Tuesday, October 14, 2014

Diabetes Management Experiment I

One of the key tenets of Adaptive Management is to "learn while doing", or using management actions to reduce uncertainties. In the management of Type 2 diabetes the real key is figuring out how your body responds to different meals. Meals are management actions, and the uncertainties are how one's body responds to each meal.

I just did one of these experiments. I've been trying to figure out why my A1c levels are representing an average blood glucose level higher than I measure before eating (pre-prandial). There are two possibilities. First, I know I have high blood glucose in the morning, which could be the "Dawn Phenomenon". The other possibility is that I experience high blood glucose levels after eating, a "post-prandial spike". The typical recommendation is to measure post-prandial blood glucose 2 hours after starting a meal. My post-prandial values then are typically pretty good, < 120 mg/dl.

So today I measured at 30, 60, and 90 minutes as well. The results are not good:

Minutes   BG
0              83
30            106
60            120
90            150
120          110

Check that out! A rise of more than 60 mg/dl! Now, if I'd eaten something loaded with carbohydrate... but no: stir fried vegies (cabbage, onions, carrots and green pepper. Not many carrots and green pepper either) along with 4 Lightlife Tofu dogs, and a couple tablespoons of Mayonnaise.

Now comes the difficulty with Adaptive Management. N=1. Even attempting to repeat the experiment I'll never replicate the conditions I had today exactly. However, the hypothesis that stirfried veg + tofu dogs isn't spiking my blood sugar just dropped in probability.

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