Ha1c moved from 10.7 to 10.2 this month. Obviously need a lot more movement (slowly but surely). Need to cut out some carbs but having a really hard time finding direction on how to even start low carbing (other than that I don't eat bread, pasta or rice already). Right now I'm at 180 g/day, but this just isn't working...
Any direction, help, or suggested websites are greatly appreciated.
The Diabetes Solution by Dr. Richard Bernstein. Also the Bernstein Group here on tuD. I also usually recommend the bloodsugar101 website but I think it is more geared to T2.
I have to be honest. If you are eating 180g/day and have an A1c of over 10% (average 240 mg/dl), your problem is probably not the level of carbs, it is your insulin regime. I would like you to think about a couple questions.
Is your basal set correctly, have you done basal tests, can you skip meals and stay rock steady in the 70-120 range?
Do you accurately count your carbs and bolus such that your blood sugar returns to your preprandial number at 3-4 hours after you eat?
Do you test and correct in the morning? Do you add corrections in if you are high before meals? Do you test and correct after meals?
I found the books "Using Insulin" by Walsh and "Think Like a Pancreas" by Scheiner very helpful. If you have not read them, I am sure you will find them helpful too.
I think we have gotten a lot closer on my basal rates and insulin/carb ratios (I have 4) and Eight different basals. I've only been working on this for about two solid months now (after completing treatment for diabulimia/bulimia. I've just found it impossible to have any level of control with the spikes from the huge insulin boluses after eating carbs. I've also started pre-bolusing which seems to be helpful.
I'm working through "Pumping Insulin" which has also been very helpful but haven't yet gotten my hands on "Think Like a Pancrease." I realize that there are a lot of issues and my team is helping me work on these. I (starting this past Valentines Day) test 8-10 times a day and for the first time in over 10 years am taking insulin regularly as I should be with my pump. Yes, correcting and calculating carbs. In fact, I've gained nearly 15 pounds in the last two months from the bolusing. I just think it would help if I cut down on the amount of carbs so my swings aren't so wild.
I do have a pump, FINALLY have a great team, and have started eating regularly and taking insulin regularly. I just feel that working on the carbs might be the next best thing. It's been a struggle. 24 years with T1 and finally getting some level of control. (I know 10.2 is still ridiculous but it's slowly moving as November A1c was 12!). AGH! It will get there.
Thanks for the advice!
Ok, then let me follow through with my own suggestions on low carb. The best advice on low carb diets are actually in the weight loss community. A good book is the "New Atkins for You" and if you want recipes, look for low carb recipe books. I really like Dana Carpender, such as "1001 Low carb recipes."
The key difficulty we often have with our "team," particularly dieticians is that with a low carb diet, you need to eat higher amounts of fat. I eat lots of fat. I don't worry about saturatd fat, but some people do. I use lots of butter, but olive oil is good and I have started to use a lot of coconut oil.
Atkins, if you follow it, will take you down to 20g carbs/day until you adjust and then bring you up to a "maintenance" level. Your total daily bolus levels will drop significantly and you should expect some drop in your basal requirements as well. Most people also find their weight normalizes. Bernstein is the best source of diabetic advice on low carb diets, but he doesn't always help you with good stuff to eat and things like that.
Thank you very much. The help and support that I get from you all on tudiabetes has been so important in helping me to re-focus.
And yes, that has been an issue with my dietician - who believes in eating processed meal replacements and shakes. These are huge points of contention between us (As I am not a milk drinker nor do I like to eat processed foods).
Looking forward to weightloss but trying to stay more focused on working towards a 7!
Thank you!
I just finished reading a book called "Cheating Destiny" and it had a little of Bernstein's history in it and a little about his philosphy. I will definitley check out the group and possibly his book.
Thanks!
I've now reached 9.8 YAY!
Keep up the good work. Have you managed to cut down on your carbs? I've found that eating pretty much the same meal for breakfast and lunch every day helps quite a bit. If a couple of eggs (or egg beaters), a slice of toast with some peanut butter and coffee avoids the spike why not eat that breakfast most of the time. You can experiment and find a meal that works for you and then go with it. Variety might be the spice of life but sometimes that spice is a blood sugar surge.
Maurie
I agree with you bsc. Fats increase the saiety( did I spell it right? level of foods, which makes you feel full, even without many carbs. I do a lot of olive oil, use butter, olivio spread, mayo. I genrally avoid white potatoes, pasta, rice, breads, crackers ( but sometimes will do a couple prsnut butter sandwich crackers prior to biking, hiking) I find such starchy items too hard to accurately bolus for. I still do fruits ( low glycemic like strawberries and blackberries) paired with plain greek yogurt to minimize the spike. You will learn how to do it. Read the books suggested and take small steps. Congrats on the work you have done so far!!!
God bless,
Brunetta
The best way to cut your carbs is to set a carb limit for each meal or snack. For example I know at breakfast I need to keep my meal below 3 carbs or I will spike above 120. At lunch I have more leeway and can handle 15 carbs. Dinner is usually around 10 carbs. Most of my snacks are mostly fat. I also suggest Dr. Bertstein's book.
A1c has moved to 9.5. Slow strides, but that's a full point from 3 months ago and 4 points from where I started! I have been eating a scrambled egg burrito with eggs, fresh mushrooms, spinach, and hot sauce in a low carb totilla for breakfast (17g), usually a salad plus Jimmy Johns sandwich or hamburger, neither with bread, for lunch and expirementing for dinner. Last night I had spaghetti squash alfredo and a flaxseed muffin. I am cutting out, or way way down on alcohol to see where that gets me. I bet that will make a huge difference! You guys are the best.
Thanks Jeannie - What sort of things do you have for snacks. I've tried pepporoni, cauliflower or mushrooms w/ranch,pork rinds, and cheese and jerky but I'm getting tired of having these same few things...
Thanks Maurie. I'm at least finding lots of LC veggies, peppers, etc to put in my eggs :)
Just want to suggest, Samiii, that as someone in recovery from an ED (as am I), that you try reducing carbs a bit at a time rather than jump into something as radical as Bernstein. Feeling deprived can be a strong trigger for us.
Congrats on the reduction in A1C - poco a poco (little by little). And good for you for sticking to your guns on what you feel is healthy eating, contrary to what your dietician feels!