Teleseminar 58: November 2020.0:00:20 Parent living in Georgia (USA). The state is opening up after Covid-19 lockdown. My daughter is a 12 year old T1D. We have been at home since March 13, 2020. Should we continue to stay at home? Is she at risk of problems from Covid-19 since she is a child? Also, should I send her back to school in the Fall or find an alternative? She also has two siblings, five years old and 14 years old, in public school. Should they return to school? 0:04:37 WARNING. Reminder that the answers are generic that are meant for the general listener population and may not solve the problem of the individual who sent in the question. The purpose of these teleseminars is to educate a lot of people and not necessarily solve the problem for the individual. No physical exam has been done by Dr B, no complete history or family history is given along with the question. No list of mediations etc. Any answer is a guess and could be totally wrong. 0:05:37 I am 36 y.o. male weighing 143 pounds (~69 kg). I am suffering from pre-diabetes for the last1.5 years. My A1c hovers around 5.6 - 6.0% [Dr B: which is on the high side so he may be a prediabetic]. I started a high protein, 150g diet in the last few weeks [Dr B: that is about 25 ounces of protein/day which is a hefty amount, possibly a little more than a 143-pound personneeds but if he gets a lot of exercise, it may be reasonable, he doesn’t talk about carbohydrate]. My creatinine has risen from 0.8 to 1.06. I got so worried that I stopped eating that much protein. Please suggest. 0:09:08 As a T1D I have taken up a low carb diet but recently I have been having symptoms of nauseaand headaches and lethargy. I had a look at my urinary ketones, and they were around 160 mg/dL. I then came across euglycemic DKA and I am concerned these symptoms may be due to high acid levels. Should I be concerned and if so, do you have any suggestions as to how I can continue on a low carb diet without causing euglycemic DKA? 0:12:45 How can a skinny LADA benefit from a low carb diet. I am 48 y.o., 5ft 6inches (~167 cm) tall and only weigh 99 pounds (~50 kg). I use insulin; Tresiba (insulin degludec) 4 units, only in the morning, Novorapid (insulin aspart) 3 units before breakfast. I ate only 60 carbs a day. My last A1c is 7.6% [Dr B: this person has a very high average blood sugar of ~200 mg/dL (11 mmol/L)]. I started this diet two weeks ago and I feel that my post meal blood sugar is almost in range. I need to gain 5 kg. 0:15:15 Everyone keeps saying: Get on an insulin pump, it is better and safer than injections. In your book you come out pretty strongly against it. Has your position changed at all with recent advances in tech?0:18:26 30 y.o. male T1D since 1998. I am very overweight. BMI >30. I have been following your diet religiously. I feel I am extremely insulin resistant. I lost 15 pounds (~7 kg) in five weeks. Fortunately, blood sugars are well controlled between 75 -95 mg/dL (4 - 5.2 mmol/L) all day [Dr B: which is pretty amazing for a T1D, but I guess he may have read my book]. Would Glucophage XR (Metformin) benefit me to further my weight loss?0:20:43 Do you have any recommendations for a 1-year-old who was diagnosed with T1D a couple ofmonths ago to help to preserve any Beta cells he may have left?0:22:49 11-year-old girl T1D for six years. I have read your book and I am curious, does this diet affect her growth, like cause a shortage of vitamins or minerals? If yes, please tell us what to do. Thanks. 0:24:45 How many ounces of cheese is allowed as part of your daily diet plan? 1 0:26:31 How much higher risk for Covid-19 infection complications is a T2D with virtually normal blood sugars?0:27:48 How does the new insulin Fiasp (insulin aspart) help in controlling high blood sugar?0:29:53 I am following your diet. Suddenly after I tried including probiotics in my regime, my intestines refuse to move - constipation. I feel paralysed inside. What medication does the least harm?0:31:43 I am a 68-year-old female who was diagnosed with T1D 5 years ago. I was trying to keep my blood sugars level with some medications such as Metformin. It worked for a while but stopped after four years. I am on insulin Tresiba (insulin degludec) now and I eat very little carbohydrate. My fasting sugar level could range from 100 - 130 mg/dL (~5.6 -7.2 mmol/L). 0:33:10 37-year-old T1D, thanks to your diet I was able to bring down my A1c from 13 (average blood glucose level of 100 mg/dL (~5.6 mmol/L)) to 4.7 % [Dr B: this is pretty darn good]. But lipoprotein (a) is at 55, it should be 20. 0:35:25 I am a thin T1D, with almost no c-peptide [Dr B: meaning that he or she is almost making no insulin, like most T1D]. If I eat one apple with 15 g of carbs my blood sugar goes up by 150 mg/dL points (~8.3 mmol/L). If I become obese, then will my blood sugars still raise up by 150 points when eating 15 g of an apple? I know it will take more insulin to bring down my blood sugar if I am obese and type one, but will my blood sugar rise up differently to the same 15g? 0:37:37 I am a T2D and I am taking Levothyroxine (T4) 100 ug for an underactive thyroid. When I woke this morning at 5:30 am, my glucose was 144 mg/dL (~8 mmol/L). I take my thyroid medication at 7 am. At 7:30 am before preparing my breakfast my glucose was 176 mg/dL (~9.8 mmol/L). Does thyroid medication affect blood sugars to that degree? 0:39:17 I am a T2D for 20 years. I am taking Glucophage (Metformin) 2000 mg/day. Jardiance (empagliflozin, SGL2 inhibitor), and Tresiba (insulin degludec) 14 units twice a day. My A1c was 5.6% last time (that is an average bgl of ~124 mg/dL (~6.9 mmol/L). Do you think I am taking too much insulin? 0:41:25 I am having a lot of trouble with my Dexcom 6. My new Freestyle meter says 99 mg/dL (~5.5mmol/L) and the Dex says 146 mg/dL (~8.1 mmol/L) and going down. This happens all the time. What is the point of having this if I don’t have hypoglycaemia unawareness? 46 years on insulin. Testing x10/day until a few months ago when I switched to a cgm. 0:45:00 I am having trouble maintaining my daughter’s weight. She is 12 years old. Her starting weight at Endo was 82 pounds (~37 kg) and now 5 months later it is 78 pounds (~35 kg). She takes Tresiba (insulin degludec) 2 units at night. We are following your plan and we have increased protein. She is drinking whey protein shakes daily but her weight will not increase. She eats until she is full. Her A1cs went from 6.2 - 5% (5 is about 100 mg/dL (~5.6 mmol/L)). Any advice you can give is appreciated. 0:49:23 I am T1D for 11 years. I read your book and found it to be very helpful. I am trying to conceive and want to know if you believe Tresiba (insulin degludec) is safe during pregnancy? My OBGYN wants me to switch to Levemir (insulin detemir). My other providerdoes not believe this is necessary. 0:50:45 I am a T1D and take Lantus (insulin glargine) pen and Humalog (insulin lispro) pen. Can I normalise my sugar with a pen or do I have to use syringes to achieve normal blood sugar? 2 0:55:30 I am a T2D and have been on a low carb diet and intermittent fasting for three months. In the first two months, I had perfect fasting blood sugars and very normal random blood sugars. It never gets over 100 mg/dL (~5.6 mmol/L). I don’t take any medications. In the last four weeks my fasting blood glucose started to rise to 110 or 113 mg/dL (~6.2 mmol/L). Yet I am still on the same diet and fasting for hours or even longer, up to 20 hours. Can you please explain why this might be? 0:58:15 I am a T2D for thirty years. I am on insulin for 20 years. I have tried to reduce the amount. I am finding it impossible to lose weight. Following the 6:12:12 plan has reduced my dosing to 7 units basal. How do I reduce the amount I am using overall? 1:01:11 That is it for our November teleseminar and video. Please come with me on Wednesday, December 30th for a final session of the year. I look forward to seeing you then. I am looking right at you now. Thank you. 3 4
Teleseminar 58: November 2020.0:00:20 Parent living in Georgia (USA). The state is opening up after Covid-19 lockdown. My daughter is a 12 year old T1D. We have been at home since March 13, 2020. Should we continue to stay at home? Is she at risk of problems from Covid-19 since she is a child? Also, should I send her back to school in the Fall or find an alternative? She also has two siblings, five years old and 14 years old, in public school. Should they return to school? 0:04:37 WARNING. Reminder that the answers are generic that are meant for the general listener population and may not solve the problem of the individual who sent in the question. The purpose of these teleseminars is to educate a lot of people and not necessarily solve the problem for the individual. No physical exam has been done by Dr B, no complete history or family history is given along with the question. No list of mediations etc. Any answer is a guess and could be totally wrong. 0:05:37 I am 36 y.o. male weighing 143 pounds (~69 kg). I am suffering from pre-diabetes for the last1.5 years. My A1c hovers around 5.6 - 6.0% [Dr B: which is on the high side so he may be a prediabetic]. I started a high protein, 150g diet in the last few weeks [Dr B: that is about 25 ounces of protein/day which is a hefty amount, possibly a little more than a 143-pound personneeds but if he gets a lot of exercise, it may be reasonable, he doesn’t talk about carbohydrate]. My creatinine has risen from 0.8 to 1.06. I got so worried that I stopped eating that much protein. Please suggest. 0:09:08 As a T1D I have taken up a low carb diet but recently I have been having symptoms of nauseaand headaches and lethargy. I had a look at my urinary ketones, and they were around 160 mg/dL. I then came across euglycemic DKA and I am concerned these symptoms may be due to high acid levels. Should I be concerned and if so, do you have any suggestions as to how I can continue on a low carb diet without causing euglycemic DKA? 0:12:45 How can a skinny LADA benefit from a low carb diet. I am 48 y.o., 5ft 6inches (~167 cm) tall and only weigh 99 pounds (~50 kg). I use insulin; Tresiba (insulin degludec) 4 units, only in the morning, Novorapid (insulin aspart) 3 units before breakfast. I ate only 60 carbs a day. My last A1c is 7.6% [Dr B: this person has a very high average blood sugar of ~200 mg/dL (11 mmol/L)]. I started this diet two weeks ago and I feel that my post meal blood sugar is almost in range. I need to gain 5 kg. 0:15:15 Everyone keeps saying: Get on an insulin pump, it is better and safer than injections. In your book you come out pretty strongly against it. Has your position changed at all with recent advances in tech?0:18:26 30 y.o. male T1D since 1998. I am very overweight. BMI >30. I have been following your diet religiously. I feel I am extremely insulin resistant. I lost 15 pounds (~7 kg) in five weeks. Fortunately, blood sugars are well controlled between 75 -95 mg/dL (4 - 5.2 mmol/L) all day [Dr B: which is pretty amazing for a T1D, but I guess he may have read my book]. Would Glucophage XR (Metformin) benefit me to further my weight loss?0:20:43 Do you have any recommendations for a 1-year-old who was diagnosed with T1D a couple ofmonths ago to help to preserve any Beta cells he may have left?0:22:49 11-year-old girl T1D for six years. I have read your book and I am curious, does this diet affect her growth, like cause a shortage of vitamins or minerals? If yes, please tell us what to do. Thanks. 0:24:45 How many ounces of cheese is allowed as part of your daily diet plan? 1
0:26:31 How much higher risk for Covid-19 infection complications is a T2D with virtually normal blood sugars?0:27:48 How does the new insulin Fiasp (insulin aspart) help in controlling high blood sugar?0:29:53 I am following your diet. Suddenly after I tried including probiotics in my regime, my intestines refuse to move - constipation. I feel paralysed inside. What medication does the least harm?0:31:43 I am a 68-year-old female who was diagnosed with T1D 5 years ago. I was trying to keep my blood sugars level with some medications such as Metformin. It worked for a while but stopped after four years. I am on insulin Tresiba (insulin degludec) now and I eat very little carbohydrate. My fasting sugar level could range from 100 - 130 mg/dL (~5.6 -7.2 mmol/L). 0:33:10 37-year-old T1D, thanks to your diet I was able to bring down my A1c from 13 (average blood glucose level of 100 mg/dL (~5.6 mmol/L)) to 4.7 % [Dr B: this is pretty darn good]. But lipoprotein (a) is at 55, it should be 20. 0:35:25 I am a thin T1D, with almost no c-peptide [Dr B: meaning that he or she is almost making no insulin, like most T1D]. If I eat one apple with 15 g of carbs my blood sugar goes up by 150 mg/dL points (~8.3 mmol/L). If I become obese, then will my blood sugars still raise up by 150 points when eating 15 g of an apple? I know it will take more insulin to bring down my blood sugar if I am obese and type one, but will my blood sugar rise up differently to the same 15g? 0:37:37 I am a T2D and I am taking Levothyroxine (T4) 100 ug for an underactive thyroid. When I woke this morning at 5:30 am, my glucose was 144 mg/dL (~8 mmol/L). I take my thyroid medication at 7 am. At 7:30 am before preparing my breakfast my glucose was 176 mg/dL (~9.8 mmol/L). Does thyroid medication affect blood sugars to that degree? 0:39:17 I am a T2D for 20 years. I am taking Glucophage (Metformin) 2000 mg/day. Jardiance (empagliflozin, SGL2 inhibitor), and Tresiba (insulin degludec) 14 units twice a day. My A1c was 5.6% last time (that is an average bgl of ~124 mg/dL (~6.9 mmol/L). Do you think I am taking too much insulin? 0:41:25 I am having a lot of trouble with my Dexcom 6. My new Freestyle meter says 99 mg/dL (~5.5mmol/L) and the Dex says 146 mg/dL (~8.1 mmol/L) and going down. This happens all the time. What is the point of having this if I don’t have hypoglycaemia unawareness? 46 years on insulin. Testing x10/day until a few months ago when I switched to a cgm. 0:45:00 I am having trouble maintaining my daughter’s weight. She is 12 years old. Her starting weight at Endo was 82 pounds (~37 kg) and now 5 months later it is 78 pounds (~35 kg). She takes Tresiba (insulin degludec) 2 units at night. We are following your plan and we have increased protein. She is drinking whey protein shakes daily but her weight will not increase. She eats until she is full. Her A1cs went from 6.2 - 5% (5 is about 100 mg/dL (~5.6 mmol/L)). Any advice you can give is appreciated. 0:49:23 I am T1D for 11 years. I read your book and found it to be very helpful. I am trying to conceive and want to know if you believe Tresiba (insulin degludec) is safe during pregnancy? My OBGYN wants me to switch to Levemir (insulin detemir). My other providerdoes not believe this is necessary. 0:50:45 I am a T1D and take Lantus (insulin glargine) pen and Humalog (insulin lispro) pen. Can I normalise my sugar with a pen or do I have to use syringes to achieve normal blood sugar? 2
0:55:30 I am a T2D and have been on a low carb diet and intermittent fasting for three months. In the first two months, I had perfect fasting blood sugars and very normal random blood sugars. It never gets over 100 mg/dL (~5.6 mmol/L). I don’t take any medications. In the last four weeks my fasting blood glucose started to rise to 110 or 113 mg/dL (~6.2 mmol/L). Yet I am still on the same diet and fasting for hours or even longer, up to 20 hours. Can you please explain why this might be? 0:58:15 I am a T2D for thirty years. I am on insulin for 20 years. I have tried to reduce the amount. I am finding it impossible to lose weight. Following the 6:12:12 plan has reduced my dosing to 7 units basal. How do I reduce the amount I am using overall? 1:01:11 That is it for our November teleseminar and video. Please come with me on Wednesday, December 30th for a final session of the year. I look forward to seeing you then. I am looking right at you now. Thank you. 3
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