The Sugar Alcohols May Not Affect BG Within The 1 or 2 Hours After A Meal That

Sugar alcohols are neither sugars nor alcohols. They're found in artificially sweetened foods, especially candy and sugar free gum. Most people tolerate them okay, but many complain of gas and diarrhea if too much is ingested. Wikipedia has a good article, but unfortunately, it uses a lot of technical-chemical language. Still and all, there's some solid info there (including the names of various sugar alcohols that you can find on ingredient lists).

The other thing you need to know about sugar alcohols is that although individuals vary, for the vast majority of people they act on blood sugar like half that amount of sugar: in other words, a candy with 10g of sugar alcohol is going to have the same effect as candy with 5g sugar.

Some people also find that although the sugar alcohols may not affect bg within the 1 or 2 hours after a meal that we generally test, they may cause an "unexplained" spike many hours later.

I'm sorry, I don't recall where I got the information; it was from a source I found likely to be valid at the time, but remembered only the information and not the context.

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Why would that hold true, or does it?

>I am still titrating my Lantus / Humalog dosage. At present I am shooting 60 units of Lantus at bedtime. My Humalog formula is one unit for each three carbs at mealtime plus a correction factor of (Meter BG - 120) / 20. This is pretty close but not yet perfect. I am curious about other folks' formulas.<

My insulin to carb ratio is 1 to 2 (1 unit of Humalog for every 2 carbs). My correction factor is 4 units for every 10 (maybe it's 15, I forget, since I don't use this very often) points over 120 on the meter pre-meal.

>I read somewhere the fast acting total for the day will be right around the amount of the long acting shot. Why would that hold true, or does it?<

FWIW, I've never heard that. Really, I don't know why that'd be true, since the two insulins have very different absorption rates and roles in the management of diabetes. I take 110 (55+55) units of Lantus and somewhere between 120 and 150 of Humalog daily, but that dosage schedule has been arrived at after literally years of ups and downs and adjustments, and I consider it very individual and absolutely not applicable to anyone in the world but me.

>What about Lantus split into two shots 12 hours apart versus one shot every 24 hours?<

It's probably too early in the game for you to make that change, simply because you don't yet know for sure what your final dosage destination is. You're adjusting both Lantus and Humalog at the same time, which I think would be kind of confusing all by itself, and to suddenly throw in this change (splitting the Lantus dose) would leave you wondering what's what. You certainly could ask your doc about it, of course, and the decision would be up to the two of you. Lantus and Levemir are considered 24 hour basal insulins, but the truth is, they don't "last" 24 hours in everyone. I was dosing at bedtime and then ending up too high in the evenings, so we decided to try dividing the Lantus into two equal doses approximately 12 hours apart. So far, I consider this a win for me-- I feel much more "even" all during the day and night, and I know I'm in a lot better control during the evening hours. But it took quite a while, at least 2-3 months, for me to really feel sure that this 12 hour thing is something that's to my advantage. Often when insulin changes are made like this, it takes a while to see the final result. At least it does in me. I'm curious to see if it makes any diff in my next A1c (one could hope...)

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How about a little sausage?

If you have the time you could make your own and freeze them, they don't have to be in skins. Buy mince meat and add seasoning and roll them and open freeze or alternatively flatten them to make a pattie, then fry along with eggs for breakfast. In Australia our butcher isn't allowed to add preservatives to mince but I am sure there are preservatives and goodness knows what else in sausages. In my opinion they are convenient, tasty but not the healthiest protein source. But it depends on how much time one has. Are eggs okay? How about a little sausage? Eggs are great. Read the label on the sausage: many have quite a bit of sugar or starchy filler.

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Substituting Tofu for Noodles Does Reduce The Number of Carbs

Good news, indeed! And substituting tofu for noodles does reduce the number of carbs. Good choice! But a caution... Rely on your own knowledge of what is "kidney-wise" and "diabetic-wise" to decide whether what they are serving is truly a wise choice for you. Others may have good intentions but their understanding may be skewed. How wonderful that you have found such flexible restauranteurs!

Today, I went in for my pho and had a bowl of spicy soup, but with fewer noodles and more bean sprouts. I also told the owners, whom I also consider to be friends, that I'm diabetic and would probably be coming in less often because I couldn't rationalize the carbs. But they are good businessfolk as well as friends and told me that they would be happy to make kidney-wise )(a phrase I invented today)dishes for me. For instance, they could substitute tofu for noodles and that they serve two or three filling salads, and that beyond that Nikko might be able to come up with thingswe hadn't even contemplated yet. So my little lunch ritual stays intact with some adjustments from my good friends at the Broadway Cafe.

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Talk To Your Doc About Getting Off The Metformin Altogether

I am not so sure about shooting insulin and being on Metformin also. It does not make a lot of sense to me. Talk to your doc about getting off the Metformin altogether. If he thinks it is better to stay on the Metformin, ask him why not start another oral antiglycemic in addition to Metformin rather than starting insulin at this point.

The cartridges cost the same as the disposable pen. We found out the pharmacist messed up and gave us the wrong things. It has finally been fixed and we are using the disposable pens as the dr ordered. One other thing is that the refills are not for the Solarstar but the OptiClick. The pen itself (for the refills) has to be gotten from you doctor. I did get to see the price on both and belive it or not they are the exact (to the penny) the same price. Both are 202.58. Shocked me. I do wish to appologize for the amount of time it has taken me to respond. I have been sick and so has my husband. I am also getting ready for a day trip tommorrow for possible Jury duty (over 2 hours away). And yes they can do that when it's the state grand jury.

Also on an update note: We found that the easiest way for him to get the insulin is in the very back of his arm. He can't reach that so I do give him his shot each night. The stomach burns, the legs are almost no fat at all and the sides of the arms are muscular. I don't mind helping him with this. He is up to 25 units of Lantus each night with an up in the Metformin to 2000 mg per day (that's the max right?). Anyway his numbers are still up there and the diet is also under tight control. He is allowed (by mutual agreement) one snack a day and one sweet treat a week provided he exercises daily. The once a week thing was his ideal but the exercise part was mine (he agreed to have only one a week if he did something to improve his numbers and I suggested exercise). I do believe he is gonna get there it's just taking longer than either of us expected. We were so naive as to think take a shot numbers are normal.

I use the disposable pens. How much less do the pens that use the cartridge cost. More specifically, not the reusable pen, but the little vials it uses? Looks like it would be cheaper.

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Pasteurized Milk and Such Being A Great Benefit

My great grandmother was just a few weeks shy of 100 when she passed away, and the majority of my relatives on both my Mom's and my Dad's side of the family all lived well into their 80's and 90's. It is only recently that we are seeing chronic health problems (not related to advanced old age), and a sudden appearance of autoimmune diseases. I agree about pasteurized milk and such being a great benefit, but I do think that certain additives and preservatives are not good, and I think refined foods are worse. And, if I had any doubts, they would have been put to rest by the college research I did over two semesters following Cornell, Johns Hopkins, and other major medical studies. That was an eye opener, even though I thought I had a good understanding of how nutrition affects disease beforehand. (Not so much!) I don't know the book or article being referenced, though. Or was it an article?

Problem is your great grandparents would not have recognized an avocado or an artichoke among thousand of other wonderful foods. They would have recognized a host of foods we now consider unhealthy, and would have probably used lots and lots of lard. This fellow's advice is silly. The principal fallacy here is that processed foods are inherently evil. I believe I will go for pasteurized milk over raw milk myself.

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Pasteurized Milk and Such Being A Great Benefit

My great grandmother was just a few weeks shy of 100 when she passed away, and the majority of my relatives on both my Mom's and my Dad's side of the family all lived well into their 80's and 90's. It is only recently that we are seeing chronic health problems (not related to advanced old age), and a sudden appearance of autoimmune diseases. I agree about pasteurized milk and such being a great benefit, but I do think that certain additives and preservatives are not good, and I think refined foods are worse. And, if I had any doubts, they would have been put to rest by the college research I did over two semesters following Cornell, Johns Hopkins, and other major medical studies. That was an eye opener, even though I thought I had a good understanding of how nutrition affects disease beforehand. (Not so much!) I don't know the book or article being referenced, though. Or was it an article?

Problem is your great grandparents would not have recognized an avocado or an artichoke among thousand of other wonderful foods. They would have recognized a host of foods we now consider unhealthy, and would have probably used lots and lots of lard. This fellow's advice is silly. The principal fallacy here is that processed foods are inherently evil. I believe I will go for pasteurized milk over raw milk myself.

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A Simple Infection Would Kill You

Are you serious? Take a walk through any old graveyard and note the ages of death for folks before the age of modern medicine (that can be considered before the discovery of antibiotics (WWII) or in our case perhaps before insulin). Things were not better before processed foods, they were horribly worse. Every Type I diabetic died a horrible and young death, A simple infection would kill you. Countless folks died just from a case of diarrhea. As to nutrition and health, the research is still scant and often half-assed. This is partly true because the ties are weak, and partly true because there are no monied interests wanting to fund same. Lets say it was true the broccoli was the miracle cure for cancer (it's not, of course); who stands to make a fortune from that?

My great grandmother was just a few weeks shy of 100 when she passed away, and the majority of my relatives on both my Mom's and my Dad's side of the family all lived well into their 80's and 90's. It is only recently that we are seeing chronic health problems (not related to advanced old age), and a sudden appearance of autoimmune diseases. I agree about pasteurized milk and such being a great benefit, but I do think that certain additives and preservatives are not good, and I think refined foods are worse. And, if I had any doubts, they would have been put to rest by the college research I did over two semesters following Cornell, Johns Hopkins, and other major medical studies. That was an eye opener, even though I thought I had a good understanding of how nutrition affects disease beforehand. (Not so much!) I don't know the book or article being referenced, though. Or was it an article?

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Metformin-Insulin Combo for Diabetes

Metformin is popular because it works well, is generally well tolerated, hardly ever causes hypo episodes, and is a doctor's wet dream for easy patient management. It is not without risk, however. The relatively huge doses required (up to two grams daily) can damage kidneys or cause other problems. I still question the wisdom of not discontinuing it when insulin therapy is initiated. There are of course other opinions. Personally, I am glad to be off of Metformin after nearly a decade of using it. It contributed to my kidney problems at the very least, and may have been the principal cause.

>I am not so sure about shooting insulin and being on Metformin also. It does not make a lot of sense to me. Talk to your doc about getting off the Metformin altogether.<

Lots of us are on both insulin and metformin-- believe me, it's not an unusual combo of meds. After all, metformin is not a hypoglycemic, plus any drug that will help a type two be less insulin resistant as well as help keep the liver from doing those unfortunate glucose dumps quite so readily, well, when it works, it's very effective.
Anyone with normal kidney function is a good candidate for at least a trial course of metformin, if they can't get their glucose under control with just diet and exercise. In fact, from what I see, metformin seems to be the first go-to drug most docs are using these days. Naturally, careful, regular monitoring is necessary to make sure liver and kidney functions stay within normal limits.

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Warm Face and Flushed?

Blisters suggest something other than neuropathy.. .maybe. Have you looked at some kind of allergic reaction, perhaps? If it was on only one extremity at a time, we might suspect herpes zoster (chikenpox), but that is unlikely if the outbreaks are symmetrical. While we are on the subject of possible "reactions" -- has anyone with neuropathy had any experience with red, hot, burning lower legs or feet? Mine seems to be limited to the fronts of my shins -- but gradually creeping around to the back sometimes. When I have a flare, there are sometimes blisters, and if they grow, take a long time to heal.

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