Newly diagnosed with diabetes and need help with diabetic exchange diet

KnitterNotAQuitter
KnitterNotAQuitter Posts: 67 Member
in Health and Weight Loss
I was diagnosed as Type 2 on Thursday. I’m supposed to adhere to a 1,200 calorie a day diet based on the diabetic exchange plan, and my doctor gave me this sheet. And I totally don’t understand how this works.

Am I missing something? Where are the vegetables? How does one exchange equal three ounces of chicken in the example? Do you have to eat the same for every meal (e.g., breakfast is always one fruit, one meat, etc.)? I was so shocked and scared when the NP that handed me this and shortly explained it, I thought I understood it, but then she started looking at my feet and couldn’t feel a pulse and ordered a scary ABI test (which I had yesterday and don’t feel it went well).

So far, I’ve just been keeping to 1,200 calories, and going to the gym every day to walk for an hour, but I feel like not following the diet is not really following instructions.

Sorry if this is rambling, I’m waffling between being devastated to tears, feeling confident (“I got this!”) and “What the f*** does it matter what I eat? This is basically a death sentence I brought on myself anyway.”, which brings more tears and the cycle starts all over again.

And in the middle of all this, my friends are asking what’s going on with me and I’m too embarrassed to tell them, I’ve just been hiding at home since Thursday. I’ve only told my mom and sworn her to secrecy, but I’m visiting my family for Thanksgiving for the first time in years, and she’s already implied that it is now ruined.

I feel so scared and alone. If I could get my eating on track, at least I’d have that. Thanks for any help.
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Replies

  • collectingblues
    collectingblues Posts: 2,541 Member
    edited November 2017
    I'm type 1, but had lots of time on exchanges for that and for another condition. I'll take a crack at this as best I can.

    So for vegetables -- in the diabetes exchange diet, those are off of your free-food list. (This is part of why vegetables get a reputation for being "free" foods.) Eat what you like of the non-starchy veg, within reason, and as your calorie count allows.

    I'm not sure how their sample meal plan is getting 3 oz of chicken for one exchange. I was always taught that one exchange = 1 oz, and that's what everything I google is telling me as well (I double checked just in case I was misremembering).

    Yes -- you don't need to eat the same *foods* for every meal, but you need to eat the number of changes the same as they are prescribed. So that'll mean one fruit, one carb, one meat, and one fat for each breakfast. Ditto with how the lunch, dinner, and snacks are set up. At this point, at least. I was usually given a little more flexibility, but part of the key with type 2 is *consistent* carbs -- so that's why things are set as they are.
  • bisky
    bisky Posts: 1,090 Member
    I would ask for a referral to a nutritionist for help....most Dr's have little training in nutrition in med school. I don't blame you for feeling scared...diabetes is an insidious disease that can cause a lot of health problems if not properly taken care of. I think there are some diabetes forums here.
  • rheddmobile
    rheddmobile Posts: 6,840 Member
    I was looking at the handouts they gave you, and wondering why so many foods are crossed out. Did anyone explain this?
  • bisky
    bisky Posts: 1,090 Member
    Thank you music fan for correcting me...there can be some crazy nutritionists out there and I don't think they are regulated as Registered Dietician are.
  • KnitterNotAQuitter
    KnitterNotAQuitter Posts: 67 Member
    @rheddmobile I forgot to mention, the scribbling was me — on the front, trying to figure out how the diet worked, and on the back, crossing out food I don’t really care for or probably won’t eat. Sorry for the confusion.

    Regarding my vitals, I’m on Januvia 100mg, my A1C was 6.4 and my blood glucose was 155. The NP said I don’t need to test ... yet. She gave me the diet and only 90 days worth or medication. I have a follow-up appointment in a month and new labs in three months. I think she wanted to give me tough love which she referred to as “medical blackmail.”
  • dsboohead
    dsboohead Posts: 1,899 Member
    bisky wrote: »
    I would ask for a referral to a nutritionist for help....most Dr's have little training in nutrition in med school. I don't blame you for feeling scared...diabetes is an insidious disease that can cause a lot of health problems if not properly taken care of. I think there are some diabetes forums here.

    This would be a helpful option.
  • dsboohead
    dsboohead Posts: 1,899 Member
    I just hate when the MD throws you a book and says....there you go! Diabetes educator and nutritionalist should be referred for you and demand it!
  • rheddmobile
    rheddmobile Posts: 6,840 Member
    The good news is that 6.4 is not that high! You are very lucky to have been diagnosed at an early stage.

    I urge you to disregard the recommendation not to test. I'm not sure why doctors do this, mine did it too, but he sure changed his tune after seeing my lab results. Without a meter you are shooting in the dark. A cheap meter costs ten dollars at Walmart, and you can get the best rated one available with everything else required to test for forty on Amazon.

    I've never been on Januvia, but Januvia supposedly doesn't cause low blood sugar, so it's not as critical for you not to skip meals as it would be for someone on insulin or a sulfonylurea like glimeperide. What you need to worry about is not eating too many carbs at one time, and especially not eating too many quick acting carbs such as refined grains and added sugars. Slow acting carbs such as the ones in fruit or beans affect different people very differently, which is one reason to test - for example, I can eat a huge serving of potatoes with no problems, but only a small amount of rice spikes me. A friend of mine has trouble with fruit which I am fine with. Unless you test, you are just guessing. The goal is to keep your blood glucose within safe levels.
  • rheddmobile
    rheddmobile Posts: 6,840 Member
    By the way, Thanksgiving is a terrible meal to have to figure out for diabetics! What a time to be diagnosed. But turkey is carb free. See if you can bring some sugar free cranberry sauce if you like cranberry sauce, and make sure there are some non-starchy vegetables available that aren't drenched in gravy or marshmellows.
  • dustbringer
    dustbringer Posts: 1,621 Member
    Unless I'm reading it wrong, it looks like on Thanksgiving you could have a serving each of turkey, a dinner roll, mashed potatoes, milk, and free vegetables with a serving of fat to cook your veggies or for salad dressing. :)

    For your "bedtime snack" you could make pumpkin mousse by whipping up a serving of condensed milk and folding in a serving of pumpkin with some pumpkin spices.

    And if your family eats Thanksgiving dinner like mine, we linger around the table talking long enough that maybe you'll have a long enough time at the table for it to be lunch, then your break, then dinner.

    I don't know much about the exchanges (even though a few people close to me have diabetes), so don't take my suggestions too literally! Definitely take everyone's advice and see a proper nutritionist! But I wanted to give you some hope that Thanksgiving is not ruined. :)
  • RodaRose
    RodaRose Posts: 9,562 Member
    Have some talks with your mom so she can be chilled out by Thanksgiving. Geez. <3

    Yes, regarding meals being mostly the same everyday on this plan.e.g., breakfast is always one fruit, one meat, etc.)

    You have veggies available to you: Bean sprouts, green beans, broccoli, carrots, celery, cooked mushrooms, onions, red or green peppers, cooked spinach, tomato, cooked zucchini, spinach, cucumber, zucchini, dill pickles.

    Good luck. The beginning of any new experience can feel overwhelming. It will get better.

    If you can find a Registered Dietician, you would (I hope) get someone who explains things to you better.

  • ZoneFive
    ZoneFive Posts: 570 Member
    edited November 2017
    Oh, honey. It's going to be okay. Diabetes is not a death sentence. You absolutely have it in your own hands to improve your condition. I was diagnosed with T2 eighteen months ago. I came to MFP with the intent of monitoring my sugars and starches, and soon moved to keeping track of my calories as well. Over the past year my A1c has gone from 7.9 to 5.4, and serum glucose from 157 to 94. Today I'm below the diabetes threshold and even the pre-diabetes threshold.

    Insist on that referral to a Diabetes Educator and RD. That diet sheet you were given is definitely outdated. There are lots of people on this forum who have their diabetes well under control by diet alone, but even if you need medication, you can still make your life very comfortable and healthy. You're not alone.

    And that was an awful thing for your mother to say. One person's diet is not what ruins Thanksgiving -- unkind and rigid attitudes do.
  • xvolution
    xvolution Posts: 721 Member
    The main part of the exchange diet you should focus on is the carbs, since that is what will cause your blood sugars to go up the most. The simplest way to count carbs is to remember that 15g carb = 1 carb exchange, so take the carb information from the Nutritional Facts label and divide that by 15. That's how many carb exchanges the food has. Fruit exchanges (if you have any) are also 15g carbs each but are exclusive to fruits. Meat exchanges (I'm assuming that 1oz = 1 meat exchange) are 7g protein, but only if there's actual meat in it as carb exchanges can also include 2g protein.
  • callsitlikeiseeit
    callsitlikeiseeit Posts: 8,626 Member
    your mother is a *kitten*. dont feel bad, i have one of those for a mother too.

    anyways, i do NOT have diabetes, but i did care and cook for my ex and grandfather who were both type 2 diabetics (among many other health conditions).

    the info you were given is outdated and makes thing harder than they are. I agree with the other poster that you DO need to test - how else are you supposed to know what your sugars are doing and how your body responds to certain foods?

    my husband was on metformin and my grandfather on insulin. They were both allowed 30 (net) carbs per meal (labels make this easy). that is the long and short of it. take any meds you are given, exercise regularly, watch the carbs. with the lower carb counts (typically) comes lower calorie consumption. Focus on proteins and veggies.

    you are NOT in a bad place, you have NOT ruined thanksgiving and there is NOTHING to be ashamed of. Do you have ANY idea how many people are diabetic? I know TONS. And every single one of them, manage it and control it, with a combination of diet, exercise, and medication (ive known a few who did so well with the diet and exercise part that they were able to stop medications, but they do continue to monitor!!!!)

  • LiftHeavyThings27105
    LiftHeavyThings27105 Posts: 2,086 Member
    @KnitterNotAQuitter - so many things running through my head right now.

    So, as someone stated already (I am going to 100% enthusiastically agree) if there is a chronic disease to have then I would pick diabetes.

    Can it be deadly? Absolutely. Can it wreak havoc on the human body? You, bet! But, of all the diseases "available", I feel that this is one of the few where MY DECISIONS | ACTIONS can greatly impact how this experience plays out.

    I mean, I have a high A1C (it has been 6.4 for a decade) . Not to go down this path too long, I was a very high performance athlete in high school and college and very active until I was about 35. Then I moved to Roanoke, VA and got married and had kids and got really fat (from a lean and mean 190 to a very pudgy 250). My nutrition was HORRIBLE (I mean, a balanced diet is three different kind of burritos from Taco Bell, right? And that was just lunch....let's talk about the other four meals....). Anyway, there was a five year time span in my life where opening the top of the 15 Mountain Dews I consumed a day was the only exercise I got. That all changed. I started running - a lot. Nutrition was still a mess, but a lot better. I lost 60 pounds and was strong as an ox and could run and run and run. Still, A1C was high. I am getting my nutrition in order now. And training is going well. I went to the Doctor for the first time in a decade to have a cyst on my back removed. I do not trust Doctors. Just going to be 100% upfront about that. In my experience, all they want you to do is to take one pill for your issue and then four more pills to 'control' the side effects. No thank you! I can find the real solution (nutritionally speaking and exercisely speaking....yes, that is a word...I just used it! LOL).

    Now, my prejudice against doctors notwithstanding, I would honestly suggest that you take any "nutritional advice" that a Doctor gives you with a grain of salt. Again, generally speaking. Most Doctors have little to no clue about this topic. So, they are generally ignorant regarding nutrition. I would absolutely recommend that you get with a nutritionist (or, is that a registered dietitian - I can never remember the difference) and get with one that has experience with your condition. It can literally be the game changer for you.

    Exercise (what I call 'training') will really help as well.

    Losing 10% of your current body weight can do - generally speaking - a world of difference. Please keep in mind that this comment is super general in nature and not specific to your situation.

    This is actually a really great opportunity for you to change life styles and to get really healthy. That is how I am (finally) looking at my situation.

    Don't look at this as a death sentence. I mean, just to be blunt, we are all going to die anyway, right? No one really knows when or how, but that moment will come for all of us. It is what we do while we are here that defines us. So, take this as an opportunity to make some simple (but not easy) changes and kick *kitten*!
  • 2snakeswoman
    2snakeswoman Posts: 655 Member
    I was recently diagnosed with prediabetes, A1c of 5.9. My doctor told me to reduce my carbs and increase my protein intake; that's all. Since then I've been on a mission to finally get serious about this weight loss thing. I set my diet goals to count sugars and carbs. I found a diabetes exchange diet online and was pretty dismayed to see that it allowed 8 (8!) servings of starch per day and only 6 of protein. That doesn't seem right! Anyway, I'm in the anti-diabetes struggle too; you're not alone.
  • nvmomketo
    nvmomketo Posts: 12,019 Member
    I agree that your doctor is woefully outdated. A CDE could help. Look up some books too. I found DrBernstein's DiabetesSolution to be a great book. He's a doctor with T1D who basically invented home testing and eating to your metre.

    I completely disagree with not getting a blood glucose metre and testing at home. It is very intimidating the first few times you do it but the amount of information you get from it is invaluable. You may discover that you are fine with bread but noodles raise your blood glucose (BG) too much. You may discover that you can eat most fruits and be fine, or that bananas raise you BG a lot and so you can not eat more than half a small banana at a time.

    Consider getting a metre. Then test when you wake up, before a meal, and then every 30-60 minutes after until your BG goes back down to pre-meal levels (usually two hours in diabetics).


    You want your BG to stay as steady as possible. No big spikes. Spikes are made the worst by sugars and refined grains (flour - bread, cereal, muffins, noodles). Most whole grains will raise BG a lot too (corn, oats,rice, pearl barley). Fruit is also a source of carbs and sugar, but dried fruit (raisins, dates) and tropical fruit (bananas, mangos, grapes, etc) tend to raise BG more than fruit grown in North America (apples, oranges, nectarines, berries, some melon).

    Meats, seafood, eggs, full fat dairy (cheese, 14% sour cream, butter, whipped cream) will not raise your BG. Foods like olives, avocados, plain yogurt, some nuts and seeds, and non-starchy vegetables (not root vegetables like potatoes or turnips) will raise your BG some but usually not like grains, sugars and highly refined and processed foods often do.

    But, the only way to know how those foods affect you is to test.

  • nvmomketo
    nvmomketo Posts: 12,019 Member
    This video could help diabetics with reducing carbs and BG.

    https://m.youtube.com/watch?v=da1vvigy5tQ
  • kittybenn
    kittybenn Posts: 444 Member
    I feel so bad for you. It IS scary. My doctor told me I had pre-diabetes a year and a half ago. I was so depressed and terrified. But you know what? It shocked me into doing something - immediately. Flash forward to today and I'm down 70 lbs and feel great. You'll figure the exchange thing out, with the help with people here. This will take time so don't be hard on yourself if you're not an expert the day after getting your diagnosis. I'm positive you'll look back on this a couple of months from now and be thrilled with how far you've come and how much better your numbers are next time you see your doctor. One of my goals was to shock the *kitten* out of my doctor on the next visit - and I did. It was so satisfying! Best of luck to you!
  • 150poundsofme
    150poundsofme Posts: 523 Member
    Hi, 6.4 AC1 not high. Did you fast before your lab test? If you didn't the 150 is so not high, and either way not high. More like prediabetic. Hospitals, if your insurance covers, they usually have classes - 5 of them, one on nutrition, one on what to eat and do when you are sick, one a counselor and 2 others. I was told 12+ years ago to do the exchange. Didn't understand either. Went to my first endocrinologist. He said I don't believe in the food exchange and then I was more confused. He didn't tell me what to do. As a diabetic, you can eat carbs, just in the right proportion, like a "normal" meal. You can still have a portion of sweet potatoes, a small piece of corn bread and a small slice of pie for your carbs. Everyone can still eat the same. Your food choices should not effect anyone. You are making your own decisions which should feel good and give you control over yourself. You should have definitely been given a blood glucose monitor so you can see after you fasted when you were asleep, what your a.m. sugar is. Then two hours after a meal you can test again. You would record these numbers to see what foods effect you more than others. Maybe you should visit an endocrinologist. They are the ones who usually have free monitors they give out. I never thought my having diabetes was embarrassing at all. Thin people, heavy people, obese people can get Type 2 diabetes. Whenever I lose weight and not eat too many carbs, my numbers are good. So focus on yourself, don't let anyone push food on you and remember, you are number 1. Hugs and more hugs
  • dsboohead
    dsboohead Posts: 1,899 Member
    Your MFP name implies strength so get it together!
    Your mom was wrong by what she said about thanksgiving but it stems from ignorance!
    Remember..."knowledge is power"!
    Everyone here has given you that so use it to your advantage <3
  • nvmomketo
    nvmomketo Posts: 12,019 Member
    I thought I'd post my thanksgiving meal (I'm in Canada so it was a month ago). We had:
    • turkey
    • stuffing (heavy on sausage, onions and celery)
    • gravy
    • mashed carrot and turnip casserole (no sugar)
    • cranberry sauce (used stevia and no sugar)
    • mashed potato
    • roasted veggies (yam, snap peas, onion) in a roasted small pumpkin
    • roasted shredded brussel sprouts and bacon
    • ham
    • salad
    • pumpkin pie (no sugar) on a cookie crust, and one with more egg and no crust
    • whipped cream (with steavia and spices)
    • chocolate vanilla swirl cheese cake squares (stevia)

    I ate small amounts (large tablespoon) of the carrot casserole and stuffing. I took a small spoon of cranberries for the taste on turkey. I used a small amount of gravy on the turkey. I also did not eat huge servings of the roasted root veggies. I had lots of meats, sprouts, salad and two types of dessert, and extra helping. I also had a bit of coffee with my whipped cream.

    It was a feast. Being a gluten free person with insulin resistance did not hold me back. I doubt my guests had any clue that their meal was GF and low carb. ;)

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