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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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Going low a lot has its own complications too, for your brain and if you're trying to obtain perfect levels all of the time, you increase the risk of a severe hypo causing death - the biggest complication of all.
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Re: The Official Diabetic Triathlete Thread [fulla] [ In reply to ]
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fulla wrote:
Going low a lot has its own complications too, for your brain and if you're trying to obtain perfect levels all of the time, you increase the risk of a severe hypo causing death - the biggest complication of all.

Have you tried going very low carb (<50g/day) for at least a few weeks straight?

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business. * * *
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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No, I like carbs too much! I have tried going "low carb' at dinner for 3 months and it was horrible.

I can get really good levels so long as I measure all of the carbs I take in and am strict.What

What do you eat on the low carb diet? Just protein and fats?

Are you able to give an example of what you might eat in one day?
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Re: The Official Diabetic Triathlete Thread [fulla] [ In reply to ]
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fulla wrote:
No, I like carbs too much! I have tried going "low carb' at dinner for 3 months and it was horrible.

I can get really good levels so long as I measure all of the carbs I take in and am strict.What

What do you eat on the low carb diet? Just protein and fats?

Are you able to give an example of what you might eat in one day?


See. With all the respect, but you and others on this thread are against low carb and even say what happens on a low carb diet without trying it.

I knew you never tried it since you said "going low all the time" -- this DOESNT happen on a low carb due to the "Law of small numbers". Which one you think will keep the levels at a healthy range (70-90)

Option 1) You start at 85mg/dl. You have a meal with 15g of carbs (or 75mg/dl), requires 1u of insulin. (lets not talk gluconeogenisis via protein for now to keep it simple)

Option 2) You start at 85mg/dl. You have a meal with 75g of carbs, requires 5u of insulin.

Option 2 presents a much higher chance your carb counting won't go as planned, lets say there is a 20% error margin (aproved by FDA) for insulin dosage, the result will be:

1) 20% of 1u of insulin (0.2u), will take you from 85mg/dl to 70mg/dl if low or 100mg/dl if high
2) 20% of 15u of insulin (3u), will take you from 85mg/dl to 00mg/dl if low or 250+mg/dl if high

--

On the I like carbs too much!! True, we all do, but I'm happy enough to be able to have a healthy life and do other things that I like more than carbs. Plus, bacon, steak, butter and avocado are pretty good too ;-)

For the menu, there's a bunch of options out there, google ketogenic diet menu.

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business. * * *
Last edited by: vinnie: Nov 6, 13 19:56
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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vinnie, I'm not sure where this FIFTH you speak of comes from going blind is a fairly extreme form of diabetic retinopathy (the blue line), the y axis represents relative risk and the x axis hba1c, a line drawn to meet the blue line from point 7.5 on the y axis would correlate to a relative risk of about 2.3, less than half of five.

I understand that you experience very little in the way of shaking, you will be familiar with the concept of hypoglycemic unawareness. just because you do not perceive symptoms does not mean you are not low, just that your body has become used to being that way. This in turn leads to a risk of nocturnal hypoglycemia which in an individual starved of glycogen can be extremely serious and fatal. perhaps this gives rise to your perception, which i do not share, that diabetes is so hazardous. Diabetes can, of course be deadly but i believe that this is only the case where there is a lack of understanding and / or a lack of supplies. The latter is thankfully less of an issue in the USA but the former is.


I wonder how many people in dialysis clinics etc have had access to a good CDE who shares and understands their goals? As someone who works with diabetes in resource poor setting i have seen many of my participants drop A1C from above 15 to below 8 merely by including more exercise in their daily lives, the massively empowering effects of education and through peer group mentor-ship. At no point did i march any of them to a dialysis clinic because i hope they never have to attend one themselves.


Instead of taking my participants to a dialysis clinic i take them on a bike ride, i share the message that diabetes is only a limitation if you allow it to be one. If you fear your diabetes, you fear your body and you fear food you will never truly understand how these things interact and (in my opinion) will not realize personal or atheltic potential. The one thing my body does not produce is insulin, but i can take that from a syringe, once i have addressed that deficit there is NOTHING that i cannot do as well if not better than a non diabetic individual.


No i have not tried a low carb diet (for the reasons outlined here http://diets4diabetes.com/...eople-with-diabetes/ and also because i enjoy food, find VLCD to be socially restrictive and performance limiting) but then again i haven't tried crystal meth either. But people who use it tell me it's great
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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i should add that i don't have a "dog in the race" here, i just care about other people,a bout their health and about their happiness. I work in non profit because it makes me very happy but I'm not invested in the whole JDRF scheme of making diabetes appear to be some kind of death sentence in order to get money from people. I want to empower people with what i do not enrich myself or anyone else.
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Re: The Official Diabetic Triathlete Thread [jamesstout] [ In reply to ]
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Hi James,

In the end we are all seeking for the same goal here, to be happy. And diabetes poses a big problem as the complications won't make life very enjoyable, at least in my view. As you said, I also like to ride my bike way too much to even think one day this activity may not happen due to one of the complications (problem with vision or neuropathy for example).

While I do understand that "you" or others are a lot more educated than "most" and "most" are the ones that get the complications, we have to stop with this idea of "you can live a normal life with diabetes", which is not true. If the trend goes to "control your blood sugar levels as close to normal as possible, you will stay out of complications", but then the first one is a lot more appealing and easy to sell, including for pharmaceutical companies and so on.

I've seen this first hand when my 2yo nephew was diagnosed with T1D a year ago. Rather than focusing on the treatment, the information was "how to use your pump to eat mcdonalds" and things like that.

Some other topics you mentioned below that I would like to express my view:

a) 80% of people with diabetes will develop Retinopathy by 20 years of the disease. Sure, there will be another 20 years of lasers treatments et all before vision loss happens (or partially) and even by then, there will be better treatments, etc, but I prefer to make my own luck. By age 55+ (40 years of T1D) I still want to be riding my bike.

b) People with pre-diabetes (A1C of 5.7-6.5%) have developed diabetes complications. Basically when your BG goes past 120mg/dl you are already kiling some beta cells.

c) Nocturnal hypos are not as severe on a VLCD due the law of small numbers as mentioned above. If you have barely any fast acting insulin on board, only your basal may take it down and you know how slow the act. This problem of nocturnal is actually dimished on a VLCD

d) Diabetes IS a limitation. I'm sorry to burst the bubble, but while a diabetic can have a pretty flexible and healthy lifestyle, certain activities or situations can be very, very troublesome for a diabetic and that includes elite athletic performance for some sports. If high performance training may not be healthy for a normal/healthy individual, much less for someone with a metabolic condition like diabetes. For one, while I think team type 1 (or novonordisk) is doing a great think, I personally do not believe their athletes can ride at a very world class level (Tour de France) WHILE maintaining a normal A1C and I will keep it flexible and say 5.5% which is normal high while a actual healthy A1C is sub 5% or in other words, they won't have a long lasting career without developing diabetes complications

e) The problems of a VLCD for diabetics from your link is basically the shift from NK (nutritional ketosis) are very different from DKA (diabetic ketoacidosis), your link also is from a non-medical website, although this isnt necessarely a problem since even ADA recommendations are killing people

Once again guys, you are against something you've never tried, while I'm trying to expose the benefits of it, as I've been on both sides of the fence. We are not arguing against who is right or wrong here, I'm only defending that THERE IS A GREAT OPTION to deal with diabetes and that is via very low card diet, but since the idea isn't well spread out there (yet), it sounds like the contrarian.

FWIW, the evidences are too strong VLC is the way to manage diabetes, and the pharma industry not getting on the way, it will be the recommended dietary guidelines very soon.

Vinnie

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business. * * *
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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geez vinnie, arent you just a little ray of sunshine! im gonna go to the tour to prove you wrong. I will be the one getting my kit off and running 25m up a hill to try and cheers on wiggens. Will need a jellybean afterwards :)
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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Hi I am not diabetic but I know Kris Freeman who is one of the top male US XC skiers and is Diabetic. He was told he would not be able to compete with the condition and has continued to do well. He has written written about it quite a bit on fasterskier blog. Google him and you will learn about him.
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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Vinnie, With all respect I do not need to try low carb. Frankly, I'm not willing to take the risk of a low overnight that will kill me. I've never tried drugs either and know many are bad.

You've ignored the Bill Carlson achievements of health. What about guys like him, Bill King and Steve Prosterman (google them if needed). Those guys have all had diabetes near 50 years or over, they're all extremely healthy and addicted to exercise. They come from the days of urinating on a stick to test blood sugar, basically doing diabetes blind. They don't have complications. They are my hero's with no extreme diets.
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Re: The Official Diabetic Triathlete Thread [mrbaseball0] [ In reply to ]
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mrbaseball0 wrote:
Vinnie, With all respect I do not need to try low carb. Frankly, I'm not willing to take the risk of a low overnight that will kill me. I've never tried drugs either and know many are bad.

You've ignored the Bill Carlson achievements of health. What about guys like him, Bill King and Steve Prosterman (google them if needed). Those guys have all had diabetes near 50 years or over, they're all extremely healthy and addicted to exercise. They come from the days of urinating on a stick to test blood sugar, basically doing diabetes blind. They don't have complications. They are my hero's with no extreme diets.

How do you know they are free of complications?Do they post their tests online? A friend of mine (T1D) has been on a ride with Bill and reported his BG were a mess, all over the place, he had to get some food from others, the usual roller coster scenario of a T1D on high carbs (been there many times before). I prefer to have Dr Bernstein as a role model and hero, 80yo, T1D since age 12, trains twice every day ;-) A1C in the 4's -- read his book, the best think you will ever do for your health, thats all I ask.

I'm sorry but once again you are blaming on something you haven't done. I respect your decision, I just wanted to be the "contrarian" on this thread to show others that there is another way other than taking industrial amounts of insulin, you CAN achieve normal blood levels, race fast and stay away from complications. The comment about going low during the night is again ignorant, since it doesnt happen as often as someone on a high carb diet (high insulin which means more hypos).

The analogy with drugs is out of place, and you can't argue with the results, there is a whole community of VLC (and Dr Bernstein followers) out there, they are all micromanaging their BG, most are sub 6, some are sub 4 while having a very flexible lifestyle, thats the part that most people don't get it since they are based off they current high carb routine.

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business. * * *
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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I'll chime in to get things a little back on track.

I'm a T1D, diagnosed back in February of this year at age 33.

Currently on 8 units of Lantus (once per day) and Humalog at about 1 unit per 30 grams carbs.

I haven't done any Tri's this year, but did an 8 hour mountain bike race back in April and a few running races this year. I've found that for me by basal insulin takes care of me pretty well during excercise (Training), although I haven't raced enough this year to fully understand the impact that the race day adrenaline will have. Generally though, I like to make sure I don't have too much fast acting insulin on board before workouts and it seems like my body does a good job of processing the Glucose I take in for fueling.

I love this thread though, as so far we have had a lot of great information. Hopefully we can keep it going so that we all have the opportunity to learn from each other.
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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vinnie,
I've tried as hard as i can to make this as civil as possible but being rude about Bill who i consider a friend, who many consider a hero and to whom ANYONE including yourself who undertakes endurance sports as a a t1d owes a HUGE debt of gratitude is unacceptable. I dare say Bill, and many others, would suggest the same regarding your bloodsugars, your a1c and your approach.

I think the drugs analogy is entirely appropriate, you feel great, you tell other people how great you feel and then one day you aren't around any more. If you want o be sick, if you want to have a life threatening "disease" (ip refer the word condition) if you want to scare people and you want to dis-empower people these things are all available to you, by all means take that path.


I'm not about to engage in a1c "penis measuring" because it's contrary to my belief that lower isn't always better but you can rest assured that my A1c is likely lower than 75% of the posters on here, diabetic or not. You can also rest assured that I suffer from no complications and intend not to and that I rarely eat spoonfuls of coconut oil.


If you want a cause to be contrarian about and a ground on which to fight big pharma join us at 100campaign.org where we advocate for 100%access to insulin by the 100th anniversary of it's creation in a laboratory. Advocating for this cause will positively benefit the health of others, your stance WRT diet is, in my opinion and that of many others not only indicative of a flawed understanding but also dangerous.
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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vinnie wrote:
Good graph and it does prove the point of "low is better" -- each to his own, but I would compromise certain foods and maybe some performance if that means I can cut in a FIFTH my chances of going blind by maintaining a 5.5% A1C compared to 7.5%, I will happily do that, thank you.

What I also find interesting is that most people here are opposite to very low carb without even trying! This part is beyong my understanding. The number of severe lows and shaking has dropped in my experience and others on a VLC that I talk to. Guys, I've done the other way, raced fast and trained hard on "higher" carbs (150g on an easy training day and 250+ on a tough training day)

In the end we are NOT healthy as people make it sound, this is a very, very serious and deadly disease, either you take full on control and bring your levels to normal, or wait a couple decades (at a best case scenario) and pay the price. If you want to speed the learning process go and see a dialisys clinic, every second person has diabetes, plus is the leading cause for blindness in the US among young people.

Take this serious, you can still race triathlon fast, but performance should be secondary to health.

Vinnie

I would assume that "most" diabetics in dialisys clinic are not "fit" Ironman type 1 diabetics?

I would speculate that most people most on this thread are much healthier diabetics than most of your "average" American diabetics

No?




jamesstout wrote:
type 1 diagnosed 2005

i've cycled all over the world, continental level so UCI races, i'm by no means a TDF winner but i can get out of my own way on a bike
I'm on levemir and novorapid and holes in my finger and on my bike a lot. I have used a CGM, it's too much diabetes and a bit of a waste of time, test lots in training and when you're racing just get on with it!

FWIW i don't think that, below 7.5 hba1c has that much meaning and some of the people i know who suffer most from diabetes do so in order to maintain a stupidly low a1c. the risk of complications comes at much higher a1c (above 8) (see below) and i don't believe a low carb diet is necessary or beneficial

i run a project workign with cycling and type 2 diabetes in a native American community in Tucson http://www.facebook.com/pascuayaquibike and i'm happy to help anyone who has any questions but don't you dare whine about your diabetes! if you're able to access the internet you're (on a global scale) pretty rich, people in sub saharan Africa die within 12 months of diagnosis, for them diabetes is a burden and a problem for us fortunate few it's a t most a hindrance and for me it's the reason i am able to maintain the (admittedly mediocre) career i've had at the top level of the sport.



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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Sorry to hijack this thread - I don't have diabetes, but my training partner was diagnosed with Type I in his late 20s (about 18 months ago).

It's interesting to read how some of you were diagnosed with Type I later in life. I'm curious - did any of you have an illness, or some other medical condition, that affected your insulin production relatively "later" in life (in terms of Type I). As a nurse, I've seen more and more instances of this.

Thanks! And I think you all are amazing to manage diabetes with a sport like triathlon!
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Re: The Official Diabetic Triathlete Thread [kristaae] [ In reply to ]
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Hi Kristaae,

I was diagnosed at 12, but almost exactly a year before I got diagnosed I had a bad case of mumps.
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Re: The Official Diabetic Triathlete Thread [kristaae] [ In reply to ]
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I was diagnosed on August 14th, 2013 at the age of 37. About two weeks prior to that I came down with a cold. Nothing crazy, just extremely tired and congested ect. Then the extreme thirst came, off the freagin chart thirst!!! Lost 15lbs, blurry vision ect



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [kristaae] [ In reply to ]
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kristaae wrote:
Sorry to hijack this thread - I don't have diabetes, but my training partner was diagnosed with Type I in his late 20s (about 18 months ago).

It's interesting to read how some of you were diagnosed with Type I later in life. I'm curious - did any of you have an illness, or some other medical condition, that affected your insulin production relatively "later" in life (in terms of Type I). As a nurse, I've seen more and more instances of this.

Thanks! And I think you all are amazing to manage diabetes with a sport like triathlon!

There is certainly a trend. I was diagnosed 12 months after Chicken Pox (agressive at an older age) and 3 months after Dengue Fever.

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business. * * *
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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runnerwv wrote:
vinnie wrote:


Vinnie

I would assume that "most" diabetics in dialisys clinic are not "fit" Ironman type 1 diabetics?

I would speculate that most people most on this thread are much healthier diabetics than most of your "average" American diabetics

No?
[/quote]

Define "healthier".

To me, when it comes to T1D healthy means: Low A1C & No complications

I've trained full time for ironman races, putting in consistently 35h a week of training, and during these times I was running chronically, high, the usual roller coster of a T1D on high carbs. A1C's in the 8's, or mid 7's, celebrating a 6.9%.

On the other side, you have a "normal & active" individual, picture 5x1h per day. They are likely to have better A1Cs than the ironman athlete. In my view, as a T1D he is a healthier individual (not necessarely fitter much less faster, but the question wasnt about the finish line).

Low Carb allows ironman athletes the best of both worlds. They can sustain a much lower blood value while training (and definitely outside of training times) while still being able to perform reasonably well. I wish I had the time to put in the IM training again, but as a quick trial, I went 61min sprint distance tri on a ketogenic diet and tested 5.3% A1C a couple weeks after that.

I'm into this "race" for life. Triathlon lifestyle with a healthy body, and to me low carb is the easiest and better approach to follow. I wish I had this information back then and that's my goal here, to allow people decide a second path towards their T1D management and training/racing.

Vinnie

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business. * * *
Last edited by: vinnie: Nov 7, 13 17:36
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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just curiously do you pump vinnie?

I wish asutralia subsidised CGM's, that would make racing so much easier to see trends.
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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By "healthier" I mean not fat and exercise and watch what you eat. Type 1 diabetics account for 5% off all diabetics. Guess my point is that diabetics on this thread are in a better overall state of health than most of the people you were referring to that are on dialysis.

I am do new to all this and am still learning. I think this will all make more sense once my pancreas totally ceases production



"Keep those feet moving!" Me
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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while it does get easier, you can honeymoon for quite some time. Im 2 years into this and taking less now than i ever have. Having said that, uou quickly learn how your body responds to the different diciplines and speeds/time etc
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Re: The Official Diabetic Triathlete Thread [coates_hbk] [ In reply to ]
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coates_hbk wrote:
just curiously do you pump vinnie?

I wish asutralia subsidised CGM's, that would make racing so much easier to see trends.


Not on a pump neither CGMs. Some people are going to laugh, but I'm about to try and follow Dr. B insulin regime and shift back to regulars + lantus. Reason is, as of now, I take about 1-2u of novorapid before most meals, but need another 0.5-1u or so 2-3h after I'm done to cover gluconegenesis (the protein that turns glucose). Regular covers that.

Would love to try CGM but hard access where I'm am, very pricey, cheaper to test blood 15+ a day which I have done many times before. These days I'm at 12 or so.

My 2yo nephew T1D is on a pump and my sister loves it, I can see it being a good deal in many situations but definitely not for all.

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business. * * *
Last edited by: vinnie: Nov 7, 13 19:14
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Re: The Official Diabetic Triathlete Thread [runnerwv] [ In reply to ]
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runnerwv wrote:
By "healthier" I mean not fat and exercise and watch what you eat. Type 1 diabetics account for 5% off all diabetics. Guess my point is that diabetics on this thread are in a better overall state of health than most of the people you were referring to that are on dialysis.

I am do new to all this and am still learning. I think this will all make more sense once my pancreas totally ceases production

You can actually be on honeymoon phase indefinitely if you shift to very low carb, if you don't mind how T1D it is now, you should do that. Once the honeymoon is over things gets way harder to control. I would barely take any insulin during my honeymoon. Read Dr Bernstein book as he explains this process of indefinitely honeymoon.

Our view on healthy is different at least when it comes to diabetes. While I do agree that not being overweight do help to stay away from complications due to lower blood pressure and better circulation, the fact you are exercising and watching what you eat can easily become insignificant by chronically high BG levels, for a T1D.

--
Vinnie Santana, Coach
http://www.ironguides.net
* * * Your best is our business. * * *
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Re: The Official Diabetic Triathlete Thread [vinnie] [ In reply to ]
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I have to admit my blood glucose levels are usually better when I am on a break as my routine is consistent day in day out - the exercise level doesn't change because I do none. But I'm not using a low carb diet then, just using a diet which sees me eat the same amounts of carbs at meals so that I'm not changing anything on a day to day basis.

Also in terms of the protein to glucose thing - I thought that didn't happen? It was something I was always told when I was diagnosed (we used to call 10 g of CHO and 7 g of protein, carbohydrate and protein "choices") but I thought that had been found to be scientifically inaccurate?
Last edited by: fulla: Nov 7, 13 19:50
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