Still poking the dog...

[Cocosilk]

I've been trying to find an acceptable amount of carbs to include in my diet, not necessarily everyday, but I find after a few days of very low carb I start feeling like I want to throw a few extra veggie carbs or fruit into my salads. I also thought I would try again with steel cut oats. But this time a smaller quantity. Not 100% sure of the total carb content but on two different days I had 100g of cooked steel cut oats (cooked in water and goat's milk) with half a teaspn of Manuka honey.

On the packets, steel cut oats are 55g carbs/100g (probably uncooked); honey is 84g carbs / 100g; and goat's milk is 4g carbs / 100ml.

Wondering what the insulin curve would have looked like for these two scenarios as well.

On the first day I'd eaten a tin of sardines one hour before I had the oats.
then
Before - 5.1 mmol (before oats and one hour after sardines)
30 mins - 7.3
60 mins - 6.4
90 mins - 4.8
2 hours - 4.9
2.5 hours - 4.2


Compare that with this:
This time I ate my usual breakfast of 2 eggs, smoked salmon, avocado, sauerkraut and a teaspoon of chicken liver pate.
As soon as I had eaten that (within half an hour of starting the eggs), I had the 100g of cooked oats / goat's milk / half teaspn honey)

Before 4.0 mmol (didn't eat breakfast till midday so I could catch up on sleep)
30 mins - 5.5 (this was 30s mins after the oats but really an hour after first bite of eggs, etc.)
60 mins - 6.3 (90 mins after eggs)
90 mins - 6.0 (2h after eggs)
2 hours - 5.9

Now I know these are all fairly acceptable bg readings. My main question is, which of the two patterns is preferable?

Is a higher earlier spike that is dealt with swiftly and over sooner, a healthier way to eat?

Or is the second pattern, of not such a high spike but a more extended time period in the 6s a better way to eat?

And any idea whether the demand on insulin would be similar in either case??

 

[woollygal]

The reason you want more carbs after couple days low carb is because your body is playing tricks. you have to keep at low carb otherwise it won’t get better.

even now after several months every so often my brain/body starts trying to make me have something.

mum never quite sure whether I really need it or they are playing silly beggars and trying to make me have something bad.

i don’t have it then hey presto I’m fine again.

If you want to reduce those you need to stick at low carb all the time.

Today I know is going to be difficult because I ate out yesterday and had way more carbs than usual. But today is back on the plan

 

[Cocosilk]

The reason you want more carbs after couple days low carb is because your body is playing tricks. you have to keep at low carb otherwise it won’t get better.

even now after several months every so often my brain/body starts trying to make me have something.

mum never quite sure whether I really need it or they are playing silly beggars and trying to make me have something bad.

i don’t have it then hey presto I’m fine again.

If you want to reduce those you need to stick at low carb all the time.

Today I know is going to be difficult because I ate out yesterday and had way more carbs than usual. But today is back on the plan

I'm trying to find a "safe" way to include carbs so I don't fall off the wagon and binge... because then I would really pay for it. But I could be wrong, I could end up with more cravings by including some carbs rather than limiting them. But for now I'm following my instincts (or maybe they were cravings ). I just feel that if I give myself some
"safe" limits then I won't feel completely deprived and I'll just get on with very low carbing every other day. I won't be fighting with myself so often in other words...

P.S. my last HbA1c was 34 (5.3%) after 6 months of low carbing. But when I tried to go back to eating a regular amount of carbs that I like (eg sweet potato wedges with sour cream) I was seeing 8s at the 2h mark. So I know I can't handle a larger amount of carbs. I just take small bites of things here and there. I'll throw 10 chickpeas, 3 strawberries and a few slithers of carrot into a huge leafy green salad. Today I also snuck in a half slice of Pumpernickle rye but it kept me in the 6s for hours. Still 6s are better than 8s at least.

 

[woollygal]

By doing every other day you are making life very hard for yourself. just reduce and stay every day then potentially drop a bit further and further over time if that’s easier.

but by doing every other day I just can’t see the point.

mots like an alcoholic getting drunk every other day and feeling like they are going sober

 

[Cocosilk]

By doing every other day you are making life very hard for yourself. just reduce and stay every day then potentially drop a bit further and further over time if that’s easier.

but by doing every other day I just can’t see the point.

mots like an alcoholic getting drunk every other day and feeling like they are going sober

Yep, it is. I'm still addicted obviously. I guess that's why I'm here. It's our relationship with food that gets us in trouble, right?
But you have to work with yourself in a way that you'll behave. I like to break rules so I'm trying to set rules that I will more likely stick with. I'm not fully commited to 100% low carb. Still breastfeeding a 6 month old so it probably sends signals to my brain to eat things that I might otherwise be able to resist, I dunno. That's my excuse for now anyway. We'll see how much easier it gets to stay very low carb once baby is weaned.

 

[ziggy_w]

Hi @Cocosilk,

If I had these results after steel-cut oats and honey, I would be ecstatic. In my view, as long as you don't spike way above 7.8 mmol/l and this elevated level doesn't last many hours, all is good.

So, imo both of these blood sugar patterns are really good and I don't think one is better than the other. Also, note that the first time you started at 5.1 (and then seeing a peak at 7.3) and this time you started at 4.0 (and peaked at 6.3), so this is roughly equivalent. Personally, I don't think the timing of the peak really matters. It is probably affected by the amount of fat/protein (i.e. the eggs) in the meal.

 

[Cocosilk]

Hi @Cocosilk,

If I had these results after steel-cut oats and honey, I would be ecstatic. In my view, as long as you don't spike way above 7.8 mmol/l and this elevated level doesn't last many hours, all is good.

So, imo both of these blood sugar patterns are really good and I don't think one is better than the other. Also, note that the first time you started at 5.1 (and then seeing a peak at 7.3) and this time you started at 4.0 (and peaked at 6.3), so this is roughly equivalent. Personally, I don't think the timing of the peak really matters. It is probably affected by the amount of fat/protein (i.e. the eggs) in the meal.

I just tried to calculate what my HbA1c might be if I had levels like this and it comes out around 5.3% (34), which is where I sit currently. I notice you wrote you were only taken off Metformin once you were 5.1% (32) and now you are 4.9% (29). Do you think it's bad to stay at 5.3% for years rather than trying to get it down further? If I eat carbs like this, I mostly likely won't be getting it down...

 

[bulkbiker]

I guess someone should say that if you keep on incessantly poking the dog it will eventually bite back.

 

[ziggy_w]

I just tried to calculate what my HbA1c might be if I had levels like this and it comes out around 5.3% (34), which is where I sit currently. I notice you wrote you were only taken off Metformin once you were 5.1% (32) and now you are 4.9% (29). Do you think it's bad to stay at 5.3% for years rather than trying to get it down further? If I eat carbs like this, I mostly likely won't be getting it down...

Personally, I don't think there is anything to worry about with an HbA1c of 5.3 mmol/mol.

The HbA1c also doesn't always absolutely accurately reflect actual blood sugar levels. For once, it is based on the assumptions that red blood cells survive exactly the same amount of time in every person. This has already been demonstrated to not be true. Arguably, they would survive longer in healthy people than in unhealthy people. So, this is why some say that HbA1c systematically underestimate real blood sugar levels when real blood sugars are high and tend to overestimate blood sugar levels, when real blood sugar levels are low. There are also other factors that influence HbA1c, not least of these the method employed to measure and calculate HbA1c. So, as long as your HbA1c is well into the non-diabetic range, I wouldn't worry.

Here's one article that talks about this: https://care.diabetesjournals.org/content/27/4/1013.

In my case, the deciding factor for reducing metformin was time rather than whether HbA1c was 5.3 mmol or 4.9 mmol. As my blood sugars (and HbA1c) were really high at diagnosis, my GP wanted to be sure the lower levels weren't a fluke before he took me off medication. (Since then he's mentioned repeatedly that he has never seen anything like this before).

 

[Cocosilk]

I guess someone should say that if you keep on incessantly poking the dog it will eventually bite back.

I guess if I poke the dog for a few more months while I am still breastfeeding and then have another HbA1c (they suggested a repeat in only 3 months), I'll soon see if the levels are creeping up. If they are, I'll know for sure that whatever I have been eating more recently will not be sustainable in the long term and I'll have to pull back again. I'm still dreaming I might be able to have low - moderate carb sometimes rather than just very low carb and maintain a reasonable bg level. Aren't some on here able to do that longer term?

 

[Cocosilk]

Personally, I don't think there is anything to worry about with an HbA1c of 5.3 mmol/mol.

The HbA1c also doesn't always absolutely accurately reflect actual blood sugar levels. For once, it is based on the assumptions that red blood cells survive exactly the same amount of time in every person. This has already been demonstrated to not be true. Arguably, they would survive longer in healthy people than in unhealthy people. So, this is why some say that HbA1c systematically underestimate real blood sugar levels when real blood sugars are high and tend to overestimate blood sugar levels, when real blood sugar levels are low. There are also other factors that influence HbA1c, not least of these the method employed to measure and calculate HbA1c. So, as long as your HbA1c is well into the non-diabetic range, I wouldn't worry.

Here's one article that talks about this: https://care.diabetesjournals.org/content/27/4/1013.

In my case, the deciding factor for reducing metformin was time rather than whether HbA1c was 5.3 mmol or 4.9 mmol. As my blood sugars (and HbA1c) were really high at diagnosis, my GP wanted to be sure the lower levels weren't a fluke before he took me off medication. (Since then he's mentioned repeatedly that he has never seen anything like this before).

Did you eat zero carbs to get to that level after having had higher numbers? And have you at any stage tried eating a few extra carbs again to see if the effect is as severe as on diagnosis? Congratulations by the way! It must feel good to have your doctor scratching his head

I'm just looking again at your numbers. You dropped to 5.3% after only 4 months of a dietary change and medication combined, right?

I had gestational diabetes and was hoping it would go away after I gave birth but it didn't seem possible to reintroduce carbs and stay in the reasonable ranges so I ate mostly low carb for 6 months (although I was regularly poking the dog then too and would eat a piece of rye bread here and there, or a mango, or whatever, just to see what it was doing to me.) My first ever HbA1c (17 Oct 2019) came back at 5.3% after more than 6 months of trying to eat mostly low carb. So I wonder how much higher it could have been if I had not been eating low carb... which is why I'm still experimenting now.
But in another few months, when I get a second HbA1c, it should at least give me some idea of which way it's trending while I am eating the few carbs that I am trying to add. If it goes up, then it's obviously going to keep heading up and I'll be in bigger trouble sooner than later.
I feel very lucky to have discovered this forum though and to know how to eat low carb now if I have no option. I won't have to go through that whole learning process all over again, I'll just have to be disciplined and do it.

 

[ziggy_w]

Do you eat zero carbs to get to that level after having had higher numbers? And have you at any stage tried eating a few carbs again to see if the effect is as severe as on diagnosis? Congratulations by the way! It must feel good to have your doctor scratching his head

Hi @Cocosilk,

Thanks so much for your kind words. I would be dishonest if I wouldn't admit that it was a good feeling to leave my GP speechless -- especially since he wasn't supportive of a dietary approach in my case. He literally said that at my blood sugar levels diet wouldn't work and that there would be no other way than insulin for me. (Personally, I wished though that my success would have inspired him to recommend this approach to other patients too, but no -- unfortunately not. Probably not an uncommon experience.)

I have usually stayed below 20g of carbs a day, with some days (though rare) up to 25g a day for the last year. (Before, the level of carbs was probably a bit higher since I didn't carb count or weigh food back then, but now am very much surprised at the amount of carbs in a slightly larger portion of veggies). To be honest, I really don't miss carbs very much -- so I am usually not tempted to go above this level.

As to your other question -- about a year back, I used to order some sweet potato fries, when we went out to a French tapas place, which we often frequent. My husband and I used to share the fries with him usually having more than half of the serving. However, on one occasion I actually ate a few more (about half the serving) with the result that my blood sugars went up to almost 8 mmol for close to 2 hours before dropping. While still in the normal range, I decided that having these fries wasn't really worth having to worry about blood sugar levels.

So, tbh it is possible that I can now tolerate carbs better than before, but why bother if I don't miss having carbs. I am also convinced that at a very basic level, I am just am unable to eat a higher level of carbs without running into the same problems again (might also be a genetic thing as there are loads of T2s in my family).

Personally, I believe your case is a bit different since you weren't a full-blown T2 diabetic and a more moderate approach might well work for you. My understanding though is that with gestational diabetes you are always at some more risk, so even if you go back to eating more carbs without problems, it might be a good idea to keep monitoring blood sugar levels at least once in a while.

 

[Cocosilk]

Hi @Cocosilk,

Thanks so much for your kind words. I would be dishonest if I wouldn't admit that it was a good feeling to leave my GP speechless -- especially since he wasn't supportive of a dietary approach in my case. He literally said that at my blood sugar levels diet wouldn't work and that there would be no other way than insulin for me. (Personally, I wished though that my success would have inspired him to recommend this approach to other patients too, but no -- unfortunately not. Probably not an uncommon experience.)

I have usually stayed below 20g of carbs a day, with some days (though rare) up to 25g a day for the last year. (Before, the level of carbs was probably a bit higher since I didn't carb count or weigh food back then, but now am very much surprised at the amount of carbs in a slightly larger portion of veggies). To be honest, I really don't miss carbs very much -- so I am usually not tempted to go above this level.

As to your other question -- about a year back, I used to order some sweet potato fries, when we went out to a French tapas place, which we often frequent. My husband and I used to share the fries with him usually having more than half of the serving. However, on one occasion I actually ate a few more (about half the serving) with the result that my blood sugars went up to almost 8 mmol for close to 2 hours before dropping. While still in the normal range, I decided that having these fries wasn't really worth having to worry about blood sugar levels.

So, tbh it is possible that I can now tolerate carbs better than before, but why bother if I don't miss having carbs. I am also convinced that at a very basic level, I am just am unable to eat a higher level of carbs without running into the same problems again (might also be a genetic thing as there are loads of T2s in my family).

Personally, I believe your case is a bit different since you weren't a full-blown T2 diabetic and a more moderate approach might well work for you. My understanding though is that with gestational diabetes you are always at some more risk, so even if you go back to eating more carbs without problems, it might be a good idea to keep monitoring blood sugar levels at least once in a while.

The thing about my situation is that I think low carb eating before my first HbA1c has actually masked the problem and that I must be at least prediabetic already. The other week after I got my 5.3% I thought, okay, it's acceptable so let me try to eat some carbs again, but it's pretty clear I don't tolerate large amounts well anymore. So I'm just looking at having 1/4 sized servings of things to see if I can stay in the 6s rather than the 8s. I guess that should be sustainable for a period of time. But if I see an upward trend in the next HbA1c, I might have to stop dreaming...

 

[ziggy_w]

The thing about my situation is that I think low carb eating before my first HbA1c has actually masked the problem and that I must be at least prediabetic already. The other week after I got my 5.3% I thought, okay, it's acceptable so let me try to eat some carbs again, but it's pretty clear I don't tolerate large amounts well anymore. So I'm just looking at having 1/4 sized servings of things to see if I can stay in the 6s rather than the 8s. I guess that should be sustainable for a period of time. But if I see an upward trend in the next HbA1c, I might have to stop dreaming...

Hi @Cocosilk,

Based on the numbers you posted on your two experiment, these look good to me and solidly in the non-diabetic range. Good luck in your trials.

 

[KK123]

The thing about my situation is that I think low carb eating before my first HbA1c has actually masked the problem and that I must be at least prediabetic already. The other week after I got my 5.3% I thought, okay, it's acceptable so let me try to eat some carbs again, but it's pretty clear I don't tolerate large amounts well anymore. So I'm just looking at having 1/4 sized servings of things to see if I can stay in the 6s rather than the 8s. I guess that should be sustainable for a period of time. But if I see an upward trend in the next HbA1c, I might have to stop dreaming...

Hi there, you might be right which is why at first diagnosis (certainly for suspected type 1) you are told to 'eat normally' so that they can gauge how you are reacting to carbs, albeit this is so they can determine your insulin ratio or help diagnose what type you have, so it's a bit different in your situation. It's hard for you now though because I guess you don't want to overdo the carbs knowing they spike you balanced with wanting to find out whether you have gone back to where you were before your pregnancy. x