Lack of Continuity in Information out There -I Give Up!

There seems to be such a lack of uniformity in information out there, I just give up. I can’t do this anymore. I am chasing clouds. ARGGGGHHHH
I go to a dietician, and she tells me I can’t have more protein than one egg or the equivalent per day. Why not make me a vegetarian? For example, I can have a 1/4 cup of tuna, for the whole flaming day. That’s it.
She told me what the last dietitian told me, that is to raise my carbs to 45 grams per meal. Thats over 100 grams of carbs per day. She wants me to eat 15 grams of carbs, too, before I go to bed. She claims my liver is having to make sugar and that is why I am going up and down. That part makes sense, but this diet seems deranged, and I don’t see how it it is going to make me better.
45 grams, 3 times per day, plus 15 at bedtime. Since I can’t use vegetables as carbs, being a
That seems like an awful lot. So, as someone who cannot eat grains, I am going to get sick of rice and potatoes.
She said vegetables don’t count as carbs, but fruits do.

How am I going to lose weight on more calories than I had been eating?

So I’m supposed to fill up on carbs, and eat 4 oz. of protein a day?
I am going to get sick on that little protein per day.

Some Veggies do count as carbs like peas, corn, and others.
I don’t know why only 15 gr of protein per day, do you have underlying problem ?
By listening to you I would say get a second opinion from another Dietician,
something doesn’t seem right here. Please get another opinion !

I don’t know what meds you are on for your diabetes?

No…she has me on 4-6 oz of protein PER day.
That’s like 2 grams of protein per meal.

Not much at all. No, I have no condition warranting limiting protein, but it seems dieticians do not like protein, and they are big on carbs.

I never thought Id be told I wasn’t eating enough carbs.

Metformin, doesn’t do anything.

What does she mean that you can’t use vegetables as carbs? You’re not to count the carbs from vegetables in your daily allotment? Never heard that veggies don’t count as carbs, but that fruit does. Fruit hits faster, but all vegetables count as carbs.

This sounds somewhat like the ketosis diet to lose weight, but that one only severely limits protein intake during the induction phase until ketones are found in urine. Not something a person should do for an extended time. It’s basically having the body burn fat reserves by being in a semi-starved state. Have a friend on this diet. She was excited when she was spilling ketones so she could move to the next phase that included more protein & carbs. Told her when I spill ketones I call my doctor:)

Limiting protein aids weight loss, but that’s low depending on your activity level. When protein is lowered, carbs are raised. A person has to eat something! Recommending a diabetic eat rice & potatoes (instant sugar) doesn’t sound like a good plan to me. On a diet like this, you’ll be constantly hungry because of the higher carbs & lower protein.

Yea, dieticians love those carbs. They’ll tell you if you limit carbs, you’ll starve your brain. Rubbish! They love the food pyramid.

Don’t get the statement about your liver making sugar being responsible for you going up & down. If you feed your liver more carbs, that will help you lose weight? I eat very low carb & this hasn’t made my liver dump more glucose or I’d have higher BG, which I don’t.

This advice on protein sounds dubious–unless the dietitian meant “3-4 oz of lean protein per meal.” And then you should also have a recommendation on including 2 or so servings of low-fat dairy daily, which also give you protein. Protein helps with making a person feel full. As mentioned in previous posts, kidney disease and lactose-issues would be possible reasons the protein/dairy allowance might be very low.

The advice on carbs (about 45 grams per meal) is the standard guideline for a small woman or a woman trying to lose weight, according to the American Dietetics and American Diabetes associations.

You’ll find that not everyone agrees with that carb count (which typically puts a person at 45-60% of their calories per day from carb sources–but that’s counting all these important food groups: grains, starchy veg, non-starchy veg, fruit, dairy). The associations do advocate that the carb sources be fiber-rich, nutrient-rich (whole fruits and veggies with fiber-rich skin, whole grains, minimally processed foods) and eaten in conjunction with proteins and healthy fats. I think the unfortunate part of the message that gets lost when a dietitian says “eat ___ grams of carbs per meal” is that the dietitian wants a person to eat fiber-rich, highly nutritious carbs–an area of eating in which most adult American do a dismal job.

The advice on vegetables not counting as carbs is simplistic but typical of the basic carb-counting advice given to people with type 2 who don’t use any meds or some meds but no insulin. That’s because many people with type 2 who use diet/exercise/metformin/weight loss to control blood sugar levels can often get good results with basic carb counting rather than advanced carb counting (in which every gram needs to correlate to dose of rapid-acting insulin). This is because, in part, they are secreting some of their own insulin.

In reality, all vegetables–even the non-starchy ones like spinach, brocolli, red peppers–have some carbs. Granted, they have fewer carbs than the starchy vegetables like corn, peas, potatoes.

With basic carb counting, however, if you eat the recommended 1-2 servings (1/2 cup cooked or 1 cup raw each) of veggies per meal and make some of your own insulin, the non-starchy veggies (at approx. 5-10 grams of carb) may not have much effect on your blood glucose and thus you may not really need to count them. Plus, when a person is limiting overall calories to lose weight, it’s nice to have one food group from which you can graze in relative abundance! But you CAN count the vegetables in non-starchy carbs if you want to.

When hearing unpleasant and confusing medical advice, it is very easy to tune out (been there, done that).

Consider calling the dietitian to confirm your understanding of the eating plan she has proposed (which sounds like has the dual goals of helping you lose weight and controlling your blood glucose levels) or find a new dietitian!

How many calories does the eating plan allot you daily? Most studies have shown that it really doesn’t matter what type of “diet” you use to lose weight (fewer carbs, less fat, more protein, whatever), it’s cutting calories, period. Of course with diabetes, the eating plan needs to cut calories but also help control blood glucose, blood pressure, and cholesterol, too.

Whatever the eating plan, it needs to work for you and be something you feel determined to do. Then, the other things that need to be in place are daily exercise, a food journal, and one-on-one or group counseling. Let us know how it goes!

PS: If metformin “doesn’t do anything” for you and your blood sugars are not controlled, please don’t rely just on eating/exercise. It may be that your body has started secreting less insulin (which happens as type 2 progresses) and you need to add another blood glucose-lowering pill, a weight-neutral injectable like Byetta, and/or insulin.

I asked her 3 times, and it is on the paper she gave me:

4-6 ounces PER DAY of protein. I asked the same thing, “Shouldn’t that be 4-6 oz. per meal??” and she said, no, you don’t need that much protein, you need carbohydrates.

She said I don’t need to worry about calories, just eat more carbs. She wants me to eat 45 grams of carbs per MEAL plus 15 for a snack each day. That seems like a LOT to me.
Being a celiac, I cannot eat bread, etc., so finding those carbs will be eating potatoes or rice all the time.
I have done daily exercise, and it does nothing for me. I upped it to a full hour a day, still nothing. It is the same if I work out hard or don’t. I will say exercise simply helps with my blood pressure, but for losing weight, killing myself walking or running a treadmill does nothing.
I can’t get Byetta. I am on Medicaid, and when I asked my doctor about it, he said, “Well, we can’t go giving you everything because then, there isnt enough money for everyone else!” Jeesh.
The dietician thought Byetta would be a good choice, but can make one nauseous, and I am nauseous all the time as a Diabetic.

Yes she said protein isn’t as important as carbs. She said, "Think CARBS!!"
I found it all odd.

Nice doctor to decide what meds Medicaid should cover.

Don’t get the you need carbs not protein theory & also her telling you not to worry about calories. I find it odd, too.

Yes, I agree. Maybe I did need more carbs, but not that much carb, and I still say vegetables, even the no-starchy ones, still count!

Kelly, and Gerri,
And I think a significant weight loss would help my insulin resistance. A doctor told me years ago, that the very thing I need to do is lose weight to help my condition, but my condition is the thing keeping me from losing weight.

I guess I am where all of you landed. On the island of “Figure It Out for Yourself”…
I think she is right on one thing. My blood sugar gets low all the time, and it is the same feeling as high blood sugar. I know when it is low by testing, too. I have used a piece of candy when I am out and I get that trembling, shaking, nauseous, weak feeling.

The dietitian said if I eat more carbs, my blood sugar will be more even, and that’s why when I eat the candy, I feel better.

Okay, I will add some more carbs, maybe some brown rice, but not 45 grams!

Weight loss helps resistence & have to question eating more carbs than you are now to get there, esp rice & potatoes that will mess with BG. Know you’re excersing a lot without it helping. Extremely frustrating:(

Could you try low carb with moderate protein, or have you done that already? I really think that eating that little protein will make you constantly hungry. If you don’t mind my asking, how much weight would you like to lose? I have a link that calculates how much protein a person needs based on ideal weight, gender, activity level. Will find it & send to you.

Is insulin an option to protect your beta cells? Hoping that your doc won’t think that’s a waste of money to get BG down.

Oh, didn’t realize you were having lows. Imagine that’s what she meant by your liver dumping glucose to compensate for your lows. Do you have highs after the lows? Some people have strong counter-regulatory responses to lows. Doesn’t sound like it if you have to eat candy.

Understand better now why she suggested more carbs, but it’s protein that keeps BG more level since it digests slowly & staves off hunger.

Do you have high BG also?

Yes, I go up and down.
My highs are from 130-210

My lows, which aren’t low to some others, but feel that way to me, are <130
Like 110 feels low to me.

I just wish these dietitians could get all of this right.

I doubt my doc would put me on insulin. My fasting glucose was 98 and my AIC was 6.3

It’s my daily BS I take that goes up and down.

I am going to count my calories, literally and maybe increase the carbs a bit, and still eat a good amount of protein. Maybe I was eating too much protein. Sometimes, I ate 2 big slices, like a cowboy, with tomatoes and other veggies for dinner. I figured I could eat all of that protein because I wasn’t eating starches, but maybe, I am eating too many calories.

It would seem with my size, any decrease in calories would cause a weight loss~!

I have to lose about half my weight. My ideal weight is about 100-110 pounds. Even after I had my kids, I was a size 8. It was about 6 years ago, when a doctor told me I was “pre-diabetic”, though he said that’s not a real term.

Fasting isn’t always a good indicator because some people have good fasting, but go high after meals. Seems to be what’s happening since your daily average is 135, if you have consistently good fasting readings.

What do you think is causing the lows? Are they frequent? Insulin might not be a good idea with frequent lows. Perhaps just some basal insulin during the day would help.

Cutting the protein should help you lose weight since you were eating a lot. I had to increase protein to gain weight since I didn’t want to add carbs & take higher insulin doses. Yep, calories count. More in than burned up will effect weight.

I’ll find that protein calculator to send you. Maybe it will help you figure how much protein is a good amount.

Sorry, didn’t see this one when I answered the other below.

Oh, that makes sense. I couldn’t understand how you’d be having lows. I retract what I said about the dietician suggesting more carbs for your lows:) With numbers like that, you’ll be even higher eating the higher carb the dietician suggests.

Yep, 110 shouldn’t feel low since normal is in the 80s. But when you’re high a lot of the time, lower BG feels like a low because your body is used to high BG.You shouldn’t be shaking at 110. Bringing your BG down slowly will help you feel normal at normal numbers.

Insulin would help, even if you just used small amounts of rapid acting for higher carb meals, or to correct those highs since the oral meds aren’t bringing you in range. Over 140 causes damage & your doctor should be more attentive to this.

If you find a good dietician let me know. The two I went to were terrible, including the one who told me low carb would cause brain damage.

You say that you go low a lot so aparently the Metiformin
is working for you. Sounds like it’s working too good.
Maybe the dosage is too high, seems like the doctors
are doing a balancing act. Making you eat more carbs to
balance the effects of the Metiformin. When I hear Cases like yours
it pisses me off no end. How long have you been diagnosed a type 2 ?
Can you tell me some A1C results that you have had. Have you noticed
weight gain since beeing on the Metiformin ? have you ever been on a
Diet and Exercise Regimen only ? Sorry for all the questions.
If your sugars are running low a lot of the time, why would you need to add
Byetta. The answer your doctor gave you, turns my stomach. These are
the types one must put up with when on Medicaid. You have to do some
reading on the subject and learn as much as you can for yourself.

I hope you can somehow come across some good professionals that
take Medicaid. They are out there but are hard to find.
Don’t give up on yourself or get too low, time will turn things around.
For now just do the best you can do. Take care of Yourself !