I've been looking around this forum. Nice place you folks have here -- very informative. I'm hoping for a little guidance. Here's the scoop...

I was recently diagnosed with T2. My A1c came in at 8.1. I'm taking 500 mg Metformin twice a day and 5 mg of Glipizide in the mornings. Due to hypo issues, the Doc cut me back to 2.5 mg twice a day. I'm 44 yrs old, 5'11" and weight in at 192. I've lost 14 lbs since diagnosed.

I'm having a little problem understanding the relationship between a diabetic and a non diabetic relative to bs. When I check in after a meal, I range from 150-180 (sometime higher). My Doc tells me that ALL people rise to this level, however, it's the time it takes to drop that is in question. Everything I've read suggests that my levels are simply too high. What should my goals be? Can anyone offer any insight on this?

My morning readings are <105 but generally in the 90s. I think this is good, right? Another twist. 1/2 hour after I wake up and get my readings, I'll move into the 140 range without having a meal.

Also, I spent the weekend at the drag races. We packed our lunches and off we went. My meals were exactly the same as if I were at home. However, I tested my bs after returning and it was 260! I couldn't figure out why this happened. The same thing happened on Sunday. What could cause this? The only difference between this weekend and a normal weekend was that it ws spent at the drag races (big time adrenaline rush) and the temperature (low 90s with a big sun burn factor).

Where exactly is the hypo range? I've been known to drop into the low 50's but can cruise in the 60s and 70s without knowing it.

One last one if ya'll don't mind... I mentioned that I've dropped 15 lbs. My wife keeps me at about 300g of carbs per day distributed over about 6 meals (50g of carbs per meal). Is this too much, too little, just right?

Any insight you might have would be greatly appreciated.

Thanks for your patience!
Dave

I'm not sure I can answer all of your questions, Dave, but I'll give it a try.

Numbers: You should work with your doctor on this, as it can be a bit individualized, but the average target ranges for a diabetic are 80-110 fasting, 120-150 postprandial (after meals), and 100-140 at bedtime.

Carbs: If you're losing weight, and you're equalizing your carbs throughout the day, then 300g may not be too much for you. As a female, my daily carb target is only 200g, but usually men can eat more overall, so 300g is probably okay. Did you work with a dietician? If so, I would definitely follow the guidelines you were given.

Blood sugar frequently rises in the morning, regardless of whether or not you ate. Someone else could probably explain it better than I can, but I know it's not an uncommon situation. Test your blood sugar 2 hours AFTER you eat breakfast and see what it is then.

The drag races: Well, first of all, you should be very careful now to avoid sunburn, which can be quite serious for a diabetic person. The reason your blood sugar probably went up so high, despite the fact that you ate the usual meal, was that you were dehydrated. Being out in the hot sun will do that. When you get deyhdrated, there is less blood volume to carry the glucose, so the reading (which is blood glucose per ml of blood volume) will be higher. In the future, when attending an outdoor event, be sure to bring PLENTY of bottled water with you, and keep drinking it. For an all-afternoon eventin that kind of heat, you'll probably need about 150-200 ounces of water. (4-6 24-oz bottles)

Originally posted by Dave Wood:
When I check in after a meal, I range from 150-180 (sometime higher). My Doc tells me that ALL people rise to this level,...

Your doctor is wrong in my opinion. People with a healthy glucose metabolism eating a diet consisting of whole natural foods would likely never exceed 120 mg/dl post meal. However, most people, if they eat too much sugary and starchy foods, both of which quickly convert to glucose in the digestive system, can overload the bodies capability to process the glucose and result in elevated glucose levels temporarily.

Everything I've read suggests that my levels are simply too high.

If you are hitting 180+ after a meal, then yes, that is way too high. Microvascular damage starts to occur at around 160 mg/dl. Not to mention the damage that all of that circulating insulin is causing to your vascular system.

What should my goals be?

Ideally you would want your bloodsugar levels to mimic someone that doesn't have problems processing glucose (this significantly reduces your chances of developing complications later on). For most Type II diabetics that still have a fully functional pancreas and follow a proper diet and get adequate exercise, this is achievable. Optimum fasting bloodsugar levels would be 70 to 90 mg/dl. The level after a meal is a little harder to pin down because there are so many variables (how much carbohydrate and what type ingested, how much protein, how much fat, how much time involved, how active you have been, etc.). If you are limiting your carbohydrate intake, then optimally you shouldn't see readings higher than 120 mg/dl after a meal. Keeping your bloodsugar level below 150 mg/dl post meal should be an initial target to set. You can likely achieve this easily by reducing the amount of carbohydrate you are consuming at that meal. And especially reducing your intake of high glycemic index carbs - sugars, white bread, potatoes, rice, and most highly processed and refined foods.

One last one if ya'll don't mind... I mentioned that I've dropped 15 lbs. My wife keeps me at about 300g of carbs per day distributed over about 6 meals (50g of carbs per meal). Is this too much, too little, just right?

That is WAY too much carbohyhdrate in my opinion. Nobody NEEDS that much carbohydrate except possibly a world class athlete in training. I would recommend that you cut that amount of carbohydrate in half at least and work on cutting it even more. Increase your intake of protien (meat, fish, eggs, dairy, etc.) and natural fats. Be careful with your medications though. By reducing your carbohydrate intake, you will likely significantly reduce your need for medication. This is a good thing, but you need to monitor it closely. By reducing your bloodsugar level through diet, and consequently your circulating insulin levels since you are Type II (insulin resistant), you will greatly reduce your chances of developing diabetic complications that are so common in those that do not tightly control their bloodsugar and insulin levels.

I highly recommend the following book to answer most if not all of your questions: "Dr. Bernstein's Diabetes Solutiion".

I go horseback riding a lot. I have noticed that when I go on trailrides that last more than one day my sugar has wide swings if I don't drink a lot of water. I generally stay between 90 and 140. However, when out for the weekend recently I hit 210 for no obvious reason. I finally figured out that I had not drank as much water as I usually do. Now I drink plenty when I go out, and my control is where it should be.
Jody

Sam/Arkie6/Jody,

I can't thank everyone enough for taking the time to explain all of this. It's hard enough trying to get used to the new diet and exercise regiment then trying to understand how it all effects the bs on top of it. I am sincerely trying to do the right thing, as all of you are, but it's been a very frustrating experience. Wanted to throw away the meter on a couple occasions http://www.healthboards.com/ubb/smile.gif

I had never given much thought to volumetric nature to bs testing. It makes sense. I didn't drink much while at the drag races. I'll know better next time and carry a large supply of water

As I mentioned, my Doctor changed my meds a little due to the drop at 11:00 AM. He actually took the 5mg tab and instructed me to break it in half taking 1/2 in the morning and again in the evening with dinner. Seems to have helped for the 11 o'clock lows.

I'm going to reduce my carb intake down to about 200/ 6 meals and see how it goes. I'll also be visiting the bookstore this weekend. It's weird... all my life I've been a carb freak. What a change.

Thanks again for taking the time to help me out!

Dave

Dave - Take Arkie's advice. The book is a good read. Most people who reduce their carb intake go off the meds if no damage has already been done. Good Luck.