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	<title>Comments on: The Most Valuable Lesson I’ve Learned about Managing Type 1 Diabetes</title>
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	<description>The highs &#38; lows of life with Type 1 Diabetes</description>
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		<title>By: Kev</title>
		<link>http://www.mevsdiabetes.com/managing-type-1-diabetes/#comment-2483</link>
		<dc:creator><![CDATA[Kev]]></dc:creator>
		<pubDate>Sun, 21 Apr 2013 22:47:23 +0000</pubDate>
		<guid isPermaLink="false">http://www.mevsdiabetes.com/?p=198#comment-2483</guid>
		<description><![CDATA[Andrew, yes, Dr. Bernstein&#039;s Law of Small Numbers (eat less carbs, use less injected insulin, and in turn avoid blood sugar swings) has done wonders for me.  I have gone from high and low blood sugar spikes to a relatively straight line on my blood sugar graphs.  Stabilizing your blood sugars will also help you to worry less in the classroom, etc.  For me, the insulin pump has helped as well, but the general theory can be very effective whether you do shots or are on the pump.  Best of luck.]]></description>
		<content:encoded><![CDATA[<p>Andrew, yes, Dr. Bernstein&#8217;s Law of Small Numbers (eat less carbs, use less injected insulin, and in turn avoid blood sugar swings) has done wonders for me.  I have gone from high and low blood sugar spikes to a relatively straight line on my blood sugar graphs.  Stabilizing your blood sugars will also help you to worry less in the classroom, etc.  For me, the insulin pump has helped as well, but the general theory can be very effective whether you do shots or are on the pump.  Best of luck.</p>
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		<title>By: Andrew</title>
		<link>http://www.mevsdiabetes.com/managing-type-1-diabetes/#comment-2479</link>
		<dc:creator><![CDATA[Andrew]]></dc:creator>
		<pubDate>Sun, 21 Apr 2013 14:22:31 +0000</pubDate>
		<guid isPermaLink="false">http://www.mevsdiabetes.com/?p=198#comment-2479</guid>
		<description><![CDATA[I am 25 years old and I&#039;ve had type 1 diabetes since I was 13.   It&#039;s crazy to think that I&#039;ve had it this long. It feels like it was just yesterday I witnessed my mom balling her eyes because of the guilt she felt upon realizing I was also a juvenile diabetic.  I tried the pump and hated it. I felt like I didn&#039;t have the time, patience, or money for it.  My endocrinologist supported my decision to go back to injections. My a1c has never been over 7.3 but I need to do better. I exercise often - mainly skateboarding and bike riding - but I still eat what I want and attempt to balance it with more insulin. I smoke weed and drink occasionally (side note).  I&#039;m worried about the cells in my body developing an insulin resistance, similar to what happens in type 2 individuals.  I appreciate your knowledge and your insight.  I&#039;ve never experienced a violent low, though both my girlfriend and I have witnessed how scary they can be with my mom.  I teach environmental science, so I&#039;m constanty worried about suffering a low blood sugar attack inside or outside of the classroom. I&#039;ve always thought to myself that it&#039;s better to be a little high then a little low, but I know in the back of my mind neither is healthy nor desirable. My hopes are to minimize the swings between kinda high and just right. I know the pump is supposed to help with this, but your solution is logical and simple (in theory). Eat less carbs, use less insulin.  It&#039;s not that I pig out on cake, but I need to be more mindful of the junk I&#039;m putting in my body.  I am not normal. Why should I assume and why should I pretend?  Thanks again. I&#039;m going to check out dr. Bernstein]]></description>
		<content:encoded><![CDATA[<p>I am 25 years old and I&#8217;ve had type 1 diabetes since I was 13.   It&#8217;s crazy to think that I&#8217;ve had it this long. It feels like it was just yesterday I witnessed my mom balling her eyes because of the guilt she felt upon realizing I was also a juvenile diabetic.  I tried the pump and hated it. I felt like I didn&#8217;t have the time, patience, or money for it.  My endocrinologist supported my decision to go back to injections. My a1c has never been over 7.3 but I need to do better. I exercise often &#8211; mainly skateboarding and bike riding &#8211; but I still eat what I want and attempt to balance it with more insulin. I smoke weed and drink occasionally (side note).  I&#8217;m worried about the cells in my body developing an insulin resistance, similar to what happens in type 2 individuals.  I appreciate your knowledge and your insight.  I&#8217;ve never experienced a violent low, though both my girlfriend and I have witnessed how scary they can be with my mom.  I teach environmental science, so I&#8217;m constanty worried about suffering a low blood sugar attack inside or outside of the classroom. I&#8217;ve always thought to myself that it&#8217;s better to be a little high then a little low, but I know in the back of my mind neither is healthy nor desirable. My hopes are to minimize the swings between kinda high and just right. I know the pump is supposed to help with this, but your solution is logical and simple (in theory). Eat less carbs, use less insulin.  It&#8217;s not that I pig out on cake, but I need to be more mindful of the junk I&#8217;m putting in my body.  I am not normal. Why should I assume and why should I pretend?  Thanks again. I&#8217;m going to check out dr. Bernstein</p>
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		<title>By: Dave</title>
		<link>http://www.mevsdiabetes.com/managing-type-1-diabetes/#comment-724</link>
		<dc:creator><![CDATA[Dave]]></dc:creator>
		<pubDate>Tue, 20 Nov 2012 03:17:25 +0000</pubDate>
		<guid isPermaLink="false">http://www.mevsdiabetes.com/?p=198#comment-724</guid>
		<description><![CDATA[Hello Heather
I am the parent of an 8 year old boy who has been Type 1 for almost 2 years now. He is on an insulin pump. I have spent countless hours surfing the internet for information about how to best control his blood sugars, and reduce the long term risk of complications. After all, he has a long way to go with this disease. 
What I stumbled upon, like Kev, was Dr Richard Bernstein, a true pioneer and in my opinion, genius in the management of diabetes. Essentially Dr Bernstein advocates the use of an extremely love carb diet to reduce the need for insulin and to help keep blood sugars in a normal range. As a result, beginning last June, we started my son on a modified low carb diet. He gets no more than 30 -35 grams of net carb (after deducting finer carbs from total carbs) per meal. His blood sugars , while certainly not &quot;normal&quot;, are far better than they were prior to the diet, and his last A1C test this Fall came in at 6.7 %, which for a child with Type 1 is excellent. So I am a believer in this diet. 
There is a great deal of literature, including many cookbooks, available about living low carb. It is really not that difficult and if you are prepared to do a litle creative cooking, you can prepare many items in a low carb way. For example, you can make low carb cheesecake using nut flours for the crust. There are also breads sold in most supermarkets that are quite low carb - Sara Lee makes one that we buy regularly. For sweetener - you can use Splenda, or better still buy liquid sucralose, available everywhere including Walmart. For our son, because we do not like the idea of giving him too much Splenda, we buy powdered Erythritol, a &quot;sugar alcohol&quot; that has no effect on blood sugars and does not cause some of the side effects (diarrheah, stomach upset) that some of the other polyols cause. Erythritol is a natural product by the way. 
You should also try to sign up for some of the low carb blogs that are out there on the net - there is a tremendous amount to learn about how to live low carb, but I can tell you that it is possible to do and it will improve your blood sugar control. As a matter of fact, when we started my son on a low carb diet i decided to join him - I lost ten pounds and feel great as a result.
I am so sorry to hear of your recent diagnosis. I am sure you are still in a state of shock - and there is so much to learn. But it will get easier, just as it has for our family. Nothing in my life caused me more pain than to receive the diagnosis about my son - I would gladly have traded places with him had I been given the choice. 
One more pointer. There are excellent diabetes conferences out there where you have an opportunity to listen to experts in the field. I am thinking specificially about the conferences organized by  &quot;children with diabetes&quot;. These conferences are equally valid for adults I believe, as I have attended three of them with my son already. 
Your job now is to learn, learn , learn. And with that knowledge, I believe you will be able to manage your diabetes well and live happily.
Kev - I truly enjoy your posts. Best of luck.
Dave g]]></description>
		<content:encoded><![CDATA[<p>Hello Heather<br />
I am the parent of an 8 year old boy who has been Type 1 for almost 2 years now. He is on an insulin pump. I have spent countless hours surfing the internet for information about how to best control his blood sugars, and reduce the long term risk of complications. After all, he has a long way to go with this disease.<br />
What I stumbled upon, like Kev, was Dr Richard Bernstein, a true pioneer and in my opinion, genius in the management of diabetes. Essentially Dr Bernstein advocates the use of an extremely love carb diet to reduce the need for insulin and to help keep blood sugars in a normal range. As a result, beginning last June, we started my son on a modified low carb diet. He gets no more than 30 -35 grams of net carb (after deducting finer carbs from total carbs) per meal. His blood sugars , while certainly not &#8220;normal&#8221;, are far better than they were prior to the diet, and his last A1C test this Fall came in at 6.7 %, which for a child with Type 1 is excellent. So I am a believer in this diet.<br />
There is a great deal of literature, including many cookbooks, available about living low carb. It is really not that difficult and if you are prepared to do a litle creative cooking, you can prepare many items in a low carb way. For example, you can make low carb cheesecake using nut flours for the crust. There are also breads sold in most supermarkets that are quite low carb &#8211; Sara Lee makes one that we buy regularly. For sweetener &#8211; you can use Splenda, or better still buy liquid sucralose, available everywhere including Walmart. For our son, because we do not like the idea of giving him too much Splenda, we buy powdered Erythritol, a &#8220;sugar alcohol&#8221; that has no effect on blood sugars and does not cause some of the side effects (diarrheah, stomach upset) that some of the other polyols cause. Erythritol is a natural product by the way.<br />
You should also try to sign up for some of the low carb blogs that are out there on the net &#8211; there is a tremendous amount to learn about how to live low carb, but I can tell you that it is possible to do and it will improve your blood sugar control. As a matter of fact, when we started my son on a low carb diet i decided to join him &#8211; I lost ten pounds and feel great as a result.<br />
I am so sorry to hear of your recent diagnosis. I am sure you are still in a state of shock &#8211; and there is so much to learn. But it will get easier, just as it has for our family. Nothing in my life caused me more pain than to receive the diagnosis about my son &#8211; I would gladly have traded places with him had I been given the choice.<br />
One more pointer. There are excellent diabetes conferences out there where you have an opportunity to listen to experts in the field. I am thinking specificially about the conferences organized by  &#8220;children with diabetes&#8221;. These conferences are equally valid for adults I believe, as I have attended three of them with my son already.<br />
Your job now is to learn, learn , learn. And with that knowledge, I believe you will be able to manage your diabetes well and live happily.<br />
Kev &#8211; I truly enjoy your posts. Best of luck.<br />
Dave g</p>
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	<item>
		<title>By: Kev</title>
		<link>http://www.mevsdiabetes.com/managing-type-1-diabetes/#comment-673</link>
		<dc:creator><![CDATA[Kev]]></dc:creator>
		<pubDate>Wed, 03 Oct 2012 19:03:03 +0000</pubDate>
		<guid isPermaLink="false">http://www.mevsdiabetes.com/?p=198#comment-673</guid>
		<description><![CDATA[Heather, I definitely know how you feel.  I remember asking my doctor, &quot;Are there any foods that I clearly shouldn&#039;t eat?&quot;  Her response was, &quot;No, so long as you shoot insulin for them.&quot;  She went on to add, &quot;Well, don&#039;t eat something like five slices of pizza at a time.&quot;  I have come to learn just how wrong her answer was.  Unfortunately, I blindly followed that advice for several years.  The truth is that Type 1 diabetics shouldn&#039;t be eating the majority of what&#039;s on supermarket shelves.  Basically, the less carbs you eat per meal, the easier it will be to stabilize your blood sugars and to keep them at a normal level.  

Also, as Dr. Richard K. Bernstein (a Type 1 himself) states in his book &quot;Dr. Bernstein&#039;s Diabetes Solution&quot;, if you can stabilize your blood sugars while you&#039;re still in the honeymoon phase, you may be able to prolong the honeymoon phase, possibly indefinitely.  I was never told this.  In fact, my first doctor actually mistakenly diagnosed me as Type 2, despite me being in good physical shape.  Needless to say, my honeymoon phase didn&#039;t seem to last too long, nor did I make the necessary adjustments to my diet to possibly prolong it.

As far as what you shouldn&#039;t eat, I recommend reading the book I mentioned above, &quot;Dr. Bernstein&#039;s Diabetes Solution&quot;.  His diet will seem extreme, but his idea of small numbers (less insulin for fewer carbs leads to less blood sugar swings) makes perfect sense.  He recommends no more than 12 carbs per meal.  This can be very difficult to pull off, especially for dinner, but I try to use the diet he recommends as a guide to what will work best, even if I&#039;m not in full compliance yet.

The frustrating truth is that most endocrinologists see roughly ten times more Type 2 patients than Type 1s.  Thus, their approach to treating Type 1 diabetics is often too similar to how they treat Type 2s.  In addition, in my experience, they often lack knowledge when it comes to treatment advancements, like CGMs, etc.  They also follow the ADA&#039;s diet recommendations, which is slowly killing Type 1 diabetics, since the ADA doesn&#039;t put strict restrictions on carbohydrates, etc., and has a &quot;whatever works best for you&quot; attitude.  

Most complications (other than the dangers from extreme highs and lows) usually develop from years of unstable blood sugars, so don&#039;t let that stress you out too much now, instead let it be a warning to keep yourself in check. Use this time to get your treatment plan and diet in place.  It won&#039;t be easy, but I find that I feel less guilt and am happier when I&#039;m doing good with my diet, exercising regularly and facing diabetes head on.

All the Best,
Kevin]]></description>
		<content:encoded><![CDATA[<p>Heather, I definitely know how you feel.  I remember asking my doctor, &#8220;Are there any foods that I clearly shouldn&#8217;t eat?&#8221;  Her response was, &#8220;No, so long as you shoot insulin for them.&#8221;  She went on to add, &#8220;Well, don&#8217;t eat something like five slices of pizza at a time.&#8221;  I have come to learn just how wrong her answer was.  Unfortunately, I blindly followed that advice for several years.  The truth is that Type 1 diabetics shouldn&#8217;t be eating the majority of what&#8217;s on supermarket shelves.  Basically, the less carbs you eat per meal, the easier it will be to stabilize your blood sugars and to keep them at a normal level.  </p>
<p>Also, as Dr. Richard K. Bernstein (a Type 1 himself) states in his book &#8220;Dr. Bernstein&#8217;s Diabetes Solution&#8221;, if you can stabilize your blood sugars while you&#8217;re still in the honeymoon phase, you may be able to prolong the honeymoon phase, possibly indefinitely.  I was never told this.  In fact, my first doctor actually mistakenly diagnosed me as Type 2, despite me being in good physical shape.  Needless to say, my honeymoon phase didn&#8217;t seem to last too long, nor did I make the necessary adjustments to my diet to possibly prolong it.</p>
<p>As far as what you shouldn&#8217;t eat, I recommend reading the book I mentioned above, &#8220;Dr. Bernstein&#8217;s Diabetes Solution&#8221;.  His diet will seem extreme, but his idea of small numbers (less insulin for fewer carbs leads to less blood sugar swings) makes perfect sense.  He recommends no more than 12 carbs per meal.  This can be very difficult to pull off, especially for dinner, but I try to use the diet he recommends as a guide to what will work best, even if I&#8217;m not in full compliance yet.</p>
<p>The frustrating truth is that most endocrinologists see roughly ten times more Type 2 patients than Type 1s.  Thus, their approach to treating Type 1 diabetics is often too similar to how they treat Type 2s.  In addition, in my experience, they often lack knowledge when it comes to treatment advancements, like CGMs, etc.  They also follow the ADA&#8217;s diet recommendations, which is slowly killing Type 1 diabetics, since the ADA doesn&#8217;t put strict restrictions on carbohydrates, etc., and has a &#8220;whatever works best for you&#8221; attitude.  </p>
<p>Most complications (other than the dangers from extreme highs and lows) usually develop from years of unstable blood sugars, so don&#8217;t let that stress you out too much now, instead let it be a warning to keep yourself in check. Use this time to get your treatment plan and diet in place.  It won&#8217;t be easy, but I find that I feel less guilt and am happier when I&#8217;m doing good with my diet, exercising regularly and facing diabetes head on.</p>
<p>All the Best,<br />
Kevin</p>
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	<item>
		<title>By: Heather</title>
		<link>http://www.mevsdiabetes.com/managing-type-1-diabetes/#comment-672</link>
		<dc:creator><![CDATA[Heather]]></dc:creator>
		<pubDate>Wed, 03 Oct 2012 01:13:11 +0000</pubDate>
		<guid isPermaLink="false">http://www.mevsdiabetes.com/?p=198#comment-672</guid>
		<description><![CDATA[Kevin,
I was diagnosed 4 weeks ago, type 1.  I am 41, very healthy, very motivated to stay that way.  Between the internist, diabetic educator and nutritionist noone will give me a straight answer of what I can&#039;t have.  I feel like I am all alone.  Currently just on Lantus at night, BG ranging from 70&#039;s to 240.  Plan is to start covering meals next week.  I am probably honeymooning because my sugars did respond to a very low carb diet and a small Lantus dose.  I am worried about how long this will last.  I wish I could talk to someone who gets it.  I am scared and I don&#039;t want neuropathies or any other complications.  I plan to read your blog for a little insight.  Thanks.]]></description>
		<content:encoded><![CDATA[<p>Kevin,<br />
I was diagnosed 4 weeks ago, type 1.  I am 41, very healthy, very motivated to stay that way.  Between the internist, diabetic educator and nutritionist noone will give me a straight answer of what I can&#8217;t have.  I feel like I am all alone.  Currently just on Lantus at night, BG ranging from 70&#8217;s to 240.  Plan is to start covering meals next week.  I am probably honeymooning because my sugars did respond to a very low carb diet and a small Lantus dose.  I am worried about how long this will last.  I wish I could talk to someone who gets it.  I am scared and I don&#8217;t want neuropathies or any other complications.  I plan to read your blog for a little insight.  Thanks.</p>
]]></content:encoded>
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		<title>By: Kev</title>
		<link>http://www.mevsdiabetes.com/managing-type-1-diabetes/#comment-663</link>
		<dc:creator><![CDATA[Kev]]></dc:creator>
		<pubDate>Mon, 10 Sep 2012 01:30:38 +0000</pubDate>
		<guid isPermaLink="false">http://www.mevsdiabetes.com/?p=198#comment-663</guid>
		<description><![CDATA[Kristen, &quot;drawing sympathy&quot; might be your interpretation of the post, but that was in no way my intention. You&#039;re also quoting me out of context.  The full quote is &quot;TYPE 1 DIABETES IS A DISEASE. I AM NOT NORMAL, NO MATTER HOW MUCH I WANT TO LIVE LIKE I AM, ESPECIALLY WITH REGARD TO MY DIET.&quot;  The point of that is that I had to come to the hard realization that my previous diet and way of living wasn&#039;t working.  By fully coming to terms with the fact that I had a disease, and fully realizing the consequences of not properly taking care of myself, I was able to adjust and stick to my diet, etc.

If I continued to try and live like I was &quot;NORMAL&quot; with regard to my diet, I would end up with numerous medical complications down the road, likely everything from macular degeneration to never damage and worse.  I&#039;m in no way saying to not try and make your daughter &quot;feel normal&quot;.  I was referring to myself and coming to terms with my own disease.  However, Type 1s and parents of Type 1s who refuse to face the true realities of the disease and what really needs to be done with regard to diet, are in effect ensuring that they or their child has an anything but &quot;normal&quot; future.  

The truth is that Type 1 diabetes is difficult. It&#039;s a worry-filled, guilt-ridden balancing act and for a child and a parent of a Type 1 child, it&#039;s exponentially tougher.  I consider myself lucky for having been diagnosed in my 20s. I didn&#039;t have to grow up with it and watch the kids around me eating whatever they wanted.  However, I&#039;ve heard too many older Type 1 diabetics say the following, &quot;I wish I could go back and tell the younger me to face the hard truths about my disease and take better care of myself.&quot;]]></description>
		<content:encoded><![CDATA[<p>Kristen, &#8220;drawing sympathy&#8221; might be your interpretation of the post, but that was in no way my intention. You&#8217;re also quoting me out of context.  The full quote is &#8220;TYPE 1 DIABETES IS A DISEASE. I AM NOT NORMAL, NO MATTER HOW MUCH I WANT TO LIVE LIKE I AM, ESPECIALLY WITH REGARD TO MY DIET.&#8221;  The point of that is that I had to come to the hard realization that my previous diet and way of living wasn&#8217;t working.  By fully coming to terms with the fact that I had a disease, and fully realizing the consequences of not properly taking care of myself, I was able to adjust and stick to my diet, etc.</p>
<p>If I continued to try and live like I was &#8220;NORMAL&#8221; with regard to my diet, I would end up with numerous medical complications down the road, likely everything from macular degeneration to never damage and worse.  I&#8217;m in no way saying to not try and make your daughter &#8220;feel normal&#8221;.  I was referring to myself and coming to terms with my own disease.  However, Type 1s and parents of Type 1s who refuse to face the true realities of the disease and what really needs to be done with regard to diet, are in effect ensuring that they or their child has an anything but &#8220;normal&#8221; future.  </p>
<p>The truth is that Type 1 diabetes is difficult. It&#8217;s a worry-filled, guilt-ridden balancing act and for a child and a parent of a Type 1 child, it&#8217;s exponentially tougher.  I consider myself lucky for having been diagnosed in my 20s. I didn&#8217;t have to grow up with it and watch the kids around me eating whatever they wanted.  However, I&#8217;ve heard too many older Type 1 diabetics say the following, &#8220;I wish I could go back and tell the younger me to face the hard truths about my disease and take better care of myself.&#8221;</p>
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		<title>By: kristen</title>
		<link>http://www.mevsdiabetes.com/managing-type-1-diabetes/#comment-656</link>
		<dc:creator><![CDATA[kristen]]></dc:creator>
		<pubDate>Thu, 06 Sep 2012 05:45:37 +0000</pubDate>
		<guid isPermaLink="false">http://www.mevsdiabetes.com/?p=198#comment-656</guid>
		<description><![CDATA[Im sorry to say this but i think youre just looking for sympathy and that fact that my 4 yr old was diagnosed at 1 1/2 does not make me feel all that bad for you. Saying ITS A DISEASE I AM NOT NORMAL, is pretty weird considering when you have a child with it, you&#039;re constantly trying to make them feel normal]]></description>
		<content:encoded><![CDATA[<p>Im sorry to say this but i think youre just looking for sympathy and that fact that my 4 yr old was diagnosed at 1 1/2 does not make me feel all that bad for you. Saying ITS A DISEASE I AM NOT NORMAL, is pretty weird considering when you have a child with it, you&#8217;re constantly trying to make them feel normal</p>
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