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terryann

Diabetic, or not? Metformin, or not?

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terryann

Hello everyone. I need your help. I have been pre-diabetic for almost 2 years now and managing it with diet, exercise and my meter. Several times in the past, and very often occasionally I have 2-hr-post-meal readings that are very high, some even in the diabetic range, low 200s. However, my A1Cs are always normal, 5.7 last time. Because of the normal A1Cs, my doctor is not willing to put me on Metformin. However, my lifestyle is becoming so narrow, for instance I have to get on the treadmill many times during the day in order to get my BS down to something reasonable, often just in order to eat the next meal. Also noticing that it is becoming more and more difficult to get the high #s down by using the bike.

 

My fasting BS is usually in the high 90s, however, even though I had a reading of 203 yesterday after eating something that was only about 45 carbs, my fasting BS this morning was 85. It makes sense, then, that my A1Cs are pretty normal when you average out 85 and 203, but that really isn't normal. What can I do?

 

I understand that recent research has shown that Metformin can be helpful for pre-diabetics in warding off diabetes, however what do you do when you doctor will not prescribe it until you are officially diagnosed? My readings that go over 200 are not official lab results, so they don't see my meter reading report as a basis for diagnosis. This is very confusing. Do I have diabetes, or not? I read that you are diabetic if you have post-meal readings over 200, but my doctors are going by my A1C and will not prescribe anything.

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foxl

Find another doctor? Because: Metformin is GENERIC and cheap. And obviously cheaper than diabetic neuropathy, nephropathy, retinopathy, cardiovascular disease ...

 

And metformin ROCKS. It helps control carb cravings so you can LOSE WEIGHT. And your blood sugars are healthier besides.

 

LOTS of things affect A1c's. I know, many endos (even) manage by A1c alone ... not a great practice. My BIL actually had a false low A1c due to renal disease (not diabetic), so they let him go for YEARS, uncontrolled.

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foxl

Not like it is an opiate ...

 

Oh, I forgot to mention: I have been trying to get my husband on it for YEARS!

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terryann

So, am I diabetic if I have occasional readings over 200? Or not?

I would have to find a doctor that is outside my health plan as none of the doctors in my HMO are able to prescribe it unless you are diabetic. Do I need to see an endocrinologist? I wonder how you find out beforehand if a doctor is able to prescribe Metformin without a diabetes diagnosis. You would just have to keep calling new doctor and going to new appointments until one said yes?

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foxl

I would ask to see an Endo -- that would take you out of the HMO and I bet they could prescribe it, D or not. "Off-label," it is used for weight control. You may actually want to use it AND avoid the D diagnosis ... since it is forever and switching insurers might become more difficult.

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foxl
Thanks Linda. I read another post about liver damage from Metformin. What do you know on that?

 

Not much. As in I have not heard much at all about it. The most I hear is GI uupset in some people, use the extended-release and start slow.

 

I had heard about it being bad in people with DKA-- renal damage then, But if oyu are not type 1 or running super-high, not a worry.

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debbiedoes
Hello everyone. I need your help. I have been pre-diabetic for almost 2 years now and managing it with diet, exercise and my meter. Several times in the past, and very often occasionally I have 2-hr-post-meal readings that are very high, some even in the diabetic range, low 200s. However, my A1Cs are always normal, 5.7 last time. Because of the normal A1Cs, my doctor is not willing to put me on Metformin. However, my lifestyle is becoming so narrow, for instance I have to get on the treadmill many times during the day in order to get my BS down to something reasonable, often just in order to eat the next meal. Also noticing that it is becoming more and more difficult to get the high #s down by using the bike.

 

My fasting BS is usually in the high 90s, however, even though I had a reading of 203 yesterday after eating something that was only about 45 carbs, my fasting BS this morning was 85. It makes sense, then, that my A1Cs are pretty normal when you average out 85 and 203, but that really isn't normal. What can I do?

 

I understand that recent research has shown that Metformin can be helpful for pre-diabetics in warding off diabetes, however what do you do when you doctor will not prescribe it until you are officially diagnosed? My readings that go over 200 are not official lab results, so they don't see my meter reading report as a basis for diagnosis. This is very confusing. Do I have diabetes, or not? I read that you are diabetic if you have post-meal readings over 200, but my doctors are going by my A1C and will not prescribe anything.

 

I'm thinking that if you're having to jump through all these hoops just to keep your BG in the normal range then you are probably now diabetic. I mean, it's one thing to have an active lifestyle, but if I had to do what you are doing, well, I'm not sure that I'd have time to live. I cycle every day (that isn't cold and rainy), and I use my treadmill about 6x/week, but I also don't work and my youngest kid is a teenager. I have time to be doing this, but I wouldn't want to feel tied to my treadmill or my bike all day, just to keep my BG under control.

 

My suggestion is to either change doctors (yours sounds stupid, I'm afraid), or to stop working so hard on the treadmill. By all means, continue living an active life, but do it for general health benefits or for recreation. At worst, your A1C will go high enough that your current doctor prescribes metformin. Some people live for years with highs before being dx with diabetes. A few months with highs until your next A1C (so that your doctor lets you have metformin) won't be the end of the world. It's for the greater good, right.

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terryann

I just got back from the doctor, this was a new doctor (not an endo, I have to arrange that). She wants to see another A1c, so doing that. Apparently the A1c is what they base your dx on. She said that my A1c should reflect these spikes I am having...but I know it does not because I have had these type of spikes occasionally for almost 2 years and my A1c has always been 5.8 or less. A1C's do seem to increase a tad each time I have one, tho.

 

I have had to do this treadmill thing since the very beginning when I was dx pre-diabetic, it isn't anything new, been doing it for almost 2 years now. I am getting a lot of conflicting information and don't know who/what to believe. I read that when you go over 160 or so, there is permanent damage being done to your beta cells. Dr. and nurse said not to worry about that so much. (????) I feel like when I see my BG over 140, especially if it gets way up over 160, I must get on the treadmill right away. Is this not the case? One nurse told me today that alot of people have spikes from certain foods. So, if that is true, then if they spike and go over 200, are they diabetic? I remember once I ate some oatmeal, and my BG went up to 300!!! Never happened again. Does *this* mean I am diabetic? Or does it mean that I am pre-diabetic and can't eat oatmeal? I am so confused, there do not seem to be any solid answers.

Thanks for you help and caring.

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samorgan

You can best control the glucose you are measuring (which I refer to as "spillover" glucose - it's the one you failed to deal with promptly) by limiting the INPUT. All glucose which reaches your bloodstream comes from either carbohydrates or proteins you have consumed. Not necessarily consumed in the last hour, either. Carbs which are in excess of immediate need can be stored in the liver and later "dumped" into your blood. Some of the protein you eat - especially when in excess of your actual need for protein - gets converted by the liver to glucose via a process called gluconeogenesis. This takes much longer than the glucose which goes straight from your gut to your blood from ingested carbs. So, the time frame between swallowing and increased glucose in your blood can vary widely, but those are ultimately the only two sources.

 

Restricting this input will address both lows and highs. Lows come about (assuming you're eating regularly and not starving) after an influx of glucose to your bloodstream. If your system's "timing" is a little off it may be slow to react and then over-react causing the low. A little counter-intuitive to some, but it is important to understand that hypos are a symptom of carbohydrate consumption, NOT an indication that you are eating too little carbohydrate.

 

Just restrict these two (carbs and proteins) until your numbers - and lack of swings - make you happy. The average for the whole population is 15% of calories from protein. I wouldn't recommend going much above that. Above 35 - 40% of calories is likely harmful to your health. After that, carbs are the main thing to cut to get blood glucose which is both within normal levels and stable.

 

We're talking proportions here, not actual quantities. Calories from carbs + calories from protein + calories from fat add up to 1.0 or 100%. I'll let you figure out what you need to eat more of.

 

I don't know if you can eat oatmeal or not. I know I can't.

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Daytona

I think that if you are seeing spikes up to 300 that you have diabetes. From what I understand, people don't just get type 2 overnight and by the time one's A1C or fasting blood sugar test earns one a diagnosis of being fully diabetic, one has actually been experiencing high blood sugars for a while.

 

So if I were seeing big spikes like that, I'd start looking at what caused me to spike and start moderating how much / often I ate those foods. Or start looking into medication to help me continue to eat as I would like. It's good that you are keeping track and asking yourself (and your doctor) these questions early on.

 

I don't have links but from what I've read extended spikes over 140 or so can do damage over time. Hopefully your new doctor can answer that question for you.

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jwags

In my opinion Pre Diabetes is Diabetes. There is not a magic cut off. I am a full blown diabetic but control my bgs very well with low carb diet and metformin ( 2550 mg). My HbA1c is 5.3 and fastings are usually below 90. As a diabetic I rarely spike much beyond 110-120. If you are spiking to 200 there is significant damage being done no matter what your fasting is. Usually the fasting bg is the last bg to change. But by spikiing to 200+ that tells me your phase 1 response is gone. Like most of us the only way to lower those 2 hour pp's is to drastically cut carbs. I tend to eat 10-20 per meal and that works for me.

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modcarb
I just got back from the doctor, this was a new doctor (not an endo, I have to arrange that). She wants to see another A1c, so doing that. Apparently the A1c is what they base your dx on. She said that my A1c should reflect these spikes I am having...but I know it does not because I have had these type of spikes occasionally for almost 2 years and my A1c has always been 5.8 or less. A1C's do seem to increase a tad each time I have one, tho.

 

I have had to do this treadmill thing since the very beginning when I was dx pre-diabetic, it isn't anything new, been doing it for almost 2 years now. I am getting a lot of conflicting information and don't know who/what to believe. I read that when you go over 160 or so, there is permanent damage being done to your beta cells. Dr. and nurse said not to worry about that so much. (????) I feel like when I see my BG over 140, especially if it gets way up over 160, I must get on the treadmill right away. Is this not the case? One nurse told me today that alot of people have spikes from certain foods. So, if that is true, then if they spike and go over 200, are they diabetic? I remember once I ate some oatmeal, and my BG went up to 300!!! Never happened again. Does *this* mean I am diabetic? Or does it mean that I am pre-diabetic and can't eat oatmeal? I am so confused, there do not seem to be any solid answers.

Thanks for you help and caring.

 

Have you kept a log of your readings and shown it to your doctor? This may help with the diagnosis as well as your a1c.

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terryann

My A1C just came back today at 5.7. No one seems concerned at all abou the spikes, I was told yesterday "don't worry about that" because alot of people have spikes from "certain foods". I am NOT eating the things that spike me, that I know of, until it happens, then I don't eat it anymore. I am *already* eating low-carbs everyone! But I am being refused medicine because my A1C is normal. My meter readings and log of readings is not helpful as the doctor said the only thing they can go by is "their lab results", and my lab results do not show these spikes.

 

The reason I go up beyond 160 is because, during the day, mealtime comes around before my BS is back to around 100 or lower, so if I eat lunch while my BS is 120 or so, it goes up over 160. The only way for me to avoid this if I want to eat a meal is to get on the treadmill First....but I can't always be near a treadmill. What has happened I think is that I have been doing the treadmill enough that my A1Cs average out to look decent, but I am living a life like a prisoner to my treadmill in order to make this happen. I am going to hope that seeing an endo is the answer.

 

Would you recommend I lower my carbs even more than I have already and just forget medicine? Yes, you can just almost elminiate carbs altogether I suppose, to keep it all low enough. Having a little help with Metformin so I don't have to stab myself so many times every day to check my levels and stay home so I can get on the treadmill seems to make sense, but no to my doctors it seems. I don't really want to have to stop using the treadmill enough so that my A1C goes up enough for a dx so they will help me. That seems awful. What is so different about me, this can't be the first time someone was having normal A1Cs and spikes at the same time.

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terryann

Salim, I didn't know this, that lows are from carb consumption. THis might explain my 10am low I seem to always get that has had me perplexed. If I eat a normal breakfast of about 45 carbs at 7:30 am when my glucose is about 80 or 90, my reading at 10:00am can drop to 65 sometimes! Do you think that is what is happening, that I am eating too many carbs for breakfast? How would I know if this is what is happening or not?

 

I find it pretty overwhelming thinking about counting percentages of calories from protein, and how to apply that every day, every meal, all the different kind of foods, etc., how to measure, etc. I didn't realize I needed to measure like this? I just try to limit protein, like meat, to eating not alot more than 3 fingers worth, which is what my nutritionist told me. Also did not realize that protein raises blood sugar. Wow, that's a new one for me.

 

Are you saying that there is no need for medication, just cut the carbs and proteins? At what point, then, does a diabetic need medicine if all they need to do is cut the carbs and proteins until they like their numbers?

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dennisA

Hi Terry Ann.

 

I would look to shop a different doctor than the ones in your current location. While they are being very helpful by not putting a diagnosis on your record. You really don't want a diagnosis as it makes acquiring life insurance much more expensive (2x-3x non diabetic rates) plus moving insurance. As Fox said above, request it for weight loss. My brothers x fiance also used it for helping with Aunt Flo, not sure why, I just took her word for it.

 

As for your higher numbers it could be possible that you are loosing some of your bolus insulin response, but your basil (longer term) seems to make up for it. Also do your highs and lows correlate to days with inadiquate sleep the night before? There have been studies that show links to insunlin resistance going up when we receive less than 7 hours of sleep per night. The more nights in a row without enough sleep, the resistance increases and it becomes harder for the body to keep blood sugar regulated.

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samorgan

Yes, I think that is exactly what is happening. It's easy enough to test, just eat a very low or no-carb (and no excessive protein) breakfast for a few days and check the results.

 

No, you don't really have to count a lot, just pay attention to all three, not just carbs. I started out using percentage of calories for each. 1g of carbs or protein = 4 calories and 1g of fat = 9 calories. (BTW, I place no limits on calories and eat as much as I want.) But it is easy enough to translate that into simple grams - easier to keep track of using labels, etc. I eat approximately 10% from carbs, 15% from protein and 75% from fat but that translates into a simple formula:

 

Twice as many grams of protein as grams of carbs, and

Twice as many grams of fat as grams of protein

 

It's pretty easy to compensate for foods with different balances of the three. I have to stay away from meats which are too lean because it is too difficult to maintain the right ratios - I'd have to drink a glass of cream or something!. Ribs are my health food! Once in a while I'll do a comprehensive check of a day's food with something like fitday.com and it's always really close. But, on a day to day basis I just enjoy my food - it takes very little counting. I definitely don't measure anything. I don't limit any foods or food in general except as necessary to maintain the correct proportions.

 

I have no need for medications of any kind approaching my 2 year anniversary after being diagnosed with an A1C of 10.7 - now in the lower 5's. It depends on what YOU want, but I have no doubt that a very large number of T2s could do it the way I'm doing if they want. It's my personal decision that I just don't trust pharmaceuticals and also don't want any "dependencies". If I couldn't do it "alone", I would probably go straight to insulin which I trust a little more than the oral meds - but I highly doubt if that will ever happen.

 

The biggest challenge is getting past the avalanche of disinformation which is being thrown at us. It is not by chance that you found the ingested carbs - hypo correlation surprising. There are LOTS of lies coming from seemingly trustworthy sources perpetuating this myth. They make people believe that hypoglycemia is a condition of insufficient CARBS when in reality it is insufficient GLUCOSE (two different things) and it cause is a faulty (late and then too much) reaction of the body to... what? CARBOHYDRATES you ate. You eat them causing glucose to rise. Your body doesn't respond right away (allowing it to go too high) and responds excessively, causing it to go low. Absent carbohydrates, the entire scenario simply doesn't happen.

 

 

 

 

 

Salim, I didn't know this, that lows are from carb consumption. THis might explain my 10am low I seem to always get that has had me perplexed. If I eat a normal breakfast of about 45 carbs at 7:30 am when my glucose is about 80 or 90, my reading at 10:00am can drop to 65 sometimes! Do you think that is what is happening, that I am eating too many carbs for breakfast? How would I know if this is what is happening or not?

 

I find it pretty overwhelming thinking about counting percentages of calories from protein, and how to apply that every day, every meal, all the different kind of foods, etc., how to measure, etc. I didn't realize I needed to measure like this? I just try to limit protein, like meat, to eating not alot more than 3 fingers worth, which is what my nutritionist told me. Also did not realize that protein raises blood sugar. Wow, that's a new one for me.

 

Are you saying that there is no need for medication, just cut the carbs and proteins? At what point, then, does a diabetic need medicine if all they need to do is cut the carbs and proteins until they like their numbers?

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ShottleBop

45 grams of carbs for breakfast is low-carb compared to the SAD, but, for many of us, is not low-carb enough to keep blood sugar under control--especially without meds. Breakfast, in particular, is a time when many folks are more sensitive to carbs than later in the day, so a lower carb count can really help. Keeping your post-breakfast number at a minimum can set you up for a better day all around.

 

Different foods can have different effects on your BGs, as well, Check out Jenny Ruhl's website, Blood Sugar 101, and read the entry on "How to lower your blood sugar levels." It's very helpful.

 

Dr. Bernstein, author of The Diabetes Solution, for example, recommends 6 grams of carbs for breakfast, 12 for lunch, and 12 for dinner. While that doesn't sound like a lot, he also recommends that we avoid fast-acting carbs--grains, milk, starchy vegetables like potatoes and other root vegetables, and most fruits--altogether. Not everyone finds it easy, or desirable, to follow that kind of regime, but some of us find it very satisfying.

 

I probably eat 40-60 grams of carbs per day, myself, but that includes an avocado at breakfast, a full-sized salad (e.g., Cobb salad, chef's salad, Greek salad (with grilled salmon or chicken on top) for lunch, and a salad, or greens, or other veggies, with dinner. I still think I'm getting plenty of phytonutrients.

 

With that avoidance of fast-acting carbs comes, for me, much less variability in my BGs. It's a rare meal that my 2-hour post-prandial BG exceeds my premeal number by 20, and I have a fair number of days (especially if I don't measure my BGs right after my evening bike ride, when my BG is often in the 50s or 60s) in which my low and my high readings are within 10 points of each other. I have very few days--fewer than 10 in the past year--in which my high reading exceeded 120.

 

Whether something similar would work for you would depend on many factors, but it might be worth trying for a few months, to see if it does.

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jwags

I really wished doctors and dieticians really explained to patients what diabetes is and what it does to bgs. They automatically assume we all are going to have high bgs and there is nothing we can do about it. My CDE told me 180 was fine after meals. Now I know damage is done at 140 or even less. The important thing is that you are in control of your diabetes, not your doctor. Don't rely on doctors for information to make you better, it won't happen. Many doctors don't even thing Type 2's should test. My doctor told me 2 times a week is more than enough. I would never have got my HbA1c down to 5.3 testing 2 times a week. Metformin is one of the best meds and it has really helped me. I am aiming for a normal HbA1c of 4.0-5.0 in the near future. Dr Bernstein is a great resource to read. He has been Diabetic for 70+ years and I think his HbA1c is in the low 4's.

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samorgan

Apparently at least in some cases doctors not only tell people these things but believe it themselves. My son-in-law's father is a pulminologist (sp?) who recently discovered he is T2. He just takes Metformin and another med I believe it is Januvia, cut out a few obvious "white foods" and rarely if ever tests his BG.

 

The other day we met at his daughter's wedding party and asked each other about A1C's. His 6.1. Mine: 5.1. And he was borderline pre-diabetic/diabetic at diagnosis. I always thought they would just tell US junk like that but if it was their own bodies they'd get smart.

 

 

I really wished doctors and dieticians really explained to patients what diabetes is and what it does to bgs. They automatically assume we all are going to have high bgs and there is nothing we can do about it. My CDE told me 180 was fine after meals. Now I know damage is done at 140 or even less. The important thing is that you are in control of your diabetes, not your doctor. Don't rely on doctors for information to make you better, it won't happen. Many doctors don't even thing Type 2's should test. My doctor told me 2 times a week is more than enough. I would never have got my HbA1c down to 5.3 testing 2 times a week. Metformin is one of the best meds and it has really helped me. I am aiming for a normal HbA1c of 4.0-5.0 in the near future. Dr Bernstein is a great resource to read. He has been Diabetic for 70+ years and I think his HbA1c is in the low 4's.

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terryann

No, I can't seem to correlate these highs and lows to days with inadequate sleep. I was completely taken aback by the 200 reading the other day. I only ate about 45 carbs, and ate only something I had eaten before *without* that kind of #. I am going through menopause, have alot of hot flashes, so I was told that can also affect it. But generally, I think I have alot of BGs between 150 and 180 because when I eat, my BG is already at 125 or 130, then when I eat, it goes up to far. Apparently this time, though, it went over 200!! Not sure why.

What makes you think my basil makes up for it? I don't understand those terms yet.

Also, why does something like oatmeal (for me) send my BG skyrocketing...to 300 one day when I ate 1/2 cup. Does this kind of sensitivity mean your bolus/basil is messed up, or just that you are hypersensitive to one food?

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ZoraP

Terry Ann, oatmeal spikes almost every diabetic I know. It's impossible for me to eat it (especially at breakfast!) if I want to keep my numbers low with diet only. Despite what is said about its health benefits, it's one of those foods most people with diabetes have to give up unless they're also using insulin, which can "cover" the carbs.

 

It sounds like you're running higher fasting levels if you're at 120 or 130 before meals. What's your first morning number before you eat anything? If you are able to lower your postprandial spikes after meals you'll probably find the fasting number going down, too -- many of us find this to be true. Metformin also helps lower fasting numbers, so that's still something to look into if you can persuade your doctor (or a new one).

 

There are two issues: how high your number goes after eating, and whether your fasting numbers are settling down again or not. Controlling the post-meal number usually helps with the other issue, so it's the place to start.

 

As far as what to eat is concerned, I usually eat scrambled eggs for breakfast, perhaps with a bit of ham or sausage, sometimes with a special low-carb "bread" I bake with ground almonds, cream cheese, and eggs (no flour, no sugar). Sometimes I have some avocado with lemon juice and sometimes a few berries with cream. I don't eat any cereal or grains at all. I have my coffee black or with a bit of cream or coconut oil, no sugar added.

 

Other people find different combinations of foods that work for them, but I think most people with diabetes generally have to avoid the same things: flour, sugar, cereals, and usually starchy veggies except in smaller portions. If your nutritionist thinks that spiking to 300 after "certain foods" is okay and normal, my personal opinion is that she doesn't know what she's talking about. Studies show that people without blood sugar regulation problems rarely go above 160 (and usually don't go above 120) no matter what they eat. So there's no way that 300 is normal, despite your relatively low A1c.

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obxpelican

Terry,

 

From what I've read elevated levels >140 for long periods can cause damage and that is why your average measured BG is reflected on your A1C, if you do not have a high BG average IMHO you are NOT doing damage, your A1Cs don't lie.

 

If you can hold off taking meds, excercise, eat less carbs (lose weight if need be) I would do it.

 

A 1 hour spike from what I've read is NOT enough to cause damage IMHO. We're all different though but you have 2 different docs telling you the same thing.

 

 

Chuck

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jillybean

A few things...

 

- My opinion: yes, if you're spiking over 200 (and even up to 300), you're diabetic.

- Another opinion: you're early enough in the progression that if you reduce your carb intake, you likely won't have to jump on a treadmill or bike all the time and shouldn't need the metformin.

- See if maybe your doc would order you a glucose tolerance test, as that should be able to show that you spike out of normal range and would be an official "lab" test.

 

I saw you asked someone what a 10-carb meal might consist of. Eliminate the following items: bread (all forms, including whole grains, english muffins, tortillas, etc.), sweets, pastries, noodles, rice, potatoes, corn, and most fruit. Sounds very restrictive, right? When someone basically tells you to just eat mostly meat, eggs, cheese, and non-starchy veggies, that sounds painfully limited, right? But when you think about it and even add a little creativity, it's actually SO much yummier most times! Breakfast could be:

 

- scrambled eggs with cheese and bacon

- an omelette with any kind of meat and veggies and cheese

- over-easy eggs with canadian bacon or breakfast ham and hollandaise sauce (also yummy to add avocado!)

- sausage patties (check the carbs) with Laughing Cow cheese wedges spread on top

- I consume breakfast in the car on my way to work, so I have a protein shake made with low-carb whey protein powder (chocolate mint flavor - yum!), unsweetened almond milk, and a tablespoon of oil for fat

 

There is also no rule that you have to eat "breakfast foods" for breakfast. I am no stranger to eating leftover steak for breakfast or even a salad when the mood strikes.

 

Lunches and dinners for me (and my husband, who isn't diabetic or obese but doesn't cook, so eats whatever I make) include things like:

 

- chicken thighs marinated in a creamy dressing and baked with cheese on top, side of baby brussels sprouts with crumbled bacon, oil, and garlic

- ham steak or sliced baked ham stuffed with Swiss cheese and hollandaise sauce, side of mashed cauliflower with butter and sour cream

- bacon-wrapped beef filets, side of broccoli with cheese (just because I like cheese and don't really like veggies, so I always have to cover them with something)

- giant salad: greens, roasted chicken, bacon, egg, cheese, avocado, slivered almonds, and creamy dressing

- hamburger (or turkey burger) patties topped with bacon, cheese, and avocado and dipped in mayo mixed with barbecue sauce

- stew beef cooked in a crock pot with a jar of salsa and a block of cream cheese, topped with melted shredded cheese

- meatballs (watch carbs on pre-made ones) and/or Italian sausage with tomato sauce (check carbs or make your own) and lots of melted cheese

- pork chops wrapped in bacon, side of green beans with almonds

 

Snacks or mini-meals throughout the day:

 

- egg salad (I'm boring - just 2 eggs chopped up with mayo)

- tuna or chicken salad

- cheese (I buy store brand Cracker Barrel type blocks already pre-sliced)

- pepperoni slices

- rolled up sandwich meat and cheese, dipped in mayo or mustard

- parmesan "chips" with dip (microwave or bake little piles of shredded parm cheese until crispy)

- almonds (plain or flavored - cinnamon roasted, cocoa roasted, habanero bbq, tuscan...)

- deviled eggs

 

I can't say I often feel too restricted :)

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