Prediabetic-help!

Does anyone remember their prediabetic days and how they narrowed down their ratio of simple sugars to complex sugars in their daily carbohydrate budget? After reading several books, I am keeping a diary of my food intake (carbs; simple and complex, fiber, prt, fat), my exercise, my water intake and stress- charting all that against the rise and fall my blood sugar using a glucometer. My goal is to discover my normal range and then see if I can decrease my HgAc1 score which is 5.7. One very difficult part of this is that the glucometer readings can be off 20% (above 75 mg/dl), 15% (below 75 mg/dl) just from the instrument alone, so that is a wide margin of error in trying to figure out what my blood sugar truly is. Good grief. Thanks for any input. Susan

On many levels, a carb is a carb. I highly recommend a LCHF lifestyle (I don’t consider it a “diet” as this word has always meant deprivation for me personally, and I don’t feel deprived when I stick to LCHF eating.)

LCHF = Low Carbohydrate / High Fat

In a very simplified nutshell: limit your total daily grams of carbs to 50 g (or less). Limit fruit to one small portion of low-carb fruit per day. Use lots of “good” fats: butter, lard, olive oil, coconut oil, avocados. Avoid the “whites”: bread, pasta, rice (all kinds, not just white), potatoes. Lots of protein.

Most nutritionists were taught the wrong things, and just about everything you learned about the almighty food pyramid (even the “revised” one) is (what’s a nice way to put it?) effed up.

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Do you follow the recommendation of frequent small meals and how do you prepare your body (blood sugar needs) for moderate exercise? How has your blood profile (HDL, LDL, total chol and fatty acids) responded to your high fat diet? I would hate to know that I have helped one aspect of my health and damaged another. Like I said, I am just learning about all this. Thanks Susan

I, myself do not have D. My 14-year-old daughter has Type 1. I, however, find myself seriously overweight (after having spent the first 44 years of my life at 115 pounds soaking wet), and my foster daughter is obese. A LCHF lifestyle (when we have the time to make it work) has resulted in better BGs for my daughter with Type 1, and weight loss and higher energy for myself and my foster daughter. My lipid profile has returned to normal (my total cholesterol and triglycerides had been elevated). Increasing your fat intake, counterintuitively, improves your lipid profile (not so much if you suffer from familial dyslipidemia) if you consume only healthy fats and limit carbs.

RE “moderate” exercise, to the best of my knowledge there is not much concern about going too low if you are not using insulin. Someone will correct me if I am mistaken.

Nothing seems to have the impact on my overall health, including BG, that low carb/high fat intake has had. My most recent HBA1C was 5.4 - I’m a T-1 initially diagnosed as T-2. If you alter your diet to low carb/ high fat be sure to drink more fluids (for kidney health), and continue to monitor for symptoms the disease has progressed. There is no cure for diabetes. Stay off Meds as long as you can - all have side effects. there is some evidence high levels of insulin and also diets high in sugar may promote tumor growth. I eat three meals a day about 5 - 6 hours apart - due to fat and protein in the meals there is no high BG spike after the meal and I stay pretty level till the next meal. I’m pretty active but not an athlete - can’t address control for intense activity levels. I applaud your testing efforts - find a balance of testing activity that you can support without burning out and keep stress levels down.

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Taking the issues in no particular order . . .

A carb is a carb is a carb. One gram of carb will raise my BG by 5 to 10 points no matter where it comes from. That is not my opinion but my meter’s.

While meters must legally adhere to that plus-or-minus 20% standard, many do much much better. A great way to check your meter’s accuracy is to take a reading at the same time as you have blood drawn for lab work. Then compare the reading you got with the number that comes back from the lab. My meter has never been off by more than 4 or 5 points, and often it’s within 1 or 2.

As for lipids . . . when I switched to LCHF (low carb high fat), my lipids dropped like a stone. Total 150 or less, HDL/LDL at around 2:1, Trigs in the 40s.

Like Rose, I don’t like the word “diet”. Diets are temporary (eat this way til you reach your goal, then you can go back to what you were doing before and it will magically be different). Put that way the illogic is obvious, but that is how “diets” are used in our culture. For a permanent result, you need a permanent change. With a lifelong disease, you need a lifelong regime to deal with it.

And finally, most nutrition “professionals” have it exactly backwards, like that traditional food pyramid. Nine out of ten will advise you to eat way too many carbs. By “way too many” I mean an amount that will make it exceedingly difficult to achieve the control your post makes it obvious you want. That’s a good goal, BTW.

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@Susan63, I am diabetic and exercise a lot. I also eat LCHF, and have some experience with your other questions:

  1. My lipid profiles have improved since moving to LCHF: my LDL is down, Triglycerides are WAY down, HDL is up. Overall cholesterol is down. Blood pressure is great, my cardiovascular risk is decreasing.

  2. As for exercise, if you aren’t on exogenous insulin, I wouldn’t worry about your BG before exercising. You have, presumably, a functioning liver and pancreas (with some insulin-resistance) as a Pre-Diabetic. This means your body is good at regulating your BG as long as you don’t consume too many calories and too many carbs. You’re unlikely to have serious hypoglycemia from exercise, although you may go moderately low. I exercise in a fasted state (before I eat), and I have extraordinarily low insulin production (I’m very early Type 1, or LADA), and I can go low (<60 mg/dL) during exercise. But only if I really push it (hard, 90 minute, biking or running at a race-pace). Test during exercise if you’re worried about your BG during and after exercise. If you’re like me, even though I eat less than 30g of carbs a day, I concentrate those carbs before, during, and after exercise on those days I exercise hard. Strength training tends to temporarily raise BG in diabetics (not sure about Pre-D, but probably), so that shouldn’t be an issue.

  3. As far as testing BG and accuracy of glucometers, you’re right: any single BG test at home (or a lab, for that matter) is likely to be accurate only to within about 10-15% of actual. Then again, if you test frequently over time, you can get a very good idea of where your BG is at and how you respond to what you eat. The accuracy issue isn’t (for me) as important as seeing the trends: I know I don’t want to be at 140 or 180 a couple hours after eating, and I know I don’t want to have a fasting BG over 100. 10-15% accuracy is enough to see how my eating and exercise affects that: if I test before eating at 90 mg/dL, and two hours after at 140 mg/dL, then I know I ate too many carbs. if I test at 90 mg/dL before and 90 mg/dL one or two hours after I eat, then I know I’ve eaten an appropriate amount of carbs (or less) for my body. Really simple. And if I see trends over time in my two-week fasting BG average, then I pay attention. I know for me that that 14 day average should be around 90 mg/dL if I’m eating and exercising as I should.

Hope that helps!

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I try to keep things as simple as possible. I have divided carbs into 3 groups. 1)stay away from, like sugar 2) OK in moderation, like tomatoes and 3) eat all you want, like broccoli.

There is quite a bit of variation in group 2 between individuals. For instance I can’t eat beans but my pre diabetic daughter has no problem with them. This is where “eat to your meter” comes in. Set a 2 hr. bloodsugar goal and find how much you can eat of certain foods and still stay within your goals. For me this means a tomato in a salad is OK but I need to stay away from concentrated tomatoes like tomato paste.

Remember there is a great deal of variation between PWD’s. By testing your reaction to food you can arrive at the least restrictive diet that will still allow you to meet your A1C goals.

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