Pre-diabetic ? about Sugar/Carbs

tigersword wrote: »

Shouldn't your doctor have given you this information?

You'd think, but unfortunately most doctors don't (especially if the OP is in the US). At best, they might get you a (possibly outdated) printout of the American Diabetic Association recommendations and say "good luck, I'll see you back here in 3-6 months, when we'll probably need to talk about putting you on Metformin." In the US, especially, there's a horrendously huge gap between diagnosing and medicating with pharmaceuticals, and using diet to prevent, mitigate, or reverse problems such as this. Some places are better than others, and some doctors are better than others (or at least good enough to acknowledge that diet is not their forte and refer you to an RD), but in my experience and that of a large number of people I know, it's still very hit or miss. (And to be fair, it's not entirely the doctors' faults, but part of a result of our system, where they spend more time and money dealing with insurance companies than they do actually helping their patients or keeping up to date on everything; and part of a result of the fact that medicine is far too huge to know the latest everything about everything.)

richardheath wrote: »

Actually, I am going to disagree with funchord's info to some extent. I think tracking your blood sugar right now is a good idea. Learning how different meals affect you 2 hours post prandial (take a reading 2 hours after the first bite) will help you learn just how many carbs you can eat at a time, in a given meal-context. Your Dr should be able to get you a glucose meter through your insurance, or I've found they are almost as cheap just through Amazon. Your Dr should also be able to help you with diet, or refer you to a diabetes specialist.

Also - make sure you have the Dr check your A1c regularly.

I eat what I call moderate carbs, and while I rarely eat things with lots of added sugar, I can occasionally. Cut out sugar-sweetened drinks like coke, sweet tea etc if you currently drink them. And exercise is very important too - at least a walk daily.

Thank you. I'm glad I'm not the only one that disagrees with his recommendations. He's got a lot of good information, but I really don't agree that watching carbs/sugar and blood glucose levels isn't necessary. Being pre-diabetic pretty much means that if you have started down the path to diabetes and means that your ability to process sugars is impaired. It may be subclinical for diabetes now, but diabetes is a progressive disorder unless you actively take action to prevent or reverse it.

Also, Diabetes isn't just about pancreatic function. The pancreas starts failing, because you first become insulin resistant. When you become insulin resistant, the body stops responding to the amount of insulin the pancreas normally puts out to keep your blood sugar down. As a result, it has to work harder to create more....and more....and more....until it eventually gives out altogether. For Type 2 Diabetes, you're diabetic at the point that your body can't keep blood sugar below a certain level -- this is long before the pancreas actually ceases to function. So, while you may not have yet reached the threshold to be considered Diabetic, that process has already started.

This goes doubly so for women, who are far more sensitive to things that cause hormonal fluctuations than men are (and prediabetes means insulin issues, which is a hormone, and can cascade into other hormonal issues). So the sooner you learn about how carbs affect your body and work to minimize the glucose/insulin spikes, the more likely you'll be able to reverse/prevent diabetes and other problems and the more successful you'll be at losing any excess weight you may have.

191g is a fairly decent starting point for carbohydrates if you're used to eating more (the average American diet is somewhere close to 300g), but I recommend considering going down to around 100-150g. 57g of sugar is also a fair starting point while you're getting used to everything, but consider trying to get it down to 25-30g. Contrary to what MaxPower said, that's not an impossible goal (as you can see, there are people on here who have that for their total carb goal, not just sugar). It is challenging and takes some adjustment, but it is doable. Get your carbohydrates primarily from non-starchy vegetables, low sugar fruits (namely berries), and the occasional (relatively) low-GI/GL starchy vegetables (carrots, sweet potatoes, etc), and you will find yourself comfortably in these ranges.

Also, don't be afraid of fats. Fats are essential to vitamin creation and absorption, as well as maintaining proper neural function and restoring any neural function high blood sugar has damaged (there's evidence that even spikes of 120-140mg/dl in blood glucose causes damage, and glucose damages the neural network primarily). You also need a fuel to replace the carbohydrates you drop, and protein is not a particularly good choice for that role (it's primary role is building and maintaining lean mass; when it's used for fuel, it's converted to glucose, which defeats the purpose of reducing carbs; that conversion is also rather difficult and becomes increasingly hard on the kidneys the more the body has to rely on it for fuel).

Fats are also good for maintaining satiety. As someone else mentioned, carbs (especially simple carbs and sugar) are jet fuel -- and IMO, sugar goes even farther and is the NOS in a street racing car -- it burns hot and fast. Protein and fat are diesel, and burn slow and steady. Eating more of them (and pairing all carbs with a fat and protein source) helps prevent the "must eat NOW" sugar crashes people (especially those with impaired glucose tolerance and/or insulin resistance) often experience a couple of hours after eating. Preventing these helps prevent overeating and making poor choices from feeling starved.

And don't worry so much about "good fats" and "bad fats." The only bad fats are artificial trans fat (hydrogenated oil) and oxidized fats (which are damaged, usually by heat). Get a good variety of fats, preferably from whole food sources (either directly, or obtainable via processes such as cold pressing, to avoid the oxidizing effects of solvent extraction), and include quality saturated fats such as coconut oil and high quality butter.

The aforementioned 35c/30f/35p is a good option for learning how to incorporate more fats and fewer carbs into your diet. I also second checking out the Paleo way of eating. Even if you don't entirely agree with it or choose not to follow it entirely, there are a lot of good recipes that are lower in carbs and it's a good framework to work with, which can help keep you from getting overwhelmed by the changes.

Sabine_Stroehm wrote: »

jgnatca wrote: »

I equate various foods as having a different energy "burn". Sugar is jet fuel. Protein is diesel. The burn rate on brown rice feels very good, much slower than white rice. Wild rice is a grass not a rice, but it also has a very nice slow burn.

Thanks for this. I'm not diabetic or pre diabetic, but once I seriously considered my own blood sugar responses to foods, the weight fell off.
On here, though, THE MODERATOR repeatedly says there's no glycemic difference between white and brown. I feel the difference (just as I feel the difference between an apple and a twinkie though they have nearly identical amounts of sugar, ha).

There might be when measured by a bomb calorimeter or other such device, but brown has nearly 5 times the fiber content (and due to having the hull, germ, etc, has a lower carb content per 100g), which would reduce the glycemic response in an actual body.

I think the distinction made in literature between North American Wild Rice as a grass separate from the cultivated Asian rice is to clarify that rice is not the cultivated stepchild of the North American variety. They are both cousins in the same flowering grass family.



Now I want to try that Bangladeshi wild rice!

richardheath wrote: »

Actually, I am going to disagree with funchord's info to some extent. I think tracking your blood sugar right now is a good idea. Learning how different meals affect you 2 hours post prandial (take a reading 2 hours after the first bite) will help you learn just how many carbs you can eat at a time, in a given meal-context. Your Dr should be able to get you a glucose meter through your insurance, or I've found they are almost as cheap just through Amazon. Your Dr should also be able to help you with diet, or refer you to a diabetes specialist.

Also - make sure you have the Dr check your A1c regularly.

I eat what I call moderate carbs, and while I rarely eat things with lots of added sugar, I can occasionally. Cut out sugar-sweetened drinks like coke, sweet tea etc if you currently drink them. And exercise is very important too - at least a walk daily.

Good call.