Tight Meal Plan = Tight BGs?

Food
1

Okay, it’s been a few months since I’ve been on here, but even though I’m not here doesn’t mean I’m not thinking of you all. :slight_smile:

I have to clear something up. No one seems to be able to give it to me “straight”, so I’m asking you fellow Type 1s, please clear the air for me. Please, if you can, tell me what your sources are as well, because I can talk big game, but sometimes I’m talking out of my… er… butt. :slight_smile:

Here’s my question: Do we HAVE to eat six meals a day to be healthy?

Let’s say that I don’t get hungry… ever… and when I do eat, I feel sick.

A typical day for me consists of:
Breakfast shake around 8:00am (about 36g carbs / 6g protein / 6g fiber)
can of V8 around 12:00pm ( 7g carbs / full serving of vegetables)
balanced dinner around 6:00pm ( usually meat, small serving of carbs, and lots of vegetables)
If I snack, it is usually some crackers, or provologne cheese.

I’m not SHY about eating. It’s not that I’m starving myself. If I go out to eat, I will eat a couple of eggs and a small side of grits at 2:00am. But… I just don’t get hungry often.

I’m basically asking if my meal plan is okay. Do I NEED to eat more to get better control of my BG? Do I NEED to eat the same basic meal schedule every single day in order to have tight BG control?

I’ve been fighting this battle for years with my family and I think that what I’m doing is okay, but… maybe I’m wrong. Maybe I need to see a nutritionist again? :frowning:

2

Your thought about seeing a nutritionist is (IMO) dead on. When in doubt, get unbiased expert advice. Ideally, they will be certified, and in a perfect world also a CDE. Good luck finding that.

I had some control problems shortly after I was diagnosed. Working with my Endocrinologist, we decided that I’d try to avoid every possible variable to determine exactly how my blood glucose reacted to meals and exercise, even noting injection sites. Times of testing, injection, eating, NPH, exercise, etc. were identical daily, also to eradicate variables. In the end, some of the post meal readings varied by as much as 118 mg/dl.

I repeated that exercise about 12 years later after gastroparesis set in, but using a pump. Again, even greater variability. With a new nutritionist, Endo, GP and Neurologist, we pretty much settled on a template of three different meal menus of 4 meals per day. That was two years ago. I gotta confess that I am pretty tired of it, and will probably work with my new team to validate this and to jigger the menu.

3

There is no ‘one size fits all’ meal plan. What you NEED to do it eat a balanced diet. You have to consider, though, that what you eat affects your entire health, not just your diabetes. If you design your meals solely to keep your BG down, you may be neglecting other areas of your health.

So, yes. Consult with a nutritionist. Show her what you’re doing and she can tell you if you’re missing something.

Terry

4

Don’t see why you have to eat six meals. I eat three meals & rarely snack. I think the constantly eating thing is a throwback to the days of diabetics having severe hypo attacks from less predictable insulins. Docs were afraid patients would die from hypos & recommended they always have food in their system.

My endo stressed that I not skip meals & told me to space meals by four hours.

Eating more isn’t going to give you tighter control. Matching insulin correctly to food/exercise will, but you know that part:) You don’t have to keep to the same meal schedule, but I’ve found that it helps me. I’m not a slave to a schedule, but It removes another variable in knowing how/when/why things effect BG.

Eating a variety foods to get a broad spectrum of nutrients is important. I stick to lean proteins, different nuts, cheese & lots of low carb veggies.

5

Hi Marps,
The only thing I’m concerned about is that you say that - if you eat, you feel sick.
Does something need checking out? Something with an internist? Do you have an ulcer?
A healthy diet is not one that makes you feel sick if you eat it. A healthy diet results in maintenance of your weight, energy, and hopefully, your blood sugar being nice and stable, not swinging. Your diet looks as if it does all that - if your blood sugars are great and your A1c is great and your BMI normal.
I’m never hungry. Protein in the morning holds me past noon, I guess, and I’m not hankering for my noon break even now and it’s 12:55pm. So I empathize with you and your diet. But if you really get sick if you eat, Marps, I’m screaming “go to an internist”.
And if it’s due to so many veggies in the shake, maybe there’s a bit too much acid in that thar shake! Sometimes I overeat on veggies. lol If you go to a nutritionist, they’ll try to press you with more carbs, and who needs more carbs if our weight is normal?

6

Hi Marps,

Absolutely see a nutritionist to get some ideas on meal variations that work for you. I can’t imagine eating the same basic meal, or meal structure, every single day. Ugh!

It sounds like you are eating a fairly low-carb diet, compared to some carbalicious eating like me. Maybe it’s a matter of tightening up your Insulin:Carb ratios, or correction factors? Do you get substantial BG swings post-meals?

As for the family, I wouldn’t worry about what they say about your meal plan unless they are registered dieticians. My mom, a retired nurse, freaks out when she sees me put a teaspoon of sugar in my morning coffee. Yet she always offers me some sort of juice. And don’t get me started with potatoes…they are the nectar of the gods, in her eyes…

Cheers, Mike

7

I’m not sure I can add anything to everyone else’s excellent responses, but I do feel compelled to say, “If it’s not broken, don’t fix it!”. I wonder if we diabetics get the highest share of unasked for opinions from everyone on what we should eat/do/not eat/not do! If your pattern of eating is working for you, as defined by good blood sugars more often than not, good health in other areas, feeling satisfied, and enjoying your food, than why change? As someone with many years recovery from an eating disorder I would feel very freaked out to eat six times a day, it would not work for me. I eat three meals a day and nothing in between (other than glucose tabs if I’m low). I eat healthy, enjoy what I eat and have found my own comfort level with insulin and with carbs. We are all different and when I have lunch with a friend who is a diabetic I’m struck by the differences in what we eat, but think of it the same way I think of being a vegetarian. I’m happy with not eating meat, but don’t care at all if others eat meat around me; it’s not for me to dictate to others what’s right for them. Same thing with diabetes. If I had a loved one whose diet was ensuring they had very high blood sugars I’d be concerned about their health, but other than that,. we each do what works.

I’m also rarely hungry, with only sometimes at breakfast, especially if I wait till later than usual to eat. But I enjoy the food and don’t have trouble eating when it’s time. I do agree with others though that your feeling sick when you eat, whether it is emotional or physical is a cause for concern and looking into.

Nice to see you again, btw!

8

I think your point about not getting hungry is one that deserves more research for type 1s.

When I’ve told various dietitians that I rarely get hunger pangs, they just shrug.

I’ve always figured it’s because of my 36-years-long weird relationship with food. Since early childhood, when I HAD to eat to cover old-time insulins and deal with the one-shot-a-day days, the fact that for many years (before pump) I stuck to a more rigid meal-timing schedule, and the fact that lows used to be treated with full-blown snacks, which made me associate them–incorrectly–with hunger. In short, I’ve had to spend a lot of my life eating when I really didn’t want to. And a lot of my life not eating things, too. No wonder it’s a tough area to balance! And then there’s blood sugars to throw in the mix.

I’m intrigued by our type 1 lack of incretin that can help with satiety signaling. That’s why drugs like Symlin have been developed. Of course, those types of drugs deal with feeling hungry after eating than not feeling hungry, but still it’s interesting that insulin isn’t the only hormone that we lack.

Yes, see a dietitian. You may not like all the suggestions, but most of us completely lack degrees in nutrition so can just make general (and probably unhelpful and wrong) suggestions.

From your sample eating plan, above, it looks like you’re lacking low-fat dairy (unless you add that to the breakfast shake?). Be sure to get a vitamin D test. I discovered I was deficient (in part, I live in a cold state = lack of sun exposure, I don’t like milk, and I don’t eat D-fortified breakfast cereals). Depending on how many veggies you eat at dinner, your meal plan may be lacking in fiber.

Are you high before dinner, usually? If so, your liver may be kicking out glucose because you don’t eat much between breakfast and dinner.

See, lots to ask a dietitian! Then take that info and figure out how you want to eat. Best wishes!

9

Thank you all for your suggestions. :slight_smile:

To clear some things up:
I feel tired and lacking of energy when I eat. I feel drained when I have a full stomach. I guess it’s not so much “sick”, but it definitely doesn’t feel good when I eat, so I eat very little to keep myself feeling good.

I feel I’m at a normal weight, I don’t have any major issues with my body, but I guess I could stand to lose a few pounds.

I’m seeing my endocronologist next week. I FINALLY get to see what my A1c is at. I sent him records of the past 3 months’ BG levels to see if he can make sense of them before my appointment.

I run a bit high. I guess my average is around 180, but I can defnitely swing from the 30s to the 300s in a day’s time. It’s frsutrating, which is also why I am wondering if it has something to do with my diet.

I have a very busy lifestyle, always running around doing something, but I don’t know if I would categorize it as “active”. ??

I would like to feel healthy again, but am having a lot of trouble. I haven’t felt GOOD in YEARS.
Every time I ask a doctor, they always tell me to eat more, eat more, eat more- it’s like they’re not even listening to me. sigh haha. I want a second opinion!

10

Hi Kelly

No, I have fantastic numbers for breakfast, lunch and dinner- it’s usually after dinner where I have the most trouble. I stick to the shake / v8 because I can trust it- I know what it does to my body and I know how to react to it. My numbers there are wonderful. It’s the dinner where I actually eat something that gives me the most grief. I have terrible numbers after dinner, but can usually clear them up before bedtime. :frowning:

It’s not the best arrangement, but… I’m trying to fudge it a little to make it work better.

I’m definitely lacking in dairy. I used to drink milk all the time, but only drink it now if I crave it- which is rare.

I certainly have an issue with hunger. I used to associate lows with food, too, so when I’m feeling “normal”, I don’t get hungry.

Again, it’s not that I’m afraid of food or anything, I enjoy a nice meal- it’s just that on an every day basis, I’m afraid that I’m hurting my body- but at the same time I don’t feel comfortable putting stuff in me that I don’t need. I don’t like to eat unless I get the first signs of hunger pains.

Does this make sense? Am I crazy? haha.

11

I guess again, I am sort of a contrarian. I like the idea of eating six times a day. If you can eat six times a day with even levels of carbs and nutrients throughout the day, that is not only healthier, it makes your blood sugar control easier. You have already recognized yourself, a limited and understood level of carbs (like a V8) is much easier to cover very closely. Having an average BS of 180 and swinging so high and low will make you feel poorly. My bet would be that breaking your meals up into six smaller well controlled mini meals might really help. They don’t have to be some sit down hot dish, you can choose ready to go things for your backpack. I make good use of things like the the sweet and salty granola bars (17g net carb/4g protein) for a quick mini meal/snack.

As to your diet, I am actually not as keen on the dietician/nutritional advice. They can certainly help you with carb counting etc, but their overall advice on what is healthy is strictly controlled advice and as far as I am concerned, not much based on medical science (like the USDA food pyramid). I will tell you that with your current eating regime, you seem to be eating only ‘one’ meal. That is not good. You should think about trying to increase the number of daily meals. Eating in a consistent level manner throughout the day willl enable your body to better utilize the nutrients and keep them available in a constant balance throughout the day. You may well be famished by dinner, eat a highly variable meal and just feel bad leading up to the meal and afterwards. Why don’t you give some thought to eating more of a meal at breakfast and lunch. Not that you have to sit down, but something more substantial, containing a balance of carbs, proteins and fats.

In my case, I have a protein shake for first breakfast, eggs and oatmeal for second breakfast, a sit down lunch with meat, veggies and a limited carb, a granola bar for afternoon snack, a sit down dinner again with meat, veggies and a limited carb and wrap up the day with a late snack of something like cottage cheese. I decided some time ago that as a diabetic, food was not just about responding to my hunger. I needed to eat a certain way as part of my ‘treatment.’ Sometimes, I have to eat when I am not hungry, and sometimes, I’ll have to curb my eating even though I may still be hungry.

12

I don’t eat 6 times a day, there isn’t enough time for all that. I’ve only ever eaten 3 meals, it works for mee. I always get my veggies, a resonable amount of carbs, some healthy fats and protein in throughout the day. I think it depends on what works for you… Just make sure your getting all the food groups! When I cut my carbs too much and stopped eating fruit (it sent my sugar rising) I wass tired all the time and my skin was really bad!

Aslong as your eating healthy and your sugars aren’t erratic I don’t see why 6 meals is essential…

13

I’m glad you wrote more! And it’s great you’re seeing the endocrinologist next week. It’s no fun to be swinging that way!
We’re all rooting for you to feel GOOD, and happy after meals.
If you don’t already do it, keep a little notebook, page a day, left hand side, the premeal test result; in the middle, list each food with the grams for the meal; and to the right, what bolus you gave.
The exact food may clue you regarding what is sending you into the 300s. And they’re draining. Best wishes. Besides the endo, a nutritionist may give you some variety and fun in your diet. Best wishes!

14

Marps, good to see you back. I agree with the “not broke, dont fix it” mentality. I am a grazer who eats all day…low carb, small snacks and things that make my friends wonder what the heck I am doing, i.e. am currently absolutely addicted to peanut butter M&M’s, but will not touch white bread or eat a sandwich for any amount of money. And I have a “roll your eyes back into your head” addiction to oven roasted brussel sprouts. They are my go to, fall back when I know I need to eat but do not crave anything. I will eat them before the PB M&M’s.

The strength of my appetite goes in phases, increasing to ravenous when I have PMS and dropping off to almost nothing at other times during the month. I just go with it.It is very unorthadox, but for now its working.

I cannot eat big meals either. They just sort of sit there, my insulin peaks, I go low, then I go high when the food does hit my bloodstream.

Just saw the dr. this morning. Since my last visit I’ve gained a very much needed 20 lbs. and my A1c was 6.5, which is a little higher than I want, but the dr. seems to think its okay. She and I may differ on that, but she is wonderful in all other areas.

But as everyone here has said time and again, we are all so different and complex that what works for someone is disasrous for another. Good luck. This is a life long learning experience.

15

I know I followed the six meal thing a lot more prior to going on the pump… but that was back in the “old days” when you had to eat to ride out the NPH wave…

When I went on the pump and went to 3 meals, I lost 15 pounds and didn’t feel hungry once.

I don’t think there’s anything wrong with wanting to eat less, but that probably means you should find really high energy foods (and I’m no nutritionist and couldn’t even begin to tell you what the are).

My other thought is that if your BS is running that high on that small of a diet, it’s probably your in-between meals insulin that needs dialed up a bit. And I agree: if you’re running 180 a lot, that will drag your energy level down, big-time.

16

I would imagine the meal plan you describe would keep your blood sugars as stable as they are going to be (though possibly lows in the middle of the day). Because you are having a decent breakfast, not much lunch to speak of and then a healthy dinner. But nutritionally, are you getting all you need from this diet? Six small meals a day (grazing) was not recommended for my niece (she is 12) because eating six small meals a day would never let her rest at a normal blood sugar for very long. Endo wants her to eat, then wait four hours and come back to a normal blood sugar. She has a light breakfast, light lunch, large afternoon snack and large dinner. This suits her eating habits and time of day she tends to get hungry. I think the endo would prefer three meals a day, but she seems to need the afternoon snack. I would not force an eating pattern on anyone; I would just try to eat healthier at the times I am hungry.

17

Despite what your family thinks, or what you’ve been doing for years, I vote for the nutritionist. STRONGLY vote for the nutritionist. I see mine at least once every 6 months…and I’d do it more if I thought it would be helpful, This person should be part of your medical team, no matter what. Exercise, meds, and eating ------ they will help you with a plan, work out what and when you need to eat, and help it fit your lifestyle…they might even say what you’ve been doing is fine…yipee. Give them a call, in most cases if you have a referral from your doc, insurance pays for it. Even better.

18

An average 180 BG can make you feel tired. Eating will make it higher and make you feel worse. Swinging between 30 to 300 can really make you feel tired. If you have a doctor that tells you to eat more and you haven’t felt good in years, get a new doctor. You deserve much better. You should be able to estimate your A1c from your blood sugar readings and it should average to 120 to 140, even lower, if you really want to feel better. Go on-line and estimate your BS from the many A1c calculators available.

19

One group who might benefit from smaller, more frequent meals are people with gastroparesis. It has helped me to normalize BG readings greatly.

20

So, I saw my endo yesterday and gave him my meal plan. He said that I seem to be eating enough- not that it’s very much, but he did not say for me to eat more. Which is good. I was pretty stern with him yesterday. :slight_smile: I’m tired of being told to try things that I don’t feel are right for me- and then watching them fail. Even though I pretty much know from the beginning of trying some new things, it still hurts when I can’t accomplish it.

So… I asked him to set up a carb couting class and a nutritionist class. They said they will call me today with an appointment time and place. It’s been 11 years since I’ve been to a carb counting class, so this should be interesting.

I’m so glad that you guys agree with me (for the most part) because I’m so tired of hearing that what I feel is right… is wrong. :slight_smile: So, thanks for your support. You guys are great.