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Hi all! I'm new here and besides my into post in New Members area, this is my first post.

I was diagnosed with liver disease in Oct '19. Since then my glucose numbers have been inching up and two weeks ago, my GP asked me to start checking my blood sugar levels twice a day and send them to her. After a week I was alarmed because my numbers were consistently higher (200+/-) than they had ever been in the dr's office so I sent her my numbers asking to bring my meter in to see if it was accurate compared to theirs. She immediately put me on 10 units of Lantus once a day.

So, now I know I'm supposed to cut carbs and sugar for my glucose levels, but I'm supposed to eat carbs for my liver along with a lot of protein. The liver nutritionist told me to eat a bedtime snack of protein and at least 30g carbs as a bedtime snack.

I see my hepatologist again next month. I am thinking of requesting a new appointment with the nutritionist because I can't figure out what in the heck I'm supposed to eat now. A low sodium diet is also part of the liver diet, btw.
 

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Hi again, Merlin. A rock and a hard place, indeed.

It has been conventional wisdom for decades among nutritionists and dietitians that people with diabetes should eat about as many grams of carbohydrates as people whose bodies can manage glucose and insulin levels normally. Now, I'm no doctor (none of us here are qualified to offer medical advice) but I never understood why bodies that can't handle high amounts of carbohydrates should eat them anyway, to the point that we need medicine or insulin to bring the levels down. Beyond a certain (surprisingly low) amount our bodies don't need carbohydrates to function well. Many of us here do just fine on the low-carb or keto diet you'll see mentioned elsewhere on this site.

Lower-carb eating is not incompatible with liver disease. Since I don't know specifically which liver disease you have, I'll link to this discussion of lower-carb eating and liver disease and you can go from there (and ask more questions here; I know we have people here with your situation). Over the years the Diet Doctor site has been a reliable source of information from a real doctor, so I trust it.
 

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Hi again, Merlin. A rock and a hard place, indeed.

It has been conventional wisdom for decades among nutritionists and dietitians that people with diabetes should eat about as many grams of carbohydrates as people whose bodies can manage glucose and insulin levels normally. Now, I'm no doctor (none of us here are qualified to offer medical advice) but I never understood why bodies that can't handle high amounts of carbohydrates should eat them anyway, to the point that we need medicine or insulin to bring the levels down. Beyond a certain (surprisingly low) amount our bodies don't need carbohydrates to function well. Many of us here do just fine on the low-carb or keto diet you'll see mentioned elsewhere on this site.

Lower-carb eating is not incompatible with liver disease. Since I don't know specifically which liver disease you have, I'll link to this discussion of lower-carb eating and liver disease and you can go from there (and ask more questions here; I know we have people here with your situation). Over the years the Diet Doctor site has been a reliable source of information from a real doctor, so I trust it.
Thanks for the welcome and for the suggestions! I will definitely check out that lower-carb thread as well as the Diet Doctor. I'm sure they'll be a big help!
 

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Carbs, converted to glucose and not burned for energy are converted to triglycerides and stored as fat. Fat stored in the liver can be one of the causes of NAFLD (non alcohol fatty liver disease). Not saying that is what you are dealing with, but if it is, something to think about would be a reduction in carbs. Less carb calories available for energy would mean more calories would be burned for energy from fats.

In my brief dealings with nutritionists, I found that almost all read out of the same playbook and was in my best interest to research as much as I could on my own and not be dependent only on their advice.
 
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Discussion Starter #5 (Edited)
Since being vague will not help me when I ask questions, I will clarify to say that I have cirrhosis due to alcohol. NAFLD is a huge cause of liver disease and is quickly catching up with alcohol as the main cause of cirrhosis. NAFLD is reversible if caught before it becomes cirrhosis; unfortunately, that was not the cause of my liver problems.

Since the cause of my liver issues had been eliminated, my liver is thankfully compensating and is relatively stable. However, one of the issues with cirrhosis, independent of cause, is muscle wasting. That is why carbs and high protein in small meals throughout the day for energy are recommended and why a carb/protein snack at bedtime is recommended. The bedtime snack is recommended because according to my doctors and research I have done a 12 hour fast for a cirrhosis patient is equal to a 72 fast for normal people.

Also, I need to gain weight which is also difficult to do without carbs. I need to have a BMI of 20 to qualify for a liver transplant. At the moment it's about 16.

I now have two serious health issues. Unfortunately, it's a lot easier for me to focus on my liver issues since I've been dealing with it since '19 and the side effects/symptoms are quite visible, unlike diabetes. However, I'm guessing the diabetes can kill me just as quickly as liver disease if I don't address it.
 

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Your thread title now has more meaning. I would think in order to gain the body mass you would need to meet qualifying for a transplant It probably wouldn't hurt to have elevated BG short term. Maybe your doctor will use the info you provide to increase your insulin dosage to keep your BG somewhat controlled. That should help with weight gain as a lot of people say that happened from using insulin. Also the muscle wasting should be offset with extra protein and if possible you could look into strength training as well if you are not already. Here is a link to an article in Healio.
 
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Based on the additional information (thank you for that, MerlintheCat), I would concur with mbuster that a controlled glucose level, even if it's above the non-diabetic 100, could be your best bet now. It allows you to eat more carbs to address the liver disease and yet it's not completely unchecked. Studies (particularly of Type 1 [insulin-dependent]) diabetics have shown that a higher level of well-controlled blood glucose causes fewer problems long-term than blood glucose that seesaws between peaks and valleys that average out to the same number. I'm going to look for those studies and link some here.

A low-carb or ketogenic eating plan may not work for everyone because of other health issues. However, if you could closely control a higher-than-normal level of blood glucose/carbohydrate intake, you might find the answer you seek.

[EDITED]Here we are: "Time in Range" as a measure of blood glucose control. That's a good starting point to the concept and some research.
 
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