[lbvandamme]

Hi everyone,
I'm Lisa and I just joined the forum. My BIL is type 1 and is on here all the time and he told me about it. I'm hoping to get some inspiration from my fellow GD mamas.

I had borderline GD in 3rd trimester with my first baby. I found it pretty easy to control with diet, and it didn't seem to have any effect on the baby. He was born 6 lbs 8 oz, so not too big. The worst part was having my BS taken in the hospital during labor. I treated myself to a big fat bagel the next morning after delivery... ah bliss!

This time, I'm borderline again, but not controlling it so well. I actually hit 2 of the 4 exact values in my 3 hour Glucose Tolerance Test... my OB said it was the 1st time in his career he'd seen that. )

I have a basic question. To test for BS, should I be waiting an hour after the beginning of the meal or the end of the meal. I assume it's the end, but just thought I'd check. Also, if I'm drinking a decaf coffee with breakfast sweetened with a little agave nectar, should I wait to test BS until I'm done that too? I probably should just cut that entirely.

I need some inspiration for BS-friendly snacks and meals. Between not really being in the mood for anything except for carbs, it's hard to snack. I don't really like nuts. I've mostly been eating cheese or small amounts of fruits. Any other suggestions for easy to grab snacks?

For breakfast I've been struggling also. If I eat an egg on 1 slice of wheat toast, I'm fine. If I stray from that my BS is high. Yesterday I had 1 slice of wheat toast with cinnamon sugar(splenda) and 4 strawberries, and my BS was 169 at 1 hour!! And I was starved. Today I ate 1 slice of wheat toast with tuna salad and cheese, and it's 147. I think what may be messing me up is that decaf coffee with agave nectar. Agave is supposed to have a lower glycemic value, and I'm probably getting a total of a tsp of it, but maybe that's increasing my BS because it takes me a while to drink it.

Anyway, just looking for some inspiration here. My 32 week appt with OB is on Monday and I'm going to ask for a referral to a good GD dietician.

Lisa

[HarlDelos]

* Postprandial blood sugar levels are based on the time since you STOPPED eating, not the time you started.

*Preprandial readings are probably more reliable.

* Learn to take your coffee black. Sweeteners make you both hungry and thirsty, even if they are non-nutritive sweeteners.

* Lipids are a problem for diabetics; we tend to form plaque in our blood vessels, eventually leading to stroke or heart attack. Cream is less a problem, and so is raw milk, because the fat globules are larger. Non-dairy creamers are a big no-no because they are made with tropical oils, or with hydrogenated oils. "Hydrogenated" means "yes, it contains trans fat, even if it says 0 grams trans fat on the label" and it really should be a no-no for anyone, whether diabetic or not.

* Cheese isn't protein; it's fat. Honest injun.

* It's hard to carry around proteins because most of them need refrigeration, so look for high-fiber snacks instead. Yes, an apple is high in carbs, relatively speaking, but it has a lot of fiber.

You didn't mention the other famous problem of women in a family way, but fiber helps that. Some diabetics have a similar problem because of neuropathy in the colon. If you eat a high fiber diet, it keeps things loose, and your digestive system operates at a higher speed. The end result is not only do you have less of a problem with your sitter-downer when you visit the Porcelain Palace, but you also digest less of the food you eat, which helps keep your blood sugar down.

I use spoon-size shredded wheat as a snack. They are sugar-coated, but the large biscuits are not very snackable. They actually help keep my blood sugar down. So do baked potatoes. That doesn't make sense - potatoes are supposed to boost your blood sugar - but in actual practice, they help a lot, both in terms of avoiding constipation and fighting high blood sugar.

The longer the food dwells in your belly, the more of it gets absorbed, believe me. They say what you eat, minus what you exercise, is what you gain, but in fact, most of what you eat gets contributed to the Metropolitan Sewer District anyway. If you send 90% of the calories down the drain instead of 80%, it's like you're eating half as much.

I'm not sure there are ANY good diabetes dieticians around. I've been reading the clinical recommendations and the scientific research on the diabetes.org site since 1994, and the diabetes educators are all spouting nonsense from the 1980s or earlier. Our cells need the same nutrients anyone else's cells need - 10% saturated fat, 10% monosaturated fat, 10% polyunsaturated fat, 15-20% protein, and 50-55% carbohydrates. You can prevent blood glucose peaks, to some degree, by getting complex carbohydrates rather than simple sugars, and by eating smaller meals more frequently rather than larger meals less frequently. Most of the research says the "don't eat before bedtime" rule is bunkum, but my experience says otherwise; maybe that's because I experience Sjogren's Phenomenon, though.

The thing is, if you meter frequently, you can learn what works for you. What works for other people really is immaterial, so take everything with a grain of salt (including advice from me.) Oh, and be careful about that, too; too much salt is bad for a person.

Hang in there, and good luck!

[Harold]

Originally Posted by HarlDelos

* Postprandial blood sugar levels are based on the time since you STOPPED eating, not the time you started.

Postpandial 2 hours post first bite by the general consensus here. Do you have some new guiding material?

[HarlDelos]

Diabetes Dictionary: P - T

Postprandial blood glucose is the blood glucose level taken one to two hours after eating. Not after starting to eat.

A postprandial brandy follows the meal, as does postprandial oratory, rather than occuring during the meal (that is, after starting the meal.)

The idea of a postprandial reading is see what your blood glucose reading is after your body has had an opportunity to recover. I've been at banquets where it took longer than two hours for them to complete service of the meal. Other times, I've grabbed a meals in ten minutes. You're going to get considerably different results if your body has had 1 hour and 50 minutes to recover, versus having not completed eating yet.

[ShottleBop]

Many of us find that strictly controlling our carb intake greatly assists us in maintaing acceptable blood sugar levels. Check out the "Low Carb Daily Dieting" thread under "Dieting", for example. Definitely, different folks respond differently to the same foods; the safest thing to do is to eat to your meter--use your post-prandial tests to guide what you eat.

[1st_rate_mate]

Anticipate 30 minutes BEFORE meals.
The idea is to keep from spiking.
Remember - insulin=energy.
Food (protein; carbohydrates; lipids; vitamins; minerals) is just stuffing.

jb@burnettfoods.com

[lbvandamme]

Thanks for all the feedback. I've learned a lot over the past few weeks. I was getting really frustrated with myself because I was beating myself up for every glucose value over 140, and basically cutting my carb intake so low that I started to lose weight... not a good thing late in pregnancy! I'd only put 13 lbs on by 32 weeks, and then lost 3. Now I've happily put 1 more lb back on since my diet adjustments.

I met with an excellent dietition and finally gave in and went to a endocrinologist. The dietition thinks I was cutting my carbs and calories way too low and that was causing my blood sugar to swing from high/low extremes. She also told me to cut myself a break, and realize that I'm not in full control of what my pancreas is doing in response to the the baby's placenta, and if I end up having to go on insulin or an oral agent, that's ok.

Now I'm on a much more reasonable diet. She gave me a goal of 248g of carbs a day, spread throughout the day into 6 small meals. That seems like a HUGE amount of carbs - about 14-16 servings a day, and I'm not usually able to consume that much. I usually get about 10-12 servings in. But, I'm amazed that my blood sugar is actually pretty close to normal throughout the day, or at least no worse than it was when I was depriving myself of everything. I try to mix carbs with protein and/or fat with every meal. She felt that it was less important whether the carbs were complex or simple, but of course complex is more filling and more fiber usually, so I still try to go in that direction.

Endo said I should pick one kind of carb at each meal, and not to mix too many. Like, if I eat a bowl of cereal, I shouldn't put fruit in it also. Either do the fruit or the cereal. I'm not sure I agree with that if the total carb value only adds up to the appropriate amount.

My fasting glucose is fine, but I'm definitely most insulin resistant in the morning after breakfast. I also just started checking my ketones this morning. Not so easy to pee on a stick when you can see past your huge belly!!!

I asked about the timing of the post-prandial reading. Nutritionist said that it's generally 1 or 2 hours after the "first bite", assuming most meals take 20 min or less to consume. If a meal takes longer than that, then figure about 40 min after the last bite.

Daytime snacks - I'm trying to get better about bringing an apple or pear on the road with me. I bought a box of high fiber breakfast bars that were 2 servings of carbs for when I'm in a pinch. Not the best I know, but better than not eating at all which is what I was doing before.

Exercise after meals... most of my daytime meals are in the car while driving or at a customer's office. I don't really have an opportunity to exercise. Nutritionist said even just some simple stretches after a meal, even if it's arm stretches at a stop light will help to move energy (glucose) through the body and can help metabolize the food better.

Interesting conversation/debate between the ob/gyns and the endocrinologist. If I do end up going on meds, the endo wants to do insulin, the ob's prefer glyburide. There's data that shows that glyburide is just as effective, doesn't cross the placental membranes, and is easier for patient compliance (of course!). I thought I'd be on something already, but both my ob and endo thought I was doing much better with diet control than I thought I was doing. So... I've got a pass for 2 more weeks without meds unless things change.

Again, thanks for all the input!

Lisa