The views expressed on this weblog are mine alone and do not necessarily reflect the views of my employer.
 Monday, July 28, 2003
Garrick Neal's Ten Commandments of Diabetes

TEN QUICK TIPS FOR TIGHT CONTROL OF TYPE 1 DIABETES

1.  Lots of testing.  Lots.  At least 8 times a day, and preferably 10 to 12, or even more when things get astray.

2.  Disciplined diet. Maximal nutrition, aka healthy foods.  No snacking... there is no insulin available for small meals. Keep the meals to known quantities of carbohydrates, protein and fat.

3.  Stay well exercised.  Exercise provides all the usual benefits that it provides to normal people and maybe 2 times more than that for diabetics.  Including the ability to handle hypoglycemia better, and less bg exasperating illnesses.  One of the most important, to the quality if life issue, is that being fit means that during normal activity you are burning muscle glycogen, instead of blood glucose...

4.  Immediate correction of hyperglycemia.  The sooner hyperglycemia is corrected the less the amount of insulin resistance that sets in.... and hence continued hyperglycemia.  It varies for different people, but it happens at somewhere around 10 (180).  Find out, and avoid breaching it.

5.  Experimentation.  You must know your carbohydrate/insulin ratio.  Also precisely how much lead time you will need to take your rapid insulin, in any, prior to starting to eat.

6.  Watch the fat intake. Watch the protein intake.  Do not eat fat or protein based meals (or snacks) without carbohydrates.  Too much fat in a meal will make you insulin resistant for about 24 hours and too much protein will cause a 'protein spike' at some unexpected later time.

7.  Use glucose tablets.  Always keep them handy.

8.  Watch out for foods that may have high glycemic index values. The carbs will have as much as double the blood glucose effect as average carbs.  Watch out for over ripe fruit.  Again, eat consistently.

9.  Don't over basal.  Too much basal insulin will stuff the liver full of glucose,  and it will spill out... into the blood. 

10.  Never, never worry.  It's not fair that we are diabetics.  We don't deserve it.  We just have it, and we have to do what we can about it.  We cannot be perfect   (though for one whole day I once managed it. 


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