Blood Sugar

[Guest guest]

Kathleen,

You wrote, " I am having a really hard time with BS control. For breakfast I

usually have 1/2 a bagle. 2 hours later, I am still sitting at 169-230. "

I am sorry to hear that you are having trouble managing your blood sugar. It

sounds like there is much conflicting opinions among your healthcare team

whether you are a diabetic or not. Since they do not realize that being

prediabetic is a serious medical condition, I recommend that you add a

diabetologist to your team. Just like the PAI recommends a pancreatologist,

since every GI may not know the pancreas, every endocrinologist, may not

understand diabetes. There are multiple specialties within the field of

endocrinology. If you do not have one locally, contact the American Diabetes

Association, for a listing. You can also contact the Joslin Clinic. They will

see you as a consult, without a referral. They are a nationally recognized

diabetic education treatment center.

The ADA 2005 standards of care state that a fasting plasma glucose level >126

mg/dl (7.0 mmol/l) or a casual plasma glucose >200 mg/dl (11.1 mmol/l) meets the

threshold for the diagnosis of diabetes. Once a person is diagnosed as diabetic,

the 2005 standards are that the premeal blood sugar should be 90-130 and the 2

hours post meal blood sugar should be less than 180. Current trends are wanting

to see the 2 hour blood sugar be close to 140, actually.

Here is the deal with the information you have given. You say that your 2 hour

blood sugar after the bagel was at most 230. Nondiabetic persons 2 hour blood

sugar are less than 140. So, that in itself is often used as a screening tool

for persons to identify a potential diabetic situation.

The other interesting piece of information that you gave was the choice of food.

A bagel has the following nutritional content: Calories 360 Fat 1 Sodium 520

Carbohydrates 75 Sugar 12 Protein 8

The Glycemic Index is a scale that ranks carbohydrate-rich foods by how much

they raise blood glucose levels compared to glucose or white bread. When you eat

food that contains carbohydrates, the sugar (glucose) from the food breaks down

during digestion and gives you energy. After you eat, your blood glucose level

rises; the speed at which the food is able to increase your blood glucose level

is called the ?glycemic response.? A bagel is considered to be a high glycemic

index food. This will result in your blood sugar being high for a prolonged

period of time after it is consumed, thus complicating your 2 hour post meal

blood sugar. IN general it can (kind of) be looked at as being better to eat

simple carbohydrates vs complex carbohydrates.

I will pipe in my 2 cents for anyone with pancreatitis, they do not have to have

diabetes, to call their local hospital Diabetes Education Department. At least

the programs in Indianapolis whom I have spoken to understand that anyone with

pancreatitis is at a high risk for developing diabetes, if they are not already

pre-diabetic. Diabetic educators, ones that understand pancreatitis, and they

all are not that clear on this disease, but for those that do, are wonderful and

willing to help you put together a meal plan that works to manage prediabetes or

diabetes, as well as your pancreatitis.

Please let me know what happens. Diabetes is a serious disease. Like

pancreatitis, the key to an optimum outcome is early diagnosis, intervention,

and care planning. There are many serious complications to diabetes, such as

heart disease, renal failure, and blindness. Check your blood sugar and check it

often.

This is not intended to scare anyone, but to make sure you understand that time

is of the essence. Persons with pancreatitis already have an impaired immune

system. Persons with pancreatitis do not produce glucagon, like normal diabetes.

Therefore achieving stable blood sugar maintenance is an extra challenge. One

that can be achieved, however, with education and support so that you can make

an informed healthcare decision. No one cares more about your health than you.

Karyn E. , RN

Executive Director, PAI

Pancreatitis Association International

[Guest guest]

Kathleen,

I'd have to stick with Mark about the bagel. My CDNE took us on a

tour of the grocery store during a monthly meeting and pointed out

the bagels, warning everyone about what a misconception everyone

had about them. They run from 48-60 carbs each, depending upon what

kind they are, and because they are so dense they don't digest

easily. Wheat toast would only be about 19-22 carbs, and a better

choice. If you have gastroparisis, I would think they would also

be difficut for you in that sense, say they would stay in your

system so much longer, thus keeping your BG's up longer.

With numbers like yours, you really should find yourself a good Endo.

I have to agree with the doc who said it was time to think about

some insulin, those numbers are too high. The ADA claims 70-110 as

" normal range " , anything more than that is indicative of problems, as

I'm sure you know.

If you are thinking about the TP/ICT, finding a good Endo now would

be in your best interests, and he/she could work with you through

the whole time. There is one type of insulin that you can buy

without a prescription, but I would not advise doing so unless you

had an Endo to help you with the dosing requirements. They can do a

C-peptide test to determine how much insulin you are already

producing, and then they determine what dosage you need according to

that.

With love, hope and prayers,

Heidi

Heidi H. Griffeth

SC Rep

SE Regional Rep

PAI

Note: All comments or advice are based on personal experience or

opinion only, and should not be substituted for consultation with your

medical professional.

[Guest guest]

Hi Kathleen,

I know we all experience the frustration of trying to deal with this disease

to somehow keep on going with our lives. And I know you are in the tough times

for your actions and decisions. I can only offer that you keep on doing what

works best for yourself at this time and I hope for you that things will get

a little better.

Best wishes, Poncho - GA

[Guest guest]

I am diabetic. I was diagnosed by an 8 hour GTT (draws every 30) about 15 years

ago. I had another one a few yrs ago. That's not the issue. The issue is my GI

doc does not want me on it, he does not think it's time for the tp.ict yet. I

think he is saying that because his hospital can't do the ict. They have to use

a donor, fly the organ to Miami and then inplant the cells. I am not willing to

do this when I can be my own donor. THAT " S the issue. I think he wants to keep

me there as his little lab rat for his research. Since I have developed CP and

the other digestion issues, my blood sugars are wacked. I eat the bagel because

it stays in me. I know the wheat toast is better choice for BS, but it makes me

vomit and gives me diahera for HOURS! Everything but the bagel does that to me.

I am thankful I eat SOMETHING.-Kathleen

KarynWms@... wrote:

Karyn E. , RN

Executive Director, PAI

Pancreatitis Association International

[Guest guest]

Hi Poncho, thanks for your post, let me just say this ONE MORE TIME...If I eat

anything other than a 1/2 bagle and sometimes mashed pototoes, I throw it up, or

it come out the other way. I have done the ginger, it's not a nausea issue, My

stomach is paralyzed, and yes, I am taking meds for it but I have now been on

them so long they are not working as well. And no, I cant try something else

because I have already done that and no, I am not getting a pacemaker because if

I get the TP/ICT, the gastroparisis, God willing, will go away in

time....Kathleen

..

[Guest guest]

Hi Kathleen,

I think I've had positive comments about GI's Salzberg and Horney, I even

like Asher but some don't, however they are all GI's. I must also say my

particular treatment is OK but there isn't much I can do but diet, enzymes, and

analgesics. So, I don't have experience with more than that.

All of these doctors work with Northside Hospital and their offices are very

close to the Northside-St Joes. complex right at the north end of Atlanta.

Best wishes, Poncho - GA