Thank you. I definitely agree about the stress affecting me. I did have my thyroid checked and my TSH, T3/T4 levels were all normal. It’s odd because some days I’m not hungry at all and have to remind myself to eat and others I am flat out starving. I’ve noticed sometimes it is when I’m high and then others I’m in normal range.
Remember only insoluble fiber is indigestible. Soluble fiber will raise BG, albeit slowly. Also remember we need both to foster a healthy gut biome. Eat real non-processed foods for as much of your diet as you can. Minimize your carbs in a way that is sustainable for you, then set the bar even lower and see how it goes.
2 Likes
For me, pre-bolusing, exercise, and carb reduction are key. Stress reduction and good sleep are also very important. Do NOT believe the marketing blurb from the pharma companies - most people need a pre-bolus of about 10-15 minutes, perhaps except for after exercise, because insulin works much faster then due to increased blood flow and heightened insulin sensitivity.
Carb reduction means fewer BG rollercoasters, and the remaining ones are not nearly as severe. You also inject less insulin, and that can help if you have weight gain problems due to insulin.
Overall, I’d recommend reducing carbs and getting yourself a couple of recipes for meals that you eat during the week. You carefully study how these meals affect your BG, how many carbs are in there, and how you best inject for them. If you have a couple of these “familiar meals”, you can prepare them in the weekend for the next week, and you no longer have to rely on guessing the carb content of food from the cafeteria, or from food from a takeaway etc. Result: Much better BG control. And, it is overall much healthier, because you prepare them yourself, so you know exactly how many carbs are in there, how much sugar, salt etc.
You can then still have some “unknown” meals every now and then (for example, in a party, or over the weekend with friends etc.). The benefit here is that in at least 5 of 7 days of the week, you eat predictable, well-studied meals, so in these 5 of the 7 days, your BG control is very good. So, occasionally, you can “risk” a less ideal BG control if you want to try out something new, because one accident won’t mess up your long term BG control much.
As for stress and sleep - well, lack of sleep is a stressful situation for the body. And stress triggers the release of hormones like cortisol, which heighten insulin resistance and stimulate liver glucose secretion. So, chill out, and sleep well.
4 Likes
I also want to add to this that eating healthy fats is highly recommended. In particular, most of us eat nowhere near enough omega-3 fatty acids. This can be migitated by eating more fish and by using oils that are rich in omega-3. Linseed oil is an excellent choice. I use that one in my salads.
This is about oils for salad though. For cooking, pay attention to the burning point instead. You don’t want the cooking oil to start smoking, because otherwise, harmful substances may form. Pick an oil with a very high burning point. Refined oils are good for that. I’ve also heard that avocado oil is excellent for cooking.
In sum, keep one oil (with lots of omega-3) for the salads, and another oil (with a high burning point) for cooking. And don’t ever mix up the two.
2 Likes
Thanks! I love avocado oil!
I can so relate to this… what helped me get back on track after a burnout was to purchase an elliptical. On times where I struggle with motivation or burnout, I commit to at least 10 mins when I wake up and before bed. That way I at least get 20 minutes in. It’s hard when I’m exhausted, but I can always manage to motivate myself for 10 minutes.
And best of all I can workout in my PJ’s! lol
3 Likes
Gail12
Not sure how I respond to you.
With a fairly tight schedule, it might help to use a plan like Daily Harvest for food. They offer mostly low carb options if you look at the nutritional details. It’s great for grab and go and I use them when my daughters are with their dad so that I actually eat something healthy. It’s cheaper than me grabbing something unhealthy from the school cafeteria. I usually make my own food, but one box of 24 can last me a while so I think it’s worth it. It’s one of my “luxuries” I will treat myself to. You can use this code to get 4 cups RE-VA824VT
a1c of 5. Wow. That is incredible. Great job!
I apologize ellerl if you have already shared this, but are using insulin? (I assume you must be.) If you are, may I ask how much daily (Basal & Bolus total). I’m just wondering how much insulin resistance is going on.
So much good information is being shared here, if you are able to implement 5%, you’ll be on your way.
It sounds like you are just so hectic with your schedule that your body isn’t responding well. The further down your BS goes, you will feel better. After I was diagnosed, I was sitting in the high 200’s, low 300’s waiting to be prescribed insulin. And when insulin brought it down to the mid 100’s, I felt a lot better. Being as high as you are has got to be slowing you down.
As much as you can, keep at it. It’s always a bit of a grind, but a lot it becomes 2nd nature. And make use of that CGM! It has made a huge difference in my control & quality of life.
Seeing this topic and having magically, not literally but nearly, achieved upper 4.x range by accident, thought I’d share. I’m not a doctor and talk to your endo before proceeding. First off, CGM is by far the best route to go. So much insight. SO MUCH.
But being diabetic, T1 or T2, our naturally higher A1C has been shown in various studies to make our bodies flush out nutrients with our urine in comparison to non-diabetics. Nutrients that don’t get stored in the liver. Like magnesium, thiamine, etc. just to name a couple.
In ~working with my endo and doing my research, I came up with common nutrients that have been found, not proven, in diabetics with entering into kidney failure to be lower than ‘healthy’ individuals – magnesium, zinc and thiamine. So after approval and between visits I started them with thiamine @ 100MG 3x a day (because of absorption and always try and keep it in body because of body flushing it out).
Next A1C test it dropped down to low 5.x range without my daily glucose, basal, bolus or diet changing. I done more search and some not proven research believed that thiamine removed glycation from the bodies nerves, hemoglobin, red blood cells, etc. I shared that with my endo and got an eye-brow raised from him. I called it cheating. Anyways, next visit, again, without lowering daily glucose levels, insulin or the original supplement schedule, it dropped down the the upper 4.x range. This is not a solution but an observation that after the fact I researched and found some very light evidence it has this effect on the body. My CGM statistics say my A1C should be in the upper 5’s and lower 6’s and I make a point to make it as accurate as possible with great glucose meter for calibation/checking, etc.
I’ll be starting a new endo soon due to moving states so will be getting their take on it soon…
Your hypo unaware because your diabetes is out of control. The only way to get your hypo symptoms back is keeping your BG in range again for some time, rest assured you will get it back though.
Wow Jim I had no Idea! Your a true lifer with diabetes like I am. Diagnosed at 4.
1 Like
Bernstein put himself through medschool at 40 filled with 30 years of diabetic complications including kidney disease and gastroparesis. The best thing you can do for yourself is read his book and implement it, your life will become much easier and you will live much longer.
1 Like
Ellercl,
I used to count every single carb but not anymore. I found there are so many things that affect your BG and also found that I react differently to the same food on different days or times. I also have read that you should consider protein and fat as they do increase BG although not as much or as fast as some carbs. Thus I have moved from planning to both planning and reacting. I found reacting and planning are equally important. It is difficult to estimate carbs, put insulin and achieve good results. When I did this I had about a 25% chance of having my BG come down to target but it spiked a lot before it came down anyway. Now I eat based on insulin I take, the exact opposite as before. And I take more insulin if I need to and eat more food if I need to. My ave BG is now 106 and before it was 166. I try not to let my BG fall below 70 or go above 150, ever. Works for me. My endo says, “Keep doing what you’re doing.”
2 Likes
One aspect of control no one ever mentions is hormones. If you are a female, they can have a HUGE impact on control. At least as big an impact as carbohydrates, exercise…but, while there are entire books dedicating to those subjects, hormones are never mentioned in any meaningful or useful way. Most doctors can’t help, either, except to say that it’s well documented that some women experience blood glucose changes due to their cycles.
Some women have their insulin needs rise and fall by more than 100% throughout the month. Unfortunately, there is no easy way to deal with this, as things are not always like clockwork month-to-month. But being aware of where you are in your cycle, how your blood sugar tends to respond, and trying to keep up with the adjustments as best you can every few days or week as changes unfold can help tremendously.
2 Likes
Jen,
If you have a CGM I would treat hormones the same way I treat food and generally mange my overall BG. Put in a lot of insulin and then eat/treat according to the CGM. I never worry about putting in too much insulin as I can always eat something if it starts dropping faster than expected. So take a lot of insulin especially if your hormones are reacting and if you’re lucky eat and if not your BG will be lower than simply planning. I guess this is also referred to as sugar surfing but with an extra does of insulin.
The problem with this strategy is that hormones can affect blood sugar significantly for several weeks at a time. Many of us have a single week out of each cycle where things are stable and predictable, and the rest of the time there is little or no stable baseline to work with. I find trying to manage with just bolus insulin is not effective—highs just do not budge if all I do is pile on corrections. Often basal needs rise by more than 100% (i.e., more than double) plus more bolus insulin is needed to cover food and corrections on top of that increased basal. But it’s not always consistent from month to month, in terms of timing and amount. So, yes, a certain amount of “sugar surfing” is useful, as is always the case. And in addition to the rises, there’s also the reverse—the often abrupt, massive drop where all the increased doses that have helped the previous two or more weeks suddenly need to be lowered to below baseline, then worked back up to baseline again, and the cycle continues (at least that’s the pattern that many women seem to have, from exchanging data on social media).
I’ve been at T1D for 28 years and, while I’m not expert, I consider myself pretty smart and on top of things. I’ve read all of the go-to diabetes books (Think Like a Pancreas, Pumping Insulin, Diabetes Solution, Sugar Surfing, and so on) and take strategies from each. I still struggle with managing hormones. It’s not a simple or straightforward issue, in part because no one has really researched it beyond, “Yeah, female hormones have a significant impact on blood glucose control.” Unfortunately, women are not often told about this huge factor. I learned about it after I’d had diabetes for 15 years from other young women with T1D. And even then, I spent years feeling like I must be doing something seriously wrong or must be really stupid to struggle with my control as much as I did. About ten years ago I went on a blinded CGM that showed my control deteriorate from 95% in range one day to 23% in range (with constant corrections) the next overnight. Seeing that data is what convinced me that I wasn’t crazy and that hormones had a hugely massive impact on my blood glucose levels.
I’ve found the best strategy is to carefully track cycle and insulin needs, though unfortunately this can’t be done in the same app. An app that can attempt to predict what’s coming up is helpful, although I’ve been putting data into Fitbit for almost a year now and it’s still not able to predict the correct days for things to happen sometimes. But at least by tracking both, you can figure out your general pattern and try to adjust insulin based on BG trends and where you are in your cycle. But even then, it’s a bit of a guessing game, and while surfing plays a useful role in dealing with some of that, it alone is not nearly enough (at least for me). I think it’s a very hard issue to understand unless you’ve experienced it. But I think it’s really important for women to know that it’s a factor that can have a really, really massive impact on their control.