les w
Posted - 13 Jun 2003 : 11:50:25 AM

Thank you for an excellent posting.
My pre-prandial readings are excellent (ave 95)but my post readings are not so good, often over 200 (even after a very lc meal). My Doc seems to concentrate only on pre-meal numbers.
I take glucophage. Before LC I used double the dosage of glcophage and took actos also.
Any advice?

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BrightLady
Posted - 13 Jun 2003 : 1:43:22 PM

DH is a DM1 on an insulin pump. With a few exceptions, he's able to maintain non-diabetic premeal readings. For all diabetics, the tighter your control, the closer you can stay to normal ranges, the better your chances of avoiding or minimizing complications.
Thanks for the post DJ. Again you're provided vital info.
Les, any medication advice should come from your doctor. As far as meal advice, are you following a low fat version of low carb? If that's the case your meal may still be hitting your system too fast or all at once. Check with your doctor if you can increase the good fats in your meals. Including high fiber veggies (raw is best) will help as well.

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DJ
Posted - 13 Jun 2003 : 3:41:57 PM

Les,
Bright told you right!
That said,
perhaps you can get your doc's attention in this situation if you log what (food and quantities -- no guessing -- measure or weigh each item), and do post-prandial) post-meal) checks at 1'; 2'; and 3', at least.
How are your Hb-A1c's doing? And your lipids?
It sounds as though your pre-meal checks are good; but as you can see from Bright's post, it's pretty important to keep your BGs in tight control -- and PP BGs at 200+ does not reflect tight control.
i have promised to post the Joslin Diabetic BG guidlines, and will do so next week after i get the new glasses...
Did your doc have you see a CDE (Certified Diabetes Educator? Your insurance will pay. Try to find one who is trained to counsel DMs who use the insulin pump -- most of them work with docs who use tightly controlled carb counts, and are far more aware of diabetic nutritional needs than regular dieticians (sp???). You need a consult in any case, but expecially if you are not terribly overweight...
Fiber, green veg & lowcarb/low glycemic fruit; healthy fat; fresh country eggs, lean fresh meat and whole milk kefir are what help keep my PPs in line, & the HbA1c's around 5.6
-- although i have been wrestling with Dawn Phenomenon (overnight glucose rise) since last June after a course of steroids for a medical emergency unrelated to DM.
Les, Best wishes,
HTH,
dj
PS: Let us know how you are doing.

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les w
Posted - 16 Jun 2003 : 1:38:08 PM

Thanks DJ and BrightLady- excellent advice.

Allow me to give a little more info. I have been type II for 12 years and have been getting by mostly with medication rather than good diet and exercise. I'm trying to correct that now.
Been on Atkins for 3 weeks now and having mostly good results(-14 lbs). My BG readings have gone down and I have been adjusting my medication accordingly. I spoken to my MD and he has warned me to measure sugar often and to see him as soon as possible. Unfortuneately he's booked for two weeks. So I am taking my readings carefully and my readings can be printed out on his computer and graphed.
In the past my Hb-A1C's have been good and my lipids are excellent (130)since I started taking Lipitor. Since I posted a few days ago, I'm seeing better readings 1 hr after mealtime, under 180.

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DJ
Posted - 18 Jun 2003 : 3:41:06 PM

Les,
180 is better than 200, but at Joslin Diabetes Center, they suggest 140 (@ 7.8)...
Another thing, FWIW,
i read last week that the 2' PP average is the index that most closely approximates the HbA1C...
To convert the US BG reading --
divide the test value by 18.01 (i,e.), 128/18.01 = 7.1
And to compare the HbA1c to the US BG (ml/dl) --
multiply the HbA1c value by 18.01 (i,e.),
5.6(18.01) = (@) 101
Another 10 lb gone will see a great improvement in your glucose levels, unless you have a bunch of weight to lose.
And don't forget one of the best tools for managing DM -- gentle, conservative exercise daily.
Other things that help??
lots of pure water;
adequate rest and sleep;
4 oz dry red wine / day;
--pure unprocessed lean meat (organic if feasible);
--45-60 g dietray fiber from green veg, low glycemic/high fiber fruit (such as blackberries & respberries)
--unrefined (cold or expellar-pressed) healthy fats, and plant fat food -- olives, coconut, avocado, mango (esp raw green mango, which makes nice salsas and/or chutney for wraps or meat, poultry and fish.
Congratulations on losing the 14 lb in 3 wks! May your glucose levels continue to improve.
Keep us posted,
Best wishes,
dj

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les w
Posted - 26 Jun 2003 : 1:35:42 PM

I promised an update.
Its taken awhile but I'm very happy to report that the pp spikes have just about disappeared. Two hr readings are almost always below 140. Lost 2 more lbs (16 in 4 wks).
Been following your advice, except for one thing. I now think I'm ready for those 4 oz. of dry red wine.
I'm going to let a bottle of Merlot breathe. It will go great with my Steak and buttered Broccoli at dinner. Gee dieting is tough!


grannycraft
Posted - 27 Jun 2003 : 09:49:06 AM

Does red wine really help? Would it help lower my BGs overnight?
I've been Type 2 for 7 years. I have yet to control my sugars. Been on every low fat diet imaginable and finally found Atkins again. (was on Atkins in 1972, lost 50 lbs the summer before my senior yr in HS). But this time around, I'm not losing nearly as much as I thought I should. I've been religously doing Atkins induction for four weeks now and have lost a total of 5.5 lbs. My BGs are 160-190 morning and pre dinner. But after reading this information, I think I should try testing more often. Also, I was on 4 insulin shots per day, 44 units of NPH at night, 28 NPH in am and Humulin as needed if BG before breakfast and Dinner were over 150. Plus, Glucophage and actos. Now I'm doing Glucophage and actos only. The actos lowered my blood sugar so much it seemed insulin was unneccesary, at least for 4 days. Then the BGs started climbing again even though I'm doing the atkins induction and haven't even thought about moving to the next phase. (I am 5'2" and 250 and my goal is 130). Any ideas would be helpful!

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BrightLady
Posted - 27 Jun 2003 : 4:23:44 PM

Granny & les, a little further down in this forum there's a thread called the importance of a bedtime snack. It talks about preventing the dawn phenomena which contributes to a high morning bg levels. I think you'll find it very helpful.

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grannycraft
Posted - 27 Jun 2003 : 5:07:13 PM

Thank you BrightLady, I'll check it out. BTW I love this site! I am so happy to find such a supportive group. I was feeling pretty much alone, even though intellectually I knew I wasn't.
les