[Hammer]

I saw the new thread about nutritious snacks, and that made me remember another question. I don't snack....I just eat two or three meals a day, and I wondered why you should only eat small meals? My logic is this....

When I was still working, I was having stomach problems which the doctor labeled as IBS. Now I think it was related to my high blood sugar, but since I was doing work where a restroom wasn't always available, I tried various things to stop my IBS from being a problem at work. The last thing I tried that worked was to not eat any breakfast or lunch, only dinner. Yes, I had a large dinner, but it wasn't that much larger than I would have eaten if I was eating breakfast and lunch.

If your blood sugar rises after each meal, why not just eat once a day and have only 1 spike for the day? I've found that even though I'm taking Byetta before breakfast and dinner, if I also take 2-3 Prandin before a meal, my BG spikes are almost non-existent. So if I took 2-3 Prandin before my one meal a day, which would be dinner, and the spike was only 25 points higher, then why would that be bad? Once the Prandin and Byetta wore off, the Lantus should keep my BG numbers at a constant level, so there would be no more spikes till the next day at dinnertime, right?

Isn't it better to have only one spike a day as opposed to three (or more if you snack)? I could see if the one large meal made your spike a really large one....say from a fasting level of 90 to maybe a spike of 200, but if you were able to keep the spike under 140, why is that bad?

[davef]

Hammer,

What you say about avoiding spikes by avoiding food, is logical, but the problem is that this disease is not logical. I wondered about this very thing, but it doesn't work. If it did then we would all have great FBG levels, cause we didn't eat. A little while ago I woke to what is a high reading for me (about 117), so I reckoned it would be best not to eat breakfast - wrong - I needed something to kick start me to get the BG's down. I'm having some shoulder/neck pain at the moment and my FBG this morning was 129.6 , but I still made myself eat something small, by lunch time it's down to 113.4, which is high for me but I reckon its "stress" from the neck/shoulder pain.

I did ask my doctor when I was DX'ed if I should be "grazing" and he said no, 3 meals a day, maybe a snack if I get hungry or before bed to help morning levels.

I do find if I skip a meal (not intentionally) that yes I can start to go low, but I can also start to see a bit of a climb in the numbers, guess it's my body kicking in.

Diabetes, wonderfully consistently inconsistent.

[Hammer]

Originally Posted by davef

Hammer,

What you say about avoiding spikes by avoiding food, is logical, but the problem is that this disease is not logical. I wondered about this very thing, but it doesn't work. If it did then we would all have great FBG levels, cause we didn't eat. A little while ago I woke to what is a high reading for me (about 117), so I reckoned it would be best not to eat breakfast - wrong - I needed something to kick start me to get the BG's down. I'm having some shoulder/neck pain at the moment and my FBG this morning was 129.6 , but I still made myself eat something small, by lunch time it's down to 113.4, which is high for me but I reckon its "stress" from the neck/shoulder pain.

I did ask my doctor when I was DX'ed if I should be "grazing" and he said no, 3 meals a day, maybe a snack if I get hungry or before bed to help morning levels.

I do find if I skip a meal (not intentionally) that yes I can start to go low, but I can also start to see a bit of a climb in the numbers, guess it's my body kicking in.

Diabetes, wonderfully consistently inconsistent.

Okay, well that brings up another question. You're on metformin, which you take with/after meals, so if you don't eat, you don't take the metformin. Or, if you do take the metformin without eating, doesn't the metformin control how much sugar your liver releases? If you haven't eaten anything, then there's no sugar for the metformin to control, right?

In my case, I take the Lantus whether I eat or not, so it's always there doing it's thing. There shouldn't be any spikes unless I eat something, so if I don't eat anything there shouldn't be any spikes, and the Lantus is controlling the basal sugar level, so do you think that it's a different situation than if I was just taking metformin?

As you say though, diabetes is so unpredictable that who knows what it will do? What I think is logical may not pertain to diabetes at all since it seems to have a mind of it's own.

[Janlaton]

To both of you. My doctor says take my metformin even if for some reason I do not eat. Unless I am going to the office for fasting blood work.

The liver will try to produce sugar for all sorts of reasons and yes stress and neck pain can make your fbs be high. It can keep it high during the day as well. SO the thing to do is deal with the pain. Take ibuprophern, use heat or massage to relieve the pain and bring down the sugar.

Small meals, or low carb meals, equally spaced with a small snack in between is often recommended, however follow you doctor's guidelines. When we graze it tends to be eat all day long and our body never gets a break from eating. We do not need to do that.

Sometimes I think it would be easier to be on insulin then I would be able to adjust the amt of med as needed but for the present I will be glan that my H1cs are staying low 6s with pills, diet and exercise.

Janlaton
40years type 2

[princesslinda]

Metformin helps you utilize the insulin your beta cells are producing...it doesn't cause them to make more insulin. Often T2s are making lots of insulin, but our cells are resistent to it.

Another class of meds (sulfonylureas) actually cause your beta cells to produce MORE insulin.

If you don't eat and take the metformin, you are more likely to experience some of the nausea/gastric discomfort than if you take it with food.

I think eating 3 meals a day is very important, as you need fuel to keep going throughout the day. If you just eat one big meal, after a few hrs, the benefits of that meal will be gone, you metabolism will slow down and you'll lose less weight....you're going into starvation mode basically...where you body is slowing so it can maintain itself as usual on less food. You need the nutrients you get from food throughout the day for your body and mind to function properly.

[BlueSky]

Originally Posted by Hammer

... If your blood sugar rises after each meal, why not just eat once a day and have only 1 spike for the day? ... Isn't it better to have only one spike a day as opposed to three (or more if you snack)? ...

Hammer,

The thinking goes something like this. If you only had one meal a day, your liver would load up big time with glycogen after the meal. Because of the lack of incoming nutrients, much of this glycogen would slowly be converted to glucose and released into the bloodstream until the next meal 24 hours later. This steady supply of glucose is required to keep your body going, especially the brain. The problem with T2 diabetics is that the control mechanism doesn't work very well and the liver overdoes it. The excessive conversion of glycogen to glucose increases blood glucose to abnormally high levels. This causes blood sugar control to deteriorate.

Eating only one meal a day would also cause huge swings in insulin levels. When we eat, the pancreas produces insulin. But with T2 diabetics, excessive amounts of insulin get produced in an effort to keep blood glucose down. The big swings in insulin levels cause big swings in blood glucose, and in many people it causes reactive hypoglycemia. They go low a few hours after a big meal.

You can get around these problems by shortening the period between meals. Eating more often means that there is a steady supply of nutrients and glucose. The liver becomes less active in supplying the needed glucose, and blood glucose levels are lower. And eating small meals often regulates insulin levels too. The result is better blood glucose control, and hopefully an improved sense of wellbeing too.

Having said all that, I am not T2 so I can't speak from experience. I have just repeated what the experts say.

[volleyball]

If you only eat a little bit at a time, you are not going to spike. It may be higher but not by much.
An analogy could be you had to carry 500 lbs across the room. It would hurt you if you did it at once. But if you took what you could easily carry and made trips, you may not even break a sweat.
Especially if you are on meds that are expecting food to work with. Not being on meds myself, if I skip a meal, I am not going hypo. though if I eat too big a meal, there isn't the help to keep it from going high.

[Hammer]

I hear what everyone is saying and you make some valid points, it's just that seeing how my BG levels react to the various meds and how I eat, I feel that what's going on with my body isn't what you're saying is happening.

There are days when I'm not all that hungry at lunchtime, so I don't eat anything. When dinnertime rolls around, it might be 10 hours since breakfast. My BG numbers are around 111. I'll make a 40 ounce can of Dinty Moore beef stew and add 1 cup of white rice to it. This amount of stew almost fills a 1.5 liter (50 ounce) pot. Before the meal, I've taken my Byetta and 2 Prandin tablets. (I know this isn't the best food to eat, but I have a bunch of these cans. Once they're gone, I won't eat this anymore. I just hate to waste them, so I'll eat them.)

When I take my BG reading two hours after I eat, I get a reading of 134. I'll take a reading 1 hour after that and it'll be around 120. I'll take another reading 4 hours after that and it'll be around 115. I go to bed and the next morning, with the Dawn Phenomenon I'll get a reading of 125.

So my conclusion (right or wrong) is that eating a large meal after fasting for 10 hours has only increased my BG levels by 23 points. If I hadn't eaten such a large meal, I wouldn't have taken the Prandin and my numbers would be about the same or higher.(the Prandin is left over from when I was taking it instead of the Byetta, so I take it on my own to see what happens.)

If I am able to achieve numbers like this, how is this bad? Apparently my liver is responding to the Byetta and Prandin and only allowing a small, steady amount of sugar to be released into my blood, and this steady release never gets that high.

As for how I feel between meals when it's been a long time since I've eaten, I feel fine. I don't feel tired or rundown. I felt the same way when I was only eating dinner. I guess the reason I'm trying to figure this out is because I don't want to eat if I'm not hungry, and if I were to eat small meals, I'd be forcing myself to eat when I'm not hungry. If I eat breakfast, which I usually do, I'm not hungry at lunchtime. I'm never hungry at lunchtime, so I never eat. When dinner time comes, I eat a large meal, but I've always eaten a large meal for dinner....most people do. Once dinner is finished, I'm not hungry again until the next day....sometimes, I'm not hungry for breakfast either.

I've tried eating breakfast and lunch, but then I'm not hungry for dinner, so no matter what I do, there's going to be one meal that I skip. If I force myself to eat three meals, I know it'll just make me gain weight, since I'll be eating when I'm not hungry. If I eat less for breakfast with the idea that this should make me hungry for lunch, it'll just make me eat lunch, but at a later time than lunchtime. Once I eat this late lunch, I won't be hungry for dinner till much later, so I'll have a very late dinner, but the dinner will still be large, only I'd probably eat it around midnight.

[davef]

Hammer,

Just wondering, when you eat Breakfast and Lunch, what are you eating that means you are not hungry for dinner. Personally, since I started in Metformin I don't (or very. very rarely) get hungry, I now eat because it's mealtime, so I try to have something, even if it's only 1 slice of wholemeal bread for breakfast, then lunch soup & bread or meat & bread and then dinner.

[Hammer]

For breakfast I usually eat eggs and sausage. If I don't feel like making eggs, I'll microwave a frozen "Breakfast Bowl" which is one serving of eggs and bacon and home fries.

Lunch I rarely have. If I do eat lunch, it will be a late lunch and it's usually a large tossed salad.(lettuce, shredded cabbage and carrots, fresh broccoli, and a cucumber, topped with fat free, low cal Italian dressing.) Eating this usually means I won't be hungry for dinner.

If I eat breakfast at say 8:30am, then if I eat lunch, it won't be till maybe 4pm, which is actually dinnertime. I may get hungry after these two meals if I stay up late, which I usually do. Staying up late means staying up till 1 or 2 am. If I'm hungry at that time, it's too late to eat. I don't like to eat before going to bed, so I'll just wait till the next day to eat again.

[davef]

Hammer,

At the end of the say, it's whatever works for you. It might be worth considering changing your menu/habits for a week to see how it helps you morning numbers.

Have a breakfast, but cut down on what you have so you are not filling up too much, mug of tea/coffee and an egg with wholemeal (bread/toast). Then try have lunch at "lunch time", maybe a small tossed salad, again to leave room for dinner and then dinner in the evening. That way you might be able to eat some protein cheese/meat (I find a couple of hotdog frankfurters with out bun works for me) before bed.

If you are trying to loose weight, eating more regular meals may help keep your system running and processing what you eat, drinking water during the day can also help. As I say, it's what works for you, mine is only a suggestion for what it's worth .

[volleyball]

Hammer, how big are you? That stew is a lot of food, can explain why you are not hungry and maybe the IBS.
I have no problem with the stew or that amount of rice that goes in it. I do think you are eating too much at one time.
I use to do buffet once a week and it was a 3 plate minimum at our table. At least my choices were healthier than my companions.
After changing my diet, all you can eat buffets are out. I don't even have a desire for them. for your stew, tupperware to break your can into smaller portions. Have it in 2 or 3 meals.
I can go buy a whole pie at the store and bring it home and eat it. Before it may have been 4 slices and its gone. Now its 20 slices and it is a little bit here, little bit there and while I may still only eat a pie a month, now I get to enjoy it past the second day