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  • Can't keep my glucose in the 80's - help.

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    Old 03-20-2008, 07:38 PM   #1
    annejan
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    Can't keep my glucose in the 80's - help.

    So I've been reading a lot of books on Type II lately, and one well-known expert in the field notes that ideally diabetics should maintain blood glucose levels in the 80's.

    I've been trying very hard to achieve this. I've been weight training and have been maintaining a fairly low carb diet with the exception of a treat I had a few days ago. But it seems no matter what I do I cannot get to the 80's. Generally my 2 hour post-prandial glucoses have ranged between 100 and 110.

    Has anyone been able to achieve/maintain blood glucoses in the 80's? If so can you please describe in detail what you're doing or what I'm doing wrong?

    I should note that I'm not on any sort of medication.

    Here's what I eat (generally) each day:

    Breakfast - 5 almonds; one boiled egg; 3-4 Triscuits with Hummus

    Lunch - Spinach salad with red onion, mushrooms, balsamic vinegar, olive oil and a bit of salmon.

    Snack - 6-7 cashews or a piece of cheese or some flax seeds

    Dinner - some kind of protein (chicken or ground beef or ground turkey or salmon) with either vegetables or lentils; 4 blackberries and some noncaffeinated herbal tea without any sugar or sweetner.

     
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    Old 03-20-2008, 08:59 PM   #2
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    Re: Can't keep my glucose in the 80's - help.

    Hi uma,
    It's incredibly difficult to keep your BG in the 80s post prandial if you are actually eating. Any carb is going to raise your BG. Having a post prandial reading of 110 is perfectly fine. A nondiabetic would have similar results. As long as you are not going high consistently, you should be doing great. Talk to a dietician if you need more guidance on managing a low carb diet.

     
    Old 03-20-2008, 09:08 PM   #3
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    Re: Can't keep my glucose in the 80's - help.

    Ditto what Wallis said!

    Ruth

     
    Old 03-21-2008, 07:42 AM   #4
    itotito
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    Re: Can't keep my glucose in the 80's - help.

    The same as everyone is saying, 80 is not a realistic target. Change the needle on your lancet, test your husband who is non diabetic and you'll see he probably isn't much lower than you.

     
    Old 03-21-2008, 11:30 AM   #5
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    Re: Can't keep my glucose in the 80's - help.

    Thanks everyone. Itotito - I know you've mentioned dr. bernstein a lot, and it was in his book that I read diabetics must maintain blood glucose levels between 80 and 100 all of the time. So I guess I'm not sure of what to think anymore but if I've misinterpreted anything please let me know.

    Also, incidentally, I did try checking my sugars against husband, and much to our surprise, his sugars have been higher than mine! Yikes. His dad's diabetic. So now we're concerned about him. I've been begging him to go in for an OGTT but he keeps blowing me off and telling me to stop nagging him. Frankly I think he's afraid of what the results might show. So I'm not sure of what to do with this situation either.

     
    Old 03-21-2008, 12:08 PM   #6
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    Re: Can't keep my glucose in the 80's - help.

    Bernstein has great ideas on what to eat, supplements, info on excercise....I will have to check what he says. but that must be fasting, because there is no way you can be at 100 after a meal. Not a T2 not on insulin. If you're at 110 2 hours after, your doing great. Where are you before meal ? I believe non diabetics range between 70 and 150 at any time during the day, closer to the 130-150 at the spike of a meal.

    By the way, if you maintained 100, 24 hours a day, your 1ac would probably be around 5.0.

    For hubby, check his fasting, and check it one day after a big meal.

    Last edited by moderator2; 03-27-2008 at 06:55 PM. Reason: please delete the quote when you are the first to reply, or, instead, use the quick reply button

     
    Old 03-22-2008, 09:02 PM   #7
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    Re: Can't keep my glucose in the 80's - help.

    Bernstein has some great ideas, but some of his stuff is a bit anal-retentive for me, and reminds me of the days before insulin...when diabetics were treated by being deprived of ALL carbohydrates in an effort to keep them alive.

    Now, I'm not saying we couldn't all reduce our carbohydrate intake significantly, but certain carbohydrates (such as those in whole grains and fruits) provide much-needed nutrients. I don't believe in eliminating whole entire classes of foods, but I do try to eat far less processed food and stick to whole grains, as well as spreading my carbs out over the day.

    The whole idea behind insulin was to allow diabetics to live fairly normal lives; which is the same idea behind the oral meds we now have for T2, along with diet and exercise. This is a disease that can and should be MANAGED, but I think you need to be realistic about goals.

    The last figures I have from the Joslin Diabetes Center set blood sugar goals for a diabetic as follows:

    AM fasting: 90-130

    Before lunch, supper and snack: 90-130

    Two hours after meals: less than 160

    Bedtime: 110-150

    A1c equal to or less than 7.0%

    Again, I'm not saying we can't do better than these goals...I personally shoot for an A1c of 6.5 or less, but I just don't think Bernstein's goals are realistic for most people.

    Ruth

     
    Old 03-23-2008, 12:30 PM   #8
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    Re: Can't keep my glucose in the 80's - help.

    Quote:
    Originally Posted by SamQKitty View Post
    The last figures I have from the Joslin Diabetes Center set blood sugar goals for a diabetic as follows:

    AM fasting: 90-130

    Before lunch, supper and snack: 90-130

    Two hours after meals: less than 160

    Bedtime: 110-150

    A1c equal to or less than 7.0%

    Again, I'm not saying we can't do better than these goals...I personally shoot for an A1c of 6.5 or less, but I just don't think Bernstein's goals are realistic for most people.

    Ruth

    Everyone is under a different set of variables. You are young, not overweight, not a T1, and excercise or can excercise. Your 1ac before diagnosis shows you control is not that bad. Most important is you are doing something about it. I think these targets are not aggressive enough for a person like you.

    This is how I see it, feel free to ignore it, since I am not you and do not know your view of things.

    If I remember your 1ac was 5.4% ? This is before you knew you had to be careful. Now that you know and are taking it seriously, you will drop. I'm guessing to low 5's. For the next few months, avoid the 1 hour spike, but eat well. Try to get a good balance of food groups, always watching that 1 hour spike. Then have your 1ac taken. If you have a low 1ac, never spike beyond 150 (the highest spike, not your 2 hour) then you have good control. If your cholesterol and BP are good, you're set. The you decide if you want to futher improve it.

    My first goal was to improve my 1ac and learn and minimize my spikes. Then I tried to further improve them. I Increased excercise levels and better balance food groups and got to know my carbs better. For example at first to mimimize my spikes I was eating too much protein. I learned to better balance veggies, good carbs, proteins and fats. The better balance combined with excercise allows to brun fat and build muscle which helps overral control. You then experiment withsupplementation like ALA. In 6 to 9 months, you will be fitter, and have a healthier diet than before. When you feal you've achieved balance, then these are your targets.

    My target is high 4s with a 30/40/30 protein/carb/fat diet. I would rather a 5.2 with proper balance than a 4.7 eating too much protein or not enough veggies.

    As you get older, maybe you will have to further tighten. But keep the faith that your tight control today will allow you to keep it in the future.

    If I am not mistaken, you have a young child. This child will see and most importantly learn your healthy habits and if he/she has genes playing against him/her, he'll at least have learned to heathly lifestyle and put all the odds in his/her favor. The biggest problem America faces is kids and parents that do not know what a healthy lifestyle consists of. I didn't until I got the big wake up call. I hope my newer eating habits will be picked up by my kids

    Is the dr insisting on met ?

    Last edited by itotito; 03-23-2008 at 04:25 PM.

     
    Old 03-23-2008, 08:10 PM   #9
    annejan
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    Re: Can't keep my glucose in the 80's - help.

    Thanks, this is incredibly useful advice. I’m seeing the doctor tomorrow so I’ll see what he says about metformin. I’m personally hoping that I don’t have to be on it since I’m fully committed to tightly controlling my diet and exercising. But during my phone call with him (before he had left for vacation) it sounded as if he was pretty insistent with the met. I have a list of questions for him, but are there any that you think are critical for me to cover during my appt?

    I agree that I’m better off being more aggressive with my blood sugar control. It’s good to hear that it’s better to have a balance of good carbs with protein. I get a bit confused with all the books containing conflicting information on whether to stick to all protein or balance protein and carbs though clearly the latter sounds more reasonable.

    I also appreciate the reassurance regarding my baby given that it seems as if both her parents will wind up with Type II, and I definitely want to do whatever I can to help her delay/prevent it. It was definitely a bit of a double whammy when we discovered that my husband’s numbers are higher than mine. I’m trying not to get too worried since the OGTT is what’ll really reveal his true status. But he’s dragging his feet about getting one.

     
    Old 03-24-2008, 04:36 AM   #10
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    Re: Can't keep my glucose in the 80's - help.

    Quote:
    Originally Posted by uma_anne View Post
    I have a list of questions for him, but are there any that you think are critical for me to cover during my appt?
    I made clear to my Dr that I was extremely committed and asked what the risk of waiting 6 months was. He acknowledged the risk was minimal given my low 1ac and my assuring him I would stay away from bad carbs during the period. But it was a deal we had, if I did not show control, I would go to Met. Show him what you've found in terms of your blood sugas over the last few weeks.Your Dr may have a very specific reason to want you on met. If your cholesterol or other blood work is showing signs of other metabolic weakness, he may want to play safe.

    One question I forgot to ask my dr, which may be pertinent to you. The ADA says some people can control their diabetes by diet and excercise. This is a well known fact. If people like me and you who are low 1ac, who are committed and willing to do all that is needed must take med, then who possibly can control it without them ?

     
    Old 03-24-2008, 12:06 PM   #11
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    Re: Can't keep my glucose in the 80's - help.

    These are excellent points! I'm going to write them down and I'll let you know what the dr. says. The more I think about it, the less I like the idea of being on met at this point (unless there's a good reason of course). I mean if I start it at 31 that's going to mean I'll be on it for the rest of my life? At this point the only compelling reason I recall the dr. mentioning at the time was my family history and trying to prevent a downward spiral. But again, I can't see why that can't be achieved through diet and exercise so we'll see what he says!

     
    Old 03-24-2008, 03:47 PM   #12
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    Re: Can't keep my glucose in the 80's - help.

    Uma Anne,
    Certainly if you can maintain keeping your two-hour post-prandial numbers down to the levels you posted, it may not be necessary for you to go on metformin yet.

    I do want to point something out, though. Type 2 diabetes usually begins with insulin resistance. Because of the cells' resistance, the pancreas must produce more and more insulin to keep the blood glucose levels down. This can actually result in some of the insulin-producing cells being worn out over time. In the old days, before they started diagnosing "pre-diabetes" at an early enough stage to make a difference, most T2's already had some loss of insulin production at diagnosis. Additionally, the older medications that were used to treat T2 worked by increasing insulin production, which then hastened the wearing out of the pancreas. Many of us who were diagnosed in our 30's (as I was) became insulin-dependent within a few years.

    Nowadays medications like metformin are so much better than what used to be available. Metformin works by decreasing your cells' resistance to insulin, thus enabling your body to utilize its own insulin production more efficiently and decreasing the strain on the pancreas.

    IMHO, it's absolutely fine for you to make a good effort to control this with diet and exercise for now, but please do make sure that you and your doctors are keeping a close eye on it over the years, and please do not let your fear or reluctance to take medications prevent you from doing so as soon as it becomes necessary. In the end, going on medication sooner, rather than later, may actually prevent or delay the necessity of going on insulin.

    Ruth

     
    Old 03-27-2008, 08:28 AM   #13
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    Re: Can't keep my glucose in the 80's - help.

    Heres an update of what took place during my drs appt. He agreed to allow me 3 months w/o met although he noted that if it were him, he would not be waiting 3 months. He made me promise that if my fasting sugars become high before my 3 month visit (120 or higher) that Id let him know. He provided the same explanation that Ruth (SamQKitty) provided below - that being on metformin now would delay or prevent the need for insulin down the road. Also, according to the dr, my A1C is normal and probably wouldnt go down much.

    Itotito, I did ask him your question regarding who could control their diabetes with diet and exercise if I couldnt, given that Im fully committed to a strict regimen of diet and exercise. The dr. noted that the diet/exercise solution is applicable to those with extra weight to loose, since insulin resistance often develops with weight gain and weight loss can resolve it. Since I really dont have extra weight to loose, diet and exercise wouldnt do much at this point as far as improving my problem goes (in other words, Im more insulin resistant than someone whos overweight).

    A new issue the dr. raised which has me worried is that I may have LADA latent autoimmune diabetes of adulthood. Basically this means that I may have late/slow onset Type 1 diabetes. Im really hoping this isnt the case as the dr. noted that Type 1 is much harder to control than Type 2. I took a blood test to see if this is the case and am waiting for the results.

     
    Old 03-27-2008, 10:34 AM   #14
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    Re: Can't keep my glucose in the 80's - help.

    I had never heard of LADA, kind of makes me wonder if this is not something I may have since Met did nothing for me. I will look into this with my Dr.

    Your Dr sounds quite competent and thorough, you are lucky. Make sure you keep that dialog with him going.

    Last edited by moderator2; 03-27-2008 at 06:54 PM. Reason: please delete the huge long quote, or, instead, use the quick reply button

     
    Old 03-27-2008, 05:56 PM   #15
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    Re: Can't keep my glucose in the 80's - help.

    Reading a little on LADA, they seem to say there is not usually a hereditary component to it, so the fact your mother may have been T2 would lead more to you being T2. So it seems.

    They also seem to imply that Met and LADA may not be the right mix. There is certainly contradictory results on this. I wonder why you doc would want you on met until this is figured out. What do you think ?

    "Some studies have demonstrated that the use of sulfonylureas and the insulin-sensitizing drug metformin, may increase the risk of severe metabolic disorder in persons with LADA"

    I wonder why he says he wouldn't wait. If you are type 2, will 3 months make a difference ? If you are LADA, it seems nothing will make a positive difference.

    I wish I knew what the dr knows. Sometimes I wonder if they really more than we do. Some times I think diabetes varies so much from one person to another that they don't really know. But I always fall back to the opinion that they are the experts. Are we correct to question them ?

    I don't say this to contradict the doctors, I sincerely think they know more than us, but it doesn't always add up. What do you think ?

    You said at one point you were overweight. I wonder if that 'triggers' Type 2. I know I was way overweight and I think that is what triggered mine, but I guess I will never know. Opinions welcome.

    Ruth, you are the voice or reason, Mark, you seem to know a lot. What do you think ?

    Last edited by moderator2; 03-27-2008 at 06:55 PM. Reason: if a word is blocked then it is not allowed - please respect our right to control the content of our website

     
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