T2 - How to lower sugar AFTER a bad meal

[Joepubli]

that quote can be interpreted in different ways.

you seem to be interpreting it as ‘so long as I don’t go too high for too long, everything is fine (and I get to eat treats regularly).’

I and others on this board interpret that quote as ‘the organ and nerve damage from blood glucose levels above 7mmol/l is longterm and cumulative, and may not become noticeable until a great deal of damage has already occurred, making future management increasingly difficult, and diabetic complications becoming more and more likely as time goes by.’

it is, of course, everyone’s personal choice as to how they evaluate their personal risk and how they manage their health and lifestyle.

my personal view is that I am 53 and would like to live another 30+ years in good health, with eyes, feet, hands and internal organs all functioning well. So I don’t want my blood glucose rising to damaging levels at any point during the day which will, over the years to come, cause cumulative damage. I also like to keep my blood glucose well below damaging levels at all times, to give me a nice safe buffer zone.
Because I am human, I don’t always achieve this, but I achieve it consistently, and when I err, I keep my blood glucose well below 11mmol/l

Your mileage may vary, but you mentioned ‘quality of life’.
I make decisions that will improve my health a great deal in future decades, which will in turn improve my quality of life.

BRUNNERIA - Thanks for a most helpful explanation.

 

[Joepubli]

The magic figure of 153 appears to be used when diagnosing Gestational Diabetes using the One Step Method. It is the response to an OGTT, and is the 2hr PP minimum for PWD diagnosis as specified for the USA and some parts of Europe.

It is also the upper threshold for diabetes diagnosis where the HbA1c is expressed in the old system of % as it equates to 7% apparently.

Thanks - yes I see that HbA1c 7% is 154mg/dl. But of course HbA1c is an average - so some times higher and sometimes lower than 154. I was trying to get to the max practically safe number for a safe post meal spike. With my Abbott Libre CGM I am trying out, I can see that most of the time I am comfortably below 154 (with a predicted HbA1c of 6.5) but there are times when I am going past 180. I am hardly ever below 100.

I know if I go and see my doctor - she will likely say on seeing 6.5! - super control. But it seems that that's only part of the picture. I have seen data/articles that suggest that Time in Range (TIR) is more relevant and I should aim for 70% TIR but avoiding lows.

 

[JoKalsbeek]

Thanks - yes I see that HbA1c 7% is 154mg/dl. But of course HbA1c is an average - so some times higher and sometimes lower than 154. I was trying to get to the max practically safe number for a safe post meal spike. With my Abbott Libre CGM I am trying out, I can see that most of the time I am comfortably below 154 (with a predicted HbA1c of 6.5) but there are times when I am going past 180. I am hardly ever below 100.

I know if I go and see my doctor - she will likely say on seeing 6.5! - super control. But it seems that that's only part of the picture. I have seen data/articles that suggest that Time in Range (TIR) is more relevant and I should aim for 70% TIR but avoiding lows.

Others have already answered your follow-up question, so right now I'll just add that avoiding lows is for T1's on insulin, and T2's on insulin or meds like gliclazide, which force insulin production. A T2 doesn't usually hypo without outside help from meds/insulin, so that criterium doesn't fly.

 

[nutribolt]

With my Abbott Libre CGM I am trying out, I can see that most of the time I am comfortably below 154 (with a predicted HbA1c of 6.5)

Just wanted to add as a word of caution though I am sure you might already know, the libre readings can really be off the mark so I hope you are using x-drip to calibrate readings or atleast a mental calibration with simulataneous regular finger prick checks... else you may be in for a surprise when you get the HbA1c results...

 

[Daibell]

answering my pown questions - seems its a C-Peptide Test

Hi. Yes it is the C-Peptide test. If the result is high it implies the body has more than enough insulin. If low the opposite applies. I've had two done privately over the years and these show my insulin to be too low hence my (own) LADA diagnosis. My GPs have not been helpful with my correct diagnosis but at least I am on insulin. As has been said, low-carb is the way to go. Various medications can help but the core problem of insulin resistance is best resolved by dietary change. It isn't easy as the Western diet is focussed around carbs which the food industry (and most diabetes organisations!) promote as they are highly profitable. The good news is that fats and proteins are fine as well as veg and non-tropical fruit. Even 85% Dark Chocolate is OK.

 

[VashtiB]

Hi Joe,

I think that we just don't know enough to be able to predict who often/long going into the high readings will have an effect on a person. I suspect it's a bit like smoking and lung cancer.

My thoughts for what they are worth is that I agree with a lot of what @Brunneria says. I am trying to keep my levels as low as possible all the time to give me the best chance of not suffering any of the complications for diabetes. Food is the thing that is most easily controlled.

Your sentence 'given that my self-control at such events is poor' made me have a couple of reactions. First this way of eating for me is not a diet- it is the way I have to eat to help my health. I consider that I have a severe intolerance to carbs. If someone has a severe intolerance to gluten for example it is not an option if they want to remain well to have gluten at such events. Similarly if you have an allergy you just avoid it rather than assume you will eat it at an event. So two things about that. My family and friends know I'm doing low carb- they don't know about my diagnosis but I will be changing that next year. So when they are catering an even t they either provide something suitable or ask me to. That actually is then no effort for them. I bring things I can eat and eat them. So maybe you should let people know you are low carb and either suggesting suitable things or bringing them yourself. My daughter is vegan (not me) so when she comes over we ensure we have suitable food for her- basilisks hospitality.
Second you have already given yourself permission to eat unsuitable food as you already assume you will not have self control. I found my self control is better when I keep very low carb and know it is a way of life not a diet. I'm not 'cheating' by eating something with high carbs I'm sacrificing my health.

I'm not perfect but if I have had more carbs than I prefer I immediately go for a walk, go on the cross trainer or treadmill. I'm not an exercise fan so would rather not have to do these things but I `want to be able to walk and read etc in 10 or more years.

So let your friends and family know what you can eat and bring stuff with you. There is a lot we can eat- I had lobster for Christmas with cheese sauce from cheese and cream- so indulgent and low carb too.

 

[Joepubli]

Thanks VashtiB. I appreciate the points you and others are making but maybe I just don't have the will power you guys have. I know I am going to have occasional lapses and I was looking for a way of handling that if possible - seems walking is the consensus. I am probably making excuses, its not always practical to prearrange things.