Advice/info first post

1

Hello, posting for the first time. Thank-you to everyone who welcomed me on board. Hope this is not too long.

I was diagnosed at the end of January 2013, A1C 7.3 it seems I showed an A1C of 6.5 9 months before in bloodwork before an op. but my PCP quote 'let it get past him'!

I am trying to control BS with mostly diet as I have a bad back.

I was trying to be what I thought was fairly low carb around 100 a day but am finding it hard to reach that as any bread type item or fruit sends my BS above 140.
However I keep coming across stuff saying lower than about 130 carbs is unwise plus the diabetic programme I am in is stressing 45 carbs a meal. If I do that I might as well forget it!

Any advice on how to get proper nutrition doing this or pointers to finding clear info on this gratefully received.

I also was trying to avoid ketosis but find low levels of this sometimes, is this a problem?

I suppose my real issue is controlling my BS but not damaging myself in some way while doing so.

I am generally in range of 105/125 2hrs after eating. However since I was trying to keep carb levels up I was eating more often, every 3 1/2 hours so blood sugar is never really coming down into the 90s before being pushed up again. I know it can go lower since if I delay eating to 4 1/2 hrs plus it does.

Is it best to go longer without eating and let it come down?

I realise big fluctuations are a bad thing.

I have lost respect for the 'diabetes education' programme I am on as for a start they did not have a meeting with a dietician until 6 weeks after enrolling and that was a group situation where mostly we looked at reading food labels.
I see the dietician one on one next Monday and I am sure I am going to be told what I am doing is wrong and to eat more carbs. Also they just want testing twice a day in the morning and before evening meal!

Thanks,evam.

2

First of all, welcome, Evam. Second of all, have you had your type clarified? Lots of us are type 1's who were misdiagnosed type 2 based solely on age. To do this you need a c-peptide test and a full antibody panel. That determines treatment

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As for "diabetic education programs" they pretty much push the ADA party line which is "eat lots of carbs and blood sugars up to 180 are fine". (which kind of go together!). People on here are very varied in how they eat but there is absolutely no reason you have to eat 130 carbs a day. Many of us eat less, some a lot less.

In addition, testing two times a day is not enough, especially in the beginning. Many of us keep to the idea of "eat to your meter" which means we try certain foods and certain amounts of foods and then see how they affect our blood sugar two hours later. Early days are for learning what does and doesn't work, and the only way you can do that is with data you get from testing and keeping careful notes.

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First, let me add my voice to the "welcome wagon." This community is a non-judgmental place where you will find an enormous well of shared experience to draw on, as well as the ability to converse with people who have been where you are and who really do "get it."

You raise a lot of issues, which is natural for someone new to diabetes. There's a lot to learn and it's impossible to do it in a few days, so don't let yourself feel overwhelmed. Take small steps and it will come into focus sooner than you may think.

I expect a number of others will chime in on this thread so I'll just address two of your points here. First, a 7.3 A1c is not something to lose sleep over. Yes, it's higher than you should be and you certainly want to bring it down, but it's not a frighteningly high number. You'd be amazed how many people are first diagnosed with A1c's up in double digit territory. Your number is simply something that needs fixing. In fact, that's the way to look at any blood sugar measurement: not as a criticism, but just as a clue to what needs to be done. By way of analogy, if your car's engine is missing badly, it doesn't mean the car is going to explode tomorrow. It just means that you need to fix what's wrong to stop it from degenerating into something worse.

Now, about what constitutes the "right" amount of carbohydrate: anyone who tells you "THIS is the right amount," no matter what the amount, is not giving good advice. When it comes to managing diabetes, one size most emphatically does not fit all! Each person's physiology is distinct and individual and responds in its own way. The diet that works perfectly for me may not work for you at all, and vice versa. We have an acronym for it: YDMV (Your Diabetes May Vary). Just means that you have to determine (usually by trial and error) what's most effective for you.

That said, I eat a very low carb diet. For me, it produces superior results.

You should consider reading this book:

Richard K. Bernstein, Dr. Bernstein's Diabetes Solution, 4th. ed. (New York: Little, Brown and Company, 2011)

Bernstein is a long time Type 1 diabetic who is also a doctor. He is a polarizing figure in the diabetes community; some people follow his recommendations religiously while others consider him much too strict. But regardless of how much of his advice you do or don't take, the book is the best explanation of what diabetes is, how it affects the body, and how to manage it that I have found. As with most "experts," the proper response is to take what's useful for you and leave the rest. Personally I consider it one of the most informative books anywhere.

Didn't intend to get quite so verbose. Again, welcome to the community and keep those questions coming! :)

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Sorry should have said,they said type 2 but did not do any of the tests you mention.

I do not think for a minute and given what I have seen on my meter that the amounts 'recommended' are acceptable.

In avoiding flour/potatoes/rice/fruit mostly/ I am having a problem fitting even 100 into a day.

And I was given supplies for 2 tests a day but have supplemented this and am doing fasting BS and before eating and 2hrs after, as twice only seemed useless info wise.

Thanks,Evam

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Yes I am going lower find it impossible to keep BS low and eat enough carbs to reach 130. But did come across places where there were dire warnings of going lower.

Today tested and strip showed small amount of ketosis.

Thanks,Evam

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Yes, have the book am reading it now. Thanks,Evam

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For a T2 the right amount of carbs to eat is the amount that allows you to achieve your blood sugar goals. I get by quite nicely on 30 to 50g, but we are all different. You are catching it at a much earlier stage than I did, so your magic number could easily be twice mine.

As a T2 you have a very low risk of ketoacidosis Here's a discussion of the difference between ketoacidosis and ketosis which is probably what your are experiencing as a result of lowering carbs.

The best advice I got was to eat to my meter. This requires an investment in strips to find out what foods are causing problems. The usual suspects are sugar, grain, fruit, starchy vegetables and legumes. I have completely eliminated these foods from my diet for more than 3.5 years and don't feel any of these foods are necessary as long as you eat a wide variety of the foods you can tolerate. I've always liked meat and veggies so I have had no problem sticking with the program. Proponents of the high carb approach say low carb is impossible to stay on, this has not been my experience. The source of the carbs is more important than the number of carbs. As you are finding out it's hard to eat the recommended levels of carbs when your main source of carbs are veggies. So forget the 45g per meal.

I second Shawnmarie's recommendation of the low carb dietician website.
The bloodsugar101 website is a good place to learn about eating to your meter.

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Thanks. I have checked out the low carb dieticians website now,looks very useful.

I have bought the bloodsugar 101 book but not read it yet.

My fear I think is failing to get the right nutrients while fairly low carb eating.

Evam

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That's a perfectly valid concern. As with everything diabetic, the following comment is prefaced with "this is what works for me, your diabetes may vary."

I deal with this by getting nearly all of my carbs from veggies, and taking a high qualify multivitamin/mineral supplement.

I also take extra Vitamin D3 because (a) most Americans are deficient in Vitamin D, and (b) more specifically, my lab tests show that I am. Vitamin D plays an important role in carbohydrate metabolism.

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Evam - Welcome to TuD. The ingrained low fat, high carb diet long pushed by the medical/nutritional establishment has done much damage to the diabetic community over the years. I’m sure there are persons with diabetes, T1 and T2, that are able to consume 150-200 grams of carbs per day and achieve acceptable blood glucose and A1c levels. But I’m not one of them! And not because I didn’t try. I bought their lie about not reducing my carb amounts because my body or brain needed that minimum for essential energy.

I now eat 50-70 grams of carbs per day and have a lot of energy. This way of eating allowed me to cut my insulin usage in half while reducing my blood glucose variability and A1c.

The low carb dietitian referred to in other comments is one of the few professional medical sources that promote this sane way of eating. Some of the best advice given here is to eat to your meter. If you can tolerate bread, potatoes, and rice and still measure 105-125 mg/dL two hours after eating then more power to you!

Limiting carbs for persons with diabetes is an idea that is ahead of its time. Eventually, the medical/nutritional establishment will also recommend this way of eating. But for the sake of my health, I’m using this method now because I feel better when I do.

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I love it too! Her blog is just chock full of information, its well researched and well written. And since she has blood sugar issues of her own she has a perspective impossible to get any other way.

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Thanks for your comment. I suppose since I keep hearing /reading in many places, not all obviously, that ketosis is bad for you that it worries me being in ketosis.

Are you ketotic,any bad effects, should I dismiss my apprehensions.

I do wish to control this without drugs.

evam