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Post by harryx1 on Jun 10, 2019 10:13:43 GMT -5
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Post by harryx1 on Jun 10, 2019 10:45:47 GMT -5
perfect example of failure based on injected insulin
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Post by shawnonafrezza on Jun 10, 2019 11:27:38 GMT -5
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Post by peppy on Jun 10, 2019 11:47:38 GMT -5
"Each 1% absolute reduction in mean A1C levels was associated with a 37% decrease in the risk of microvascular complications and a 21% reduction in the risk of any diabetes-related complication or death." I think what I have learned is the lower the HbA1c with type ones, the more hypoglycemia. I believe that is why the new recommendations allow a HbA1c of 7 = 154mg/dl. It is an average? 250 high, 50 low? really a piece of chit.
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Post by shawnonafrezza on Jun 10, 2019 12:01:14 GMT -5
"Each 1% absolute reduction in mean A1C levels was associated with a 37% decrease in the risk of microvascular complications and a 21% reduction in the risk of any diabetes-related complication or death." I think what I have learned is the lower the HbA1c with type ones, the more hypoglycemia. I believe that is why the new recommendations allow a HbA1c of 7 = 154mg/dl. It is an average? 250 high, 50 low? really a piece of chit. I don't think I follow. Are you saying the recommendation for the 7% is due to fear of hypoglycemia? If so you're spot on (and this is ignoring that A1C is a bad tool to gauge glucose control). Too many endos don't know about Afrezza or Dr. Bernstein's work on low carb.
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Post by peppy on Jun 10, 2019 12:28:47 GMT -5
"Each 1% absolute reduction in mean A1C levels was associated with a 37% decrease in the risk of microvascular complications and a 21% reduction in the risk of any diabetes-related complication or death." I think what I have learned is the lower the HbA1c with type ones, the more hypoglycemia. I believe that is why the new recommendations allow a HbA1c of 7 = 154mg/dl. It is an average? 250 high, 50 low? really a piece of chit. I don't think I follow. Are you saying the recommendation for the 7% is due to fear of hypoglycemia? If so you're spot on (and this is ignoring that A1C is a bad tool to gauge glucose control). Too many endos don't know about Afrezza or Dr. Bernstein's work on low carb.YES. Regarding Low carb. what the heck thread is this I am going to steal. Forgive me. let's talk. You type ONE. I have gone over this and over this trying to learn it by heart. Let's see if I can spell it out. BECAUSE I have a question. Low carb eat = plenty of meat and diary. so proteins, meats. fats = meat and diary. Meats/Proteins. After the nitrogen is cleaved in the liver, made into ammonia NH3 and the urea NH2 and excreted, the carb and hydrogen part of the protein molecule are made into ketone bodies. when with gluconeogenesis they are made into acetyl. Chemical formula: C2H3O Acetyl group - (acetone, acetoacetic acid, beta-hydroxybutyric acid) produced during the metabolism of fats. agedhippie shawnonafrezzahere is my question? eating a bunch of meat/fat increases ketone bodies. How does that affect type one in terms of DKA? Does Dr. Bernstein talk about this? What does he say?
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Post by shawnonafrezza on Jun 10, 2019 12:54:36 GMT -5
I don't think I follow. Are you saying the recommendation for the 7% is due to fear of hypoglycemia? If so you're spot on (and this is ignoring that A1C is a bad tool to gauge glucose control). Too many endos don't know about Afrezza or Dr. Bernstein's work on low carb.YES. Regarding Low carb. what the heck thread is this I am going to steal. Forgive me. let's talk. You type ONE. I have gone over this and over this trying to learn it by heart. Let's see if I can spell it out. BECAUSE I have a question. Low carb eat = plenty of meat and diary. so proteins, meats. fats = meat and diary. Meats/Proteins. After the nitrogen is cleaved in the liver, made into ammonia NH3 and the urea NH2 and excreted, the carb and hydrogen part of the protein molecule are made into ketone bodies. when with gluconeogenesis they are made into acetyl. Chemical formula: C2H3O Acetyl group - (acetone, acetoacetic acid, beta-hydroxybutyric acid) produced during the metabolism of fats. agedhippie shawnonafrezza here is my question? eating a bunch of meat/fat increases ketone bodies. How does that affect type one in terms of DKA? Does Dr. Bernstein talk about this? What does he say? DKA only happens in the absence of insulin. If you're T1 you have your basal and then bolus insulin for protein because in a low carb setting the body will convert some protein to glucose. I forget what part of the Krebs cycle that is. The typical approach is to dose for half the protein as you would carbs so 40g of protein is about 20g CHO. The absorption takes about 6-8 hours which is why T2 patients can use it since they lack the strong phase one response but often still have adequate phase two. Low carb also isn't just meat/dairy. Carrie Diulus M.D is a great example as she is vegan, T1, and goes low carb.
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Post by agedhippie on Jun 10, 2019 16:16:16 GMT -5
here is my question? eating a bunch of meat/fat increases ketone bodies. How does that affect type one in terms of DKA? Does Dr. Bernstein talk about this? What does he say Shawn pretty much covered it. There is dietary ketosis and diabetic ketosis and they bear the same relationship to each other as a tabby cat and a saber toothed tiger - both the same thing at root but very much different in what you get. As I understand it in dietary ketosis there is still a level of insulin and that keeps things in check with the body easily able to deal with the byproducts of ketones. In diabetic ketosis the insulin that keeps the process in check is missing so the throttle jams wide open and the body's ability to cope with the acidity generated is swamped. Your body is not designed to handle this level of acidity and you rapidly wind up with wildly unbalanced electrolytes and dehydration. Full blown DKA is fatal if not treated. Dr Bernstein has no problem with dietary ketosis, in fact if you follow his diet it is unavoidable I think (but I stand to be corrected). He is a really interesting person; originally an engineer and suffering from T1 he decided low carb was the way to go but could get no traction because he was not an endo, so he went to medical school and became an endo. For a long time the low carb high fat diet was heavily opposed, but it is now quite mainstream and was the best attended dietary group at this year's ADA conference.
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Post by peppy on Jun 10, 2019 18:16:54 GMT -5
here is my question? eating a bunch of meat/fat increases ketone bodies. How does that affect type one in terms of DKA? Does Dr. Bernstein talk about this? What does he say Shawn pretty much covered it. There is dietary ketosis and diabetic ketosis and they bear the same relationship to each other as a tabby cat and a saber toothed tiger - both the same thing at root but very much different in what you get. As I understand it in dietary ketosis there is still a level of insulin and that keeps things in check with the body easily able to deal with the byproducts of ketones. In diabetic ketosis the insulin that keeps the process in check is missing so the throttle jams wide open and the body's ability to cope with the acidity generated is swamped. Your body is not designed to handle this level of acidity and you rapidly wind up with wildly unbalanced electrolytes and dehydration. Full blown DKA is fatal if not treated. Dr Bernstein has no problem with dietary ketosis, in fact if you follow his diet it is unavoidable I think (but I stand to be corrected). He is a really interesting person; originally an engineer and suffering from T1 he decided low carb was the way to go but could get no traction because he was not an endo, so he went to medical school and became an endo. For a long time the low carb high fat diet was heavily opposed, but it is now quite mainstream and was the best attended dietary group at this year's ADA conference. yes, I know about metabolic acidosis, mostly in relationship to respiratory acidosis. I have seen arterial blood gasses 6.98. I know they get worse. ok, thanks aged.
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Post by sportsrancho on Jun 12, 2019 10:08:25 GMT -5
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Post by sportsrancho on Jun 12, 2019 15:41:44 GMT -5
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Post by sportsrancho on Jun 12, 2019 17:18:21 GMT -5
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Post by markado on Jun 12, 2019 19:17:27 GMT -5
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Post by sweedee79 on Jun 12, 2019 19:21:58 GMT -5
This Dr. Hirsch just makes me sick.. Also makes it clear what we are up against.... But why then are there a handful of docs who are willing to prescribe? What's the difference between them and this doc Hirsch who obviously has an attitude..
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Post by mnkdfann on Jun 12, 2019 19:30:03 GMT -5
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