Whats wrong with my diet?

[megga]

ok, first let me say sorry for the bombardment of questions, i know i have only just joined, and can become a pain in the bum very quickly.
But there is a lot of knowledge on this forum and i wish to guzzle as much up as i can, and if i can help with anything i will.

But what is your normal diet, as i have stated my hba1c is high, and i need to get it down.
So for me
Breakfast weekdays, 1 slice of toast with marg
weekends 1 slice of toast, with marg, tin toms, backon and some mushrooms (i have a big breakfast weekends as i skip lunch.

Weekdays, pack lunch 1 ham sandwich, 2 boiled eggs, either a chicken drumstick or a peperami.

dinner, a small amount of mash pots (20 grams) then some broc and colli mashed in to bulk it out, veg, and fish/meat
but some times (twice a week, i have oven chips)

i dont snack in the day, but at night if i do, i'll have zero carbs, some cheese, pickled onions or a carrot.

I did drink nearly every night, but now just sunday, white wine or beer (and i dont get drunk)

Other drinks coffee (black) and diet pop thats it.

Saying all this, i am getting something wrong, otherwise my hba1c would be fine.

When i have bacon, i take 1 unit for that as the fats turn in to carbs, but apart from that, i only basel for carbs.

As i am on the pump, i do do some fasting, to make sure my background is right, and its always stable so i know thats right.

 

[Northerner]

What sort of bread are you eating? Many of our members (me included!) find that Burgen Soya and Linseed is one of the better varieties, around 12g per slice and slow-release with all the seeds - tasty too! 🙂

Also, do you test after meals to find the spikes? It could be that you are spiking up bu back to normal levels before your next meal. If ound that this was happening to me and began adjusting the timing of my bolus dose so that the insulin peak would coincide (more or less!) with the food digesting and converting to glucose. I found that by doing this my post meal levels at the one and two hour marks were more likely to be in the range of 6-8 than 10+.

Your diet sounds fine to me!

 

[Pumper_Sue]

Nothing wrong with your diet.
You say you have basal tested and all is fine. So that leaves the bolus 🙂
What are your numbers before meals and 2 hours after?
Have a look at your delivery of the bolus. You have a lot of protien in your diet so do you use a split bolus? If high two hours after the meal have you looked at the timeing of the bolus? Many find 15 - 20mins before a meal is the best time to bolus.
What insulin do you have in your pump and what is your duration of insulin set at?
Also do you have the book pumping insulin by John Walsh (amazon) if not treat yourself, the book is worth it's weight in gold and known as the pumpers Bible.

Another thought for you if your numbers do not add up to a high A1c has any other reason been looked into as to why it's high?

 

[Lizzzie]

Hi Megga and Welcome

I could do a critical analysis of your diet.

However, I am a fairly recently diagnosed type 1 (3 yars) with an HbA1c of 5.5 - 6 and what I have always been told, since being diagnosed is that there is no need to eat differently because you are type 1 diabetic. Lots of people including GPs still tell you otherwise - the old fashioned way - but lots of us eat a perfectly slobby diet and still have good control.

Talk to your diabetic team about a course you can go on called DAPHNE, dose adjustment for NORMAL eating.

Ok so occasionally, I think: 'wont have that because it'll make my blood sugar do a massive spike' or 'that's too complicated to carb count' or something. But that's my choice.

 

[Lizzzie]

Another point if you spike at 2 hours, inject half an hour before food

 

[trophywench]

I'm just wondering - lunches - quite a lot of protein? is that sending your BG up? (unless it was either/or as opposed to all)

What actually happens to your BG when you eat? Give us a few examples, before meal, after meal, before next meal .....

And the important bit really ...... is your meter right? I've droned on about this elsewhere and people are prolly sick of me saying it but I'd had a meter a few years, exactly the same model as I had before that, loved it so just had a new one of them once it was dunno, 5 or 6 years old .......

When I had my pump the new meter with that read consistently higher mostly but sometimes lower. I hated it. Yet there was a funny thing - after I MADE myself swap to the new meter, miraculously within a couple of months my A1c dropped from high 7s/low 8s - to 6.5. So probably it was a combination of meter inaccuracy (and lack of basal fine tuning) that were the problems.

When they first invented meters, I used to check mine with the hospital one, using the same drop of blood and they would match (this isn't an exact science, but they should be near enough the same) Have you ever checked yours?

 

[LeeLee]

A couple of thoughts to add to the mix... caffeine can raise BG for some people, and a swap to a spirit with carb-free mixer instead of wine/beer might be worth a go.

 

[megga]

My bg always spike 2-3 hours after eating, even if i have had very little carbs.
I did get Burgen (only ?1 from iceland) but found that it spiked.
I know there is too much protien in my diet, but dont know what else to have.

Any advice on other options for pack lunch would be greatfull accepted.

 

[Pumper_Sue]

My bg always spike 2-3 hours after eating, even if i have had very little carbs.
I did get Burgen (only ?1 from iceland) but found that it spiked.
I know there is too much protien in my diet, but dont know what else to have.

Any advice on other options for pack lunch would be greatfull accepted.

You don't need to change what you eat, just learn to deliver your insulin to your needs 🙂
Do you bbolus for protien?
It sounds to me as if you need to do combination bolus for your meals due to the high protien.
Try doing some experiments with how and when you bolus. Note down the results for future ref it all helps 🙂
Personally I find I need a lot more insulin for a high protien meal than I do for a carby meal, so again worth looking into that side of things.

 

[megga]

So if your b/g is between 4 and 5 would you still bolus early??
The only reason i have a lot of protien is that i just dont know what else to have. Same as breakfast, i'm sick of toast, but the way o see it, is with my hba1c so high, i just dont want more carbs incase it gets evan higher, i'd love a bowl of ceral or some marmalade.

 

[Pumper_Sue]

So if your b/g is between 4 and 5 would you still bolus early??
The only reason i have a lot of protien is that i just dont know what else to have. Same as breakfast, i'm sick of toast, but the way o see it, is with my hba1c so high, i just dont want more carbs incase it gets evan higher, i'd love a bowl of ceral or some marmalade.

megga,
protien takes a long time to digest so you need to do a split dose if you eat a lot of protien. Many also find they need more insulin for a high protien meal.

All you can do is experiment and find what suits your own needs.
I use animal insulin in my pump and if I have a fatty meal I bolus just before I eat, instead of 30 mins before the meal.
Protien packed meal involves a very extended bolus esp if eaten for evening meal.

PS a bg between 4 and 5 is a normal bs for me before meals and yes I do bolus early for normal meals. You need to match your insulin action with the food you eat. Analogues take anything from 15 - 30 mins to start working. Do you actually know if your carb ratio is correct?

 

[bennyg70]

I gave the low carb thing a go and found it unpreictable whether a steak might spike me or not due to the protein etc, I now eat a moderate carb diet - approx 150g per day but eat healthily (I find the carbs are more predictable). Ie brown seeded breads, Brown pastas and rices and noodles, a few new potatoes, the odd jacket, Low fat where possible. Timing of injectinos is really important to me to control the spike as im just rediscovering. 20 mins before for any medium GI stuff. Low gi or high fat meals need a bit more thoguht - Ie splitting injections etc. I mainly stick to a low - medium gi diet, and ive also lost 3 stone over the last year on this diet as a bonus.

 

[everydayupsanddowns]

When i have bacon, i take 1 unit for that as the fats turn in to carbs, but apart from that, i only basel for carbs.

As i am on the pump, i do do some fasting, to make sure my background is right, and its always stable so i know thats right.

Hi Megga

Your diet sounds very controlled.

Assuming that is a typing error and that you do bolus (dose) for the carbs you are eating, not just rely on your basal (background) to sort them out.

If you have fasting tested your basal (background) and know that that is holding you steady then as Sue says the spikes you see will be down to bolus (meal) doses not matching the food you are eating. This will be either in terms of insulin:carb ratio or timing of the dose.

How much insulin do you administer per 10g of carbs? Have you experimented with that much?

 

[megga]

Well far today, one of the best days i have had.
Took some advice and took my bolus 1/2 hour before (i was a bit worried as i was scared of hypo's) AND THIS IS THE FIRST DAY I HAVE NOT BEEN IN DOUBLE FIGURES Cant express how very pleased i am, so a big thanks to you all.
But i have found another problem, my meter, last night my bg was 6.5, 8.9 and 7.5 all at the same time, so reverted back to my old meter today and accu-check are sending me a replacment.

 

[Pumper_Sue]

Glad to hear you have have managed to stay in single figures well done 🙂

 

[bennyg70]

Well far today, one of the best days i have had.
Took some advice and took my bolus 1/2 hour before (i was a bit worried as i was scared of hypo's) AND THIS IS THE FIRST DAY I HAVE NOT BEEN IN DOUBLE FIGURES Cant express how very pleased i am, so a big thanks to you all.
But i have found another problem, my meter, last night my bg was 6.5, 8.9 and 7.5 all at the same time, so reverted back to my old meter today and accu-check are sending me a replacment.

With the plus / minus of 20% meter accuracy I think those numbers fall in line. I used to think that my right hand was sweeter than my left, but it turned out theres a crazy tolerence on how accurate these metres need to be. (In my opinion anyway)

Ps well done - One of my biggest steps toward better control and lower spikes was adding in a little more planning and injecting 15 - 30 mins up front for meals, watch for those meals with a higher fat content though as you could get caught out.