Hi all! I was just diagnosed with T2 two months ago with an A1C of 6.8. For now I am working to control it with diet and exercise. Overall, I feel super negative about the whole diagnosis and feel like it’s changed my outlook on life for the worse. But I’m trying!
I have met with a CDE recently, and I feel like she gave me some conflicting information from what my GP had told me, and what I’ve read. She said to stick with a low-fat diet and limit carbs to what the ADA says. She also told me to never exercise after meals because it will cause my liver to release more sugar?
Meanwhile, my GP said not to worry about fat, and that being low-carb (fewer than the ADA recommends) is the most important thing to remember with my diet. She also said to try to exercise as soon after meals as possible, even if I just do a brisk walk for 20 minutes.
Aaaaand, of course the internet is all over the place on both subjects. So I’m wanting to know - what have you all been told is the better path to lowering BG? What is working for you so far?
I like your doctor’s advice. She seems enlightened, tuned-in to new thinking about food, and really gets the piece exercise plays. I’m guessing your CDE is also a dietitian because the low fat, whole grain, high carb advice is what their association, the AND, endorses. It might work for some but it’s not realistic for me to eat that way and have good BGs.
People have strong opinions about food, especially what they eat. Most of the world does not have to live with a broken pancreas, however. Diabetes is a disease of carbohydrate intolerance. You don’t have to avoid all carbs just a certain threshold above which the glucose metabolism goes out of control into high variability and lots of highs and lows. And drama.
Test your blood glucose before and after selected meals so that you know what your blood glucose is doing. Keep records. I wouldn’t be surprised if you found that certain meals drive your post meal sugar levels higher and longer than you think. If you don’t go out of range then at least you have a baseline comparison for later.
Sounds like you got a knowledgeable GP, and a standard-issue CDE. My experience is that the low-carb, high fat and exercise routine (before and after, when possible) is the most effective to bring BGs down sans medication. Exercise is often undervalued in terms of treatment (probably because it’s difficult and most people don’t enjoy it).
Even better advice is to try different things (eating, exercising, etc.), test your BG a lot (3-5 times a day, initially), and adjust so that you find what works best to keep your BG in the range that you want. For me that range is 70-126 mg/dL and under 100 mg/dL fasting. You get to decide your own range!
You’re getting good information here, and I endorse everything above. Since this is so new and bewildering (and it always is, we all began there), let me add a note or two of historical perspective to help put it in a little better focus.
The low-fat high-carb mantra is yesterday’s traditional wisdom. A lot of it comes from the fat-is-bad-for-you rule that we’ve been indoctrinated with for the past half century or so. Trouble is, that formula is more politics than science, and in fact the science is calling it further and further into question these days. Which is a long winded way of saying that your CDE is preaching the old gospel and your doctor sounds much more up to date.
As Terry says, diabetes, in whatever form and at whatever level, is a disease of carbohydrate intolerance. If carbs are the problem, then the fewer of them you have to process, the better control you’ll have. This reasoning seems so obvious that it’s at the level of two plus two equals four.
That being said, each physiology is distinct and individual and the amount of dietary carbohydrate that produces the best result is likely to be different for each of us. But the general rule is, less is better.
I am going to agree with all of the responses so far.
I had almost exactly the same experience when my doctor sent me to a CDE to help me understand all of this. It was the biggest waste of $150 ever, and I have wasted a lot of money over the years.
If you read between the lines on all of the answers here you will discovers the real true answer to all of your questions is “it depends”. Because the right answers all have to work well for you, your diabetes and your lifestyle. That is the best way to do this successfully.
Learn all that you can and don’t be afraid to ask questions. Especially dumb questions. Because those are the ones we don’t ask that turnout to really matter a lot.
Don’t be afraid to experiment some. What you will learn is custom info about you and your metabolism. Personal diet, exercise, and medication adjustment (for me, insulin) were all worthwhile to figure out via personal experimentation.
LCHF is what works for me, where as LFHC results in a blood sugar disaster. Search this site for “eat to your meter” using this system you will find your individual tolerance for carbs and then be able to make rational food choices.
Bernstein gave me the numbers I wanted—taking my A1c from 6.9 to 4.9 in six months ten years ago. Since then, that A1c has never gone over a 5.5…That’s 30 carbs or less per day…
But that does NOT have to happen all at once. Do start a food log—you need to eat, exercise, and test every day to see what foods you can tolerate in what quantities. And you can gradually figure out the variations that work for your body. For instance, I am one of those for whom exercise raises my blood sugar briefly. So, after a walk or gentle workout, I sit quietly with a cup of green tea–or chamomile–for half an hour before I test. The benefits of exercise far outweigh the briefly elevated blood sugar…
The main thing is–keep in mind that “If you want to treat diabetes by the book, you need to write a new book for every diabetic.”…Good luck and keep us posted!..Judith in Portland
I’m sorry that you’re caught between what it sounds like is a helpful medical practitioner and one that’s less than helpful. I wish I’d written several of the above comments but find them to ring true and wish you all the best as you experiment–and learn what this means for your new life.
And well done, you, for trying despite the diagnosis affecting your perspective. Don’t see how this diagnosis couldn’t affect you, really.
When Judith refers to “Bernstein”, above, she means the doctor who wrote this book:
Richard K. Bernstein, Dr. Bernstein’s Diabetes Solution, 4th. ed. (New York: Little, Brown and Company, 2011)
There are some truly good books out there (“good” from the standpoint of being full of information you can actually use to make a difference). That is one of the best.
buy a meter with the cheapest strips you can find, because that is where the money is spent… A blood glucose meter won’t lie to you, as to how much carb is too much.
Of course you’ll want to see what works for you - a while back, @Brian_BSC brought these articles to our attention
We have folks with type 1 and 2 here and there’s a wide variety of diets followed. I’ve never heard of the CDE’s advice on not exercising after meals. imo that’s your best way right now to curb the post- meal spikes from carbs.
In my personal experience, aerobic exercise—whether after meals or at any other time—is a highly effective way to lower BG. In fact, before insulin, it was my only effective way to deal quickly with a high.
Thank you thank you so much, everyone! I’m happy to hear my doctor is on track - I’ll be following her advice. And I have lots of reading to do, now! It sounds like there’s no one-size-fits-all and that there may be some room for experimentation - I’m sure this will keep me busy.
And thanks for the words of encouragement. It helps to know people have been through this and are making it work.
You’re sporting the cover of Dr. Bernstein’s Diabetes Solution as your avatar yet your opinion contradicts his advice.
Dr. Bernstein recommends the most accurate meters (short of a Hemocue) – specifically the Freestyle and Contour NEXT – for all PWDs – regardless of type.
Dr. Bernstein recommends a relatively flat BG of 83. His target goal for postmeal excursions is +/- 10 mg/dL.
How would one attempt to achieve Dr. Bernstein’s euglycemic goals w/ a “+/- 20% accuracy” meter?
Per box of 100/price per strip –
~18¢ Reli-on at walmart.com
~23¢ Contour NEXT strips at amazon.com
Eligible privately-insured/cash-paying patients can save significantly using the Contour Choice program.
