[kmillet]

Hello everyone, my name is Ken Millet and have been diabetic since 1999. Unlike, I would think, most of you, my diabetes was caused by high dose steroids for a neurological condition (80mg of Prednisone for 2 years). There is no history of diabetes in any of my family. Until this year my treatment consisted of Glucophage and diet. Occasionally we would try Amaryl but that had a tendency to bring my blood sugars way too low (mid to high 30's) so we stopped that.

In the spring of this year I was diagnosed with Neuroendocrine Carcinoma and was treated with Octreotide monthly. This treatment, it was thought, had a negative effect on my blood sugars. Within the past 4-5 months my sugars have fluctuated wildly which led me to insulin. In an attempt to stabilize my sugars my endo now has me on 20 units of Humalog before breakfast, 7 units before lunch and 17 before dinner, with 32 units of Lantus at bedtime. My poor endo probably wants to take me into a dark alley and shoot me. (Just kidding, he and his nurse have been wonderful to me)

I've had close to 20 surgeries on my feet due to infections over the years including a transmetatorsal amputation of my left foot (due to MRSA) and most recently the removal of the small toe and metatarsal on the right foot. I now have a Portacath installed in my chest as PICC lines are no longer possible (my veins are pretty well shot). With all that is going on I still consider myself lucky; my vision and my kidneys are unaffected, so let’s count that as a blessing. I hope everyone is having a good day.
Ken

 

[diabetes86]

WOW that is a boat load of problems. Keep the chin up!!

do you eat a lower carb diet? lower carb diet makes the insulin use less less carbs less insulin less swings in BG. At least for most of us.

 

[Shanny]

We're always pleased to meet our lurkers! Thank you for joining us, Ken, and for introducing yourself. And with your attitude in the midst of all these afflictions, you are a class act, good sir!

Diabetes86 makes a good point - if you're eating a low-carb diet, that could offset the higher numbers caused by the octreotide. Under ordinary circumstances, low-carb eating would reduce the amount of insulin required to maintain lower glucose levels, and in this case it might at least help stabilize your levels - eliminate the wide swings - making management easier. Could you go any lower carb than you already do?

 

[kmillet]

low carbs

WOW that is a boat load of problems. Keep the chin up!!

do you eat a lower carb diet? lower carb diet makes the insulin use less less carbs less insulin less swings in BG. At least for most of us.

Thanks for the the kind replies. Currently I'm trying to maintain under 50 grams/meal which can be sort of tough on a former meat and potatoes guy. So far the low carbs have not had a great impact on my blood glucose numbers. To give you an idea of the wild swings my morning sugars yesterday was 80, the evening number was 240.

 

[smorgan]

Thanks for the the kind replies. Currently I'm trying to maintain under 50 grams/meal which can be sort of tough on a former meat and potatoes guy. So far the low carbs have not had a great impact on my blood glucose numbers. To give you an idea of the wild swings my morning sugars yesterday was 80, the evening number was 240.

I have to eat about 1/5 that many carbs to get good BG control. I didn't find it as hard as I expected. Just switch that "meat and potatoes" meal for meat and a green vegetable smothered in butter (or better yet, Hollandaise sauce). It can be every bit as satisfying and much better for your BG.

 

[Shanny]

Thanks for the the kind replies. Currently I'm trying to maintain under 50 grams/meal which can be sort of tough on a former meat and potatoes guy. So far the low carbs have not had a great impact on my blood glucose numbers. To give you an idea of the wild swings my morning sugars yesterday was 80, the evening number was 240.

Salim has given you good advice - I use the same trick - butter & hollandaise by the bucketful! I could never make it on as many carbs as you eat . . . indeed 50g is over my limit for the DAY. It may seem impossible, but in order to save what's left of your feet, I think it would be good to take it lower. Add more fat & you'll miss the carbs a lot less.

Are you off the prednisone & octreotide now?

 

[kmillet]

Salim has given you good advice - I use the same trick - butter & hollandaise by the bucketful! I could never make it on as many carbs as you eat . . . indeed 50g is over my limit for the DAY. It may seem impossible, but in order to save what's left of your feet, I think it would be good to take it lower. Add more fat & you'll miss the carbs a lot less.

Are you off the prednisone & octreotide now?

Yes, I am off the prednisone and octreotide. I do like the idea of butter, etc., however, that has a negative effect on my lipids, which my docs don't like either. "The Lady or the Tiger?"

 

[moon]

My lipids have been improving on a high-fat diet - healthy fats, mind.

 

[smorgan]

My lipids have been improving on a high-fat diet - healthy fats, mind.

Mine, too and I don't buy the "healthy" fats line if that means more monounsaturated and polyunsaturated and less saturated.

My definition of "healthy" is things found in that state in nature and which have been consumed my humans for millennia (no Canola!). That excludes nearly every oil on the supermarket shelf except for virgin olive oil.

Contrary to the myths of the last 40 years, saturated fats are very beneficial to health including heart health because among other things they raise HDL and lead to "large and fluffy" LDL (less oxidation) which is not a risk factor for CVD even if "high" in overall quantity (the simple tests only measure overall quantity, not particle size which is more important).

The much touted PUFAs (polyunsaturated fats) on the other hand cause increased oxidation of LDL making it "small and dense", i.e., possibly dangerous as a risk factor for CVD.

So, I eat very high fat, none of the fad oils or highly processed vegetable oils limited PUFAs but don't worry about quantities of saturated fat (e.g., beef fat, butter, cream, coconut oil, etc.) or monounsaturated fat (e.g., olive oil, avocados, etc.) I consume.

All of my lipid numbers have improved dramatically after switching to this way-of-eating. According to my labs, I am at "very low" risk for CVD after these improvements. All that while getting 75% of my calories from fat and not following the established "rules". Either I'm a freak of nature or many people have gotten it very, very wrong.

 

[Shanny]

Yes, I am off the prednisone and octreotide. I do like the idea of butter, etc., however, that has a negative effect on my lipids, which my docs don't like either. "The Lady or the Tiger?"

I would hope that being off these drugs would allow your body to return to a more normal state & possibly be able to process the true natural fats in a better way that doesn't elevate your lipids profile. We were always TOLD that consumption of fats raises cholesterol, but found the opposite to be true when my husband had his checkup this year. All of his lipids changed dramatically for the better - HDL increasing & everything else dropping. His triglycerides dropped through the FLOOR - went from 379 to 138, just by eating LC/HF.

Good luck!

 

[moon]

Salim, yes I think we share the same definition. I'm quite sure, with my high triglycerides/low HDL and general low-fat, high-carb diet when I was dx'ed, that my abundant LDL were the small dense kind.

As my trigs went down, HDL went up, ratios got into (low) normal range, and every test improves (LDL is remaining stubborn) - I wonder how long it takes for the small dense kind to be replaced by the large fluffy. I'm not at all clear on the mechanics of this - but am not inclined to test for particle size since I'm not prepared to do anything pharmaceutically about it.