Carbs and strange bg behaviour

Michael, I am T1 and don't really understand much of anything when it comes to T2. The only thing
that makes sense to me is that the 50g carbs you referenced are possibly slower acting carbs, such
as whole grains. Or, possibly slow acting carbs with fats. The fats will delay the carbs absorption.

Watch out for those ketones! I've dealt with DKA, and it is no fun. (Ketones scare the dickens
out of me.)

I will be watching this thread with interest. I hope someone has some good ideas about this mystery.

Steph

"Michael Wäsch" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

Hi there,

I am type 2. Cirrently no meds, diet and excercise only.

When I eat 20g of carbon hydrates my bg level would rise from 110 mg/dl to 200 mg/dl and stay
there for 4 hours, me spitting ketones (up to ++ positive). After 4 hours I would have 250 mg/dl
(and no more ketones) and one hour later I would be at 130 mg/dl.

But: If I ate 50g of carbon hydrates, my bg levels would only rise up to 170-190 mg/dl and after 4
hours I would be at 120-130 mg/dl.

How comes? Any ideas?

More strange values:

If I eat 50g carbon hydrates starting with 120 mg/dl I'd get, as said before, 180 after meal. Now
in several cases I had to start eating with 170 mg/dl and thought I would get really high values,
may be even forcing me to apply insulin, but nothing happend. 1,5 hrs after meal I had 185 mg/dl.

Weird?

Michael

"Michael Wäsch" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Hi there,

I am type 2. Cirrently no meds, diet and excercise only.

When I eat 20g of carbon hydrates my bg level would rise from 110 mg/dl to 200 mg/dl and stay
there for 4 hours, me spitting ketones (up to ++ positive). After 4 hours I would have 250 mg/dl
(and no more ketones) and one hour later I would be at 130 mg/dl.

The ketones thing bothers me Mike. As a T2, you shouldn't be spilling them at those levels. I'd
suggest (as an option) another trip to your doc for a more "in depth" look at your diabetes. Ketones
are usually associated with a LACK of insulin, not an excess which is common among T2's.

Also, at four hours after eating such a miniscule amount of carbs, you shouldn't be anywhere NEAR
250. You may hit a 250 some time between eating and TWO hours, but definitely not four hours. This
is sounding more and more like an early start to adult onset T1 to me.

Quoted message said:

But: If I ate 50g of carbon hydrates, my bg levels would only rise up to 170-190 mg/dl and after 4
hours I would be at 120-130 mg/dl.

How comes? Any ideas?

Unfortunately, it's a strange disease and one day I can eat a meal containing 50 - 60 grams of carbs
and not go above 100, and on another day I'll DROP to almost hypo levels for the same meal and the
same amount of insulin/exercise. No two days are alike.

Quoted message said:

More strange values:

If I eat 50g carbon hydrates starting with 120 mg/dl I'd get, as said before, 180 after meal. Now
in several cases I had to start eating with 170 mg/dl and thought I would get really high values,
may be even forcing me to apply insulin, but nothing happend. 1,5 hrs after meal I had 185 mg/dl.

Weird?

Not really, just the nature of the beast., but Istill thik another trip to your doc is in order.
Please go there:-)

Beav

Beav said:

"Michael Wäsch" <[email hidden]> wrote in message "]news:[email hidden]...

Quoted message said:

Hi there,

I am type 2. Cirrently no meds, diet and excercise only.

When I eat 20g of carbon hydrates my bg level would rise from 110 mg/dl to 200 mg/dl and stay
there for 4 hours, me spitting ketones (up to ++ positive). After 4 hours I would have 250 mg/dl
(and no more ketones) and one hour later I would be at 130 mg/dl.

The ketones thing bothers me Mike. As a T2, you shouldn't be spilling them at those levels. I'd
suggest (as an option) another trip to your doc for a more "in depth" look at your diabetes.
Ketones are usually associated with a LACK of insulin, not an excess which is common among T2's.

Also, at four hours after eating such a miniscule amount of carbs, you shouldn't be anywhere NEAR
250. You may hit a 250 some time between eating and TWO hours, but definitely not four hours. This
is sounding more and more like an early start to adult onset T1 to me.

Quoted message said:

But: If I ate 50g of carbon hydrates, my bg levels would only rise up to 170-190 mg/dl and after
4 hours I would be at 120-130 mg/dl.

How comes? Any ideas?

Unfortunately, it's a strange disease and one day I can eat a meal containing 50 - 60 grams of
carbs and not go above 100, and on another day I'll DROP to almost hypo levels for the same meal
and the same amount of insulin/exercise. No two days are alike.

Quoted message said:

More strange values:

If I eat 50g carbon hydrates starting with 120 mg/dl I'd get, as said before, 180 after meal. Now
in several cases I had to start eating with 170 mg/dl and thought I would get really high values,
may be even forcing me to apply insulin, but nothing happend. 1,5 hrs after meal I had 185 mg/dl.

Weird?

Not really, just the nature of the beast., but Istill thik another trip to your doc is in order.
Please go there:-)

Beav

Hi Michael

First, I agree with Beav. It's time to see your doctor to explain this properly.

Just a couple of thoughts. You don't mention some other factors - the type of carbs because their GI
may significantly affect the timing and length of a spike; the time of day because dawn effect or a
liver dump may be involved; or even the time since the last meal if a short fast was involved.

But even if all those factors were involved, the ketones would send me straight to the doc.

Let us know what he says please; it may help one of us as well.

Cheers Alan, T2, Oz. dx May 2002 , A1C 8.2=>5.8, wt 117kg=>90kg, no meds, diet and not enough
exercise. I have no medical qualifications beyond my own experience. Choose your advisers carefully,
because experience can be an expensive teacher.
--
Everything in Moderation - Except Laughter.

Hi,

Quoted message said:

are possibly slower acting carbs, such as whole grains. Or, possibly slow acting carbs with fats.
The fats will delay the carbs absorption.

I am always slowing down carbs with fats. Bread with lots of butter, chesse
e.g. and meals with salads (olive oil). I have also experienced that if I eat some "fast" carbs with
my meals (ketchup containing glucose) my bg levels are even better. In some cases they stay
below 160 mg/dl all the time.

Quoted message said:

Watch out for those ketones! I've dealt with DKA, and it is no fun. (Ketones scare the dickens
out of me.)

Out of me too, but they laughed at me twice in hospital, complaining that ketones can't be harmful
if I had bg around 130 mg/dl. In my bad times I had bg levels >>330 mg/dl an guess what, no ketones.
I only have ketones with low values.

Quoted message said:

I will be watching this thread with interest. I hope someone has some

good

Quoted message said:

ideas about this mystery.

I have my ideas as well, but do not want to share them right now in order not to get
influenced answers.

Michael

Hi,

Quoted message said:

The ketones thing bothers me Mike. As a T2, you shouldn't be spilling them at those levels. I'd
suggest (as an option) another trip to your doc for a more "in depth" look at your diabetes.
Ketones are usually associated with

a

Quoted message said:

LACK of insulin, not an excess which is common among T2's.

As I just told Stephanie: They just would laugh at me at hospital. I was told (over and over again)
that I am only in danger when my bg levels are higher than 300 mg/dl and ketones are +++ positive.
Then there is a chance of a developing ketoacidosis. Ketosis with 100-200 mg/dl doesn't eben my
specialist doc.

And then I was told (over and over again) that ketones ++ positive could also arise from not
having eaten.

Quoted message said:

Also, at four hours after eating such a miniscule amount of carbs, you shouldn't be anywhere NEAR
250. You may hit a 250 some time between eating and TWO hours, but definitely not four hours. This
is sounding more and

more

Quoted message said:

like an early start to adult onset T1 to me.

I was recently tested an diagnosed: HBA1c = 6,4 C-Peptid = 2,5, antibodies = normal. Doc: "Nothing
indicates some sort of Type-1-diabetes, but everything points towards Type-2-Resistency-Diabetes.
Its ok for me If you cease applying insuline, but don't throw it away, it could be, that you will
need it again."
MW: "When?" Doc: "That can't be said. Next year, next decade or even never.".

Quoted message said:

I'll DROP to almost hypo levels for the same meal and the same amount of insulin/exercise. No two
days are alike.

I can't drop to hypo levels.

Quoted message said:

Not really, just the nature of the beast., but Istill thik another trip to your doc is in order.
Please go there:-)

To get another portion of laughter?

Michael

On Fri, 13 Feb 2004 22:48:25 +0100, "Michael Wäsch" <[email hidden]>

Quoted message said:

Hi,

Quoted message said:

The ketones thing bothers me Mike. As a T2, you shouldn't be spilling them at those levels. I'd
suggest (as an option) another trip to your doc for a more "in depth" look at your diabetes.
Ketones are usually associated with

a

Quoted message said:

LACK of insulin, not an excess which is common among T2's.

As I just told Stephanie: They just would laugh at me at hospital. I was told (over and over again)
that I am only in danger when my bg levels are higher than 300 mg/dl and ketones are +++ positive.
Then there is a chance of a developing ketoacidosis. Ketosis with 100-200 mg/dl doesn't eben my
specialist doc.

And then I was told (over and over again) that ketones ++ positive could also arise from not
having eaten.

Quoted message said:

Also, at four hours after eating such a miniscule amount of carbs, you shouldn't be anywhere NEAR
250. You may hit a 250 some time between eating and TWO hours, but definitely not four hours.
This is sounding more and

more

Quoted message said:

like an early start to adult onset T1 to me.

I was recently tested an diagnosed: HBA1c = 6,4 C-Peptid = 2,5, antibodies = normal. Doc: "Nothing
indicates some sort of Type-1-diabetes, but everything points towards Type-2-Resistency-Diabetes.
Its ok for me If you cease applying insuline, but don't throw it away, it could be, that you will
need it again."
MW: "When?" Doc: "That can't be said. Next year, next decade or even never.".

Quoted message said:

I'll DROP to almost hypo levels for the same meal and the same amount of insulin/exercise. No two
days are alike.

I can't drop to hypo levels.

Quoted message said:

Not really, just the nature of the beast., but Istill thik another trip to your doc is in order.
Please go there:-)

To get another portion of laughter?

Michael

Michael

I have no idea how difficult it may be in your situation, but I know I'd be changing doctors.
Yesterday.

Laughter is great therapy - when you are the one laughing. I have grave doubts about it's
therapeutic value when the doc is laughing at you.

Cheers Alan, T2, Oz. dx May 2002 , A1C 8.2=>5.8, wt 117kg=>90kg, no meds, diet and not enough
exercise. I have no medical qualifications beyond my own experience. Choose your advisers carefully,
because experience can be an expensive teacher.
--
Everything in Moderation - Except Laughter.

Hi,

Quoted message said:

But even if all those factors were involved, the ketones would send me straight to the doc.

Let us know what he says please; it may help one of us as well.

See above. You just would get laughed at. Please remember. I live in Germany, that means that I live
in a third world country concerning medical assistance. Keep that in mind.

The last time I was in hospital when I was high in ketones they refused to treat me, arguing that I
was not in immediate danger, since my bg levels were quite low. They told me that they had to treat
other people first and so I saw an aold woman who had real pain in her stomach and was near complete
breakdown. Her daughter was with her and since I was following their discussion I learned, that this
poor lady had to wait 5 hours in the emergency room in order to get treatment. Then, finally, the
doc arrived and told that poor lady: "Ma'am, you are full of [censored]! We can't do anything for you. Go
home, drink a lot and have a huge dump!".

Wow, that did it for me. I had to leave the room, because I had to laugh so loud, although it wasn't
funny at all. I went straight home, refusing to let me treat by those [censored], had two Big Macs and
my 3 IE Human-R did fine in handling it.

BTW. I have diabetes since 1995, treated with oral antidiabetica. Then it became insuline dependent
in 2003 due to liver problems and Eppstein-Barr-Virus. Then the virus (ugly thing, hold you down
for more than 6 months) expired, my liver recovered and my insuline dependency was gone with the
wind so to speak.

My doc (regular doc) wanted to give me some sort of glitazone (as stand alone) to lessen my insuline
resistance but my other doc (specialist dor diabetes) did not agree. He said: "I'm not here to
execute your liver! Make excercises instead!".

Michael

Hi,

Quoted message said:

I have no idea how difficult it may be in your situation, but I know I'd be changing doctors.
Yesterday.

I can't change. After a year full of change and search, these are the best. All other are much less.
Please keep in mind that Germany now is a third world country!

Quoted message said:

Laughter is great therapy - when you are the one laughing. I have grave doubts about it's
therapeutic value when the doc is laughing at you.

They didn't want to treat me. I was really close in just getting away with my complaints and not
landing in the psychiatry. That's just to show you how bad medical care is in Germany.

I can tell you stories, you would not believe (me either, but I experienced it). There's no chance,
no help, no escape.

BTW: I have those ketones for years. Nothing ever happend, and I am fully aware that I have to call
the emergency immediately if I start to drink huge amounts of liquid, have to stay on the toilet
just for peeing, have to vomit and bg levels are out of control.

Well, as said, I have my own conclusions about this strange behaviour of my bg levels and
ketones some times, but please allow me to wait until more answer come in, then I will share my
thoughts with you.

Michael

Michael Wäsch said:

Out of me too, but they laughed at me twice in

hospital, complaining

Quoted message said:

that ketones can't be harmful if I had bg around 130

mg/dl. In my bad

Quoted message said:

times I had bg levels >>330 mg/dl an guess what, no

ketones. I only

Quoted message said:

have ketones with low values.

You can show ketones if you are eating very low carb.

"Michael Wäsch" <[email hidden]> wrote in message
"]news:[email hidden]...

Quoted message said:

Hi,

Quoted message said:

The ketones thing bothers me Mike. As a T2, you shouldn't be spilling

them

Quoted message said:

Quoted message said:

at those levels. I'd suggest (as an option) another trip to your doc for

a

Quoted message said:

Quoted message said:

more "in depth" look at your diabetes. Ketones are usually associated

with

Quoted message said:

a

Quoted message said:

LACK of insulin, not an excess which is common among T2's.

As I just told Stephanie: They just would laugh at me at hospital. I was told (over and over
again) that I am only in danger when my bg levels are higher than 300 mg/dl and ketones are +++
positive. Then there is a chance of a developing ketoacidosis. Ketosis with 100-200 mg/dl doesn't
eben my specialist doc.

Only in danger of ketoacidosis, but that doesn't mean you're doing yourself any good by spilling
ketones. It wasn't really the concern about reaching DKA that prompted me to mention it Mike, is was
purely the fact that as a T1 I've NEVER spilled ketones since dx, and as a (supposed) T2, they're
not something you shuld EVER see unless you're eating a no or ultra low carb diet. I didn't get the
impression you were doing either.

Quoted message said:

And then I was told (over and over again) that ketones ++ positive could also arise from not
having eaten.

Indeed, because ketones usually present when there's too little insulin, not too much sugar. This is
why I mentioned it. If you're spilling ketones, your medication isn't correct.

Quoted message said:

Quoted message said:

Also, at four hours after eating such a miniscule amount of carbs, you shouldn't be anywhere
NEAR 250. You may hit a 250 some time between

eating

Quoted message said:

Quoted message said:

and TWO hours, but definitely not four hours. This is sounding more and

more

Quoted message said:

like an early start to adult onset T1 to me.

I was recently tested an diagnosed: HBA1c = 6,4 C-Peptid = 2,5, antibodies

=

Quoted message said:

normal. Doc: "Nothing indicates some sort of Type-1-diabetes, but everything

points

Quoted message said:

towards Type-2-Resistency-Diabetes. Its ok for me If you cease applying insuline, but don't throw
it away, it could be, that you will need it again."
MW: "When?" Doc: "That can't be said. Next year, next decade or even never.".

Or even today? If you're running the levels you ARE running, then you either need insulin or some
medication to address your resistance problem, but again, if you're insulin resistant, you'll more
than likely to be producing excess amounts of the stuff and that would all but eliminate the chances
of spilling ketones. Your A1c's aren't "whoopie" either, as you've gone beyond the point the DCCT
use as a "trigger" for increasing your chances of possible complications down the line. They (the
DCCT) advice we keep our A1c's below 6.2. All this points to your medication being wrong or
insufficient (from where I'm sitting)

Quoted message said:

Quoted message said:

I'll DROP to almost hypo levels for the same meal and the same amount of insulin/exercise. No
two days are alike.

I can't drop to hypo levels.

I can see why too. You mentioned in another post that your doc refused to script you for Glicazide
and instead told you to take exercise, but there's a BIG problem here. If you're not medicated and
exercise doesn't bring your sugar levels down, the exercise itself can cause more harm than good.
You need to be able to burn the glucose that the muscles use for fuel and if you can't, the result
of exercising is a HIGHER sugar level.

Quoted message said:

Quoted message said:

Not really, just the nature of the beast., but Istill thik another trip

to

Quoted message said:

Quoted message said:

your doc is in order. Please go there:-)

To get another portion of laughter?

I feel for you Mike, I really do, but I can't do anything other than tell you what I'd do in your
(then) unknown circumstances. If the docs you've seen laugh at you, isn't there an alternative
hospital/medical centre.something you can go to? Can you not go private for a single "real"
consultation? If MY life and health depended on doing that, then that's what I'd do.

Are you on ANY medication for you diabetes btw, because it's screaming out for at least a script for
one of the drugs in the Metformin group.

Beav

Hi,

Quoted message said:

something you shuld EVER see unless you're eating a no or ultra low carb diet. I didn't get the
impression you were doing either.

I eat between 100 and 140 grams of carbon hydrates a day.

Quoted message said:

Indeed, because ketones usually present when there's too little insulin,

not

Quoted message said:

too much sugar. This is why I mentioned it. If you're spilling ketones,

your

Quoted message said:

medication isn't correct.

There is nothing I can do about. In days I had to inject insulin my values were even worse and I had
a lot more ketones.

Quoted message said:

Quoted message said:

Doc: "That can't be said. Next year, next decade or even never.".

Or even today? If you're running the levels you ARE running, then you

either

Quoted message said:

need insulin or some medication to address your resistance problem, but

My doc says that I can not. Although my liver values are better now, he thinks that oral
antidiabetica would harm it again.

Quoted message said:

spilling ketones. Your A1c's aren't "whoopie" either, as you've gone

beyond

Quoted message said:

the point the DCCT use as a "trigger" for increasing your chances of possible complications down
the line. They (the DCCT) advice we keep our A1c's below 6.2. All this points to your medication
being wrong or insufficient (from where I'm sitting)

In Germany my doctors are very happy with my values. We are supposed to keep A1c below 6,5 and bg
levels after meals below 160 mg/dl.

Quoted message said:

a BIG problem here. If you're not medicated and exercise doesn't bring

your

Quoted message said:

sugar levels down, the exercise itself can cause more harm than good. You need to be able to burn
the glucose that the muscles use for fuel and if

you

Quoted message said:

can't, the result of exercising is a HIGHER sugar level.

Excercise will bring me down, not fast, but it will. I have never seen any rising sugar levels by
doing excercises, except if I had to work (physically) very hard.

Some examples:

Without medication: Let's say 240 mg/dl after meal. Then gone for a short walk outside (5 minutes)
then resting 10 minutes. Measuring again: 190 mg/dl.

With insulin: I would surely have more than 300 mg/dl (thats a proven fact). Same walk, same rest.
Measure again: 170 mg/dl.

Taking again insulin would worsen my values to the limit of my imagination:

Example out of my insulin days:

Same food, same time, same starting bg level, diffrent amount of insulin.

Day 1: Before meal: 120 mg/dl, 9 IU human r, after meal (1,5 hrs) = 220 mg/dl Day 2: 10 IU, After
meal = 220 mg/dl Day 3: 12 IU, After meal = 240 mg/dl Day 4: 15 IU !!!, After meal = 280 mg/dl !!!

Doc says: "Thats normal! As type-2 you don't stand a chance of getting down those values with this
small increase of insulin. You would have to increas in 10 IU-steps and then are in severe danger of
hypoglycaemia.".

But what for. I did exactly that for 6 months only to create some sort of receptor-down-regulation.
I then needed more than 80 IU of insulin a day, steadily increasing. No, insulin doe not do any good
for me. My values are now way better than before, even if they are not good enough, compared with US
or GB standards.

Quoted message said:

centre.something you can go to? Can you not go private for a single "real" consultation? If MY
life and health depended on doing that, then that's

what

Quoted message said:

I'd do.

I could do and I tried it twice, but the only thing they do for you there is to rigidly shoot your
values down by using fast working insulin types like lispro or aspart. They won't even accept, that
I might get into hypos very fast. They never believed any of my argumentation.

One night I was so hungry (while at home), so I wanted to eat anothe 25g of carbon hydrates at 2 am,
but I still had 220 mg/dl. But I couldn't resist, so I ate and applied 1 single IU of human R for 25
carbs plus 220 mg/dl, then the hell broke loose. Within 15 minutes my bg levels dropped below 150
mg/dl so fast falling I had never experienced before. In shere panic I woke my girlfried in order to
get a doctor if I fall unconsciousness. To that point my bg levels were already down below 120
mg/dl. I felt that I had to die and drank Cola in order to stop my bg levels from falling any
further, but it was of no use. In the end I had to drink the equivalent of 70 grams of carbon
hydrates in order to stabilize bg levels at 120 mg/dl.

Let's summarize: 220 mg/dl starting value, 25 carbs eaten, then 1 IU human r, then another 70 carbs
in order to survive.

Well, the doctors don't care. They don't get hypos and they don't get blind. Oh yes blind. More than
a couple of people were now blind, because they got too much insulin and got too often too fast down
while being used to have higher values. The doctors don't care. They just walk away without any word
of excuse and they even get rewarded for their good work!

Quoted message said:

Are you on ANY medication for you diabetes btw, because it's screaming out for at least a script
for one of the drugs in the Metformin group.

I can't take metformin. I just get diarrea from it.

Michael

"Michael Wäsch" <[email hidden]> wrote on Fri, 13 Feb 2004 15:42:48 +0100:

Quoted message said:

Hi there,

Hi, Michael!

Quoted message said:

I am type 2. Cirrently no meds, diet and excercise only.

Quoted message said:

When I eat 20g of carbon hydrates ...........

Just a linuistic point. The word in English is "carbohydrate(s)".

Quoted message said:

Michael

Grüß aus München!

--
Alan Mackenzie (Munich, Germany) Email: [email hidden]; to decode, wherever there is a repeated
letter (like "aa"😉, remove half of them (leaving, say, "a"😉.

"Michael Wäsch" <[email hidden]> wrote on Fri, 13 Feb 2004 22:48:25
+0100:

Quoted message said:

Hi,

Quoted message said:

Quoted message said:

Not really, just the nature of the beast., but I still think another trip to your doc is in
order. Please go there:-)

Quoted message said:

To get another portion of laughter?

Persevere with the docs, Michael. I've been in Munich for not quite 6 years, and I'm already on my
third specialist.

The first one couldn't write couldn't write prescriptions. He was using some computer program for
printing them out, and it was the program's fault that they weren't always right, or sometimes it
was my fault for not having a "normal" requirement. Like, I'd ask for five boxes of testing strips,
and only one would be prescribed. Several times I made the mistake of asking for "5 x (5 x 1.5ml)
Actrapid Penfill cartridges", and this was slovenlily [D: "schlampig"] transferred as "5" to the
prescription and I'd just get one box of 5. Of course, the prescription was printed in such a
strange symbolic language that even the pharmacist often had to 'phone the doc's practice to ask
what it meant. Somebody persuaded me to get out of that one. Phew!

The second one was fine, as long as you were a meak worried person who just wanted to be told
exactly what to do. Actually, I think he'd be superb for such a patient. Not for me. Tried to use
Human NPH as a basal for some time (not to be recommended). Was waking up with BS typically over
200. "We'll put you on Lantus, just what you need!" "Oh no you won't! I'm not touching that fragile
garbage! I'll have beef or pork Lente, please!". And the conversation deteriorated from then on,
till he told me I'd be better finding a different doctor. He was right, there!

The third one seems just right for me, even though his surgery is a bit out of town. He got me onto
pig Semilente, a true wonder drug.

The way I found #3 was, I 'phoned up my Krankenkasse (health insurance fund) and asked them for some
addresses. I spammed four doctors with a letter explaining my current difficulties, what I wanted,
what I _didn't_ want, asking them if they felt they'd be the right doc for me. Two of them replied,
one by email. His email read thus:

:Sehr geehrter Herr Mackenzie,

:eine Ihnen angenehme Lösung wird sich mit Sicherheit finden. Ich :akzeptiere Ihre Bedenken gegen
Lantus, mit denen Sie in der Fachwelt ja :nicht ganz alleine dastehen. Man könnte Ihnen vielleicht
Semilente :vorschlagen, das Sie allerdings selbst aus der Stechflasche aufziehen :müssten - aber mit
Ihrer Diabeteserfahrung müßte das ja zu :bewerkstelligen sein.

[Dear Mr. Mackenzie,

A solution which is acceptable to you can certainly be found. I accept your concerns about Lantus,
and you've certainly got good company amongst experts here. We could suggest Semilente, perhaps, but
you'd have to draw this out of a vial yourself - but with your experience of diabetes, I'm sure
you'd manage this.]

So, _write_ to as many internists as you can. Describe exactly the problems you've had with the
previous ones. One of them, at least, will reply positively. Failing that, I could give you the
telephone number of my specialist, if you don't mind a 4 hour train journey to get to him.
:-)

Quoted message said:

Michael

--
Alan Mackenzie (Munich, Germany) Email: [email hidden]; to decode, wherever there is a repeated
letter (like "aa"😉, remove half of them (leaving, say, "a"😉.

Hi,

Quoted message said:

Just a linuistic point. The word in English is "carbohydrate(s)".

No "n"? I see. Thanks for the hint.

Michael

Hi,

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Persevere with the docs, Michael. I've been in Munich for not quite 6 years, and I'm already on my
third specialist.

I have tried more doctors than that. All garbage, less than garbage to the point that I felt it
would be better some authority sjould take away their academic degrees.

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prescription and I'd just get one box of 5. Of course, the prescription was printed in such a
strange symbolic language that even the pharmacist often had to 'phone the doc's practice to ask
what it meant. Somebody persuaded me to get out of that one. Phew!

I know what you mean.

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pork Lente, please!". And the conversation deteriorated from then on, till he told me I'd be
better finding a different doctor. He was right, there!

Standard german doc ...

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The third one seems just right for me, even though his surgery is a bit out of town. He got me
onto pig Semilente, a true wonder drug.

I have no basal rate, but I was happy with lantus. Lantus was the only insulin that actually did
something for me. Of course, my pancreas counter-measured the surplus insulin by reducing its
output, but since it could do that on a 24 hour scale it was stronger if I ate something.

And now something for another laughter: The highest dose of lantus I could stand was 2 IU ...
literally nothing.

Michael

On Sat, 14 Feb 2004 15:45:37 +0100, "Michael Wäsch" <[email hidden]>

Quoted message said:

Hi,

Quoted message said:

Persevere with the docs, Michael. I've been in Munich for not quite 6 years, and I'm already on
my third specialist.

I have tried more doctors than that. All garbage, less than garbage to the point that I felt it
would be better some authority sjould take away their academic degrees.

<snip>

Sounds like good advice from Alan in Gemany, Michael.

As you say you can't find a good one locally, I'd be checking out the travel arrangements.

Cheers, Alan, T2, Oz.
--
Everything in Moderation - Except Laughter.

"Michael Wäsch" <[email hidden]> wrote in message
"]news:[email hidden]...

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Hi,

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something you shuld EVER see unless you're eating a no or ultra low carb diet. I didn't get the
impression you were doing either.

I eat between 100 and 140 grams of carbon hydrates a day.

That amount shouldn't cause you to spill. Something else would appear to be going on here. (like a
lack of insulin?)

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Indeed, because ketones usually present when there's too little insulin,

not

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too much sugar. This is why I mentioned it. If you're spilling ketones,

your

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medication isn't correct.

There is nothing I can do about. In days I had to inject insulin my values were even worse and I
had a lot more ketones.

That doesn't make a lot of sense to me, in fact it makes NO sense. Maybe you've got another problem
other than the diabetes. I "would" say go to see a doc but apparently that's not going to happen.

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Doc: "That can't be said. Next year, next decade or even never.".

Or even today? If you're running the levels you ARE running, then you

either

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need insulin or some medication to address your resistance problem, but

My doc says that I can not. Although my liver values are better now, he thinks that oral
antidiabetica would harm it again.

So now you're not using ANY meds??

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spilling ketones. Your A1c's aren't "whoopie" either, as you've gone

beyond

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the point the DCCT use as a "trigger" for increasing your chances of possible complications down
the line. They (the DCCT) advice we keep our A1c's below 6.2. All this points to your medication
being wrong or insufficient (from where I'm sitting)

In Germany my doctors are very happy with my values.

Well if a doctor told me that HE was happy with my A1c's f they were above
6.2, I'd congratlate him on his care and promptly find another doctor. (and we're in the HS over
here so you can't tell me much about health care and the people within it)

We are supposed to keep

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A1c below 6,5 and bg levels after meals below 160 mg/dl.

Both figures are too high. A1c below 6.2 and post meal BG;s below 140.

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a BIG problem here. If you're not medicated and exercise doesn't bring

your

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sugar levels down, the exercise itself can cause more harm than good.

You

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need to be able to burn the glucose that the muscles use for fuel and if

you

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can't, the result of exercising is a HIGHER sugar level.

Excercise will bring me down, not fast, but it will. I have never seen any rising sugar levels by
doing excercises, except if I had to work (physically) very hard.

Isnt that what exercise is? I'm not saying a stroll in the park will raise your already high
BG's, I'm saying that if they're high and you exercise (which means hard physical effort) they'll
go higher.

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Some examples:

Without medication: Let's say 240 mg/dl after meal. Then gone for a short walk outside (5 minutes)
then resting 10 minutes. Measuring again: 190 mg/dl.

That's about right for mild exercise.

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With insulin: I would surely have more than 300 mg/dl (thats a proven

fact).

Well you SAY it's a proven fact, but like I said before, maybe something else is going on. Insulin
is THE most effective "material" for lowering BG's, yout it causes yours to go high. that's a VERY
strange system you're operating with there.

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Same walk, same rest. Measure again: 170 mg/dl.

Taking again insulin would worsen my values to the limit of my

imagination:

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Example out of my insulin days:

Same food, same time, same starting bg level, diffrent amount of insulin.

Day 1: Before meal: 120 mg/dl, 9 IU human r, after meal (1,5 hrs) = 220 mg/dl

you dont say what the meal is, and if the igestion of the meal doesn't "match" the activity crve of
the insulin, you can go high and then drop low. get the curves of the food and the insuoin working
together however, and the BG rise is almost zero, as is the following drop. Actrapid (Human R) is
one of THE worst insulins to "match" food too because it's too slow to get going and it has a too
long tail, so after the food is "gone", the R keeps on shoving your BG down. Try eating either a
MUCH slower meal (add fibre wherever possible and LOTS of it) or change to using a faster insulin
such as Humalog or NovoRapid. both of these are MUCH MUCH faster in their "start-up" time, and both
"rin out of steam" a long time before R does. This could be an option.

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Day 2: 10 IU, After meal = 220 mg/dl Day 3: 12 IU, After meal = 240 mg/dl Day 4: 15 IU !!!, After
meal = 280 mg/dl !!!

Doc says: "Thats normal! As type-2 you don't stand a chance of getting

down

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those values with this small increase of insulin. You would have to

increas

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in 10 IU-steps and then are in severe danger of hypoglycaemia.".

He may have a point, (although I doubt it) but have you considered a faster insulin?

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But what for. I did exactly that for 6 months only to create some sort of receptor-down-
regulation. I then needed more than 80 IU of insulin a day, steadily increasing. No, insulin doe
not do any good for me. My values are now way better than before, even if they are not good
enough, compared

with

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US or GB standards.

Please don't confuse our standards and those in the US as being "tighter" than yours in Germany. The
same standards are worldwide. Just because you're German doesn't mean you're not at risk from
complications at the same "point" as the rest of the world. Your doctor needs a serious slap in the
mouth, or you NEED another doctor.

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centre.something you can go to? Can you not go private for a single

"real"

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consultation? If MY life and health depended on doing that, then that's

what

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I'd do.

I could do and I tried it twice, but the only thing they do for you there

is

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to rigidly shoot your values down by using fast working insulin types like lispro or aspart.

But do they not then tell you to continue with lispro/aspart insulins? It seems to me that doing so
would be an EXTREMELY good idea.

They won't even accept, that I might get into hypos very

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fast. They never believed any of my argumentation.

Well which medico's do? None that I've ever come across, so I don't give them reasons or arguments,
I give them a choice. Give me what I want or I get it from someplace else.

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One night I was so hungry (while at home), so I wanted to eat anothe 25g

of

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carbon hydrates at 2 am, but I still had 220 mg/dl. But I couldn't resist, so I ate and applied 1
single IU of human R for 25 carbs plus 220 mg/dl, then the hell broke loose. Within 15 minutes my
bg levels dropped below

150

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mg/dl so fast falling I had never experienced before. In shere panic I

woke

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my girlfried in order to get a doctor if I fall unconsciousness. To that point my bg levels were
already down below 120 mg/dl. I felt that I had to die and drank Cola in order to stop my bg
levels from falling any further, but it was of no use. In the end I had to drink the equivalent of
70 grams of carbon hydrates in order to stabilize bg levels at 120 mg/dl.

Ok, so you had a good old hypo, and they happen frm time to time (to ALL of us), but it's entirely
possible that your insulin injections caught a vein which DOES make for a "rapid" drop. You did what
we all have to do on occasion though, and had a high carb drink and didn't die. A singe unit if
insulin into fat or muscle would NOT drop you that far, that quickly, it's just physically not
possible. It's also possible that the insulin injection was "perfectly" timed with your own pancreas
dumping insuoin to bering down the high BG, so you gat a "double whammy". Having said that, calling
the doctor when your BG is 150 isn't going to win you any doctor friends.

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Let's summarize: 220 mg/dl starting value, 25 carbs eaten, then 1 IU human r, then another 70
carbs in order to survive.

Well, the doctors don't care. They don't get hypos and they don't get

blind.

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Oh yes blind. More than a couple of people were now blind, because they

got

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too much insulin and got too often too fast down while being used to have higher values.

It's not the coming down that causes blindness, it's the constantly being high. (Above 120 for me is
a definite no-no)

The doctors don't care. They just walk away without any word

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of excuse and they even get rewarded for their good work!

I know that, and I feel the same as you regarding them.

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Are you on ANY medication for you diabetes btw, because it's screaming

out

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for at least a script for one of the drugs in the Metformin group.

I can't take metformin. I just get diarrea from it.

Most people get it when they first begin with it, but most people "work through it". If you can't do
that, and your doc won't prescribe sulphs because of your liver, then insulin is your ONLT
alternative.#

Beav

Hi,

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That doesn't make a lot of sense to me, in fact it makes NO sense. Maybe

It doesn't make sense to me either, but it is like it is.

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you've got another problem other than the diabetes. I "would" say go to

see

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a doc but apparently that's not going to happen.

I have drawn the same conclusion half a year ago and told my docs. They have made every test they
knew. The results were of no avail. Now they are totally clueless and when I come again with my
complaints and symptoms they laugh at me or they tell me that they haven't heard such weird symptoms
in their 30 years lifespan of duty.

In hospital they would tell me that this is normal for having diabetes and no problem for them.
They would give me rigidly insulin, hoping everything would turn out fine. If not, the docs
wouldn't care.

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So now you're not using ANY meds??

Correct.

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Well if a doctor told me that HE was happy with my A1c's f they were above
6.2, I'd congratlate him on his care and promptly find another doctor.

(and

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we're in the HS over here so you can't tell me much about health care and the people within it)

Forgive me if I laugh, but these numbers are only that strict, because I live in a big city. My
mother and my grandmother also have diabetes and they live in the country. Their docs would only
start to worry if their A1c is above 10 ...

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Both figures are too high. A1c below 6.2 and post meal BG;s below 140.

Not in the banana republic of Germany.

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Isnt that what exercise is? I'm not saying a stroll in the park will raise your already high
BG's, I'm saying that if they're high and you exercise (which means hard physical effort) they'll
go higher.

Not always. Sometimes. Then I sit down and wait. Strolling in the park is enough for me to
come down.

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Well you SAY it's a proven fact, but like I said before, maybe something else is going on. Insulin
is THE most effective "material" for lowering BG's, yout it causes yours to go high. that's a VERY
strange system you're operating with there.

Thats me. I can't so anything about that. Go to hospital and get a new body? Sorry the docs here are
absolutely clueless. Thats the reason for me writing here and get some information from other
countries. Sometimes I stumble about some interesting material giving my docs a chance to make
another test of which they didn't think before. It's so frustrating to do the work for them, but my
only hope.

Half a year ago, a guy in the house where I live got some sort of face-cancer. The doctors haven't
seen such a thing for their whole lives. They simply couldn't do anything for him, except to leave
him to go home in order to die, which he did. It wasn't the sort of cancer you could identify, but
simply not heal. It was something really new and the docs haven't had any idea about it.

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of THE worst insulins to "match" food too because it's too slow to get

going

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and it has a too long tail, so after the food is "gone", the R keeps on

I thought so too. That was the reason why I wanted to try lispro. But lispro expires after 40
minutes (for me).

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He may have a point, (although I doubt it) but have you considered a

faster

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insulin?

Yes I tried with desastrous results.

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"point" as the rest of the world. Your doctor needs a serious slap in the mouth, or you NEED
another doctor.

This is the best doctor I could find. Every diabetic here goes straight to him. All others are much
less? Slap them too? And then?

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Ok, so you had a good old hypo, and they happen frm time to time (to ALL

of

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us), but it's entirely possible that your insulin injections caught a vein which DOES make for a
"rapid" drop. You did what we all have to do on occasion though, and had a high carb drink and
didn't die. A singe unit if

No it wasn't like that. It took me 3 hours to stabilize my bg levels, drinking coke. If I had
injected the insulin into a vein it should have been expired after 10 minutes. And besides: 1 IU
should drop my bg levels for 60 mg/dl maximum.

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was "perfectly" timed with your own pancreas dumping insuoin to bering

down

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the high BG, so you gat a "double whammy". Having said that, calling the

Could perfectly be, but 2 IU should not get me below 130 mg/dl after eating 25 carbs starting with
200-220 mg/dl.

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doctor when your BG is 150 isn't going to win you any doctor friends.

Well thats a point. I have severe fears of hypoglycaemia to the point of total panic, so I was
advised to make psychotherapy. Well, you have to wait 2,3 or even 4 years to get a place and when
you tell a psychiatrist about diabetes, he tells you that he has no idea how he could help.

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It's not the coming down that causes blindness, it's the constantly being high. (Above 120 for me
is a definite no-no)

I was told otherwise.

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I know that, and I feel the same as you regarding them.

Wow, I am no longer alone with that 🙂))

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Most people get it when they first begin with it, but most people "work through it". If you can't
do that, and your doc won't prescribe sulphs because of your liver, then insulin is your ONLT
alternative.#

I know, but I prefer life quality over quantity and when I am steadily in panic when I have to take
insulin. What sort of life is that?

Michael

On Fri, 13 Feb 2004 15:42:48 +0100, "Michael Wäsch" <[email hidden]>

Quoted message said:

Hi there,

I am type 2. Cirrently no meds, diet and excercise only.

When I eat 20g of carbon hydrates my bg level would rise from 110 mg/dl to 200 mg/dl and stay there
for 4 hours, me spitting ketones (up to ++ positive). After 4 hours I would have 250 mg/dl (and no
more ketones) and one hour later I would be at 130 mg/dl.

But: If I ate 50g of carbon hydrates, my bg levels would only rise up to 170-190 mg/dl and after 4
hours I would be at 120-130 mg/dl.

How comes? Any ideas?

More strange values:

If I eat 50g carbon hydrates starting with 120 mg/dl I'd get, as said before, 180 after meal. Now
in several cases I had to start eating with 170 mg/dl and thought I would get really high values,
may be even forcing me to apply insulin, but nothing happend. 1,5 hrs after meal I had 185 mg/dl.

Weird?

Michael

Michael,

I've returned to your first post to go back to basics.

Alan from Germany, and Beav and others have given good advice. I won't buy into the discussion on
meds and insulin, because I don't take them

Forgive me if I am telling you something you have tried already. If you can't control properly using
the local medics, have you tried to minimise the damage with careful diet?

I know you are at a more complex and difficult stage than I am, but I would recommend that you
follow the programme advocated by Jennifer and others to modify your diet to gain, or at least
improve, control.

I know that the diet I encountered in Germany last year is high in starches like bread, potatoes,
pastries, beer etc. It was one of the countries where I had significant difficulty in trying to
follow my own diet. I developed it by modifying what I ate following the advice you have seen
Jennifer post here often. If you want to review it, go to alt-support-alt-support-Open ↗
diabetes.org/Newly%20Diagnosed.htm .

Best wishes.

Cheers Alan, T2, Oz. dx May 2002 , A1C 8.2=>5.8, wt 117kg=>90kg, no meds, diet and not enough
exercise. I have no medical qualifications beyond my own experience. Choose your advisers carefully,
because experience can be an expensive teacher.
--
Everything in Moderation - Except Laughter.