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Medical Forum / Diseases and Disorders / Diabetes / October 2005

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Hemoglobin is 6.3%  Glucose 95

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Newbie to the group - 19 Oct 2005 22:22 GMT
My doc ( who is excellent .. open .. smart ) says I am somewhat
borderline ..
and he suggests big changes in diet.  I agree. My situation is such
that I am
not the best cook in the world .. and have another condition which
makes me
slightly disabled.  Any suggestions appreciated. In the meantime I will
be on
a mission :)  Doc also likes  Zone diet.
Tiger Lily - 19 Oct 2005 22:30 GMT
the Zone diet is close to what i follow for % of
food by groups

read Jennifer's advice in the URL below........ i
hope your Dr Rx'd  a meter and strips for you

kate

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> My doc ( who is excellent .. open .. smart ) says I am somewhat
> borderline ..
[quoted text clipped - 5 lines]
> be on
> a mission :)  Doc also likes  Zone diet.
Susan - 19 Oct 2005 22:36 GMT
> My doc ( who is excellent .. open .. smart ) says I am somewhat
> borderline ..

Borderline WHAT with an A1c of 6.3?

> and he suggests big changes in diet.  I agree. My situation is such
> that I am
[quoted text clipped - 3 lines]
> be on
> a mission :)  Doc also likes  Zone diet.

The Zone is too carby for any but a most physically active diabetic; my
doc and my own bg experience agree.  It's 40% carbs!  Lipids researchers
feel any diet with only 30% calories from fat cannot supply optimal
levels of essential fatty acids.

Your use of a glucose meter after meals will show you what your ideal
meal composition should be.

As for cooking, the Zone requires more prep and chef skills than any
plan I've ever attempted, and it's a PITA to calculate every snack in %.

Here's some advice from one of our posters:

http://www.diabetic-talk.org/jennifer.htm

Susan
Newbie to the group - 20 Oct 2005 00:04 GMT
Perhaps I did not state the situation correctly :)  Doc says that 6.3
is of concern to him.  For more than a few years I have felt
tired...sometimes a
bit dizzy, strange walking gait, overall just dont feel well. Went to
every doc, quack etc. You name it.  Nobody could find anything.  So I
found yet
another new Doc ... who was testing me for Thyroid problems.  No probs
there ..but he is concerned about the 6.3  and the  95 Glucose.  I hope
this clears up my posting.  Thanks for reading my e mail :)  Any
thoughts appreciated.  It looks like the group is excellent !!
Thomas Muffaletto - 20 Oct 2005 01:08 GMT
 it is not up to me to choose your diet the zone diet may work best for
you.
but I feel when it comes to food - it is not a 1 size fits all thing.
I feel it is best to work with a dietitian.

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Tom
Exercise Today = Life Tomorrow
ADA's Diabetes Learning Center
http://www.diabetes.org/all-about-diabetes/chan_eng/channel.htm
Information you can trust from the diabetes experts...
Your American Diabetes Association
http://www.diabetes.org/home.jsp
the American Diabetes Association's Message Boards
http://community.diabetes.org/n/pfx/forum.aspx?webtag=amdiabetesz&nav=index
Pictures of My motorcycle and I think 2 of my doggies.
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> Perhaps I did not state the situation correctly :)  Doc says that 6.3
> is of concern to him.  For more than a few years I have felt
[quoted text clipped - 6 lines]
> this clears up my posting.  Thanks for reading my e mail :)  Any
> thoughts appreciated.  It looks like the group is excellent !!
Julie Bove - 20 Oct 2005 02:27 GMT
> Perhaps I did not state the situation correctly :)  Doc says that 6.3
> is of concern to him.  For more than a few years I have felt
[quoted text clipped - 6 lines]
> this clears up my posting.  Thanks for reading my e mail :)  Any
> thoughts appreciated.  It looks like the group is excellent !!

The problem is that you are NOT borderline.  Your situation sounds like mine
upon diagnosis.  I got to the point where I could not walk at all.  It's
called neuropathy.  Nerve damage caused by the high BG.  You should consider
seeing an Endocrinologist.

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Thomas Muffaletto - 20 Oct 2005 01:06 GMT
From the American Diabetes Associations web site.
1. Why do I need to see a dietitian?

Registered dietitians (RDs) have training and expertise in how the body uses
food. RDs who understand diabetes can teach you how the food you eat changes
your blood glucose level and how to coordinate your diabetes medications and
eating. Do you know how many calories you should eat each day? How to cut
down on the fat in your meals? How to make eating time more interesting? An
RD can help you learn the answers to these, and lots of other questions.
Your dietitian will work with you to create a healthy eating plan that
includes your favorite foods.

2. Can I eat foods with sugar in them?

For almost every person with diabetes, the answer is yes! Eating a piece of
cake made with sugar will raise your blood glucose level. So will eating
corn on the cob, a tomato sandwich, or lima beans. The truth is that sugar
has gotten a bad reputation. People with diabetes can and do eat sugar. In
your body, it becomes glucose, but so do the other foods mentioned above.
With sugary foods, the rule is moderation. Eat too much, and 1) you'll send
your blood glucose level up higher than you expected; 2) you'll fill up but
without the nutrients that come with vegetables and grains; and 3) you'll
gain weight. So, don't pass up a slice of birthday cake. Instead, eat a
little less bread or potato, and replace it with the cake. Taking a brisk
walk to burn some calories is also always helpful.

3. Why does losing weight help my diabetes?

Weight loss helps people with diabetes in two important ways. First, it
lowers insulin resistance. This allows your natural insulin (in people with
type 2 diabetes) to do a better job lowering blood glucose levels. If you
take a diabetes medicine, losing weight lowers blood glucose and may allow
you to reduce the amount you're taking, or quit taking it altogether.
Second, it improves blood fat and blood pressure levels. People with
diabetes are about twice as likely to get cardiovascular disease as most
people. Lowering blood fats and blood pressure is a way to reduce that risk.

4. How can I cut the fat in my diet? :)

Here are some beginning hints. See a dietitian for more advice. Stir-fry
foods in tiny amounts of oil and lots of seasonings. Choose nonfat or
low-fat selections, such as nonfat or 1% milk or low-fat cheese. Keep
portion sizes on target. Avoid fried foods -- bake, grill, broil, or roast
vegetables and meat instead.

place comments here :)

5. Are some fats better than others?

Yes. Monounsaturated fats are the healthiest for your body. Nuts -- like
almonds, cashews, hazelnuts, and peanuts -- and avocados contain this type
of fat. Choose olive or canola oil for cooking. Polyunsaturated fat is the
next healthiest fat. This is found in corn oil, safflower oil, soybean oil,
and mayonnaise. Use small amounts of foods that contain saturated fats like
butter, lard and meat fat, bacon, and shortening. There are lower-fat
versions of foods that contain saturated fats, like sour cream and cream
cheese. A healthy diet includes less than 30% of calories from fat, with
less than 10% of these from saturated fat.

6. What foods can I eat a lot of?

Forget about eating with abandon. The key to healthy living is moderation.
Air-popped popcorn may be low in fat, but it still has calories. And
calories count. If you can control the portion sizes of the food you eat,
you will be able to eat a wider variety of foods, including your favorites,
and still keep your blood sugar in your target range.

7. What can I do if I overeat over the holidays?

Put on your walking shoes and head for the pavement. Being more active helps
lower your blood sugar, blood pressure and cholesterol. Physical activity
uses up extra sugar in your blood and helps your insulin work better.

8. Can I use low calorie sweeteners?

Low calorie sweeteners are safe for everyone except people with
phenylketonuria, who should not use aspartame. Calorie-free sweeteners like
aspartame, saccharin, sucralose and acesulfame-K won't increase your blood
glucose level. The sugar alcohols -- xylitol, mannitol, and sorbitol -- have
some calories and do slightly increase your blood glucose level. Eating too
much of any of these can cause gas and diarrhea.

9. How much weight should I lose each week?

Limiting your weight loss to 1/2 to 1 pound a week will keep you healthy,
and let you enjoy the foods you love in small amounts. A slow steady weight
loss is the key to keeping lost weight off.

10. Can I drink alcohol?

Yes, in moderation. Moderation is defined as two drinks a day for men and
one drink a day for women. A drink is a 5-ounce glass of wine, a 12-ounce
light beer, or 1-1/2 ounces of 80-proof distilled spirits. Make sure that
your medications don't require avoiding alcohol, and get your doctor's okay.

11. Isn't glucose control easier if I eat the same things every day?

Probably, but this method of blood glucose control isn't very nutritious,
not to mention boring. One of the keys to nutrition is eating a variety of
foods each day. By checking your blood glucose two hours after starting to
eat a meal, you can learn how different foods affect you. Over time, you
will be able to predict how foods, and combinations of foods, affect your
blood glucose level.

12. What vitamins will help my diabetes?

If you have a vitamin or mineral deficiency, it could be causing problems
with your glucose control. For instance, one study found that taking the
trace element chromium improved glucose control in subjects who had a
chromium deficiency. More studies need to be done. If you choose a variety
of fruits, vegetables, grains, and meat each day, and keep your blood sugar
close to your target range, you probably don't need to take vitamin
supplements because of diabetes.

13. Are there herbs that will help my diabetes?

Many herbs supposedly have glucose-lowering effects, but there are not
enough data on any herb to recommend it for use in people with diabetes.
Herbs are not considered food by the Food and Drug Administration and are
not tested for quality or content. Therefore, products can be promoted as
helping health conditions without having to show evidence of this. Discuss
the herbal dietary supplements with your doctor or dietitian before trying
them. They may interact poorly with your diabetes medication.

Signature

Tom
Exercise Today = Life Tomorrow

Information you can trust from the diabetes experts...
Your American Diabetes Association
http://www.diabetes.org/home.jsp
the American Diabetes Association's Message Boards
http://community.diabetes.org/n/pfx/forum.aspx?webtag=amdiabetesz&nav=index
Pictures of My motorcycle and I think 2 of my doggies.
http://www.adventurseofvtx1300c.com.50megs.com/photo.html

--
Tom
Exercise Today = Life Tomorrow
ADA's Diabetes Learning Center
http://www.diabetes.org/all-about-diabetes/chan_eng/channel.htm
Information you can trust from the diabetes experts...
Your American Diabetes Association
http://www.diabetes.org/home.jsp
the American Diabetes Association's Message Boards
http://community.diabetes.org/n/pfx/forum.aspx?webtag=amdiabetesz&nav=index
Pictures of My motorcycle and I think 2 of my doggies.
http://www.adventurseofvtx1300c.com.50megs.com/photo.html

> My doc ( who is excellent .. open .. smart ) says I am somewhat
> borderline ..
[quoted text clipped - 5 lines]
> be on
> a mission :)  Doc also likes  Zone diet.
Julie Bove - 20 Oct 2005 02:20 GMT
> My doc ( who is excellent .. open .. smart ) says I am somewhat
> borderline ..
[quoted text clipped - 5 lines]
> be on
> a mission :)  Doc also likes  Zone diet.

First, there is no such thing as "somewhat borderline".  And with an A1c of
6.3 you do have diabetes, unless your lab has some wildly different range
than mine.  What is the normal range for A1c?

I would suggest that you find another Dr. who will treat your diabetes
seriously.  As for the Zone diet, I am not that familiar with it.

I am disabled.  And I am a good cook, but don't always have time to do it.
I also have a daughter with food allergies so that further complicates
things for me.  Plus, I'm a picky eater.  I often cook chicken breasts ahead
of time so my daughter will have something to eat in a pinch, but I can't
stomach chicken unless it is prepared in certain ways.

Many times I eat salad for lunch or dinner.  I usually buy the washed bagged
salads and add other things like peppers, onions, tomatoes, olives, etc.  If
there is no other protein with my meal, I'll also add cheese, boiled eggs,
cooked dried beans, cooked meat or tuna.  Sometimes I add some pecans or
walnuts.  Sometimes I add thin slices of pear or apple. I don't like
dressing.  But I might on occasion add a squeeze of lemon.  If you like
dressing, you'd need to read the labels to find one that is appropriate for
your diet.  Beware of the "diet" or "fat free" dressings.  These are often
little more than water, or they might have a lot of sweetener to make up for
the lack of fat.  Vinegar and oil dressing is usually okay for most diets.

If you have trouble chopping things, you can buy a lot of these things
already prepared.  Strips of cooked chicken are available in most stores.
I've also seen cubes of ham, and occasionally cooked roast beef.  Be sure to
check for added ingredients that might not work for your diet.  My husband
was going to do Atkins but could never stick to it.  I did read the book
though and know that most lunch meat is not suitable because of the added
sweeteners.  Don't know if this would apply to the Zone or not.

Roasted chicken is another option for a quick meal, if you have a store or
restaurant near you that makes it.  If you live alone, one chicken could be
enough for several meals.

I find it is easier if I can do some things up ahead of time.  I mentioned
the chicken breasts for my daughter.  I simply cook them in a skillet with a
bit of olive oil, salt, peppers and a bit of water or broth until they're
cooked through.  I then put them in sandwich bags and freeze them.

For myself, I cook up a couple of pounds of ground beef at one time.  I add
quite a lot of chili powder.  I like spicy food!  I then put up sandwich
bags with individual portions to be used for taco salads or other things.
I can make a quick dip by heating up a package of the meal with some cheese,
onions and peppers and maybe some canned beans if I can manage the carbs at
that meal.  I then use chunks of peppers or tortilla chips to scoop up the
dip.

Another easy dip is to take some cottage cheese, grated cheddar, chopped red
onion and a bit of black pepper and whip it with an immersion blender.  This
is wonderful with raw veggies and makes a low carb meal or snack.

Stuffed tomatoes are another quick meal.  Take a largish tomato and slice
not all the way down through it, then spread the "petals" for stuffing.
Then fill with a scoop of your favorite meat, fish, egg salad or cottage
cheese and you've got a meal!

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Dave - 21 Oct 2005 12:05 GMT
95 without medication is not diabetic!!!

See a Doctor (endocrinologist) who can really tell you.

>> My doc ( who is excellent .. open .. smart ) says I am somewhat
>> borderline ..
[quoted text clipped - 77 lines]
> Then fill with a scoop of your favorite meat, fish, egg salad or cottage
> cheese and you've got a meal!
Jenny - 21 Oct 2005 15:50 GMT
> 95 without medication is not diabetic!!!
>
[quoted text clipped - 81 lines]
>>Then fill with a scoop of your favorite meat, fish, egg salad or cottage
>>cheese and you've got a meal!

95 without meds is diabetic if your blood tests over 200 mg/dl in two or
more random tests.

It's right there in the ADA criteria for the Diagnosis of Diabetes
Mellitus.

There are several different profiles of diabetic blood sugars.
http://www.geocities.com/lottadata4u/progression.htm details the
Baltimore Longitudinal Study of Aging data that illuminates this.

There are people with both high fasting and high post-prandial numbers.

There are people with normal fasting numbers and high post-prandial
numbers. These tend to be women over 50 and people of color. They also
tend to die of heart disease at a much higher rate than people of their
age who do not have the high post-prandial numbers.

There is even a small subgroup (mainly males) who have diabetic fasting
blood sugar levels but normal post-prandial values.

It all depends on what is broken. Type 2 Diabetes is not a single
condition but many different breakdowns in the glucose processing
pathway that have in common only that they result in high blood sugars.

--Jenny

http://www.geocities.com/lottadata4u/  Type 2 Diabetes info
http://www.geocities.com/jenny_the_bean/  Low Carb info
Julie Bove - 21 Oct 2005 17:11 GMT
> 95 without medication is not diabetic!!!

An A1c of 6.3 is!  Are you telling me that no diabetic ever has 95 when they
test?

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Wes Groleau - 22 Oct 2005 04:48 GMT
> 95 without medication is not diabetic!!!

Depends on WHEN you're 95.  I am never
over a hundred except shortly after eating.
And I am not on medications.  By the AACE's
definition, however, I AM diabetic.

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Wes Groleau
  "To know what you prefer, instead of humbly saying
   Amen to what the world tells you you should prefer,
   is to have kept your soul alive."
                         -- Robert Louis Stevenson

Dave - 21 Oct 2005 12:05 GMT
What you have is "syndrome x" or what is known as Metabolic Syndrome.
Have an endo check it out and monitor it.

>> My doc ( who is excellent .. open .. smart ) says I am somewhat
>> borderline ..
[quoted text clipped - 77 lines]
> Then fill with a scoop of your favorite meat, fish, egg salad or cottage
> cheese and you've got a meal!
Julie Bove - 21 Oct 2005 17:11 GMT
> What you have is "syndrome x" or what is known as Metabolic Syndrome.
> Have an endo check it out and monitor it.

Not with an A1c of 6.3!

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Quentin Grady - 20 Oct 2005 05:01 GMT
This post not CC'd by email
On 19 Oct 2005 14:22:00 -0700, "Newbie to the group"
<fastpitstops@aol.com> wrote:

>My doc ( who is excellent .. open .. smart ) says I am somewhat
>borderline .. and he suggests big changes in diet.  I agree.
>My situation is such that I am not the best cook in the world ..
>and have another condition which makes me slightly disabled.  
>Any suggestions appreciated. In the meantime I will
>be on a mission :)  Doc also likes  Zone diet.

G'day G'day "Newbie to the group",

Welcome to asd.  T2 diabetes is bit like that hotel in the song. Many
come in but none can leave. Diabetes is for life.  The good news is
that most of the folks here have adjusted to that and many are
paradoxically enjoying better health than they did before diagnosis.

A couple of points.  To what does the 95 refer. Is this a FASTING
blood glucose in mg/dL units as commonly used in the US?  If it is
then you must be having some high readings after meals.

What are your typical hour and two hour after meal readings?

Let's say, just for the sake of discussion, that you are having 96
mg/dL USA readings on your home blood glucose meter AND that you are
having some whacky high readings after meals.  What this would suggest
is that your aren't a borderline diabetic ... you are however likely
to be a diabetic who is early in the diabetic progression.  
This is not a diagnosis. A GP or anyone else for that matter, cannot
diagnose diabetes from an A!c reading. It just isn't done that way.
Mind you one can make a pretty good guess. It is just that using A1c
to diagnose diabetes is flawed and it something no one wants to get
wrong.

That is good news.  It means if you act appropriately and promptly you
have a better chance than many of us had in avoiding the seven or so
ugly ways T2 diabetes can take away enjoyment of life and even life
itself.

The Zone diet isn't the worst choice anyone could make especially if
one looks at the Anti-inflammation Zone diet Barry Sears has recently
published.  Avoiding what is known as silent inflammation is one of
the wiser paths for T2 diabetics to follow.  Whatever.  Many people
find Zone cumbersome to follow and then there is the reality factor.
You can choose a diet but it might not choose you.  I realise you
would like to have the diet thing nailed down but that approach is a
bit like speed dating ... the results aren't always what you
anticipate.  Put simply, you are unique. Even on brief acquaintance it
is apparent that you have aspects of your medical condition that make
you different from others here. Being all diabetic doesn't make us the
same ... only seemingly the same ... nah ... we're all different. The
other folks here are weird, I'm unique. <grin>

What I'm about to suggest in my rambling way is that your diet will
have to be tailored for you. No one else's diet will work optimally
for you.  A dietician may make a pretty good guess at a suitable diet
but that will only be a starting point.  Your diet will require
modification for you, for the progression of the diabetes (if it
progresses), for your weight which will vary, for the seasons and for
what is available locally.  

Many, many folks have benefited from reading and taking on board
Jennifer's advice to newbies.  Learning from regular feed back
provided by regular testing is vastly sounder than prescriptive
approaches which attempt to calculate what is right for you and
ascribe any shortcomings to you rather than an indication that
modifications need to be made.

Best wishes,

Signature

Quentin Grady       ^  ^  /
New Zealand,       >#,#< [
                   / \ /\    
"... and the blind dog was leading."

http://homepages.paradise.net.nz/quentin

 
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