First testing - 3.7 fasting to 11.4 post meal!

[Bolouswki]

Hi

just did my first self administered test. I was wondering if this sounds reasonable (although the results after eating were bad, I'm wondering if it sounds like it shouldve been like this?)

Just to give the prelude

8:00 Hours
1x Mandarin Orange
40 minute swim

09:30 Breakfast
Bowl of porridge with spoonful of sultanas and nuts
Skimmed milk

13:00 Lunch
200g Fresh Salmon with leaf salad, 2x tablespoon of couscous, grated carrot
20 minute walk

18:00 Hours
40 minute walk

Test 19:30 pre-meal 3.7
19:30 Evening meal
200g Baked beans
2 Slices Wholegrain bread
50g Sliced Ham
Dessert
2xShredded Wheat with 2 Tablespoons of 3 Berry Granola

Tested 21:00 hrs - 11.4!!!

My guess is that the worst here was the granola - turns out it has "unrefined sugar cane" as its 3rd highest ingredient! Binned the rest of the pack - but is the rest of the evening meal one that would likely cause such a huge surge in BG?

 

[smidge]

Hiya there!

The amount of carb you had in that evening meal would probably have put me in hospital! If your BG was only 11 after that, you can consider yourself lucky - although I think it might rise higher around the 3 to 4 hour mark.

OK, beans, bread and shredded wheat all very high in carbs. It is the total carb content of your meal you need to look at, not just the sugar. All carb breaks down into glucose and causes your blood glucose levels to rise. 3.7 before your meal was a bit low - but this is probably because you did 40 mins exercise without eating. The idea really is to try to keep your BG consistent and avoid the swings of low to high that you've had today. Test before your meal (you don't want to be below 4 as this is actually a hypo) and then two hours after your meal - you are aiming to get your post-meal level back to about the same as your pre-meal level - although this will only come with time and experience. If you find that your level has shot up like it has today, cut back on the carb. The higher your BG spikes, the lower it is likely to fall later, so you need to try to avoid that.

Smidge

 

[HLW]

If I ate a whole lettuce with 1 grain of sugar added, sugar would be the second item on the ingredients list. You need to be looking at the nutrition information, eg how much carbohydrate it has in it, not the list of ingredients.

Of your evening meal, the baked beans, bread, shredded wheat, and the berry granola will all contain carbohydrates. No idea about ham, I don't eat meat.

All carbohydrates cause blood sugars to rise. It doesn't matter if it's jelly babies or grapes, it will still have an effect on blood sugar, don't fall into the trap of thinking fruit = healthy = can eat as much as you want with no effect on blood sugars.

When I saw the dietician after being diagnosed type 1, she said 1 piece of fruit max (and one piece equals for example 5 grapes, not a whole bunch), the rest of 5+ a day should be veg.

 

[Bolouswki]

Thanks for replies - very helpful! Yikes - this isn't as straightforward as I thought! I deliberately ate carbs as I thought 3.7 was too low - obviously i went overboard! Should i being trying to mix it up with slow release stuff? My meal was quite small compared to previous (pre-diag) portions - what is a reasonable amount of carbs per meal/per day?

 

[HLW]

It depends on the person really. By testing, you'll be able to work out the amount you can eat and still have OK blood sugar levels. Have you seen a dietician? The diet forums here might be worth a read too, for meal ideas etc.

 

[Bolouswki]

I've been testing for about a week now, and other than the incident described above, I've been between 4 and 8.5 the whole time, generally sitting around the 6 mark. Which according to what I've read in books etc seems to be about the right mark. Didn't know there was a diet forum so will check that out - thanks for the tip!

 

[menawati]

(you don't want to be below 4 as this is actually a hypo)

Is that true ?
I had tests done recently and my fbg was 3.5. (A1c was 4.9)
Doctor said it was fine.
(I'm not fully diabetic but have been eating low-carb as I had tests 6 months ago that put me at the top end of normal)

 

[Bolouswki]

hmmm - similar incident today

Dinner of salad made from
150g chicken breast, 250g Iceberg lettuce, 6 strawberries, 1/2 apple, wensleydale cheese, 30g walnuts, sprinkle of mixed seeds and tablespoon of dressing (6g carb per 100g - tablespoon was about 30g I guess?)

anyways - this took me from 5.6 pre meal to 10.4 nearly 2 hours later!
Thing is - i've had all those items before and none of them shot me up that high - is it to do with combinations or something? Or was it quantity based? The above was essentially a big salad bowl worth of salad. (say, about 3-5 cereal bowls?)

Any opinions greatefully received!

 

[snurger]

I recently completed an excellent short-course for type 2 diabetics (operated by our local Area Health Authority) called "Jugglers". I'm not sure whether it's been rolled out on a national basis, but it might be worth checking with your GP.

The course clearly explained production of glucose by the varying forms of carbohydrate consumption, and how quickly they enter the blood stream:
Slow release: e.g. granary/wholemeal bread, bran flakes, Shredded Wheat, etc)
Medium: e.g. Weetabix, mashed potatoes, white bread
Quick release: e.g. Cakes, biscuits, sweets, sugary cereals, fruit juice.
Instant: Lucozade

For your main meal, carbohydrates should take up about 33-40% of your total food consumption at each meal, along with about 40% vegetables (these do not add to your blood sugars). You should also aim to take in 2-daily proportions of dairy produce (milk, cheese, yoghurt etc) for your calcium intake (again these do not affect your BG). Finally, you should look to consume 3-portions of protein a day (meat, fish, eggs), none of which will affect your BG, unless of course you are a veggie - then you will generally increase your consumption of vegetables and probably nuts/pulsars.

Portion-size is crucial, and this can leave you hungry. So you can fill-up on UNLIMITED amounts of salads and vegetables (except for potatoes). Take care with fruit, no more than 3 - 5 portions a day, and no more than one portion at a time! Beware of fruit juice - the sweetened types should be avoided, and only 125ml of pure fruit juice a day!

Apparently there are 3-levels of readings that you are likely to encounter: 4. 7. 10
Below 4 you will be into hypo, and of course that should be avoided.
You should be aiming for a consistent reading of between 4 and 7.
Up to a couple hours after having a meal, you may achieve readings of up to 10 - beyond that and you're into hyper territory, and again this should be avoided.

The course clearly explained the various forms of medication, when they should be taken, and how the various types assist with dealing with BG and your body's production of insulin and its ability to resist it!

The "Jugglers" course also addressed the perils of the diseases associated with diabetes 2, and the affects of your life-style on the illness: exercise, diet, weight, stress, etc.

I can't recommend the course highly enough. It clearly addressed the misnomas and half-truths, and put all the conflictions you'll inevitably experience, into sharp focus.

 

[raydavies]

I see why it's called "Jugglers". If you fancy juggling with your health OK. but if you follow a high carb diet like this you could well be heading for trouble.

"mashed potatoes, white bread" medium release - what?

Ray

 

[phoenix]

I'm glad you found the course useful, I think it's quite hard sometimes for them to give a lot of info in a short time.
Personally I I agree that using the speed of carbs ie the GI is a good way to choose the carbs you eat. I have T1 but I know that there are others here with T2 that use this as a guide.
Unfortunatley I think the list you were given was a bit misleading. The GI of carbs is a method of ranking the effect/speed of various carbs on glucose levels. They are compared with glucose. Glucose is a very fast sugar and is given a GI of 100. The lower the figure then the lower the GI. You will usually read that :
Low GI = 55 or less
Medium GI = 56 - 69
High GI = 70 or more
Recently though some GI experts have suggested that below an average of 45 for a meal is a good target. (tthis would include all elements and is a bit hard to work out!)
These are the foods are your list you were given and their GI
granary bread( mixed heavy grain )45
Wholemeal bread (Sainsbury UK) 71
Bran flakes 74
Weetabix 75
Shredded wheat 64
mashed potatoes (depends on variety) 70-101
white bread average 74
So all but a couple are actually high GI, 'normal' wholemeal may not be that different to white bread.(a lot of people find burgen bread to be quite low GI )
In fact some cakes because of their fat content might be actually be lower (but still not good except on the odd occasion)

So what are lower: Heres a few
All Bran 50
Porridge made with jumbo oats and milk 40
Sweet potatoes 48
New potatoes boiled 54
Basmati rice 58
Brown rice 50
white converted rice 50
Green lentils 30
red lentils 21
Chickpeas 48You can find lots of details about using the GI and a database of foods here. http://www.glycemicindex.com/
Note that pulses tend to be low and are a good choice for all of us not just vegetarians.

It appears that we all have different reactions to certain foods (porridge is notorious) and it's much better if you can test the effects on your own body using a meter. Portion size is important.. 30-40g of oats is a reasonable portion (unless you're very active) and doesn't look much before it's cooked.

 

[viviennem]

It's also misleading to say that "vegetables . . . do not add to your blood sugars". Vegetables contain varying amounts of carbohydrate, and some are relatively high (broad beans have 10g carb per 100g; peas about 9g carb per 100g; parsnips 12.9g per 100g). Not much individually, but the portion size does need controlling.

It's a good idea to get yourself a carb counter book - 'The Calorie, Carb and Fat Bible' is good; Collins also do one in their 'Gem' series, which is not as accurate but far more portable. Eat as you normally do for a while, but try to work out the carbs you are eating. test after every meal, so you can work out which foods do what to your blood glucose levels. Then you will know what you can and can't eat, and how much. A GI book is also useful.

Each of us is different, and we all need to work out which foods we can and can't eat. It takes a bit of work at first, but eventually it becomes automatic.

Viv 8)

 

[snurger]

Back to the drawing board for me then!
Thanks Phoenix for your very constructive comments and further information - I shall certainly be exploring the aspects you have outlined.

I attended the Jugglers course, which I still consider was very useful, because I am struggling with my weight and lapses into eating entirely the wrong foodstuffs.

I am now 62-years of age, and have lived through a variety of opinions as to what is good for your health, and what is not. Even now my GP, diabetic nurse, and the course dieticians seem to be at variance.
Naturally, these conflictions can be worrying, and add to this Ray's comments that in his opinion, by following a "high carb diet like this", I could be "heading for trouble"!

In the course I attended, I was given to understood that foodstuffs in the carbohydrate category (i.e. rice, wheat, oats, potatoes; and therefore bread, pasta, breakfast cereals, etc.) should account for about 30% of our daily intake, rising up to 50% if on a weight-loss regime, and that it was better to consume the more complex molecular, starchy foods which are slow to digest such as:
Pasta
Brown Rice
Granary Bread (and other bread with "bits" in)
Porridge Oats
Boiled Potatoes
Noodles, and
High-Bran Cereals (Bran Flakes, Shredded Wheat etc.)

The course suggested that other derivations of carbohydrate foods, whilst still acceptable, are quicker to get into the bloodstream, because they are more easily digestible, and include:
Mashed Potatoes
White Bread
Weetabix (as it is much more easy to digest than bran, oats, and shredded wheat)

The carbohydrate foods to be wary of, because they are quickly digested (simple molecular), and therefore releasing glucose into the bloodstream much more quickly, include:
Cakes and Biscuits
Sugary breakfast cereals
Fruit Smoothies
Lucozade

So I think there is a degree of confusion, certainly in my mind between the distinctions made by the "Jugglers" course, and the rating that these foods achieve of the GI scale (which incidentally was not heavily featured in the course).

So it seems I have to take both Phoenix carefully explained advice and information, as well as Ray's dire warning into account, along with "digesting" the Jugglers course!

Any other comments would be gratefully received.

 

[raydavies]

One of the problems with the medical profession is they generally pass on what they've been told. This may, or not be correct. Perhaps a nurse has taken the initiative and taken on board some of the current knowledge about carbs and diabetes. This may be at variance with some doctors and maybe in accord with others! My doctor told me to just watch the diet a bit (?), take the pills and don't test, "it just gives you a sore finger". The diabetic nurse was freaked out when she saw the startling success of my diet and was genuinely interested. Apparently I have the best results of any of her patients. I pointed out this was not due to the doctors efforts - she turned away with a sort of "Mona Lisa" smile.

In other words you need to be sceptical and, at the same time inquisitive. Read some of the excellent books available and tailor your diet to suit you and your lifestyle. More importantly, find a diet that controls your blood glucose levels.

I hope all goes well.

Ray

 

[Bolouswki]

Thanks for all the wonderfuly informative posts and for all the time everyone took to express their opinions and advice here - I'm getting a better understanding through these boards and am highly confident that that particular spike was due to quantity and the imbalance of protien/carbs. However "healthy" the particular carbs seemed, it was still a pretty big bowl of salad!

On the GI stuff, I can handle potatoes really well, but bread sends me pretty high. Swings and roundabouts it seems!

 

[viviennem]

Salads - I eat a big mixed salad at least once a day, made up of mixed lettuce, cucumber, celery, up to 8 cherry tomatoes, half a red, green or orange pepper cut into slices, sometimes spring onions and/or sliced raw mushrooms and'or a few olives (not stuffed). Today I will have a version of that with a whole avocado. Other times it's with any cold meat, or hard-boiled eggs, or fish

I eat avocados only rarely, 'cos even though low carb they are very high calorie, though full of good nutrients so I'm allowed one once in a while. I have to eat a whole one 'cos they don't keep once cut :lol:

That whole bowl of salad will have no more than about 10-15g carb.

If you look on the Low Carb Forum, you'll find 'Viv's Modified Atkins Diet'. It gives a list of the 'allowed' vegetables for the 20-25g Induction phase of the diet. I'm not suggesting that you follow it (though it works for me) but if you stick to that list of vegetables as a base, you can add extra carbs to your own preferred level.

Edit: I forgot the radishes! - about 6.

Viv 8)

 

[Bolouswki]

Great! I checked it out - looks good indeed. I'm gonna continue testing myself to see what/how much of different stuff I can handle, but I certainly like what you propose and my previous experience with Atkins (did it for 6 weeks) was that I liked it after the induction was up!

 

[Grazer]

The two slices of wholegrain bread would also have a big impact. Although better than many breads, would still have in the order of 36 grams of carbs, and comparitively high GI carbs (quick acting) I eat low GI bergen soya and linseed bread, (sainsburys stock it), only 21 grams two slices and slow acting. Get much lower readings. Why the cereal after the meal?? Sounds a bit harsh. I have shredded wheat (2) at breakfast and handle it well as active after.
Your exercise regime sounds gruelling. Did you always do all this?
Look after the low GI carbs (not too many) to look after your sugar, and I believe the rest will look after itself
Malc (Type 2, diet and exercise, 61 years young, last HbA1c 5.9, aiming for 5.5 next. Not peaked at over 8 on self-administered post-meal test for 3 months)

 

[Pneu]

(you don't want to be below 4 as this is actually a hypo)

Is that true ?
I had tests done recently and my fbg was 3.5. (A1c was 4.9)
Doctor said it was fine.
(I'm not fully diabetic but have been eating low-carb as I had tests 6 months ago that put me at the top end of normal)

Didn't see a response to this one... so just a quick one..

A 'normal' persons fasting blood sugars can be anywhere between 3.5 and 4.5 mmol/l lower in the morning and slowly rising during the day with the average being around 4.0mmol/l.. as a diabetic you are advised that anything under 4.0 mmol/l should be considered a 'hypo' however I believe that technically anything under 2.5 mmol/l is considered a medical hypo. So as a non-diabetic your reading was low but not abnormal.

Personally if my blood sugars were 3.7 pre-meal then I wouldn't be ramming additional carbohydrate down, I would just be correcting my insulin to ensure that my fasting levels post meal would correct to around 4.5 mmol/l... but everyone is different and I have a very good hypo sense that kicks in at 3.5 mmol/l and therefore I can run tight sugars without the worry I am going to drop below 3 without knowing.