My Doctor Has No Time For Me..

[stuffedolive]

generally it is the overall effect of the meal that I am interested in....... But to be honest, I am unlikely to be eating more than one thing that may be a bit high carb per meal. So if for example I spiked, ......, then I won't be having it again. That is all I needed to know.

You didn't need to test to work that one out though.

If anybody can explain why a square of chocolate fudge Rocky Road cake with biscuits, marshmallows, and glace cherries, doesn't raise my blood sugars at all, at any point, on three separate occasions, I would be very grateful! It freaks me out a little bit! And it is taking a supreme effort of will to not eat more of it

I think you have made my point for me. Testing is not really much help. Common sense and avoiding carbs is the pragmatic answer to keeping BGs down.

 

[Finzi]

So... thinking about it, testing is more to find out what I CAN have, rather than what I can't. Yes, after a meal with basically zero carbs in it, I would probably not bother to test at all. Just as I never bother testing after breakfast, because I only have a combination of two to three things that I have extensively tested previously and know are fine. Although I did test recently after 40g of porridge, which used to spike me (wouldn't have known about that without testing) and now doesn't (wouldn't have known that without testing either).

Yes, it may have been obvious without testing that a piece of French bread would spike me. But not necessarily. Would I, for instance, have guessed that I have no problem with croissants, providing I put plenty of butter on them? Or that most things from the curry house are fine as long as I religiously avoid anything with lentils in? As another example, I have been prepared to spend quite a premium on Dreamfields pasta, because I have proved through extensive testing at 1,2,3,4, and 5 hours on several occasions that it doesn't spike me (I gather that it doesn't work for everyone, and I certainly didn't want to take any chances).

But I'm just explaining why *I* test. If you get on fine without, that's great too. But I object to GP's telling someone that it is "too confusing". It really, really isn't.


Type 2 on Metformin, diagnosed Jan 2013, ultra low carber, Hba1C at diagnosis 8% (11mmol), now between 4.5 and 5.5 mmol. 20kg lost so far

 

[Anonymous]

If only testing were as simple as some make it out to be...

I for one eat meals which are comprised of a number of different foods. If I were to test afterwards I wouldn't know which of the foods had spiked me. So to understand what actually spikes me I would have to eat single item meals e.g. just rice, and then test or just carrots, and then test.

This is madness as when those foods are recombined they actually have a different effect in combination. So then I would have to test every combination - more madness. Furthermore, I could test one type of potato and find a one reading and then another type of potato and get a different reading. Then there's the way its been prepared - a raw carrot is going to be different to a boiled one which will be different to a roast one. So I have to test every variety and every preparation method.

I think this is a glass half full/glass half empty matter. Yes, of course each meal is going to consist of various different foods. I personally try to keep the majority of the foods I eat as low carb as possible, and generally it is the overall effect of the meal that I am interested in. If I were to have a huge spike after a meal, I would then take a closer look at the meal to see what the culprit might have been. But to be honest, I am unlikely to be eating more than one thing that may be a bit
high carb per meal. So if for example I spiked, as I did, to 8.8 after a meal consisting of salami, olives, and a slice of French bread, it was pretty clear that it was the French bread that was the problem. I haven't eaten it since. Conversely, if I know that a roast Sunday dinner consisting of meat, gravy, vegetables, one roast potato, and a Yorkshire pudding, will raise my sugars to around 6.8, I can live with that, and I don't really care which of the individual ingredients did that. That's what I eat when I have a roast dinner, and I will stick with that. Similarly, if I know that a meal from the fish and chip shop, consisting of a small battered cod and six chips, will raise my sugars to 8.5, then I won't be having it again. That is all I needed to know.

If anybody can explain why a square of chocolate fudge Rocky Road cake with biscuits, marshmallows, and glace cherries, doesn't raise my blood sugars at all, at any point, on three separate occasions, I would be very grateful! It freaks me out a little bit! And it is taking a supreme effort of will to not eat more of it

I take a similar view except that I would have the fish and chips again. Isn't the purpose of managing diabetes about avoiding persistent high bGs over a period which can lead to complications (e.g. persistently over 7.0 rather than short-lived spikes)? Please someone tell me if I have got it all wrong. For example, if I spike after each meal of the day (which I don't) I would in the dodgy zone for about 6 hours per day. The remaining 18 hours are within recommended guidelines. Is that a persistent high?

 

[mo1905]

I also have similar issues. Depending when I test, I can tell whether my results will be good or bad. Before breakfast and prior to all meals, I around 5-6. If I test 2 hours after eating, I am around 10 or so. I test to look for trends rather than spikes or individual readings. Maybe this is not the way forward but I feel it can be very easy to become obsessive about testing. Each to their own.


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[Q007]

I've lost the plot, so confused now. Can someone please help with a "noddy does low carbs diet" explanation. Sorry to sound thick, but I've been used to eating what the hell I like, I know all the names of foods I like but don't know which are going to send my sugar levels high. A) what foods are carbs? B) what's a GI carb C) I don't drink nor smoke but have a weakness for olive oil base spreads on hot cross buns, is the spread a no go? D) I have a bacon and egg roll which olive oil spread in a seeded bun for breakfast is that ok? E) what is best for breakfast? Some say porridge some say no? F) what's best to have for breakfast please?

If someone can help break down the jargon that long established diabetics understand I'd be so grateful.

Kind wishes to all

Q..


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[Anonymous]

I also have similar issues. Depending when I test, I can tell whether my results will be good or bad. Before breakfast and prior to all meals, I around 5-6. If I test 2 hours after eating, I am around 10 or so. I test to look for trends rather than spikes or individual readings. Maybe this is not the way forward but I feel it can be very easy to become obsessive about testing. Each to their own.


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I also go by averages and trends. Until about a month ago I hadn't tested myself for 4 months. Out of curiosity, I decided to check my bGs fasting and post evening meal regularly whilst continuing to eat the same as before. My average bG is 5.9. My highest recent reading was 9.4 (unusual for me) post evening meal which is the 'worst' meal for me but within 40 minutes it was 7.0. I have experimented and found that every 20 minutes after a test I drop by about 1.0. That's how I know I am only in the 'dodgy' zone for short periods and why I asked if my bGs would be considered to be persistently high.

 

[Yorksman]

So... thinking about it, testing is more to find out what I CAN have, rather than what I can't.

There are plenty of research papers plotting glycaemic response curves for various foods in both non diabetic and type 2 diabetics. Never the sort of foods you or I may wish to try and invariably something more exotic like a pawpaw. But, the priciple is the same. I like pasta and most pastas are made from durum wheat and supposedley low GI. But, how the stuff is processed is important because high rolling temperatures alter the properties so some are definitely better than others and the only real way is to test. I also find that Blue Dragon Wholewheat noodles are OK. Most others are not. I probablt don't have a culinary portfolio of more than a couple of dozen dishes so it's not too difficult to work out what type of noodles I need to use for a thai style chicken and prawn soup. This weekend I shall try making a Pasta con le sarde so I will, for the first time, be trying a wholewheat spaghetti. Buitoni wholewheat penne works for me so I guess their wholewheat spaghetti will too. But, the only way to be sure is to test before and after.

 

[mo1905]

This is what I sometimes find slightly odd. A lot of people with diabetes tend to stick with similar foods at similar times of the day. However, some people test their blood sugars 10 or more times a day ! Now, I'm not trying to discourage anyone from monitoring or anything and I'm sure that exercise or occasional food variations may have to be considered but apart from that, why keep testing ? I generally start the day with peanut butter on toast. I test my levels every morning, generally pretty similar. So why am I actually testing ? Is it just habit ? I'm genuinely interested in those that test much more often, every hour etc. do you really change that much every day ?


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[Yorksman]

A) what foods are carbs? B) what's a GI carb C) I don't drink nor smoke but have a weakness for olive oil base spreads on hot cross buns, is the spread a no go? D) I have a bacon and egg roll which olive oil spread in a seeded bun for breakfast is that ok? E) what is best for breakfast? Some say porridge some say no? F) what's best to have for breakfast please?

Have a look at daisy's introductory thread

Basic information for Newly Diagnosed Diabetics
viewtopic.php?f=39&t=26870#p247834

That has some very basic ifor on carbs and some links to further info.

When I was diagnosed I knew that I had to avoid sweets, buns, biscuits, chocolate bars, sugary drinks etc because I equated diabetes with sugar. However, it came as a surprise to me, via testing, to discover that a ham or beef sandwich was nearly as bad. The culprit here was the white flour used in the sandwich. This white starch, as with white rice, is very quickly digested and turned into sugar. Unrefined starches, such as brown rice are not as highly processed and, again by testing, I discovered that I could eat brown rice and it did not raise my blood sugar levels by much. I later found out that this is because it has a low GI or Glycaemic Index, that is, the carbohydrate, because it is unrefined and more complex, takes longer to digest and the release into the blood is much slower. Some carbohydrates are not digestible at all. This is typically what is used in zero calorie sweeteners. Unfortunately, because you don't digest them and they pass through you, they can have a certain laxative effect.

Some people like to keep all carbohydrate content as low as possible, almost negligible. Meat and two veg is OK but no potatoes. Bacon and egg is OK but no fried bread and definitely no toast and marmelade. People like me eat some carbs but only ever low GI foods or maybe a small portion of medium GI foods. Porridge is one of those foods that affects some people but not others. The seeded bun and hot cross bun have a good chance of raising your sugar levels. Rye bread is ok for me but refined wheat products are off limits. Wholewheat breads are OK for me if you can trust the bread to be truly wholewheat. One loaf sold by a supermarket as wholemeal actually only contains 6% wholegrain, the rest is white flour, dye, soya flour, and a number of other strange ingredients. You'll see many discussions on the subject of bread.

 

[Yorksman]

I generally start the day with peanut butter on toast. I test my levels every morning, generally pretty similar. So why am I actually testing ? Is it just habit ?

I think that once you get BG levels that you are happy with, it's still good to test daily as a check, to see that they are not creeping up. They crept up before, when I was tested every 6 months. Not by much but then all of a sudden I was diabetic. It's like someone who was once a flood victim. Every time it rains, they check the river levels and the forecast. If you've ever been burgled, you double check that everything is locked. I don't want any more sudden shocks.

 

[Finzi]

I also have similar issues. Depending when I test, I can tell whether my results will be good or bad. Before breakfast and prior to all meals, I around 5-6. If I test 2 hours after eating, I am around 10 or so. I test to look for trends rather than spikes or individual readings. Maybe this is not the way forward but I feel it can be very easy to become obsessive about testing. Each to their own.


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Fair enough. I suppose it depends what you are doing with that knowledge. Just knowing that you are spiking to a 10 is no help if you do not change what you are eating to prevent that. Personally, if I ate something that spiked my blood from 5mmol up to 10 mmol two hours later, I wouldn't eat it again. Or maybe you are happy spiking to a 10 providing that all your pre-meal tests are okay. I think that may broadly be Gezzathorpe's view - that spikes are only a few times a day, and it's what happens the rest of the time that matters. I can broadly see the logic of that. I suppose it's just that I would like to avoid the spikes as well, if at all possible.

 

[mo1905]

@Yorksman, I totally get what you're saying about testing to ensure levels don't start to rise. I test at least 4 times a day myself for this very reason. My point is I'm not convinced they're all necessary. My levels remain very similar because my diet remains very similar. Now, I'm only saying this is my opinion. I also understand that many people have poor control and DVLA requires more testing but I'm still intrugued by this. Do your readings vary a lot ? I'm not trying to preach, genuinely interested. Thanks


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[mo1905]

I also have similar issues. Depending when I test, I can tell whether my results will be good or bad. Before breakfast and prior to all meals, I around 5-6. If I test 2 hours after eating, I am around 10 or so. I test to look for trends rather than spikes or individual readings. Maybe this is not the way forward but I feel it can be very easy to become obsessive about testing. Each to their own.


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Fair enough. I suppose it depends what you are doing with that knowledge. Just knowing that you are spiking to a 10 is no help if you do not change what you are eating to prevent that. Personally, if I ate something that spiked my blood from 5mmol up to 10 mmol two hours later, I wouldn't eat it again. Or maybe you are happy spiking to a 10 providing that all your pre-meal tests are okay. I think that may broadly be Gezzathorpe's view - that spikes are only a few times a day, and it's what happens the rest of the time that matters. I can broadly see the logic of that. I suppose it's just that I would like to avoid the spikes as well, if at all possible.

Thanks for your reply. My intention is not to do nothing about the rise in BG levels. I count carbs and inject accordingly. Also, these readings are not one offs, they are for the majority of my meals. So, is a reading of 10 two hours after a meal bad ? Do you think I should inject more ? I thought I was normal lol !


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[Yorksman]

My point is I'm not convinced they're all necessary. ..... Do your readings vary a lot ? I'm not trying to preach, genuinely interested.

About 4 weeks ago I'd have 25% in the 4s, 50% in the 5s and 25% in the 6s. The last two weeks though they are just about all in the 5s with isolated examples of 4.9 and one 6.7. On the one hand, I can't see the point in testing if I know the result is going to be in the 5s on the other hand I am very curious as to why I hardly get any variation at all.

Maybe I should treat myself to fish and chips and test then.

 

[mo1905]

@Yorksman, with readings like that, you deserve fish and chips ! If only to remind you that you are diabetic lol ;-)


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[EFL 43]

Will I end up on meds because of ageing process? Can I stay in control without meds? Q..

Australia. Have had T2 since February, was on 4 insulin injections a day for about 6 weeks. Now I am on diet only (and Metformin). I know I can't have a low anymore (thankfully) but I felt as if I was having one today so checked my level, it was 4.1 which I know is OK. So I am curious why did I have symptoms when 4.1 is acceptable and I'm not on insulin. :?:

 

[Anonymous]

This is what I sometimes find slightly odd. A lot of people with diabetes tend to stick with similar foods at similar times of the day. However, some people test their blood sugars 10 or more times a day ! Now, I'm not trying to discourage anyone from monitoring or anything and I'm sure that exercise or occasional food variations may have to be considered but apart from that, why keep testing ? I generally start the day with peanut butter on toast. I test my levels every morning, generally pretty similar. So why am I actually testing ? Is it just habit ? I'm genuinely interested in those that test much more often, every hour etc. do you really change that much every day ?


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I am not in the '10 times or more tests per day' league but have tested myself frequently, sometimes every 10 minutes after my 2-hour test which has been very revealing to me. A drop of 1.0 every 20 minutes sounds to me like good news rather than bad. My overall bGs have improved after a 4-month gap in testing. Had I focussed on my recent, often erratic, bG readings from the last month or so I might not have expected an improvement. Yes, I could have managed, quite easily, my bGs to be lower and more consistent by eating to my meter, but would I be benefitting from having an average bG of, say, 5 rather than 6. They are both within guidelines and well outside the persistent high blood glucose levels, which, for me, is the main purpose of managing my diabetes. Some people weigh themselves every day and that, also, is likely to show erratic movements, which, in a short period of time, may not give them a clear picture of their weight loss.

 

[noblehead]

Although there has to be time restraints on clinic appointments 10 minutes does not seem long enough, I would complain to the practice manager and ask that you be seen longer at your next visit.

 

[stuffedolive]

To test nor not requires a different answer depending on whether you are taking insulin or not.
This thread was started by someone who I understand is not taking insulin and therefore testing advice by insulin dependent diabetics is confusing - sorry guys, you need to step into Q's shoes.

Q - as some one said Daisy's guide to low-carbs is good. However, you do have to do this for yourself. Lots of research ....

Carbs are what raises blood sugar. It's impossible to give a list of what foods contain them as they are incorporated as an ingredient of so many foods. You are just going to have to read food labels (carbs and sugar per 100g) and start weighing your food. Then you can work out how many grams of carbs you are eating per day. Try to keep this low (150g is a good start) and spread thru the day. Also the carbs you do have should have a high carbs/sugar ration (easy to work this out). These are called low GI foods and there are plenty of lists on the web. I was shocked how bad fruit is for diabetics after all the positive dietary advice about them. Whereas meats and dairy are on the whole carb free. Low-fat dairy tends to have added sugar though.

There are good food analysis sites too
http://nutritiondata.self.com/facts/veg ... cts/2648/2
http://www.fineli.fi/foodclass.php?clas ... ss&lang=en

You also need to understand, intuitively what happens to carbs when they are processed. Put simply carbs start off as long 'strings' . Low-glaecemic-index strings are longer that high-GI strings. The shorter the string the faster your body will absorb it. Any processing (ie cooking) will shorten the string and raise the GI of the food - this is potentially bad for you.

Conversely, exercise tends to reduce blood sugar (simplistic but on the whole true) so you need plenty of this.

So put simply, exercise and eat a low carb diet incorporating as many unprocessed ingredients as possible.

Good luck

 

[IanD]

.....
Thanks for your reply. My intention is not to do nothing about the rise in BG levels. I count carbs and inject accordingly. Also, these readings are not one offs, they are for the majority of my meals. So, is a reading of 10 two hours after a meal bad ? Do you think I should inject more ? I thought I was normal lol !

I would be worried about 10 2 hours after a meal. It suggests an even larger spike after 1 hour. In the days when I followed the DUK high carb diet, my HbA1c was below 7, and I progressively suffered complications. Changing to a low carb diet cleared those complications. Occasional checks on "normal foods" I find a one hour spike of about 14, that in two hours falls to 6-9, & in 3 hours below 5. A low carb meal rarely goes above 8.