1. Is there anyone here who weights and measures EVERYTHING and eats virtually the same foods each day and eats somewhat low carb (100g per day or less)? And still experiences high variability in their BG?
2. Is there anyone here who struggled to get an A1c below 7% for years and then managed to do it? (Note: I'm not talking about people who were burned out and/or not really trying, only people who put in a concerted effort.) If so, what finally enabled you to get great control?
I don't feel like I can add significant insight but these are 2 questions that I've been really curious about for a while now. so I had to chime in...
1. Yes. Did this for a while a few years ago trying to put diabetes into overdrive when I realized my prior goals weren't very good. Significantly better, still some variability from test to test. I definitely think there is something here.
2. Yes* BUT I didn't have great control. Too much work to get high 6's, plus hypos, plus $$$. I couldn't figure out anything sustainable.
Don't know if my input will help, as I'm a comparative newbie of only about 5 years. But between the diabetes and allergies, I've become a bit preoccupied with food. So I do weigh pretty much everything. (Like when it says a recipe is 6 servings, I'll weigh out the final product and divide to determine the exact serving size.) And because my low symptoms mimic my allergic reaction symptoms, I had a limited menu for quite a while. It's only since I got the Dexcom that I've branched out in menu choices. I find that I usually have reasonable control but definitely have roller coaster days that don't always have anything to blame it on even when eating the same foods.
You would probably say I eat moderate carb, averaging about 120-130/day. Low-carb seemed too hard for me personally while being limited in food choices and trying to gain weight at the same time. What I've noticed recently is that my roller coaster days seem to often be a full 24-hour period after having had a medium-high-fat meal, not just a few hours. Eating moderate-carb, very-low-fat seems to work best for me at this point in time, although YDMV. Am guessing that although a ketogenic low-carb diet needs the fats, it can mess up a carbier meal plan.
Don't know if any of that will help. But I definitely empathize. It's a constant puzzle, isn't it?
1. As I am usually at home & do all the cooking I do weigh nearly everything, but some carb factors are guesses that have worked in the past. I probably eat about 120-130 carbs a day. Yes I do experience unexpected highs but not excessive, very rarely over 250.
2 Up until 2006 my A1C was high 7s or low 8s, I could not get it lower. Then the Endo suggested I try a pump, since 6 months after starting pumping my A1C has been 6.5 or lower. I do have too many lows but I feel them & cope with no help from others.
I am pretty much like you - due to allergies I a preparing almost 100% of my own food. And before that, the only time I didn't weigh/measure food was when I ate out. So, for the past two months I have been weighing and measuring everything. And yet ... I still have highs and lows every day! My blood sugars range from about 55-230 pretty much every day.
Both of the endos I've had as adults have said they thought part of my variability was inaccurate/sloppy carbohydrate counting (even after I tell them I use a scale), but now that I've eliminated that factor, obviously that's not it.
I agree with oou that I don't like a really low-carb diet. The time I tried it for a few months it was a) way too much work (and now would be impossible since I can't eat nuts, eggs, or cheese), and b) I had a pump site fail on me and I developed massive ketones within a few hours—I have never seen the ketone strip turn even darker than the darkest purple until that point. That's what really turned me off ...
I'm currently weighing and measuring literally everything since I'm preparing literally all of my own food due to food allergies. I'm still having a lot of variability in my blood sugars. I have been accurately weighing/measuring most of my own food for a few years now, but always figured the times I ate out (which was a few times a week) were adding variability to my blood sugar, but now I don't think that was the case.
I am already on the pump, and that dropped my A1c from around 8% to the low 7% range. The few times I hit the 6% range I was having too many lows, and when I have too many lows I stop feeling them early, which isn't good. I am hoping if I can get a CGM that it might make the difference in me getting into the lower 6%. Not sure I will ever get to the 5% range, though. :/
Oh crap...eating low carb without eggs and cheese would be hard.
Jen, could it be your basal/bolus is off? Maybe more basal testing? Perhaps a different insulin would improve things? Maybe a great diabetes educator could help you figure stuff out. It just sounds like you are doing a lot of work and not getting great results.
Initially; I was reading labels and weighing everything. From my perspective; that effort was to build up a reference in my minds eyes of sizes and what they look like.
Eating to my meter provided feedback on foods and sizing and things to restrict closely.
Today I run off my reference in my brain as well as watching my glucose meter 2 hours after eating meal as well as the 5-6 hour point as well for any miscues.
So far that has served me well. To make matters easily; I eat small lower glycemic meals at breakfast carefully limiting grains, breads etc. That makes matters far easier. I make my dinner the larger meal.
My approach is to run on 1200 calories a day gross with 300 calories for breakfast and 300 for lunch and 600 for dinner.
In the past starting out this diet and what should "I eat was tough, painful and drove my wife nuts. Today matters are much easier while still allowing choices and careful variability!
In the end, careful portion sizing is critical and careful restricting portion size on high energy grains, sugars and food stuffs.
I was doing this, except I also do very low carb (less than 30g/day). But my weight and blood sugar kept creeping up, even on a careful 1200 calories a day. That sucks. So, for 45 days I did <500 calories and <20g carb a day. I wanted to see if I could determine where the maintenance point would be. On the second day, my blood sugar fell 20-30 points, into the 75-90 range, and it stayed there for the duration. I lost weight. I don't know how much, the scale is not my friend, I can get obsessive about it, but I can wear the clothes I did two years ago and that's good enough for me. My conclusion is that yes, a T2 at least can get good control over blood sugar by being OC about carbs and calories. I don't really know where to go from here, though, this diet is not sustainable. The low carb part is fine, I just stay away from them and after 7 years of this, it's no big loss. I'm just afraid my "maintenance" diet is going to be about 800 calories a day, which doesn't leave much wiggle room. I'm also afraid that my surly body will figure out a way to make fat out of air. One good thing, my grocery bill is very cheap.
I asked my GP for a serum insulin test so I could see if I overproduce insulin, which is why I have a problem with weight. She said "no", not understanding that insulin resistance isn't the same thing as hypoglycemia, which she says I don't have because I don't have those symptoms. I get so tired of institutionalized ignorance in the medical profession.
1. I weigh everything at home. Sometimes it's a pain the butt. Measuring cups, scales measuring spoons, etc. When I am out on the road, I use my hand to guesstimate. It can be a waste of money on the road. I go through a mickey D's and order a child's hamburger and the buns go right into the trash. Portion control drives me crazy because sometimes I am still hungry after I eat. And yes, my GL fluctuates. It's annoying.
2.I never struggled with A1C. I was in denial of my disease the first few years. I was angry that I could not go to Baskin Robinns and eat ice cream cake. Then I watched 2 freinds slowly detieorate through agony of diabetes and they died. That woke me up. I sold my car, surrendered my driver's license over to the state of California, and bought a bike. I watch what I eat and exercise everyday. My A1C is now below 7.
First, I have to confess that I am in no way a foodie, or really interested in food. I think that comes from being raised in a ballet studio where the joke was, if we wanted a ballet company potluck it would be really easy - just pictures of food we thought might taste good. I used to weight stuff until I got good at knowing how many carbs were in things. I am not particularly low carb since I count broccoli, brussels sprouts and the like as carbs. If I am hungry I can get a much better meal from a pile of those types of veges than grains. There are some people who only count "starches" as carbs.
I've managed an 1C of 5.4 -5.8 for several years now. I give credit to my CGM and my following the trend arrows, testing 10-15x day, and my pump. All three work together so that I can micro dose when necessary and stay between 70-130 or so. I do have the occasional surprise, but then, I do have type 1. My attitude is that I deserve to have "non-D" numbers if I am willing to do the work. I do run into a wall with my current Endo who doesn't seem to believe I can do it without a bunch of lows. Fortunately my CGM data shows I am doing well.
Wow! Staying between 70-130 most of the time is amazing!
I am not really a foodie, either, more of a "forced" foodie between diabetes and allergies!
I am not good at estimating carbs by sight alone, which is partly why I weight things. Counting something is easy enough, but trying to tell if something is a cup or a cup and a half is virtually impossible for me.
I probably could test more than I do, although part of my problem is that if I tested 15x a day I wouldn't know what to do with some of those readings. I can test an hour after eating and I'm high, but if I try to correct it my pump recommends no correction bolus because of the food. I suppose the lesson in that might be to pre-bolus sooner, but then I get into issues with going low. I think a CGM will help me a LOT when I finally get one, though unfortunately that won't be for a while yet (still waiting on work benefits to kick in, and can't afford to purchase one at the moment).
I pretty much have the foods I eat memorized (and a lot that I don't eat memorized). But for me (probably due to my visual impairment) I have a really hard time telling if something is, say, one cup or one and a half cups. If it's something like an apple that I can hold then it's easier, btu even then, it's easy to be off by 5-10g of carbs which (for me) make a big difference.
I'm fortunate in a way that I was diagnosed as a kid. So there was no real diet adjustment for me as an adult. Although, when I started on an MDI regiment I was told I could "eat anything" and that really messed me up for about five or six years and was hard to go back to the mentality that I really couldn't eat "anything" if I wanted good control. I wish Type 1s weren't told that, although I know there are some here who do it and manage fine.
Not sure how to help. I am Type 1 so have no experience with Type 2. I wouldn't think eating 800 calories a day is healthy, though. Are you losing weight eating that many calories? Maybe exercising more (resistance training I've heard is better than cardio) would help reduce insulin resistance and weight?
I think a bit part of it at the moment is that my insulin dose is changing, yes. In the past two months I have lost 15 pounds (a good thing!) and between that, getting back into exercise, and not eating out or snacking, my insulin dose has almost been cut in half. My TDD has gone from 60 units to about 35 units! But even with that, there's no real pattern to when I go high or low. I can eat a meal late one day and go low, and do the same thing the next day and be fine. I am seeing my endo at the end of July, and so he may have some feedback - but he (and he has Type 1) plus my old endo and a CDE I have seen - have always said they think my pump settings are fine and that my blood sugar is just variable. I feel like my main problems are that every little thing seems to have a pretty big effect on my blood sugar - being 5g off on a meal, going grocery shopping, monthly hormones, the weather changing from cool one day to hot the next, and that's not even the stuff I'm unaware of like the state of my body internally! I'm looking very forward to whenever I can get a CGM to see if that can provide any insights into my blood sugar.
I must say it isn't because I am so disciplined, more because I boring. I eat basically the same thing everyday. The CGM is a major help. I test, look at the trend arrows and adjust the bolus accordingly. If my trend is going up, I'll up the correction to accommodate that. I am also a great user of the temp basal.
My view of my diabetes is that it is a board game, and I am gonna out trick it.
I like the board game analogy. But without a CGM, it's like I'm only able to see every fourth move ... I read posts here all the time about how people increase their basal until they start going down, or bolus a bit more if they notice themselves going up. Those are two things that are pretty much impossible for me to do. I also really wish I truly knew what my blood sugar did after eating different foods and what it did overnight when I ate versus didn't eat versus exercised, and so on.
I would sooooo bike everywhere if I could! I really like the idea of biking around the city. Unfortunately not something I can do. :( I do get transit everywhere, though, which means more walking than the average person.
Yeah, I find the CGM worth it so I pay out of pocket. It's expensive, but what am I to do. I bring it up with my health care system, but they spout "evidenced-based" medicine as the reason they don't cover it. Well to that I say, I'm evidence., Look at the tight control! Oh well, I'll suck it up and pay for it. At leszt by being used to paying for it out of pocket, when the time comes for Medicare, I won't go into shock.
I'm guessing that I'll probably end up paying out of pocket for mine, too. I'm just waiting until I'm done paying tuition, and then I can put that money towards a CGM. :) (I will check with my work benefits, first, though, just in case they do cover it by some miracle.)
