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[IPk] Re: fasting to fix basal rates etc - weirder still

Thanks very much for the compliment - I am very honoured, especially
coming from you.
Meanwhile things have got somewhat more weird, or at any rate
The reason why I had dared to rock the foundations, as you so nicely
put it, was that while I had always noticed that my requirements were
different when fasting than when eating, the difference in the mornings
had become even more dramatic in the previous 3 weeks. Just to remind
you, although, like John and others, in general I need a lower basal
rate when fasting, in the mornings, for the first 3-4 hours after my
normal breakfast time (7.15-ish) I actually need a *higher* basal if
fasting. In the last 3 weeks, the difference between fasting and eating
breakfast became even more pronounced, and because it seemed quite
absurd to lower my already low mid-morning basal rates (0.2), I
stupidly left them as they were, and only when I started feeling hypo,
turned them to temporarily low rates - I found that I had to go down to
only 40% of normal (that would be 0.08 units/hour) in order to maintain
BG at about 4, and lost chunks of my mornings' concentration at work in
the efforts. And on days that I didn't eat breakfast this did not
happen at all, on the contrary, BG's went up. 
On Thursday I got back the results of blood tests - I had initiated
these tests because I was worried that I had lapsed from a better
eating pattern and BG control had been less good, and also in order to
check that my liver function was back to normal (it was badly effected
by cholesterol lowering medication Simvastatin) so that I could try
another medication for my somewhat raised cholesterol. I was amazed -
HbA1c had gone down to 6.4 - it has never been this low since
diagnosis, and what is more, cholesterol had gone down to within normal
limits - went down more this month than it did in the month that I was
taking Simvastatin - of course I am totally delighted. I talked about
it with the endocrinologist. There was only one thing I did differently
in the last month - I sprinkled a dessertspoon full of linseeds on my
breakfast cereal every morning (because someone said that linseeds
contain phytoestrogens which help lower cholesterol, as well as
reducing symptoms of menopause, so without any great hopes, I thought I
would try). My experience indicates that apparently linseeds also
affect glucose metabolism, particularly during the first hours after
eating them - though I'm not sure that anyone understands exactly how.
As my endocrinologist said, whatever they are doing to me, it seems
good, and he suggested that I continue, but lower morning basal rates
to reduce the hypos, and repeat all the blood tests in 3 months to see
if the effect is maintained.
I'm certainly not suggesting that everyone go out and buy linseeds, but
this is interesting. Incidentally, someone wrote about eating soy
scones for breakfast - the phytoestrogens in soy may have something of
the same effect, though they are different from those in linseeds
(isoflavones in soy, lignans in linseeds). And I have now found that
there is something in the literature about phytoestrogens effecting
insulin resistance in type 2 diabetics, so maybe it can also effect
insulin sensitivity in type 1 - due to a temporary glitch with my
internet access to the literature I have yet to get hold of the
relevant papers.
By the way, it occurs to me that if one can eat foods that result in a
lower basal rate for many hours after one eats them, then it is equally
plausible to believe that there are foods that might result in a higher
basal rate. Either way this confirms my heretical hypothesis that the
method of fasting to determine basal rates should perhaps be regarded
only a good first approximation, not as a golden rule.

> >On a slightly different tack, Melissa wrote suggesting the need for
> >more checking of basal rates by fasting. I have come to despair
> >somewhat of this method of testing. My basal requirements are almost
> >never the same when fasting.
> Nanette - always nice to hear someone rocking the foundations of
> modern
> diabetes treatment :-) And I'm not surprised the person is you - one
> of
> life's original thinkers! And you know what? I'm inclined to agree
> with
> you. Yes, Melissa, I know the textbooks tell us to skip meals and
> track
> what our BG does, but I sometimes find it is hard to define what
> constitutes a "meal" in my slightly chaotic life. I suspect I may
> share
> similarities with Nanette. Don't know. And you, Melissa, at Oxford,
> surely
> have a chaotic life as well ;-)

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