"Managing Type 2 Diabetes" (How?)

rheddmobile wrote: »

As stated above, the best thing you can do is to quickly get to a healthy BMI.

What I did to bring my a1c from 11 at diagnosis to consistently under 5 (in the normal range, not even pre-diabetic) is called “eating to the meter.” While a diabetic educator is a good start, every diabetic is at a different place in the disease and different people have different tolerances for the same foods. Eating to the meter means getting a blood glucose meter and strips - I recommend the Bauer Contour next plus but Walmart has a good inexpensive option, the main thing is to get strips inexpensively so you won’t be shy about testing often. They are cheaper on Amazon than at a drugstore. Then test before and after meals until you learn how your blood glucose responds to different foods and amounts of foods. Log everything, count your carbs, and try testing at different times after eating - ADA advice is to test 2 hrs after meals, for example. But in my case bg tends to peak about 45 minutes after eating and is nearly back to normal by 2 hrs, so if I followed ADA recommendations I would never know it was high!

Then plan your diet around the foods and amounts you know you can safely eat and keep your bg within range. Again, I don’t follow the ADA recommendations, which say anything below 180 following a meal is okay. It’s not okay. Anything over 150 is cooking your nervous system and doing gradual damage at that moment. Normal following a meal is below 140. So I aim to keep mine below 140 at all times.

Doing this, I found some surprises - for example, I can eat sweet potatoes and oranges in large amounts without spiking my glucose, but even a tiny amount of rice (including brown rice) or flour tortillas will spike me. I can eat a corn tortilla but not a flour one! And someone else might be completely different. I have a friend who can’t eat tomatoes, which don’t spike me. Another surprise I found was that taking naps wrecks my glucose control - if I take a nap and then eat, a meal which normally is fine will send my glucose through the ceiling!

Doing this is guaranteed to give you the information you need. No doctor or dietician can tell you the results of different foods on YOUR body, but testing will. With this information you can make good decisions and become your own advocate.

Also test around exercise, because exercise affects different people differently. For example, there’s another poster here who gets huge spikes from running, whereas for me running lowers my bg rapidly. Many people see a spike during heavy lifting, but lower bg for hours afterwards. If you test you will learn how it affects you.

In time you will learn the patterns and not have to test as often. I’ve had normal a1c for 4 years now and only test in the mornings, plus when I do or eat something unusual, or when I’m sick. (Because stress and sickness will change your bg.)

Best of luck to you, feel free to ask questions.

russellholtslander1 wrote: »

I would try to get set up to take a diabetic class.. they are a full 8 hour day, and they feed you lunch, and you test, and they explain diabetes in detail, and answer questions. I didn't enjoy it, but I did find a lot of what they said helpful... like finding out why I was supposed to record LOW blood sugar reactions when I was averaging over 300 mg/dL. I thought it could only be HIGH.

Basically, they cut my carbs in half, to 150 grams.. this was 20 years ago, so maybe it's a bit less simple now. You will need a meter, if you don't have one yet, but after you do the class, I'd ask for a referral to see a dietitian, and design a meal plan.

They did yell at me when I asked.. if cutting carbs in half, helps control blood sugars more.. why not cut it in half again, to 75 grams a day? They told me that was dangerous. About 9 years later, I first read Atkins.

How do I control my blood sugar? Without details, I cut carbs more. People vary. Some might see good control with meds and 150 grams of carbs, some might do well at 100 grams. You need to figure out 2 things. One.. how much meds for diabetes do you want to take. If you are fine taking pills, or even Insulin, then you simply need to figure out how to get your A1C down to the proper level. I decided I want to get off meds, so I am much lower in carbs.

So get your meds set, and then start using those blood sugar readings. They want me under 7.0 A1C. Your doctor may desire 6.5 these days. 7.0 is equivalent to an average of 154 mg/dL over the 3 months between tests.. 6.5 is equivalent to 140 mg/dL.

Back when I was diagnosed.. ONE result of 125 mg/dL, and you were a diabetic.. today they have " pre-diabetics ", which I think is just to make the numbers better, but also to give hope to people who might be able to get back below 125 mg/dL, if they make permanent, quick changes. Does it really matter what they label you though? The important thing is that you should want to be at a normal blood sugar, if you take meds for it, right? Why would 140 mg/dL be OK? It isn't. You still have damage, but it's a goal they hope you will be able to reach.

Do you want to NOT know what you should be at though. Why set a goal, where it is still high? a 6.0 A1C is about an average of 126 mg/dL.. which is the high end of normal.

So what is normal? 70-120. So let's split the difference.. 25 pts. and say the average, from 70 in the morning after fasting, to 120 2 hours after your biggest meal. That is 95 mg/dL. at that level, you should be at a 5.0 A1C ( 97 avg ). A healthy person would be 4.5-5.6 ( sources vary ).. so 5.0 is a good goal.

So how would you reach that? Your doctor puts you on meds, and you cut some carbs, eat the prescribed diet.. see the results, although, you will see daily blood sugar numbers, so you shouldn't be too shocked.

Are the results good.. meaning they hit your goal. 7.0, 6.5, or 5.0? Whatever goal you set, did you reach it? If not, did you improve? If so, give it another 3 mos. See if you improve, or reach your goal. I hope you do.

If you don't though, the doctor will only have one choice.. increase the dose of your pills. That has limits though, and eventually Insulin might be suggested. If you do that, you should be able to reach a normal blood sugar. The goal is not to have an elevated blood sugar, so while your doctor may be fine with 6.5 A1C, are you? That is still elevated.

The only other option, if meds don't get you to goal, is stop eating the foods which raise your blood glucose so high.. limit the carbs. It works, because, even at the start, cutting carbs is one of the first things they do. That drops blood sugars, especially if you cut the junk food. Your doctor may be reluctant to drop any more though, and at that point, you may find yourself at max pills, or on Insulin, eating half the carbs you want to, and still have elevated blood sugars. You are slowing the damage, but over time, the damage happens. If you are 65, maybe issues 20 years from now, are not a major worry. If you are 28, like I was.. they are. It's been 19 years for me, and before I decided to cut carbs more, on my own, I had a lot of damage to my teeth.. I lost 6, and had chips, and cavities in 21 more. My vision got worse.

I'm at being full time on Insulin, or eating low carb. So far, I decided to eat low carb.. for many that isn't an option.. but I wanted to state that there are options, and you will want to know them, so you can discuss them with your doctor, and make an informed choice on what your goals are, and how you plan to reach them.

If you ask your doctor if a 6.5 A1C drops you to a level where you avoid most of the damage from diabetes, and why should you average 30 pts. ABOVE the average for a healthy person.. how is that safe? They will likely be stumped. You may want to ask to see a specialist for diabetes.. an endocrinologist, because you PCP basically knows very little other than general ideas to IMPROVE your blood sugars.

Do your own research, read up on the disease, ask a LOT of questions, and if you don't get answers, see specialists, and don't settle for the simple plan your PCP will tell you, UNLESS you get to a normal level of blood sugars, on THAT plan.. it's possible their plan works.. and if so, GREAT!! .. but be prepared if it doesn't, to work with your medical team to form a plan that DOES work. This is NOT a general health issue. It is a deadly disease, which ravages the body, just like heart disease or cancer.. neither of which you would treat the way most people treat diabetes.. you would have specialists, and your PCP would deal with your general health.

Good Luck, whatever you decide. I hope you and your doctors get things under control, and you no longer have to ask for advice on the internet. Make them work to get the results YOU can live with.