Any of you T2s out there have tried this?
For those who don’t know what it is, You measure BG BEFORE eating and modify your meal to make sure you don’t go above 120 an hour after.
You have to do a lot of tryin out at first to find which foods spike you too much
I did something like this shortly post-diagnosis – not eating until I was below a certain benchmark, and only enough to not spike above a postprandial benchmark. (Postprandial is considered to be 90 minutes to 2 hours after eating, depending on who you ask.) It ended up with seriously disordered eating that could have easily progressed into anorexia nervosa had I not addressed it with my doctor once I noticed the pattern. She stated that it was vital to not go more than 4-5 hours without eating, regardless of my readings.
I also find that if a postprandial spike/high does not moderate by 3.5-4 hours postprandial, the only way to get it to drop is to eat something with a moderate amount of fast-acting carbs (i.e., a fruit) in order to get my blood glucose to moderate correctly.
Right now I find the issue is less specific foods in general than threshold values of those foods. And it’s not an issue of carbs in general, or sugars in general, either.
I have been reading ALL I can and come to the conclusion that 125 or 7.0 is the absolute limit. That’s the point at which microvascular damage begins. I have got my fasting BGs into the 81 - 87range (4.5 -4.8) I am only using Metformin 500s 3x daily and keeping to a tight diet. Eating almost No visible carbs, to stay, below 5 (90) most of the time and 6 (110) at ALL times. I’m using what I’ve learned to try to pursuade my doctor to let me have more test strips.
The PCT ( primary Care Trust) who control the local NHS purse strings have decided in their wisdom that, T2 diabetics who have good control need only test their BG twice per week. Some don’t mind, but it matters a lot to me. My doctor is allowed to give me more if I can make a good enough case. Remember Diabetics don’t pay for any medication under NHS rules. The PCT has announced that test strips were costing more than medication and that according to the Irish Study ( the rubbish one!) their’s no advanage to the T2s in more frequent testing!.
My pre-meal BG is usually just under 90 ( except for before lunch where it is almost alway under 80 ). Post-meal ( 2 to 2.5 hours later ) is usually under 120. My endo does not have diabetes and wore a CGMS just to show me what to expect. His post-meal BG spiked to 160 before coming back down. Of course his BG returned to normal values faster than mine did but you get the point.
I eat three balanced ( carb, protein, fat ) a day regardless of what my pre-meal BG is. If my pre-meal BG is high ( say 120 ), I adjust the insulin dosage to compensate.
I am confused about going over 120 after a meal. My doctor told me I needed to have a BG reading of 80 - 120 before meals, and that my BG should not go up more than 70 two hours (postprandial reading) after a meal, which would put my after meal reading at 150 to 190. In doing my own research I found that the ADA recommended postprandial is <180 mg/dl and that the AACE (recommended postprandial is <140 mg/dl (7.8 mg/dl). What data or source states that one should not exceed 120 after a meal?
I have been following my doctors instructions and have maintained an A1C of 5.6.
Regarding your test strips - we have found a small portable unit from Walgreens called the Side Kick. There are 50 test strips in it, and we just got it on sale for 9.99!!! The expiration dates are not for another 6 months - 1 year!!! It does not have a lancing device but you can use any lancing device - those are cheap in comparison!!
I spoke to a representative from a testing kit manufacturer and she does not recommend these but I have had my son test himself with his regular meter and this kit and they are always within 1 point of each other. Other pharmacies carry them but I have never seen them on sale. They are very small and so easy for my son to place in his pocket . I would recommend them if you are looking for something a little more economical. My Mom went to every Walgreens store in her home town to buy them for me!!! Nancy
Joslin’s stats for someone without diabetes circa 2002, per my doctor (apparently the ones online were/are a bit too lax) were: fasting under 100, postprandial under 120, (don’t recall pre-bed offhand, but I think it’s “over 100”). Their goals for someone with diabetes are: fasting 100-110, postprandial under 130, pre-bed 100-130. Many of us wishing to minimize complications believe we should be aiming for the numbers and control of people without diabetes. (Can’t seem to find my electronic version of the document at the moment.)
Probably because the NHS is the biggest purchaser, there are very few brands of Meter availble in Britain ( I have a Freestyle Mini) there aren’t many places to buy strips either. I can get them from the meter supplier Abbott Diabetes Care for £14.33 a pack of 50. they cost double that from a pharmac. Ebay sellers often do good deals too.
Officially, I don’t pay for any of my medicines, because of age and long term condition, but there are several layers of administration between patient and accountant. Hence the difficulty of getting strips.
A1c shows the average level of BGs. the point made by AACE is that low averages cover up wide variation and it’s the “spikes” that cause the damage.
A steady BG of 100 could so easily produce the same A1c as a set of swings from 50 to 160 on a regular basis. ( I’m not going to mess about making up numbers. It’s a fairly basic bit of maths) However every time the BG rises above 140, microvascular damage results.
I’m with Bernstein. Non diabetic BG levels are achievable. Admittedly it’s much harder for a T, depending in injectd insulin1 than a T2, who still has some insulin production.
There’s no reason to set a target much above non-diabetic levels. They do that because they don’t expect patients to be compliant and motivated and it’s an imposition to expect them to give up things they like.
“…control of people without diabetes.” I expressed a similar sentiment in my monthly article at
http://www.dlife.com/dLife/do/ShowContent/daily_living/Viewpoints/grubbs_100608.html
I am not trying to plug my article, but I am very interested in the correct goals for BG readings, etc. I saw my doctor this past week and his attitude toward my concerns and questions really pissed me off. This is probably the first time that has happened and I have been his patient for the past 15 years. I think that him not being type 2 is part of the problem.
Thanks for the tip! I will check them out. I have been looking for a meter that is very small that will fit in my pocket.
It’s slightly more complex than not expecting volitional compliance: sometimes economic factors play a more significant role than we’d like to believe. Consider people of low income whose choice is cheap beans and rice or no food at all…
I agree that it is possible to keep BG within the norms for a person without diabetes ( my A1C is 5.4 ), but is it generally much harder to do. It involves lots of rigour around what is eaten and seeing getting the carb to insulin ratio and timing jut right.
That is probably worse in other countries than the Uk, where support is available. However, I did read something from a Diabetes Specialist Nurse about its being unfair to expect people to give up food they like.
My feeling is that there are many instances in life where we have to do things we’d rather not.
I agree. Just because “we like it” does not mean it is good for us. We should minimize or eliminate things that harm our bodies.
Again… for those of us who are “succeeding” and are “poster children for compliance”, yeah… but what about folk who literally cannot afford to eat anything other than beans, rice, and spaghetti? Or the folk who live in neighborhoods where no fresh produce is available, and cannot get outside their neighborhoods (no cars in the area, no mass transit, no taxicabs, etc.)? Seriously, these folk do exist.
My mother, who is also type 2, lives off less than $800 a month. She, along, with my wife and I, buys groceries at WalMart (we take her because she has no car, and has very poor vision). My mother has lost weight due to eating less and learning about carbs, etc. from the dietician at our local hospital. She stopped buying potato chips, and other junk food. My mother’s doctor set up the appt., and it was paid for by medicare.
Also, my wife and I eat a lot beans, such as black beans and kidney beans. We normally buy the cheaper brands (Walmart carries the Great Value brand), but I think we buy Bush’s Beans. We buy and eat fresh produce. some of it we buy from Walmart, and some of it we grow ouselves. We eat sweet potatos, bell peppers, egg plant, cucumbers, etc. My wife prefers to “cook from scratch” as opposed to buying conveinence food such as boxed or frozen meals. We buy Walmart chicken, especially the hot wings, pork chops (we grill them), etc.
I’m surprised at anyone being able to live off $800 a month, since as far as I can see there is no apartment or house in a 100-mile radius of here that is less than $1000/month, not counting taxes and utilities, and very few apartment shares under $800/month. And that is with rent control and rent stabilization in a number of communities.
What can I say? The cost of living, taxes, etc. varies across the US. It is cheaper to live in the parts of Georgia compared to New York.
My 90 year old mother, in Britain, lives on pensions of about £10,000 a year. She owns her home and pays reduced property taxes, because of her age. She’s in a tiny village and gets most of her fruit from her own garden and vegetables from her neighbours.
She’s a very clever cook and uses unpopular cuts of meat, which are cheaper, to make delicious meals.
My mother grew up in Central Europe, during the privations of the 20s and 30s and WW11. I think those that did that learned to do well on very little.
I hope I’ve learned enough from her. I too have a limited budget and and the cost of living is so much higher in Brtiain than in most of the USA.
I was amazed at what is sold and people will buy in the US. Ready chopped mushrooms, for goodness sake! What a waste of money! Also I discovered that many Americans don’t eat liver, kidneys and other internal parts of the animal. Heart for instance is nearly fat free pure protein. Liver is vitamin rich.
The better a cook you are, the less it costs and paying for someone else to prepare what you can do for yourself in minutes is wasteful. Then again there’s waste.With proper meal planning, that can be cut to a minimum. I saw on TV a couple of weeks ago a woman( here in England) who regularly at weekends, buys and roasts a chicken, serves the white meat to her family and throws the rest away. To me that’s criminal. The life of that bird, should be valued enough not to waste it. and the brown meat is delicious. I remove every scrap from the carcass, give any bits I didn’t want to the dogs and make soup from the bones and stew the rest with mushrooms, or leeks, or something…