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My Diabetes counselor does not like my fasting blood sugar? Help wanted.

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  • #16
    Well it has been 7 days since I first posted my question to the masses. To summarize; By using Grok's eating guidelines, I had stabilized my blood sugars but my morning fasting sugars were running in the 120 & 130. I was informed that the larger quantities of fruit I had been eating could be the culprit so I cut my fruit intake down to 1 a day. This did the trick. I also quit taking my metformin (500mg/day) at the same time based on advice from my diabetes counselor to evaluate how much the metformin was actually helping - she actually suggested trying no metformin and then doubling it (to 1000mg/day) and compare the results. I am happy to report in the last 4 days, my highest fasting blood sugar has been 104 and it seems to keep going down (97 this morning). As a side note, this corresponds with the weight loss seeming to speed up. I am currently down to 223.6 from roughly 233 five weeks ago. My energy levels are good and even when I am physically active, my blood sugar has not dropped below 80 (on the medications I had been on, Prandin & Metformin, I was still experiencing highs of 200 and lows of 60 - sometimes in a 90 minute perriod).

    I am planning on staying with the Paleo diet until I am scheduled to get my blood work done in February. There I am very interested in my A1C and cholesterol results.

    Thank you all for your feedback and support.

    Comment


    • #17
      Originally posted by JimN View Post
      Well it has been 7 days since I first posted my question to the masses. To summarize; By using Grok's eating guidelines, I had stabilized my blood sugars but my morning fasting sugars were running in the 120 & 130. I was informed that the larger quantities of fruit I had been eating could be the culprit so I cut my fruit intake down to 1 a day. This did the trick. I also quit taking my metformin (500mg/day) at the same time based on advice from my diabetes counselor to evaluate how much the metformin was actually helping - she actually suggested trying no metformin and then doubling it (to 1000mg/day) and compare the results. I am happy to report in the last 4 days, my highest fasting blood sugar has been 104 and it seems to keep going down (97 this morning). As a side note, this corresponds with the weight loss seeming to speed up. I am currently down to 223.6 from roughly 233 five weeks ago. My energy levels are good and even when I am physically active, my blood sugar has not dropped below 80 (on the medications I had been on, Prandin & Metformin, I was still experiencing highs of 200 and lows of 60 - sometimes in a 90 minute perriod).

      I am planning on staying with the Paleo diet until I am scheduled to get my blood work done in February. There I am very interested in my A1C and cholesterol results.

      Thank you all for your feedback and support.
      Don't be too upset if your A1C is not as good as you thought it would be, its a poor predictor for folks who are paleo. Your MD won't know this unless you educate them.

      http://chriskresser.com/why-hemoglob...eliable-marker

      The Paleo Solution – Episode 73

      Comment


      • #18
        Originally posted by Karma View Post
        Don't be too upset if your A1C is not as good as you thought it would be, its a poor predictor for folks who are paleo. Your MD won't know this unless you educate them.

        http://chriskresser.com/why-hemoglob...eliable-marker

        The Paleo Solution – Episode 73
        Karma,
        I really appreciate the information you have given. Dr. Kresser's link was very informative but my computer did not want to down load Episode 73 but I will work on that. I am hoping to take the information in Dr. Kresser's article as well as the information on the VAP test to him prior to my Feb labs. By reading his article I am Pre-diabetic for fasting blood sugar (97-107), Normal for post meal (<120) and A1C is still unknown (last lab in October it was 6.3 which is Pre-Diabetic). Which considering I WAS in the full blown diabetic catagory in the last few months, this is not bad. In Dr. Kresser's article, he states that fasting blood sugars in low carb diets may be elevated and as long as the Post meal and A1C are in check then you are OK. But he also states that the A1C may not be accurate for the low carb diet also.

        Sooo...here comes the question...What then are my target numbers? I was diaognosed with Type II diabetes in 2006 w/ an A1C of 11.2. In six months I had dropped 40 lbs and dropped the A1C to 5.2. My lowest A1C was 4.8 about 1 year after and has slowly been going up (highest way 9 months ago at 6.4). Most of the raise I blamed on poor diet control, reduced work out (initially I was walking 2-4 miles a night after work) and gaining 10-15 lbs back of the 40 I lost. Once again I am in a motivatoinal stage and am working out, eating right, loosing weight and watching my blood sugars closer.

        Don't get me wrong - over all I am happy with the treatment my Dr. has given me. Other than the blood sugar levels, I have no other complications associated with diabetes. I realize (based on his and my diabetic counselors information) that it is typical that diabetics will generally require more medication/insulin as they get older and the disease progresses BUT being a bullheaded Dutchman (as my Grandpa used to say), I am not happy with "Oh, well, it has to come to insulin shots sometime, nothing I can do about it." The bigest challenge will be to get him and my diabetic counselor on board with what I am doing. And as long as I can explain the numbers my labs come up with, I think I have a decent chance to do so.

        Again, Thank you for the information and thanks to all who have given me advice. In the last 8 days I have made lots of progress on my fasting blood sugars but I would still like them to be in the 80s, this may not be possible with the Paleo diet.

        Comment


        • #19
          Today is 15 days in since my first post and 5 weeks eating Paleo. I will see my counselor in two hours so we will see what she has to say. My blood surgars have risin a little in the last week, 107 seems to be the magic number give or take a few. The weight loss has sort of stopped so I am going to look closer at my carb intake, morning blood sugars compared to what I ate the night before and also how late I ate. I am also considering adding back the metformin for two weeks to see if that will bring my sugars below 100 consistantly. I will post again when I have more to report.

          Comment


          • #20
            compared to the standard values from the WHO youre doing very well. im no endocrinology expert but - for a diagnosed diabetic - anything less than 110 fasted is non-pathological in my opinion. if you want to get down those last 7-8mg/dl just to be below 100... well that depends exclusively on your personal goals (for a non-pathological range ofcourse)
            in terms of medication: you should never mess around with it without at least speaking to the doctor, but ive seen hundreds of patients in the hospital i work where we just dropped metformin etc. cold turkey for various reasons (e.g. surgery). id encourage experimenting, with the ultimate goal to be completely off drugs, but make sure you are looked after by pros.

            also, im interested in what your HbA1c value is.

            Comment


            • #21
              Just to add some spice to the pot, let me relate what I discovered. I am a type 1 diabetic, so I face some challenges you (luckily) shouldn't have to. But my increased sensitivity may help you with your diet. Since going Primal (and a low carb variant thereof), my HbA1Cs average to 5.3. I have eliminated all fruit (and even berries) from my diet, though once in a while I do cheat (roughly every two or three weeks as a desert calls to me). For obvious reasons, I am also gluten free.

              For me, the toughest time is the morning, or the "dawn syndrome" (or whatever it is called). Biologically, the human liver produces quite a load of morning glucose. It is fairly safe to assume that the purpose was to give Grok some good energy to burn in the morning while trying to track down/hunt/gather lunch and maybe dinner. I have found that skipping breakfast completely (minus a couple of cups of coffee with heavy cream) means that I can take less insulin, though the "less insulin" still almost equal to the amount of insulin I take over the rest of the day.

              For you, I would definitely consider Intermittent Fasting in the morning - unless you are a breakfast person, in which case I'd recommend fat with a wee tiny bit of protein, but no carbs. Protein, of course, can be synthesized into glucose, so you'd want to keep it down. Due to your taxed pancreas having problems keeping up with the insulin race, minimizing food (or eliminating it) in the mornings will likely have a huge impact in overall taxation (if my study of 1 analysis holds true) over the course of the day.

              Good luck, and keep us informed!

              --Me

              Comment


              • #22
                Originally posted by nogger View Post
                compared to the standard values from the WHO youre doing very well. im no endocrinology expert but - for a diagnosed diabetic - anything less than 110 fasted is non-pathological in my opinion. if you want to get down those last 7-8mg/dl just to be below 100... well that depends exclusively on your personal goals (for a non-pathological range ofcourse)
                in terms of medication: you should never mess around with it without at least speaking to the doctor, but ive seen hundreds of patients in the hospital i work where we just dropped metformin etc. cold turkey for various reasons (e.g. surgery). id encourage experimenting, with the ultimate goal to be completely off drugs, but make sure you are looked after by pros.

                also, im interested in what your HbA1c value is.
                My initial A1C in Jan 2006 was 11.2. My A1C in September this year was 6.3 (down from 6.4 in March - low of 4.8 in Sept 2006). At my appointment this morning my diabetes counselor checked my BP because she was concerned that I had dropped the ACE inhibitor/BP med I was on. It was 128/82, up from 117/70 something in September. That is the first time I had checked it but she and I are going to watch it and see what happens in the next month till our next appointment. She was happy with the drop in fasting blood sugars and said that if I want them below 100 it is not a bad goal but not necessary. I have been cautioned by others (see post of 12-12-11 and from my counselor) about dropping my meds cold turkey. The reason I did it had to do with the very small dose I was taking and the small change I saw in cholestrol and BP when I first started taking them. I want to see the change not taking them but I wanted to give myself enough time to get my system clean of it prior to my February labs.

                Comment


                • #23
                  Originally posted by adamm View Post
                  Just to add some spice to the pot, let me relate what I discovered. I am a type 1 diabetic, so I face some challenges you (luckily) shouldn't have to. But my increased sensitivity may help you with your diet. Since going Primal (and a low carb variant thereof), my HbA1Cs average to 5.3. I have eliminated all fruit (and even berries) from my diet, though once in a while I do cheat (roughly every two or three weeks as a desert calls to me). For obvious reasons, I am also gluten free.

                  For me, the toughest time is the morning, or the "dawn syndrome" (or whatever it is called). Biologically, the human liver produces quite a load of morning glucose. It is fairly safe to assume that the purpose was to give Grok some good energy to burn in the morning while trying to track down/hunt/gather lunch and maybe dinner. I have found that skipping breakfast completely (minus a couple of cups of coffee with heavy cream) means that I can take less insulin, though the "less insulin" still almost equal to the amount of insulin I take over the rest of the day.

                  For you, I would definitely consider Intermittent Fasting in the morning - unless you are a breakfast person, in which case I'd recommend fat with a wee tiny bit of protein, but no carbs. Protein, of course, can be synthesized into glucose, so you'd want to keep it down. Due to your taxed pancreas having problems keeping up with the insulin race, minimizing food (or eliminating it) in the mornings will likely have a huge impact in overall taxation (if my study of 1 analysis holds true) over the course of the day.

                  Good luck, and keep us informed!

                  --Me
                  I have noticed that on the mornings that my sugars are high and I have my 'bullet proof coffee', that within an hour or so my sugars drop, usually to the 90s. So, in short, I think what you are suggesting has worked for me and may be a way to get my sugars down prior to my breakfast (I get up at 4:30 am and eat breakfast at 7:30. Not sure how inportant it is to keep my fasting sugars below 100, but psycologically for me, it helps me believe I have this diabetes on the run and I am winning. Bottom line I feel better and my sugars are much better than prior to switching to the paleo diet so I am going to keep it up until someone can show me where I am hurting myself or I start not feel well.

                  Comment


                  • #24
                    Ignoring the spam, I'd add that the A1C is not reliable unless you know exactly how long your blood cells actually live.
                    Crohn's, doing SCD

                    Comment


                    • #25
                      Hey Jim, very interesting to read your progress. To throw in my own experience... I was on Metformin for PCOS and hypoglycemic symptoms as well as a blood pressure med. I also went off them cold turkey once I did primal -- I think the longer you are primal the more your levels will balance out. The body does have the amazing ability to heal itself and as long as you're monitoring your numbers (which clearly you are) I would support you in your goals of ditching the medication and adopting a more holistic approach. My numbers dropped drastically after I was primal for a month, making meds completely unnecessary. Ovulation was restored after several months. Listen to your body and track the weight loss. It's usually a good indicator of what's happening inside. Best of luck to you and fingers crossed for continued progress!
                      Lindsay Groks On

                      "Be careful about reading health books. You may die of a misprint."
                      -- Mark Twain

                      Comment


                      • #26
                        Originally posted by Lindsay Grok View Post
                        Hey Jim, very interesting to read your progress. To throw in my own experience... I was on Metformin for PCOS and hypoglycemic symptoms as well as a blood pressure med. I also went off them cold turkey once I did primal -- I think the longer you are primal the more your levels will balance out. The body does have the amazing ability to heal itself and as long as you're monitoring your numbers (which clearly you are) I would support you in your goals of ditching the medication and adopting a more holistic approach. My numbers dropped drastically after I was primal for a month, making meds completely unnecessary. Ovulation was restored after several months. Listen to your body and track the weight loss. It's usually a good indicator of what's happening inside. Best of luck to you and fingers crossed for continued progress!
                        It is amazing to me that this "primal" eating plan has worked so fast for me also. Like you, it only took about a month and I saw better glucose readings throughout the day. As this thread was started, the fasting blood sugar was the "last holdout" for the most part. I am now typically getting fasting blood sugars from 107 to 118, not perfect but better. Thanks to the advice I have received on this blog and some of the sources quoted, I have become less and less concerned with this "magic" number. The bottom line for me right now is on Thanksgiving week I weighed 233 lbs and my blood sugars were all over the place, I made the cold turkey jump to primal and now 6+ weeks later I weigh 218, haven't taken my metformin in over a month, blood sugar has not been over 145 (and only once) or below 80 in that time. I am no longer needing to eat every few hours to maintain my blood sugar (last Friday I had 2 cups of coffee in the morning and did not eat at all until dinner - 24+ hrs since my last meal). The IF I did last Friday was a first for me, my blood sugar stayed between 80 and 100 all day, I was busy, had lots of energy, and I was hungry at times but never Starving, needing to eat. In the last week, I have cut out breakfast for two reasons. First to see if I could do it and second to try and counteract the "morning effect" that seems to be part of the reason my fasting sugars are not perfect. Also, I could add a third and say it saves me time because I now don't have to pack a breakfast to take with me to work (I work from 6am to 2pm and the rest of the crew stops to eat around 7:30 breakfast so it was a habit to also eat at this time vs. 4:30 when I get up).

                        My biggest challenge with all of this recently is getting enough calories and balancing out the fat, carbs, and protein. Lately it seems I am low on my fat calories, OK with my carbs (see post fm QuiU93W above), and over on my protein. My initial goal to loose 20 lbs at 2 lbs per week had me eating 2300 cal w/ 169g fat, 75g carbs, and 121g protein. I have been averaging over the last week or so about 1800 calories and right now don't really need more than that. As stated above, I feel good, loosing weight at a decent pace, so far no complaints. Well, as I have stated before, the next big measuring tool will be February when I get my blood work done again. So off we go again - good luck to all and thanks again for the advice and support.

                        Comment


                        • #27
                          Sounds good Jim! As you continue to lose some weight that number may naturally change as well. You're making great progress as it stands and your health sounds exponentially improved in many areas. Keep with it! ^.^
                          Lindsay Groks On

                          "Be careful about reading health books. You may die of a misprint."
                          -- Mark Twain

                          Comment


                          • #28
                            You are doing remarkably well. May I ask why you have your carb count so high? I am trying to lose weight and avoid Type II diabetes developing and I aim for under 50g carbs a day - presently I am averaging about 30g.
                            Odille
                            F 58 / 170cms / SW 131.5 kgs / Current 112.4/ GW 65
                            following Primal Lifestyle and swimming my way to health

                            My Primal Blog / Photo Blog / RedBubble shop / My Calendars / My Facebook

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                            • #29
                              I'm also type 1. If I eat past about 6:30 or so, my fasting bg is high. If I eat a small dinner with limited protein and no carb, my blood sugar in the AM is great (for a type 1, so 90-110 fasting is typically my safe goal). If it's high, I tend to IF til lunch.
                              Type 1 Diabetic. Controlling blood sugar through primal life.

                              2012 Goals:
                              Maintain A1c of 6.0 or lower
                              More dietary fat, less carbs, moderate protein
                              LHT and sprint as per PB fitness
                              Play more!

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                              • #30
                                Wow -- really interesting. I have been checking my morning glucose on and off for the last couple of months -- and it is often over 100 in the am -- but generally not over 110. It is often lower after eating. I was beginning to think I was just weird, but now I find it is not that abnormal for low carb (I'm almost always under 50 -- even tho I'm eating/drinking more dairy of late -- raw milk and home-made kefir and yogurt -- on a tooth remineralizing program.) I'll be checking out some of the references given above. This is such a great place to find information. I'm also checking out how much exercise -- and what type and duration -- helps.
                                Life is an ongoing Experiment of One, so here's to science!

                                My Primal Journal: http://www.marksdailyapple.com/forum/thread37576.html

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