I know there’s several diabetics out there, so let’s yammer some. I’d also love the opinions of all you docs and nurses out there.
First off, the disclaimer: I’m not looking for medical advice, diagnosis, or anything like that. I’m soliciting opinions and personal anecdotes. You’re not my doctor. I’m not your doctor. I’m not doing anything other than what my own team of medical professionals tell me, and I will ignore everything you yahoos say that differs. Also, I did check with the mods before posting, and they’re OK with it.
I was diagnosed with type 2 (though I having a suspicion that will change to one of the more rarer forms like LADA eventually) in late November, and have spent the last couple months obsessing over All Things Diabetic. This includes visiting diabetes-related message boards, where I’ve noticed an interesting dichotomy between almost all message board participants and diabetes nutritionist’s advice about eating.
Virtually everyone agrees that the standing advice of the ADA and their own medical professional’s advice about What To Eat While Diabetic is a bunch of hooey. And indeed, my own experience seems to jive with that. The diabetes educator I talked to told me I should be eating between 45 and 75 grams of carbohydrates with every meal - if I eat more than, say, 30 grams, my blood sugar ends up around 250 or higher. Mention the 45-75 number on a diabetes forum is like starting a thread about tipping here on the SDMB: everyone lines up to tell you how wrong you are.
So what’s up with that? Obviously anecdotal info from the Internet is hardly something to take too seriously, but it got my attention because it was so universal - people on many completely unrelated message boards say the same thing.
Is there really that much of a disconnect between Doctors and Patients that it causes so many people to just decide their doctor’s don’t know what they’re doing? Why would that be? I mean, if I can figure this out with two months of looking on the Interwebs, why aren’t there any docs out there taking a look at it?
The other thing that I’m interested in is blood sugar levels. ADA says to keep it under 180 1-2 hours after meals. American Association of Clinical Endocrinologists says under 140 1-2 hours after meals. Anyone with any good info/sites that back up one number or the other?
One is “tight” control and one is loose control. Generally in kids or others where the risk of hypoglycemia out weighs the (long-term) risk of microvascular complications, you might want to shoot for 180 at 2 hours. Note that that still is high. An adult that is willing and able to monitor their glucose might want to stay at 140 at 2 hours post-prandial, since the data are quite convincing that the lower your average glucose is ( which is measured by hemoglobin A1C) the less risk of complications.
Regarding the carbohydrates, I guess if I were seeing you as a patient I’d ask you what KIND of carbs you are eating, since they are not all the same. Whole-grain rice is not going to have the impact on your blood sugar that white flour pasta is.
For me, personally, it’s any carbs, whole grain or other. Steel cut oats make it go up, as does multi-grain bread, as does quinoa, as does a cookie.
Going back to my OP, the people on the boards I’m reading say the same thing - were they to eat what the dietitian told them, all whole grain healthy stuff - they see the same spikes I see.
Just about 9 months since being diagnosed with type 2 diabetes. I couldn’t really tolerate the drug (forget the name right now) and stopped taking it. Have to go to the doc every 6 weeks to get blood tested. With very little change to lifestyle or diet, my A1c levels have dropped from 8.5 (high) to 6.6 (relatively normal).
But we are also juggling other meds (BP, gout, antibiotics) - I am still new to this diabetes thing and really think that if I could begin exercising again, things could get managed quite well in short order. But I am still learning. Getting lots of advice from other fellow diabetics (at work) and my head keeps swimming from all the contradictory examples I get, to include from my doc.
I test my blood twice daily. Today was: 9:30 AM (fasting) 157. While still grazing on lunch at 4:00 PM. 155. Don’t really understand the food connection.
My next appt. is next week. I look forward to this thread and getting questions to ask the doc.
A couple more things on your post, PharmBoy - Thanks for the info on the tight control versus loose control. That’s good to know.
And as far as the type of carb - my doc and diabetes educator say the opposite. I’m looking at the documentation they gave me on diet, and it goes out of its way to say that a carb is a carb is a carb. My internist mentioned Glycemic Index, but said that most docs don’t believe in it.
Uncle Brother Walker sums things up for me when he says “my head keeps swimming from all the contradictory examples I get, to include from my doc.”
I was diagnosed type II in April of 2007, I thought I had the flu. That morning my fasting sugar was 312 and my A1C was 11.7!
I’m on 2000 MG of Metformin a day and I only test once (first thing in the “morning”).
Due to my crazy “lifestyle” (I work on the road, 87.5 hours a week and 3 to 9 weeks at a stretch) I have had to learn how to control it “on the fly”.
I eat EXACTLY THE SAME things every DAMN day!:
For “Breakfast” (I work nights so that’s 15:30) I have 2 chicken fajita tacos on corn tortillas with cilantro, onions and cheese and 3 cheese enchiladas.
I snack on pretzels, bananas, sugar free candy and peanut butter on SF wheat bread with SF jelly.
For “dinner” I have 2 sausage, egg and cheese croissant sammiches from the donut store.
My fasting sugar is averaging 107 now and I had one of those 5 minute A1C tests a few weeks ago, it was 5.7!
I have been actively forgetting to exercise for the last few months.
Since I’m a type 1 I won’t be participating in this thread, but did want to point out the those who are newly diagnosed and confused that most medical practitioners do not know the difference between type 1 and type 2, (even those specially trained in “diabetology”) and will throw any old advice out there without first determining if it’s appropriate considering their patient’s status as a type 1 or type 2. Your best bet, IMHO after almost 30 years of type 1, is to teach yourself EVERYTHING you can find about BOTH types - then you’re much better equipped to discern which advice you’re being given is worthwhile, and which is not. Furthermore, you’ll be in the position of not being so dependent on your medical providers as you’ll be able to make more decisions on your own.
No, please do! The more I read, the more the line between Type 1 and Type 2 blurs.
My Endo has told me I’m Type 2, but my C-Peptides show that my pancreas is barely producing insulin, so I’m looking at total insulin dependency within a few years. From what I gather, the practical difference between an insulin-defendant Type 2 and a Type 1 is very small.
I am not diabetic, but my dad is (mildly). If he’s at 140-150, he’s extremely high. He tends to keep it around 95-120 all the time. He tests daily, but doesn’t really watch his food intake. He’s cut pasta and sausage out of his diet, but eats cereal with fruit, ice cream, pie, cake, donuts, etc. He controls his with the metformin pill, and a pretty low dosage, at that.
I agree that the whole subject is confusing. I just read on (I think) the ADA site, that no foods are off limits. My mother in law has about the same type of diabetes that my dad has, and she’s downright paranoid about anything she ingests. I’m going to print out some info for her to put her mind at ease.
I’m no diab expert, but my goal for our pregnant patients (gestational diabetics, mostly) in the hospital (where I work) are to keep fastings below 100 and 2 hour PP’s below 120, 130, or 140, depending on the Doc.
Our guidelines may be more stringent because of the realtionship betwen diabetes and birth defects/fetal demise.
You can’t really measure carbs properly without learning about the glycemic index. Foods with a high glycemic number (basically sugars and starches) result in a lot of glucose in your bloodstream in a short amount of time. Low-glycemic foods are sort of time-release, and don’t cause your glucose to spike. It’s amazing how many nutritionists don’t know about the glycemic index, and talk about carbs as if they’re all the same.
My internist (who is my family practice doc) knows about glycemic index and discussed it with me. His opinion was that although it was a popular tool, the medical research has not backed up its claims to help control blood sugar.
He wasn’t against it, per se, he just said don’t look at it as a magic solution. And indeed, my body doesn’t seem to make much of a distinction between low-GI carbs and high-GI carbs.
If anything, the time of day seems to be most important. Any little bit of carb, low-GI or otherwise, pushes my blood sugar up in the morning. Sometimes at night or in the afternoon I can get away with some multi grain bread or (gasp) a cookie.
That said, keep in mind that I still don’t have very good blood sugar control, and my meds will probably be changing as me/my docs learn more about what I respond to.
When I was diabetic during my pregnancy, I found that the glycemic index was a very good predictor of which carbs would spike my blood sugar the fastest. Sushi rice, even a small bit, spiked my blood sugar, Basmati rice, not as much, and maple syrup hardly at all. I paid attention to the amount of carbs for diet planning, but the glycemic index really predicted how fast they hit me, which was important to be because high blood sugar made me feel horrible.
Also it was extremely important that I ate protien with my carbs. I was on insulin and tested frequently. I maintained extremely tight control during my pregnancy. My dietician said that protien and fat with carbs gives your my something else to chew on so that the digestion of the carbs took place over a longer time which made it easier for the insulin I had to deal with it. My doctor echoed the same sentiment.
I was diagnosed as a type II diabetic at age 33, 15 years ago. I noticed something was up because, in addition to the peeing, I lost 25 pounds in two weeks. At the time, I was maybe 30 pounds overweight. Given that the broad-brush profile for diabetes is to become Type II over the age of 50 or type I under the age of 20, and in both cases, obese for half your life, my doctor was not happy with me, because I didn’t fit the profile.
Two years later, after having little or no luck keeping my blood sugars down, the docs decided I was a type I after all and put me on insulin, which has worked a little better at keeping the blood sugars down, and gives me something to do if my numbers go really high. However, given that my numbers are all across the scale, even with a fairly rigid diet, I am continuing to annoy my doctors, and they’re thinking of putting me on metformin in addition to humalog and lantus.
I’m actually not sure about some of the numbers being bandied around here for Blood Sugar levels, in the 100’s etc. I test using a little monitor once a day and get a number (hopefully) between 4 and 8. I got a reading of 20 plus on a couple of occasions right at the start before I started a proper diet.
My biggest problem was having to decide whose advice I was going to take in regards to diet. In Australia it’s pretty much canon now that as a diabetic you need to go Low GI. Right after diagnosis I was on 1000mg Metformin tables twice a day. But since I’ve been eating Low GI, I haven’t needed them.
To be perfectly honest though I had a massive sweet tooth, and I suspect a lot of what has helped me has come from my no longer drinking soft drinks (once upon a time I would easily drink 2-3 litres of Coke a day) eating lollies and other sweet treats.
I hesitate to mention it because some people will call it quackery, but my old man, who is also diabetic, put me onto an eating plan from an Australian doctor who is also a practioner of chinese medicine. It seems to be working for me.
His eating plan basically separates food into Bad Carb’s, Moderate Carbs, Low Carbs, and Proteins/Lipids. Bad Carbs (High GI) are completely out (that’s most pasta’s, all breads, potatoes, etc). Moderate Carbs (medium GI) Low Carbs (Low GI).
Essentially he advocates in any given meal (and for three hours after) having either a Carb meal (Medium & Low Carbs) or a Protein meal (Low Carbs and Proteins). His take on this is with only very low GI carbs very little insulin is released which inhibits the uptake of any of the fats in the proteins. So that if you have a ‘Carb’ meal which is still only Medium carbs <55 GI, you have to avoid any fats with that meal. Don’t if it’s 100% accruate about the body working that way but it is working for me.
I was one of those unlucky pregnant women who developed gestational diabetes. During my pregnancy I was able to control it very well. Then after I had my son, it never went away. UGH.
I guess a small percentage of GD women will go on to develop type II. I was one of them.
I really have never had a blood sugar reading higher than 180, and it is usually around 140. This is for the morning/fasting readings.
I am currently on Metformin 500mg (2 a day), and Glyburide 2.5mg, and my dosages were just raised. The thing that has bothered me is that since day one of the prescriptions, my numbers haven’t changed a bit. And it has been a few years. I feel like I am taking this stuff for nothing.
I am much heavier than before I was pregnant, so I know thats half the battle, but it is one war I am not winning currently. So until I can move more, and get this weight down, I don’t expect much to change.
Oh and, I developed a bit of numbness and tingling in my toes last year. I swear that my Diabetes Nurse told me about this one week, and the next I had it! It has been going on for about a year, and is very irritating, but not debilitating. I am worried, but apparently not enough to get off my ass, and exercise more. It is just so maddening.
I was diagnosed with type-2 thrice. The first time by a diabetic co-worker who said, “You’re going to the bathroom every 30 minutes, your vision sucks, that’s your eight cup of water since breakfast, and you’re biting everyone’s head off; you have diabetes. Get thee to the doctor!”
The second time was by my optometrist, who said, “This is the second time you’ve had to change your prescription in a month. Plus all that other stuff. Get thee to the PRIMARY CARE doctor! Also, stop choking me.”
The third time was when I got myself to the doctor, whose nurse checked my blood sugar, blanched, checked it again, got even paler, and ran out of the room. The doctor began saying, “We need to get you to the…” and I assume the next word was “hospital,” as that’s where I woke up two days later.
Nearly dying made me take it very seriously. My 47-year-old friend dying of diabetes-related complications made me take it even more seriously.
When I was diagnosed I started off taking an glyburide (which kicks the pancreas into action) and Avandia (which improves insulin sensitivity). Avandia did approximately nothing for me, and it’s expensive, so I started taking just glyburide. Then I lost my corporate job and health insurance, which didn’t matter much for PAYING for the glyburide–it’s very cheap–but did matter for getting my Rx refilled (needed a doctor’s appointment). So I started exercising a lot. Currently I try to do an hour on the treadmill or bike each morning, both of which I hate with the heat of a thousand novas until I check my blood sugar. This morning it was 90-something.
I check my blood sugar several times a day–every morning before I eat, and before I get behind the wheel of a car unless I’m leaving someplace where ijust ate. I find it easier to give up all sweets than to go by half-measures.
IANADiabetic, but I was wondering what it feels like/how you know you have it. I’ve heard about the peeing/thirsty thing, but not much else. How did you know something was wrong?
There is a whole raft of ‘indicators’ but for me it was the classic signs, frequent peeing and always thirsty, and a loss of weight - I dropped about 10 kg with no change in diet or exercise. Actually it wasn’t just frequent peeing for me, it was urgent peeing :eek: I would go from fine, to badly needing to pee in less than 5 minutes.
I test using a little monitor once a day and get a number (hopefully) between 4 and 8. I got a reading of 20 plus on a couple of occasions right at the start before I started a proper diet.