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RE: [IPk] Re: Control >4 and <8

I just stick to the low fat, low sugar diet that is
recommended for 'normal' people i.e. lots of fruit and
vegetables, wholemeal bread, semi-skimmed milk etc...
I used to count carbohydrates (exchanges) religiously
when I was diagnosed in 1986 but that is now outdated
isn't it? Maybe I do count them without being aware of
it but I find that if I eat a well balanced healthy
meal then I'm okay. My last HbA1c was 7.6 and that's
without being on the pump yet so I must be doing
something right!
I admire the people who 'make a study of their
condition and control it to a fine art ' but I'd
rather be sensible but enjoy life to the full at the
same time.
I hope that going on the pump is not going to result
in me having to be much stricter about what and how
much I eat. I understood that it would give me even

Dear Susan - a lot of people in the UK see counting carbohydrates as old
hat. Unfortunately it has a strong predictor of what your BG will be -
otherwise pumps wouldn't work so well. Most people with diabetes will be
told - low fat (particularly saturated and trans fats), high fibre and
low sugar. What the pump/Intensive insulin regimens and the new range of
insulins (Humalog) do is allow people to have more flexibility with what
they eat because they give insulin to suit what they want to eat rather
than the old...you take x units and eat this much - which didn't work
before because twice daily insulin and old insulins didn't work in a way
that allowed you to deviate from a strict food allowance and lifestyle.
Plus humalog insulin acts so quickly - you can generally see you BG
return to premeal levels within 2-4 hours. Diet advice should be
tailored to your requirements (insulins sensitivity, lifestyle etc..)
rather than a blanket eat low fat/no sugar/high fibre. Of course we
would encourage a healthy diet - not just for cholesterol etc... but the
main idea to keep everyone happy and guilt-free (well almost) is good
control - which can also be achieved on higher sugar/fat foods as well -
as long as you take the correct dose of insulin. If your team is a bit
behind the times (hopefully everyone will have the opportunity to be
updated by the end of the year...) perhaps ask to be referred to another
team? Or as most pumpers do.... read up and discuss your
condition/health with the consultant team rather than  dictate to them -
you'll get further. It is all about team work. Best of luck... jules 
Julette Kentish
Diabetes Research Dietitian
Royal Bournemouth Hospital
Castle Lane East - Bournemouth DORSET BH7 7DW
ph: 01202 704929
email @ redacted

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