[Amian]

Hey all, got a question.

I'm an overweight type 2 with fairly low numbers, so my doc doesn't want to do meds just yet. She said I should try to control my diabetes through diet and exercise.

I know that losing weight will help and I am working on it. I am also testing several times a day to see what makes my BG go up and down. Seems like only very low carb meals keep it under 140, which is my goal. However, my diet plan also includes 2 meals a day with some healthy carbs that raise my BG to over 150, sometimes over 160.

My question is... when my doctor speaks of controlling it through diet, does she mean I am supposed to eat only meals that keep my BG low?

Or is the idea mainly to follow a weight loss diet (putting up with reasonable post-prandial highs in the process) with the expectation that when I am thinner the carbs won't cause my BG to go up?

I hope that was clear enough to understand. Thanks in advance for any help.

[princesslinda]

In my opinion, being diet/exercise controlled means that if you are successfully controlling your blood sugars, they should be at the same levels as that of a non-diabetic. I am on metformin, and the doctors told me to aim for non-diabetic levels, the assumption being that if you have the levels of a non-diabetic, you'll have the same risk factors complication-wise as that of a non-diabetic.

I was told that my 2 hr post meals readings should be 140 or less, and my personal goal is 120 or less.

Even on metformin, if I don't stick to a strict low-carb diet, I note higher post meal readings. That being said, there are times you just have to have something that may not be the best for your blood sugar. At those times, exercise more and eat only a small portion of whatever it is, then check and see how it affect your blood sugar, as each of us respond differently to different foods.

As you continue to lose weight, your blood sugars will probably lower and your post meal #s may lower as well; however, it's a safe bet that the more carbs you eat, the higher your blood sugar will go, esp. if you eat very much in the way of potatoes, rice, pasta and bread.

If i'm going to eat something with more carbs, something like a burger on whole wheat bun, i'll make sure that the rest of the day, i've eaten pretty low carb. I also drink a little vinegar mixed with water and Splenda just before my meal and this does help with your post-meal #'s.

Sounds like you're being very proactive in your diabetes management. Keep up the good work. Hopefully, you'll be able to stay off meds for a long while, but don't let the fear of meds cause you to ignore your blood sugars if they begin to rise as time passes.

Lastly, keep an eye on your A1C, as it is a good indicator of your control.

[hannahanne]

I'm sure that your doctor means that you should only eat foods that keep your blood sugar low. And I know that this is very, very difficult, but the alternative is worse. If you don't keep you blood sugar down, then your diabetes will progress; and you will need medicine to control it. Taking medicine is not the end of the world; I take metformin. However, it's to your advantage to put off having to take medicine as long as possible.

And don't be too hard on yourself! Having diabetes is a constant struggle, but it gets easier as you learn how to deal with it.

[pdxdennisj]

Been there, done that. I was diagnosed with a BG of 327 and I weighed 215 lbs. My doctor (the head of the Gladstone Institute in San Francisco) had me go through training with his dietition and also placed me on medication (glipizide) to control the BGs. I lost weight and when I got down to 187 I started having hypoglycemic episodes. He pulled me of the meds an all my numbers were in the "magic zone" for a couple years until I gained weight again. One of the posters opines that control indicates Bgs of a non-alcoholic. That is a very good thing and laudable. It isn't, however I tink, what doctors usually mean by "control". I think "control" means below the following values. The Joslin Diabetes Institute (Harvard)suggests an max A1c of 7.0 (Avg. BG=171).The American Association of Endroconologists suggests a max target A1c of 6.5 which equals an average BG of 154. When my A1c was 6.5 my Endo was quite content. My A1cs are now running between 5.5 and 6.0 but that is only with meds. Lower is better.

[wiseguy]

Originally Posted by Amian

I'm an overweight type 2 with fairly low numbers, so my doc doesn't want to do meds just yet. She said I should try to control my diabetes through diet and exercise.

I applaud your doctor for giving you the option to control your BG levels without meds as most do not. I think that princesslinda gave you a very accurate response to your question. While some associations will give you BG numbers to "settle" for, it is only common sense that to avoid all complications of diabetes you must maintain non-diabetic BG levels.

Originally Posted by pdxdennisj

One of the posters opines that control indicates Bgs of a non-alcoholic.

Hmm... I guess as long as the non-alcoholic is also a non-diabetic.

[amyjo29]

I am also on just diet and exercise. I am not overweight but have to control my sugars through what I eat. I eat low carb healthy meals. Yes, I do occasionally eat a low carb but not so healthy meal every now and then. When you eat healthy your sugars will be fine. Just stay away from all the starchy stuff; rice, bread, potatoes, pasta. If you do have to have these stuff which I admit I do...then eat a very small portion. For example, I LOVE velvetta shells and cheese so when I make it for my husband I take one or two bits of his and thats it...just to cut the craving and not deny myself. I also do that with starbucks but I would not recommend drinking the whole thing...just a sip or two. Drinking your carbs is not good because it goes right to your blood stream cause there is nothing to break down and digest.

I do need to have a break from being diabetic so I give myself 2 meals a month where I eat what I want and don't test and not worry about it. If your sugars stay pretty much in control the majority of the time as mine do (I'm like you and am at the very beginning stages of diabetes) it won't matter because your overall A1C is what counts. Just don't
do it everyday or every week.

[Amian]

Thank you all for your help. I will work on getting my carb count down.

I don't know how such a plan will work out for me over the long term, though. A diet of nothing but meat, eggs and low-carb veggies sounds awfully bleak. I don't care much about bread, pasta, rice or cereal. But I like to have dairy and a little fruit each day, and these are the things that keep pushing me too high.

I wonder if I went on met, would I be able to add these items back to my diet? I'm not opposed to meds and the doctor might be willing to try them if I ask.

Princess Linda, I forgot about the vinegar! I experimented with it for a few weeks and found it helped keep my numbers lower after a normal meal (alas, it did not seem to have much effect on a snack of half a pound of peanut M&M's ) I quit using it because I thought it might be upsetting my stomach but maybe I will try it again and see.

[Harold]

Originally Posted by Amian

I don't know how such a plan will work out for me over the long term, though. A diet of nothing but meat, eggs and low-carb veggies sounds awfully bleak. I don't care much about bread, pasta, rice or cereal. But I like to have dairy and a little fruit each day, and these are the things that keep pushing me too high.

Try adding green vegetables to at least two meals a day. They are low carb, have most of the vitamins and minerals you need, and they fill you up because you can eat a lot of them.

[sweetcheeks]

to be nutrionally balanced, you need to eat fruit, just not alot of it.

Banana's = bad for most people
they have more carbs

try a small apple, a couple strawberries, a bite or two or watermelon etc. Even if you want to take bites here and there all through out the day in stead of having the hole serving at once.

Grapes for instance.... roughly 10 grapes...
2 with breakfast, 3 snack between meals, 2 lunch and another 3 between lunch and dinner.. That might even out the higher readings

[HelenM]

My question is... when my doctor speaks of controlling it through diet, does she mean I am supposed to eat only meals that keep my BG low?

Or is the idea mainly to follow a weight loss diet (putting up with reasonable post-prandial highs in the process) with the expectation that when I am thinner the carbs won't cause my BG to go up?

I'm sure that your doctor means both! ie controlling bg and losing weight. Losing weight in itself will help lower insulin resistance.
A moderate carbohydrate diet will probably help reduce BS but you won't lose weight if you replace the calories from carbs with calories from other sources. As Harold and Sweetcheeks said green veggies and fruit are part of a balanced diet. The calcium from mik products is also very important. You might consider investigating a low glycaemic index rather than low carb diet. Theres an intro to low GI eating for type 2 and prediabetes at GI News
Whatever you decide to do, keep track of your changes by keeping up with your testing and you'll discover what works for you.
And don't forget the other part of the equation : exercise. If you look up my link on diet and scroll down theres a a short article suggesting that as little as fifteen minutes a day can be beneficial in lowering BG levels.

[jvetter18]

Don't forget, the dr. wants you to use excersice as a tool as well. You can eat a fairly carby meal, excercise an hour after (cardio 30-60 minutes) and have 2 hour post prandial of less than 100. This is how i manage my diabetes. I eat sensibly througout the day, no meals higher than 40g carbs, then i can eat sensibly for dinner (don't have to watch the carbs as much if i'm going to excercise).

the excercise helps w/ insulin resistence, and metabolism. (and weight loss )
I'm sure the Doc doesn't want you to be over 140 at anytime. You should be aiming for non-db #'s, it's always a good goal, and it's achievable.

Remember, it's not a quick fix, it's a lifestyle. Good luck!!