First HBA1C since diagnosis....

Ho Manogwent,
The diet you have described doesn't look to be too bad, although I would certainly drop the banana and grapes - these are two of the highest carb fruits you can have. This is where the Collins Gem Carb Counter book would come in handy. In the section on fruits it tells you
"Most carb-controlled diets advise that you don't eat fruits during the induction phase while you're bringing your blood sugar levels under control, because they deliver a burst of easily absorbed fruit sugar into your blood stream. . . . . Bananas are high on the glycaemic index so will be restricted or banned on most low-carb diets, but all kinds of berries, grapefruit, plums, peaches and apples are recommended."

For your lunch, instead of the banana and grapes, you could halve the carbs by putting the cooked meat between 2 slices of Nimble or Weightwatchers bread, or substitute the fruit for a couple of plums or an apple.

One other thing I noticed is that you have a huge gap (7½ hours) between breakfast and lunch. This is long enough for your liver to have gone into overdrive and started pumping glucose into your blood. A high-protein snack mid-morning, like a piece of cheese or a handfull of nuts (not peanuts or cashews) would keep the liver happy and prevent the unwanted glucose production. If high blood sugars in the morning are a problem, then the same kind of snack before you go to bed would do the same thing.

If you can, try to cut down the carbs that little bit more, but make up for it with a larger portion of protein. It is the high protein foods that leave you feeling fuller for longer and will stop the hunger pangs. Remember the old "joke" about Chinese meals - you eat until you're full but an hour later you want another one! The reason is simply that they contain a high proportion of carbohydrate and that's exactly what high-carb food does - fills you up temporarily but the full-up feeling rapidly wears off.

Hi, Dennis, thanks for that, reason i don't snack in mid morning is that i can't. i work in an environment where i do not get a break until 11.30ish and also can't test because lancets pose security risk. will try what you suggested re bananas as went from apples to those as nurse suggested that. i was not having any bread at all for lunch but try what you suggested to do instead, many thanks,manogwent.

Dennis said:

Ho Manogwent,
The diet you have described doesn't look to be too bad, although I would certainly drop the banana and grapes - these are two of the highest carb fruits you can have.

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I agree with everything else Dennis writes too. Just to add as well as dropping the fruit I'd substitute the breakfast toast for bacon. I can't handle anything containing wheat until the evening but can do oatcakes at breakfast, that's about the only morning carb I can do. High protein moderate fat low carb is my best breakfast, I usually have fish and salad. Inter-meal snacks might help, also a late night snack

http://www.diabetic-talk.org/dp.htm

you'd need to tinker with the contents to find something that brings your fasting numbers down.

Long term the increased metformin and as much exercise as you can manage would be a good plan to bring down the insulin resistance. You can have significant IR without being overweight.

Hi, Trinkwasser, i have tried some of what you suggested like eating greek yoghurt, cheese, oat crackers at night but still got high 7's and 8's on getting up. have tested at 2/3 am when going to loo and been down in 4's. generally BG numbers drop somewhat over the course of the day to 5's and 6's now at the time when i get home at 6 pm'ish and then i eat 7 to 8pm which makes me 8 to 9 2 hrs after dinner. can handle 2 slices toast without too much trouble as only sends me up a % 2 hrs after. after 3 months, it is only the last 2 weeks that have seen me going down to 4 and 5 before dinner so perhaps that is why i got a higher reading than expected. At least it is heading in right direction and perhaps following your advice will bring it into the 'magic numbers'. many thanks, peter.

Dennis makes a lot of sense there (and also told me some things I hadn't realised, like eating apples and plums is ok - on that note I've had great results with strawberries and cherries, both delivering low pp bgs) - regarding the environment in which you work, as a diabetic worker you are entitled to have the chance to test when necessary and also to eat (it takes a few seconds to eat a piece of cheese, I find the pre-wrapped cheddar slices, although expensive, are handy) and you should by law have access to hand washing facilities - might it be possible to take a bathroom break midway between starting work and your first break? At this point you could wash your hands, do a blood test and shove a piece of cheese in your mouth? All in four minutes haha ... Understanding of course that many people are nervous of bringing their diabetes into any workplace discussion (yes, we're all nervous of losing our jobs and don't want any extra ammo given!) but your first priority should be your health ... and for the sake of a 4 minute break you may be a healthier more productive member of the team (or that;s how I might word it LOL) ... all the best and keep the faith, Jem xo

Dawn Phenomenon can be weird, I don't get it at all (I'll sell you some of my genes for only £39.99) but my BG may go up rapidly if I overexert myself in the morning, which doesn't happen later in the day.

Some people have it really fierce and only insulin will tame it. A friend swears by a glass of red wine and a handful of nuts at night.

Paradoxically eating something as soon as you get up may quickly knock it down, you need the right amount of carbs, not too many, not too few.

It may well improve over time as you work on the rest of your numbers, which seem to be coming out better already.

hoolyuk said:

Trinkwasser said:

What's your HDL?

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Sorry for the delay only got to the docs on tuesday.

My overall cholesterol was 4.1, which i thought was good, but apparently not in diabetics.

My good cholersterol was 0.76 which he said was terrible....went in feeling 15 came out feeling like i was about to keel over :cry:

Switched me from atorvastatin 40mg to rosuvastatin 10mg to see if those figures would improve.

Also happened to notice that the range for "normal" fasting glucose levels was 4.7-7.8....surely that cant be right?

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HDL needs to come up a bit - exercise, red wine, more fat and less carbs

My GP is quite happy with that as a total, it all depends on the breakdown. Did you get a number for triglycerides?

Those FBG numbers are normal in the sense that losing legs is "normal" for diabetics.

One VA clinic in the States lists an A1c of 8 as "very good" and 7 as "Excellant!" (their spelling) no wonder people do so badly.

Trigs/HDL ratio is around 2.5 and ideally needs to be half that (or less)

Pretty good going for a beginner though!

You're getting the Big Picture right, now you need to concentrate on the details.