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[IP] spike?

marion wrote:
> Regular soft drinks spike the sugar as they are very glycemic.  

everything with any carb at all is "glycemic". It is inherent in the 
definition of the word.  Whether it is HIGH glycemic or LOW glycemic can, and 
does, play a role in the rise of one's blood sugar, diabetic or non defective 
 alike.  Nor are we any more "resistant" to high glycemic food.  You will 
STILL need the same amount of insulin for 30 carbs of coke or 30 carbs of 
orange juice or 30 carbs of  white bread or 30 carbs of Ben and 
Jerry's....The ONLY variable is the TIMING of that insulin.   In the "olden" 
days of Regular Insulin, they told you to inject 1/2 hour to 45 minutes 
before you ate, so the insulin could get in and start being effective when 
those first carbs hit the blood stream.  With Humalog and Novalog that wait 
time is diminished, but perhaps for a super high simple carb "food" such as a 
regular coke, or a glass of apple juice, you might want to give yourself a 
5-10 minute advance bolus, depending on your sensitivity to the insulin (for 
osme people, the Hum/Novalog starts to lower bg in as little as 5 minutes so 
you don't want to wait too long) For a higher fat 30 grams, you might want to 
split that bolus or dole it out in a square wave.

Personally, i believe it is a FALLACY that a body needs "more" insulin to 
bring down a high blood sugar and I am sure 30 of you will write in with your 
own true life experiences of needing 200 units to bring down a bg of 450, but 
it is MY PERSONAL conviction that if you DO NOT Freak out when you have a 
high blood sugar and try and FORCE your blood sugar down to 125 in an hour, 
then your body will NOT react by dumping in more sugar raising counter 
regulatory hormones.  So many people bolus, then test in an hour and see they 
have only come down 20 points, so they dump in another chunk of 
insulin.....THIS is when the hypos start!  Your body is FIGHTING this drop in 
blood sugar by dumping in counter regulatory hormones, like adrenaline, 
cortisol, growth hormone, etc...all these are sugars...all are released when 
the body thinks you are going into starvation - which is thinks when your 
blood sugar drops more than 40-50 points in an hour.  THink about it...If 
"normal" is 90-120, what do you think the brain is going to do with a drop of 
50 points...FREAK OUT...and send a frantic message to the liver - 
"ahhhoooogah ahhhooogahh...all hands on deck....we are starving...dump 
glycagen, dump adrenalin, dump dump dump!!!"  Then, us, the flailing 
diabetic, not going down, freaks out and puts in MORE insulin...ahhhoooogah 
ahhhooogahh...and so on and so on til you have used 40 units of insulin to 
bring your blood sugar down 300 points.

To lower a bg of 450 to 150, I would need 6 units of insulin...if one unit 
lowers me 50 points.  rather than give it in one bolus, however, I will 
spread it out over the next 2-3 hours using a temp basal.  This way, my bg 
will be lowered SLOWLY and my body will not have a reason to overreact and 
dump in the hormones.  If, at that three hour mark, I am not down about 100 
points, I will NOT freak out,knowing I still have insulin on board....Perhaps 
at the 4 hour mark, I might give another unit bolus...Sure it takes a LONG 
time, but that is 6-7 units as opposed to the 10, 15, 20 I mihgt have used if 
I freaked it and tried to slam it down in 2 hours....

Our bodies WILL dump these hormones whether you are going from 450 to 350 in 
an hour, or 140 to 60 in under an hour...We can not circumvent our genetic 
predisposition to do this...unless we have our livers removed, and that is a 
whole other ball of earwax.  To try and beat the highs by over bolusing 
perpetuates the rollercoaster, AND the "myth" that high blood sugars REQUIRE 
more insulin.

Don't believe me?  Please don't simply write and tell me what an idiot I am, 
SHOW me your logs, where you have actually given this theory a couple of 
trys.  I will be happy to show you my extensive collection that shows the 
accuracy of this idea.  Sure, you have to deal with a high blood sugar for a 
few extra hours, but in the LONG run, you don't need more insulin and you 
don't set your body up for bounces...and isn't the  long run what we are 
concerned with?

Marion wrote
> The more insulin needed, the more chance of overdosing and 
> hypo. IMHO, always better to avoid things that cause spikes

well, naturally I disagee ;-) I think it is better to attempt to accurately 
bolus the first time (adjusting amount AND timing) and avoid both the spike 
and the crash....I would say that if a diabetic INSISTS on having a regular 
soda, just as with drinnking apple juice or grape juice (1/4 cup!!! is 15 
grms CHO), that he or she drink it WITH some complex carb, or protein/fat 
mix, to SLOW DOWN the absorption of the carb and avoid the spike


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