[PC76]

Hi there, my dietitian told me not to count carbs and make sure I have carbs with every meal. I've been eating about 130-160g a day of carbs, is that bad? My blood sugar has been good, my average is about 6.1 (109). fasting has been 5.5-6 (100-107). But she aslo stated the importance of protein with a carb, that the carb will take longer to break down with a portein. Now I guess my question is: Can I lower my BG even more if I cut carbs? Or stick with what is working?

 

[Joshua Shorter]

Chances are you will lower your BG if you cut carbs. Your numbers look good so if you're wanting to experiment, now that you have a baseline, it might be the time to do it. Cut out some carbs each meal and see what it does.

 

[foxl]

And, please read through this thread ....

http://www.diabetesforum.com/diabetes/6113-seriously.html

 

[PC76]

Interesting thread, insightful. Let me clarify too, the carbs I do eat are whole grains. Brown rice, high fiber cereal, high fiber crackers. The only one that isn't is potatoes but that is once every other week.

 

[jasonsandeman]

Hi there, my dietitian told me not to count carbs and make sure I have carbs with every meal. I've been eating about 130-160g a day of carbs, is that bad? My blood sugar has been good, my average is about 6.1 (109). fasting has been 5.5-6 (100-107). But she aslo stated the importance of protein with a carb, that the carb will take longer to break down with a portein. Now I guess my question is: Can I lower my BG even more if I cut carbs? Or stick with what is working?

The question I would ask you is what do YOU want? I was told the very same thing by my "dietitian" and I was also told by the "Pharmacist" not to test so often. (I'm a type 1, jeepers!)
If you want to lower your BG, then yes, cutting carbs is an option. The reason your dietitian is telling you to eat carbs is to avoid a hypoglycemic reaction. (From your Metformin.) For me, if I eat 160 g of carbs a day, I gain weight, and my blood sugar is all over the place.
If you are looking to preserve your pancreatic function, and to avoid going on insulin therapy, you might look into cutting the carbs - as this is one school of thought.
The other school is to up the exercise for your insulin resistance. (Type 2 is mainly an insulin impairment.) The more you exercise, the more carbs you will need to cover that exercise *especially cardio!* but your body will be able to use the insulin better.
A very good book by Ginger Vieira is called, Your Diabetes Science Experiment by Ginger Vieira in Diet & Health
The only advice I will commit to giving you is to TAKE CONTROL of your own diabetes. It is easy to let the doctors, dietitians, pharmacists, etc to dictate what you should do. I found that by researching, asking the questions (like you are doing here!) is the best route to go. Congrats on that!

 

[foxl]

BUT met does NOT cause hypos. SU's cause hypos ...

I would add, be sure that you test that whole grain. I do not eat any grains at all -- I found absolutely NO difference between my reaction to whole grains and white flour or rice. NONE. Of course, you might be very different from me.

I did eat some low-carb tortillas and pita for a while, but even that is now too much for my system.

 

[Patdart]

You do have good numbers, but after following my meter and staying under 120 for heaviest meal, I find mine are lower and I'm on no meds. My meter is my dietician!

 

[jasonsandeman]

BUT met does NOT cause hypos. SU's cause hypos ...

I would add, be sure that you test that whole grain. I do not eat any grains at all -- I found absolutely NO difference between my reaction to whole grains and white flour or rice. NONE. Of course, you might be very different from me.

I did eat some low-carb tortillas and pita for a while, but even that is now too much for my system.

I forgot that when I was first diagnosed, they put me on NPH + Metformin. The concern was the Metformin would make the NPH more efficacious.

Plus, my average BG numbers were 24ish (420ish,) so they were very concerned about a quick drop in numbers.

 

[PC76]

What I want is to not worry that I am not doing the wrong thing because a 26 year old dietitian says it's ok. I know my BG has been ok, I'd like it better but after I eat breakfast, I have a bowl of high fiber cereal and an apple. That is at about 645am. By 845 to 930 my BG is 4.1-4.8. So does that mean I am not getting enough carbs or I should not take the meds? I know you guys aren't Dr's. The other day I had crackers 30g of carbs and hummus, 2 hours later I was 3.9. But the weird thing is, the afternoons are my high times. Well not high but higher.

 

[beefy]

What I want is to not worry that I am not doing the wrong thing because a 26 year old dietitian says it's ok. I know my BG has been ok, I'd like it better but after I eat breakfast, I have a bowl of high fiber cereal and an apple. That is at about 645am. By 845 to 930 my BG is 4.1-4.8. So does that mean I am not getting enough carbs or I should not take the meds? I know you guys aren't Dr's. The other day I had crackers 30g of carbs and hummus, 2 hours later I was 3.9. But the weird thing is, the afternoons are my high times. Well not high but higher.

Keep in mind some of the more complex carbs may take longer to digest then others, and as such longer to spike you. Also, some people digest more slowly than others.

When I tried brown rice my spike came around 3-4hrs later if I remember correctly. I've never tried hummus.

Regarding your breakfast and your 2hr post numbers... it may be you're eating the right amount of carbs for you. There's nothing wrong with those 2hr post numbers as long as your liver doesn't dump. You may want to look at eating every 3 hours or so like some of us do to avoid those spikes.

I still try to keep myself under 150g of carbohydrate daily, and as I've said before, I probably eat 2x as much as most people on the board (around 3,600 to 4,200 calories daily.)

Even with only 150g of carbohydrate I can fuel decently-long bike rides (100km / 62.5 miles) without any issue. I've planned another 100km ride today and so far I've had only 13g of carbs. I'll eat most of my carbohydrate today during my ride and at my post-ride meal.

It's just not worth it for me to eat MORE carbohydrate than that. 100g is what I'll eat daily if I don't do a long ride. And my blood glucose readings aren't as good as yours...

 

[PC76]

Beefy,

Yeah I usually do eat every 3 hours. I'll eat breakfast at 645am, snack at 930-10am, Lunch at 12-1230, snack at 330pm and dinner at 6pm. It's not quite 3 hours but I keep it tight. Sometime I have an evening snack too.

My calorie intake is roughly 2000-2200 and 13o-160g of carbs. I weighed 295 in November, 275 at diagnoses in March and now I'm 235. I still haven't hit full potential of exercise either which I should be doing. So maybe that will help too.

Today I've had about 100g of carbs so far.

 

[jasonsandeman]

What I want is to not worry that I am not doing the wrong thing because a 26 year old dietitian says it's ok. I know my BG has been ok, I'd like it better but after I eat breakfast, I have a bowl of high fiber cereal and an apple. That is at about 645am. By 845 to 930 my BG is 4.1-4.8. So does that mean I am not getting enough carbs or I should not take the meds? I know you guys aren't Dr's. The other day I had crackers 30g of carbs and hummus, 2 hours later I was 3.9. But the weird thing is, the afternoons are my high times. Well not high but higher.

I'm not a doctor, but it sounds like you may have a Basal problem. Your "rapid" insulin is fine, (hence the normal range of 4.1-4.8.) The problem comes later with your long-acting insulin (which you are probably resistant to.)

I can only give you my experience. I can eat as many carbs as I want in a day, as long as I bolus for them. The trade off is that my basal insulin needs increase. (That's my long acting.)

Metformin does 2 things, it slows your liver from dumping glucose into your system (by the rebound effect of too much insulin in your blood stream.)

The second effect is that it increases your sensitivity to insulin. (I belive mostly the fast acting insulin though.)

So, what happens in my case is that while I "cover" the carbs in my meals, when my long acting insulin runs out, I have a huge spike in BG, until I get more long acting.

It makes for a viscous cycle. The more carbs you eat, means the more insulin needed to "cover" those carbs, which means the more resistant you get.

There may come a point where your Metformin won't do the trick anymore, then it will be on to insulin. (That's not necessarily a bad thing though...)

Keep in mind, a 3.9 mmol might feel horrible, but it is not technically a low. Your dietitian will want to keep you higher, because Metformin normally doesn't cause Hypos, but they do rarely occur, especially if mixed with any other treatment.

I hope that helps.

 

[PC76]

I won't say it's a huge spike but ny biggest numbers have been after dinner. Lunch is ok, usually 6-6.5. My biggest spike has been a 12 but I over did it, it was father's day and I ate like I wanted too. I had spghetti and a huge piece of bread for dinner. But also, my after dinner average is about 7 and the other reading average 6-6.5.

When I had the 3.9 I didn't feel bad, I just felt starving, it wasn't till after I saw the 3.9 I got worried. With metformin though I feel safe that I won't hypo.

 

[jasonsandeman]

Careful though, it us uncommon to Hypo on Metformin, but it can happen. (Very rarely though.)

 

[PC76]

Oh I am very careful. If I feel hungry I usually eat. When I feel hungry is when i am the lowest.

 

[Gizmo]

I wonder if they figure the bg numbers different in Canada than they do in the U.S. because you said 6.1 =109 and 5.5-6 = 100-107. But in the U.S., 6.1 would be 128 and 5.5-6 would be 111 to 114 if you are talking 5.5 to 5.6. If you are talking 5.5 to 6.0, it would be 111 to 125.

Does anyone know if the numbers ARE different in Canada?

 

[PC76]

Gizmo,

I just used an online conversion of mmol to mg. On Bloodsugar101 it says also that 5.5 is 100.

 

[Gizmo]

Gizmo,

I just used an online conversion of mmol to mg. On Bloodsugar101 it says also that 5.5 is 100.

Hmmm... Guess I must have got hold of an inaccurate chart online. I'll have to find one that is correct. Which means my A1c's have been running lower than I thought, that's good. Thanks, PC.

 

[HardBackStrider]

The conversion factor is 18 so a 5.0 mmol is 90

 

[ShottleBop]

I wonder if they figure the bg numbers different in Canada than they do in the U.S. because you said 6.1 =109 and 5.5-6 = 100-107. But in the U.S., 6.1 would be 128 and 5.5-6 would be 111 to 114 if you are talking 5.5 to 5.6. If you are talking 5.5 to 6.0, it would be 111 to 125.

Does anyone know if the numbers ARE different in Canada?

You're confusing BGs with A1cs. In Canada, they measure BGs in mmol/L, while here in the US we use mg/dL. The conversion factor is 18.05 (18 works for everyday). So a reading of 5 mmol/L=90 mg/dL.

A1c, which can be confused with mmol/L because the numbers tend to be in a similar range, is not a direct measurement of blood glucose, but measurement of the percentage of one type of hemoglobin that has become glycated. The conversion of A1c to an average BG (expressed as mg/dL) is very different, and that is what you are referring to in your post.