Advice on meters, lowering insulin resistance , indices.

[FrankE]

Hello, new on the board here and first post.

Dad,84, has recently been tested for DM type 2. He also had a full blood count U&Es, ESR, C-RP, liver function tests, kidney function tests, thyroid function tests and blood glucose (non fasting)
All OK except random blood glucose post-prandial was 8.3
Fasting HbA1c came back today; a little high.
FGTT to be done in a couple of weeks time.

It's not alarmingly high, he is certainly not diabetic but I would certainly like to get his glucose under control and in normal range.

He is quite overweight 95kg / 1.65m and his diet has been deteriorating for the last year despite my intervention efforts. Not sure why anyone would want to eat skanky pies, french fries, macaroni cheese, white shop loaf and rubbish like that when I have offered home cooked nutritious food which is also tastes good. Maybe his diet has an element of DSH as he has been down since his companion went into a care home a year ago with Dementia due to Alzheimers.

He is almost certainly pre-diabetic. Hopefully the Doctors input will result in his self care improving, him taking more exercise and improving his diet.

As I stay with him to help him out with personal care (housework, podiatry, reading, writing, picking things off the floor, barber, social secretary ) I'd like to monitor his glucose and try to get him to eat healthier foods and exercise more.

Meters.
What meters would you recommend. Dad is partially sighted (not diabetes-related he fell and retina is detaching) as am I, so something with decent-sized readout, easy to use and good value for test strips. The one I had which was stolen errored quite often despite suffient peripheral blood samples and timed out wasting expensive strips. There were too many functions on each key so sometimes it would dispense a strip when I was trying to review series of test resuts. The writing in the manuals, though in nearly every language known to man, was tiny.

Vinegar, Cinnamon and other such insulin resistance reducing foodstuffs.
Just how much hypoglycaemic effect or effect on insulin resistance do these have?

Glycemic Index v's Insulin Index
Which is best in your experience to use as a guide?

 

[HLW]

Meters - the one you had before sounds quite complicated. All the ones I have used have been simple to use (with the exception of the Optimum Xceed - I don't recommend it). Have a look at the meters in a chemists, they usually have life-sized pictures of the meter and display on the box, or have a transparent section so you can see the meter.
I use the Accu-chek Aviva Nano, it has a large display and is simple to use.
The lancet device that comes with the accu-chek meters (multiclix or something like that) is far far better than any others I have seen, it is much quicker and easier to use. So even if you decide on a different meter, I would recommend this lancet device.

I've never heard of 'insulin index'. Check the diet forums for food tips.

 

[Ali H]

Both of my parents live with us due to poor health and being very old, 86 and 77. Both are type 2, test religiously at least twice a day and constantly eat junk! I cook the main meal of the day but the rest of the time my Dad feeds them and has no idea at all. No matter what I say or what guidance I offer he ignores me. If he feels mum's blood sugar is a little low at bedtime out comes the weetabix with proper sugar on it, night after night, she is now the size of a house. She eats digestives ad lib and they seem to graze constantly. Oh and low to him is a 7 or 8 although she has never had a hypo.

So be warned, what you want Dad to do and what he will do may be two entirely different things. I have had this battle for 5 years now but I cannot be in their room 24/7 and the minute my back is turned they are scoffing more junk. If he cooks for them, out comes the frying pan accompanied by bacon, sausages, eggs etc and always the disgusting mechanically recovered stuff never good quality high meat content things. Oh the eggs are ok, we keep chickens!

Total waste of test strips just for Dad to sit and write them in his little book but hey, if the GPs want to keep wasting money carry on. Why they don't ascertain how people are using them before stopping them for people who want to improve matters is beyond me!

The final straw came when he shunned a pizza that had the word caramelized on the box, had he read the panel he would have seen the sugar content was in fact "trace" on that particular product!

I don't know whether it is stubbornness, the fact that I am a woman or he just plain cannot understand where he is going wrong!

Forewarned is forearmed..........

Ali

 

[FrankE]

The GP (NHS) was wrong, and Dad does have DM II.

He can be very self-disciplined when he wants or needs to be and has changed his fatalistic attitude to one of wanting to improve his quality of life.I had a stern word with him that even though he "must die of something" it would be bally selfish of him to expect me to pick up the pieces if he didn't try and control his blood sugars. He has set targets, substituted most of his refined carbs for long chain lower GI ones eg white rice with brown basmati, white pasta with wholewheat, oatmeal with oatmeal and oatbran.
I labelled everything in his dry store cupboard to help him make healthy choices when I'm not breathing down his neck.

My Dad hates waste so he'll deplete the snack noodle pots which he had every second day for lunch. The hot dogs will have to go ... when did he sart eating them, he wouldn't allow me to eat hot dogs when I was young "they're full of ..it".

More importantly he is eating smaller meals with larger proportions of each meal being vegetables. I have broccol and spinach at nearly every meal so I think he was persuaded by lower energy costs of us preaparing a common-mode components of our meals at the same time.

I made up a 2* A4 logbook for his food intake, BG readings should I need to take them and a column for exercise, activities, energy levels etc.
After a few weeks he can now see the correlation between what he has eaten, the exercise he has taken and his energy levels. I /he may not even have to take his BG, he's getting the gist.
I'm slowly getting him onto food stuffs etc which will refuce his serum inflammatory cytokines but reducing his mass and therefore visceral adipose tissue and getting his circulation up is a priority for now.

I took his mass at the scales gondola at John lewis bathroom department the other day and he has lost a few kg on his healthier regime.

Am I wrong to use lab rat psychology and non-food treats to reinforce positive behaviours and train him? "You've done well this week so I'll give you a haircut". "Wow, 91kg from 95kg! that's good ... I'll iron your shirts".

It's all going quite well so far. Only thing is he eats dinner awfully early at 17:00 hours and is therefore a bit peckish by 21:00 hours and therefore snacks. Still, at least his evening snack isn't what most people would consider a meal.