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Medical Forum / Diseases and Disorders / Diabetes / January 2004

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Proper T2 Diet

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Preston Rich - 12 Jan 2004 16:54 GMT
Hi all.  I'm getting pretty fed up with all the contraversy over T2
diabetic diet and nutrition.  Frankly, I don't know what to do
anymore.  After perusing the literature, NG's and related websites
along with Medline searches I see two opposing camps on this issue.
One says to increase carbs to 50% of daily diet and decrease fats, and
the other says to follow the glycenic index and restrict carbs.  Who
the Hell is likely right on this extremely important issue????

-Preston
Colleen - 12 Jan 2004 17:10 GMT
> Hi all.  I'm getting pretty fed up with all the contraversy over T2
> diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 5 lines]
>
> -Preston

Look for Jennifer's advice to Newbies.  She'll probably be posting it soon.
It seems to be the best way that the majority of us have found to control
our blood sugar.

Using a blood glucose meter to check your glucose at fasting, post-prandial,
and before bedtime will help you to figure out which foods work for you in
your life.  It is the BEST daily tool you have for learning to control
diabetes.

I eat a diet of about 100-125 grams of carb per day.  My A1c's are below 6%
and my lipids are fine.  I don't ascribe to any one "diet" method as I find
that doesn't work.  I eat to what my meter says, exercise, and use meds to
help the control.  I was diagnosed in Oct. of '03 with an A1c of 10.8%.  I
started testing multiple times per day, started watching my carb portions,
watched saturated and trans-fats (don't worry about the good fats) and
eating lots of fresh veggies and unprocessed foods and three months later my
A1c was 5.4%.  Must be doing something right.

There are extremists on both sides of the carbohydrate debate.  I'm not a
proponent of any one diet method or guru or organization.  I use the tools
available, information from reliable sources, and input from my physician to
keep my health in check.

So far so good.
c
Rose - 12 Jan 2004 18:03 GMT
>Hi all.  I'm getting pretty fed up with all the contraversy over T2
>diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 5 lines]
>
>-Preston

Who is right?  The short answer is :  your meter readings and A1c
results.

Your body is individual.  You have to experiment, test, and figure out
what works for you.

Rose
T2
Julie Bove - 12 Jan 2004 19:05 GMT
> Hi all.  I'm getting pretty fed up with all the contraversy over T2
> diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 3 lines]
> the other says to follow the glycenic index and restrict carbs.  Who
> the Hell is likely right on this extremely important issue????

Nobody is right and nobody is wrong.  Each case of diabetes is different.
Bottom line is that you need to find a way of eating that gives you all of
the nutrition you need.  Also one that you can live with.  And one that
gives you nice numbers on your meter.  That's why we say so often YMMV (Your
mileage may vary).

Signature

Type 2
http://users.bestweb.net/~jbove/

bistoury@earthlink.net - 12 Jan 2004 20:01 GMT
You know!  I do what I want and fit in-between the the two.  I love
carbs as in fruits and pastas.  Can't live without them.  I have tried
over the last many years to eat what I test and test what I eat.  I have
found that 1/2 cup of pasta to one cup will do very well when dressed
with olive oil, garlic and fresh tomatoes.  1/2 cup with sauce/gravy.
I always check and see where the bg's are going and then do a bolus or
more exercise.
It doesn't always work but I can't live a completely strict diet with no
goodies...but then, to me goodies are a carrot, peach and bowl of
strawberries, a fresh ear of corn and a big giant thick steak (pre mad
cow) and pre gastroparesis.
I know this doesn't fit everyone's idea of what they should eat or how
to manage DM but it works for me and lets me have a semi normal life.
Matt

> Hi all.  I'm getting pretty fed up with all the contraversy over T2
> diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 5 lines]
>
> -Preston
Extreme-cc's - 12 Jan 2004 20:36 GMT
we are all individuals and not to many can follow the same diet.
I remember feeling the same way as you in the beginning.
I simply went to a dietitian and had a diet worked out for ME.

Signature

http://www.diabetes.org/homepage.jsp
Extreme-cc's
39 - Male - Type - 2
http://www.cruisercustomizing.com/memberdetail.cfm?user_ID=162139

> Hi all.  I'm getting pretty fed up with all the contraversy over T2
> diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 5 lines]
>
> -Preston
BlkBear - 12 Jan 2004 20:59 GMT
>Hi all.  I'm getting pretty fed up with all the contraversy over T2
>diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 3 lines]
>the other says to follow the glycenic index and restrict carbs.  Who
>the Hell is likely right on this extremely important issue????

Howdy Preston,

Best thing to do is, start somewhere and test your bg levels until
you find what works best for you.  It really does not matter what
"They"  say as far as a proper diet.  What actually matters is what
you will do as far as exercise and what you will eat, to help keep
your personal blood glucose levels in the range you want to keep it
in.

So if you CAN eat 50% in your daily diet, that's for you, if you
can't, you will of course have to eat less than 50% carbs in your
diet.

As to who is right, the people that find out what works best for
them are right, but right for them.  What many type 2's find is that
while a friend or family member can eat cartian things in varied
amounts, that they themselves can't.  Some  people have better
access to certain type of foods, in the area they happen to live.
Some people are such picky eaters, that it would not matter what
type of access to foods in glycenic index scale, if they won't eat
them, not much help to them.  ANd of course there are those that
refuse to make any changes in how and what they eat.

So  start where you are most comfortable and work up or down the
scale from there.
--
Terrell
type 2, dumped the metformin
D&E for now...
Ozgirl - 13 Jan 2004 00:52 GMT
> Hi all.  I'm getting pretty fed up with all the contraversy over T2
> diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 3 lines]
> the other says to follow the glycenic index and restrict carbs.  Who
> the Hell is likely right on this extremely important issue????

Just do some research on what nutrients a healthy body
needs and build your own diet around that bearing in
mind you have to count carbs to gain good control.  As
long as you cut bad fats like sat and trans fat and add
back good fats like those found in avocados, olives,
nuts, olive oil etc then there is no need to "cut
fats".  There is no need to have more "carbs" than your
blood sugar levels can tolerate either.  As long as you
replace vital nutrients that may be in a carb food with
a food that contains the same nutrients etc then you
should be ok.  Raw veges for example can supply you
with whatever you might get in a fruit but without the
added carbs. As no two diabetics are the same then it
is in your best interests to figure out your own
personal diet by researching vitamins, minerals etc.

Find out how much protein, calcium etc etc you
personally need in a day for good health.  Swap a
higher carb source of that nutrient for a lower carb
one etc.  Read about GI of foods too, the lower GI
foods are generally better for control than higher GI
foods.
Colleen - 13 Jan 2004 01:05 GMT
Excellent advice.  I think we should make it the diabetics mantra.
c

> > Hi all.  I'm getting pretty fed up with all the
> contraversy over T2
[quoted text clipped - 33 lines]
> foods are generally better for control than higher GI
> foods.
Jennifer - 13 Jan 2004 01:55 GMT
Who is right?

You are.

You and your meter.

Here's the advice I give all newbies:

There is so much to absorb... you don't have to rush into anything.  Begin
by using your best weapon in this war, your meter.   You won't keel over
today, you have time to experiment, test, learn, test and figure out just
how your body and this disease are getting along.  The most important
thing you can do to learn about yourself and diabetes is test test  test.

The single biggest question a diabetic has to answer is:

What do I eat?

Unfortunately, the answer is pretty confusing.

What confounds us all is the fact that different diabetics can get great
results on wildly different food plans.  Some of us here achieve
great blood glucose control eating a high complex carbohydrate diet.
Others find that anything over 75 - 100g of carbs a day is too
much.  Still others are somewhere in between.

At the beginning all of us felt frustrated.  We wanted to be handed
THE way to eat, to ensure our continued health.  But we all
learned that there is no one way.  Each of us had to find our own path,
using the experience of those that went before, but still having
to discover for ourselves how OUR bodies and this disease were coexisting.

Ask questions, but remember each of us discovered on our own what works best
for us.  You can use our experiences as jumping off points, but eventually
you'll work up a successful plan that is yours alone.

What you are looking to discover is how different foods affect you.  As I'm
sure you've read, carbohydrates (sugars, wheat, rice... the things our
Grandmas called "starches") raise blood sugars the most rapidly.  Protein
and fat do raise them, but not as high and much more slowly... so if you're
a T2, generally the insulin your body still makes may take care of the rise.

You might want to try some  experiments.

First:  Eat whatever you've been
currently eating... but write it all down.
Test yourself at the following times:

Upon waking (fasting)
1 hour after each meal
2 hours after each meal
At bedtime

That means 8 x each day.  What you will discover by this is how long
after a meal your highest reading comes... and how fast you return to
"normal".  Also, you may see that a meal that included bread, fruit or
other carbs gives you a higher reading.

Then for the next few days, try to curb your carbs.  Eliminate breads,
cereals, rices, beans, any wheat products, potato, corn, fruit... get all
your carbs from veggies.  Test at the same schedule above.

If you try this for a few days, you may find some pretty damn good
readings.  It's worth a few days to discover.

Eventually you can slowly add back carbs until you see them affecting your
meter.

The thing about this disease... though we share much in common and we
need to
follow certain guidelines... in the end, each of our bodies dictate our
treatment and our success.

The closer we get to non-diabetic numbers, the greater chance we have of
avoiding horrible complications.  The key here is AIM... I know that
everyone is at a different point in their disease... and it is progressive.
But, if we aim for the best numbers and do our best, we give ourselves the
best shot at heath we've got.
That's all we can do.

Here's my opinion on what numbers to aim for, they are non-diabetic numbers.

FBG                           under 110
One hour after meals       under 140
Two hours after meals     under 120

or for those in the mmol parts of the world:

Fasting                              Under 6
One hour after meals         Under 8
Two hours after meals       Under 6.5

Recent studies have indicated that the most important numbers are your
"after meal" numbers. They may be the most indicative of future
complications, especially heart problems.

Listen to your doctor, but you are the leader of your diabetic
care team.  While his /her advice is learned, it is not absolute.   You
will end up knowing much more about your body and how it's handling
diabetes than your doctor will.   Your meter is your best weapon.

Just remember, we're not in a race or a competition with anyone but
ourselves... Play around with your food plan... TEST TEST TEST.  Learn what
foods cause spikes, what foods cause cravings... Use your body as a science
experiment.

You'll read about a lot of different ways people use to control their
diabetes... Many are diametrically opposed. After awhile you'll learn that
there is no one size fits all around here.  Take some time to experiment
and you'll soon discover the plan that works for you.

Best of luck!

Jennifer

> Hi all.  I'm getting pretty fed up with all the contraversy over T2
> diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 5 lines]
>
> -Preston
Preston Rich - 14 Jan 2004 15:44 GMT
Jennifer--

After assimilating all this good advice here is my particular problem.
My stomach is _very_ slow to empty--perhaps twice normal.  I also
have the "nighttime liver pump" syndrome in which my fasting morning
glucose is always the highest of the day-regardless of what I eat as
my liver pumps significant glucose overnight.  How can one possibly
draw proper correlations under this scenario to food intake/glucose
readings?

-Preston

> Who is right?
>
[quoted text clipped - 120 lines]
> >
> > -Preston
Jennifer - 14 Jan 2004 17:00 GMT
If by slow to empty, do you mean you have gastroparesis?

I would suggest you break out a big box of strips and for a week or two
test yourself starting 1 hour post meals and every 15 minutes thereafter
UNTIL you've peaked and returned to your baseline.

If you do that for a week's worth of three meals a day (a lot of strips
I know), you should have a decent idea of where your peak comes.

Then you can use that info and instead of testing at 1 hour and 2 hours,
you can test at your peak and one hour later.

It's all about what a meal does to your BGs.

As for the overnight thing... I would have to say 75 percent of the
folks here have the dawn phenomenon.  Here's some info:

Here's what happens to all of us over night.

During the night while you're asleep and can't be eating, the body still
needs some energy to keep it going.  So, glucose, which has been stored in
the liver as "glycogen" is released into the blood.  In preparation for
waking, the body sends out the biggest batch of glycogen in the last few
hours before waking... usually between 3a - 8a. Also in these wee hours of
the morning, the body puts out  other hormones from the adrenal and
pituitary glands... It's all part of the normal cycle for these hormones.
They signal to the body that a new day is starting.  They rev you up and
get you ready to awaken.  BUT... they also have an added effect on the
liver that makes it less sensitive to insulin.  In non diabetics, this
doesn't pose any problem...  But in us diabetics, the liver dumping
glucose, coupled with the insulin dampening hormones mean we awaken with
high BG.

Now.  What can be done?

When I was first diagnosed 6/99 ... I worked
soooo hard to gain control of my BG.  And I did pretty damn good.  The only
thing I couldn't get under control were my morning numbers (FBG; Fasting
Blood Glucose).

I read all I could on the subject. (That's how I could come up with the
lengthy response above)... but no answers.  I tried every suggestion that
anyone came up with.  High carb snacks before bed.  Low carb snacks before
bed.  Not eating anything after 6p.  A glass of wine at 10p (that one I
liked)... etc. etc. etc.

Nothing changed it.  No matter what I did, my FBG numbers were always the
highest of the day.  My other numbers were just where I wanted
them... (I tested often... 1 hour after each meal and 2hrs after each
meal, morning and bedtime... 5 - 8x a day).  And my A1cs were and continue
to be under 5.7
Because of that, I chose not to lose any sleep over those pesky FBGs.

So, in my opinion, keep trying, but work much harder on your Post Prandial
readings (Post Prandial or PP means "after meals").  There have been
studies that say they are the most indicative of future problems... not the
FBG.

Hang in.  It's all a learning process.  The best thing you can do is TEST
TEST TEST.

Jennifer

> Jennifer--
>
[quoted text clipped - 132 lines]
>>>
>>>-Preston
Preston Rich - 15 Jan 2004 14:26 GMT
Jennifer--

Boy, what a great answer!  I didn't realize so many of us had the
"dawn phenomenon".  Yes, I have mild to moderate gastroparesis.  In
fact 25 years ago, well before I became a corpulent slob ;-) and a T2,
I was having difficulty with my vegas nerve and experiencing some mild
vasomotor reactions and chronic PAT as a result.  I remember taking
Reglan for awhile, but it made me jump out of my skin and had to stop.
Now, years later, I still have mild to moderate gastroparesis which
will greatly complicate my GB control.  However, like you, my hBA1c is
only 5.5.  Fortunately, my BG readings run between 70-120 and only
spike to 160 after being a "very bad boy".  Thanks so much for your
great help and observations.

-Preston

> If by slow to empty, do you mean you have gastroparesis?
>
[quoted text clipped - 195 lines]
> >>>
> >>>-Preston
Jonathan - 14 Jan 2004 21:14 GMT
You may not be able to fix the liver-dump problem with diet.  I tend
to have the same problem.  My doctor put me on 15 units of Lantus (a
slow-acting insulin) at bedtime.  That's worked very well.

> Jennifer--
>
[quoted text clipped - 132 lines]
> > >
> > > -Preston
Pete - 13 Jan 2004 09:20 GMT
>Hi all.  I'm getting pretty fed up with all the contraversy over T2
>diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 4 lines]
>the Hell is likely right on this extremely important issue????
>-Preston

Do what I and loads of others have done...............test
eat test eat test eat test eat. Each of us is different and
no matter which 'camp' you attach yourself to initially you
will find that you might respond very differently from what
you'd expect based upon the advice of others.

The best for you will be specific to you and the only way
you will find that out is from experience. However, there
are general guidelines to set you off on the experimental
route and information abounds.

In my case I restrict carb content - severely and over the
last 9 months have successfully lost excess weight, became
controlled with improving A1c's and on a minimum of meds.

YMMV

Diagnosed 20/03/03 Type II D&E + Metformin + Gliclazide
+ Asprin 210lbs at Dx to BMI 166lbs achieved.
To mail: aspen at freeuk.com
Priscilla H Ballou - 13 Jan 2004 21:24 GMT
Pete <aspen3@freeuk.com> quoth:

>Do what I and loads of others have done...............test
>eat test eat test eat test eat.

Or test, eat, test, test,     test, eat, test, test,   test, eat, test,
test....

;-)

Priscilla
Pete - 13 Jan 2004 22:05 GMT
>Pete <aspen3@freeuk.com> quoth:
>
[quoted text clipped - 5 lines]
>;-)
>Priscilla

There is a fine dividing line between paranoia and.......

:-))

Diagnosed 20/03/03 Type II D&E + Metformin + Gliclazide
+ Asprin 210lbs at Dx to BMI 166lbs achieved.
To mail: aspen at freeuk.com
Colleen - 13 Jan 2004 22:08 GMT
Is this a new rap song???
c

> Pete <aspen3@freeuk.com> quoth:
>
[quoted text clipped - 7 lines]
>
> Priscilla
Priscilla H Ballou - 14 Jan 2004 19:38 GMT
Colleen <colleen@privacy.net> quoth:
>Is this a new rap song???

Hey, it's got a beat, and I can dance to it!  

>> Pete <aspen3@freeuk.com> quoth:
>> >Do what I and loads of others have done...............test
>> >eat test eat test eat test eat.
>> Or test, eat, test, test,     test, eat, test, test,   test, eat, test,
>> test....
>> ;-)

Priscilla
Colleen - 14 Jan 2004 19:55 GMT
boon shacka lacka boom!
c

> Colleen <colleen@privacy.net> quoth:
> >Is this a new rap song???
[quoted text clipped - 9 lines]
>
> Priscilla
Pete - 14 Jan 2004 22:02 GMT
>boon shacka lacka boom!
>c

Err.noooooo........its morse for YYY

[[Test = dash{dah} & eat = dot{di-except when it the last
item when it is dit}]] hence

ie:  test, eat, test, test,  [dah di dah dah = Y]  
test, eat, test, test, [dah di dah dah = Y]
test, eat, test, test....[dah di dah dah = Y]

>> Colleen <colleen@privacy.net> quoth:
>> >Is this a new rap song???
[quoted text clipped - 9 lines]
>>
>> Priscilla

Diagnosed 20/03/03 Type II D&E + Metformin + Gliclazide
+ Asprin 210lbs at Dx to BMI 166lbs achieved.
To mail: aspen at freeuk.com
Colleen - 14 Jan 2004 22:19 GMT
Picky, picky.  ;>)
c

> >boon shacka lacka boom!
> >c
[quoted text clipped - 25 lines]
> + Asprin 210lbs at Dx to BMI 166lbs achieved.
> To mail: aspen at freeuk.com
Pete - 14 Jan 2004 22:37 GMT
>Picky, picky.  ;>)
>c

Are you referring to my eating habits?

>> >boon shacka lacka boom!
>> >c
[quoted text clipped - 26 lines]
>> + Asprin 210lbs at Dx to BMI 166lbs achieved.
>> To mail: aspen at freeuk.com

Diagnosed 20/03/03 Type II D&E + Metformin + Gliclazide
+ Asprin 210lbs at Dx to BMI 166lbs achieved.
To mail: aspen at freeuk.com
David Robin - 13 Jan 2004 12:48 GMT
>Hi all.  I'm getting pretty fed up with all the contraversy over T2
>diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 5 lines]
>
>-Preston

At the risk of being no help at all, I'll suggest that you have to ry
an approach, see if it works for you.  If it doesn't try another
approach.

The reason you have 2+ compeating diets is because some people benefit
from each approach.  What is important is what works for you in the
framework of the rest of your program:  that is, your meds (if any)
and your exercise regimen.

Remember, the trick is to find a COMBINATION OF THE THREE that allows
for BG control w/out your feeling that you are about starve, or that
you are always gaining weight.

The problem with the "diet wars" is that diet is treated as a magic
bullet that is the start and finish of your program.  It ain't the
case.

David
Mack - 14 Jan 2004 12:46 GMT
>Hi all.  I'm getting pretty fed up with all the contraversy over T2
>diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 5 lines]
>
>-Preston

what does your BG meter tell you?

Mack
Type 1 since 1975
http://www.alt-support-diabetes.org
http://www.insulin-pumpers.org

In tribute to the United States of America and the State
of Israel, two bastions of strength in a world filled with strife and
terrorism.
hemyd - 15 Jan 2004 08:14 GMT
Do you have a bg meter? Use it - frequently. To find out what each type of
food does to your blood glucose. Also get tests doen on your cholesterol and
triglycerides. You'll soon make up your own mind.

Henry

> Hi all.  I'm getting pretty fed up with all the contraversy over T2
> diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 5 lines]
>
> -Preston
hemyd - 15 Jan 2004 08:16 GMT
As well as mesuring your bg to check the effects of your diet, you should
also take into account the effects of excercise. That can also influence the
diet you can tolerate.

Henry

> Hi all.  I'm getting pretty fed up with all the contraversy over T2
> diabetic diet and nutrition.  Frankly, I don't know what to do
[quoted text clipped - 5 lines]
>
> -Preston
Preston Rich - 15 Jan 2004 20:53 GMT
Regarding lipids, I went to the Johns Hopkins and had a expanded VAP
lipid panel ordered from Atherotec.  Results not in yet.  Am also
checking my serum for Apo B-100, Apo C3, IDL, LPa, homocysteine and
CRP2 as well as size and density.  Yes, I have a ng meter and have
been using (and abusing ;-) it), but it hasn't revealed any secrets
yet.

-Preston

> As well as mesuring your bg to check the effects of your diet, you should
> also take into account the effects of excercise. That can also influence the
[quoted text clipped - 11 lines]
> >
> > -Preston
 
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