Medical Forum / Diseases and Disorders / Diabetes / January 2004
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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