The Great Diabetes and Pizza Controversy

PizzaDiabetes and pizza.  Hmmmm?  If you have diabetes, and you love pizza, you’ve probably experienced the blood sugar roller coaster that occurs after you’ve filled your tummy with as much as it can stand without exploding.  (Everybody’s done it!)  Over the last week or so, for some reason, pizza has come up in conversation with many of my diabetes peeps. Then today I read this neat story at www.sixuntilme.com about pizza, and I figure this is the universe telling me to blog about it.

I love pizza, but I don’t eat it, partly because I don’t have the math skills to figure out the bolus required for eating pizza.  Here’s what typically happens to diabetics that don’t yet understand pizza and diabetes.  Let’s say you eat 4 slices of pizza, and you start with a normal blood sugar of about 100 mg/dl.  4 slices is approximately 100g of carbs.  Notice I said approximately.  You never really know how many carbs are in each piece for a bazillion reasons.  (It’s a word.  It’s MY word.)  So you bolus for 100g carbs.  Between 1 and 2 hours later, you crash hard.  Your blood sugar is like, . . . in the 50′s.  So you eat what you’re suppose to, exactly 12 carbs, and you check, and your blood sugar is around 80 mg/dl.  Then 2 hours later it’s 270!  WTH?!

Here’s what probably happened.  The high saturated fat content in the cheese caused temporary insulin resistance, slowing down the initial blood sugar spike, AND hours later it causes your remaining bolus and your basal to be less effective  So you bolused for 100g, and since the fat slowed down the carbs, your blood sugar didn’t rise as quickly as it would otherwise, but your insulin still did it’s job, so you crashed.  Then you corrected at about the same time that the fat is causing insulin resistance, so you’re rising from your correction, AND you’re rising from the insulin resistance.  This can last for hours.

Now if you didn’t know this, don’t feel bad.  I only learned about saturated fat’s effect on my blood sugar last year.  I have my CDE (Certified Diabetes Educator) to thank for educating me on this.  Have I mentioned that she’s amazing?  Now that I understand this, I have a lot less “unexplained high blood sugars”.  Below is how I deal with high saturated fat meals.

First, don’t just try this without first consulting your endo or CDE, because saturated fat doesn’t effect every diabetic the same way.  I’m just sharing what I do.  So here goes.  This first bit is VERY IMPORTANT.  When my meal has more than 25g of saturated fat, then I increase my total bolus amount by around 25%, BUT I  DON’T TAKE IT ALL AT ONCE.  I take 40-60% of it with my meal, and then I take the rest of it in a dual-wave bolus set for 4 hours.  That usually works for me, but you have to fine tune it every time depending on how much carbs, and how much saturated fat you eat in a meal.  When you’re meal has less than 25g of saturated fat, it’s less likely to affect you this way, so if you only eat 2 pieces of pizza, you don’t usually have to bother with this, but again, it’s different for everybody.  (I know, to many commas.  I don’t care. It’s my blog! *grin*)

I actually don’t eat pizza anymore because I try to follow the paleo lifestyle most of the time.  However I do eat large amounts of saturated fat every once in a while, so I still have to deal with this.  It’s been so long since I ate pizza, that I honestly can’t even remember the last time I had it?  Some diabetics will say pizza is horrible and you shouldn’t eat it, some will say anything is ok in moderation, and others don’t limit themselves and enjoy what they like.  Whatever you choose, I hope this blog helps you understand pizza’s effect on your blood sugar.

If you found this blog helpful, please share or comment, or both.  Thanks!

Have you ever had a diabetic seizure?

diabetic seizureI’ve been diabetic for 42 years.  I left home for college at 17.  I haven’t owned a glucagon shot since then.  I see a lot of people post blogs, videos, tweets, about having a glucagon shot in their diabetes bag, but I’ve never had one as an adult.  My parents kept them when I was a kid, and used them a few times, but I’ve never kept one as an adult.  I wondered if I was the only one who didn’t keep one, so I tweeted about it, and got tons of responses immediately from other type 1′s who don’t have them either.  So I guess I’m not alone.

What is glucagon?  Why does a diabetic keep a shot of it?  What does it do?  Well it comes in a shot because it’s for those times when you’re blood sugar is so low that you’re unconscious, or sleepy, or otherwise unable to eat carbs.  So it kinda needs someone else around to give you the shot.  If you live alone like me, what’s the point, right?  So back to what it does.  I’ll bet you know what insulin is?  Glucagon is the opposite of insulin.  It’s insulin’s sister hormone.  Insulin is a builder, and glucagon breaks things down.  The 2 can’t co-exist in the blood stream at the same time.  What glucagon does for a diabetic when it’s injected, is it places a high concentration of glucagon into the blood stream which quickly forces the liver to start converting (breaking down) glycogen into glucose, or converting protein (amino acids) into glucose via gluconeogenesis.    This quickly raises blood sugar so you can recover from your hypoglycemia.  So glucagon is for when you’re unable to help yourself out of hypoglycemia.

I can remember regularly. . . VIVIDLY . . . when I was a kid, having a diabetic seizure in my sleep from low blood sugar, and mom and dad trying to force different forms of sugar down my throat while I was seizing.  When I say vividly, I mean I can still see mom and dads faces hovering over me while seizing and I can see the bright light of the hallway behind them, shadowing their heads.  I can hear them yelling, urging me to eat what they were trying to force down my throat.  Honey, sugar cubes, juice, etc.  They didn’t believe me, but I was FULLY CONSCIOUS while I was seizing, and I always got furiously mad at them for trying to force that food my throat instead of letting me try to eat it myself.  A few times they used a glucagon shot to bring me out of those seizures, but when I saw them coming with that shot, I’d get the strength of bigfoot and I’d fight them.  (I used to have nightmares of bigfoot as a kid.)  They never believed I’d be ok, unless they did these things.  It’s ok mom and dad, I understand, BUT I WAS RIGHT!!!  LOL!!!

When I went away to college, I was lucky that I never had a seizure with roommates in the apartment.  Or did I?  Crap!  I don’t remember now.  John, Mike, do you remember if I did?  Anyway, after college, living alone, I did have seizures now and then.  Mom and dad never understood until I moved away, that I would come out of those seizures on my own, and I could then get glucose into my system on my own.  I was always 100% conscious, and aware of what was wrong, and what I needed, while seizing.  There’s one night in particular that I remember like it was yesterday.  It was probably 18 or so years ago.  I was seizing in my waterbed, which is a horrifying experience by the way, because as you’re seizing you’re arms and legs are outstretched trying to stop you from falling every couple of seconds, even though you’re not falling, and the bed moves.  *shivers*  Yeah, horrifying.  Anyway, as I was seizing, I was able to roll myself out of bed and onto the floor after many minutes.  I then seized my way about 20 feet into my kitchen over who knows how many minutes.  I knew I needed to get to the kitchen where the sugar was.  When the seizure stopped.  I calmly stood up, stepped over to the sugar container, took out the 1 cup scoop and started swallowing raw sugar.  I knew I’d be fine, but the experience was definitely not fun.  Now I keep glucose tabs on my nightstand.

Now, here’s the kicker.  When I went on the pump, the seizures stopped.  Haven’t had a seizure in over 6 years.  It’s that damn long acting insulin dumping in the bloodstream all at once!  All my life I had been on either NPH or Lantus, along with Regular, until I went on the pump when I changed to Humalog.  I still have low blood sugars in my sleep, but they come on so slow, that I ALWAYS wake up.  When I get any low blood sugar, it comes on way slower on fast acting insulin.  Explain that?!   I think I’m hypo right now actually, so I’m gonna sign off and get some glucose tabs.

********** Now ya know, and knowing is half the battle.  Go Joe!!! **********

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Weight Gain With Insulin Pump Therapy

A couple of days ago, a young diabetic Twitter friend from Baghdad asked me if insulin can cause weight gain.  The quick answer is yes, absolutely.  I thought that would make a good blog article, so here goes.

I don’t remember exactly when I started my insulin pump therapy, but I think it was 6 or 7 years ago.  When I started asking around about it before getting my first pump, everybody told me that I should expect to gain about 20lbs.  I said “WHAT?!!!”  There was no way I was going to get a pump if that was a side effect.  Well, when I checked into it, many people do gain weight, but it’s because using a pump is so much easier than shots, that people just start gorging their pie holes with carbs like they’re no longer diabetic.  More carbs + more insulin = more fat.  I was working out like a bodybuilder at the time, in the gym 4 days a week, lifting seriously, and I knew I could avoid this pitfall.  So I went ahead and got my pump, . . . and never gained a pound.

You see insulin is an anabolic hormone.  That’s a fancy scientific word that means it’s a growth hormone.  When you eat carbs, first they are turned to glucose for transport in the bloodstream, and then they are stored in your muscle cells and liver as glycogen.  When the muscle cells and liver are full, the rest of the glucose is stored as fat.  Insulin is the key to this process.  Without insulin, muscles won’t grow, and neither will fat cells.  So if you’re body can only store 20 carbs per meal (just as an example) in muscle and liver, but you’re eating 60 carbs per meal, and you’re bolusing for 60, then 40 carbs per meal will be stored as fat.  That ratio of what you store in muscle vs. what you store as fat, is different for everyone.  So I’m afraid I can’t give you a magic formula to help you lose weight.  What I can tell you, is that when you start insulin pump therapy, don’t go crazy eating whatever you want just because you don’t have to take shots anymore, and you should do fine.

If you’ve recently become diabetic, and you’re not on a pump yet, like my friend from Baghdad, a different scenario applies.  You see, if you’ve recently been diagnosed as type 1 diabetic, then you’ve not had the right amounts of insulin for a while.  This means limited muscle growth, and limited fat storage.  This is what causes the symptom of sudden, un-explainable, and rapid weight loss before you’re diagnosis, which is a telltale marker of un-diagnosed type 1 diabetes.  So now you get diagnosed, you start taking insulin, and now your body has what it needs to store the glycogen and fat properly.  So you start to gain weight again.

The key for everyone, diabetic or not, is that to control your weight, you have to control your insulin.  To control your insulin, you have to control your carbs.  Low fat diets won’t make you lose weight, and they won’t reduce your cholesterol.  A lower carb diet will (not necessarily low carb, just less carbs), and there’s science to explain why it will.  It’s not calories in, calories out, like so many trainers, doctors, nurses, and dieticians will tell you.  Insulin control is the key to weight loss.  For an amazing book that can teach you about insulin, that’s disguised as a simple diet book, read “Protien Power“.

********** Now ya know, and knowing is half the battle.  Go Joe!!! **********

If you found this article helpful, please give it a LIKE and share it with others who might benefit from it.  Thanks for paying it forward!  If you’d like to connect with me, you’ll find my social networking profiles to the right:  ————————>

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