I have recently started treatment for cancer and the oncologist wants me to stay on a 2000 calorie a day diet. I am 69 and 168 lbs type two. I have always been a lean type 2. Up until my cancer diagnosis I was able to control by sugars with diet, exercise and 1000mg metformin. Now I have been told mild exercise if I can (getting more difficult) and load up on the calories, they want me to gain weight. How do I do that and keep my sugars in check? They are already getting quite high, 10.4 (over 180) Fasting. My nutritionist is saying don;t worry short term, let them dance up around 15-18. My GP has put me on some Gliklizide and it doesn't seem to be doing much. Is the answer bolus shots after meals? The cancer folks want the carbs to be the priority. ?
Tough call terrors. I had breast cancer 6 years ago and no one said anything to me about carbs, but things have changed a lot. Maybe have a conversation with your oncologist and ask if you can add the carbs IF you start to lose weight?
Boluses are injected before meals, based on the number of carbs you're going to eat. If you do have to eat so many, IMO that would be the way to go. I definitely wouldn't rely on a nutritionist, but go to an endocrinologist.
thanks, maybe it has to do with the cancer being under my tongue and the worries around swallowing issues and they want to get as much into me as possible before I am unable to eat very well. Right now I have to keep my partial dentures out and am moving to softer and softer food heading to the liquid. I am about 1/3 of the way through. By the time I got to see an endo around here it would be spring. I tend to direct my GP and so far we have been on the same page and the possibility of insulin. Interesting for me to hear what others think.. thanks again
Terrors U might want to call ur endo & see if he can see u earlier and be sure to tell the resepionist what's up. After hearing ur situation she might help u out in getting in earlier.
thanks doris, I have not seen an endo for many years (actually the man I was seeing retired a couple of years ago) and the process here is that you need to be referred but I will talk to my GP when he returns next week.
I totally understand the referral thingy. I too have to be refreed to other drs. but talking to ur GP will help alot there.
I am NO doctor, however I think , you may indeed want to discuss with GP to start insulin , while you are receiving your treatment . I also had breast cancer ( 1984 ) and received radiation treatments , which made it difficult to swallow ..I needed my food intake /nourishments . I would think BG 's of 15-18 is even for the short term high ...you could feel very tired with these numbers .Is there a dietitian available to you at the Cancer Clinic , who is familiar with diabetes ?? there was when I was under their care ( in Vancouver ) Maybe person will suggest liquid Boost etc. ?? ..
I wish you well ...one day at the time !!
thanks, the nutritionist at the Cancer Clinic (Victoria) is the one pushing for the higher sugars, I feel it a bit, I miss being on my bike. I think I need to also start using my trainer. I know I can drop my BG 4pts with 15 min pedaling but won't be able to do that for long. I still have 4 weeks to go and then there is after.
I really have to say that it is "bad" advice to tell you to let your sugars run high when battling cancer. Cancer has been found to feed on high blood sugars. I think it is better to closely control your blood sugars. I would encourage starting insulin as a way of maintaining good blood sugar control. And as to calories, you can always up the protein and fat. I really like whey protein shakes and you can make them with cream for a low carb, calorie whopping, gentle on the tongue kinda meal.
thanks, i will try the shake, I have been doing some with ice-cream, protein powder milk, and banana. I am finding the banana to be a bit acidic and starting to taste funny, anything acidic is horrible in the mouth. I sure will be talking to my GP next week. I have run it by him and he wanted to try the glicklizide modified release first but I am finding it doesnt do much. I mention slow release insulin to him and he would rather use fast acting. He is concerned about having too much insulin on board and then going low if I am unable to eat.
I should have mentioned in my first post when I said I am 168lbs that I am 5 11,
No doubt in my mind ..the treatment will slow you down , so will your appetite ...and maybe you are a LADA ?? ...so would need to use insulin in any case ...wonder what /which bsc would recommend ? ...my thoughts : why not try the bolus before meals for a week or so ...more flexibility ?? ...you may need carb counting mentoring , if you not familiar with the method
....nothing is carved in stone !
Has anyone suggested Vit D3 ..or get your Vit D level checked ?
You can eat high calorie while also eating low carb. Low carb is high fat & moderate protein. If you lose weight, increased protein will help maintain your weight.
Agree wholeheartedly with bsc. Allowing high BG is not healthy for anyone & particularly with cancer. Actually, I'm shocked that a nutritionist would say not to be concerned about 15-18 (275-325)! I'd find someone else, if you can, who knows what he/she is talking about.
thanks Gerri, there is only the one nutritionist at the cancer agency, easy enough to deal with I just won't tell her my numbers, they are totally concerned that I maintain a 2000 calorie a day intake. Looks like ice cream and Dairy Queen milkshakes. :)
That's exactly what I was thinking--don't tell her. Eat eggs, cream, cheese, meat, fish &, of course, vegetables. Your body needs the most nutrition dense food, not carbs.
When I lost too much weight from low carb, my doctor said eat more carbs. Well, then I'd be back where I started on the BG roller coaster. I nodded & did what was better for my body. I increased protein. I also use protein shakes. Whey isolate protein is the highest in protein. Get unflavored & it's very low carb. I use unsweetened almond milk, some cream, unsweetened cocoa powder & a bit of stevia. Sometimes I toss in a raw egg yolk. Delicious, thick & filling. Better than Dairy Queen:) Easy to make panna cotta, which is like soft ice cream. Yummy & also low carb, but lots 'o calories.
However how can you keep your BG numbers " quiet " , if you / your Doc ...( a GP ) are thinking to start on insulin ??? ...I am confused . I think this sounds like over symplification .
hi nel, not quite sure what you mean here? My oncologist insists i maintain 2000 calories a day diet. It sounds like, and my GP says much the same, the important thing here is dealing with the cancer. Short term it is ok for my sugars to go up, but not as high as the nutritionist is saying. I also feeel better when they are lower but am entering that faze of radiation where it is hard to sort out what is what in terms of not feeling good.
thanks gerri, at this point there is not much solid food I can take, mashed potatoes, shepherds pie, etc.
I think I mentioned earlier that I did have to have some teeth extracted and I am also keeping my partial plates out because they are starting to contribute to mouth sores and that is definetly something they don't want to happpen.
I try again : you stated : " easy enough to deal with I just won't tell her my numbers " .. your team will have to know BG numbers , how else would the team and you know, how much insulin to deliver, if you indeed go the insulin route ...did I make it clearer ?? .
As I said in my first response ...: I agree 15-18 numbers too high ... not advisable .
I wonder too, if the " nutritionist " can network and hook up with a CDE dietitian from RJH and include that person as part of your team ? Am I correct , the CA Agency is next door to Royal Jubilee hospital ...both centers " state of the art " ? ....one day at the time !
yes nel both centres are there and that is a good idea to try and put them together. The cancer team at this point is not very involved at all in my diabetes regime. My GP is on the periphery and not part of the cancer team per se. He does get some reports. At this point the GP would be making the insulin decisions exclusive of the nutrionist at the Cancer Agency. The nutritonist likes the high numbers because she believes it tells her I am taking on lots of calories which is what they want. I don't think she is that diabetes savvy. At least with the way mine works.
Am sorry. You sure don't want additional mouth sores & discomfort. Blenderizing vegetables to make soup is a good way to get lots of veggies. If you like cream soups, another way to get more calories is by adding cream & butter to soup. Omelettes with cooked vegetables & cheese are easy to make & chew. I have a low carb chicken pot pie recipe that's delicious & a soft food. I'll send you some recipes. One is cauliflower based & tastes just like potato soup. My husband loves it. Easy to make.
To get additional nutrition, you can use try green drinks. They come powdered.