New to All of This

Garystorts2324

Looking for some friendly advice and encouragement. I'm a 62 yo male who discovered I have a blood sugar problem about three weeks ago. My blood sugar was 278 and My A1C was 11.3. My doctor put me on MetFormin. We've drastically changed our diet, eating more vegetables, leaner meats and no sweets. Cut out almost all alcohol, Walking 1-3 miles per day, more water.... Using MyFitnessPal to monitor my food intake, and my blood sugar is down in the 150s.

One of my questions is that there seems to be the conflict in the information that is out there, that carbs are evil and should be avoided. Almost like an Atkins diet. Yet, MyFitnessPal has my carb macro goal at 50%. Any comments on this topic would be appreciated.

2t9nty

You are doing good things. Monitor your BG to see how you are responding to the carbs. Not everyone is the same, and you may find that certain carbs do not cause the spikes. You can also change the carb macro to match your own goals.

NYPhotographer2021

MFP has the macros set at a default. You need to change it in Goals. Click on the green edit button and chose the percentages you want. Carbs are not evil, but if you are a diabetic, then it's best to limit the simple carbs and eat more complex. You would need to experiment a bit to see what your body responds to best. For me, strict keto helped. My numbers went from 160-200 mg/dl to 85 - 110 mg/dl. I have my macros set at c-10, p-20 & f-70. But that's just me and what my body responded to. So maybe bring your carb count down a bit to 45 or 40. If that's still too high, adjust it again. Some people also count net carbs which is the carb gram minus the fiber gram. So if a food is high in fiber, it's probably good for you. But you really should speak to a diabetes dietician. They can give you better guidelines and help you monitor it all. Good luck! Oh, and READ! This group is chock full of excellent advice to help you along the way!

2t9nty

I am also keto, but this is where the numbers led me. Not everyone can find enough variety in keto to satisfy, and different people respond in different ways, so I am not saying keto is the answer. I will say it has worked very well for me to control the BG and help me lose/maintain weight.

russellholtslander1

I am on Carnivore.. just meat, fish, fowl, cheese, eggs, fats, and water.. nothing else, maybe 5 grams of carbs a day.. the " diabetic diet " I was put on in 2002, was 1/2 the carbs I was eating before.. stopped weight gain, but my A1C was still over 12, and I was still 361 lbs. 10 years later.

So I did Atkins, then Keto, and now worked my way down to Carnivore.

The lower you go on carbs, probably the less medicine you will need to take to help your body stay in the proper range.. 70-120.. yep, 150 is better, but you should want to have normal readings, if possible.

11.3 A1C works out to an average 278 mg/dL That is not easy to do.. lots of carbs, and sugar.. junk food. Sounds like you have changed your lifestyle. Exercise will drop blood sugars, and help raise HDL too.. I would guess you are losing weight too, which is good.

Diabetes management is treated like the most complicated thing, but it is simple in concept.. harder in reality/practice. You aren't producing the right amount of Insulin, and your cells are not recieving Insulin correctly, which is the hormone which transports glucose.. when it does put the glucose in the muscle, for example, you are hyper, like a kid, and can perform better physically, and you burn it off.. glucose is simply energy.

So you have excess glucose in the blood.. it isn't giving you energy, and is toxic to the blood, so the body stores it as triglycerides.. bodyfat. You are tired, don't exercise, and the extra glucose makes you fat, instead of being used.. welcome to diabetes.

All we are doing is manipulating our glucose levels.. simulating what our bidy did normally when we were kids ( Type 2 ). We eat carbs, and produce glucose.. BUT, to keep it at normal levels, we have 2 main choices.. we eat less carbs, so have less glucose.. and the body uses it, or ketones, if we get low enough.. but you do not have glucose in the blood.. which is what we measure.. less glucose, lower BG, right? BUT, most of us like carbs, so the other option is to take meds/Insulin, to help the cells USE the glucose.. same thing.. we want less glucose in our blood. All an A1C test is, is the amount of measureable sugar attached to your blood platelets.. which die off every 2.5 months, which is why they test you every 3 months.. to see if you've been bad.

The lower you can get your BG with diet, the less meds you need.. If you like carbs, maybe you need some pills of Insulin.. if you eat lower carbs, you need less, or may be able to get off meds completely.

If the goal is 70-120, and you are at 150 average.. basically, you either need to eat less carbs, so you produce a bit less glucose.. OR burn it off with exercise.. more, since you already do so.. those are how you lower it normally.. the other option is more meds.. once again determined by A1C, or daily by using your monitor.

To be honest, I think they should just put people on Insulin, and teach them how to administer units of it properly, so when they eat cheesecake for example, they can take X amount of Insulin, but if the have a steak with onions & mushrooms, with water, you take less, and use the monitor to confirm that it did what they want, or if they need more or less Insulin.. basically, you would become an expert at using Insulin, as your experience grew, and you repeated Thanksgiving meals for example.. you would plan X amount of indulgence, and take Insulin, and test 2 hours later, and fine tune it. The problem is, the learning process.. you can overdo with Insulin.. so we get pills, and they dissolve, and provide help, on an unsteady basis.. dissolve quick, and your blood sugar my plummet.. slowly, and it may drop it 20 pts. for 12 hours.. we have slow and fast acting pills, and the same with quick acting Insulin, and basal Insulin, which covers you 24 hours, instead of correcting your BG quickly with fast acting Insulin after a meal.

Your BG is like an elevator.. you want to ride down to 70, be hunngry, eat, and it pops up to 120, and you feel full.. just like a normal person would. Meds are used to drop it, foods make it go UP.. and we have many factors, like time between meals, exercise intensity, and it's really complicated.. so at first you struggle.. your doc will give you a weak goal like 6.5 or 7.. 140-154 average. That limits the damage, but most patients never use the numbers or are part of the process. They have no idea what X amount of a food does to their blood sugar, and simply wait for their doctor to switch meds, or give them a diet, and the doctor who sees them one day in 3-6 months, has to figure out what happened, and how they should get you in range, WITHOUT dropping your BG down below 70.. and they have almost NO data on you.. just a few numbers each day, and 1 A1C test, which says how you did on average.

You sound as if you are running away with the ideas presented to you, taking this serious, but with 154 average, you will have a 7.0 A1C.. the daily numbers don't count where you are EVERY minute of the day.. so you may be lower or higher over 3 months. If you eat cake before bed, take Insulin and pills, and test in the morning, and its 150.. awesome! except for the fact it was 150-250 all night, slowly dropping.. right? A1C always is more accurate.. if your A1C is 7.8, you are averaging 177 mg/dL, even if it's 150 when you test.. BUT, if you get a lot of 150's, it certainly will be FAr lower than 11.3 when next you test.. your doctor will be happy, but here's the catch.. they don't want to be sued, because they gave you harmful info, based on some numbers and a test.. so they never work to get you to 5.0 A1C.. 97 average, because how low do you go to get there?

The worry about LOW blood sugar is too high, since they have almost no control over you, and you haven't been trained to manage your diabetes.. if you didn't eat any carbs, maybe you have a real low blood sugar, and harm yourself.. due to this, most doctors, seeing you at most 1 day in 30.. try to push you lower, but not too low, right.. if you are at 6.5.. 140 average, your lows will be 100, which is fine, and your highs may be 165-175.. not too bad, doing a lot less damage to your eyes, kidneys, feet etc.., and your risk of heart disease or cancer is lower.. that is the bext someone who sees you 1 day in 3 months can do, without being concerned that you go too low.

Only YOU can become an expert on you.. you can fine tune your diet, exercise, and drop the number 10 points, IF you know how each bite of food, and a 30 miute walk affect you..

That allows you to drop to 110 average, and maybe see a drop in dosage, so you can eat even less carbs, and produce less glucose, OR exercise harder to burn it off.. OR, you may like where you are.. at 110... or even 150, and ask your doctor to give you a slightly larger dose, and monitor it to see that it puts you IN range, not below 70 mg/dL.. basically, you either reduce the glucose, or up the meds.. until you stay in range.. like an elevator.. then just aty between 70-120..

Your doctor can't do this.. you have to build trust, and be consistent.. stay at 150, then either decide to drop to 100 g of carbs, or 50, and see what it does at your current med rate.. let your doctor know of these changes, so they can run tests, and you know how these actions produced results, and EXACTLY how much, so you can either lower them more, or say with certainty.. at 100 g of carbs, I can't get my A1C below 7.. still 34 mg/dL above normal.. and ask the doctor to adjust meds a tiny bit, and see how THAT affects you as well.

In the end, whatever you do.. eat lower/high carb, exercise more/less.. will have a set affect, and what your doctor is doing, is taking the data you give them, and determining how much meds you need to take to be at the right level.

Since most diabetics barely get involved in their management.. they never fine tune their diet, exercise, and meds, so they can reapt the amounts, and get steady results in the 70-120 range. If you change diet or exericse, meds will likely change, understand? It is a balancing act, which can maintain a 7.0 A1C.. OR a 5.0 A1C.. depending on how much you put into experimenting, and documenting the variables which determine your BG levels.. food, exercise, and your doctor does meds. If my BG is 125 mg/dL, I look to see what I did wrong.. did I not exercise enough, or did I slip a few extra grams of carbs in.. I stay strictly between 70-120 by doing this, and if I start creeping up to 130.. I let my doctor know, and probably take more basal Insul to help get back in range.

You don't have to stay at a 7 A1C, living with high BG is what I am saying... but it does take a little participation, and you have to make some choices, which means a little experimenting, then studying the results, so you have the knowledge to make thos choices, and form a plan with your doctor..

You can get this down to know what you BG will be within 10 mg/dL, if you have enough data.. it all depends HOW much control you want, and how strict you want to be.

I could simply eat normall, and take a lot more Insulin.. but what you should try to avoid, is believing that 150 mg/dL all the time is OK.. the damage is slower, but still happening. Either cut carbs, or add meds.. that's simply choice.. lower one, and you'll likely lower the other.. but only you can know if you can eat low carb.. if you can't.. at the very least, take enough meds, to keep you below 120.. and being consistent in whatever you decide will help you and your medical team choose the proper amount of meds to do so.. If you are incosistent, you probably won't be able to get the doctor to change meds much, or get much control on your diabetes... that may be OK with you, and just getting them lower 6.5-7, is good enough.

Weigh all the options, and DO what you can do consistently.. don't try Atkins, if you won't stick to it.. eat the best you can, exercise a consistent amount, and let the doctr cover any issues with meds.. at that point, if you stay consistent, and so do the meds.. the results should stay the same for quite a while, and you will be in control of your diabetes, and it will become a much more minor issue on a day to day basis, which is a goal of mine.. I eat, test 3 times a day, walk some, take my pills, and in 3 months, I wan't my A1C to be the same, or drop some.. if it drops low enough.. I ( my doc ) cut some meds.. simple.

You can do this slowly.. fine tuning shouldn't be done quickly.. make minor changes, and stay in tune with the doc.. telling him if you ate poorly, or didn't exercise, if your A1C is a bit higher.. and the reverse as well. You are close now.. see what your A1C is, and then ask if that is OK.. if not, make some subtle changes, after discussing it with your doc..

Good Luck!