How do you learn to control your diabetes?

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alison

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I have posted on here before about my Mum having diabetes and how unhelpful her doctor was...since then she has bought herself a blood glucose tester (sorry I don't know proper name) and when she tested this morn 3 hours after her b'fast it said she had a reading on 16.0....I'm sure I read somewhere it shouldn't be over 13.0!!!

She had eaten fruit and fibre and some friut plus a yogurt if it helps to know but my question is how do you know what foods you can/can't eat when you eat a pretty healthy diet anyway? She is hoping to be put in touch with a dietician soon but thought I would ask on here too.

x
 
alison said:
a blood glucose tester (sorry I don't know proper name)
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The "proper" name is a glucometer, but its usually referred to as a "BG meter" or just a "meter" round these parts 😉

alison said:
She had eaten fruit and fibre and some friut plus a yogurt if it helps to know but my question is how do you know what foods you can/can't eat when you eat a pretty healthy diet anyway? She is hoping to be put in touch with a dietician soon but thought I would ask on here too.
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A dietician may be quite happy with that breakfast and recommend it (mine did), but you've seen what it does to her BG. This is because carbohydrates raise BG, particularly in the morning for many people.

So to put it another way, for breakfast she had carbohydrates, carbohydrates and carbohydrates with a bit of fibre and a touch of protein.

What I consider to be the best way to learn is to learn from your meter. You do have to bear in mind that you need to get all the usual nutrients, but this can be done in such a way that does not affect your BG too badly. Have a read of this and see if it might help:
http://www.diabetes-support.org.uk/joomla/jennifers-advice
 
Hello Alison

Sorry to hear your mum is still having problems. I wasn't sure where to start this response so thought I'd do some quick calculations so got the following levels broadly for you to consider

Fruit and fibre 30g -20g chd
Apple - 120g - 14g chd
Mullerllight yoghurt 200ml -16g chd

First thing in the morning 50g of chd would put me up by between 7.5 and 10 if I had the elements I counted for breakfast at the 2 hour mark. So this morning before breakfast my fasting level was 5.5 so slap bang in the middle of the recommended range of 4-7. The best I would have done with that breakfast is 13 so way above the 2 hour recommended level of 8.5 and that is with both metformin and gliclazide

As others have said on this forum - the only way to work out what affects your mum is to test, test and test. Really recommend Gretchen Becker's book on Type 2 Diabetes the first year for working out what is right for your mum. One thing is certain - we all vary and, for example, I can tolerate more of a carbohydrate load at lunchtime and in evenings as - like many - my insulin resistance is at its highest first thing in the morning

Hope this helps


Vanessa
 
remember even if something is low or light it refers to the ammount of fat usually, so a light yoghurt has less fat in it but still has the sugars.

For me it is very much a question of trial and error and how much physical activity I do. If I'm not well that pushes the levels up too.

Sounds like your mum is getting lots of support from you..

I can only tell you what works for me, but there is lots of good advice here, so see what others say and use the advice that works best for your mum.
 
Thanks for your replies and I found the link most helpful...have made a few notes and from what it says no wonder my mums reading was high. I will try and find Gretchens book too as I think we need all the help we can get at the mo.

Was wondering though...if eating carbs in the morn affect most peoples BG then what do you eat for breakfast?
 
alison said:
Was wondering though...if eating carbs in the morn affect most peoples BG then what do you eat for breakfast?
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This might give you some ideas:
http://www.diabetes-support.org.uk/joomla/diabetes-blogs/Shopping-For-Breakfast.html?blogger=VBH
At the bottom of that blog post is a link to Alan's blog with his excellent suggestions - I think he's a little less lazy than me 😉

Speaking of lazy, heres another blog post I did about cutting down prep time particularly for the mornings:
http://www.diabetes-support.org.uk/...ing-Chopping-and-Convenience.html?blogger=VBH
 
Thanks although I couldn't open the link at bottom of page? Also any suggestions for someone who doesn't eat meat as thats what was mostly advised on the first link.
 
For my breakfast I have one Oatibix (yep, the oat version of Weetabix!) with a bit of semi skimmed milk. That keeps me going till about 10am when I have an apple. That lasts me till lunch.
Oats are low GI so won't spike your blood sugars too badly and will keep you going for a few hours.
That's my recommendation, or go for porridge in the winter!!
 
SamInnocent said:
For my breakfast I have one Oatibix (yep, the oat version of Weetabix!) with a bit of semi skimmed milk. That keeps me going till about 10am when I have an apple. That lasts me till lunch.
Oats are low GI so won't spike your blood sugars too badly and will keep you going for a few hours.
That's my recommendation, or go for porridge in the winter!!
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You're using insulin. The T2 in question isn't.

Try that without shooting bolus and any of the above will cause a spike.
 
alison said:
Thanks although I couldn't open the link at bottom of page? Also any suggestions for someone who doesn't eat meat as thats what was mostly advised on the first link.
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Sorry about the dud link. I've fixed it but here's a direct link:
http://loraldiabetes.blogspot.com/2006/10/breakfasts.html

Alan also posts the odd extra recipe on there including one for stuffed mushrooms, so have a rummage in his blog.

No meat eh? Bit trickier I suppose but there are some options. If she eats eggs, then frittatas can be a good move, prepared in advance and just grab & go.

So long as the main components of a breakfast are low/no-carb veggies plus protein/fat then there should be no problem. So you might have to get creative. Also depends what the individual can get away with. So the option I have on my blog for mushrooms, peppers, onions, kidney beans and skip the bacon should work for example. Same with the omelette (if she eats eggs of course).

Pulses are pretty good overall, but bear in mind that although they are low GI they are relatively high GL. So you may still get a bit of a BG spike, but it might hit later. So go ahead and use pulses, but just be a bit cautious.

If she eats fish, then kippers have always been popular. Youngs do some frozen ones which could be cooked while in the shower.

So meatless breakfasts are not really a strong point for me. You might find something adaptable here:
http://www.diabetes-support.org.uk/joomla/recipes

And the low/no-carb veggies list is here:
http://www.diabetes-support.org.uk/joomla/free-veggies

Hope thats of some use and sorry I could not be more help.
 
alison said:
I have posted on here before about my Mum having diabetes and how unhelpful her doctor was...since then she has bought herself a blood glucose tester (sorry I don't know proper name) and when she tested this morn 3 hours after her b'fast it said she had a reading on 16.0....I'm sure I read somewhere it shouldn't be over 13.0!!!

She had eaten fruit and fibre and some friut plus a yogurt if it helps to know but my question is how do you know what foods you can/can't eat when you eat a pretty healthy diet anyway? She is hoping to be put in touch with a dietician soon but thought I would ask on here too.

x
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Hi Alison,

Sorry to hear about your mum's predicament. I hope you get to see a Dietitian soon. It would be useful to know what medication your mother is on? Pehahps it needs reviewing?

Unfortunately with T2DM it is a progressive condition, where the pancreas (organ that makes insulin) will eventually in the future gradually produce less and less insulin, then stop altogether. This means you mother's need for medication and eventually insulin will increase over time.

It's important that she should be able to eat a normal healthy diet, and her medication should be adjusted around this - not the other way around.

Hope this helps,

Mo 🙂
 
Mojo said:
Unfortunately with T2DM it is a progressive condition, where the pancreas (organ that makes insulin) will eventually in the future gradually produce less and less insulin, then stop altogether
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Thats a bit of a generalisation I'm afraid. T2 is only as progressive as you allow it to be.

Complications including the failure of beta cells tend to run roughly in parallel so you will get similar rates of deterioration over time. Complication rates correlate with A1c.

So for example over a period of 15 years, the chances of third-stage retinopathy are as follows:
A1c of 6% - 2% chance.
A1c of 7% - 16% chance
The curve of that particular graph is exponential. I don't have the rest of the figures on me but from memory, if you have an A1c of (I think) 10% for 12 years you are guaranteed retinopathy.
(anyone got Gretchen's book to hand? Its p73 or p93 I think. The only table of data in the book).

So the rate of damage caused to the eyes will generally be along similar lines to the damage to the pancreas.

Or to put it simply - T2 is as progressive as you allow it to be.

The closer you can get to a non-diabetic A1c, the less damage should be caused. According to the DCCT study, non-diabetic A1cs are 6% and under, although closer to 5 would be better.

For decades, diabetics have been told to aim for 7%.....which is probably why they have also been assured that T2 is progressive.
 
VBH said:
Or to put it simply - T2 is as progressive as you allow it to be.

The closer you can get to a non-diabetic A1c, the less damage should be caused. According to the DCCT study, non-diabetic A1cs are 6% and under, although closer to 5 would be better.

For decades, diabetics have been told to aim for 7%.....which is probably why they have also been assured that T2 is progressive.
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Fair point, but eventually the beta cells do pack up. The only reason some T2DM do not end up on insulin is because they don't live long enough to make it(!) Even some of the medications speed up the process e.g. glitazones and sulphonylureas. The realistic fact is that unfortunately most do not get non-diabetic A1c. But yes, you can delay the progression, which is why we strive for good control.

Mo 🙂
 
Not exactly positive thinking but fair enough.
 
VBH said:
You're using insulin. The T2 in question isn't.

Try that without shooting bolus and any of the above will cause a spike.
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The principle is the same though - go for low glycaemic index foods as they won't spike your blood sugar in the same way that medium and high GI foods do. It doesn't matter whether you're using insulin or not when it comes to this.

Oh, and by the way, you assume I'm on a basal-bolus regime. I'm not. I'm on three times a day injections - before breakfast, before lunch, before dinner (pork insulin too - I'm a bit old school!) so have to watch what I eat and eating low GI foods helps.
 
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I just think there's a bit of difference in perception here between T1 and T2.

Premix insulin is a mixture of basal and bolus so either way you have some bolus. In either case it replaces the first-phase insulin response that T2s are usually lacking.

T2 is mostly about insulin resistance and its common to have higher insulin resistance in a morning - particularly for T2s. So carbs can have a greater effect in the morning. Unless you are particularly overweight then as a T1 you are not likely to have insulin resistance, so its a bit different.

Lowering the GI is fine in principle, but in practice its extremely rare that any of those options will work for a non-injecting T2. They're not particularly low carb and certainly not low GL. They may be lower than others but that doesn't make em good. You're still suggesting a breakfast that is pretty much 80% carb (discounting fibre as irrelevant) at a time of day when IR is likely to be at its peak.
 
VBH said:
I just think there's a bit of difference in perception here between T1 and T2.

Premix insulin is a mixture of basal and bolus so either way you have some bolus. In either case it replaces the first-phase insulin response that T2s are usually lacking.

T2 is mostly about insulin resistance and its common to have higher insulin resistance in a morning - particularly for T2s. So carbs can have a greater effect in the morning. Unless you are particularly overweight then as a T1 you are not likely to have insulin resistance, so its a bit different.

Lowering the GI is fine in principle, but in practice its extremely rare that any of those options will work for a non-injecting T2. They're not particularly low carb and certainly not low GL. They may be lower than others but that doesn't make em good. You're still suggesting a breakfast that is pretty much 80% carb (discounting fibre as irrelevant) at a time of day when IR is likely to be at its peak.
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Errrmmm... I think you're misunderstanding me! GI is all about how quickly (or slowly) those carbohydrates are absorbed by your digestive tract and converted into blood sugar. Low GI foods are absorbed slowly so something like an Oatibix biscuit may be high in carbohydrates but that carbohydrate is trickled into the blood stream over 3-4 hours so won't spike your blood sugars. Granted the milk is medium-high GI, but you really only need a very small amount, just enough to make it wet!

My dad's a maturity-onset Type 2 diabetic by the way who controls his diabetes using diet and exercise so I know about both Type 1 and Type 2! He has a very low carb diet but low GI foods are part of that, including an Oatibix in the morning if he feels like it. Otherwise he'll have a protein-based breakfast (smoked haddock/bacon etc. etc.).

Really though, it's a case of "each to their own". What works for one person won't work for the next. Diabetes is a lot about trial and error unfortunately, as I'm sure you know!
 
Ah I see. We're not too far apart on this then. I think part of the misunderstanding is that you were posting about what you do a as a T1.

But the milk is a big factor, as you suggest. To most people "with milk" is a bit more than "a very small amount" and it does make a big difference. Same with porridge if its made with water instead of milk, but a lot of people don't like it when its made with water. So a lot is down to perception really.

Personally the only time I have either is when I am exercising an hour after breakfast, burning off the BG, but whatever works for the individual is fine by me.
 
I think we are all individuls and what works for one does not always work for another. Read the posts and see what others have to say, then make a decision based on that.

Foe me personally it has been a learning curve, very much tiral and error. When I asked for help or to be refred to a dietician to help me understand a little better my GP looked at me as thoe I was mad, so I come here!
 
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