Very confused. Please help

[Superjew78]

I am 30 years old, i was just recently diagnosed with type 2 diabetes and high cholesterol. My A1C was 9.3 :( and my cholesterol was 395. Also my Triglycerides were 2600 when normal is <150.

Now On friday i was given 2.5 Mg of glipizide once daily and 20 mgs of pravachol also once daily. My dr said i need to eat better and he wants me to see me in 3 weeks. Didnt give me a diet or anything. My mom works at the local hospital and called to the hospital Dietitian, She gave me a ADA 1700 Calorie diet based on my BMI and age and such. Now with this diet i am to have 15 total carb "exchanges" . 10 Starch, 2 Milk, 3 fruit. Thats something along the lines of 225 grams of carbs a day! If i am calculating this right.

Now while taking my medicine as prescribed and following this 1700 calorie ADA diet. My blood sugar (which i just started monitoring friday evening). Has gone anywhere from 281 to my lowest of 160. But it will jump from like 160 then like 2-3 hours later to 210. I havent cheated and i am commited to getting this under control.

Is that normal for being on medicine and following the diet? Or is it going to take like a week or so for my body to regulate itself?

Also isnt that a bit much on the way of carbs for me? I dont know what to do

[cyberus]

In my opinion that is way way way too many carbs ... thats 4 times what I eat a day and thats after I got a grip on this thing in the last 6 weeks, the first week after finding this forum I was down to <40 a day until the meds started to kick in.

[NoraWI]

You are right! That is the standard ADA diet and it has way too many carbs! Read Dr. Bernstein's "Diabetes Solution." He recommends 30g of carbs per day. Perhaps a bit low, but do-able. In any case, omitting anything made with grain... pasta, bread, etc... corn, rice, potatoes, fruit will bring your blood glucose numbers down. Then you can test before you eat and then one and again two hours afterwards to see which foods and how much of them your body can tolerate.

[cyberus]

You are right! That is the standard ADA diet and it has way too many carbs! Read Dr. Bernstein's "Diabetes Solution." He recommends 30g of carbs per day. Perhaps a bit low, but do-able. In any case, omitting anything made with grain... pasta, bread, etc... corn, rice, potatoes, fruit will bring your blood glucose numbers down. Then you can test before you eat and then one and again two hours afterwards to see which foods and how much of them your body can tolerate.

Yeah .. thats also very important TEST TEST TEST ... some carbs spike one persons BG and doesn't bother others.
For me its tomato sauces :( only italian type sauce I can do with tomato is to toss some diced tomato into white (olive oil) sauce for the flavor.

[Superjew78]

i test 4 times a day. I dont think the medicine i am on is working right. I spoke to my uncle (he is diabetic and takes the same medicine) and he said the medicine i am on is fast acting and isnt a medicine that lasts all day.

I always test right before i eat and i take my medicine right before breakfast. I also eat breakfast lunch and dinner and a snack before bed. These were my readouts while on the 1700 calorie diet, following it to a T.

281 - 8-8-09 9:30pm
218 - 8-9-09 9.00am
236 - 8-9-09 12:36pm
174 - 8-9-09 4:00pm
179 - 8-9-09 10:30pm
199 - 8-10-09 9:10am
230 - 8-10-09 12:36pm
160 - 8-10-09 5:00pm
219 - 8-10-09 8:30pm

[Noturningback]

I know how you feel and so do many people here. You've just learned the truth. The diabetic diet is not a good diet for diabetics. Ironic huh?

As someone said, read Dr. Bernstein's Diabetes Solution. It is extremely informative even if you decide not to use his diet. He suggests 30 grams of carbohydrates daily broken down to 6g - breakfast and 12g for each lunch and dinner. I know that is a low carb diet and may seem difficult at first but, when you keep your protein moderate and stop being fat phobic - like "they" have told us, you'll see your blood sugars stabalize and you will not crave the carbs plus, you will be satiated. I worked myself from a zone diet to Dr. Bernstein's 30 grams.

I wish I had known this information years ago. Personally, I worked out like a crazy woman and dieted contantly using the typical high carb, low fat diet and all I got for my effort was more weight. Thanks to the wonderful advice given to me here, I have lost 11 lbs without exercise, due to an injury, and my blood sugars have normalized greatly. That has only been since July 1st.

When your numbers stabilize and you loss excess weight - if you have any to lose - you may be able to increase your carbs.

Test your blood sugars often and you will quickly learn what you can and can not eat.

~Danielle

[Superjew78]

IS that including dietary fiber? since you arent supposed to really count that in your carbs. that seems awfully low for carbs. I am not even sure how you could break it down to 6 for breakfast. Would that be like 1/4 of a peice of toast? :D

[matingara]

IS that including dietary fiber? since you arent supposed to really count that in your carbs. that seems awfully low for carbs. I am not even sure how you could break it down to 6 for breakfast. Would that be like 1/4 of a peice of toast? :D

worrying about fiber isn't worth it. just count the carbs.

and - yes - 6g for breakfast would be 1/4 piece of toast!

so forget eating toast. also avoid, potatos, pumpkins, pasta, rice and fruit (except avocados).

try having a 2 egg mushroom omelette with bacon for breakfast.

here is a link to some low carb recipes -> Atkins (http://www.atkins.com/Recipes.aspx)


:)

-- Joel.

[Superjew78]

I will look into that book tomorrow. How much protein are you allowed on that diet? I mean with that low of carbs it sounds like you will go hungry?

Can someone describe what a typical lunch or dinner would consist of on that diet?

I am just confused since i am over weight, diabetic, have high cholestoral. My grandmother died from complications due to diabetes. She was blind, had kidney failure, was on dialysis and took a massive heart attack.

[cyberus]

I will look into that book tomorrow. How much protein are you allowed on that diet? I mean with that low of carbs it sounds like you will go hungry?

Can someone describe what a typical lunch or dinner would consist of on that diet?

I am just confused since i am over weight, diabetic, have high cholestoral. My grandmother died from complications due to diabetes. She was blind, had kidney failure, was on dialysis and took a massive heart attack.

Yesterday I had for my meals
.. a 2 fried eggs and sausage patty for breakfast 2g carbs
.. tuna salad in half a ww pita with some radishes on the side 14g carbs
.. cottage cheese and Dole romaine salad mix salad with turkey and parm vinegarette 9g carbs
.. salisbury steak with mushroom gravy and green beans 16g carbs

Total carbs 41g

[matingara]

How much protein are you allowed on that diet? I mean with that low of carbs it sounds like you will go hungry?

well. try to eat as much protein and fat as it takes to fill you up. you feel full much faster on these foods.

also, with this lower carb diet you should/may find that you are almost never hungry except at meal times! that is what i experience.

i think you will find that protein and fat are self limiting.

:)

-- Joel.

[matingara]

.. salisbury steak with mushroom gravy and green beans 16g carbs

last night i made beef schnitzel with a home-made garlic/mushroom sauce. with a side of a globe artichoke and home-made vinaigrette.

number of carbs = low...

:)

-- Joel.

[matingara]

Can someone describe what a typical lunch or dinner would consist of on that diet?

for lunch today i am having (as we speak) a caesar salad (cos lettuce, chicken, hard boiled egg, bacon.

i replaced the croutons with sliced black olives.

number of carbs = ? = low though.

-- Joel.

[Superjew78]

I just picked up the book today. Going to read it further now.

I took it upon myself to switch what i had for breakfast today. I had 2 egg beaters with mushrooms, red peppers and a slice of Slender American cheese melted in. (No carbs) and a piece of toast. (12carbs) I had the toast because i am on medicine and i didnt want to bottom out. So i had a piece of toast to be safe. Its still like 4 servings less of carbs then my "diet" recommands for breakfast.

My diet recommends i have 5 carb exchanges, 3 starches, 1 milk 1 fruit. 1 meat exchange and one fat exchange.

[Noturningback]

Most low carb diets are high fat and moderate protein.

Another great book is Gary Taubes' Good Calories, Bad Calories.

It took me time to realize how low in carb I needed to go. Honestly, I went through denial because for my entire life, I was told to eat low fat and that grains are good for us. I kept thinking no bread ...no rice? How about brown rice or whole wheat bread with 10 grams of fiber - that must be good?

However, a carb is a carb. That isn't to say that they are the same nutritionally. However, they will both spike blood sugar no matter how healthy it seems. If you keep the carbs low and make sure the few you choose are high fiber/low GI. Your numbers will stabilize. If you were to follow the ADA diet, you'll most likely pump large amounts of insulin into yourself as well. Some people choose that route because they don't want to give up the carbs. Personally, I'd rather cut carbs and avoid as much medication as possible.

~Danielle

[xMenace]

I will look into that book tomorrow. How much protein are you allowed on that diet? I mean with that low of carbs it sounds like you will go hungry?

Can someone describe what a typical lunch or dinner would consist of on that diet?

I am just confused since i am over weight, diabetic, have high cholestoral. My grandmother died from complications due to diabetes. She was blind, had kidney failure, was on dialysis and took a massive heart attack.


For lunch (ya, early - I'm in AST too) today I bought a salad and a bowl of clam chowder. I bolused for 30g (lotsa cream/milk).

Saturday night I had a plate of EVOO stir-fry beef which had an assortment of veggies including three types of beans from my garden. Zero carbs but I bolused some anyway. Meat will make me rise as does consuming anything.

I cheated yesterday ;)

[Superjew78]

well after what i had for breakfast, 2 egg beaters, some mushrooms mixed in, a slice of slender cheese and a piece of toast. My blood sugar was at 188, 2 hours after breakfast. thats still high for having only like 15 carbs.

[princesslinda]

Try having 2 scrambled eggs with cheese and bacon for b/fast (or egg substitute and turkey bacon)..no toast, and see what your #s are afterwards.

How was your blood sugar before b/fast? It may be that your morning #s are high to begin with, then your breakfast takes it even higher.


Here's my menu from yesterday:

B/fast: 2 eggs, 2 slices bacon, hot tea

Lunch: Chicken fajita on low carb tortilla w/grilled onions and peppers, cheese and s/cream, salad with balsamic dressing

Dinner: Green beans, baked sweet potato w/splenda and cinnamon, baked pork tenderloin

Evening snack: 1/2 cup Breyer's carb smart choc. icecream.

[BrianSCohen]

I just picked up the book today. Going to read it further now.

I took it upon myself to switch what i had for breakfast today. I had 2 egg beaters with mushrooms, red peppers and a slice of Slender American cheese melted in. (No carbs) and a piece of toast. (12carbs) I had the toast because i am on medicine and i didnt want to bottom out. So i had a piece of toast to be safe. Its still like 4 servings less of carbs then my "diet" recommands for breakfast.

My diet recommends i have 5 carb exchanges, 3 starches, 1 milk 1 fruit. 1 meat exchange and one fat exchange.

Superjew,

Welcome to the forums. I'm sorry you did get more support in how to deal with diabetes. The drug you were give (glipizide) pushes your pancreas to produce more insulin. It may or may not be effective for you at this point. It would not be the first drug I would suggest for a type 2, in my opinion a better opionion would be metformin. You should ask your doctor about metformin next time you see him. Don't worry about your cholesterol, your triglycerides will come down when you get your diabetes under control.

The most important thing right now is to work on your diet. Drop the exchanges, use a low carb diet. It is enough to just understand where all the carbs are in food and to count them. Target 20-30 grams of carbs for each meal max, lower if you manage it.

Come back here for help and support. People here are very knowledgeable and generous with their support.

[Superjew78]

Thanks Brian!

As for metformin, i tried that once before and i had a bad side effect to it. First night i took it i had severe diarrhea. So that ended that.

Well 188 was my lowest morning since i started monitoring. Since then i have been checking and my Blood sugar is slowly going down and its consistent. Unlike when i was on the ADA diet it was sparratic going from like 160 to 210 in 3 hours. Today my blood sugar has gone from 206 before breakfast, to 188 2 hours after to 174 before lunch then 166 before dinner.

For lunch i had a turkey breast & cheese wrap with a side salad.

For dinner i just had some ground turkey breast with red peppers and mushrooms, some cheese melted on it and some broccoli.

I know i had alot of turkey today but i usually dont, I do switch it up with fish and chicken and such. Typically i am having about 10-15 carbs a meal. For breakfast tomorrow i am going to cut out the Carb and make sure i dont bottom out.

The only real way i watch my cholestoral is by not eating a ton of seafood and i avoid eggs. I just use egg beaters. I like how they taste anyway.

Anyone have any suggestions on how my first days meals were? should i cut some stuff out or add something else?


Oh also as for my doctor, i am planning on switching. I gave him my readings today and his response was to double my medicine as opposed to cutting out some of the "15 carb exchanges." So i am taking it upon myself to do this diet and go from there. Thats why i am hesitant to completely cut out carbs right from the start. I want to see how my body reacts. So far i seem to be doing good.

As for a snack at night, before bed, what do you guys recommend?

[cyberus]

well after what i had for breakfast, 2 egg beaters, some mushrooms mixed in, a slice of slender cheese and a piece of toast. My blood sugar was at 188, 2 hours after breakfast. thats still high for having only like 15 carbs.

You need to check your math on the carbs, the slice of toast probably had least 15 carbs (bad carbs as starch and sugar spike you), egg beaters 1g per 1/4 c serving, the so called slender or "diet" cheeses tend to have more carbs to lower the fat so I'm gonna guess 3 carbs there, and mushrooms are high fiber water vegs so we'll skip those.

So "only like 15 carbs" was probably more like 20 and the toast carbs were the bulk of those .. which is most likely to be the culprit for the spike.

[Superjew78]

The cheese is land o'lakes slender which has 6 fat, 1 carb & 7 protein according to their website (http://www.landolakes.com/products/ViewProduct.cfm?ProductID=48856) and the bread i was using has 13 carbs per slice. I only had the bread for the reason of making sure i didnt bottom out with my blood sugar.

The one thing i am actually good at is getting down to exact counting with nutrition info.

Actually 188 isnt really a spike for what my blood sugar has been at, anywhere from 160-230 on that stupid ADA diet, that had me having 15 carb exchanges. My blood sugar hasnt been consistent till today, when i started to drastically cut down on my carbs. Its starting to come down so i will notice more tomorrow. Thanks for the tip though. :)

[Dan Gato]

Hi Super,
Welcome to the Forums :shakehand

Good that you're following a low carb diet, that's the key to better BG's reading.

Give it another try to Metformin, maybe a very low dose,
It's OK to split/cut the pills. you can take it like half hour before a meal, I do it.
Metformin helps with weight loss.

Don't drink regular sodas, I drink diet coke.

Eat broccolli, spinach, cucumbers, salads, fish, avoid breads.

[GeishaGirl]

Thanks Brian!

As for metformin, i tried that once before and i had a bad side effect to it. First night i took it i had severe diarrhea. So that ended that.
. . . . .
As for a snack at night, before bed, what do you guys recommend?

Dude, I've been on Met for a year -- I get those diarrhea attacks about 2-4 times a week. You do what you have to do to avoid something worse. Sometimes you have to take the side effects if it IS the best medicine for you. (It may not be, but this is my story :))

As for the snack at night, try something more protien/fat oriented -- cheese, or half an apple with peanut butter if you want a few healthy carbs.

[Superjew78]

i got the diarrhea to the point i couldnt walk it hurt so bad.

As for the snack i was thinking maybe like a string cheese. They only have like 1-2 carbs in them.

[cyberus]

You might also ask to try the ER (extended release) version of metformin .. it helped me with the side effects a lot ... and if you were eating "normally" aka lots of carbs it seems to make the effects worse for many people

[Superjew78]

Maybe i will try that.

I have another question. I have cut down my carbs to about 60 a day, started today. Is it going to take more time for my blood sugar to drop alot more? Cause my lowest reading today was 166. and i am not having alot of carbs.

Just wondering if it will continue to drop if i stick with this or should it have dropped more already?

[cyberus]

Maybe i will try that.

I have another question. I have cut down my carbs to about 60 a day, started today. Is it going to take more time for my blood sugar to drop alot more? Cause my lowest reading today was 166. and i am not having alot of carbs.

Just wondering if it will continue to drop if i stick with this or should it have dropped more already?

This is just in my opinion.

First you are going to have to go lower than that to start .. 30-40 (in my opinion) what you consider "not a lot" seems to be "a lot"

Second you are going to have to take all the bad carbs completely out at first .. bread, pasta, rice, sugared anything ... you can start adding stuff back when you get things under control.

Third .. you have to realize that 188 is a spike .. anything over 140 is considered a problem if its a constant thing. Worrying about "going low" at this stage is a bit premature since low is around 70-80.

Once you get things under control you can maybe try that slice of toast again .. but I'm willing to bet that 2 hours after you eat it when you test you're gonna go bug-eyed and wonder whyinthehell you ever ate that stuff. :)

[matingara]

The only real way i watch my cholestoral is by not eating a ton of seafood and i avoid eggs. I just use egg beaters. I like how they taste anyway.

avoiding eggs is a false strategy. eggs have cholesterol in them - but this cholesterol does not go into you.

the best way to get your cholesterol down is to get your blood sugar down. do this by lowering carbs as near to zero as you can. (see the numbers in my signature).

most of the cholesterol in your body is produced by your liver.

i don't even know what an "egg beater" is but it sounds nasty. real eggs are one of God's given wonders. don't avoid them.

for lunch today i had a two egg, steak, mushroom and (full fat) cheese omelet, yum.

-- Joel.

[notme]

Egg beaters are egg whites. Not nasty at all.

[matingara]

Egg beaters are egg whites. Not nasty at all.

ok! they are not available in Australia - or at least i have never heard of them.

i DO know that Bernstein specifically cites eggs as something not to be afraid of. i was concerned that these beater things might have additives.

give me a good ole free range egg any day.

:)

-- Joel.

[Superjew78]

They are actually made from whole eggs, they have the yolks in them also. They taste just like eggs to me and they have about 1/4th of the cholesterol.

Also, my body seems really out of whack. Last night, before my snack, i tested and my blood sugar was 133. i then had one string cheese stick for a snack. 1 carb some fat and calories. When i work up this morning, before breakfast, my blood sugar was 165. The only thing i ate was that one cheese stick. Is it common for your blood sugar to go up when you sleep when you haven't really eaten?

[cyberus]

They are actually made from whole eggs, they have the yolks in them also. They taste just like eggs to me and they have about 1/4th of the cholesterol.

Also, my body seems really out of whack. Last night, before my snack, i tested and my blood sugar was 133. i then had one string cheese stick for a snack. 1 carb some fat and calories. When i work up this morning, before breakfast, my blood sugar was 165. The only thing i ate was that one cheese stick. Is it common for your blood sugar to go up when you sleep when you haven't really eaten?

That could be either meds wearing off during the night OR Dawn Phenomena, which happens to some people, their body releases glucose to give you the energy to get up and climb down the tree and look for food :D

[davef]

They are actually made from whole eggs, they have the yolks in them also. They taste just like eggs to me and they have about 1/4th of the cholesterol.

Also, my body seems really out of whack. Last night, before my snack, i tested and my blood sugar was 133. i then had one string cheese stick for a snack. 1 carb some fat and calories. When i work up this morning, before breakfast, my blood sugar was 165. The only thing i ate was that one cheese stick. Is it common for your blood sugar to go up when you sleep when you haven't really eaten?

I actually find that my numbers are more likely to be higher if I don't eat something before going to bed. I have also found that if I take my last Metformin dose (500mg) just before bed rather than with my dinner that it helps keep my morning numbers down. It has taken a little time to work out but I've found that about 11.30pm is the optimum time for me to take the metformin and I normally have some cheese (or even a dry cookie) with it.

[matingara]

They are actually made from whole eggs, they have the yolks in them also. They taste just like eggs to me and they have about 1/4th of the cholesterol.

sounds like an interesting product. i am glad you like it.

but it does sound to me like a product borne out of the whole low-fat, low cholesterol craze!

i no longer fear eggs. i no longer fear the real butter i cook them in.

since i have been eating eggs this way and reduced my carbs my cholesterol and triglycerides have been more than stellar (see below).

-- Joel.

[Superjew78]

I am trying to cut down on fat also because i am trying to lose weight also.

I also think my numbers could be high because i am not getting enough medicine.

I didnt have any breads for breakfast or lunch, My carbs came from the mushrooms i used in my eggs. At lunch i had a chef salad with turkey, cheese and lettuce. My numbers are still around 170-180. I am on 2.5 mgs of Glipizide, once daily in the AM.

[Real4]

IS that including dietary fiber? since you arent supposed to really count that in your carbs. that seems awfully low for carbs. I am not even sure how you could break it down to 6 for breakfast. Would that be like 1/4 of a peice of toast? :D

You don't eat toast. Ham and eggs is zero - 0.

[Superjew78]

I am trying to cut down on fat also because i am trying to lose weight also.

I also think my numbers could be high because i am not getting enough medicine.

I didnt have any breads for breakfast or lunch, My carbs came from the mushrooms i used in my eggs. At lunch i had a chef salad with turkey, cheese and lettuce. My numbers are still around 170-180. I am on 2.5 mgs of Glipizide, once daily in the AM.


anyone think perhaps this is to low of a dosage?

[matingara]

i cannot make a comment about dosages etc.

it will take a while for your numbers to come down even if you eat zero carbs. so give it time and be patient.

try eating as few carbs as possible (for 3-4 days) and see if (a) your numbers start to trend downward or (b) your numbers don't start spiking high again.

either of these is s a good result.

then you can see if you can continue low carbing. it does take a few days for your numbers to start stabilizing/going down.

:)

-- Joel.

[Superjew78]

Thanks joel for all the help. My before dinner reading was actually within norms, 107, so i am pretty happy. Hopefully i can keep it there.

[birdyland]

Wow... with cholesterol and triglycerides that high... did they also check you for thyroid issues? If they have not, please insist on it.