Questions about diabetes/what did y'all do?/is my doctor BSing me?

In My Humble Opinion
1

Not asking for medical advice, asking what I need to be asking my doc/if I should be getting a new one!

So I got some routine bloodwork done. My fasting glucose was at diabetic level, and with my weight and family history of diabetes the doc told me I was early stage Type II and to try and lose weight by eating more meat and less carbs and come back in a month.

Being the good Doper I am, I commenced internet research immediately and now I feel like I definitely don’t know anything and my doctor basically left me out in the cold.

I’ve been trying to figure out how many carbs I should be having, but everyone online just talks about what they figured out they needed via testing their blood sugar. But my doc didn’t say anything about testing my blood sugar with meals! He hasn’t tried to send me to an endocrinologist. He hasn’t ordered me any more specific tests. All he has is one fasting glucose reading.

Right now I’ve just decided the first step to take is purge the junk food and try and replace it with veggies. No more chips or candy - eat a carrot instead. But supper feels the worst for me, because that’s a carbo load usually. And I’m at odds with nuts being a good diabetic snack because it’s low carb, but since I need to lose weight, that fat is bad for me right? Argh.

2

My DH is a Type 2 diabetic, and his doctor of the time was a bit more informative than yours apparently was. I recommend proceeding to your nearest bookstore or library and obtaining “Type 2 Diabetes: The First Year” by Gretchen Becker or “Diabetes for Dummies”. Both are useful. Also get yourself a blood glucose meter (my husband favors Walmart’s Relion line due to lower ongoing cost for strips), and look up info on “glycemic index” for foods (this is basically how fast carbs in a food break down and dump glucose into your system, in simple terms). Unfortunately, about the only way you’re going to figure out how specific foods affect your specific body is by testing. We’ve figured out that some carbs don’t spike my husband’s blood sugar as badly as others.

3

It’s probably just barely over the line and he wants to see if you can get it down with diet before doing anything. And carrots actually have a lot of sugar. You have to have some carbs- just make it whole wheat bread instead of white, whole wheat pasta, etc. Nuts are a good source of healthy fats, if you can keep it to a small serving. Exercise also really helps to control blood sugar- even just walking daily.

4

My husband would second Alice’s comment about exercise and blood sugar control.

5

Good advice here so far. Not all carbs are created equal – whole grains tend to not be as bad (i.e., they usually won’t cause your blood sugar to spike as high or as quickly). Exercise (even moderate exercise) can help a great deal. When I was diagnosed with Type 2 diabetes 7 years ago, I started walking regularly, which did have an impact. Two years ago, I started running, and that’s had an even more pronounced effect (my “hemoglobin A1C” number, which is a long-term blood sugar number, is down nearly 1 full point).

If you get a glucose meter, there’ll be instructions on how to test, and when. I test first thing in the morning (which gets at your fasting number), and one hour after I start a meal (which shows you how that meal is causing your sugar to elevate – it will elevate after a meal; the question is how highly).

6

What were your numbers? What do you usually eat? These details can help move the advice in the right direction.

7

There’s a difference in approach depending on whether your BG was closer to 150 or 400.

8

Best advice in the thread.

Some doctors give limited information to newly-diagnosed patients, apparently on the assumption that overloading patients with too much information is worse than not giving them enough information. Personally I disagree. I’d consider calling your doctor’s office back and asking if he’ll write you a prescription for a glucose meter and some test strips, and if they won’t do it, consider finding a new doctor that’s more hip to current diabetes care management protocols.

I’ll also second the recommendations for regular exercise.

9

Do you need a prescription to buy a glucose meter and some test strips?

10

No, but if you have medical insurance, you might get those covered and significantly reduce costs if you have a prescription.

11

The diabetic diet I followed (and still mostly follow) is 2 or 3 “carb units” per meal, 3 times a day. Each carb unit is 15g of carbs. Start looking at labels. If you balance it out with reasonable portions of protein you can lose weight. I’ll warn you in advance it requires some willpower. It’s all about portion control, mostly. If you want a snack later, you have to save a carb from one of your meals. In other words, you can have 2 carbs at dinner and have your third carb for a snack later. Ate 3 carbs at dinner? You’re screwed. No snack for you.

A slice of bread is one carb unit. Fruits and veggies aren’t necessarily your friend. They often contain sugar and have to be counted as a carb unit. A potato is two or three carb units depending on how big it is. A scoop of rice (enough for a side dish) is one carb unit.

There are a lot of 100 calorie snack packs. They aren’t like eating real snacks. Sure you get a bunch of cookies, but they are all miniature teeny tiny cookies. But that’s all you can have.

It sounds like your doctor didn’t explain diabetes very well to you. Your cells have insulin receptors on them, which is how the body regulates your blood sugar. If there is too much sugar, then your body produces more insulin. This is produced in special cells in your pancreas. If you eat a lot of sugary foods, the cells have to work harder, which strains them, and after years of abuse they will start to die off. The thing about these cells is that they don’t regrow. If you kill them, they are gone forever.

Being overweight clogs up the insulin receptors in your cells with fat, which means that the body has to produce more insulin to regulate your sugar, further straining those cells in your pancreas. If you lose weight, then you’ll get rid of the fat that’s blocking the insulin receptors, and even though you may have already damaged your pancreas a bit, it may be able to produce enough insulin to regulate everything properly. So you can kinda “cure” your diabetes by losing weight, sometimes. It’s not really a cure, though. It’s more that you have managed your diabetes to the point where you don’t need medicine and don’t need to worry about it. The damage to your pancreas is permanent and still there.

So losing weight is very important.

You are probably at the beginning stages of type II diabetes, which means that if you lose weight and watch what you eat, there’s a good chance you haven’t done too much damage to your pancreas and you won’t need meds or anything later.

If you don’t lose weight and don’t watch what you eat, you’ll do even more damage to your pancreas and then you’ll end up on meds for the rest of your life.

Count carbs and don’t go excessive on other foods to make up for it, and you can lose weight. Don’t worry so much about fat content of nuts and stuff like that. Focus on the carbs. You don’t have to be anal about getting the exact total grams right. If you round to the nearest carb unit that’s usually good enough. Eat well rounded meals with the right carb amounts and you’ll be fine.

ETA:

One other thing. Keep moving. That helps burn off calories and reduces your blood sugar which means your pancreas doesn’t have to work as hard. Walk a lot. You don’t need to start jogging or go extreme on the exercise. Just walk around a lot. Move around a lot while you are sitting at your desk. It all helps.

12

Minor addendum: fiber does not count toward the carb count for a food, since it doesn’t metabolize into sugar.

13

Some doctors hand out free glucose meters, which come with a small pack of strips. That’s not necessarily the way to get the one with the cheapest test strips, though, and the strips will be most of the cost in the long run.

14

IANAD, IANA nutritionist, etc. But as I understand it, carrots get an unfairly bad rap, and actually are perfectly fine when eaten in moderation on a low-carb diet. One cite from a cursory Google check:

15

I had a single anomalous blood sugar reading after passing out from an asthma attack and being taken to the ER and shot up with epinephrine, in the same stay all other blood sugar readings were normal. I declined the blood sugar meds and diet counseling. I monitored my blood sugar since then and it has never been higher than normal. Funny thing was the other doctors were saying all other readings were normal, but the senior doctor said one reading is paramount.

I’m guessing it was the salbutamol inhaler, my wife said after I passed out she was spraying it into my mouth, then the cops that came and transported me to the hospital were spraying it into my mouth. A 75% full salbutamol inhaler had become empty by the time I regained my faculties!

My point is one reading does not usually mean anything, if I were you I’d get a glucose meter and strips and keep track of your blood sugar. For all you know you might have accidentally broken the fast( it is really easy).

16

That’s not an anomalous reading; that’s a high reading as the result of taking epinephrine. This is a known effect and I’m somewhat surprised/shocked that a doctor would have thought it was indicative of actual diabetes.

The OP had fasting bloodwork done; it is much, much, much more unlikely that the reading in his case was anomalous or a fluke, and it is very appropriate and sensible for he and his GP to take it seriously and start treatment protocols.

17

My guess would be that the OP’s fasting glucose reading was somewhere between 100-125, which would be classified as impaired fasting glucose. Lots of people like to call this “prediabetes.” It isn’t diabetes, yet, but it could easily turn into it if ignored. But with a little bit of therapeutic change like exercise and lower carb intake, it could just as easily not. If that’s the case, the doctor’s advice was just fine–a little more insight on how to incorporate these changes would have been nice. At that level, though, blood sugar monitoring, further testing, and endocrinology workup aren’t warranted.

18

Thanks for the advice guys! Canada does the readings a little differently than the US because of measurements. Mine was 9.4 by Canadian readings, which seems to convert to 169 in the US measurements, if the internet has served me correctly. :smiley:

I definitely need to lose weight and it could probably control the diabetes - most of my calories are starchy carbs and junk food. I’m kinda just going on the premise that I’m going to replace the junk food with veggies and fruit, which may not affect my weight significantly, but it’s healthier calories. Like, if I’d have a bag of chips at lunch, do a bunch of carrots instead. It’s a huge lifestyle change for me, and I think this is the best way to make it stick for now. I know the carrots may not be the best choice overall, but it’s better than the chips, you know? This is the Dope where if you don’t do it all the way people will beat you up over it, but I gotta do what I think I can stick to.

After making this thread last night I decided to make an appointment with my previous GP back in my hometown. I’m fairly new to this city so the only doctors taking new patients are the doc-in-a-box guys who try to shove you out in 15 minutes. I’ll be going home for a visit in October, so I’ll do my follow-up visit with the first doctor to see if he gets any better for me and then I’ll get a second opinion from the trusted doctor who will cut through the BS with me.

Seanette, I’ll be looking for that “Type 2 Diabetes: The First Year” book. It got really good reviews on Amazon.

19

Yea I was just telling him that IF he doubts the test he can keep track of it himself and confirm it for himself, the meters and strips are cheap enough. Not that he shouldn’t take it seriously or should not start treatment, just that if he doubts it well confirmation is easy.

20

I got a copy of a 1500 calorie diabetic meal plan. It calls for 3 meals and 3 snacks a day. Every meal or snack calls for one carb (about 15 grams) except dinner, which allows 2 carbs. That brings the total carbs for the day to about 100.

A 15 gram serving of carbs would be one piece of bread, 1/2 cup of cereal/oatmeal/pasta/rice/potato, one small apple or orange, 4 ounces of juice, 6 ounces of yogurt, or 1 cup of (skim) milk- stuff like that.

But, you could get 2-3 cups of raw veggies for that, too.

You want to ‘spend’ your carbs wisely. You would do better to always pick the grainier or fresher thing- whole wheat over white, salad bar veggies over cooked veggie casseroles. You can have a(n occasional) donut, but it costs 2 carbs. Like highly processed bread, it also is used quickly.

And watch our for restaurant food. Those are not ‘servings’. Many pasta places give you up to 2 cups of pasta- way too much since a ‘serving’ is 1/2 cup.

You can have the junky stuff you like but as occasional treats, not regular food items. I’m finding I am losing my taste for those things over time. Two years ago, I would have told you my favorite junky snack was Lays’ potato chips. Now I find the greasy feeling in my mouth a little off-putting and the salt overwhelming, so it’s not hard to just have a few.