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Preview: Type 2 Diabetes - A Personal Journey

Type 2 Diabetes - A Personal Journey

Ideas based on my personal experiences in learning how to manage type 2 diabetes. I stress that I am a diabetic, not a doctor nor a dietician. I have no medical qualifications beyond my own experience. Nothing written here is intended as medical

Updated: 2018-02-22T01:22:26.253+11:00


Slow Cooked Beef Brisket


I bought my first slow cooker a few weeks ago. In the past I used stove-top large saucepans for slow cooking and braising. The method worked but needed regular stirring to prevent sticking. When a post-Christmas special appeared for a very cheap large slow cooker I decided to give it a try. I wish I’d bought one years ago! I have experimented a few times now. I prepare the veges and meat after breakfast, toss them and some stock and liquids in the cooker and lift the lid eight or nine hours later for a delicious dinner. This is my favourite of the recipes I have tried so far. It didn’t occur to me to take pictures last night; I will add them next time I cook it. Beef Brisket Ingredients Portion sizes, herbs etc are flexible. Adjust to suit your own taste.1-1.5Kg (2-3lbs) beef brisket or any similar cut. I prefer a piece at least 2-3cm (1”) thick and roughly rectangular which fits comfortably in the cooker.1 large or 2 medium onions, sliced.1 large or 2 medium carrots.1 cup chopped celeryChopped herbs to taste. I used parsley, thyme, rosemary and mint from my garden.2 or 3 bay leaves.1 teaspoon mild paprika.1 cup red wine.1 can (400gm, ~1lb) chopped tomato.1-2 cups beef stock (or pork or chicken; I make my own from bones and herbs).2 cloves garlic.Salt and pepper. Optional: 3-5cm (1½ “- 2”) chunks of potato. MethodServes 4 or more  depending on appetites and portion sizes. Slice the carrots lengthways, cut them into rough chunks and place them on the floor of the cooker to become a base for the meat. Roughly trim excessive fat from the beef. Leave some on for flavour. Lightly salt both sides of the meat and place it in the slow cooker. Grate some pepper over the meat to taste. Fry the onions in oil in a skillet until soft, add the chopped celery and minced garlic and continue frying until the onions are starting to brown then transfer the cooked veges to the slow cooker. Deglaze the skillet with the cup of wine and add the liquid to the cooker. Add the paprika, chopped tomato and stock. Stir to mix the liquids and settle the meat among the veges. If necessary add water sufficient to come just level with the meat. Cook on low for 8 or more hours (my cheap cooker has only three heat settings: low, high, keep warm). As my spouse likes potatoes I added some chunks into the liquid around the meat at the 4 hour mark. Possibly those could be included at the start. Serving. Gently remove the meat from the cooker, trying not to remove too much attached liquid and veges as you transfer it to a cutting board. Using a slotted spoon remove the carrots (and potato if added) from the sauce and transfer them to a serving dish. Don’t get too fussy if some liquid and other ingredients stick to the carrots or potato. Remove the bay leaves and blend the remaining liquid and contents with a stick blender to become a smooth sauce. Use a potato masher if you don't have a stick blender. It doesn't have to be perfect. Carve the meat across the grain into roughly 6mm (1/4”) slices and transfer to a serving dish. Pour the sauce liberally over the meat. Diners serve themselves from the dishes.I have not worked out the carbs, fat etc but the main carbs are in the onions, carrot and potato if added. This did not even cause a blip in my 1hr post-meal blood glucose test.Bon AppetitCheers, Alan, T2, Australia.Everything in Moderation - Except Laughter There is Nothing I Could Eat I like More Than my Eyes[...]

What is a Balanced Diet For a Type 2 Diabetic?


This question came up on one of the forums I am on recently. There were many conflicting responses, often including discussion about various macronutrients (fat, protein, carbohydrates) and micronutrients (minerals, vitamins etc), the evils of sugar, cholesterol and saturated fats, the need for lots of fruit or grains etc etc. A lot of people also went into great detail about maximum and minimum percentages for fats, carbs and protein.

I believe in KISS, so I try to keep it simple with easy to follow rules for my way of eating. As I have to eat this way for the rest of my life I do not want an excessively complicated food selection system.

My definition of a balanced diet for a type 2 diabetic (me) is pretty basic and not in terms of percentages of anything. The basic description is simple, although the personal investigation creating the way of eating I follow today was fairly complex. The links at the foot of this post describe the journey to this point.

The simple version:
  • I let my meter show me my carbohydrate limits for the time of day and the meal.
  • I let common sense and satiety limit my protein and fat portions.
  • I include a reasonably wide variety of vegetables in my menu, favouring fresh and seasonal vegetables where possible.
  • I also include fruits but those are limited to minimise blood glucose spikes.

In applying those basic rules for myself I also take these factors into account:
  • Variety in choices of meats, fish, seafood, dairy, vegetables and fruits makes the menu interesting and also improves the chances of getting all needed vitamins and micronutrients.
  • Excess of any macronutrient is not wise.
  • Excessive restriction of any macronutrient is just as unwise.
 These links to past posts expand on those points and others: 

Cheers, Alan, T2, Australia.

Everything in Moderation - Except Laughter 
There Is Nothing I Could Eat I like More Than my Eyes

Small New York Baked Low Carb Cheesecake


I posted the recipe for a delicious Large New York Baked Low Carb Cheesecake based on one posted by Angie, Granny Red, on the ADA forum a couple of years ago. It is a rather big cheesecake which I cut into 16 portions of 6gms carb each. Since then I have experimented several times with a reduced size because I found the large cake was too big for our needs. This is the recipe for those who prefer a smaller cake. The size reduction not only cuts the cost in half but is a little easier to prepare and needs less cooking time. The slight increase in egg proportions also tends to make a creamier texture.I have modified the Splenda and sugar proportions as a reasonable compromise between my wife's sweet tooth and my need to keep the carbs down. Feel free to adjust that to suit yourself as the carb count will be directly reduced as you reduce the sugar. The nutrition count is based on the listed details. IngredientsCrust 1 cup almond flour or meal2 tablespoons(tbsp) Splenda1 tbsp sugar4 tbsp butter, melted Filling 12 oz (375gm) cream cheese1/3 cup Splenda2 tbsp sugar2 eggs1 teaspoon(tsp) vanilla extract 1/2 tsp lemon extract or a good squeeze of lemon; orange can be substituted as a variation.8 oz (300ml) sour creamNote: the eggs, cheese and sour cream need to be at room temperature. If the cheese is too stiff to beat easily, sit the containers in warm water for a little while until the cheese softens. MethodCrust Base Use extra butter to grease an 8 or 9 inch (20-25cm) spring-form pan. I also put a circle of greased brown paper on the bottom to be certain the cake does not stick; this step may not be necessary if you use a non-stick pan.   Mix the splenda and almond flour (sometimes I make my own coarse version from almonds in the blender; it works just as well) with melted butter, press evenly onto the bottom of the pan for a thin layer without holes and press any excess up the sides of the pan. If you don't have enough almond flour to go all the way up the sides don't worry; it's not really critical as long as the base is covered. Set the pan aside while mixing the filling. Filling Beat the cream cheese until light and creamy, keeping the mixer on a low-medium setting throughout the beating and mixing process. Add the mixed splenda and sugar a little at a time and continue beating until creamy.Add one egg at a time and beat briefly after each egg. When the eggs have been mixed into the cream cheese add vanilla and lemon extract (or lemon juice) and mix briefly until just combined. Add the sour cream last and beat briefly until fully incorporated. Baking Pour the mixture into the springform pan. Bake at 300 F or 150C for about 40 minutes then check to see if it is set and starting to brown slightly on top. If not, let it cook for another 15 minutes. Try not to over-cook it as it may become too dry. When it is set and beginning to brown turn off the heat, prop open the oven door slightly and leave it in the oven for at least an hour. Remove it from the oven and allow it to cool in the spring-form pan to room temperature before placing it in the fridge until the next day. Don't try to serve it on the day of cooking; it will not be set properly if you do. Do not be disappointed if it sinks slightly in the middle. That is normal, or, at least, it was for the ones I made.The result is 8-12 satisfying slices. I individually wrap some in clingwrap for the freezer; they freeze and defrost well. Nutrition per serve: 8 12 Kcals 3000 375 250 Fat 275 34.4 22.9 Carb 100 12.5 8.3 Fibre 12 1.5 1.0 Protein 62 7.8 5.2 Bon appetit, Alan, T2, Australia.Everything in Moderation - Except Laughter [...]

Fat: The New Health Paradigm


I have just read the opening summary of a startling document published by the Credit Suisse Research Institute.Fat: The New Health ParadigmI predict that this publication is going to become one of the most hotly debated documents in the fat vs carbs diet wars this year. The conclusions the authors arrive at are summarised very succinctly on the opening pages.Their conclusions will not surprise many in the on-line diabetes community as most of us have been saying this for years (for example Eggs, Carbs and Cholesterol, Cholesterol, Fats, Carbs, Statins and Exercise) but they will cause consternation in many of the world's respected dietetic and diabetes authorities. This is not a journalist's article or a book by an organisation with an agenda or a diet to sell; it is a very well researched and supported scientific paper. Below are abbreviated selections from the summary; these statements are well supported in the body of the document which I am still in the process of studying. I decided to post early to alert readers to the document and allow others to read it in full.••Triangulating several topics such as anthropology, breast feeding, evolution of primates, height trends in the human population, or energy needs of our various vital organs, we have concluded that natural fat consumption is lower than “ideal” and if anything could increase safely well beyond current levels.••Saturated fat has not been a driver of obesity: fat does not make you fat. At current levels of consumption the most likely culprit behind growing obesity level of the world population is carbohydrates.••A proper review of the so called “fat paradoxes” (France, Israel and Japan) suggests that saturated fats are actually healthy and omega-6 fats, at current levels of consumption in the developed world, are not necessarily so.••The big concern regarding eating cholesterol-rich foods (e.g. eggs) is completely without foundation. There is basically no link between the cholesterol we eat and the level of cholesterol in our blood.••Doctors and patients’ focus on “bad” and “good” cholesterol is superficial at best and most likely misleading. The most mentioned factors that doctors use to assess the risk of CVDs—total blood cholesterol (TC) and LDL cholesterol (the “bad” cholesterol)—are poor indicators of CVD risk. In women in particular, TC has zero predictive value if we look at all causes of death. Low blood cholesterol in men could be as bad as very high cholesterol. The best indicators are the size of LDL particles (pattern A or B) and the ratio of TG (triglycerides) to HDL (the “good” cholesterol).••Based on medical and our own research we can conclude that the intake of saturated fat (butter, palm and coconut oil and lard) poses no risk to our health and particularly to the heart. ••The main factor behind a high level of saturated fats in our blood is actually carbohydrates, not the amount of saturated fat we eat. Clinical trials show that a low carbohydrate diet is much more effective in lowering the level of saturated fat in our blood than a low-fat diet.Cheers, Alan, T2, Australia.Everything in Moderation - Except Laughter [...]

I Think I May Have Diabetes...


"I think I may have diabetes....and I don't want to die..."The wording varies but I see this question with increasing frequency on all the forums I read. I have written replies to these posts so often I felt it was time to archive a standard response. The web is a wonderful source of information but too often people who really should be asking questions like this of their doctor are asking strangers on the net. My usual answer is very brief and says exactly that: see your doctor. I highlighted that because it needs to be emphasised.Unfortunately that isn't always immediately possible for everyone. There can be many reasons for that.  The most common excuses are lack of money, lack of availability of medical support or simply fear of hearing bad news. For those with an urgent need and obvious hypo or hyper symptoms or who have tested repeatedly high on a glucometer the suggestion changes from "see your doctor soon" to "get to an ER (emergency room) fast".  For others unable to see their doctor soon I urge them to at least make the appointment. Do what is necessary to find the money or time or courage but not seeing the doctor can turn out to be much more expensive in the long term. Another variant has appeared recently. Some doctors appear hesitant to diagnose if A1c is OK but fasting or casual blood glucose are just over diagnostic thresholds even when the patient has some symptoms. Too many doctors appear to have forgotten that A1c was only recently approved as a diagnostic tool because the patient can be diabetic if other indicators are high despite a normal A1c. I see an increasing number of posts from people in those circumstances who were told they are “borderline” - whatever that means - or “you are not diabetic yet, just eat healthy and exercise and you'll be fine” without a meter or other advice being prescribed.At this point I will remind readers: I am a diabetic, not a doctor, and only a doctor can diagnose diabetes.What follows are suggestions for people whose situation is not urgent, who have a long wait to see their doctor or who have seen their doctor but are still unsure. Part 1. DiscoveryObtain a home blood glucose test meter and an adequate supply of test strips. How you do that will vary depending on your local health support system. In the US cheap meters and strips are available from several sources; Walmart's Relion Prime was one of the first cheap meters but you may find others if you search. Note that the cost of test strips will be more important than the cost of the meter in the long term. In Australia you will have to pay full price until you are officially diagnosed, but check with the chemist because there are often discount specials.When you get your meter read this (click on it): Painless Pricks.  Test four times a day for two or three days: immediately on waking (fasting) and one hour after your last bite of breakfast, lunch and dinner. The results you are hoping for are as follows:Fasting: 4 to 5.5 mmol/l (Australia, Canada, UK or other millimole countries) or 70 to 99 mg/dl (USA and other milligrams countries). Post-meal: 4 to 8mmol/l or 70 to 140mg/dl. If all your tests are inside those ranges, relax. Diabetes is most unlikely to be your problem. Don't throw your meter away because it may be wise to occasionally test in future years to see if anything has changed. In that case be aware that test strips have an expiry date.If any of your results are outside those ranges immediately wash your hands and re-test. If, after re-testing, it is still out of range just record it the first time. If a second test at another time is out of range make an appointment with the doctor for qualified diagnostic testing. Part 2. Action.If your tests were outside the ranges read this while you wait for your appointment with the doctor: Getting Started  For those unable to obtain a meter, this may help while waiting to see the doctor: What to[...]

Blood Glucose Targets 2015


Several years ago I investigated the different targets suggested by three major respected US diabetes authorities. As a result I wrote this: Blood Glucose Targets. My 2006 summary included this comparison table: Over the years those have changed very little. The 2015 comparison noting significant changes in bold is: Sources: ADA, Joslin, AACE. The ADA and Joslin now agree on the looser 2hr post-prandial target of 180(10) and both have also lowered the threshold for fasting. The AACE guidelines are unchanged. If you read the details on the linked pages all add caveats concerning relaxation of targets in case of other medical conditions, age etc.Thirteen years after diagnosis, thankfully still free of complications, I see no reason to significantly change my closing remarks originally written nearly ten years ago.The AACE advise much tighter post-prandial targets. I doubt that anyone would consider the American Association of Clinical Endocrinologists, a professional community of several thousand physicians specializing in endocrinology, diabetes, and metabolism as a bunch of fanatical radicals. Nor would they be promulgating guidelines impossible to be attained by the majority. Unfortunately, nobody but pro-active type 2 diabetics talks much about 1hr PP targets. My personal logic is that I treat their 2hr as my recommended max peak for any post-prandial, as I discussed in When To Test? Those AACE guidelines then agree very closely with Jennifer's Test, Test, Test advice.Make your own judgment on which of those guidelines you think will lead to fewer complications.Sadly, it appears that only 1/3 of senior diabetics are achieving even the loose ADA targets, but that is a discussion for another topic.Cheers, Alan, T2, Australia.Everything in Moderation - Except Laughter [...]

Comments Allowed


I was a little disappointed to notice the lack of comments over the past year or so.

Recently a friend informed me she tried to comment and was blocked.

I had not checked my blog settings for years, as I didn't see a need to change them. I was surprised to find Google had changed my settings without my knowledge and comments were now restricted.

I have changed them back. I welcome comments from anyone, anonymous or named. My only restriction is to moderate them before publishing.

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

Are Diabetes Complications Inevitable? Not necessarily...


This is a very personal post, reporting on my own recent reports on three aspects of my health: my eyes, my heart and my other affliction, leukaemia.I am writing this partly to celebrate but also to motivate any newly diagnosed type 2 diabetics, shocked and scared, who have been warned by their doctors of the inevitability of their diabetes progressing to complications. I suppose some doctors feel they need to do that to scare new people into making lifestyle changes, but too often I find dire predictions of long term complications or heart attacks lead to loss of hope. That can lead to a 'why bother' mentality. Please, do not give up. I know managing type 2 diabetes can be bloody inconvenient. You will have to make some annoying changes to your life such as pricking holes in yourself, adding some activity to your day, forever watching what you eat and drink and possibly taking meds and insulin. Let me assure you: taking control of your blood glucose levels is worth the trouble. I am just one example of many I read on the better diabetes forums where pro-active type 2s are learning how to take control. Possibly my continuing story will give you hope.I was first diagnosed with leukaemia and type 2 diabetes in 2002 at the age of 55. I discovered early I could do nothing at all about the leukaemia; for that reason I concentrated on beating the diabetes. I was thirsty for knowledge. For the first couple of years I spent a lot of time learning from many wise people, mostly on usenet. Some were medical professionals but most were experienced diabetics. I learned something from all of them, even if the main thing I learned was how to tell good advice from bad because, unfortunately, a lot of it was bad. I still believe the best advice was Jennifer’s Test, Test, Test: “Use your body as a science experiment.” I tested and experimented to find what worked for me. On usenet over the next couple of years I gradually changed from reader and student to lay advisor, passing on information based on my experience. In 2004 I joined some online forums. In 2006 I started this blog. Eventually I wrote a book based on my experience to help any newly diagnosed people who might not be computer-savvy. Of course, as my suggestions for good type 2 management differ significantly from the mainstream there will always be critics. In part this is a response to the critics, describing the results of practising what I preached for the past decade.MotivationWe each must find our own motivation for maintaining the discipline. For me, it is my sight. Since the day I first learned about the possible complications of diabetes my over-riding motivation has been my vision. I came to accept the possibility of death and I certainly don't want to lose limbs from neuropathy or kidneys from nephropathy, but the thought of living in darkness scared me silly. I have tremendous respect and admiration for vision-impaired people who successfully live with that daily. But I do not want to join them. I am a reader of books, an appreciator of beauty, a user of computers and above all I want to see my grand-daughter’s joy as she grows and learns.The tests used by doctors to monitor our diabetes such as HbA1c, fasting blood glucose and post-prandial blood glucose are all important but they are really only surface indicators. I use those indicators to set my goals, but they don't directly alert me to dying nerves or optic cells. The acid test is whether complications eventually appear as the years pass. Limbs and KidneysSo far neither blood tests nor physical symptoms, including filament tests by my podiatrist, have indicated any signs of neuropathy or nephropathy. I am hopeful that will continue.EyesI had some good news last month. It is over thirteen years since diagnosis and I had not seen the ophthalmologist since 2010. I had a good report then after[...]

Catering For Different Tastes When Cooking


I see variations on this question asked many times on the various forums I am on:Being head cook and bottle washer, I have a question. Having D, I need certain foods, my son has become a meat and potatoes guy, my wife eats most anything, except a variety of veggies. I do not want to have to cook 3 separate plates to satisfy all. How do you cater to each taste, or do you? Is there a happy middle?The same problem occurs for the person who is not the cook but does not want to offend the person who is. This may help those people: Cooking as a Survival Skill. But I realise that is not possible or practical for some.Here is my own method for dealing with the situation. I am the cook in our household, mostly just for the two of us. Mum is invited for dinner a couple of times a week. It is important to keep in mind that I am the only person with diabetes. Although I may believe others would benefit from my way of eating it is not my role or place to force them to eat as I do. We each have our own food likes, dislikes, aversions or allergies.I am diabetic and careful about carbohydrates but otherwise omnivorous. My wife has a very limited menu, by choice, and a long list of foods she detests. For example, she will not eat fish or seafood, eggs, steak, many vegetables, milk, the list goes on. Her likes are basically meat (other than steak), starchy vegetables, peas, tomatoes and silverbeet (chard). My mother is omnivorous but, like most people, has a few foods she prefers to avoid.If I restricted myself to cooking only the foods we all like my menu would become very limited and boring. I also actively seek to include fish and a wide range of seasonal vegetables in my diet. Therefore, at most meals for the two of us I cook three types of foods. Those I can eat, those my wife will eat, and those we both eat. The other night was a typical example. In the steamer I had potato and pumpkin (winter squash) simmering in the bottom section with silverbeet, carrots, cabbage and broccoli in the top. I cooked two loin lamb chops under the grill (broiler) for her and when they were almost cooked I seared and fried a fillet of Atlantic Salmon in a small skillet for myself.At the table I put the salmon on my plate, the lamb chops on hers, and all the vegetables on a platter in the middle. We served ourselves from the platter. She had most of the potato and silverbeet; I took most of the rest.When my mother or other people are dining with us I use the same method. I find out whether anyone has specific protein likes or dislikes and serve that appropriately, letting them select their own vegetables and starches from the centre of the table. For major feasts such as Christmas dinner everything is served buffet-style for diners to select as they wish.It really isn't as difficult as it sounds, with a small amount of extra thought and effort keeping everyone at the table happy and healthy.[...]

It Must Be OK - It's Sugar-Free! Wrong!


A very brief post to emphasise an important point.When we as diabetics are choosing foods for the menu or checking the ingredients of a recipe, sugar should be treated as just another carbohydrate. It is more concentrated than most carbs but my meter has repeatedly shown me it is the total carbs that count, not just the sugar content, when I test my blood glucose after eating.Food products which are marketed as sugar-free are very rarely carbohydrate-free. In fact, more often than not they have just as many carbs as the sugared versions. I encountered a classic example of this a couple of days ago when I saw a large display in my local Aldi store promoting 'healthy' sugar-free products. These are photos of just some of the products. Sorry about the smart-phone quality of the pics; the carb counts are clear enough. I'll let them prove my point.99.5% Sugar-free Shortbread = 67.9% carbohydrates 99.5% Sugar-free Chocolate Digestive Biscuits = 61.3% carbohydrates99.5% Sugar-free Wafer Biscuits = 62.4% carbohydrates99.5% No Added Sugar Dark Chocolate = 57% carbohydrates The piece-de-resistance. Sugar-free Mixed Fruit Drops:   I could not believe this one when I turned the can over. There was no added sugar, so it must be healthier than other fruit drops...yeah, right. It is 93% carbohydrates.  Always read those labels, folks. Cheers, Alan, T2, Australia.Everything in Moderation - Except Laughter[...]

Do Doctors Matter?


I feel this is a very important point needing emphasis for the many type 2 diabetics I know participating in diabetes web forums, social media groups and similar online support groups.

I have seen this question posed too often lately:

"Do doctors matter other than for renewing prescriptions?"

The questioner usually complains about poor support (in their eyes) from their medical advisors and praises the help and support they have received from other diabetics on the web.

I understand where they are coming from. I have seen some abysmal diagnostic, testing and dietary advice by medical professionals reported on many forums by newly diagnosed people. I have seen those same people turn their lives around using suggestions from experienced people on those forums. 

I still unequivocally believe our doctors matter and must always be our primary source of medical information. 

I have learned a great deal about type 2 diabetes over the past decade but I do not pretend to have medical qualifications even though in some specific areas, such as testing or diet for type 2, I may believe I know more than some doctors.

I know my own limitations. If and when the time comes for more medication or insulin the doctor will be the first person I consult. After I consult him I may use the web or ask questions on forums to research the meds he prescribes to decide whether or not I will choose to follow his advice. But I will always see him first. 

If your own doctor does not meet your needs it is time to find another better doctor, not to simply ignore your doctor's advice.

On the rare occasions I decide not to follow prescribed advice after doing my own research I will also let him know and discuss it further with him before acting; as I have for the statins my doctor prescribes but I choose not to take. 

The final decision deciding the action to take is mine but I would be a fool to weigh anonymous advice on the web higher than the qualified advice of my doctor without a lot of thought and discussion with him.

The web is an incredible, wonderful and very useful information source but it is not always easy to sift the wheat from the chaff nor do we always have the training or experience to do that sifting wisely. The web will never replace the ability of a good doctor to interact with and personally treat a patient.

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

Must I test Before Meals Too?


Over a decade ago I learned this advice from a wise lady named Jennifer: Test, Test, Test. These days I endeavour to pay it forward by passing that on to every newly diagnosed person I encounter who is prepared to read it or listen to it. In that respect I am a testing evangelist ‘spreading the word’ although I do not press the point if the person does not want to hear it. My reasons are simple: twelve years later I am still awaiting the development of complications. When I look back to the day I first read it in 2002 I am quite convinced reading those words saved my life. Not all want to hear it, nor do those who do always accept it.  By far the two most common reasons for resistance are inconvenience and cost of the initial level of testing. Although I do not consider it a high level of testing new people do because their doctors either did not recommend testing at all or suggested only once or twice a day. Although my usual response to those objections is to point out everything has a price and failing to test sufficiently now may have a much higher health cost in later years, I fully accept that both points can be valid for individuals. If the new type 2 diabetic leads a busy life, at home or at work or both, it can be a major inconvenience to put everything on hold for five minutes one and two hours after every meal. Add fasting and bedtime tests and you have a minimum of eight tests per day, more if snacks are included. That is swiftly reduced when discovery of the post-prandial peak enables reduction of post-meal tests from two to one, but that is still five to eight tests daily. Personally, I tested up to 20 times a day in that first week but I had the luxury of being retired at the time with government-subsidised test strips.The good news is that such a high level of testing is not necessary for very long as the personal food-effect data-base grows from the results. I discuss that in detail in I'm a New Type 2. Do I Really Have to Test so Much? But for a new person the initial high testing load I suggest can be quite daunting.The other objection is also valid for many. In some countries test strips can be either very expensive or restricted in prescribed quantity for type 2s by insurers or misguided doctors. When it can cost up to a dollar a test, ten tests a day can be a very significant drain on a limited budget. Some solve the problem by buying less expensively on the web, with associated risks including possibly dishonest suppliers and passed expiry dates; others search for the cheapest meters and strips available to them. Some of those can be good (I read good reports on forums about the Walmart Relion, but I have not used it myself) but in general ‘you get what you pay for’ tends to be true in any marketplace.Those are the reasons I wrote Testing on a Budget. The method works less rapidly, but it still works eventually and uses a lot less strips.With that background I quite deliberately choose not to recommend testing before meals to newly diagnosed people. Persuading a new person to test whose doctor did not even suggest a meter is hard enough, persuading them to test as Jennifer suggests is more difficult. Adding even more tests before meals can be pushing the envelope too far.Those who promote testing before the meal tend to ignore that aspect. They suggest testing after meals is a waste of time if the person does not also test before the meal. Their logic is that without the pre-meal test the rise in blood glucose caused by the meal cannot be accurately known. That last part is technically true but I do not think it is of sufficient value to add those tests to the load. Knowing the trends for the actual peaks reached, without knowing the pre-meal base levels, was quite sufficient for me to[...]

Simple Low Carb Soups II - Asparagus


My Simple Spargelsuppe. 

I call it that because I never ate asparagus soup until I wandered around Germany in spargel season in 2003. I wasn't sure I'd like it, but one day we stopped in a village where it was the only thing on the lunch menu, with crusty bread. I discovered I loved it. We don't get those big whitish German asparagus, but our local green ones with the purplish heads aren't bad either.

This is very similar in technique to the mushroom soup. I usually buy my asparagus in small bunches, which is the way they appear in our supermarkets:


I buy three bunches, eat a couple and reserve one for soup. Soup preparation is almost identical to the mushroom soup. This makes two or three serves.

Fry an onion in olive oil and butter until caramelising. Add the roughly chopped asparagus spears, reserving the tender tips, and cook until they start to sweat. Add about a litre/quart of stock (chicken or vegetable) and simmer for about 30 minutes. If you aren't sure how much stock to use, begin with a little less. You can always add more later. Season with salt and grated pepper.

When the asparagus is tender purée the soup and return the reserved tips to it. Return the soup to the stove for five minutes to cook the tips, stirring if necessary to ensure the thicker soup does not stick. Adjust for consistency; second time around you will know exactly how much stock to use.

I am a parsimonious type that hates waste. When I eat the other bunches I snap off the "woody" ends. I keep those woody stubs in the fridge for the soup. When I make the soup I slice off and discard the really woody ends from the stubs and simmer the slightly softer remainders in some chicken stock while preparing the main soup. Just before I return the reserved asparagus tips I purée the "woody" part thoroughly so that any stringy bits disappear. I add that purée to the main pot.

Add a dollop of cream to each bowl when serving.

I have a few variants of this recipe. My favourite is to add an equal portion of broccoli, reserving some small florettes in the same way that I reserve the asparagus tips, for an asparagus and broccoli soup. I adjust the stock quantity accordingly. I also vary flavour using nutmeg and/or garlic.

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

Simple Low Carb Soups I - Mushroom


Mushroom Soup

This is based on about 250gm or 8oz mushrooms. It's hard to be precise on the quantity, because I usually make soup when the mushrooms have been left in the fridge or pantry too long and have dried out, so they weigh less than when bought. If they aren't dried out, they become a breakfast omelette instead. I make soup with leftovers as I don't like waste.

For soup I don't bother peeling the mushrooms. If the mushrooms are very dry, soak them in enough chicken stock to cover them for a while until they are soft again; if not don't bother. Strain the liquid off and retain it.

Fry a medium/large sliced onion in a couple of tablespoons of olive oil and a nob of butter until just starting to caramelise. Sometimes I add a clove of garlic, but not always. Chop the mushrooms roughly and add to the onions, frying gently. Cook briefly, then add about a litre/quart of chicken stock (including any reserved liquid) and bring to a simmer. Season with salt (mushrooms need a little extra salt), grated black pepper and the secret ingredient: some grated nutmeg to taste.  Simmer for about half an hour; longer if the mushrooms were originally very dry. I like some texture; before I use the stick blender I strain out about a half cup of the mushrooms and reserve them.

I blend the soup, not quite to puree, and return the lumpy bits. If the result is too thick, add more stock and cook it in for a little while. If it is too thin, simmer a bit longer to reduce it. When serving add a large dollop of real cream in the centre of the soup in each bowl.

The only significant carb content is the onion. That allows me to have a slice of buttered bread with it. 

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

Tammy's Story


Occasionally I come across inspirational stories on forums. I like these stories because I am sure they help new people believe that the light at the end of the tunnel is not necessarily a train heading their way.Tammy posted her story last month on the ADA forum. I received her permission to post it here. I hope it helps someone who has stumbled across this blog, newly diagnosed, scared and wondering what lies in their future. My Story: Tammy  I will never forget that morning. It was Tuesday, May 29th, 2013 and was two days before my 42nd birthday. My doctor called to tell me I had diabetes and I needed to see my endocrinologist right away. My A1C was 10.7 and this could not wait. My heart was racing, and I really don't remember driving home. I cried all the way home in a complete state of panic. My name is Tammy and I am a registered nurse, having spent most of my career working in ICU. Two years ago I started working per diem, once I was accepted into grad school. It is stressful! I am in my last year of the nurse practitioner program and am so excited to be graduating next year! At the end of last semester I started having panic attacks with chest pain during finals and I was always tired - always! That’s part of working and going back to school, right? Wrong! After my finals were over, I went to the cardiologist - my exam was fine, my EKG was fine. He wanted me to come back for an echocardiogram and sent me for tons of blood work, including an A1C.  I was diagnosed with PCOS when I was about 20 yrs old, which is basically a hormonal imbalance (simplified), which causes irregular periods and CAN predispose you to diabetes. I told my doctor that my endocrinologist told me two years ago I was insulin resistant and my fasting glucose was 114. I was always afraid of getting diabetes but really never thought it would happen. Diabetes doesn't run in my family. My parents are both healthy, I exercised off and on, and although I loved carbs, I ate a lot of fruits and vegetables and considered myself mostly healthy. That same day I made an appointment with a nutritionist, a Certified Diabetes Educator, and saw my endocrinologist. He started me on Metformin 500 mg two times a day and said, "You need to lose 20 or 30 pounds and then you can come off the medication.” He gave me a prescription for another A1c to repeat in eight weeks. Nothing made any sense to me. The only symptom other than the fatigue was a dry mouth. That’s it. I had such minor symptoms that it could have been ANYTHING! The nutritionist changed my life. I began exercising consistently and writing down every single thing I put in my mouth. I began Googling everything I could find on diabetes, causes, symptoms, and of course, complications. I came across the ADA Forum, this wonderful website, where I read stories for hours, and I never imagined I would learn this much from complete strangers. It is such a wonderful feeling to be among others who share your story, who relate to your concerns and who understand your pain. In eight weeks I lost 25 pounds and my A1C went to 6.5. I am now exercising daily, four miles on the treadmill, and eating lots of veggies. To date, my A1C is 6.0, I have lost 40 pounds, and although I am not yet at my goal, I am close. What keeps me going is not the weight loss but the desire to be healthy. I have never looked or felt better! It is a very scary diagnosis, but here I am four months later and I'm doing what I need to do! What I have learned throughout this ordeal is that we have a lot more power than we realize when it comes to managing this illness. I refused to take on the "poor me" attitude at diagnosis. I said to myself "Ok, I've [...]

Konjac and Shiritaki Noodles


I have heard and read this question many times: "what food can I eat to lower my blood glucose levels?"My standard answer has always been to advise that there is no such food and the dietary way to lower blood glucose levels is to select carbohydrate portions that do not raise blood glucose levels excessively. I may have to add a caveat to that response in future. For the past three years I have been making occasional experiments with an unusual food called Konjac. This food has several other names in different parts of the world.Scientific: Amorphophallus konjac. Also known as:KonjacshiritakiGlucomann devil's tonguevoodoo lilysnake palmelephant yam You can read more about the plant and its variants here on wiki: Konjacand Shiritaki noodles.There are several forms: powder, noodles, gel and cake. The version available locally to me is noodles, which are packaged in a brine solution.   The noodles look like pasta but are quite different in texture. After draining, separating and rinsing to remove the slightly fishy odour they have a slippery feel and are more chewy than the equivalent spaghetti or fettucine. They do not soak up sauce juices in the same way as pasta, consequently I have learned to reduce my sauces more when preparing konjac dishes. Despite those differences, my experiments show that for me they are a taste worth acquiring.  These are extracts from posts on the ADA forum since I started experimenting with konjac. 1.I rinsed 120gm (4oz) Konjac several times and then let it drain in a sieve for 30 minutes. In my wok I stir-fried 2/3 cup of shredded cabbage and half a medium sliced onion in a splash of peanut oil. When the onion was starting to caramelise I added 50gm shredded ham, warmed it through and then transferred the ham and veges mix to my serving bowl.I fried the Konjac in a tablespoon of peanut oil until the noodles started to separate and dry out and occasionally "popped". They never went hard or dry, but became a little more springy and less moist. I returned the veges and ham to the mix. I continued to stir as I cooked for a couple of minutes until the veges were softened and thoroughly mixed with the noodles. I transferred it to the bowl, adding 15gm (1/2 oz) of shredded cheddar and a splash of cream, stirring it well. It was surprisingly good. The noodles shape was similar to thin spaghetti but the texture was chewier and springy. The noodles seemed to have no flavour of their own but took on the flavours of the other foods in the recipe.Here comes the good news. Pre-meal: 5.8 mmol/L (105 mg/dl)45 minutes post-meal: 5.3 mmol/L (96 mg/dl)75 minutes post-meal: 5.3 mmol/L (96 mg/dl)The post-meal numbers may have been aided by 150ml (5oz) of Shiraz between the end of the meal and the 45 minute test.2.The next experiment with Konjac was not quite as successful. But it was educational. I made up my usual bolognaise sauce, using some mince steak (ground beef to the trans-Pacificans). I browned the meat, then added a cup of my Napoli Sauce and cooked it for a while to incorporate it. When used as a sauce with pasta it is delicious with a dusting of grated parmesan.I prepared 200 gm of the Konjac noodles in the same way, rinsing, draining, separating and lightly frying in olive oil. However, when I added the sauce and tried to “cook it in” as I usually do with wheat pasta the mixture stayed too liquid. Unlike pasta, Konjac noodles do not absorb the sauce liquid.The result was edible but chewy and not terribly appetising. Next time I will cook the Konjac longer and reduce the sauce a lot more, to thicken it and remove a lot of the liquid. After the meal I drank my usual glas[...]

Stress and Blood Glucose Levels.


Stress, like blood glucose spikes, has an insidious effect on the body. I am not qualified to go into the biological aspects of stress, but over the past three weeks I have certainly been forcibly made aware of the physical and mental consequences.I have also been reminded that I have not cured my diabetes over the past decade; at best I have maintained good control. Control which can swiftly degrade under stress. I post my story partly as an explanation to the people on various forums who may have wondered at my absence over the past month, and also as an example to others undergoing stress to reassure you that you are not alone, we all experience our own personal tragedies and stresses. I am not looking for sympathy, I have already received a great deal of support. My intention is to show that this can happen to anyone. If your numbers are rising when under stress, the cause is not always poor diet or inadequate medications. Resolving or dealing with the causes of the stress are just as important. To set the scene, my usual fasting blood glucose over the past few years has been in the range 5.5(100) to 6.5(117). I suffer from Dawn Phenomenon so I am reasonably happy with that. My A1c has been in the low 6% range. In contrast, for the past two weeks I have not seen a fasting blood glucose under 7.5(135) and if my A1c was tested right now I doubt it would be under 7%. Physical stress. Three weeks ago I was cooking sausages on the barbecue raising money for our local Neighbourhood Centre, something I have done twice a month for several years. After cooking several hundred sausages I had to empty the hot drained fat container and carelessly spilt some on my hand, mainly my right index finger. The doctor said it was second and possibly third degree burns. That placed my system under some stress as it slowly healed; I took the final bandages off yesterday, but I am still applying ointments. At least I can type with two fingers again. I noticed that my fasting numbers immediately rose about a mmol (18mg/dl) – and stayed up.Financial stress. Just before I burned my hand I arranged tradesmen to renovate my bathroom. Plumber, carpenter, tiler etc. I am an experienced home handyman so the budget was based on doing most of the preparation work – removing old tiles, shower screens, cabinets etc – myself. Suddenly all that had to be done at tradesmen's rates. The budget has blown out.Personal stress. About three years ago my younger brother was diagnosed with cancer. Over the next couple of years he underwent chemo but made the wise decision to spend as much time as he could travelling with his family and enjoying life between chemo sessions. He did not change his bright, happy character at all.Three days after I burned my hand my brother's wife rang to say we needed to go to the hospital, two hours away. When we arrived it became clear he would not be leaving hospital alive. We stayed for a couple of days, then returned home. On return we received an email that one of my wife's best friends had died in hospital, also from cancer. Four days later my brother's pain left him. Two days later we attended my wife's friend's funeral. Two days ago we went to my brother's funeral. Some time during that period we discovered that the bathroom renovation required more extensive work than we first realised. It didn't really seem that important now.This morning my fasting blood glucose was over 8(144). However, my bandages are off, I will continue to grieve but the worst is over, and today is a new day. In reviewing the past few weeks I realise that I also let my usual dietary regimen slip. Not surprising, but [...]

For UK Type 2s: A Petition to Make Test Strips Available to People With Type 2


This is a brief but important post. I know I have some readers in the UK.

For those not aware of it, test strips are severely restricted for type 2s in many NHS districts. The terrible paper by Farmer et al back in 2007 is often used to support this. I comment on a later paper citing that one here: Is Testing Worthwhile? 

This excerpt from a recent speech by the head of the NHS suggests there may be a brief opportunity to get this changed. 

After the expected introductory words this appears:
"I went to see my GP, they did all the stuff, they said, yes, you've got diabetes. It's quite a difficult thing, I think, particularly for someone, a healthcare professional, someone who has worked in the NHS, to kind of reflect on that and say, right, I have an illness now, a condition which could involve me losing my limbs, my kidneys packing in, having a heart attack and probably dying of a stroke."
  If you read it you'll see why I left out the next sentence. Then he says:
"one of the things they gave me was a monitoring machine, so I take my blood glucose levels four times a day and I have a little chart that I put them on. Now I'm not a stereotype here, but give me a chart and a target and a trajectory and I'm absolutely -- I'm absolutely with you. They could have designed -- they could have absolutely designed that interaction for me and I have been absolutely at it since then."
A friend of mine who runs a UK forum has started a petition to Sir David. I invite UK readers to read it; if you agree, please sign it.  

Click here: David Nicholson, Chief Executive of NHS England: Make blood glucose test strips available to people with T2 diabetes 

There is a short window of opportunity. He retires from the post in a few months.

Cheers, Alan
Everything in Moderation - Except Laughter. 

There is nothing I could eat I like more than my eyes.

George's Story


Here is another inspirational story from a cyber-friend who posted this on the ADA forum recently. I asked his permission to post it here because I believe our success stories help others, especially newly diagnosed people who fear an unknown future. My Story: Lucky to Have Diabetes Hi. I am George_M. What follows is my story, and why I feel so lucky to have diabetes.In August of last year, I was feeling like I had been blessed with a wonderful life. After a disastrous first marriage, I had found the woman of my dreams, and we had enjoyed 23 years of happiness together. My life had its full share of bumps in the road, but those all seemed behind me now. After many years of working 60+ hour weeks, my wife and I were both retired. We had the time and sufficient retirement income to care for our needs and some of our desires. We had a long period of caring for her mother, which was very difficult and emotionally exhausting, but her mother had passed away peacefully at age 95 a few months before. We were able to indulge our joint passion for traveling to interesting places.I get an annual physical exam. The last two had been OK, nothing much to worry about. Triglycerides and cholesterol were somewhat high, and my doctor advised me to cut fat out of my diet. And, oh, one other little thing. My fasting blood glucose in 2010 was 99. In 2011 it was 101. My doctor said that was getting somewhat high. If it went up more she would diagnose prediabetes. She said I should lose weight.I was normal weight for my first 50 years, but weight had definitely become a problem for me the last 20 years. I gradually put on 140 pounds over 10 years. I lost that all in one year on Weight Watchers, then gradually put it all back on over the following 10 years. I was constantly very hungry, even an hour or two after eating a very large meal. Now the doctor was telling me to lose weight. Well, OK, I would try.Then, about two months later, the most miraculous thing happened! I started to lose weight, without any particular effort! I lost about three pounds per month, for 10 months. This is great, I thought, my doctor will be very pleased. I figured my body must have changed as I got older and was naturally shedding weight.Then I went in for my annual checkup in August 2012. The doctor listened to my heart and lungs, said how pleased she was about the weight loss and sent me to the lab to have blood drawn. A couple of days later, I got an email from the hospital that my lab test results were available. I logged on. Most of the tests were about where they had been the year before. But my fasting blood glucose was 235. The lab put a note in the report that they assumed the test was not fasting. The problem was, I knew it was a fasting test.What did this mean? I did some research on the internet and found out that I had type 2 diabetes. How could this be? There was no diabetes in prior generations of my family. My brother has type 2 and is on insulin, but he had been exposed to Agent Orange in Vietnam, and the government says that if someone who was exposed to Agent Orange develops diabetes, the presumption is that it was caused by the Agent Orange. I had not been exposed. How come I had diabetes? And what happened to that prediabetes, where I could know that this was serious and make some changes to keep it at bay?A couple of days later, I got a phone call from my doctor’s secretary. She said my fasting blood glucose was high, that I should avoid sweets and cut back on starches for the time being and come back in two more weeks to repeat the tests. By this time, m[...]

Type 2 Diabetes and the Shame Game


Some time ago I repeated on this blog three guest posts originally published on dLife: The Diabetes Diet WarsMiracles and WondersTurning PointsI re-posted them here to ensure that they did not disappear if the dLife editors chose not to archive them.Since then I have written a couple of guest posts for DiabetesMine and CarbSmart. For similar reasons I will post them here occasionally to ensure they do not disappear. This was published on DiabetesMine in 2011. It is a topic which rears its ugly head a little too often. Type 2 Diabetes and the Shame GameIgnorance may not be bliss after all, and there are occasions where it can be downright dangerous to a type 2 diabetic. But there are some times in life when it can be useful. For me, one of those occasions was April 2002 when my doctor advised me of my diagnosis with type 2 diabetes. At that time I was blissfully ignorant of diabetes in all its forms. So I never suffered diagnosis guilt. Sure, I was overweight, but in my country at that time we weren’t bombarded with commercials earnestly and incorrectly telling us “for our own good” that diabetes is caused by obesity. Just as importantly, the lack of that media barrage meant none of my relatives or friends or any of the type 1s I met at my local support group sneered at me for causing my own condition. I never wasted any time or effort on guilt or recriminations.I didn’t realize it at the time, but I had a major advantage over my American friends, whom I met later on diabetes forums. Far too often over the past eight years I have encountered misery and depression as a consequence of the “blame game” in newly diagnosed type 2s; conditions which often interfered severely with their diabetes management. I reckon that is a direct result of media campaigns, often well-intentioned, which make it abundantly clear that new type 2 diabetics are just as guilty of a self-inflicted wound as the soldier who shoots himself in the foot to avoid a battle. And just as shameful, placing an enormous load on the nation’s healthcare system.It is also becoming a divisive wedge between type 1 and type 2 diabetics on forums and in the media. We should be working with a common purpose where our needs intersect — not fighting each other. We are increasingly seeing complaints from type 1s who should know better but who get upset at being “lumped together in the public mind” with those fat, old, lazy slobs like me: the type 2s.From my reading, it is becoming increasingly clear to me that the genetic tendency to diabetes is related to the genetic tendency to obesity, and which comes first is becoming a chicken-and-egg argument. There is a correlation between obesity and diabetes, correct. But correlation is not causation. And that is irrelevant here anyway. What really matters is that all those idiotic commercials promoting weight loss to prevent diabetes are a counter-productive waste of money; they do not lead to weight loss, they only reinforce the blame game. Worse, they often lead the viewer to sites promoting “low fats and lots of whole grains” diets. It’s hard to imagine a more rapid path to the unwanted goal. They’re essentially recommending a high-carb diet for people with diabetes or a strong tendency towards developing it.To the type 2s reading this: drop the guilt. Whatever the reason for your condition, there isn’t a darn thing you can do to change the past. What matters is what you will do today to improve your future.To the type 1s reading this:[...]

What's In a Name? Am I a Diabetic or A Person With Diabetes?


A very brief post today about a regularly recurring question. Lately I have seen several posts on different forums from people getting upset about being referred to as a diabetic.The bard put it, as usual, so well:What's in a name? that which we call a roseBy any other name would smell as sweet;So Romeo would, were he not Romeo call'd,Retain that dear perfection which he owes   Romeo and Juliet, Act II, Scene II, by William Shakespeare.I don't get precious about labels. Many will disagree with me, but I also tend to be a bit old-fashioned about many of the politically correct terms that have entered our language since I went to school.Context matters. I rarely care about the word that is used to refer to me if the context is appropriate and the speaker or writer's intentions are good. For example, I am:a fathera sona brothera husbandan engineerex-RAAFretiredex-military officera pensioneraged 66 an oldiea senior an ancient a child (to my mother)  a traveller a seeker after wisdom an omnivore a curmudgeon (at times ) a man a baldy a six-footer a diabetica leukaemiac a hypogammaglobulinemicand many other thingsAll of them are descriptively accurate, none define me. I object to none of those words in the proper context. To me the intent in context of the writer or speaker is far more important than any of the specific words. I cringe sometimes when I see the unwieldy "person with diabetes" or even "person with type 2 diabetes" when diabetic or "type 2" may be simpler, more succinct and probably more apt, especially when used by a medical professional, another diabetic or some-one who cares for the diabetic. There are times when the longer description may be more appropriate, but not many in my opinion.Stop worrying so much about words. If a word offends you, look deeper than the word to discover the cause before reacting. Be more concerned about correcting ignorance than the words used to display it. For years I used my own version of Hanlon's Razor before I found others had discovered it before me: Never assume malice when stupidity will suffice. Never assume stupidity when ignorance will suffice. Never assume ignorance when forgivable error will suffice There are more important things in life and diabetes.Cheers, Alan, T2, Australia.Everything in Moderation - Except Laughter   [...]

I'm a New Type 2. Do I Really Have to Test so Much?


I see that question a lot. The answer is no, nobody has to.   But I believe it is wise to. Your meter, properly used, is the bright beacon that will light your way through the dark and confusing maze of food advice that bombards type 2 diabetics. You will get advice from every side. If you have not encountered the Food Police yet, you will. Expect to be told that you should change your diet in all or any of the following ways: low fat; low carb; lots of wholegrains; lots of fruit; vegetarian; vegan; raw; no red meats; avoid sweeteners; sugar-free; no dairy; add expensive herbs and supplements; the list goes on and on. What is right and wrong for you? Is no food safe?Let your meter guide you to the answer. There is no doubt that the Test, Test, Test method is a lot of testing at first when compared with the minimal testing prescribed for type 2s by most doctors. But I believe it is well worth it. The investment of time and test strips in a concentrated effort in the short term has tremendous long term benefits that will last you the for the rest of your hopefully longer, healthier life. And, fairly swiftly, the need to test so much is reduced. The initial period is the heaviest testing load because at that stage you have a blank slate. As you fill in the blanks the load swiftly decreases.I recommend the following intensive testing routine for people newly diagnosed with type 2 diabetes. It can also be very useful for those who have been diagnosed for a while but who feel they have "hit the wall" in their progress towards good control. For the first couple of days test fasting blood glucose (on waking, before breakfast) and also at one and two hours after absolutely everything you eat, unless you eat again before the second test. That includes breakfast, lunch, dinner and all snacks. This may help if you are not used to testing so much: Painless PricksLog everything on the menu including drinks, sides and portion sizes. Every evening spend a few minutes reviewing that log and use it to plan the following day's menu with a view to achieving better results. Some people are adamant that you must also test before meals. I agree that it may help to know the starting point when assessing a rise, but I do not think it is necessary to add an extra half a dozen tests every day to an already heavy initial load when the other tests will still achieve your goal.  On the evening of the second day take some time to review all the results. Some of them will seem crazy, but you should see some patterns emerge. The first thing to look for is the timing of your most consistent peaks. That may be a little different for breakfast, lunch and dinner. Is it closer to one hour or two? If you can pick the most consistent peak time then replace the one and two hour tests with just one test at the peak time after each meal. If the peak time is unclear then continue to test at one and two hours and re-assess each evening until it is clear. If necessary add tests at 30 or 90 minutes to be sure; you won't need to do those for long.Use of the peak post-meal time reduces your test load to fasting and peak time after every meal and snack. My own peak time is about one hour after my last bite, but yours may be different. Over the next few days, using this Test, Review, Adjust technique you should be able to discover several "safe" menus for various meals. You will also find that some meals are OK for the morning but not for the evening or vice-versa[...]

The Fat Tax: Dare I say I Told Them So?


I am flat out preparing for departure on my Myanmar trip tomorrow but I could not let this news item pass unnoticed:Denmark to scrap world's first fat tax"The fat tax and the extension of the chocolate tax - the so-called sugar tax - has been criticised for increasing prices for consumers, increasing companies' administrative costs and putting Danish jobs at risk," the Danish tax ministry said in a statement. "At the same time it is believed that the fat tax has, to a lesser extent, contributed to Danes travelling across the border to make purchases. "Against this background, the government and the (far-left) Red Green Party have agreed to abolish the fat tax and cancel the planned sugar tax."I wrote earlier on this subject: Taxes For Our Own Good, concluding that I believe that the suggestions to tax foods for public health reasons are misguided at best and may be counter-productive at worst. Not only do such taxes not work, especially when they choose the wrong foods to tax, they can become expensive liabilities for the businesses forced to become tax collectors on the government's behalf adding accounting and red tape costs. As Danish businesses were quick to report:Businesses call fat tax a failure on all frontsLevy costs millions of kroner and has not resulted in consumers making healthier choices, say food producers. Finance minister Bjarne Corydon (Socialdemokraterne) is not opposed to trimming the fat tax, but the lost revenue will have to be made up Denmark's surcharge on the fat content of foods has cost businesses 200 million kroner since it was implemented last October, according to Dansk Erhverv, a business advocacy group. The tax has been expensive,” chamber spokesperson Lotte Engbæk Larsen told Jyllands-Posten newspaper. “Businesses have had to absorb the costs of administration, set up new IT systems and explain it all to customers and suppliers.”Larsen said that the red tape was the only thing to come from the levy, since it did not encourage customers to pick less fatty food. “There have been absolutely no health benefits gained from this tax,” said Ole Linnet Juul, of DI Fødevarer, a food industry advocacy group.Yes, I will say I told them so. Food taxes are not the way to improve public health. Hopefully the social engineers promoting these taxes in other parts of the world, including my own country, will heed the lessons of this failed Danish experiment.Cheers, Alan, T2, AustraliaEverything in Moderation - Except Laughter[...]

Lisa's Story


One of the nice things about being on several forums is seeing the success stories. Ordinary people doing extraordinary things. Not Olympic athletes but people like you and I who decided that they were not going to become part of the abysmal diabetes statistics but that they would restart their lives for longer, healthier happier lives with less risk of diabetes complications. I have collected a limited selection and listed them on Other's Stories.Today this story was posted on the ADA forum. Lisa graciously granted me permission to repeat it here. Hi! My name is Lisa, I have type 2 diabetes and this is my story. I am a working mother/wife with four grown children and one grandchild. I am not very athletic, and my most favorite activity is reading my Nook. (Just ask my darling hubby! Oh boy, is he ever sorry he gave me that thing!) Exercise is a challenge for me. I am not into marathons or trendy exercise programs, just old-fashioned walking and biking. I am active in my church and love to help out wherever I can. I love my five cats. Yes, five! I acquired them while working through my empty-nest phase.My story begins like most of us: hearing that my fasting blood glucose (BG) reading put me over the “limit.” No prediabetes, do not pass go, go directly to full-on diabetes. No “get out of jail free” card for me.This had been on my radar for quite some time. Oddly, it still took me by surprise. I am on medications for high triglycerides, cholesterol, blood pressure and allergies. My liver is slightly enlarged due to non-alcoholic fatty liver disease (NAFLD). I don’t take medicine for this or my diabetes, but I was advised to lose weight. Gee, that never occurred to me! Still, I sometimes joke that I am a walking pharmacy. The pharmacy knows me by sight. This can be a good thing, actually.Six years ago, I managed to lose 40 pounds and kept it off two years by eating a very low-carb, high-protein diet and lots and lots of walking and biking. Then a series of unfortunate life events sort of took the stuffing out of me, and much of that weight crept back on. I might have forestalled my diagnosis a few years with all that. Little did I know that the low-carb/high-protein diet was perfect for a person with diabetes!Since my diagnosis in December 2011, with an A1C of 6.4 and fasting blood glucose of 146, my doctor agreed I should try to manage with diet and exercise. I went home, cried, ranted and then threw out all my junk foods. I went back on my diet program and got to walking again at least for 30 minutes as many days of the week as I could manage. I lost 20 pounds in three months. I’m kind of stuck there now. But, the A1C went down from 6.4 to 5.9 three months later, and then 5.8 after the next three months. So that’s good progress.The hardest thing to deal with is feeling ashamed for allowing this to happen. I can sometimes feel alienated from others and resentful of my situation when I have to say “no" to certain food—foods that I am, on the inside, drooling to devour! Also painful is that the media tends to focus on the questionable idea that diabetes is caused by being overweight . . . like it was my fault.Within the American Diabetes Association’s online community, I have found hope and the knowledge that this was not my fault. I have realized that I can manage my diabetes and still live a full, happy life. I found necessary information on what BG lev[...]

Large New York Baked Low Carb Cheesecake


I owe thanks for this recipe to a great cook on the ADA forum who posts as Granny Red. She attributed her source as After baking it several times I have modified it slightly by experimenting. Ingredients Crust1 1/2 cups Almond Flour 6 Tbsp Splenda5Tbsp butter, melted Filling24 oz (750gm) cream cheese¾ cup SplendaOne tablespoon of sugar3 eggs2 tsp vanilla extract 1 tsp lemon extract or a good squeeze of lemon16 oz (600ml) sour creamNote: the eggs, cheese and sour cream need to be at room temperature. If the cheese is too stiff to beat easily sit the containers in warm water for a little while until the cheese softens. MethodCrust Base Use extra butter to grease an 8 or 9 inch (20-25cm) springform pan. I also put a circle of greased brown paper on the bottom to be certain the cake does not stick; this step may not be necessary if you use a non-stick pan.   Mix the splenda and almond flour (sometimes I make my own coarse version from almonds in the blender; it works just as well) with melted butter, press evenly onto the bottom of the pan for a thin layer without holes and press any excess up the sides of the pan. If you don't have enough almond flour to go all the way up the sides don't worry, just go up as high as you reasonably can. It's not really critical as long as the base is covered. In that situation I use greased brown paper around the sides to minimise sticking. Set the pan aside while mixing the filling. Filling Beat the cream cheese until light and fluffy, keeping the mixer on a low-medium setting throughout the beating and mixing process. Add the mixed splenda and sugar a little at a time and continue beating until creamy. The original recipe had more Splenda, but I found that a tablespoon of sugar with less Splenda improved the flavour for my non-diabetic wife without raising the carbs too much. You can adjust that to your own taste. Add one egg at a time and beat very briefly after each egg. When the eggs have been mixed into the cream cheese add vanilla and lemon extract or lemon juice and mix briefly until just combined. Add the sour cream last and beat briefly until incorporated.Pour the mixture into the springform pan. Bake at 300 F or 150C for about 1 hour, then check to see if it is nicely brown on top. If not, let it cook for another 15 minutes. When it is cooked, prop open the oven door, turn off the heat and leave it in the oven for at least an hour. Then remove it from the oven and allow it to cool to room temperature before placing it in the fridge until the next day. Don't try to serve it on the day of cooking; it will not be set properly if you do. Do not be disappointed if it sinks slightly in the middle. That is normal, or, at least, it was for the ones I made. The result is 16 satisfying slices. I individually wrap some in clingwrap for the freezer; they freeze and defrost well. Calories 340 Fat 32 gm Protein 8 gm Carbohydrates 6 gmCheers, Alan, T2, AustraliaEverything in Moderation - Except Laughter [...]