[WalterLiv]

Diagnosed as T2 in 2004. BS at diagnosis was around 380. Dr put me on Glipozide, and my numbers were all over the place between 200 and down to as little as 60. A1c stayed below 6.9%. Dr & I wanted a little more stability, so we changed to Metforman 500 x1. Fasting BS in the morning was usually between 150-170. Couldn't get my BS down to <120. Went to Metforman 500 x2. Still couldn't get BS down.

Fast forward to Feb 2011 - during a normal quarterly blood test we found I had Acute Lymphoblastic Leukemia, with a positive Philadelphia Chromosome. Got rid of all leukemia cells, and rebuilding marrow in a maintenance chemo. Taking Vincristine and Decadron (steroid). Decadron jumps my BS to above 290 within 6 hours of treatment. Stays above 260 for an additional 24 hours, then gradually goes down to about 150 48 hrs post treatment.

To try to do a better job of controlling BS while undergoing chemotherapy, Dr put me on Novolog FlexPen on a sliding scale. I take my Bs before eating, then inject based on sliding scale. So, I've been using insulin for 5 days. I just haven't seen much progress in lowering my BS. Working closely with Fam Dr, Oncologist, Cardiologist.

 

[moon]

You have had quite a ride ... wow. Welcome to the forum!

I know nothing about chemo or insulin, but when people join us and ask how to get their blood sugar under control, the first thing we tend to ask is 'what do you eat? what's your diet?' There's a good reason for that. For a Type 2 diabetic, diet is the first line of defense, and the area where the mainstream gives us very controversial (to be kind) to very bad advice.

You might have the diet angle licked, but just in case ...

We're advised to eat a high-carb diet (up to 200 or more/day) which is simply too many for most diabetics. I got my A1C down dramatically in 3 months by giving up rice, bread, pasta, cereal, grains, fruit (except berries) - and there's no amount of meds that could give me the numbers I have now (and am still working to improve) if I were to eat 200 carbs/day. Well, maybe there's some crazy amount of insulin, but I shudder to think -

How many carbs do you eat in an average day?

 

[jwags]

Welcome to the Forum. I'm sorry for all you are going through. I am not on insulin yet. So far I've been using 2550 of metformin to control my bgs. On lower doses I didn't have very good control. I do know that a lot of diabetics on insulin find that counting specific carbs and matching insulin dose to carbs consumed works much better than sliding scale approach.

 

[WalterLiv]

Still new to T2 diabetes, Leukemia, and insulin usage

... I do know that a lot of diabetics on insulin find that counting specific carbs and matching insulin dose to carbs consumed works much better than sliding scale approach.

Thanks for your comments jwags. I don't have an endo, just a good Fam Dr, and we are working to get my BS down. He wanted to see if the sliding scale worked okay. We discussed upping my dose of metforman, but wanted to see if the insulin helped drop my BS following chemotherapy treatments (once a week) that include Decadron (steroid). It's tough trying to control everything that is going on right now - T2 diabetes, Leukemia, glaucoma, high cholesteral. Each has medications, each has restrictions, each has recommendations, and my wife and I read the product notices judiciously and ask lots of questions of the pharmacy at the Montgomery Cancer Center. We've found we've have to prioritize
a few meds, with cancer and diabetes sharing 1st place, and high cholesteral and glaucoma sharing 2nd place.

 

[WalterLiv]

... For a Type 2 diabetic, diet is the first line of defense, and the area where the mainstream gives us very controversial (to be kind) to very bad advice.

You might have the diet angle licked, but just in case ...

We're advised to eat a high-carb diet (up to 200 or more/day) which is simply too many for most diabetics. I got my A1C down dramatically in 3 months by giving up rice, bread, pasta, cereal, grains, fruit (except berries) - and there's no amount of meds that could give me the numbers I have now (and am still working to improve) if I were to eat 200 carbs/day. Well, maybe there's some crazy amount of insulin, but I shudder to think -

How many carbs do you eat in an average day?

My Diabetes Trainer told me I am restricted to 60 carbs, per meal !! That's a hefty amount per day, but I don't do that much.

My typical eating plan:
Breakfast: Cheerios MultiGrain, 2% milk (approx 40 carbs); 1/2 cup oatmeal w/sugar-free syrup (27 carbs, 11 sugar alcohol carbs); Egg-white "pucks", 1 slice ham, 1 slice cheeze on split english muffin (approx 28 carbs total) I previously owned a bakery and used egg whites - found out they were absolutely great as a low-fat protein. Mixed 1.5 cups egg-white and 1 whole egg for scrambled eggs.
mid-morning snack: usually nothing, but when I do it's usually low-calorie yogurt (24 carbs)
lunch: sandwich on lo-carb bread, diet drink (approx 18 carbs)
mid-afternoon snack: approx 1 oz nuts (6 carbs)
Dinner: typical 6 oz protein (pork, chicken) 2 times a week; salad night w/olive oil and Ponzu dressing 2 or 3 times a week; fish (broiled salmon), veggies, a starch like sweet potato fries or a small baked potato. (usually about 30-60 carbs, except for salad which is extremely low carbs) We use Dreamfields Pasta (great for diabetics) as a pasta sometimes once every 2 weeks.
Late evening snack: sugar-free jello (zero carbs)
Just before bed: about 3 times a week - Jay Robb Whey Protein shake made with water (1 carb), or made with a banana (15 carbs) and milk (11 carbs) (total of 26 carbs).

So to answer your question of how many carbs per day - I'd say approx 130-150 per day.

I'm a big man, 6'3", was 280 when first diagnosed, and now down to 252. My problem has always been portion control. When I first started my chemo treatments - the kind that killed all my white/red blood cells my energy level was absolutely zip - could only get from bed to easy chair in living room, and needed help getting to bathroom. I don't use anything that contains sugar, except for very low dosages in some snacks. I've used Splenda and just recently Stevia, and Agave Necture. I've been on diet drinks for many years. I drink at least 2 liters of filtered water a day flavored with sugar-free flavor stiks. Unfortunately, chemo treatments totally destroy my energy for at least 5 days - I can't do much more than simple home exercises. Prior to the leukemia my wife and I did strength and cardio training at a gym. I really miss it. I have a PICC 3-port line in my upper right arm where I receive blood when needed, and all my chemo treatments, so I can't do anything to restrict my right arm, like blood pressures, weekly blood tests, or play golf (big bummer !!).

 

[moon]

You've got a lot on your plate, a lot that is demanding courage. Any input I give doesn't take your chemo into consideration because that's an area about which I'm fortunate to know nothing. I'm sorry this has to be part of your knowledge/experience base ...

My first suggestion would be to restrict your breakfast carbs, i.e. have eggs, meat, cheese for breakfast, no cereal or oatmeal or toast. We're most sensitive to carbs in the morning. Are you testing 2 hours after your breakfast? Compare those numbers to ones you get without all those carbs.

Other comments:

- Agave Necture is a simple carb sugar. 1 tablespoon has 16 carbs. I would eliminate that the same way you eliminated sugar.
- Dreamfields pasta can be tricky with a very delayed spike. It's not great for diabetics, it's tolerated by some. You might want to test before you eat it, then every hour for 4-5 hours to see how your body is actually handling it.
- mid-morning snack I'd suggest something lower carb. You're having a carb breakfast, then a carb snack, pretty much setting you up for higher numbers ...
- try a low-carb snack before bed vs milk+banana

I think you will see lower blood sugar and fewer huge swings if you experiment with lower carbs - esp in the morning - and doing some initial close testing to get a fix on what your body is able to handle.

 

[jwags]

Moon gave you some great suggestions. It always bothers me that dieticians tell diabetics to eat 60 carbs a meal and then wonder why our bgs are so high which forces many onto Insulin. Is there a reason you are avoiding fats? Fats help stabalise bgs. I would cut out some of the processed cereals and breads and add real fats. Real eggs, real butter, real sour cream and real cheese and red meat. Especially going through Chemo you need all the energy you can get. Eat lots of veggies, but limit the fruits. I think all of us have been give bad information on diets from our CDE's. I lived with way too high numbers for over 2 years until I went totally low carb. I still eat fantastic but rarely eat more than 40-50 carbs per day. I eat tons of veggies, no bread or cereal, tons of homemade snacks made with almond meal including cookies, muffins and even chocolate. I usually eat meat at least one meal a day, red meat at least 2-3 times a week. I eat homemade ice cream made with all sorts of good ingredients. Eating this type of diet rarely pushes me above 110.