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Discussion Starter · #1 ·
kind of complicated med history- briefly- stomach has been partially bypassed, i have iliostomy, so no large intestines, had the ruyan y procedure (SP?) (the partial bypass). Crohn's disease, Chronic fatigue. I also have numb feet- almost compeltely- but still some feeling- but, I had cancer, and the chemo i took i beleive worsened the condition considerably- up till then i only had prickly sensations in feet, like 100 tiny mild bee stings feeling- then the chemo made my feet actually numb- hands too, but the hands have recovered

ok, so what happens is, I will eat breakfast around 11 am- (I only eat twice a day, and not very large meals), and feel fine till around 4 pm when i must take a nap 2 hour to make it through rest of evening. Some days I'm weak in my muscles, other days not as much weakness- shaky, feel hot, but not too badly- I'll also go through spells where i wake up at night drenched head to toe with sweat- it lasts for say a month or so, then clears up for several months it seems

About an hour after dinner, i get all shaky, weak, dizzy, sweating, confused, feel like I'm blacking out, voices sound far off, etc- all symptoms which seem to indicate low blood sugar. I will take as much as 4 glucose tablets spaced 15 minutes or so apart, and start to come out of it, but I'm left drained and weak for the rest of the evening (remember i have Crohn's and Chronic fatigue, so my body gets run down very easily with things that stress it, and it takes em awhile to recover to my usual semi yucky feeling level- days sometimes)

However, when i check my sugar, when i get real dizzy and confused and weak etc- it's generally been quite high- 300 to 500 range, yet the glucose tablets are what helps me get out of the symptoms from whatever is going on. Why would this be?

my morning readings when i wake, before eating, are between 100-120.

my 2 hour readings after meals is always around 110- 160 (with a few exceptions up around 180 range)

I don't know what it is that happens an hour after eating- Is it hypo? Hyper? Reactive hypo? Short bowel Syndrome? Dumping Syndrome?

Of note- I just went on an 'Elemental Diet" to give my intestines a rest, and wow did the sugar issue, whatever it is, get bad. I was able to calm it some by sipping the drink through the day instead of taking all at once- but still had several episodes that made me a bit nervous-
 

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Hello, Nazareth. Welcome to our site!

Interesting set of symptoms. Some symptoms certainly sound like hypglycemia to me -- but some also are symptoms of diabetic ketoacidosis and even hypokalemia (lack of potassium). I'm not a doctor, so don't consider this medical advice. This is a question best posed to medical personnel. But...

The Elemental Diet presents a bit of a wildcard. Many of those preparations are quite high in glucose, which would hamper a body already unable to properly manage glucose or insulin levels. The fat in the preparation should blunt the onslaught of carbs somewhat, but I'm guessing the food probably is geared to the typical "mostly-carbs" Standard American Diet. The report that sipping makes it easier on you supports this; when taken all at once, your body (likely) sees all that glucose and goes into overdrive to respond to it. There's also the question of whether what you're eating keeps your potassium and magnesium levels where they should be, and whether you're sufficiently hydrating.

A couple of other questions to fill out the information you provided:
  • When you're not eating the elemental diet, what are you eating? Approximate protein/carbohydrate/fat intake? Complex carbohydrates?
  • Any history of allergies and do symptoms seem worse after a particular food or kind of food?
 

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Discussion Starter · #3 · (Edited)
Hi- thanks for the welcome and answering-

when not on the diet (which admittedly may have been a mistake to go on- but being desperate to try to feel better, i tried it for 3 weeks) i eat 2 meals a day- At 11:00 am, I eat a ham and cheese sandwich, every morning, on spinach burrito bread wrap (Which i throw most out to the crows i feed- they liek hte bread- i'd estimate i throw out about 1/2 of the bread)- no dressings or addons liek lettuce or anything- and have a soda with it.

I would estimate the calories somewhere i n the nature of 400 maybe? 500 tops maybe for this meal?Then during the day i don't snack, but do drink a couple glasses o water-

i have to nap around 3-4 pm, get up around 6 pm and have some typ of protein like chicken, steak, pork- i guess right around 6 ounces, maybe some veggies with it, or green beans, or carrots- nothing else except water till around 12:00 am, then have a soda before bed- or a glass of cool aid-

I hardly ever deviate from this 'diet' - I'm not a snack person any more- not even for 'healthy snacks'- I know it's horrible eating habits- and likely nowhere near enough calories even (i weigh about 180 lbs)- i've mostly eaten this way all my life (56 right now)- 3 meals a day just made me feel kidna awful, slower, weaker- etc- so i settled into just 2 per day-

I have tried eating smaller meals a couple times a day for awhile- didn't seem to do much with weakness, strength issues, burning muscles etc- so went back to regular 2 meals

One reason i tried the elemental diet was i thought maybe i wasn't gettign enough food absorbed due to iliostomy, and stomach bypass operation- currently I'm eating food again, but now tryign to add one glass of predigested amino acids in whey form along with the food now- just started doing this, so can't comment on how that's working yet- so far- no change except not as many sugar spikes thoughout hte day liek i was having o n the elemental only diet-

As for the food allergy possibilities- I settled on the ones i do eat after many years because i seem to do the best on them- some foods like tomatos, potatoes etc seem to cause more weakness- so i avoid them- the 'caveman diet' was what was recommended for folks with crohn's- and i do ok on it- though do add in two sodas, day and night- folks with crohn's i understand ted to go for caffeine and sugar to give boost to weak muscles- but in long run i guess it hurts more than helps-

Magnesium seems to help sometimes when y muscles are really burning bad- but i can't take m uch of it due ot diarrhea with the iliostomy- and it doesn't help the muscle issue a whole lot- but does help some- not sure about potassium- i have kidney problems- currently at 36- whatever that means? They said it should be at 60? so roughly lost almost 1/2 the function i guess? I remember doc mentioning something about potassium- think they said to be cautious of it because of soemthing- maybe it was because of my liver readings? I can't remember now-

I'll check out ketoacidosis- I've told my docs for 25 years now that the burning muscles feel exactly like how your muscles feel when you overwork them and they begin to burn and hurt and get weak- only this is going on constantly- with no work- it feels like lactic acid burn- or what they call acid burn i n the muscles- Docs don't know what is causing it, and say it's 1 Crohn's itself, 2 chronic fatigue, 3 fibromyalgia (despite me not having any tender points), or combination- just typing this my arm muscles are weakening and burning- so that's where I'm at with this issue- not fun-

I've had thyroid all checked- it is fine- parathyroid too- Been trying to find answers for a very long time now- dumped tons of money into trying all kinds of things- Tried many different diets, supplements, amino acids, proteins, juicing, no sugar diets, herbs, just a ton of stuff- some so disgusting tasting it would gag a maggot.

whatever it is struck me down in my late 20's- i had been very active up until then- hardly ever sleeping, on the go all the time- almost hyperactive really- then the rug got pulled out- and down i went- healthwise-
 

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Discussion Starter · #4 ·
just forgot to mention- my blood tests never indicate low potassium- most tests show almost all are normal o neverything- only things that are off were liver and kidney readings- but chemo messed up liver- which is back to normal now
 

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Nazareth, that's a bundle of things to deal with! It's not made easier, either, when doctors hang anything that has changed on whatever chronic condition(s) you may have. We see that often with diabetes.

Again, not a doctor. But I see someone whose diet is fairly high in calories from carbohydrates (assuming the soda pop and cool-aid are the sugared variety) and relatively low on protein. From the AARP Web site:

The current recommended dietary allowance (RDA) for protein is 0.8 grams per kilogram (g/kg) of body weight a day for adults over 18, or about 2.3 ounces for a 180-pound adult. But research is showing that higher levels may be needed for adults age 65-plus.

In our older years, we are at risk of sarcopenia, which is the loss of muscle mass, strength and function. [...]

People with sarcopenia may need 1.2 to 1.5 g/kg of protein a day, according to the Mayo Clinic; that's 3.5 to 4.3 ounces for a 180-pound adult. It is also important to eat the right type of proteins, including some that include the amino acid leucine
Understandably, there are issues in just overhauling an eating plan. I know a couple of people who've had bariatric surgery and it's not easy for them to swing to one big meal a day or lots of protein or fat or fiber in one meal.

Magnesium and potassium are tricky -- some forms are more digestible than others and, still, too much can cause as many problems as too little. It might be worth your while to hit up some Web sites that offer nutritional breakdowns of foods to see if you can determine how much Mg and K you're taking in on a typical day.

People eating low-carb/keto do not have the water retention most people have, so Mg and K are not retained well for them; they often need to add to their intake through food or supplements. That doesn't sound like your concern, however -- carbs appear to be a substantial portion of your diet (again, assuming sugared beverages). So you probably should make sure you're getting at least the Required Daily Amount and not substantially more.

I found this link discussing the nutritional effects of phosphoric acid (found in many soft drinks) on Mg, K, and other foods. (I'm not crazy about the credentials of the site itself [they largely don't exist] but they are referencing studies it should be possible to find on the Internet, which then can be gauged for their usefulness to you.)

Maybe at this point it's useful to review this information and how well it may apply to you and then determine what next to pursue? Right now I'm just trying to rule out this or that based on what I know (admittedly little).
 

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Discussion Starter · #6 ·
Thanks for responding, sorry for delay i n gettign back- been busy- I'll go over your post more i na bit- but briefly, yeah, my protein is low- which is why i have started takign hte pre digested proteins in whey form hoping to get them into my system quicker and easier-

I'm wicked dizzy right now- shaky and weak, 2 hours after my breakfast (ham cheese sandwhich, soda, protein drink) , I just tested BS and it was fine, 114- i did it twice to make sure- Trying to concentrate is awful right now- and i gotta go to the bank lol- wish me luck haha- anywways- I'm researchign the ketoacidosis issue you suggested- , I'll be goign to docs abotu htis issue in about a 1/2 month or so- i wanna get at least a good solid weak of blood testing morning, noon, night, bedtime in a chart to give them, plus i think i want to try the 72 hour fasting testing too on my own (probably not a good idea at this point- but meh- I'm curious-)

I'll go over your post more when i get back tonight- thanks for answering- i do appreciate it- it's justy so complicated and frustrating all these years tryign to figure out what 'May Be Happening', hard to even know which direction to go in to research what it may be- I think sugar may be the right direction to pursue at htis point- but perhaps not- but just seems liek that is what is going on, or the other thigns you mentioend too- maybe a combo-
 

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Discussion Starter · #7 ·
oh and excuse my typos- I'm not dyslexic, just my typing finger is- i make so many repetetive mistakes (like hte, adn, etc) - it takes forever to correct them all
 

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No worries, Nazareth. Some of us don't type too well even without dizziness or other issues! I've resorted to keyboard macro software to fix some of my most common errors.

Not sure how much the ketoacidosis plays into this, but at this point almost anything plausible is worth looking at, eh? Your symptoms, though, don't seem to correlate with diabetes specifically, but some of your blood glucose readings are concerning given what else is going on.
 

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Discussion Starter · #9 ·
yeah, i just took it again after dinner- 2 hours after- i guess that is when I'm supposed to take it- and it was 121- I dunno what's going on- i did a week testing oh about 1/2 year ago or so- I'll see if i can find the readings- and do a quick chart here of them-
 

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Discussion Starter · #10 · (Edited)
thaks for the phospheric acid link- I'll check that out in more detain too- o gotta check if the orange soda i drink has it- i think the coolaid does- I just gotta find a good substitute to drink that isn't water- can't stand unsweetened stuff- juice kinda upsets my stomach- most anyways- I think i can do grape juice ok though=- but still those are kinda high in sugars too-

ok here's my readings for one week i did- mornign readings don't look good, but the others don't look too bad? The "2 hrs after breakfast" category- i had sodas with breakfasts- did not have sodas with dinners, but woudl have one before bedtime- usually drink one right till i went to bed:

Day--mornings before bkfast--2 hours after bkfst--Before dinner---2 hrs After dinner--Before Bed::::
Mon----115---- 266----138-----137-----142
Tue----112------185----152------142-----134
Wed----120-----106-----180-----108-----145
Thu------113-----140-----216-----121-----125
Fri-------109------153----160------180-----113
Sat------104------110-----99-------134-----124
Sun-----120------158-----107------158-----130
 

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Discussion Starter · #11 ·
the sarcopenia, not sure it's that- i lost my muscle mass and strength in my late 20's (The mass kept on for awhile, maybe 5 years, but began losing it due to muscle weakness gettign worse, and doing less as a result-

I do take Vit K as i have to take it along with Vit D to try to prevent kidney stones- the K helps redirect the calcium that the D pulls or soemthing liek that- i just kniow i was told to take K with the D- The Magnesium, i can tell when i get low in it as the burnign i nthe muscles gets worse- so I'll take it for a coupel of days- and the burning calms down to tolerable level- I've tried taking more, thinking it woudl help with hte rest of the burning in muscles, but it didn't- just caused more Diarheah, so now i only take when the burnign gets too bad-
 

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Discussion Starter · #12 ·
something just occurred to me- my morning BS always seems to be higher than it should be- and during the night, I'll wake up sweating sometimes- This i guess could be result of 'high carb before bedtime'? I awoke an hour early this morning, a bit hot and sweaty- and thought I'd check the BS out of curiosity- it was 130- (which isn't high for daytime BS- but it is for morning BS i guess? then i went back to sleep- and awoke at normal time, checked again, and the BS was 112 (still kinda high for morning BS- but it had come down some)

Guess I'm gonna have to go a week or more with no carb drink right before bed, see if it makes a difference in morning bs levels- I'll try drinking gatoraid or something instead- see what happens-
 

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Guess I'm gonna have to go a week or more with no carb drink right before bed, see if it makes a difference in morning bs levels- I'll try drinking gatoraid or something instead- see what happens-
If by "no carb" you mean a drink without carbohydrates, watch the Gatorade. There are sugar-free versions but most versions are at or above fruit-juice levels of carbohydrates. It will get rid of the carbonation (if that’s an issue for you) and the versions I saw did not include phosphoric acid. But if the aim is to avoid sugar overnight, choose your drink carefully (and note that you're taking away 140 or so calories by not drinking the sugared version).

Also beware that fasting blood glucose can be one of the last BG measures to come down on a permanent basis, so it may take longer than a couple of weeks without the sugared beverage to see FBG go down based on this change (assuming that's what's behind the morning levels).

You have hit on an important aspect of managing chronic illness, though: everyone is different. Same with diabetes. Some foods will really spike blood glucose on some diabetics; others will barely notice it. Timing also is important. My fasting blood sugar is lower if I have a non-carby snack before I go to sleep. The only way to know what works for us is to try things out.

I'm still looking at the chart of numbers; I'm sure I'll have more on that later.
 

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Discussion Starter · #14 ·
that's true about the gatoraid- uggh- i gotta find something to drink- Yep- the calorie loss will hurt a bit too-

I'm gonna try eating greek yogurt- no sugar, before bed- supposedly that 'regulates bs-

The chart- i couldn't type it out so it was easy to read unfortunatley- tried several times lol- even tried using an online html formatter- didn't work-
 

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that's true about the gatoraid- uggh- i gotta find something to drink- Yep- the calorie loss will hurt a bit too-
There are drink flavor concentrates (brands like Mio, Stur, and others) that use stevia or artificial sweeteners. A squeeze or two into water and you've got water that's as flavored as you want it. I hear you on drinking glass after glass of straight water -- some days it's tough by the time I get to the 5th or 6th glass. Only issue there (besides finding some of the brands) is making sure your body tolerates the sweetener.

The chart is fine. I date back to ASCII days, so it's not that hard to read. Life just got unexpectedly busy yesterday so I haven't had the time I want to examine.
 

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Discussion Starter · #16 ·
yeah i can't do artificial sweeteners with the crohn's and stomach issues-

I'm not sure if my blood sugar testers is working right- went to bed last night with 89 reading, woke up again at 5 and read 130, then a couple hours later read 113, had breakfast, 2 hours later my reading is 89. I thought it was low, so tried again right away, the meter said 97- back to back tests shouldn't be off by that much should they? I never had 80's readings before- and now I've had 2 of them in 2 days- I just began using new test strips by one touch- they are supposed to be good till sept-

anyways- doesn't look to me so far, that i have low blood sugar- if anything- it looks slightly high, so I'm not sure what is going on when I have the spells of dizzy, weak, sweating, shaking, pounding heart (that i can 'hear' in my ears- probably more feel it than hear it), coming close to passing out. I do know the elemental diet threw me way off- wish i had tested the BS durign that time- but didn't think to- kept getting the 'spells' over and over- now that the diet is over- I am still getting dizzy and weak, but not nearly like i was during the diet- and i haven't seen a low blood sugar reading yet- even at my dizziest/weakest spells-

Something in the 'Food to energy' process isn't working as it should be- something has gotten messed up somewhere along the line- and eating seems to make the problem worse for a few hours after eating- even though my sugar levels seem to be ok- I don't know if it's a mitochondrial problem, glucose, dumping syndrome, or what? Like right now, my sugar is fine, (IF my meter is working correctly)- and I'm dizzy, weak, 3 hours now after eating- enough so that now the rest of my day is ruined strength and energy-wise- these spells just drain me- The symptoms all would seem to indicate low blood sugar- but nope- I'm just not seeing it i n the test results-

I basically just went on an 'elimination diet' for the most part- but symptoms got worse- so it's hard to know what, if any, particular foods might be the culprit- i did have a couple instances on the diet where the bs shot up to 466 i think it was, but most of the time it was in range- even when feeling the most awful-

So frustrating not knowign what direction to even go in for possible clues-
 

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Well, let's start by eliminating what we can know.

Good meter? It's probably worth changing the batteries in the meter for fresh ones. Old, weak batteries can give wonky results. Might as well inspect the battery compartment for any corrosion, too.

The meter is allowed to be ±15% off the true reading. Most meters are closer than that (I would expect a functional OneTouch to be) but they are allowed that variation. Those 130 and 113 readings you got are both within that range if your actual BG was 121. Blood is not homogeneous; fat molecules and sugar molecules and other materials occupy that fluid, so you could take two readings seconds apart on the same finger and still potentially see that kind of variation.

Testing site; same general place every time? The sides of the fingers are best. Even though some meters let you test elsewhere (palm, upper thigh) you then have to make allowances for that. That's not as big an issue for you since you're not trying to treat diabetic lows by dosing insulin, but consistency doesn't hurt.

Cleanliness: wash your hands before testing. Use a neutral soap (sometimes scented soaps leave residues that can throw off readings). Warm water helps bump up the amount of blood in your fingers and helps ensure enough blood for the sample (too small a sample can be provide false readings). Clean towels or -- maybe better right now -- paper towels will help avoid contaminants from previous towel uses (including detergents).

The strips: do you have another vial to open up? I hate to break open a new vial when I don't have to, but sometimes things go wrong or the strips were stored improperly in transit or something; wouldn't hurt to try a different pack of strips to see if that's the issue (but don't make this change before the others).

Toss the lancet you've been using and put in a new one.

So I would suggest reviewing your testing protocol to make sure there's nothing there that's tripping it up.

I will mention that when I first got off the higher-carb foods I experienced several of what felt like sugar lows. I would test my BG, though, and it was nowhere near low. If your body is getting used to a lower level of glucose, you can experience these false hypo feelings.

And I'll mention that a sudden large influx of carbs (soda pop [sorry], sack of french fries, whatever) will end up stored in the liver and that glycogen will be provided for days, depending on how many carbs were ingested. The fasting blood glucose test in the morning is stubborn and one of the last to go down because of the long-term feeding by the liver. We can look at addressing that once the really high and low numbers are not in the picture.
 

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Hello Nazareth, welcome to the forum.

I can only add a couple of things for consideration to what itissteve has already touched on.

You mentioned feeling hypo in your first post but checking your BG it was high but taking glucose tabs helped ease the feeling. Although not technically a hypo, but if you your BG does go up and then start to suddenly drop, you can experience hypo like feelings. It is called a false hypo. That may or may not explain without without more BG readings around the events. Were those readings at typical 2 hours after the meal or before? BG tends to spike high around an hour after eating and is returning back toward pre-meal numbers at 2 hours. Not always true but generally speaking.

I've re3ad that magnesium levels tested in bloodwork does not give a good indication of if there could be a deficiency at a cellular level. You might consider using a transdermal application of magnesium oil or epsom salt baths to see it that helps any with muscle issues, it should avoid the digestive issues oral supplementing can have. Diet tonic water with quinine helps some people with aching muscles without adding to sugar intake.
 
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Discussion Starter · #19 ·
hey thankls for detailed response- yes, batteries are new as of 5 days ago- I test at same site- middle of middle finger pad at end of finger- each time- Yes, i have a new vial i could open- I will give those a try for a few days see what haPPENS with the readings-

I'll try washing the hand before testing, see if it makes a diff.

[[If your body is getting used to a lower level of glucose, you can experience these false hypo feelings.]]

This could be, and seems ot be what happened- but wow- i mean it was awful- I really felt very close to passing out- but now that I'm off the diet for several days already- i haven't been that close again- just dizzy, somewhat shaky now- my diet though remains the same as it was before the elemental diet- I don't vary it hardly at all-the only carbs i get really are the 2 sodas, one morning, one night- and the tortilla bread, which i do the spinach, not the corn ones- so not sure what the carbs are on it- but again- i thrown nearly 1/2 or better of it to the birds, and mostly just eat the ham and cheese with just enough tortilla to hold it together- perhaps thye two sodas are just too much- -

As a test- i ate dinner tonight- about 6-8 ounces or so of cube steak- that's it- little salt, with worchestirshiresauce on it- Then i ate 8 of the smarties candies you would get for Halloween- I tested one hour after the meal, and sugar was 260. I tested at 2 hours- it was 192, then again at 3 hours- just out of curiosity- and it was 139, so it seems sugar does shoot my bs up --sometimes-- sometimes it seems not to- like i tested right before bed last night, right after finishing off my soda, which i sipped over the course of an hour and a half, and bs was 89 as mentioned in last post- other times I've tested after finishing sodas and they have been in normal range too- . then other times it's really high- I'm gonna eat dinner tomorrow no sugar at all- see what happens after the meal-

[[It is called a false hypo. That may or may not explain without without more BG readings around the events. Were those readings at typical 2 hours after the meal or before?]]

Those were about 2 hours after my elemental drinks, along with honey for calories-

about the muscles- it's not an ache so much as it's a 'burning weakness' - what it feels like is pins and needles all over the muscles- and they are weak, as if they have fallen asleep and are just waking up- you can use them, but it feels really odd to use them. I guess it does involve lactic acid burning pain too- I do drink quite a lot of quinine water as i get cramps a lot too - which also would indicate mag deficiency too- I'll give that transdermal a try- see what happens- I do suffer very painful hands when it';s cold- even holding a cold can of soda is painful - i know mag helps with that issue too-
 

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As a test- i ate dinner tonight- about 6-8 ounces or so of cube steak- that's it- little salt, with worchestirshiresauce on it- Then i ate 8 of the smarties candies you would get for Halloween- I tested one hour after the meal, and sugar was 260. I tested at 2 hours- it was 192, then again at 3 hours- just out of curiosity- and it was 139, so it seems sugar does shoot my bs up --sometimes-- sometimes it seems not to- like i tested right before bed last night, right after finishing off my soda, which i sipped over the course of an hour and a half, and bs was 89 as mentioned in last post- other times I've tested after finishing sodas and they have been in normal range too- . then other times it's really high- I'm gonna eat dinner tomorrow no sugar at all- see what happens after the meal-
Thanks for the update. So it looks like we're starting to weed out testing as a source of this issue.

For what it's worth, there are 3 grams of carbs in every tablespoon of worcestershire sauce and around 6 grams of carbs in the Smarties (and none in the cube steak). Frankly, unless your steak was swimming in worcestershire sauce, that's 9-12 grams of carbs, which even in us diagnosed diabetics, should not push BG up 150 points from "average" -- but
  • there still is that testing protocol issue (clean hands and known-good strips) and
  • I didn't see a pre-meal measurement. You could have been rolling into dinner at 90 or 115 or so or come in higher from something else (after all, it took several hours for your BG to come down to 139).
So there's still some information needed. Around here we promote something called "eat to your meter": foods affect some diabetics more than others. I can eat a few pieces of watermelon without much BG "grief"; other diabetics can't. But the way to know that is to measure your BG just before you eat and then at the 1 and 2 hour intervals after that (even 3 hours if the second hour total is still kind of high). That's how you know what you can eat and how many carbs at a sitting are too much.

So it would be good if you could prepare your meal, wash your hands, test your BG before the meal and then at intervals afterward. You don't have to do this for every meal (especially since you tend to eat the same foods). But this will help establish a baseline for your BG to see if there are some foods you have to avoid or if you're better limiting the number of carbs at one time (this fits in with the Elemental Diet measurements, too, as far as how many grams of carbs your body can handle).

In view of the questions about testing, I'm going to hold off on interpreting the chart. But let's find out what you measure for the next couple of days and see what's up. I appreciate your patience as we try to figure this out.
 
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