New ac1, a bit disappointed would like opinions please

[nordgirl]

For background info, here are my type 2 husband's previous ac1's (they were all listed on the lab report which is great because I didn't have any)

Taking Metmorfin and another medication, don't remember the name...

03 Nov 2010: 7.6
11 Feb 2011: 8.6
04 Apr 2011: 8.2
20 Jul 2011: 8.7
14 Oct 2011: 6.9 (starting vegan diet, had lost about 10 pounds at that point)
12 Jan 2012: 5.4 (had lost 30 pounds and was taking 1000 mg metmorfin a day)
02 Apr 2012: 6.5 (had lost 42 pounds and stopped all meds Feb 1st)

Other numbers noted:

Total cholesterol: 143 LDL: 67 HDL: 58 Triglycerides: 91

It's disappointing to see that his previous ac1 was better, albeit with metmorfin. We've only started testing bg a few weeks ago and learnt to alter his diet to avoid spikes. In terms of numbers, his fasting level is usually around 115, and if eating properly will not go over 140. The question is, can we improve on his ac1 just by diet and controlling his spikes or should we consider going back on the metmorfin again? Husband is seeing his doctor tonight so I would be really grateful for your opinions.

[anvu]

does black rice help him? i think the drop from 8.7 is really big improvement. btw, im thinking about taking metformin, but i have heard it might damage the kidney.

[Jan B]

Honest opinions? I just heard you say yes!

A starch based diet is a big red flag. Your diet may be great for non-diabetics, but not so much for diabetics. If you continue this diet, I'd say he needs to get back on the metformin. But, if reducing the carbs/starches, I bet diet/exercise alone might be sufficient. The weight loss is wonderful, BUT it's not the end-all of T2 diabetes. Plenty of T2s have lost all extra weight, but still have to limit those carbs. Just being a great weight doesn't equal diabetic health.

Personally, I still struggle with how many carbs to eat, because I'm not all the way sold on the majority of my diet being fats and protein. But then, I have the choice to balance insulin to carbs. However, I'm stuck in a place of avoiding carbs in general (except for green things) because of the better bg results without them. It's easier not to have to chase carbs with fast acting insulin. If you guys are not going to eat animals, then it would make sense to eat more starches, which would mean he needs the metformin. Too bad we can't all stick to a diet of only green vegetables.

[nordgirl]

does black rice help him? i think the drop from 8.7 is really big improvement. btw, im thinking about taking metformin, but i have heard it might damage the kidney.

He's only had it twice so it's hard to tell

If you guys are not going to eat animals, then it would make sense to eat more starches, which would mean he needs the metformin.

Tell me the truth Jan, you just want him to have one of those bacon cheese ice burgers, don't you?

[Bakerboy]

According to this chart : Hb-A1c to Average Blood Glucose Conversion Table, in mg/dl and mmol/l , an A1C of 6.5 represents an average blood sugar of 154. To get an average of 154, he is probably spiking to 200 or beyond on a daily basis. This is well beyond the level at which damages begin to occur.

Honestly, he needs to reconsider his diet, if he is absolutely wedded to the starch based diet, he is going to have to consider going back on meds. Many people here seem to gain better control with a low carb diet, myself included.

[Bakerboy]

In all honesty, I think his control would improve and his numbers would go down if HE were posting here and not you. Like it or not, all the information from this board is filtered twice by you before your husband gets it. Even with the best of intentions on your part, his information is interpreted by you and posted here. Then our responses are interpreted by you and given to him.

I realize your participation here is founded by love and a desire to help your husband, and I am sure he is grateful for it, but he needs to talk to us, and we need to talk to him. Our message, whatever that may be, is not effectively getting through to him. We and you husband share the same disease, the same problems, and possibly the same outcomes. If you and his doctor cannot adequately explain to your husband that his sugars are at a dangerously high level, then maybe we can.

[Jan B]

Nordgirl - I didn't eat animals for over a year because actually . . . I love all animals and don't like that we eat them! Once, when at a fair, this woman was talking about how delicious this little calf was going to be (while she was petting him!!!). I was sickened. I'm back to eating meat (being protein deficient was a feeling I'll never forget), but I'll never in my life eat veal after learning several years ago about the treatment they get while living, that makes them "taste good". I pet and feed pears to the cows behind my yard. They eat the pears they can reach, but I enjoy hand feeding them more. I have just accepted they will one day be food, but they have lovely pasture and good living conditions while here. Now I'm about to struggle with my own thoughts again.

[Moonpie]

well, if he wants to avoid meds, then he will have to modify his diet, I think all the beans & grains may be making him spike later & longer. ( so you are not catching it in the 2pp) If he wants to continue being a vegan, then he will need meds (IMO)

[jenb]

If you've decided that the starches are integral to a healthy diet, perhaps adding some insulin is something to pursue. It's really the only treatment that directly attacks the issue - carbohydrates.

Jen

[Peggy_TX]

According to this chart : Hb-A1c to Average Blood Glucose Conversion Table, in mg/dl and mmol/l , an A1C of 6.5 represents an average blood sugar of 154. To get an average of 154, he is probably spiking to 200 or beyond on a daily basis. This is well beyond the level at which damages begin to occur.

Nordgirl >> You need to take this to heart. Those are NOT ideal numbers for him.
BUT, there's some "good news" to the results you posted that you might want to consider.
You've only been on this forum since march. That means his A1C only contains 1 month of the results from AFTER you started understanding that many of the carbs he was eating on your diet plan were giving him big spikes.
I think what you're seeing now is validation of what you've been learning this last month -- diabetics are NOT non-diabetics.
It's possible to eat a vegan diet that is going to keep your husband healthy. But that diet is going to be quite limited, as you need to eliminate all those carbs you've been eliminating these last couple weeks.
And, for a "foodie", I suspect that this is going to leave him a depressingly low set of food choices.
Possible? Yes. Ideal? Depends on your goals.
My feedback would be
1) consider getting him back on Metformin if he wasn't having trouble with it before
2) continue to have him test, test and test how various carbs impact him
3) realistically assess his goals and yours. Is it better for him, physically and emotionally, to eat a veggie burger with a carb-laden bun, or an "ice burger"? And it's not "all or nothing" You can and SHOULD "pick and choose" the things you've learned on the diet you've been doing -- MODIFIED by the things you're learning here about what's best for diabetics.

I know you've gotten a lot of flack from how you've approached things here, but you're clearly wanting what's best for your husband and you've been open to things that have been suggested.
Keep that up, and you'll have success.

[IrinaHarr]

12 Jan 2012: 5.4 (had lost 30 pounds and was taking 1000 mg metmorfin a day)
02 Apr 2012: 6.5 (had lost 42 pounds and stopped all meds Feb 1st)

Nordgirl, looking at the list of a1c results he should go back on metformin on the same diet.

[Ela]

Hi Nordie,

Well, you probably know what I’m going to say, don’t you?
Honestly I’m not surprised at these results at all, I was amazed how your husband was able to reduce his A1C on the diet he was on. However it seems that some overweight diabetics can reduce their A1C just by losing weight in the beginning. But it also seems that it is hard to sustain.

His A1C is actually consistent with his home testing and as you know he did have spikes to 200+ eating certain foods. Just as comparison; my last A1C is 6.2 and at the time I took that test my home testing average was 106 and and my FBG is below 100 most of the time. I didn’t have spikes over 150 for a few months either (knock on the wood!)

And an interesting thing is that I was able to achieve A1C of 5.7 when having more and bigger spikes and when my BG were generally less stable, but that was also the time when I just drastically changed my diet and was losing weight too.

It seems to me that often many diabetics can have fast good results in a few months after the start of treating their disease more aggressively. But then the next phase is harder and there is often some set back, but then with some hard work and more food/exercise adjustments most are able to stabilize their BG again (look at people’s signatures). I hope my next A1C that I’m going to get soon is better and I hope the same for your husband.

I think Peggy said it the best and there are few possibilities and one of them to at least go back on Metformin. I think even if your husband’s diet was OK for him (which I’m not sure about at all), usually people don’t try to go off the meds unless their BG are consistently around 100 and FBGs are below 100 or even 90 all the time. It doesn’t seem that his BG stabilized at least not yet and he got off Met too soon.

On the other hand there are many diabetics that are able to control their disease with the diet and exercise alone but then all of them are mindful of carbs.

So my final suggestion would be to abandon Dr. Barnard’s and MacDougal theories (as obviously they don’t work as no diabetic can eat unlimited amounts of “healthy carbs”) and develop your own menu that suite your tastes, morals and lifestyle and most importantly - good for your husband's BG. You don’t have to go all the way back and eat all the meat and bacon you can get, but you can add maybe some seafood and maybe some eggs or even some cheese.
The choice is yours and your husband’s and I’m sure it could make your life easier and happier and your husband BG better.

Good luck!

[NickP]

If you've decided that the starches are integral to a healthy diet, perhaps adding some insulin is something to pursue. It's really the only treatment that directly attacks the issue - carbohydrates.

Jen

Jen, sorry, but I have to strongly disagree!

While from a Type 1 perspective, you are correct; however, for a T2 that is still producing a fair amount insulin, taking additional insulin can actually be unhealthy.

Many of us T2's are more Insulin Resistant (IR) than Insulin Deficient. Putting a mega dose of insulin into your body will drop the BG's, but if you don't resolve the IR issue, you will doing more damage to your body.

IMHO, having too much insulin circulating can be just as damaging as too much BG. Unfortunately, it is very easy to measure our BG levels, but not easy to measure our insulin levels.

For OPTIMAL health, you want to minimize both your insulin and BG levels.

From my own experience, I produce plenty of insulin, but am very IR. Taking Metformin helps resolve the IR issues, and allows my BG to stay lower, using less insulin.

For the OP, it is tough eating a LCHF Vegan Diet. It can be done, but eating starchy food will just make your husband's BG issues much worse.

Type 2 Diabetes is a Carbohydrate Intollerance Disease. To control Diabetes, you need to minimize your Carb intake (find the right amount to keep you healthy, energetic, and happy). This takes time and effort to figure it out, and all of us are different. Most of us have not solved this issue in a few months. So, keep trying, you are doing well and keep encouraging your husband.

Please keep us updated on his progress.

[Ed B]

I agree that the obvious thing to do right away is to reintroduce the metformin with his current diet. That may very well pull his numbers back down to < 6.0 again. If his numbers aren't down to where they need to be after 3 months of that, then consider further carb restriction, perhaps just identifying and eliminating more bad carbs. Otherwise, if the diet cannot be altered, then additional medicine might be needed.

Best of luck to you both.

[Caravaggio]

For background info, here are my type 2 husband's previous ac1's (they were all listed on the lab report which is great because I didn't have any)

Taking Metmorfin and another medication, don't remember the name...

03 Nov 2010: 7.6
11 Feb 2011: 8.6
04 Apr 2011: 8.2
20 Jul 2011: 8.7
14 Oct 2011: 6.9 (starting vegan diet, had lost about 10 pounds at that point)
12 Jan 2012: 5.4 (had lost 30 pounds and was taking 1000 mg metmorfin a day)
02 Apr 2012: 6.5 (had lost 42 pounds and stopped all meds Feb 1st)

Other numbers noted:

Total cholesterol: 143 LDL: 67 HDL: 58 Triglycerides: 91

It's disappointing to see that his previous ac1 was better, albeit with metmorfin. We've only started testing bg a few weeks ago and learnt to alter his diet to avoid spikes. In terms of numbers, his fasting level is usually around 115, and if eating properly will not go over 140. The question is, can we improve on his ac1 just by diet and controlling his spikes or should we consider going back on the metmorfin again? Husband is seeing his doctor tonight so I would be really grateful for your opinions.

Hmmm, I'm just curious. What does he think?