Pre-Diabetic
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@earlnabby wrote this on another thread but she is T2DLate to the party. Let me explain. No, there is too much, let me sum up:
- I am T2Dm
- I did not get it by eating too much sugar. I got it by eating too much food and by taking antidepressants for a long period of time (one of the lesser risk factors. Other medications like statins are also a known risk factor)
- People who develop T2Dm typically have a combination of 2 or more risk factors. Genetics being the most common, excess weight being the second most common.
- I was diagnosed with an A1C of 7.3.
- I don't know (or care) if I am IR or my body does not produce enough insulin. The results are the same, as is the management
- I do NOT watch my sugar intake
- I DO watch my total carb intake, keeping it to less than 180 g daily
- I am in total remission
- I do not take medication, my remission is due to diet and exercise only
- My last A1C (done a week ago) was 5.0
- I am not unusual OR special. Most who are in remission have done it exactly the way I have (according to my Certified Diabetes Educator doctor)
This. Restrictive low carb is not necessary, unless your doctor prescribes this.
I would rewrite that to say " restrictive low carb is not always necessary."
No thanks, I won't be rewriting anything.
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I am /was prediabetic too. The only advice my endocrinologist gave was eat MORE fruits and veggies and leaner cuts of meat, and they would monitor it. Basically, they advised me to add carbs and cut fats. It was useless advice for me.
I was only 20lbs over a normal BMI and losing alost 40 lbs hasn't fixed things for me. For some people with insulin resisitance (like a T2D) it does help, but it didn't fix me, and I doubt advice to eat more fruits and veggies and leaner meat would normalize a diabetics blood sugar to a healthy level. And I don't mean the "normal high" that many doctors settle for, I mean normal.
Anyway, I started on a low carb high fat diet that is laid out by Dr Richard Bernstein in his book, Dr Bernstein's Diabetes Solution. Bernstein was an engineer who developed T1D back in the day when most diabetics didn't hit 40. He was able to use one of the first 5 minute BG monitor kits to check his blood and found that a diet very low in carbs, well below 50g of daily carbs, made it possible for him to stabalize his BG at a normal level - the same as a healthy person - because his insulin needs were so much less.
He then went back to school, became a doctor, specialized in treating diabetes, and has been slowly revolutionizing how diabetes is treated.
... Sorry. I gushed, but the man changed my life.
I follow his low carb high fat diet, which at first is a nutritional ketogenic diet (not to be confused with a medical ketogenic diet used to treat epilepsy). Some with IR find they can raise their carbs from a low 20-30g per day up to 50 g or more, but that is not the norm in his experience. He keeps most patients with IR on very low carbs, and it works.
Following that diet has improved my health in so many ways, including areas that I ddin't even realize had declined.
If I keep my diet below 30g of carbs per day, my FBG stays very good. Often a 4.2-5.0 (about 75-90) but if my carbs get above 30g, and if I eat more than moderate protein, my FBG rises. For example, yesterday was a "higher" carb day for me and my FBG was a bit higher than normal and getting close to the prediabetic FBG of 5.6. My diet yesterday consisted of coffee and coconut cream and a bit of protein powder, a cup of pistachios and a pepperoni stick, a salmon patty with sriachi mayo, and then a party where I ate about 1.5-2 cups of raw broccoli and cauliflower, and 10-15 jumbo shrimps all dipped in a 1/3 - 1/2 cup of execllent hot cheese dip. That was a fair amount of protein and my carbs from the nuts and veggies (and the pepperoni and coconut cream) was around my upper limit of 20g/day. If I ate like that again today, my FBG would probably be firmly into pre diabetic range again for a day or two.
My very LCHF ketogenic diet consists of 75% fats, 20% protein and 5% carbs. I eat lots of nuts, eggs, cream, sour cream, cheese, butter and healthy oils like full fat, sugar free salad dressing, meats, seafood, seeds, coconut and coconut cream, and veggies - usually green ones and those grown above ground. I skip all grains (corn, wheat, etc) and all products made from flours. I avoid quinoa and rice because I'd rather get my carbs from veggies. I limit my starchy root veggies (potatoes, carrots, etc) and fruit intake (usually berries). It means skipping the usual desserts but I have my stand ins like sugar free cheese cake or whipped cream with cocoa and shaved chocolate instead of icecream.
If you do lower your carbs, be aware that you'll lose some water weight and with it some electrolytes. Most people who cut carbs will need to increase their salt to avoid muscle aches, fatigue and headaches. This is especially true if you lower your carbs to ketogenic levels; you'll need to bring your sodium up to around 3500-5000mg per day.
I really recommend Bernstein's book. If you decide to follow his plan, there is a lot of good information on ketogenic diets like Phinney and Volek's book, The Art and Science of Low Carbohydrate Living. Moore has a simplified, easy to read book called Keto Clarity for those who aren't as interested in reading science. And Atkins, phase 1, is also a rough guid that could give you some ideas.
There is also a LCHF group called the Low Carber Daily which is very helpful.
Good luck. I hope you find something that works well for you.
THIS as well.
Basically, use a meter and go by that. See which foods raise your BG, and reduce or eliminate those.
You will see what foods affect you more, and it can be surprising.
I found out my homemade sweet potato soup affected my BG like a candy bar!
When you do this, learn about the combination of foods as well. If you have a cheese burger for example, the parts raising BG are the bun and ketchup, far more than the meat and cheese.
I have normal BG readings now because I ate to my meter and found what worked for me.
You hopefully won't have to be as extreme, but I bet if you cut out or reduce processed foods, that will be a big change in itself.0 -
@earlnabby wrote this on another thread but she is T2DLate to the party. Let me explain. No, there is too much, let me sum up:
- I am T2Dm
- I did not get it by eating too much sugar. I got it by eating too much food and by taking antidepressants for a long period of time (one of the lesser risk factors. Other medications like statins are also a known risk factor)
- People who develop T2Dm typically have a combination of 2 or more risk factors. Genetics being the most common, excess weight being the second most common.
- I was diagnosed with an A1C of 7.3.
- I don't know (or care) if I am IR or my body does not produce enough insulin. The results are the same, as is the management
- I do NOT watch my sugar intake
- I DO watch my total carb intake, keeping it to less than 180 g daily
- I am in total remission
- I do not take medication, my remission is due to diet and exercise only
- My last A1C (done a week ago) was 5.0
- I am not unusual OR special. Most who are in remission have done it exactly the way I have (according to my Certified Diabetes Educator doctor)
This. Restrictive low carb is not necessary, unless your doctor prescribes this.
I would rewrite that to say " restrictive low carb is not always necessary."
No thanks, I won't be rewriting anything. 0 -
@earlnabby wrote this on another thread but she is T2DLate to the party. Let me explain. No, there is too much, let me sum up:
- I am T2Dm
- I did not get it by eating too much sugar. I got it by eating too much food and by taking antidepressants for a long period of time (one of the lesser risk factors. Other medications like statins are also a known risk factor)
- People who develop T2Dm typically have a combination of 2 or more risk factors. Genetics being the most common, excess weight being the second most common.
- I was diagnosed with an A1C of 7.3.
- I don't know (or care) if I am IR or my body does not produce enough insulin. The results are the same, as is the management
- I do NOT watch my sugar intake
- I DO watch my total carb intake, keeping it to less than 180 g daily
- I am in total remission
- I do not take medication, my remission is due to diet and exercise only
- My last A1C (done a week ago) was 5.0
- I am not unusual OR special. Most who are in remission have done it exactly the way I have (according to my Certified Diabetes Educator doctor)
This. Restrictive low carb is not necessary, unless your doctor prescribes this.
I would rewrite that to say " restrictive low carb is not always necessary."
No thanks, I won't be rewriting anything.
Yeah... That's why I wrote:" I " would rewrite that to say " restrictive low carb is not always necessary."0 -
@earlnabby wrote this on another thread but she is T2DLate to the party. Let me explain. No, there is too much, let me sum up:
- I am T2Dm
- I did not get it by eating too much sugar. I got it by eating too much food and by taking antidepressants for a long period of time (one of the lesser risk factors. Other medications like statins are also a known risk factor)
- People who develop T2Dm typically have a combination of 2 or more risk factors. Genetics being the most common, excess weight being the second most common.
- I was diagnosed with an A1C of 7.3.
- I don't know (or care) if I am IR or my body does not produce enough insulin. The results are the same, as is the management
- I do NOT watch my sugar intake
- I DO watch my total carb intake, keeping it to less than 180 g daily
- I am in total remission
- I do not take medication, my remission is due to diet and exercise only
- My last A1C (done a week ago) was 5.0
- I am not unusual OR special. Most who are in remission have done it exactly the way I have (according to my Certified Diabetes Educator doctor)
This. Restrictive low carb is not necessary, unless your doctor prescribes this.
I would rewrite that to say " restrictive low carb is not always necessary."
No thanks, I won't be rewriting anything.
Yeah... That's why I wrote:" I " would rewrite that to say " restrictive low carb is not always necessary."
" I " would rewrite that to say " restrictive low carb is not usually necessary."0 -
Good enough.0
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I would see a nutritionist if your health ins plan would allow. Many hospitals offer free Diabetic education classes. Check it out. Also check out the American Diabetes website for dietary information.0
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I was diagnosed Type 2 in July. I have been watching my carbs approx 30-45grams per meal and 30 grams for snacks around 2-3 snacks per day. If you are watching carbs, the sugar is included, so no need to monitor both. By keeping yourself in a deficit, you will lose weight and most likely get your blood sugar in check. With this and exercise I have lost 30 lbs and have an A1C of 6. I do not requires meds at this point. Many diabetics have had a lot of success with the low carb high fat diet. They keep their carbs around 50grams per day. I have a lot of difficulty doing this and at this point try to keep my overall carbs around 120 for the day. I think once you become aware of carb content, you will make better choices. Your goal is to keep your blood sugar as level as possible.0
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It might be helpful to read up on Glycemic Index/Glycemic Load of different carbs, too, if you are eating to a glucose monitor. I have a higher carb count if I don't count things like lentils that don't spike my BG. I find that the lower GI foods really are good for me to eat, carbs or no. And the high ones really are the ones that spike my glucose.
You can also prepare things different ways and it affects how the carbs will be absorbed by the body. Sweet potatoes are like candy if the sugars get caramelized. You have to boil them for them to stay medium GI. Pasta is lower if cooked al dente, etc. Quick oatmeal spikes BG more than non-quick oats.
And common sense tells me that an apple is probably better than a cookie. Unfortunately, if you test your glucose, you'll probably find that's true for you, too, lol. A lot of sugar in a food really is one thing I have to watch very closely for portion size. I have to eat half a cookie, usually. And I take the top buns off of burgers or sandwiches.
Spread out the carbs. You might be able to eat a fairly high total number if you don't eat them at the same time. For me, my overnight BG will start creeping up if I don't watch the overall total, though, even if the spikes were ironed out nicely. I tried to sneak another sweet a day in, but that doesn't work for long, darnit!
If you do eat something like a couple of cookies, go for a walk after. Use up the extra glucose by getting it into those muscles. Regular exercise is very important for BG problems anyway.0 -
Some amazing advice in here! Thank you so much and will have a proper read in the morning as I am in the UK so currently in bed lol
thank you again xx 0 -
cafeaulait7 wrote: »It might be helpful to read up on Glycemic Index/Glycemic Load of different carbs, too, if you are eating to a glucose monitor. I have a higher carb count if I don't count things like lentils that don't spike my BG. I find that the lower GI foods really are good for me to eat, carbs or no. And the high ones really are the ones that spike my glucose.
You can also prepare things different ways and it affects how the carbs will be absorbed by the body. Sweet potatoes are like candy if the sugars get caramelized. You have to boil them for them to stay medium GI. Pasta is lower if cooked al dente, etc. Quick oatmeal spikes BG more than non-quick oats.
And common sense tells me that an apple is probably better than a cookie. Unfortunately, if you test your glucose, you'll probably find that's true for you, too, lol. A lot of sugar in a food really is one thing I have to watch very closely for portion size. I have to eat half a cookie, usually. And I take the top buns off of burgers or sandwiches.
Spread out the carbs. You might be able to eat a fairly high total number if you don't eat them at the same time. For me, my overnight BG will start creeping up if I don't watch the overall total, though, even if the spikes were ironed out nicely. I tried to sneak another sweet a day in, but that doesn't work for long, darnit!
If you do eat something like a couple of cookies, go for a walk after. Use up the extra glucose by getting it into those muscles. Regular exercise is very important for BG problems anyway.
It can sometimes deceiving. Foods with fructose as opposed to glucose or sucrose (glucose and fructose) won't be as high. Fructose is mainly handled by your liver, and will not affect blood glucose readings the same as glucose.
And items like ice cream appear low because of the fat content even with all the sugar it has.
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Hi, I was pre-diabetic for years, controlling through diet, and I am now in remission from significant weight loss. The life of a diabetic is one of balance. The most important advice I got in those early days was to eat on a routine starting with breakfa0
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Breakfast. The second tip was to portion my plate with all the macros with lots of fruit and vegetables.
http://www.diabetes.org/food-and-fitness/food/planning-meals/create-your-plate/0 -
DeguelloTex wrote: »@earlnabby wrote this on another thread but she is T2DLate to the party. Let me explain. No, there is too much, let me sum up:
- I am T2Dm
- I did not get it by eating too much sugar. I got it by eating too much food and by taking antidepressants for a long period of time (one of the lesser risk factors. Other medications like statins are also a known risk factor)
- People who develop T2Dm typically have a combination of 2 or more risk factors. Genetics being the most common, excess weight being the second most common.
- I was diagnosed with an A1C of 7.3.
- I don't know (or care) if I am IR or my body does not produce enough insulin. The results are the same, as is the management
- I do NOT watch my sugar intake
- I DO watch my total carb intake, keeping it to less than 180 g daily
- I am in total remission
- I do not take medication, my remission is due to diet and exercise only
- My last A1C (done a week ago) was 5.0
- I am not unusual OR special. Most who are in remission have done it exactly the way I have (according to my Certified Diabetes Educator doctor)
This. Restrictive low carb is not necessary, unless your doctor prescribes this.
I would rewrite that to say " restrictive low carb is not always necessary."
No thanks, I won't be rewriting anything.
Yeah... That's why I wrote:" I " would rewrite that to say " restrictive low carb is not always necessary."
" I " would rewrite that to say " restrictive low carb is not usually necessary."
This is what I agree with. 0 -
fatgirlslims87 wrote: »I am currently just cutting out snacks as the snacks I ate I knew was bad, so it's a start with the calorie deficit.
The aim from tomorrow is to start calorie and macro counting properly from tomorrow as I think the diagnosis has given me the kick up the bum I need to lose weight.
Good for you that you want to nip it in the butt before an actual diagnosis, because even people who reverse their type 2, it never goes away in the medical record. So cheers to that!
Honestly, doctors aren't usually the people to help in the diet and food department, as you said, an appointment with the dietitian is likely the best bet. May take a few sessions to get things moving and learn the basics. I work with many of them and often I see the recommendation to cut out the snacks, as you mentioned before and aim for 3 well balanced meals. Three meals verses 6 smaller meals can actually help to balance out average glucose levels as the body has more time to metabolize in between and get back to a baseline before the next feed.
As many have said, the weight loss should help direct everything back to normal. Diabetes is a terrible disease and it rips through people and families. Prevention is definitely the answer. You will be able to do this if you don't give yourself any other option!0 -
DeguelloTex wrote: »
" I " would rewrite that to say " restrictive low carb is not usually necessary."This is what I agree with.
This is what I agree with too, as does the majority of those in the medical field trained to treat diabetes.0 -
Leslierussell4134 wrote: »fatgirlslims87 wrote: »I am currently just cutting out snacks as the snacks I ate I knew was bad, so it's a start with the calorie deficit.
The aim from tomorrow is to start calorie and macro counting properly from tomorrow as I think the diagnosis has given me the kick up the bum I need to lose weight.
Good for you that you want to nip it in the butt before an actual diagnosis, because even people who reverse their type 2, it never goes away in the medical record. So cheers to that!
Honestly, doctors aren't usually the people to help in the diet and food department, as you said, an appointment with the dietitian is likely the best bet. May take a few sessions to get things moving and learn the basics. I work with many of them and often I see the recommendation to cut out the snacks, as you mentioned before and aim for 3 well balanced meals. Three meals verses 6 smaller meals can actually help to balance out average glucose levels as the body has more time to metabolize in between and get back to a baseline before the next feed.
As many have said, the weight loss should help direct everything back to normal. Diabetes is a terrible disease and it rips through people and families. Prevention is definitely the answer. You will be able to do this if you don't give yourself any other option!
Actually, many feel that 3 meals and 2 snacks balances out the blood sugars better so you don't get the highs and lows. The trick is to keep the snacks small and, if it is a carb snack, include protein and fat.
Good snacks: a hard cooked egg or piece of cheese with some nuts. Greek yogurt with some fresh fruit. A snack bar (watch the macros on these, though). Peanut butter on celery. Hummus with fresh veggies.0 -
I have to admit . . . I'm quite surprised, and very disappointed, that your physician has given you so little direction.
I have not been diagnosed as "pre-diabetic." I've been diagnosed as "insulin resistant," which is kind of a step before your diagnosis. Basically, my blood glucose is horribly regulated and is all over the place (low and high), but it doesn't quite approach pre-diabetes levels when it is high.
My physician spent decades working in Africa with "Doctors without Borders." As a result of frequently not having the medicine he required to treat people (or not having enough of what medication he did have), his approaching to treating conditions is always nutrition and lifestyle first. Trying to get a prescription for anything out of the man is like pulling teeth, unless it is 100% required.
My physician prescribed me almost a total elimination diet (he still permits me to have high fat dairy) that is low-carb and high (saturated) fat, with moderate protein. Basically, it is low-carb paleo with high-fat dairy. He demanded that I commit to eight weeks of his eating plan. I asked to be referred to a dietitian. He rolled his eyes, but referred me to a registered dietitian (NOT a "nutritionist"). She concurs with him.
Tracking my blood glucose levels was a real eyeopener.
By the end of week one my blood glucose levels had stabilized to a very narrow window well within the healthy range, concluded from readings taken once an hour (with well timed meals and snacks) during waking hours. Note that stable and healthy doesn't mean perfect. My fasting glucose is still a touch high (not officially pre-diabetic, but not quite normal). My physician also suspects that I'm dealing with one episode of transient night-time hypoglycemia which we are now trying to deal with. I have only had one episode of daytime hypoglycemia in the last month. I used to have two or three episodes a day.
My recommendation would be to start tracking your blood glucose levels right away. If anything causes a big spike don't consume that item, in the same way, again. This is something you can start doing before you see a dietitian, and it might provide you with some data you can give to the dietitian: to get a head start on developing your new nutrition plan.0 -
By the end of week one my blood glucose levels had stabilized to a very narrow window well within the healthy range, concluded from readings taken once an hour (with well timed meals and snacks) during waking hours. Note that stable and healthy doesn't mean perfect. My fasting glucose is still a touch high (not officially pre-diabetic, but not quite normal). My physician also suspects that I'm dealing with one episode of transient night-time hypoglycemia which we are now trying to deal with. I have only had one episode of daytime hypoglycemia in the last month. I used to have two or three episodes a day.
My recommendation would be to start tracking your blood glucose levels right away. If anything causes a big spike don't consume that item, in the same way, again. This is something you can start doing before you see a dietitian, and it might provide you with some data you can give to the dietitian: to get a head start on developing your new nutrition plan.
I'm glad your hypoglycemia is resolving. That is no fun.
I seem to have had issues with hypoglycemia too. My BG would spike up after carbs and then plummet below where ther started. If I stay in ketosis, it doesn't seem to happen. I did slip out of ketosis for a week or so when I stopped checeking with ketostx and my carbs were up to 30-50g per day. When I lowered my carbs again I had my first repeat of hypoglycemia in months. Shakes, weak, not as with it as normal. My BG was between a 3.2 and 3.6 (about a 55-67). Once I had my glycogen stores depleted again the problem seems to have disappeared. I'm usually between a 4.4 and 5.4 now. It's pretty stable unless my carbs get above 30g or I eat too much protein, or just too much, at night.
My FBG is usually my highest reading of the day. Dawn phenomenom I guess. It seems weird that it goes up when I haven't eaten anything for 12 hours. My FBG bounces back into prediabetic range when I just had a "higher" carb day of over 30g, have eaten too much the previous evening, or had too much protein (over 85g seems to be a problem for me). In fact last night was the Gey Cup and I ate a lot of meats, shrimp, pistachios and cheeses. This morning my FBG was back to a 5.8-5.9, which is prediabetic here.
To the OP: Sorry. I rambled on. I do agree to eating to your metre. It's the only way to find out what will work for you. Moderate carb and exercise might be fine, or you might need something more restrictive like I do, but the only way to know is to test frequently.
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My doctor didn't like what my insulin resistance was doing. His attitude is that many, many people reverse the problem completely by losing weight and increasing exercise. Even a 20-pound loss sometimes does the trick. It's not necessarily all that important exactly what you eat to achieve the loss as long as you achieve it. If you're confused about grams of this and that, and "good" and "bad" foods, why not try getting a certain amount of weight off to start with? It could be as simple as limiting portions of the foods you prefer. And--bonus--you'll look and feel better. If you get your weight down and your blood sugar still looks iffy, you could always start watching your carbs like a hawk, and you'd be starting from a position of greater health, too.0
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