Husband was diagnosed about a month ago, type 2. At that time the doc gave him little or no information, but thankfully, he has been to most of my education appts. We did have an appt with the health educator at the clinic. BUT she was of no use what so ever! The appt was a loss of time, and worthless as well as being the most humiliating experience thus far. So, here is his information, he is 5'11";256 lbs, has lost 50 in the last 6 - 8 months. He wasn't given any meds or meter to test. "We'll see how you do on meds for now"....no meds called into pharmacy. He eats as I do, I get 80-100 carbs a day, have lost 80 lbs in the last two years. He walks 2 miles daily, and works as a baker...no he doesn't eat at work, if you bake or cook for so long, you get sick of it. He packs a breakfast and a snack. Here are the questions, how many carbs or how would we figure out how many he needs in a day? He is allergic to milk / but not yogurt so he uses that for his dairy. He has been eating about 100 carbs a day....25 for each meal and 10 for each snack or less. He hates meds, but will take a pill that is safe for him. Doc told him Metformin 1000/ 2 a day....but with his Ibprofen he doesn't want to take that one as it's famous for upset stomachs and taking those two in tandem would give up a digestive problem. AND that is a higher dose than is really necessary to start, in my opinion I have a call into the nurse, but am not sure after his horrible experience, he will go back. AND they don't want to see him until Feb. for another A1C. Initial diag. test was 7.5 and an average 166 daily reading,. any ideas offered kindly will be acceptdd. ASK if you need more information. I know that you aren't docs, but I don't know where to go with all of this for a simple answer
My advice really to figure out how much carbs he should be eating, is go somewhere like a wal-mart or target and buy one of their inexpensive store brand meters. Wal-Marts relion meter is like about 9 dollars to buy, and the strips for 50 are around maybe 25 dollars. I've found when money was tight that my old Relion meter was just as accurate as my one touch. He needs to test before eating and AGAIN two hours later. Keep track of serving sizes and the carbs in those serving sizes and see where his blood sugar is 2 hours after eating. Unfortunately everyone has a different limit to what they can tolerate and what foods they can and can't tolerate. Eggs for some reason spike me...was mid 90's this am...had eggs, two hours later I was mid 120's. Go figure lol. But it's not the first time I've had eggs and notice a spike with them that you wouldn't think would occur. Your just going to have to kind of play around with it and see what works best. For me I tend to try to stick around to 30-40 carbs per meal...sometime a bit more sometimes less. For others that would be WAY to many carbs. Also your husband needs to figure out what he wants his "target" BG to be. I really STRIVE to keep my 2 hour post meals bg less than 130, even if I do have carbs. But he really does need to test even if that means picking up a meter at the store on your own.
I really don't what to tell you. You have gone through so much trying to get your blood sugar under control and you know what happens if you don't take care of your blood sugars. Maybe your husband can change his diet and lose weight and manage his condition, but maybe it won't work and he will have to work to take medication. I think all you can do is try to help him make an informed decision and support him in his choices. You can offer to help him start with a small dose of metformin and work up. It is often recommended to start with 500 mg and work up over a period of weeks. Some also think the extended version (Metformin XR) is tolerated better. But in the end, if he resists and decides he won't do it, there is only so much you can do.
ps. Long-term use of ibuprofen is not good, it destroys your stomach and can hurt your liver.
I agree w/ BSC about the ibuprofen. I usually use Naproxen for injuries/ aches. After the last major bike accident, I had an rx for vicodin, which is always fun but I noticed naproxen was more effective at turning down the aches and pains. I am not really a stomach problem person (other than my pancreas of course...hee hee) and never had problems but my mom has had a lot of problems w/ ibuprofen. I pretty much stopped taking painkillers all the time as when I cut back on them, I noticed I'd drop a couple of pounds when I stopped and gain them back when I took them.
It doesn't seem rational to declare one's hatred for meds if you want to survive and be healthy with diabtes. There are lots of examples of people who do ok w/o meds by exercising and cutting carbs but I think 100 is too much to win that battle? Maybe 30-40/ day might hold them down but, if you do that and are used to 100, it may be a challenge and every time you binge and have extra carbs, it seems likely your BG will go up.
My bg goes up all the time too. A lot of people's goes up when they have traumatic injuries or surgery, even if they don't have diabetes. If you have diabetes, the only way to control it without a fairly strong will, is to use medication, either pills or insulin. I look at food as medication too. When I go to wild rock concerts I'm always concerned that a zealous bouncer will get squidgy about my bag of jelly beans but they are not "candy", they are "medicine" and you will want me to have them or you will be doing more work helping the paramedics get to the mosh pit.
many who have chronic pain, due to chronic illness (arthritis) or disease, do very well with taking low doses of ibuprofen daily, or as directed by a doctor, same thing with aceteminophen (sp?)...much better, safer than narcotic pain medications and at low doses, they are effective and safe.
good luck with your husband!
It's unconsciounable that he wasn't given the tools to test his blood sugar! Was the health educator you saw a CDE(Certified Diabetes Educator) or a generic one? He won't be able to see how the meds (if he takes it) or how various foods/ # of carbs change his BG without frequent testing.
I'd either call the doc you saw, or find a new one (an endo if possible) and get a meter/strips prescribed, as well as speak with a CDE
Yep about the IB....I'm the one who has to watch liver enzymes etc with the IB....as I can take 2400mg a day for my arthritis.....I have two other alternatives, but when it hits every joint in my body the IB is the only thing that works, He eats a banana before work, he's on his feet for 8 or 9 hours a day....and then maybe a 200 mg IB if more than moderate pain sets in.
I do wish that was a choice, meaning and endo or another doc. We live in a very rural/doc starved area of South Dakota. We are lucky to have one or two professionals that know anything current about diabetes. I put in a call to the nurse who works with the doc he saw....and she was furious at the treatment he got, She thought the health educator ( not a CDE would have given him all the tools he needed) We had an appt with the CDE in our area, but he had to go into work for someone who got sick, so now our appt is Jan 5. The doc's nurse ordered him the strips, meter, etc and also 500mg tabs of metformin to start with. I told her all the problems he had with the health educator, and she said, she'd take care of it. And we have an appt to have A!C done and appt with docs (we don't see the same person) within 45 mins of each other at the same clinic.
I keep telling him it pays to get assertive, not aggressive, but tell them what you want and then work it out. I still don't have a number of carbs to go by, so I guess we start with 100 a day,and go from there.
I've been following that dialogue for a while and read one and a half of Gary Taubes' books (not D-specific, more history of science but exploring carbs vs. fat...) and I don't think that there's a "consensus" on how many carbs are "good" other than to eat to your meter and see what you can do. If you can work a 1/2 hour walk/ swim/ elliptical into your day after every meal, you can stave off medicine more easily but I'm not a huge fan of that as I prefer to sort of kill myself as much as I can when I exercise so I can only do once/ day or every other day most of the time. I know a lot of T2 people manage to go 3x/ day or at least regularly? To me, that seems really tough to do. Everybody's different though. I' glad to hear the CDE is available and seems to be aware the "health educator" is challenging?
So glad you have an app't. with a CDE, and have gotten the supplies you need! Yes, assertive is good, and you'll probably find yourself being assertive frequently.
Once he has the meter, you'll be able to figure things out, I'm sure!
The doc's nurse ordered him the strips, meter, etc and also 500mg tabs of metformin to start with. I told her all the problems he had with the health educator, and she said, she'd take care of it.
I'm glad he is finally getting a meter.
That is the single most important weapon in his armoury for his battle with the beast. It is also the most precise and effective way to answer this question:
how many carbs or how would we figure out how many he needs in a day?
Actually, the question needs amendment. Here is the right question:
how many carbs or how would we figure out how many he can eat at each meal?
Please ask him to read this, and some of the relevant included links: Getting Started
I know he is not brand new, but the ideas in that will be new to him. He will have lots of questions after that, please ask him to drop in and ask them.
Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter.
Alan, thank you for the information. I did go through the "Getting Started" information that you advised, and agree with most of it.
The one thing I do have a problem with is the not eating baked goods. And it's not because I am the wife of a baker, either. it's because we have just spent over a year (my diabetes group) going through baked goods or recipes that people here submitted to us to find the carb count / calorie count/ along with changing the recipes to make them carb friendly, For example, one of the BIG major ethnic desserts in South Dakota is Kuchen For some people this rich dessert is a part of their being. By tweaking the amount of flour, the amount of filling or kind of filling in the middle we were able to come up with a kuchen piece that is 16 carbs count. Kucken is a German pie, much like a crust that is fairly dense and filled in the middle with pudding and fruit. Very high in carbs in it's original form, but we changed enough things that after we did the changes we had the University
Health and Dietary professors double check our work. It was fine, and they even suggested ways we could reduce it further. So along with ANYTHING a diabetic puts in their mouth, we have to realize portion control, tweaking the recipe, and being totally mindful of ingredients....it can be done. Most people won't go to this much work, but for some baked goods, it is totally worth the time and effort.
I sympathize over the struggle over baked goods but - without doubt the grains, rice and corn hit hard.
My sense is that portion control is essential and make sure sufficient hearty exercise regularly can ease the load from that.
The baked goods are high energy food and even worse than sugars.
The other factor is that liver leakage throwback force one to hit harder on carbs reduction in diet and metformin can help in that area slowing liver down.
good luck.
The one thing I do have a problem with is the not eating baked goods.
That advice on avoiding baked goods is part of the preliminary advice as a temporary measure for people who are not yet testing after meals.
Once you start testing your meter will tell you what is OK, or not, for you. You will find that it matters little what the official carb count is; that is just a guide for the first time you test after you eat.
The real judge is your meter. Favourite food or not, ethnic food or not, baked food or not, calculated as low carb or low GI or not, if my meter at my post-prandial peak shows me that portion size of that food is harming me I reduce it.
Trust your meter.
Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter.
I think if your husband tests 2 hours after meals he will figure out pretty quickly what foods work and which ones don't. 500 mg of metformin is not alot, so he may have to increase it. I had to fight with my doctor to increae my metformin twice. He kept telling me I would go too low. Well, he really didn't believe me that my bg rarely goes below 100. I would think with him being a baker he would enjoy creating lots of Low Carb baked goods. Cooking was always my hobby and cooking and baking low carb really saved me. It gave me a creative outlet. I like to go to lots of Gluten Free Sites like www.comfybelly.com or www.elanaspantry.com
They have tons of recipes made without flour. All he would have to swap out is the honey or the sugar.
Testing after meals is a good way to see what is happening. However, 2 hours may or may not be when he peaks. Most, but not all, type 2s peak earlier.
It is a good idea to do a little extra testing to find when the most consistent peak time occurs and use that time.
Cheers, Alan, T2, Australia.
Everything in Moderation - Except Laughter.
just for grins:
my timing usually is 1.5 to 2 hours to peak, lasts 1 to 2 and then final bump at 6 hours as hard to digest and fats come off as glucose. this is what i watch on cgms.
Allan makes fine point about adjusting portion size.
aslo whole grains behave better.
other interesting riot i watch is rice. when boiled white - it shoots up bg fast.
fry the rice as in fried rice using a good oil and that slows down the riot and flattens it well. but fat police will scream and rant.
my main approach is always watch portion control like a hawk and no sneaking extra snacks. Some snacks ok but watch bg always.
pastas are outright nasty causing digestion delay as gut somtimes has to resort digestive juices for odd ball mixes of food. Sometines i will see little bump in bg and then stall for 2 hours and then hit full force.