The Diabetes Forum Support Community For Diabetics Online banner

1 - 8 of 8 Posts

·
Registered
Joined
·
9 Posts
Discussion Starter #1
So a little under a month after I was initally diagnosed with T2, I had to take a week off and go to NY for wedding planning with my fiancee. I have heard stories of people scared out of their mind the first time I having to travel with diabetes, I have been doing alright I think, my average BG from my tests (morning, then after dinner) since I have been on the road is 117. So I think I have handled it well.

Few questions to the non-rookies out there...

1) I am about 6'6 around 195 lbs and my nutrionist says I should be having 2900 calories and have 350 g of carbs per day. I have been slowly buidling up to that level, as she says not getting enough carbs can damage your liver. Even I think that is a bit high but she is a nutrionist...your thoughts?

2) I understand that you should try to get your a1c as low as possible. My goal is under 6.5, but should I be aiming lower like 5.5 or even 5?

3) When you were initally diagnosed did anyone prescribe an ACE inhibitor to help out your kidneys? Did you have to take that forever, or just for a period of time?

4) My average fasting for about the past 3 or 4 weeks is around 108? Is that considered normal for diabetics or does it need to be lower?
 

·
Registered
Joined
·
633 Posts
Ace inhibitors are the norm to prevent kidney damage as well as retinal damage. They help protect the micro vascular system from having blowouts. 350 grams of carbs is about 3 times more than I need and I think it would take a starvation diet to harm your liver, it is the one organ that grows back rather quickly. Most just find a level that is comfortable for them and doesn't send thier blood glucose through the roof.
 

·
Registered
Joined
·
460 Posts
... my [nutritionist] says I should be having 2900 calories and have 350 g of carbs per day. I have been slowly [building] up to that level, as she says not getting enough carbs can damage your liver. Even I think that is a bit high but she is a [nutritionist]...your thoughts?
By my reckoning: it is high levels of refined/concentrated Carbohydrates that lead may of us to Type 2 Diabetes in the first place, so how in the heck does throwing more at an already overwhelmed Blood Glucose (BG) management system help in any way, shape or form! :eek:

Here is just 100g Carbohydrates in the form of Real Whole Food (there's spinach behind the apples)...



...even some of those foods may be hard for many with diabetes to eat and still maintain decent BG (the apples, carrots and peas for example)... so consider just what kind of food you would need to get over 300g Carbs every day..? Bread, potatoes, pasta, rice, cereal, fruit juice... all foods that send my BGs sky high.

Seriously... it is time to fire that nutritionist. :boxing:

---

Here is my usual spiel on diet (in this case it simply means "what I eat", as opposed to a drastic short-term weight-loss change)...

Real whole food, is the order of the day... preferably local and in-season, grown/reared on nutrient rich land... grass-fed beef and pastured chickens for example. This means eat whole (unprocessed, unpackaged, unadulterated) food, which includes a natural balance of fat, protein and carbohydrates (as well as vitamins, minerals etc...) ...there really is no need to be afraid of natural fat... it's gotten a bad rap.

Those of us with Diabetes need to pay particular attention to the foods which have the most effect on our Blood Glucose (BG) levels. There are obvious things to watch out for like candy, cola, cakes and sweets (these are high in refined/concentrated carbohydrates)... next in line are the "white" foods like bread, pasta, potatoes, rice, breakfast cereal... but even something assumed to be healthy like orange juice has about as much sugar as a cola... fat reduced milk can have an higher proportion of lactose (sugar), especially in low-fat products such as yogurts which may have High Fructose Corn Syrup (HFCS) added to replace the fat... and so it goes on. That does not mean you need to feel deprived or hungry to eat this way, not by any means. You may even find you can work in an occasional family cake... for example. The keyword there being "occasional" as it used to be when our Grandparents baked cakes only for Birthdays etc... not everyday (muffins, donuts, pastries) for breakfast.

You may have heard the phrase "eat to your meter" and this deceptively simple message is very wise... test around your food and figure out what works best for YOU.

Some ideas for snacks: nuts, cheese, dark chocolate (70% cocoa or higher), pork rinds/scratchings, cold meats, boiled eggs, peanut butter.

While we are encouraged to eat "so many servings of fruit and veg daily", many of these can spike our BGs so test, test test... for many of us, green leafy vegetables seem to work best... but you may also help reduce/slow the BG spike by mixing foods... for example: instead of eating an apple by itself, try just half the apple in slices with some peanut butter or cheese... or have a few berries with some cream.

I'd suggest that BG control be your primary aim... while minimising the need for insulin which is the major fat storage hormone -- reducing excess fat mass, improving cholesterol/lipids, hypertension etc... all these tend to improve with more normal BGs.

I am not big on setting unrealistic "exercise" goals... flogging yourself at the gym... unless you feel especially motivated to do so. I think you are better off with something sustainable in the long term. There are many health benefits of activity but I'm not convinced that losing weight is a major one. I do believe in building activity into your daily routine (rather than finding excuses for missing the gym)... take the stairs, park further away, get off the bus a stop earlier... go for a walk at lunchtime... take "smoke breaks" at work where you walk around the block instead. Physical activity can help with your BG numbers as it tends to lower Insulin Resistance (IR) , as well as using up glucose but as with food, it is advisable to test and see how it affects you
 

·
Registered
Joined
·
24,394 Posts
Nutritionists to the contrary, James, I can't see anything wrong with what you're doing, and I sure as heck don't see any need for you to be upping your carbohydrate consumption when you have your BG averaging out so nicely already! Nothing I know of indicates liver damage from low carb eating, and many of us have been eating low carb for a long long time. I know what 6'6" & 195# looks like, and while you're nice & lean, I don't think you need more carbs to "beef up".

I was already on meds for hypertension at the time of my D diagnosis . . . I tried the ACE inhibitor Lisinopril, but I do better on the beta blocker Atenolol. Thing is, getting your BG under control may well remedy hypertension too, and reduce the risk to your kidneys all the way around.

As for the A1c . . . my doc wants me under 6, but doesn't harp for anything lower than that. One easy rule of thumb I found on this forum awhile back from one member's endo, is to keep BG at 100 plus or minus 20 at all times. That gives a target range of 80-120, and that's isn't bad at all.

Kudos on maintaining so well on the road trip! I hope I do as well next month when I'm on the road!
 

·
Registered
Joined
·
460 Posts
...
2) I understand that you should try to get your a1c as low as possible. My goal is under 6.5, but should I be aiming lower like 5.5 or even 5?

3) When you were [initially] diagnosed did anyone prescribe an ACE inhibitor to help out your kidneys? Did you have to take that forever, or just for a period of time?

4) My average fasting for about the past 3 or 4 weeks is around 108? Is that considered normal for diabetics or does it need to be lower?
2)An A1c closer to the truly normal non-diabetic seems like the ideal to aim for BUT consider how safely and easily you can achieve it? For those using insulin, aiming low can increase the risk of hypoglycaemia (although it does not automatically follow). You also need to consider your quality of life... this is for life, so may not want to become a slave to BG management

3)As above, this is fairly standard, prudent treatment and may be for life... but if you have significant weight to lose and lose it, and are able to manage near normal BG levels (effectively Diabetes in remission -- not "cured") at that point it might be worth discussing stopping them with your Doctor.

4)I'd say a Fasting BG around 108mg/dl is not bad at all ;)
 

·
Registered
Joined
·
253 Posts
my nutrionist says I should be having 2900 calories and have 350 g of carbs per day.
Dr Bernstein recommends less than 15 grams of carbs/day. I'm not saying anyone should do that and I don't myself, but there are different opinions. You do find professionals saying some of the goofiest things.

I once had a nurse tell me alcohol is a sugar. It is so unique it is almost a food group by itself, but after it is in the body the liver makes one change to it, and then it is a fat.

350 gms of carbs a day sounds nuts, bananas, and crackers to me. Don't mind me. I'm getting louder, maybe grouchier, and more expressive as I get older. I used to be so quiet and pleasant :)

You are doing really well with keeping your blood sugars low. That isn't easy. It took a few years with insulin before I could do it well and not wind up unconscious.

best wishes
 

·
Registered
Joined
·
460 Posts
I'm just proud of myself for so far resisting the urge to answer the thread with "Yes.. I also have many questions about Time Travel!" :D

---

Seriously I just wanted to throw out there that so far as is currently known, there is NO requirement to eat ANY Carbohydrates... not that I am necessarily recommending it... just saying is all :rolleyes: The body still makes and uses Carbohydrates (Glucose from Protein via Gluconeogenesis)... we just don't need to put them in our mouths.

Is dietary carbohydrate essential for human nutrition? -- Westman 75 (5): 951 -- American Journal of Clinical Nutrition
The currently established human essential nutrients are water, energy, amino acids (histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine), essential fatty acids (linoleic and {alpha}-linolenic acids), vitamins (ascorbic acid, vitamin A, vitamin D, vitamin E, vitamin K, thiamine, riboflavin, niacin, vitamin B-6, pantothenic acid, folic acid, biotin, and vitamin B-12), minerals (calcium, phosphorus, magnesium, and iron), trace minerals (zinc, copper, manganese, iodine, selenium, molybdenum, and chromium), electrolytes (sodium, potassium, and chloride), and ultratrace minerals (4). (Note the absence of specific carbohydrates from this list.)
 
1 - 8 of 8 Posts
Top