hours after dinner and, if I have eaten either
differently or unwisely, at other pp times." That is
obsessive and extreme according to studies published in
Australia, Canada and the UK over the past 18 months.
So keep on being a moderately obsessive extremist Wendy,
because it is obviously working for you.
And for me:-)
Cheers, Alan, T2, Australia.
d&e, metformin 1500mg, ezetrol 10mg
Everything in Moderation - Except Laughter.
--
http://loraldiabetes.blogspot.com
Latest: ACCORD, Foxes and Grapes
MI
On 2/10/08 1:39 PM, in article lbruq3h20mgc7vvn3...@4ax.com,
"Alan S" <loralgtwei...@gmail.com> wrote:
A few years ago when our Pharmacare insisted on prescriptions for strips it
was difficult to get enough. I asked my endo and he said don't worry I'll
see you get all the strips you want. He then said that the reason they don't
push T2's is because most of us don't do anything with the information and
therefore if you not going to do anything with it, why tax the medical
system. I replied that since he had given me all the strips I had been able
to lower my A1C from 7.2 to 5.7. He said keep testing as often I felt
necessary and wished there were more people like me. I owe it all to you
guys.
--
Martha T2 Canada
1500mg. Metformin, 4mg. Avandia
morris
study was announced, February's Diabetes Forecast had arrived, and I
read through it last night and found contradictory studies to the
ACCORD results.
One was a report on follow up studies of the participants inthe
Diabetes Control and Complications Trial (DCCT), a 10 year study of
1441 Type 1s that started in 1983. The study compared T1s on a 2-shot
a day regimen with average A1cs of 9 with people on flexible insulin
plans who achieved an A1c of just over 7. "The difference in the risk
of micro-vascular complications was so dramatic that the study was
stopped early."
In the 2005 follow-up study of the same participants, called
Epidemiology of Diabetes Interventions and Complications, the
researchers found that the lower A1c group from the DCCT had less than
half the number of CVD events as the higher A1c group.
Another study, the Veterans Affairs Diabetes Trial (VADT) is
concluding this spring. This study has 1700 men and women with long
standing T2, with average A1c of 9.4, and all 1700 have been treated
for high blood pressure and cholesterol. All are on a daily dose of
aspirin. They have been counseled on healthy diets, staying active and
quitting smoking. The participants were divided into 2 groups, an
intensive glucose control group, with A1c expected to drop to a goal
of under 6.5, and a standard treatment group , with A1c expected to
improve to 8.5.
How familiar does that sound? This one started in December 2000 and
will end in April. Outcome in both groups will be measured in terms of
heart attacks, strokes and amputations.
This one sounds comparable in goals and methodology to ACCORD, with
the goal of seeing how much additional benefit is provided by tighter
glucose control, as compared with just treating blood pressure and
cholesterol. It should be interesting to see how the results differ
from ACCORD.
Ultimately we have to remember that any one study rarely tells the
whole story, and the results of studies have to all be considered
together as a group before conclusions can be drawn. I am reminded of
contradictory studies on the benefits of cinnamon, and chromium, and a
host of other areas where studies show different results. When that
happens we can try to figure out why, and as more questions are
answered by a fuller report on ACCORD, we may be able to say for sure
that THIS is why the results of ACCORD differ from other studies.
Until that information becomes available, and by that I mean not only
on the design of the study, but the actual experience of the
participants, including how many meds at what dosages they were
taking, how successful they were in meeting the stated goals, what
their diet and exercise level actually was, when that information
becomes available, then we can draw firm conclusions on what happened
with ACCORD. Until then, however, we are guessing, and should
certainly not base any actions or changes in what we are doing on
those guesses or published reports.
Morris
On Feb 6, 1:45 pm, morris <morrisol...@comcast.net> wrote:
> Is that what the cessation of the ACCORD Study, announced today is
> really saying? Or just in high risk patients? or...?
> Morris
> *********************************************************
> MSNBC.com
> Major diabetes trial halted after deaths
> 257 patients died after intense therapy to lower blood sugar, NIH
> reports
> The Associated Press
> updated 7:34 a.m. PT, Wed., Feb. 6, 2008
>
> WASHINGTON - An unexpected number of deaths among patients receiving
> intense therapy to lower their blood sugar forced the National
> Institutes of Health to abruptly cut short part of a major study on
> diabetes and heart disease.
>
> The therapy was aimed at reducing to normal levels the blood sugar of
> type 2 diabetics at especially high risk of heart attack and stroke.
> There were 257 deaths among people receiving intense diabetes
> treatment, compared with 203 in the standard treatment group, NIH's
> National Heart Lung and Blood Institute said.
>
> More than 18 million Americans have diabetes, with type 2 the most
> common form.
>
> Last fall the Food and Drug Administration added new warnings to the
> label of the popular diabetes drug Avandia, listing concerns about
> heart ailments. However, in Wednesday's announcement NHLBI officials
> stressed that they have been unable to link the increased deaths in
> the study to any drug, including Avandia.
>
> Some 10,251 people were enrolled in the Action to Control
> Cardiovascular Risk in Diabetes study, with an average participation
> time of four years.
>
> The participants were in groups receiving three types of treatment,
> intensive lowering of blood sugar, lowering blood pressure or reducing
> cholesterol.
>
> "A thorough review of the data shows that the medical treatment
> strategy of intensively reducing blood sugar below current clinical
> guidelines causes harm in these especially high-risk patients with
> type 2 diabetes," said Dr. Elizabeth G. Nabel, director of the
> institute.
>
> "Though we have stopped this part of the trial, we will continue to
> care for these participants, who now will receive the less-intensive
> standard treatment. In addition, we will continue to monitor the
> health of all participants, seek the underlying causes for this
> finding, and carry on with other important research within ACCORD,"
> she said in a statement.
>
> Multiple risk factors
> The study focuses on treatments for adults with type 2 diabetes, the
> most common form, who are at especially high risk for heart disease,
> meaning they had at least two risk factors, which include high blood
> pressure, high cholesterol, obesity and smoking.
>
> Dr. William Friedewald, professor of Public Health and Medicine at
> Columbia University, and chairman of the ACCORD Steering Committee,
> said that there were "about 10 percent fewer nonfatal cardiovascular
> events such as heart attacks in the intensive treatment group compared
> to the standard treatment group. However, it appeared that, if a heart
> attack did occur, it was more likely to be fatal. In addition, the
> intensive treatment group had more unexpected sudden deaths, even
> without a clear heart attack."
>
> The action was recommended by an independent advisory group of experts
> in diabetes, heart disease, epidemiology, patient care, biostatistics,
> medical ethics and clinical trial design that has been monitoring
> ACCORD since it began.
>
> Participants will continue to receive blood sugar treatment from their
> study clinicians until the planned trial conclusion in June 2009.
>
> Nabel stressed that diabetes patients should not change their
> treatment without consulting their doctor. The American Diabetes
> Association agreed and said it continues to encourage control of blood
> sugar in treatment of diabetes.
>
> NHLBI said the intensive treatment group had a target blood sugar goal
> of less than 6 percent, which is similar to blood sugar levels in
> adults without diabetes. The standard treatment group aimed for a
> target similar to what is achieved, on average, by those with diabetes
> in the United States, of 7 to 7.9 percent.
>
> (c) 2008 The Associated Press. All rights reserved. This material may
> not be published, broadcast, rewritten or redistributed.
Alan S
Thanks Morris. Valuable info. More reading to do.
Kurt
> Until that information becomes available, and by that I mean not only
> on the design of thestudy, but the actual experience of the
> participants, including how many meds at what �dosages they were
> taking, how successful they were in meeting the stated goals, what
> their diet and exercise level actually was, when that information
> becomes available, then we can draw firm conclusions on what happened
> with ACCORD. �Until then, however, we are guessing, and should
> certainly not base any actions or changes in what we are doing on
> those guesses or published reports.
Well said, Morris. I'd like to see the above listed as a disclaimer
every time a study is posted in this newsgroup. Just replace the word
ACCORD with the name of whatever study du jour is posted. It's
important to keep all of what you said in mind when evaluating, or
even considering, the results of any study.
Kurt
Quentin Grady
<fw...@adelphia.netexopheno> wrote:
>> Now this is an interesting assumption. The dietary advice given put
>> the group that received intensive treatment at a disadvantage. Their
>> intensive treatment had to be MORE intensive, more intensive than
>> would have been necessary if they had had a diet that restricted
>> carbohydrate in some way. Then their level of insulin and other
>> anti-hyperglycemic drugs would have been similar to those in the less
>> intensive treatment arm. The point is simple. Although they were
>> given the same dietary advice, the consequences of being given that
>> advice made what happened to them far from equal.
>
>This would seem to be a good conclusion. The blood glucose swings
>post-prandially would be more extensive in the intensively treated group
>giving them more of a yo-yo BG effect.
G'day G'day Frank,
Thanks for that. It seemed apparent to me from the start. Even if
their blood glucose didn't yo-yo they'd be subjected to more insulin
and other anti-hypoglycemic drugs.
Best wishes,
Quentin Grady
wrote:
>Eyup Quentin,
>The group that aimed for A1cs under 6 by intensive treatment achieved a 50%
>rate as compared to all T2s. Given that fact your assertion above that "the
>standard high carb diets with intensive medication .... raise the death
>rate," is just a falsehood. The reverse is clearly true and you should
>reconsider that statement you made.
G'day G'day Peter,
You seem determined to miss the point I've made.
It isn't whether they achieved the goal of getting under 6 that is
significant. Oh it might be to you. It simply isn't to me and if it
is to you then you're engaged in a debate with yourself which I
suppose could be entertaining for the rest of us.
IMHO what is significant is that they received an increased amount of
medication.
>But the average subject in the trial failed to achieve under 6 so what we
>really need to see is the results for the minority in the intensive
>treatment group that did actually achieve under 6.
It all depends on what you wish to achieve.
> If they prove to have the lowest death rate then the issue would appear
> to be not with the regime ( your assumption ) but with compliance to
> the dietary and medication recommendations.
Well that is another hypothesis.
As I see it non-compliance at the A1c under 6 level doesn't make them
have worse control than those who are compliant at the under 7 level.
Best wishes,
Peter C
>
> You seem determined to miss the point I've made.
>
> It isn't whether they achieved the goal of getting under 6 that is
> significant. Oh it might be to you. It simply isn't to me and if it
> is to you then you're engaged in a debate with yourself which I
> suppose could be entertaining for the rest of us.
Hey ho,
I suppose we are making some progress,
at least you are no longer claiming that a 50% decrease in heart-related
mortality among the intensively treated group is actually a rise.
feli...@gmail.com
<heartdo...@emorycardiology.com> wrote:
> feliph...@gmail.com wrote:
> > Andrew, in the Holy Spirit, boldly wrote:
> > > feliph...@gmail.com wrote:
> > > > Andrew, in the Holy Spirit, boldly wrote:
> > > > > friend GysdeJongh wrote:
> > > > .
> > > > .
> > > > .
> > > > > > Page 78 :
> > > > > > Medical Nutrition Therapy
> > > > > > Medical Nutrition Therapy (MNT) consists of weight control and dietary
> > > > > > modification. The American Diabetes Association (ADA) position statement on
> > > > > > "Nutrition Recommendations and Principles for People with Diabetes Mellitus"
>
> > > > > Clearly the focus on lowering blood glucose in type-2 diabetics to
> > > > > improve health is wrong:
>
> > > > >http://groups.google.com/group/alt.support.diabetes/msg/eb22e6e360a74...
>
> > > > > It is time to direct the focus on removing the harmful black fat
> > > > > (visceral adipose tissue aka VAT) that is the source of the
> > > > > proinflammatory adipocytokines (PIACs) that are fueling the
> > > > > inflammatory cascade which is the proximate cause of the insulin
> > > > > resistance (IR/MetS) that caused the type-2 diabetes from the outset:
>
> > > > And visceral adipose tissue is "black fat"....why, exactly?
>
> > > The same reason that subcutaneous adipose tissue is white fat.
> > I am unable to unearth a single reference wihch describes VAT a
> > being "black".
>
> > Perhaps you will provide one or more?
> GOD has provided those who work at slaughterhouses to testify to this.
>
> They call the VAT of slaughtered animals...
>
> B L A C K F A T
Actually, I'd rather talk about human adipose tissue,
and I'd rather take the word of medical researchers over
hearsay alleged to have come from unspecified
slaughterhouse workers.
And what medical researchers say about human VAT
is that it is primarily white in color, with a minor component
which is brown, due to the presence of mitochondria.
The fraction of brown VAT to white VAT drops sharply
in adulthood, with some workers unable to identify
any at all.
www.jlr.org/cgi/reprint/24/4/381.pdf
http://www.vivo.colostate.edu/hbooks/pathphys/misc_topics/brownfat.html
Procyonophile
Andrew B. Chung, MD/PhD
> Andrew, in the Holy Spirit, boldly wrote:
> > feliph...@gmail.com wrote:
> > > Andrew, in the Holy Spirit, boldly wrote:
> > > > feliph...@gmail.com wrote:
> > > > > Andrew, in the Holy Spirit, boldly wrote:
> > > > > > friend GysdeJongh wrote:
> > > > > .
> > > > > > > Medical Nutrition Therapy
> > > > > > > Medical Nutrition Therapy (MNT) consists of weight control and dietary
> > > > > > > modification. The American Diabetes Association (ADA) position statement on
> > > > > > > "Nutrition Recommendations and Principles for People with Diabetes Mellitus"
> > > > > > > reports that "medical nutrition therapy is integral to total diabetes care
> > > > > > > and an essential component of successful diabetes management" (ADA 2000a).
> >
> > > > > > Clearly the focus on lowering blood glucose in type-2 diabetics to
> > > > > > improve health is wrong:
> >
> > > > > >http://groups.google.com/group/alt.support.diabetes/msg/eb22e6e360a74...
> >
> > > > > > It is time to direct the focus on removing the harmful black fat
> > > > > > (visceral adipose tissue aka VAT) that is the source of the
> > > > > > proinflammatory adipocytokines (PIACs) that are fueling the
> > > > > > inflammatory cascade which is the proximate cause of the insulin
> > > > > > resistance (IR/MetS) that caused the type-2 diabetes from the outset:
> >
> > > > > And visceral adipose tissue is "black fat"....why, exactly?
> >
> > > > The same reason that subcutaneous adipose tissue is white fat.
>
> > > I am unable to unearth a single reference wihch describes VAT a
> > > being "black".
> >
> > > Perhaps you will provide one or more?
>
> > GOD has provided those who work at slaughterhouses to testify to this.
> >
> > They call the VAT of slaughtered animals...
> >
> > B L A C K F A T
>
> Actually, I'd rather talk about human adipose tissue
It is the collective clinical experience of those of us, who are
practicing physicians, who also have biomedical research experience
visiting slaughterhouses, that human VAT is essentially the same as
animal VAT so that calling it "black fat" remains appropriate.
May reading this help motivate folks to eat less, down to the right
amount:
Prayerfully in the infinite power and might of the Holy Spirit,
Andrew <><
--
Andrew B. Chung, MD/PhD
Lawful steward of http://EmoryCardiology.com
Swordbearer for the KING of kings and LORD of lords.
http://HeartMDPhD.com/Sword
feli...@gmail.com
restoring snippage:
> > Actually, I'd rather talk about human adipose tissue
> > and I'd rather take the word of medical researchers over
> > hearsay alleged to have come from unspecified
> > slaughterhouse workers.
> > And what medical researchers say about human VAT
> > is that it is primarily white in color, with a minor component
> > which is brown, due to the presence of mitochondria.
> > The fraction of brown VAT to white VAT drops sharply
> > in adulthood, with some workers unable to identify
> > any at all.
> It is the collective clinical experience of those of us, who are
> practicing physicians, who also have biomedical research experience
> visiting slaughterhouses, that human VAT is essentially the same as
> animal VAT so that calling it "black fat" remains appropriate.
Again, I will take word of published studies in peer-review journals
over that of one practicing -- although I am lately given to
understand
that "practicing" is controversial in this case -- over the word of
one
person claiming to speak, with zero independent confirmation,
for the "collective clinical experience of those of us, who are
practicing physicians".
No physician who I know personally would dream of making so
sweeping, and so upsupportable a claim.
But as always, the interested reader should decide for him/herself:
Andrew B. Chung, MD/PhD
J666
>
> It is the collective clinical experience of those of us, who are
> practicing physicians, who also have biomedical research experience
> visiting slaughterhouses, that human VAT is essentially the same as
> animal VAT so that calling it "black fat" remains appropriate.
>
OAF
Actually with apes and monkeys who are with Dr. Chung in Chung's
captivity in Omersatan, this is true and is one more sign that the
monkeys have taken over Chung's postings or even his mind.
Let us pray for Dr Chung's fast and safe release even though for some
reason God has not chosen to respond to our prayers
Andrew B. Chung, MD/PhD
J666
<heartdo...@emorycardiology.com> wrote:
> http://HeartMDPhD.com/Convicts/OriginalAssinineFool
OAF
This is one more sign that the monkeys have taken over Chung's
postings and even mind.
We have heard that Dr. Chung is up to 2 gallons of bananas a day and
will remain at that level because OmaGOD, the God of the apes, monkeys
and chimpanzees in Omersatan had written in the holy Book, Volume,
that need 2 gallons of bananas everyday per person as OmaGOD supplied
to Mosesape et al when wandering for 40 years in the jungle. This
gets the VAT, Vital Ape Tissue, to the optimal amount.
Let us pray for Dr Chung's fast and safe release and his return to his
usual state of mental health even though for some reason God has not
chosen to respond to our prayers. We must believe that the Holy
"Father Knows Best."
Andrew B. Chung, MD/PhD
> Andrew, in the Holy Spirit, boldly wrote:
>
> > http://HeartMDPhD.com/Convicts/OriginalAssinineFool
>
> OAF
This simply shows your sockpuppet has "black fat" in its brain:
http://HeartMDPhD.com/BlackFat
May we, who are Jesus' brethren, continue to rebuke you at each GOD-
given opportunity as GOD desires:
http://HeartMDPhD.com/Convicts/Rebukesatan
<><
May dear neighbors, friends, and brethren have a blessedly wonderful
2008th year since the birth of our LORD Jesus Christ as the Son of
Man ...
... by being hungrier:
http://TruthRUS.org/KnowingGOD
Hunger is wonderful :-)
It's how we know what GOD wants, which is what is good.
Yes, hunger is our knowledge of good versus evil that Adam and Eve
paid for with their and our immortal lives.
Those who suffer from the powerful delusion predicted by the prophecy
of 2 Thessalonians 2:9-11 would deny this and perish ( gone !!! )
forever ...
http://HeartMDPhD.com/Convicts/CrazyOne
http://HeartMDPhD.com/Convicts/CrazyTwo
http://HeartMDPhD.com/Convicts/CrazyThree
http://HeartMDPhD.com/Convicts/CrazyFour
http://HeartMDPhD.com/Convicts/Bob
... gone:
http://YouTube.com/watch?v=Qb6d_z5C35E
Such will be the demise of all those who refuse to know **and** love
the truth, Who is LORD Jesus Christ:
http://HeartMDPhD.com/Love/TheTruth
Be hungry... be healthy... be hungrier... be blessed:
http://HeartMDPhD.com/HolySpirit/BeBlessed
"Blessed are you who hunger NOW...
... for you will be satisfied." -- LORD Jesus Christ (Luke 6:21)
Amen.
J666
This is one more sign that the monkeys have taken over Chung's
postings and even mind.
We have heard that Mark D. Sade is opening a BDSM Club in Omersatan -
our worry is that Dr. Chung will be Mark D. Sade's bondservant.
We are making arrangements to open a branch office in Omersatan to be
better work to get Dr. Chung's release.
Let us pray for Dr Chung's fast and safe release and his return to his
usual state of mental health even though for some reason God has not
chosen to respond to our prayers. We must believe that the Holy
"Father Knows Best."
On Feb 12, 5:07 pm, "Two" Poundus/Andrew B. Chung,typed in Omersatan
> Lawful steward ofhttp://EmoryCardiology.com
Quentin Grady
wrote:
>
I'm glad to see you're happy.
IMHO that is a good place to leave things. As far as I'm aware I've
never claimed a 50% decrease in heart-related mortality amongst the
intensively treated group is actually a rise. Without knowing the
particular context it would appear to be quite illogical to do so. It
seems to me very much like a misinterpretation has occurred somewhere,
the sort of thing that would be easily recognized.
One small request. Please in future Peter, could you ignore my posts.
I'm not interested in the sort of conversations that often develop and
would prefer to put my time and energy into helping people
Others are bound to find the style of interaction you enjoy more to
their liking. IMHO it would be better for all concerned if you sought
out their company.
Thank you and best wishes,
Peter C
> On Tue, 12 Feb 2008 10:11:14 GMT, "Peter C" <pet...@hotmail.co.uk>
> wrote:
>
>>
>>Hey ho,
>>I suppose we are making some progress,
>>at least you are no longer claiming that a 50% decrease in heart-related
>>mortality among the intensively treated group is actually a rise.
>
> G'day G'day Peter,
>
> I'm glad to see you're happy.
>
> IMHO that is a good place to leave things. As far as I'm aware I've
> never claimed a 50% decrease in heart-related mortality amongst the
> intensively treated group is actually a rise. Without knowing the
> particular context it would appear to be quite illogical to do so. It
> seems to me very much like a misinterpretation has occurred somewhere,
> the sort of thing that would be easily recognized.
>
> One small request. Please in future Peter, could you ignore my posts.
No.
This is an open, unmoderated, uncensored newsgroup.
When you mount one of your hobby-horses and start shooting from the lip ( as
you did with the first news of this ACCORD study ) you are bound to get
commented on.
If you do not LIKE the comments made about your opinions, the traditional
alternative is open to you - lump it.
Frank t2
"Alan S" <loralgtwei...@gmail.com> a écrit ...
> , "BillW50" <Bil...@aol.kom> wrote:
>
>>Alan S typed :
>>> "BillW50" <Bil...@aol.kom> wrote:
>>>
>>>> Paul L typed on Wed, 6 Feb 2008 15:03:46 -0700:
>>>>> I'd like to know what "intense therapy" is in this study. Drugs?
>>>>> Diet? Exercise? All ? This is the key to knowing what this
>>>>> means. I don't think it was lower a1c that was the problem, it must
>>>>> have
>>>>> been whatever means were used to get lower a1c.
>>>>
>>>> You don't think lower A1c was the problem? Think about it for a
>>>> second. Lower A1c means lower available fuel for your cells. Thus a
>>>> lot of cells starve and die! Which increases the chances that the
>>>> patient dies too if too many cells die. So how are you thinking that
>>>> lower A1c is somehow healthier? I am so curious?
>>>
>>> You're serious?
>>>
>>> Start here, then do a little checking for more on Google
>>> Scholar: http://www.bmj.com/cgi/content/full/322/7277/15
>>
>>I can't read that Alan! I'm an electrical engineer and it is all Greek
>>to me. Explain in laymen terms how starving the patient by lowering A1c
>>is somehow healthier? If I starve my goldfish it dies! If I starve my
>>dog, it dies! If I starve my children (if I had any and I don't have any
>>dogs either) they die! Are you trying to tell me through some magic of
>>mumbo-jumbo it isn't true?
>
> Who is talking about starving? That would be A1c=0. Read my
> sig: "Everything in Moderation". I agree that you can go too
> low. What we disagree on is the definition of that point.
>
> Now, to help define when it starts to get too high, here is
> my layman's precis of that paper:
> http://www.bmj.com/cgi/content/full/322/7277/15
>
> "HbA1c was continuously related to subsequent all cause,
> cardiovascular, and ischaemic heart disease mortality
> through the whole population distribution, with lowest rates
> in those with HbA1c concentrations below 5%."
>
> Means lowest rates of death occur with A1c less than 5%.
>
> "An increase of 1% in HbA1c was associated with a 28%
> (P<0.002) increase in risk of death independent of age,
> blood pressure, serum cholesterol, body mass index, and
> cigarette smoking habit"
>
> Means that, starting at 5%, your risk of death increases by
> 28% for each 1% rise in A1c.
>
> I reckon that is pretty darn clear in both medicspeak and
> layspeak.
Much appreciated, your 'translation', Alan.
Frank t2
"DonnaB shallotpeel" <shall...@comcast.net> a écrit ...
>
> Where is Jackie Patty?
Precisely on topic : (lol)
You could also add ... Loretta, Will too and I am confident
there are some others 'missing' ...
Ozgirl
" Frank t2" <a@b.c> wrote in message
news:47b3a1ef$0$20807$79c1...@nan-newsreader-07.noos.net...
Loretta is still sending emails. Jackie worries me more.
BillW50
Alan S typed on Fri, 08 Feb 2008 13:53:16 +1100:
> On Thu, 7 Feb 2008 20:04:45 -0600, "BillW50"
> <Bil...@aol.kom> wrote:
>
>> In news:t4cnq39a0qlhjdbu4...@4ax.com,
>> Alan S typed on Fri, 08 Feb 2008 12:31:03 +1100:
>>> On Thu, 7 Feb 2008 18:09:00 -0600, "BillW50"
>>> <Bil...@aol.kom> wrote:
>>>
>>>> In news:tfadnaX-Gp58szfa...@comcast.com,
>>>> Paul L typed on Wed, 6 Feb 2008 15:03:46 -0700:
>>>>> I'd like to know what "intense therapy" is in this study. Drugs?
>>>>> Diet? Exercise? All ? This is the key to knowing what this
>>>>> means. I don't think it was lower a1c that was the problem, it
>>>>> must have
>>>>> been whatever means were used to get lower a1c.
>>>>
>>>> You don't think lower A1c was the problem? Think about it for a
>>>> second. Lower A1c means lower available fuel for your cells. Thus a
>>>> lot of cells starve and die! Which increases the chances that the
>>>> patient dies too if too many cells die. So how are you thinking
>>>> that lower A1c is somehow healthier? I am so curious?
>>>
>>> You're serious?
>>>
>>> Start here, then do a little checking for more on Google
>>> Scholar: http://www.bmj.com/cgi/content/full/322/7277/15
>>
>> I can't read that Alan! I'm an electrical engineer and it is all
>> Greek to me. Explain in laymen terms how starving the patient by
>> lowering A1c is somehow healthier? If I starve my goldfish it dies!
>> If I starve my dog, it dies! If I starve my children (if I had any
>> and I don't have any dogs either) they die! Are you trying to tell
>> me through some magic of mumbo-jumbo it isn't true?
>
> Who is talking about starving? That would be A1c=0. Read my
> sig: "Everything in Moderation". I agree that you can go too
> low. What we disagree on is the definition of that point.
Hi Alan. Apparently.
> Now, to help define when it starts to get too high, here is
> my layman's precis of that paper:
> http://www.bmj.com/cgi/content/full/322/7277/15
>
> "HbA1c was continuously related to subsequent all cause,
> cardiovascular, and ischaemic heart disease mortality
> through the whole population distribution, with lowest rates
> in those with HbA1c concentrations below 5%."
>
> Means lowest rates of death occur with A1c less than 5%.
>
> "An increase of 1% in HbA1c was associated with a 28%
> (P<0.002) increase in risk of death independent of age,
> blood pressure, serum cholesterol, body mass index, and
> cigarette smoking habit"
>
> Means that, starting at 5%, your risk of death increases by
> 28% for each 1% rise in A1c.
>
> I reckon that is pretty darn clear in both medicspeak and
> layspeak.
I can't speak for others or even so-called experts like doctors, etc.
But I can speak for myself. And things don't work like they tell me they
should. When I keep my BG in the 80 to 120 range, I lack energy to do
much of anything. And I have to stop and rest and thus I get nothing
done.
Although when I keep my BG in the 120 to 200mg/dL range, I feel great
and I have never ending energy. I am still keeping my BG in the 80 to
120 range, but I am considering this isn't the correct range for me. As
I can't live like this anymore. I really need my life back! I am really
close to saying the hell with 80 to 120 range and just keep it wherever
I feel better at.
I really feel science trying to put everyone into one group is
ridiculous! Sure it maybe great to get an overall average. But for the
individual, it is just worthless! For example, I can eat peanuts all day
long and nothing bad happens and I actually get regular. But if my aunt
just smells peanuts, it just may kill her. Big difference, eh? Since
this is a fact, why is it so strange to learn that many other things
also makes us differnet? The medical community are some of the dumbest
people I know, because they are too stupid to understand simple basic
facts.
--
Bill
DX 1992 (ignored till 4/2007)
A1c 4/2007 10.5
A1c 6/2007 7.4
A1c 8/2007 6.8
BillW50
Alan S typed on Sun, 10 Feb 2008 08:34:03 +1100:
> On Sat, 9 Feb 2008 15:11:18 -0600, "BillW50"
> <Bil...@aol.kom> wrote:
>
>>> Why do you assume that eating brings a spike? Eating a lot of carbs
>>> will likely cause a spike, but eating protein, non-starchy vegies,
>>> and fat won't cause a spike in most people.
>>
>> True Priscilla! But also true is that I take insulin 2 to 3 times a
>> day like many other diabetics. And I would be very, very happy
>> taking out all carbs from my food source. Unfortunately, taking
>> carbs out of my diet almost always causes very low BG.
>
> On milk and lettuce, why are you surprised? Whatever carbs
> you are eating, your insulin should be adjusted to balance
> that. You are way out of balance.
Alan... I eat very little nowadays. And my BG is usually too low, thanks
to the so-called experts. I agree with you, but the so-called experts
gets pissed whenever I adjust myself. As they know better they say and
screw everything up.
For example, I am told I am supposed to take 5R and 18NPH in the morning
and 7R and 7NPH in the evening. The reason why so much NPH in the
morning is to stop the high BG and the liver dumping for most people.
Well that is fine for most people, but my BG doesn't change while I am
asleep. Whatever it is when I go to bed, it is almost always the same
when I wake up. Which is totally different than most people.
>> And oddly enough, the lows
>> generally happen 4 to 6 hours after my regular and NPH injection. I
>> used aspart and NPH for a month and lows still happens in the same
>> time frame. I also found if I eat carbs after my injections, I have
>> less of a chance to have low BG readings 4 to 6 hours later. So how
>> can people like me avoid carbs and peaks?
>
> By eating the right portions of carbs, fats and protein and
> essential nutrients for your needs and, if insulin is
> needed, adjusting the insulin/carb ratio until it is
> correct. Beyond that, I'll leave insulin discussion to the
> experts.
>
> Balance and moderation Bill. Not extremes in any direction.
Experts are making it worse! My mom's BG is usually in the 40's to 80's
range. My dad's BG was all screwed up until he started to control it
himself and not listening to the doctors. I personally feel I should not
listen to the experts and do this myself and learn what works best. As
they are killing me with their method.
And the dietician wants me to lose 15 lbs by the end of this month (she
ask me to do this late November). But even eating very little isn't
working. What can I say? I'm 6'1" and weigh 224lbs (102 kilograms).
BillW50
Alan S typed on Sun, 10 Feb 2008 08:29:48 +1100:
> On Sat, 9 Feb 2008 14:12:09 -0600, "BillW50"
> <Bil...@aol.kom> wrote:
>
>> In news:jnfpq35amk3tgmvcq...@4ax.com,
>> DonnaB shallotpeel typed on Fri, 08 Feb 2008 15:56:21 -0500:
>>> Yes, I've been listening. And, in another post, finally, you
>>> replied, to someone else, that you got this way of eating from the
>>> military, although it seems that you got it as a means of losing
>>> weight - not as a way of getting your HbA1c down. I still have no
>>> idea where you got the idea that it was a way to eat for that
>>> purpose.
>>>
>>> But, look at the big picture. Why do you want to get your HbA1c
>>> down? To be healthier, longer as a diabetic. How can you do that? By
>>> getting the right balance of medication, exercise & food *for you*.
>>> Where should you aim for with your HbA1c? As low as you can get it
>>> *for you* without going too low.
>>>
>>> So, now, look at drinking milk & eating iceberg lettuce. How does it
>>> figure into the picture? It doesn't. It's not nutritional. There is
>>> no nutritional value in iceberg lettuce. (There once was a little
>>> bit but they've long since cut & discarded most, if not all, of
>>> that.) Iceburg lettuce is considered a 'free' food in terms of
>>> calories. It can give one the pleasure of chewing, add some fiber &
>>> make the stomach feel full, if you're trying to lose weight or eat
>>> smaller portions, etc., etc. So, that leaves you with dairy only.
>>>
>>> Are these the only foods you have access to? Are you allergic to all
>>> other foods? Can you just not stand to eat anything else?
>>>
>>> What kinds of supplements do you take?
>>
>> Well Donna... I am told over and over again that diabetics has to
>> eat 3 times a day. And I have such a hard time making sense out of
>> this. And for some people like me, I don't even feel hungry until 2
>> to 3 days without eating. When you eat 3 times a day, you spike
>> three times a day. Why not just spike only once a day, isn't that
>> better? Isn't that giving you better average BG and A1c? Yes I think
>> so.
>>
> No, I don't. Presuming the same calories and carbs in the
> day, if you break up that one big meal into at least three
> of 1/3 the portion size (for me it's 5+) then you change
> from one giant spike to lots of little blips. Think about it
> a bit longer.
No I am not talking about pigging out Alan. I don't feel hungry, so I
don't need to eat a lot, remember? And I feel fine eating 200 to 500
calories once a day. Thus why do that 3 times a day when once a day
works better? I understand some (okay most) people feel ill if they eat
only once a day, but I don't. And since I am different than others, why
do I have to follow other peoples habits? It just doesn't make sense to
me.
>> Yes I believe some people need to eat 3 or more times a day. Heck
>> very many people I have talked to (diabetics and non-diabetics) have
>> told me they get very bad headaches when they skip a meal. And I
>> have a hard time relating to these people because I never ever felt
>> that way in the last 32+ years.
>>
>> Supplements? I take a multi called Certagen. I saw Dr. Oz on TV a few
>> days ago and he said to break multivitamins in half and take both
>> halves. I thought that was a good idea. But I take a half in the
>> morning and the other half in the evening before meals.
>>
>> http://jn9.co.uk/pharmacy/d-455942140-Goldline_Certagen_Tablets_100ct.php
>
> Have you ever been tested for other types such as LADA or
> MODY?
Very doubtful. I don't even know what they mean.
BillW50
krom typed on Fri, 8 Feb 2008 08:45:18 -0600:
> Bill the amount of carbs a person needs is entirely up to thier
> system.
Agreed! :)
> To say starving yourself is the solution to lowerign blood glucose is
> like saying smashing ones face with a hammer is a good way to stop
> smoking..will it work?..possible but theres far better ways to get it
> done.
I quit smoking back in '81, got fat, and I got diabetes! If I continued
to smoke, would I have diabetes today? My parents also quit smoking and
they got diabetes too. Screw it! I started smoking again 15 years ago
and I never felt better. I only smoke outside and I feel this makes a
big difference.
> This is why most here stress testing to find out what carbs and foods
> raises you and what ones do not.
True, but the same foods each day doesn't cause the same BG effect.
Although it maybe somewhat predictable, but not always.
> For example if i want to eat fruit i know a bannana or apple will
> spike me but pineapple and most all berries will not.
> So i eath those fruits which dont spike me and the same applies to
> all foods i eat.
Sometimes a banana almost does nothing. And sometimes it rises me up 40
or more mg/dL. The lower the BG, the higher it usually rises me. But not
always.
> Theres some beans that will raise..some that wont..so i am basiclaly
> eating the same menu as a non diabetic who is eating healthy..just
> different choices.
Since nothing is predictable for me, I believe feeding your body what it
carves is best. And I rarely carve carbs, so that works most of the time
for me.
> A none diabetic might eat a meal of checiken potato and
> broccoli...and i would eat the chicken and broccoli and replace the
> potato with cauliflower/potato mix to avoid the spike but im eating
> jsut as nutritiously.
Yes true.
> I too think you might be having a bit of fun with us but if not then
> i hope you will seriously discuss making the choice to modify your
> diet and test to see whats best for you.
>
> It is your life at stake.
No I *only* speak totally honestly! My real life experiences are vastly
different than medical science. Sometimes I wonder what planet they are
from? So I can understand why some would think so. :(
BillW50
krom typed on Sun, 10 Feb 2008 01:27:26 -0600:
> Well thats why we are here to figure this stuff out.
>
> Maybe a timed released metformin would stabalise you more?
>
> I dunno just tossing that out there..
>
> KROM
>
> "BillW50" <Bil...@aol.kom> wrote
>> Yes I am serious about diabetes. And doing it so-called right way
>> isn't working for me very well. As I was untreated for 15 years and
>> most of that 15 years, I felt much better than I do right now. And
>> having my BG is the normal range, I feel awful 50% of the time.
>> Meaning severely lacking energy.
Yes I love for all of us to figure this all out. Yesterday I goofed and
I gave myself my evening dose of insulin in the morning. Which is far
less than my morning dose. And I have felt the best I have in the last 6
months. My BG stayed good 127 (morning), 83 (noon), and 116 (dinner).
Today I tried the same, and it was 121 in the morning, but I had a
sandwich corn beef for breakfast (far more carbs than usual and it was
all in 2 pieces of white bread) and I peeked at noon at 202. I hit
myself with more insulin (unusual for a noon shot) and 2 hours later I
am 164. So I screwed up with eating two pieces of bread. If I had my
regular dose, I probably would have been ok in this case. But I normally
don't eat any carbs for breakfast or lunch. To be honest though, I feel
great! I have had close to normal BG readings since April of last year.
And normal makes me feel really weak even today.
I would love to try Metformin. But the so-called experts want me on
insulin. I suppose ignoring my diabetes for 15 years gave them that idea
that pills won't do it for me. I dunno, I am willing to try anyway to
see what happens.
Alan S
<Bil...@aol.kom> wrote:
>I can't speak for others or even so-called experts like doctors, etc.
>But I can speak for myself. And things don't work like they tell me they
>should. When I keep my BG in the 80 to 120 range, I lack energy to do
>much of anything. And I have to stop and rest and thus I get nothing
>done.
>
>Although when I keep my BG in the 120 to 200mg/dL range, I feel great
>and I have never ending energy. I am still keeping my BG in the 80 to
>120 range, but I am considering this isn't the correct range for me. As
>I can't live like this anymore. I really need my life back! I am really
>close to saying the hell with 80 to 120 range and just keep it wherever
>I feel better at.
>
>I really feel science trying to put everyone into one group is
>ridiculous! Sure it maybe great to get an overall average. But for the
>individual, it is just worthless! For example, I can eat peanuts all day
>long and nothing bad happens and I actually get regular. But if my aunt
>just smells peanuts, it just may kill her. Big difference, eh? Since
>this is a fact, why is it so strange to learn that many other things
>also makes us differnet? The medical community are some of the dumbest
>people I know, because they are too stupid to understand simple basic
>facts.
Bill, I agree that we are all different. But I don't agree
that we are so different that 120-200 is OK on a long-term
basis.
But it's your body, your life. In your position I'd be
talking to your doctor because you may have an undiagnosed
cause of that fatigue unrelated to your diabetes.
However, we are never going to agree; I don't see a lot of
point in further argument. As I said, it's your body, your
life.
Best wishes.
Alan S
<Bil...@aol.kom> wrote:
Bill, the best advice I can offer you is to find a new
doctor to work with, go back to a normal diet to set a
baseline under the doc's supervision for any needed changes
in insulin dosage, and start again.
At 6'1" and 102 Kg you are a tad overweight but not obese.
So forget weight for the moment and concentrate on those
BG's in consultation with the new doc. And with a good,
nutritious, moderate menu as a starting point.
Alan S
<Bil...@aol.kom> wrote:
>I would love to try Metformin. But the so-called experts want me on
>insulin.
Bill you should be arguing this case with them, not us.
BillW50
Alan S typed on Sun, 10 Feb 2008 07:35:02 +1100:
> Was "Lower A1c's Increase Death Risk?"
>
> On Sat, 9 Feb 2008 13:07:53 -0600, "BillW50"
> <Bil...@aol.kom> wrote:
> <snip>
>> Yes I am serious about diabetes. And doing it so-called right way
>> isn't working for me very well. As I was untreated for 15 years and
>> most of that 15 years, I felt much better than I do right now. And
>> having my BG is the normal range, I feel awful 50% of the time.
>> Meaning severely lacking energy.
>
> would you have considered a good breakfast? A good lunch? A
> good dinner? What did you eat for snacks?
We have been through this before Alan. Although updated:
Breakfast:
1) Nothing, or
2) One egg, or
3) 15 peanuts, or
4) A cold hot dog or two
Lunch:
Usually 15 peanuts if I am hungry or if I skipped breakfast (most of the
time).
Dinner:
I don't know, it varies. Hamburger with fries, pastie (most people don't
know what this is), spaghetti, fish, pork, pizza, salad, or whatever.
> May I suggest that you re-start there. Pick one to start
> with; say, breakfast. Of course, you could keep doing what
> you're doing. It's entirely up to you.
If I am not hungry, I feel I should not eat. I was in the hospital once
and when they started treating my diabetes (4/2007). I swear they gave
me a pound of food 3 times a day. They gave me diabetic foods they said.
Although it was low in calories, not necessary low in carbs. And they
wanted to make sure I ate everything they gave me. Okay I did and I
didn't like it. I thought they wanted me to do this to adjust my
insulin. Sadly, it had nothing to do with it. It was the way they
expected me to eat. No way, I can't eat all of that everyday. Just for 5
days was really pushing it. I didn't like eating that much and if I had
to do it again, I wouldn't go along with their plan.
> I read what you said about variable results, but over time
> you can discover trends that may work.
Well you can see trends ok, but even sticking to the same everyday can
be very different. Especially over time. Your medication can change,
your body can change, illness can change, etc.
> Eat, then test after eating at your spike time (NOT
> necessarily two hours, but your PEAK which may be much
> earlier) and if BG’s are too high then review what you ate
> and change the menu next time. Then do that again, and
> again, and again until what you eat doesn’t spike you. You
> will get some surprises, particularly at breakfast time. The
> so-called "heart-healthy" breakfasts are NOT for most type
> 2's.
Alan, sometimes I peek in 90 minutes, sometimes I peek in 4 or more
hours.
> As you gradually improve your blood glucose levels, review
> the resulting way of eating to ensure adequate nutrition,
> fibre etc are included and adjust accordingly. That is
> critical - your present menu is ghastly. Try some breakfast
> ideas from here:
> http://loraldiabetes.blogspot.com/2006/10/breakfasts.html
>
> Then test again. And again, and again, and again until you
> can reasonably consistently predict the out come.
>
> Then move on to lunch. Then dinner.
>
> Best wishes.
Yes I believe in testing over and over again. But I believe you can't
stop testing as it changes daily as well. And I have a hard time
following people (even the so-called experts) say you have to eat this
way and do this. Most of them don't follow their own advice first of
all. Secondly if they do, just because it works for them doesn't mean it
will work for me or anybody else.
Listen to me for second. A lot of people put a lot of trust in medical
science. Heck I used too as well. But there are tons of evidence that it
just doesn't work as they say it does. Take Old Tom Parr for example. He
was born in 1483 and lived supposedly 152 years old (died in 1635). As
great as medical science goes, can they promise you longer life than Old
Parr? Nope! Not at all! Thus why trust in those broken promises? Who are
they trying to kid? Real intelligent people should not buy what they are
selling.