I am diabeties 2 and take 5mg of prandin before breakfast and before supper.

Could someone explain tight control and how you maintain it when eating? I tried the low carb and I ended up with ketones in urine. I am 150/5'8"' in the buff. Regurdless if someone could explain what it means and how to control it I sure would be grateful.

Also are readings for people different. For instance is an 80 glucose reading for some low while for some others might be just fine.

Twp more questions. Is it ok if one day a week you over eat and your bs goes up just below 300, but comes down? I know this may sound like a silly question, but Saturday night I find myself being a pig out of control. How much harm does that do?

Somewhere I read you should not exercise if your bs is above 250. What is the reason for this if it is factual? It looks like one should try to get it down. Thanks for any response. - sam

One of the best ways to keep tight control is to keep a food diary. Keeping a diary allows you to see how your blood sugar coorelates to what you eat. You can then find your trigger foods, the one's that make your blood sugar higher, and avoid them or limit them greatly. Another important tip is to be regular with your healthcare. Don't be afraid to go back to the Dr when a regimen isn't working. Don't be afraid of ketones. Going low carb and having ketones probably means that you are burning fat. It is uncommon for type 2's to get ketones related to high blood sugars though it can happen. Watching for ketones and keeping track of how often they occur with help your Dr make the best decisions for your diabetes control.

Blood sugars affect people in a sense like pain affects people. People have different tolerance levels. Some can feel a blood sugar of 80 and feel low while others dont even notice it. This is why it is especially important not to rely on how you feel to control your diabetes.

It is never really ok to let your blood sugar get high. Ideally, you want to plan your menu so that you don't feel that you have to have days where you pig out. Having a blood sugar of 300 puts a stress on your system. Over a long period of time, you can develop the complications common to diabetics. I would try to work in some of the foods you feel that you are witholding in your diet.

Exercise takes energy. This causes your body to use the fuel, glucose, in the system. You can burn extra glucose through cardio workouts to help bring your numbers down. It is factual that exercise will bring blood sugars down though it is not an accurate way to control highs. You never know with exercising how much your blood sugar will fall and exercise can affect blood sugars for 36 hours. Frequently checking your blood sugar can help to control any problems.

Good luck and I HTH

Thank you so much. A few questions again. When I eat my blood sugar goes up. How high can it go before I really have to worry. It comes down, but it may take awhile. Today it was 289 one hour after I ate. Two hours it was 269 and I had walked on my treadmill a bit to try and bring it down. I don't take it but once or twice a day. I always take it before bed. I eat a snack if it is below 110. I asked my doctor and he said I could go to bed without a snack if it was 110. I woke up a few weeks ago and it had been pretty high before bed. I checked it and it was 104. That really shocked me.

My largest problem is I snack right after I eat. I watch tv and I feel like I have to have something to eat. I weigh 150. I got down to 140 and my doctor became concerned about my blood pressure. It was getting pretty low. So I am at 150 and am stablized. Thanks again for you information.- sam

Sadly, it sounds like the Prandin is simply not controlling your blood sugars. In that case, you would want to go back in and let the Dr know that you need to try something else. Being a type 2, it is normal for your blood sugar to slowly come back down as your pancreas still produces insulin to a certain degree. You really want to keep your blood sugars below the 200 range as even that high, you are putting a stress on your body. Sugars in the 200 range put a stress on your nerves and your heart. Blood sugars that are higher can put you in an immediate risk.

It sounds like you weight needs to stay about the same as it is now so I wouldn't focus on a strict low carb diet. I would focus more on eating healthy and choosing low carb foods for snacks. Be careful with sugar free items as they often contain just as many carbs. Fat free or low fat items are often higher carb to compensate for taste. You might also want to focus on eating high protein snacks or complex carb snacks. Both have little effect on your blood sugar.

You might want to try working on the habit of snacking. You can try to set a timer for how long you will wait to snack. You can tell yourself that you will finish one show before you snack on something. You can also take a small bowl of something rather than taking the whole bag with you. You can make sure you drink while you snack so that you will feel full.

It sounds to me that you are getting used to the highs to the point that you are afraid of the lows. Some people keep their blood sugars high as they know that a low poses a more immediate risk. Once you acknowledge that line of thought, you can resist the urge to keep it high.

HTH

I am back again! I just posted another question, some of which you may have answered. Lets say my bs before I eat is 155. Should I eat very little or go ahead and eat as normal and let it gradually come down. If it is 155 and I eat it is going to go up even higher. It looks like you should not eat for awhile until it gets down to 115 and then eat. But I have been told not to miss a meal reguardless if it is high.

I am limited on so many foods. I have a-fib and take coudamin. So I don't eat very many greens. A few other things I don't understand. One, what is a health team and the other, how do you keep your diary. Do you take your bs many times a day and record it? The strips are so expensive I can't do that. I am wanting to get this undercontrol. My A1C was a 6 last time. The doctor was happy about that. I don't understand how it can be a 6 when it jumps around so much. Sorry to have bothered you again. I just don't know what to do. If I eat less I lose weight and the doctor doesn't want me losing anymore weigh. If I eat more I gain weight. He doesn't want me doing that. Just confusing. When you say yours is under control what tells you this and how are you doing it? - sam

Here is the problem with the A1c. Simply put... It can be fooled. The A1c is just an average of your blood sugars. So you have numbers, and these are hypothetical, of 80 and 300. The average of those is 190. This can get really tricky when you are used to having lows like in the 40's. The average of 48 and 300 would be 174 so you can see where things can go astray when you only look at the A1c.

A good Dr is going to look at your logs along with your A1c and make decisions based on a variety of things. A health team is you, a Nutritionist, a GP, and an Endocrinologist all working together and on the same page to control your diabetes. You are the leader of this team as you live in your body day in and day out so you know what is working and what isn't. Waiting for a Dr to tell you what to do can be a very wrong move.

Keeping a diary takes practice. I take a fasting blood sugar, what I ate for breakfast, and a 2 hour post prandial blood sugar. I do this for every meal including snacks. I am only recently starting this back up due to high blood sugars so I don't want to paint the picture that I have it all together. I take at least 4 blood sugars a day. How many you take totally depends on the control you have. People who are controlled with minimal assistance don't need to take theirs as often. Having highs is an indicator that you need to take your blood sugars more.

It is possible to go to your Dr and have him increase the number of strips in your prescription. I get a total of 150 strips per prescription. At this point, I would ask for a referral to see an Endo and try to get tighter control. There is always the option to by urine sticks to tell you what your blood sugar is but they are not as accurate. They are cheaper though. You put them in your urine stream and it tells you what your blood sugar is running. I believe it tells you in ranges of 50. So it would be 100, 150,200,etc. That will at least give you a clearer picture.

HTH

I highly recommend going to an Endocrinologist as well. I have been a type II diabetic for 10 years. After a few years of denial (I was in my 20's), I started to go to my Dr about it.

I thought simply going to my GP would be enough to control it, but I never understood why he just kept increasing my meds and my numbers weren't improving.

I finally broke down and went to a endo specialist who then also assigned me a nutritionist. Well long story short, I was over medicating and not really watching what I eat, when I should be balancing carbs and medication. Now I have great control over my bs and am able to make smart decisions when eating. I can't stress how enlightning it has been for me and my wife.

Hi Sam061, I have been away for a while, but I am back now. I agree with all of the advice given so far, but I will add my thoughts regarding tight control with diet/excercise. I am a T2 who is now experiencing tight control with no medication. My most recent HA1C was 5.0 and my daily fasting is 90. I rarely even test at home any more because my diet is tight and I always read the same.

I think you wrote that you tried low-carb and it didn't work for you. But other than that, you did not mention what you eat and how often you eat. I am a true believer that most T2 diabetics can control with diet (although there are some who cannot) but it does typically require a lifestyle change. This does not mean you have to eat foods you don't like and it does not mean you have to go hungry. It does mean that you have to change you approach to eating so that it is focused around gaining control of your disease.

After much research and experimentation, I have firmly applied 7 rules to my diet. Not only have I gained complete control of my diabetes, but I have lost A LOT of weight (80+ lbs), and reversed my high cholesterol. Here are the rules:

1. QUALITY: Improve the quality of your food
2. QUANTITY: Eat the correct quantity of food every meal
3. BALANCE: Balance your macronutrients with EVERY meal (carb/protein/fat)
4. FREQUENCY: Increase the frequency of meals (eat every 3 hours you are awake)
5. DETOXIFY: Reduce your toxic load (through healthier food choices and improved environment)
6. HYDRATION: Increase hydration, preferably with pure water
7. EXCERCISE: Increase Activity/Excercise

I would be happy to elaborate fully on each of the 7 rules above - I have a very scientific approach. There are also strategies in applying these rules that will make your life a lot easier. For example, it will help to plan your meals and snacks 1 day in advance so you always know exactly what you will eat and when you will eat it. Also its important to document everything you consume, at least in the beginning. I no longer need to document because its become so mechanical to me. But its funny - if someone were to ask me what I ate for lunch I could recite the complete ingredients, # of carbs, protein, fat, fiber, sodium, and cholesterol, and exactly what portion size I had. This is what is meant by "tight control" and you do get used to it!

Your BS numbers seem quite high after meals so I am curious exactly what and how much you eating in your meals. One mistake that many T2s make is that they avoid meals or eat too little thinking that it will help to stabilize their blood glucose levels. They are wrong. The best way to stabilize it to eat smaller amounts more frequently... in the beginning this may cause some high readings but after 2-4 weeks you will notice a significant change. Its very important to eat the correct amount of calories for your body size, age, and activity level. Its also extremely important to avoid foods that spike your blood glucose.

Last but not least, I cannot stress the importance of focusing on the health of your liver. Rule #1 and #5 address this. Your liver is the primary organ that controls your metabolism, and most diabetics have a liver that is not healthy. Focusing on improving liver function will have an amazing impact on your blood glucose levels.

Let me know if you want the details of my plan/diet rules.

Just wanted to say Welcome Back JDMassimo :wave:

Just wanted to say Welcome Back JDMassimo :wave:
Thank you! :wave:

JD,
I most certainly would like to have more details. I have Afib along with this so I need all of the help I can get. So if you have the time, I am willing to listen.- Sam

JD,
I most certainly would like to have more details. I have Afib along with this so I need all of the help I can get. So if you have the time, I am willing to listen.- Sam I forgot- I don't need to lose weight. I was told to put some on because my blood pressure was going to low. - Sam

Sam, I am working on it... stay tuned for a detailed reply!

Sam, I am working on it... stay tuned for a detailed reply!

JD,
Just read your e-mail. I am staying in tune. Thanks a bunch. - sam

Sam, Apparantly I am too long-winded (lol) so I need to break this up into multiple posts. Here is Part 1:

Please keep in mind that this information I am offering is intended only as advice. I strongly recommend that review any dramatic changes to your lifestyle with your doctor, ED, and/or RD.

As I mentioned, after I was dxd I suffered through 7-8 weeks of intolerable symptoms on medication (Amaryl) and a "diabetic diet" (from an RD). The meds were literally killing me and I was in and out of the ER 3X per week. I decided to take things into my own hands. I did (and continue to do) a ton of research in an effort to learn how my body functions and take control of my health. So far, everything I have learned and applied is working and I now control my health mostly without medication. (I still take synthroid for my thyroid and a small dose of lisinopril for a kidney disorder). I take no medications for diabetes, cholesterol, pain, or indigestion - all meds that I was previously taking.

I have honed my findings into 7 basic rules that I apply to my diet/lifestyle. I will share them with you, and offer explanations of their importance, but it is COMPLETELY up to you as to how firmly you will apply these rules to your own situation. According to your posts, your glucose levels are still running quite high, even though you are on medication. This warrants serious attention and should not be taken lightly. Having said that, I believe that your primary goal, at least early on, should be to focus on healing the metabolism. Early on it will be helpful if you shift your mindset from constantly trying to lower your glucose level to instead sustaining a steady blood glucose level at all times, To clarify, you may be better off striving to regulate your glucose levels at one specific number (say,140, just as an example), rather than hitting a 240 after a meal and then attempting to drive it down to 100 with excercise or medication. Only you will be able to figure out exactly what formula will enable you to accomplish this. My suggestions below will help. Once you begin to regulate your glucose levels you will find that 1. it will become easier to strategically lower your glucose levels, and 2. Your glucose levels will begin to lower naturally because your body is healing. This may take 4-8 weeks before you notice any changes, but for some there are immediate improvements - within the first week or two.

You may wonder why I recommend maintaining a higher glucose level in the beginning, but keep in mind that really isn't the objective. Diabetes is a metabolic disorder and as I mentioned before, your primary goal early on should be to stabilize and heal the metabolism. You have a better chance of acheiving this if you can avoid the extreme highs and lows. Because your condition is still not well controlled, this may mean that an even 140 reading (again, just as an example - this may be different for you) maintained throughout the day might actually be better for you than bouncing around from 300 to 90 to 250. After you accomplish this first goal, then you can work on further lowering your glucose levels to the 90-120 range, which would be ideal. You won't necessarily be actually able to acheive a completely steady glucose level, but your approach to dietary changes should be with that goal in mind.

Another primary focus here is strengthening your liver function. Your liver is the control center for your metabolism. Your liver processes all the food you eat and converts it into glucose, amino acids, cholesterol, and toxic waste. Improving the health of your liver will, without doubt, improve your ability to regulate your glucose levels. It will improve your overall metabolism and will likely address other health problems you experience. Rules 1, 5, and 6 are aimed at liver detoxification. You can get further information on improving the health of your liver by doing a google search on "liver doctor" and on "doctor yourself."

Part 2 follows...

Part 2:

1. Improve the quality of your food.
This means eliminating processed foods, highly processed flour and sugar products, high fat, high sodium, and high cholesterol foods from your diet. This will not necessarily be easy at first.

Here are the foods you want to avoid at all costs:
All white flour products including bread, crackers, and pasta.
All sugars including table sugar, honey, maple syrup, sweetened fruit, cake, cookies, candy.
All high sodium/high fat/highly processed foods including bacon, deli meat, processed cheese slices, canned soups, sauces, and gravies. Get back to basics. Read labels. It can be as complicated or simple as you make it. Focus on natural foods such as lean fresh meats, fish and seafood, poultry, eggs, block cheese (not processed slices), LF cottage cheese, fresh or frozen vegetables, potatoes, brown rice, fruit, etc. If you don't know what is in a food or can't identify the ingredients, don't eat it. For example, do not eat sauces or soups from restaurants because you don't know their nutritional composition or what ingredients are in them.

2. Eat the correct quantity of food.
Everyone's body has different caloric needs based on age, height, weight, gender, activity, medical conditions, and genetics. The minimum number of calories needed by your body to sustain physical structure and life is called your Basal Metabolic Rate. This is how many calories your body burns just being alive, in a completely sedentary state. In addition to this number you need to account for your day-to-day activities such as walking, excercise, etc. I can only point you in the right direction here. The best tool for this is using a "BMR Calculator" (you can google this phrase) but make sure you use one that factors in activity levels. I don't know your age or your activity level, but I do know that you are 150 lbs, 5'8". Assuming you are a 55 yrs old male (I know you are over 50 from another post) your BMR is approximately 1500 calories. Assuming further that you engage in moderate excercise (running, strength training, swimming, team sports) for 30 minutes per day and light excercise (like walking, golfing) for 30 minutes per day you would add another 200 calories for a total of 1700 calories per day. Given the fact that you might need to gain weight, or that you might have a "fast metabolism", or that you are more active than my estimate, you can probably go with 1800-2000 calories per day, and I recommend that you start with these higher numbers. You can always adjust this later. What to do specifically with these calories follows...

3. Increase the frequency of your meals.
This may be one of the most important rules. This, in and of itself, is a primary factor in acheiving that even, steady glucose level I mentioned earlier. You must, without question, eat EVERY 3 hours you are awake. There are no variables here. This means you must be prepared at all times. You must carry snacks with you and prepare your main meals in a timely manner so that you can take your first bite of a meal/snack exactly 3 hours after the first bite of your last meal/snack. Also important is dividing these meals/snacks evenly throughout the day. What these meals and snacks consist of is further covered in rule #4. So here are some sample schedules based on 2000 calories per day:

3 meals/2 snacks
9am: 500 calories
12pm: 500 calories
3pm: 250 calories
6pm: 500 calories
9pm: 250 calories

5 equal meals
9am: 400 calories
12pm: 400 calories
3pm: 400 calories
6pm: 400 calories
9pm: 400 caloriesThere are several benefits to eating 5 equal smaller meals:

1. You prevent your glucose levels from dropping too low, which can cause hunger and stress.
2. You eat fewer carbs with each smaller meal, so the impact on your glucose is less each time you eat.
3. You are providing your body with nutrients as they are needed througout the day - much more efficient use of fuel.
4. You place less of a burden on your vital organs (kidneys, liver, heart, etc...) and your digestive system - your body can function more efficiently if it has less to do more often.

When you eat 3 large meals per day with long gaps of time between you cause a bit of a rollercoaster effect - your bg drops really low, then you raise it really high, then it drops really low again, etc etc etc. This may make the results of your HA1C seem okay (because its based on an average of your highs and lows), but your metabolism is not actually functioning at its best. Think of the best way to keep a campfire going... you don't let the fire die and then add another huge log to it... you aim to keep the fire at a steady level by adding smaller amounts of wood to it on a regular basis. That's the best analogy I can come up with.

But there is more to this process that spacing out your meals - you also need to balance them, so on to step 4...

4. Balance your macronutrients.
One of the biggest mistakes people make is either not eating enough protein (especially at breakfast) or eating excessive amounts of protein. Neither extreme is healthy. Excess protein is extremely dangerous for a diabetic because their kidneys and liver are already at risk. Yet there are several consequences if you don't eat enough protein. If you don't eat enough protein you, 1. probably consume too many carbs, and 2. the carbs you eat are absorbed and converted to glucose too quickly. Striking a balance here is critical for a diabetic, and once you know how many calories you should be eating, this is easy to calculate. I recommend 20-30% of total calories as protein, but for you, I would aim at 30%, which will help to limit your carb consumption. But you need to look at the other macronutrients as well.

There are several reasonable ratios diabetics can work with - 50% carb, 25% protein, and 25% fat is reasonable for most people. This is something that ultimately you will need to tinker with to find what works best for you. Because you are still having quite high glucose readings I recommend that you start off with no more than 40% of your calories as carbs, so the best ratios for you to start with might be 40% carb, 30% protein, and 30% fat. Here is how that would play out in your specific plan:

3 meals/2 snacks
meals: 500 calories consisting of 50 carb grams, 38 protein grams, and 17 fat grams
snacks: 250 calories consisting of 25 carb grams, 19 protein grams, and 8.5 fat grams

5 equal meals
Each 400 calorie meal consisting of 40 carb grams, 30 protein grams, and 13 fat grams (this is my recommendation!)To accomplish these ratios requires some planning. You will need a kitchen scale, good measuring cups/spoons, and the USDA database (google "USDA Food Data). Calculate out a variety of meals that fit into your plan and rotate them. Personally, I have about 4 different breakfasts that I eat and I just switch them up from one day to the next. But I never need to think about it anymore. If you want I can offer you some sample meal plans - just ask.

There are some people who absolutely cannot tolerate this many carbs, but this is rare, and you have to understand that it is not without risks. You need to give it your best shot to find good carbs that your body can tolerate - this will help to protect your vital organs.

It is also important to understand what is considered a carb, a protein, and a fat. I know for many this seems obvious, but many people do not know so I will spell it out, just in case.

Carbs: Foods that grow in the ground or are processed from foods that grown in the ground. This includes all vegetables, fruits, and grains. Processed carbs include all sources of sugar and flour including bread, pasta, cake, cookies, table sugar, honey, mollasses, etc. Keep in mind that not all carbs are the same - Simple carbohydrates are sugars and complex carbohydrates include both starches and fiber. Complex carbs are absorbed and converted to glucose more slowly, while simple carbs cause glucose levels to spike. Some simple carbs, such as natural whole fruits (apples, strawberries) will not cause problems and you should include them in your diet. But clearly you want to consume mostly complex carbs (whole grains and high fiber foods) and forget about most of the high-sugar foods that are classified as simple carbs. As your body heals, you will become more tolerant of simple carbs, though as a rule you will always avoid them.

Protein: Protein can be found in a variety off foods - animals are the most common sources of protein such as meat, poutry, fish, eggs, milk, cheese, etc. But some vegetables and grains also have protein small amounts of protein, especially soy, nuts, legumes, and whole grains. Carbs that are highly processed typically have the protein stripped away, so for example white flour used in bread and pasta has little or no protein yet wheat germ and wheat bran has higher levels of protein.

Fat: Fat can come from animals and vegetables. Animal fat is saturated fat and is what contains cholesterol. Vegetable fats can be some combination of poly- and mono-unsaturated fats. The better fats are from olive oil, canola oil, grapeseed oil, peanut oil. Other vegetable oils may or may not be good depending on how they have been processed. Transfats are highly processed fats that are extremely unhealthy. These are used to improve consistancy of foods. Anytime you see the words hydrogenated or partially hydrogenated - these are your transfats and you should avoid them at all costs.

Part 3 follows...

Part 3:

5. To support your health and further strengthen your metabolism dramatically decrease toxic substances from your food and environment. This helps your liver metabolize your food more efficiently. To do this, reduce or eliminate from your diet ALL chemical additives, preservatives, artificial sweeteners, unnecessary medications, alcohol, caffeine, and anything you cannot pronounce. Again, read labels carefully. If foods contain ingredients you can't pronounce, skip them. This includes deli meats (loaded with sodium nitrate preservatives), processed cheese slices, even some dairy products are terrible. If you eat cottage cheese pay special attention to the label. There should not be whey products, sodium nitrates and phosphates listed. If there are, choose another brand. Same with butter - it should only contain cream and salt (and I do recommed you use butter or pure vegertable oil and skip the margerine which is loaded with toxins). Avoid most canned food products, though you will find a rare can of tuna or fruit that is not loaded with chemicals. Bottom line is you really want to check EVERYTHING. This step is critically important.

6. Hydration
Most people are unwilling, but I strongly recommend that you consume water as your only beverage. Drink lots of it - in your case, at least 75 ounces per day. This should not be that difficult. This step is really important to support liver and kidney function, as well as digestion. This will help control and stabilize the metabolism.

7. Excercise.
It doesn't have to be a lot - 30-60 minutes per day. Just do it. In your case, you may want to do smaller amounts of excercise spread out throughout the day (like 3 20-minute walks) this will further help top control your glucose levels.


In summary, early on, this may be somewhat difficult because it is likely a dramatic shift from how you eat today. In the beginning you need to plan and document your meals and snacks, measure and weigh portions, etc. After a while, you can stop measuring and weighing - everything becomes automatic. Here are some strategies that will help you apply these rules to your diet:

1. Plan ahead. Always know what your next meal is going to consist of. Be prepared. Have snacks available in the fridge, in your car, in your pocket, that fit into your plan, You never want to be in a situation where you are scrambling to find something that fits into your plan.

2. Learn what foods cause your glucose to spike. You may be suprised. You may find that you cannot eat a whole baked potatoe but you can eat 1/2. You may not be able to eat a banana, but have no problem with an apple. Everyone is different. You need to pay attention and document your findings until you learn how your body responds to different foods. Keep a food diary and compare your glucose readings to what you eat.

3. Of course you want to test your glucose levels regularly per your doctors instructions, but don't let a specific glucose reading steer you away from eating a scheduled meal or snack. It will take some time for you to regulate, and its unlikely that eating as posted above would cause spikes in glucose in the long term. As mentioned earlier, if you find a food that ALWAYS causes spikes, stop eating that food.

4. Don't be shy - don't be afraid or embarrassed to tell people what you are doing. It will just make it that much easier.

5. Find alternatives for your favorite foods that have now been elimiated from your diet. For me, I was a cheese doodle finatic - Now I eat cheddar cheese flavored soy chips instead.

6. Avoid foods labeled "low-carb" or "diabetic" - these foods are usually loaded with artificial sweeteners and hydrogenated fats, breaking rule #1 and #5.

7. Keep it simple. Keep it natural. Get back to basics

I know this is a lot to read! Sorry about that :) Don't hesitate to ask for clarification on anything here!

JD,
Thank you so much. I have printed it out and will now refer to this as my D-Bible. I was told I had diabetes eight years ago, but everything I learned came from books. Most of those were about what caused and what is diabetes. I followed the glycemic index for awhile. It just didn't seem to work for me. I never understood the "counting carbs" method. So I have been using more or less my own method. I am going to lay down and read this now. Thanks again for all of your help and time. - sam

JD,
I just finished reading this material. By the way, I am 61.

I never eat anything with flour, hydorgenated fats, or any refined foods.
For breakfast each morning I have the following:
Eggbeaters, 4 tbs of oatmeal, three tbs of blueberries, and 1/3 of banana.

Lunch: 3 oz of salmon, 1/2 of legumes, 4 oz cup of Low sugar Minute Maid Orange jucie, and some cookies my wife's made from Almond flour, oats, canola oil, Splenda, and butterscotch chips. The only oil we ever use is canola and extra virgin olive oil. ( I eat this evey day except on Saturday we go out to eat and I have baked fish with a some fries.

Supper: usually fish, ostrich, venison, or ground turkey, a vegetable, and a salad ( I am on a blood thinner so I eat very little green, but more tomatoes, avocado, and small pieces of walnut, and the a 3-4 cookies. Oh, I do eat low carb bread but just a few times a week. We eat around 6 pm. By 10 pm I usually don't need a snack and my bs is sometimes too high, sometimes just right.

Now this is another problem I run into. If my bs is high and we have sex, it will drop into the 70-80 range. So after having sex, I have to take it and usually end up eating a snack. This always presents a problem because if it is already around 110 wouldn't it drop to low?

What changes would you make to this diet? I don't understand why you eliminate all sweetners. Do you just not eat any sweets?

Also, what kind of snacks do you recommend? And yes, I would like to know what you eat for breakfast? But basically I would like to know where I am going wrong and what you would do different? Also do you believe in the glycemic index? - Sam (Thanks again for all of this information)

Sam, I'll answer your questions as best I can.

First and foremost, here are the problems that I see with your current diet. I may be wrong, but I am going by your posts :D

1. You are only eating 3 primary meals per day and only an occassional snack. I am not sure what you have as a snack, but it needs to be balanced as per the formulas I posted in rule #4. You really need to eat every 3 hours. That is critical in balancing and healing the metabolism. Once you accomplish this you may not ever need to be concerned about your activity levels or when you have sex. For now, have you considered incorporating strawberries and unsweetened whipped cream into your lovemaking? It might help! :D :D :D

2. Because there are no portion sizes listed for parts of your meals, its hard to know what ratios you are currently eating. For example, how much egg-beaters do you have with your breakfast? How many tomatoes with lunch? I suspect that your meals are still somehwhat carb-heavy. Don't misunderstand - your portions are small, but you need to shift your diet to include more protein and less carb.

Here is a recommendation. Go through the excercise of precisely calculating each of your meals that you ate today. In other words, go to the USDA Food database and look up every item that you ate and figure out EXACTLY how many carbs, protein, and fat you ate, and then calculate the ratios. You might be surprised. I'll see if I can help you with this.

3. Ditch the cookies, banana, orange juice, and oatmeal, for now. Substitute with alternatives. These foods are common triggers for many diabetics. The cookies have a lot of carb and sugar in them even though they are made with splenda and those butterscotch chips might be killing you! Oatmeal can be problematic for many diabetics - it can really spike your glucose levels, especially if you are not eating it with enough protein. And OJ - well, I say NO JUICE, at all, EVER! Juice and diabetics don't mix - you are asking for trouble. Instead, have an apple or some strawberries - these have much lower impact on your glucose levels. In fact don't drink your calories, eat them.

Now I will try to answer some of your questions.

Why no splenda or artificial sweeteners? Rule #5. You need to detoxify the body so your liver can focus on your metabolism. Chemicals interfere with metabolic function. Omit chemicals whereever possible. I know, they SAY splenda is made from sugar, but what they don't say is that it is chemically processed, chlorinated sugar. It should be on your DON'T list for now - perhaps after you gain control you can add it back in occassionally. Same is true for all artificial sweeteners, chemical additives, and preservatives. Here is an example - You know those pork loin roasts in the supermarket that are vaccuum wrapped in plastic and soaking a marinade? Well that brine is loaded with sodium nitrates and I WILL NOT eat that meat. If I want a pork roast I only will buy from a butcher, cut to order. Just another example of applying rule #5.

Do I believe in the Glycemic Index? Yes and No. I think the GI is a great reference to begin to learn about foods in general and their impact on your blood glucose. But I don't necessarily believe that the ratings are entirely accurate and in fact their methods of deriving the ratings are somehwhat questionable. For some foods, the control groups are as little as 10 people. Then again, none of those 10 people were me. My point is that we are all individuals in how we respond to foods. I can eat baked white potatoes, but not sweet potatoes while the opposite may be true for you. And according to the GI, pasta is very low impact, but most diabetics cannot tolerate pasta as well as other carbs. In summary, take a look at some of the charts, but don't live by them. Be your own control group and determine what effects YOU and your glucose levels.

In general, please remember that I have gone through a dramatic lifestyle change. It took many months of calculating numbers, researching food data, and planning menus to reach a point where I don't have to think about it any more. But it is so worth it to gain control and it will be evident in your labs as well.

JD, One thing I need to mention. I take a lot of medications so I think the toxic effect I will always be with me.

The oatmeal. I was having a lot of problems with constipation and a friend of mine told me to begin eating it. I just eat 3-4 table spoons full in the morning. But it did the trick. I had tried other things, for instance flax meal, and it gave me indigestion and my stomach would burn hours after taking it.

OH, wouldn't you know that strawberries is the only berry I don't really like. I do like apples though.

I can tell you what I ate for my different meals today:

Breakfast: 1/2 cup of eggbeaters: 4 tbs of oatmeal; 3 tsps of blueberries; 1/3 of a banana. I usually eat at 6am, but today I ate at 8am. My wife is off for a week so I eat later because we are not getting up as early. But this is my normal breakfast each day only at 6 am.

no snack

Lunch: 1/2 cup of beans (red and black mixed): 1/2 cup of the reduced sugar orange juice; 1/3 banana ( I usually have 1/2 cup of salmon, but we were out of it)

no snack

Supper: 3-4 oz of Salmon poached (went to the store this afternoon); Medium salad ( three slices of tomato, 3 small brocolli flower; a small amount of lettuce (very small); three mushrooms; with vinegar and oil. Then some cookies. You see I thought using the Almond flour there would be little carbs. I do see what you mean about the butterscotch, but I read that a little sugar wouldn't hurt you.

I just took my blood sugar. I finished eating at 7:30 pm and it is now 9 pm. My bs is 185. Way too high. I am only allowed enough stips to take my bs three times a day.

Now I know what not to do. What do you eat for your meals and snacks so I will get a general idea as to how to begin getting this under control. Oh, before you eat your snack, what is your blood sugar? Or do you take it? It is really difficult not eating any sweets, but if I have to I will. I have a pork lion chop in the refrigerator. I told my wife it is now her's.

no snack:

Sam, You are right about the meds you take - even MORE reason why you need to eliminate toxins from your food. There are certain toxins that are unavoidable - necessary meds, environment, etc. You need to do everything in your power to reduce your toxic load where you can. Omit toxins from your food wherever possible. I promise, this will help your metabolism and help you gain control of your glucose, your cholesterol, and even your digestive problems.

Now, about that pork loin chop in your fridge - Its probably fine to eat, unless it is in a brine or has been pre-marinated. I was referring to the pork loin roasts (Hormel, is an example) where the meat is injected with a sodium nitrate solution for flavor and preservative. Always look at the ingredients on pre-packaged meats, even the ones at the butcher counter. You will be surprised what you will find.

I calculated out your meals and here are my findings:

Breakfast:
Calories: 213
Protein: 16g - 30%
Fat: 2g - 7%
Carb: 34g - 63%

Lunch:
Calories: 192
Protein: 9.2g - 19%
Fat: .5g - 2%
Carb: 38.9g - 81%

Dinner (without the cookies):
Calories: 326
Protein: 22g - 27%
Fat: 24g - 66%
Carb: 6 g - 7%

Now, I really do not have nutritional value on the cookies, but I did an estimate. What I did was a took a "low-carb" health food brand almond cookie and added data for hershey's butterscotch chips. I calculated this for 3 cookies. This is probably not entirely accurate, but might be close.

Dinner (with the cookies):
Calories: 877
Protein: 31g - 27%
Fat: 56g - 57%
Carb: 62 g - 28%

Summary:
1. You are not eating enough calories throughout the day and then you load up at night.
2. Your balance of nutrients is off - even though you are making healthy food choices, you are eating a high percentage of carbs in your meals. From what I can see, this is a result of your effort to eat "fat-free" because your protein is in a good range. You need to shift your balance of nutrients. This might be eaily accomplished by simply adding some additional food items to your menu. What's interesting is that your dinner (with the cookies) actually has a better nutritional balance, but unfortunately its with the wrong type of carb so it does not work for you.
3. You are not eating often enough. This is likely causing a glucose rollercoaster. This will never lead to tight control.
4. I will say it again, the cookies are killing you. Omit them. Find another "treat" that fits into your plan.

You asked about eating sweets and mentioned that you thought "a little" sugar is okay. Actually I agree with that. In fact I am inclined to use white table sugar before I use artificial. Some of the health foods that I buy have a little sugar in them - but its VERY LITTLE and I know exactly how much. And it's all factored in to my calculations for each meal and snack.

I guess my recommendation to you is that you get a pad and pen and start calculating out and planning meals and snacks that adhere to rules 2 3, and 4.
Use the USDA Food database and try to put meals together that work. As you do this, consider increasing your calories per meal, and increasing frequency of meals. This is so important in gaining control.

I will share some of my numbers with you in another post.

Here are a sample of a typical day for me:

BREAKFAST: 9AM
1 Amy's organic breakfast burrito
3/4 cup LF whipped cottage cheese

Calories: 415
Protein: 33g - 32%
Fat: 8g - 16%
Carb: 54g - 52%

LUNCH: 12 NOON
4 ounces lean ground beef
1/2 bag frozen mixed veggies
1/2 7 oz baked potato (total 3.5 oz)

Calories: 460
Protein: 38g - 33%
Fat: 12g - 24%
Carb: 51g - 44%

SNACK: 3PM
1 Apple
2 ounces of swiss cheese

Calories: 318
Protein: 11g - 15%
Fat: 16g - 45%
Carb: 32g - 40%

DINNER: 6PM
6 oz broiled scallops basted with 1 tsp of olive oil
1 cup brown rice
1.5 cups fresh steamed green beans

Calories: 511
Protein: 50g - 40%
Fat: 9g - 15%
Carb: 58g - 45%

SNACK: 9PM
1 bag Genisoy Soy crisps

Calories: 350
Protein: 24g - 27%
Fat: 7g - 18%
Carb: 48g - 55%

SUMMARY FOR DAY:
TOTAL CALORES: 2054
PROTEIN: 156g - 30%
FAT: 51g - 22%
CARB: 241g - 47%

My recent glucose tests are as follows:

Fasting: 90-95
2 hours post-prandial: ranges between 100-115
pre-meal: ranges between 95-100
Recent HA1C: 5.0

I rarely test anymore because the results are always the same.

Also note in my example:

cholesterol intake: 226 mg
fiber intake: 37 g
sodium intake: 2817 mg

I will also share that my cholesterol has dropped from over 300 to 170. Trigs dropped from 348 to 98. LDL dropped from 198 to 107.

BP averages 100/60.

I don't know what my intakes are JD. I do know my cholesterol was 131 three months ago. My blood pressure is anywhere from 99/60+ to 114/60+. Sometimes the systolic gets up to 125-30, but rarely. Only if I get mad or extemely nervous.

I ate 3/4 cup of eggbeaters, 2 tbs of oatmeal, and 2 tbs of blueberries at breakfast. I cut the carbs by 1/3. This was at 8:30 am. At 11 am my bs was 154 and I didn't sit all morning either. I hate to give up that oatmeal because I will be constipated again.

One thing I wanted to mention. My brother and I both began taking flax meal. It has really lowered our cholesterol. Also I wanted to know if you think there is any truth to cinnamon helping to keep bs levels down. My mother sent me an article on it. My brother is Ceo of Jcraig and he said the same thing. I have tried it, but after a few weeks it did nothing. - sam

Sam, I still recommend that you sit down with a pad and pen and plan/calculate some meals that follow rules 2, 3 and 4. Just go through this excercise. Try to come up with 4 different breakfasts, 4 different lunches/dinners, and several snacks. Think of it as homework. :D Going through these steps will really help you learn about some of the changes you need to make.

Also, PLEASE remember that these steps will not provide instant results. Of course your glucose is still high - you only made a change for ONE meal! It can take weeks to stabilize your metabolism. Your body needs to normalize and re-learn what "normal" is.

You still are not eating enough food. Starving the body will cause glucose to rise. So will stress. Ubernier posted a great explanation of this in this thread:
http://www.healthboards.com/boards/showthread.php?t=216069

You really should be eating between 350-500 calories for breakfast. I think today you only had 140 :eek: You need to stop thinking that eating in general is causing your problems - its how, what, and when you eat.

Finally, you don't necessarily need to give up oatmeal, but I strongly recommend that you omit it for 4-5 days to see if your readings drop, especially if you have been eating it every day. It can be so simple - sometimes just one little thing that will mess you all up. The only way to know for sure is to try omitting it. There are many other natural ways to combat constipation, oatmeal is not the only cure!

This is a bit of a lifestyle change. Break out of your box and give it a try.

Ok JD. I thank you for all of the information you have given me. The difficult part will be doing the figuring and coming up with different breakfasts. Eggs and cereal are about all I have even eaten for breakfast. Now other than the oatmeal I may not be able to eat any cereal. I cut back on my carbs one time and had some ketones in my urine. The doctor wasn't that worried, but it scared me.

I am no mathematician that is for sure. You have taken a tremendous amount of your time in helping me. I just want you to know it is truly appreciated. That is what I like about this site. People helping people. Thanks again. As Motherof4 stated, "It is good to have you back on this site." I believe people as yourself having so much knowledge are truly needed. - sam

Hi Sam, Just wondering how its going... :wave:

Hi Jd,
I am doing a little better. Keeping track of what you eat and how much is pretty difficult. And I forget to take my blood sugar two hours after than before. I have been looking for a watch that has alarms on it. I found a Casio, but don't know if they are very good. In fact I don't know much about them at all.

You know I have had this for close to ten years and have had no complications thus far. I have a former friend whose husband has it and he has had it ten years with all kinds of complications. The doctor told me my kidneys were remarkable. I took my bs last night before bed and it was 134. I took it just before lunch and it was 134. Yesterday morning it was 135. I got a diary and forgetting is my largest problem. On the weekends it is really difficult. I used to drink and haven't had even one beer for five years. The doctor told me I could have one or even two, but I have chosen not to. I miss it though. I again want to thank you for taking the time to write out all of the material you did. And thanks for checking in on me. - sam