Random diabetes questions from a fairly new Type 2

Type 2
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Okay, folks. Still trying to get this beast under control! I was diagnosed with an A1C of 6.8 in January. Treating with diet and exercise.

I’m kind of on my own with all of this, so good thing I have all of you!

Today’s dumb questions:

  1. How many carbs do you shoot for in a day in your diet? I imagine this varies greatly depending on male vs. female, on meds vs. not, etc. But I’m still curious. I struggle daily with what to eat and feel like low-ish carb is the way to go, but not sure what that means and finding so much different info online that I’m confused. Also, I’m hungry all the time and I’m not used to that.

  2. The CDE I saw said I should shoot for these numbers:
    Between 80 and 130 before breakfast and other meals,
    Less than 160 two hours after meals,
    and between 100 and 140 at bedtime.
    Do these sound right? It’s not that I don’t trust my health people, but sometimes I wonder if I’m getting the best/most recent info…

  3. Should a Type 2 wear a medical alert bracelet? Do people even do that anymore? Is it a dumb idea? I had an awful hypo-type of experience at my job the other day and I realized if I passed out, I might be in trouble with people not knowing that I’m diabetic. Then again, maybe I just feel like shopping for accessories. :slight_smile:

Thanks for any light any of you can shed!

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[quote=“modmama, post:1, topic:60937”]
Today’s dumb questions:

There are no dumb questions here. :slight_smile:

How many carbs do you shoot for in a day in your diet? I imagine this varies greatly depending on male vs. female, on meds vs. not, etc. But I’m still curious. I struggle daily with what to eat and feel like low-ish carb is the way to go, but not sure what that means and finding so much different info online that I’m confused. Also, I’m hungry all the time and I’m not used to that.

I target about 30 - 50 g of carbs / day. I basically eat a ketogenic approach. This is low carb (est. 30 g), moderate protein (est. 80 g for me, a middle aged female), and enough fat (I don’t count this) that I won’t be hungry. How much for you? You need to work that out for yourself based on your blood sugar response; “eat to your meter”. When eating low carb, you must get enough fat (and protein) so that you get enough calories and are not hungry. I use fatty meats, eat butter, cream, moderate amounts of oil in cooking, nuts, etc.

The CDE I saw said I should shoot for these numbers: Between 80 and 130 before breakfast and other meals, Less than 160 two hours after meals,and between 100 and 140 at bedtime. Do these sound right? It’s not that I don’t trust my health people, but sometimes I wonder if I’m getting the best/most recent info…

This is 'controversial". If one wants tight control and “normal” levels 'a la Dr. Richard Bernstein", then one shoots for 83 all the time. I personally adopt the following before eating and fasting: Target 70 - < 90, ideally in the 80s). 2 hours post eating (< 120, ideally in the 80 - 100 range). You will need to find the levels that you are comfortable with.

Should a Type 2 wear a medical alert bracelet? Do people even do that anymore? Is it a dumb idea? I had an awful hypo-type of experience at my job the other day and I realized if I passed out, I might be in trouble with people not knowing that I’m diabetic. Then again, maybe I just feel like shopping for accessories.

If you are having trouble with lows, then an alert bracelet is not a bad idea. Make sure the people you work with know about your diabetes. Test frequently enough to pick up lows before they get serious. Why are you going low? What meds are you on? Sulfonureas can cause lows in type 2… of course insulin can cause lows in anyone…

I use insulin. Low carb eating, for me, means less meds and lower and slower lows.

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Hi. I’m a fairly new T1 & by no means, an expert but i will answer your questions based on my experiences.

  1. I was told by my endo to shoot for no more than 45g carbs per meal. She also advised me not to snack. I count all carbs & don’t subtract the fiber so the numbers add up. I try to pick “good” carbs but lately have been losing the battle with Cool Whip :disappointed: I suggest you do some rsch on foods you like & “shop” through the food labels & glycemic index. Through trial & error you will find foods that fill you & are worth the carb investment. I do snack (cheese or almonds) & have a couple of fast food choices if i have to go that route. At first, i ate the same things everyday, trying to get a handle on my numbers, but i am branching out now to avoid burning out.

  2. My number guidelines are a little different from yours but yours seem appropriate. They are not doable for me just yet. My fasting bg are higher due to dawn phenomenon & doc & i are tinkering w insulin levels. After meals, she said i could get to 180. If you can reach your targets, do a happy dance!! I’m in target about 80% of the time, so little by little, right? :wink:

  3. I just ordered a medical alert bracelet (a very pretty, jewelry-ish one) from Etsy, so yes, I think you should wear one. I bought an Alex & Ani-type bracelet at a trade show, but i wanted something more obvious but not too medical-looking. There are so many nice ones that can be engraved with your emergency contact, etc. Let’s hope you never need it, but if you do, it could save your life.

Last thing… There are no dumb questions! I hope this helped. There are great ppl here who will give you good ideas. Be sure to search through old threads. I’ve learned a lot!! :blush:

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Here are my answers. As has been mentioned everyone should find their own way.

  1. Eat to your meter. Set your after meal goals and seek to eat meals that will enable you to meet those goals.

  2. Unless you are on insulin your before meal numbers and morning numbers are essentially “uncontrollable.” Monitor them so you know how you are doing and can maybe adjust medication but unless your diabetes goes out of control, nothing you do with diet or or exercise is likely to have any immediate impact on these. You should choose your after meal target in consultation with your medical team and others, everyone is different, there is nothing wrong with 160 mg/dl. It is actually better than the ADA number.

  3. Unless you are on insulin or at risk of DKA there is really no reason to wear a bracelet. If you are just on a medication like Metformin there is essentially no risk of a hypo requiring assistance.

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@modmama –

If you’re hoping to treat T2 with diet and exercise, I suggest you head over to @Jenny’s Blood Sugar 101.

@Judith_in_Portland, amongst many others, has managed her T2 w/ diet and exercise alone for many years and may offer some advice.

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My own answers:

  1. As with so many aspects of diabetes, this is controversial; you’ll get as many different answers as people you ask, and some of the answers will be very passionate and hotly defended. (You’ll get used to that, participating in a diabetes forum :wink:). Personally I am in the Bernstein camp. I aim for about 30-40 carbs a day with adequate protein and fat.

  2. The numbers you were given are pretty traditional. This, too, can start lively debates. IF one is aiming for really tight control, those numbers are too loose. My personal goals are 70 to 90 fasting and under 100 two hours after eating. BUT, big disclaimer: I am on insulin. That sort of control may not (probably won’t) be achievable without it. So as with every other aspect of this insane condition, you have to work out the solution that is best for you and that you can do and maintain long term. As long as you can avoid hypos, lower is better.

  3. You don’t say what meds if any you are using, but if you had a scary hypo the other day I presume you are on some sort of BG-lowering agent, e.g., a sulfonylurea or meglitinide or something else. Regardless, if your circumstances are such that you are subject to potentially serious hypos, alert jewelry or tattoos make sense. You can’t tell the EMT what’s wrong if you’re not able to speak. However, a non-insulin user’s risk of that is fairly low, and will be even lower as you gain experience and practice managing. I would file it away as a possible “some day” option and leave it there for now.

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:grinning:

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An alternative to medic alert jewelry is to utilize the emergency contact/medical ID feature if your phone has it—iPhones do as part of the built-in Health app, not sure about others. (Putting info on the lock screen is another option.) Gives you a lot more options and space in terms of entering diagnoses, allergies emergency contact info, meds, blood type, etc too. I am never without my phone and always keep it charged, especially since it functions as my CGM, so I feel comfortable enough with that vs a medic alert.

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That’s guys for ya (smh)… They just don’t get that we will use any excuse to shop for jewelry! :wink:

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I would ain for no more that 40 points above your premeal number at 2 hours. and a goal of under 140, I found the wakeup number was the last one to come good.

fat and fiber stops you being hungry, you really do need the fats to replace the energy. lost from carbs
The hardest part is overcoming the low fat dogma for the last 40 years.

Dr Trudi Deakin PhD - 3 Reasons Why We Need To Bin Dietary Guidelines In Relation To Saturated Fat

I would cut the Sugars: including fruit/juice. Cut Starches: including breads, pasta, rice, potato etc. Eat lots of low carb vegetables, salad, moderate protein and add healthy fats… Use a home blood test meter, to see what will work.

This gives a simple overview to how it works for me. The more carbs I eat, the more carbs I want. They don’t give up easy and it’s biochemical
Big Fat Fiasco pt. 5 - YouTube

more info on low carb
A Low Carb Diet Guide for Beginners – Diet Doctor

what to expect the first week, besides being hungry for the first 2 days, then it stops
Preventing Carb Withdrawal on Low-Carb Diets

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@jack16 - These are all great resources for people who want to learn more and possibly implement a lower-carb way of eating in their life. This method has worked wonders for me. I’m now at the five year mark in my lower carb journey. I’ve varied my carb limits in the last five years and now I’m at approximately less than 75 grams/day. I say approximately because I don’t measure it.

If there’s one thing I’d wish the lower carb eating style proponents would drop is their fetish with the term “reverse diabetes.” To me it is an unneeded touting. If they simply added the word “symptoms” to their claims, I would respect their rhetoric more.

I believe that people can reverse their diabetes symptoms, not their diabetes – a crucial distinction. Diabetes simply goes into remission, an honest term and great outcome. This dishonest use of language is spreading and I’m finding it has inundated the LCHF community on both sides of the Atlantic.

Despite that criticism, I think LCHF eating for anyone with diabetes is one of the most effective tools for living well with diabetes.

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If by phone or medical ID I would wear something in an emergency situation it IS important that people are aware this is part of your medical history,just my opinion. Nancy

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When i read about people’s carb consumption, i’m always stumped. For example…i eat a lot of salad. A half-bag of spinach has 4.5g, a handful of shredded carrots (~3.5g), half cucumber (3g), shredded cheese (2g), balsamic vinegar (4g)…That’s 17g. (I add chicken and sometimes a hardboiled egg) i might eat this for lunch & dinner. For bread, i eat one of those small, flat “thins” at 100 cal & 21g, and not everyday. Greek yogurt is about 8-10g. One ounce of almonds is 5g! With some of the daily carb counts, what do you guys eat?! I used to think 45g was a lot until i did the math. If i have two cups of coffee w 1/2c cashew milk & 2TB half & half, that’s about 5g. Believe me, i treat carbs like money & try to spend wisely but i’m dying to understand what y’all eat, doggone it!! Sorry for the whine lol :sunglasses:

I tried deducting the fiber but my bg were higher than when i didn’t so i just count the actual carbs.

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I do subtract carb fiber grams. My insulin to carb ratios reflect that. I only eat two meals per day, a late breakfast and then an early dinner. I often eat a Starbucks sausage, cheddar, and egg sandwich, but I only eat 1/4 of the bread - about 16 grams of carbs total. A typical dinner is chia pudding with walnuts and blueberries. that’s about 22 grams of carbs. I don’t really keep close track of my carbs except that I know the approximate quantity that I consume. If I start eating a lot more carbs, even though I’ll dose for them, my BG control will suffer.

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Having the information on your health in an app on your iPhone is an excellent idea. I have all of my information on my iPhone as well… however, I do not ever count on that as a means to alert EMTs or others to my medical conditions. Case in point: if you are in a serious automobile accident or a bike accident, your iPhone may not stay on your person. Phones have a way of getting lost, and in such cases, I want to have an ID bracelet to let EMTs know that I am diabetic. Yes, if they can find my phone, all the better. If they see my OmniPod still stuck to my body (and know what it is!), all the better. But having too much identification as to being diabetic is far better than having too little. iPhones are great, but they are good for nothing if they are crushed or otherwise inoperable.

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Modmama,
I agree these are very good ?'s. I have been on this rollercoaster for about 3 years with some success. I mainly try to eat low carb but I am not going overboard. Not yet anyway. I try to stay at 130g per day. I’d like to go lower, I think it would help with my A1c but I’ve read that your brain prefers carbs and I want to support brain function. I never have high fasting numbers and my post meal numbers are usually where they need to be, 130ish.
I did pass out at work. It was before I was diagnosed and I didn’t have an explanation for it, then or now. So I think it is a good idea to wear a med. ID. I bought a bracelet that stores info and adapted it so I could wear it around my neck. If I pass out again I want medical people to have the info they need to help me. I wear it around my neck because I don’t think the entire world needs to know. However when I am on a trip I wear a bracelet as well.
I take a low dose of metformin plus I do low carb and walk.That’s all. I was diagnosed at 7.7, now I’m 6.2 and would very much like to be in the 5% neighborhood. Maybe next A1c!

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This is a common misunderstanding among patients, doctors, and even dietitians. Here’s an excerpt from a Psychology Today article on this very topic:

Fortunately, we have a terrific system of fuel for periods of fasting or low carbohydrate eating, our body (and brain) can readily shift from burning glucose to burning what are called ketone bodies.

It is true that some parts of some brain cells can only burn glucose, but fortunately our bodies can turn protein into glucose through a process known as gluconeogenesis. This fact means that while there are essential requirements for both fat or protein (meaning we would die without eating at least some fat and at least some protein), we can live quite happily while consuming no carbohydrate at all. That’s not saying there aren’t some disadvantages or side effects to a so-called “zero carb” diet, but it won’t cause the massive health problems and death that consuming zero fat or zero protein would.

Our bodies have amazing redundancies built-in. I guess that’s why we’ve survived as a species for so long. I think it’s dishonest for medical professionals to perpetuate this myth. I’m not saying you should change your carbohydrate consumption but you shouldn’t feel that 130 grams per day forms a border between healthy and unhealthy carb consumption.

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I can’t second what Terry says strongly enough. This is one of those pernicious myths that doesn’t deserve to keep being perpetuated, especially by those who are really supposed to know better.

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If anyone tells you you need 130g a day…regardless to amount you have, run away, never see them again. they are clueless

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Terry4,
Thank you. I’ve been totally willing to experiment with my own health. I am glad to find out that I’m not totally on my own. that’s how I have felt for quite a while.
I’m going to see how low I can go and maintain.
Glenn