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Old 12-21-2009, 10:23 PM   #1
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Can YOU eat potatoes, popcorn, brown rice, or whole wheat bread?

All four of these have glycemic index over 70, which is considered high.

This means they are supposed to raise blood sugars fairly high and rapidly. Consider serving sizes of 1/2 of medium potato, 3 cups popcorn, 1/2 cup brown rice, and one slice of whole wheat bread.

Someone on a low-carb diet could still eat these in limited amounts although they have 12-20 g carbs each.

I'm trying to determine if what I read in the medical literature translates into real life.

If you have diabetes, have you indeed found these items indeed interfere with glucose control? Do you see less glucose elevation if you eat them with other foods?

Thanks for your opinion.
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Old 12-21-2009, 11:30 PM   #2
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I see my BS number go up when I eat starches. Not sky high but it does go up. For
me the real problem with eating starches is it creates cravings for more starches
which can lead to sugar. I still give in to temptation now and then but on the whole
I have cut way back on eating the wrong thing. Others may be able to eat starches
and have no problems. We are all different on how our bodies react. My two cents. SMW
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Old 12-22-2009, 04:46 AM   #3
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Quote:
Originally Posted by Steve Parker, M.D. View Post
All four of these have glycemic index over 70, which is considered high.

This means they are supposed to raise blood sugars fairly high and rapidly. Consider serving sizes of 1/2 of medium potato, 3 cups popcorn, 1/2 cup brown rice, and one slice of whole wheat bread.

Someone on a low-carb diet could still eat these in limited amounts although they have 12-20 g carbs each.

I'm trying to determine if what I read in the medical literature translates into real life.

If you have diabetes, have you indeed found these items indeed interfere with glucose control? Do you see less glucose elevation if you eat them with other foods?

Thanks for your opinion.
Steve,

Those are the exact items I've NOT consumed since VLCing. And my presumption is it is them, along with jasmine rice and plenty of pasta responsible for a big part of my out of control levels just over a year ago.

I used to buy every 2 weeks, 3 32 oz. containers of carrot, 2 64 oz. Paul Newman Grape, 64 oz. 100% Pomegranate, and 2 32 oz. Acai/blueberry juices.....all from Costco.... This would be consumed by me, and my 2 boys in less than 2 wks! Today we buy NONE of these....

Much too, too much sugars and starches in the end. So what has replaced these, java and some diet pop. Now that's the next habit, I've got to address.....

In conclusion, it was a "combination" starches, fruit juices, and other carbs, compounded with the negative effects of lower metabolism entering the 60's, which led me to my subsequent foray to VLCing and total control of T2 Diabetes currently.
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Old 12-22-2009, 05:18 AM   #4
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Hi Steve,

Those are among the things that I avoid in order to keep my blood glucose levels under control.

I could probably have a very small serving of any one of them ... from time to time and not see an appreciable rise in my bg levels ... but if I have a serving size in the amount that you suggest, my bg levels would rise.

It's almost worse for me to have those kinds of things than it would be to have sugar itself.

I have found that while having, say, a very small [and I do mean small] portion of, say, a dessert ... my blood sugar will rise fairly quickly but will also come down again fairly quickly. If, however, I have even a small portion of the starchy carbs, my bg levels will rise for a much longer period. Perhaps this is because the starches take a while to actually convert to sugar ... but I don't know about that.

Mary
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Old 12-22-2009, 10:05 AM   #5
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I can't eat any of those items without a rapid significant BS increase (never tried the rice, but have tried the other 3 in small quantities and see a significant rise).

Grains, root veggies, and fruits are all out for me (and ofcourse any sugars at all).
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Old 12-23-2009, 03:05 AM   #6
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In a word: No.

Well, I *could,* but my blood sugar would be ridiculous later.
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Old 12-23-2009, 11:26 AM   #7
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Quote:
Originally Posted by Steve Parker, M.D. View Post
All four of these have glycemic index over 70, which is considered high.

This means they are supposed to raise blood sugars fairly high and rapidly. Consider serving sizes of 1/2 of medium potato, 3 cups popcorn, 1/2 cup brown rice, and one slice of whole wheat bread.

Someone on a low-carb diet could still eat these in limited amounts although they have 12-20 g carbs each.

I'm trying to determine if what I read in the medical literature translates into real life.

If you have diabetes, have you indeed found these items indeed interfere with glucose control? Do you see less glucose elevation if you eat them with other foods?

Thanks for your opinion.
I can eat brown rice (measured 1/2 c serving), sweet potatoes, an occasional red or other waxy potato, and high fiber whole wheat bread or cereal as long as I eat them with protein and fat without spiking the blood sugars. I eat beans daily and 1-2 servings of whole unrefined starch/grains a day. Since I started South Beach my readings have steadily declined and are almost back to normal. I take no medication. The cravings are also gone.

I avoid corn like the plague.
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Old 12-26-2009, 11:15 PM   #8
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Thanks to all respondents. I guess the glycemic index is indeed helpful in the real world.

Sweet potato, by the way, is on the American Diabetes Association list of Top 10 Superfoods - published last year, I think. Sweet potato GI is 61 compared to 85 for raw white potato.

-Steve
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Old 12-27-2009, 05:44 AM   #9
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Originally Posted by Steve Parker, M.D. View Post
Thanks to all respondents. I guess the glycemic index is indeed helpful in the real world.

Sweet potato, by the way, is on the American Diabetes Association list of Top 10 Superfoods - published last year, I think. Sweet potato GI is 61 compared to 85 for raw white potato.

-Steve
Hi Steve,

Which "real world" are we talking about here? The "real world" of a diabetic ... or the "real world" of a non-diabetic?

Since the glycemic index is based on the blood sugar reactions of non-diabetics, it would stand to reason that those foods that are higher on the index would affect diabetics in a more extreme way. However, if you look at the lower index foods, you might be surprised at how they affect a diabetic.

As most of us here have found, each of us is different ... and a given food that might drastically spike my blood sugar, may have minimal affect on another diabetic ... and vice versa.

What's more, I think most of us have found that a very small portion of carb-heavy foods may be eaten every once in a while without too much impact on our overall blood sugar ... if we were to consume those same foods on a regular basis, our blood sugars would react differently.

Just my thoughts ...

Mary
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Old 12-27-2009, 10:16 AM   #10
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I don't have diabetes, but one of my close friends does and we were just having a conversation about this a few days ago. She claims that she can eat whole-wheat pasta and brown rice (as part of a balanced meal) without spiking her blood sugar but the white versions certainly do spike them.
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Old 12-31-2009, 02:04 AM   #11
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hpjrt-

My initial question was indeed directed to the diabetic world. I'm trying to give my patients with diabetes advice on low-carb eating. Overall it sounds like the glycemic index concept would apply to people with diabetes. But individual testing is important, as many have pointed out.

-Steve
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Old 12-31-2009, 07:17 AM   #12
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Quote:
Originally Posted by Steve Parker, M.D. View Post
hpjrt-

My initial question was indeed directed to the diabetic world. I'm trying to give my patients with diabetes advice on low-carb eating. Overall it sounds like the glycemic index concept would apply to people with diabetes. But individual testing is important, as many have pointed out.

-Steve
Steve,

If diabetics must choose to eat carbs, then lower glycemic index foods is a better choice whether eaten daily, weekly, or seldom.

However here's where I find a significant risk. The possibility of falling off the wagon is quite real and the consequences are dire to say the least with diabetes. You have to ask, "Just how bad is bad?" Do we get away for a meal, 2 or 3?

Why tempt fate? I've found consistency in life, balance, control, minimal stess levels, and manageable eating regimens with a working plan to follow and live by 24/7. the key to avoiding the complications inherent with this disease.
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Old 12-31-2009, 08:01 AM   #13
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I can eat all the foods you mention--if I inject fast acting insulin at the ratio of 1 unit per 20 grams of carb. (2 units if it's at breakfast when I'm more insulin resistant.)

Otherwise. No way.
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Old 12-31-2009, 06:24 PM   #14
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I have been afraid to eat potatoes and rice of any kind since my diagnosis, but I have eaten small amounts of popcorn and double fiber whole wheat bread without causing a huge rise of my BG numbers.

I do try to use the Glycemic Index in planning my food.
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Old 12-31-2009, 11:28 PM   #15
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My MIL eats low carb bread, low carb tortillas, 1/2 cup rice or whole wheat pasta, sweet potato. She always eats these with protein & fat, never alone. She has not seen spikes in BS but she also takes metformin. Without the medication she could not eat these items. Here is an example of her daily diet.

B - 2 eggs, 2 slices bacon, 1 low carb tortilla

L - 1 slice low carb (10g) wheat bread, cheese, sliced cucumbers, sf jello

S - 1/4 cup walnuts, 1/4 apple

D - Salad, sf italian dressing, 2 pork chops, almond flour cupcake with sf cool whip
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Old 01-04-2010, 06:12 PM   #16
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I have never tried to eat any of those since changing my diet. However I have found I can eat beans with plenty of fat and have very little change in my BG. I ate a lot of chili while out of town. That said it all gave me horrible heartburn and gas and I am not sure it was worth it!
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Old 01-04-2010, 06:41 PM   #17
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Can someone point me in the direction of understanding how the body is different with diabetes? I'm non-diabetic and BMI 29, therefore have some weight to lose. Am experimenting with low carb. Not sure if I'm liking it - will give it a go though. I cant help but think of the benefits of wholegrains, fruits, legumes - and even "high carb" fruits and veggies.

For a while now, the grains I have been consuming are in fact wholegrains, and I have always felt good on all of the above.

Can someone explain to me how my body (as a non diabetic) is different to a diabetic (or pre diabetic)? Or point me to the link. I've read bits and pieces about insulin etc, but just can't seem to get my head around it all just yet.

Something I am wondering about: overweight diabetics are probably like most overweight people - seriously lacking in exercise. I can't help but wonder (and have read on this but cant remember where), how much this has to do with the inability to handle carbs?

e.g. On a calorie restricted diet, everyone loses weight. If a diabetic eats a diet containing all food groups (calorie restricted) AND adopts an exercise plan (walking at a minimum, growing to some occasional intense exercise) - would they (or would they not) do just as well as any other plan?

Steve
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Old 01-04-2010, 08:50 PM   #18
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Thank you very much - will have a read.
Then I am left wondering, is it going too far to say that maybe diabetics need a specific diet of their own (i.e. low or very low carb), whereas the non-diabetic population are better calorie restricting?
Who knows!

I know its a common story, but I was reading in some more detail about the guy that went to live with the eskimos all those years ago. Meat, meat and more meat!

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Old 01-05-2010, 06:16 AM   #19
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Thank you very much - will have a read.
Then I am left wondering, is it going too far to say that maybe diabetics need a specific diet of their own (i.e. low or very low carb), whereas the non-diabetic population are better calorie restricting?
Who knows!

I know its a common story, but I was reading in some more detail about the guy that went to live with the eskimos all those years ago. Meat, meat and more meat!

Steve
Steve,

People with diabetes do best on a less restrictive low carb diet because they don't have the luxury of burning out and going back to their old eating patterns which is what most LC weight dieters do after their conversion experience enthusiasm wears off.

The typical successful person with diabetes eats about 80-100 g a day and uses carefully chosen medications to make that level work. I have been active in the online diabetes community since 1998. I started out much more stringent and ended up blowing the diet off completely in year 4, when I came back, I looked at the strategies of those who made it work long time and settled at a higher level with helpful meds. I'm in year 7 of my second attempt now with excellent blood sugars.

Re the Eskimo guy. I have researched this (I have a degree in Anthro) and sadly, the guy they keep quoting was a self-promoter writing for a popular audience. Real research on Inuit diets shows they ate little muscle meat much rancid blubber (with hair still on) gut contents, brains organs etc, and even animal droppings.

Their health wasn't anything you'd want for yourself, either, and of course, the surviving Inuit were those who could flourish on that kind of diet, so those who couldn't didn't live to reproduce.
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Old 01-09-2010, 09:24 AM   #20
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well, Dr Steve, I had gestational diabetes which I controlled with diet and I've watched my mom struggle w/ type II diabetes, going on and off low-carb eating. (she does SO much better eating LC). Anyway, there are some differences, but basically GD is like having temporary type II diabetes.

I'd be surprised if diabetics could really eat those things if they are attempting diet control or to reduce their need for medications with diet.

While pregnant, I tested 60 minutes after I started eating. Pretty quickly I found out what worked for me. What I noticed was things like: even 1/4 c of cooked brown rice sent my blood glucose levels over limits- tight ones- that I was aiming for. I could have maybe 5 piece of whole wheat pasta as part of an otherwise low-carb meal and stay under 130 an hour later. However, I could eat things like lentil soup (no potatoes), that are big no-nos for some low-carbers.

IF you have someone keep a VERY detailed diet and exercise log, including medications, and measuring all their food (if they don't already) for about 2 weeks, you can find out how foods affect them. They can even eat those questionable foods on purpose to see what happens. (Diet logs for just a few days are not good- people will change how they eat b/c they are writing it down.) I did mine in a week-by-week matrix, 2 pages (one for diet and exercise, one for blood sugar readings). I could look at a whole week at a time that way. Then if you wish, you can review it with them, or even have them email it to you. My midwives looked over my weekly food/blood sugar logs with me and they could also give me feedback about how my diet was working.

If I had eaten according the the diet plan I was given by the OB practice, I would have been on medications and maybe even insulin, I think. Everyone knew it too- even the nutritionist who gave the GD "training" class told us (verbally) not to eat as much of the starches and to eat protein, fat, and veggies without limit.

BTW I found "blood sugar 101"s website to be INCREDIBLY helpful and informative when I was dealing w/ the GD. I would recommend you read that and maybe it will be helpful for your patients!

editing to say: blood sugar 101 is also totally on point when she says that its important for diabetics to think about long-term sustainability. I had some interesting conversations w/ my mom who was like "why are you being so strict, why not go on meds" and my thought was, I am only pregnant temporarily and I'd really like to avoid meds (for a couple of reasons, some of which are really so off point so I'm not going to go there!). I don't think I could be that strict for the REST OF MY LIFE. Better to find a way of eating that is humane and livable for someone, together with medications, than expect people to "live without" completely for the rest of their lives.

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Old 01-09-2010, 09:35 AM   #21
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e.g. On a calorie restricted diet, everyone loses weight. If a diabetic eats a diet containing all food groups (calorie restricted) AND adopts an exercise plan (walking at a minimum, growing to some occasional intense exercise) - would they (or would they not) do just as well as any other plan?
have you read Gary Taubes? He says this is not true and that there has been plenty of experimental and clinical evidence disproving the idea that everyone loses weight on calorie restriction. Certainly gels with the personal stories of people who've tried that way to lose weight unsuccessfully! He also points out that people don't generally tell a thin person who is not active (and please, we ALL know plenty of them) that they "seriously lack exercise", only a heavy person.

Basically his point is that there are people who have the same diet and exercise levels- some of whom are slim, some heavy... so maybe there is wrong thinking going on in saying that the REASON someone is overweight has to do with being a lazy glutton...
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Old 01-09-2010, 11:48 AM   #22
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I had some interesting conversations w/ my mom who was like "why are you being so strict, why not go on meds" and my thought was, I am only pregnant temporarily and I'd really like to avoid meds (for a couple of reasons, some of which are really so off point so I'm not going to go there!). I don't think I could be that strict for the REST OF MY LIFE. Better to find a way of eating that is humane and livable for someone, together with medications, than expect people to "live without" completely for the rest of their lives.
BINGO!

The most troubling thing about the low carb weight loss diet is how hard it is for people to stick to it. People with diabetes do not have the luxury of giving up their diets. The cost won't be a cosmetically displeasing weight gain, but worsening the likelihood of kidney failure, blindness, heart attack and amputation.

These complications are real. I know people who have them. So the best strategy for diabetes control is the one easiest to adhere to.

Newly diagnosed people (including myself 12 years ago) often feel like keeping off drugs is a plus. In fact, some drugs make control a lot easier and are safe. The problem is, those AREN'T the drugs most doctors are prescribing to the newly diagnosed, thanks to drug company promotions.

If you are newly diagnosed the safe drugs are metformin, Byetta, and insulin. Of the three Byetta is the one whose safety is least assured. The others are excellent. Avoid all the rest of the drugs. There are serious problems with all of them.
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Old 01-09-2010, 08:50 PM   #23
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I'm T2, and find that I do well on more carbs than a typical "lowcarb" diet, but far below the standard diet. I get most of those carbs from veggies and fruit, some milk, and some small amounts of whole grain foods. I have A1C levels below 6.0 % every time I'm checked. I'm still fat, alas, but to be honest, I'm a lot more concerned with having good blood sugars and feeling happy in myself than in striving for thin thighs.

I'm on metformin, and am considering asking my doctor if it might be wise for me to start insulin. One thing I've noticed that has surprised the heck out of me is that after I was diagnosed with Hasimoto's disease this past summer, and was put on synthroid, my blood sugar levels actually improved slightly, and I seem to tolerate the slightly increased levels of carbs. My A1C dropped by .2, then down another .1, the two times I've been tested since starting the synthroid. I don't know if this is a common side effect or not.
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Old 01-10-2010, 05:58 AM   #24
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I'm on metformin, and am considering asking my doctor if it might be wise for me to start insulin. One thing I've noticed that has surprised the heck out of me is that after I was diagnosed with Hasimoto's disease this past summer, and was put on synthroid, my blood sugar levels actually improved slightly, and I seem to tolerate the slightly increased levels of carbs. My A1C dropped by .2, then down another .1, the two times I've been tested since starting the synthroid. I don't know if this is a common side effect or not.
Doctors don't like Insulin for Type 2 because THEY have to put in some effort teaching patients to use it and don't have the staff. If they dose for tight control they figure you'll kill yourself with a hypo, so they discourage us from using it until we're about to go blind. It took me three years of effort to FINALLY get a prescription, then I was given the wrong dose and it is a very good thing I had read Dr. Bernstein's book and learned how to figure out a dose on my own.

Re the Thyroid--low thyroid increases insulin resistance so that is probably why you saw the difference. Having the thyroid disease suggests a possibility that your "Type 2" has an autoimmune component. If so, insulin would be very helpful.

Eliminating gluten completely sometimes does very good things for people with autoimmune components to their diabetes. It would be worth giving it a try for a month, as difficult as it is to do.
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Old 01-10-2010, 09:53 AM   #25
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aaahhh... Thanks for the info on the thyroid connection to the insulin resistance and blood sugar levels. That has been a puzzlement. Heh, a happy mystery, shall we say. I *have* been considering really giving gluten-free a shot, and I actually have some of the foods on hand to do it. I bought a couple books about it, thinking it may be a good step to make, but then delayed because I thought perhaps being tested for gluten sensitivity before taking such a big PITA step might be a good idea. Hell.

I have both of Bernstein's books, and have read them several times each in an effort to educate myself a bit before talking to the doc about the insulin. But I do suspect I'm in for a struggle there. Or perhaps not -- she may surprise me. She does know I put a lot of work into watching my diet and tracking my blood sugar and so on, so she might not be as worried about me being responsible for taking the insulin carefully.
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Old 01-11-2010, 01:07 PM   #26
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I do not use insulin, therefore I control my BG with metformin, diet and exercise. I have tried 1/2 a medium sized baked potato with a steak and I was able to eat it with very minimal increase in my BG.

I loved it.......
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Old 01-13-2010, 09:53 AM   #27
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i am considered pre diabetic but have been lc for a long while so i suspect that if i was still eating the whole grain diet from my vegetarian/vegan days, my range would no longer be pre.
i never wanted the GTT because i would not be doing anything differently than now as long as my BG is in control.

i've played around w some carbs but not a wide range since i no longer have a taste for them.
one interesting little experiment was CALP; for my reward meal i ate a ham or turkey sandwich on ezekial bread w lettuce and tomato four days in a row.
1st FBG was stellar, the next day, a little higher but still under 100. then over 100 and so on.....
more recently i have been eating a small chili from Wendy's when i'm out on the road working (i am a hospice RN, home visits only). it seems that i can get away w the small size occasionally but too many days in a row and the same result as above.

so i made a pot of chili at home w many less beans. i ate it pretty much daily til it was gone. well, guess what, no increases to speak of....at least none out of the range of my normal fluctuation. but there is not even a 'serving' of beans in a serving of this chili.

i would consider a 1 slice sandwich but i am a single person and can't make myself buy an expensive loaf of bread just to toss a good part of it. it is not great after being frozen any length of time....and i don't like commercial bread at all.

there is also the question of gluten grains and their relation to autoimmune problems my family started lc because of my daughter's severe digestive issues. unfortunately, i had something to do w this since she was raised in a vegetarian household; we all overdosed on grain. i'm not real willing to revisit that place...although quantity may have something to do w it, once the damage is done, one must be cautious.

Dr Harris from PaNu has some discussion that might be of interest in this area.
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Old 01-22-2010, 12:12 PM   #28
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Steve, this is just another of the "Your Mileage May Vary" things we have to deal with.

Of course one can eat these things and inject humalog to "cover" the carbs. Back when I was eating like that, prior to June last year for awhile, I needed one unit per seven grams of carbs, on top of a HEFTY underlying dose of Lantus.

But there are so many aspects of this question to consider for every patient. Personally, I think that high blood insulin levels are just as dangerous long term as high blood sugars, and eating these things just perpetuates and worsens insulin resistance.

Second, these are JUST the things overweight people will have portion control problems with. One isn't driven to gorge on cauliflower all that often! I think it's just easier not to have them around.

Third, there is a very real "carb addiction" many obese people deal with, and keeping carbs very low enables us to break that craving cycle. I know you know these things, sorry; it just gets me worked up!

I think you will be doing them a great favor by telling them to cut all this high carb stuff out completely. Once they have their cravings, diabetes, and weigh under better control, you and they can experiment in a very controlled way with reintroducing set portions of these "dangerous" foods.

But it's always like the recovering alcoholic trying a glass of wine to see if it bothers him now, and finding, yes, the cravings are back and yes, he's going to give in to them for awhile. That's when you sort of take a little break from sensible eating, just a rest, and suddenly look up and see you have regained everything and more! It's not worth it.
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Old 01-26-2010, 02:17 AM   #29
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Several times, I have had the popcorn at the movies, only to come home to lower blood sugar than expected. It did not cause the rise, I thought it would.
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Old 01-26-2010, 09:43 AM   #30
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Been experimenting lately, as I am finding that I definitely tolerate certain carbs much better than others. I can eat some corn products, including popcorn, and have no issues. The same thing with potatoes, both white and sweet (IF I have those along with fat and protein; if I eat them alone, I spike). The key for me with those things is moderation. If I ate them like I used to, my numbers would be off the charts, but I can tolerate a small amount, and it does not create cravings.

There was a time, not that long ago, that I really did not like LC'ing. I was glutting myself on protein and fats. I felt like I had to in order to be satisfied. I was not losing much weight and was pretty discouraged. The funniest thing, as I ate less, I wanted less. I found I was satisfied with much smaller portions; and that gave me the opportunity to add more variety into my diet. I can't even begin to explain how shocked I STILL am when I sit down to a nice, balanced, small meal and am still satisfied 3 or 4 hours later. I was always a binge eater. Now, if I get hungry, I grab a piece of cheese, or a few berries, and voila- I'm quite content.

That said, there are definitely things that remain a big "no no" for me. White sugar, refined flours, brown rice? Even the tiniest amount makes my blood sugar skyrocket! I had 4 tiny Sweet Tarts the other day (the perils of having children!)- which was about 7 carbs, 6 of which were sugar, and my reading was 225! So, I know that I simply can't touch the stuff.

It amazes me how individualized this disease is. How bodies respond SO differently to the nutrients they take in. I know I eat things that others on a LC diet would not; yet, I test my blood 3-5 times a day, and that, along with the scale, keeps telling me that for the most part I'm on the right track. So, in my opinion, it's definitely a YMMV thing.
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