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How many limiting carbs can a Type 2 without any medication take in a meal (Breakfast, lunch, and dinner, no snacks)?

M

mysorian

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52
Type of diabetes
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I am a vegetarian. I eat cooked oats for breakfast with walnuts and soy milk). For lunch, I eat cooked Fos-Tail with Indian Rasam or Sambhar (not sure how much card is contributed), dry vegetable curry, 1 tbsp of yogurt, and sometimes roasted Okinawan sweet potato, Dinner is like lunch, and I may have a salad (Onion, avocado, spinach, or arugula with balsamic vinegar). After lunch, I may eat half of an orange or a kiwi fruit. I want to establish the quantities.
 
It depends on the individual and the only way to determine how many carbs you can tolerate is by testing your reaction to carbs with a meter. That will help you to decide which foods you can and should not eat without affecting you BS too much. I have been a diet controlled T2 for 11 years and have been able to maintain a normal hba1c for 10 years on approx 130g carbs per day however I recognise that I am lucky as many T2s have to severely restrict their carb intake.
 
Everyone is different. I can only eat 20g of carbs a day. As @Daphne917 has said if you get a metre, test your BS just before you eat and 2 hours after your first mouthful and if it’s within 2 mmol/l of your first test then it’s not spiking you BG. If it’s more than that you need to identify what you’ve eaten that has caused the rise.
 
It's both a function of how many carbs are in a given food and how much of that food you eat. One way is to think about the percentage of the food that is carbohydrate. I'm perfectly happy having a pickle that's 35% carb because I'm only going to have 10g of it: that is 3.5g carb. Eating 400g of a food that's 8% carb will mean eating 32g carb, and that's not acceptable for me.

Things like oats and sweet potato are high in carb and we tend to have larger portions of them. Fruit often contains a lot of sucrose and fructose.

If you have a look at something like the diet doctor website


you will find information on a lot of foods and their carb content per 100g.
 
I’m another one that needs very low carbs and echo the advise to test your response and limits.

I don’t know what fos-tail is but I’d start the testing with the oats as most of us have a big spike from them just at the point of the day we usually struggle most to cope with carbs. Sweet potato would be the next thing I check followed by anything with lentils in. These are items that do produce a big rise in blood glucose in a lot of us.
 
Breakfast
BF1: 69gms of gala apples7:59 a.m
9.66​
BF2: 39 gm gala apples9:38 a.m.
5.46​
153 gms of Soya Milk
6.12​
85 gms of Cooked Quacker old-fashioned oats
9.18​
14 grams of walnut
1.918​
Two-hrs after BF11:38 a.m.
Total carbs
32.338​

Does this feel right? I mean the carbohydrate numbers.
 
That would be a lot for me and that many carbs in one meal would definitely spike my BG levels by more than 2 mmol/L when I check it 2 hours later.

Like many responding so far, I generally consume around 20g of carbs per day. From testing, I can tolerate up to 30g, providing those 30g are split across all meals for the day and not consumed in one sitting.

Everyone is different though, so as others have said, testing BG before a meal and 2hrs after will guide you as to what you can tolerate.
 
I’m not so sure these are accurate. Oats are typically 2/3rds carbs. So that would make an 85g serving in the region of 55g carbs not 9g. I do however note you say cooked amount whereas the nutritional labels are all for the dry amount and you then need to add whatever liquid you use. So how much uncooked oats and what liquid was used.

More importantly what does your glucose meter say before and 2hrs after breakfast?

Also those carb numbers are very oddly precise. With anything like apples or nuts the values provided will always be a bit of an average as each nut and fruit could be a little different in terms of ripeness, variety etc. Even being within a couple of grams in accuracy is good enough let alone to several decimal points.

ETA: 9g of carbs in oats would mean just 14g of uncooked oats and made with water not any form of milk. Highly unlikely.
 
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Not really. Firstly, I don't believe there are only 9g carb in 85g cooked oats. I would expect maybe 2/3 of that 85g to be carb. Secondly, the only thing that really matters to you is what your meter readings were before and afterwards. If you can tolerate +30g (or +60) carb at breakfast, that's fine. I don't think I could, but what would happen to me is no reason for you to change anything.
 
You are right on the carbs in Quacker Old Fashioned Oats. The 'before and after' item needs clarification as blood has continuously changing glucose content. While 'before' is known 'after' needs a definition. 'after' when? 1hr, 2hr? Also, this 'after' may be individual dependent.
 
The "After" bit is normally taken to be at +2 hrs. This is because at that point any carbs eaten (at baseline) will have been digested and the body's insulin responses should have largely cleared them from the bloodstream - so you should be at or near where you started off. The test is in practice a test of current insulin efficiency.

In my experience - a test at +30 mins and you should see (maybe) the start of a rise in glucose (assuming some level of carb in the food eaten) - this can happen much more quickly where the carb is in an easily digestible form, such as hot sweetened milk.

test at +1 hr could be around the glucose peak, depending:

test at +1hr 30 mins should be seeing the start of glucose falling as the insulin starts to reduce glucose in the blood.

All this is really clear on a CGM. It's also subject to variation depending on many things, but in general if we eat carbs there will be a natural rise and fall.
 
Thanks. The CGM, while a nice alternative, has opened a host of other questions. Firstly, how it matches with glucose in the blood. Secondly, does each point on the CGM correspond to a proportional glucose in the blood? Is it a linear relationship? If I sound skeptical, you are not wrong.
 
My experience as a T2 with a CGM is that it is great for showing patterns and changes over time. It doesn't measure blood glucose, but rather glucose in interstitial fluid, and the two are not the same. I am told that CGMs now employ better algorithms to rationalise the difference between the two, and also to cope with the time lag.

When I have used a CGM, the readings did not match to fingerpricks - the best I got was consistent error. The one I've used was a Libre, and it showed values in mmol/litre, just as my fingerprick readings would have.

My conclusion has been that it's a nice addition, and shows you things you would not see any other way (such as what happens when you're asleep) but it only supplements and does not replace either HbA1c or fingerprick readings. It's also relatively expensive.
 
You are on the money. I agree totally. It does show the trend. I have used Libre recently. I like their comprehensive report which could improve more. I used the 14-day earliest version. They now have versions 2 and 3. As I do not take insulin my doctor cannot prescribe it as Medicare in the USA does not cover it. I could buy it on my own but it is expensive.
 
 
Honestly, I don't attach a great deal of accuracy to any of the values, neither the diet nor the glucose measurements. There is so much variability in the raw materials used in the diets and the measurement accuracies. My oats values are off by a large margin. I realized this soon after posting. It is all the more necessary to really get 'good' information. I am new to this 'carb counting' business. I was skeptical of this as I was measuring glucose only once after getting up.
 
Carb counting itself can be stressful unless one is the sort of person who likes that level of detail. I opt for: "if it's got carbs, I'm not eating it". That's easy for me, but doesn't suit everyone. The trick is knowing one's own personality and working with it rather than a one-size-fits-all.

Once BG levels are down, one can add some carby things one at a time with measuring before and after that meal to see how those carbs affect you.

Good luck, and we are all here for you - keep asking!
 
Thank you. I am skeptical of most things and most of all this counting thing. I am not even convinced of the glucose measurement's repeatability.

The other thing that is indeterminate that varies from person to person is the glucose peak and when it occurs after a meal. Most measure after two hours. What if the peak occurs after one hour? What if this peaking is food-dependent? I am trying to tie down the peaking time with a CGM. The peak seems to occur anywhere from one to one and one half-hour. After two hours it is below 140.

Also, which one defines Type 2, a fasting value of less than one hundred, or a two-hour after-meal value of less than 140? Also, do both fasting and after-meal must conform, not just one of the two? What if one is OK and the other is not?

As a vegetarian, the option to choose a food with few carbs is limited as most of them have carbs. Even after carb counting you may have to starve a bit to achieve the standards of control.
 
Everyone even none diabetics can peak as high as 11 in the first 2 hours depending on how many carbs are consumed, the difference is the people without diabetes drop into much lower numbers by the 2 hours, people with T2 don’t have this drop and can stay higher for longer, that’s what makes us T2 diabetics .

For me it’s the 2 hours after first bite that matter, a rise of no more than 2, the same as, or lower is what I’m looking for. If I get a rise of 3 or more it’s either a no more of that meal or I may test again at 2hrs.30 minutes to see if I’ve dropped back to acceptable level and if I have I adjust my portion size next time and test again, if I get same results as before then it’s definitely off the table
 
From this and your previous posts I suspect you are looking for hard and fast rules and precision that simply doesn’t exist and will drive yourself crazy trying to make it so.

1. Meters are not precise tools. But they are sufficiently accurate to inject a potentially lethal medication (insulin) so they are also good enough to give those of us doing this by diet the information we need about which foods are more or less problematic for us. Yes different meters will give different readings and even the same blood drop on the same meter will. No getting around it. Pick one meter and stick to it and use it as a comparative tool as much as a quantitive one. (Same for the cgm)

2. Yes the timing of the peak is variable. No getting around that. It does depend on the food and the mix of foods in a particular meal. Generally speaking more fats or more fibre delays a peak. More simple carbohydrates like actual sugar speeds it up. Also some people have a better or worse first stage insulin response meaning they have a smaller or bigger job of clearing the glucose at the main spike time . (1st stage = An initial smaller hit of insulin minutes after eating and then 2nd stage = main slower longer response an hour or so later). Again test YOUR meals (not just individual items) against YOUR meter

3. Diagnosis of type 2 diabetes in almost all cases is done by hba1c. This measures different things than a fasting test does, as does a 2 hr post meal or OGTT. Ideally you’d want all three measures meeting goals. In reality they have a draw a line in the sand somewhere. If any of these tests are consistently giving poor results then you have an issue whether it gets a label or not. Look at what factors might be causing the poor result and what you can do about it. Personally I believe the after meal figures are the most relevant to management of the condition and these being brought into line by eating the right foods means the hba1c falls accordingly. Fasting levels are the one I worry least about and can directly do least about. If the other two come into line that will likely do so eventually too. Fasting can also be effected by low carb eating and be a physical response not a disease driven one and not a worry. (look up adapative glucose sparing).

4. Yes as a vegetarian you have fewer low carb choices. That’s a fact you either accept or change your way of eating to include foods you’ve previously chosen not to eat. Your decision. But there are people making low carb vegetarian eating work for them. There’s a whole section of the forum about it here https://www.diabetes.co.uk/forum/category/vegetarian-diet-forum.71/

5. You should not have to starve at all. Fill up on a lot of lower carb options rather than a few high carb ones. Carbs actually drive hunger hormones and block satiety ones. Eating fewer carbs allows those signals to work properly. It’s carbs you are trying to restrict not proteins or fats (or even calories for most of us once the signals are working properly) so use more of those macros instead.
 
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